• Journal of Korean Academy of Rural Health Nursing
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• v.6 no.1
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• pp.33-43
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• 2011

Purpose: This study was done to verify the effects of a self-regulation program for management of hypertension. Method: Thirty patients with hypertension registered in a community health center were selected as the experiment group, and control group were patients in another community health center, matched for age and gender. The self-regulation program included daily blood pressure checks, periodic counseling, and health education. A self-check digital device with instructions was provided for self-monitoring of blood pressure, and the participants were interviewed before they took part in the program. Results: The first hypothesis was supported: There will be a greater reduction in both systolic and diastolic blood pressure for patients with hypertension who participate in the self-regulation program compared to patients in the control group. The second hypothesis was also supported: Patients with hypertension who participate in the self-regulation program will perform self-care activities better than those in the control group. Conclusion: The findings indicate that a self-regulation program reduces systolic and diastolic blood pressure and improves self-care in patients with hypertension. It is recommended that this self-regulation program be used in community health clinics for management of hypertension and prevention of complications.

• Korea Journal of Hospital Management
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• v.18 no.4
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• pp.97-112
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• 2013

This study is a proposal of quality scale and measurement for the Mobile Hospital Information System Usability used to the Chungnam National University Hospital in Daejeon Korea. This study is to provide decision- making guideline for hospital managers and to provide feedback for the users' information needs in Mobile Hospital Information System. The target people of the study were medical doctors in Chungnam National University Hospital. The service contexts of usability were request of medical Care, Vital sign check of Patient, Care Agreement of Patient, Blood management, Check of care state, Sign of choice doctors, Query of doctor order and patient measurement result. The Usability factors were the efficiency, effectiveness and satisfaction of quality model ISO9241-11. This study shows that the Mobile HIS is used for the communication and education between doctor and patients. Especially, The Care Agreement of Patient is a part of the most utilized in the Mobile HIS.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.371-374
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• 2015

We present a rare case of a patient with aortoiliac occlusive disease on the background of type A crossed renal ectopia, for whom open surgical intervention was required. Aortic exposure in patients with concomitant crossed renal ectopia can present technical challenges to the vascular surgeon. The knowledge of variations in the ectopic renal blood supply is of paramount importance when performing surgery to treat this condition and affects the choice of surgical exposure. We present and discuss the operative details of our patient and outline an approach to this subset of patients.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.275-278
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• 1996

The placement of epidural catheter may cause complications such as epidural hematoma, epidural abscess and neural damage. Among the above complications, epidural abscess is a rare but serious complication. This report pertains to a diabetic metlitus patient who developed spinal epidural and subdural abscess after continuous epidural catheterization for management of pain caused by reflex sympathetic dystrophy. The patient experienced urinary incontinence, as a neurologic sign, 8 days after epidural catherization. In was considered that the poor prognosis was due to a combination effects of a delayed visit to the hospital for treatment, rapid progression of abscess and uncontrolled blood sugar level. We therefore recommend aseptic technique and proper control of blood sugar level to prevent infection during and after epidural catheterization for diabetic patients. Early diagnosis of epidural abscess following surgical procedure must be required to avoid sequelae.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.1
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• pp.60-65
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• 2015

We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.

• International journal of advanced smart convergence
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• v.11 no.2
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• pp.194-204
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• 2022

This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.

• Biomedical Science Letters
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• v.7 no.1
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• pp.7-15
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• 2001

Although extracorporeal circulation (ECC) has been routinely used for cardiovascular surgery, hyperoxemia during ECC may produce oxygen toxicity and cellular injury. This study was performed to investigate the clinical influences of hyperoxemic ECC during cardiovascular operation. 40 adult patients scheduled for elective cardiovascular surgery were classified into normoxemic (arterial oxygen tension: 115 mmHg, n＝20) and hyperoxemic (arterial oxygen tension: 380 mmHg, n＝20) ECC. At preoperative and postoperative period, total leukocyte and neutrophil counts, platelet counts, iron, glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine in peripheral arterial blood, malondialdehyde (MDA) and troponin-T concentration (TnT) in coronary sinus blood, pulmonary vascular resistance (PVR), and postoperative blood loss volume (BLS) were measured and compared between groups. Hyperoxemic group had postoperatively higher total leukocyte and neutrophil counts, MDA, TnT, PVR total BLS, iron, glucose, AST, ALT, BUN, and creatinine than normoxemic group (p<0.05).0 conclusion, hyperoxemic ECC results in greater inflammatory response and oxidative damaging effects on the heart lung, liver and kidney, probably being adverse to postoperative patient recovery. For reducing these deleterious effects and improving postoperative outcomes, management lowering oxygen tension during ECC is recommended.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.531-534
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• 2007

Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.407-414
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• 2003

Purpose: The purpose of this study was to discern the effects of music therapy on the patients' level of anxiety and operative satisfaction during cataract surgery under local anesthesia. Method: The subjects for this study were fifty patients. Half of the subjects were categorized as an experimental group and the other half as a control group. All of the subjects were admitted to one hospital in Seoul for cataract surgery. This study was conducted from September 7 to October 2, 2002. The level of anxiety determined by self-reporting anxiety, pulse rate, systolic blood pressure, and diastolic blood pressure, was measured before and after the music therapy. The satisfaction degree was measured after the surgery. The tools for this study were Spilberger's state anxiety inventory and Patient Care Management System. Each patient in the experimental group chose the music used in his/her surgery and it was played through an audio system in the operating room. The data analysis was performed using the SAS/pc+(version 8.0). Results: 1. The anxiety of the experimental group decreased significantly compared to the control group. 2. The pulse rate of the experimental group decreased more than the control group. 3. The blood pressure of the experimental group decreased more than the control group. 4. The operative satisfaction of the experimental group was higher than the control group. Conclusion: According to the previous results, music therapy turned out to be a very efficient way to increase the satisfaction of a cataract patient after surgery by reducing the anxiety and the pulse rate of the patient during an operation with local anesthesia.

• Journal of Trauma and Injury
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• v.28 no.1
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• pp.34-38
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• 2015

The case of a patient with a transfusion-related acute lung injury (TRALI) to whom extracorporeal membrane oxygenation (ECMO) had been applied is reported. A 55-year-old male injured with liver laceration (grade 3) without chest injury after car accident. He received lots of blood transfusion and underwent damage control abdominal surgery. In the immediate postoperative period, he suffered from severe hypoxia and respiratory acidosis despite of vigorous management such as 100% oxygen with mechanical ventilation, high PEEP and muscle relaxant. Finally, ECMO was applied to the patients as a last resort. Aggressive treatment with ECMO improved the oxygenation and reduced the acidosis. Unfortunately, the patient died of liver failure and infection. TRALI is a part of acute respiratory distress syndrome (ARDS). The use of ECMO for TRALI induced severe hypoxemia might be a useful option for providing time to allow the injured lung to recover.