• Title/Summary/Keyword: Surgical Management

Search Result 1,854, Processing Time 0.025 seconds

Perceptions of Quality Nursing care of Patients and Families (질적 간호에 대한 환자와 가족의 지각)

  • Chi, Sung-Ai;Kwon, Sung-Bok;Park, Eun-Hee
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.4 no.1
    • /
    • pp.247-275
    • /
    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

  • PDF

Urinary Lithiasis in Children : A Single Center Study (소아 요로 결석 : 단일 기관 연구)

  • Lee, Hyun-Kyung;Lee, Sung-Ha;Han, Kyoung-Hee;Lee, Beom-Hee;Choi, Hyun-Jin;Ha, Il-Soo;Choi, Yong;Cheong, Hae-Il
    • Childhood Kidney Diseases
    • /
    • v.11 no.2
    • /
    • pp.280-287
    • /
    • 2007
  • Purpose : Urinary lithiasis is uncommon in children, however, it may lead to chronic renal insufficiency and even end stage renal disease. The etiology of stone formation in children is largely unknown; although the most common causes are known to be associated with congenital anomalies of the genito-urinary(G-U) tract, urinary tract infections(UTI), and metabolic diseases. Methods : A total of 73 children(male:female=42:31, mean age $6.6{\pm}5.3$ years) presented with urinary lithiasis between Sep. 1998 and Jul. 2007 at Seoul National University Children's Hospital. The medical records were reviewed retrospectively. Results : The most common presenting symptoms were gross hematuria(28/73, 38%) and flank or abdominal pain(23/73, 32%). The stones were located in the upper urinary tract in 48 patients(66%), in the bladder in 18(24%), and in both the bladder and upper urinary tract in 2 (3%). Congenital anomalies of the G-U tract with/without UTI were detected in 30 children (41%), hypercalciuria with/without hypercalcemia in 15(20%), and other metabolic diseases in 8(11%). In 17 patients(23%), no underlying cause of stone formation was detected. The majority of stones were infected stones(24/36, 67%), which were followed by calcium stones(8/36, 22%), uric acid stones(3/36, 8%). and cystine stones(1/36, 3%). Thirty-four patients(46%) underwent surgical procedures and/or extracorporeal shockwave lithotripsy for stone removal, and 13(18%) passed stones spontaneously with/without medical management. Stones recurred in 6 patients(8%): 4 with neurogenic bladder augmented by ileocystoplasty, 1 with cystinuria, and 1 with unknown etiology. Conclusion : The common causes of urinary lithiasis in children were congenital anomalies of the G-U tract with/without UTI and metabolic disorders including hypercalciuria/hypercalcemia. For the management of stones, minimally invasive procedures should be chosen on the basis of accompanying symptoms and the composition, locations and etiology of stones.

  • PDF

Study on Association of All DSOM Fluents for Uterus Myoma in Oriental Medicine - Control Group : Outpatient and Clinical Demonstration Data - (자궁근종 발생에 대한 DSOM 모든 변수의 연관성분석 - 대조군 : 한방부인과 외래환자와 임상시험 피시험자 -)

  • Lee, Yong-Tae;Ji, Gyu-Yong;Kim, Jong-Won;Jeon, Soo-Hyung;Kim, Kyu-Kon;Lee, In-Sun
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.21 no.1
    • /
    • pp.250-257
    • /
    • 2007
  • Uterus myoma is a benign tumor of smooth muscle in the wall of the uterus, In oriental medicine, we used to made an effort to management this patients without surgical operation. Doctors have treated patients of uterus myoma mainly by checking over each symptom they have. Then we think that patients have some symptoms in relation to an etiological cause. So I have carried out this study to investigate association of DSOM scores and an attack of uterus myoma in oriental medicine. We chose 3 groups, the first one is 257 uterus myoma patients who visited Dongeui University Oriental Medical Center from May 2001 to June 2006, the second one is 558 outpatients who didn't have uterus myoma from May 2005 to June 2005, the third one is 129 clinical trials who volunteered for Sasang constitutional medicine. Then we made up 3 groups to checkup DSOM, and investigated the All DSOM Fluents which effect uterus myoma patients using regression model. Logistic regression analysis indicate as follows ; In comparison with 558 outpatients data, blood stasis(血瘀), dryness(燥) is associated positively and insufficiency of Yang(陽虛), spleen(脾), phlegm(痰) negatively, and mean of the index for pathogenic factor(病機指標 平均) of deficiency of qi(氣虛), heart(心) negatively. In comparison with 129 clinical trials data, blood stasis(血瘀) is associated positively and phlegm(痰) negatively, and mean of the index for pathogenic factor(炳機指標 平均) of deficiency of Yin(陰虛), liver(肝), diarrhea positively, heart(心) negatively. 3. In investigation of DSOM items, items of blood stasis(血瘀), deficiency of Yin(陰虛), coldness(寒) is associated positively and items of heart(心), spleen(脾), Phlegm(痰) negatively.

Clinical Experience with Colonic Atresia (선천성 결장 폐쇄증의 경험)

  • Hwang, Jihee;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
    • /
    • v.18 no.2
    • /
    • pp.68-74
    • /
    • 2012
  • Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.

  • PDF

Arthroscopic Outside-in Repair of Tears of the Triangular Fibrocartilage Complex (삼각 섬유연골 복합체의 파열에 대한 관절경적 Outside-in 봉합술)

  • Byun, Jae-Yong;Kang, Shin-Taek;Kim, Bo-Hyun;Hwang, Chan-Ha;Choi, Seung-Woog;Jung, In-Ho
    • Journal of the Korean Arthroscopy Society
    • /
    • v.10 no.1
    • /
    • pp.83-86
    • /
    • 2006
  • Purpose: We repoted the clinical results and introduction of surgical techniques for the patients with tears of the triangular fibrocartilage complex (TFCC) who had arthroscopic management. Materials and Methods: According to Palmer classification, nine patients(9 wrists) with type 1B lesions of the triangular fibrocartilage complex from 2001 to 2004 were included in this study. The mean follow-up period was 28 months. Six were male and three were female, right side was in seven cases and left side in two cases. Nine patients received arthroscopic debridement and repair by outside-in technique. To assess the clinical outcomes, the visual analogue pain scale(VAPS), grip strength, range of motion were investigated. Results: The average of VAPS improved from 6.2 to 1.4. The grip strength of wrists of all nine patients improved after surgery and the range of motion of all wrists reached full range. Conclusion: Arthroscopic repair of type 1B tear of the triangular fibrocartilage complex has satisfactory results. The repair by outside-in technique was simple and we could have secure fixation.

  • PDF

Oral Features in a Child with Noonan Syndrome : A Case Report (누난 증후군 환자의 구강 내 특징 : 증례 보고)

  • Hwang, Inkyung;Lee, Yeonju;Sim, Dohee;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.45 no.1
    • /
    • pp.115-122
    • /
    • 2018
  • Noonan syndrome is characterized by distinctive facial features, short stature, and congenital heart disease. It is a congenital genetic disorder with a prevalence of between 1/1,000 and 1/2,500 in both genders. An 11-year-old boy with Noonan syndrome visited the hospital with an ectopically positioned tooth. A pulmonary stenosis was diagnosed and his growth and development were delayed. In many cases of this diseases there is obvious hemostasis, which he was not experiencing. His facial appearance showed characteristic features of Noonan syndrome. The patient showed a dental class II relationship, labioversion of the upper anterior teeth, and a shallow overbite. Radiographic examination revealed that the upper right canine was ectopically positioned, which led to root resorption of the upper right lateral incisor. A lateral cephalometric radiograph revealed a craniofacial pattern that was within normal limits. Surgical opening and button attachment on the impacted upper right canine were performed and traction was applied on the impacted tooth using a removable appliance. This patient was mildly affected by Noonan syndrome and showed some dental problems. However, few studies have reported the oral characteristics of Noonan syndrome despite its high incidence. Thus, this case report describes the oral features and management of Noonan syndrome.

Treatment Outcome of Supraglottic Partial Laryngectomy and Neck Dissection for Supraglottic Carcinoma (성문상부암종에서 성문상 후두부분절제술과 경부청소술의 치료성적)

  • Tae, Kyung;Min, Hyun-Jung;Song, Mi-Na;Shin, Kwang-Soo;Lee, Seung-Hwan;Kim, Kyung-Rae;Lee, Hyung-Seok
    • Korean Journal of Head & Neck Oncology
    • /
    • v.23 no.1
    • /
    • pp.15-20
    • /
    • 2007
  • Background and Objectives:Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods:Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results:Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions:Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.

TREATMENT OF MAXILLARY FIRST MOLARS WITH ERUPTION FAILURES (맹출장애를 가진 상악 제1대구치의 치료)

  • Kwon, Soon-Yeon;Kim, Hyun-Jung;Kim, Yeung-Jin;Nam, Sun-Hyun
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.36 no.2
    • /
    • pp.281-287
    • /
    • 2009
  • An eruption failure can be observed for child and adolescent periods when the primary dentition is changed to the permanent dentition through the mixed dentition frequently. The eruption failure can lead to miss erupting times of the tooth, then it will cause a lot of problems including root resorption, esthetic problem, transposition of adjacent tooth, malocclusoin and etc. Especially, the maxillary first molar is importantly concerned with occlusion and growth and is an essential tooth for development and maintenance of occlusion. So, it is a momentous part of more proper occlusal management to find these abnormal cases at the early stage and solve the problems. The sorts of eruption failures of the maxillary first molars can be divided into delayed eruption, impaction and the primary retention and the secondary retention. When physical obstacles cause impaction, first of all they must be removed then we can treat the impaction with observation after removal, surgical exposure or orthodontic traction. If the source of impaction is an ectopic eruption, the treatment can be a brasswire, a pendulum appliance, a space maintainer or space regainer after the extraction of the second deciduous tooth and etc. These cases are made a diagnosis of eruption failures of the maxillary first molars in mixed dentition period and have good prognosises after my treatments. So I reported them.

  • PDF

Catamenial Hemoptysis Treated by Video-assisted Thoracoscopic Surgery (비디오 흉강경 수술로 완치된 월경성 객혈)

  • Cho, Chang Beom;Kim, Dong-Gyu;Kim, Changhwan;Park, Ji Young;Lee, Seok Won;Jang, Seung Hun;Jung, Ki-Suck;Jun, Sun-Young;Lee, Jae Woong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.65 no.1
    • /
    • pp.29-33
    • /
    • 2008
  • Catamenial hemoptysis is a rare condition that's characterized by recurrent hemoptysis occurring in association with menstruation, and this is associated with the presence of intrapulmonary or endobronchial endometrial tissue. The diagnosis of pulmonary endometriosis can be made according to a typical clinical history and with exclusion of other causes of recurrent hemoptysis. Treatment of pulmonary endometriosis can be medical or surgical; however, the optimal management of this condition is still a matter of debate. Medical therapy may be problematic, due to recurrence of symptoms despite hormonal ablation, and adverse effects from long-term hormone therapy can also be a problem. We report here on a case of pulmonary endometriosis in a 23-year-old woman who presented with hemoptysis that occurred during the first 3 days of menstruation, and this happened over a 4 month period. She was successfully treated by video-assisted thoracoscopic surgery (VATS). No more hemoptysis was noted during 12 months of follow-up.

Dismantling Simulation of Nuclear Reactor Using Partial Mesh Cutting Method for 3D Model (3D 형상 모델의 부분 절단 기법을 이용한 원자로 해체 시뮬레이션)

  • Lee, Wan-Bok;Hao, Wen-Yuan;Kyung, Byung-Pyo;Ryu, Seuc-Ho
    • Journal of Digital Convergence
    • /
    • v.13 no.4
    • /
    • pp.303-310
    • /
    • 2015
  • Game technologies are now applied in various engineering areas such as the simulation of surgical operation or the implementation of a cyber model house. One of the essential and important technology in these applications is cutting of the 3D polygon model in real time. Real-time cutting technology is an essential technology needed to implement the simulation of a building demolition or a car assembly for training or educational purpose. Previous cutting method using the conventional BSP-Tree structure has some limitations in that they divide the whole world including the 3D model and its environment, only into two parts with respect to an infinite plane. In this paper, we show a technique cutting the 3D model in a finite extent in order to solve this problem. Specifically, we restricted the cut surface in a finite rectangular area and constructed the mesh for the divided surface. To show the usefulness of our partial cutting technique, an example of the dismantling process simulation of a nuclear reactor polygon model was illustrated.