• Journal of Chest Surgery
• /
• v.29 no.6
• /
• pp.614-620
• /
• 1996

The method of treatment in lung cancer patients with invasion to parietal pleura, diaphragm, peri- cardium or vertebra is controversial, and resection of these invasion together with pneumonectomy is called "complex pneumonectomy" From March 1990 to February 1994 we performed 18 cases of "complex pneumonectomy". Seven patients had resection of chest wall, 10 patients had pericardial re- section, and one patient had resection of diaphragm Right pneumonectomy was done in 8 cases and left pneumonectomy was done in 10 cases. The age of patients were from 40 to 70 years(mean 58 years) with male to female ratio of 17 to 1. The chief complaints of the patients on admission were cough (13), dyspnea on exertion (11), chest pain (10), weight loss (9), general fatigue (9), and sputum production (4 . Postoperative pathology were 13 squamous cell carcinoma, 3 adenocarcinoma, and one case each of adenosquamous carcinoma and small cell carcinoma. The postoperative pathologic stages were 2 T3NO MO, 4 TIWIMO, 6 T3N2MO, 5 T4N2MO, and 1 TIWIMO. There was one operative mortality(5.5%). Excluding one follow up loss, 14 patients expired during the follow-up and the mean survival was 9.07 $\pm$ 4.82 months. One patient with stage TINOMO who had chest wall resection is alive at 35 months follow-up and a patient with T3N2MO who had diaphragm resection is alive at 36 months follow-up. Therefore, selection of patients for "complex pneumonec- tomy" is very important, and a long term survival is possible.ong term survival is possible.

• The Journal of Korean Medicine
• /
• v.19 no.2
• /
• pp.296-312
• /
• 1998

BACKGROUND The purpose of this study was to find out predictors influencing on the clinical course of stroke during the first 4 weeks after the onset through statistical research, especially whether the blood glucose level after stroke and the stroke with Diabetes Mellitus correlate with functional impairments and neurological outcome or not. METHOD During 7 months period(from 1-1-1997 to 7-31-1997), 32 selected patients prognosed as acute cerebral thrombosis were studied by using Modified Barthel Index, PULSES profile in an attempt to correlate Diabetes Mellitus and hyperglycemia(more than $120mg/d{\ell}$, $150mg/d{\ell}$) with functional impairment and neurological outcome and to evaluate the influence of sex, the side of hemiparesis and age at admission, 1 week and 4 weeks after admision(admitted within 2 days after the onset). RESULT 1. The sex, side of hemiparesis and age had no significant effect upon functional impairment during first 4 weeks after the onset, but recurrent-stroke resulted in significantly higher degree of functional impairment than first-stroke during first 4 weeks after the onset. 2. The patients with Diabetes Mellitusin in acute cerebral thrombosis resulted in significantly higher degree of functional impairment than the patients without Diabetes Mellitus in acute cerebral thrombosis during first 4 weeks after the onset. 3. The patients with hyperglycemia in acute cerebral thrombosis resulted in significantly more severe neurological outcome than the patients without hyperglycemia in acute cerebral thrombosis within 2 days after the onset. CONCLUSION The study suggested that recurrent-stroke and Diabetes Mellitus were the poorer prognosis factors of functional impairment in acute cerebral thrombosis patients during first 4 weeks after the onset. and the poorer prognosis factor of neurological outcome in acute cerebral thrombosis patients was hyperglycemia within 2 days after the onset.

• Journal of Acupuncture Research
• /
• v.18 no.6
• /
• pp.1-13
• /
• 2001

Objective : To broaden understanding about relationship between Meridian Tendino-musculature and muscles in a lumbar area and to evaluate the effect of Meridian Tendino-musculature acupuncture and release therapy on acute lumbar sprain. Materials and Methods : From Oct. 1st, 2000 to Mar. 31th, 2001, 692 outpatient's chart of Kyung Won University Hospital were reviewed. Out of them, 39 outpatients were selected. they had low back pain, were diagnosed with acute lumbar sprain, showed only straightened curvature on lateral view of lumbar spine X-ray and get the Tendino-musculature acupuncture and release therapy. Results : 1. On patients' first visit, 72% had GrIII and Gr.IV predominantly. 2. Major muscles related with low back pain were divided into two groups. One was Quadratus lumborum group and the other was Rectus abdominis group. In the correlation with Meridian Tendino-musculature, the former was mainly related with Chok-taeyang(B) and slightly related with Chok-soyang(G), Chok-taeum(SP), the latter was mainly related with Chok-taeyum(SP), Chok-yangmyong(S) and slightly related with Chok-taeyang(B), Chok-soyang(G). 3. In the evaluation of treatment effect, Exellent was 27(69%), Good was 10(6%), Fair was 2(5%) and Bad was 0(0%). Fair rate reached 100% eventually. 4. Most of Gr.Ⅲ, Gr.Ⅳ patients who had severe conditions that almost every R.O.M. was limited and Milgram test positive was shown on the physical examination, were fully recovered and lived normal daily life without admission by Meridian Tendino-musculature acupuncture and release therapy within 3 to 5, 4 to 7 days, respectively, since they had started to get their outpatient treatment. 5. Two patients was troubled with pain induced, by twitching response and acupuncure stimuli, which lasted around acupunctured muscle for about a day after treatment, so they coudn't endure the pain and quitted treatment in spite of Fair condition. conclusion : Meridian Tendino-musculature acupuncture and release therapy was found to be helpful to patients who wish to recover from their back pain induced by acute lumbar sprain as soon as possible, but the treatment actually had some problems to be overcome such as pain during or after the treatment. therefor, in order to make this treatment method more available, we should pay more attention to improving treatment appliance and acupuncture technique.

• Journal of Korean Academy of Nursing Administration
• /
• v.9 no.3
• /
• pp.337-352
• /
• 2003

Purpose: The purpose of this study is to analyse research trends related to the evaluation of quality of nursing, thereby obtaining basic data relating to the identification of current situation of instrument development of quality of nursing, and of future research orientation and to the development of performance index of nursing organization. Method: The data were collected from June to December, 2002 through the review of total of 32 research papers which had evaluated quality of nursing among published papers in Korea from 1976 to August 2002. The analysis was done in terms of research period, the periodicals in which research papers were published, domains and the approaches of evaluation of nursing quality. The content analysis of lowest-level items amounting was performed using NIC developed by McCloskey & Bulecheck(1998) and consequential indices of quality of nursing developed by Chi(1995). Results: Twenty-three of 32 papers(71.8%) turned out to be published after 1995, indicating surging interest in the evaluation of quality of nursing from the mid 1990s. Also, ten of 12 research papers dealing with subjects' diseases were published after 1995. In content analysis of lowest-level items of the process-oriented evaluation of quality of nursing, the highest nursing intervention was patient education about procedure and treatment; followed in descending order by patient education about disease process, strengthening of communication, managing environment, infection control, admission care, defecation and urination care. In content analysis of lowest-level items of the outcome-oriented evaluation of quality of nursing, items of physical and psychological state, of patient and family satisfaction, of knowledge and home care, of change of patients' state, of addressing nursing issues, and of patient recovery were the outcome indicators in more than 60 percent research papers. Conclusion: The findings provided the foundation for their effective use in nursing practice with comparing and presenting various core evaluation items representing process and outcome domains.

• Korean Journal of Hospice Care
• /
• v.5 no.1
• /
• pp.74-81
• /
• 2005

Purpose: The purpose of this study is to help apply spiritual care in clinics by testing whether spiritual support like prayer and praise, which is appled on a patient who has been cared for by Facility Hospice can have an effect on their physical pain, emotional anxietv, loneliness and well being. Method: This research was done on a subject patient who had been hospitalized in Saemmul from Jan, 2002 to June, 2003, and who could easily communicate. Questionnaire of quality of life, they had this test from the date of admission into the hospital 1week, 3week, 5week later. The Target was 182 people for the hospital data, 124 people after one week, 84 people after 3 weeks and 54 people after for 5 weeks later. For statistics, SPSS for Window(SPSS inc. ver.10), student T-test and one way ANOVA were used. The interrelation between pray and pain was analyzed by the "Pearson correlation". In case where the P-value was below 0.05, we concluded it had statistical-value. Results: When we compared both the party which had a low degree of peace by prayer and praise and the B party which had the highest degree, B party had an increasing tendency for less anxiety and loneliness and more well-being. Each of the data 0, 1, 3 and 5 week showed visible difference between both parties. Conclusion: First, in case that a late cancer patient is hospitalized, the difference for tranquility and pain control by prayer and praise is not noticeable. While, 1 and 3 weeks later, the difference is visible, so we concluded the relationship between the cancer patient's spiritual tranquility and physical pain are closely related with each other. Also the patients who are in spiritual peace by prayer and praise can control the pain better than the other patients. Second, because the patient who can feel calm from the data of being admitted into the hospital is mentally calm, both party's difference is noticeable in each period of the 1, 3 and 5th week. Compared with other patients, the object patients who have spiritual tranquility will have less anxiety and loneliness and more tranquility.

• Korean Journal of Clinical Pharmacy
• /
• v.23 no.1
• /
• pp.42-48
• /
• 2013

Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

• Journal of Science Education
• /
• v.43 no.3
• /
• pp.400-416
• /
• 2019

The purpose of this study is to find ways to improve education about safe medication use by investigating the current status of medication use by middle and high school students, and by evaluating their knowledge, attitudes, practices and education needs toward safe medication use. For this purpose, a survey was administered to 200 middle and high school students in Seoul and Gyeonggi Province. Over the past year, 92.0% and 57.5% of respondents used over-the counter drugs and prescription drugs at least one time, respectively. Regarding the experience of education on safe medication use, 34.0% of respondents have been educated more than once since their admission to middle school. The overall mean score of knowledge·attitude·practice (KAP) toward safe medication use was 3.79, but the mean score of practice scope was relatively lower than the others. Moreover, there were no significant differences in KAP scores for safe medication use by school grade or educational experience. Based on these findings, we suggest further studies regarding 1) expansion and differentiation of education content on safe medication use, 2) transition of education method to outcome-based education approach, and 3) inclusion of education on safe medication use in the regular curriculum of middle and high schools.

• Quality Improvement in Health Care
• /
• v.18 no.1
• /
• pp.27-36
• /
• 2012

Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.

• Journal of Chest Surgery
• /
• v.34 no.12
• /
• pp.937-943
• /
• 2001

Background: The aims of this study are to determine the predicting factors related with cardiovascular injuries in sternal fractures and to suggest the indication of emergency echocardiography. Material and Method: A retrospective review of the Ewha Womans University Mok-Dong Hospital trauma registry revealed 40 patients, that visited the hospital with a sternal fracture a over 5-year period. We analyzed 4 factors as predicting factors; 1) presence of restraint, 2) presence of associated injuries, 3) presence of a past medical history involving cardiovascular system, and 4) Revised Trauma Score(RTS). We, also, assessed the utility of conventional study methods involving cardiovascular injuries, such as ECG, chest X-ray, and enzyme level. Based on the methods, we inferred an indication for emergency echocardiography in sternal fractures. Result: Statistically significant predicting factors were the presence of a past medical history involving cardiovascular system and abnormal RTS on admission. Usage of emergency echocardiography depended upon the predicting factors and the results from conventional evaluations. We can now suggest the indications of emergency echocardiography in sternal fractures as 1) if more than two studies reveal abnormality without any significant predicting factors, and 2) if more than one study reveals abnormality with any significant predicting factors. Conclusion: The past medical history involving cardiovascular system and initial vital signs imply the presence of cardiovascular injuries in sternal fractures. And if needed, emergency echocardiography should be performed.

• Communications of Mathematical Education
• /
• v.31 no.2
• /
• pp.187-201
• /
• 2017

The study in this paper, which is part of a bigger study investigating non-cognitive characteristics of Korean students at the 4-12 grade levels, aims to identify the influential characteristics that explain students' decision to give up on mathematics learning. We consider seven non-cognitive student characteristics: value, interest, attitudes, external motivation, internal motivation, learning conation and efficacy. Data were collected from 21,485 Korean students, and were analyzed with a logistic regression method using SPSS. The findings show that efficacy was the most significant indicator of students' decision to give up on mathematics learning in all three grade level bands: elementary (4th-6th), middle (7th-9th) and high (10th-12th). In particular, the causal model analysis shows that students who highly value mathematics tend to have stronger internal and external motivation, which bring about stronger interest and learning conation, which in turn lead to positive attitudes and strong efficacy regarding the learning of mathematics. It was further found that while external motivation was a significant indicator of upper grade level students' decision to give up on mathematics learning, it was only a moderate indicator for lower grade level students. The findings of this study provide useful information about which non-cognitive areas need to be focused on, in what grade levels, to help students stay on track and not fall behind in learning mathematics.