• Title/Summary/Keyword: Indwelling

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Study on Prolonging Peripheral Intravenous Catheter Indwell Time Based on Phlebitis Rate (정맥염 발생률에 근거한 말초 정맥관의 정규교환 시기 연장에 대한 연구)

  • Yoon, Hee Sook;Park, Mee Ah;Park, Eun Jung;Choi, Jhin Hee;Kim, Mi Young;Lim, Ji Mi;Lee, Seung Ja;Lee, Chang Kwan
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.145-153
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    • 2010
  • Purpose: The purpose of this study was to re-assess the replacement time intervals of Peripheral Intravenous Catheters (PICs) by investigating phlebitis rates according to the indwelling times of PICs. Methods: The study was conducted on 340 patients in S hospital by an IV team. After PIC insertion, IV team members evaluated once a day. The PICs were replaced every 96 hours, and let them in situ when the patients wanted to, in the absence of any sign of complications, from 97 hours to 153 hours. Results: Total phlebitis rate was 19.6%. There were no significantly different factors associated with the occurrence of phlebitis. The incidence rates of phlebitis were 12.6% and 7.0% before and after 72 hours of PIC insertion, and recorded zero after 96 hours. Conclusion: It would be recommendable to maintain PIC in situ for longer than 72 hours if there is no sign of complication such as phlebitis in close monitoring of PIC insertion site.

Path Analysis of the Effects of Nurse Staffing on Patient Outcomes in Long-Term Care Hospitals (요양병원 간호인력 배치수준이 환자결과에 미치는 영향에 관한 경로분석)

  • Seong, Jiyeong;Cho, Sung-Hyun
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.3
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    • pp.249-260
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    • 2023
  • Purpose: The study aimed to examine the effects of nurse staffing levels on patient outcomes in long-term care hospitals in South Korea using path analysis. Methods: We conducted a secondary analysis of national data, which included the 2021 hospital assessment results of long-term care hospitals from the Health Insurance Review and Assessment Service. Data collection was performed between June 19 and June 27, 2023. The study sample consisted of 1,215 hospitals, and we analyzed the data using SAS 9.4 and Mplus 8 software. Results: The average numbers of patients per registered nurse, certified nursing assistant, and nursing staff, including both registered nurses and certified nursing assistant, was 10.00, 7.43, and 4.00, respectively. Path analysis revealed that the number of patients per registered nurse had direct effects on improvements in activities of daily living and indirect effects on indwelling catheterization, pressure ulcer improvement, and weight loss. The number of patients per certified nursing assistant had direct effects on new pressure ulcer development and pressure ulcer improvement, with no indirect effects. The number of patients per nursing staff had direct effects on pressure ulcer improvement and no indirect effects on other patient outcomes. Conclusion: The findings suggest that establishing policies to evaluate staffing levels of registered nurse and certified nursing assistants separately is necessary in order to improve registered nurse staffing levels and patient outcomes in long-term care hospitals.

Increased accuracy of estrus prediction using ruminoreticular biocapsule sensors in Hanwoo (Bos taurus coreanae) cows

  • Daehyun Kim;Woo-Sung Kwon;Jaejung Ha;Joonho Moon;Junkoo Yi
    • Journal of Animal Science and Technology
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    • v.65 no.4
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    • pp.759-766
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    • 2023
  • Visual estrus observation can only be confirmed at a rate of 50%-60%, which is lower than that obtained using a biosensor. Thus, the use of biosensors provides more opportunities for artificial insemination because it is easier to confirm estrus than by visual observation. This study determines the accuracy of estrus prediction using a ruminoreticular biosensor by analyzing ruminoreticular temperature during the estrus cycle and measuring changes in body activity. One hundred and twenty-five Hanwoo cows (64 with a ruminal biosensor in the test group and 61 without biosensors in the control group) were studied. Ruminoreticular temperatures and body activities were measured every 10 min. The first service of artificial insemination used gonadotropin-releasing hormone (GnRH)-based fixed-time artificial insemination protocol in the control and test groups. The test group received artificial insemination based on the estrus prediction made by the biosensor, and the control group received artificial insemination according to visual estrus observation. Before artificial insemination, the ruminoreticular temperature was maintained at an average of 38.95 ± 0.05℃ for 13 h (-21 to -9 h), 0.73℃ higher than the average temperature observed at -48 h (38.22 ± 0.06℃). The body activity, measured using an indwelling 3-axis accelerometer, averaged 1502.57 ± 27.35 for approximately 21 h from -4 to -24 h before artificial insemination, showing 203 indexes higher body activity than -48 hours (1299 ± 9.72). Therefore, using an information and communication techonology (ICT)-based biosensor is highly effective because it can reduce the reproductive cost of a farm by accurately detecting estrus and increasing the rate of estrus confirmation in cattle.

Acupuncture-Induced Abscess in the Retroperitoneal Cavity and Thigh Muscle: A Case Report (침술로 인한 후복막강 및 허벅지 근육의 농양: 증례 보고)

  • Duk Ju Kim;In Chul Nam;Doo Ri Kim;Jeong Sub Lee;Kyung Ryeol Lee;Bong Soo Kim;Guk Myung Choi
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.463-467
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    • 2024
  • Acupuncture is increasingly being used in Asian countries and is generally considered a relatively safe procedure. However, adverse events have been reported consistently. Therefore, clinicians should be aware of the possibility of acupuncture-related complications and should actively treat serious cases. We report a case of an acupuncture-induced large abscess in the retroperitoneal cavity and thigh muscles treated with percutaneous catheter drainage, surgical incision, and drainage.

Effects of Intraoperative Doxycycline Pleurodesis with Concomitant Video-assisted Thoracoscopic Bullectomy (흉강경을 이용한 폐기포절제 수술과 동시에 시행한 Doxycycline Pleurodesis의 효과)

  • Kim, Hyeong-Guk;Han, Jae-Yeol;Kim, Gwang-Ho;Kim, Jeong-Taek
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.59-62
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    • 1996
  • Chemical pleurodesis with doxycycline has been used during video-assisted thoracoscopic surgery (VATS) as an auxiliary method to enhance therapeutic goal in patients with pneumothorax. However, the therapeutic effect of doxycycline pleurodesis (DP) has not been clearly defined yet. To evaluate the effect of DP, we compared two groups of patients who were given VATS bullectomy from October 1993 to June 1995. Group I composed of 21 patients who received DP and group II composed of 20 patients who did not received DP Doxycycline 500mg with saline 200ml were instilled into the pleural cavity upon a completion of bullec omy, and retained there for 0.5-1 hour and then drained out. The age of group I was 30.9 $\pm$ 20.0 and that of group II was 24.3 $\pm$ 9.49 years. Male to female ratio was 20: I in group I and 20 : 0 in group II. The postoperative indwelling time of chest tube was 5.86 $\pm$ 4.69 days in group I and 3.80 $\pm$ 2.28 days in group II. Seven patients had more than 100m1/day of chest tube drainage on the postoperative third day in group I compared to one patient in group II. Five patients had postoperative indwelling time of chest tube greater than 7 days in group I compared to two in group II. The number of patients who had postoperative fever were 3 in both group, analgesic requirements were 2.19 $\pm$ 2.77 amples in group I and 2.30 $\pm$ 1.95 ambles in group II. Follow-up was done from 2 months to 16 months after surgery. During the follow up periods, four patients had recurrence 2 (9.5%) in group I and 2 (10%) in group II. We conclude that concomitant doxycycline pleurodesis with video-assisted thor coscopic bullectomy In patients with pneumothorax is not necessary.

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A Comparison of Video-assisted Thoracic Surgery with Mid-axillary Thora- colomy in the Treatment of Spontaneous Pneumothorax Video-assisted Thoracic Surgery in the Treatment of Spontaneous Pneumothorax- (원발성 자연기흉의 폐기포 절제시 비디오 흉강경수술과 정중액와 개흘술의 비교 -폐기포 절제시 비디 오흉강경수술-)

  • 오성철;김대식
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.728-733
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    • 1996
  • Since thoracoscopy was originally described by Jacobaeus in 1922, video-assisted thoracic surgery has been used to treat many thoracic diseases. From June 1994 to July 1995, 35 patients with spontaneous pneumothorax'underwent video-assisted thoracic sugery as experimental group, and same number of patien:s with blob resection through mid-axillary thoracotomy as co trol group in our hospital.'The authors compared the clinical results between each group. 1. The sex distributions were 28 males, 7 females in experimental group and 30 males, 5 females in control group. The mean age of experimental group was 28.5 $\pm$ 12.6 years of age and that of control group was 2).9 $\pm$ 6.3 years of age. 2. The operative times were 98.8$\pm$ )9.3 minutes in experimental group and 103.6$\pm$ )2.6 minutes in control group. ). The duration of chest tube indwelling at postoperative period was 2.60 $\pm$ 0.98 days in experimental group, 4.80 $\pm$ 2.08 days in control group (P< 0.01). The periods of postoperative hospitalization were 17 $\pm$ 1.22 days in experimental group and 6.69 $\pm$2.52 days in control group. The durations of post-oper- ative chest tube indwelling and hospital stay in experimental group were shorter than in control group (P< 0.01 respectively). 4. The injection of analgesics at postoperative period was less in experimental group than control group. At the operative day and postoperative 1 st and 2nd day, the number of injections were respectively 1. 57$\pm$0.74, 1.97 $\pm$0.70 and 1.00$\pm$0.68 times/person in experimental group, 2.23 $\pm$0.60, 2.60 $\pm$0.67 and 2. 17$\pm$0.76 times/person in control group(P<0.01 respectively). The mean duration and dose of postoperative analgesic injection were 2.48$\pm$ 1.01 days/person and 4.88 $\pm$3.70 ampules/person in experimetal group, 3.70$\pm$ 1.40 days/person and 8.94 $\pm$4.21 ampules/person respectively (P< 0.01, p<0. 01).

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Clinical Study of the Treatments for Abdominal Aortic Aneurysm; Comparison between the Retroperitoneal and Transperitoneal Approaches (복부대동맥류 치료의 임상적 고찰; 후복막 접근법과 경복막 접근법의 비교)

  • Son, Bong Soo;Chung, Sung Woon;Lee, Sang Kwon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.34-40
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    • 2009
  • Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.

The effect of 8 French catheter and chest tube on the treatment of spontaneous pneumothorax (자연기흉에 있어서 8 French 도관과 흉관의 삽입 치료 효과)

  • Kang, Yoon-Jeong;Koh, Hyoung-Gee;Shin, Jong-Wook;Lim, Seong-Yong;Choi, Jae-Sun;Yu, Ji-Hoon;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho;Seo, Seung-Cheon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.410-419
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    • 1996
  • Background : Spontaneous pneumothorax have been managed with a variety of methods. The technique most frequently used is chest tube drainage. Small caliber catheters were first used in the management of pneumothorax complicating the percutaneous needle aspiration lung biopsy, and the try to treat spontaneous pneumothorax also has been reported. However, the value of small caliber catheters in spontaneous pneumothorax has not been fully evaluated. So, we tried to elucidate the efficacy of 8 French catheter in the management of spontaneous pneumothorax. Method : From January, 1990, to April, 1994, 44 patients with spontaneous pneumothorax treated at Chung-Ang university hospital were reviewed. The patients were sub-divide into 8 French catheter insertion group (n=21) and chest tube insertion group (n=23). We compared the presence of underlying lung disease, the extent of the collapse, the duration of indwelling catheter and complication between two groups. Results : 1) The duration of indwelling showed no significant difference between 8 French catheter group and chest tube. But, complication after insertion as subcutaneous emphysema was developed in only chest tube group. (p<0.05) 2) In the primary spontaneous pneumothorax, all case of the pneumothorax of which size was less than 50% showed complete healing with 8 French catheter insertion. Whereas the success rate in patients with large pneumothorax (more than 50%) was tended to be dependent on the age. 3) In the patients with secondary spontaneous pneumothorax who were managed with 8 French catheter, the success rate was trended to be high if the underlying disease of pneumothorax was not COPD and if the patient was young. Conclusion : These results show that 8 French catheter insertion probably was effective in the pneumothorax less than 50%, the primary spontaneous pneumothorax, young age or secondary pneumothorax not associated with COPD.

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Clinical Study of Corrosive Esophagitis (부식성 식도염에 관한 임상적 고찰)

  • 이원상;정승규;최홍식;김상기;김광문;홍원표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.6-7
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    • 1981
  • With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

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Yeast Culture and Vitamin E Supplementation Alleviates Heat Stress in Dairy Goats

  • Wang, Lizhi;Wang, Zhisheng;Zou, Huawei;Peng, Quanhui
    • Asian-Australasian Journal of Animal Sciences
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    • v.29 no.6
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    • pp.814-822
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    • 2016
  • This study was conducted to determine and compare the effects of yeast yeast culture (YC) and vitamin E (VE) supplementation on endotoxin absorption and antioxidant status in lactating dairy goats suffering from heat stress (HS). Three first lactation Saanen dairy goats (body weight $30{\pm}1.5kg$) were surgically fitted with indwelling catheters in the portal vein, mesenteric vein and carotid artery, and were randomly assigned to a $3{\times}3$ Latin square design. Dietary treatments were the basal diet, and the basal diet supplemented with either 100 IU VE or 30 g YC. Goats were kept in temperature and humidity-controlled room at $35^{\circ}C$ from 8:00 to 20:00 and at $24^{\circ}C$ from 20:00 till the next morning at 8:00. The relative humidity was kept at 55%. HS increased dairy goats' rectum temperature and respiration frequency (p<0.01). HS reduced plasma flux rate of milk goats (p<0.01), but the plasma flux rate increased when the animal was under the conditions of the thermo-neutral period (p<0.01). The VE supplementation lowered dairy goats' rectum temperature during thermo-neutral period (p<0.01). Meanwhile, no significant differences were observed between the control and YC treatment in rectum temperature and respiration frequency (p>0.05). Dietary supplementation of VE and YC reduced heat stressed dairy goats' endotoxin concentration of the carotid artery and portal vein (p<0.01). However, the endotoxin concentration of the YC treatment was higher than that of the VE treatment (p<0.01). Both VE and YC supplementation decreased heat stressed dairy goats' absorption of endotoxin in portal vein (p<0.01). The endotoxin absorption of YC treatment was higher than the VE treatment (p<0.01). The addition of VE and YC decreased dairy goats' superoxide dismutase (SOD) concentration during HS and the whole experiment period (p<0.01). The addition of VE lowered SOD concentration during thermo-neutral period (p<0.01). Likewise, the addition of VE and YC lowered dairy goats' malonaldehyde (MDA) concentration during HS and the whole experimental period, and the MDA concentration in the VE treatment was lower than the YC treatment (p<0.05). The addition of VE decreased MDA concentration during thermo-neutral period. On the contrast, the addition of VE increased dairy goats total antioxidant potential (TAP) concentration during HS, thermo-neutral and the whole experimental period (p<0.01). The addition of YC increased TAP concentration only during HS period (p<0.01). It is concluded that both VE and YC are useful in alleviating HS of dairy goats by weakening endotoxin absorption and promoting antioxidant capacity. Compared with YC, VE is much more powerful in easing dairy goats HS.