• Clinical Endoscopy
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• v.56 no.2
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• pp.239-244
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• 2023

Tuberculosis is an adverse event in patients with Crohn's disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn's disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient's condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.203-215
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• 1994

The purpose of this study was to investigate the needs for exercise of adult inpatients and ultimately to provide basic data for planning nursing intervention of patients who need exercise. The tool used for this study was a structured questionnaire which consisted of 42 items. The test items were classified into seven factors. The seven factors of the needs for exercise were need for achievement, need for activity, need for affiliation, need for autonomy, need for catharsis, need for homeostasis, and need for exhibition. Subjects of this study were 127 patients in two general hospitals in Seoul, and one general hospital in Chun Ann City. The needs of exercise were identified and the data were analyzed by gender, age, occupation, education level, monthly income, size of patient room, patient group who requires exercise and the other patient group who requires bed rest, using one-way ANOVA and Scheffe test as post-hoc. The findings of this study were as follows ; 1) Among the needs for exercise of adult patients, the highest level of the needs was the need for homeostasis. The next highest was the need for achievement, then need for activity, need for catharsis, need for autonomy, need for affiliation, and the lowest was the need for exhibition. 2) Maintaining physical fitness stood first in the need for homeostasis, relieving psychological and physical powerlessness in the need for activity, mood diversion in the need for catharsis, happiness of the family in the need for affiliation, maintaining the balanced body figure in the need for exhibition, practicing planned life in the need for achievement, and improving the ability to overcome the crisis in the need for autonomy. 3) Male patients exhibited the higher level of the needs than female patients in all factors except the need for exhibition and homeostasis. 4) There was no statistical difference in the needs between age, occupation, monthly income, and the size of patient room. 5) The need for achievement was high as the level of education goes higher. 6) The patients who performed regular exercise before admission had higher needs for activity, achievement, and autonomy, compared with the patients who did not perform the regular exercise before admission. 7) There was no statistical difference in the needs between patient group who requires exercise and the other patient group who requires bed rest. The need for homeostasis was the highest in both groups. The results from this study suggest that the need for exercise of adult inpatients should be assessed before planning exercise intervention.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.3-12
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• 1979

A survery was carried out in order to know the status of student health service and student medical insurance of universities and colleges in Korea from 1 July to 30 September. 1978. And the following results were obtained; 1. Out of seventy universities and colleges, 54.8% of them had student health service facility such as student health conte. (30.0%) or health room (24.8%). 2. Out of twenty-seven national and public universities and colleges, 44.4% of them had student health service facility and out of forty-three private universities and colleges, 60.5% of them had student health service facilities. 3. Each of 80.0% of 25 universities, 43.3% of 30 colleges and 33.3% of 15 junior colleges had student health service facility. 4. Major roles of student health service were physical examination (92.1%), health counselling (86.8%), primary medical care (78.9%), tuberculosis control (68.4%), insect and rodent control (52.6%), parasite control(47.4%), water source sanitation (44.7%), and dental health care (28.9%). 5. Out of 21 universities and colleges, 66.7% of them had full time doctor and 81.0% of them had full time nurse for student health center. And out of 17 universites and colleges, 5.9% of them had full time doctor and 33.3% of then had full time nurse for student health room. 6. The range of health fee was varied from 100 won to 1,400 won per student per semester and the average was 520 won. 7. Among 55 universities and colleges, 78.6% of them had carried out annual physical examination in 1977 and the rate of physical examination was 57.4%. 8. Out of 70 universities and colleges. 45.7% of them had tuberculosis control program and the prevalence rate was 6.0 per 1,000 students. 9. Student medical insurance program was developed by ten universities and one college among 25 universities and 45 colleges. 10. Student medical insurance benefit was varied according to university and college; the reduction rate of medical fee was 20% to 80% for not only in-patient but also out-patient. 11. The upper limit of pay claim was varied according to the university and college from 5,000 won to no-limitation for out-patient and from 30,000 won to no-limitation for in-patient. 12. The highest utility rate of student medical insurance program was found in university 'F' with the rate of 791 for out-patient and 12 for admitted patient per 1,000 students.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.406-408
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• 2014

A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

• Journal of Chest Surgery
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• v.8 no.2
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• pp.119-124
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• 1975

This is a case report of the rupture of the trachea and the esophagus following external blunt trauma without any associated injury. A 7 year old male patient was brought to the emergency room. Hanyang University Hospital, on 23 Jul, 1974 while he played under the pile of pingpong table A table was fall down over the patient accidentally. The patient was injured by the table and found lying in unconsciousness on the ground.There was subcutaneous emphysema on his anterior chest and neck. A contusion on the upper part of the sternum was noted. The breathing sound were diminished over the left side of the chest. Ronchi were heard over the right lung field. This patient was suffered from vomiting, dypsnea, and irritable mental state after this accident. On the chest roentgenogram in A-P view, hyperlucency at the mediastinum and parapericardiac area suggested the pneumomediastinum. On the next day, a diagnosis of the tracheal and esophageal rupture was confirmed by the esophagogram with Lipiodol swallowing. A right thoracotomy was performed and ruptured orifice of the trachea and the esophagus were closed with interrupted sutures. Postoperative course was uneventful and primary closure of the rupture of the trachea and the esophagus were succeeded.

• The Journal of Korean Physical Therapy
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• v.9 no.1
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• pp.37-50
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• 1997

Low back Pain(LBP) is a common problem, and the resulting disability frequently contains nonorganic, psycho-logical and social elements that are difficult for the physical therapists to manage. The physical therapist-patient relationship is the most important factors in the management of low back pain as chronic disease. The purpose of this study was to evaluate and to identify factors that had influenced low, back pain patients satisfaction with physical therapist The subjects of this study were 223 out-patients(116 males and 107 females) who had been visited to physical therapy room of medical institutions in Seoul and Uijgngbu city. They were examined by the questionaire of Dimatteo and Hays which was amended to serve the purpose of this study by author. The collected data was analyzed by ANOVA according to the purpose of this study. There was no difference with statistic value in LBP patient's satisfaction according to occupation, sex, schooling, religion, marital status, medical security, duration of disease, the tine required, recurrence, but was a difference according to age, income, period of treatment, cost, diagnosis, waiting time, the number of physical therpy's sort, sex ane age of physical therapists (p<.05). LBP patients was satisfied with physical therapist's communicative behavior, but was dissatisfied with physical therapist's competence.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.1
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• pp.42-46
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• 2020

Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5℃, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO₂ 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO₃^- 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.128-131
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• 2017

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.165-167
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• 2009

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

• Korean Journal of Adult Nursing
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• v.24 no.6
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• pp.597-606
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• 2012

Purpose: This study was to describe the uncertainty, depression, physical symptom, and family support among patients undergoing dialysis. Further, the factors that impact uncertainty were also examined. Methods: A convenience sample of 145 patients who received dialysis was selected. A descriptive correlation study was conducted. Data were collected using structured questionnaires and the collected data were analyzed using descriptive statistics and multiple regression analysis. Results: The patient who received more than five years of dialysis reported higher levels on inconsistency of uncertainty than patient with less than five years. These latter patients' reported uncertainty was positively correlated with depression, whereas, patients family support was correlated with uncertainty. The group's uncertainty with less than five years of dialysis explained about 13% of the variance. In contrast, variables of education level, family support, and monthly income were predictors of uncertainty and explained 33% of the variation. Conclusion: These results can provide for nursing intervention to facilitate reduction of uncertainty. To provide dialysis period-sensitive nursing intervention for uncertainty among dialysis patient, depression should be considered below five years. While factors such as education level, family support, and monthly income should be taken into account over five years.