• Title/Summary/Keyword: Adult disease

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Radiographic diagnosis of canine heartworm disease without clinical signs (임상증세를 보이지 않는 개심장사상충증의 방사선학적 소견)

  • Shin, Sung-shik;Seo, Young-woo;Kwon, Jung-kee;Kim, Sang-ki;Kim, Jong-taek
    • Korean Journal of Veterinary Research
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    • v.41 no.2
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    • pp.233-241
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    • 2001
  • Dirofilaria immitis, the causative agent of canine heartworm disease, inhabits mainly in the pulmonary arteries and the heart of dogs and cats, causing circulatory and respiratory disorders. Although diagnosis of the disease is based on the presence of microfilaria in the peripheral blood or of specific antigens released from the adult worms into the peripheral blood, the severity of the infection and the assessment of disease progression are based on the clinical signs and radiographic image analysis. We analysed 12 mixed-bred Jindo dogs naturally infected with Dirofilaria immitis without any clinical signs and compared the radiographic images of the heart and the lung with the number of adult worms at necropsy. The dorsoventral radiographs of 12 infected dogs revealed that the right caudal lobar pulmonary arteries (RCaLPA) were dialated in 66.7% of dogs, whereas the main pulmonary artery segment was enlarged in 50.3% of dogs. The cranial lobar pulmonary arteries (RCrLPA) were dilated or pruned in 33.3% of dogs. All dogs displayed the interstitial lung pattern, while the vertebral heart size (VHS) was of normal range. Although a range of 9 to 166 adult worms (av. 45.6) was found in the pulmonary arteries, in the heart or in the vena cava, no correlation with the radiographic findings and/or with the clinical signs was observed.

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Phenomenological Approach of Self Regulation Related to Health of patients with Adult Disease (성인병 환자들의 건강과 관련된 자기조절에 대한 현상학적 연구)

  • 김숙영
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.562-580
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    • 1995
  • This research was an attempt to make it possible to provide nursing care and health education meet- ing the need not of care givers but of patients by identifying the nature of patients' self regulation experiences. The specific objective of this study was : 1) to explore self regulation experiences of patients with adult disease. The phenomenological approach in qualitative studies is used to serve this purpose. Colaizzi's method is used for the phenomenological analysis of the data in this study, which were collected from 25 patients hospitalized in the internal medical ward and oriental medical ward of a Seoul hospital, suffering from adult disease such as hypertension, arteriosclerosis and diabetes mellitus. The research was conducted over a period of March to September, 1994. The investigator conducted participated observations and in-depth unstructured interviews which were audiotaped under the permission of patients. The investigator read the data repeatedly to identify and categorize significant statements, formulating meanings, themes and theme clusters. The result is categorized as follows : Self regulation activities, their barriers and predisposing factors of a disease. Thirteen theme clusters of self regulation activities related to health identified were. “maintaining diet regimen”, “maintaining exercise regimen”, “maintaining medication regimen”, “maintaining oriental medical regimen”, “maintaining health monitoring regimen”, “maintaining self effort”, “maintaining religious life”, “maintaining social sup-port systems”, “maintaining peaceful mind”, “maintaining moderation in life”, “maintaining sincere attitude in life”, “maintaining natural life”, and “maintaining folk remedy” This findings confirm the fact that self regulation is complicatedly and diversely influenced by oriental medicine and folk remedy, and Korean traditional ideas melted in Confucianism, Buddhism, Taoism and Shamanism, and modern medical care and western culture. Seven theme clusters of self regulation barriers identified were : "lack of knowledge and self aware-ness", "lack of social supports", "lack of awareness of need in continuous regimen and treatment", "dissatisfaction with hospital and health care provider", "lack of self management ", "lack of will to combat illness", and "overconfidence in folk remedy" Four theme clusters of predisposing factors of a disease were : "cumulation of stressors", "fatalism", "careless life style", and "family history". In conclusion, this. study will prove helpful not only in understanding clients in light of our traditional culture but also in providing them with the kind of nursing care and health education satisfying their demands and particularly cultural needs.

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Preliminary Study of Neurocognitive Dysfunction in Adult Moyamoya Disease and Improvement after Superficial Temporal Artery-Middle Cerebral Artery Bypass

  • Baek, Hyun Joo;Chung, Seung Young;Park, Moon Sun;Kim, Seong Min;Park, Ki Suk;Son, Hee Un
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.188-193
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    • 2014
  • Objective : Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease of unknown etiology. In addition, the neurocognitive impairment of adults with MMD is infrequently reported and, to date, has not been well described. We attempted to determine both the neurocognitive profile of adult moyamoya disease and whether a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis can improve the neurocognitive impairment in exhibiting hemodynamic disturbance without stroke. Methods : From September 2010 through November 2012, 12 patients with angiographically diagnosed MMD underwent STA-MCA anastomosis for hemodynamic impairment. Patients with hypoperfusion and impaired cerebrovascular reserve (CVR) capacity but without evidence of ischemic stroke underwent a cognitive function test, the Seoul Neuropsychological Screening Battery (SNSB). Five patients agreed to undergo a follow-up SNSB test. Data from preoperative and postoperative neurocognitive function tests were compared and analyzed. Results : Five of 12 patients were enrolled. The median age was 45 years (range, 24-55 years). A comparison of preoperative to postoperative status of SNSB, memory domain, especially delayed recall showed significant improvement. Although most of the domains showed improvement after surgery, the results were not statistically significant. Conclusion : In our preliminary study, large proportions of adult patients with MMD demonstrate disruption of cognitive function. This suggests the possibility of chronic hypoperfusion as a primary cause of the neurocognitive impairment. When preoperative and postoperative status of cognitive function was compared, memory domain showed remarkable improvement. Although further study is needed, neurocognitive impairment may be an indication for earlier intervention with reperfusion procedures that can improve cognitive function.

Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease (파킨슨병 환자의 우울, 불안 및 만성질환에 기대되는 낙인 중재를 위한 전화사용 인지행동치료 효과)

  • Bae, Eun Sook;Yeum, Dong Moon
    • Korean Journal of Adult Nursing
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    • v.27 no.2
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    • pp.223-232
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    • 2015
  • Purpose: Parkinson's disease (PD) has a high incidence of psychiatric comorbidity, specifically depression and anxiety. This study examined the effectiveness of group cognitive behavioral therapy (CBT) in treating depression and anxiety. Methods: The study included 42 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression and anxiety. Patients were attending a department of outpatient neurology at D University Schools of Medicine in B Metropolitan city. A structured telephone-administered cognitive behavioral therapy was conducted for eight weeks. A repeated measure ANOVA was used to analyze results at pretest, post-test, and four weeks follow up. Results: According to service method, there were significant differences between the two groups in depression, anxiety and stigma was significant difference between time (p<.05). Analysis of the interaction between time and service method revealed significant differences in depression and anxiety (p<.05). Conclusion: The results suggest that telephone-administered cognitive behavioral therapy may be effective and may provide opportunity to adapt to individual needs for treating depression and anxiety in patients with Parkinson's disease.

An Explanatory Model on Functional Capacity in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 기능적 용량 설명모형)

  • Bang, So-Youn
    • Korean Journal of Adult Nursing
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    • v.20 no.4
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    • pp.652-663
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    • 2008
  • Purpose: This study was conducted to develop and test an explanatory model on functional capacity in patients with chronic obstructive pulmonary disease using path analysis. Methods: Data were collected from 149 chronic obstructive pulmonary disease patients using 6-minute walk test, measurement of oxygen saturation, pulmonary function test, and self-reported questionnaires from June to October, 2005. The collected data were analyzed using SPSS/WIN 12.0 program and AMOS/WIN 4.0 program. Results: The overall fitness indices of modified model were good($x^2$ = 14.324, p = .281 GFI = .981, RMSEA = .006, AGFI = .944, NFI = .927, NNFI = .999, CFI = .999, PNFI = .613, $x^2$/df = 1.194). Functional capacity was influenced directly by age(${\beta}$ = -.304, p = .000), dyspnea(${\beta}$ = -.278, p = .000), self-efficacy(${\beta}$ = .240, p = .000), social support(${\beta}$ = .175, p = .004), pulmonary function(${\beta}$ = .169, p = .008), and oxygen saturation(${\beta}$ = .099, p = .048). These variables explained 39.3% in functional capacity. Conclusion: The findings of this study suggest that comprehensive nursing interventions should focus on decreasing dyspnea and increasing self-efficacy, social support, and oxygen saturation. In this perspective, pulmonary rehabilitation would be an effective strategy for improving functional capacity in patients with chronic obstructive pulmonary disease.

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Experience of High Risk Women Who Have Congenital Heart Disease : Transition to Parenthood (고위험 선천성 심장질환 여성의 부모 전환 경험 : 외롭고 두려운 자기완성)

  • Choi, Kyung-Sook;Jun, Myung-Hee;Lee, Heung-Jae
    • Korean Journal of Adult Nursing
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    • v.17 no.4
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    • pp.548-560
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    • 2005
  • Purpose: High risk women with congenital heart disease decide to get pregnancy is determined by not individual autonomous intention but complex interaction with their physical status and socio-psychological environments. This study tried to the answer to the question. : "What is experience high risk women who have congenital heart disease during transition to parenthood?". Method: A micro-ethnographic research method and oral historic research approach were done at the Grown-Up Congenital Heart Disease Clinic in one Korean metropolitan city from July 2002 to September 2003. Result: It was discovered that high risk women's experience of transitional parenthood is accounted as the process of lonely and fearful self-accomplishment. Their need for self-accomplishment creates them seek more opportunities to increase enduring abilities for their parenthood. Conclusion: We suggest that from the time of beginning of patient's making decisions about becoming pregnant, collaborative efforts must be considered that priority level of patient's needs be reviewed and find appropriate advices for their situation. Special counseling program should be provided to all the prospective parents with understanding their meaning of parenthood.

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The Relationships of Illness Intrusiveness and Quality of Life in Chronic Liver Disease Patients (만성 간 질환자의 지각된 질병장애정도와 삶의 질과의 관계)

  • Son, Haeng-Mi
    • Korean Journal of Adult Nursing
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    • v.14 no.4
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    • pp.501-509
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    • 2002
  • Purpose: This study was performed to identify the illness intrusiveness, quality of life, and their relationships in patients with chronic liver disease. Method: Data was collected using scales of illness intrusiveness developed by Devins et al and Korean health related quality of life (KoQoLS) developed by Shim et al to measure the illness intrusiveness and quality of life from 141 chronic liver disease patients. Result: The total mean score of illness intrusiveness was $38.85{\pm}18.45$. The domain of illness intrusiveness which showed the highest mean score was health ($4.60{\pm}2.02$), and the lowest mean score domain was relationship with spouse ($20.4{\pm}1.69$). The subcategory of KoQoLS which showed the highest mean score was bodily pain ($6.96{\pm}2.98$), and the lowest mean score subcategory was vitality ($2.75{\pm}1.20$). There were negative relationships between illness intrusiveness and KoQoLS in all subcategories. Abovel all, Illness intrusiveness had the strongest negative relationship with role limitation (r=-0.641) among the KoQoLS subcategories. Conclusion: Because the illness intrusiveness had negative influence on the quality of life in patients with chronic liver disease, further research will need to specify detailed illness intrusiveness and to explore influencing factors on quality of life in them.

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Congenital Heart Disease in the Adult - 122 Cases Analysis - (성인의 선천성 심질환;122례 분석)

  • 정신현
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.769-776
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    • 1992
  • Total 632 cases of open heart surgery were performed in the department of thoracic and cardiovascular surgery, Pusan Paik Hospital, Inje University from october 1985 to december 1990. Among them, there were 503 cases of congenital heart disease and 129 cases of acquired heart disease. In the cases of 503 congenital heart disease surgically corrected, 122 cases over 15 years of age were reviewed and its results were summarized as follows ; l. In total 122 cases 65 were male and 52 female. 2. There were 54 patients under 20 years of age, 31 between 20 & 24 years, 20 between 25 & 29 and 17 over 30 years of age. The eldest was a 46-year-old female of atrial septal defect group. 3. There were 63 cases of VSD[51.7%], 38 of ASD[31.2%], 11 cases of TOF[9%] and so on. 4. In recovery cases, main post-operative complications were as follows; cardiac tamponade, arrhythmia, low cardiac output syndrome, pulmonary, edema pericarditis, mediastinitis, sepsis and DIC. 5. There were 3 cases of post-operative death in this series, so operative mortality rate was 2.5% compairing with 1.8% of pediatric cases below 15 years of age. 6. This reviewed series reveal that aggressive surgical approach in adult congenital heart disease can be justified with low operative mortality like as pediatric age group.

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Long-chain Fatty Acid Oxidation Disorders and Therapeutic Approach (장쇄 지방산 산화 장애와 치료적 접근법)

  • Lee, Jung Hyun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.22 no.1
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    • pp.1-8
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    • 2022
  • Long-chain fatty acid oxidation disorders (LC-FAOD) are an autosomal recessive inherited rare disease group that result in an acute metabolic crisis and chronic energy deficiency owing to the deficiency in an enzyme that converts long-chain fatty acids into energy. LC-FAOD includes carnitine palmitoyltransferase type 1 (CPT1), carnitine-acylcarnitine translocase (CACT), carnitine palmitoyltransferase type 2 (CPT2), very long-chain acyl-CoA dehydrogenase (VLCAD), long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD), and trifunctional protein (TFP) deficiencies. Common symptoms of LC-FAOD are hypoketotic hypoglycemia, cardiomyopathy, and myopathy. Depending on symptom onset, the disease can be divided as neonatal period, late infancy and early childhood, adolescence, or adult onset, but symptoms can appear at any time. The neonatal screening test (NBS) can be used to identify the characteristic plasma acylcarnitine profiles for each disease and confirmed by deficient enzyme analysis or molecular testing. Before introduction of NBS, the mortality rate of LC-FAOD was very high. With NBS implementation as routine neonatal care, the mortality rate was dramatically decreased, but severe symptoms such as rhabdomyolysis recur frequently and affect the quality of life. Triheptanoin (Dojolvi®), the first drug for pediatric and adult patients with molecularly confirmed LC-FAOD, has recently been approved by the US Food and Drug Administration in 2020. In this review, the diagnosis of LC-FAOD and treatment including triheptanoin are summarized.

The Future Direction of Learning Objectives and National Nurse's Licensing Examination in Adult Health Nursing (성인간호학 교육의 학습목표와 국가고시 문제 개선방안)

  • Song, Rha-Yun;Shin, Su-Jin;Suh, Yeon-Ok;Shin, Sung-Rae;Park, Yeon-Hwan;Kang, Youn-Hee;Kim, Yeong-Kyeong
    • Korean Journal of Adult Nursing
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    • v.23 no.5
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    • pp.503-513
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    • 2011
  • Purpose: The purpose of this study was to identify a model based on f the learning objectives in adult health nursing curriculums. The model can be eventually reflected in Korean National Nurse's Licensing Examination (KNNLE). Methods: The model was developed through a series of practical analysis by the task force team from June to October, 2011. The research team conducted the data synthesis and analysis from the learning objectives of adult health nursing drawn from selected national and international universities, from the adult health nursing areas in KNNLE, and from the current disease prevalence from clinical data in the representative university hospitals in Korea. Results: The current disease prevalence and mortality rates are on the increase especially for malignant neoplasm, heart diseases, suicide and diabetes. The items on the KNNLE of adult nursing are categorized by body systems into digestive system (15%), introduction (13.8%), respiratory system (11.3%), and cardiac system (11.3%). While the current system-based learning objectives covers extensive areas of adult health nursing, the core items are required to be selected based on core competences and core learning objectives to restructure the items of KNNLE. The first revised model is to consolidate and restructure the items microscopically in the subjects of adult health nursing by system. The second proposed model from macroscopic perspective is to build a comprehensive scheme of nursing curriculum by encompassing 8 subjects under current KNNLE and adjust the number of items accordingly. Conclusion: The items of KNNLE need to be gradually redesigned by considering the intervention need at clinical practice and the modified learning objectives of adult health nursing. Based on the job analysis on core competences for newly employed nurses performed by the Korean Accreditation Board of Nursing, it is necessary to establish the core learning objectives of adult health nursing and set up standards for core items in KNNLE.