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Early and late results of cardiac valve replacement (판막치환수술의 조기 및 장기성)

  • 유병하
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.678-686
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    • 1984
  • Between Jan. 1978, and Dec. 1983, a total and consecutive 117 patients have undergone cardiac valve replacement using various artificial tissue valve. Out of 117 patients, single valve surgery was 78 consisted of MVR 74, AVR 3 and AVR & supracoronary ascending aorta replacement 1. Multiple valve surgery was 39 cases consisted of MVR+TAP 20, MVR+AVR 13 and so on. Early death with 30 days after operation was 12 cases [early mortality 10.3%] and causes of death were cardiac origin 5, technical problem 4, and others 3. The 105 early survivors were followed-up for a total of 190.5 years over a period of 2 to 64 months [Mean\ulcornerD:21.9\ulcorner4.9 months]. During follow-up, 7 cases died [late mortality:6.7%]. The rate of thromboembolism was 2.1% episodes per patient-year and bleeding due to anticoagulant was 3.1% episodes per patient-year and valve failure was 1.6% episodes per patient-year. Actuarial analysis of late results indicated an expected survival rate at 5 years of 84.6% for patients with single valve surgery and 82.1% for patient with multiple valve surgery and overall was 83.8%. Symptomatically, 86.7% of patients were in NYHA class I or II at the end of follow-up.

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Analysis of Patient Satisfaction with Hospital Foodservice Quality (병원급식의 품질특성에 대한 환자만족도 분석)

  • 이연경
    • Journal of Nutrition and Health
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    • v.33 no.4
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    • pp.464-476
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    • 2000
  • The purpose of this study was to measure patient satisfaction with hosptial foodservices, and thereby identify areas for improvement and provides basic data for the introduction of total quality management into hospital foodservice in the Taegu·Kyungpook area. This survey was carried out on 676 hospitalized patients in 11 hospitals with over 200 beds to determine the quality satisfaction with foodservices. The subjects were 62.4% male and 37.6% female. Sixty-two percent of the subjects were over age 40, 46.7% were only educated to middle school or below, 41.8% were hospitalized for 1 - 10 days. Eighty-seven precent of the subjects did not receive any nutrition education. The expectation and perception grid showed that the high expectation to the low perception items were the seasoning of the meals, taste of the meals, and prompt dealings with meal complaints. The quality satisfaction values of all the attributes indicated a minus. The unsatisfied quality attributes were the opportunity to meet with a dietitian, seasoning of the meals, taste of the meals, explanation of the meals, and prompt dealings with meal complaints. Among the demographic characteristics, age, education, length of admission, and experience with nutrition education produced significant differences in the quality satisfaction scores. In conclusion, it would seem to be desirable that hospital foodservice department introduce selective menus, hygiene education for foodservice employees, standard recipes, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.

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Development of an Algorithm for Emergency Nursing Care of Dyspneic Patients (호흡곤란 환자 응급간호 관리를 위한 알고리즘 개발 연구)

  • Yang, Jin-Ju;Jang, Keum-Seong
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.4
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    • pp.491-505
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    • 2009
  • Purpose: This study was to develop an algorithm for emergency nursing care of dyspneic patients. Methods: This methodological study was done through reviews of medical records and literatures, checklists of emergency nursing care for dyspneic patients, interviews with nurses, and experts' validity. Results: Firstly, the initial assessment confirmed the identification of airway patency, accessory muscle usage, RR, $SpO_2$, v/s, skin color, and mental status. Immediate emergency care provided oxygen, checked ABG, EKG, and chest X-ray, established a semi-fowler position, maintained IV routes, administered medication orders, and conducted careful monitoring. Secondly, if the patient exhibited $SpO_2$ of less than 90%, the nurse considered the patient's condition to be aggravated. Thirdly, if the patient showed improvement of more than 90% $SpO_2$, the nurse administered secondary assessment and carried out specific nursing care. However, if the patient continuously showed $SpO_2$ of less than 80%, the nurse assisted the intubation and then executed ventilator therapy. Conclusions: This study suggests that the algorithm is an effective decision tool and utilizing the algorithm is expected to improve the emergency nursing care for dyspneic patients.

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A Study of the Effect of Medical Service Quality on Patient Satisfaction with a Focus on the Telemedicine Service of Colonoscopies

  • Lee, Jeong Sun;Lee, Min Jung
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.3
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    • pp.47-56
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    • 2016
  • Recently many small and mid-sized hospitals are closing down or experiencing financial difficulties. As a result, in order to provide exceptional service that would increase their competitiveness, they implemented telemedicine service for the prescription of medicine necessary before a colonoscopy. This study is an analysis of how telemedicine service affects patient satisfaction. Through the focus group interview (FGI) of medical service providers, regarding telemedicine service and face-to-face service, it was appraised that telemedicine service was more effective than face-to-face service. Afterward, a second survey aimed at endoscopy patients was conducted in order to find out the value of telemedicine service. First, through the analysis of the three main factors of telemedicine service, conclusions were drawn(safety/reliability, convenience/rapidity, and economics). A follow-up analysis showed that convenience/rapidity had the greatest effect on telemedicine service satisfaction. Next the factors of the quality of medical service were analyzed and 3 main factors were deduced (the superiority of the external and internal environments/appropriateness, superiority of the medical team, telemedicine service). A follow-up analysis found that telemedicine service had the greatest effect on patient satisfaction. This study found that providing exceptional medical service that utilizes telemedicine service would improve patient satisfaction. Therefore, we would be able to form a strategic plan that would strengthen the competitiveness of small and mid-sized hospitals.

Case Report of Temporomandibular Joint Disorder Patient by "Yangmuji Anchu Traction Technique" (양무지 안추 신전법을 이용한 악관절장애로 인한 개구장애 환자 치험 3례)

  • Lee, Joong-Keun;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.121-135
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    • 2009
  • Objectives : This study was carried out to investigate the effects of "Yangmuji Anchu Traction Technique" on Temporomandibular Joint Disorder Patient. Methods : The therapies were Chuna("Yangmuji Anchu Traction Technique"), acupuncture treatment, Carthami-Semen Herbal Acupuncture treatment and herbal medicine. We estimated the effects of treatment by measuring from a lower front teeth to upper front teeth in open mouth, measuring a gap of center line on front teeth in open mouth. And by measuring Visual Analog Scale(VAS) and Patient Global Assessment(PGA) before and after treatment. Results : After treatment, we confirmed these improvements : the length measuring from a lower front teeth to upper front teeth in open mouth and the gap of center line on front teeth in open mouth was improved in all cases. Also Visual Analog Scale(VAS) was improved in all cases. Conclusions : These results suggested that "Yangmuji Anchu Traction Technique" effected for Temporomandibular Joint Disorder Patient.

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A human case of internal myiasis in Korea (내부 승저증(internal myiasis) 1례)

  • 정평림;정영헌
    • Parasites, Hosts and Diseases
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    • v.34 no.2
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    • pp.151-154
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    • 1996
  • A 71-year old male patient was admitted in Inha hospital due to right facial palsy, quadriplegia and aphasia. This patient was operated to replace his heart valves 7 years ago and has been treated with Coumarin. an anti-coagulant drug. to prevent the formation of thrombus in the hpart. A number of fly maggots continuoully crawled out from the nasogastric tube set up for supplying a liquid diet and patient's mouth for 2 days until his death in the intensive care unit of hospital. These maggots were about 11.5 mm long on the average and identified as genus Lucilio belonging to family Calliphoridae. The lesion of this myiasis case might be regarded in the castro-intestinal . System of patient. This is the first report of an internal myiasis case in Korea.

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Using Intervention Mapping to Develop a Community-based Disease Self-management Support Program for Patients with Osteoarthritis (Intervention Mapping을 적용한 지역사회기반의 골관절염 자기관리지지 프로그램 개발)

  • Ahn, Yang Heui
    • Journal of muscle and joint health
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    • v.22 no.3
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    • pp.245-257
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    • 2015
  • Purpose: The purpose of this study was to apply intervention mapping (IM) to develop a community-based disease self-management support program for patients with osteoarthritis. Methods: IM was applied as follows: i) a needs assessment has been carried out by a literature review, survey and interview with osteoarthritis patients; ii) on the basis of the needs assessment, identification of expected outcomes and change objectives for the target population; iii) selection of theory-based methods and practical applications to influence self-management and the determinants of behavior; iv) design of the intervention by developing activities and materials such as osteoarthritis self-management guide and smart patient pocket book. The activities were integrated into an existing healthcare activities; v) implementation and evaluation plan has been developed. Results: The program is aimed at improving health status through activating patients by a patient-centered and tailored intervention for patients with osteoarthritis; consists of 8 sessions with coaching and cognitive emotional psychological skills; includes smart patient, communication, osteoarthritis, medication adherence, pain control, depressive mood control, physical activity and healthy diet. Conclusion: The IM is a systematic and feasible method for developing the program. The next step is to evaluate the impact of the intervention on activation, and health status.

The Effect of Horse-Riding Exercise on Pain and Body Flexibility for the Patient with Chronic Low Back Pain (승마 운동이 만성요통환자의 통증 및 체간 유연성에 미치는 영향)

  • Lee, Chaewoo;Lee, Insil;Kim, Hyeonsu
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.3
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    • pp.111-118
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    • 2013
  • Purpose : The purpose of this study was to investigate the effect of horse riding exercise for pain and body flexibility in the patient with chronic low back pain. Method : 26 subjects in H-equestrian were randomly divided two group, ball exercise(BE) group and horse-riding exercise(HE) group. Each group carried out 40 minutes exercise three times a week for 8 weeks. VAS were measured for pain, and evaluation of body flexibility in position with forward and backward. Result : The results were as follows, the pain scales of VAS(visual analog scale) between ball exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The flexibility scales of body between ball exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horse-riding exercise was effective on pain and body flexibility of patient with chronic low back pain so that these exercise can be new altematives exercise for pain and body flexibility in the patient with chronic low back pain.

The Effect of Half Day Nasal Packing in Results of Closed Reduction of Nasal Bone Fracture (반나절 비강충전이 비골 골절 수술결과에 미치는 영향)

  • Han, Dong Gil;Kim, Tae Seob
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.119-124
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    • 2012
  • Purpose: Closed reduction and nasal packings for 3-7 days is usual procedures in managing nasal bone fracture. Most patients experience several discomfort owing to lack of nasal breathing. There are many reports concerning how to reduce patient's discomforts or complications. But it is obvious that the duration of nasal packing is 3-7 days. The aim of this study is evaluate the effect of half day nasal packing in results of nasal bone fracture. Methods: The study was performed on 97 nasal bone fracture patients who had simple nasal bone fractures from January to June 2012. The incidence, cause, patient's discomfort and satisfaction with half day nasal packing are analyzed according to patient's medical records and questionnaire at each nasal packing removal, postoperative 4 weeks. Results: Young male patients, especially the teenagers and the twenties were the common age group, and physical violence was most common cause of injury. A total of 78 out of 97 patients were male. In 92 cases, closed reduction were applied. Approximately, 87% of the patients were satisfied with the outcomes. Conclusion: Half day nasal packing is considered as an effective method to minimize patient's discomfort owing to prolonged absence of nasal breathing with maintenance of stability.

Multiple Cervical Spinous Process Fractures in a Novice Golf Player

  • Kim, Sei-Yoon;Chung, Sang Ki;Kim, Dong-Yun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.570-573
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    • 2012
  • Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.