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Extracorporeal Life Support in Organ Transplant Donors

  • Chang, Wonho
    • Journal of Chest Surgery
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    • v.51 no.5
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    • pp.328-332
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    • 2018
  • Background: Extracorporeal life support (ECLS) can be applied in brain-dead donors for organ perfusion before donation, thereby expanding the donor pool. The aim of this study was to examine the benefits and early clinical outcomes of ECLS for organ preservation. Methods: Between June 2012 and April 2017, 9 patients received ECLS with therapeutic intent or for organ preservation. The following data were collected: demographics, purpose and duration of ECLS, cause of death, dose of vasoactive drugs, and need for temporary dialysis before organ retrieval. The early clinical outcomes of recipients were studied, as well as survival and graft function at 1 month. Results: ECLS was initiated for extracorporeal cardiopulmonary resuscitation in 5 patients. The other patients needed ECLS due to hemodynamic deterioration during the assessment of brain death. We successfully retrieved 18 kidneys, 7 livers, and 1 heart from 9 donors. All organs were transplanted and none were discarded. Only 1 case of delayed kidney graft function was noted, and all 26 recipients were discharged without any significant complications. Conclusion: The benefits of protecting the vital organs of donors is significant, and ECLS for organ preservation can be widely used in the transplantation field.

Acute Viral Hepatitis A with Cholestatic Hepatitis Treated with Traditional Korean Medicine : A Case Report

  • Kim, Jun-Young;Joung, Jin-Yong;Kang, Ji-Young;Son, Chang-Gue;Cho, Jung-Hyo
    • The Journal of Korean Medicine
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    • v.36 no.4
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    • pp.114-121
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    • 2015
  • More and more patients suffering from hepatitis A, the number of patients representing symptoms that are uncharacteristic to hepatitis A is also increasing. There are occasions of serious complications among adult hepatitis A patients that can cause fulminant hepatitis or cirrhosis which can be fatal. A 43-year-old male was diagnosed as acute hepatitis A and was treated at a Western hospital over the course of three months, which included two months of hospitalization. However, his symptoms did not improve, so he was admitted to Oriental hospital. We prescribed Chunggan extract (CGX) four times a day. Acupuncture was performed twice a day. From the twenty-fourth day of admission, the total bilirubin fell under 10 mg/dL for the first time and next day he was discharged. Following his discharge, he consistently took CGX three times a day. 21 days after discharge all of his symptoms disappeared. This study demonstrated that traditional Korean medicine (TKM) for acute viral hepatitis with cholestatic hepatitis might be effective and safe with no adverse effects.

A Tele-rehabilitation System with an Automated Pegboard Utilizing Radio Frequency Identification

  • Jeong, Da-Young;Ryu, Mun-Ho;Yang, Yoon-Seok;Kim, Nam-Gyun;Kim, Seong-Hyun
    • International Journal of Contents
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    • v.6 no.4
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    • pp.8-13
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    • 2010
  • Due to the expense of health care and the need to contain costs, many stroke patients are discharged from hospitals while still in an impaired condition. Using Tele-rehabilitation, these patients can receive rehabilitation services remotely. A pegboard is a conventional rehabilitation therapeutic device that integrates cognition, sensation and hand motor function. This study proposes a Tele-rehabilitation content with automated pegboard and shows its functional feasibility. The evaluation of the pegboard session was automated with RFID (radio frequency identification), and a 16-hole pegboard was rapid-prototyped. After a pegboard session is completed, the session result is uploaded to a server automatically for viewing on a web browser by a remote therapist. The therapist can also send messages to remote patients to encourage them or to manage the rehabilitation process.

Effectiveness of the Self-care Education for the Medication and Symptoms Management on the Psychiatric Patients' Quality of life (약물 및 증상관리에 대한 자가간호교육이 정신질환자의 삶의 질에 미치는 효과)

  • Son Kyung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.300-314
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    • 1999
  • This study is an attempt to evaluate the effect of the medication and symptoms self-care education on the psychiatric patients' quality of life. This exploratory study was designed to a quasi-experiment of pretest-postest with a non equivalent control group. Subjects of 40 patients who were discharged from a mental hospital in Pusan were selected to be experiment and control group, with each group consisting of 20. The research period was from March, 6 to May, 29, 1999 and the pre-post test was given before and after implementing MSSE to the both experiment and control group. The results finding were summarized as follows ; 1. subjects who attended self-care education scored significantly higher than control group in quality of life.(Z=-2.06, P=0.034) 2. Those who were in the experiment group reported more significant higher scores than control group in item of quality of life, living situation(A=-2.62 P=0.012), relations with spouse (Z=-2.31 P=0.038) and children (Z=3.37, P=0.008), fear (Z=-1 95, P=0.049) and anger(Z=-2.07 P=0.041), work functioning (Z=-2.34, P=0.021), environmental adjustment. (Z=-2.05, P=0.039)

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A Study of Motivational Factors and Health Behaviors in Patients with Coronary Artery Disease (관상동맥질환자의 동기요인과 건강행위에 관한 연구)

  • Kim, Kum-Ja;Yi, Myung-Sun
    • The Korean Journal of Rehabilitation Nursing
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    • v.10 no.2
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    • pp.125-133
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    • 2007
  • Purpose: The purpose of this study was to identify motivational factors that may influence health behaviors of patients with coronary artery disease. Methods: Structured questionnaires were used with a convenience sample of 164 subjects who were discharged from the hospital. The subjects were recruited for an interview at outpatient clinic in hospitals. The tools for the study were the motivational factors and health behaviors measure for the Elderly with cardiovascular disease. The data were analyzed using frequency, t-test, ANOVA, sheffe, Pearson correlation coefficient and stepwise multiple regressions. Results: There were significant correlations between motivational factors and health behaviors, ranging from r=.192 to .692. Stepwise multiple regression analyses indicated that 51% of variance in health behaviors was explained by self-efficacy and perceived benefits among four motivational factors(F=34.988, p<.01). Self-efficacy contributed the greatest amount of variance in health behaviors(${\beta}=.467$), followed by perceived benefits(${\beta}=.235$). Conclusions: The results of the study indicate that motivation, especially self-efficacy, was very important in predicting health behaviors of patients with coronary artery disease. Thus it would be necessary to include motivational factors in designing rehabilitation program for people with coronary artery disease.

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The Fifth Outbreak of Trichinosis in Korea

  • Rhee, Ji-Young;Hong, Sung-Tae;Lee, Hye-Jung;Seo, Min;Kim, Suk-Bae
    • Parasites, Hosts and Diseases
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    • v.49 no.4
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    • pp.405-408
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    • 2011
  • Trichinosis is a food-borne zoonotic disease caused by the nematode, Trichinella spp., and had been reported several times in Korea. Recently, there was an additional outbreak, involving 5 patients, the findings from which are reported herein. On 30 November 2010, 8 persons ate sashimi of the meat of a wild boar. Then, 2-3 weeks later, they complained of myalgia and fever. Unfortunately, muscle biopsy was not performed, but ELISA was performed using their sera. Two people among 8 were positive for Trichinella on the 34th day post-infection (PI), and 3 patients who initially revealed negative ELISA were additionally proved to be positive for trichinosis on the 42nd day PI. Hence, the confirmed patients of trichinosis were 5 in total in the present outbreak. They were treated with albendazole and discharged uneventfully. This was the fifth outbreak of trichinosis in Korea.

Moderating Effect of Structural Complexity on the Relationship between Surgery Volume and in Hospital Mortality of Cancer Patients (일부 암 종의 수술량과 병원 내 사망률의 관계에서 구조적 복잡성의 조절효과)

  • Youn, Kyungil
    • Health Policy and Management
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    • v.24 no.4
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    • pp.380-388
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    • 2014
  • Background: The volume of surgery has been examined as a major source of variation in outcome after surgery. This study investigated the direct effect of surgery volume to in hospitals mortality and the moderating effect of structural complexity-the level of diversity and sophistication of technology a hospital applied in patient care-to the volume outcome relationship. Methods: Discharge summary data of 11,827 cancer patients who underwent surgery and were discharged during a month period in 2010 and 2011 were analyzed. The analytic model included the independent variables such as surgery volume of a hospital, structural complexity measured by the number of diagnosis a hospital examined, and their interaction term. This study used a hierarchical logistic regression model to test for an association between hospital complexity and mortality rates and to test for the moderating effect in the volume outcome relationship. Results: As structural complexity increased the probability of in-hospital mortality after cancer surgery reduced. The interaction term between surgery volume and structural complexity was also statistically significant. The interaction effect was the strongest among the patients group who had surgery in low volume hospitals. Conclusion: The structural complexity and volume of surgery should be considered simultaneously in studying volume outcome relationship and in developing policies that aim to reduce mortality after cancer surgery.

Burr-Hole Trephination of an Acute Subdural Hematoma with Idiopathic Thrombocytopenic Purpura: A Case Report (급성 경막하 혈종이 발생한 특발성 혈소판 감소성 자반병 환자에게 시행한 두개 천공 배액술: 증례보고)

  • Kang, Jiin;Bae, Keumseok;Pyen, Jinsu;Kim, Jongyun;Cho, Sungmin;Whang, Kum;Kim, Sohyun;Oh, Jiwoong
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.238-242
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    • 2013
  • Idiopathic thrombocytopenic purpura (ITP) is the condition of having an abnormally low platelet count with an unknown cause. Acute subdural hematomas (ASDHs) usually develop in trauma patients and often involve a high bleeding tendency. However, ITP patients rarely have a large ASDH, and when a traditional decompressive craniectomy is performed on patients with coagulopathy, the mortality rate is higher because of the greater bleeding risk. We report the case of an ITP patient with a large ASDH who treated with a burr-hole trephination and irrigation and who was discharged without any neurological deficit.

A Study on the Experiences of Total Knee Replacement in Elderly Women (여성노인의 슬관절 전치환술 경험)

  • Lee, Hyun Ok;Lee, Soon Hee
    • Journal of muscle and joint health
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    • v.21 no.3
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    • pp.206-214
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    • 2014
  • Purpose: The aim of this study was to explore the elderly women patients' experience of treatment for total knee replacement. Methods: The participants in this study are 10 elderly women age 65 and over who were discharged after total knee replacement. The data were collected from August 5, to September 20, 2012, and it has been done by in-depth interview. Data were analyzed the phenomenological method of Colaizzi. Results: In this study, four categories were extracted: 'Suffering due to intolerable pain', 'A stable mind and body', 'Retrospection about old wounds', 'A desire for a new life'. Conclusion: This study provides the useful basic data to understand the elderly women patients who have experienced total knee replacement. Nursing intervention is required for pain control after surgery in order to improve the quality of life. In addition, nursing care through individual counseling and emotional support during the recovery period is very important. Therefore, various programs should be developed for elderly women patients to help their body recovery as well as psychological support after total knee replacement surgery.

Minimally Invasive Radio-guided Parathyroid Surgery (최소침습 방사능 유도 부갑상선 수술)

  • Chung Woong-Yoon;Chang Hang-Seok;Lee Jong-Doo;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.194-199
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    • 1999
  • Introduction: Since 1996, Dr. James Norman has successfully performed mimimally invasive radio-guided parathyroidectomy(MIRP) using intraoperative nuclear mapping with $^{99m}Tc$ sestamibi scanning and radioactivity detection probe. Objectives: We aimed to introduce this new surgical technique and evaluate it's efficacy by our own experiences. Method: From May to October 1999, five consecutive patients with primary hyperparathyroidism underwent parathyroidectomy by using modified MIRP technique. $^{99m}Tc$ sestamibi scanning was performed 1.0 or 1.5 hour before operation. After intraoperative localization of the tumor under the guidance of quantitative gamma counting with a NEVIGATOR probe, an unilateral small skin incision(3.0-4.0cm) was placed. Without a skin flap, the strap muscle was directly divided with the use of a Harmonic scalpel. After careful dissection, the parathyroid tumor was removed. Result: In all patients, a single adenoma could be easily detected and removed by this new technique. Mean incision length was 3.2cm(3.0-4.0cm) and operative time ranged from 40 to 110minute. All the patients were discharged within 2 days of surgery without any complication. Conclusion: This new operative technique could become the most minimally invasive alternative to the standard operative procedure for parathyroid adenoma.

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