• Title/Summary/Keyword: 징후 및 증상

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Influence of Education and Knowledge Levels of Stroke Patients on Level of Subjective Perception in 119 Emergency Medical Technicians (119구급대원들의 뇌졸중 환자에 대한 교육 및 지식수준이 주관적 인식수준에 미치는 영향)

  • Choi, Mi-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.39-50
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    • 2020
  • This study examined the effect of 119 emergency medical technicians' education over one year on the stroke knowledge and subjective perception of stroke care. A survey was conducted from February 17 through July 31, 2018, on 196 men and women who worked as 119 emergency medical technicians in G-do, C-do, and the provinces. The collected data was analyzed by SPSS 20.0 version for Windows. The findings of the study were as follows. First, the general characteristics of the 119 emergency medical technicians were found to have affected their stroke education and their need for professional education, awareness levels of knowledge concerning stroke and their subjective awareness levels of stroke patient care. Second, one-year education for the 119 emergency medical technicians was found to have impacted on their stroke knowledge and subjective awareness levels concerning care for stroke patients. Third, the knowledge of the 119 emergency medical technicians on stroke was found to have influenced their subjective awareness levels of stroke patient care. Therefore, the results suggested that regular education and proper management to improve their knowledge on stroke and subjective awareness.

Clinical Study of the Patients, in Whom Pulmonary Embolism was Suspected by Lung Perfusion Scan (폐 관류주사검사상 폐동맥 색전증 소견을 보인 환자의 임상적 고찰)

  • Lee, Gwi-Lae;Kim, Jae-Yeol;Park, Jae-Suk;Yoo, Chul-Gyu;Kim, Young-Whan;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.889-898
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    • 1997
  • Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism. But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of lung perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), ICH (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results, of lung perfusion scan were HPPE 40 cases(26.8 %), IPPE 21 cases(14.1%), LPPE 88 cases (59.1%), and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42.9%), LPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy (4.1%), thrombolytics (2.0%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (69.4%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) and recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytic therapy. Conclusion : Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.

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DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA (모야모야병(moyamoya disease) 환자의 전신마취 하 치과 치료)

  • Sang, Eun Jung;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.108-113
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    • 2017
  • Moyamoya disease is a disorder in which certain arteries in the brain are constricted. Blood flow can be blocked by the constriction and blood clots. The patients frequently experience transient ischemic attacks (TIA), cerebral hemorrhage, or may not experience any symptoms at all. It is reported that they have a higher risk of recurrent stroke and a distinct underlying pathophysiology. A 3-year-8-month old boy with moyamoya disease experienced cerebral infarctions five times, and he underwent a cerebrovascular anastomosis surgery four years ago. He showed swallow disturbance, general delayed development, hemiplegia, and strabismus. Also he had hypocalcified teeth with or without multiple caries lesions in all dentitions. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation. Moyamoya disease is associated with various medical conditions requiring a thoughtful deliberation and a careful examination before and during dental treatment. Pain and anxiety control during dental treatment is important because hyperventilation induced by crying has been seen to trigger TIA. Both isoflurane and sevoflurane are commonly used in patients with MMD, but dynamic autoregulation is better preserved during sevoflurane than isoflurane anesthesia. So sevoflurance general anesthesia may be recommendable to manage dental patients having multiple caries with moyamoya disease.

Nursing Activities Identified through Pediatric Nursing Simulation (간호활동을 중심으로 한 아동간호시뮬레이션 실습 분석)

  • Shin, Hyun-Sook;Shim, Ka-Ka;Lee, Yu-Na
    • Child Health Nursing Research
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    • v.19 no.2
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    • pp.111-119
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    • 2013
  • Purpose: This research was a descriptive study of nursing activities observed in nursing simulation during a senior nursing student practicum. Content and frequencies of nursing activities during the simulation practice were identified. Methods: Thirty-six episodes of pediatric nursing simulation were videotaped. Both verbalizations and descriptions of nonverbal behaviors were recorded from the videotapes. The data were coded and analyzed. The coded nursing activities were evaluated for frequency and purpose of interaction. Results: Average time per simulation episodes was 27 minutes and ranged from 3.30 to 32.54 minutes. Nursing activities in these simulation episodes included nursing assessments such as vital sign measurement, associated symptom assessment, and check of patient condition, nursing interventions such as medication, tepid water massage, fluid therapy, provision of oxygen, suctioning, hyperglycemia and hypoglycemia management, communication such as parent education, procedure guidance, and communication among providers. Activities in assessment were most frequent, and among them, vital sign measurement and check of patient condition were more frequent than others. Conclusion: Students showed enhanced nursing activities such as more frequent nursing assessment, communication and interventions in their simulation experience. Therefore simulation experience can be considered as one strategies to provide nursing students with better and more intense practicum experience.

The Influence of Atopic Findings on Severity of Pneumonia in Children with 2009 Pandemic Influenza A (H1N1) Infection (2009 신종 인플루엔자 A (H1N1) 폐렴 환아에서 아토피 소견이 폐렴의 중증도에 미치는 영향)

  • Kim, Jong Hee;Kim, Hyun Jeong;Kang, Im Ju
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.182-192
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    • 2011
  • Purpose : Atopic findings may be associated with severity of pneumonia in 2009 pandemic influenza A (H1N1) infection, which could suggest a possible association between atopic findings and the severity of viral infections. Thus, we studied association between atopic findings and severity of disease in children with H1N1 influenza infection. Methods : A retrospective study was performed in 74 children admitted in a single tertiary institute and confirmed as H1N1 patients by reverse transcriptase (RT) - polymerase chain reaction (PCR). They were divided into 2 groups according to the severity of pneumonia. We evaluated whether the atopic finding is risk factor between the two groups. Results : Children with severe pneumonia had higher percentages of serum eosinophilia (88% vs 40%, P <0.001), asthma (65% vs 35%, P =0.011), allergic rhinitis (71% vs 40%, P =0.009), and IgE level (P =0.007). We found positive correlations between aeroallergen sensitizations and severity of pneumonia (82% vs 53%, P =0.007). Conclusion : Among patients with H1N1 pneumonia, asthma and atopic findings are risk factors for severity of pneumonia.

Clinical and Arthroscopic Findings of Medial Meniscus Posterior Horn Insertion Tear (내측 반월상 연골판 후각 기시부 파열의 특징 및 관절경 소견)

  • Lee, Jun-Young;Kim, Dong-Hui;Ha, Sang-Ho;Lee, Sang-Hong;Gang, Joung-Hun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.33-38
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    • 2009
  • Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

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Etiology and Clinical Features of Viral Lower-respiratory Tract Infections in Children in Winter, 2003 (2003년 겨울철 소아의 바이러스성 하기도 감염증에 대한 원인 및 바이러스별 임상양상)

  • Yun, Byung Ho;Lee, Hee Chul;Chun, Jung Mi;Yoon, So Young;Lee, Woo Gill;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.723-730
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    • 2005
  • Purpose : This study was performed to characterize the etiology and clinical features of acute viral lower-respiratory tract infections(LRI). Methods : Etiologic agents and clinical features of acute viral LRI were studied from October. 2003 through March. 2004 in hospitalized children with LRI(253 cases) at Samsung Cheil Hospital. The viruses were identified by indirect immunofluorescent method. Medical records of patients with proven viral LRI were reviewed retrospectively. Results : Ninety two cases(36.4%) were confirmed as viral infections. The identified pathogens were respiratory syncytial virus(RSV, 76.0%), adenovirus(ADV, 12.0%), influenza virus type A(INFA, 9.8 %), influenza virus type B(INFB, 1.1%) and parainfluenza virus(PIV, 1.1%). Eight four point eight% of patients were younger than 2 years of age. Clinical diagnosis of LRI were pneumonia(56.5%), bronchiolitis(35.9%), tracheobronchitis(4.3%) and croup(3.3%). The clinical symptoms and signs were cough(98.8%), rhinorrhea(82.6%), fever(70.7%), rale(67.4%), wheezing(29.3%), chest retraction(28.3%) and cyanosis(4.3%). The severe respiratory symptoms and signs were more common in RSV-infected patients, even cyanosis could be observed. Seventeen point four percent of patient had fever of $38.5^{\circ}C$ or higher and their most common etiologic agent was INFA(66.7%). Twenty three point nine percent had fever more than 5 days and common etiologic agent was INFA(77.8%). The elevated WBC count($>14{\times}10^3/{\mu}L$) was in 14.1%, and common etiologic agents were INFA(22.2%) and ADV(18.2%). C-reactive protein(CRP >4.0 mg/dL) was increased in 13.0%, and common in ADV(63.6 %). Increased aspartate aminotransferase(AST)/alanine aminotransferase(ALT) was detected in 10.9%, and the most common etiologic agent was RSV(12.9%). Conclusion : The common agents of acute viral LRI were RSV, ADV and INF, respectively. Because the etiologic agents present variable clinical features, it may be helpful to treat and to evaluate acute viral LRI that we should understand their etiologic variability.

A Case of Primary Endobronchial Leiomyoma (원발성 기관지내 평활근종 1예)

  • Lee, Hee Kyung;Lee, Jae Hyung;Kim, Sang Heon;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Min, Kyueng Whan;Paik, Seung Sam;Kang, Jung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.273-278
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    • 2006
  • Endobronchial leiomyoma is a rare tumor that accounts for less than 2% of pulmonary benign tumors. A 32 year-old woman was admitted with fever, cough and sputum for a month. She had suffered from intermittent cough over three years. The chest X-ray and chest CT(computed tomography) showed a nodular lesion obstructing the proximal portion of the left lower lobar bronchus and atelectasis of the left lower lobe. Flexible Bronchoscopy detected a mass obstructing the distal portion of the left main bronchus and endobronchial biopsy showed benign smooth muscle cells. There was no abnormal finding in the uterine examination. Therefore this case was diagnosed as primary endobronchial leiomyoma. The lobectomy was performed due to intractable pneumonia and secondary parenchymal destruction. Postoperative course was uneventful and she was discharged in good health.

Three Cases of Aseptic Meningitis Following the Use of Intravenous Immune Globulin (정맥용 면역글로불린 투여 후 발생한 무균성 수막염 3례)

  • Lee, Joon Ho;Song, Eun Kyoung;Lee, Jin A;Kim, Nam Hee;Kim, Dong Ho;Park, Ki Won;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.202-207
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    • 2005
  • Intravenous immune globulin(IVIG) is widely used for immune thrombocytopenic purpura (ITP), Kawasaki disease and other autoimmune neuromuscular disease. Aseptic meningitis was one of the most serious neurologic complications reported following the use of IVIG. We experienced 4 episodes of aseptic meningitis associated with IVIG usage in 3 patients from 2003 to 2004. Underlying disease of each patients was ITP, Kawasaki disease and myathenia gravis and all of them received high dose IVIG treatment for their underlying disease. Within a days, they started to complain severe headache and diagnosed meningitis by cerebrospinal fluid analysis. Cerebrospinal fluid leukocyte counts varied from 92 to over a thound per microliter with dominance of polymorphonuclear leukocytes. Microbiologic studies revealed no organisms. All of them were free from headache within 2 days and did not suffer any neurological sequelae.

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Evaluation of Methods Used in Nutrition Surveys in Korea(1960-1990) (국내 영양조사(1960-1990년)에서 적용된 영양평가 방법의 내용 및 추이분석)

  • 최영선
    • Journal of Nutrition and Health
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    • v.25 no.2
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    • pp.187-199
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    • 1992
  • The purpose of the study is to assess and evaluate methods employed in nutrition surveys and to give an information on methodological considerations for future studies in Korea. Three hundred thirty six papers of nutritional surveys published from 1960 to 1990 were classified into 9 groups according to the survey subject and analyzed for methods used in survey. The frequency of publications according to the survey subject was as the following order : 'in-fants and preschool children' 'school age children' 'adolescence' 'college students' 'preg-nant and lactating women' 'housewives' 'the elderly' 'workers' and 'patients' Eighty five percents of papers applied methods of dietary assessment. of which weighing method recall method an record method were extensively used in the order. Questionnairs included items related to nutrition such as food habit nutrition knowledge etc. Anthropometric techniques were employed in 53% of papers and in general growth measurement were undertaken for children and body composition was emphasized for adults. biochemical assessment was limited to 32% of papers and assessment of anemia was the major test. Clinical studies were applied to 26% of the studies. of which only 5% employed examination of clinical signs of malnutrition Recently self-reported health status assessed using questionnaires has been adopted frequently. Further researches are required for evaluation of the methods employed in nutrition surveys in order to develop the standard model for nutrtion survey so that obtained data can become more reliable and utilized efficiently.

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