A clinical study was performed on 152 cases of surgical esophageal disease treated by the Department of Thoracic & Cardiovascular Surgery of Korea University Hospital from Jan. 1989 through July 1994. The most common esophageal disease was cancer which was seen in 73 cases (48%) among 152 cases. All were treated surgically' 52 patients (71%) were managed by curative or palliative resection with reconstruction and feeding gastrostomy or jejunostomy, otherwise Celestine tube insertion was performed on the remaining 21 patients for palliatio'n. Esophageal leiomyoma occurred in 6 cases(3.9%), among them 1 case was performed with trio recoscopic enucleation . Achalasia were in 7 cases (4.6%) and was treated with modified Heller's m otomy and with Belsey Mark IV operation. Diverticulum were in 11 cases (7.2%). Esophageal stricture occurred in 20 cases (14.1 %) and 17 of 20 cases were managed with bypass surgery. Esophageal perforation was seen in 20 cases, its cause was instrumental trauma in 7 cases, stab wound in 4 cases, foreign body in 4 cases, spontaneous perforation in 3 cases, and others 1 case Other disease including congenital lesion was seen In 1 Scases.
The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.
Chang, Ye Rim;Chang, Sung Wook;Kim, Dong Hun;Yun, Jeongseok;Yun, Jung Ho;Lee, Seok Won;Jo, Han Cheol;Choi, Seok Ho
Journal of Trauma and Injury
/
v.30
no.4
/
pp.113-119
/
2017
Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.
Ji, Joong-Ryong;Alam, Md. Rafiqul;Na, Chong-Sam;Kim, Nam-Soo
Journal of Veterinary Clinics
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v.28
no.2
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pp.219-224
/
2011
The health status of three groups of Hanwoo steers (n=157) aged 2-3 years, raised at three different altitudes (600 m, n=50; 200-400 m, n=58; plane land, n=49) and environment with more or less similar management have been evaluated through hematological, biochemical and globulin examinations in order to determine the optimum environment suitable for raising cattle while at the same time minimizing the risk of disease. Five mL of blood samples from each animal were collected by jugular veinipuncture and 2 mL was transferred to a tube containing EDTA for complete blood count (CBC) and 3 mL in lithium heparin for chemistry screening (CS) and immunoassay. Among the CBC parameters a significantly higher white blood cell count (tWBC), total red blood cell count (tRBC), hemoglobin (Hb) and packed cell volume (PCV) were noticed in the high altitude groups, whereas those were lower in the plane land group. In the CS parameters higher levels of aspartate aminotransferase (AST), creatinine, lactate dehydrogenase (LDH) and total bilirubin (TBL) were found in the plane land group, whereas those were lower in the high altitude groups. The total protein (significantly) and globulins were higher in the 600 m group. The results of this study revealed that the overall health status of the Hanwoo cattle based on the hemato-biochemical indices was superior in the highest altitude and inferior in the plane land group but all the parameters were within the reference range in all the groups. Therefore, for recommendation of a suitable environment at an appropriate altitude for raising cattle there need to be further studied along with the hemato-biochemical parameters; considering, breeding, feeding, management, marketing, waste disposal and other factors.
Kim, Sung-Joon;Kim, Se-Il;Song, Hyo-Jeong;Kahm, Se-Hoon;Lee, Byoung-Jin
The Journal of the Korean dental association
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v.53
no.1
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pp.36-46
/
2015
Objectives: The objective of this work was to investigate the hospital nursing care of oral and maxillofacial health in jeju province. Methods: 438 Registered nurses(RN) who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. The data were analyzed via frequency analyses and one-way ANOVA to assess the state of RN on hospital nursing care of oral and maxillofacial health. Results: The class of education on density in formal density that marked '0 hour' and '1-3 hours' were 73.5% and 19.9%, respectively. The class of refresher training on density that marked '0 hours' and '1-3 hours' were 92.9% and 6.6%, aggregately 99.5%. The nursing education on appearance after tumor of maxillofacial area that marked 'formal education' and 'none' were 45.2% and 52.1%, respectively. The score of question 'function, effect and side effect of hexamedin gaggle' was $2.68{\pm}0.95$ by Likert 5-point scale. Likewise, the scores were $2.82{\pm}0.88$ on question 'management of removal denture', $2.83{\pm}0.95$ on question 'preventive dental treatment before anticancer therapy', $2.88{\pm}0.86$ on question 'function of saliva', $2.96{\pm}0.99$ on question 'oral management of tube feeding patient', $3.13{\pm}1.00$ on question 'bacterial endocarditis from oral microflora', $3.36{\pm}0.89$ on question 'dysphagia' and $3.62{\pm}1.03$ on question 'aspiration pneumonia'. RN replied that 'lack of knowledge' and 'delay of cooperation' formed 53.7% and 33.3% respectively, on question 'problem in dental consultation other diseased patient'. Conclusions: From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial nursing. Authors suggest further co-study and nation-wide research.
The Journal of Korea Assosiation for Disability and Oral Health
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v.12
no.2
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pp.87-91
/
2016
Pierre Robin syndrome (PRS) is characterized by the triad of congenital mandibular hypoplasia, glossoptosis and cleft palate. Infant PRS patients are frequently suffering from upper airway obstruction, gastroesophageal reflux and growth retardation caused by above mentioned problems. We report a dental caries treatment of 3-year old girl with Pierre Robin syndrome with multiple caries. The cause of multiple caries was mainly presumed as patient's eating habit caused by her general condition. She had some feeding problems and had history of gastric tube. She was still using milk bottle and took more than an hour to finish a meal. The treatment was performed under general anesthesia considering patient's condition; mild autism, poor cooperation and respiratory problem due to micrognathia. Severely affected upper incisors were treated with pulp treatment and restored with zirconia crown for esthetic purpose. Lower incisors were treated with pulp treatment and restored with composite resin. Upper right first primary molar was restored with stainless steel crown and other primary molars were treated with composite resin. There were no postoperative complications. According to her parents, the patient's compliance to oral hygiene management was greatly improved after the treatment since she was very pleased with the esthetic result and highly motivated by her looks. The treatment without sedation or general anesthesia would be possible once the airway is improved as the mandible grows.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.2
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pp.1264-1272
/
2015
This study was performed to compare the perceived importance and performance frequency of the core nursing skills between general and special department. Subjects were 182 nurses who work on the hospital. Data was collected using items made by Korean accreditation board of nursing education and analyzed by frequency, mean and t-test. There were differences of importance and frequencies about nursing core skill between general and special wards. Core nursing skills of general wards were higher importance on intradermal injection(p=.011), transfusion(p=.028), simple catheterization(p=.047), cleansing enema(p=<.001), preoperative and postoperative care(p=.035), management administration(p=.027) and oxygenation with cannular(p=.002) than special wards. Actual performance frequency core nursing skills of general wards were higher similar on transfusion(p=.002), intermittent tube feeding(p=.032), simple catheterization(p=<.001), cleansing enema(p=<.001), preoperative care(p=.001), postoperative care(p=<.001), management administration(p=.001), protection equipment for quarantine room and waste disposal(p=.021), oxygenation with cannular(p=<.001) than special wards. It is needed to develop efficient and sequential program to learning the nursing core skills for nursing students.
This study describes to analyze the characteristics for separation and recovery of both the dried particles and the purified solvent from the waste solvent through the vaporization process by the continuous and instantaneous vacuum drying system. The vacuum drying system for the waste solvents recovery consists of a feeding pump, a double pipe heat exchanger, a vacuum spray chamber, and a condenser. The vacuum drying system heats the waste solvent to the vapor in the double pipe heat exchanger and the expanded vapor is sprayed at the end of the tube. The vaporized solvent in the condenser are recovered. The particles in the waste solvent are separated and dried from the vapor in the vacuum spray chamber. Performance evaluation of the vacuum drying system was conducted using the mixture of the dried pigment particles and benzene or alkylbenzene as test samples. For the mixture of 10 wt% pigment particles an 90% benzene, the recovery efficiency of benzene was 88% with the purity of 99% and the recovery efficiency of dried particles was 94% with the moisture of 1.1 wt%. The size of pigment particles was decreased from $6.5\mu\textrm{m}$ to $5.6\mu\textrm{m}$ in diameter due to high speed spraying and dispersion in the vacuum drying system during drying process. Therefore, the vacuum drying system showed to be an effective method for separating particles and solvent in the waste solvent.
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.4
/
pp.570-577
/
2017
The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.
Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥2-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.
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