• Journal of Chest Surgery
• /
• 제26권3호
• /
• pp.224-227
• /
• 1993

We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

• Journal of Chest Surgery
• /
• 제51권1호
• /
• pp.69-71
• /
• 2018

A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left atrium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission. We therefore performed an emergency operation. The bronchogenic cyst was resected by thoracotomy and the patient was discharged 12 days after the operation without any complications over 5 years of follow-up.

• Journal of Trauma and Injury
• /
• 제28권4호
• /
• pp.272-275
• /
• 2015

Pelvic bone fracture with unstable vital signs is a life-threatening condition demanding proper diagnosis and immediate treatment. Unlike long bones, the pelvic bone is a three dimensional structure with complex holes and grooves for vessels and nerves. Because of this complexity, a pelvic bone fracture can lead to complicated and serious bleeding. We report a case of a fifty-year-old male suffering from a pelvic bone fracture due to a fall. An imaging study showed fractures of both the superior and the inferior ramus of the pubic bone, with contrast extravasation underneath them, resulting in a large preperitoneal hematoma. He was sent for angiography, which revealed a hemorrhage from a branch of the left obturator artery. Embolization was done with a glue and lipiodol mixture. The patient recovered without complication, and was discharged at four weeks after admission.

• Journal of Trauma and Injury
• /
• 제27권2호
• /
• pp.29-32
• /
• 2014

Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

• 성인간호학회지
• /
• 제18권2호
• /
• pp.183-193
• /
• 2006

Purpose: The purpose of the study was to test the effects of music therapy on postoperative pain in patients with total hip replacement. Method: The research design was a nonequivalent control group pretest-posttest design. The subjects were composed of thirty patients with total hip replacement. Fifteen of them were assigned to the experimental group and fifteen to the control group. Fifteen minutes tailored music therapy was given to the experimental group during five consecutive days. The instruments used for this study were pain NRS(numerical rating scale). The data were analyzed using percent, mean, standard deviation, ${\chi}^2-test$ and repeated measure ANOVA using SPSS WIN 11.0. Results: Hypothesis 1 "The score of pain NRS of experimental group will be lower than those of control group" was accepted(F=15.945, p<.001). Hypothesis 2 "The frequency of PCA analgesics of experimental group will be fewer than those of control group" was accepted (t=-2.312, p=.028). Hypothesis 3 "The vital signs(pulse, systolic BP and diastolic BP) of experimental group will be different from those of control group" was rejected. Conclusion: This music therapy can be recommended as an efficient nursing intervention to reduce postoperative pain in patients with total hip replacement.

• 한국응급구조학회지
• /
• 제15권1호
• /
• pp.79-88
• /
• 2011

Purpose : Prehospital emergency care for shockable rhythm is one of major concerns of emergency medical services. But, in Korea, prehospital medical service systems are not yet well established. We tried to offer one of the fundamental data to develop of these system. Method : After application of exclusion criteria, 200 patients who had shockable rhythm from January to December, 2008 were included in this study. Restrospective review of Prehospital care Reports of these patients was done. Result : Total 200 cases of shockable rhythm and prehospital arrest were analyzed. The rates of assessment of vital signs were 89.0%, the rate of level of consiousness was 99.5%. Just 6.0% were communicated with medical director providing the prehospital care. The frequency of defibrillation was performed 58.5%. Conclusion : Survival rate was higher in defibrillation group than that of nondefibrillation group(20.5% vs 2.4%, p=0.000).

• Journal of Korean Biological Nursing Science
• /
• 제15권4호
• /
• pp.247-256
• /
• 2013

Purpose: This study aimed to determine the effects of listening to music on pain and vital signs of critically ill patients with ventilatory support in intensive care units during nursing treatment (changes of posture and tracheal suction). Methods: The experimental treatment was to use an mp3 player and a speaker to let them listen to classical music by Mozart during nursing treatment. To determine the effects of music intervention, pain (Critical-Care Pain Observation Tool-K) was used. The data analysis was carried out by using PASW Statistics 20.0. Results: Hypothesis "The scores for pain would differ between the experimental group provided with music intervention during nursing treatment, and the control group" was supported. Conclusion: Application of music intervention during nursing treatment for critically ill patients with ventilatory support in intensive care units was found to be effective in reducing pain. Therefore, music intervention during nursing treatment for critically ill patients with ventilatory support can be used as non-pharmaceutical nursing intervention to reduce pain for the patients.

• 대한한방내과학회지
• /
• 제19권2호
• /
• pp.81-87
• /
• 1998

BACKGROUND : Hwabyung is a culturally-related syndrome of Korea diagnostically confounded with somatization, depressive and generalized anxiety disorders, representing typical clinical manifestations of wide range in their severity. METHODS : This clinical study was carried out on 200 inward stroke patients who had stable vital signs and had stayed at least for 10 days after admission. The patients were devided into two groups, hwabyung and non hwabyung group after an interview with an oriental neuropychiatrist. Than we compared the two groups with general characteristics, past history, stroke type, clinical manifestations and serum lipid levels. Also we investigated recent stressors in hwabyung group. RESULTS : The results showed that the incidence of hwabyung was about 28.5% in stroke patients. The greater number of subjects with hwabyung were women in lower educational level. Aphagia were observed more frequently in hwabyung group and verbal disturbance in non-hwabyung group. The most recent stressor of male in hwabyung group was finantial difficulties due to dishonor, unemployment, cheated and so on. As to female, the conflicts with husband or his family were the most recent stressor. As a whole, finantial difficulties were highly ranked as a recent stress in hwabyung group.

• 대한전기학회:학술대회논문집
• /
• 대한전기학회 2005년도 학술대회 논문집 정보 및 제어부문
• /
• pp.41-43
• /
• 2005

PDA-based monitoring is used to acquire continuously the patient's vital signs, including electrocardiography, activity, heart rate and $SpO_2$. In this paper, A biomedical signal acquisition device was designed using 3-axial MEMS accelerometer and 1-ch ECG amplifier, to have the function of monitoring activity and electrocardiography. The proposed system is composed of transmitter and receiver. Through the Zigbee communication, subject's biosignals can be transmitted in real-time to receiver, and transmitted data confirmed using PDA. The packet size used in this device was set not to exceed a maximum payload size of 116 byte. One packet consists of two segments. The transmission speed was 21 packet per second, 420 ECG samples per second, and 42 acceleration samples per second. The proposed method can be used to develop Activities of Daily Living(ADL} monitoring devices for the elderly or movement impaired people and enables patients to be monitored without any constraints. Also, this method will reduce medical costs in the aged society.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제42권5호
• /
• pp.295-300
• /
• 2016

Submucosal infiltration and the topical application of epinephrine as a vasoconstrictor produce excellent hemostasis during surgery. The hemodynamic effects of epinephrine have been documented in numerous studies. However, its metabolic effects (especially during surgery) have been seldom recognized clinically. We report two cases of significant metabolic effects (including lactic acidosis and hyperglycemia) as well as hemodynamic effects in healthy patients undergoing orthognathic surgery with general anesthesia. Epinephrine can induce glycolysis and pyruvate generation, which result in lactic acidosis, via ${\beta}2$-adrenergic receptors. Therefore, careful perioperative observation for changes in plasma lactate and glucose levels along with intensive monitoring of vital signs should be carried out when epinephrine is excessively used as a vasoconstrictor during surgery.