• Journal of Digital Convergence
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• v.14 no.11
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• pp.369-377
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• 2016

This study examined artificial joint replacement surgery for early intervention and prevention of the occurrence of delirium surgery. Data of study were analysed using the sample through the EMR (Electronic Medical Record) and after surgery to provide basic data. The subjects were elderly aged 60 years or more and the number of the sample was 821. Data were analysed by using SPSS 20.0 with t-test, $x^2$-test and multiple logistic regression analysis. The study results showed patients with artificial joint replacement surgery incidence of delirium was 13.5%, findings of these variables insisted that the main influencing factors of delirium were caused by age, fall history, physical activity, emotional status, body mass index (BMI) before surgery. The study suggested that the above findings are required for early intervention, early detection and prevention of delirium.

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.633-638
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• 2001

Objective : Stroke is the most frequent cause of death in Korea. Because it remains severe disablities disturbing normal life, it is important to carry out intervention preventing from progression of condition in patients with acute ischemic stroke within therapeutic time window. Thus early thrombolysis is beneficial for patients with acute ischemic stroke. However its therapeutic efficacy is not known in combination with oriental medical therapy. In this study, we investigated the safety and the clinical effect of continous intravenous urokinase therapy and oriental medical therapy. Methods : Twenty eight patients with acute onset of ischemic stroke no later than three days received continous infusion of urokinase and oriental medical therapy. We estimated the subjects's neurological deficit and functional status with National institute of Neurologic Disorders and Stroke Scale(NIHSS) and Europian Stroke Scale (ESS) prior to therapy, on day 3, 7, 14 after the starting urokinase therapy and on day at discharge. Results: After day 7, the scores of NIHSS and ESS were improved significantly. There are no differences in therapeutic effects of the interval between onset of stroke and initiation of therapy. Complication were noted in four(14%) patients, but these are not fatal complication and make no neurological deficiency. Conclusion : The results of these investment suggest that continuous intravenous urokinase with oriental medical therapy could be a safe and effective intervention to prevent from progression in acute ischemic stroke. But this findings should be confirmed in multicenter double blind controlled trial.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.252-258
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• 2017

Purpose: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries. Methods: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed. Results: Age of the patients ranged from 3-11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children. Only 3 patients had associated injuries and all were haemodynamically stable. Serum amylase levels were raised in 12 patients at admission which ranged from 400-1,000 IU. Computed tomography scan made a correct diagnosis in 14 patients. Grades of the injury varied from grade I-V (1, 3, 6, 4, 1 patients respectively). Fourteen patients were managed conservatively. One patient underwent laparotomy for suspected superior mesenteric hematoma. The average duration of enteral feeds was 3.7 days and of hospital stay was 9.4 days. Six patients formed pancreatic pseudocysts; two were managed conservatively while the other four underwent cystogastrostomy. The patients were followed up for a period of 1-12 years. All remained asymptomatic and none had exocrine or endocrine deficiencies. Conclusion: Non-operative treatment for isolated blunt trauma of pancreas in children may be safely followed for all the grades of injury; if associated injuries requiring surgical intervention are ruled out with a good quality imaging and the patients are hemodynamically stable. It did not increase the hospital stay and morbidity and avoided operative intervention on acutely injured pancreas.

• Journal of the Korea Convergence Society
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• v.12 no.10
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• pp.353-363
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• 2021

This study aimed to investigate subtypes, risk factors, symptoms and the interventions to inpatients with delirium. The data of 108 inpatients who had the diagnosis of delirium during their hospital stay were collected from Electronic Medical Record at a university hospital and were analyzed by SPSS for Windows V. 26.0 program. As a results, Patients had a high proportion of elderly, male, orthopedic, and with fractures or amputations. The subtypes of delirium were hyperactive (51.9%), hypoactive (6.5%), and mixed (41.7%). Among the risk factors, depression and use of psychotropic agent were more common in those with hypoactive delirium. Among delirium interventions, behavioral symptom management and aggressive behavioral intervention were mainly implemented for those with hyperactive or mixed types, and emotional support was mainly implemented for those with hypoactive or mixed types. The delirium related intervention was more likely given immediately when the patients showed aggressive behaviors. Therefore, intervention strategies and protocol development are required for early detection of delirium in inpatients.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.420-422
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• 2012

Cerebral aspergillosis is rare and usually misdiagnosed because its presentation is similar to that of a tumor. The correct diagnosis is usually made intra-operatively. Cerebral abscess with fungal infection is extremely rare and few cases have been reported, but it carries a poor prognosis. A 73 year-old man presented with decreased visual acuity and paresis of the right cranial nerve III. Magnetic resonance imaging (MRI) revealed a mass in the right cavernous sinus, extened to the anterior crainial fossa and the superior orbital fissure. During surgery, a well encapsulated pus pocket was found, and histopathological examination of the mass resulted in the diagnosis of aspergillosis. Despite appropriate anti-fungal treatment, the patient eventually died from fatal cerebral ischemic change and severe brain swelling. The correct diagnosis of cerebral aspergillosis can only be achieved by histopathological examination because clinical and radiological findings including MRI are not specific. Surgical intervention and antifungal therapy should be considered the optimal treatment. Early diagnosis and aggressive antifungal treatment provide good results.

• Korean Medical Education Review
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• v.24 no.3
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• pp.215-230
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• 2022

The purpose of this study was to explore the psychosocial characteristics of academically maladjusted students and the College's current status regarding academic maladjustment based on 4-year medical student cohort data collected from 2018 to 2021 and through interviews with 10 medical education experts using the integrated research method. This study included 223 students who consented to inclusion in the student cohort and participated in the emotional behavior test and college adaptability test of whom 65 students experienced academic maladjustment. Academically maladjusted students had significantly higher scores for social stress, anxiety, sense of inadequacy, attention, hyperactivity, and school maladjustment, and significantly lower scores for relationships with parents, interpersonal relationships, self-esteem, self-confidence, and self-strength. Academic and social integrity, emotional stability, university satisfaction, and university service satisfaction were all significantly lower in the academically maladjusted students than in the non-maladjusted group. The expert interviews indicated that academic maladjustment was mainly recognized as a personal problem, with causes such as lack of motivation and learning methods, vulnerability to stress, lack of social relationships and alienation, lack of support from the family, and insufficient resilience. Systematic support other than counseling for academically maladjusted students is required, and an early diagnosis and preventive intervention are important.

• Journal of Preventive Medicine and Public Health
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• v.40 no.2
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• pp.130-136
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• 2007

Objectives : Recent educational efforts have concentrated on patient's early hospital arrival after symptom onset. The purpose of this study was to evaluate the time interval between symptom onset and hospital arrival and to investigate its relation with clinical outcomes for patients with acute ischemic stroke. Methods : A prospective registry of patients with signs or symptoms of acute ischemic stroke, admitted to the OO Medical Center through emergency room, was established from September 2003 to December 2004. The interval between symptom onset and hospital arrival was recorded for each eligible patient and analyzed together with clinical characteristics, medication type, severity of neurologic deficits, and functional outcomes. Results : Based on the data of 256 patients, the median interval between symptom onset and hospital arrival was 13 hours, and 22% of patients were admitted to the hospital within 3 hours after symptom onset. Patients of not-mild initial severity and functional status showed significant differences between arrival hours of 0-3 and later than 3 in terms of their functional outcomes on discharge. Logistic regression models also showed that arrival within 3 hours was a significant factor influencing functional outcome (OR=5.6; 95% CI=2.1, 15.0), in addition to patient's initial severity, old age, cardioembolism subtype, and referral to another hospital. Conclusions : The time interval between symptom onset and hospital arrival significantly influenced treatment outcome for patients with acute ischemic stroke, even after controlling for other significant clinical characteristics. The findings provided initiatives for early hospital arrival of patients and improvement of emergency medical system.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.767-773
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• 2018

Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.1
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• pp.107-124
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• 1998

Based on King's goal attainment theory, this research deals with applying nursing intervention of mutual goal settings to gastrectomy patients. It tests the effects of nursing intervention, according to the patients' health locus of control, suggested as external boundary criteria for the theory by employing a quasi-experimental design which consists of a pretest-posttest non-equivalent control and experimental groups. The subjects of this research were 62 gastrectomy patients hospitalized at Y medical center and the experimental and control groups consisted of 31 subjects. The experimental group received nursing intervention at the mutual goal setting of 5 times from the day before the surgery to the 5th day after the surgery, while the control group received only routine nursing care. Recovery indicators of both groups were measured and compared. Measurement variables included patients' characteristics, health locus of control, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, bowel movement recovery, mobility recovery, level of pain, patients' stress and patients' satisfaction. Data were analyzed using SPSS statistical package and the hypotheses were tested by ANOVA and ANCOVA. Results of the analyses are summarized as follows : 1) Internal health locus of control had higher effects of the nursing intervention of mutual goal setting than external health locus of control on pulmonary ventilatory functions of forced vital capacity, forced expiratory volume in one second, and peak expiratory flow. 2) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the bowel movement recovery between the internal and external health locus of control. 3) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the mobility recovery between the internal and external health locus of control. 4) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of pain between the internal and external health locus of control. 5) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of stress between the internal and external health locus of control. 6) There was a statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with provision of nursing information between the internal and external health locus of control, and there was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with outcome of nursing between the internal and external locus of control. On the basis of the research results, the following are recommended : 1) Repeated research on responses to health locus of control is necessary. 2) Not only the effectiveness of nursing intervention in acute recovery periods, but also the long term effects are to be investigated. 3) The development of instruments is needed to accurately measure mutual goal setting regarding postoperative deep breath, coughing, early ambulation, etc. so that the relationship among the postoperative recovery indicators may be explored. 4) It is required that an instrument be developed to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

• Journal of Veterinary Clinics
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• v.33 no.2
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• pp.135-137
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• 2016

A 6-month-old, weighing 2.8 kg, female, domestic short-haired cat presented with open fracture at right distal radius about a month ago. Based on radiological findings, hyperplasia at the right radioulna and left humerus was found. Results of the cytological examination were inflammatory reaction and reactive osteoblast. Distal radial ostectomy proceeded with necrotic bone debridement. Three weeks after operation, the radial bone lysis was seen on radiograph but clinical condition improved. Hyperplasia at the right radioulna and left humerus was dissolved. Two months after operation, she can use her both forelimbs despite right elbow have been diagnosed as arthrosclerosis because of periosteal reaction. Six months after operation, clinical symptoms of limbs were not detected. In this case, open fracture was treated through delayed surgical debridement procedure, therefore hematogenous osteomyelitis occurs at another forelimb. The longer a wound remains open, the more likely it is that infection will develop. The infection can occur to fracture bone and seed from hematogenous spread to another normal bone. In conclusion, when open fracture occurs, early antibiotic treatment and urgent surgical intervention are recommended.