• Title/Summary/Keyword: Patient fall

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Anterior Decompression and Internal Fixation with Anterior Instrument and Surgical Titanium Mesh in Thoracolumbar Unstable Spine Injuries (Long-term Follow-up Results) (흉·요추 불안정성 척추 손상 환자에서 전방 감압술과 전방기기 및 Surgical Titanium Mesh를 이용한 내고정술 (장기적 추적 검사 결과))

  • Park, Hwan Min;Lee, Seung Myung;Cho, Ha Young;Shin, Ho;Jeong, Seong Heon;Song, Jin Kyu;Jang, Seok Jeong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.58-65
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    • 2000
  • Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

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The Use of the Movie 'The Island' for Nursing Informatics in Nursing Students (간호정보학 이해를 위한 영화 'The Island' 활용)

  • Oh, Jina;Shin, Hyewon;De Gagne, Jennie C.
    • The Journal of the Korea Contents Association
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    • v.15 no.4
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    • pp.330-341
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    • 2015
  • The purpose of this study was to examine the effect of the film 'The Island' on 2nd year nursing students' nursing informatics (NI) competency. The participants were sixty-eight students in a baccalaureate nursing program of a private university, taking the course, 'Nursing & Informatics' in the 2012 fall semester. Over the 15 weeks, the film was used for five weeks as introduction to NI, peer-to-group discussions, and self-reflection on lessons learned regarding NI. A qualitative content analysis was used to explore the students' experiences and perceptions on their NI competency. As a result, students signified the NI concept as the assessment of biometrics data, promotion of optimal health with the support of various technologies, and integration of patient-centered care into routine practice. They also highlighted the importance of security and safety measures as well as high quality health technology including the ubiquitous health monitoring system. Overall, the lesson outcomes of the course were met. As a supportive, instructional strategy, the use of the movie, 'The Island', was effective for nursing students in achieving NI competencies. Further study is warranted to determine if movies can be used as a means of continuing education to improve informatics competences in healthcare professionals.

Capecitabine Pattern of Usage, Rate of Febrile Neutropaenia and Treatment Related Death in Asian Cancer Patients in Clinical Practice

  • Phua, Vincent Chee Ee;Wong, Wei Quan;Tan, Pei Lin;Bustam, Anita Zarina;Saad, Marniza;Alip, Adlinda;Ishak, Wan Zamaniah Wan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1449-1453
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    • 2015
  • Background: Oral capecitabine is increasingly replacing intravenous 5-fluorouracil in many chemotherapy regimens. However, data on the risk of febrile neutropaenia (FN) and treatment related death (TRD) with the drug remain sparse outside of clinical trial settings despite its widespread usage. This study aimed to determine these rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). Materials and Methods: We reviewed the clinical notes of all patients prescribed with oral capecitabine chemotherapy for any tumour sites in University Malaya Medical Centre (UMMC) from $1^{st}$ January 2009 till $31^{st}$ June 2010. Information collected included patient demographics, histopathological features, treatment received including the different chemotherapy regimens and intent of treatment whether the chemotherapy was given for neoadjuvant, concurrent with radiation, adjuvant or palliative intent. The aim of this study is to establish the pattern of usage, FN and TRD rates with capecitabine in clinical practice outside of clinical trial setting. FN is defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$ (de Naurois et al., 2010). Treatment related death was defined as death occurring during or within 30 days of last chemotherapy treatment. Results: Between $1^{st}$ January 2009 and $30^{th}$ June 2010, 274 patients were treated with capecitabine chemotherapy in UMMC. The mean age was 58 years (range 22 to 82 years). Capecitabine was used in 14 different tumour sites with the colorectal site predominating with a total of 128 cases (46.7%), followed by breast cancer (35.8%). Capecitabine was most commonly used in the palliative setting accounting for 63.9% of the cases, followed by the adjuvant setting (19.7%). The most common regimen was single agent capecitabine with 129 cases (47.1%). The other common regimens were XELOX (21.5%) and ECX (10.2%). The main result of this study showed an overall FN rate of 2.2% (6/274). The overall TRD rate was 5.1% (14/274). The FN rate for the single agent capecitabine regimen was 1.6% (2/129) and the TRD rate was 5.4% (7/129). All the TRDs were with single agent capecitabine regimen were used for palliative intent. Conclusions: Oral capecitabine is used widely in clinical practice in a myriad of tumour sites and bears a low risk of febrile neutropaenia. However, capecitabine like any other intravenous chemotherapeutic agent carries a significant risk of treatment related death.

A study of Literature review on the retaining needle (유침(留針)에 관한 문헌적(文獻的) 고찰(考察))

  • Park, Chun-ha;Kim, Jae-hong;Wu, Tung-sun;Park, Eun-ju;Shin, Jung-chul;Han, Sang-gyun;Yun, Yeu-chung;Cho, Myung-rae
    • Journal of Acupuncture Research
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    • v.20 no.1
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    • pp.85-96
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    • 2003
  • Objectives : We were studied the retaining needle to offer basic materials for the study of it. methods: To study the retaining needle, we were reviewed the ancient, the present text and the thesis. Results: 1. There are many ways form general acupuncture technique to needle-embedding therapy by the spending time of the retaining needle. 2. The method retaining needle is divided into Active method of the retaining needle(動留針法) and Passive methoid of the retaining needle(靜留針法) by the existence of Qi-promoting. 3. In case of Deficiency Syndrome, protracted discase, dolorific disorder, convulsive disorder, and Cold Syndrome, the spending time of the retaining needle takes longer, in case of Heat Syndrome and exterior Syndrome, the spending time of the retaining needle takes shorter. 4. In case of acute disease and attack of chronic disease, we can use Active methoid of the retaining needle(動留鍼法) with retaining needle for a long time, in case of chronic disease, we can use Passive methoid of the retaining needle(靜留針法). 5. In case of Young people, a man in the prime of life, and a people who can stand the stimulation of needle, we can make the spending time of the retaining needle be longer and use Active methoid of the retaining needle(動留針法), but in case of a baby and a weak people, we had better shorten the spending time of the retaining needle or not do it. 6. The spending time of the retaining needle must be shorter in spring and summer, must be longer in fall and winter. 7. The spending time of the retaining needle is various by acupuncture point. 8. When the spending time of the retaining needle is too longer, we can injure Vital-qi of a patient, otherwise in opposite situation, Pathogenic is stagnated so pathogenic stage is repeated.

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Retrospective clinical study of mandible fractures

  • Jung, Hai-Won;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Jun;Lee, Jung-Woo;Lee, Hyun-Woo;Moon, Chang-Sig;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.21-26
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    • 2014
  • Objectives: The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of mandible fractures that were treated by the Department of Oral and Maxillofacial Surgery in Kyung Hee University Dental Hospital from January 2002 to December 2012. Materials and Methods: This was a descriptive and analytic retrospective study that evaluated 735 patients that were treated for mandible fracture. Results: This study included 1,172 fractures in 735 patients. The ratio of male to female patients was 5.45 : 1; the maximum value was in patients between 20 and 29 years (38.1%) and the minimum in patients over 70 years old. The monthly distribution of facial fractures peaked in the fall and was lower during winter. No specific correlation was identified based on the annual fracture distribution. Among the 735 fracture patients, 1.59 fracture lines were observed per patient. The most frequent site was the symphysis, which accounted for a total of 431 fractures, followed by the angle (348), condyle (279), and body (95). The symphysis with angle was the most common site identified in combination with fracture and accounted for 22.4%, followed by symphysis with condyle (19.8%). The angle was the most frequent site of single fractures (20.8%). The major cause of injury was accidental trauma (43.4%), which was followed by other causes such as violence (33.9%), sports-related accidents (10.5%), and traffic accidents (10.1%). Fracture incidents correlated with alcohol consumption were reported between 10.0%-26.9% annually. Conclusion: Although mandible fracture pattern is similar to the previous researches, there is some changes in the etiologic factors.

A CLINICAL AND STATISTICAL STUDY OF MAXILLOFACIAL FRACTURE IN THE UIJUNGBU AREA (의정부지역의 악안면 골절에 대한 임상 통계적 연구)

  • Kim, Hyoun-Tae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.63-68
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    • 1991
  • The author has arrived at the following result after having carried out multilateral study based on a total of 282 maxillofacial fracture patients who have receive treatment at the Euijeongbu general hospital and Shinchun general hospital in the northern district of Kyunggido from march 1988 to august 1990. 1. Sex distribution of Mx. facial fx. patient was higher in male by 4.6:1 and was predominant in the 3rd decade with 40.4% followed in decreasing order by the 2nd decade and the 4th. 2. A majority were in the Mn. with 40.2% followed in decreasing order by zygoma. nasal bone and maxilla. 3. For the sex distribution according to anatomy, make to female ratio was 6.2:1 in the mandible, followed in decreasing order by zygoma, and nasal bone with predominance in male. 4. Car accident with 42.8% was the most common cause of fx. followed in decreasing order by violence, workmen's accident, and fall down. 5. The involvement of other trauma areas are head. 79.0%, abdomen-thorax, and the extremities in decreasing order. 6. In the mandibular fx. a majority were in the symphysis with 73.9% followed in decreasing order by angle, Condyle, and body. 7. Maxillary fx. of the type LeFort II was estimated to be 41.2% 8. Fracture in the zygoma including zygomatic arch was estimated to be 72.5%

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Abdomino-perineal Organ Injuries Caused by Cultivators (경운기 사고에 의해 발생한 복부 및 회음부 장기 손상)

  • Yeo, Kwang Hee;Park, Chan Yong;Kim, Ho Hyun;Park, Soon Chang;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.60-66
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    • 2015
  • Purpose: Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. Methods: We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. Results: All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was $64.0{\pm}11.1$ (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors ($17.8{\pm}8.5$ vs. $27.0{\pm}16.0$; p=0.010). Conclusion: With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.

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Die politische Diskussion des Patientenrechtegesetzes in Deutschland und die wesentliche Regelungen (독일의 환자권리법에 대한 입법정책적 논의와 중요내용)

  • Kim, Ki-Young
    • Journal of Legislation Research
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    • no.44
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    • pp.465-485
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    • 2013
  • Mit dem Patientenrechtegesetz, das im $Fr{\ddot{u}}jahr$ 2013 in Kraft treten soll, $f{\ddot{u}}rt$ der Gesetzgeber eine jahrzehntelange Diskussion um die Rechte von Patientinnen und Patienten zu einem guten Ende. Demnach geht es darum, Transparenz ${\ddot{u}}ber$ die bereits heute bestehenden, umfangreichen Rechte der Patientinnen und Patienten herzustellen, die $tats{\ddot{a}}chliche$ Durchsetzung dieser Rechte zu verbessern, zugleich Patientinnen und Patienten im Sinne einer verbesserten Gesundheitsversorgung zu $sch{\ddot{u}}tzen$ und insbesondere im Fall eines Behandlungsfehlers $st{\ddot{a}}rker$ zu $unterst{\ddot{u}}tzen$. In Verfolgung dieser Zwecke $schl{\ddot{a}}gt$ die Bundesregierung ein Artikelgesetz vor, dessen wesentliche Teile das BGB und das Recht der sozialen Krankenversicherung betreffen. In das BGB soll ein neuer Abschnitt ${\ddot{u}}ber$ den "Behandlungsvertrag" $eingef{\ddot{u}}gt$ werden. Als Standort ist der ${\ddot{U}}bergang$ vom Dienstin das Werkvertragsrecht vorgesehen, der um die neu zu schaffenden Vorschriften der ${\S}{\S}$ 630 a bis 630 h BGB erweitert wird. Die acht Paragrafen enthalten im Kern eine Kodifikation der von der Rechtsprechung entwickelten $Grunds{\ddot{a}}tze$ zur Arzthaftung. Der Beitrag stellt die bisherige politische Diskussion des Patientenrechtegesetzes vor (II). Im Anschluss daran wird die einzige wesentliche Neuerung des Gesetzes $n{\ddot{a}}her$ untersucht und werden Regelungsziel und Grundkonzept der Kodifikation einer $Pr{\ddot{u}}fung$ unterzogen (III). $Schlie{\ss}lich$ werden einen politischen Ausblick auf die neuen Herausforderungen und die Bewertung der $gegenw{\ddot{a}}rtigen$ Lage und der erwarteten Entwicklung gezogen (IV).

Emergency preoperative angioembolization without computed tomography to treat unstable pelvic fractures with bowel perforation (장 천공을 동반한 혈역학적으로 불안정한 골반골 골절에서 전산화 단층촬영 전 시행한 혈관색전술의 지혈효과: 증례보고)

  • Park, Chan-Yong;Kang, Wu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.417-422
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    • 2019
  • Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

Evaluation of the Usefulness of the Aid Table to Prevent Patient Fall Risk in the ERCP Operation (ERCP 검사 시 환자 낙상방지 테이블 보조기구사용의 유용성 평가)

  • Kwon, Byongnam;Park, Shineui;Choi, Namgil
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.1-8
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    • 2019
  • The purpose of this study is to evaluate usefulness of aid table in ERCP operation. Fifteen patients (mean age: $76.0{\pm}11.4$) and Six Staffs are took part in the questionnaire survey. We evaluated usefulness of aid table as follows: comfortableness, psychological stability, satisfaction from extreme satisfaction as 1 point to extreme satisfaction as 5 point by questionnaire. In the results of comfortableness, the patients reported uncomfortable as $1.7{\pm}0.5$ point at ERCP operation without aid table but they are reported comfortable at using aid table as $4.4{\pm}0.5$ point (p-value${\leq}0.000$). In the psychological stability, the patients have satisfaction ($4.8{\pm}0.4$ point) for aid table. In the addition, the patients felt satisfaction ($4.9{\pm}0.3$ point) for aid table. These results are considered that to use of aid table will give a useful to ERCP operation.