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Prostate spindle cell neoplasm associated with early voiding difficulty after transurethral resection of the prostate

  • Chang Lim Hyun;Jung Sik Huh;Kyung Kgi Park
    • Journal of Medicine and Life Science
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    • v.20 no.2
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    • pp.94-98
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    • 2023
  • This report presents the case of 75-year-old men with spindle cell neoplasm. The patient underwent percutaneous nephrolithotomy and transurethral resection of the prostate (TURP) for renal stones and benign prostatic hyperplasia. One month postoperatively, the patient was able to void without any difficulty. Five months later, the patient experienced difficulty voiding and presented to the emergency room with severe pelvic pain. Computed tomography (CT) showed regrowth of the prostate mass into the posterior bladder and penile root. The prostate-specific antigen level remained constant at 1.14 ng/mL during the pre-and postoperative periods. Five months before the TURP operation, the patient's CT scan showed a soft and mildly enlarged prostate with no protrusion into the bladder. Biopsy of the prostate, however, showed a protruding mass, indicative of a spindle cell neoplasm. The patient was subsequently treated with the chemotherapeutic drug adriamycin. Unfortunately, treatment was unsuccessful, and the patient died 18 months later.

The Effects of Discharge Planning for the Elderly with Pulmonary Disease in the Emergency Room (퇴원계획중재가 응급실 내원 호흡기 질환 노인의 퇴원준비도, 간호서비스 만족도, 재입원율에 미치는 효과)

  • Kim, Hyeon-Ju;Park, Yeon-Hwan
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.24-32
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    • 2014
  • Purpose: The purpose of this study was to examine the effects of discharge planning on patient satisfaction, the readmission rate and preparedness for discharge in the elderly admitted to the emergency room (ER) for pulmonary disease. Methods: A quasi-experimental intervention study design was used. Older adults with pulmonary health problems in the ER in one general hospital were randomly allocated to either an experimental (n=21, 74.2 years) or control group (n=19, 70.7 years). The experimental group participated in a discharge planning program by a geriatric nurse practitioner. Data were collected from medical records, physical measurements and structured questionnaires including information on demographics, patient satisfaction, readmission, and preparedness for discharge. Results: Participants in the experimental group had significantly better outcomes with regard to patient satisfaction with nursing services (p=.003) and preparedness for discharge (p=.034). However, there was no significant effect on the readmission rate (p=.392) Conclusion: The results suggested that a discharge planning program could bolster nursing service satisfaction and preparedness for discharge in older patients admitted to the ER for pulmonary health problems. To clarify the effects of discharge planning on older patients admitted to the ER, a larger sample population, better instruments for various measures, a new manual on discharge planning and frequent follow-up will be necessary.

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Healthcare Process Pattern Analysis with Triage in the Emergency Department (환자의 중증도 분류를 고려한 응급실의 진료 프로세스 패턴 분석)

  • Sim, Seungbae;Choi, Jaehyung;Kim, Bosung;Oh, Jisoo;Kim, Seungho;Park, Yooseok;Park, Incheol;Chung, Taenyoung;Oh, Kyounghwan;Jeong, Bongju;Lee, Young Hoon
    • Journal of the Korean Operations Research and Management Science Society
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    • v.37 no.4
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    • pp.111-124
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    • 2012
  • Emergency room process is very important in the whole hospital processes because it is first diagnosis for patient. Above all, triage is important activity which quickly diagnose the status of emergency patient and sets the priority for treatment. This paper analyzes the treatment process pattern by triage type. The results show that the treatment process after triage such as residence time, diagnosis and checkup type, and joint treatment are dependent on triage types. We can use these analysis results for improving the current triage system and developing the new triage system considering a domestic emergency medical service environment.

Penetrating Chest Injuries Caused by the Sideview Mirror of the Patient's Car - Report of 2 cases - (자동차의 사이드미러가 흉강에 박힌 채로 내원한 흉부관통상 - 2례 보고 -)

  • Kim, Soo Sung
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.47-51
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    • 2007
  • Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest

  • Seok, Junepill;Wang, Il Jae
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.284-287
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    • 2021
  • We report a case of delayed chest wall reconstruction after thoracotomy. A 53-yearold female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and "on the way out" SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.

Development of the Upper Wear Fixation Device for Chest AP X-ray Imaging on the Emergency Stretcher Bed (응급실 침대 위 흉부전후방향 엑스선 검사를 위한 상의고정장치 개발)

  • Lim, Woo-Taek;Hong, Dong-Hee
    • Journal of radiological science and technology
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    • v.45 no.3
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    • pp.205-211
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    • 2022
  • This study aimed to provide basic data for 3D printing in the medical health field by developing upper wear fixation device (UWFD), an auxiliary device for shortening chest AP examination time on emergency room beds and non-contact with patients. The standard of hooks was modeled according to the bed frame using the Autodesk Fusion 360. It was printed with Form2 (Formlabs, Somerville, MA, USA), as SLA (stereo lithography apparatus) method, and was washed and hardened using Form Wash and Form Cure. The completed UWFD conducted an online survey on 4 items of stability, convenience, availability, preference and general characteristics. The total stability average was 3.93±0.80, the total convenience average was 3.93±0.68, the total availability average was 4.01±0.89, and the total preference average was 3.80±1.08. This study was significant in suggesting improvements in the general X-ray examination process in the emergency room by designing and making aids to easily fixing the patient's top to the frame of the emergency bed while meeting promptness and non-contact with the patient.

Penetrating right ventricular injury following a single gunshot to the left flank in Iraq: a case report

  • Zryan Salar Majeed;Yad N. Othman;Razhan K. Ali
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.253-257
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    • 2023
  • A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.

An unstable patient with a large sucking chest wound managed with gauze packing for preventing tension and bleeding control before surgery in Korea: a case report

  • Chang-Sin Lee;Min-Jeong Cho;Tae-Wook Noh;Nak-Jun Choi;Jun-Min Cho
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.147-150
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    • 2024
  • This case report describes the management of a 51-year-old female patient who arrived at the emergency room with a stab wound to the upper right chest. Immediate medical interventions were undertaken, including blood transfusions and endotracheal intubation. To prevent tension and control bleeding, gauze packing was applied directly through the large open wound. Further surgical exploration identified a laceration in the lung, necessitating a right upper lobe resection. Postoperatively, the patient's vital signs stabilized, and she was subsequently discharged without complications. This case highlights the decision-making process in selecting between an emergency department thoracotomy and an operating room thoracotomy for patients with penetrating chest trauma. It also illustrates the role of gauze packing in managing tension and hemorrhage. In summary, gauze packing can be an effective interim measure for stabilizing patients with traumatic injuries, unstable vital signs, and large open chest wounds, particularly when a chest tube is already in place, to prevent tension and facilitate bleeding control prior to surgical intervention.

The Effects of the Inpatients' Stress and Privacy for the Satisfaction with Patients' Room (입원환자의 프라이버시와 스트레스가 병실 만족도에 미치는 영향)

  • Shin, Eun-Gyeong;Park, Soobeen
    • Korean Institute of Interior Design Journal
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    • v.25 no.5
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    • pp.148-156
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    • 2016
  • This study proposes the structural model of inpatient's satisfaction with their room. Relationship among patients' privacy, patients' stress, and patients' satisfaction were evaluated and were discussed. Survey research followed the literature review, in which the subjects answered questions of the 12 items for the patients' privacy requirements, 10 items selected from the HSRS, and an item of patients' satisfaction. A total of 120 copies were analyzed through the statistical process using the SPSS Win Program 20.0 and SEM by the AMOS 20.0. Results and conclusions are as follows: (1) the inpatients' privacy requirements was subdivided into 'the reserve factor', 'the territoriality factor', and 'the solitude factor'. (2) The inpatients' stress level was subdivided into 'the relationship factor', 'the unfamiliarity factor', and 'the control factor'. (3) The model of relationship among the subjects' privacy requirements, stress level and their satisfaction with the patients' room showed that the subjects' stress level affected their satisfaction with the patients' room directly and the subjects' privacy requirements gave an direct and indirect effect on their' stress level and an indirect effect on their satisfaction with patients' room.

Radiographic Status of the Visited Patients at University Hospital Emergency Room (한 대학병원 응급실 내원환자의 방사선촬영 실태)

  • Ahn, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.81-92
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    • 2011
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.