• Title/Summary/Keyword: Complex sign

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Behcet`s Syndrome with Aortic Aneurysm: A Case Report (Bechet`s 병과 합병된 상부대동맥류: 치험 1례 보고)

  • Gang, Jeong-Ho;Lee, Jeong-Ho;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.98-105
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    • 1977
  • A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

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A Study on Value Orientation of Health of Rural Health Center Milieu (농촌지역 보건소 환경에 있어서의 건강가치관에 관한 일 조사연구)

  • 김순자
    • Journal of Korean Academy of Nursing
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    • v.5 no.1
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    • pp.17-30
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    • 1975
  • The concept and definition of nursing and her role have been changing in accordance with the socio-cultural factors of the initial society. At present, nursing is conceptualized as a health care profession assisting man to restore, maintain and promote health by providing knowledge, wilt strength and resources through various processes of interaction. Man′s behavior, of individual and group activities for health inclusive, is driven by the initial man′s value orientation. The purpose of this study is to investigate the value orientation regarding health of rural health center milieu in order to give data for; 1. the planning for the delivery of community nursing service, 2. the health education plan at all level of nursing care activities, and 3. the planning of curriculum for nursing education. A hundred opinion leaders among the labor population residing in rural areas (P-group), hundred and six professional nurses at rural health centers (N-group) were indirectly interviewed through questionaries. And ninety five of N-group were interviewed likewise of their perceptions of P-group (NP-group) from July 15, to October 15, 1974. The result is as follows: 1. Maintenance of health is revealed to be the most valued component for man′s happiness in all the three groups. (P-group: 7.30 S. D.=1.31), (N-group :7.84 S. D. =49), and (NP-group : 5.93 S. D. =2.28) 2. The average value score of the maintenance of health revealed significant difference by P〈.001 level between each of the three groups. (Between N-group and P-group : T= -4.07 P and NP ; T=-6.93, N and NP: T=-9.35) 3. Basic health maintenance activities necessary for maintenance and promotion of personal health were moderately valued by all the three groups, P-group ; 3.74 (S. D. =.43) , N-group: 3.52 (S. D. =.34), NP-group: 3.07 (S. D. :.55) Among the 8 categories of basic health maintenance activities, "food intake" was highly valued by P-group (mean value score; 4.00 S. D=.51) , "exercise and rest" and "personal cleanliness" was highly valued by both P-group (4.02, 4.08) and N-group (4.08, 4.22). 4. The mean value score of basic health maintenance activities revealed significant difference by P〈.001 level between each of the three groups (between P-group and N-group: T=-4, 07, N-and NP: T=-6.93, P and NP T=-9.35) 5. Among the 30 questionaries, dynamic activities for health maintenance were more valued in comparison to passive activities in an tile three groups. 6. In N-group, correlation between the value of basic health maintenance activities and the personal health status personal revealed moderate significance. Correlation between the value of basic health maintenance activities and the age revealed low significance. 7. In group, correlation between the value of basic health maintenance activities and; perception of personal health status revealed non significance, between the age and sex revealed low sign affiance, and between the educational status revealed moderate significance. Recommendations are as follows ; 1. The efforts towards alteration of value orientation concerning health in general in community nursing practice de focussed be that of family Planning. 2. In order to prepare professional nurses competent in understanding individual and group, social science and behavioral science be strength ended in planning nursing curriculum. 3. Milieu of nursing experience during nursing education be Planned to begin at simple nursing problem and move towards complex, f. e. home care towards health crisis situation in order to achieve dynamic role mastery.

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A Study for the Present Conditions and the Service Satisfaction with Hospital Home Care Service (병원가정간호사업 운영 현황 및 서비스 만족도에 관한 연구)

  • Hong, Chun-Sil;Oh, Kyong-Ok;Park, Mi-Young;Sim, Hee-Sook;Cha, Young-Nam
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.8 no.2
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    • pp.121-134
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    • 2001
  • The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

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Analysis of the Nursing Interventions Performed by Home Health Care Nurses in a Hospital : An Application of NIC (병원중심 가정간호중재 분석: NIC 체계 적용)

  • Yong, Jin Sun;Yoo, In Ja;Yoo, Ji Youn
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.606-618
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    • 2000
  • The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.

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EU Integration and Its Aviation Relationship with Third Countries (유럽연합(EU) 통합과 제3국과의 항공관계)

  • Lee, Jong-Sik
    • The Korean Journal of Air & Space Law and Policy
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    • v.21 no.1
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    • pp.135-167
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    • 2006
  • Air service agreements between EU Member States and third countries concluded by Sweden, Finland, Belgium, Luxembourg, Austria, the Netherlands, Denmark and the United Kingdom after the Second World War infringe EU law. They authorize the third countries to withdraw, suspend or limit the traffic rights of air carriers designated by the signatory States. According to the Court of Justice of the European Communities (CJEC), these agreements infringe EU law in two respects. On the one hand, the presence of nationality clauses infringes the right of European airlines to non-discriminatory market access to routes between all Member States and third countries. On the other hand, only the EU has the authority to sign up to this type of commitment where agreements affect the exercise of EU competence, i.e. involve an area covered by EU legislation. The Court held that since the third countries have the right to refuse a carrier, these agreements therefore constitute an obstacle to the freedom of establishment and freedom to provide services, as the opening of European skies to third countries' companies is not reciprocal for all EU airlines. In the conclusion, in order to reconstruct these public international air law, The new negotiations between EU member states and third countries, especially the US, must be designed to ensure an adequate set of principles, so that Member States, in their bilateral relations with third countries in the area of air service, should consider following three models. The 1st, to develop a new model of public international air law such as a new Bermuda III. The 2nd, to reconstruct new freedoms of the air, for example, the 7th, 8th, and 9th freedoms. The 3rd, to explore new approaching models, such as complex system theory explored in the recent social sciences, to make access world-wide global problems instead of bilateral problems between EU member states and United States. The example will show any lessons to air talks between European Union and ROK.

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Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

An Exploratory Study on Marketing of Financial Services Companies in Korea (한국 금융회사 마케팅 현황에 대한 탐색 연구)

  • Chun, Sung Yong
    • Asia Marketing Journal
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    • v.12 no.2
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    • pp.111-133
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    • 2010
  • Marketing financial services used to be easier. Today, the competition in financial services is fierce. Not only has the competition become more intense, financial services have also changed structurally. In an environment with various customer needs and severe competitions, the marketing in financial services industry is getting more difficult and more important than before. However, there are still not enough studies on financial services marketing in Korea whereas lots of research papers have been published frequently in some international journals. The purpose of this paper is (1)to review the literature on financial services marketing, (2)to investigate current marketing activities based on in-depth interview with financial marketing managers in Korea, and (3)to suggest some implications for future research on the financial services marketing. Financial products are not consumer products. In fact, they are not products at all in the way product marketing is usually described. Nor are they altogether like services. The financial industry operates in a unique way, and its marketing tasks are correspondingly complex. However, the literature review shows that there has been a lack of basic studies which dealt with inherent characteristics of financial services marketing compared to the research on marketing in other industries. Many studies in domestic marketing journals have so far focused only on the general customer behaviors and the special issues in some financial industries. However, for more effective financial services marketing, we have to answer following questions. Is there any difference between financial service marketing and consumer packaged goods marketing? What are the differences between the financial services marketing and other services marketing such as education and health services? Are there different ways of marketing among banks, securities firms, insurance firms, and credit card companies? In other words, we need more detailed research as well as basic studies about the financial services marketing. For example, we need concrete definitions of financial services marketing, bank marketing, securities firm marketing, and etc. It is also required to compare the characteristics of each marketing within the financial services industry. The products sold in each market have different characteristics such as duration and degree of risk-taking. It means that there are sub-categories in financial services marketing. We have to consider them in the future research on the financial services marketing. It is also necessary to study customer decision making process in the financial markets. There have been little research on how customers search and process information, compare alternatives, make final decision, and repeat their choices. Because financial services have some unique characteristics, we need different understandings in the customer behaviors compared to the behaviors in other service markets. And also considering the rapid growth in financial markets and upcoming severe competition between domestic and global financial companies, it is time to start more systematic and detailed research on financial services marketing in Korea. In the second part of this paper, I analyzed the results of in-depth interview with 20 marketing managers of financial services companies in Korea. As a result, I found that the role of marketing departments in Korean financial companies are mainly focused on the short-term activities such as sales support, promotion, and CRM data analysis although the size and history of marketing departments to some extent show a sign of maturity. Most companies established official marketing departments before 2001. Average number of employees in a marketing department is about 58. However, marketing managers in eight companies(40% of the sample) still think that the purpose of marketing is only to support and manage general sales activities. It shows that some companies have sales-oriented concept rather than marketing-oriented concept. I also found three key words which marketing managers think importantly in financial services markets. They are (1)Trust in customer relationship, (2)Brand differentiation, and (3)Rapid response to customer needs. 50% of the sample support that "Trust" is the most important key word in the financial services marketing. It is interesting that 80% of banks and securities companies think that "Trust" is the most important thing, whereas managers in credit card companies consider "Rapid response to customer needs" as the most important key word in their market. In addition, there are different problems recognition of marketing managers depending on the types of financial industries they belong to. For example, in the case of banks and insurance companies, marketing managers consider "a lack of communication with other departments" as the most serious problem. On the other hand, in the case of securities firms, "a lack of utilization of customer data" is the most serious problem. These results imply that there are different important factors for the customer satisfaction depending on the types of financial industries, and managers have to consider them when marketing financial products in more effective ways. For example, It will be necessary for marketing managers to study different important factors which affect customer satisfaction, repeat purchase, degree of risk-taking, and possibility of cross-selling according to the types of financial industries. I also suggested six hypothetical propositions for the future research.

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