• Title/Summary/Keyword: 임상요인들

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Clinical Significance of Hydronephrosis in Febrile Urinary Tract Infection (발열성 요로 감염 환아에서 발견된 수신증의 임상적 의의)

  • Oh, Jung-Min;Lee, Na-Ra;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.71-78
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    • 2010
  • Purpose : Hydronephrosis is found about 30% of children with urinary tract infection (UTI). It can be caused by various conditions, although most childhood hydronephrosis is congenital. This study was performed to investigate the relationship between febrile UTI and hydronephrosis. Methods : We retrospectively reviewed the medical charts of 183 patients diagnosed as UTI between January 2007 and May 2009 at Korea University Guro Hospital. Inclusion criteria were as followings; 1) fever more than $37.5^{\circ}C$ measured in the axilla, 2) positive urine culture, 3) no history of urinary tract anomaly on antenatal sonography and urinary tract infection. We classified the enrolled children into two groups of patients with hydronephrosis (HN) and those without hydronephrosis (NHN). Results : The 80 patients were HN and 103 patients NHN. Hydronephrosis was found in 58 patients with left kidney, 8 right and 14 both kidneys. Most of hydronephrosis were of low grade. Compared with NHN group, initial renal cortical defects on DMSA scan significantly increased in HN group (HN 37.5%, NHN 16.5%, P<0.05). The incidence of VUR was not different between the two groups (HN 22%, NHN 12.1%). White blood cell counts and C-reactive protein were not different between the two groups. Follow-up DMSA scan (about 6 months later after UTI) showed no difference of renal scarring in both two groups. Conclusion : Our data suggests that hydronephrosis in febrile UTI patients is clinically useful for detecting renal cortical defects, but is not associated with follow-up renal scar.

The relationships between clinical variables and renal parenchymal disease in pediatric clinically suspected urinary tract infection (소아 요로 감염 및 의심 환아에서 신 실질 병변 및 방광요관 역류와 임상 변수와의 연관성)

  • Byun, Jung Lim;Lee, Sang Taek;Chung, Sochung;Kim, Kyo Sun
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.222-227
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    • 2010
  • Purpose : To evaluate the significance of clinical signs and laboratory findings as predictors of renal parenchymal lesions and vesicoureteral reflux (VUR) in childhood urinary tract infection (UTI). Methods : From July 2005 to July 2008, 180 patients admitted with a first febrile UTI at the Pediatric Department of Konkuk University Hospital were included in this study. The following were the clinical variables: leukocytosis, elevated C-reactive protein (CRP), positive urine nitrite, positive urine culture, and fever duration both before and after treatment. We evaluated the relationships between clinical variables and dimercaptosuccinic acid (DMSA) scan and voiding cystourethrography (VCUG) results. Results : VCUG was performed in 148 patients; of them, 37 (25.0%) had VUR: 18 (12.2%) had low-grade (I-II) VUR, and 19 (10.5%) had high-grade (III-V) VUR. Of the 95 patients who underwent DMSA scanning, 29 (30.5%) had cortical defects, of which 21 (63.6%) had VUR: 10 (30.3%), low-grade (I-II) VUR; and 11 (33.3%), high-grade VUR. Of the 57 patients who were normal on DMSA scan, 8 (14.0%) had low-grade VUR and 6 (10.5%) had high-grade VUR. The sensitivity, specificity, and positive and negative predictive values of the DMSA scan in predicting high-grade VUR were 64.7%, 69.9%, 33.3%, and 89.5%, respectively. Leukocytosis, elevated CRP, and prolonged fever ($36{\geq}$ hours) after treatment were significantly correlated with the cortical defects on DMSA scans and high-grade VUR. Conclusion : Clinical signs, including prolonged fever after treatment, elevated CRP, and leukocytosis, are positive predictors of acute pyelonephritis and high-grade VUR.

Spay-Related Urethral Sphincter Mechanism Incompetence Concurrent with Pituitary-Dependent Hyperadrenocorticism in a Bitch (암캐에서 부신피질기능 항진증 및 난소제거 이후 발생한 요도 괄약근 기능부전 증례)

  • Kang, Min-Hee;Kim, Ju-Won;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.258-261
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    • 2011
  • An 8-year-old spayed female, Yorkshire terrier dog was presented with a urinary incontinence. Unaware urine dribbling during sleeping was observed eight months after spaying. Polyuria and polydipsia were also reported. Physical examination revealed obesity and hypertension. Characteristic laboratory findings in this dog were polycythemia, hyperlipidemia and elevated hepatic enzyme. Other causes of the urinary incontinence were ruled out through further diagnostic tests and spay-related urethral sphincter mechanism incompetence (USMI) was made as a presumptive diagnosis. In addition, the dog was also diagnosed with pituitary-dependent hyperadrenocorticism. Both conditions can cause urinary incontinence in dogs; therefore, definite diagnosis was made through a therapeutic approach. The synthetic estrogen, diethylstilbesterol, was initially administered and successfully managed the urinary incontinence in this dog. To the best of the author's knowledge, this is the first case report describing the clinical and laboratory features of spay-related USMI concurrent with hyperadrenocorticism and treatment outcomes in our country.

A Case of Osteotomy of the Distal Radius and Ulna with Panarthrodesis of Carpus for Reform of (성장판 조기페쇄에 따른 요척골 외전과 완관절 아탈구 교정들 위한 요척골 절단술 및 광범위 완관절 고술의 일례)

  • 이종일;김남수;최인혁
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.485-489
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    • 2000
  • A 23.5 kg179, 8 months olds non-spaycd female Rottweiler dog was submitted to the veterinary teaching animal hospitals Chonbuk: national university, for chronic bitten trauma on right foreleg with pain, lameness, and pronation. The patient fought with a neighboring dog about five months ago and had mild anorexia, depression, bolt normal walking at that time. CBC and blood chemical examination were in normal range. Physical examination resulted in the right foreleg with edema and interval rotation of carpal joint. Radiograph of the right carpus showed varus and subluxation. We finally diagnosed the patient as the growth deformity of distal radius and ulna caused by medial premature closure of distal radial physis. Osteotomy was performed fur reforming of the varus of the distal radius and ulna with 6-hole straight plate and six 3.5 mm screws. Panarthrodcsis of carpus was preformed for correcting subluxation using 6-hole T-shaped plate and four 3.5 mm screws with cortical onlay autograft and strengthened by two 3.5 mm screws and tension wire band in lateral aspect of the carpus. Follow-up radiographs after 16 weeds of the surgery showed complete coaptation of osteotomy sire of the radius and uIna. After 6 months of the procedurc, talc plate, screws and the wire were removed except 7-shaped plate and four screws fur arthrodesis. The patient was seen in normal forelimb and could walk and run without lameness after 7 months of the procedure.

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Factors affecting Clinical Practice-related Fatigue among Nursing Students (간호 대학생의 임상실습 관련 피로에 영향을 미치는 요인)

  • Park, Sujung;Choi, Ja Yun
    • The Journal of the Korea Contents Association
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    • v.16 no.2
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    • pp.456-466
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    • 2016
  • The purpose of this study was to identify factors affecting clinical practice-related fatigue among undergraduate nursing students. The data were collected from a questionnaire distributed among 129 juniors and seniors (3rd and 4th year students) in nursing college at the G city, who were at the end of clinical practice. Multiple regression analysis found that the significant major predictors of clinical practice-related fatigue among nursing students were sleep quality (${\beta}=.30$), anxiety (${\beta}=.26$), exercise frequency (${\beta}=-.21$) and clinical practice stress (${\beta}=.19$). These variable factors could explain 33.6% of clinical practice-related fatigue among nursing students. This study suggests that sleep quality, anxiety, exercise frequency, and clinical practice stress are significant factors of clinical practice-related fatigue among nursing students. Therefore, strategies improving sleep quality and exercise and managing anxiety and stress should be developed to reduce the fatigue for nursing students during clinical exposure.

Normalization of Clinical Medical Records by Disambiguating Abbreviations and Acronyms (약어와 두문자어의 모호성 해결을 통한 임상 의무기록의 정규화)

  • Inho Bae;Jin-Sang Kim;Yoon-Nyun Kim
    • Proceedings of the Korea Information Processing Society Conference
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    • 2008.11a
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    • pp.676-678
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    • 2008
  • 임상 의무기록에 나타나는 많은 두문자어들은 기계적인 처리과정에서 의무기록의 모호성을 크게 증가시키기 때문에, 정보추출이나 텍스트 마이닝을 하기 전에 전처리 과정으로 의무기록이 정규화 되어야 한다. 본 연구에서는 임상 의무기록 중 하나인 퇴원요약지에 사용된 약어와 두문자어들의 모호성을 제거하기 위한 정규화 시스템을 설계하고 구현했다. 정규화를 위해 문맥정보를 이용하여 의무기록의 종류와 기록내 위치정보를 파악하였고 이를 이용하여 약어와 두문자어의 의미를 학습하고 분류하였다. 본 연구에서 구현한 정규화 시스템은 실험에서 6가지 두문자어들이 가지는 16가지 의미들에 대해 94.7%의 정확률을 얻었다.

Comparison of the Results of Multistix$^{(R)}$SG and Comber-9-Test$^{(R)}$ RL Urine Dipstick Assay (Multistix$^{(R)}$-SG와 Comgur-9-test$^{(R)}$RL에 의한 요시험지봉검사 성적의 비교)

  • Kim, Dae-Chul;Kim, Kyung-Dong;Jung, Bo-Chan;Kim, Chung-Sook;Cho, Kil-Ho
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.42-52
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    • 1991
  • Two types of urine dipstick assays, Multistix-SG and Combur-9-test RL, were compared for compatibility, accuracy, specificity and predictive values of a positive and negative test in 501 patients urine and artificially prepared specimen. We found that the results of semiquantitative tests of Multistix-SG and Combur-9-Test RL performed were statistically similar in patients specimen. The urinary leukocyte estrase tests of Combur-9-Test RL assays compared with urine sediment microscopy in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test 83.7%, 48.1%, 90.3%, 47.4% and 90.1%, respectively. The urinar nitrite tests of Comber-9-Test RL assays compared with urine culture tests, in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative tests were 90.3%, 19.4%, 84.7%, 53.8% and 94.1%, respectively. For the urinary protein, the sulfosalicylic acid method was the most sensitive test for any kinds of protein, and Multistix-SG appeared more sensitive than Compur-9-Test RL for the albuminuria. For the urinary bilirubin and glusose, two dipstick assays were similar in their diganostic efficiency. Finally in the urinary occult blood tests, Combur-9-Test RL assays was more sensitive than Multistix-SG.

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Evaluation of Therapeutic Effect of the Extract from Rhubarb (Rheum officinalis) in Dogs with Chronic Renal Failure (개의 만성 신부전에서 대황 추출물의 치료학적 효과의 평가)

  • Kim, Ye-Won;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.435-440
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    • 2012
  • This study was designed to evaluate the clinical efficacy and safety of Rhubarb extracts ($Rubenal^{(R)}$) in dogs with chronic renal failure (CRF). Client-owned 40 dogs with CRF graded International renal interest Society (IRIS) II-III were enrolled in this study. The dogs were equally allocated and blindly administered with $Rubenal^{(R)}$ or placebo. The following items were evaluated at day 0, 30, 90 and 180: body condition score (BCS), clinical score (appetite, polydipsia/polyuria, quality of life score), hemogram (WBC, RBC, PCV), serum biochemistry (ALT/AST, ALP, Creatinine/BUN, total protein, albumin), serum electrolyte (Na, K, Cl, Ca, P), systolic blood pressure, urinalysis (UPC, USG) and IRIS stage. In this study, we found that the $Rubenal^{(R)}$ preparation was well tolerated by dogs and induced no adverse effects. Statistically significant improvements were observed in clinical score (quality of life score by vet and clients), serum BUN and creatinine levels, serum phosphorus concentration, level of proteinuria, and the IRIS score of CRF in dogs after 6 month of treatment of $Rubenal^{(R)}$. Those findings suggested that the Rhubarb extracts can improve the clinical signs of CRF (i.e. azotemia, hypertension, proteinuria, hyperphosphoremia) and the quality of life (i.e. BCS, clinical score) and can retard the progression of CRF in dogs. Therefore the Rhubarb extracts can be a good supplementary drug for treating dogs with subclinical and clinical renal diseases. However, care should be taken for interpreting our result, because this study is not double-blinded controlled study but pilot study.

Validity and Reliability of a Korean Version of Nurse Clinical Reasoning Competence Scale (한국어판 간호사 임상적 추론 역량 척도의 타당도와 신뢰도)

  • Joung, Jaewon;Han, Jeong Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.304-310
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    • 2017
  • This study is a methodological research study that tests the validity and reliability of the NCRC (Nurse Clinical Reasoning Competence scale), an instrument developed by Liou and his colleagues as the basic data for enhancing the clinical reasoning competence of nurses, by translating it into Korean and checking the similarity of the sentence structure and meaning (between the two versions?). This study verified its validity and reliability by examining 166 nurses working in four tertiary hospitals located in Seoul and Busan. An analysis of the content validity by experts showed that all of the items have a content validity higher than CVI 0.8. From the exploratory and confirmatory factor analysis, it was found that the instrument includes a total of 15 items consisting of one factor. In addition, the correlation with the Korean version of the Nurse Clinical Reasoning Competence scale is confirmed to test the concurrent validity, by using a measurement tool of nurses' critical thinking dispositions and clinical decision-making abilities (correlation coefficient =.55-.64(p<.001) and Cronbach's ${\alpha}=.93$). Thus, the Korean version of the NCRC may be a useful instrument for evaluating the clinical reasoning competence of Korean nurses and providing the basic data for assessing their clinical reasoning competence and developing their promotion strategies.

Assessment of Relapsing Urolithiasis from K43 with Erosive Gastritis (미란성 위염 환자 K43에서 재발성 요로 결석에 관한 연구)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.1
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    • pp.44-52
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    • 1997
  • Nephrolithiasis is the most common disorder of the urinary tract in hospitalized patients, more frequently increased in 30~50 years of age, more common in males than in females, prior right stone to left side, and than upper ureteral stone is found in cultural country, while lower ureteral stone is increased in uncultural country. Stone components are classified as calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid, cystine, and their mixed stone, respectively. According to the pathophysiology of urinary stones, supersaturation/crystalization of inorganic salt concentration in urine, organic matrix, inhibitor deficiency, and epitaxy theory could be based on the stone formation. Not only hypercalciuria, hyperparathyroidism, hyperoxaluria, hyperuricosuria, and cystinuria, but also renal tubular acidosis, hypervitaminosis D, and peptic ulcer, are significantly associated with nephrolithiasis. In this study upper ureteral stone component were analyzed with chemical analysis, infrared spectrum, and image analyzer from K43 patient wit erosive gastritis. As the results, mixed stone of calcium oxalate dihydrate and calcium phosphate apatite was identified, the values of clinical test in blood and urine maintained normal revels. The relapsing urinary stone from K43 have no correlation between factors for stone formation reported early, also have no evidence for risk from erosive gastritis.

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