• Title/Summary/Keyword: adult patients

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Emergency Cranial Irradiation Effects in Adult Leukemia with Extremely High Leukocytosis (극심한 백혈구 증다증이 동반된 성인 백혈병에 있어서 응급 두개부 방사선 조사의 효과)

  • Park Seoung-Ho;Cho Moon-June;Kim Samyong
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.255-259
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    • 1992
  • We have treated adult acute leukemia 64 patients between January 1990 and October 1991 at the Chungnam National University Hospital. They were examined for the impact of presenting WBC count on the initial course and from them we have chosen twenty patients whose leukocyte count is over one hundred thousands per cubic milimeter, We divided the twenty patients into 4 groups on the base of treatment modalities: conservative therapy only, chemotherapy only, cranial irradiation only, and chemotherapy with cranial irradiation. Early sudden death rate is lower in cranial irradiation with/without chemotherapy groups than the conservative only or chemotherapy only patients. Also the remission rate is high in cranial irradiation with chemotherapy patients. Therefore we suggest that the rapid intervention of cranial irradiation in adult acute leukemia could be helpful in reducing the early sudden death rate and perhaps in increasing the remission rate.

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Efficacy of Isoproterenol as a Marker of Epidural Test Dose in Patients Anesthetized with Enflurane (Enflurane 전신마취중 경막외 시험용량의 표식자로서 Isoproterenol의 효율성)

  • Kim, Keon-Sik;Kang, Wha-Ja;Lee, Doo-Ik
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.186-192
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    • 2001
  • Background: Epidural test doses containing epinephrine are an incomplete marker for the detection of inadvertent intravascular injection. Therefore, many investigators have attempted to find a more reliable marker as an alternative to epinephrine in adult patients anesthetized with enflurane. The present study was designed to test whether two different simulated intravenous test doses of isoproterenol could be used as a reliable marker for the detection of inadvertent intravascular injection in adult patients anesthetized with $O_2-N_2O$-enflurane. Methods: Forty healthy adult patients were anesthetized with 1% end-tidal enflurane and nitrous oxide after endotracheal intubation and were randomized to one of two groups according to the dose of isoproterenol. Group 1 and 2 (n = 20 each) received 3 ml of 1.5% lidocaine with 3 and 5 g isoproterenol intravenously, respectively, to simulate an intravascularly administered test dose. Heart rate (HR) and systolic blood pressure (SBP) were measured at 20-second intervals for 4 min after injection. Results: Mean maximal HR increases were $24{\pm}17$, $35{\pm}11$ bpm (P < 0.05), mean maximal SBP increases were $14{\pm}8$, $13{\pm}9$ mmHg and mean maximal SBP decreases $20{\pm}11$, $22{\pm}9$ mmHg following the IV injection of 3, $5{\mu}g$ isoproterenol, respectively. The incidence of hypotension was similar in both groups. Isoproterenol 3 and $5{\mu}g$ produced 75%, 100% sensitivity in the HR criteria ($\geq$ 20 bpm increase) and 60%, 70% sensitivity in the SBP criteria ($\geq$ 15 mmHg), respectively. Conclusions: These results indicate that based on the HR response, the epidural test dose containing $5{\mu}g$ isoproterenol to simulate an intravascular administration is a more reliable marker than $3{\mu}g$ isoproterenol in adult healthy patients during enflurane anesthesia.

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The effects of low dose doxycycline regimen on gingival crevicular fluid enzyme actmty of diabetic patients with periodontitis and adult periodontitis patients (저용량 독시싸이클린 투여가 당뇨환자 마치 성인성 치주염 환자의 치은열구액내 효소 활성도에 미치는 영향에 관한 비교연구)

  • Jeong, Seong-Nyum;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.27 no.4
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    • pp.701-722
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    • 1997
  • It was reported that low dose doxycycline(LDD) regimen could inhibit pathologically elevated collagenase activity in the gingival crevicular fluid of petients with adult periodontitis without producing typical antibiotic side effects. The purpose of this study was to evaluate the effects of LDD regimen(20mg) administered during non-surgical therapy on clinical index and gingival crevicular fluid enzyme activity in diabetics who are at high risk for periodontal disease. Forty-nine subjects having at least two sites with probing pocket depths greater than 4mm were selected. In this double-blind, placebo-controlled study, the patients were administered 20 mg doxycycline capsule or placebo capsule b.i.d. for 2 weeks. Clinical parameters of dental plaque, gingival inflammation, probing pocket depth and probing attachment level were assessed at week 0, 2, 4, and 8. Gingival crevicular fluid samples were collected at the same time to evaluate the activities of collagenase and elastase. Clinical parameters and elastase activity were significantly reduced in all groups compared to the baseline value after treatment. Significantly greater reduction in pocket depth and gain in attachment level was shown in the LDD-administered group compared to placebo group in both adult periodontitis and diabetic patients. Total collagenase activity was also reduced significantly in all groups after treatment, but the greater reduction was seen in the LDD-administered diabetics group compared to relevant placebo group(at 4, 8week). Significantly greater reduction in active collagenase activity was also seen in the LDD-administered group compared to placebo group in diabetic patients(at 2, 4, 8week). These results indicated that use of low dose doxycycline could be aueseful adjunct to instrumentation therapy in the management of diabetic patient with periodontitis as well as adult periodontitis patient.

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The Usefulness of the Ivy Sign on Fluid-Attenuated Intensity Recovery Images in Improved Brain Hemodynamic Changes after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis in Adult Patients with Moyamoya Disease

  • Lee, Jung Keun;Yoon, Byul Hee;Chung, Seung Young;Park, Moon Sun;Kim, Seong Min;Lee, Do Sung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.302-308
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    • 2013
  • Objective : MR perfusion and single photon emission computerized tomography (SPECT) are well known imaging studies to evaluate hemodynamic change between prior to and following superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis in moyamoya disease. But their side effects and invasiveness make discomfort to patients. We evaluated the ivy sign on MR fluid attenuated inversion recovery (FLAIR) images in adult patients with moyamoya disease and compared it with result of SPECT and MR perfusion images. Methods : We enrolled twelve patients (thirteen cases) who were diagnosed with moyamoya disease and underwent STA-MCA anastomosis at our medical institution during a period ranging from September of 2010 to December of 2012. The presence of the ivy sign on MR FLAIR images was classified as Negative (0), Minimal (1), and Positive (2). Regions were classified into four territories: the anterior cerebral artery (ACA), the anterior MCA, the posterior MCA and the posterior cerebral artery. Results : Ivy signs on preoperative and postoperative MR FLAIR were improved (8 and 4 in the ACA regions, 13 and 4 in the anterior MCA regions and 19 and 9 in the posterior MCA regions). Like this result, the cerebrovascular reserve (CVR) on SPECT was significantly increased in the sum of CVR in same regions after STA-MCA anastomosis. Conclusion : After STA-MCA anastomosis, ivy signs were decreased in the cerebral hemisphere. As compared with conventional diagnostic modalities such as SPECT and MR perfusion images, the ivy sign on MR FLAIR is considered as a useful indicator in detecting brain hemodynamic changes between preoperatively and postoperatively in adult moyamoya patients.

Development of Cancer Patient Guide for Nausea & Vomiting Management in Chemotherapy (항암화학요법을 받는 암 환자의 오심, 구토관리를 위한 환자용 지침 개발)

  • Yi, Ji-Eun;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.570-581
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    • 2010
  • Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

Factors Influencing Barriers to addressing Patients' Sexual Health among Clinical Nurse (임상간호사의 성건강 간호 장애감에 영향을 미치는 요인)

  • Kim, Jung-Hee
    • Korean Journal of Adult Nursing
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    • v.22 no.2
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    • pp.113-120
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    • 2010
  • Purpose: The purpose of this study is to examine the factors influencing the barriers faced by Korean nurses in addressing the patients' sexual health. Methods: The subjects in this study were nurses working at hospitals in Seoul and Jeonju. The data for this study were collected between November 2008 and December 2008. The subjects were assured of anonymity and confidentiality. Results: The barriers to addressing the patients' sexual health were moderate in the subjects. The nurses had moderate sexual knowledge and communication skills. In a stepwise regression analysis, the areas of work, communication skills, participation in sexual health training, and experience in Obstetrics and Gynecology accounted for 18.3% of the variance of the barrier for addressing the patients' sexual health. Conclusion: These findings emphasize the need for the development of a patient-centered sexual health-related curriculum for nurses, which has been briefly discussed in Korea. An educational program that improves the nurses' communication skills will be effective in reducing the barriers to addressing the patients' sexual health and will help the nurses become sexual health specialists.

Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis (후향적 자료분석을 통한 낙상위험 사정도구의 타당도 비교: 종합병원 입원 환자를 중심으로)

  • Kang, Young Ok;Song, Rhayun
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.29-38
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    • 2015
  • Purpose: The purpose of the study was to validate fall risk assessment scales among hospitalized adult patients in South Korea using the electronic medical records by comparing sensitivity, specificity, positive predictive values, and negative predictive values of Morse Fall Scale (MFS), Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS), and Johns Hopkins Hospital Fall Risk Assessment tool (JHFRAT). Methods: A total of 120 patients who experienced fall episodes during their hospitalization from June 2010 to December 2013 was categorized into the fall group. Another 120 patients, who didn't experience fall episodes with age, sex, clinical departments, and the type of wards matched with the fall group, were categorized to the comparison group. Data were analyzed for the comparisons of sensitivity, specificity, positive and negative predictive values, and the area under the curve of the three tools. Results: MFS at a cut-off score of 48 had .806 for ROC curves, 76.7% for sensitivity, 77.5% for specificity, 77.3% for positive predictive value, and 76.9% for negative predictive value, which were the highest values among the three fall assessment scales. Conclusion: The MFS with the highest score and the highest discrimination was evaluated to be suitable and reasonable for predicting falls of inpatients in med-surg units of university hospitals.

A Study on Manifest Needs of the Patient with Hyperthyroidism (갑상선 기능항진증 환자의 욕구구조에 관한 연구)

  • 최영희;강익화
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.69-82
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    • 1981
  • The purpose of this study was to compare the needs among the patients of hyperthyroid, malignant tumor and normal adult to clarify the level of the need for the patient of hyperthyroid. We analysed relationships between their personal characteristics and their needs to contribute comprehensive nursing care for the patient of hyperthyroid. The . subjects were chosen from 60 persons who visited for general physical examination at Ewha Woman's University Medical Center., 72 patients having diagnosis with hyperthyroidism, and 72 patients admitted with malignant tumors at atomic neuclear medical center. The data was collected from September 1 to December 31, 1980, and the study population was selected by means of convenience sampling. The data was analysed by means of the standard deviation and analysis of variance. The results were as follows: 1. In the patients having hyperthyroid, male to female ratio was 1 :13.5, and incidence was peak at the age groups of 20 to 40. 2. In compare with the needs among 3 groups, there are significant relationships: the patient of cancer has shown the highest score with Achievement, Aggression and Dominance, the patient of hyperthyroid shown higher and the normal adult shown low score. .In the need related with sex, there is significant relationship: the normal adult has shown highest score, the patient having hyperthyroid shown the higher score and the patient of cancer shown the low score. 3. Tn compare with Whang's Edward personal preference schedule, the Hyperthyroidism shown relatively higher needs for aggression, dominance, exhibitionism and sex.

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The Effect of Bobath and Conventional Method in Gate of Adult Hemiplegic Patients (보바스치료와 일반적치료가 성인 편마비 환자의 보행능력에 미치는 영향)

  • Lee, Keun-Heui;Kim, Hyoung-Su;Han, Dong-Wook;Kim, Byung-Jo
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.4
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    • pp.277-284
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    • 2008
  • Purpose : The purpose of this study was to identify the influence of Bobath and conventional method has an effect on gait of adult hemiplegic patients. Methods : The data were collected by each 15 adult stroke patients. The treatment was based on Bobath and conventional approach. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. Results : The gait step (p<.05), gait velocity (p<.05), cadence (p<.05) and step length (p<.05) was significantly different with the Bobath method. The Gait step (p<.05) and gait velocity (p<.05) was significantly different with the conventional method. But the cadence and step length was not significantly increased in the conventional method. Conclusion : The Bobath method is more useful to improve the gait in hemiplegic patients than conventional method.

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Validation of Major Nursing Diagnosis-Outcome-Intervention(NANDA-NOC-NIC) Linkage for Adult Surgery Patients of Post Anesthetic Care Unit (회복실 성인 수술환자의 주요 간호진단, 간호결과 및 간호중재 연계검증)

  • Cho, Eun Jaung;Kim, Nam Cho
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.141-151
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    • 2008
  • Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

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