• Title/Summary/Keyword: 저온요법

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The Effect of Cool Dialysis on Dialytic Stability, Feeling of Fatigue, Pruritus and Dialysis adequacy in Hemodialysis Patients (저온투석이 혈액투석환자의 투석안정성, 피로감, 소양증과 투석적절도에 미치는 영향)

  • Kim, Yun Ah;Han, Eun Kyoung;Kim, Mi Young
    • The Journal of the Convergence on Culture Technology
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    • v.4 no.4
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    • pp.11-20
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    • 2018
  • The purpose of this study was to examine the effect of the application of cool dialysis on dialytic stability, feeling of fatigue, pruritus and dialysis adequacy in hemodialysis. Methods: The study design was nonequivalent control group pretest-posttest design. The subjects were 50 patients who were hospitalized to hemodialysis. The experimental group cool dialysis(n=25) and the control group received only the usual treatment (n=25). The collected data were analyzed using independent t-test to examine study hypothesis. Results: The level of dialytic stability (F=5.53, p=.023) and feeling of fatigue (F=4.01, p<.001) in the experimental group were significantly different from that of the control group. However, the level of pruritus(F=.74, p=.394) and dialysis adequacy(F=1.02, p=.327) in the experimental group were not different from that of the control group. Conclusion: The study findings confirm that cool dialysis as an effective intervention alleviating dialytic stability and feeling of fatigue.

Effect of Cold Oral Gargling on the Oral Discomfort among Patients Receiving Chemotherapy (찬 구강함수액이 항암 화학요법 환자의 구강불편감에 미치는 영향)

  • Chun, Soon-Mi;Lee, Hae-Jung;Kim, Myung-Soo
    • Asian Oncology Nursing
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    • v.7 no.1
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    • pp.68-78
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    • 2007
  • Purpose: The purpose of this study was to examine the effects of cold oral gargling on oral discomfort among Non-Hodgkin's lymphoma patient undergoing chemotherapy. Method: An quasi-experimental, nonequivalent control group design was used. Thirty two patients receiving chemotherapy at G hospital in P city were recruited from August 1, 2002 to October 20, 2002. Sixteen were conveniently allocated into the experimental group and 16 into the control group. Participants in the experimental group used cold oral gargling while their counterparts used room temperature oral gargling. Subjective and objective oral discomforts were measured by the instruments developed by Beck. The SPSS WIN 10.0 program was used to analyze the data with t-test, ${\chi}^2$ -test, and repeated measures ANOVA. Findings: The participants in the experimental group reported less oral discomfort and showed better oral conditions than those in the control group at the post 7th, 14th, and 21st days. Participants in the experimental group reported better oral conditions in taste, tongue, eating, and saliva than those in the control group. Conclusion: The cold oral gargling seemed to be more beneficial than room-temperature oral gargling in reducing oral discomfort for the Non-Hodgkin's lymphoma patients undergoing chemotherapy.

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Clinical Experiences of Continuous Warm Blood Cardioplegia ; Valvular Heart Surgery (연속 온혈 심정지액의 임상경험 - 심장 판막 수술 환자 대상 -)

  • 이종국;박승일;조재민;원준호
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.353-361
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    • 1998
  • Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.

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Reconstruction of Extensor Mechanism After Prosthetic Replacement of The Proximal Tibia (근위 경골에 발생한 악성종양 절제 후 슬관절 신전력 재건술 -증례 보고-)

  • Park, Jong-Hoon;Oh, Jung-Moon;Kim, Jin-Wook;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.120-123
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    • 2004
  • Benign and malignant bone tumors occur most commonly around the knee. The proximal tibia is the most technically demanding site for limb salvage surgery. The most difficult problem using an endoprothesis for proximal tibial resection has been reconstruction of the extensor mechanism. After excision of proximal tibia, we resected distal femur and made a composite with resected distal femur, low heat treated autogenous proximal tibia and endoprothesis. Patella was fixed into the resected down-loaded distal femur. This article shows the new technique and the results of reconstruction of extensor mechanism after prosthetic replacement of the proximal tibia.

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The Bibliographical Investigation of the Lettuce (상추에 대한 사상의학적(四象醫學的) 고찰(考察) -백거, 와거, 고거, 고채(苦菜)를 중심으로-)

  • Kim, Jong-dug;Koh, Byung-hee
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.341-359
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    • 1999
  • In the medical science of 'Sa-sang', a constitutional examination(diagnosis) and a medical treatment are important, however a dietary cure is considered as very important at the medical prevention and treatment. But there has been a confusion due to the different view concerning the constitutional foods in between scholars. There it is necessary for us to bring up the theoretical basis of the 'Sa-sang' constitutional - dietary cure by menas of the bibliographical study in relation to a historic, characteristics, efficiency of the major foods.

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Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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Surgical Treatment of Metastatic Tumor in Pelvis (골반부 전이성 종양의 수술적 치료)

  • Kim, Jae-Do;Park, Woong;Jo, Myung-Rae;Son, Jung-Whan;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.61-70
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    • 2004
  • Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

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Clinical Experiences of Continuous Tepid Blood Cardioplegia; Valvular Heart Surgery (미온혈 심정지액의 임상적 고찰)

  • 이종국;박승일;조재민;원준호;박묘식
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.130-137
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    • 1999
  • Background: In cardiac surgery, hypothermia is associated with a number of major disadvantage, including its detrimental effects on enzymatic function, energy generation and cellular integrity. Warm cardioplegia with normothermic cardiopulmonary bypass cause three times more incidence of permanent neurologic deficits than the cold crystalloid cardioplegia with hypothermic cardiopulmonary bypass. Interruptions or inadequate distribution of warm cardioplegia may induce anaerobic metabolism and warm ischemic injury. To avoid these problems, tepid blood cardioplegia was recently introduced. Material and Method: To evaluate whether continuous tepid blood cardioplegia is beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Warm group(37$^{\circ}C$) consisted of 18 patients who underwent valvular surgery with continuous warm blood cardioplegia. Tepid group(32$^{\circ}C$) consisted of 17 patients who underwent valvular surgery with continuous tepid blood cardioplegia. Result: Heartbeat in 100% of the patients receiving continuous warm blood cardioplegia and 88.2% of the patients receiving continuous tepid blood cardioplegia converted to normal sinus rhythm spontaneously after removal of the aortic cross clamp. There were no differences between these two groups in CPB time, ACC time, the amount of crystalloid cardioplegia used and peak level of potassium. During the operation, the total amount of urine output was more in the warm group than the tepid group(2372${\pm}$243 ml versus 1535${\pm}$130 ml, p<0.01). There were no differences between the two groups in troponin T level measured 1hr and 12hrs after the operation. Conclusion: Continuous tepid blood cardioplegia is as safe and effective as continuous warm blood cardioplegia undergoing cardiac valve surgery in myocardial protection.

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