• Journal of Korean Academy of Nursing
• /
• v.30 no.3
• /
• pp.549-559
• /
• 2000

The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

• Journal of Trauma and Injury
• /
• v.22 no.1
• /
• pp.65-70
• /
• 2009

Purpose: Many studies have addressed a psychiatric analysis of self-injury patients who have self-injurious behavior and who have attempted suicide. Few studies on the injury characteristics of self-injury related trauma patients have been conducted. We analyzed the injury characteristics of self-injury patients. Methods: A retrospective review of the medical records extracted from the injury surveillance system of Wonju Christian Hospital for the period from August 2006 to February 2008 was conducted. Of the 121 cases extracted, 103 were included in this study. We analyzed the sex ratio, age group, place of injury, injury mechanism, location of injury, management results, injury severity, and relation with drinking. Results: One hundred three cases were included (sex ratio: 1.06), and the mean age was $33.9{\pm}14.2$ years old. Fifty-six patients (54.4%) were discharged from the emergency department (ED) on the day of injury after primary care, and 9 patients (8.7%) were discharged, because they refused treatment. Seven patients (6.8%) died. Of these, 4 patients (3.9%) died after attempted cardio-pulmonary resuscitation in the ED, 1 patient (1%) was dead on arrival, and 2 patients (1.9%) died after admission. Sixteen patients (15.5%) were admitted to the hospital, including 2 patients (1.9%) needing emergency surgery. Sixteen patients (15.5%) were transferred to other hospitals. Sixty-one cases (59.2%) involved drinking, and 31 (30.1%) did not; for 11 cases (10.7%), the involvement of drinking was unknown. The mean revised trauma score (RTS) was $11.26{\pm}2.52$, and 88 cases (85.4%) hat a RTS of 12. The mean injury severity score (ISS) was $5.80{\pm}14.56$, and 9 (8.7%) severely injured patients had scores of more than 15. Conclusion: Most self-injuries were mild traumas related to drinking and occurred at a young age. Most cases were not so severe, and the patients were discharged from the ED, but some patients needed hospitalization. Other patients had injuries so severe that they died.

• Journal of Veterinary Clinics
• /
• v.22 no.2
• /
• pp.148-152
• /
• 2005

An intact female, 5-year-old, Pekingese, weighing 3.5kg with a history of a palpated abdominal mass was referred to Veterinary Medical Teaching Hospital, Seoul National University. In laboratory examination, there were no remarkable abnormalities. Radiographic findings included a left mid-abdominal mass with ill-defined margin, serosal detail loss of peritoneal space, non-uniform opacity of retroperitoneal space, and a radiopaque cystic calculus. On abdominal ultrasonography, a heterogeneous parenchymal mass with irregular contour in the left renal region was found. Computed tomographic findings showed a tumor embolus within the caudal vena cava and an invasion into mesentery, small bowel loops, spleen and pancreas around the large left renal mass. Unilateral nephroureterectomy was performed. Histopathologic examination of the resected mass confirmed the diagnosis of renal cell carcinoma. The dog died one day after surgery. Although ultrasonography could give diagnostic information about mass characteristics, computed tomography (CT) can provide key imaging features of mass characteristics.

• Journal of Life Science
• /
• v.20 no.3
• /
• pp.345-349
• /
• 2010

Good health-related quality of life is regarded as the goal of elderly residential care. Treatment for breast cancer produces side effects that diminish functional capacity and quality of life among survivors. Tai-Chi exercise offers the benefits of fitness and health. Tai-chi has been claimed to generate beneficial effects with respect to a wide range of diseases. The object of this research is to evaluate the effects of tai chi exercise on shoulder joint movement and cardiovascular function in elderly breast cancer patients. The subjects were 40 patients residing in B metropolitan city, who had undergone surgery for breast cancer within 2 months. They underwent post-operative radiotherapy and an anti-cancer chemical treatment. They practiced tai-chi exercise for 60 min a day, four times a week for 12 weeks under the direction of a special tai-chi instructor. Shoulder joint movement and heart rate, were measured before and after the experiment. The results were as follows; Shoulder joint movement, including flexion, extention, adduction and abduction, significantly increased (p<0.05) after treatment, and heart rates significantly decreased after treatment (p<0.05). From the results, Tai-Chi exercise was shown to be extremely effective in improving shoulder joint movement and heart rate in elderly breast cancer patients. Further study is needed in this area.

• The Journal of Korean Medicine
• /
• v.31 no.3
• /
• pp.17-27
• /
• 2010

Objectives: Cocaine has been well known as a representative drug of abuse for its strong reinforcing effect linked to the mesolimbic reward system including dopamine, and such reinforcement leads to the addiction. Acupuncture has been used widely in eastern Asia for the treatment of various diseases including mental disorders and psychiatric problems, and is gathering more interest as one of the complementary and alternative medicines in western countries. In a previous study, we demonstrated that acupuncture at HT7 could affect dopamine release in the mesolimbic system of rats sensitized to alcohol and morphine. This study was designed to investigate whether acupuncture at HT7 could attenuate cocaine intake or not. Material & Methods: Male Sprague-Dawley rats weighing 270-300 g at the start of experiment were trained to self-administer food pellets under a fixed ratio 1 schedule. After the success of acquisition of 100 pellets within 3 h for 3 consecutive days, animals were subjected to surgery whereby Silastic tubing was implanted into right jugular vein and secured with mesh under the anesthetization using pentobarbital injection (50 mg/kg, i.p.). Following recovery, rats were trained to self-administer cocaine (0.25 mg/kg) in daily 2 h sessions under fixed ratio 1 schedule over 10 days. Each treatment was performed on the next day of each establishment of baseline. Results: Results show that acupuncture at HT7, but not at control points, reduced cocaine intake significantly. Acupuncture at HT7 decreased selectively active lever response from $63.15{\pm}3.35$ to $51.46{\pm}3.99$ corresponding $82.12{\pm}5.31%$ compared to basal level. Also, it was demonstrated that the effect of acupuncture was mainly occurred at the half period. Nevertheless, acupuncture at HT7 did not influence the food taking behavior. Conclusions: From the results of this study, it may be suggested that acupuncture at HT7, at least in part, could contribute to the treatment of cocaine abuse.

• YAKHAK HOEJI
• /
• v.46 no.2
• /
• pp.129-136
• /
• 2002

The pathogenesis of cholestatic liver injury as well as the modulation of hepatic fibrogenesis is causally associated with involvement of reactive oxygen species (ROS) and free radical reactions. In this study, we investigated whether dried extracts of oriental medicine (LH) have antioxidant and antifibrotic effect under the biliary liver fibrosis (cirrhosis) c ondition. The female Sprague-Dawley rats were divided in six groups (Normal, N-LH, op-2, op-4, opLH-2, opLH-4) and were observed in 2 weeks or 4 weeks. For this purpose the rats were operated by bile duct ligation/scission (BDL/S), which induced to liver fibrosis and cirrhosis. After surgery, the prepared LH was administered p.o. 2 mι/day/rat in 2 weeks or 4 weeks for opLH groups. During the observation period, jaundices appeared in eyes, ears and tail of all BDL/S operated rats. And at the time of sacrifice, cholestasis was observed in proximal bile duct, especially the color of bile juice and urine in opLH-4 group showed more clear than op-2, op-4 and opLH-2 group. The value of clinical parameters and product of lipid peroxidation (MDA) in sera and the hydroxyproline (hyp) content in liver tissue were significantly increased in all liver fibrosis (cirrhosis) developed rats (p＜0.001~0.05). Among the clinical parameters of sera, value of BUN, ALP in opLH-4 group showed significantly lower than in op-4 group (p＜0.05, p＜0.001). The content of hyp in opLH-2, opLH-4 group (478.0 $\pm$ 134.3 $\mu\textrm{g}$/g 897.5 $\pm$ 118.2 $\mu\textrm{g}$/g) showed lower than in op-2, op-4 group (528.9 $\pm$ 220.7 $\mu\textrm{g}$/g, 1023.8 $\pm$ 277.1 $\mu\textrm{g}$/g) and then the value of MDA in opLH-4 was also significantly reduced to 59.4% of that in op-4 group (p＜0.001). The histological change (bile duct proliferation, fibrosis, collagen bundle) was similarly observed in op-2 group and in opLH-2 group, but the weak fibrosis and bile duct proliferation were observed in opLH-4 group compared with in op-4 group. Our data indicate that the 4 weeks treatment with LH extract suppressed lipid peroxidation and inhibited fibrotic (cirrhosis) process, and experimental cholestatic liver disease is associated with increased lipid peroxidation in BDL/S operated rats. Hence we concluded that the measurement of MDA and hyp can be useful monitor for the screening of antioxidant and antifibrotic effect in experimental liver fibrosis (cirrhosis), and LH has been shown to have hepatoprotective effect, antifibrotic effect and antioxidant effect.

• Journal of the Korean Dietetic Association
• /
• v.15 no.4
• /
• pp.335-342
• /
• 2009

Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1${\pm}$7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58${\pm}$0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.

• Journal of Veterinary Clinics
• /
• v.24 no.3
• /
• pp.315-319
• /
• 2007

Transgastric endoscopic cholecystectomy was successfully accomplished in a 1-year-old, 15 kg, female, mongrel dog. Single-working channel flexible gastric endoscope was used with the aid of one abdominal laparoscopic port. Gastrotomy was performed using endoscopic needle knife at the ventral antral region. Through the gastric incision endoscope was advanced and retroflexed for the visualization of gallbladder. For the better exposure of surgical field, gentle traction was applied at the fundus of the gallbladder using laparoscopic grasping forceps. Cystic duct and artery was ligated using endoclips. After transecting the duct and artery, gallbladder was dissected using endoscopic coagulating grasping forceps and needle knife. Resected gallbladder was retrieved through the mouth and gastric incision site was sutured using endoclips. There was no evidence of bile leakage or stomach leakage on postoperative day (POD) 3. On POD 16, gastric endoscopy and laparoscopy was performed. Gastric endoscopy revealed complete adhesion of incision site. The content of the peritoneum appeared healthy, with no sign of infection, bile staining, or organ injury. The omentum was adhered over resected gallbladder fossa and the serosal surface of gastrotomy site. This is the first report of NOTES cholecystectomy in the dog and provides new concept of cholecystectomy of the dog.

• Journal of Life Science
• /
• v.12 no.3
• /
• pp.332-339
• /
• 2002

The pathogenesis of cholestatic liver injury as well as the modulation of hepatic fibrogenesis is causally associated with involvement of reactive oxygen species and free radical reactions. In this study, we investigated whether flavonoids (fustin, sulfuretin) which were isolated from Rhus verniciflua Stokes (RCS) have antioxidant and antihepatotoxicity effect under the biliary liver fibrosis condition. After surgery (control) and posttreated RCS methanol extract (250mg/kg), ethyl acetate extract (250mg/kg) and flavonoids were administered p.o. 10mg/kg/day in two weeks for control groups. The concentration of clinical parameters and product of hepatic lipid peroxidation and the hydroxyproline content were significantly increased in liver fibrosis developed rats. Among the clinical parameters of serum, value of ALT, AST, SDH, total bilirubin and ${\gamma}$ -GT in posttreated RCS components-group showed significantly lower than in control-group. The content of hydroxyproline in posttreated RCS components-group showed lower than in control group and then the value of MDA in posttreated RCS components-group was also significantly reduced to 40~60% of that in control group. The hepatic xanthine oxidase and aldehyde oxidate activities were posttreated RCS components-group showed significantly lower than in control-group. The hepatic SOD and glutathione peroxidase activities were posttreated RCS components-group showed significantly higher than in control-group. Hence we concluded that active components of fustin and sulfuretin which were isolated from R. verniciflua Stokes were hepatoprotective effect in experimental liver fibrosis.

• Journal of Bone Metabolism
• /
• v.25 no.4
• /
• pp.195-211
• /
• 2018

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.