• 제목/요약/키워드: Clinical finding

검색결과 1,054건 처리시간 0.034초

척수종양의 임상적 분석 (Clinical Analysis of Spinal Cord Tumor)

  • 최원림;신원한;조성진;김범태;최순관;변박장
    • Journal of Korean Neurosurgical Society
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    • 제30권1호
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    • pp.47-53
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    • 2001
  • Objective : This study was undertaken to evaluate operative results and prognosis according to preoperative clinical status and histopathological finding of spinal cord tumor. Methods : We analyzed of clinical feature, tumor location, histopathologic finding, operative results and prognosis in 55 patients with spinal cord tumor during last 10 years. Results : 1) The incidence of spinal cord tumors varies with the age of affected patients who are 2 to 75 years of age. Peak incidences were in the 5th & 7th decade of life, and the ratio of male to female was 1.2:1. 2) The most common histopathologic type was neurinoma(41.9%). 3) The tumors were located most frequently in the thoracic area(22 cases, 40.0%) and in the intradural extramedullary space(30 cases, 54.5%). 4) The most common initial clinical feature was pain in 20 cases(36.4%). For neurologic status on admission, 30 cases(54.5%) showed motor disturbance. 5) In radiologic studies, there were abnormal finding in 21 cases from plain X-rays among 37 cases. The entire 20 cases in when myelography was done showed subarachnoid blockade, either complete or incomplete. The magnetic resonance imaging, regard as the most accurate diagnostic method, revealed the exact location of the tumor and the relationship of the tumor with the adjacent anatomical structure. 6) The total removal was possible in 36 cases(65.5%), subtotal removal in 17 cases(30.9%) and biopsy in 2 cases (3.6%). Nineteen cases(90.5%) among 21 cases with preoperative radiculopathy group showed recovery or improvement, where as only 11 cases(36.7%) among 30 cases with preoperative motor weakness group showed recovery or improvement, with statistically significant difference(p<0.01). Pathologically, 26 cases(83.9%) among 31 cases of neurinoma and meningioma showed postoperative recovery or improved, but only 1 case(6.3%) among 16 cases of metastatic tumor, astrocytoma and ependymoma recovered. Postoperative complication noted in 5 cases(9.1%), and were noted postoperative hematoma, pneumonia, pulmonary edema and spinal cord infarction. Conclusion : Preoperative neurologic status and histopathologic finding are considered important factors of Postoperative outcome in patients with spinal cord tumor.

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Cerebral Toxoplasmosis Combined with Disseminated Tuberculosis

  • Hwang, Eui-Ho;Ahn, Poong-Gi;Lee, Dong-Min;Kim, Hyeok-Su
    • Journal of Korean Neurosurgical Society
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    • 제51권5호
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    • pp.316-319
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    • 2012
  • A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.

간호대학생의 비판적 사고성향과 임상수행능력에 관한 연구 (A Study on the Critical Thinking Disposition and Clinical Competency of Nursing Students)

  • 조학순
    • 한국간호교육학회지
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    • 제11권2호
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    • pp.222-231
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    • 2005
  • Purpose: The purpose of this study was to identify the relationship between critical thinking disposition and clinical competency of nursing students. Method : The sample consisted of 151 nursing students, who have ever had clinical practice. Data were collected by self reporting questionnaire for 13 days from April 18-30, 2005. The data were analyzed by descriptive statistics, t-test, ANOVA, Duncan test, Pearson Correlation Coefficient with SPSS Programs. Result : The result of this study were as follows : 1. The total mean score of critical thinking dispositions in the nursing students was moderately(3.50). There was a statistically significant difference in critical thinking disposition according to satisfaction with the nursing major(F=5.563, p=.005). 2. The total mean score of clinical competency in the nursing students was slightly high(3.37). There was a statistically significant difference in clinical competency according to adaptation with the nursing major(F=5.202, p=.007), satisfaction with clinical practice(F=3.172, p=.045). 3. A significant positive correlation between critical thinking disposition and clinical competency was founded(r= .421, p<.000). Conclusion : In conclusion, this study revealed that critical thinking disposition influences clinical competence. Therefore, the finding of this study may provide significant basic data for nursing education and nursing practice.

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네트워크 분석을 이용한 불면의 무작위임상시험 해외 연구 동향 (Research Trends of Randomized Clinical Trial for Insomnia Using the Network Analysis)

  • 백영화;진희정
    • 한국콘텐츠학회논문지
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    • 제13권12호
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    • pp.1036-1047
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    • 2013
  • 본 연구는 불면과 관련된 무작위임상시험의 해외 연구 동향을 살펴보기 위하여 시계열적 키워드 비교 분석 및 네트워크 분석을 실시하였다. 분석에 사용된 자료는 'Insomnia'와 'Randomized Clinical Trial'의 연관 키워드를 사용하여 ClinicalTrials의 379건, Web of Science의 132건을 선정하였다. 분석 결과, ClinicalTrials에서는 불면과 약물요법을 중심으로 인지행동요법, 우울 등의 키워드가 네트워크를 이루고 있었다. WOS에서는 ClinicalTrials의 결과에 멜라토닌 키워드가 추가적으로 나타났다. 또한, 연구 대상자 중 특징적으로 노인과 여성에 대한 연구가 꾸준히 진행되는 것으로 파악되었다.

시뮬레이션에서의 간호대학생의 임상적 판단 기술 분석: Tanner의 Clinical Judgment Model을 적용하여 (Nursing Students' Clinical Judgment Skills in Simulation: Using Tanner's Clinical Judgment Model)

  • 김은정
    • 한국간호교육학회지
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    • 제20권2호
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    • pp.212-222
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    • 2014
  • Purpose: The purpose of this study was to evaluate the nursing students' clinical judgment skills in simulation using Tanner's Clinical Judgment Model. Method: Forty-five teams of a total 93 nursing students participated in a post-operative patient care scenario using human patient simulator. Data were collected from students' responses in scenario and guided reflective journaling according to the framework of Tanner's model which comprised noticing, interpreting, responding, and reflecting on response. Data were analyzed using descriptive statistics. Results: The students' responses of the situation were in accordance with the goals of scenario, i.e. relieving patient' pain and preventing pulmonary complications. However, most of students needed clinical cues and focused on a given clue to solve the issues. They were lack of ability to collect additional information as well as connect the relevant clues in simulated clinical situation. Conclusion: The nursing students have difficulty in what they notice, how they interpret finding, and respond appropriately to the situation. The simulation training using Tanner's model could provide faculty and nursing students with an effective teaching and learning strategy to develop the clinical judgment skills.

Comparison of gastric and other bowel perforations in preterm infants: a review of 20 years' experience in a single institution

  • Lee, Do Kyung;Shim, So Yeon;Cho, Su Jin;Park, Eun Ae;Lee, Sun Wha
    • Clinical and Experimental Pediatrics
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    • 제58권8호
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    • pp.288-293
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    • 2015
  • Purpose: In this study, we aimed to review the clinical presentation of preterm infants with gastrointestinal perforations and compare the clinical features of gastric perforation with other intestinal perforations. Methods: The medical records of preterm neonates with pneumoperitoneum, admitted to the neonatal intensive care unit (NICU) between January 1994 and December 2013, were retrospectively reviewed. Results: Twenty-one preterm infants underwent exploratory laparotomy to investigate the cause of the pneumoperitoneum. The sample consisted of five patients (23.8%) with gastric perforation and 16 patients (76.2%) with intestinal perforation. No statistical differences were found in the birth history and other perinatal factors between the two groups. Underlying necrotizing enterocolitis, bilious vomiting, and paralytic ileus preceding the perforation were statistically more common in the intestinal perforation group. All preterm infants with gastric perforation survived to discharge; however, six preterm infants with intestinal perforation expired during treatment in the NICU. In the gastric perforation group, sudden pneumoperitoneum was the most common finding, and the mean age at diagnosis was $4.4{\pm}1.7days$ of life. The location and size of the perforations varied, and simple closure or partial gastrectomy was performed. Conclusion: Patients with gastric perforation did not have a common clinical finding preceding the perforation diagnosis. Although mortality in previous studies was high, all patients survived to discharge in the present study. When a preterm infant aged less than one week presents with sudden abdominal distension and pneumoperitoneum, gastric perforation should first be excluded. Prompt exploratory laparotomy will increase the survival rates of these infants.

한약제제 KOB03의 랫드에서의 4주 반복 경구투여에 의한 독성 연구 (Dose range finding study of KOB03, a new polyherbal medicine for the treatment of allergic rhinitis, by oral administration for four weeks in Sprague-Dawley rats)

  • 정진기;박용기
    • 대한본초학회지
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    • 제27권3호
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    • pp.101-106
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    • 2012
  • Objectives : To evaluate the toxicity of KOB03, polyherbal medicine for the treatment of allergic rhinitis, we performed the dose-range finding test of KOB03 by oral supplementation for 4 weeks in Sprague-Dawley rats. Methods : The water extract of KOB03 consisting of five different herbs was supplied from GLP company. KOB03 was supplemented by gavage at 0, 500, 2,500 and 5,000 mg/kg/day for 4-week consecutive days. We recorded the clinical signs of toxicity, body weight, organ weights, hematology, gross and histological changes in target organs of rats, and clinical chemistry analysis. Results : KOB03 at all doses was shown no mortality or abnormal clinical signs in rats during at the observation period. Furthermore, there was no difference in body weight and food-take consumption, organ weight, gross pathological findings, and urine analysis among the groups of rats treated with different doses of KOB03. The hematological analysis and clinical blood chemistry data were revealed no toxic effects from KOB03-supplemented rats. Conclusions : The results suggest that KOB03 is a wide margin of safety on dose-range toxicity in rats. The no observable adverse effect level (NOAEL) of the test, KOB03 in rats is no less than 5,000 mg/kg/day.

간호대학생의 진로탐색과정: 예비간호사의 진짜 간호사 찾아가기 (Career Exploration Process of Nursing Student in Clinical Practice: A Voyage to Find the Authentic Nurse of Pre-registration Nurses)

  • 손현미;홍윤경;김영혜
    • 한국간호교육학회지
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    • 제25권1호
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    • pp.69-82
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    • 2019
  • Purpose: The purpose of the study is to understand the experiences of career exploration among nursing students during their clinical practice and to develop a theoretical framework for the career exploration process. Methods: From February 2 to 28, 2015, data were collected through focus group interviews from 24 participating fourth-year nursing students. The data were analyzed using grounded theory. Results: The central phenomenon of 'confusion between the ideal and the reality of nursing' occurred in contexts for various reasons of choosing one's major, nurses in the ideal, a vague fear of the field, arduous nursing assignments in the field, and severe adversity in the nursing field. Nursing students tried to deal with their confusion by using interaction strategies such as pursuing the intrinsic value of nursing, finding role models, trying to project oneself, and preparing for adapting to reality. The career exploration process in clinical practice was a voyage to discover the authentic nurse of the pre-registration nurse. Conclusion: This result shows that nursing students were to gain confidence in their career choices by finding the value of nursing and interacting with patients. Therefore, opportunities for learning experiences about interaction with patients and various positive experiences in clinical practice should be provided for nursing students.

Suspecting Intussusception and Recurrence Risk Stratification Using Clinical Data and Plain Abdominal Radiographs

  • Oh, Ye Rim;Je, Bo Kyung;Oh, Chaeyoun;Cha, Jae Hyung;Lee, Jee Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권2호
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    • pp.135-144
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    • 2021
  • Purpose: Although ultrasonography is the gold standard of diagnosing intussusception, plain abdomen radiograph (AXR) is often used to make differential diagnosis for pediatric patients with abdominal pain. In intussusception patients, we aimed to analyze the AXR and clinical data to determine the characteristics of early AXR findings associated with diagnosis of intussusception and recurrence after reduction. Methods: Between January 2011 and June 2018, 446 patients diagnosed with intussusception based on International Classification of Diseases-10 code of K56.1 were admitted. We retrospectively reviewed medical records of 398 patients who received air reduction; 51 of them have recurred after initial reduction. We evaluated six AXR features including absent ascending colon gas, absent transverse colon gas, target sign, meniscus sign, mass, and ileus. Clinical data and AXR features were compared between single episode and recurrence groups. Results: Two groups did not show significant differences regarding clinical data. Mean time to recurrence from air reduction was 3.4±3.2 days. Absent ascending colon gas (63.9%) was the most common feature in intussusception, followed by mass (29.1%). All of six AXR features were observed more frequently in the recurrence group. Absent transverse colon gas was the most closely associated AXR finding for recurrence (odds ratio, 2.964; 95% confidence interval, 1.327-6.618; p=0.008). Conclusion: In our study, absence of ascending colon gas was the most frequently seen AXR factor in intussusception patients. Extended and careful observation after reduction may be beneficial if such finding on AXR is found in intussusception patients.

간호학생의 비판적, 반영적 임상실습 경험 내용분석 - 임상실습 지식 습득 과정 - (Content Analysis of the Student Nurse's Critical-reflective Clinical Practice Experience)

  • 조계화
    • 한국간호교육학회지
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    • 제9권2호
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    • pp.310-319
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    • 2003
  • The purpose of this study was to determine what effect reflection on clinical practice experience had students as learners and care providers. Qualitative research method was used to study a group of four-year undergraduate nursing course. Content analysis was done using the classification method of Carper's four patterns of knowing. Results of the study indicated that the use of the reflective process of clinical debriefing and journaling was impact on the aspect of nursing science, moral component of knowledge in nursing, personal knowing in nursing and the art of nursing. Especially, students moved from a passive to a more active mode of learning. The most significant finding was that over time, reflective processes resulted in the emergence of the client as the central focus of care. It was suggested that reflection was an important learning tool in professional education and that the skills required for reflection need to be developed in professional courses.

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