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Correction of Persistent Enophthalmos after Surgical Repair of Blow Out Fracture Using Orbital Decompression Technique of Contralateral Eye (안와골파열골절 정복술 후 지속되는 안구함몰 환자에서 정상측 안구의 안구 감압술의 치험례)

  • Lee, Jun-Ho;Park, Won-Yong;Nam, Hyun-Jae;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.101-104
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    • 2008
  • Purpose: Diplopia and cosmetically unacceptable enophthalmos are the major complications of blow out fracture. Prolapse of orbital tissue into the sinuses, enlarged orbital volume, atrophy of orbital fat and loss of support of orbital walls play a role in the pathogenesis of enophthalmos. To correct post-traumatic enophthalmos, freeing of incarcerated orbital contents combined with reduction of bony orbital volume and reconstruction of suspensory support of globe is necessary. But remained enophthalmos after surgical treatment is difficult to correct completely. In this case, the authors performed implant insertion for affected orbit and endoscopic orbital decompression for unaffected orbit for correction of late enophthalmos. Method: We reviewed a girl patient with right inferomedial orbital wall blow out fracture, right zygoma fracture treated at our hospital for correction of enophthalmos. An 18-year-old female had sustained posttraumatic enopthalmos. Two surgical management was performed for correction blow out fracture at the other hospital. But residual diplopia, enophthalmos, cheek drooping were found. And then she transferred to our hospital. She had severe enophthalmos(5 mm) also had diplopia and extraocular muscle limitation. We performed operation for correction of enophthalmos. After operation, she showed minimal improvement of diplopia and enophthalmos(3 mm). The authors make plan for operation for correction enophthalmos due to cosmetical improvement. Implant insertion was performed for affected orbit. For unaffected orbit, nasoendoscopic medial orbital wall decompression was proceeded. Result: Correction of enophthalmos was found after operation and was maintained for nine years follow-up. Patient expressed satisfaction for the result. Conclusion: To correct persistant enophthalmos, we could have satisfactory result with orbital wall reconstruction on affected eye and decompression on unaffected eye.

Oral care practices for dementia patients and social support and depression in family caregivers of dementia patients (치매환자 부양가족의 치매환자 구강관리 실태 및 우울과 사회적지지)

  • Nam, Young-Ok;Lee, Kyeong-Hee;Park, Il-Soon
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.5
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    • pp.845-858
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    • 2019
  • Objectives: This study aims to contribute to devising systems for family caregivers of dementia patients by examining the state of oral care of dementia patients, and depression and social support among family caregivers of dementia patients. Methods: Family caregivers of dementia patients in the metropolitan area were selected in this study. The inclusion criteria were individuals who have provided care for a dementia patient at home for at least six months and those who come in contact (including phone calls) with the patient at least twice a week. Results: Oral health knowledge of the elderly, caregiving burden, depression, and social support were examined. The mean scores for oral health knowledge of the elderly and caregiving burden were $57.11{\pm}16.94$ out of 100 and $17.33{\pm}8.61$ out of 48, respectively. Further, the mean caregiving behavior score, depression score, and social support score were $8.49{\pm}13.71$ out of 100, $5.11{\pm}3.05$ out of 10, and $72.75{\pm}17.03$ out of 100, respectively. Factors affecting oral health knowledge of the elderly were examined. The results showed that the level of oral health knowledge of the elderly increased with an increasing perception of a need for oral health education (p<0.05), caregiving burden (p<0.01), and social support (p<0.01). Conclusions: These findings suggest that developing and popularizing oral care intervention programs for family caregivers of dementia patients are necessary to ensure systematic oral care for dementia patients.

The Distribution and Patient Care in Radiography for Emergency Outpatients (응급환자의 방사선영상검사 분포 및 Patient Care)

  • Lee, Hwan-Hyung;Kang, Won-Han
    • Journal of radiological science and technology
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    • v.19 no.1
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    • pp.55-74
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    • 1996
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distribution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 761 emergency outpatients who visit during JAN, 1994 at ER of the general hospital in Pusan city. The results is as follows: Emergency radiography rate of simple radiography was 61.1 %, special radiography 2.5 %, CT 12.6 %, and ultrasonography 6.7 %. In simple radiography rate, a high rate was distributed on male(63.6 %), thoracicsurgery part(90.0%), admission patient(74.9 %), and long stayed patient at ER. In special raiography rate, a high rate was observed in urologic part(28.6%), and in CT rate, observed neurosurgery part(49.2 %) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8 %) and internal medicine part(15.9 %). There are distributed regional radiography rate in radiographic type that chest(55.3 %) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0 %) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neurosurgery, chest(90.0%) in thoracic-surgery, abdomen(58.0%) in general-surgery, spine (40.0% ) in neuro-surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic-surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiographic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transfered patient(2.7) in patient type, and on neurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional part was highly distributed on chest(499 case number). Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, radiographer should know well about dealing with contrastmedia administration and related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography, Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always silted with CT room and monitoring-patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiography should be established in ER area, and the radiographer of this room should be stationed radiologic technician who is career and can implement emergency patient care.

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A study on the attitude toward dying and hospice (임종태도와 HOSPICE에 관한 연구)

  • Kim, Young-Uck;Lee, Jung-Hoon;Lee, Jong-Bum;Park, Byung-Tak;Cheung, Sung-Duk;Kim, Myung-Se;Kim, Hoo-Ja
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.55-66
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    • 1990
  • This research is focused on the attitudes toward dying and hospice. 4subjects groups are Ca. patient, Ca. patien's family, elderly, medical personnel. A 40 questionare was filled out by each participant. For this study chi-square and T-test was done. The result were as follows : 1. Telling the truth 61.2% of all subject groups agreed upon telling the impending death. About 40% of elderly groups and cancer patient group were disagreed which is the highest percentage in all groups. Particularly medical personnel group were remarkably high in telling the truth. 2. Attitudes of medical personnels 43.3% of all groups agreed upon medical personnels prefer to avoid dying patient. In medical personnel group. 44% of respondents disagred comparably higher than other group. But 37.7% of medical personnel agreed. It showed that medical personnels admitted their negative feelings toward dying patient in considerable degree. 3. Attitudes toward mechanical assistance for life-expanding or hopeless patient. 44.8% of all groups disagreed upon mechanical assistance for hopeless case. Elderly (54.9%) and medical personnels (50%) disagreed, which is higher than cancer patient (33.3%) and (22.8%) of cancer patient's family. 4. Special facility and educational preperation for dying patient. 67.4% of all groups agreed upon the needs of special facility for dying, 81.3% of medical personnels agreed which is highest percentage in all group. 5. Attitudes of family members of dying patient. 82.3% of all groups agreed upon the family members feel annoyed at dying patient. 34% of cancer patient's family member and 48% of cancer patients group agreed, but elderly group showed highest percentage(84%). 6. Perception of dying patient about imminent death. 58.3% of all group thought dying patients are aware of their impanding death even though they had not beent told. 77.3% of medical personnel agreed which is highest percentage in all group.

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Factors Influencing on Patient Safety Management Activities in Operating Room Nurses (수술실 간호사의 환자안전관리활동 영향 요인)

  • Kang, Hee;Choi, Soo-Kyung;Kim, In-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.9
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    • pp.329-339
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    • 2016
  • The purpose of this study was to investigate the level of job stress and organizational commitment, as well as to identify the factors that influence patient safety management activities among the operating room nurses. Participants were 136 nurses working at 1 university hospital and 9 general hospitals located in G metropolitan city. The data were collected between July 25 and August 7, 2014 using structured questionnaires. Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and multiple regression analysis using SPSS version 21.0. The level of job stress, organizational commitment, and patient safety management activities was 3.76, 3.09, and 4.15, respectively, out of a 5-point scale. Patient safety management activities were significantly correlated with organizational commitment. The significant factors that influence patient safety management activities were organizational commitment and number of patient safety education, which explained 23% of patient safety management activities. In conclusion, organizational commitment and patient safety education have a positive effect on the improvement of patient safety management activities of operating room nurses. It is necessary to develop various intervention programs for operating room nurses to improve organizational commitment and should be reinforced via continuous, systematic patient safety education on patient safety management.

A case of Seborrheic dermatitis treated by Bangpungtongsungsangamibang (방풍통성산가미방을 병행한 지루성 피부염 치험 1례)

  • Koo, Jin Suk;Seo, Bu Il
    • The Korea Journal of Herbology
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    • v.31 no.2
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    • pp.1-5
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    • 2016
  • Objectives : Seborrheic dermatitis is an inflammatory skin disorder affecting the scalp, face, and torso. Typically, it presents with scaly, flaky, itchy, and red skin. It may be aggravated by illness, psychological stress, fatigue, sleep deprivation, change of season. The purpose of this study was to report the clinical effects of herbal medicine on Seborrheic dermatitisMethods : We employed oriental medical treatments; herbal-medication (Bangpungtongsungsangamibang), acupuncture, moxibustion and cupping therapy. At the same time, the patient sweated out the skin poison. We treated him two times a week with oriental therapy method. He took medicine three times a day after a meal. During taking medicine, we let him avoid fatty food, flour based food, and alcohol. We took a picture the patient's body parts and compared the symptom with previous symptom. With the picture, we evaluated the patient's condition.Results : After taking treatment - 77 times' acupuncture, moxibustion and cupping therapy during 9 months and taking herbal-medicine, the skin condition of the patient was much improved. At first, he was troubled with itching and hot feeling at reddish area, time after time the itching and hot feeling was weakened. The reddish area was changed to scaly and flaky skin and changed to normal state.Conclusions : Herbal medicine (Bangpungtongsungsangamibang) with oriental medical treatments was an effective in the treatment of Seborrheic Dermatitis and it helped to improve regenerating the skin in the body.

A study of Nursing care need and the patient's satisfaction level of the nursing care in the emergency department (응급실 환자의 간호 요구도 및 만족도 분석)

  • Park, Yeong-Sook;Yoon, Jung-Won
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.1
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    • pp.73-85
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    • 2009
  • Purpose : The purpose of this study was to analyze the nursing care needs which can properly cope with patients' needs in emergency room, and grasp the patients' satisfaction level which can assess the care quality. It was aimed to check the level of today's care and provide basic data for care performance and care standard. Method : Data were collected from 192 patients in general hospitals in Daegu. The results are as followed. Results : First, the result of analysis conducted on the degree of overall patients' need for nursing care revealed that the need for nursing information (4.21+57) was the highest, followed by the order of information of patient's condition (4.05+53), emotional support (3.98+47), and nursing participation (3.65+54). Secondly, our study revealed that there was a significant negative correlat interrelation between care need and care satisfaction (r=.516, p<.01), indicating the higher the overall emergency room patients' nursing care need, treatment and nursing information, patient's condition, emotional support and nursing participation were, the lower the actual feeling of their satisfaction turned out. Conclusion : The study shows that treatment and nursing related information is the most highly needed and the patients' satisfaction level relies on actual care participation.

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Two Cases of Stage IV Colorectal Cancer Patients by Combined Treatment of Rhus Vernifciflua Stokes Decoction and Chemotherapy (옻나무 전탕추출물 한방치료와 항암화학요법을 병용한 대장암 4기 환자 2례)

  • Kim, Bo-Geun;Park, Sang-Chae
    • Journal of Korean Traditional Oncology
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    • v.16 no.2
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    • pp.63-70
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    • 2011
  • Background & Objectives : Colorectal Cancer is 10% of all cancer incidence and the motality from colorectal cancer is nearly 450,000 a year. Since chemopreventive agents from Herbal medicine is hot issue recently, to prove antitumor effecicacy of Rhus vernifciflua STOKES decoction(Chijong-tang), clinical study was carried out. Here we report two patients with colorectal cancer of stage IV. One is colorectal cancer patient with liver, lung metastases underwent operation, chemotherapy. The other patient with liver metastasis underwent chemotherapy. All of two patients acquired tolerance. Methods : One patient visited Hana oriental medicine Clinic in 2010 and was treated using Chijong-tang for 17 months at Hana Oriental Clinic. The other patient visited Hana oriental medicine Clinic in 2011 and was treated using Chijong-tang for 5 months at Hana Oriental Clinic. Results : Chijong-tang showed no side effect, no more tolerance during its treatment with chemotherapy and tumor size was retarded based on CT scanning. Overall, this case report suggests that Rhus vernifciflua STOKES can be a potent cancer preventive agents for colorectal cancer but it is still required to verify the scientific and clinical evidences for Rhus vernifciflua STOKES decoction (Chijong-tang).

The Effect of SBAR Communication on Nurse's Perception about Communication and Attitudes toward Patient Safety (SBAR를 이용한 의사소통이 간호사의 의사소통 인식과 환자안전에 대한 태도에 미치는 효과)

  • Kim, Mi Young;Kim, Kyeong Sug
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.23-33
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    • 2018
  • Purpose: The purpose of this study was to investigate the effect of SBAR communication program on nurse's perception about communication and attitudes toward patient safety. Methods: A single-group pre-post experimental study was conducted. A SBAR education program was provided to 167 nurses working in 9 general wards of a hospital in Seoul. A total of 153 questionnaires were included for the final analysis. Statistical analysis included analysis of variance, paired sample t-test, and Cochran-Mantel-Haenzel test. Results: After applying SBAR communication education, nurses perceived significant improvement in three of the five categories of communication between nurses and doctors; satisfaction (p=.001), accuracy (p=.001), and understanding (p=.002). The indicators of communication between nurses were also improved significantly in the order of accuracy (p=.001), satisfaction (p=.001), shift communication (p=.001), and openness (p=.016). The scores of nurse's attitudes toward patient safety demonstrated a significant increase in the five categories out of the six; perception of management (p=.001), working condition (p=.001), safety climate (p=.001), teamwork climate (p=.001), job satisfaction (p=.012). Conclusion: It is recommended that nurses and doctors use SBAR communication in their practice. Developing education programs and utilization methods is required for the effective establishment of SBAR communication.

Development of a Medication Error Prevention System and Its Influence on Patient Safety Culture and Initiatives (투약오류예방 시스템 구축에 따른 환자안전문화와 환자안전행위계획)

  • Kim, Myoung-Soo;Kim, Hyun-Hee
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.1-10
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    • 2015
  • Purpose: The objective of this study was to examine patient safety culture (PSC) and patient safety initiatives (PSI) according to IT-based medication errors prevention system which is constructed in this study, and to identify the relationships among system construction, perception to the usage, PSC and PSI. Methods: The subjects were 180 nurses who work at 12 different hospitals with over 300 beds. The questionnaire included the characteristics of participants, a system construction status, the perception to the usage using electric pharmacopoeia (EP), a drug dose calculation system (DDCS), a patient safety reporting system (PSRS) and a bar-code system (BS). The data were collected from July 2011 to August 2011. Descriptive statistics, ANOVA, Pearson correlation and MANOVA were used for data analysis. Results: Systems were constructed in participating hospitals; For EP and PSRS, 83.9%, DDCS, 50%, and BS, 18.3%. The perceptions on the usage of the system were marked highest in BS as 4.54 followed by EP as 3.85. There were significant positive correlations between PSI and EP construction (r=.17, p=.028); PSRS (r=.17, p=.028) and DDCS (r=.23, p=.002). Conclusion: The developed system for improving the user experiences and reducing medication errors was found out well accepted. It is hoped that the system is helpful for PSC and PSI improvement in clinical settings.