• Title/Summary/Keyword: Long-term care Hospital

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Sacrococcygeal Teratoma : A Tumor at the Center of Embryogenesis

  • Phi, Ji Hoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.3
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    • pp.406-413
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    • 2021
  • Sacrococcygeal teratoma (SCT) is an extragonadal germ cell tumor (GCT) that develops in the fetal and neonatal periods. SCT is a type I GCT in which only teratoma and yolk sac tumors arise from extragonadal sites. SCT is the most common type I GCT and is believed to originate through epigenetic reprogramming of early primordial germ cells migrating from the yolk sac to the gonadal ridges. Fetal SCT diagnosed in utero presents many obstetrical problems. For high-risk fetuses, fetal interventions (devascularization and debulking) are under development. Most patients with SCT are operated on after birth. Complete surgical resection is the key for tumor control, and the anatomical location of the tumor determines the surgical approaches. Incomplete resection and malignant histology are risk factors for recurrence. Approximately 10-15% of patients have a tumor recurrence, which is frequently of malignant histology. Long-term surveillance with monitoring of serum alpha fetoprotein and magnetic resonance imaging is required. Survivors of SCT may suffer anorectal, urological, and sexual sequelae later in their life, and comprehensive evaluation and care are required.

Medical Complications of Lung Transplantation

  • Park, Moo Suk
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.338-356
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    • 2022
  • Lung transplantation (LT) is now considered as an effective treatment option for end-stage lung diseases that improves the short and long-term survival rates and quality of life. As increasingly many LT procedures are being performed, the medical complications of LT are also increasing in frequency and emerging as a very important issue for transplant clinicians. Although chronic lung allograft dysfunction and infection are major causes of death after LT, many medical complications, several of which result from immunosuppressive treatment, contribute to increased mortality and morbidity. This article reviews the most frequent and important medical complications of LT, accompanied by a review of the literature and studies from South Korea, including lung allograft rejection, infection, and non-allograft organ systemic complications.

Exacerbation Prevention and Management of Bronchiectasis

  • Joon Young Choi
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.183-195
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    • 2023
  • Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. Despite its increasing prevalence and clinical significance, bronchiectasis was previously regarded as an orphan disease, and ideal treatment of this disease has been poorly understood. The European Respiratory Society and British Thoracic Society have recently published guidelines to assist physicians in the clinical field. Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. In this review, we summarize recent updates on bronchiectasis treatment to prevent exacerbation and manage clinical deterioration.

Comparison of Infection between Internal-External and External Percutaneous Transhepatic Biliary Drainage in Treating Patients with Malignant Obstructive Jaundice

  • Xu, Chuan;Huang, Xin-En;Wang, Shu-Xiang;Lv, Peng-Hua;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2543-2546
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    • 2015
  • Purpose: Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patients with malignant obstructive jaundice. We here compared the infection incidence between internal-external and external drainage for patients with malignant obstructive jaundice. Methods: Patients with malignant obstructive jaundice without infection before surgery receiving internal-external or external drainage from January 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), if the guide wire could pass through the occlusion and enter the duodenum, we recommended internal-external drainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients with infection after procedure received a cultivation of blood and a bile bacteriological test. Results: Among 110 patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure in the internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainage group, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infection was controlled, as compared to 12 (63.1%) in the external group (p< 0.05). The mortality rate for patients with infection not controlled in internal-external group in one month was 42.8%, while this rate in external group was 28.6% (p< 0.05). Conclusion: External drainage is a good choice, which could significantly reduce the chance of biliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-term prognosis.

Effect of Education on Infection Control for Multidrug Resistant Organism on Infection Control by NICU Nurses (다제내성균 감염관리 교육이 신생아 중환자실 간호사의 감염관리에 미치는 영향)

  • Lim, Jihee;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.22 no.3
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    • pp.172-181
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    • 2016
  • Purpose: This study was conducted to examine the effect of education on infection control for multidrug resistant organism (MDRO). Methods: One group pre-post time series design was used. Infection control education for MDRO infection was provided to nurses working in the Neonatal Intensive Care Unit (NICU). Knowledge and recognition were evaluated before and after education. Hand hygiene compliance, MDRO isolation rate and central line-associated bloodstream infection (CLABSI) rate were used as outcome variables. Data from 45 nurses was used for analysis. Results: General knowledge about MDRO increased (p=.011). Responses to questions about image of MDRO and MDRO management tended to change in a positive direction (p=.046). Hand hygiene compliance was 100% at pre-test, 79.5% during education period and 98.4% at post-education period. MDRO isolation rate was 6.83 per 1,000 patient days at pre-test, 10.24 during education period and 6.68 at post-education period. CLABSI rate was 3.76 per 1,000 central line days at pre-test, 6.84 during education period and 4.71 at post-education period. Conclusion: Findings indicate that the education program is effective in improving knowledge about MDRO in NICU nurses. However, more reliable indicators should be used to determine long-term effects.

A Study on Research Trends of Age-Friendly Using Text Network Analysis : Focusing on 「The Korean Journal of Health Service Management」 (2007-2018) (텍스트 네트워크 분석을 활용한 고령친화 분야의 연구동향 분석 : 「보건의료산업학회지」 게재논문(2007~2018)을 중심으로)

  • Ko, Min-Seok
    • The Korean Journal of Health Service Management
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    • v.13 no.4
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    • pp.19-31
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    • 2019
  • Objectives: The purpose of this study was to analyze research trends in age-friendly research and suggest directions for future research. Methods: For this study, 112 articles related to age-friendly research were selected, from 605 published articles in The Korean Journal of Health Service Management (2007-2018). Content analysis and text network analysis were conducted using SPSS 23.0 and NetMiner 4. Results: First, 2 authors (30.4%) and 4 keywords (45.5%) were the most studied. Most of the studies used quantitative research (93.8%). Primary data (61.9%) and SPSS (77.7%) were the most used for analysis. Second, there were seven common keywords in the top 10 in all the centralities. They were Elderly, Geriatric Hospital, Depression, Care Workers, Long-Term Care Facilities, Experience, and Attitude. Conclusions: This study shows the need for diversity of research topics, subjects, research methods, and analytical tools in future age-friendly related studies. In addition, it suggests activating convergence research in this field linked to various industries and services.

Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy (전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고)

  • Mok, Seo-Hee;Lee, Ji-Won;Lee, Tae-Jong;Seo, Jung-Bok;Kim, Kyoung-Ah;Kim, Joe-Young;Park, Byung-Jun;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.71-80
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    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.

A study on perception of stress and coping patterns of family members of the hospitalized in patients (가족구성원의 입원으로 인한 가족의 스트레스와 대처방안에 관한 연구)

  • Kwon Eun-Ok
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.35-52
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    • 1991
  • The purpose of this study was to assess the degree of stress and patterns of coping for that Stressful events on family members because of the hospitalization of the patients. Stress and coping were measured with a tool on the basis of Volicer and Bell's questionnaire. In data collection, the modified 38 items of Volicer's stress scale and Bell's 18 item coping scale were administered. The subjects consisted of 259 family members of general ward-patients in Seoul National University Hospital during April in 1990. They were randomly selected on the basis of relationship of patients; patient's spouse, patient's daughters or sons. The stressors of the family members were ranked as follows; The first rank Stressful events was related to the patient's diseases and pain, the second ones was related ·to caring of their patients and family's psychosocial life. Families used long term coping method significantly more than short term ones. The results indicated that there was no difference in use of coping method between pre and post hospitalization. Finding out more about situation and optimism were the most common coping methods, and the least frequent coping method was the use of drugs. In conclusion, the identification of perceived stress and coping patterns of family members provides useful information for family nursing and aimes at better nursing care for the hospitalized in patients.

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Successful management of absent sternum in an infant using porcine acellular dermal matrix

  • Semlacher, Roy Alfred;Nuri, Muhammand A.K.
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.470-474
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    • 2019
  • Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

Prevalence, Awareness, Control, and Treatment of Hypertension and Diabetes in Korean Cancer Survivors: A Cross-Sectional Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

  • Choi, Kyung-Hyun;Park, Sang Min;Lee, Kiheon;Kim, Kyae Hyung;Park, Joo-Sung;Han, Seong Ho
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7685-7692
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    • 2013
  • Background: Management of hypertension and diabetes in cancer survivors is an important issue; however, not much is known about the level of management of such chronic disease in Korea. This study therefore assessed the prevalence, awareness, control, and treatment of hypertension and diabetes in Korean cancer survivors compared to non-cancer survivors. Materials and Methods: A cross-sectional design was employed, wherein data were obtained from standardized questionnaires completed by 943 cancer survivors and 41,233 non-cancer survivors who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2007-2011). We calculated adjusted proportions for prevalence and management of hypertension and diabetes in non-cancer survivors and cancer survivors. We also assessed the associated factors with prevalence and management of cancer survivors. Results: Cancer survivors are more likely than the general population to have higher prevalence, awareness, treatment, and control of hypertension. However, diabetic management was not significantly higher in cancer survivors than in non-cancer survivors, despite their having a higher prevalence. Several factors, such as, age, drinking, years since cancer diagnosis, self-perceived health status, and specific cancer types were found to affect to management of hypertension and diabetes. Conclusions: These data suggest that cancer survivors appear to be better than non-cancer survivors at management of hypertension, but not diabetes. There is a need for healthcare providers to recognize the importance of long-term chronic disease management for cancer survivors and for the care model to be shared between primary care physicians and oncologists.