PURPOSE: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. METHODS: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient’s pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. RESULTS: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). CONCLUSION: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.
Analgesics* ; Drug Therapy ; Education ; Hand* ; Hospice Care ; Hospices ; Humans ; Massage* ; Non-Randomized Controlled Trials as Topic

BACKGROUND: Recently the cases of varicose veins are increasing because the patients with latent disease have come to realize that they want a positive treatment. Accordingly, the purpose of this study is to compare and analyze two methods the conventional phlebectomy (CP) and transiliuminated powered phlebectomy (TIPP). MATERIAL NAD METHOD: From March 2001 to December 2004, 114 patients (167 legs) with varicose vein were operated in Pusan National University Hospital. A retrospective review was performed on the clinical records. We analyzed age, sex, duration of illness, chief complaints, duplex doppler findings, number of skin incisions, operative time, length of hospitalization, complications, and remnant lesions. RESULT: Operative time was significantly shorter in the TIPP group than CP group (for one leg 108.4+/-27.6 min vs 83.4+/-24.4 min, for both legs 184.7+/-28.4 min vs 137.8+/-24.4 min). There was significant statistical difference in average number of skin incisions per leg between the CP group and the TIPP group (5.9+/-2.2 vs 4.2+/-1.6). Mean duration of hospitalization was significantly shorter in the TIPP group than CP group (4.4+/-1.0 days vs 5.8+/-1.9 days). Complications were pain (15.9%), remnant lesion (9.5%), and ecchymosis (4.8%) in the CP group and ecchymosis (19.6%), pain (7.8%), and remnant lesion (7.8%) in TIPP group. Sclerotherapy or reopertaion was done for the patients who had remnant lesions. CONCLUSION: Transilluminated powered phlebectomy in varicose vein could reduce operative time and number of skin incisions, and almost completely removed the multiple lesions. Although there were postoperative complications such as ecclymosis, they were absorbed within 2 months and patients were satisfied. Therefore, TIPP is a more effective operative technique than conventional phlebectomy in varicose veins.

A tracheo-innominate artery fistula is a highly lethal complication following tracheostomy; therefore, it's early recognition and prompt treatment is mandatory. A 37-years-old man who had undergone a tracheostomy several days earlier, following brain surgery, was found to have a tracheo-innominate artery fistula with an exsanguinating hemorrhage from his tracheostomy site. After temporary control of the bleeding with ballooning, a stent graft was implanted through the femoral artery into the innominate artery. The patient experienced rebleeding from the mouth 50 days later. Aortoinnominate interposition grafting and patch closure of the trachea were performed for the permanent control of bleeding and to maintain the airway. This delayed operation is easier and safer than an emergency operation; therefore, we could expect better operative results under such circumstances. 12 months after surgery, the patient is in a state of well being.
Arteries* ; Blood Vessel Prosthesis* ; Brachiocephalic Trunk ; Brain ; Emergencies ; Exsanguination ; Femoral Artery ; Fistula* ; Hemorrhage ; Humans ; Mouth ; Stents* ; Trachea ; Tracheostomy ; Transplants

BACKGROUNDS: Insufficient intermaxillary space is caused by non-restoration following tooth extraction in the past, and this involves eruption of the opposing teeth and changes of the arch structure. Such cases are difficult just by a simple prosthetic approach, and diversified treatment plans should be established. Among these, posterior maxillary segmental osteotomy (PMSO) is an efficient treatment option than extraction of opposing teeth as it surgically repositions multiple erupted teeth and alveolar bone. PMSO can preserve the natural teeth; therefore, it is being regarded as a treatment method which can improve insufficient intermaxillary space significantly. CASE PRESENTATION: In this case report, the first patient received PMSO in order to place an implant in the mandibular edentulous space after decreased vertical dimension is restored, and the second patient received PMSO along with orthodontic treatment to obtain the intermaxillary space and balance the interarch molar width. CONCLUSION: PMSO is the treatment of choice when occlusion is compromised in the presence of decreased vertical dimension or arch length discrepancy.
Humans ; Methods ; Molar ; Orthognathic Surgery ; Osteotomy* ; Tooth ; Tooth Extraction ; Vertical Dimension

165Dy Hydroxide Macroaggregates(165Dy HMA) has a short half life(2.3 hours) and a size range of 3-5µm that give the advantage of reduced leakage and a shorter hospital stay. This report will show the results of a prospective open study on the efficacy and safety of 165Dy HMA in 178 knees of 141 patients with chronic synovitis refractory to conventional antirheumatic therapy. The final global assessment was classified as good, fair or poor. Extra-articular leakage of 165Dy HMA was determined by the scintigraphic evaluation of liver, groin and knee joints. The optimum radiation dose was 250 mCi. The mean follow up periods were 32.4(14-112) weeks. Thirty seven percent of the knees showed good results, 48% fair results and 15% poor results. In the knees with stage I radiographic changes, 82% showed improvement including 32% of the patients with good results. In the knees with stage II radiographic changes, 90% showed improvement including 42% of the patients with good results. The mean period of improvement for the 158 knees that responded to treatment was 41.4(24-106) weeks. Leakage of radioactivity from the injected joint was minimal. Adverse reactions were rare(radiation burn : 4 cases, transient postinjection swelling : 14 cases). In conclusion, 165Dy HMA radiation synovectomy is a safe and useful therapy for chromic synovitis of the rheumatoid knees.
Arthritis, Rheumatoid ; Burns ; Follow-Up Studies ; Groin ; Humans ; Injections, Intra-Articular ; Joints ; Knee Joint ; Knee ; Length of Stay ; Liver ; Prospective Studies ; Radioactivity ; Synovitis

BACKGROUND: Although patients with a ruptured abdominal aortic aneurysm (RAAA) often reach the hospital alive, the perioperative mortality is still very high. We retrospectively reviewed thirty patients who underwent repair of RAAA to identify the factors affecting postoperative mortality in a single hospital. MATERIALS AND METHODS: Between September 2007 and May 2011, thirty patients with RAAA underwent emergent surgery (n=27) or endovascular aneurysm repair (n=3). Their medical records were retrospectively reviewed regarding three categories: 1) preoperative patient status: age, gender, vital signs, serum creatinine, blood urea nitrogen, hematocrit, and hemoglobin level: 2) aneurysmal status: size, type, and rupture status; and 3) operative factors: interval time to operating room, operative duration, and amount of perioperative transfusion. RESULTS: The 30-day postoperative mortality rate was 13.3% (4/30); later mortality was 3.3% (1/30). On multivariate analysis, the initial diastolic blood pressure (BP), interval time to operating room and amount of preoperative packed cell transfusion were statistically significantly linked with postoperative mortality (p<0.05). CONCLUSION: In this study, preoperative diastolic BP, preoperative packed cell transfusion amount and interval time between arrival and entry to operating room were significantly associated with postoperative mortality. It is important to prevent hemorrhage as quickly as possible.
Aneurysm ; Aortic Aneurysm, Abdominal ; Blood Pressure ; Blood Transfusion ; Blood Urea Nitrogen ; Creatinine ; Hematocrit ; Hemoglobins ; Hemorrhage ; Humans ; Medical Records ; Multivariate Analysis ; Operating Rooms ; Retrospective Studies ; Rupture ; Vital Signs