• 제목/요약/키워드: Indwelling

검색결과 168건 처리시간 0.025초

의료기관 가정간호 대상자의 다제내성균 보유 위험요인 (Risk Factors for Mutidrug-Resistant Organisms Carriage Among Home Health Nursing Patients)

  • 박민아;장정숙;조영이;최지연;이종은
    • 가정∙방문간호학회지
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    • 제30권2호
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    • pp.155-162
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    • 2023
  • Purpose: This study was conducted to identify the status and risk factors for the carriage of multidrug-resistant organisms carriage in home health nursing patients. Methods: This retrospective study enrolled 122 participants who received home health nursing and analyzed the data obtained from chart review and diagnostic tests for multidrug-resistant organisms carriage from January 2019 to January 2021. Results: Multivariate analysis revealed that surgical procedures in the preceding year, injectable antibiotic use in the preceding month, pressure ulcer, and indwelling nasal tubes were significantly associated with multi-drug resistant infection. Conclusions: Infection-control strategies need to be developed and customized for use in the home health-nursing service for patients who are carriers of multidrug-resistant organisms.

Rigid Bronchoscopy for Post-tuberculosis Tracheobronchial Stenosis

  • Hojoong Kim
    • Tuberculosis and Respiratory Diseases
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    • 제86권4호
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    • pp.245-250
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    • 2023
  • The healing process of tracheobronchial tuberculosis (TB) results in tracheobronchial fibrosis causing airway stenosis in 11% to 42% of patients. In Korea, where pulmonary TB is still prevalent, post-TB tracheobronchial stenosis (PTTS) is one of the main causes of benign airway stenosis causing progressive dyspnea, hypoxemia, and often life-threatening respiratory insufficiency. The development of rigid bronchoscopy replaced surgical management 30 years ago, and nowadays PTTS is mainly managed by bronchoscopic intervention in Korea. Similar to pulmonary TB, tracheobronchial TB is treated with combination of anti-TB medications. The indication of rigid bronchoscopy is more than American Thoracic Society (ATS) grade 3 dyspnea in PTTS patients. First, the narrowed airway is dilated by multiple techniques including ballooning, laser resection, and bougienation under general anesthesia. Then, most of the patients need silicone stenting to maintain the patency of dilated airway; 1.5 to 2 years after indwelling, the stent could be removed, this has shown a 70% success rate. Acute complications without mortality develop in less than 10% of patients. Subgroup analysis showed successful removal of the stent was significantly associated with male sex, young age, good baseline lung function and absence of complete one lobe collapse. In conclusion, rigid bronchoscopy could be applied to PTTS patients with acceptable efficacy and tolerable safety.

Biliary Self-Expandable Metal Stent Could Be Recommended as a First Treatment Modality for Immediate Refractory Post-Endoscopic Retrograde Cholangiopancreatography Bleeding

  • Sun Young Moon;Jun Heo;Min Kyu Jung;Chang Min Cho
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.128-135
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    • 2022
  • Background/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaining hemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. We compared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding. Methods: Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediate ERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding, change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis. Results: A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusions were needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued by angioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9-491) min. Conclusions: Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMS insertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has a role as rescue therapy when SEMS does not work effectively.

척수 손상 환자에 관한 실태 조사 (A Study of the Evaluation of the Spinal Cord Injuries)

  • 김명훈
    • 대한물리치료과학회지
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    • 제3권2호
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    • pp.1011-1019
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    • 1996
  • The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

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Effects of the Combination of Glucose, Chromium Picolinate, and Vitamin C on Lipid Metabolism in Steers

  • Lee, Hong-Gu;Yin, Jin-Long;Xu, Cheng-Xiong;Hong, Zhong-Shan;Lee, Zhe-Hu;Jin, Yong-Cheng;Choi, Chang-Weon;Lee, Do-Hyeung;Kim, Kyoung-Hoon;Choi, Yun-Jaie
    • Asian-Australasian Journal of Animal Sciences
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    • 제24권12호
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    • pp.1674-1680
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    • 2011
  • This study was conducted to examine the effects of glucose, chromium picolinate (CrP), and vitamin C (Vit C) on lipid metabolism in Korean native steers fitted with indwelling catheters. A total of 12 Korean native steers were randomly allocated to the following treatments: 1) normal control diet, 2) same as 1) +250 g of glucose by intravenous (IV) infusion, 3) same as 2)+13.5 g CrP administered orally, and 4) same as 3)+2.52 g Vit C by IV infusion. Glucose, Vit C, and CrP treatments were administered for five days. At days 1 and 3, serum insulin was higher in treated animals than in those fed the control diet (p<0.05). Serum non-esterified fatty acid (NEFA) concentration in the steers on treatment 2), control+13.5 g CrP, was lower than those on other treatments at 90 min post-infusion on days 1 and 3 (p<0.05). The expression of peroxisome proliferator-activated receptor-${\gamma}$ (PPAR${\gamma}$)2, stearoyl-CoA desaturase-1 (SCD), fatty acid synthase (FAS), and glucose transporter type 4 (Glut 4) in the longissimus muscle of steers on treatment 2 was higher than those on other treatments. In conclusion, the results suggest that CrP is associated with the regulation of gene expression involved in adipogenesis.

기본간호실습교육의 발전을 위한 일 연구 -일 지역의 3년제 간호대학을 중심으로- (A Study for the Development of the Fundamental Nursing Practice Education -Focused on A Nursing College -)

  • 제미순
    • 기본간호학회지
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    • 제6권2호
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    • pp.331-346
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    • 1999
  • Many studies have reported that a lot of nursing colleges do not have good facilities for the nursing practice in hospitals, so many students do not have the good ability which is needed to be a competent nurse. The purpose of this study was to develop a program in which students could improve their ability in fundamental nursing skills before the graduation. This study was primarily designed to identify items of the fundamental nursing practice in which nursing college students have perceived deficiencies. According to previous studies, a total 75 items were presented. In Identifying them, a modified Porter format was used. The questionnaire contained three sections. A. How well do you think you can/could perform the item when you graduate/graduated the college? B. How well do you think you should perform/should be able to perform the item when you graduate/graduated the college? C. How important do you think the item is? For each of the 75 items, the respondents were instructed to answer the above three questions, by circling a number on a rating scale extending from 1 to 5, where low numbers represented a low degree of performance or minimum amount, and high numbers represented a high degree of performance or maximum amount. The perceived degree of deficiency in performance on each questionnaire item was obtained by subtracting the answer to Part A of an item from that to of Part B. The larger difference means a larger perceived degree of deficiency in performance. This method of measuring the perceived degree of deficiency in performance is an indirect measure derived from two direct answers by the respondent for each item. From this result Part C of each item was used to rank the items, and the items were prioritized. The items which had the highest priority were IV injection, simple catheterization, indwelling catheterization, CPR, and nurse recording. By this method, through these results from a nursing college, and the items which will be used first in developing the supplementation program for nursing college students can be identified.

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Biological effects of dietary probiotics on blood characteristics in Hanwoo heifers subjected to lipopolysaccharide (LPS) challenge

  • Park, Bo Hye;Kim, Ui Hyung;Jang, Sun Sik;Yang, Seung Hak;Lee, Eun Mi;Kang, Dong Hun;Kwon, Eung Gi;Chung, Ki Yong
    • 농업과학연구
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    • 제43권5호
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    • pp.818-827
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    • 2016
  • This study hypothesized that dietary feed additive containing probiotics alter either immune-related serum substances or serum metabolites in Hanwoo heifers. A probiotic treatment was given at 0.5% top-dressing of concentrate diet for 6 months. The change of immunological indicators in the blood was analyzed under LPS (Lipopolysaccharide) challenge. One day before administration of LPS, all heifers were fitted with an indwelling jugular vein catheter for serial blood collections. Both a serum tube and an EDTA-coated tube were collected at 30-min intervals from - 2 to 8 hours relative to the LPS challenge at time 0 ($1{\mu}g/kg$ of BW). Serum was used for analyzing albumin (ALB), glucose (GLU), total protein (TP), triglycerides (TG), phosphorus (IP), and non-esterified fatty acids (NEFA). Plasma was used for analyzing white blood cell (WBC), red blood cell (RBC), platelet (PLT) and inflammation-related factors (NE, LY, MO, EO, BA, Hb, HCT, MCV, MCH, MCHC, RDW, MPV). There were significant differences in ALB, GLU, TG, IP, and NEFA concentration with the passage of hours post challenge (p < 0.05). The level of ALB, GLU, TG, and IP showed significant difference (p < 0.05) between treatments. However, none of the data showed interaction between time and treatments (p > 0.05). The level of WBC, EO, LY, and MO were reduced after LPS challenge (p > 0.05). In conclusion, LPS challenge after dietary supplementation of probiotics changed the levels of both serum metabolites and inflammation-related factors. The increase of GLU and TG indicated a probiotics-positive response under LPS challenge (p < 0.05).

개에서 발생한 이소성 요관의 외과적 교정 (Surgical Correction of Ectopic Ureter in Dogs)

  • 최성진;이기자;강은희;장세웅;황의희;정인성;김남수
    • 한국임상수의학회지
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    • 제31권2호
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    • pp.137-140
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    • 2014
  • 말티즈(증례1)와 라브라도 레트리버(증례2)가 요실금 증상으로 내원하였다. 전신상태는 양호하였으며, 혈액혈청검사 및 방사선검사상에서 이상소견은 나타나지 않았다. 증례 1에서는 투시검사, 증례2에서는 컴퓨터 단층촬영을 통해 배설 요로조영검사를 실시하였다. 증례1은 우측 강외성 이소성 요관으로, 증례2는 양측성 강내성 이소성 요관으로 진단되었다. 각각의 증례는 neoureterocytostomy (증례1)와 neoureterostomy (증례2)를 실시하였다. 술후, 3일동안 요관 카테터를 장착하였다. 술후 요실금 증상은 개선되었으며, 다른 임상증상은 나타나지 않았다. 개의 이소성 요관 형태에 따른 적절한 수술법을 통해 이소성 요관을 효과적으로 치료할 수 있었다.

경막외 카테터의 고정방법과 수술후 카테터의 위치 변화와의 관계 (The Relationships between the Methods of the Epidural Catheter Fixation and the Postoperative Position Change of the Catheter)

  • 신우종;염종훈;김희수;김용철;이동호;김경헌;심재철;황정혜
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.64-68
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    • 1997
  • Background : Patients mover more as their post operative pain decrease. With the increase in movement there will be a tendency for the epidural catheter to migrate out of its original position. We studied 2 methods of fixation of the epidural catheter and the changes in position as related to patient movement. Methods : Patients were divided into two groups. Patients in Group A had their epidural catheter formed with a circular loop at the (skin) exit site then directed over the right shoulder. Group B had the epidural catheter flxed with Fixomull on the exit site without forming a circular loop. At the end of the operation, 3 mg of epidural morphine was injected via indwelling epidural catheter for postoperative pain control. Epidural catheter depth was measured 24 hours later. Results : The overall rate of migration of epidural catheter was 61.9%. In Group A, number of patients whose catheter migrated over 0.5 cm was 23(69.9%) with 14 inward migration and 9 outward migration. Group B had 16(53%) patients catheters migrate over 0.5 cm, with 2 patients having inward migration and 14 outward migration. Conclusions : Although the rates of migration of epidural catheter were similar for both groups, the number of inner migration of catheter, which could result serious complications, was significantly lower in Group B than Group A. Based on our results we recommend the epidural catheter be fixed without a circular loop.

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Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction

  • Lee, Seung-Hoon;Kong, Doo-Sik;Seol, Ho-Joon;Shin, Hyung-Jin
    • Journal of Korean Neurosurgical Society
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    • 제49권4호
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    • pp.217-221
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    • 2011
  • Objective : This paper presents data from a retrospective study of endoscopic third ventriculostomy (ETV) in patients with shunt malfunction and proposes a simple and reasonable post-operative protocol that can detect ETV failure. Methods : We enrolled 19 consecutive hydrocephalus patients (11 male and 8 female) who were treated with ETV between April 2001 and July 2010 after failure of previously placed shunts. We evaluated for correlations between the success rate of ETV and the following parameters : age at the time of surgery, etiology of hydrocephalus, number of shunt revisions, interval between the initial diagnosis of hydrocephalus or the last shunt placement and ETV, and the indwelling time of external ventricular drainage. Results : At the time of ETV after shunt failure, 14 of the 19 patients were in the pediatric age group and 5 were adults, with ages ranging from 14 months to 42 years (median age, 12 years). The patients had initially been diagnosed with hydrocephalus between the ages of 1 month 24 days and 32 years (median age, 6 years 3 months). The etiology of hydrocephalus was neoplasm in 7 patients; infection in 5; malformation, such as aqueductal stenosis or megacisterna magna in 3; trauma in 1; and unknown in 3. The overall success rate during the median follow-up duration of 1.4 years (9 days to 8.7 years) after secondary ETV was 68.4%. None of the possible contributing factors for successful ETV, including age (p=0.97) and the etiology of hydrocephalus (p=0.79), were statistically correlated with outcomes in our series. Conclusion: The use of ETV in patients with shunt malfunction resulted in shunt independence in 68.4% of cases. Age, etiology of hydrocephalus, and other contributing factors were not statistically correlated with ETV success. External ventricular drainage management during the immediate post-ETV period is a good means of detecting ETV failure.