• Journal of Korean Neurosurgical Society
• /
• v.49 no.4
• /
• pp.241-244
• /
• 2011

Sparganosis is a rare parasitic infection affecting various organs, including the central nervous system, especially the lumbar epidural space. This report describes the identification of disease and different strategies of treatments with preoperative information. A 42-year-old man presented with a 2-year history of urinary incontinence and impotence. He had a history of ingesting raw frogs 40 years ago. Magnetic resonance (MR) imaging showed an intramedullary nodular mass at conus medullaris and severe inflammation in the cauda equina. A 51-year-old woman was admitted with acute pain in the left inguinal area. We observed a lesion which seemed to be a tumor of the lumbar epidural space on MR imaging. She also had a history of ingesting inadequately cooked snakes 10 years ago. In the first patient, mass removal was attempted through laminectomy and parasite infection was identified during intra-operative frozen biopsy. Total removal could not be performed because of severe arachnoiditis and adhesion. We therefore decided to terminate the operation and final histology confirmed dead sparganum infection. We also concluded further surgical trial for total removal of the dead worm and inflammatory grannulation totally. However, after seeing another physician at different hospital, he was operated again which resulted in worsening of pain and neurological deficit. In the second patient, we totally removed dorsal epidural mass. Final histology and enzyme-linked immunosorbent assay (ELISA) confirmed living sparganum infection and her pain disappeared. Although the treatment of choice is surgical resection of living sparganum with inflammation, the attempt to remove dead worm and adhesive granulation tissue may cause unwanted complications to the patients. Therefore, the result of preoperative ELISA, as well as the information from image and history, must be considered as important factors to decide whether a surgery is necessary or not.

• Journal of Korean Neurosurgical Society
• /
• v.55 no.6
• /
• pp.370-374
• /
• 2014

To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

• Journal of Korean Academy of Nursing Administration
• /
• v.14 no.4
• /
• pp.421-431
• /
• 2008

Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

• Journal of the Korean Data and Information Science Society
• /
• v.26 no.3
• /
• pp.715-727
• /
• 2015

This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

• Journal of Korean Medicine Rehabilitation
• /
• v.25 no.3
• /
• pp.119-125
• /
• 2015

A chronic subdural hematoma (CSDH) is an old collection of blood and blood breakdown products between the surface of the brain and its outermost covering. We present two cases with tibia fracture caused by traffic accident progressed to chronic subdural hematoma. A 72-year-old male patient had shown signs of headache, urinary incontinence and mental storm when he has been in the hospital after 3weeks without CSDH diagnosis. And a 78-year-old male patient with mild head injury suffered from right side headache after traffic accident. We took korean medical treatments associate with tibial fracture. And we knew subdural hematoma through Brain CT. It is good report which shows CSDH can can occur from traffic accident. It requires correct diagnosis and closed observation for traffic accident patients.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.12 no.1
• /
• pp.46-52
• /
• 2018

The purpose of this study was to investigate the factors affecting falls in 107 elderly living in the city aged 65 or older by evaluating general characteristics, chronic disease status, medical variables related to falls, balance-related confidence, physical ability and depression. Also, the correlations between the significant differences in variables were identified, and the prediction power was determined by deriving the variables with high influence to induce the fall. In the faller group, urinary incontinence, foot pain, lower extremity weakness, number of chronic disease and medication use were significantly higher than those of the nonfaller group. Also, statistically significant differences were evaluated in ABC (Activities-specific Balance Confidence) score, BBS (Berg Balance Scale) score, SGDS (Short Geriatric Depression Scale), FRT (Functional Reach Test) value. The main correlated factor for fall was ABC score, the lower the ABC score, fall risk is increased which is a significant negative impact. When the evaluation is performed by combining those scales, the hit ratio to classify whether faller or nonfaller is increased to 70.01% which is quite higher value.

• Herbal Formula Science
• /
• v.11 no.1
• /
• pp.45-55
• /
• 2003

From the study of the symptom, pathology in prescription of Ha-Tong from The Bangyakhapeun. I have reserched 163 prescription. It can be concluded as follows. 1. Prescription about Fecal disease which was the most as 11.66% of the whole, following order Internal disease(6.75%), Uterus Disease(5.52%) Sick-by-Cold Disease(5.52%), Eye Disease(4.91%), Blood Disease(4.91%), Unbalanced humoral status Disease(4.91%), Gynecologic Disease(4.91%). 2. The Fecal Disease divide diarrhea and dysentery; The Internal Disease divides with Sik-sang(食傷) Chu-sang(酒傷), Sik-juck-yu-sang-han(食積類傷寒), Carbonic acid, Vomiting acid; The Uterus Disease divides with Urinnary Disadvantage, Urinary retention, Incontinence; The Sick-by-Cold Disease divides with yang-myung-byung(陽明病), sang-han-goi-jng(傷寒壞證), sang-han-bun-gal(傷寒煩渴), sang-han-sum-ou, sang-han-hyul-jng(傷寒血證), sang-han-ja-ri(傷寒自利), sang-han-bun-jo-jng(傷寒煩燥證). 3. The Diarrhea and Dysentery many used o-ryung-san, hwng-gum-jak-yak-tang(黃芩芍藥湯) hyang-ryun-hwan(香連丸) etc, and The Internal Disease many used pyung-we-san(平胃散) as a basic prescripton. 4. The organ problem use the Sil-yuol(實熱) of the liver, stomach, lung, uterus, small intestine; six natural factors problem used the Sil-jng(實證) of the wind, fire, heat, cold, dampness; And used Unbalanced humoral status, lntrnal hurt, qi and blood, seven extream feeling.

• Journal of Korean Academy of Nursing
• /
• v.43 no.2
• /
• pp.145-153
• /
• 2013

Purpose: The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Methods: Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Results: Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership. Conclusion: There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

• Journal of Sensor Science and Technology
• /
• v.9 no.4
• /
• pp.256-267
• /
• 2000

In this paper, we studied the ultrasonic urine volume sensor of urinary alarm system for home use to detect the time of urination as a assistive methodology for the incontinence patients and the correlation between urine volume and bladder interwall distance by using developed sensor. The developed sensor was designed to minimize the measurement error by using ultrasound with 2.25 MHz center frequency which provides higher resolution as well as longer penetration depth. To verify usefulness of the developed sensor, we performed a preliminary experiment of estimating bladder volume from the measured distance between interior and posterior wall of bladder. In the preliminary experiment, bladder volume estimated from the result using a commercial ultrasonography system. The experimental results show there exists god correlation between the actual urine volume and the measured interwall distance of the bladder. In conclusion, the developed ultrasound bladder volume sensor can be applied to an urine alarm system which provides patient the exact time of urination, it will be contribute in health care and welfare society.

• Journal of Veterinary Clinics
• /
• v.26 no.2
• /
• pp.185-188
• /
• 2009

A six-month-old Boston terrier presented with an extruded penis caudally, incompletely formed preputial sheath, bifid scrotum, retained testicle and deformity of the os penis. On physical examination, the urethral orifice was located on the surface of the perineum and a fibrous band was observed running from the grans to the urethral orifice on the perineum. The dog also had urethritis that was infected by ascending bacteria entering through the contaminated urethral orifice. Corrective surgery was undertaken to excise the external genitalia and retained testicle. The prepuce, penis and retained testicles were successfully excised. After the urethral orifice was cleaned periodically and antibiotics were administrated, recurrent urethritis disappeared. Using this therapeutic regime it is not necessary to reconstruct the anomaly located urethral orifice, if the location of urethral orifice is not the cause of recurrent urethritis and urinary incontinence.