• Title/Summary/Keyword: Pain Control

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The Homecare Needs of Cancer Patients (암환자의 퇴원 후 가정간호 요구)

  • Kwon, In-Soo;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.743-754
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    • 1999
  • The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurses caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care : 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's $\alpha$=.9101 for total items. The data was collected from March 1st to May 31th, 1998, by two graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational need category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support for having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care need, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.

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The Study of Safety of Herbal Medicine Including Fuzi(附子) on High Range of LFT, RFT Patients (간, 신장수치 이상 환자에 부자(附子) 배합 처방 투여가 미치는 영향)

  • Lee, Young-Jun;Hwang, Won-Duk;Lee, Jae-Wook;Jeong, Hui-Jin;Bae, Su-Hyun;Kim, Kyu-Gon
    • Herbal Formula Science
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    • v.19 no.2
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    • pp.179-189
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    • 2011
  • Objectives : Aconiti Lateralis Preparata Radix(fuzi, 附子) and its class herbs(chaunwu, caowu etc.) are necessary for some clinical conditions, such as cold pain, chilling etc,. But, they has some poison component. And, they have been known to cause liver and kidney injury, and dangerous in the patients who has abnormal range of LFT and RFT. This study shows the consequences for aspartate aminotransferase(AST), alanine aminotransferase(ALT), blood urea nitrate(BUN), and Creatinine were analyzed using samples from patients who took the decoction containing fuzi. Methods : Blood samples for Experiment Group(E) were collected from 63 patients, who took the decoction containing fuzi, admitted into the 6th internal medicine department of Dong Eui Oriental Medical Hospital between from January 2007 to March 2011. In compared to those of experiment group, blood samples as Control Group(C) were collected from 64 patients, who took the decoction not containing fuzi, admitted into the same hospital from January 2009 to April 2011. Results and Conclusions : 1. AST No changed : E 4.17%, C 2.63%, Increased : E 12.5%, C 28.95%, Decreased : E 80.33%, C 68.42% 2. ALT No changed : E2.94%, C5.13%, Increased : E 8.82%, C 20.51%, Decreased : E 88.24%, C 74.36% 3. BUN No changed : E 0%, CG 7.14%, Increased : E 32.25%, CG 14.29% Decreased : EG 67.65%, CG 78.57% 4. Creatinine No changed : EG 5.00%, CG 0%, Increased : EG 35.00%, CG 54.55% Decreased : EG 60.00%, CG 45.45% 5. The results suggest that the decoction containing fuzi isn't harmful AST, ALT, BUN, Cr of the patients who has high range of them.

A STUDY OF CLINICAL RESULTS ON STERI-OSS ENDOSSEOUS IMPLANTS (Steri-Oss 임플랜트의 임상 결과에 관한 연구)

  • Min, Young-Kyu;Kweon, Hyeog-Sin;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.2
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    • pp.258-272
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    • 1998
  • This investigation evaluated patients who received Steri-Oss implants from the Dental Hospital of Chosun University during the period from March 1989 to August 1997. 346 fixtures of 127 patients were included in this study. The results were as follows ; 1.The follow-up period was defined as the period between the surgical placement of the implants and the last follow-up examination. The mean follow-up period was $2.17{\pm}1.21$ years. 2.The period between fixture installation and second surgery was $0.71{\pm}0.44$ years in the maxilla and $0.46{\pm}0.21$ years in the mandible. 3.The number of fixtures which were installed in the upper jaw(112) was less than that in the lower jaw(234) and in the posterior region(260) was more than in the anterior region(86). 4.The length of fixture which was most frequently used was 12 mm and least was 8mm. Screw implants were installed more than cylindrical implants. 3.8mm implant was the most common implans, followed by 4.5mm and 3.25mm. 5.The number of augmentation cases was more than that of non-augmentation cases and the rate of augmentation cases in the maxilla was more than that in the mandible. 6.Implant restorations for partial edentulos patients(94cases) were more than single- tooth implant restorations(33cases) or implant restorations for complete edentulos patients(10cases). 7.Free-standing prostheses for partially edentulous patients were more commom than any other type of connection between implants and natural teeth. 8.Plaque Index($0.95{\pm}0.74$) and Gingival Index($0.31{\pm}0.52$) were very similar around the natural teeth and reflected an acceptable level of plaque and gingivitis control. Mean value for keratinized mucosa index($1.93{\pm}1.20$) remained fairly constant around level 2(1-2 mm keratinized epithelium). 9.Patients were generally satisfied with implant in terms of comfort, function, speech and esthetics. 10.There was not a statistically significant differences in overall survial rate between implants placed in the maxilla (91.5%) and those placed in the mandible (93.8%). Fourteen implants lost before the prosthetic rehabilitation and eleven implants lost following variable periods in function after the prosthetic phase of the treatment. 11.Cause of implant failures was exfoliation or removal of fixture due to non-osseointegration before the prosthetic rehabilitation or due to fracture of fixture, masticatory pain after the prosthetic rehabilitation. 12.The survival rate of Steri-Oss implants using the Kaplan-Meier statistical analysis was 93.8% at 2 year and 86.6% at 5 year, In all cases, implant losses occured predominantly in the healing period. There was a steep decline in the rate of implant loss after the first year. 13.The survival rate of Steri-Oss implants in the anterior region was 94.8% at 2 year and 94.8% at 5 year and that in the posterior region was 92.8% at 2 year and 75.9% at 5 year. In conclusion, this study revealed a number of parameters and guidelines for achieving an optimal success rate in osseointegration.

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Effects of Artemisia capillaris Methanol Extract on the Amounts of Splenocytes-derived Cytokines in Tumor Cells Inoculated Mice (인진쑥 Methanol 추출물이 암이 유발된 마우스의 비장세포 유래 Cytokine 함량에 미치는 영향)

  • Kim, Hong-Tae;Ku, Sae-Kwang;Kim, Ju-Wan;Jin, Tae-Won;Koo, Sung-Wook;Lim, Mee-Kyung;Do, Yoon-Jung;Jang, Kwang-Ho;Oh, Tae-Ho;Lee, Keun-Woo
    • Journal of Veterinary Clinics
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    • v.26 no.5
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    • pp.408-412
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    • 2009
  • The Artemisia capillaris THUNB is a perennial herb that belongs to the family Compositae spp. and probably the most common plant among the various herbal folk remedies being used in the treatment of abdominal pain, hepatitis, chronic liver disease, jaundice and coughing in Korea. This experiment was conducted to investigate the effects of Artemisia capillaris extracts on the amounts of splenocytes-derived cytokine ($TNF-{\alpha},\;IL-1{\beta}$ and IL-10). In in vivo experimental tests using 210 ICR mice with Hepa-1c1c7 or sarcoma 180 cancer line, splenocytes derived cytokine contents were significantly (p < 0.05) reduced in the Hepa-1c1c7 and Sarcoma 180 inoculated vehicle controls, HP and SP, compared to those of the intact vehicle control on both the $28^{th}$ day and the $42^{nd}$ day, respectively. However, these decreases of $TNF-{\alpha},\;IL-1{\beta}$ and IL-10 levels induced by tumor inoculations were significantly (p < 0.01, p < 0.05) inhibited by mACH (Artemisia capillaris methanol extracts) treatment regardless of the type of experiments and tumor cells inoculated. The results suggest that Artemisia capillaris methanol extracts have prominent anti-inflammation effects on the cancer cell lines Hepa-1c1c7 and Sarcoma 180.

Renal Artery Aneurysm in a 13-year-old Child (13세 남아에서 발견된 신동맥의 동맥류 증례 보고)

  • Yeh, Hye Ryun;Kim, Min Jee;Kang, Eun Gu;Han, Jee Yeon;Lee, Joo Hoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.51-55
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    • 2014
  • Primary renal artery aneurysm has been estimated to account for an incidence of 0.015-1% with associated morbidities including renovascular hypertension and rupture. Renovascular hypertension associated renal artery aneurysms in children is not a common disease. In patients with complicated renal vascular disease, renal autotransplantation has been used as an alternative to percutaneous transluminal angioplasty, which may be hazardous in these situations. We report a case of a renal artery aneurysm in a 13-year-old Korean child presenting hypertension detected during school health examination. Preoperative workup demonstrated a $2.8{\times}2.1{\times}1.9$ cm saccular aneurysm in the right renal hilum that was not amendable to endovascular repair. A surgical strategy including extracorporeal renal artery reconstruction with autotransplantation was applied in order to restore renal artery anatomy and to treat renovascular hypertension. Immediately he complained of severe right flank pain and postoperative doppler sonography revealed lack of perfusion. On the 5th day after autotransplantation, the patient underwent a transplant nephrectomy. He was well postoperatively and was found to have a normal kidney function and stable blood pressure control without antihypertensive medication. This is the first pediatric case of renal artery aneurysm in Korea who underwent extracorporeal repair followed by autotransplantation failure. More pediatric cases with renal artery aneurysm should be reported to identify therapeutic outcome and long term prognosis.

Gallstones Risk Factor and Prevalence in the Elderly in Jeju Island (제주지역 노인의 담낭결석 유병률 및 위험요인)

  • Sim, Hyun-Sun;Choi, Joon-Lock;Park, Jae-Jin;Lee, Su-Yeon;Lee, Ji-Min;Jung, Hong-Ryang;Lim, Chung-Hwan;Kim, Jung-Gu
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.293-298
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    • 2009
  • Background/aim : Gallbladder stone is the most common disease of biliary tract. It is lead to acute abdominal pain. The cholecystitis which is caused by in gallbladder stone occurs frequently and the possibility of the gallbladder cancer comes to be high. Our study was designed to determine the prevalence and risk factors gallbladder stone in a population who community. Materials and Methods : We enrolled a total of 826 (male : 297, female : 529) persons who 60 or older in Jeju-do 10 places from 2008 July one months. The height, weight, liver function tests, lipid profile, fasting blood sugar, were all measurement. They had their gallbladder examined with using ultrasonography. Statistical significance was defined as a p-value less than 0.05. Results : Among 826 persons, gallbladder stone was found in 49 persons (5.9%). The male is 6.1% and the female is 5.8%, the male 1.03 times appeared more highly the female. The body mass index above of 23.0 kg/$m^2$ with the gallbladder stone was 69.3% (p<0.047). Conclusion : The gallbladder stone appeared highly according to age increases. The obesity is the risk factor of gallbladder stone. The weight management and diet control is a possibility of reducing a gallbladder stone creation.

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Panperitonitis with Advanced Gastric Cancer - Based on Seminar of Korean Family Medicine Palliative Medicine Research Group - (진행된 위암 환자에게 발생한 범복막염 치료의 완화의학적 접근 - 대한가정의학회 완화의학연구회 세미나를 기초로 하여 -)

  • Jung, Yun-Joo;Kim, Dae-Kyun;Choi, Youn-Seon;Korean Palliative Medicine Research Group, Korean Palliative Medicine Research Group;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.35-39
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    • 2006
  • A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.

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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.

Changes in Perceptions and Attitudes of Medical Students toward End-of-Life Care after Hospice and Palliative Medicine Education

  • Cha, Jeehyun;Lihm, Hoseob;Kim, Yoonyoung;Kang, Jihun
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.166-173
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    • 2019
  • Purpose: High-quality hospice and palliative medicine curricula are necessary in Korean medical schools. This study evaluated changes in students' knowledge and attitudes toward both hospice and palliative care following the completion of a course on these topics, as well as the course's overall role in the basic medical education curriculum. Methods: Questionnaires measuring knowledge and attitudes were collected before and after the course from 76 fourth-year medical students, who had received instructions integrating both hospice and palliative care in 2016. Results: The questionnaire item "Select the correct answer on the use of opioid pain control in hospice and palliative care" changed the most in terms of number of correct answers pre- and post-course (3.50 and 5.32, respectively; P<0.001). Pre- and post-course, the numbers of students who answered "Strongly Agree" and "Agree" to questions concerning their attitudes toward hospice and palliative care ("I know the purposes and roles of hospice and palliative care") were 17 (22.4%) and 65 (85.6%), respectively (P≤0.001). Affirmative responses also increased for "As a pre-physician, I know when to describe and advise hospice and palliative care to patients", from 22 (28.9%) to 65 (85.6%; P≤0.001). Conclusion: This study showed that comprehensive hospice education in the form of an integrated educational course might promote changes in medical students' knowledge and attitudes toward hospice and palliative medicine.

DISTRACTION OSTEOGENESIS OF THE MIDFACE WITH A RIGID EXTERNAL DISTRACTOR (RED) (강성 외장형 신장기(Rigid External Distractor)를 이용한 중안면부의 골신장술)

  • Oh , Jung-Hwan;Alexander, Kuebler.;Zoeller, Joachim E.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.2
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    • pp.161-164
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    • 2002
  • In recent, distraction osteogenesis has been used to correct skeletal malformations and discrepancies in the craniofacial area. It also seems to be considered as an alternative in the treatment of severe midfacial hypoplasia. There are some types of distractors for midfacial distraction such as subcutaneous distractors and rigid external distractors. We used a rigid external distractor for correction (RED) of craniofacial hypoplasia. Seven patients underwent a midfacial distraction osteogenesis with a rigid external distractor between April 2000 and July 2001. Three patients suffered from Apert's syndrome, three patients from Crouzon's syndrome, and one patient suffered from midfacial hypoplasia due to midfacial radiotheraphy during childhood. On average, the mean distance of distraction was 19.8mm ($10{\sim}25mm$) and the distraction lasted for 24 days. The patients showed no severe complications like infections, optic disturbance, or wrong distraction vectors. One patient complained pain on the site of the occipital fixation of the distractor. In one patient who underwent subtotal craniectomy 3 months before Le Fort III distraction, the distractor was dislocated as the cranial bone was too weak to support the distractor. This report reveals that the application of rigid external distractor and transfacial pull results in an exact control of the distraction vectors and an excellent correction of midfacial hypoplasia without any severe complications.