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Surgical Treatment for the Shoulder Joint in Rheumatoid Patients

  • Yoon, Hyung Moon;Jo, Young-Hoon;Lee, Bong Gun
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.179-185
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    • 2016
  • Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.

A Case of Laryngeal Rhabdomyosarcoma (후두부횡문근육종의 1례)

  • 이순철;김석도;김시원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.9.3-9
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    • 1981
  • Rhabdomyosarcomas are relatively rare and highly malignant tumors which originated from mesenchymal cells. A 50-year-old man, suffered from hoarseness for 2 months, visited to the Dept. of ENT, Seoul Red Cross Hospital. By indirect laryngoscopic examination, a sessile based whitish polypoid mass (0.5cm$\times$0.3cm) was noted at the one third portion of right true vocal cord. Under general anesthesia, local excision was performed. Biopsy revealed rhabdomyosarcoma of the embryonal type. To our knowledge, only 24 cases of laryngeal rhabdomyosarcoma have been reported in the world literature.

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Mechanical Property and Problems of the Self-expandable Metal Stent in Pancreaticobiliary Cancer

  • Thanawat Luangsukrerk
    • Journal of Digestive Cancer Research
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    • v.10 no.2
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    • pp.92-98
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    • 2022
  • Self-expandable metal stent (SEMS) is effective for biliary drainage, especially in pancreaticobiliary cancer. The mechanical properties, material, and design of SEMS are important in preventing recurrent biliary obstruction and complication. Radial and chronic expansion forces play roles in preventing stent migration and collapse. Complications, such as stent impaction, cholecystitis, and pancreatitis, were related to the axial force. The nickel-titanium alloy shows more flexibility, conformability, and optimal axial force compared to previously used stainless steel. Additionally, the stent structure affected the mechanical properties of SEMS. Therefore, understanding the mechanical properties, material, and design of SEMS will provide the best outcome for biliary drainage, as well as better SEMS development.

Immunopathogenesis of childhood idiopathic nephrotic syndrome

  • Hae Il Cheong
    • Childhood Kidney Diseases
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    • v.27 no.1
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    • pp.1-10
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    • 2023
  • Pediatric nephrotic syndrome (NS) is a clinical syndrome characterized by massive proteinuria, hypoalbuminemia, and generalized edema. Most childhood NS cases are idiopathic (with an unknown etiology). Traditional therapeutic approaches based on immunosuppressive agents largely support the key role of the immune system in idiopathic NS (INS), especially in the steroid-sensitive form. Although most previous studies have suggested the main role of T cell dysfunction and/or the abnormal secretion of certain glomerular permeability factors, recent studies have emphasized the role of B cells since the therapeutic efficacy of B cell depletion therapy in inducing and/or maintaining prolonged remission in patients with INS was confirmed. Furthermore, several studies have detected circulating autoantibodies that target podocyte proteins in a subset of patients with INS, suggesting an autoimmune-mediated etiology of INS. Accordingly, a new therapeutic modality using B cell-depleting drugs has been attempted, with significant effects in a subset of patients with INS. Currently, INS is considered an immune-mediated disorder caused by a complex interplay between T cells, B cells, soluble factors, and podocytes, which may vary among patients. More in-depth investigations of the pathogenic pathways of INS are required for an effective personalized therapeutic approach and to define precise targets for therapeutic intervention.

Experiences of the Use of External Breast Prosthesis among Breast Cancer Survivors in Korea (유방암 생존자의 인조유방 사용경험)

  • Jun, Eun-Young;Choi, Soon-Ran;Kang, Hee-Sun
    • Women's Health Nursing
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    • v.18 no.1
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    • pp.49-61
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    • 2012
  • Purpose: The purpose of this study was to examine the experiences of the use of external breast prostheses among breast cancer survivors in Korea. Methods: A qualitative descriptive study was conducted, using focus groups. Data were collected from breast cancer survivors who were patients of C women's hospital in Seoul, Korea. Data were analyzed using content analysis in order to identify significant themes. Results: Participants included forty breast cancer survivors who had mastectomy as a surgical treatment. Four themes emerged from the collected data were: 1) concern over the high price of external breast prosthesis, 2) irregular use of external breast prosthesis, 3) unsatisfied with mastectomy bra, and 4) wanting to hide or not to talk about using breast prosthesis openly. Conclusion: Since most participants reported irregular use and negative experiences related to external breast prosthesis or mastectomy bra use, healthcare workers should allow more time for proper fitting and counseling and consulting with breast cancer survivors. In addition, health care providers as well as family and friends should keep in mind that cancer survivors need support that can help them cope by using positive reframing. Furthermore, improvements in the coverage of costs and services are needed for these women. This would be helpful for breast prosthesis users.

Knowledge, Attitudes and Perceptions of Nurses on Personal Protective Equipment: Response to the Middle East Respiratory Syndrome Coronavirus (간호사의 개인보호장비에 대한 지식, 태도 및 인식: 메르스 대응을 중심으로)

  • Kim, Kyungnam;Lee, Ogcheol
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.4
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    • pp.402-410
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    • 2016
  • Purpose: Personal protective equipment (PPE) is critical to protect healthcare workers from pandemic outbreaks. This study was designed to identify nurses' knowledge, attitude and perceptions on PPE. Methods: Data were collected from 154 nurses working at a tertiary general hospital, where positively diagnosed and suspected patients were accepted and admitted during the Middle East Respiratory Syndrome Coronavirus outbreak in 2015. The PPE tool consists of 20 items for knowledge, and 5 each for attitudes and perceptions. Results: Overall, knowledge for PPE was higher than moderate (76.95/100), but there was a lack for items related to powered air purifying respirator (PAPR). For attitudes, willingness to work in pandemic outbreaks was the most positive (4.04/5.00). Goggles and PAPR were perceived as the most uncomfortable barriers to work. There was no correlation between knowledge, attitude and perceptions, despite a strong positive correlation between attitude and perceptions. PPE training was identified as a factor to improve knowledge and attitudes on PPE. Conclusion: To respond to pandemic influenza, nurses need to expand their knowledge on PPE up to Level C, and be updated through regular training. Study findings suggest that repetitive studies targeting nurses and other healthcare workers at various hospital settings are necessary.

Identifying the Needs of Home Care Patient's Family Caregivers (가정간호 가족 돌봄 제공자의 요구도)

  • Baek, Hee-Chong;Choi, Yun-Jung
    • Journal of Home Health Care Nursing
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    • v.15 no.2
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    • pp.115-121
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    • 2008
  • Purpose: The purpose of this study was to identify the needs of family caregivers of home care patients. Methods: A total of 40 caregivers had been selected from a hospital-based home care agency in Gyunggi province. The instrument developed by Hileman, Lackey, & Hassanein(1992) was modified to 55 items and used in this study. The instrument consists of 6 categories: informational, household, patient care, personal, spiritual, and psychological needs. Out of 29 analysed with descriptive statistics, Mann-Whitney U test, and Spearman correlation test using SPSS 14.0. Results: Most caregivers were females, with a mean age of $60.0{\pm}15.5$, 32.1% were spouses, and 92.9% were living with patients. Patient's activities of daily living score was very low, and 44% of patients had cerebrovascular disease. Caregiver's needs were moderate, and the greatest being personal need. There was a significant difference between caregiver's monthly income and needs. Conclusion: Home care nurses need to teach and support family caregivers with specific programs and services to meet the identified and unmet needs of caregivers of home care patients. In-home respite and institutional respite are recommended for family caregivers taking care of patients with chronic disease.

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Development and Feasibility of a Video Recording-Based Standardized Handoff Program for Ward Nurses: A pilot study (비디오 녹화 기반 병동 간호 인수인계 프로그램 개발 및 적용가능성 : 예비연구)

  • Seo, Eun Koung;Kim, Sun-Hee;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.71-84
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    • 2018
  • Purpose : This study develop a Video Recording-Based Standardized Handoff (VRSH) program at shift change for ward nurses. Methods : The study was conducted in five medical, three surgical, and one comprehensive nursing care service wards affiliated with a secondary general hospital. In this methodological study, the VRSH program was developed between April and December, 2017. It is noted that 65 nurses who were involved in the VRSH program participated in this study. Results : In line with the modified Situation, Background, Assessment, Recommendation tool, the VRSH program consisted of three phases. In the VRSH program, the average time for handoff duration was 3-5 minutes per patient. More than 90% of the ward nurses were satisfied with the VRSH program since it benefited them by reducing overtime work and improving the performance, as well as effective communication, of nurses. The content analysis of nurses' VRSH program experience, revealed three categories and eight sub-categories. Conclusions : This study provides evidence that the VRSH program improves effective nursing performance and, the handoff communication and relationships between nurses. Future studies on large sample sizes and multiple settings are required to substantially evaluate the impact of the VRSH program on clinical outcomes.

Development of the Nursing Practice Guideline for Pain Management according to the Guideline Adaptation Process (간호 분야 실무지침의 수용개작 방법론에 따른 통증간호 실무지침의 개발)

  • Eun, Young;Yu, Mi;Gu, Mee Ok;Cho, Yong Ae;Kim, Kyung Sook;Kim, Tae Hee;Lee, Hyun Hee;Jeon, Mi Jin
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.1
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    • pp.1-14
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    • 2019
  • Purpose: This study was done to develop a evidence-based guideline for pain assessment and management in Korea by adapting previously developed pain guidelines. Methods: The guideline adaptation process was conducted using 24 steps according to the guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed pain management guideline consisted of 9 domains and 234 recommendations. The number of recommendations in each domain was: 13 general instruction items, 51 pain assessments, 14 pain interventions, 66 pharmacological interventions for acute pain, 41 pharmacological interventions for chronic cancer pain, 35 pharmacological interventions for chronic noncancer pain, 21 non-pharmacological interventions, 2 documentations, 10 nursing education items, for pain. Conclusion: The findings suggest that the new pain management guideline can be used to address pain in hospital settings.

Recent Trend in Clinical Research of Tongue Diagnosis of Cancer Patient (암 환자의 설진에 대한 최신 연구 동향)

  • Jaeho, Song;Su Bin, Park;Jee-Hyun, Yoon;Eun Hye, Kim;Seong Woo, Yoon
    • Journal of Korean Traditional Oncology
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    • v.27 no.1
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    • pp.13-23
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    • 2022
  • Objective: The purpose of this review is to analyze the clinical studies on tongue diagnosis in cancer patients. Methods: Domestic and foreign databases were used, such as Pubmed, google scholar, Wanfang med online, Scopus, and OASIS. Searching keywords were tongue diagnosis, tongue color, tongue fur, tongue inspection, cancer, tumor, neoplasm, carcinoma, etc. Studies on tongue diagnosis in cancer patients were included. The published year was limited from 2000 to June 2022. Results: Thirteen studies were enrolled. All selected studies were cross-sectional studies. Cancer patients tend to have a dark and blue-purple tongue, thick fur, yellow fur, fissure tongue, and red dots on the tongue compared with non-cancer patients. With the aggravation of cancer, the rate of patients having dark or blue, or purple tongues increased, and the patients' sublingual veins became wide and tortuous. Conclusion: This study suggests that cancer patients tend to have distinct features of tongue diagnosis. Further researches are warranted.