• Title/Summary/Keyword: Clinical sign

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Relationship among Essentials of Fundamental Nursing Skills Performance, Stress from Work and Work Capability of New Clinical Nurses (신규간호사의 핵심기본간호술 수행과 업무스트레스 및 업무수행능력과의 관계)

  • Bang, Soon Sik;Kim, Il-Ok
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.4
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    • pp.628-638
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    • 2014
  • Purpose: This study identifies the relation among the essentials of fundamental nursing skills performance (EFNSP), work capability and stress from work experienced by new clinical nurses. Method: This is a cross-sectional descriptive study with a self-reported questionnaire. The subjects were 224 new clinical nurses employed by general hospitals having more than 400 beds. The data, collected from February 10 to March 7, 2014, were analyzed using descriptive statistics, t-tests, ANCOVA, Pearson's correlation analysis and hierarchical linear regression. Results: The highest frequency of EFNSP of new clinical nurses was vital sign measurement (4.74, ${\pm}.89$) and the lowest frequency of performance was Basic CPR & defibrillator application (1.81, ${\pm}.94$). There were significant positive correlations between frequency and confidence of EFNSP (r=.64, p<.001), frequency and work capability (r=.34, p<.001), and confidence of EFNSP and work capability (r=.48, p<.001), but negative correlation stress from work and work capability (r=-.17, p=.009). General characteristics, stress from work, frequency and confidence in EFNSP and stress from work explain 25.1% of work capability. Conclusion: This result suggests the importance of EFNSP education in nursing schools and availability of opportunities to practice EFNSP during the post-graduation waiting period until assignment to a hospital.

Classification of Sa-sang typology based on index signs for Tae-Geuk acupuncture: a narrative review (태극침지표에 따른 사상체질감별에 대한 객관적 방법연구)

  • Kim, Jae-kyu
    • The Journal of Korean Medicine
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    • v.40 no.2
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    • pp.89-93
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    • 2019
  • Objectives: There are substantial variations on the methods of identifying Sa-sang typology in clinical practice. This review aimed to describe the clinical experiences on the classification of Sa-sang typology based on index signs for practice of Tae-Geuk acupuncture. Methods: Core physical signs and interpretation of treatment response for the classification of Sa-sang typology are suggested based on 42-year clinical experiences of the expert (the first author). Results: Epigastric tenderness and hepatic dullness sound are the most important physical sign in the classification of Sa-sang typology. Clinical experiences indicate that there may be a positive association between the presence of epigastric tenderness and hepatic dullness sound. Four sets of acupuncture points are matched for four types of Sa-sang institution, respectively. Appropriate match will resolve epigastric tenderness and hepatic dullness sound, while this will not happen if inappropriate match is employed. Conclusion: I suggest that two physical signs (i.e., epigastric tenderness and hepatic dullness sound) are essential for the classification of Sa-sang typology in Tae-Geuk acupuncture.

Detection of Macro-Aspartate Aminotransferase (AST) in an Asymptomatic Patient with Persistent Elevation of AST (지속적으로 AST가 증가된 무증상 환자에서 Macro-AST의 검출)

  • Yang, Eun Ju;Lim, Sung Soo;Shin, Kyeong Seob
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.188-192
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    • 2021
  • The persistent increase of aspartate aminotransferase (AST) due to the presence of a macro-AST can confuse diagnostic or therapeutic decisions in many clinical situations. In this study, we report a case of isolated and persistent AST-elevation without any clinical sign of dysfunction in organs such as the liver, skeletal muscle, cardiac muscle, etc. Despite various investigations, no definite cause for the elevation of AST could be found. With the help of polyethylene glycol (PEG) precipitation, we showed that macro-AST formation was responsible for the elevation of the AST titer in this case. Early recognition of macro-AST by PEG precipitation can prevent diagnostic confusion and unnecessary and even invasive tests.

Surgery versus Conservative Treatment for Spontaneous Supratentorial Intracerebral Hemorrhage in Spot Sign Positive Patients

  • Kim, Hui-Tae;Lee, Jong-Myong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.309-315
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    • 2015
  • Objective : An advantage of surgical treatment over conservative treatment of spontaneous intracerebral hemorrhage (ICH) is controversial. Recent reports suggest that contrast extravasations on CT angiography (CTA) might serve as a crucial predictor of hematoma expansion and mortality. The purpose of this study was aimed at investigating the efficacy of surgical treatment in patients with spot sign positive ICH. Methods : We used our institutional medical data search system to identify all adult patients who admitted for treatment of ICH between January 1, 2007 and January 31, 2012. Patients were classified two groups into a surgical group (n=27) and a conservative treatment group (n=28). Admission criteria were the following: age 20-79 years, spontaneous supratentorial ICH, Glasgow Coma Score Ranging from 9 to 14, ICH volume ${\geq}20mL$, and treatment within 24 hours. Results : Fifty-five patients were analyzed. There was no significant difference in the ICU stay between the conservative treatment group ($7.36{\pm}3.66days$) and the surgical treatment group ($6.93{\pm}2.20days$; p=0.950). There was a significant difference in the in-hospital stay between the conservative treatment group ($13.93{\pm}8.87days$) and the surgical treatment group ($20.33{\pm}6.37days$; p=0.001). Overall mortality at day 90 after ICH was 36.4%; this included 16 of 28 patients (57.1%) in the conservative group and 4 of 27 patients (14.8%) in the surgical group. In univariate analysis, there was a positive effect of the surgical treatment in reducing mortality at 90 days (p=0.002), Glasgow Outcome Scale (GOS) at 90-day (p=0.006), and modified Rankin Scale (mRS) at 90-day (p=0.023). In multivariate logistic analysis, there was a significant difference in mortality (odds ratio, 0.211; 95% confidence interval, 0.049-0.906; p=0.036) between the groups at 90-day follow-up. However, there was no significant difference in GOS (odds ratio, 0.371; 95% confidence interval, 0.031-4.446; p=0.434) and mRS (odds ratio, 1.041; 95% confidence interval, 0.086-12.637; p=0.975) between the groups at 90-day follow-up. Conclusion : In this study of surgical treatment of supratentorial ICH in patients with spot sign positive in CTA was associated with less mortality despite of long duration of in-hospital stay. We failed to show that clinical outcome benefit of surgical treatment compared with conservative treatment in patients with spot sign positive ICH.

Transvaginal Ultrasonographic Analysis of Endometrial Pattern and Thickness Changes in Normal Menstrual Cycle (정상 월경주기를 가진 불임환자에서 질식초음파검사를 이용한 자궁내막 형태 및 두께의 변화 양상에 관한 연구)

  • Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Moon, Shin-Yong;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.2
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    • pp.153-160
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    • 1998
  • The objective of this retrospective study was to evaluate whether the transvaginal ultrasonographic analysis of endometrial pattern and thickness could predict the stage of menstrual cycle. Endometrial pattern and thickness were observed in those patients receiving infertility work up from April, 1994 to July, 1998 at Seoul National University Hospital. The study group was 185 patients with normal regular menstrual cycles. Among them, 44 patients received endometrial biopsy, and the date of endometrium was compared with the observed endometrial pattern and thickness. The observed endometrial pattern was presence or absence of central cavity echogenicity, triple line sign, endometrial hypoechogenicity, ring sign, endometrial hyperechogenicity and posterior acoustic sonic enhancement. The results were as follows; Central cavity echogenicity was seen throughout menstrual cycle. Triple line sign was observed in 81.1% of patients during early secretory phase. However, in mid to late secretory phase, triple line sign was appeared in only 6.8%. The percentage of positive endometrial hypoechogenicity was highest in early secretory phase. In contrast to hypoechogenicity, positive endometrial hyperechogenicty was highest in mid to late secretory phase. Ring sign was observed in 73.5% of the patients during early secretory phase with peak incidence. Posterior acoustic enhancement was seen in 72.7% of the patients during late secretory phase. The sensitivity and specificity of being a secretory phase if the patients showed hyperechogenic endometrium, were 84.2%, 83.3% respectively. The sensitivity and specificity of being a secretory phase if the patients showed posterior acoustic enhancement were 93.8%, 58.3% respectively. Endometrial thickness was not correlated with endometrial dating. In conclusion, transvaginal ultrasonographical delineation of the endometrial pattern might be useful tool in predicting endometrial status during normal menstrual cycle. But, endometrial thickness could not predict the endometrial dating.

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A Study on the Performance Activities in Emergency Medical Technology Students Field Training (응급구조과 학생의 현장실습 수행활동 조사 연구)

  • Koh, Bong Yeun;Kwak, Min Chul;Sin, Hyun Nam
    • The Korean Journal of Emergency Medical Services
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    • v.3 no.1
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    • pp.55-64
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    • 1999
  • This study was conducted to acquire the basic materials for effective field training to identify performance activities of emergency medical technology students. The method used in the study was a descriptive survey using a skill checklist. The subjects for the study were 43 emergency medical technology students who were 2nd grade in D college. The collected data were analyzed using the SPSS computer program, yielding frequencies and percentage. The results of study were as follows; 1. In 'emergency treatment skill', 26.6% of subjects are revealed as 'performed' in 'ambulance practice' and 22.1% of subjects are revealed as 'performed' in 'clinical practice'. 2. In 'airway management', 41.9% of subjects are revealed as 'performed' in 'ambulance practice' and 14.1% of subjects are revealed as 'performed' in 'clinical practice'. 3. In 'oxygen therapy', 52.8% of subjects are revealed as 'performed' in 'ambulance practice' and 35.6% of subjects are revealed as 'performed' in 'clinical practice'. 4. In 'ventilation skill', 17.8% of subjects are revealed as 'performed' in 'ambulance practice' and 10.7% of subjects are revealed as 'performed' in 'clinical practice'. 5. In 'vital sign check', 61.1% of subjects are revealed as 'performed' in 'ambulance practice' and 56.3% of subjects are revealed as 'performed' in 'clinical practice'. 6. In 'patient assessment', 40.7% of subjects are revealed as 'performed' in 'ambulance practice' and 20.0% of subjects are revealed as 'performed' in 'clinical practice'. 7. In 'basic life support(CPR)', 1.7% of subjects are revealed as 'performed' in 'ambulance practice' and 11.9% of subjects are revealed as 'performed' in 'clinical practice'. 8. In 'airway obstruction', 6.4% of subjects are revealed as 'performed' in 'ambulance practice' and 1.1% of subjects are revealed as 'performed' in 'clinical practice'. 9. In 'electrical therapy', 0.7% of subjects are revealed as 'performed' in 'ambulance practice' and 20.0% of subjects are revealed as 'performed' in 'clinical practice'.

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A Case of Vancomycin-Resistant Enterococci Infection Treated with Korean Medicine (반코마이신 내성 장구균 감염 환자에 대한 한의치험 1례)

  • Dabin Lee;Siyun Sung;Sunghee Hong;Ye-chae Hwang;Gyeongmuk Kim;Han-Gyul Lee;Sang-Kwan Moon;Woo-Sang Jung;Seungwon Kwon
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.167-175
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    • 2024
  • Hospital-acquired bacterial infections, including vancomycin-resistant enterococci (VRE) infection (MIC: 32 mcg/ml), are common. We describe the case of a 63-year-old female patient with subarachnoid hemorrhage and VRE infection treated with Jashin-bowon-tang and Samhuang-sashim-tang for 57 days and 22 days, respectively. The therapeutic effect was assessed weekly via culture, color and viscosity of pus from a coccyx sore, and C-reactive protein (CRP). Vital signs were checked four times a day. Seventeen days after treatment, VRE was not colonized in patient and color and viscosity of pus, CRP and vital sign were improved. This case report suggests that Jashin-bowon-tang and Samhuang-sashim-tang might be an alternative option for VRE infection patients reducing the need for extended isolation periods and speeding up recovery times.

Incidental double duct sign: Should we be worried? Results from a long-term follow-up study

  • Lu Yao;Hoda Amar;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.53-58
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    • 2024
  • Backgrounds/Aims: Double duct sign (DDS) (dilated common bile and pancreatic duct) is synonymous with pancreatic head/peri-ampullary tumor (PHPAT). There is limited evidence on whether incidental DDS (I-DDS) is associated with an increased risk of malignancy. This study aimed to evaluate 5-year outcomes of I-DDS. Methods: Patients were categorized according to their risk of malignancy. 'Low-risk' patients, including those with I-DDS between 2010 and 2015, were analyzed in this study. The primary outcome was incidence of PHPAT within five years of identification of DDS. Histology results from endoscopic ultrasound-guided biopsy were considered diagnostic. Secondary outcomes were incidence of benign causes, extent of follow-up investigations, and clinical indicators of malignancy in patients with DDS. Results: Among 103 patients with DDS, 20 had I-DDS. Subsequent follow-up of these 20 patients found no patient with PHPAT, two (10%) patients with chronic pancreatitis, and 18 (90%) patients with no cause found. The median follow-up duration for 'low-risk' patients was 7.3 years (range, 6-11 years). The mean number of follow-up investigations per patient was two (range, 0-9). Investigations included computed tomography (n = 27), magnetic resonance cholangiopancreatography (n = 23), endoscopy (n = 16), and ultrasound (n = 14). Patients with jaundice were more likely to have malignancy (p < 0.01). Those with abdominal pain were more likely to have a benign cause (p < 0.01). Hyperbilirubinemia and/or deranged liver enzymes and raised CA19-9 were more likely to be associated with PHPAT (p < 0.01). Conclusions: Patients with I-DDS have a low risk of developing PHPAT within five years.

Congenital Dermatofibrosarcoma Protuberans: A Case Report (선천성 융기성 피부섬유육종: 증례보고)

  • Yun, Byung-Min
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.285-288
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    • 2010
  • Purpose: Dermatofibrosarcoma protuberans is a rare tumor, accounting for 0.1% of all malignant tumors. Although metastasis is very uncommon, local recurrence occur frequently. Dermatofibrosarcoma protuberans occurring in children is even more rare; this is the first case report of congenital dermatofibrosarcoma protuberans in Korea. Methods: The patient is a 14-month-old male infant with a lesion that was first thought to be a birthmark. The lesion grew larger, and a punch biopsy revealed dermatofibrosarcoma protuberans. A wide local excision was performed with a 2 cm peripheral resection margin beyond the gross tumor lesion. Deep fascia and a portion of muscle underneath the central part of the lesion were also taken. The surgical defect was covered by a split-thickness skin graft. Results: There has been no clinical sign of recurrence over one year after the surgery. Conclusion: A patient with congenital dermatofibrosarcoma protuberans detected at an early stage underwent a wide local excision of the tumor after accurate diagnosis was carried out by biopsy and immunohistochemical studies. There was no clinical evidence of tumor recurrence during over a 1-year follow-up.

Intrahepatic portosystemic shunt with a second degree atrioventricular block fixed by transvenous coil embolization in a dog

  • Lee, Seung-Gon;Nam, So-Jeong;Kim, Hyun-Wook;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.48 no.4
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    • pp.493-500
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    • 2008
  • A 2-year-old female Pekingese dog was presented with primary complaints including exercise intolerance and neurological sign associated with hepatic encephalopathy. The major findings in clinical examination included an intermittent seizure, a slow heart rate with pulse deficit, leukocytosis and anemia in hemogram, elevated pre- and post-prandial serum bile acid and hepatic enzymes, hypoproteinemia, coagulopathy, ammonium urate crystaluria and bilirubinuria. Diagnostic tests revealed an intrahepatic portosystemic shunt complicated with a second degree atrioventricular block and QT prolongation. The case was successfully treated with a transvenous coil embolization. Clinical signs were gradually improved and cardiac bradyarrhythmia disappeared. This case is a rare case of intrahepatic portosystemic shunts complicated with a cardiac bradyarrhythmia in a small breed dog fixed by a transvenous coil embolization.