• Title/Summary/Keyword: 임상양상

Search Result 1,892, Processing Time 0.046 seconds

Relationships between Nursing Practice Stress and Stress Coping of Nursing Students in Korea (한국간호대학생의 임상실습 스트레스와 스트레스 대처)

  • Kim, Jihyun
    • Journal of Digital Convergence
    • /
    • v.12 no.2
    • /
    • pp.409-415
    • /
    • 2014
  • This study was done to identify the relationships between nursing practice stress and stress coping for the nursing students in Korea. Data were collected at 2 universities located in C city in Korea. Participants were 160 nursing students. Data were analyzed by SPSS 18.0 using descriptive statistics and Pearson's correlation coefficient. Nursing practice stress was $2.72{\pm}6.2$. Stress coping was $2.60{\pm}0.37$. Stress was correlated with wishful thinking coping strategy when doing orientation (r=0.32, p<0.01), conference(r=0.52, p<0.01), homework(r=0.29, p<0.01). Stress for practice exam was correlated with problem focused coping strategy(r=0.31, p<0.05). Stress was correlated with positive view coping strategy when face nurse(r=0.31, p<0.01) or interpersonal relations(r=0.35, p<0.01). Stress related to practice environment and class was correlated with indifference (r=0.26, p<0.01) and tension relieve strategy (r=0.28, p<0.01). There's no stress when they meet or serve direct care to patients. Students managed the stress by showing active coping pattern. It is considered that the experience gave students an excellent capacity to cope with stress. Since the degree of stress and coping pattern can differ from adaptability of situation, a research of change in clinical training stress by seasonal clinical training and coping patter is proposed.

Group A Streptococcal Bacteremia in Pediatric Patients: A Single-Center Study (소아환자에서의 A군 사슬알균 혈류감염: 단일기관 연구)

  • Kim, Dongsub
    • Pediatric Infection and Vaccine
    • /
    • v.27 no.2
    • /
    • pp.83-89
    • /
    • 2020
  • Purpose: Group A streptococcus (GAS) is a common pathogen in pediatric patients and often causes acute pharyngotonsillitis and skin and soft tissue infections. In addition, bacteremia with significant morbidity and mortality can also occur. This study was conducted to describe the clinical manifestations and treatment outcomes of pediatric GAS bacteremia patients in Korea. Methods: This was a single-center, retrospective study. From January 2000 to December 2016, pediatric patients aged ≤18 years with GAS bacteremia were studied. Clinical manifestations, underlying diseases, intensive care unit stay, and antibiotic susceptibility were evaluated. Results: During the study period, 19 patients had GAS bacteremia. Ten (53%) were male, and the median age was 7.4 years (range, 0.3-17.4 years). Fourteen (74%) had chronic underlying diseases. Five (26%) were immunocompromised (leukemia and chronic kidney disease). Eight (42%) had lymphatic or vascular malformations, of which seven had lesions with signs of inflammation. Three (16%) developed pneumonia, and two of them received ventilator care. The 30-day mortality rate was 6% (1/19), and the cause of death was bacteremic pneumonia. All GAS isolates were sensitive to penicillin. Fifteen (79%) were sensitive to both erythromycin and clindamycin. Conclusions: This study identified various clinical manifestations of GAS bacteremia. GAS should be considered as a potential pathogen that can cause bacteremia and result in a serious clinical course.

The Etiologic Agents and Clinical Outcomes of Adult Community-acquired Pneumonia in Jeju (제주지역 성인 지역사회획득 폐렴의 원인균 및 임상양상)

  • Jeon, Bong-Hee;Kim, Miok;Kim, Jeong Hong;Shin, Sang Yop;Lee, Jaechun
    • Tuberculosis and Respiratory Diseases
    • /
    • v.66 no.5
    • /
    • pp.358-364
    • /
    • 2009
  • Background: The appropriate empirical antimicrobial choice in the treatment of community-acquired pneumonia (CAP) should be advocated by community-based information on the etiologic pathogens, their susceptibility to antimicrobials, clinical characteristics and outcomes. Jeju is a geographically isolated and identical region in Korea. However, there is no regional reference on adult CAP available. This study investigated the etiologic agents and clinical outcomes of adult patients diagnosed with CAP in Jeju, Korea, to help guide the empirical antimicrobial choice. Methods: A prospective observational study for one year in a referral hospital in Jeju, Korea. Patients diagnosed with CAP were enrolled with their clinical characteristics. Microbiological evaluations to identify the etiologic agents in the adult patients with CAP were performed with blood culture, expectorated sputum smear and culture, antibody tests for mycoplasma, chlamydophila, and antigen tests for legionella and pneumococcus. The clinical outcomes of the initial empirical treatment were analyzed. Results: Two hundred and three patients with mean age of 64 and 79 females were enrolled. Ten microbials from 90 cases (44.3%) were isolated and multiple isolates were confirmed in 30. Among the microbial isolates, S. pneumoniae (36.3%) was the most common, followed by M. pneumoniae (23.0%), C. pneumoniae (17.0%), S. aureus (9.6%) and P. aeruginosa (5.9%). The initial treatment failure (23.8%) was related to the isolation of polymicrobial pathogens, elevated inflammatory markers, and the presence of pleural effusion. Among the 30 isolates of S. pneumoniae, 16 (53.3%) were not susceptible to penicillin, and 19 isolates (63.3%) to erythromycin and clarithromycin. However, 29 isolates (96.7%) were susceptible to levofloxacin and ceftriaxone. Conclusion: S. pneumoniae, M. pneumoniae, S. aureus, and P. aeruginosa are frequent etiologic agents of adult CAP in Jeju, Korea. The clinical characteristics and antibiotic resistance should be considered when determining the initial empirical antimicrobial choice. Respiratory quinolone or ceftriaxone is recommended as an empirical antimicrobiotic in the treatment of adult CAP in Jeju, Korea.

CASE STUDY : FLUOXETINE INDUCED MANIA IN A SCHIZOPHRENIC PATIENCT AND REVIEW OF LITERATURES (정신분열증 여아환자에서 Fluoxetine 투여후 발생한 조증 증례보고 및 문헌고찰)

  • Kim, Bung-Nyun;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.6 no.1
    • /
    • pp.116-122
    • /
    • 1995
  • 목적 : 다음과 같은 fluoxetine으로 유발된 조증 증례를 보고한다. 이와 함께 fluoxetine사용이후 보고된 조증 증례보고를 모아서 정리하고 함께 문헌고찰을 하였다. 증례요약 : 가족력상 기분장애의 병력이 없었으며, 다른 주요 정신과적 질환의 병력은 없었다. 환아는 개인력상 5세경에 주의력 결핍, 과잉행동의 양상을 보였던 병력이 있었고, 13세때에 피해 망상, 환청이 지속되어 haloperidol로 치료받기 시작하였다. 이후 피해 망상의 내용을 언급하거나 환청에 영향받는 행동은 없어졌고 간혹 우울감을 호소하였다. 이후 정신분열증의 진단 하에 haloperidol만으로 3년간 유지하였다. 1994년 환아는 18세때 고3이 되면서 대입에 대한 걱정과 신체적인 허약감을 자주 호소하며, 우울증상이 두드려져 fluoxetine 20mg를 3일간 투여하던 중 갑자기 조증의 임상적 양상을 보이기 시작하여 본원의 입원치료를 받게 되었는데, 입원당시 보인 임상양상은 앙양된 기분, 이자극성(irritability), 사고의 비약, 연상의 이완과 지리멸렬, 과대망상, 피해망상, 관계망상, 환청 등이었고 사람, 장소, 시간에 대한 지남력까지 일시적으로 상실되는 심헌 정신병적 조증상태였다. 토의 : fluoxetine 사용이후 현재까지 세계적으로 문헌상 보고된 14개의 증례보고를 모아서 정리하였다. fluoxetine-induced mania의 병태생리학적인 기전은 명확하지 않지만 가능한 기전에 대해 토론하였다. 이 약물의 중대한 부작용중의 하나인 조증을 예방하기 위해, 이 약물을 다루는 의사는 가능한 조증 발병의 위험인자들에 대하여 인식하고, 약물의 용량조절시에도 주의를 하여야 한다. 가능한 발병 위험인자들에 관해서도 검토하였다.

  • PDF

Septic encephalopathy: Atypical clinical manifestations of Appendicitis (패혈성 뇌증 : 급성 충수염의 비정형적인 임상양상)

  • Lee, Soo Young;Seung, So Jin;Kwak, Ga Young;Hwang, Hui Sung;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
    • /
    • v.15 no.1
    • /
    • pp.68-71
    • /
    • 2008
  • Septic encephalopathy is defined as brain dysfunction secondary to sepsis. It occurs in septic patients as a manifestation of multi-organ dysfunction. Without evidence of intracranial infection, various extracranial infections causing severe sepsis may induce septic encephalopathy. We report a patient with septic encephalopathy complicating acute appendicitis. Initially, the patient presented with impaired mental state and raised liver enzymes.

  • PDF

CLINICAL AND RADIOLOGIC STUDY OF ODONTOGENIC KERATOCYST (치원성 각화 낭종의 임상 방사선학적 연구)

  • Kim Sung Rae;Park Tae Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
    • /
    • v.14 no.1
    • /
    • pp.27-38
    • /
    • 1984
  • 치원성 각화 낭종의 임상적 방사선학적 양상을 연구하였다. 32명의 환자(21명의 남자, 11명의 여자)를 이 연구를 위하여 사용하였다. 환자들의 기록과 방사선사진을 통하여 성별 및 연령의 분포, 호발부의 방사선사진의 양상, 재발율 임상적 소견들을 조사하였던 바 아래와 같은 결과를 얻었다. 1. 남성이 여성에 비해 약 2배 호발하였고, 10대와 20대에서 가장 많이 발생하였다. 2. 호발부위는 하악의 구치에서 하악지에 이르는 부위였고 하악골이 상악골에 비해 호발하였다. 3. 원기성 낭종에서 각화성 변화를 일으킨 것이 가장 많았다. 4. 치근의 흡수를 많이 보였으며, 하악골에서 경계는 원형과 부채형(scalloped)이 거의 동등히 나타났고 상악골에서는 대부분 원형의 단발형 낭종이었다. 5. 높은 재발율을 보였다. 6. 감염이 되어 있는 경우가 많았다.

  • PDF

Clinical Findings of Genotypes in Korean Patients with Glycogen Storage Disease Type Ia (한국인 당원병 제 Ia형에서 유전형의 임상 양상)

  • Ko, Jae Sung;Yang, Hye Ran;Kim, Jong Won;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
    • /
    • v.48 no.8
    • /
    • pp.877-880
    • /
    • 2005
  • Purpose : Glycogen storage disease type Ia(GSD Ia) is an autosomal recessive disorder caused by the deficiency of glucose-6-phosphatase(G6Pase). The aim of the study was to investigate the spectrum of G6Pase gene mutations and relationship between genotype and clinical findings in Korean patients with GSD Ia. Methods : Genomic DNA was extracted from peripheral leukocytes of 20 patients with GSD Ia. The five exons of G6Pase gene were amplified and PCR products were directly sequenced. The frequency of short stature, hypoglycemia, hypercholesterolemia, hyperuricemia, hypercalciuria, nephrocalcinosis and hepatic adenoma was compared between 727G>T homozygotes and 727G>T compound heterozygotes. Results : A total of 5 different mutations were identified. The most common mutation was the 727G>T with an allele frequency of 80%. All patients were either homozygous(12/20) or heterozygous(8/20) for the 727G>T mutation. G122D was found in 3 patients, P178A in 1, G222R in 2, and S339R in 2. There was no difference in the frequency of short stature, hypoglycemia, hypercholesterolemia, hyperuricemia, nephrocalcinosis, and hepatic adenoma between 727G>T homozygotes and heterozygotes. Conclusion : Diagnosis of GSD Ia can be based on clinical and biochemical abnormalities combined with mutation analysis instead of enzymatic diagnosis that requires liver biopsy. Homozygosity for the 727G>T does not seem to alter the disease phenotype as compared with the heterozygous state.

Antibiotic Susceptibility and Genetic Diversity of Enterococci Isolated from Clinical Specimens (임상검체에서 분리한 장구균의 항생제 감수성 및 유전적 다양성)

  • Lim, Chae Won;Kim, Hyung Lag;Kim, Yang Ho
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.36 no.2
    • /
    • pp.76-88
    • /
    • 2004
  • The purpose of this study was to investigate the distribution of Enterococci isolated from clinical specimens, and identify the aspect of antibiotic susceptibility and analyze the genetic difference by executing Rep-PCR over the strains resistant to aminoglycoside-typed antibiotics. From an assortment of the clinical specimens, 100 strains were isolated. The collection consisted of 49 strains of E. faecalis, 34 strains of E. faecium, 9 strains of E. avium, 4 strains of E. gallinarum, 3 strains of E. casseliflavus, and 1 strain of E. hirae. Ninety five were isolated from inpatients, and five strains were isolated from outpatient. Most of the E. faecalis and E. faecium were originated from urine, pus, and sputum. Most Enterococci showed 80% resistance to the cephalosprin-typed antibiotics. E. faecium showed the high resistance to all the antibiotic substances. One tenths of Enterococci showed the resistance to vancomycin. And also, most Enterococci showed the high resistance to amikacin and gentamicin as aminoglycoside-typed antibiotics. Genetic diversity of the resistant strains to aminoglycoside estimated using Rep-PCR was not significanty different.

  • PDF