• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.194-198
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• 2009

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7627-7632
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• 2015

Background: The present study was conducted to evaluate the technical feasibility, safety and adequacy of surgical margins with salvage transoral robotic surgery (TORS) for recurrent or residual head and neck squamous cell carcinoma patients. Materials and Methods: Thirty patients who underwent salvage TORS using the 'DaVinci' robot were enrolled in the study and data related to their surgical time, complications and functional outcome were recorded. Results: The feasibility of salvage TORS in our study was observed to be 100%. Positive margins were encountered in only 6.7% of patients. Mean blood loss was 23.3 ml with no patient requiring blood transfusion. Postoperative complications in the form of primary haemorrhage requiring active surgical intervention occurred in 13.3%. Oral feeding could be started as early as the 3rd postoperative day in a few patients, with nasogastric tubes being removed on the 12th postoperative day. Long term gastrostomy tube dependency was seen in 10% cases. Median survival of patients was 19 months. Conclusions: Salvage TORS is a safe, effective and feasible option in the management of treatment failure cases. It offers an alternative surgical approach with unexpected benefits in terms of tracheostomy tube use, Ryle's tube and gastrostomy dependence.

• 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.

• Journal of radiological science and technology
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• v.45 no.4
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• pp.299-304
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• 2022

This study uses the 'S-align' function to present a reference value of the X-ray tube angle for the realization of an image similar to that of the chest PA image during chest AP radiography. This study targeted dummy phantom and used a 17"×17" DR image receptor. The irradiation conditions were 110 kVp, 160 mA, 50 ms, and the distance between the central X-ray and the image receptor was set to 180 cm and 110 cm, respectively. The end of the catheter was placed at the 11th thoracic height to indicate the nasogastric tube. In the case of lung apex length measurement, the mean value of measurement was 30.53±0.47 in PA. T 0°, TCA 5~25°, TCE 5~15° were 21.07±0.29, 27.60±0.21, 34.13±0.44, 39.86±0.31, 45.96±0.61 mm, 54.13±0.37 mm, 16.16±0.46 mm, 9.81±0.35 mm, 2.75±0.30 mm, respectively. For the depth of the catheter end, the average value measured at PA was 6.70±0.31 mm. T 0°, TCA 5~25°, TCE 5~15° were 15.72±0.38 mm, 24.10±0.50 mm, 29.24±0.86 mm, 34.35±0.35 mm, 41.06±1.08 mm, 48.07±0.38 mm, 12.85±0.25 mm, 7.92±0.36 mm, 3.01±0.39 mm, respectively. The length of the lung apex was similar to that of chest PA when the angle of incidence was adjusted from 5° to 10° in the leg direction, and the depth of the catheter tip was most similar when the X-ray tube angle was incident at 10° in the head direction. Therefore, To change the X-ray tube angle according to the purpose of the examination during the chest AP radiography using 'S-align' function is considered necessary.

• Journal of Korean Biological Nursing Science
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• v.13 no.3
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• pp.204-210
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• 2011

Purpose: The purpose of this study was to provide basic data for the guidelines for cleaning the feeding bags by comparing the level of contamination according to cleaning and disinfection methods when feeding tube of Neurosurgery Intensive Care Unit patients. Methods: This study was a true-experimental study, with 48 cases in total. The feeding bag of 48 patients were randomly assigned to detergent cleaning method or disinfectant decontamination method. The period of the experiment was January to July 2008, and enteral nutrition was given within 30 minutes for 2 hours, 4 times a day at 7AM, noon, 5PM, and 9PM for seven days. Feeding bags were cleaned after each feeding according to the assigned cleaning and disinfection method followed by microbial cultures on 4th and 8th day before the 7AM feeding. Results: After three and seven days of feeding and cleaning, the level of contamination was significantly lower when bags were cleaned with disinfectant than cleaning with detergent and tepid water. Conclusion: In cases where feeding bags are reused, for example, intensive care unit and home care settings, study findings indicate that cleaning bags with disinfectant is an effective way to prevent contamination of bags.

• Parasites, Hosts and Diseases
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• v.34 no.2
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• pp.151-154
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• 1996

A 71-year old male patient was admitted in Inha hospital due to right facial palsy, quadriplegia and aphasia. This patient was operated to replace his heart valves 7 years ago and has been treated with Coumarin. an anti-coagulant drug. to prevent the formation of thrombus in the hpart. A number of fly maggots continuoully crawled out from the nasogastric tube set up for supplying a liquid diet and patient's mouth for 2 days until his death in the intensive care unit of hospital. These maggots were about 11.5 mm long on the average and identified as genus Lucilio belonging to family Calliphoridae. The lesion of this myiasis case might be regarded in the castro-intestinal . System of patient. This is the first report of an internal myiasis case in Korea.

• Korean Journal of Head & Neck Oncology
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• v.25 no.1
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• pp.18-23
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• 2009

Objectives : In $CO_2$ laser surgery for supraglottic cancer, neck dissection is generally done in second stage. We investigated simultaneous neck dissection with primary resection could be available in laser supraglottic surgery. Material and Methods : We analyzed 13 patients with supraglottic cancer who were treated with transoral supraglottic laryngectomy and simultaneous neck dissection from 2001 to 2007. Tumor stage, extent of laser surgery, histological results, survival rate, local control rate, complications, and functional results were reviewed. Results : 5-year local control rate, survival rate and disease specific survival rate from the neck was 100%, 69.9%, 100% respectively. Tracheotomy was done in all 13 cases. One patient had a long tracheotomy indwelling (191 days). In the rest of 12 patients average decanulation time was 7.4 days(1-22 days). Nasogastric tube was inserted in 5 cases, and average oral intake was possible in 3.5 days(1-16 days). Average hospital days was 29.7 days. There was no serious complication associated with neck dissection. Conclusion : Simultaneous neck dissection with primary laser resection for supraglottic cancer is oncologic sound and can be performed without significant surgical morbidity.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.3
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• pp.395-403
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• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.1
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• pp.58-62
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• 2004

Acid ingestion can cause not only caustic injury on esophagus and stomach but also fatal outcome through systemic complications. We report the case of a patient who died early after severe caustic injury with strong acid. A 38-year-old man who ingested about 400ml of hydrochloric acid of unknown concentration was transferred to our hospital from a private clinic, in which he was managed with gastric irrigation through a nasogastric tube. He was complaining dyspnea and abdominal pain. Physical examination demonstrated tenderness and rebound tenderness on epigastric region. Severe metabolic acidosis and leukocytosis were noted. Radiological findings suggested perforation of gastrointestinal tract, although the physical signs were not typical. Endoscopy revealed caustic injuries of grade I on esophagus and of grade Ⅲ on stomach, which indicate more severe injury on the stomach than on the esophagus. Exploratory surgery was recommended but unfortunately not permitted by his family. Despite intensive measures, his vital signs deteriorated rapidly and he died 50 hours after the ingestion.

• Child Health Nursing Research
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• v.16 no.1
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• pp.84-92
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• 2010

Purpose: One of the main reasons why mothers quit breast feeding is that the volume of breast milk is inadequate due to insufficiency in suckling. We believe suckling experience may be a factor affecting nipple confusion. So an alternative feeding method, namely cup, spoon, finger, or nasogastric tube feeding may be needed to prevent nipple confusion. The purpose of this study was to construct a predictive model for demand for alternative feeding education by nurses. Methods: A descriptive design with structured self-report questionnaires was used for this study. Data from 175 nurses working in hospitals in Busan were collected between April 1 and 15, 2009. Data were analyzed by decision tree method, one of the data mining techniques using SAS 9.1 and Enterprise Miner 4.3 program. Results: Of the nurses, 81.1% demanded alternative feeding education and 5 factors showed that most of them expressed intention to pay, desire to know about alternative feeding, age, and learning experience. From these results, the derived model is considered appropriative for explaining and predicting demand for alternative feeding education. Conclusion: This confirms that knowledge and compliance in alternative breast feeding for newborn babies should be correct and any inaccuracies or insufficient information should be supplemented.