• Journal of Korean Academic Society of Home Health Care Nursing
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• v.22 no.2
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• pp.216-227
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• 2015

Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.

• Journal of Chest Surgery
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• v.27 no.4
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• pp.331-334
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• 1994

Pneumatic rupture is a rare cause of esophageal injury, as evidenced by only 19 cases reported in the literature. We experienced one case of esophageal rupture due to bursting of a truck inner tube. The patient, who was a 45-year old male, had severe chest pain, respiratory distress, flushing in the face and neck, and subcutaneous emphysema after tire explosion. Three days after the incident, a diagnosis of rupture of the thoracic esophagus was established by esophagogram using water soluble contrast media, and then emergency operation was done. The operation involved mediastinal and thoracic drainage and resection of the esophagus combined with cervical esophagostomy and feeding gastrostomy. On the 105th day after the operation, cervical esophagogastrostomy via substernal route was performed. The patient was successfully treated with the staged operations. As in the other reported cases, the injury was located in the lower one third of the esophagus. Four main characteristics of the clinical signs of pneumatic rupture are 1] wounds or burns to the face or mouth, 2] chest pain or epigastric pain, 3] subcutaneous emphysema, and 4] respiratory distress. We emphasize that the high index of suspicion of esophageal rupture is very important in diagnosis and that diagnosis should be based on the same findings common to other forms of esophageal injury.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.27-30
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• 2019

Parathyroid adenoma can cause extracapsular bleeding. In 1934, Capps first reported a case of massive hemorrhage secondary to rupture of a parathyroid adenoma. Recently, we experienced a 73-year-old female presented with pharyngeal discomfort and extensive ecchymosis over the neck without history of trauma. Endoscopic investigation revealed submucosal hemorrhage in the posterior wall of the hypopharynx. CT scan and ultrasonography demonstrated the presence of a mass below the left thyroid lobe. Serum calcium level was normal and PTH level was elevated. We underwent left thyroidectomy and parathyroidectomy 2 weeks later from first visit. During the operation, hypopharyngeal mucosa was teared and it was treated with pharyngostoma formation and L-tube feeding. We report a rare case of normocalcemic parathyroid adenoma with spontaneous hemorrhage and propose the proper management period with a literature review.

• Journal of Veterinary Clinics
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• v.24 no.1
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• pp.29-31
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• 2007

A thirty-month-old male Moluccan Cockatoo (Cacatua moluccansis) with mild anorexia was referred. Through physical examination, fireign body was palpated at the crop region. Radiopaque, lineal foreign body was visualized on the lateral radiographs of the thoracic esophageal region. The patient was definitively diagnosed esophageal foreign body which is ingested feeding tube. The foreign body removal was undertaken using a flexible endoscope and a grasping forcep without any other complications. This case report demonstrated that successful esophageal foreign body removal with endoscopy in birds.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.53-57
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• 1985

Many pictures must be taken for the presumption of the stereorelation of the cerebral artery, which obtained with ordinary cerebral angiography. And it is very difficult to understand the stereoimage and required many experiences. But it is able to presume the stereorelationship in only brief eye's training without the aid of the stereoscope using the prism. For the stereoview, we need the paired angiograms obtained only straight and tilting the X-ray tube. In practice, with this stereoview in cerebral angiogram, we could know the directions of the aneurysmal neck and fundus with the stereorelationship of the cerebral artery and indeed helps us greatly in operation field. In addition, we might guess the location and stereorelationships of the feeding artery and draining vein in arteriovenous malformation and other vascular tumors and it was great aid in diagnosis and operation. Now we present the methods of the pictures for the stereoview in cerebral angiogram and the methods for eye's training.

• Child Health Nursing Research
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• v.18 no.3
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• pp.119-126
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• 2012

Purpose: The purpose of this study was to examine and analyze the post operative fasting period of neonates in the intensive care unit (ICU) after receiving open heart surgery in order to provide optimal nutrition support for these neonates. The variables included biochemical nutrition indexes (albumin, total lymphocyte count, total cholesterol) and patient outcomes (duration of mechanical ventilation, ICU stay, hospital stay, infectious complication). Methods: The participants were 124 neonates in ICU after receiving open heart surgery, and the design of this study was to investigate their post operative fasting period retrospectively to analyze the biochemical nutrition indexes and patient outcomes according to post operative fasting period. Results: The results for 4 groups according to post operative fasting period showed that the group with less 48 hours of fasting had the best biochemical nutrition indexes and patient outcomes, followed by the 48-72 hour group, the 72-144 hour group, and the over 144 hour group. Conclusion: The results indicate that for new born babies receiving open heart surgery, the period of fasting after the operation should be minimized and tube feeding should be started as soon as possible.

• Journal of Gastric Cancer
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• v.19 no.1
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• pp.132-137
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• 2019

The occurrence of hiatal hernia after total gastrectomy with Roux-en-Y reconstruction is rare. We report the case of a 76-year-old man who presented with dyspnea, vomiting, and fever around 8 days after total gastrectomy with Roux-en-Y reconstruction. Abdominal computed tomography revealed a hiatal hernia containing part of the small intestine in the left thoracic cavity. Emergent reduction and repair of the hiatal hernia were performed later. Operative findings revealed that the Roux limb was incarcerated in the left pleural cavity. Esophagojejunostomy leakage, perforation of the small intestine with transient ischemic change, and pyothorax were also found. Thus, feeding jejunostomy, thoracoscopic decortication, and diversion T-tube esophagostomy were performed. Considering that the main cause of hiatal hernia is blunt dissection with division of the phrenoesophageal membrane, approximating the crus with 1 or 2 figure-8 sutures, according to the size of the defect, to prevent the incidence of hiatal hernia after total gastrectomy may be performed.

• The Korean Nurse
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• v.35 no.2
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• pp.71-91
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• 1996

The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

• Journal of Aquaculture
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• v.9 no.3
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• pp.195-203
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• 1996

Six strains (OKK, MOK, CHA, WON, 505 & PUA) of Korean rotifer, Brachionus plicatilis (S-type) were isolated from salt pond, and the resting egg production of these strains was investigated with the different salinities (10, 20, 30 put), Rotifer were cultured at $28^{\circ}C$ and 2,000 lux in 20 ml test tube with feeding Nannoohloris oculata. The maximum rotifer density was 2,050 inds./ml at 10 ppt for OKK strain, and MOK strain showed the highest specific growth rate (1.028) at 10 ppt. Mixis rate of CHA and WON strains increased with the lower salinity, while MOK strain increased the rate with salinity. PUA strain did not show the mixis rate even at the high rotifer density, and OKK strain showed the very low mixis rate ranging from 1.1 to $3.0\%$. Fertilization rate of CHA, MOK, SOS and WON strains was ranged from 10.4 to $68.8\%$, and OKK strain did not showed any fertilization rate. The highest production of resting egg in 20 ml test tube was 4,065 eggs at 10 ppt for WON strain. The results may suggest that the selection of rotifer strain and salinity are important factors for the mass production of resting egg.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.2
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• pp.35-51
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• 1995

This study was done to define nursing diagnose and to test the validity of the characteristics for patients with cerebrovascular accidents being seen at home by home health care nurses. This study was a descriptive study. The sample consisted of 10 experts(professors and home health care nurses) who had had a variety of experience using nursing diagnoses in clinical practice, and 336 nurse progress notes for 18 patients with cerebrovascular accidents. First, 32 nursing diagnoses were defined by the analysis of 336 nurse progress notes, and ten nursing diagnoses were selected according to a criteria of frequency and four nursing diagnoses from home health care clinical practice. Second, content validity was examined by an expert group which considered the sign / symtoms of the fourteen nursing diagnoses. The instrument used for this was a checklist for sign / symtoms based on the nurse progress notes and literature : Carpenito(1993), Kim Cho Ja et al (1994), Lee Sun Ok et al.(1994), Kim Mae Ja et al. (1992), Seoul University Hospital (1993) , Kim Mi Ja et al. (1991). The data were collected from March 1995 to April 1995. Data were analyzed using Content Validity Incidence where if 80% or more of the expert group agreed, characteristics were defined as a major sign/symtoms, if between 50% and 79% of the expert group agreed with the characteristic it was defined as a minor sign / symtoms. The results of this study are summarized as follows : 1. Thirty-two nursing diagnoses related to patients with cerebrovascular accidents were defined. There was a high frequency for the following : 'Potential for disuse syndrome (61%)', 'Impaired physical mobility(50%)', 'Impaired skin integrity (44.4%)', Potential for aspiration(33.3%)', 'Potential for infection: respiration(33.3%)', 'Self-care deficit : bathing /hygine(27.8%)', 'Ineffective family coping(22.2%)', 'Potential for trauma(22.2%)', 'Alteration in nutrition: less than body requirements(22.2%)'. The following diagnoses were also used in home health care clinical practice : 'Anxiety in family (50%)', 'Caregiver fatigue(27.8%)', 'Ineffective treatment behavior (22.2%)', 'Ineffective Levin tube management and Levin tube feeding(22.2%)'. Fourteen nursing diagnoses were selected. 2. Ten of the nursing diagnoses for patients with cerebrovascular accident were listed as nursing diagnoses by NANDA but four nursing diagnoses were new nursing diagnoses used in home health care clinical practice. 3. Characteristics of the ten Nursing Diagnoses from NANDA were developed from the sign /symtoms in the literature and in the nurse progress notes. These characteristics was verified as major or minor sign / symtoms by the expert group. 4. Characteristics of the four nursing diagnoses used in home health care were not defined by the literature but only by the nurse progress notes and verified as major or minor signs /symtoms by the expert group. On the basis of the findings of this study, the following recommendations are made : 1. Continual study is necessary to identify other signs /symtoms not verified in this study. 2. It is necessary to use verified signs /symtoms in home health care clinical practice. 3. It is necessary to define related factors which define each diagnoses in this study. 4. It is necessary to develop of standardized nursing are plans which include defined signs and symtoms. 5. It is necessary to study the outcomes of the standardized nursing care plans.