• Title/Summary/Keyword: Long-Term care

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Study of Efficiency of the East-west Medical Combined Treatment of Advanced Gastric Cancer in Patients Case (진행성 위암 환자 증례를 통한 한양방 병용치료의 효용성 연구)

  • Lee Nam-Heon;Shim Jae-Chul;Chae Eun-Yeong;Yoo Hwa-Seung;Cho Jung-Hyo;Lee Yeon-Weol;Son Chang-Kyu;Cho Chong-Kwan;Yun Dam-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.6
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    • pp.1681-1684
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    • 2005
  • Gastric cancer is the most common disease which is the highest genetic rate, chemotherapy is the only known way to treat, especially advanced gastric cancer. Although, it is the remedy, the harmful side-effects are an obstacle of the sustaining treatment and negative effect on immunologic ability of patients prologed. Consequently, it is surely necessary that effective control for sequele of anti-cancer treatment, and remedy which can improve the quality of patients life. 1, the writer, medicate patients, diagnose as gastric cancer in 4th stage, with Sohap-hyangwon and Chungwoolhyadamjen who complained of pain in sequele of anti-cancer treatment. The size of the metastastic liver tumor is decreasing in patients and the immunologic abilities are maintaining stable. This clinical cases are shown that the oriental medical care in long-term can improve the quality of life of the patients who has sequele of anti-cancer treatment.

A Study on the Shape and Color Analysis of the Symbols of Nursing Hospitals in Korea (국내 요양병원 심벌마크의 형태 및 색채 분석 연구)

  • Son, Jeong-Eun;Jung, Eui-Tay;Lee, Hana;Paik, Jin-Kyung
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.113-120
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    • 2019
  • South Korea is an aging society with 10.9 percent of its population over 65 years of age, and the aging population naturally leads to a surge in elderly care costs. Compared to general hospitals and other hospitals that have systematic management strategies in an environment of intensifying hospital competition, the design and management strategies of nursing hospitals are insufficient due to the hospital's characteristics of long-term hospital admission and treatment. In this study, We conducted a symbol mark color and form analysis of nursing hospitals to establish a design strategy to meet the increasing demand on nursing hospitals. The subjects of the study were 131 hospitals that received the first grade of nursing hospitals in Korea, and each symbol mark was collected to analyze its form and color. Analysis of the form of symbol revealed that the most anthropogenic symbols were made with artificial objects, and among them, the number of symbols with crosses, hearts and human forms were higher. The color analysis showed that more than 50% of symbols consisted of two colors and the main colors were blue and green. It is expected that this research data will be used as a reference in the design of the symbolism of nursing hospitals, which will help consumers choose and develop strategies for hospital management in order to compete with the ever-increasing demand of nursing hospitals and hospital competition.

Effects of Nursing Intervention of Mutual Goal Setting on Gastrectomy Patients According to Health Locus of Control (위절제술환자의 건강통제위에 따른 상호목표설정 간호중재의 효과)

  • Jang Eun-Hee
    • 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.

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The Study on Identifying the Components of Community Pharmacy Externship Based on Korean Community Pharmacists' Consensus (약학교과과정의 개국약국실습 방향에 관한 연구)

  • Kim, Sung Hyun;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.2
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    • pp.109-118
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    • 1999
  • The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

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Effects of Community-based Case Management Program for Clients with Hypertension (고혈압 대상자의 지역사회 중심 사례관리 프로그램 효과)

  • So, Ae-Young;Kim, Yun-Mi;Kim, Eun-Young;Kim, Chang-Yup;Kim, Cheol-Hwan;Kim, Hee-Gerl;Shin, Eun-Young;Yoo, Weon-Seob;Yi, Ggod-Me;June, Kyung-Ja
    • Journal of Korean Academy of Nursing
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    • v.38 no.6
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    • pp.822-830
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    • 2008
  • Purpose: The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community. Methods: The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence. Results: Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months. Conclusion: The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

Dental Treatment of a Patient with Cerebral Palsy under General Anesthesia (뇌성마비 환자의 전신마취 하 치과치료)

  • Chung, Jun-Min;Seo, Kwang-Suk;Yi, Young-Eun;Han, Hee-Jung;Han, Jin-Hee;Kim, Hye-Jung;Shin, Teo-Jeon;Kim, Hyun-Jeong;Yum, Kwang-Won;Chang, Ju-He
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.1
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    • pp.22-28
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    • 2008
  • Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

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Effects of the Duration of Highly Intensive Exercise on Lymphocyte Cell Death in Rats (고강도운동 지속시간이 rat의 림프구 세포사에 미치는 영향)

  • Kim, Hyeong-Soo;Hyun, Kyung-Yae
    • Journal of Life Science
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    • v.22 no.3
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    • pp.312-317
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    • 2012
  • The time-dependent effects of highly intensive exercise on the hematological properties of leukocytes, as well as $CD4^+$ and $CD8^+$ level changes as T-lymphocyte activation subsets and the cell death of lymphocytes in rats were studied in this research. Twenty, 60, and 120 min of highly intensive exercise was performed daily for 8 weeks. Total leukocyte counts in the blood of rats exercising for 20 min were elevated; they then decreased to less than the level of the control group up to 120 min. The patterns of lymphocyte level changes were directly influenced by exercise duration and the extents of alteration were similar to the total leukocytes counts. The levels of $CD4^+$ and $CD8^+$ in the blood of the exercising rats were not statistically different even when the exercise was continued for 120 min; thus, the exercise did not affect T-lymphocyte activation. Early- and late-stage lymphocyte apoptosis was not affected by the length of exercise, except that late-phase apoptosis was slightly increased at 120 min, suggesting that aging processes for lymphocyte apoptosis might be stimulated at that time. As the exercise time became longer, stimulated necrosis of lymphocytes was observed, so damage in lymphocytes and a potential loss of immunity might be presumed. The current observation suggests that long-term, highly intensive exercise might result in a loss of immunity that could be due to the damage of lymphocytes in terms of both their numbers and inflammation-related functions. The results suggest that under highly intensive exercise conditions, more than 20 min of exercise should not be suggested for health care purposes.

High Prevalence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Infection in Thailand

  • Wanich, Nattawat;Vilaichone, Ratha-Korn;Chotivitayatarakorn, Peranart;Siramolpiwat, Sith
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2857-2860
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    • 2016
  • Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.

A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device (스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Yerim;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

Percutaneous Endoscopic Gastrostomy Tube Insertion-induced Superior Mesenteric Artery Injury Treated with Angiography (경피 내시경하 위루술 후 발생한 상장간막 동맥 손상 1예)

  • Lee, Seo Hee;Moon, Hee Seok;Park, Jae Ho;Kim, Ju Seok;Kang, Sun Hyung;Lee, Eaum Seok;Kim, Seok Hyun;Sung, Jae Kyu;Lee, Byung Seok;Jeong, Hyun Yong
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.308-312
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    • 2018
  • Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition. However, during the insertion procedure, needle puncture had to be attempted twice before successful PEG tube placement was achieved, and a day after the procedure his hemoglobin had fallen and he developed hypotension. Abdominal computed tomography revealed injury to a pancreatic branch of the superior mesenteric artery (SMA) associated with bleeding, hemoperitoneum, and pancreatitis. Transarterial embolization was performed using a microcatheter to treat hemorrhage from the injured branch of the SMA, and the acute pancreatitis was treated using antibiotics and supportive care. The patient was discharged after an uneventful recovery. Clinicians should be mindful of possible pancreatic injury and bleeding after PEG tube insertion. Possible complications, such as visceral injuries or bleeding, should be considered in patients requiring multiple puncture attempts during a PEG procedure.