• Journal of Trauma and Injury
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• v.24 no.2
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• pp.82-88
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• 2011

Background: The incidence of abdominal trauma with intra-abdominal organ injury or bowel rupture is increasing. Articles on the diagnosis, symptoms and treatment of small bowel perforation due to blunt trauma have been reported, but reports on the relationship of mortality and morbidity to clinical factors for prognosis are minimal. The purposes of this study are to evaluate the morbidity and mortality of patients with small bowel perforation after blunt abdominal trauma on the basis of clinical examination and to analyze factors associated with the prognosis for blunt abdominal trauma with small bowel perforation. Methods: The clinical data on patients with small bowel perforation due to blunt trauma who underwent emergency surgery from January 1994 to December 2009 were retrospectively analyzed. The correlation of each prognostic factor to morbidity and mortality, and the relationship among prognostic factors were analyzed. Results: A total of 83 patients met the inclusion criteria: The male was 81.9%. The mean age was 45.6 years. The mean APACHE II score was 5.75. The mean time interval between injury and surgery was 395.9 minutes. The mean surgery time was 111.1 minutes. Forty seven patients had surgery for ileal perforations, and primary closure was done for 51patients. The mean admission period was 15.3 days, and the mean fasting time was 4.5 days. There were 6 deaths (7.2%), and 25 patients suffered from complications. Conclusion: The patient's age and the APACHE II score on admission were important prognostic factors that effected a patient's progress. Especially, this study shows that the APACHE II score had effect on the operation time, admission period, the treatment period, the fasting time, the mortality rate, and the complication rate.

• Journal of Acupuncture Research
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• v.15 no.2
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• pp.393-406
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• 1998

Twenty five cases of the patient admission-treatment from chiefly complained of neck pain observed clinically from first January 1997 to thirty first December 1997 in the Dept. of Acupuncture and Moxibustion, Oriental Hospital, Taejon University, Taejon, Korea. And the results were obtained as follows; 1. The distribution of sex was male 13(52%) cases, female 12(48%) cases and the male to female ratio was 1.1 : 1. The distribution of age was the most predominant as the fifties 6(24%) cases. 2. The contributing factors were the most predominant as the reason unknown 9(36%) cases, unstable position 5(20%) cases. 3. The distribution of duration was the most predominant of 9(36%) cases in a week. 4. The distribution of before admission-treatments were the most predominant as west-medication 13(32.5%) cases. 5. The distribution of patient's condition of first treatment was the most predominant as Gr.III 13(52%) cases. 6. The distribution of duration for admission was the most predominant as 13(52%) cases in a week. 7. The distribution of radiological studies were the nust predominant as the HIVD 26(63.4%) cases. 8. The distribution of clinical symptoms were the most predominant as neck pain 25(21.0%) cases, radiating pain to the upper extremities 23(19.3%) cases. 9. The distribution of located on clinical syrnptoms were the most predominant as neck-shoulder and back-upper extremities 11(44%) cases. 10. The distribution of clinical diagnosis was the most predominant as HIVD 16(45.7%) cases. 11. The distribution of methods of treatment were the most predominant as Acupuncture -­ Herb Medication - Electro Acupuncture treatment 8(32%) cases. 12. The effect of treatment by discharge was the most predominant of 11(44%) cases as Good result.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.28-30
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• 2013

A 66-year-old male with chronic alcoholism presented with tremor, gait disturbance, memory impairment, insomnia, decreased appetite, and confusion. The patient had been taking lithium daily for treatment of bipolar disorder. Brain CT showed no specific abnormality, and serum lithium and ammonia levels were 3.63 mEq/L (therapeutic range, 0.6~1.2 mEq/L) and $85{\mu}g/dL$ (reference range: $19{\sim}54{\mu}g/dL$), respectively. Therefore, the initial differential diagnosis included chronic lithium intoxication, hepatic encephalopathy, Wernicke encephalopathy, or alcohol withdrawal syndrome. Even with the provision of adequate hydration, the patient's neurologic status did not show improvement, so that lactulose enema, thiamine replacement, and continuous venovenous hemodiafiltration (CVVHDF) were started on the third admission day. By the fifth admission day he had made a rapid neurologic recovery, and was discharged on the 20th admission day. Therefore, CVVHDF might be a treatment for patients with chronic lithium intoxication, because, even if serum lithium concentration is normal, lithium concentration in the brain may be different from that of the serum.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.27-43
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• 1970

This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

• Journal of Acupuncture Research
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• v.15 no.2
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• pp.427-436
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• 1998

Thirty two cases of patient with Thoracolumbar Compression Fracture were treated and observed clinically from November, 1997, to August, 1998, in the Dept. of Acupuncture and Moxibustion, Chon-an Oriental Medical Hospital, Taejon University. The results were obtained as follows; 1. The distribution of sex was male 6 cases(18.7%), female 26 cases(81.3%) and the distribution of age was seventies 17 cases(53.2%) the most. 2. The distribution of the causes was Slip-down 17 cases(53.2%) the most. 3. The distribution of the period before admission was within a week 19 cases(59.4%) the most. 4. The distribution of treatment duration in descending order: Under a week and two weeks under four weeks was the most number in 11 cases(59.4%) each. 5. The distribution of the injured level was L1 body 15 cases(18.3%) the most. 6. In the distribution of grading clinical severity on admission, the most cases were Gr.IV(18cases, 56.3%). 7. In the distribution of clinical symptoms on admission, 30 patients(21.9%) complained lower back pain and disturbance in turning over. 8. In the distribution of treatment result, the most cases(18 cases, 56.3%) was good. 9. The distribution of treatment duration according to the clinical grade on admission was as follows: Two weeks under four weeks was the most number in 8 cases(25%) in the group of Gr.IV, under two weeks was the most number in 6 cases(18.7%) in the group of Gr.III, and under four weeks was the most number in 2 cases(6.2%) in the group of Gr.II. 10. The distribution of treatment result according to the clinical grade on admission was as follows: Good was the most number in 10 cases(31.2%) in the group of Gr.IV, 6 cases(10.7%) in the group of Gr.III and 2 cases(6.2%) in the group of Gr.II. 11. The distribution of treatment result according to the treatment duration was as follows: Good was the most number in 4 cases(12.5%) under two weeks, 6cases(18.7%) two weeks under four weeks, and 6 cases(18.7%) four weeks under six weeks.

• IE interfaces
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• v.24 no.4
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• pp.274-280
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• 2011

Delayed access to surgery may lead to deterioration in the patient condition, poor clinical outcomes, increase in the probability of emergency admission, or even death. The purpose of this work is to decide the number of patients selected from a waiting list and to schedule them in accordance with the operating room capacity in the next period. We formulate the problem as an infinite horizon Markov Decision Process (MDP), which attempts to strike a balance between the patient waiting times and overtime works. Structural properties of the proposed model are investigated to facilitate the solution procedure. The proposed procedure modifies the conventional value iteration method along with the binary search technique. An example of the optimal policy is provided, and computational results are given to show that the proposed procedure improves computational efficiency.

• The Korean Journal of Pain
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• v.7 no.2
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• pp.270-272
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• 1994

A 43 year old male patient injured in a traffic accident was admitted to the department of general surgery for the treatment of spleen rupture and multiple rib fractures. After subphrenic abscess occurred after splenectomy was treated. After 50 days of admission, left facial palsy occurred with sensory neural hearing loss, and tinnitus by longitudinal fracture of left temporal bone. The patients was consulted to pain clinic for further evaluation and treatment. The patient was treated with stellate ganglion block with 1% lidocaine 6ml one time daily. On 19th day, stellate ganglion block was given as usual, and the patient complained of pain in the neck and headache the next day. Two days later, mild fever elevation and hematoma in the neck were found. Hematoma was drained with hemovac. Ruptured muscular branch of vertebral artery was ligated surgically but the ligation was released in the next day and the hematoma was removed and the artery religated. Five units of packed RBC were transfused during the period and the patient was discharged without any sequelae.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.1006-1017
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• 2022

Objectives: This study examined a clinical case of a recurrent polyarticular gout patient treated with Korean medicine. Methods: The patient was treated with Korean medicine (Gyejigagye-tang, Soshiho-tang-gami, Gyejigajakyak-tang, acupuncture, and moxibustion), Western medicine, and rehabilitative therapy. Their effects were evaluated using the Visual Analog Scale. Results: After receiving Korean medical treatment for two admission periods, the Visual Analog Scale score for joint pain improved or disappeared. Moreover, Korean medicine was able to manage the symptoms of the gout patient. Conclusions: Proper Korean medicine treatment could be effective in improving the symptoms of recurrent polyarticular gout pain.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.816-827
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• 1988

Since 1978, We have experienced 87 cases of Fontan operations and the candidates of that increased in numbers recently with the improvement of the diagnostic and operative technique. We studied the prerequisite factors and hemodynamics of 22 cases of Fontan operations, done during the last one year period, which were 3 tricuspid atresia, 16 functional single ventricle and 3 anatomic single ventricle. The mean age was 68 months and the mortality rate 24%, and 9 patients of under 4 years of age were operated with 22.2% mortality rate, but the youngest, 16 months of age, patient survived well without problems. The preoperative pulmonary artery pressure[PAP], pulmonary vascular resistance[PVR] and postoperative right atrial pressure[RAP], left atrial pressure[LAP] value influenced the mortality, but age, preoperative Hb, preoperative PaO2 and pulmonary artery index[PAI] did not. There were favorable survival tendency in under 15mmHg of preop. PAP, 2a of preop. PVR and under 25cmHyO of postop. RAP, under 15cmHyO of postop LAP. The younger, the more pleural effusion and the longer postoperative admission days. The higher preop. Hb related to the higher postop. transpulmonary pressure gradient and the lower preop. PaO2 and PAI. The higher preop. PaO2, the less pleural effusion and postop. admission days. Preop. PAP closely related to preop. PVR and postop. LAP and high PVR increased the pleural effusion and postop. admission days. The larger PAI, the larger CI. We concluded that there were so many factors influencing the postoperative condition, but preop. PAP, PVR, Hb, postop. RAP and LAP were the most ones.

• Korean Journal of Adult Nursing
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• v.29 no.1
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to identify the factors and the relative risk associated with admission of patients with diabetes mellitus (DM). Methods: The sample included one hundred twenty-eight patients with type II DM. Seventy-seven patients who were admitted within six months of a hospitalization to one hospital from the first of February to the 31st of August 2014, were compared with fifty-one patients who regularly attended an outpatient clinic and had no hospitalizations. Results: Hospitalization probabilities among patients who had only diet and exercise or took oral diabetic medication were 0.03 (p=.004) and 0.21 (p=.007) times independently lower than the ones with insulin injection. The risks for hospitalization increases 6.33 times if there is absence of a spouse (p=.027) whereas the presence of a spouse seems to make hospitalization less likely. The risk among the ones having diabetic complications was 5.15 times higher than ones having no recognition of the complications (p=.040). For every one point increase in self-efficacy and every 1 mg/dL increase in high density lipoprotein (HDL) cholesterol, there was a 0.84 (p=.005) and a 0.96 (p=.036) decrease in hospitalization risk, respectively. Conclusion: Nurses should be sensitive to the risk groups of hospital admission among patients with DM including no spouse, insulin injection, diabetic complications, low self-efficacy, and low HDL cholesterol.