• Journal of Korean Academy of Nursing Administration
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• v.16 no.3
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• pp.326-335
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• 2010

Purpose: This study was conducted to develop nursing standards for medical patients with Coronary Artery Disease (CAD) patients. Methods: This study was a methodological study. The content of nursing standards for medical patients with CAD developed in this study was validated. The nursing standards of cardiovascular nursing developed by the American Nurses Association (2008), the nursing standards developed by the Korea Nurses Association (2003) and a clinical manual of patients with CAD developed by K teaching hospital were reviewed. Literature regarding CAD nursing standards was also reviewed. The basic contents of nursing standards for medical patients with CAD were selected by an expert group including two nursing faculties, a cardiovascular unit manager, and two cardiologists. A pilot study was conducted then in real clinical settings, in which includes cardiovascular outpatient clinic, cardiovascular inpatient units, and cardiac intensive care units to evaluate clinical suitability of the nursing standards. Results: The final version of the nursing standards for medical patients with CAD included 12 standards, 24 criteria, 38 indicators and 92 nursing activities. Conclusion: The nursing standards developed in this study can be used in evaluating quality of nursing service and in educating nurses who are involved in patients with CAD.

• Journal of Korean Academy of Nursing
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• v.41 no.4
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• pp.491-499
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• 2011

Purpose: The study was conducted to develop and test a hypothetical model which explains self-care behavior in patients with type 2 diabetes was established based on the Self-Determination Theory. Methods: The participants were 218 patients with type 2 diabetes mellitus enrolled in an outpatient clinic of one endocrine center in Korea. The data were collected using questionnaires from April 5 through May 7, 2010. The descriptive and correlation statistics were analyzed using the SPSS/WIN 15.0 and the structural equation modeling procedure was performed using the AMOS 7.0 program. Results: The results of this study showed that competence and autonomous motivation were the strong factors influencing self-care behavior in patients in this sample. Support from health provider for autonomy was a significant indirect factor on self-care behavior. These factors explained 64.9% of variance in the participants' self care behavior. The proposed model was concise and extensive in predicting self-care behavior of the participants. Conclusion: Findings may provide useful assistance in developing effective nursing interventions for maintaining and promoting self-care behavior in patients with type 2 diabetes.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.268-271
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• 1999

Intrathecal phenol-glycerin block is a potent tool in stepwise approach to intractable perineal pain. At outpatient clinic, intrathecal phenol-glycerin block have been frequently used to control the cancer pain, as this procedure does not require special equipment. However, undesirable effects may occur with any given intrathecal injection. Although most side effects do not last long, they deserve well to prevent. Recently, we have been controlled the perineal and perianal cancer pain with intrathecal phenol-glycerin block without any specific complications. However, one patient we managed experienced that one patient, with this procedure for chronic non-malignant perineal pain control experience gait disturbance and one-week of voiding and defication difficulties. This research reports these practices, including the review of literature.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.301-303
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• 2015

We report on a case of an 87-year-old woman who showed spontaneous resolution of a large chronic subdural hematoma which required surgical decompression. She had suffered from confused mentality and right side weakness of motor grade II for 10 days. The initial brain CT scan showed a 22 mm thick low density lesion located in the left fronto-temporo-parietal region with midline shift (12 mm) which required emergency decompression. However, because she and her family did not want surgery, she was followed up in the outpatient clinic. Five months later, follow up brain CT showed that the CSDH had disappeared and the patient became neurologically normal. The reasons for spontaneous resolution of CSDH remain unclear. We discuss the possible relation between mechanisms of physio-pathogenesis and spontaneous resolution of a large chronic subdural hematoma (CSH) in an elderly patient.

• Journal of Chest Surgery
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• v.46 no.1
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• pp.84-87
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• 2013

A 60-year-old man visited the outpatient clinic due to one month of recurrent exertional chest pain. Eleven years earlier he had undergone off-pump coronary artery bypass grafting using bilateral internal thoracic artery (ITA) Y-composite grafts based on the left ITA. Preoperative coronary angiography showed patent distal graft anastomoses and visualized the left ITA retrogradely. The arch aortography revealed near-total occlusion of the left subclavian artery at the level of the ostium. The patient underwent left carotid-to-subclavian artery bypass grafting using a 6 mm vascular conduit. Postoperative computed tomographic angiography revealed a patent bypass conduit between the left common carotid artery and left subclavian artery. The patient was discharged on postoperative day 4 with no symptoms or signs of myocardial ischemia.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.231-233
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• 2001

Atrophic rhinitis is characterized by mucosal atrophy, bony absorption, persistent fetid odor and resistance to medical and surgical treatment. Stellate ganglion block (SGB) can be used as a therapeutic modality by improving the regional blood flow through sympathetic blockade. We present a case of a 57 year-old male patient who had been treated unsuccessully for atrophic rhinitis for several years by surgical and conservative measures. The patient presented at our pain clinic with shoulder pain and received stellate ganglion block once or twice a week. He received more than 75 SGBs in addition to the routine conservative treatment for atrophic rhinitis. As the number of blocks performed increased, the patient demonstrated subjective symptom relief. We measured regional mucosal blood flow using a laser doppler flowmeter after the 28th, 63rd and 75th blocks. Nasal mucosal blood flow was improved by 4.9%, 28.8% and 36.3% respectively. We also were able to observe the recovery of mucosal atrophy to an almost normal level by nasal endoscopy. The patient is currently free of symptoms and is being followed up on an outpatient bases.

• Women's Health Nursing
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• v.12 no.2
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• pp.87-96
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• 2006

Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

• Korean Journal of Adult Nursing
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• v.27 no.2
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• pp.170-179
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• 2015

Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.46-48
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• 2013

Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.207-209
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• 2016

A 4-month-old boy diagnosed with acute myocarditis was treated with extracorporeal membrane oxygenation (ECMO). Follow-up echocardiography eight hours after ECMO revealed intracardiac thrombosis involving all four heart chambers. Because of the high risk of systemic embolization due to a pedunculated thrombus of the aortic valve, we performed an emergency thrombectomy. After the operation, the patient had a minor neurologic sequela of left upper arm hypertonia, which had almost disappeared at the last outpatient clinic two months later. He was diagnosed with a major mutation in MTHFR (methylenetetrahydrofolate reductase), which is related to thrombosis.