The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).
Tension pneumocephalus may follow a cerebrospinal fluid(CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.
Journal of Korean Society for Atmospheric Environment
/
v.12
no.3
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pp.315-322
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1996
Recently, hospital acquired infections have an increase interest as a public problems, which are caused of indoor pollutants in hospital. Microorganisms, ethylene oxide, formaldehyde, and anesthetic gases are main hazardous pollutants in hospital. The possible pathways of the infection are a respiratory channel as well as a blood channel. The blood channel is concerned since these pollutants might be dissolved into the Ringer's solution. The objective of this research was to evaluate the removal efficiencies of adsorption trap for formaldehyde and microorganisms as indoor pollutants which permeated into the Ringer's solution. Dissolved formaldehyde in the solution was increased with the injection dose time. The amount of dissolved formaldehyde was 67.5 $\pm$ 9.5% in Ringer's solution when injection dose time was controlled about 7hrs. An adsorption trap was designed for preventing formaldehyde and microorganisms to be permeated into Ringer's solution. The adsorption trap was packed with 0.4g of active carbon (60/80 mesh) in a sterilized plastic tube (7.79 cm length, 0.46 cm i.d.) and both ends were packed with glass wool. Devised infusion set equipped with the adsorption trap showed 99.9% of removal efficiency for formaldehyde. Microorganism numbers detected on sterilized water for injection and 5% dextrose infusion used in the hospital were 2,695 $\times 10^3$ cells/l and 4,190 $\times 10^3$ cells/l, respectively. Removal efficiency by the adsorption trap was 92.3 $\pm$ 8.5% as for microorgnisms.
Pentastarch is a hydroxyethyl starch similar to hetastarch, but lower average molecular weight and fewer hydroxyethyl groups which result in enhanced enzymatic hydrolysis and faster renal elimination.This report was performed to compare the clinical efficacy and safety of 10 % pentastarch[Pentaspan , group I] for plasma volume expansion after open heart surgery with that of 5% albumin[Plasmanate, group II]. There were no statistically significant differences between the group I [n=18] and group II [n:19] in the preoperative parameters [age, sex, body weight] and operative parameters[bypass time, aorta cross clamping time]. During the first 24 hours after arrival of the patient in the surgical intensive care unit, colloid solution [500--1000 ml] was infused to maintain left atrial pressure of more than 8 mmHg, or cardiac index of 2.0 L/min/M2 of more. In results, there were 3 complications of hypotension immediately after infusion of 5 % albumin solution and 2 among the 3 patients were excluded for the study. However there was no complication after infusion of 10 % pentastarch solution. Hemodynamic responses to infusion was similar for both groups, although in group I a greater increase in both left atrial pressure[mean 1.8 versus 0.7 mmHg, p< 0.05] and right atrial pressure [mean 2.2 versus 1.7 mmHg, p < 0.05] was observed during infusion of the first 500 ml. There were no significant differences in any of the measured respiratory parameters[PaO2, intrapulmonary shunt, and effective lung compliance]. Homodilution with colloid significantly reduced hemoglobin [mean 1.2 versus 0.8 gm/dl], and serum protein and albumin level[total protein;4.8$\pm$ 0.5 versus 5.2 $\pm$0.5 gm/dl, p < 0.05: albumin: 3.2 $\pm$0.4 versus 3.6 $\pm$0.6 gm/dl, p < 0.05] by 6:00 AM on 1 day postoperatively, however there were no significant differences on 7 day postoperatively. The mean serum colloid osmotic pressure and osmolarity was similar in both group.There were no abnormal findings of liver function and kidney function in all the patients. There were no significant between-group differences in bleeding time, platelets, prothrombin time, activated partial thromboplastin time and amount of chest tube output measured on 1st and 7th postoperative day. These findings demonstrated that 10% pentastarch is more effective and safe for plasma volume expension than 5 % albumin solution with no adverse effects on coagulation. Also 10 % pentastarch is less expensive than 5 % albumin and it would appeare to be a reasonable first choice for plasma volume expansion.
Journal of the Korea institute for structural maintenance and inspection
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v.22
no.2
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pp.68-75
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2018
In this study, to solve the problems of the conventional crack repair and injection method, high elasticity latex was used as the material of the storage tube to withstand the high pressure in the center part differently from the general port. When the repair solution was injected into the crack part, The TPS method was developed so that the air existing in the TPS can be discharged. In addition, a new infusion port in which a valve blocking the backflow of the remediation solution was installed at the injection port was developed and the physical characteristics of the port were analyzed. As a result of the evaluation, it was found that the filling rate of the remedial solution was improved compared to the existing ordinary injector method, and the cracks were completely filled in the test conditions. Compressive strength and tensile strength after repair showed about 20% decrease after repair in case of using ordinary injector method, while TPS method showed about 2~7% increase after repair. The results of this study showed that the injection port method using the elastic storage tube increased the injection performance and the quality after repair compared to the conventional injector method. The result of this study is expected to be utilized as the basic data for application and commercialization of the result to the practical structure.
Respiration is one of the most important functions which are carried out in stomatognathic system. When nasal orifice is obstructed or the resistance of upper airway is increased mouth breathing is initiated. Mouth breathing is regarded as an important etiologic factor of dentofacial anomalies. This experiment was performed to observe the influences of metabolic acidosis, tracheal resistance and vagotomy on mouth breathing. After rabbits were anesthetized with sodium pentobarbital, a pair of wire electrode was inserted into mylohyoid muscle, anterior belly of digastric muscle and dilator naris muscle to record EMG activity. Femoral vein and artery were cannulated for infusion of 0.3N HCl and collection of blood sample to determine the blood pH, and tracheal intubation was done to control airway resistance. Mouth breathing was induced by metabolic acidosis. Increase of the airway resistance through tracheal cannula intensified the activity of dilator naris, mylohyoid and digastric muscle. The higher the resistance, the larger the EMG amplitude. After bilateral vagotomy, respiratory volume and inspiatory time were increased and the activities of dilator naris, mylohyoid and digastric muscle were strengthened. It was concluded that the muscle activity related to mouth breathing was induced by metabolic acidosis and increase of tracheal tube resistance.
During the last 10 years of period, one hundred patients with various pulmonary diseases were pneumonectomized upon at the Department of Chest Surgery of Pusan University Hospital. This paper is concerned with the clnical results of these patients along with the serious postoperative complications such as postoperative intrapleural infection and hemorrhage. The results were obtained as follows. 1.Left pneumonectomy was done in sixty-six of 100 patients [66 %] and the right one was done in the rest thirty-four[34 %]. The ratio between left and right was nearly 2:1. 2.Of all oostoperative complications, the intrapleural infection was most common, and these were 53 % in empyema thoracis and 12.7 % in pulmonary tuberculosis respectively. 3.More postoperative complications could be seen after right pneumonectomy than the left one. 4.It was thought that the postoperative intrapleural infection was closely correlated with the methods of pleural dissection at pneumonectomy,postoperatlve tube drainage, time of operation, massive hemorrhage during operation, prolongation of bleeding time, and dysfunction of the liver. 5.The repeated thoracenteses with infusion of neomycin into the infected thoracic cavity and intravenous administrations of the high units of penicillin were effective in treatment of the postoperative intrapleural infection, however, the refractory cases have to be cured by thoracoplasty with open window. 6.Immediate secondary open thoracotomy appears to be the method of choice in life saving who developed massive intrathoracic hemorrhage after pneumonectomy. 7.The mortality rate was 10 % in our cases and the main causes of death were postoperative respiratory insufficiency, pulmonary edema, hemorrhage and sudden cardiac arrest.
Journal of The Korean Dental Society of Anesthesiology
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v.10
no.2
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pp.190-196
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2010
Difficult airway management including difficult intubation, difficult ventilation and difficult mask ventilation is a life threatening issue during anesthesia care. A 23-year-old woman with Treacher Collins syndrome was scheduled for distraction osteogenesis. She had hypoplasia of mandible and malar bone, bilateral deformities of auricles with partial deafness and antimongoloid slant of the palpebral fissures. A 56-year-old woman with mandibular hypoplasia due to childhood trauma was scheduled for distraction osteogenesis. She had a history of difficult intubation. We anticipated a difficult intubation and ventilation. Fiberoptic bronchoscopic guided awake intubation was selected for anesthesia induction. After intravenous injection of midazolam and remifentanil, 10% lidocaine pump spray on the pharyngolarynx with a direct laryngoscope and on the nasal canal. However fiberoptic bronchoscopic guided awake intubation was failed due to severe gag reflex. After intravenous injection of propofol and remifentanil using the target controlled infusion (TCI), mask ventilation was easily performed and, after intravenous injection of vecuronium, fiberoptic bronchoscopic guided intubation was easily performed using a wire reinforced endotracheal tube. The operation was completed successfully without any adverse events.
Journal of the Korean Society of Manufacturing Technology Engineers
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v.21
no.1
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pp.161-166
/
2012
Intravenous (IV) injection is widely used to supply Ringer solution directly into a vein in hospital. Generally, a passive injection method has been used, which causes the inconsistent flow rate of fluid and inappropriate control of injection time by a patient. It leads to an unnecessary nurse's overwork and decrement of IV injection's effect. To solve these problems, flow control infusion pumps have been developed. But because of relatively heavy weight and high price, its usage has been limited. In the present study, a new automatic IV injection system is developed. It is installed with a small pressing mechanism driven by a small electric motor to regulate the flow rate by pressing tube. Proportional integral derivative (PID) feedback control algorithm is applied to control the electric motor. The system is smaller in size and uses lower power than the existing commercial product. The newly developed system is also installed with networking capability, which enables monitoring the status of several automatic IV injection system at the same time.
Four pluriparous Korean black goat does were superovulated with FSH and mated with fertile bucks. Anesthetized animals were placed in lateral recumbency, then size 8 Foley catheter was inserted into the uterus through the cervix under the vaginal speculum and the balloon was inflated to fix the catheter in the uterine body. The opposite end of the catheter was connected to a 3-way and a flushing medium was infused into the uterus. Modified Dubecco's PBS with 1% FBS was used as the flushing medium. Four goats were allocated in two groups depending on the type of medium infusion into uterus. Injection group; the flushing medium was injected into uterus and the infused medium was collected by to-and-fro method using a syringe. Gravity-flow group; the flushing medium was allowed to enter the uterus by gravity flow by lifting the medium bottle and drained out of the uterus into a collecting tube. All four goats had catheter inserted through the cervix and uteri flushed successfully. The volume (recovery rate) of recovered medium varied considerably from 87 ml/200 ml (43.5%) to 148 ml/160 ml (92.5%). Nine embryos/ova in total were recovered from Gravity-flow group goats. Although the embryo recovery rate was low, the possibility of a transcervical embryo recovery in Korean black goat had been proven in this preliminary experiment.
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