• Title/Summary/Keyword: Fever management

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A Case of Massive Pulmonary Gangrene Complicated by Klebsiella Pneumonia (클렙시엘라 폐렴의 합병증으로 발생한 광범위 폐괴저)

  • Ha, Jun-Wook;Eom, Kwang-Seok;Jang, Seung Hun;Bahn, Joon-Woo;Kim, Dong-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.381-385
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    • 2004
  • Pulmonary gangrene is a rare and severe complication of bacterial pneumonia, where a pulmonary segment or lobe is sloughed due to parenchymal devitalization of the parenchyma, with secondary anaerobic infection and necrosis caused by pulmonary vascular thrombosis. Prior to the antibiotic era, massive pulmonary gangrene was potentially fatal. Herein, a case of pulmonary gangrene in a 67-year-old man is reported. He complained of fever, chills, dyspnea and purulent sputum of 5 days duration. The plain chest radiograph showed well-marginated right upper lobe consolidation, with bulging minor fissure, suggestive of a Klebsiella infection. A contrast CT scan demonstrated consolidation of the right upper lobe, with a central necrotizing portion. Klebsiella species was confirmed from both sputum and blood cultures. After appropriate antibiotics, the chest X-ray and CT scan 3 weeks later showed a large cavity with an air-fluid level, sloughing-off and extrusion of necrotic lung tissue, suggestive of pulmonary gangrene. Seven months later, the right gangrenous lung showed severe volume loss on a chest radiograph. The management of pulmonary gangrene has been somewhat controversial. Herein, it was managed without surgical drainage or resection. If the antibiotic therapy had failed, then a surgical approach would have been considered.

A Study on the Guardian's Experience about Tepid Massage of Children Who were Admitted to a Pediatric Emergency Room (소아응급실을 내원한 환아 보호자의 미온수 마사지 경험실태)

  • Kang, Hae-Sook;Yun, O-Bok
    • Perspectives in Nursing Science
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    • v.7 no.1
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    • pp.65-74
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    • 2010
  • Purpose: The purpose of this study was to investigate the guardian's experience about tepid massage of children who visited Pediatric Emergency Room (PER). Methods: Data for this study was collected from August 1 to September 30, 2009 using questionnaires of 300 guardians who visited a PER. All data analyses were done using the SPSS 17.0 program and statistical data on frequency and percentage were obtained. $x^2$ test was done as well. Results: The results of this study were as follows: 73.7% of the guardians were doing the tepid massage, and 40% of them were doing the tepid massage when guardians thought that their children had a fever. 8.6% of them were incorrectly doing the tepid massage on their children such as using ice or alcohol. 90.5% of the children's condition changed when they had the tepid massage applied. Only 48% of the guardians got information about tepid massage, and 52.8% of the guardians got this information from the medical team. There were significant differences according to the education background about tepid massage (p<.001) and past hospital admissions history. There were differences according to whether their child had experience with febrile seizure(p=.085) and having more than one child at home (p=.085). Conclusion: This study revealed that the guardians were incorrectly doing the tepid massage on their children. The results of this study suggest that it is necessary to develop certain emergency nursing processes on accurate information and management strategies about tepid massage, and further studies on the effects of this kind education intervention are necessary.

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A Study on Factors Determining the Level of Smartwork : Focusing on the Role of Middle Level Manager (스마트워크 수준 결정요인에 관한 연구 : 중간관리자 역할을 중심으로)

  • Cho, Young-Ku;Hyun, Keum-Yi;Lee, Han-Chul;Park, Seong-Taek
    • Journal of Digital Convergence
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    • v.10 no.8
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    • pp.63-71
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    • 2012
  • Smart is becoming a social fever since Apple had invented iPhone. It looks old fashioned, if the word Smart is missed in TV, phone even white electronic goods. Korean's major firms made a slogan Smart Work as an important business strategy and tried to implement some activities. These Smart trends influenced the way people's working and organization. In this research, we explore the key factors related to smart work and empirically test the significance of antecedent variables such as Dynamics, Collaborativeness, Connectivity in determining the smartwork level. The statistical result, based upon survey responses, shows that organizational dynamics, organizational collaborativeness and process collaborativeness are the most salient factors for smarkwork level. As a conclusion, the academic and practical implications of these findings are also discussed.

Investigation of Ingredients and Hazardous Substances in Disinfectants Used against COVID-19 and Some Livestock Diseases (코로나바이러스감염증-19와 일부 가축전염병 방역소독제품의 함유성분 및 유해물질 조사)

  • Kim, DongHyun;Lim, Miyoung;Lee, Kiyoung
    • Journal of Environmental Health Sciences
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    • v.46 no.4
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    • pp.470-479
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    • 2020
  • Objectives: The Coronavirus Disease 2019 (COVID-19) pandemic has caused the death of 740,000 people around the world as of August 12, 2020. Foot-and-Mouth Disease, Avian Influenza, and African Swine Fever are serious livestock diseases. Government agencies in Korea have provided ingredient information and usage instructions for disinfectants used to counter those infectious diseases. The purpose of this study was to provide information on the chemical ingredients in disinfectant products used against COVID-19 and certain livestock diseases. Methods: We collected information from the Korean government. The Central Disaster Management Headquarters and Central Disease Control Headquarters provided information on disinfectant products used against COVID-19. The Animal and Plant Quarantine Agency of Korea provided information on efficacy-certified disinfectant products for use against selected livestock diseases. Health hazard and environmental hazard information on the ingredients in the disinfectants was collected from the Korea Occupational Safety & Health Agency's Material Safety Data Sheets, and toxicity value information was collected from United States Environmental Protection Agency's CompTox Chemicals Dashboard. Results: There were 76 COVID-19 disinfectant products in use, and the most common ingredients were benzalkonium chloride (51%), alkylbenzyl dimethyl ammonium (30%), and ethanol (3%). There were 216 livestock disease disinfectant products comprised of 89 acidic, 88 oxidic, 30 aldehydic, three alkaline, and six other products. Among the 49 active ingredients used in the disinfectants that were investigated, health and environmental hazard information was provided for many of them, but only 20 chemicals had official toxicological information. Conclusion: Since the disinfectants included numerous chemicals, an understanding of their chemical characteristics could be critical to prevent unintended human or environmental exposure.

Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition (경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향)

  • Rha Mi yong;Kim Eun mi;Cho Young Y.;Seo Jeong Meen;Choi Hay mie
    • Korean Journal of Community Nutrition
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    • v.11 no.1
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

Giant Brain Abscess in a Neonate: Good Outcome with Single Transfontanelle Aspiration and Antibiotic Therapy

  • Ko, Jin-Hee;Choi, Yu-Mi;Shim, Kye-Shik;Bae, Chong-Woo;Chung, Sa-Jun;Bang, Jae-Seung;Yoon, Kyung-Lim
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.399-403
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    • 2011
  • Brain abscesses in neonates are extremely rare and usually occur in patients with certain risk factors. A 1-month-old boy presented at the hospital with fever and irritability. As a result of preterm delivery and low birth weight, he had a history of admission to the neonatal intensive care unit. Neuroimaging revealed a large, space-occupying lesion in both frontal lobes, which was suspected to be an abscess with the midline shifting to the right. With a single aspiration and abscess drainage along with concurrent prolonged parenteral antibiotic therapy, the patient showed an excellent treatment outcome with normal development. The focus will be placed on minimally invasive surgical management as well as positive outcomes.

National Level Response to Pandemic (H1N1) 2009 (정부의 신종인플루엔자 A(H1N1) 대응)

  • Lee, Dong-Han;Shin, Sang-Sook;Jun, Byung-Yool;Lee, Jong-Koo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.99-104
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    • 2010
  • The World Health Organization (WHO) announced the emergence of a novel influenza on April 24, 2009, and they declared pandemic on June 11. In Korea, the proportion of influenza-like illness and the consumption of antiviral agents peaked in early November. The government established the Central Headquarters for Influenza Control and operated the emergency response system. In the quarantine stations, we checked the body temperature and collected quarantine questionnaires from all the arrivals from infected countries. We also isolated the confirmed cases in the national isolation hospitals. However, as the community outbreaks were reported, we changed strategy from containment to mitigation. We changed the antiviral agent prescription guideline so that doctors could prescribe antiviral agents to all patients with acute febrile respiratory illness, without a laboratory diagnosis. Also the 470 designated hospitals were activated to enhance the efficacy of treatment. We vaccinated about 12 million people and manage the adverse event following the immunization management system. In 2010, we will establish additional national isolation wards and support hospitals to establish fever clinics and isolation intensive care unit (ICU) beds. We will also make a computer program for managing the national isolation hospitals and designated hospitals. We will establish isolation rooms and expand the laboratory in quarantine stations and we will construct a bio-safety level 3 laboratory in each province. In addition, we plan to construct a bio-safety level 4 laboratory at a new Korea Centers for Disease Control and Prevention (KCDC) facilities in Ossong.

Clinical Analysis about Complications of Stroke Treated Intensively in the Intensive Care Unit (뇌졸중으로 중환자실에서 집중치료한 환자들의 합병증에 관한 임상적 고찰)

  • Kim, Dong-Woung;Han, Myoung-Ah
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.369-376
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    • 2000
  • Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.

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Temperature Detection and Monitoring System of Livestock Through Ear-Tag Based on IoT (IoT 기반의 이표를 통한 가축 온도 변화 감지 및 모니터링 시스템)

  • Park, Young-Soo;Park, Kyoung-Yong;Kim, Min-Sun;Park, Jun-Kyu;Kwon, Seong-Geun
    • Journal of Korea Multimedia Society
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    • v.20 no.3
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    • pp.474-481
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    • 2017
  • In Korea, foot-and-mouth disease has not been reported for several decades, but it began to develop again in 2000. For 2010~2011, when the worst occurred, 3.5 million animals were disposed of resulting in a loss of 2.8 trillion won. In order to prevent the harmful effects of foot-and-mouth disease, vaccination and housing management are being implemented. Despite these measures, foot-and-mouth disease is infected with air through the respiratory tract and accompanies fever after latency. Therefore, it is recognized that measuring and managing the body temperature of livestock at the early stage is the first step of managing this disease. In this paper, we propose a temperature monitoring system that can measure the body temperature by incorporating temperature sensor mounted in ear-tag of cattle and collect body temperature data of each individual cattle through BLE into the control server. The proposed body temperature monitoring system has various advantages such as easy installation without the help of livestock specialists and not damaging the organs of the livestock. So, it is possible to manage the abnormal symptom of cattle in real time and it is believed that the proposed monitoring system will revolutionize the prevention of foot-and-mouth disease.

Clinical characteristics of Kawasaki disease with sterile pyuria

  • Choi, Ja Yun;Park, Sun Young;Choi, Kwang Hae;Park, Yong Hoon;Lee, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.56 no.1
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    • pp.13-18
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    • 2013
  • Purpose: Kawasaki disease (KD) is a systemic vasculitis and affects many organ systems. It often presents sterile pyuria, microscopic hematuria, and proteinuria due to renal involvement. The aims of this study were to define clinical characteristics of acute KD patients with pyuria and to analyze meaning of pyuria in KD. Methods: The medical records and laboratory findings including serum and urine test of 133 patients with KD admitted to Yeungnam University Hospital from March 2006 to December 2010 were reviewed retrospectively. Results: Forty patients had sterile pyuria and their clinical characteristics including age, gender and body weight were not significantly different with those who did not have pyuria. Fever duration after treatment was significantly longer in KD patients with pyuria. Erythrocyte sedimentation rate, C-reactive protein and serum concentration of alanine aminotransferase were significantly higher in patients with pyuria. Hyponatremia and coronary artery lesion were seen more often in patients with pyuria but there was no significant difference. Also serum blood urea nitrogen was significantly higher in KD patients with pyuria. Urine ${\beta}_2$-microglobulin was elevated in both patients groups and showed no difference between two groups. Conclusion: We found more severe inflammatory reaction in KD patients with pyuria. We also found elevation of some useful parameters like ${\beta}_2$-microglobulin that indicate renal involvement of KD through the urine test. Careful management and follow up will need for KD patients with pyuria and it is necessary in the future to study the specific parameters for renal involvement of KD.