• Title/Summary/Keyword: Admission Patient

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Safety and effectiveness of early cardiac rehabilitation in a stroke patient with heart failure and atrial fibrillation: a case report

  • Lee, Sang Cheol;Ko, Eun Jae;Lee, Ju Yeon;Hong, Ae Lee
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.361-365
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    • 2021
  • Stroke patients have reduced aerobic capacity. Therefore, intensive structured exercise programs are needed. We report the case of a patient with stroke and cardiac disease who underwent early inpatient cardiac rehabilitation (CR). A 38-year-old male patient with atrial fibrillation, heart failure, and cerebral infarction underwent a symptom-limited exercise tolerance test (ETT) without any problems on day 45 after admission. He completed a 2-week inpatient program and an 8-week home-based CR program. Follow-up ETT showed increased exercise capacity. The present case might be the first to report a safely performed CR program in a patient with stroke and cardiac comorbidity in Korea. Systematic guidance is needed for post-stroke patients to receive safe and effective CR for the secondary prevention of stroke and cardiovascular risk.

A Rehabilitation protocol for Arthroscopic Bankart repair in Korean Medicine : A Case Report (Bankart 병변의 관절경적 복원술 후 한방 재활치료 프로토콜을 적용하여 호전된 증례 보고)

  • Geum, Ji-Hye;Baek, Dong-gi;Lee, Jung-Han
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.177-187
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    • 2019
  • Objectives: The aim of this study was to report the clinical improvement of a patient who underwent arthroscopic Bankart repair using a rehabilitation protocol involving Korean medicine. Methods: The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy, and Doin exercise therapy during the admission period. To estimate the patient's status, we used the Numeric Rating Scale (NRS), Pain Disability Index (PDI), assessments of the range of motion (ROM) and Muscle Manual Test (MMT) for the shoulder joint. Results: After administering the abovementioned treatments, we found that the patient's NRS, PDI, and ROM and MMT for the shoulder joint were improved. Conclusions: The rehabilitation protocol involving Korean medicine can be applied to and produce good results for patients who undergo arthroscopic repair for Bankart lesions. The limitation of the study was that the number of cases we studied was insufficient to prove the effectiveness. Hence, further studies are needed for designing the rehabilitation protocol involving Korean medicine.

A Case Study of Overactive Bladder Patient Treated with Soeumin Sibimigwanjung-tang (소음인 십이미관중탕으로 호전된 과민성 방광 환자 치험 1례)

  • Halim, Jang;Mi Hye, Kwon;Wonkyoung, Moon;Hyeri, Lee;Euiju, Lee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.4
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    • pp.38-48
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    • 2022
  • This study was aimed to report an significant improvement of urinary disturbance in overactive bladder patient using Soeumin's Sibimigwanjung-tang based on Sasang constitutional medicine. Methods A female overactive bladder patient with urinary disturbance including urgency, frequency, nocturia, tenesmus, weak stream was enrolled in this study. The patient was diagnosed as Soeum type greater-yin pattern and medicated with Sibimigwanjung-tang three times a day. Clinical improvement was evaluated with urination diary, International Prostate Symptom Score, Overactive Bladder Symptom Score, Numeric Rating Scale, and percentage of improvement compared to the day of hospitalization. Results Significant improvement was seen in urinary disturbance after 26 days of admission treatment. Also, symptoms of dyspepsia, coldness of hands and feet, and facial edema were improved. Conclusions This clinical case suggests that Sibimigwanjung-tang can be valuable option in treating urinary disturbance in overactive bladder within Soeum type greater-yin pattern.

Clinical Effects of Moving Cupping Therapy Combined with Integrative Korean Medicine Treatment on Peripheral Facial Palsy: Case Series

  • Jihun Kim;Yeonhak Kim;Taewook Lee;Eunseok Kim;Gi Young Yang
    • Journal of Acupuncture Research
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    • v.40 no.2
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    • pp.167-175
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    • 2023
  • This study aimed to report the effect of moving cupping therapy (MCT) on peripheral facial palsy (PFP). Four patients with PFP treated with MCT combined with integrative Korean medicine treatment (KMT). Patients were hospitalized for < 17 days. House-Brackmann Grading System (HBGS), Yanagihara grading score (Y-score), and Sunnybrook Facial Grading System (SBGS) were used to assess the changes during treatment periods, and facial photos were taken at admission, interim, and discharge. Facial paralysis symptoms and HBGS grades improved in all patients (Patient 1: HBGS of IV to II; Patient 2: HBGS of V to III; Patient 3: HBGS of IV to II; Patient 4: HBGS of IV to II) following an average of 14.5 days of treatment. The mean (± standard deviation) Y-scores and SBGS scores also increased (Δ[Y-score]: 13.75 ± 3.50 and Δ[SBGS]: 40.00 ± 13.11) from baseline to end of treatment. These findings suggest the clinical effectiveness of MCT combined with integrative KMT in treating patients with PFP.

A Case of Bronchoesophageal Fistula Treated by Bronchial Stent Insertion and Endoscopic Histoacryl Injection (기관 스텐트 삽입과 히스토아크릴 주입법으로 치료한 식도 누공 1례)

  • Dong Joon Oh;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.21-23
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    • 2014
  • We report a bronchoesophageal fistula that treat with bronchial stent insertion and histoacryl injection. A 52-year-old man with esophagel cancer was transferred for dysphagia management. At the CT scan that underwent on admission, esophageal cancer with multiple lymph node metastasis was observed. At the gastroduodenoscopy and contrast study, bronchoesophageal fistula was observed. Recurrent stent insertion treatment was failed, and then, By the broncoscopy, covered stent was inserted to right bronchus, and By the endoscopy, fibrin glue and histoacryl was injected in the fistula opening. At the contrast study, contrast leakage was not observed, and the patient was discharged. But, at the 14 days after discharge, the patient was admitted to the emerency room because of cough symptom whenever he eat food. The patient was diagnosed with aspiration pneumonia, we were determined that it is unable to oral intake. The patient received a jejunostomy and antibiotic treatment for aspiration pneumonia. He was discharged after symptomatic improvement.

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Visual Disturbance following Autologous Fat Injection into Periorbital Area (안와부 자가지방이식술 후 시력 저하에 대한 증례보고)

  • Jeon, Young Woo;Kim, Sung Soo;Ha, Sang Wook;Lee, Young Dae;Seul, Chul Hwan;Tark, Kwan Chul;Cho, Eul Jae;Yoo, Won Min
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.663-666
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    • 2007
  • Purpose: Autologous fat injection into the facial area is a frequently used technique in aesthetic plastic surgery for augmentation of the soft tissue. Fat injection is a very safe procedure because of the advantage of being autologous tissue. Minimal foreign body reaction or infections are noted after fat injection. However, there may be some complications including those as severe as blindness. There have been some case reports on visual disturbances after autologous fat injection reported in the literature. Methods: A 21-year-old female patient underwent autologous fat injection into left eyebrow area to correct depression of soft tissue. Immediately after injection of autologous fat, she complained sudden visual loss on the left eye. She had come to our emergency room and ophthalmologic evaluation showed that the patient could only recognize hand motion. There was no abnormality of the optic nerve on magnetic resonance imaging. Suspecting an ischemic optic neuritis from fat embolism of the central retinal artery, the patient was treated conservatively with occular massage, antiglaucomatic agent, anti-inflammatory drugs and antibiotics. Visual field examination showed visual defect of half the lower hemisphere. Results: While maintaining antiglaucomatic agents and non steroidal anti inflammatory drugs, fundoscopic examination showed no abnormalities on the second day of admission. Visual field examination showed an improvement on the fourth day along with decreased eyeball pain. Significant improvement of vision was noted and the patient was discharged on the fifth day of admission. The patient was followed-up 2 days afterwards with improved vision and visual field defect. Conclusion: We describe an unusual case of sudden unilateral visual disturbance following autologous fat injection into periorbital area.

Marasmus and Kwashiorkor by Nutritional Ignorance Related to Vegetarian Diet and Infants with Atopic Dermatitis in South Korea (아토피피부염 영아의 영양장애 사례보고와 채식주의에 관한 고찰)

  • Chung Sang-Jin;Han Young Shin;Chung Seung Won;Ahn Kang-Mo;Park Hwa Young;Lee Sang Il;Cho Young Yeun;Choi Hye Mi
    • Journal of Nutrition and Health
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    • v.37 no.7
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    • pp.540-549
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    • 2004
  • Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

Development of an evaluation tool of quality of nursing care for gastrointestinal surgery patient (위.장관계 수술 환자간호의 질평가를 위한 도구개발)

  • Lee, Byeong-Suk;Park, Jeong-Ho;Jo, Hyeon
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.260-278
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    • 1997
  • Background : Quality of professional nursing care is the most essential factor for survival and growth of nursing profession. Then, nursing professionals have responsibility for the evaluation of quality of professional nursing care. The purpose of this study was to develope an evaluation tool of nursing care for patients received gastrointestinal surgery with general anesthesia. This study was a primary work for the developement of a computer program for the evaluation of nursing care. Methods : This study was done through some consecutive steps. They were (1) Developement of items for the tool (2) Developement of an evaluation tool of nursing care quality for the G-I surgery patient (3) Test of reliability and validity of the tool. Two groups of experts and expert pannels who had much experience of the QA and the care of G-I surgery patients participated for developement of the items. 85 nursing records were used for the test of reliability and validity of the developed tool. The evaluation tools were developed with two types of scoring, norm-referenced tool and criterion-referenced tool. Results The system of items for tool was evaluation area evaluation item-indicator. There were 7evaluation areas which contained 32evaluation items which contained 7lindicators. Evaluation areas 1, 2, 3, 4 were for the evaluation of process and 5, 6, 7 were for the evaluation of outcome of nursing care for G-I surgery patient. For the test of interrator reliability, correlation coefficients of each scores of items and intragroup correlation coefficients were calculated. The average correlation coefficients between two rators were 0.65, 0.54 and the intragroup correlation coefficient were 0.99 and 1.00 by the types of scoring. The Cronbach alpha coefficients of the tools were 0.54 and 0.46 by the types of scoring. The average content validity index of the items was 0.95 from 4 pairs of experts. Because there were significant differences between some scores of quality of nursing care of 3 general hospitals regardless of the types of scoring, the tools could be thought to have some construct validity. And also, there were significant correlations between some scores of quality of nursing care and admission days and admission days after surgery regardless of the types of scoring, the tools could be thought to have predictive validity. Conclusion In this study, the evaluation tool of nursing care was developed for the very specified group of patient, G-I surgery patient. And the items were developed and tested by the experts of nursing practice. Because of these reasons, it was supposed that the tool could be used effectively in nursing pratice. And the procedures for the development and the test of the evaluation tool of nursing care in this study were supposed to be used for the developement of other tools.

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Severity of Emergency Patient classified by Triage System (중증도 분류체계를 이용한 중증도분류(Triage))

  • Bae, Jung-Hee;Sohn, Sue-Kyung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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A Study on the Knowledge-Based T.P.N. System (1) (지식 구조화 경정맥 완전 영양공급 시스템의 개발에 관한 연구 (I))

  • Jeon, Gye-Rok;Choe, Sam-Gil;Byeon, Geon-Sik
    • Journal of Biomedical Engineering Research
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    • v.11 no.2
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    • pp.305-314
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    • 1990
  • In this paper we have implemented and tested TPN which is system to supply sufficent nutrition to nutritionally deficient patient by means of ES (expert system) a kind of A.1 (artificial intelligence) . This system affords to evaluation of nutritional state of patient which is essential to physi- cian. who performs TPN, decision of performing TPN and management of patient-data & calculation of information needing to making TPN fluid. The features were as follolv 1. we input data, take ideal weight of patient and 24hr's creatlnln In urine according to chart in system compare TSF (triceps skin fold), MAC (mid-arm circumference), AMC (arm muscle circumference) to 5th, 15th, 50th percentile and evaluate the nutritional state of patient. 2. Calculation of protein & nonprotein calorie needing to treament of patient can be made exactly by stress factor, activity factor and body temperature. 3. patient's personal recording needing to management of patient date name of chief doc- tor, name of department of admission, chart number, history can by taken very easily. 4. The way of system operating is pull-down Menu one, It can be processing very efficiently. 5. Date processing in system, we can manage memory volume of computer verlr efficiently using of dynamic allocation variables. 6. We can make it very easy to edit & revise the input data, processed data is saved to diskette in 2 files (TDF, THF) , these are semipermanent preservation.

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