Heart transplantation is an accepted procedure for treatment of end-staged cardiac failure. A return to near-normal quality on life can be expected in many patients with a nonrejecting cardiac allograft, and many of these patients will return to the operating room for noncardiac surgical procedures. Anesthesiologists should be alert to recognizing problems caused by the presence of infection in immunosuppressed patients, modes of presentation of rejection phenomena and how transplanted organs, notably significantly denervated ones, may behave and respond under the pathophysiologic circumstance that arise during surgery, resuscitation and intensive care. The use of regional techniques require adequate preloading to avoid exaggerated hypotension and aseptic technique to avoid infection. Hypobaric spinal anesthesia has some benefit. It does not depress cardiovascular and respiratory system and keep adequate venous return by trendelenberg position. We report herein a case of successfully undergone total hip replacement in a patient who had previously undergone orthotopic heart transplantation under hypobaric spinal anesthesia.
Allografts ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Heart Failure ; Heart Transplantation ; Heart* ; Humans ; Hypotension ; Critical Care ; Operating Rooms ; Respiratory System ; Resuscitation

The effects of hyperbaric oxygen therapy have been documented in 10 patients with radiation-induced cystitis refractory to conventional management. Seven patients were treated for 40-70 consecutive days, 90 minutes each day with 100 per cent oxygen at 2.4 atmospheres absolute pressure in a multiplace unit. Seven patients achieved the relief of gross hematuria and improvement of bladder irritative symptoms without side effect for an average 16.7 months (range 6 to 27 months). Hyperbaric oxygen therapy was stopped in three patients because of febrile sense in trunk, pneumonia and cancer recurrence. This experience suggests that hyperbaric oxygen therapy might be considered the primary treatment of patients with symptomatic radiation-induced cystitis.
Atmosphere ; Cystitis* ; Hematuria ; Humans ; Hyperbaric Oxygenation* ; Oxygen ; Pneumonia ; Recurrence ; Urinary Bladder

No abstract available.
Chancre ; Lip

PURPOSE: The purpose of this study was to examine the effects of hand massage on fatigue, sleep satisfaction and blood pressure of the aged in a long-term care facility. METHODS: The data were collected from June to August 2008. The subjects were randomly recruited from a long-term care facility in Junnam Providence and were randomly assigned to the experimental group (n = 22) or control group (n = 22). Hand massage was carried out every other day in the evening for two weeks. Massage was administered to each forearm and hand for 10 minutes. Descriptive statistics, x2-test and t-test were performed using SAS program. RESULTS: In the experimental group, the fatigue (p = .017) was significantly lower and the sleep satisfaction (p = .043) was significantly higher than for the control group. CONCLUSION: On the basis of the results of the study, hand massage can be recommended for the elderly with sleep disturbance to reduce fatigue.
Aged ; Blood Pressure ; Fatigue ; Forearm ; Hand ; Humans ; Long-Term Care ; Massage ; Phenothiazines

Paragonimiasis is widely distributed in Far East and Southeast Asia, particularly in Korea. The centralnervous system is the most frequent location for paragonimiasis outside the lungs. We analized the computedtomographic findings of 17 cases which were diagnosed pathologically and clinically as cerebral paragonimiasis.The results were as follows; 1. The ratio of male to female was 10:7 and about 88% of cases were under the age of40 years. 2. The common location so cerebral paragonimiasis were the occipital (12 cases ) and temporal (11 cases) lobes. 3. Precontrast CT findings of cerebral paragonimiasis were low density with calcifications in 6 cases,low and isodensities in 4 cases, mixed densities in 3 cases, only low density in 2 cases and only calcification sin 2 cases. Hydrocephalus (7 cases), mass effect (6 cases), atrophic change(6 cases) and cyst formation (3 cases)were associated. 4. The shape of calcifications in CT scan were soap-bubble or ring in 6 cases, nodular or oval in6 cases, stippled in 4 cases and amorphous conglomerated in 2 cases. 5. The contrast-enhanced 8 cases were 5 ringor rim like, 2 nodular and 1 irregular enhancements, while 9 cases were not enhanced.
Asia, Southeastern ; Far East ; Female ; Humans ; Hydrocephalus ; Korea ; Lung ; Male ; Paragonimiasis ; Tomography, X-Ray Computed

Electrical burn is thought to be similar to crushing injury in that it usually involves skin, muscle and neurovascular structure simultaneously. Especially in extremity, there are many occasions that amputations are inevitable. Since the demarcation between viable and non-viable tissue tends to be obscure, electrical burn greatly differs from other types of injury in detailed methods of treatment, such as the level, the timing and the technique of amputation. During the past 10 years from January, 1978 to December, 1987, authors experienced 285 amputations in 181 cases of electrical burn at Orthopedic Department of Hanil Hospital. The clinical data of our experience were reviewed and analysed. The results were as follows ;l. Amputation rate in electrical burn was 22.4%. 2. Out of total 285 amputations, the number of upper extremity was 187 (65.6%) and it was 1.9 times more than that of lower extremity. Right forearm was 1.8 times more than left forearm. 3. Multiple limbs amputation were performed in 83 cases (45.9%). 4. Among 285 stumps, more than one operation were done in 74 stumps because of infection (50%), necrosis of stump end (35.1%), bony overgrowth at stump end (8.1%) and neuroma(6.8%).
Amputation ; Amputees ; Burns ; Extremities ; Forearm ; Humans ; Lower Extremity ; Necrosis ; Orthopedics ; Skin ; Upper Extremity

Purpose: The purpose of this study was to examine the influences of nursing professionalism and job stress on problem solving ability of community health practitioners. Methods: The participants were 167 community health practitioners. Data were collected from December 18 to 28, 2019. Self-report questionnaires were administered to collect data regarding general characteristics, degree of nursing professionalism, job stress, and problem solving ability. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Pearson correlation coefficients and multiple regression analysis. Results: The factors influencing the degree of problem solving ability of the community health practitioners were professionalism of nursing (β=.29, p<.001), and interpersonal factors (β=-.25, p=.001). It was found that 15% could explain problem solving ability. Conclusion It is necessary to strengthen the professionalism of nursing and to decrease the interpersonal factors due to job stress for the community health practitioners. The results indicate a need to increase development of educational programs for capacity building of community health practitioners.

Myopathy due to hypothyroidism can be detected in its early stage, but as the symptom is mild, complications such as rhabdomyolysis are rare. Thrombotic thrombocytopenic purpura in hypothyroidism is not yet clearly defined, and rare cases of it are reported. Reported herein is a case of thrombotic thrombocytopenic purpura and rhabdomyolysis associated with acute renal failure in hypothyroidism. A 70-year-old male was admitted to the hospital due to general weakness and muscle pain. Later, based on the laboratory findings, he was diagnosed with rhabdomyolysis associated with acute renal failure and thrombotic thrombocytopenic purpura combined with hypothyroidism. Initially, he was treated with fluid resuscitation due to rhabdomyolysis combined with acute renal failure but eventually, the levothyroxine supplement lowered the thyrotropin-stimulating hormone level. As a result, the patient recovered from rhabdomyolysis and thrombotic thrombocytopenic purpura without receiving plasmapheresis treatment.
Acute Kidney Injury* ; Aged ; Humans ; Hypothyroidism* ; Male ; Muscular Diseases ; Myalgia ; Plasmapheresis ; Purpura, Thrombotic Thrombocytopenic* ; Resuscitation ; Rhabdomyolysis* ; Thyroxine

PURPOSE: This study is aimed at identifying the effects of telephone counseling as nursing support on distress, anxiety, depression, and adverse events in cancer patients undergoing their first chemotherapy. METHODS: This was a randomized controlled trial (pretest-posttest design). A total of 70 patients who showed 4 or higher distress scores were selected from the screening process. Four patients dropped out; therefore, 66 patients participated in this research. Thirty-two and 34 patients were randomly assigned to the experimental and the control group, respectively. After a preliminary survey, telephone counseling support was given to the experimental group at three time points. The post survey was done before the second cycle of chemotherapy. RESULTS: Regarding distress, both groups showed a statistically significant decrease in the scores: 3.4 for the experimental group and 1.8 for the control group (p=.002). Furthermore, the experimental group demonstrated a statistically significant decrease relative to the control group. Anxiety and depression showed no statistically significant difference between the two groups. CONCLUSION: This study concludes that nursing support through phone counseling is effective in decreasing distress in patients undergoing chemotherapy for the first time.
Anxiety* ; Counseling* ; Depression* ; Drug Therapy* ; Humans ; Mass Screening ; Nursing ; Telephone*

PURPOSE: To identify the type of disease-related stress experienced by women who received mastectomy for breast cancer using Q methodology. METHOD: Q sample included 30 statements obtained from literature and interviews with women with mastectomy. P sample consisted of 22 patients with mastectomy. The data were collected from November to December 2002 and analyzed using QUANL program. RESULT: Four types of disease-related stress experienced by women with mastectomy were found. Type 1 was manifested for a short duration following surgery and characterized by lowered self-esteem, feelings of emptiness and depression because of impaired body image. Type 2 was characterized by declined physical strength, resulting in frequent fatigue in the daily life and less intimate relationship with spouse. Type 3 was manifested by perfectionists with strong sense of self-pride who received or considered breast reconstruction surgery. Type 4 was reported by those who had long period of post-surgery. This type reported a strong sense of discomfort for wearing an artificial breast but didn't show any intention of trying breast reconstruction surgery. CONCLUSION: Women with mastectomy were found to experience different type of disease-related distress. Therefore, nurses should assess the type of stress the patient experiences following a mastectomy to provide appropriate nursing care.
Body Image ; Breast ; Breast Neoplasms ; Depression ; Fatigue ; Female ; Humans ; Intention ; Mammaplasty ; Mastectomy* ; Nursing Care ; Spouses