• Title/Summary/Keyword: Teaching hospital

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The Preliminary Study for the evaluation of the Rehabilitation Nursing Program integrated with Day Care Program of Stroke Survivors (뇌졸중환자의 낮 병동 재활간호프로그램의 적용평가를 위한 예비연구)

  • Suh, Moon-Ja;Kang, Hyun-Sook;Lee, Myung-Hwa
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.1
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    • pp.98-107
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    • 2000
  • A Preliminary study for the evaluation of the Rehabilitation Nursing Program(RNP) implemented to the 25 stroke survivors at the Day Care Program Center of National Rehabilitation Hospital in Seoul was done at 1999. The purposes of this study was to assess the psychological effects as outcome-variables such as depression, powerlessness and self efficacy of the stroke survivors who were discharged from acute care hospitals. The Rehabilitation Nursing Program (RNP) integrated with the Day Care Program for rehabilitation was implemented and the psychological outcome variables were measured by 3 psychologic instruments of Zung Depression Scale, Millers's powerlessness and the Bandura's self efficacy scale. These instruments were translated into Korean and the contents validity and the reliability were tested. The subjects were 17 males and 8 females and 52% were aged over 51 years old and 24% were from 31 to 50 years old. Most of them (72%) had been educated more than high school level. The contents of RNP were 8 sessions composing of self-introduction, individualized assessment, health contract and feedback, management of depression, shaving experiences, effective communication, self efficacy teaching, health information, and daily care activities. This study found that the level of depression and the powerlessness were within average level and had not been changed the level of self efficacy after RNP were somewhat higher than before, but it was not changed significantly. According to the results, the psychological state of the subjects were not changed significantly. Only the level of self efficacy was a little improved after having the RNP. Based on theses results, the RNP should be focussed on the psychological nursing care and the psychological outcome variables were retested strictly with the enough sample size.

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The Impact of Implementing Critical Care Team on Open General Intensive Care Unit

  • Kim, Ick Hee;Park, Seung Bae;Kim, Seonguk;Han, Sang-Don;Ki, Seung Seok;Chon, Gyu Rak
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.2
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    • pp.100-106
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    • 2012
  • Background: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. Methods: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. Results: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). Conclusion: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.

Factors Associated with Indeterminate and False Negative Results of QuantiFERON-TB Gold In-Tube Test in Active Tuberculosis

  • Cho, Ki-Won;Cho, Eun-Ha;Kwon, Soo-Hoon;Im, Sang-Hyuk;Sohn, In;Song, Sook-Hee;Kim, Hye-Ok;Kim, Su-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.416-425
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    • 2012
  • Background: The sensitivities and specificities of interferon-gamma release assays (IGRAs) vary among different population studies, and the data on the routine use of IGRAs are limited. The aim of this study was to evaluate the role of QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of active tuberculosis. Methods: We conducted a prospective study, enrolling 77 patients with suspected pulmonary tuberculosis (TB), at a secondary care teaching hospital in Seoul. Results: In total, 12 (15.6%) patients showed indeterminate results due to positive control failure on the QFT-GIT test. Indeterminate results were significantly associated with the elderly, history of the intensive care unit stay, lymphocytopenia, especially low CD4 count, increased C-reactive protein and decreased protein levels. Of the 77 patients, 44 (57.1%) were diagnosed with active pulmonary tuberculosis, and the percentage of false negative results of the QFT-GIT was 36.4% (vs. 31.8% with TST). In the TB group with >65 years old (n=12), the proportions of the indeterminate (33.3% vs. 3.1%) and the false negative results (58.3% vs. 25.0%) of the QFT-GIT were significantly higher than in the younger TB group (n=32). Conclusion: Indeterminate and false negative results of QFT-GIT test were not infrequent in tuberculosis, especially in the elderly. Care should be considered for the interpretation with the elderly, immunocompromised, chronic and severely diseased patients.

Surgical Correction of Chronic Hypertropic Pyloric Gastropathy in a Dog (개에서의 만성 비후성 유문 위장애에 대한 수술적 치료)

  • Kim Joon-young;Jeong Soon-wuk;Park Sang-heuk;Yoon Hun-young;Han Hyun-jung;Jang Ha-young;Lee Bo-ra;Kim Gu-yuong
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.398-401
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    • 2004
  • A ten-year-old, female Yorkshire terrier dog with intermittent vomiting, weight loss, polydipsia and depression was referred to the Veterinary Medical Teaching Hospital of Konkuk University. On the radiological survey, gas and fluid-filled gastric distention was detected. No contrast medium entraneed to the small bowel, in 60 minutes after contrast medium administration. And marked fluid accumulation in gastric body and thickening of the pyloric mucosa were found with ultrasonograph. So gastric obstruction by reason of pyloric stenosis was strongly suspected. At the surgery, hypertrophied mucosa was resected adequately, and Heineke-Mikulicz pyloroplasty was applied. Microscopically the symptom was characterized by gastric mucosa hyperplasia and mild diffuse Iymphoplasmocytic gastritis. So this condition was diagnosed as chronic hypertrophic pyloric gastropathy. Intermittent vomiting and mild depression were shown for 9 days after the operation. After that, the patient was recovered gradually. One month later, the patient had normal appetite and activity without complications.

Acupuncture Therapy of T12-Ll Intervertebral Disk Disease in Dogs (개에서 T12-Ll의 추간판 질환시 침치료 증례)

  • Kim Nam-soo;Lee Cheol-ho;Lee Jong-il;Park Young-jae;Lee Byung-gon;Choi In-hyuk
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.380-383
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    • 2004
  • Two dogs with hindlimb paralysis were referred to the Teaching Animal Hospital of Chonbuk National University. We performed an acupuncture in two cases. Case No.1 was a 5-year-old, 3kg intact mixed breed female dog presented with hindlimb paralysis during last 3 days. Physical examinations, CBC, serum chemistry, urinalysis and radiography carried out. The diagnosis was the thoracolumbar disk disease of Tl2-Tl3 on the basis of above these tests. Acupoints selected were Lumbosacral point, GV-5(Xuan Shu), GV-20(Bai Hui), GB-30(Huan Tiao), GB-31(Feng Shi), ST-36(Zu San Li) and GB-34(Yang Ling Quan). we performed an acupuncture therapy five times at 2 days intervals for 15 minutes each time. Case No.2 was 7-year-old, 6.0kg, mixed breed male dog which was presented with the history of hindlimb paralysis since 2 months. The medical history of the patient revealed that the condition did not respond to medicinal therapy. The diagnosis was the thoracolumbar disk disease of Tl3-Ll and left patellar luxation (one or two grade). We decided to perform acupuncture in this case also and the Lumbosacral point, GV-5(Xuan Shu), GV­6(Ji Zhong), GV-7(Zhong She), GB-30(Huan Tiao), GB-31(Feng Shi), ST-36(Zu San Li), GB-34(Yang Ling Quan) were used. We performed acupuncture therapy at day 3, 6, 8 and 10 for 15 minutes each time. The response to an acupuncture therapy in two patients was good and the patients were almost recovered from hindlimb paralysis.

Primary Retrobulbar Meningioma in a Dog (개에서 발생한 원발성 안구 후방 수막종 1례)

  • Ahn, Jae-Sang;Jeong, Man-Bok;Kim, Won-Tae;Kim, Se-Eun;Park, Young-Woo;Kim, Tae-Hyun;Ahn, Jeong-Taek;Ha, Jeong-Im;Kim, Dae-Yong;Choi, Min-Cheol;Yoon, Jung-Hee;Seo, Kang-Moon
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.97-101
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    • 2010
  • A 13-year-old neutered female Maltese was referred to Veterinary Medical Teaching Hospital of Seoul National University with 8-month-history of gradually enlarging retrobulbar mass in the right eye. On the ophthalmic examinations, exophthalmos, exposure keratitis, and cataract were observed, and menace response was absent in the eye. The fellow eye was normal except for nuclear sclerosis. On the ocular ultrasonographic evaluation, a mass was identified in retrobulbar and periocular region in the right eye. Exenteration was performed in order to remove the mass. Histopathologic evaluation revealed that most part of the mass was composed of epithelial-like neoplastic cells. Invasion into adipose cells and osseous metaplasia around the mass were also confirmed. Based on the radiologic and histopathologic examination, the mass in the right eye was diagnosed as primary retrobulbar meningioma. Eleven months after the surgery, recurrence was not observed.

Veiled Paraquat Poisoning - A Focus on Clinical Characteristics (베일에 가린 파라쿼트 중독 - 임상적 특징을 중심으로)

  • Song, Ye-Wan;Choi, Sang-Cheon;You, Young-Yeol;Shin, Yeoun-Ho;Park, Eun-Jung;Ahn, Jung-Hwan;Min, Young-Gi;Jung, Yoon-Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.14-19
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    • 2011
  • Purpose: Most paraquat poisonings are easily diagnosed by history taking on physical examination, however, some are failed to be diagnosed initially if the poisoning was veiled. The purpose of this study was to explore the clinical characteristics of veiled paraquat poisoning. Methods: We retrospectively reviewed the medical records of patients whose discharge diagnosis was paraquat poisoning in one university teaching hospital between 1 Jan, 2001 and 31 Dec, 2010. Veiled paraquat poisoning was determined when there was a positive urine paraquat kit in patients who did not mention paraquat poisoning in an initial physical examination or had unknown cause of pulmonary fibrosis, acute renal failure, or multi-organ failure. Results: Of the 117 patients with paraquat poisoning during the study period, 6 patients (5.1%) had veiled paraquat poisoning. The clinical characteristics were 1) proteinuria - 6 (100%), 2) increased creatinine - 4 (66.7%), 3) green skin stains - 2 (33.3%), 4) mucosal ulcer - 3 (50%). Blood chemistry results were variable. Conclusion: We should suspect veiled paraquat poisoning for patients who have proteinuria, increased creatinine, green skin stain, mucosal ulcer and vomiting, or if they have rapidly progressing acute renal failure or multi-organ failure with unknown cause, even if patients didn't mention about paraquat poisoning upon the initial physical examination. In cases with the above clinical conditions, a thorough repeated physical examination including history taking and use of urine paraquat kits should be performed.

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The Influence of Scapular-Pelvic Patterns of Proprioceptive Neuromuscular Facilitation on Hemiplegic Gait -A Case Report- (PNF 어깨뼈-골반 패턴이 편마비 환자의 보행에 미치는 영향 -증례보고-)

  • Choi, Jae-Won;Hwang, Sin-Pil
    • PNF and Movement
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    • v.16 no.1
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    • pp.27-32
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    • 2018
  • Purpose: This study examined changes in gait speed and stride length after an intervention involving simultaneous scapular and pelvic patterns of proprioceptive neuromuscular facilitation in a hemiplegic patient. Methods: A 58-year-old woman with left hemiplegia who had complained of slowness of gait speed and weakness of leg strength took part in an intervention involving scapular postdepression patterns on the affected side and pelvic postdepression patterns on the nonaffected side. The intervention was performed with the patient lying on her left side, in a half kneeling position, and in a standing posture. Rhythmic initiation was used for teaching the movements to the patient and improvement of kinesthesia, and a combination of isotonic was employed for increasing strength and irradiation of the scapula and pelvic movement. The intervention took place for 30 min. It was implemented twice a day, 5 days a week, for 3 weeks. After three repetitions, the average time taken to complete the 10-m walk test (10 MWT), in addition to stride length, was measured to determine gait speed. Results: After the 3-week program, the patient's performance in the 10 MWT improved from 21.7sec to 17.1sec, and her stride length improved from 31.4cm to 38.7cm. Conclusion: The results showed that trunk movement exercise, especially coordinative movements of the scapula and pelvis can improve gait speed and stride length by increasing trunk stability and mobility. A combination of pelvic and scapular patterns can facilitate trunk rotation, thereby improving gait speed and stride length.

A Clinical Study on an Acute Therapy for Recovering the Normal Physiology in Narcotists using Tuo Yin Tang Jiang made of Chinese Medical Herbs

  • Yu, Zhao-Qun;Lee, J.I.
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2000.10a
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    • pp.34-51
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    • 2000
  • Narcotic drugs generally refer to serious and habitual hidden rash such as opium, heroin, methyphetamin, nabinol, cocaine, and so forth. At present, narcotic drugs are spread unchecked and are causing a big social problem. So many countries and narcotists are making every effort to set up a barricade against narcotic drugs. And there is a limit suitable treatment for them. Thus Tuo Yin Tang hang is developed. As indicated by Chinese letters, Tuo yin Tang Jiang(TYTJ) is a crude drug. It is a traditional chinese medicine developed by the study done from lune in 1998 to lune in 1999 that Hubeisheng was entrusted with by People's Republic of China. This study is a treatise on etiology and syntomatology or narcotism. TYTJ is a medicine which is in accord with Pharmacopeia of the People's Republic of China in order to remove from the body the toxic materials resulting from narcotic drugs such as opium and heroin. According to the standard diagnosis on narcotism, 105 cases are studied and treated at the Rehabilitation Center attached to Enshi Autonomous Region Hospital in Hubeisheng. 105 cases are divided into 2 groups by double-blind method. One is the experimental group which has 56 cases. The other is the control group which has 49 ones. 13 cases among 105 cases are addicted by intravenously injections. 9 cases are by oral takings. It took 10 days for this experiment to be performed. Two groups didn't show a striking individual variation based on the age, gender, period of taking drugs, withdrawal symptoms, complication, and state of health. The experimental group had a higher effect of treatment than the control group had. TYTJ treats diseases effectively and has no side effect, irrespective of the serious or slight addiction to opium and morphine.

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A Case of Necrotizing Meningoencephalitis in a Maltese Dog (말티즈견에서 괴사성 뇌막뇌염 증례)

  • Park Jin-hee;Eom Ki-dong;Kim Jae-hoon;Seong Yun-sang;Lee Hae-oon;Lee Sang-gwan;Jang Kwang-ho;Lee Keun-woo;Kweon Oh-deog;Park Hyun-jung;Oh Tae-ho
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.284-287
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    • 2005
  • A 18-month-old, male Maltese dog with acute seizure was referred to Veterinary Medical Teaching Hospital, Kyungpook National University. Abnormal neurologic findings included a tendency to fall to the left, turn and circle to the right, negative bilateral menace responses and pupillary light reflexes, and diminished responses to facial sensation testing on both sides. Radiographic signs were normal, except for occipital dysplasia. Magnetic resonance imaging of the brain revealed bilateral asymmetric ventriculomegaly, which is more on left side. Cerebral edema was also suspected. The dog died after 9 days from the onset of seizure, and a necropsy was performed. Histopathologically, the brain lesions in the meninges and the cerebral cortex of this dog was presented. There was severe diffuse nonsuppurative inflammation in perivascular area of the meninges and the cerebral white matter. Based on the results, this case was diagnosed as necrotizing meningoencephalitis in Maltese dog.