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Critical Care before Lung Transplantation

  • Lee, Jin Gu;Park, Moo Suk;Jeong, Su Jin;Kim, Song Yee;Na, Sungwon;Kim, Jeongmin;Paik, Hyo Chae
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.197-205
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    • 2018
  • Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

A study on the Factors of the patient satisfaction for nursing care in general hospital (종합병원 간호단위에서의 간호만족 영향요인 분석)

  • Kim, Kyeong-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.53-64
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    • 2001
  • The study was done to evaluate patient satisfaction with nursing care. The study subjects were patients admitted in a general hospital in Gangwon province. The instrument used in the study was developed by Lamonica. The reliability alpha of this tool 0.8596. The survey method was applied to collect data period of data collection was total 21days from September 4rd to September 24th in 2000. The data was analysed by statistical method of %, mean, ANOVA, Pearson's Correlation Coefficients though SPSS program. The follows are the summaries of results of the study. 1. The highest scores of satisfaction was shown in the area of technical professional nursing and the lowest scores was shown in area of nursing education. 2. The crossed analysis of patient general characteristics and satisfaction of nursing care showed a significance by marriaged status(p<0.05) but no significance by factors of sex, ages, education, religency. 3. Job satisfaction of nurses showed 2.79 in average on the basic of 5 marks. 4. The significant Correlation were found between job satisfaction degree and bed rotation rates , number of patients by one nurse, experience of nurse(p<0.05). 5. The significant Correlation were found between nursing satisfaction degree and ages, job satisfaction, bed rotation rates, number of patients by one nurse(p<0.05), experience of nurse(p<0.01). On basis of the above findings the following recommendations are made : to suggest to improve environment of nursing unit. And to suggest to improve job satisfaction for improvement of nursing satisfaction in practice.

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Risk Factors for Recurrence of Anterior Shoulder Instability after Arthroscopic Surgery with Suture Anchors

  • Choi, Chang-Hyuk;Kim, Seok-Jun;Chae, Seung-Bum;Lee, Jae-Keun;Kim, Dong-Young
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.78-83
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    • 2016
  • Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

The comparative study with administrative and clinical standard of conservative treatment on herniated intervertebral lumbar disc patients (요추 추간판 탈출증 환자에 대한 보존적 치료의 행정기준과 임상기준에 관한 비교 연구)

  • Ghang, Goon-Yong;Kim, Young-Bae
    • Journal of Korean Physical Therapy Science
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    • v.13 no.3
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    • pp.27-40
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    • 2006
  • The purpose of this study is comparative with administrative and clinical standard of conservative treatment on herniated intervertebral lumbar disc patients. The persons who diagnosed to herniated intervertebral lumbar disc were attended in this study. The number of cases were 120 cases. We evaluated their chart, X-ray and MRI. The result of the group 1 study(60 cases) were as follows; 1. The patients who treated for 41days were improved 100%, which was 3cases(5%). 2. The patients who treated for 45days were improved 90%, which was 13cases(22%). 3. The patients who treated for 43days were improved 80%, which was 28cases(47%). 4. The patients who treated for 39days were improved 70%, which was 6cases(10%). 5. The patients who treated for 28days were improved 60%, which was 5cases(28%). 6. The patients who treated for 22days were improved 50%, which was 4cases(7%). 7. The patient who treated for 28days were improved 40%, which was 1case(2%). The result of the group 2 study(60 cases) were as follows; 1. The patients who treated by administrative standard were improved 40%, which was 8cases(13%). 2. The patients who treated by administrative standard wereimproved 30%, which was 32cases(53%). 3. The patients who treated by administrative standard wereimproved 20%, which was 7cases(12%). 4. The patients who treated by administrative standard were improved 10%, which was 9cases(15%). 5. The patients who treated by administrative standard wereimproved 0%, which was 4cases(7%). Conclusion ; In herniated intervertebral lumbar disc patients who had conservative treatment. The highest improve patients were 28 cases(47%), who treated for 43 days in group 1. The lowest improve patient were 4 case(7%), who treated by administrative standard in group 2. The Effective duration of conservative treatment was more than 43 days in group 1. Group 1 which applied to clincal standard was much batter than group 2 which applied to administrative standard.

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Clinico-Epidemiological Patterns of Cutaneous Leishmaniasis Patients Attending the Anuradhapura Teaching Hospital, Sri Lanka

  • Galgamuwa, Lahiru Sandaruwan;Sumanasena, Buthsiri;Iddawela, Devika;Yatawara, Lalani;Wickramasinghe, Susiji
    • Parasites, Hosts and Diseases
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    • v.55 no.1
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    • pp.1-7
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    • 2017
  • Cutaneous leishmaniasis (CL) caused by Leishmania donovani is an endemic vector-borne disease in Sri Lanka. Over 2,500 cases have been reported since 2000 and the number of CL cases has dramatically increased annually. Total 57 clinically suspected CL patients attending the dermatology clinic in Anuradhapura Teaching Hospital were recruited from January to June 2015. Slit skin smears and skin biopsies were taken from each of the subjects. Clinical and epidemiological data were obtained using interviewer administered questionnaire. Forty-three (75.4%) patients among 57 were confirmed positive for L. donovani. The majority (77%) of infected patients was males, and the most affected age group was 21-40 years. Soldiers in security forces, farmers, and housewives were identified as high risk groups. The presence of scrub jungles around the residence or places of occupation (P=0.003), the presence of sandflies (P=0.021), and working outsides more than 6 hr per day (P=0.001) were significantly associated with CL. The number of lesions ranged from 1-3, and the majority (76%) of the patients had a single lesion. Upper and lower extremities were the prominent places of lesions, while the wet type of lesions were more prevalent in females (P=0.022). A nodular-ulcerative type lesion was common in both sexes. The presence of sandflies, scrub jungles, and outdoor activities contributed to spread of Leishmania parasites in an endemic pattern. Implementation of vector control programs together with health education with regard to transmission and prevention of CL are necessary to control the spread of this infection.

A Clinical Analysis of Intervertebral Disc Change on Magnetic Resonance Imaging(MRI) Scan of the Patients Who were Diagnosed as Spondylolisthesis (척추전방전위증 환자에서의 자기공명영상 상 추간판 변형 형태 고찰)

  • Kim, Seok;Bahn, Hyo-Jung;Yoon, Hyun-Seok;Kim, Sun-Min;Jun, Byung-Chul
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.119-130
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    • 2011
  • Objectives: The purpose of this study is to find cut the characteristics of intervertebral disc changes arid relative factors of the patients with spondylolisthesis. Methods: We investigated 95 cases of patients who visited one Korean traditional medicine hospital and were diagnosed as spondylolisthesis on lumbar spine X-ray and lumbar spine magnetic resonance imaging(MRI). We selected these cases retrospectively and randomly. We analysed the relativity between number of changed discs and type of change disc and age, level of spondylolisthesis and type of spondylolisthesis. Results: 1. The number of changed discs increased with older and degenerative spondylolisthesis type(p<0.05) and was not related to the level of spondylolisthesis. 2. Bulging disc is the dominant type of disc change(74.12%). The type of changed disc was shown to be similar in lytic and degenerative spondylolisthesis. It was not relative to the level of spondylolisthesis(p>0.05). 3. The direction of nerve compression was diffuse type in about halfly of the patients(47.06%) and the symptoms of patent and dermatome did not matched in 54 cases. Conclusions: The patients who visited a Korean medicine hospital and were diagnosed as spondyolithesis have different characteristics from the established studies. Their discs changed dominantly to diffuse bulging type and the symptoms of patient were not related with the direction and level of the changed discs were spondylolisthesis existed.

Magnitude of Patient's Cost-sharing for Hospital Services in the National Health Insurance in Korea (의료보험 환자가 병원진료시 부담하는 본인부담 크기)

  • 김창엽;이진석;강길원;김용익
    • Health Policy and Management
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    • v.9 no.4
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    • pp.1-14
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    • 1999
  • The purpose of this study was to estimate the magnitude of patient's actual cost-sharing for hospital services in the National Health Insurance which has been estimated with only a few hospitals or limited number of patients. Also we aimed at analysis of factors influencing the magnitude. Sources of analyzed data were two databases. 1997 medical benefits record of the National Federation of Medical Insurance and 1997 Statistics for Hospital Management from the Korea Institute of Health Services Management(KIHM). We merged two databases and related records for 224 hospitals. based on the identification details of each hospital. The average percent of patients' cost-sharing was 51.7% of total hospital revenues from the insurance. with 40.3% of revenue in inpatient and 67.4% in outpatient. respectively. The contributing hospital factors to the magnitude of cost-sharing were size of hospitals. teaching status. location. number of employed physicians. etc. Larger and university hospital. urban location. and with more physicians were positively correlated with higher level of cost-sharing. Additionally, the higher the expenses of inpatient's treatment was, the higher the size of patient's cost-sharing was. These findings suggest that present level of patients' cost-sharing is quitely high and it is urgent to reduce the patient's cost-sharing to the reasonable level. It would be necessary to extend the coverage of insurance benefits and to develop policies focusing on larger hospitals and inpatient services.

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Effects of Acupuncture Therapy on Dry Eye Syndrome: 43 Case Series (안구건조증 환자 43례의 침치료 효과에 대한 임상적 연구)

  • Lee, Chang-Woo;Lee, Eun-Kyoung;Jeon, Ju-Hyun;Kim, Jung-Ho;Kim, Young-Il;Kim, Jung-Il
    • Journal of Acupuncture Research
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    • v.27 no.6
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    • pp.85-94
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    • 2010
  • Objectives : The aim of this study was to evaluate the effect of acupuncture therapy on dry eye syndrome. Methods : We investigated 43 cases of patients with dry eye syndrome. They were treated with acupuncture therapy twice or three times a week. Symptoms score, number of dry eye symptoms, Ocular surface disease index were compared between eyes before and after treatment to evaluate the efficacy of acupuncture therapy. Results : After 24 times treatment, symptom score, number of dry eye symptoms, Ocular surface disease index were significantly decreased. Conclusions : Acupuncture therapy was effective to improve symptoms of dry eye syndrome patients. There should be more observation about patients with dry eye syndrome and further study will be needed.

The Insight Paradox among Outpatients with Schizophrenia (조현병 외래 환자에서 병식 모순)

  • Kim, Tae Yong;Kim, Jun Gee;Kim, Chul Kwon
    • Korean Journal of Schizophrenia Research
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    • v.22 no.2
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    • pp.56-65
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    • 2019
  • Objectives: The primary objective was to test the phenomenon known as the insight paradox, which refers to the association between higher levels of insight and lower self-esteem, higher hopelessness, and a higher perception of social prejudice among patients with schizophrenia. Methods: A total of 216 outpatients with schizophrenia according to the DSM-IV diagnostic criteria were recruited. All participants were receiving ongoing outpatient treatment and were in a stable phase of the disorder. The participants were divided into a good-insight (N=109) and a poor-insight (N=107) group by the direct interview and the mean score of questionnaire. The parameters used for analysis and comparison were demographic variables (age, gender, education), clinical variables (age at onset, number of hospitalizations), self-esteem, hopelessness, self-stigma, and quality of life. Results: Compared with the poor-insight group, the good-insight group was found to have a lower number of hospitalizations, lower self-esteem, higher hopelessness, lower quality of life, and a higher level of internalized stigma. Conclusion: The insight can cause the negative consequences in patients with schizophrenia. Therefore, clinicians should pay attention to the negative aspects of insight for improving the quality of life in the treatment of patients with schizophrenia.

A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic

  • Shin, Bisol;Yoo, Seunghoon;Kim, Jongsoo;Kim, Seungoh;Kim, Jongbin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.203-208
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    • 2016
  • Background: In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. Methods: This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Results: Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was $132.7{\pm}77.6min$, and the mean duration of treatment was $101.9{\pm}71.2min$. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Conclusions: Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.