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Clinical Significance of Repeated Delayed Air Reduction in Unsuccessful Initial Reduction of Intussusception (초기 정복에 실패한 장중첩증 환자에서 반복 지연 정복술의 임상적 의의)

  • Shin, Song-Heui;Rho, Young-Il;Park, Young-Bong;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.175-180
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    • 2001
  • Purpose: The advantages of air reduction are the ease of performing the procedure, reduced radiation time and lower morbidity rate if perforation occurs. But, patients who fail air reduction undergo a laparotomy at which 10% have spontaneously reduced. The first enema decreases the edema and venous congestion of bowel wall, thus repeated reduction may succeed. The aim of this study is to evaluate the efficacy of delayed repeated pneumatic reduction of intussusception in patients with failure of an initial attempt. Methods: Between January 1998 and December 1999, 21 patients with proven intussusception received repeated delayed reduction 1 to 3 hours following the first failed attempt. These patients were in stable condition and did not have peritonitis, shock or toxic sign. Results: Before reduction, the patients had symptoms and signs for 6 to 48 hours (median 24 hr). The interval from the first reduction to the repeated was 1 to 3 hours (median 2.2 hr). The success rate of repeated reductions was 76.2% (16 of 21 patients), and 23.8% (5 of 21 patients) required surgery. Four of 5 patients requiring surgery were manually reduced and 1 spontaneously reduced in the operating room. Conclusion: We recommended a repeated reduction in patients with intussusception who are in stable clinical condition after an unsuccessful initial reduction attempt.

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An Experimental Study on the Effect of Hydrogen Peroxide in the Treatment of Carbon Monoxide Poisoning (일산화탄소중독(一酸化炭素中毒)의 약물치료효과에 관(關)한 실험적(實驗的) 연구(硏究) -과산화수소(過酸化水素) 관장법(灌腸法)을 중심(中心)으로-)

  • Choi, D.W.;Yoo, K.Y.;Park, H.B.
    • Journal of Preventive Medicine and Public Health
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    • v.13 no.1
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    • pp.13-18
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    • 1980
  • The ultimate goal of treatment of carton monoxide poisoning is to promote dissociation of carboxyhemoglobin and to maintain arterial $PO_2$ above 50mmHg throughout the course of treatment to protect vital organs from damage caused by hypoxia. The hyperbaric chamber designed and manufactured for this purpose has obviousely made an enormous contribution and yet has several handicaps to be overcome by any means. These handicaps are: the financial impact to purchase the chamber (especially in a small, remote community), an extra manpower requirement to operate the device, limitation in the capacity of the chamber (one man type), and the possible hazard of oxygen intoxication and dysbarism. The primary objective of this study is to develope a new therapeutic measure as an alternative to the hyperbaric chamber when it is not available or contraindicated. The effect of intestinal perfusion with hydrogen peroxide has been studied by many investigators and was known to be an excellent way of extrapulmonary oxygen supply. the advantage of this method will include; 1) much more amount of oxygen is delivered to the tissue than one would expect from 100% saturation with oxygen at 1 ata, 2) the procedure is simple and most economical, 3) neither sophisticated equipment nor extra manpower is required. As a study preliminary to the clinical application, authors conducted a series of experiment to observe the effect of hydrogen peroxide enema on dissociation of carboxyhemoglobin in intoxicated rabbit blood. Using an animal gas chamber, 20 rabbits were exposed to CO gas of 6,000 ppm for 60 minutes. Ten rabbits of control group were given 10cc of warmed normal saline solution by reactal perfusion and for the other 10 of the experimental group, the same amount of 1% $H_{2}O_{2}$ solution was given by the same way. Two blood specimens were drawn from each rabbit: the first one immediately following the exposure and the second one after rectal perfusion, about 30 minutes after the first sampling. The result was as follows; 1) The decrease in carboxyhemoglobin concentration during the first 30 minutes in the control and experimental group were $18.18{\pm}4.49%\;and\;23.03{\pm}4.13%$ respectively shelving the significant difference (p<0.05) between the two groups. 2) Hemoglobin and hematocrit value showed no significant difference between two groups and not altered significantly by intestinal perfusion with $H_{2}O_{2}$.

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Protective Effect of DA-9601, an Artemisiae Herba Extract, on Radiation-induced Colitis in Wistar Rats

  • Ahn, Byoung-Ok;Oh, Tae-Young;Ryu, Byoung-Kweon;Kim, Soon-Hoe;Kim, Won-Bae;Kang, Seung-Hee;Chun, Mi-Son;Yoon, Jung-Hee
    • Biomolecules & Therapeutics
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    • v.6 no.1
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    • pp.37-44
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    • 1998
  • This study was performed to examine the effects of DA-9601, a novel antiulcer agent extracted from Artemisiae Herba, on radiation colitis in the rat. Female Wistar rats received a 30 Gy dose of irradiation to the 2 cm of distal colon in length using an intrarectal applicator system. 30 mg/tg or 100 mg/kg of DA- 9601 was administered orally 30 min before and 4 h after radiation on day 1. And the same dose of DA-9601 was given to the animals twice a day from day 2 to 14. As a reference control, sucralfate suspension (100 or 300 mg/head) was given as an enema based on the same treatment schedule of DA-9601. Body weight change and the frequency of diarrhea were recorded during the observation period as markers of radiationinduced injury, All animals were sacrificed on day 15 for evaluation of macro- and microscopic findings and mucosal myeloperoxidase (MPO) activity. Radiated animals showed diarrhea, mucosal redness and histologic changes characterized by edema and eosinophilic infiltration of the periglandular lamina propria with loss of colonic epithelium. Radiation also significantly increased mucosal MfO activity of affected colon f\\\\\\\\`<0.05). However, most of these changes were completely protected by oral administration with DA-9601. DA-9601 reduced radiation-induced histologic alteration significantly in a dose-related manner (P<0.05). In addition, mucosal MPO activity in rats receiving high dose of DA-9601 decreased significantly when compared with that in radiated control. High dose of sucralfate (300 mg/head) alleviated radiation-induced histologic lesion, but failed to reach statistical significance. The results of this study suggest that DA-9601 can be useful for the prevention of acute clinical symptoms of radiation proctocolitis and that decrease of mucosal MPO by DA-9601 plays a role in its protective mechanism(s), at least in part.

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A Convergence Study on the Effect of Self-directed Practice based Peer-tutoring on Performance, Confidence and Self-efficacy of Core Nursing Skills in Nursing Students (동료 교수학습 기반 자율실습이 핵심기본간호술 숙련도, 수행자신감 및 자아효능감에 미치는 효과에 관한 융합연구)

  • Koo, Heesun
    • Journal of the Korea Convergence Society
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    • v.10 no.12
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    • pp.453-463
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    • 2019
  • The purpose of study was the non-equivalent control group pretest-posttest design to test the effect of self-directed nursing practice based peer-tutoring of same sophomore, on the level of confidence, performance and self-efficacy of core nursing skills in nursing students. The subjects were 68 nursing students in K City from May 1th to June 12th in 2019. The participants were shared into the peer tutoring practice group (experimental group, n=34) and the lecturer guided practice group (control group, n=34). The results of study, the experimental group scored significantly higher on the foley catheterization performance (t=11.60, p<.001), confidence (t=4.123, p<.001) and wearing protection equipment performance (t=5.91, p<.001), confidence (t=4.24, p<.001) and enema performance (t=2.82, p=.008), confidence (t=2.09, p=.044) and self-efficacy (t=4.52, p<.001) than control group. Therefore, the results justified that self-directed nursing practice based peer-tutoring could be effective in improving the performance, confidence and self-efficacy of core nursing skills in nursing students. Based on this, I suggest the study that examines the effects of peer-tutoring by applying it to various majors.

Comparisons between the KKU-Model and Conventional Rectal Tubes as Markers for Checking Rectal Doses during Intracavitary Brachytherapy of Cervical Cancer

  • Padoongcharoen, Prawat;Krusun, Srichai;Palusuk, Voranipit;Pesee, Montien;Supaadirek, Chunsri;Thamronganantasakul, Komsan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6115-6120
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    • 2014
  • Background: To compare the KKU-model rectal tube (KKU-tube) and the conventional rectal tube (CRT) for checking rectal doses during high-dose-rate intracavitary brachytherapy (HDR-ICBT) of cervical cancer. Materials and Methods: Between February 2010 and January 2011, thirty -two patients with cervical cancer were enrolled and treated with external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). The KKU-tube and CRT were applied intrarectally in the same patients at alternate sessions as references for calculation of rectal doses during ICBT. The gold standard references of rectum anatomical markers which are most proximal to radiation sources were anterior rectal walls (ARW) adjacent to the uterine cervix demonstrated by barium sulfate suspension enema. The calculated rectal doses derived from actual anterior rectal walls, CRT and the anterior surfaces of the KKU-tubes were compared by using the paired t-test. The pain caused by insertion of each type of rectal tube was assessed by the visual analogue scale (VAS). Results: The mean dose of CRT was lower than the mean dose of ARW ($Dmean_0-Dmean_1$) by $80.55{\pm}47.33cGy$ (p-value <0.05). The mean dose of the KKU-tube was lower than the mean dose of ARW ($Dmean_0-Dmean_2$) by $30.82{\pm}24.20cGy$ (p-value <0.05). The mean dose difference [($Dmean_0-Dmean_1$)-($Dmean_0-Dmean_2$)] was $49.72{\pm}51.60cGy$, which was statistically significant between 42.32 cGy -57.13 cGy with the t-value of 13.24 (p-value <0.05). The maximum rectal dose by using CRT was higher than the KKU-tube as much as 75.26 cGy and statistically significant with the t-score of 7.55 (p-value <0.05). The mean doses at the anterior rectal wall while using the CRTs and the KKU-tubes were not significantly different (p-value=0.09). The mean pain score during insertion of the CRT was significantly higher than the KKU-tube by a t-score of 6.15 (p-value <0.05) Conclusions: The KKU-model rectal tube was found to be an easily producible, applicable and reliable instrument as a reference for evaluating the rectal dose during ICBT of cervical cancer without negative effects on the patients.

Effects of Abdominal Meridian Massage with Aroma Oils by Volunteers on the Relief of Constipation in Hospitalized Disability Patients with brain lesions (자원봉사자에 의한 아로마 복부경락마사지 제공이 입원 뇌 병변 장애환자의 변비완화에 미치는 효과)

  • Kim, Tae-Im;Nam, Mi-Jung;Bang, Young-Ie;Yeon, Young-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2267-2277
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    • 2012
  • The purpose of this study was to evaluate the effects of 7 minutes a day, 3 times a week, for 4 weeks of abdominal meridian massage with aroma oils (AMMAO) by Volunteers on the relief of constipation among hospitalized disability patients with brain lesions. One group pretest-posttest quasi experimental research design was used. Subjects were 38 hospitalized disability patients with brain lesions. Data were collected from May 9 to June 19, 2011. Frequencies, mean, standard deviation and Repeated Measures ANOVA with SPSS 19.0 were used to evaluate the effects of AMMAO. The results were as follows; 1. There were significant difference noted in the amount of defecation(F=3.56, p=.033) by time. 2. There were no significant difference was noted in the frequency of defecation, the frequency of suppository or enema application by time. Accordingly, it is concluded that AMMAO would be an effective nursing intervention in relief of constipation among hospitalized disability patients with brain lesions. Therefore it is recommended that AMMAO be used in clinical practice as an effective nursing intervention for hospitalized disability patients with brain lesions.

Importance of Education Contents and Competencies on Home Care Nursing of the Hospital and Public Health Nurses in Korea (임상간호사와 보건간호사가 지각한 가정간호 교육내용의 중요도 및 업무수행능력)

  • Yu, Sook-Ja;Kim, Soon-Lae;Baek, Hee-Chong;Lee, Jong-Eun
    • Journal of Home Health Care Nursing
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    • v.7 no.1
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    • pp.5-14
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    • 2000
  • This study was conducted during the time period of September 1997 to February 1999. in order to provide data concerning important facets of horne care nursing and the degree to which practicing hospital and public health nurses believe themselves to be competent in each area. The study subjects consisted of 610 hospital nurses, 158 public health nurses and 21 other nurses from Seoul and the province of Kyunggi. Korea. Data was collected through self-reporting questionnaires which was used by Kim et al.(1999) to evaluate the status of home health nursing and the varying ideas of self-competence that practicing nurses have. The results of the study were as follows: 1) The mean scores of perceived important components and competencies on home health nursing measured on the Likert 4 point scale were $3.15{\pm}0.36$ for importance. and $2.56{\pm}0.36$ for competency. Of the four categories regarding nursing services, the 'Nursing skill' factor had the highest importance and competency. 2) There were significantly higher scores for hospital nurses' importance components and competencies of home care nursing as compared to those scores for public health nurses. 3) The significant factors of the importance component of home care nursing listed in order of priority were 'general infection control', 'bed sore care skill', 'rehabilitation care', 'keeping maintenance of the client's confidentiality', 'malpractice', 'diabetes patient care', 'ability for problem solving' respectively. In contrast, of low priority in the importance components of home care nursing were 'referring nursing as a job to others'. 'record keeping', 'family dynamics', 'medical equipment', 'economic problems', 'environmental assessment', 'suture removal', 'multidisciplinary coordination' respectively. 4) The high priority of the degree to which practicing nurses believe themselves to be competent in home health nursing were the 'blood sugar test', 'enema skill', 'injection skill', 'skin care', 'bed sore care skill', etc. In contrast, lower competence for home care nursing as perceived by nurses were 'AIDS care', 'family violence care', 'substance abuse care', 'mental health care' respectively.

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A Study of Convergence on Frequency of Performance, Self-Confidence, Performance Assessment Scores of Core Nursing Skills of Nursing Students (간호학생의 핵심기본간호술 수행빈도, 수행자신감, 수행능력에 관한 융복합적 연구)

  • Han, Hyun-Hee
    • Journal of Digital Convergence
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    • v.14 no.8
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    • pp.355-362
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    • 2016
  • This study is descriptive research to investigate frequency of performance, self-confidence and performance assessment scores of core nursing skills by 227 nursing students. As the result of this study, they who experienced more than 10times in clinical practice was V/S and they never experienced items such as transfusion, enema and T-tube care. For pre self-confidence, they had the highest V/S and the lowest transfusion. For post self-confidence, they had the lowest IM. As a result of the evaluation, oxygen therapy with nasal cannula was measured highest, and IM was measured lowest. Frequency of performance had positive correlations with self-confidence(r=0.414, p<.001) and performance assessment scores(r=0.322, p=.007). Self-confidence with performance assessment scores had positive correlation(r=0.281, p=.003). Study results suggested that clinical practice is carried out, non-invasive, simple measurements, and they had low self-confidence of the items with low frequency of performance, so convergency training methods to complement this point are needed.

결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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Task Analysis of Paramedics of Korea Based on DACUM Method (DACUM 기법에 의한 1급 응급구조사의 직무분석)

  • Bae, Ki-Sook;Koh, Bong-Yeun;Lee, Jung-Eun;Lee, In-Mo;Choi, Keun-Myoung;Kim, Soo-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.5-23
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    • 2011
  • Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.