• Title/Summary/Keyword: Shock patient

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A Study on the Clinical Nurse's Ethical Value (인간생명에 대한 간호사의 윤리의식)

  • Moon, Young-Im;Tak, Young-Ran;Kim, Myoung-Ae;Kim, Seon-Ae;Park, Kyung-Sook;Im, Dong-Sik;Park, Ho-Ran
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.4
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    • pp.541-557
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    • 2003
  • Purpose: This descriptive study was designed to explore the clinical nurse's ethical value regarding human life. Method: Data were collected from September to October, 2002. Study subjects were 527 clinical nurses working in General Hospital as tertiary located in Seoul. Ethical value was measured with questionnaire developed by researchers and consisted on items regarding ethical value on human life. Result: Among the items, most nurses highly agree with the item, "When a patient requests his/her health care provider to keep his/her personal secret, the health care provider is obliged to do so." and "When a patient asks for information on his/her medicinal and dietary contents, his/her wish must be granted." Most clinical nurses mainly agree with the item. "Health care providers must always be honest to the patient and/or his/her family". However, most nurses disagree with the item, "When a patient is on the verge of death after an accident, it is justifiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them". Most clinical nurses mainly disagree with the items, "When a patient is on the verge of death after an accident, it is justiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them" and "It is justiable that various new ways of treatment should be applied to patient at his/her terminal stage to prolong his/her life, even for the purpose of research". There were significant differences in some items of ethical value according by clinical nurse's age and professional experience, current position, religion, education, marital status, continued education on ethics, and the experience of holing on life saving treatment. Conclusion: It is intensifying the notion of ethical underpinning for human rights, truthfulness is essential to a trust relationship under what circumstances. Also most clinical nurses agree with that It is essential to trust in the nurse-patient relationship, patients have the right to know and it is the ethical thing to do as health care provider.

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Literature Studies for Tennis Elbow (테니스팔꿉증에 대한 문헌 고찰)

  • Moon, Dalju;Kang, Taesung
    • Journal of The Korean Society of Integrative Medicine
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    • v.3 no.2
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    • pp.1-8
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    • 2015
  • Purpose: This study was conducted to know the evidence case to assessment about literatures of extensor carpi radialis therapeutic strategy of tennis elbow about dysfunction wrist extension with anatomy, biomechanic and function. Method: Patient was received the physical therapy program with medication for two weeks. Physical therapy program consists of strengthening exercise, stretching exercise and extracopereal shock wave therapy. Results: Patients could do computer and house works at three weeks significant with improved pain. The amounts used repetitive muscle was reduced slowly over a period of a day or two days for wrist moving. Wrist flexor strengthening exercise and could reduced the wrist extensor injury. Conclusion: Clinicians certainly realized biomechanic effects and anatomy of extensor carpiradialis and elbow joint.

A case of sciatica; did not respond to prolotherapy and extracorporeal shock wave therapy (프롤로테라피와 체외충격파에 반응 없는 요각통(腰脚痛) 환자 1례)

  • Lee, Hye-Yoon;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.2
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    • pp.57-64
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    • 2016
  • This is a case report about left leg radiating pain treated with complex traditional Korean medical intervention, while the case did not responded to prolotherapy and extracorporeal shock wave treatment for lumbar herniated intervertebral disc (HIVD). The patient was diagnosed with a piriformis problem after a physical examination and was treated with lumbar and piriformis muscle treatment. After 9 sessions of treatment for 33 days, Numeric Rating Scale (NRS) for pain has been decreased from 8 to 3. Further studies with more cases and longer observation period should be conducted to provide evidence for optimum acupuncture procedure considering its effectiveness, safety and patients' compliance altogether.

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A Case Report of Rhabdomyolysis Resulting from Shock Caused by Overworking (과로로 인한 쇼크 후 발생한 횡문근 융해증 1례)

  • Kim, Sul Gi;Park, Sueng Hyuk;Park, Ok Ju;Cho, Nam Geun
    • Journal of Acupuncture Research
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    • v.32 no.1
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    • pp.127-131
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    • 2015
  • Objectives : The purpose of this study is to report a case of Rhabdomyolysis that occurred after shock related to overworking, presenting myalgia(especially in the neck), muscular weakness, and dark urine. Methods : A patient diagnosed with Rhabdomyolysis received Korean medical treatment from November $17_{th}$ to $24_{th}$. Clinical improvement was evaluated using a numerical rating scale(NRS), neck disability index(NDI), and laboratory tests which included complete blood count, kidney function, liver function, serum eletrolytes and Creatinine kinase(CK). Results : After treatment, myalgia, muscular weakness and dark urine each improved. Laboratory results, including CK, had decreased to within normal range. Conclusions : Korean medical treatment could be effective for Rhabdomyolysis patients. Further extensive studies should be carried out.

Non-invasive estimation of the shock amplitude inside the body of the patient undergoing extracorporeal shock wave lithotripsy (체외 충격파 쇄석술 환자의 비침습적인 체내 충격파 압력 추정)

  • Choi Min Joo
    • Proceedings of the Acoustical Society of Korea Conference
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    • spring
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    • pp.389-392
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    • 2002
  • 체외 충격파 쇄석술 (ESWL)은 인체 외부에서 발생된 충격파를 인체 내부의 결석 부위에 집속하여 결석을 분쇄하고 치료 효과를 얻는 혁신적 치료술이다. 충격파의 압력 및 파형은 결석의 분쇄 효과 즉 치료 효과를 좌우한다. 체외에서 충격파의 압력은 고감도 하이드로폰을 이용하여 측정할 수 있지만, 인체 체내에서, 특히, 비침습적으로 충격파를 측정하기는 매우 어렵다. 본 논문에서는 ESWL 충격파에 의해 활성화된 체내의 기포군으로부터 방출된 음향 신호 (CIAE)를 측정하여 비침습적으로 충격파의 압력을 추정하는 방법을 실험하였다. 충격파 압력의 추정은 측정된 CIAE 신호에서 1차 기포군 파열음과 2차 파열음 간의 시간 지연은 충격파의 압력과 선형적인 관련성 가진다는 실험 결과 (Coleman et al 1996)에 근거하고 있다. 본 논문에서는 충격파 압력 측정 시스템을 구성하여 생체 외 실험을 수행하였고, 개발된 시스템의 임상적인 활용 가능성을 확인하였다.

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Delayed Splenic Rupture Following Minor Trauma in a Patient with Underlying Liver Cirrhosis (간경화증 환자에서 경도 외상 후 발생한 지연 비장 파열)

  • Jeung, Kyung-Woon;Lee, Byung-Kook;Ryu, Hyun-Ho
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.52-55
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    • 2011
  • The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

Analysis of the Correlation between Expressions of HSP90α, HSP90β, and GRP94, and the Clinicopathologic Characteristics in Tissues of Non-Small Cell Lung Cancer Patients (비소세포 폐암 환자 조직에서 Hsp90α, Hsp90β, GRP94의 발현과 임상병리학적 특성과의 상관관계 분석)

  • Kim, Mi Kyeong
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.4
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    • pp.460-469
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    • 2017
  • Heat shock proteins (HSPs) are induced as a self-defense mechanism of cells when exposed to various external stresses, such as high fever, infection, free radicals, and heavy metals. They affect the prognosis in the process of tumor formation. HSP is classified into four families: HSP27, HSP60, HSP90, and HSP100, depending on molecular weight. Heat shock protein 90 (HSP90), a molecular chaperone, plays an important role in the cellular protection against various stressful stimuli and in the regulation of cell cycle progression and apoptosis. In the present study, we assessed the differential expression of HSP90 family proteins in non-small cell lung cancer (NSCLC), and the correlation of their expression levels with clinicopathologic factors and patient survival rates. The result of this study can be summarized as follows; $HSP90{\alpha}$ showed higher expression in patients with no lymphovascular invasion (p=0.014). $HSP90{\beta}$ showed a higher expression of squamous cell carcinoma (p=0.003), and an over expression of glucose-related protein (GRP94) was significantly associated with poor differentiation (p=0.048). However, none of the HSP90 proteins showed a significant association with the survival status in patients with NSCLC. This study also indicates that $HSP90{\alpha}$ might contribute more to the carcinogenesis of NSCLC than $HSP90{\beta}$, and GRP94 and isoform selectivity should be considered when HSP90 inhibitors are studied or utilized in the treatment of NSCLC.

Prediction of Length of ICU Stay Using Data-mining Techniques: an Example of Old Critically Ill Postoperative Gastric Cancer Patients

  • Zhang, Xiao-Chun;Zhang, Zhi-Dan;Huang, De-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.97-101
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    • 2012
  • Objective: With the background of aging population in China and advances in clinical medicine, the amount of operations on old patients increases correspondingly, which imposes increasing challenges to critical care medicine and geriatrics. The study was designed to describe information on the length of ICU stay from a single institution experience of old critically ill gastric cancer patients after surgery and the framework of incorporating data-mining techniques into the prediction. Methods: A retrospective design was adopted to collect the consecutive data about patients aged 60 or over with a gastric cancer diagnosis after surgery in an adult intensive care unit in a medical university hospital in Shenyang, China, from January 2010 to March 2011. Characteristics of patients and the length their ICU stay were gathered for analysis by univariate and multivariate Cox regression to examine the relationship with potential candidate factors. A regression tree was constructed to predict the length of ICU stay and explore the important indicators. Results: Multivariate Cox analysis found that shock and nutrition support need were statistically significant risk factors for prolonged length of ICU stay. Altogether, eight variables entered the regression model, including age, APACHE II score, SOFA score, shock, respiratory system dysfunction, circulation system dysfunction, diabetes and nutrition support need. The regression tree indicated comorbidity of two or more kinds of shock as the most important factor for prolonged length of ICU stay in the studied sample. Conclusions: Comorbidity of two or more kinds of shock is the most important factor of length of ICU stay in the studied sample. Since there are differences of ICU patient characteristics between wards and hospitals, consideration of the data-mining technique should be given by the intensivists as a length of ICU stay prediction tool.

Extracorporeal Shock Wave Therapy (ESWT) in Patients with Chronic Proximal Plantar Fasciitis (체외 충격파를 이용한 만성 근위부 족저 근막염의 치료)

  • Kim, Byung-Soo;Lee, Keun-Bae;Choi, Jin;Park, Yu-Bok;Baik, Long-Bin
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.163-167
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    • 2006
  • Purpose: To evaluate the results of extracorporeal shock wave therapy (ESWT) for patients with chronic proximal plantar fascitis. Materials and Methods: Between April 2005 and April 2006, 35 cases (24 patients) who were followed more than 6 months were evaluated. By $EvoTron^{(R)}$, 2 sessions of ESWT (Group 1: 1200 and Group 2: 1500 shock waves / session of $0.12\;mJ/mm^2$) were performed at 2 weeks interval. The mean age was 40.0 (range, 15-59) years. 13 patients were male and 11 patients were female. Visual analogue scale (VAS) on daily activity and a 100-point scoring system including 70 points for pain and 30 points for function were used. The clinical outcomes were rated as follows: excellent, no pain on daily activity; good, less than 50% of previous VAS; fair, 50-75% of previous VAS; or poor, more than 75% of previous VAS. Excellent and good were graded as satisfactory results. We compare clinical results between groups and evaluate the relationships between clinical results and duration of symptom, fascial thickening and previous steroid injection were evaluated. Results: Overall satisfactory rate were 71.4%. There was no significant difference of clinical results between groups. And there were no significant difference between clinical results and duration of symtom, preoperative fascial thickening and previous steroid injection. Conclusions: ESWT for recalcitrant chronic proximal plantar fascitis is useful treatment method with high patient satisfaction and pain relief, but more long-term study must be needed.

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The Choice of Management in Patients with Splenic Blunt Trauma : A Single Center Study (외상성 비장 손상 환자의 치료방법의 선택: 단일 기관 연구)

  • Jang, Ji Young;Lee, Seung Hwan;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.280-285
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    • 2013
  • Purpose: Nowadays, non-operative management increases in patients with blunt splenic injury due to development of diagnostic and interventional technique. The purpose of this study is to evaluate the management in patients with blunt splenic injury and effect of clinical state such as shock on the choice of management. Methods: From April 2007 to July 2013, we retrospectively reviewed the medical charts of fifty patients who had splenic injury after blunt trauma. The demographic characteristics, American Association for the Surgery of Trauma (AAST) grade of splenic injury, management method (emergency operation, angiographic embolization or observation) and clinical outcome were analyzed. Results: The mean age was $41.5{\pm}21.4$ years and male was 44(88%). Twenty patients(40%) were in shock condition initially and five patients(10%) underwent emergency operation due to hemodynamic instability. Emergency angiographic embolization was performed in 20 patients(40%) and 25 patients were managed conservatively. When patients were divided into shock group (SG) and non-shock group (NSG), Patients in SG had significantly higher serum lactate level and base deficit than NSG (lactate; $4.5{\pm}3.4$ mmol/L, base deficit; $5.8{\pm}4.4$ mmol/L vs $1.9{\pm}1.4$ mmol/L, $2.8{\pm}2.5$ mmol/L, p=0.007, p=0.013). There was no significant difference of AAST grade and contrast blush rate in abdomen CT between two groups. Among 45 patients with non-operative management, four patients(8.9%) got delayed angiographic embolization and 3 patient died from companied organ injury. Conclusion: Non-operative management can be acceptable management option in patients with splenic blunt trauma under intensive hemodynamic monitoring.