• Clinical and Experimental Pediatrics
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• 제58권5호
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• pp.194-198
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• 2015

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospital, Seoul, Korea, were enrolled in this retrospective study. We diagnosed each patient on the basis of the CIDP diagnostic criteria developed in 2010 by the European Federation of Neurological Societies/Peripheral Nerve Society Guidelines. We present the cases of four pediatric patients diagnosed with CIDP to understand the variable clinical course of the disease in children. Our four patients were all between 8 and 12 years of age. Patients 1 and 2 were diagnosed with acute cerebellar ataxia or Guillain-$Barr{\acute{e}}$ syndrome as initial symptoms. While patients 1 and 4 were given only intravenous dexamethasone (0.3 mg/kg/day) for 5 days at the first episode, Patients 2 and 3 were given a combination of intravenous immunoglobulin (2 g/kg) and dexamethasone (0.3 mg/kg/day). All patients were maintained with oral prednisolone at 30 mg/day, but their clinical courses were variable in both relapse intervals and severity. We experienced variable clinical courses of CIDP in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval.

• 보건의료산업학회지
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• 제8권4호
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• pp.149-161
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• 2014

The purpose of this study was to identify the association of factors related to clinical practice training for clinical competence among nursing students, and to analyze those factors influencing clinical competence, providing recommendations for improving their clinical competence and clinical learning environment. This descriptive correlative study completed organized questionnaires from 557 nursing students. The data was analyzed by SPSS 19.0. The most important factor affecting the clinical competence among nursing students was teaching effectiveness (${\beta}=.22$). followed by critical thinking (${\beta}=.19$). and the professional self-concept (${\beta}=.19$). The explained variable for clinical competence was 45.2% in nursing students. Thus, the development of an effective clinical internship program is important for strengthening nursing students' clinical competence. We suggest that the capability of nursing students should be strengthened and effective clinical internship programs should be developed to improve the clinical competence of nursing students.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.1232-1235
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• 2004

The purpose of this study is to design electrical stimulation system for pharyngeal dysfunction(dysphagia) in stroke patients. Pharyngeal muscle group activity is important, because contracting muscles provide the driving force at the initiation of the swallow and generate the pressure gradients necessary for bolus movement into the esophagus. Although we have many treatment methods for dysphagia, electrical stimulation system will be useful for stroke patients having dysphagia. Electrical stimulation can be divided into the body stimulation and electrodes. The body stimulation is divided again into frequency counter, time control and current measurement part. These parts are to control the current intensity, frequency and stimulating time. And they can be variable according to the patient's clinical assessment. The electrode plays a role to deliver the current from the system to the muscle. Also the position of the electrode can be variable according to the treatment method. We performed the clinical experiment with the stroke patient who has swallowing disorder. The videofluoroscopy was used for the observation. From the result of clinical experiment based on electrical stimulation, we expected that the dysfunction(in pharynx) level of the patient can be improved. However we could not have enough effectiveness of the treatment because of the number of patients, patient's adaptation and treatment period. We will design the optimized electrical stimulation system based on enough clinical experiment in the future.

• 한국정밀공학회지
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• 제22권7호
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• pp.185-190
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• 2005

The purpose of this study is to design electrical stimulation system fur stroke patients with pharyngeal dysfunction(dysphagia). Dysphagia is that the food has trouble in passing to the mouth from the stomach. Although we have many treatment methods for dysphagia, electrical stimulation system will be useful for stroke patients having dysphagia. Electrical stimulation system can be divided into body and electrodes. The body stimulation is composed to frequency counter, time control and current measurement part. These parts are to control the frequency, stimulating time and current intensity And they can be variable according to the patient's clinical assessment. The electrode plays a role to deliver the current from the system to the muscle. Also the position of the electrode can be variable according to the treatment method. We performed the clinical experiment with stroke patients who had swallowing disorder. The videofluoroscopy was used fur the observation. From the result of clinical experiment based on electrical stimulation, we expected that the dysfunction(in pharynx) level of the patient could be improved. However we could not have enough effectiveness of the treatment because of the number of patients, patient's adaptation and treatment period. We will design the optimized electrical stimulation system based on enough clinical experiment in the future.

• 대한임상독성학회지
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• 제4권2호
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• pp.113-121
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• 2006

Purpose: Previous studies have reported that plasma cholinesterase (AchE) concentration can serve as a useful prognostic parameter in cases of acute organophosphate (OP) poisoning. However, there has been considerable disagreement regarding the degree of its prognostic value. Earlier cross-sectional and one- time point studies were plagued with methodologic flaws, making it difficult to interpret their results. The purpose of this study was to clarify the prognostic value of time-variable cholinesterase levels and their relationship with clinical outcomes in OP poisoning. Methods: We reviewed medical and intensive care records of patients with acute OP poisoning admitted to our emergency department between March 1998 and Sep 2006. We collected patient information regarding poisoning, clinical, and demographic features. Patients were assessed for clinical outcomes and AchE concentrations on days 1, 2, 3, 5, and 7 and on the final day. Results: During the study period, 58 patients were enrolled in this study. There was a statistically significant difference in the AchE differentials on 1-3 days for patients requiring mechanical ventilation and for patients with mild poisoning (p<0.05). Also, the decrease in the log AchE concentration correlated with longer durations of mechanical ventilation (r=-0.411, p=0.002). Conclusion: In severe OP poising, measurements of time-variable AchE concentrations can be helpful in the prediction of mortality, the development of intermediate syndrome, and duration of mechanical ventilation.

• 한국간호교육학회지
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• 제8권1호
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• pp.51-60
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• 2002

The purpose of this study was to identify the relationship between self-esteem, self- efficacy and clinical practice performance, academic achievement, decision making of major field in clinical practice . The study subjects consisted with 244 students from G. junior nursing college that will adapt a new majoring program of clinical nursing practice funded by Ministry of human and resources development. Data were analyzed using descriptive statistics, and t-test, Pearson correlation, and multiple regression. The results of this study were summarized as follows: 1. The students were relatively performed well in clinical practice setting (total M :3.78). The item of student's personal relationship between patients, patient's family, and professional staff showed high score (M=3.96). However students did not feel comfortable to communicate with patients, patient's family and professional staffs in clinical setting(mean=3.56). 2. Students who had experiences of temporal absence from school showed significant difference in the variable of academic achievement and decision making of major field in clinical practice Students who entered to nursing school with self-motive revealed statistically significant difference in the variable of clinical practice performance, academic achievement, self-esteem, self-efficacy, and decision making of major field in clinical practice. 3. There was a significant correlation between self-esteem and clinical practice performance, (r=.512, p<.000). And the relation between self-esteem and decision making of major field in clinical practice was significantly correlated(r=.377, p<.000). Self-efficacy and clinical practice performance(r=.567, p<.000), and decision making of major field in clinical practice (r=.441, p<.000) showed significant correlations. Also relation between academic achievement and self-esteem reveled a significant correlation(r=.129, p<.05) but correlation between self-efficacy and academic achievement was not significant. 4. Correlation between clinical practice performance and decision making of major field in clinical practice also identified a significant relation(r=.498, p<.000). 5. Self-esteem and self-efficacy variables predicted clinical practice performance and explained 37.7% of clinical practice performance. 6. Aptitude and personal interests(m=4.07) reveled important factor affecting to select majoring area in clinical practice, and advice from parents reflected low percentage on selecting places(m=2.42). In conclusion, the variables of self-esteem and self-efficacy showed significant correlations with the variables of student's clinical practice performance, academic achievement, and decision making of major field in clinical practice. Thus it is recommended that student's affective domain of self-esteem and self-efficacy should be developed by nursing intervention before clinical nursing education.

• 대한치과의사협회지
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• 제50권12호
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• pp.720-726
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• 2012

Oral mucosal lesions with a papillary or verrucous surface are a heterogenous group of conditions with widely varying clinical behaviour. The etiology is variable and includes infective, traumatic or neoplastic processes. The majority of these lesions are precanceous lesion. Therefore, a biopsy is required to establish a diagnosis and the microscopic examination must be coordinated with the clinical findings. This paper reviews the clinical features and significance of papillary or verrucous lesions.

• 대한의생명과학회지
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• 제22권1호
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• pp.9-17
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• 2016

Unfortunately, the five-year survival rate of lung cancer is relatively low compared with other cancers. Therefore, better predictors are need for prognosis, therapeutic strategy, risk stratification and predicting long-term mortality of lung cancer. Recently, increasing data suggest that Glasgow Prognostic Score (GPS) and procalcitonin levels are useful predictor cancer prognosis. In this study, we retrospectively investigated the correlation of GPS or procalcitonin to clinical variables in patients with pretreatment lung cancer. In 135 patients with pretreatment lung cancer, GPS, procalcitonin, demographic characteristics, hematological, coagulation, biochemical, inflammatory and cardiac markers were measured. Monocyte, eosinophil, basophil, neutrophil to lymphocyte ratio, red cell distribution width (RDW), platelet to lymphocyte ratio, mean platelet volume to platecrit ratio, D-dimer and prothrombin time (PT) levels were higher, whereas mean platelet volume was lower than their normal ranges. Glucose and sodium levels were low, whereas gamma glutamyl transferase (GGT), total bilirubin, creatinine and inorganic phosphorus concentrations were increase compared their normal ranges. Procalcitonin, high sensitivity C-reactive protein and troponin-I concentrations were elevated compared with their normal ranges. GPS had significantly positive or negative relations to cancer stage, hematological, coagulation, biochemical, inflammatory and troponin-I. Based on the data, we suggest that GPS may be a potent and useful predictor for prognosis, therapeutic strategy, risk stratification and predicting long-term mortality of lung cancer.

• Journal of the Korean Data and Information Science Society
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• 제23권4호
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• pp.643-648
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• 2012

여러 임상자료를 이용하여 반응변수와 설명변수간의 관계를 규명하는 분석이 많이 이루어지고 있다. 이를 위해서 회귀분석이 흔히 사용되고 있으며, 이를 통해 설명변수가 반응변수를 얼마나 설명하는지 또한 모형이 얼마나 자료에 적합한지에 대해 분석하고 있다. 그러나 임상자료로 분석된 회귀모형에 대한 타당성 확인은 대부분 분석된 회귀모형이 얼마나 자료를 설명하는가를 나타내는 결정계수만을 살펴보는 것에 그치고 있다. 결정계수 이외의 다른 방법으로도 분석된 회귀모형의 회귀계수에 대한 타당성을 확인할 필요가 있다. 따라서 본 논문에서는 잭나이프 회귀분석과 붓스트랩 회귀분석을 이용하여 임상자료로 분석한 회귀모형의 회귀계수에 대한 타당성을 확인하는 방법을 소개하고자 한다.

• 대한물리의학회지
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• 제5권3호
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• pp.331-339
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• 2010

Purpose : Cervical spondylotic myelopathy is a varied clinical syndromes and the most serious condition of cervical spondylosis. Spinal cord dysfunction is often caused by the compression on spinal cord. The purpose of this report was to describe physical examination and the process of disorders on cervical spondylotic myelopathy(CSM). Methods : Three cases with cervical myelopathy were presented with magnetic resonance image(MRI), Nurick's grade and Japanese Orthopaedic Association(JOA) score. Results : This studies showed a variable clinical course with gradual neurological deterioration in two cases. but one case was improved by operation and a regular aerobic exercise. MRI, Nurick's grade, JOA score are a useful adjunct for CSM evaluation. Conclusion : The state of CSM is variable, which may affect conservative treatments and surgery. It is needed to be a carefull approach and studies for a conservative treatment and management on CSM.