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Clinical Evaluation of Coronary Artery Fistula (관상동맥루의 임상적 고찰)

  • Lee Sak;Park Han-Ki;Lim Sang-Hyun;Hong You-Sun;Chang Byung-Chul;Kang Meyun-Shick;Cho Bum-Koo;Park Young-Hwan
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.699-704
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    • 2005
  • Background: Coronary artery fistula is rare congenital anomaly, which account for $0.27\~0.40\%$ of all congenital heart diseases. We report the clinical observations of 45 patients with coronary artery fistula. Material and Method: We reviewed all patients presented with or without symptoms of coronary artery fistula between 1987 and 2004. Age ranged from 1 to 83 years. Twenty-six patients were female. The patients were divided into 2 groups according to the presenting symptoms. Twelve patients were in group A (asymptomatic) and 33 patients in group B (symptomatic). The most common clinical presentation in group B was angina (18) followed by dyspnea (7), atypical chest pain (5), syncope (1), fatigue (1), and palpitation (1). Twenty-five patients were associated with other cardiac diseases, which were atrial septal defect (4), coronary artery occlusive disease (6), hypertension (12), and valvular heart disease (2). Result: Patients were followed-up for a mean period of $64.8\pm62.7$ months. There was no complication related to coronary artery fistula during the follow-up period in both group. There was no mortality related to coronary artery fistula. Conclusion: In symptomatic patients, early surgical treatment is recommended considering the low perioperative morbidity. In asymptomatic patients receiving medical treatment, close follow up may be necessary.

Effect of Green Tea on Tissue Distribution and Deposition of 14C-Benzo[a]pyrene in Rats (흰쥐에서 녹차의 섭취가 14C-Benzo[a]pyrene의 조직 분배 및 잔류에 미치는 영향)

  • Kim, Ju-Yeon;Noh, Sang-K.
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.6
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    • pp.818-823
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    • 2011
  • Recently, we showed that green tea extract (GTE) markedly lowers the intestinal absorption of $^{14}C$-benzo[a]pyrene ($^{14}C$-BaP) and enhances its secretion into the biliary route, suggesting a protective role for GTE against body burden. These findings indicate that green tea could be used as an effective dietary means against the toxicity of BaP. The present study, therefore, was designed to investigate if green tea intake could affect the tissue distribution and deposition of $^{14}C$-BaP in rats. Male Sprague-Dawley rats had free access to a nutritionally adequate AIN-93G diet and deionized water. At ~340 g of weight, the rats were injected intraperitoneally with 27.4 kBq of [4-$^{14}C$]-BaP and 5.0 mg of BaP dissolved in $300\;{\mu}L$ of olive oil and then assigned randomly to the following two groups: one group (GTE) of rats was fed the AIN-93G diet with GTE via drinking water at approx. 4.7 mg of catechins/d, whereas the other was fed the same diet but without GTE (control). At 4 wk of dietary treatment with GTE, animals were euthanized and heart, liver, brain, spleen, kidney, retroperitoneal fat, testis, and epididymal fat were collected, weighed, and analyzed for tissue $^{14}C$-BaP. Both the control and GTE groups continuously gained weight throughout the study, but there was no significant difference between the groups. No significant differences were observed in the weights of heart, liver, brain, spleen, kidney, retroperitoneal fat, testis, and epididymal fat. However, the radioactivities of $^{14}C$-BaP, expressed in dpm/g, were significantly lower in the heart, liver, brain, spleen, and epididymal fat of rats receiving GTE as compared to their respective controls. These data indicate that green tea intake markedly lowers tissue accumulation of $^{14}C$-BaP. Taken together, these findings suggest that the decreased tissue levels of BaP by GTE intake may be associated with lowered intestinal absorption of BaP and its enhanced secretion into the bile.

Permanent Brachytherapy of Localized Prostate Cancer: Preliminary Results (국소 전립선암의 영구적 근접치료: 조기 결과)

  • Park, Hye-Li;Chang, Sei-Kyung;Kim, Ja-Young;Lee, Bo-Mi;Ko, Seong-Young;Kim, Sung-Joon;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.71-82
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    • 2011
  • Purpose: To evaluate the biochemical control rate and the rate of side effects after performing permanent brachytherapy of localized prostate cancer. Materials and Methods: 67 patients with localized prostate cancer were treated with brachytherapy between April 2007 and December 2008. Of these, 43 patients who were followed up and did not receive external radiotherapy were evaluated for the change in prostate specific antigen (PSA) level and the occurrence of side effects. In total, 18 patients were classified as low risk, 19 patients as intermediate risk, and 6 patients as high risk. The prescription dose was 145 Gy. Results: A PSA increase greater than 2 ng/mL occurred in 2 patients (4.7%). Radiation Therapy Oncology Group (RTOG) grade 1 and 2 acute urologic complications (UC) occurred in 40 and 3 patients, respectively. Further, 5 patients had RTOG grade 1 acute rectal complication (RC). The numbers of RTOG grade 1, 2, and 3 chronic UC were 1, 4, and 1, respectively. The numbers of RTOG grade 1, 2, and 4 chronic RC were 5, 10, and 3, respectively. The statistically significant risk factors (RF) of acute RC were the minimal dose in the most irradiated 0.1 cc volume ($D_{0.1cc}$, p=0.041) and absolute volume receiving 150% of the prescribed dose ($V_{150cc}$, p=0.038) in the entire rectum (ER). The percentage ($V_{100%}$, p=0.019) and absolute volume ($V_{100cc}$, p=0.047) in the involved rectum (IR) were also statistically significant. The RF of chronic RC were $V_{100%}$ (p=0.011) in the ER and the $D_{0.1cc}$ (p=0.049), $V_{100cc}$ (p=0.023) in the IR. The number of used seeds were related with acute UC (p=0.028). Conclusion: Permanent brachytherpy of localized prostate cancer showed a favorable short term biochemical control rate. As such, selective intermediate and high risk patients can be managed with permanent brachytherapy. The effort to reduce rectal complication is also necessary.

Automatic Notification System for Nuclear Medicine Blood Test (핵의학 혈액 검사의 경고치 자동통보 시스템)

  • Sim, Seong-Jae;Yoon, Pil-Young;Lim, Soo-Yeon;Cheon, Jun-Hong;Shin, Young-Kyoon;Yu, Seon-Hui;Cho, Si-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.159-164
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    • 2009
  • Purpose: The automatic notification system for alarm values on blood tests conducted by this hospital is designed to immediately inform the attending physician of the result of a blood test, to help the relevant patient to promptly receive proper treatment, and furthermore, to reduce the likelihood of a fatal influence to the patient. From 2004, the clinical pathology department of this hospital has been operating an automatic notification system for blood tests, in relation to the items of WBC, Hb, Plt, PB cell morphology, Malaria, PT, aPTT, BT, fibrinogen, Ca, K, Na, Cl, Mg, Glucose, Ketone, Digoxin, PKU, Homocystinuria, 17-OHP, Neonatal TSH, and Galactosemia. Recently, the blood test room of the nuclear medicine department has been operating an automatic notification system for the alarm values of a blood test, in relation to three items of TSH, FT4, and 17-${\alpha}$-OH-PGR, and the details of its operation will be described here. Materials and Methods: The subjects were newborn babies that were receiving TSH, FT4, and $17{\alpha}$-OH-PGR prescriptions from February $19^{th}$ to May $11^{st}$, 2009, and who met with the following criteria: N2340 Thyroid-Stimulating Hormone: >$10{\mu}IU/mL$ (Reference value: 0.4~5.0). N2360 Free-Thyroxine: <$0.8{\mu}g/dL$ (Reference value: 0.8~1.9), N2444 $17{\alpha}$-OH-Progesterone: >$30\;{\mu}g/mL$ (Reference value: Male (0.6~3.42), Female follicular phase (0.19~1.8). The automatic notification system was operated by entering test items, relevant treatment departments, and standard values for reporting alarm values into the OCS program, and then transmitting results that met with the input conditions to the PDAs of the prescription and the attending physician by SMS. Results: Reporting an alarm value of the nuclear medicine blood test, which can have a fatal influence on the lives of patients, will help cure patients, improve the quality of the test, and furthermore, will increase the patient's satisfaction with the prescription and treatment of the test.

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Ovarian and Endometrial $^{18}F$-FDG Uptake During the Menstrual Cycle in Normal Premenopausal Patients: Evaluation by PET/CT (월경주기에 따른 $^{18}F$-FDG PET/CT의 자궁 내 섭취에 관한 연구)

  • Bahn, Young-Kag;Park, Hoon-Hee;NamKoong, Hyuk;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.43-47
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    • 2009
  • Purpose: The menstrual cycle of normal premenopausal patients was divide into menstrual flow phase, proliferative phase, ovulatory phase, secretory phase. The aim of this study was to ovarian and endometrial $^{18}F$-FDG uptake during the menstrual cycle in normal premenopausal patients. Materials and Methods: We identified 200 incidental $^{18}F$-FDG uptake in the ovary. The patient fasted at least 6 hours before receiving an intravenous injection of 370-592 MBq (10-16mCi) of $^{18}F$-FDG. Scanning from the base of the skull though the mid thigh was performed using the Discovery Ste PET/CT system (GE Healthcare, Milwaukee, WI, USA). Ovarian and endometrial $^{18}F$-FDG uptake (expressed as standardized uptake value) was measured on PET/CT image. Results: Two peaks of increased endometrial $^{18}F$-FDG uptake were identified during the menstrual cycle. The $SUV_{avg}$ and $SUV_{max}$ was $2.89{\pm}1.04$ and $3.17{\pm}1.59$ in menstruating patients, $2.4{\pm}0.88$ and $2.98{\pm}1.14$ in proliferative phase patients, $3.59{\pm}1.76$ and $3.17{\pm}1.67$ in ovulatory phase patients, $2.58{\pm}1.39$ and $3.1{\pm}1.8$ in secretory phase patients. Conclusions: Increased ovarian and endometrial $^{18}F$-FDG uptake could be found the time of menstrual flow and ovulatory phase of menstrual cycle. Increased uptake in endometrial adjacent to a cervical tumor does not necessarily reflect endometrial tumor invasion. Since increased uptake was dependent on the menstrual cycle, it can be avoided by scheduling PET/CT just after menstruation. Non-menstrual-related endometrial uptake may be instrumental in establishing a diagnosis in a premenopaual patient.

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A Study of Community Residents' Consciousness of Taking Herb Medicine (지역사회 주민의 한약복용에 대한 의식 조사 연구)

  • Kim Sung-Jin;Nam Chul-Hyun;Kang Young-Woo;Suh Ho-Suk;Jeon Bong-Cheon;Chang Young-Jin
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.15-35
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    • 2002
  • This study was conducted to provide basic data for policy of Oriental medicine by analyzing community resident's consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 2001 to May 31, 2001. The results of this study are summarized as follows. 1) The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 2) In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. 3) 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 4) According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it because persons around them recommended it. 5) 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain food should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 6) In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 7) 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 8) 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 51.9% does not know whether taking herb medicine in summer is effective or not because the effect is different according to their physical constitutions. 35.5% thinks that taking herb medicine is summer is effective because their physical stamina is weakened after sweated a lot, while 12.6% thinks that it is not effective because the effect of herb medicine disappears with sweat. 9) According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 10) According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

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Housewives' Knowledge Level of Herb Medicine and Its Related Factors (가정주부의 한약에 대한 지식수준과 관련요인)

  • Suh, Ho-suk;Nam Chul-Hyun;Park Chan-Woo;Kim Sung-Jin;Lee Mi-Kyung;Ha Eun-Pil
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.95-95
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    • 2002
  • This study was conducted to examine housewives' knowledge level of herb medicine and its related factors in Korea. Data were collected from 667 housewives from April 1, 1999 to June 30, 1999. The results of this study are summarized as follows. 1. According to general characteristics of the subjects, 29.1$\%$ of the subjects was over fifties. 28.6$\%$ was primary school graduate. while 25.5$\%$ was high school graduate. In case of job, the unemployed was 67.0$\%$ and professional/clerical worker was 19.6$\%$. 82.0$\%$ had spouses and 45.7$\%$ believed in Buddha. 50.8$\%$ of the subjects lived in big cities and 76.7$\%$ was the middle class. In case of their health condition, 33.4$\%$ was in good health, while 5 1.1$\%$ suffered from certain diseases and 43.9$\%$ was not satisfied with health conditions. 2. The proportion of experience in taking herb medicine was 86.4$\%$. The marital status and health condition were significantly related to the experience in taking herb medicine. When the respondents took diseases, 68.0$\%$ of them were experienced in folk remedy. The variables of age and religion were significantly related to experience in folk remedy. 3. According to the respondents opinions of the effect of the folk remedy, 'effective' was 78.5$\%$ and 'common' was 17.6$\%$, while 'not effective' was 3.9$\%$. 59.3$\%$ of the respondents thought that the folk remedy had scientific basis. 4. In case of information sources on herb medicine, 59.7$\%$ of the respondents obtained the information from TV or Radio. 13.7$\%$ of them got it from magazines related to Oriental medicine and 13.3$\%$ of them obtained it from newspapers or related books. The information sources were significantly related to age and health condition. The knowledge level of herb medicine was 20.76${\pm}$2.66 point on the basis of 30 points. The knowledge level was significantly related to age, occupation, health condition, information sources, experience in taking herb medicine, and opinions of scientific basis of the folk remedy. 5. The respondents marked 2.23${\pm}$0.64 points on the basis of 3.0 points in the question of the effect of taking herb medicine in summer, 2.30${\pm}$0.61 points in the question of the relationship between taking deer antlers and becoming clear-headed, 2.72${\pm}$0.56 points in the question of ginseng, 2.51${\pm}$0.56 points in the question of the relationship between taking herb medicine and being harmful to the liver, 1.94${\pm}$0.74 points in the question of taking herb medicine during the period of pregnancy, 1.84${\pm}$0.78 points in the question of the relationship between menstrual irregularity and motherwort, 2.00${\pm}$0.83 points in the question of the relationship between taking herb medicine and getting fat, 1.76${\pm}$0.89 points in the question of the relationship between Ssanghwatang and cold, 2.15${\pm}$0.76 points in the question of taking honey, and 1.45${\pm}$0.77 points in the question of selecting foods during the period of taking herb medicine. 6. The factors influencing decision of taking herb medicine were experience of taking herb medicine, intention of receiving treatment by folk remedy, occupation, health condition, and age. As seen in the above results, the knowledge level of taking herb medicine during the period of pregnancy, the relationship between menstrual irregularity and motherwort, Ssanghwatang, honey, and selecting foods during the period of taking herb medicine was very low. Therefore, it is necessary to develop education programs in order to provide community residents with basic knowledge of herb medicine. In doing so, the government, Oriental medical doctors, and associations related to herb medicine must make great efforts.

Housewives' Knowledge Level of Herb Medicine and Its Related Factors (가정주부의 한약에 대한 지식수준과 관련요인)

  • Suh Ho-Suk;Nam Chul-Hyun;Park Chan-Woo;Kim Sung-Jin;Lee Mi-Kyung;Ha Eun-Pil
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.96-116
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    • 2002
  • This study was conducted to examine housewives' knowledge level of herb medicine and its related factors in Korea. Data were collected from 667 housewives from April 1, 1999 to June 30, 1999. The results of this study are summarized as follows. 1. According to general characteristics of the subjects, 29.1% of the subjects was over fifties. 28.6% was primary school graduate. while 25.5% was high school graduate. In case of job, the unemployed was 67.0% and professional/clerical worker was 19.6%. 82.0% had spouses and 45.7% believed in Buddha. 50.8% of the subjects lived in big cities and 76.7% was the middle class. In case of their health condition, 33.4% was in good health, while 51.1% suffered from certain diseases and 43.9% was not satisfied with health conditions. 2. The proportion of experience in taking herb medicine was 86.4%. The marital status and health condition were significantly related to the experience in taking herb medicine. When the respondents took diseases, 68.0% of them were experienced in folk remedy. The variables of age and religion were significantly related to experience in folk remedy. 3. According to the respondents opinions of the effect of the folk remedy, 'effective' was 78.5% and 'common' was 17.6%, while 'not effective' was 3.9%. 59.3% of the respondents thought that the folk remedy had scientific basis. 4. In case of information sources on herb medicine, 59.7% of the respondents obtained the information from TV or Radio. 13.7% of them got it from magazines related to Oriental medicine and 13.3% of them obtained it from newspapers or related books. The information sources were significantly related to age and health condition. The knowledge level of herb medicine was $20.76{\pm}2.66$ point on the basis of 30 points. The knowledge level was significantly related to age, occupation, health condition, information sources, experience in taking herb medicine, and opinions of scientific basis of the folk remedy. 5. The respondents marked $2.23{\pm}0.64$ points on the basis of 3.0 points in the question of the effect of taking herb medicine in summer, $2.30{\pm}0.61$ points in the question of the relationship between taking deer antlers and becoming clear-headed, $2.72{\pm}0.56$ points in the question of ginseng, $2.51{\pm}0.56$ points in the question of the relationship between taking herb medicine and being harmful to the liver, $1.94{\pm}0.74$ points in the question of taking herb medicine during the period of pregnancy, $1.84{\pm}0.78$ points in the question of the relationship between menstrual irregularity and motherwort, $2.00{\pm}0.83$ points in the question of the relationship between taking herb medicine and getting fat, $1.76{\pm}0.89$ points in the question of the relationship between Ssanghwatang and cold, $2.15{\pm}0.76$ points in the question of taking honey, and $1.45{\pm}0.77$ points in the question of selecting foods during the period of taking herb medicine. 6. The factors influencing decision of taking herb medicine were experience of taking herb medicine, intention of receiving treatment by folk remedy, occupation, health condition, and age. As seen in the above results, the knowledge level of taking herb medicine during the period of pregnancy, the relationship between menstrual irregularity and motherwort, Ssanghwatang, honey, and selecting foods during the period of taking herb medicine was very low. Therefore, it is necessary to develop education programs in order to provide community residents with basic knowledge of herb medicine. In doing so, the government, Oriental medical doctors, and associations related to herb medicine must make great efforts.

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Percutaneous Autologous Marrow and Heterograft Bone Grafting in a Treatment for Simple Bone Cyst (경피적 자가 골수 및 이종골 이식을 이용한 고립성 골낭종의 치료)

  • Lee, Keun-Bae;Rowe, Sung-Man;Yoon, Taek-Rim;Son, Il-Jin;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.24-30
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    • 2003
  • Purpose: To clarify the results of simple bone cyst (SBC) treatment in children by percutaneous autologous bone marrow grafting and xenografting. Materials and Methods: We studied seven cases (4 males, 3 females) of SBC, which were treated by percutaneous autologous marrow and heterograft bone grafting from January 1996 to February 1999. Their mean age at surgery was 10 years (6 to 15), and the mean follow-up period was 35.6 months (20 to 52). Three cases were located in the proximal and middle humerus; three cases were in the proximal femur; and one case occurred in the ilium. Mean volume was 14.7 $cm^2$ (10 to 23). Six cases were active, and one was inactive. Five patients had a history of receiving a mean of 3.2 steroid injections. The mean quantity of bone marrow used in treatment was 14.3 ml (10 to 20), and the mean amount of $Lubboc^{(R)}$ heterograft bone (Transphyto S.A. Clermont Ferrand, France) used was 6.4 blocks (5 to 10). Results were analyzed using the modified Neer classification. Results: Five cases completely healed with obliteration of the cyst cavity (Grade IV). Two cases demonstrated sclerosis around a partially visible cyst (Grade III). All treatment results were satisfactory and without intraoperative or postoperative complications. Conclusione: Percutaneous autologous marrow and heterograft bone grafting is recommended as an effective treatment method for simple bone cyst. It offers ease of operative technique, a high rate of healing, a low recurrence rate, low morbidity, a low incidence of postoperative complications, and free from bone graft donor site problems.

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A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
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    • v.31 no.4
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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