An, Jae-Hong;Hwang, Mi-Soo;Park, Bok-Hwan;Koh, Jung-Kon
Journal of Yeungnam Medical Science
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v.14
no.2
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pp.393-398
/
1997
An accurate early diagnosis of congenital midgut malrotation is essential to prevention of catastrophic effects of volvulus. To evaluate the usefulness of radiologic examinations in diagnosing intestinal malrotation, we retrospectively analyzed radiologic findings and operation records of 17 intestinal malrotation patients, who were radiologically diagnosed. The age range of the patients studied were from 1day to 12years. The presenting symptoms were vomiting, vomiting with abdominal pain, abdominal distention, diarrhea and failure to thrive. The viewpoints of this analysis were the location of duodeno-jejunal flexure on barium meal and cecal location on barium enema. Sixteen of 17 patients, who were radiologically diagnosed, were surgically proven, but one patient with annular pancreas was false positive. In the case of 3 surgically proved patients, malrotation was suspected on barium meal prior to the barium enema, but final diagnosis was determined on barium enema examination. We concluded that a barium enema should be performed on all children with suspected malrotation where the initial upper gastro-intestinal study was normal or suspicious on account of the small incidence of false positive and false negative barium meals.
Working as nurses, authors found that some patients were not content with their hospital life. Some patients wanted to move to another ward, and others complained about their ward atmosphere. In spite of patients' discomfort, nurses didn't know what made some patients complain about their ward. So, authors tried to find factors that influence atmosphere of hospital wards of the neurosurgery patients. To know the atmosphere of wards, authors selected five neurosurgery ward of a university hospital in Seoul. Observation took a month. An author observed using molar approach, in the morning, in the day time, and in evening time. Authors used concealment /no intervention technique. An author checked condition of people in the wards, and observed their verbal and nonverbal communication behavior their activities and environmental characteristics, and interpreted their meaning through ethnographic research methodology by Spradly. Authors found there was an important factors that influence the atmosphere of ward. It was a human and his attitude. At least one person who was willing to help others made ward atmosphere better. Helping others physically whenever needed, sup-porting the depressed emotionally, offering foods, or talking to others friendly brought good atmosphere. On the contrary, if everyone was indiffernt to others, the atmosphere became cold. Self-centered or selfish behaviors such as occupying too much area, using the toilet too long, covering other's suction bottle without permission and seeing others delicate or urinate were hurtful. In addition to the attitude of patients and their families, unkindness of medical teams including nurses and doctors and tasteless meal caused bad ward atmosphere. Based on this research finding, authors suggest the followings. A For the better atmosphere of ward 1. Nurses should try to make the ward atmosphere better by introducing new patient to older ones. 2. Every ward should have dividing curtains to keep patient's privacy. 3. All hospital personnel should be kind enough to make patients feel that they are repected. 4. Hospital should serve high quality meals to patients. 5. Patients had better stay with those in the similar condition. B. For the future studies 1. Repeated researches are necessary to check reliability of this results. 2. Researches for patients in different area such as ICU, or hemodialysis unit are necessary.
Purpose: Quality of life (QOL) assessment should be applied in surgical settings to compare treatment options. We compared QOL after a subtotal versus a total gastrectomy for gastric cancer to identify which resection would produce a better QOL for the patient. Patients and Methods: We studied 362 patients with no evidence of recurrent disease after curative surgery for gastric cancer. The QOL was measured by assessing patient health perceptions according to the Spitzer index and Troidl score and by treatment-specific symptoms according to Korenaga and others with some modifications. High scores reflect a better QOL. Results: The mean score of the Spitzer index was $8.87\pm1.36$ after a subtotal gastrectomy and $8.80\pm1.23$ after a total gastrectomy. More than $80\%$ of the patients in both groups maintained good quality of life when measured by the Spitzer index. The mean Troidl score was $10.41\pm2.12$ after a subtotal gastrectomy and $9.79\pm2.16$ after a total gastrectomy (p=0.033). Swallowing difficulty was more frequent after a total gastrectomy (p=0.002). There was a statistically significant difference in the meal size (p=0.044). Other variables of the Troidl score revealed no statistically significant differences. Dizziness was significantly more frequent after a total gastrectomy than after a subtotal gastrec tomy (p=0.009). Conclusion: We conclude that in terms of postoperative quality of life, a subtotal gastrectomy has advantages over a total gastrectomy. In those cases where an adequate proximal safety margin can be achieved by a subtotal gastrectomy, that procedure is preferable to a total gastrectomy.
To evaluate the current practices of the tube feeding and the status of tube feeding patient 76 adult in-patients at 6 hospitals located in Seoul and Chung-buk province were examined through reviewing patient charts observing patients and interviewing patients nurses dietitians patients' family or care-givers. The results were as follows : 1) An average age of the patients was 54.5 years with 41% over 60 years old. Patients with decreased mental status dysphagia esophageal obstruction and respiratory problem were fed by tubes. 2) The range of duration of tube feeding is between 4 days and 6 years. Most patients were received formula through nasogastric tube(89.5%) while 7.9% of gastrostomy and 2.6% of jejunostomy. Administration method for formula were bolus feeding regardless of the route of formula delivery. 3) Mean total calories received for men were 1590 kcal and 1450 kcal for female. Mean volume per meal was 282m, l and mean frequency of feeding was 5.68 while mean feeding interval 3$\frac{1}{4}$ hours and mean rate of infusion 68.4ml/min. All patients received hospital-blenderi-zed formula as the major source of nutrition. Home-blenderized formula and commercial formula as a supplement were used 35%, 13.2% respectively. 4) Thirty-eight percent of patients was hypoalbuminemia and 61% was at the moderate level of deficiency in hemoglobin. 5) Complications associated with tube feeding were diarrhea (22.4%) constipation(21.1%) vomiting(11.8%) and so on. 6) Serum albumin levels of patients who have complications associated with tube feeding were significantly lower than those of patients without complications In planning a tube feeding regimen the type of a formula must be integrated with both a delivery system and a protocol for administering the tube feeding. the multidisciplinary effort required to deliver enteral therapy is essential to improve current practices used at hospitals.
1. Objecrives Although Lee Je-Ma emphasized it is important to be aware of our own Nature & Emotion(性情) and control them properly, there is few case report about Taeyangin focused on their psychological sides. This report is about a Taeyangin patient who had Hae Yuk and Yul Gyuk syndrome caused by her stress from the work place and relationship with her seniors 2. Methods We observed the female patient had hospitalized in the Oriental Hospital of Dongguk University more than twice has been followed up for the last one year. We prescripted Mi-hoo-teung-shik-chang Tang as her physical symptom. The improvement of her physical conditions were checked through her sleep, meal, menstruation, stool and urine. And MMPI has been tested three times for the last one year to analyze her psychological progress. 3. Results and Conclusions Working in a group can cause hard stress for Taeyangin who is not good at adjusting themselves to whatever environment they are in. Mi-hoo-teung-shik-chang Tang could improve Taeyangin's physical conditions such as Hae Yuk, Yul Gyuk, insomnia, nausea, anorexia and hypouresis. But as her psychological aspect, she was getting more anxious, depressed and avoiding contact with others due to the stress. It is necessary to rake care of patients' psychological sides as well as physical conditions through managing their Nature & Emotion(性情).
Jina Son;Ha I Kang;Eun young Jung;Hae won Ryu;Kyung-Ha Lee
Clinical Nutrition Research
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v.12
no.2
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pp.99-115
/
2023
Patients with colorectal cancer may experience symptoms such as diarrhea, nausea, and anorexia, during surgery and chemotherapy, which can increase the risk of malnutrition. In addition, dietary habits play a key role in the onset of colorectal cancer; therefore, it is necessary to improve dietary habits to prevent recurrence during treatment after diagnosis. In this study, a clinical nutritionist conducted 4 interviews for patients diagnosed with colorectal cancer and scheduled for colectomy: before surgery, after surgery, 1st chemotherapy, and 2nd chemotherapy, and provided nutrition care for each treatment course to determine its effects on nutrition status and disease prognosis. Significant weight loss but no decrease in muscle mass was observed during treatment. Body fat mass, although not statistically significant, showed a decreasing tendency. The percentage of people who responded 'yes' to the below items increased after compared to before receiving nutrition education: 'I eat meat or eggs more than 5 times a week,' 'I eat seafood at least three times a week,' 'I eat vegetables at every meal,' 'I eat fruits every day,' and 'I eat milk or dairy products every day.' These results indicate that the patients changed their dietary habit from a monotonous eating pattern to a pattern of consuming various food groups after receiving nutrition education. These results suggest that continuous nutrition care by clinical dietitians, according to the patient's treatment process, can help improve the patient's nutritional status and establish healthy eating habits.
Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
Journal of the Korean Dietetic Association
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v.16
no.4
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pp.378-396
/
2010
The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.
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.
Objectives: This case report is to present a complete recovery from Kaposi's varicelliform eruption (KVE) that occurred in a patient with atopic dermatitis by applying Korean Medicine therapies. Methods: Hwangyeonhaedoktang pharmacopuncture (HP), 0.3 mL, and 25% bee venom pharmacopuncture (BVP), 0.1 mL, were injected, 0.2 mL each, at both BL13 acupoints once a day in the morning. Acupuncture was applied at Sama Upper, Middle and Lower of the Master Tung acupuncture points and at ST44 on the left lateral for 30 minutes twice a day. The affected face was gauze dressed with mixture of 2.0 mL HP and 1.0 mL 25% BVP with 20 mL of normal saline twice a day. Herbal Medicine, Seungmagalgeuntang, was administered three times a day after each meal. Results: Rashes and papules on the face were completely cleared after 10 days of treatments. Conclusion: KVE, an acute and urgent dermatitis, can be effectively treated with Korean medicine.
To determine the effects of guar suksolgi on blood glucose and lipids in type-ll diabetic subjects, a piece of guar suksolgi(36.3g, 54Kcal) was administered to eight patients for 3 weeks every meal. No significant differences occured indietary intakes and body weight before and after the treatment. Fasting blood glucose levels were decreased from 132.38mg/dI to 114.75mg/dI after the treatment, but not statistically significant. Blood TG levels were increased from 159.13mg/dI to 175.00mg/dI after the treatment, but not statistically significant. Excluding one patient who had extremely high TG level, blood TG levels tended to be decreased from 148.00mg/dI to 121.00mg/dI. TC LDL-c, HDL-c levels were decreased after the treatment, but not statistically significant. HbAIC concentrations were decreased from 8.54mg/kI to 7.80mg/dI after the treatment, but not statistically significant. In the case of three patients who had had normal fasting blood glucose levels, blood glucose levels tended to be decreased at postprandial 30, 60 minutes, and blood insulin levels tended to be decreased at postprandial 30, 60, 90, 120 minutes, although none of the levels were statistically significant. Therefore, if guar suksolgi is adinistered to type-ll diabetic subjects being more hyperglycemic than our patients, their blood glucose and lipids will be decreased significantly.
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