The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.
Block of superior hypogastric plexus has been advocated as a useful technique in the palliation of various of pelvic pain syndromes. This technique has been performed under fluroscopic or CT guidance using bilateral placement of needles. We performed a modification of transdiscal approach with the patient in oblique position permitting successful superior hypogastric plexus block using a single needle placed under fluoroscopic guidance. Our experience suggest transdiscal approach performed in oblique position allows easier, safer, and more accurate needle placement for superior hypogastric plexus block.
The purpose of this study was to introduce effects of Chukyu pharmacopuncture and Brainspotting on knee pain, headaches, and acute stress disorder of a patient with a traffic accident. We treated a patient with Chukyu pharmacopuncture and Brainspotting. Numerical rating scale (NRS), Range of Motion (ROM), Hyperextension Position (HEP), Effusion (Eff), Patella Compression Test (PCT), Frontal Flexion Position (FFP), McMurray (MCM), Lateral Joint Line Tenderness (LJLT), Medial Joint Line Tenderness (MJLT), Anterior Drawer Test (ADT), Lachman Test, Varus/Valgus stress, Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), Core Seven Emotions Inventory Short Form (CSEI-S), Subjective units of disturbance scale (SUDs), and Heart rate variability (HRV) were used to evaluate the patient. After the patient was treated by Chukyu pharmacopuncture and Brainspotting, the patient showed improvement in NRS, physical examination, and psychological symptom assessment. These results indicate that Chukyu pharmacopuncture and Brainspotting are effective on knee pain, headache, and acute stress disorder after a traffic accident.
Alopecia is a minor complication following open heart surgery, but it is a cosmetic and psychotic problem to the patient. Especially the extensive long period of operation, prolonged mechanical ventilation and no change of patient head position during operative and recovery period may serve the localized scalp pressure effect, which causes postoperative alopecia. So, for prevention of the postoperative alopecia, adequate blood flow and pressure must be maintained with alternative change of head position during operative and recovery period. The author experienced one case of occipital alopecia following open heart surgery and reports with literature.
Purpose: This study was designed to investigate inter-rater and intra-rater reliability of navicular drop measurements by clinicians in sitting and standing positions. Methods: Fourteen subjects with pronated foot were recruited. Two physical therapists randomly assessed the same patients on different occasions but on the same day. Almost all patients were assessed on more than one day. The intra-rater and inter-rater reliability of navicular dropwas estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of navicular drop measurements ranged from 0.93 to 0.87, the inter-rater reliability from 0.98 to 0.70 with the patient in standing and sitting positions. These results showed good reliability for calculated variables. Intra-rater and inter-rater reliability of navicular drop in standing position was higher than those of sitting position. Conclusion: Although inter-rater and intra-rater reliability of navicular drop in the sitting position was lower than in the standing position, measurement of navicular drop in the sitting position showed good reliability and was acceptable for patients who could not stand alone without assistance. We recommend that having the patient in the standing position is appropriate in navicular drop measurement.
The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.
The purpose of this study was to investigate the relationship between the head and neck postre and the cervical curvature, especially in forward head postrue(FHP). Sixty patients with craniomandibular disorders and thirty dental students without any signs and symptoms of craniomandibular disordres participated in this study as patient groups and sa control group, respectively. The author evaluated the head and neck posture of all subjects by plumb line and CROM( Cervical Ragne of Motion), and had taken cephaograph in natural head position. On the cephalograph the angle of cervical inclination formed by true horizntal plane and 4th cervical vertebra(C4) and the radius of cervical curvature from C1 to C5 were measured. A specially designed ruler was used for measuring cervical curvature. Occlusal contac number and force with T-scan system, electromygraphic activity of cervical muscles with Bio-EMG, and distance of freeway space with Bio-ECN were recorded, respectively. The collected data were processed by SAS/STAT progrm. The obtained results were as follows : 1. In subjects with longer radius which was less cervical curvature, head positioned more anteriorly than subjects with smaller radius, and they showed slightly straight cervical vertebra. 2. Between the patients and the control group, there were no differences in cervical curvature, in forward head position by plumb line and in CROM. But the patient group had a greater cervical inclination than the control group had. 3. There were positive correlation between cervical curvature and forward head position by plumbline,between forward head position y plumb line and that by CROM in patient group. The cervical inclination, however, had negative correlation with cervical curvature, and with forward head postion by plumb line, respectively. 4. In case of showing more cervical curvature and more forward head position by plumb line the head position was defined as forward head posture. In patient group, subjects without forward head posture showed greater posterior teeth contact force than subjects with forward head posture, but in control group, there were no difference between the two subjects. 5. There were higher electromyographic activity in almost all muscles and smaller freeway space in induced forward head posture than those in natural head position in subjects without forward head posture. In conclusion, head position of patients with craniomandibular disorders were not more anterior than that of normal control person, but they had tendency to head extension. From the result of this study, forward head posture could be defined as posterior rotation of upper cervical segment with a straight lower cercial segment due to loss of normal lordosis.
Objectives : This study aimed for desirable cure through the investigation of The Patient-Doctor Relationship in Eastern Medicine. Methods : Research materials is data of the patient the doctor and the Patient-Doctor Relationship in Eastern Medicine bibliography except medical theory and clinical contents. Results and Conclusion :. 1. Relatively the doctor's position origin from exorcist has it over patient's that. 2. In spite of clinical doctor, Confucian physician have Confucianism and the ethics so they set The Patient-Doctor Relationship in Eastern Medicine essentially. 3. Each of doctor(the doctor-doctor relationship) emphasize the partnership in the Patient-Doctor Relationship. 4. Patient's choice for doctor is source of the Patient-Doctor Relationship basically and the choice are prudent. 5. The patient must carry into practice psychological and body medical affairs related to health preserving 6. For desirable Patient-Doctor Relationship, doctor's inquire is considered with temper and circumstance and a consultation room are also required stability. 7. Poor Patient-Doctor Relationship are come about when patient is not trust doctor, patient is not follow doctor's order and doctor's indifference to patient.
Journal of the Korea Academia-Industrial cooperation Society
/
v.19
no.6
/
pp.345-354
/
2018
This study was conducted to identify the levels of patient safety culture, critical thinking disposition, and patient safety nursing activities and determine the factors affected by patient safety nursing activities among nurses in comprehensive nursing care service wards. Subjects consisted of 150 nurses from general hospitals in B city, Korea, and data were analyzed using the SPSS Win 21.0 program. The mean scores of awareness of patient safety culture, critical thinking disposition, and patient safety nursing activities were $3.32{\pm}0.32$, $3.50{\pm}0.31$, and $4.28{\pm}0.46$, respectively. The awareness of patient safety culture was significantly different by clinical career in the present unit (F=4.79, p=0.001). The critical thinking disposition was significantly different by age (F=3.89, p=0.010) and position (F=6.40, p=0.002). There were differences in the scores of patient safety nursing activities according to position (F=3.19, p=0.044). Additionally, hospital environment (${\beta}=0.25$, p=0.014), supervisor attitude (${\beta}=0.20$, p=0.046), and position (${\beta}=0.14$, p=0.040) accounted for a 44.4% variance in patient safety nursing activities. To promote patient safety nursing activities in comprehensive nursing care service wards, positive awareness of the hospital's safety environment and support from the manager are required.
Purpose : Fluoroscopy equipment, depending on the type of changes that occur in the patient's position ESD and study the patient's scatter ray of ESD Practitioners considered a comparative analysis was to evaluate the correct dose. Materials and Methods : HITACHI four overtube type TU-8000 Flat Detector and Under tube C-Arm Philips' Multi Diagnost Eleva with Flat Detector type were measured by. Each devices is a measure of the patient's esd randophantom position in tabel unfors Xi multi funtion then fixed to the abdomen fluoroscopy and 10 seconds, spot was measured three times, practitioners of the incident surface dose by considering the patient's scatter ray of the table for each device in the average human stomach 21cm thickness acrylic phantom ($25cm{\times}25cm$) Place the practitioner position after position randophantom unfors Xi multi funtion in the thyroid and stomach 1 minute by a fixed one-time fluoroscopy and measured. Results : 10 seconds and the patient perspective of the c-arm ESD 1.2 times smaller on the AP and oblique measurements were measured in the 6-13 times smaller. spot positions to changes in the measured three times on the AP of the abdomen, ESD is 18 times smaller c-arm measurements and the oblique measurement was 19-30 times smaller. And 1 minute at practitioners fluoroscopy esd in the thyroid 2.12 times the c-arm, chest 1.75 times less the dose was measured. On the AP, depending on the device, but the lack of dose difference oblique positions of the two devices depending on changes in the area due to changes in both the AP than on the dose increased, the difference in dose between the two devices, the maximum difference was approximately 27 times. Conclusion : Fluoroscopic equipment at the time of inspection in accordance with changes in dose according to the patient and the patient's positions changes, because the area of the scatter ray considering the change of dose measurements be made, and study of the equipment according to the characteristics of the efficiency and the exposure of the patient and practitioner is considered smooth study equipment manufacturers that can be done is to build the system and think that is also important. Various fluoroscopy when you check future changes in many factors of change in dose for the equipment in the laboratory system by considering the scatter ray radiation shielding for the management to take advantage of reckless undertube have been utilized as more exposure Reduction activities can help is considered as the direction.
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