Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus excavatum Recently, Remodelling Plasty of Costochondral Rib Cage has been introduced as an minimally invasive procedure and expanded its application for pectus excavatum. Outcomes and acute complications were reviewed Material and Method: A retrospective survey of 55 patients who underwent Remodelling Plasty of Costochondral Rib Cage from September, 1999 to February, 2002 was conducted to review complications, postoperative treatments, and outcomes. Result: Age ranged from 1 to 27 years(mean 11.4 $\pm$ 7.1). 35(64%) were less than 15-year old and 20(36%) were more than 15-year old. There were 44(80%) Male patients and 11(20%) female patients. Length of hospital stay was 7.8 $\pm$ 2.1 days for less than 15-Y-old group, 10.6 $\pm$ 6.2 days for more than 15-Y-old group(p = 0.042) One substernal bar was inserted in 52 patients and two substernal bars were inserted in 3 patients. As for stabilizer, one lateral side was fastened in 15 patients and both lateral sides were fastened in 6 patients. In the less than 15-Y-old group, 4 patients needed stabilizer, whereas in the more than 15-Y-old group, 18 patients needed stebilizer(s)(p = 0.000). Including all kinds of complications, 28(51 %)patients had postoperative complications. Of them, only 7 patients were treated for complications(C-tube insertion was done in 7 patients and reoperation for bar refixation or removal was done in 3 patients of them). Conclusion: Most complications after Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum were trivial without treatment although C-tube drainage was needed in some patients. However bar displacement such as rotation and lateral sliding should be corrected as soon as detected in order not to remove the bar(the worst situation).
Kim, Young-Lak;Kim, Shin-Woel;Chung, Eun-Kyung;Choi, Jin-Su
Journal of agricultural medicine and community health
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v.27
no.1
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pp.51-64
/
2002
This study was aimed to provide the basic data for the development of effective educational program by reflecting the opinions of the visiting health service workers. The subjects were 144 visiting health service workers in Gwangju and Jeollanam-do area who responded the mail questionnaire. The data were collected from June to July, 2001 using questionnaire composed of the education need, knowledge by subjective appraisal, and experience of education. The major findings of this study were as follows: 1. The number of respondents who received at least one education within recent three years were 43(29.9%) at the central level, 57(39.6%) at the provincial level and 53(36.8%) at the district level. The satisfaction with education was higher at the central level than at the provincial and district level. 2. Knowledges by subjective appraisal on the 'chronic degenerative diseases management' and 'health promotion' was relatively high. while that of 'rehabilitation' was low. 3. The knowledge by subjective appraisal of visiting health service was related with experience of education and license status. The knowledge was higher in registered nurses than in nurse aids. The curricula related to increased level of knowledge of visting health service workers were 'elderly health care', 'rehabilitation' and 'psychiatric-mental health nursing' educations at the central level 'continuing education for the community health practioners' and 'psychiatric-mental health education' at the provincial level and 'elderly health care', 'rehabilitation' 'psychiatric-mental health' and 'acute diseases control' educations at the district level. 4. The respondents preferred elderly health management as the contents of education, officer group education as the method of education, province(30.4%) as the main body of education, exercise and practice as the form of education, 2-3 times per year as the frequency of education, and 3-5days as the period of education. The findings of this study could suggest that future education program should be planned to increae the knowledge level of visiting health service workers by reflecting their educational need.
Purpose: The purpose of this study was to survey the knowledge and needs of hospice for inpatients' family. Methods: This study was carried out with 277 inpatients' families at J General Hospital located in J city, Korea during the period from March to May, 2004. The data were collected through a self-reporting questionnaire constructed by the authors. The data were analyzed by descriptive statistics and $x^2-test$ with SPSSWIN 10.0. Results: 83.8% of the respondents heard about hospice mostly through mass communication. 76.9% of the respondents recognized hospice to be helpful and to provide comfort during the remainder of life and to confront the moment of death. Most of the respondents responded positively to the necessity of hospice service, and would receive hospice if necessary. 76.5% of them would consider arranging preparation for death if he/she were to be diagnosed with a terminal illness. 63.9% of the respondents wanted only to be with their family members, 31.4% wanted both the family and hospice members at the moment of death. They named the best helper among the hospice members to be the nurse. 81.6% of the respondents wanted a hospice institution to be established, 23.8% of them report that the most adequate hospice management institution would be the hospice ward in hospital. Conclusion: Consequently, most respondents wanted hospice services. So Korean society is in need of developing adequate teaching and care programs for hospice according to local needs.
Purpose : The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients in the hospice units. Method : The convenient sample of this study consisted of 58 terminally ill cancer patients at three hospice units in university-affiliated hospitals. Patients were interviewed with structured questionnaires. The data was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. Result : The results of this study were as follows : 1) The mean age of the participants was approximately 57 years. Regarding diagnosis, stomach cancer showed the highest frequency (24.1%), followed by lung cancer (17.2%) and rectal cancer (13.8%). Regarding motivation for admission to the hospice unit, the majority of the participants indicated pain control (67.2%), followed by spiritual care (39.7%), and symptom relief (27.6%). 2) The mean pain level measured by VAS was 5.13 (${\pm}2.61$). Regarding pain type, the highest pain frequency the participants experienced was deep pain (53.4%), followed by multiple pain (20.7%), intestinal pain (17.3%), and neurogenic (5.2%) and superficial pain (3.4%). 3) Regarding the factors influencing pain, the pain level was significantly affected by the depression level (P<0.01) and the opioid use (P<0.01). Conclusion, In summary, the higher the level of pain the terminally ill cancer patents had the higher the depression level as well as the opioid use. Thus, health care professionals need to continuously provide holistic care for them to die comfortably.
Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.
Kim, Ki-Up;Gil, Hyo-Wook;Lee, Suk-Ho;Kim, Do-Jin;Na, Moon-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
Tuberculosis and Respiratory Diseases
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v.52
no.1
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pp.46-53
/
2002
Background: Pulmonary aspergilloma is relatively common in korea. It arises from the colonization and proliferation of Aspergillus in preexisting lung parenchymal cavities, in particular tuberculosis. The most common symptom in this disorder is hemoptysis, which mayor may not be massive and life threatening. A routine chest radiography and computed tomography (CT) are the most important diagnostic procedures. A surgical resection of the aspergilloma has recently been recommended, because of the relatively low incidence of postoperative complications than in the past. A more concentrated sample of patients with aspergilloma, who either underwent a thoracotomy or tested positive for aspergillus antibodies, were reviewed. Method : The medical records of twenty-two patients with aspergilloma, who had a proven thoracotomy (9 cases), or who tested positive for the diagnostic procedure and/or aspergillus antibodies (13 cases) from January 1995 to December 2000, were reviewed retrospectively. Results : The most common underlying lung disease was a current or old healed tuberculosis, and 3 patients had cultures of mycobacterium other than tuberculosis (MOTT). The mean time until the aspergilloma was detected 5.91 years in the healed tuberculosis cases. The others cases involved a lung abscess, bronchiectasis and without lung disease. The extrapulmonary disease was alcoholism and diabetes. Hemoptysis was most common in 72.7%. A computed tomography (CT) is useful for diagnosis. The right upper lobe, especially the posterior segment, is the most common location. Bronchial artery embolization is ineffective for a long term follow-up. A lobectomy is most common in a thoracotomy, and intra-operative and post-operative complications are rare. During follow-up, the mortality rate, not from the aspergilloma but from respiratory failure, was 13.6%. Conclusion : Aspergilloma is a common cavitary lung disease, It mainly arises from tuberculosis, either current or healed, but extra-pulmonary disease including alcoholism or diabetes are other possible risk factors. Their most common problem in aspergilloma is hemoptysis. Surgery has a low risk of post-operative complications and is recommended in relatively preserved lung function or healthy patients. Medical maneuvers including embolization, and the local insertion of certain materials needs to be studied more closely.
Ryu, Han-Sung;Lee, In;Han, Chang Woo;Kim, So Yeon;Hong, Jin Woo;Park, Seong Ha;Kwon, Jung Nam;Choi, Jun-Yong
Journal of Society of Preventive Korean Medicine
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v.17
no.3
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pp.155-164
/
2013
Purpose : This study was conducted to assess whether Korean medicine doctors' attire influences patients' preference (confidence, comfortability, neatness) in a university hospital. Materials and Methods : Employing a cross-sectional design, outpatients answered a questionnaire in a university hospital of Korean Medicine. Respondents were asked for completing the questionnaire to estimate their preference of doctor's attire for confidence, comfortability and neatness after watching 4 types of attire in both male and female Korean medicine doctors, including white coat, traditional attire, formal suit and casual clothes. Whether Korean medicine doctors' attire on a patients' preference is important was also asked for the respondents using a 5-point Likert scale. Results : All 175 patients were enrolled, of whom 38.9% were male respondents, 46.3% graduated from a university at least and mean age of responders was 47.1. Most had a tendency for preferring white coat followed by traditional attire and only a small portion of respondents preferred for formal suit and casual clothes. When comparing preferences in confidence between white coat and traditional attire only, male patients preferred white coat more than female patients did with statistical significance. In addition, 85.4% of respondents answered that Korean medicine doctors' attire is important to a clinical situation with higher ratio of female respondents (87.9%) than male respondents (80.9%). Conclusion : Patients preferred white coat and traditional attire mostly for the Korean Medicine doctor's attire with only small preference for formal suit and casual clothes. Also, Patients recognized that Korean medicine doctors' attire is important in the clinical situation.
Severe congenital heart disease (CHD) is a chronic disease requiring continuous and holistic health management to improve patients' quality of life. This study explored the health management experiences of adolescents with severe CHDs in Korea. On the basis of in-depth interviews with nine youths, four categories and 12 subcategories were identified. The participants lacked a full understanding of their health status and the need for appropriate health management for their health status. Nonetheless, they practiced health management to some extent, in ways that were affected by heart function, self-identity, and social support. Although adolescents with severe CHDs were affected by physical limitations and the discriminatory gaze around them, they tried to achieve normalcy through managing information, seeking homogeneity with peers, and fostering positive acceptance about their disease. Regarding demands for health management programs, disease knowledge and mental health content were preferred, and the preferred delivery methods were self-help group camps and smartphone applications. Based on the results of this study, we suggest a health management intervention to promote a healthy transition to adulthood for adolescents with severe CHDs, and that policy-makers should consider measures that would enable a successful transition to adulthood in the future of youth with severe CHDs.
Journal of the Korean Society of Food Science and Nutrition
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v.38
no.9
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pp.1131-1138
/
2009
In this study, the breads with medicinal herbs (MH) composites showing cognitive function were prepared and their characteristics were examined. Fifteen kinds of medicinal herbs were extracted with hot water and divided into 3 groups (MH-1, MH-2, MH-3) based on their contents. All groups showed cognitive function in terms of promoting muscarinic receptor, NMDA receptor and acetylcholinesterase inhibition. In the preparation of breads containing MH extracts of various contents (0, 10, 20, 30, and 50%), there were no significant difference among loaf weight of all groups, but loaf volume of all groups were significantly (p<0.05) decreased with increasing content of MH extracts compared to the control group. The "a" and "b" values of bread crumb increased with the content of MH extracts while "L" value decreased, but these values of bread crust were similar to the control group. The most improvements in hardness, fracturability, cohesiveness, gumminess and chewiness of bread were noticed by the addition of 10$\sim$20% MH extracts, while adhesiveness and springiness of bread were the most by the 30% addition ones. Through the sensory evaluation, it was revealed that appearance, mouth feeling, taste, overall preference and crumb texture of bread were not significantly different (p<0.05) between control and those with the 10% addition ones. Therefore the 10% addition ones, which got similar scores to control, will make the most desirable product.
This study was carried out to investigate and analyze the congnitive degree of dental subjects and general pubic who have an experience to be treated for their teeth on the dental knowledge, operative dentistry, and dental prothesis in the oral health care through the questionnaires. The results are as follows: 1. In the knowledge on the care of dental prothetic stuff, there isn't any significant difference, but the degree of therapeutic knowledge was significantly high as showing 71.6% in I can prevent a gingivits;(P<0.01) Therefore, they have well known an importance of prevention. 2. In the knowledge on the orthodontics, it was appeared to cure their teeth due to an esthetic reason(47.9%). There is not any significance in the Statisics, but it appeared the relatively high knowledge in the time and period of orthodontics(P<0.01) 3. In the congnition on the necessity of dental prothesis, it appeared relatively high, but 'Be necessary' didn't show the significance as 77.2%. The proferance to dental prothesis material showed the similar difference of porcelain(45.6%) and gold(43.7%), and the moderns tend to ptefer porcelain teeth similar to the color of matural teeth in the modern, getting out of the existing cognition of preferring the gold. Accordingly it is considered to be preferentialy necessary the motivae the general public for the oral thealth education on the dental knowledge, operative dentistry, and dental prothesis the knowledge and practice of general public have an important effect upon the oral health as the abovementioned results.
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