We report the case of a 72-year-old female with persistent atrial fibrillation who underwent a totally thoracoscopic ablation. A successful normal sinus conversion was achieved.
Aged ; Atrial Fibrillation* ; Female ; Humans ; Thoracoscopy

PURPOSE: This study was to testify the effects on self esteem and spiritual well-being of holistic hospice nursing intervention program ("Rainbow program") for inpatients of hospice palliative care unit. This was designed as a preliminary experimental study with one-group pre-post test. METHODS: A total of 27 patients who were over 18 years old, and admitted in hospice palliative care unit of S hospital in P city, submitted informed consent for this study, participated in holistic hospice nursing intervention program(total 10 sessions and 1,200 minutes for 2 weeks) from April 6, 2004 to April 20, 2005. To test the effects of this intervention, Self Esteem Questionnaire (SEQ) and Spiritual Well-being Questionnaire were used. The collected data were analyzed by Paired t-test with SPSS/WIN 12.0 program. RESULTS: (1) Hypothesis No. 1 "The experimental group which received Rainbow program will have a higher degree of self esteem than before" was supported (t=11.554, P<0.001). (2) Hypothesis No. 2 "The experimental group which received Rainbow program will have a higher degree of spiritual well-being than before" was also supported (t=6.387, P<0.001). CONCLUSION: This Holistic Hospice Nursing Intervention Program was effective in increasing self-esteem and spiritual well-being of patients in hospice palliative care unit. Therefore, it can actively be used and also applied to hospice palliative care practice, research, and education as a useful model of interdisciplinary team approach by hospice professionals.
Evaluation Studies as Topic ; Hospices ; Humans ; Informed Consent ; Inpatients ; Palliative Care ; Self Concept ; Surveys and Questionnaires

Purpose: The purpose of this study was to develop and apply a motivation-strengthening obesity management program for obese subjects with visual impairment and evaluate its effects. Methods: The program development and evaluation periods were from March to August 2018. The study design was an experimental study of non-equality, control repeat design. 25 subjects in the experimental group participated in the 12-week obesity management program and the 26 people in the control group did not. Results: The motivation-strengthening obesity management program included stretching exercises for 30 minutes in the morning five times a week. In addition, counseling, education, and group discussions were continued once a week for motivational strengthening. Special custom exercises for blind patients were also completed once a week simultaneously. Both of these activities were continued for 50 minutes a week for a total of 12 weeks. Measurements were recorded periodically to identify the sustained effects of the program.The obese subjects with visual impairment improved their knowledge of obesity, perceived disability, self-efficacy of exercise, and quality of life related to obesity through the motivational obesity management program. Waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood sugar were also improved in obese subjects. Conclusion The study findings indicate that this program could be an active intervention for the control of weight gain in participants with visual impairment. Therefore, the motivation-strengthening program based on the ADDIE (Analysis, Design, Development, Implementation& Evaluation) model could be an effective strategy for better health outcomes of obese subjects with visual impairment.

PURPOSE: This study was conducted to examine the late effects, social adjustment, and quality of life in adolescents who had been completely treated for childhood leukemia and their parents. METHODS: Participants consisted of 41 pairs of adolescent survivors (13-18 years) and their parents. Parents checked for their child's physical late effects. The Korean Version of Post-Traumatic Symptoms for psychological late effects, social functioning questionnaire for social adjustment and the PedsQL 4.0 Generic Core Scales for quality of life were completed by adolescents and parents. Data were analyzed using SPSS. RESULTS: Twenty out of 41 adolescents had one or more physical late effects. Adolescents showed more serious psychological late effect than parents. Five children and seven parents had above cut-off scores and they were considered the high risk group for posttraumatic symptoms. Parent-reported scores were significantly higher than child-reported scores in terms of social adjustment and emotional functioning of quality of life. Low school functioning in adolescents was associated with physical late effects. CONCLUSION: The results indicate that long-term and systematic management for childhood leukemia survivors affect positive social adjustment and can further improve quality of life.
Adolescent ; Adult ; Humans ; Leukemia/*psychology ; Parents/psychology ; *Quality of Life ; Questionnaires ; *Social Adjustment ; Stress, Psychological ; Survivors/*psychology ; Time Factors ; Translating

BACKGROUND: Tumor recurrence is the most common cause of treatment failure, even after complete resection of early-stage non-small cell lung cancer (NSCLC). In this study, we investigated the prognosis of patients with early recurrence in order to identify independent risk factors related to early recurrence. METHODS: Between February 1995 and December 2012, 242 patients who underwent surgical resection for stage I NSCLC at Dong-A University Hospital were reviewed. The factors predicting overall survival (OS) and early recurrence were investigated. We also investigated the relationship between the patterns and period of recurrence and clinicopathological factors. RESULTS: For patients with stage IA and IB NSCLC, the 5-year OS rate was 75.7% and 57.3% (p=0.006), respectively. A multivariate Cox proportional hazards model demonstrated that gender (p=0.004), comorbidity number (p=0.038), resection type (p=0.002), and tumor size (p=0.022) were the statistically significant predictors of OS. Moreover, the multivariate analysis revealed that smoking history (p=0.023) and histologic grade (p=0.012) were the independent predictors of early recurrence. Additionally, only histologic grade (poor differentiation) was found to be significantly associated with a higher frequency of distant metastasis; there was no relationship between the patterns and period of recurrence and clinicopathological factors. CONCLUSION: The present study demonstrated that smoking history and histologic grade were independent prognostic factors for early recurrence within two years in patients with early-stage NSCLC. Patients with these predictive factors may be good candidates for adjuvant therapy.
Carcinoma, Non-Small-Cell Lung* ; Comorbidity ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis* ; Proportional Hazards Models ; Recurrence* ; Risk Factors ; Smoke ; Smoking ; Treatment Failure

Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.
Aorta ; Arteries ; Bradycardia ; Cause of Death ; Chest Pain ; Diagnosis ; Emergencies ; Heart Rupture* ; Hematoma ; Humans ; Infarction ; Myocardial Infarction ; Rupture ; Shock ; Transplants

Purpose: This study compared the subjective and objective sleep quality between subjects with and without thoracic hyper-kyphosis. Methods: Forty participants were divided into a hyper-kyphosis (n = 17) and normal group (n = 17) by thoracic spinal angle measurement. The subjective sleep quality was measured using PSQI, a self-report, and objective sleep quality was measured using an actigraphy that measures time according to sleep patterns. Results: The PSQI scores of subjects with thoracic hyper-kyphosis were significantly higher than those with normal thoracic curvature (p = 0.013). The total sleep time and real sleep time were less in subjects with hyper-kyphosis than in normal subjects (p = 0.006;p = 0.029). The light sleep time was less in subjects with excessive spondylolisthesis than in normal subjects (p = 0.010). Light sleep time was less in those with hyper-kyphosis, but deep sleep time was similar to the subjects with a normal thoracic curvature (p = 0.003;p = 0.140). Conclusion Subjects with thoracic hyper-kyphosis had a decrease in subjective sleep quality, such as sleep discomfort, and objective sleep quality, such as a decrease in sleep time compared to normal subjects.

Purpose: This study aimed to identify the effects of the Horticultural Therapy Program on interpersonal relations, self-efficacy, and stress awareness for patients with mental illness. Methods: This was a non-equivalent control group pre and post-test design study. Participants were recruited from a closed ward of mental health hospitals located in the G city. 23 patients from two hospitals were in the experimental group and 20 patients from four hospitals were in the control group. A ninety-minute horticultural program was performed once a week for 8 weeks. Results: Results revealed that the Horticultural Therapy Program was effective for self-efficacy (z=-3.06 p=.002) and stress awareness (z=2.92, p=.004) for patients with mental illnesses. Conclusion These results indicate that the Horticultural Therapy Program is effective for self-efficacy and stress awareness in patients with mental illnesses. Therefore, the Horticultural Therapy Program is recommended as an effective psychiatric nursing intervention for mental health promotion and rehabilitation.

Objective: When mass casualty incidents occur in Korea, disaster medical assistance teams (DMATs) and public health disaster response teams (PHDRTs) treat casualties at the scene. However, the appropriateness of their on-site responses has not been assessed so far. In this study, we evaluated their response and the variations in their response according to the accessibility of medical care. Methods: We analyzed mass casualty incidents that were reported to the Disaster Emergency Medical Service Situation Room of the National Emergency Medical Center from July 2014 to December 2018. We divided the accident locations into medically underserved areas (MUAs) and adequately served areas (ASAs) and compared the responses of the two teams in each area. Results: Of the 61 incidents, 20 occurred in MUAs, and 41 occurred in ASAs. In MUAs compared to ASAs, time from DMATs' dispatch to arrival was longer (48 [40-58.5] vs. 23 [18-32], P<0.001) but the time taken by the PHDRTs did not vary between two areas (19 [14-35] vs. 15.5 [9-24.5], P=0.263). In MUAs, the time elapsed from the PHDRTs' dispatch to arrival was less than that of the DMATs (48 [40-58.5] vs. 20 [15-35], P<0.001). In MUAs, the distance of the PHDRTs from the scene was lower (31.4 [25-50.95] vs. 13.6 [5.3-19.7], P=0.001) and more members were dispatched to the scene than the DMAT (5 [4-6] vs. 9 [5-10.5], P=0.013). Conclusion Because of the low accessibility to the scene in MUAs, DMATs took a long time to initiate medical support . To provide adequate disaster medical support, the PHDRTs must be specialized and trained.

Objective: When mass casualty incidents occur in Korea, disaster medical assistance teams (DMATs) and public health disaster response teams (PHDRTs) treat casualties at the scene. However, the appropriateness of their on-site responses has not been assessed so far. In this study, we evaluated their response and the variations in their response according to the accessibility of medical care. Methods: We analyzed mass casualty incidents that were reported to the Disaster Emergency Medical Service Situation Room of the National Emergency Medical Center from July 2014 to December 2018. We divided the accident locations into medically underserved areas (MUAs) and adequately served areas (ASAs) and compared the responses of the two teams in each area. Results: Of the 61 incidents, 20 occurred in MUAs, and 41 occurred in ASAs. In MUAs compared to ASAs, time from DMATs' dispatch to arrival was longer (48 [40-58.5] vs. 23 [18-32], P<0.001) but the time taken by the PHDRTs did not vary between two areas (19 [14-35] vs. 15.5 [9-24.5], P=0.263). In MUAs, the time elapsed from the PHDRTs' dispatch to arrival was less than that of the DMATs (48 [40-58.5] vs. 20 [15-35], P<0.001). In MUAs, the distance of the PHDRTs from the scene was lower (31.4 [25-50.95] vs. 13.6 [5.3-19.7], P=0.001) and more members were dispatched to the scene than the DMAT (5 [4-6] vs. 9 [5-10.5], P=0.013). Conclusion Because of the low accessibility to the scene in MUAs, DMATs took a long time to initiate medical support . To provide adequate disaster medical support, the PHDRTs must be specialized and trained.