• Title/Summary/Keyword: Sign and Symptom

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Nurses' Perceptions Regarding Sign & Symptom Management in End of Life Care in Nursing Homes (노인요양시설 간호사의 임종 징후 관리에 대한 인식)

  • Lee, Se-Hyun;Chang, Sung-Ok;Kim, Mi-So
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.2
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    • pp.209-219
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    • 2010
  • Introduction: The phenomenon related to sign & symptom management for end of life of the patients is of interest to researchers in nursing society today. This study was conducted to clarify and to conceptualize the factors of sign & symptom management in end of life care though nurses' perceptions on this phenomena. Methods: The qualitative study method was used to explore the experienced nurses' perceptions related to sign & symptom management in end of life care. It included a field study carried out in South Korea using in-depth interviews with 30 experienced nurses from three nursing home facilities. Results: This study identified the following categories related to end of life care with sub-categories for each category: (1) nurses' modes in identifying the signs related to patients' end of life, (2) nurses' perceived directions on patients' end of life care, (3) nurses' perceived strategies in end of life care and (4) nurses' perceived barriers in end of life care Conclusion: Through this study, characteristics of the way nurses' provide for patients' end of life care are identified, along with how nursing decisions are made to manage the sign & symptom indicating patients' end of life.

Correlations of Deficiency and Excess Patterns between Menstrual Symptoms and Whole Body Symptoms (월경통(月經痛) 증후(證候)와 전신 증후(全身 證候)의 허실(虛實) 상호 관련성 연구)

  • Hwang, Jae-Ho;Jeong, Hui-Jin;Lee, Geon-Seok;Yun, Young-Jin
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.1
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    • pp.47-55
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    • 2012
  • Purpose: Dysmenorrhea mostly depends on the causative factor, which usually falls under the categories of Deficiency and Excess pattern in traditional Oriental medical theories and diagnosis. Thus, we investigated menstruation symptom and sign related to dysmenorrhea and verified the validity of Deficiency and Excess pattern identification. Methods: We investigated menstruation symptom and sign related to dysmenorrhea in total 14 gynecology-medical books including the book ${\ll}$Exemplar Of Korean Medicine (Dongui Bogam)${\gg}$ and whole body symptom and sign identifying Deficiency and Excess pattern at the same time. A survey based on this investigation was carried out targeting women of childbearing age. Results: Total of 14 gynecology-medical books have mostly narrated pre-menstrual and mid & post-menstrual pelvic pain depending on the time of its manifestation for identifying Deficiency and Excess pattern. Dysmenorrhea in pre-menstrual period belonged to Excess pattern and dysmenorrhea in mid & post-menstrual period belonged to Deficiency pattern. Among a total of 343 women, 196 subjects suffered from dysmenorrhea. The number of dysmenorrhea in pre-menstrual period (Excess pattern) was 116 people and in mid & post-menstrual period (Deficiency pattern) was 80 people. Deficiency and Excess pattern of dysmenorrhea in menstrual period significantly correlated to Deficiency and Excess pattern of whole body symptom and sign in the statistics(P-value < 0.05). Conclusion: The results suggest that pre-menstrual and mid & post-menstrual pelvic pain depending on the time of its manifestation is preferentially utilized as symptom and sign related to dysmenorrhea identifying Deficiency and Excess pattern.

Correlations of Cold and Heat Pattern between Menstrual Symptoms and Whole Body Symptoms (월경통(月經痛) 증후(證候)와 전신(全身) 증후(證候)의 한열(寒熱) 상호 관련성 연구)

  • Hwang, Jae-Ho;Yun, Young-Jin
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.4
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    • pp.27-37
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    • 2012
  • Purpose: Dysmenorrhea is mostly depending on the causative factor, which usually falls under the categories of Cold and Heat pattern in traditional Oriental medical theories and diagnosis. Thus, we investigated menstruation symptom and sign related to dysmenorrhea and verified the validity of Cold and Heat pattern identification. Methods: We investigated menstruation symptom and sign related to dysmenorrhea in total 14 gynecology-medical books including ${\ll}$Exemplar Of Korean Medicine (Dongui Bogam)${\gg}$ and whole body symptom and sign identifying Cold and Heat pattern at the same time. A survey based on this investigation was carried out targeting women of childbearing age. Results: According to 14 gynecology-medical books, polymenorrhea is relevant to Heat pattern, oligomenorrhea to Cold pattern and darkness of menstrual blood is relevant to Heat pattern. Among the total of 343 womens, 196 subjects suffered from dysmenorrhea. The number of dysmenorrhea with polymenorrhea(Heat pattern) was 6 person, with oligomenorrhea(Cold pattern) was 27 person. And the number of dysmenorrhea with darkness of menstrual blood(Heat pattern) was 39 person. As the result of checking correlations of menstrual symptom scores and whole body symptom scores, there was no significance of Cold and Heat pattern between menstrual symptoms and whole body symptoms. Conclusions: The results suggest that the period of menstrual cycle and the color of menstrual blood provides some informations of Cold and Heat pattern identification. But considering with other whole body symptom and sign is needed for more precise result.

Which Emphasizing Factors Are Most Predictive of Hematoma Expansion in Spot Sign Positive Intracerebral Hemorrhage?

  • Kim, So Hyun;Jung, Hyun Ho;Whang, Kum;Kim, Jong Yun;Pyen, Jin Su;Oh, Ji Woong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.86-90
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    • 2014
  • Objective : The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. Methods : We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. Results : Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were $2.42{\pm}1.24$ hours and $3.69{\pm}2.57$ hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were $192.12{\pm}45.97$ and $151.10{\pm}25.14$ for expansion and no expansion, respectively (p=0.001). Conclusions : The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.

A Study on the Concept of 'Physical symptom(形證)' in Dong-uibogam - Focused on Physical symptom & Medication of Six Meridians in the Han(寒) Chapter - (『동의보감(東醫寶鑑)』의 '형증(形證)' 개념(槪念)에 대한 고찰 - ≪한(寒)≫ <육경형증용약(六經形證用藥)>을 중심으로 -)

  • Shin, Sang-Won;Jeong, Chang-Hyun;Baik, You-Sang;Jang, Woo-Chang
    • Journal of Korean Medical classics
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    • v.27 no.4
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    • pp.101-119
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    • 2014
  • Objectives : In Dong-uibogam, Heo Jun used the concept of 'Physical symptom(形證)' that had not used frequently in practical description of pathological condition. Especially, He used the terminology, 'Physical symptom(形證)' as a title in the Han(寒) Chapter that described Sanghan(傷寒). Methods : It has been done to analyse verses that include the concept of 'Physical symptom(形證)' in Dong-uibogam. And, to find the context including the terminology diachronically. Results : Diachronically, 'physical symptom' and 'pulse sign' had been considered as bilateral factors of disease, and Heo jun cognized the concept of 'Physical symptom' in these means in Dong-uibogam. Conclusions : Introducing the concept of 'Physical symptom' is an important decision of Heo Jun, it can express the purpose of an observation to objective symptoms.

Discriminant Model V for Syndrome Differentiation Diagnosis based on Sex in Stroke Patients (성별을 고려한 중풍 변증진단 판별모형개발(V))

  • Kang, Byoung-Kab;Lee, Jung-Sup;Ko, Mi-Mi;Kwon, Se-Hyug;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.1
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    • pp.138-143
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    • 2011
  • In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. As a part of researches for standardization and objectification of differentiation of syndromes for stroke, in this present study, we tried to develop the statistical diagnostic tool discriminating the 4 subtypes of syndrome differentiation using the essential indices considering the sex. Discriminant analysis was carried out using clinical data collected from 1,448 stroke patients who was identically diagnosed for the syndrome differentiation subtypes diagnosed by two clinical experts with more than 3 year experiences. Empirical discriminant model(V) for different sex was constructed using 61 significant symptoms and sign indices selected by stepwise selection. We comparison. We make comparison a between discriminant model(V) and discriminant model(IV) using 33 significant symptoms and sign indices selected by stepwise selection. Development of statistical diagnostic tool discriminating 4 subtypes by sex : The discriminant model with the 24 significant indices in women and the 19 significant indices in men was developed for discriminating the 4 subtypes of syndrome differentiation including phlegm-dampness, qi-deficiency, yin-deficiency and fire-heat. Diagnostic accuracy and prediction rate of syndrome differentiation by sex : The overall diagnostic accuracy and prediction rate of 4 syndrome differentiation subtypes using 24 symptom and sign indices was 74.63%(403/540) and 68.46%(89/130) in women, 19 symptom and sign indices was 72.05%(446/619) and 70.44%(112/159) in men. These results are almost same as those of that the overall diagnostic accuracy(73.68%) and prediction rate(70.59%) are analyzed by the discriminant model(IV) using 33 symptom and sign indices selected by stepwise selection. Considering sex, the statistical discriminant model(V) with significant 24 symptom and sign indices in women and 19 symptom and sign indices in men, instead of 33 indices would be used in the field of oriental medicine contributing to the objectification of syndrome differentiation with parsimony rule.

Os Submalleolare in Sports players (스포츠 선수에서 발생한 내과하 부골증)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Lim, Tai-Kang
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.218-222
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    • 2003
  • Purpose: The objective of this study was to define the Os submalleolare as an any ossicles below medial malleolus of tibia and to determine the characteristics of clinical and radiological characteristics and to evaluate results of surgical treatment of Os submalleolare in sports player group. Materials and Methods: Twenty-two patients with Os submalleolare were identified between November, 1, 1998 and June, 30, 2002. Results: The mean age was 18.3 years. All patient were male and soccer players comprised 71%(20 cases). Associated disease were 8 cases(29%) of chronic ankle instabilities, one case(4%) of anterior impingement syndrome and one (4%) of plantar fascitis. The most common clinical symptom was pain during walking and sports activity and sign was tenderness around medial malleolus. Only simple radiograph could reveal presence of ossicle and differentiate with acute fracture. If symptom and sign obscured, Bone scan(7 cases) and MRI(3 cases) identify causes of pain and tenderness. As a surgical treatment, all bony fragment caused symptom and sign were eliminated and medial collateral ligament was reattached meticulously. Associated chronic ankle instability were present, modified Brostrom procedure was done simultaneously. On follow-up, The symptomatic pain were wholly disappeared at average 2.2 months (1-6months) after operation. On one year follow-up, all patients have been daily life without any complaints and have gone back to the game within three months. Conclusion: as submalleolare have relatively rare incidence in sports players and most common clinical symptom and sign is tenderness on medial malleolar area of ankle, can be diagnosed both physical examination and plain X-ray film. As a treatment, Removal of ossicle and reattachment of MCL could obtain excellent or good results.

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Leak Sign on Dynamic-Susceptibility-Contrast Magnetic Resonance Imaging in Acute Intracerebral Hemorrhage

  • Park, Ji Kang;Hong, Dae Young;Jin, Sun Tak;Lee, Dong-Woo;Pyun, Hae Wook
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.3
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    • pp.154-161
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    • 2020
  • Purpose: A CT angiography spot sign (CTA-spot) is a significant predictor of the early expansion of an intracerebral hemorrhage (ICH-Ex). Dynamic-susceptibility-contrast magnetic resonance imaging (DSC-MRI) can track the real-time leaking of contrast agents. It may be able to indicate active bleeding, like a CTA-spot. Materials and Methods: From September 2014 to February 2017, we did non-contrast CT, CTA, and DSC-MRI examinations of seven patients with acute ICH. We investigated the time from symptom onset to the first contrast-enhanced imaging. We evaluated the time course of the contrast leak within the ICH at the source image of the DSC-MRI and the volume change of ICH between non-contrast CT and DSC-MRI. We compared the number of slices showing CTA-spots and DSC-MRI leaks. Results: The CTA-spot and DSC-MRI leak-sign were present in four patients, and two patients among those showed ICH-Ex. The time from the symptom onset to CTA or DSC-MRI was shorter for those with a DSC-MRI leak or CTA-spot than for three patients without either (70-130 minutes vs. 135-270 minutes). The leak-sign began earlier, lasted longer, and spread to more slices in the patients with ICH-Ex than in those without ICH-Ex. The number of slices of the DSC-MRI leak and the number of the CTA-spot were well correlated. Conclusion: DSC-MRI can demonstrate the leakage of GBCA within hyperacute ICH, showing the good contrast between hematoma and contrast. The DSC-MRI leakage sign could be related to the hematoma expansion in patients with ICH.

Spalding's Sign in a Domestic Cat with Dystocia and Its Medical Management

  • Lee, Seok-Hee;Park, Eun-Jung;Jo, Young-Kwang;Hahn, Sang-Eun;Lee, Byeong-Chun;Jang, Goo
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.116-118
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    • 2019
  • A 2-year-old female Persian cat weighing 2.95 kg was admitted for dystocia. The levels of white blood cells and thrombocytes were decreased in blood analysis. In radiography and ultrasonography, there were four fetuses with no remarkable signs of blood flow and heartbeat. In particular, one of them showed symptom of Spalding's sign, which is a rare symptom that indicated overriding of the fetal cranial bones and shrinkage of the head with a decreased volume. It was reported that Spalding's sign is one of the strong indication of fetal death in human uterus and it occurs rarely with normal fetus without apparent reason prior to labor in human. This is the first report to provide the Spalding's sign in domestic cats and this will be applied in a strong presumptive evidence that fetal death has occurred with brain disruption sequence while pregnancy in domestic animals.

Hydronephrosis during Conservative Treatment for a Renal Injury Patient

  • Kim, Maru;Kim, Joongsuck;Kim, Sung Jeep;Cho, Hang Joo
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.47-50
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    • 2017
  • A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications.