• Title/Summary/Keyword: selected patients

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Nonoperative Treatment for Abdominal Injury in Multiple Trauma Patients: Experience in the Metropolitan Tertiary Hospital in Korea (2009~2014) (다발성 손상 환자에서의 복부 손상에 대한 비수술적 치료: 권역 외상 센터가 아닌 3차 병원의 치료 경험(2009~2014))

  • Oh, Seung-Young;Suh, Gil Joon
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.284-291
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    • 2015
  • The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.

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A study on learning needs about altered elimination of spinal cord injury patients : A comparison patients에 and nurses에 perceptions (척수손상환자의 배설장애에 대한 학습요구 : 환자 대 간호사 지각 비교)

  • 김인자
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.129-142
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    • 1994
  • The purpose of this study determine and compare spinal cord injured(SCI) patients’ and nurses’ perceptions of SCI patients’ learning needs about altered elimination and then provide nursing data for more effective SCI patients’ learning process. Data collection was done from September 3 to October 2, 1993. For this study, 36 SCI Patients(12 paraplegia, 24 quadriplegia) and 20 nurses who were working neurosurgery or rehabilitation unit in 3 general hospitals in C and I city were selected. Data collection was accomplished by Questionnaire method and the instrument developed by the investigator, elicited information about learning needs about altered elimination of SCI patients from SCI patient, nurse, rehabilitation doctor, nursing professor, nursing graduate students. The questionnaire composed altered urinary elimination part with 10 categories and altered bowel elimination part with 10 categories. The results of this study were as follows : 1. There was no significant difference in learning needs about altered urinary elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered urinary elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=2.48, p=.017). 2. There was no significant difference in learning needs about altered bowel elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered bowel elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=-3.00. p=.005). 3. Degree of paraplegic SCI patients’ perceived learning needs about altered urinary elimination was 2.4083 and quadriplegic SCI patients’ perceptions were 2.0750. Degree of paraplegic SCI patients’ perceived learning needs about altered bowel elimination was 2.3972 and quadriplegic SCI patients' perceptions were 2.181.

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Song-Induced Autobiographical Memory of Patients With Early Alzheimer's Dementia (노래를 통한 초기 알츠하이머 치매환자의 자서전적 기억)

  • Han, Seung Ah
    • Journal of Music and Human Behavior
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    • v.13 no.2
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    • pp.49-66
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    • 2016
  • This study investigated the song-induced autobiographical memory of patients with early Alzheimer's Dementia (AD) by comparing the effects of patient-selected songs (M-AD) versus music therapist-selected songs (M-MT). A total of 19 patients with early AD participated in this study. In the M-AD and M-MT conditions, each participant listened to a song and was instructed to recall memory. The time to recall memory, the specificity of the memory, mood changes, and the type of recalled memory were measured. Perceived familiarity and preference of the used songs and association of the song with the recalled memory were also analyzed. The results of the study showed that the M-AD condition elicited more specific memory and positive mood change than the M-MT condition. In addition, AD patients reported a higher level of familiarity with and preference of songs in the M-AD condition, compared to the M-MT condition. These results indicate that patient-selected songs, which have a personal meaning to an individual, could be effectively used for intervening with memory of this population, which would support music therapists to make better decision with regard to song selection. Further studies would be needed to deepen the understanding of autobiographical memory in older population with cognitive impairment and to propose more effective music therapy strategies for intervening with memory.

The Effects of Prompted Voiding Therapy on Urinary Incontinence Control of Elderly Patients (노인환자의 요실금 조절을 위한 자극배뇨 요법의 효과)

  • 이경자;김미경;송희영
    • Journal of Korean Academy of Nursing
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    • v.27 no.4
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    • pp.943-952
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    • 1997
  • This study was done to analyze the effects of prompted voiding therapy on urinary incontinence in elderly patients in an elderly care hospital. Specifically, this study looks to evaluate the effects of prompted voiding as an intervention for improving independent voiding and also identified the relationship of urinary continence to cognitive, emotional, and physical factors. The study was based on a pre-experimental design used to evaluate the effects of prompted voiding therapy on an experimental group without a control group. An experimental group of 143 patients was selected through convenience sampling from patients in an elderly care hospital. The data was collected from November 4 to December 14, 1996. Prompted voiding therapy is a behavioral therapy for managing incontinence and it is applied to patients who are cognitively impaired and dependent. In this study, the patients were asked at each designated time whether or not they had to urinate. If they answered yes, they were either given a bedpan or were assisted to the bathroom, and if the patient answered no, their diaper was checked to determine whether or not it was wet. The results were then recorded on the patients urinary voiding record. The urinary voiding score based on the model presented by Burton(1984), Burke and Walsh(1992), Chenitz, Stone & Salisbury(1991) was modified and used as a tool in this study. After forty six out of the total of 143 patients were selected for interviews through random sampling the levels of cognitive functions, mental depression and ADL(activities of dally life) within the given time frame were measured. In this study, the cognitive function was measured using the scale developed by Kabhn, Goldfarb, Pollack & Peck(1960), elderly mental depression, using the tool developed by Sheikh & Yesavage(1986), and the ADL(activities of dally living), through the Barthel Index. The data was analyzed through SPSS windows for descriptive statistics, repeated measured ANOVA and Pearson's correlation. According to the results of the study, the application of the prompted voiding therapy can improve the voiding pattern of patients. It was shown especially that incontinence could be controlled by the intervention developed according to the individual voiding pattern. In terms of the relationship between cognitive function, mental depression and ADL and the voiding function score, a close correlation was not found. It was shown that urinary incontinence can be improved through therapy even though patients have problems nth their cognitive, mental and physical functions.

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Effect of Oral Intake on Nutritional Status after Gastric Resection (위절제술 후 경구섭취가 영양상태에 미치는 영향)

  • Lee Kyu Eun;Lee Hyuk-Joon;Kim Ji Young;Kim Yoon Ho;Lee Kuhn Uk;Choe Kuk Jin;Yang Han-Kwang
    • Journal of Gastric Cancer
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    • v.2 no.4
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    • pp.205-212
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    • 2002
  • Purpose: Malnutrition is a common postoperative complication that occurs after gastric resection. Several causes for malnutrition have been proposed, which include malabsorption and poor oral calorie intake. We performed this study to evaluate whether nutritional counseling would increase oral calorie intake and improve nutritional status in patients who had undergone gastrectomy. Materials and Methods: Twenty-two patients were randomly selected as the study group from among patients who had undergone gastrectomy for early gastric cancer and gastric polyp between October 1999 and December 2000. Body weight, hemoglobin, serum albumin, and serum transferrin were checked before and after the gastrectomy. Oral calorie intake was evaluated by using a 3-day oral-intake diary, and one nutritionist performed outpatient-based nutritional counseling. Eighteen patients who had undergone gastrectomy for the same disease during the same period were selected as the control group. Results: During an average interval of 14.8 months, the study patients received nutritional counseling an average of 3.4 times at an average interval of 4.4 months. The study group took a mean of $2055.6\pm418.1$ Cal per day and the control group $1792.1\pm421.9$ Cal (P=0.05). Sixty-eight percent (15 patients) of the study group patients reached the daily-required calorie intake. Postoperative bodyweights were $64.0\pm9.9$ kg for the study group and $64.3\pm10.8$ kg for the control group (P>0.05). No statistically significant differences were observed among the other. Sixty-five percent of the patients (26 patients) had a weight loss of less than $10\%$ of the preoperative body weight, and $35\%$ had more than a $10\%$ weight loss, but there was no statistical difference between the calorie intakes of these patients. Conclusions: Nutritional counselling increased the oral calorie intake, but nutritional status was not improved. These results suggest that nutritional derangement after gastrectomy cannot be corrected by adequate oral intake itself.

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Clinical Application of $^{18}F-FDG$ PET in Wilms Tumor (빌름스 종양 (Wilms Tumor)에서 $^{18}F-FDG$ PET의 임상 이용)

  • Seok, Ju-Won
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.137-139
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    • 2008
  • Wilms Tumor is a great therapeutic success story within pediatric oncology. Therefore, accurate initial staging is needed to assess tumor spread and to assign patients appropriately to the different risk branches. However, it is recognized that FDG-PET can provide useful information about tumor and has better accuracy than CT and MRI for staging, but its role in Wilms tumor is unclear. According to clinical research data, FDG PET may be useful for the management of selected patients with Wilms tumors.

Clinical Evaluation of Mandibular Condyle Fractures (하악 과두 골절 환자의 임상분석)

  • Lim, Hyoung-Sup;Kim, Su-Gwan;Oh, Ji-Su;Jeong, Mi-Ae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.53-57
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    • 2012
  • Purpose: This study considered the effects and proper treatments of mandibular condyle fractures by comparing clinical differences and complications according to analysis and treatment plan. Methods: From September 2007 to August 2010, patients who were diagnosed with condylar fracture and monitored for more than 3 months were selected. Cases were divided in a reductive manner and evaluated by type and period of intermaxillary fixation (IMF), status of occlusion and trismus according to the Spiessle/Schroll method. A total 50 patients were examined. Results: The number of the unilateral condyle fractures was 45 and 30 patients had multiple fractures. Type of fracture was categorized by the Spiessle/Schroll method. There were 21 patients with type I, 11 patients with type II, 3 patients with type 3, 10 patients with type V and 5 patients with type VI; there were no patients with a type IV fracture. 11 patients were operated on with open reduction. Among them, 9 patients were type II and 2 patients were type I. For type I patients, an intra-oral approach was conducted with an endoscope and trocar. For 3 of the type II patients, an retromandibular approach was conducted and for the rest of the type II patients, the same approach as type I was used. The periods of IMF were 2.36 weeks (mean) in open reduction group and 2.9 weeks (mean) in closed reduction group and the total mean period is 2.78 weeks. All patients had stable occlusion after removing the IMF. Trismus occurred in 1 patient for open reduction and 5 patients for closed reduction. Facial nerve palsy was observed in one patient postoperatively that resolved after 6 months. Conclusion: In this study, similar prognosis was shown after an open and closed reduction was conducted. Therefore, treatments need to be planned depending on the degree of condyle fracture and the amount of displacement. Additionally, the period of IMF could be shortened with open reduction.

Evaluation of Scopolamine Patch Pharmacotherapy for Motion Sickness in S. Korean

  • Lim, Sung-Cil;Lee, Myung-Koo;Lee, Chong-Kil;Lee, Bo-Reum
    • Biomolecules & Therapeutics
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    • v.16 no.2
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    • pp.161-167
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    • 2008
  • Scopolamine patch is an effective anticholinergic and antiemetic agent for motion sickness in S. Korea. Since this medication is Over The Counter (OTC) medication and may cause serious side effects when misused. Therefore, we evaluate the safety and efficacy for scopolamine patch in this study. We selected and surveyed total 43 patients who purchased scopolamine patch from three different pharmacies located at S and C Express Bus terminals and P Port at Seoul, Cheongju, and Busan. In the result, 11 patients (8${\sim}$15 year old:25.6%) were correctly used scopolamine patch with a children dose and 2 patients were misused. 26 (15${\sim}$60 year old: 60.4%) and 4 (over 6o year old: 9.3%) patients were correctly used with a adult dose. 33 patients (69.9%)answered that they knew the directions well how to use scopolamine patch correctly. Only 24.2% (n=8) patients learned the directions by pharmacist's consultation. Most patients (45 frequencies with duplicate counts) had some experienced side effects and among those drowsiness is the most common one. In conclusion, scopolamine patch as a non-prescription drug (OTC) should be monitored by pharmacist with correct drug consultation.

A Exploratory Study on the Personality Type, Problematic Drinking Pattern, and Stress Coping Style of the Nasal Bone Fracture Patients Due to Violence (폭력으로 인한 비골골절 환자의 성격 유형, 문제성 음주 및 스트레스 대처 방식에 대한 탐색적 연구)

  • Park, Ji-Suk;Oh, Hyun-Soo;Seo, Wha-Sook;Ham, Ok-Kyung
    • Korean Journal of Adult Nursing
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    • v.20 no.3
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    • pp.461-469
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    • 2008
  • Purpose: This study was conducted to identify the personality type, problematic drinking pattern, and stress coping style of the nasal bone fracture patients by comparing those with general fracture patients. Methods: 50 nasal bone fracture patients due to violence and 50 general fracture patients due to simple trauma, such as fall and traffic accident were conveniently selected. Results: The study results showed that nasal bone fracture patients due to violence significantly presented higher level of A type personality and more problematic drinking pattern than general fracture patients due to simple trauma. Stress coping style, however, did not show significant difference between two groups. Conclusion: In order to prepare prevention strategies for basal bone fracture in the future, health education alter problematic drinking habit to sound drinking pattern may be offered and provided nursing interventions tailored to A type personality.

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Endoscopic transaxillary prepectoral conversion for submuscular breast implants

  • Park, Si-Hyun;Sim, Hyung-Bo
    • Archives of Plastic Surgery
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    • v.45 no.2
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    • pp.158-164
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    • 2018
  • Background During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20-38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. Results The mean follow-up period was 14 months (range, 6-24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160-300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. Conclusions Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.