• Title/Summary/Keyword: Clinical investigation

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Clinical Investigation of Surgical Spontaneous Pneumothorax (외과적 자연기흉의 임상적 고찰)

  • 윤윤호
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.19-24
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    • 1968
  • A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical mana-gement. Males outnumbered females 15:2. Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abscess, cyst and blebs. It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abscess, cyst, blebs were above 4 th decade. Pulmonary tuberculosis was far advanced bilateral and active. The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed. The complications were pleural effusion and bronchopleural fistula. The former was 13 cases [76.4%] in which 3 cases combined with mixed infection, and latter was 5 cases. As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suc-tion. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage. This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho-pleural fistula. The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases. Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis. Decortication & lung resection was carried out in 2 patients among which ruptured lung abscess 1 case and ruptured multiple blebs 1 case. There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.

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Investigation of Clinical Research of Acupuncture Intervention in Assisted Reproductive Technology in Pubmed (보조생식술에 있어서 침의 중재에 대한 임상연구 동향 - Pubmed를 중심으로 -)

  • Bae, Geung-Mee;Cho, Hye-Sook;Lee, Seung-Hwan;Lee, In-Sun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.4
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    • pp.65-82
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    • 2009
  • Purpose: The purpose of this study is to examine acupuncture intervention suggested in the papers of assisted reproductive technology(ART, hereafter) in medicine journals and to establish the further direction. Methods: The papers published between 1996 and 2009 in Pubmed were reviewed. Results: 1. A variety of randomized controlled trials and case series were found in Pubmed concerning influence of acupuncture in ART. It was investigated into improvement of pregnancy rate, analgesic effect during oocyte retrieval, change of serum hormone, and reduction of anxiety. 2. It was on clinical pregnancy rate that main focus of the investigation was placed and the improvement of pregnancy rate differed from studies. 3. For the analgesic effect during oocyte retrieval, the electro acupuncture was mainly used and the studies reported the reduced pain rate, tiredness, and nausea. 4. Acupuncture was reported as significant in improving the state of anxiety during ART. Conclusion: It would be necessary to further study the period of acupuncture intervention, the selection of acupoint through well-designed study, and establish standard of evidence of them.

The Perceived Causal Structure Model on Stress Experienced by Nursing Students during Clinical Practice (간호학생의 임상실습스트레스에 관한 인지적 인과구조모형)

  • Park, Mi-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.10 no.1
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    • pp.54-63
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    • 2004
  • The purpose of this study is to identify the factors that influence stress experienced by nursing students and to provide a perceived causal structure model among these variables. The ultimate goal of this study is to develop efficient guidance to clinical nursing education in this population. This study intends to apply perceived causal structure: network analysis method which was developed by Kelly(1983), and has been applied in nursing research. This method is selected to show dynamic relationship of stressor using network method. Data was collected from convenient sample of 186 junior college nursing students who had the clinical practice experience during 10 weeks. Data collection and analysis was conducted in 2 steps from December, 9, 2002 to February, 8, 2003. Step 1.: Data was collected using literature review(10 articles) to identify the causes of stress. Nine causes of stress were extracted. Step 2.: As perceived casual structure network study, data was collected using questionnaires which included 9 extracted cause and stress. The questionnaire contained a 10 X 10 grid table with 10 causes and effects printed. In network analysis, 'Yes' was scored as 1, 'No' was scored as 0, and the mean(maximum 1, minimum 0) was calculated. Construction of the network under inductive eliminative analysis which stopped the construction of the network when the consensual agreement level dropped near 50% was proceeded by adding causes in order of the mean rating level. In this study, construction of the final network was stopped by consensual agreement level of 52% of the total subjects. The results are summarized as follows : Step 1: Investigation of the causes of stress ; The extracted causes of stress from quality data was identified 9 categories ; negative nurse, lack of clinical practice opportunity, ambiguous role, negative patient, lack of nursing knowledge and skill, difficult of personal relations, inefficient clinical practice guidance, gap of theory and practice, lack of support. Step 2 : Construction of the perceived causal structure model ; 1) The most central cause of stress is ambiguous role in the systems of causation. 2) The distal cause of stress is inefficient clinical practice guidance 3) The causes that have a number of outgoing link are negative nurse, ambiguous role. 4) The causes that have a number of incoming link are ambiguous role, gap of theory- practice, lack of clinical practice opportunity, lack of nursing knowledge- skill. 5) There is a mutual relationship between stress and difficult of personal relations, stress and ambiguous role, ambiguous role and negative nurse, ambiguous role and lack of clinical practice opportunity, ambiguous role and lack of nursing knowledge-skill, lack of nursing knowledge-skill and gap of theory- practice. In conclusion, the network suggests that the first centre cause is related on ambiguous role and the second on negative nurse, inefficient clinical practice guidance in the systems of causation

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Prevalence and Comparison of Diagnostic Methods for Trichomonas vaginalis Infection in Pregnant Women in Argentina

  • Perazzi, Beatriz E.;Menghi, Claudia I.;Coppolillo, Enrique F.;Gatta, Claudia;Eliseth, Martha Cora;De Torres, Ramon A.;Vay, Carlos A.;Famiglietti, Angela M. R.
    • Parasites, Hosts and Diseases
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    • v.48 no.1
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    • pp.61-65
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    • 2010
  • The objectives of this study were to conduct a prevalence survey of trichomoniasis in pregnant women and to evaluate the utility of different methods for its diagnosis. A total of 597 vaginal exudates from pregnant women who were examined at the Hospital de Clinicas in Buenos Aires, Argentina from 1 August 2005 to 31 January 2007, were prospectively and consecutively evaluated. The investigation of Trichomonas vaginalis was made by different microscopic examinations, and culture on liquid medium. The sensitivity and specificity of the microscopic examinations were assessed considering culture on liquid medium as the "gold standard". The prevalence of T. vaginalis obtained by culture on liquid medium was 4.0% (24/597). The prevalence of T. vaginalis obtained by direct wet smear, prolonged May-Grunwald Giemsa staining, and sodium acetate-formalin (SAF)/methylene blue staining-fixing technique was 1.8%, 2.3% and 2.5%, respectively. The sensitivity of the direct wet smear was 45.8%, that of the prolonged May-Grunwald Giemsa staining was 58.3%, and that of the SAF/methylene blue method was 62.5%. Considering the 3 microscopic examinations altogether, the sensitivity rose to 66.7% and the specificity was 100% for all of them. This is the first time that the prevalence data of T. vaginalis by culture in pregnant women are published in Argentina. Due to the low sensitivity obtained by microscopy in asymptomatic pregnant women, the use of the liquid medium is recommended during pregnancy, in order to provide an early diagnosis and treatment.

The latest trend of research and clinical usage about Bojungikki-Tang in Japan -searching medical science articles published from 2003 to 2008- (일본에서 보중익기탕(補中益氣湯)에 대한 최신 연구와 임상 응용 동향 -2003년에서 2008년까지 학술논문 분석-)

  • Park, Ju-Yeon;Yi, Hyo-Seung;Park, Sun-Dong
    • Herbal Formula Science
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    • v.16 no.2
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    • pp.11-29
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    • 2008
  • Objective : The aim of this study was to analyse the latest trend of medical science articles about Bojungikki-Tang published in Japan. Methods : We searched medical science articles published from 2003 to 2008 in Japan on the web site, CiNii and then these articles were reviewed and classified according to experimental subject and method. Results : Fifty-two articles, related to Bojungikki-Tang were searched and these were classified into three classes, pharmacological signaling studies, clinical case studies and the others. As a result of classification, clinical case studies were most abundant by 38 cases, pharmacological signaling studies were 10 and the others were 4. This result suggested that the study of Bojungikki-Tang was mainly focused on clinical study rather than experimental study. Among the clinical case studies, clinical studies related to immune disease took the most greatest number and number of other clinical studies were evenly distributed over the various disease. Immune intensification effect of Bojungikki-Tang can be thought continuous with reinforce the middle Jiao Qi in company with improvement effect on growth hormone failure and male infertility. A fact that the one prescription, Bojungikki-Tang could be used to treat various diseases reflects a viewpoint of Oriental medicine that is based on the respect for and understanding of individual constitution and disposition while paying attention to the gender difference and individuality. The clinical usefulness of Bojungikki-Tang on obstructive sleep apnea syndrome and visceroptosis concerns with ascend Yang and treat Qi sinking. Pharmacological signaling studies were mainly focused on diseases that were treated Bojungikki-Tang in clinic, however, there was one study that experimented on changes of numerous gene expression according to the treatment of Bojungikki-Tang using DNA array. Conclusion : The therapeutic system of Oriental medicine is different in various aspects form that of Western medicine and appropriate harmonization of east and west is expected to improve the quality of medical care. In this regard, continuous investigation and analysis about herbal medical science papers in Japan can also be useful to make progress in Korean traditional medicine.

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A contact investigation after exposure to a child with disseminated tuberculosis mimicking inflammatory bowel disease

  • Kim, Dongsub;Lee, Sodam;Kang, Sang-Hee;Park, Mi-Sun;Yoo, So-Young;Jeon, Tae Yeon;Choi, JoonSik;Kim, Bora;Choi, Jong Rim;Cho, Sun Young;Chung, Doo Ryeon;Choe, Yon Ho;Kim, Yae-Jean
    • Clinical and Experimental Pediatrics
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    • v.61 no.11
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    • pp.366-370
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    • 2018
  • Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-$Gu{\acute{e}}rin$ vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.

A Tuberculosis Contact Investigation on Health Care Workers in One Hospital (일개 병원 내 의료종사자에서의 결핵 접촉자 조사)

  • Kim, Tae Hee;Jang, Yoon Suk;Jung, Sun Ju;Kim, Yeon Jae;Pai, Hyun Joo;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • v.23 no.2
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    • pp.94-101
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    • 2016
  • Purpose: This study aimed to describe the results of a contact investigation on health care workers after exposure to a house officer with smear-positive pulmonary tuberculosis (TB). Methods: Eighty nine out of 101 subjects who had close contact with the index patient agreed to be enrolled in the investigation. The first contact investigation was conducted approximately 30 days after the index patient's onset of symptoms, followed by the second investigation after 10 weeks. In both, clinical manifestations were studied, and chest X-ray and tuberculin skin test (TST)/QuantiFERON-TB Gold (QFT-G) in dual screening strategy were conducted. Results: The first TST resulted in positive in 34 subjects (38.2%). QFT-G was conducted on 16 subjects who tested positive in the first TST and aged under 36. Six of them (37.5%) were positive. The second TST was conducted on 41 subjects with negative results in the first TST. Seventeen (41.5%) were positive and among them, three (17.6%) showed positive QFT-G. None of the subjects were diagnosed with active TB. The probability of TB infection through contact with the index patient was 7.3% (3/41) in dual screening strategy while it was 41.5% (17/41) in TST strategy. Conclusions: This first hospital-setting contact investigation for tuberculosis in Korea revealed that latent tuberculosis infection (LTBI) rates vary depending on different diagnostic strategies. This indicates the need for systematic guidelines for diagnosing LTBI in health care workers who have professional exposure to TB.

Pathogenesis of Hantaan Virus Infection in Suckling Mice -Clinical, Virologic and Serologic Observations-

  • Kim, Gum-Ryong;Mckee, Jr, Kelly T.;Lee, Ho-Wang
    • The Journal of the Korean Society for Microbiology
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    • v.20 no.1
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    • pp.115-125
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    • 1985
  • Hemorrhagic fever with renal syndrome (HFRS) is a debilitating disease of humans caused by Hantaan virus (HV), the prototype member of a newly proposed genus of Bunyaviridae. Studies of HV pathogenesis have been limited by the absence of a well defined model for a virus-induced disease state. In an attempt to devise a model for HV pathogenesis in laboratory rodents, newborn outbred suckling ICR mice were shown to be uniformly susceptible to lethal infection with non- mouse adapted HV by intracerebral (IC), intraperitoneal (IP), intramuscular (IM), and subcutaneous (SC) inoculation routes. Clinical coures, mean time to death, and fatal outcome were age-dependent. With an inoculum of 10 $LD_{50}$, mortality was 100% in mice infected within 72h of birth, but declined to 50% by 7 days. By 2-2.5 weeks, animals developed complete resistance to clinical disease. Virus was consistently detected in serum by day 6 post-infection in IC- and IP- inoculated animals, and reached peak levels of $10^5\;PFU/ml$ by day 8 Mice infected IM and SC showed delays in onset of viremia, but achieved similar titers. Immunofluorescent antibody appeared by 17-18 days, and neutralizing antibody by 15 days, in all experimental groups. Two of 8 inbred mouse strains were identified as resistant to clinical disease : SJL/J and A/J. Manipulation of this model will allow investigation of natural rodent pathogenesis with HV, as well as offer insight into disease mechanisms and therapy of HFRS.

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An overview of acupuncture for cancer related pain (암성통증에 대한 침치료의 고찰)

  • Kim, June-Lae;Yoo, Hwa-Seung;Lee, Nam-Heon;Yoon, Dam-Hee;Cho, Jung-Hyo;Lee, Yeon-Weol;Son, Chang-Gue;Cho, Chong-Kwan
    • Journal of Haehwa Medicine
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    • v.15 no.1
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    • pp.41-45
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    • 2006
  • Aims: This overview summarizes the existing evidence on acupuncture for cancer-related pain. Methods: Literature searches were conducted in 7 databases. All clinical studies of acupuncture, electroacupuncture, ear acupuncture and transcutaneous electrical nerve stimulation (TENS) in cancer patients with the main outcome measure of pain were included. Results: Of the 8 studies included, one high quality randomized clinical trial (RCT) of ear acupuncture showed statistically significant pain relief in comparison with placebo ear acupuncture. All the other studies were either non-blinded (n = 2) or uncontrolled clinical trials (n = 5). Most investigations suffered from methodological flaws such as inadequate study design, poor reporting of results, small sample size and overestimation of the results. Conclusions: The current evidence does not support the use of acupuncture as an adjunctive analgesic method for cancer patients. Only one high quality RCT showed promising results thus warranting further investigation into this under-researched area.

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An Investigation of Retirement Expectation among Medical Technologists in Korea (한국 임상병리사들의 은퇴 기대 조사)

  • Jo, Yoon-kyung;Lee, Duck-Hye;Sung, Hyun-Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.171-179
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    • 2017
  • This study investigated the influence factors of retirement expectations among medical technologists at medical centers in Seoul and Gyeonggi area, Korea. Subjects were 158 medical technologists. Using a sampling survey method, data was analyzed between July 2015 and December 2016. There was a negative correlation between educational level and economic preparation, but gender and monthly income did not reach retirement expectation level. Conversely, we found no change in the trends with respect to gender, monthly income; nonetheless, we observed that frustration gradually increased with age and working duration. In conclusion, our findings show that there are four factors that significantly influence retirement expectation and preparation: age, level of education, working duration, and family condition. This study contributes to understanding retirement expectations and can be a reference for retirement preparation in medical technologists.