• Title/Summary/Keyword: Enema

Search Result 145, Processing Time 0.026 seconds

Delayed Continuous Venovenous Hemodiafiltration in Chronic Lithium Intoxication (만성 리튬 중독환자의 지연성 정정맥 혈액 투석여과 사례)

  • Kim, Tae Su;Cha, Yong Sung;Kim, Hyun;Kim, Oh Hyun;Cha, Kyoung Chul;Lee, Kang Hyun;Hwang, Sung Oh
    • Journal of The Korean Society of Clinical Toxicology
    • /
    • v.11 no.1
    • /
    • pp.28-30
    • /
    • 2013
  • A 66-year-old male with chronic alcoholism presented with tremor, gait disturbance, memory impairment, insomnia, decreased appetite, and confusion. The patient had been taking lithium daily for treatment of bipolar disorder. Brain CT showed no specific abnormality, and serum lithium and ammonia levels were 3.63 mEq/L (therapeutic range, 0.6~1.2 mEq/L) and $85{\mu}g/dL$ (reference range: $19{\sim}54{\mu}g/dL$), respectively. Therefore, the initial differential diagnosis included chronic lithium intoxication, hepatic encephalopathy, Wernicke encephalopathy, or alcohol withdrawal syndrome. Even with the provision of adequate hydration, the patient's neurologic status did not show improvement, so that lactulose enema, thiamine replacement, and continuous venovenous hemodiafiltration (CVVHDF) were started on the third admission day. By the fifth admission day he had made a rapid neurologic recovery, and was discharged on the 20th admission day. Therefore, CVVHDF might be a treatment for patients with chronic lithium intoxication, because, even if serum lithium concentration is normal, lithium concentration in the brain may be different from that of the serum.

  • PDF

Radiographic Diagnosis of Atresia Coli in a Korean Native Calf (한우 송아지에서 결장폐쇄의 방사선 진단례)

  • Seong, Yun-Sang;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
    • /
    • v.28 no.3
    • /
    • pp.336-338
    • /
    • 2011
  • A 5-day-old male Korean native calf was referred with the primary complaint of anorexia, absence of feces, depression, and abdominal distention. Although this case was tentatively diagnosed as atresia coli, plain and contrast radiography was performed to confirm site and appearance of obstruction. A plain radiograph revealed gas distension in the large intestine, with absence of fecal material in the descending colon. In a contrast radiograph, the blind part of descending colon that was accumulated with contrast media smoothly protruded to distended colon with gas and the middle part was seen as narrow. These findings were well corresponded with the mucosal blockage junction between distended spiral loop with gas and descending colon that was hypoplasia or atropy in necropsy. In conclusion, contrast radiography was considered very useful method to identify the site and type of obstruction in diagnosis of atresia coli.

Recognition of Home Care Services for Nurses and Physicians (일 지역 의료인의 가정간호사업 및 서비스 제공 가능성에 대한 인식 조사)

  • Ko Young Aie;Baek Hee Chong;Park Jin Kyung;Kim Mi Ju
    • Journal of Korean Public Health Nursing
    • /
    • v.19 no.1
    • /
    • pp.108-116
    • /
    • 2005
  • The purpose of this study is to determine the level of recognition of home care services and to provide basic data for implementation of home care services. Data collection was carried out between December 2004 and January 2005 by surveying 88 nurses and 40 physicians working at a general hospital and 28 physicians working at different clinics in the Seoul metropolitan city area. The results of this study were as follows: 1. Home care services were recognized by $94.2\%$ of nurses, $77.5\%$ of physicians and $92.9\%$ of clinic physicians. The main sources of information for most of them were medical and nursing journals. 2. The percentages of staff regarding find home care services as necessary for the institutions were $88.6\%$ of nurses, $74.4\%$ of physicians and $57.1\%$ of clinic physicians. All of them anticipated that home care services would maintain 'continuous care' and 'long-term patient care'. 3. The percentages of staff willing to refer their patients to home care were $95.5\%$ of nurses, $100\%$ of physicians and $87.1\%$of clinic physicians. However, only $7.1\%$ of clinic physicians were willing to refer actively. 4. Most nurses and physicians replied that a majority of test-related services is suitable for home care services. However, among medication-related services, intravenous injections were not suitable for home care services. Among treatment-related services, most nurses and physicians replied that Levin tube feeding, oral and nasal suction, simple dressing, perineal care, and enema were suitable for home care services, but incision and drainage, and tracheostomy tube change were not suitable for home care services. In conclusion, for the implementation of hospital-based home care services, it is necessary to educate nurses and physicians on the present condition and precedent at other hospitals.

  • PDF

A Study on Learning Experiences and Self-Confidence of Core Nursing Skills in Nursing Practicum among Final Year Nursing Students (졸업학년 간호학생의 핵심기본간호술 학습경험과 수행자신감 조사연구: 실습교과를 중심으로)

  • Han, Aekyung;Cho, Dong Sook;Won, Jongsoon
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.21 no.2
    • /
    • pp.162-173
    • /
    • 2014
  • Purpose: This study was done to identify learning experiences and self-confidence and to analyze nursing students' self-confidence according to learning experiences for core nursing skills (CNS). Method: Participants were 502 final year nursing students. Data were collected using a structured questionnaire and analyzed using descriptive statistics and t-test. Results: Over 60% of participants had practiced 15 items of the 24 CNS in the basic nursing lab (BNL). In clinical practice (CP), they had practiced five items but experienced only one item in a simulation lab (SL). Items with the highest confidence level were vital signs (4.69) followed by blood sugar test (4.60), pulse oximeter (4.38), and oral medication (4.12). Items with the lowest confidence level were blood transfusion (2.17) followed by enema (2.64) and indwelling catheterization (2.67). The group with CNS experience in the practice curriculum was generally more confident than the group with no experience. Self-confidences in some skills was significantly different depending on availability of SL, credits for BNL and CP, and presence of preceptors. Conclusion: Results indicate a need to develop practice education strategies such as changing the CP to practice-centered learning with preceptors and including well-designed SL to increase confidence of nursing students.

Case Report of Aspiration Pneumonia Treated with Yukgunja-tang (육군자탕 투여 후 호전된 흡인성 폐렴 환자 치험 1례)

  • Park, Sung-woon;Kim, Min-ji;Seo, Yoon-jeong;Kang, Da-hyun;Kim, Young-ki;Noh, Hyun-in;Bae, Jae-ryong;Lee, Jae-won;Lee, Jin-won;Choi, Geun-wook;Lew, Jae-hwan
    • The Journal of Internal Korean Medicine
    • /
    • v.37 no.2
    • /
    • pp.176-181
    • /
    • 2016
  • Objectives: This clinical study reports on the effects of Yukgunja-tang on aspiration pneumonia.Method: This case examined a comatose male patient who suffers from continuous regurgitation. He showed symptoms of aspiration pneumonia with accompanying gastroesophageal reflux. We gave the patient Yukgunja-tang for 28 days and observed any changes in symptoms.Results: During the period when the patient was given Yukgunja-tang, he defecated on his own without glycerin enema, regurgitation occurred less frequently, and the aspiration pneumonia symptoms improved.Conclusion: Yukgunja-tang helped the patient's bowel movements move more quickly and smoothly through his colon. As a result, Yukgunja-tang appears to have prevented regurgitation and aspiration pneumonia.

Review for Clinical Studies of Oriental Medicine on the Prevention of Ovarian Hyperstimulation Syndrome (난소과자극증후군의 예방에 관한 한의 임상 연구 고찰)

  • Ku, Su-Jeong;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.33 no.1
    • /
    • pp.1-18
    • /
    • 2020
  • Objectives: This review is aimed at assessing the efficacy and effectiveness of oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome (OHSS) through literature research and overview. Methods: Database searching was conducted to identify relevant randomized controlled trials (RCTs) on oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome. Studies were searched from Journal of Korean Obstetrics and Gynecology, Korean studies Information Service System, Korean Medical Database, China National Knowledge Infrastructure, Cochrane library, PubMed and EmBase up to 7th November, 2019. Results: Ten RCTs were finally selected. Eight studies intervened with oral Chinese herb medicine, one is intervened with Chinese medicine enema and the other with acupuncture. Eight studies concluded that intervention with oriental medicine significantly decreased OHSS incidence. Five studies showed significantly higher pregnancy rate in the intervention groups. Two studies reported higher ovulation rate and other two studies showed more maturated eggs than the control groups. Four studies showed opposite results in serum Estradiol level. Vascular Endothelial Growth Factor level was significantly lower in the intervention groups in two studies. Conclusions: From ten studies, oriental medicine reduced OHSS incidence rate and showed preventable effectiveness. Further strictly designed studies and acupuncture intervened studies are needed to establish evidences.

Review of Clinical Studies of Traditional Chinese Medicine on Genito-Pelvic Pain/Penetration Disorder in Women (음부-골반통/삽입질환에 대한 중의학 임상연구 동향)

  • Nam, Eun-Young
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.32 no.3
    • /
    • pp.214-226
    • /
    • 2019
  • Objectives: The purpose of this study is to review clinical studies of Traditional Chinese medicine (TCM) on Genito-Pelvic Pain/Penetration Disorder (GPPPD) in women. Methods: Key words "Dyspareunia", "Vaginismus" were searched on Chinese National Knowledge Infrastructure Database (CNKI) on April 21th 2019. Results: 2 case reports and 7 clinical trials were collected in accordance with the selection and exclusion criteria. Among the 7 trials, 4 were controlled trials, and 3 were single-arm trials. The types of intervention were herb medication in 8 studies, and compound TCM treatment including acupuncture, moxibustion, and cupping therapy in 1 study. All 4 controlled trials were about dyspareunia and conducted by herbal medicine of TCM. The study results and methods of intervention were analyzed. Conclusions: 2 case reports described the effectiveness of compound TCM treatments (acupuncture, moxibustion, cupping therapy) and herb medicine in dyspareunia. In 4 controlled trials, 2 trials described the effectiveness of herb medicine (oral or vaginal agent) compared to western treatment in dyspareunia, and other 2 trials described no effectiveness of herbal enema compared to danazol. In 3 single-arm trials, 1 trial of dyspareunia and 2 trials of vaginismus described the effectiveness of herb medicine. All the 9 selected studies reported improved or disappeared symptoms of GPPPD, or high effective rate after TCM treatment. There was limitation that the selected studies were retrieved from only one site of CNKI, and generalized results could not be derived, further studies should be carried out. Additional well-designed clinical studies on GPPPD in women are needed in Korea.

Efficacy and Safety of Polyethylene Glycol(PEG) with Electrolytes for Disimpaction in Children with Chronic Functional Constipation (소아에서 만성 기능성 변비의 분변 박힘 제거에 대한 전해질이 함유된 Polyethylene Glycol(PEG)의 효과 및 안전성에 관한 연구)

  • So, Hong Seop;Bae, Sun Hwan;Yoon, Hei Sun;Hwang, Jin Soon
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.11
    • /
    • pp.1089-1094
    • /
    • 2003
  • Purpose : Polyethylene glycol(PEG) with electrolytes has been used for intestinal clearance for colonoscopy and operations in children. But its efficacy and safety for disimpaction in children with chronic functional constipation has been studied little. Methods : This study enrolled 26 patients with chronic functional constipation(11 children had failed to disimpaction by conventional management at OPD) who were admitted to the Eul-Ji Hospital between May 2000 and July 2003. PEG with electrolytes was administered per oral and/or rectal enema. We observed the effects for disimpaction by measuring the frequency and consistency of stools, and by simple abdominal X-ray. We evaluated the safety by measuring serum electrolytes and osmolarity in three hours after PEG with electrolytes administration, and by observation of the clinical status of the patients. The protocol of PEG with electrolytes was a dose of 60-80 mL/kg within three hours per oral and/or of 15-25 mL/kg by rectal enema. Results : In all patients, simple abdominal X-ray films showed improvements of fecal impaction. Consistency and frequency of stool were improved in all patients except one. As for side effects, diarrhea developed in three patients(11.5% of all patients). Headaches developed in one patient(3.8% of all patients) but it improved without treatment. Serum electrolytes was checked in 16 patients after PEG with electrolytes management and mild hypernatremia(146 mmol/L) was checked in one patient. Serum osmolarity was checked in 11 patients after PEG with electrolytes management and was normal in all patients. Conclusion : PEG with electrolytes was effective and safe for disimpaction in children with chronic functional constipation, including patients who had failed in disimpaction by conventional management.

Early and Late Bowel Complication Following Irradiation of Cancer of the Uterine Cervix (자궁경부암의 고선량 치료후의 장관 합병증)

  • Kim Myung Se;Kim Kyung Ae;Kim Sung Kyu;Shin Sei One;Lee Sung Ho;Chang Jae Chun
    • Radiation Oncology Journal
    • /
    • v.7 no.1
    • /
    • pp.59-70
    • /
    • 1989
  • Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still $44\%$ of patient will develop recurrent cancer. This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen Which is $5500\~1000 CGy$ higher than Other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was $46\%$, but only 1 patient $(1\%)$ had operative treatment because of incomplete obstruction of small bowel. Most symptoms appeared within 12 months and most common complaints were frequent bowel movement. Barium enema and sigmoidoscopy were performed for persistent symptomatic patients. Only one patient had abnormal finding in barium enema which showed inefficiency of this method for detecting bowel complication. Patient's age, total tumor dose, total TDF, rectal dose were not significant risk factors for complication, but boost dose, previous history of operation had some relationship with complication risk. Even though dose of point A and rectum is $500\~1,000cGy$ higher than other institution, such a low rate of severe complications may suggest that fear of complications should not be overestimated than cure rate and the possibility of more aggressive treatment for better local control should not be underestimated.

  • PDF

The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture (흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jeoung-Eun;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
    • /
    • v.17 no.2
    • /
    • pp.41-51
    • /
    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

  • PDF