• 제목/요약/키워드: Symptom distress

검색결과 128건 처리시간 0.029초

종격동 기형종의 흉막강내로의 자연 파열 1예 (A Case of Mediastinal Teratoma Complicated by Spontaneous Rupture into Pleural Cavity)

  • 이태훈;이성은;백재중;정연태
    • Tuberculosis and Respiratory Diseases
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    • 제47권2호
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    • pp.265-271
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    • 1999
  • 저자들은 전에 증상이 없던 환자에서 돌발적인 흉통과 호흡곤란이 발생하고, 단순흉부사진상 종격동 종괴와 좌흉막유출을 보여 종격동 기형종의 흉막강내 파열의 기능성을 고려했다. 진단이 쉽지 않은 급성증상에 대해 다른 흔한 흉곽내 질환들과의 감별진단이 필요했으며, 흉막강천자상 편평상피세포와 모발을, 흉부 단층촬영사진상 지방밀도를 포함한 다양한 밀도를 가진 종격동 낭성종괴를, 초음파유도 경피적 세침흡인술상 무핵의 편평상피를 포함한 무균성의 양성 낭성병변을 확인했다. 이러한 임상적, 세포학적, 방사선학적 검사소견으로 수술 전에 종격동 기형종의 흉막강내 파열을 진단할 수 있었으며, 본 증례에서는 측정되지 못했지만, 낭종액와 흉막유출액의 amylase 측정은 이러한 진단을 지지할 수 있을 것으로 생각된다.

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Changes in the Laterality of Functional Connectivity Associated with Tinnitus: Resting-State fMRI Study

  • Shin, Yeji;Ryu, Chang-Woo;Jahng, Geon-Ho;Park, Moon Suh;Byun, Jae Yong
    • Investigative Magnetic Resonance Imaging
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    • 제23권1호
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    • pp.55-64
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    • 2019
  • Purpose: One of the suggested potential mechanisms of tinnitus is an alteration in perception in the neural auditory pathway. The aim of this study was to investigate the difference in laterality in functional connectivity between tinnitus patients and healthy controls using resting state functional MRI (rs-fMRI). Materials and Methods: Thirty-eight chronic tinnitus subjects and 45 age-matched healthy controls were enrolled in this study. Connectivity was investigated using independent component analysis, and the laterality index map was calculated based on auditory (AN) and dorsal attention (DAN), default mode (DMN), sensorimotor, salience (SalN), and visual networks (VNs). The laterality index (LI) of tinnitus subjects was compared with that of normal controls using region-of-interest (ROI) and voxel-based methods and a two-sample unpaired t-test. Pearson correlation was conducted to assess the associations between the LI in each network and clinical variables. Results: The AN and VN showed significant differences in LI between the two groups in ROI analysis (P < 0.05), and the tinnitus group had clusters with significantly decreased laterality of AN, SalN, and VN in voxel-based comparisons. The AN was positively correlated with tinnitus distress (tinnitus handicap inventory), and the SalN was negatively correlated with symptom duration (P < 0.05). Conclusion: The results of this study suggest that various functional networks related to psychological distress can be modified by tinnitus, and that this interrelation can present differently on the right and left sides, according to the dominance of the network.

Risk Factors of the Masticatory Function in Patients with Temporomandibular Disorders: A Cross-Sectional Cohort Study

  • Kim, Keon-Hyung;Park, Jo-Eun;Kim, Mee-Eun;Kim, Hye-Kyoung
    • Journal of Oral Medicine and Pain
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    • 제44권3호
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    • pp.92-102
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    • 2019
  • Purpose: To investigate the masticatory function of patients with different temporomandibular disorders (TMD) phenotypes, and to explore the risk factors for the masticatory function of TMD patients among multiple biopsychosocial variables using patient-reported outcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewing medical records. Psychosocial factors were evaluated using four questionnaires representing pain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain Catastrophizing Scale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R) and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSK-TMD). Masticatory function, as a dependent variable, was determined using the Jaw Functional Limitation Scale (JFLS). Kruskal-Wallis test and Spearman's rank correlation were used for analyses. Results: A total of 145 cases were included and classified into four subgroups including group 1: TMD with internal derangement without pain (n=14), group 2: TMD with muscle pain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-joint combined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highest in group 2, but the mean global score of JFLS was the highest in group 3, followed by group 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean global score of PCS and the mean global score of TSK-TMD showed significant and moderate correlation with the mean global score of JFLS. All subdimensions and the global severity index of SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMD phenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobia seem to be more influential risk factors on jaw function than psychological distress, such as depression and anxiety.

Jeune 증후군 환아에게 시행한 외측 흉벽 확장술 (Lateral Thoracic Expansion Surgery for Jeune's Syndrome)

  • 김준범;문일홍;최병민;이기형;최인철;박승일
    • Journal of Chest Surgery
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    • 제38권12호
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    • pp.873-877
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    • 2005
  • Jeune 증후군은 체염색체 열성으로 유전되는 질환으로 다발성 연골 형성장애에 의한 흉벽, 골반, 사지 등의 골격계 발달 이상을 보이며 신장, 간, 췌장, 망막 등에도 병변을 동반할 수 있는 드문 질환이다. 예후에 가장 중요한 인자는 흉곽 기형의 정도인데 특징적으로 경직된 종 모양의 제한적 흉곽을 보이며, 이로 인해 호흡부전과 폐렴의 증상을 보이게 된다. 어린 나이에 증상이 발현될수록 예후가 좋지 않은 것으로 보고되고 있으며 흉곽 기형을 교정하기 위한 여러 수술 방법들이 소개되어 왔으나 1세 이전에 증상이 발현된 경우에 있어서는 수술 교정을 했다고 하더라도 대부분 사망하는 것으로 보고되고 있다. 생후 11개월 된 남자 환아가 출생 후부터 지속된 호흡부전과 폐렴 증상을 주소로 내원하여, Jeune증후군으로 진단받고 측흉벽 확창술을 우측에 시행하였다. 수술 후 호흡 부전이 해결 되지 않아 첫 수술 3개월째 좌측에 대해서도 같은 시술을 시행하였고, 수술 후 좌측 티타늄 판 골절이 발생하여 티타늄 판 재이식술을 시행하였다. 이후 호흡 양상의 호전과 악화를 반복하다가 첫 수술 6개월째 퇴원하였다. 환자는 퇴원 2개월 후 폐렴의 증상으로 재입원하였으며, 재입원 치료 5개월째에 결국 호흡부전으로 사망하였다. Jeune증후군에 대한 측흉벽 확창술을 시행하였기에 그 결과를 문헌 고찰과 함께 보고하는 바이다.

퇴원 후 전화상담중재가 부인암환자의 지각된 건강상태, 심리적 안녕과 간호만족도에 미치는 효과 (Effects of Telephone Counseling on Health and Service Satisfaction after Discharge in Gynecologic Cancer Women)

  • 박영숙;한경자;하양숙;송미순;김성재;정재원;박연환;고진강;권원경;이주영;황신우
    • 한국간호교육학회지
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    • 제14권2호
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    • pp.294-304
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    • 2008
  • Purpose: Cancer patients experience a range of physical and psychological sequelae. Consistent nursing support should be provided along the cancer treatment path. This study aimed to i)examine the effects of a telephone counseling program after discharge on perceived health, psychological well-being, and satisfaction with nursing services, and ii)describe symptom distress and their coping methods. Method: The study was a quasi-experimental design with a non-equivalent pre-post test. The sample included 20 women with gynecologic cancer in the experimental group and the same in the control group from a university hospital in Seoul. The telephone intervention was given once from 5 to 7 days after the chemotherapy. The General Well-Being Schedule and Symptom Distress Scale were used. Result: An effect from telephone counseling was found only in the vitality subscale of psychological well-being. Other subscores, perceived health, or satisfaction with nursing services did not differ between the two groups. Pain, skin change, decreased appetite, and constipation were the major symptoms and a relatively few coping strategies were utilized. Conclusion: Protocol of telephone counseling led by a nurse needs to be further developed in regard to best timing, amount, and target effects for follow-up care of gynecologic cancer patients.

자궁경부암환자의 삶의 질에 영향을 미치는 치료관련 및 심리사회적 요인 (Medical-and-Psychosocial Factors Influencing on the Quality of Life in Patients with Cervix Cancer)

  • 전미선;이은현;문성미;강승희;유희석
    • Radiation Oncology Journal
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    • 제23권4호
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    • pp.201-210
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    • 2005
  • 목적: 본 연구의 목적은 자궁경부암 환자의 삶의 질에 영향을 미치는 치료관련요인과 심리사회적 요인을 파악하기 위함이다. 대상 및 방법: 경기도 A 대학병원에서 자궁경부암 진단을 받고 치료 중이거나 추후관리 중인 환자 147명을 대상으로 삶의 질과 심리사회적 변수(기분장애, 삶의 성향, 사회적 지지)에 대해 설문조사하였다. 그리고 치료관련 변수로 암의 병기, 치료방법, 추후관리기간은 의무기록을 통해 조사하였고 증상 경험은 설문조사하였다. 결과: 치료관련 변수들과 심리사회적 변수들은 자궁경부암 환자의 전체 삶의 질의 63.3%를 설명하였다($R^2=0.533$, F=16.969, p=.000). 암의 병기, 증상 경험, 기분장애정도, 사회적지지 중 가족지지, 그리고 삶의 성향은 자궁경부암 환자의 삶의 질에 영향을 주는 유의한 요인이었으며 이 중 가족지지가 가장 영향력이 큰 변수였다. 결론: 자궁경부암 환자의 삶의 질을 증진시키기 위해서는 환자의 증상관리 뿐만 아니라 심리사회적 중재가 치료와 함께 병행되어야 하며 그 내용으로 기분조절, 사회적 지지, 삶에 대한 긍정적인 태도를 취하는 것이 포함되어야 한다.

기능성소화불량 환자의 BMI에 따른 변증 유형 분포 및 다빈도 처방 분석 : 후향적 차트 리뷰 (Distribution of Pattern Identification According to BMI in Functional Dyspepsia Patients and Analysis of Frequently Used Herbal Medicines: A Retrospective Chart Review)

  • 윤채림;금창열;한아람;최수현;최수현;정다희;정해인;하나연;김진성
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.645-660
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    • 2023
  • Objectives: This study analyzed the clinical characteristics of patients with functional dyspepsia (FD) who received Korean medicine treatment. Methods: A retrospective chart review was conducted to investigate sociodemographic characteristics, clinical characteristics, and prescribed treatments. The clinical records of 192 patients who visited Kyung Hee University Korean Medicine Hospital for FD from May 1, 2022, to May 31, 2023, were analyzed. In addition, the distribution of pattern identification and symptom type according to body mass index (BMI), as well as prescription history, were analyzed. Results: As the degree of obesity increased, the proportion of Spleen-Qi deficiency pattern patients decreased (p=0.012), and the proportion of damp-phlegm pattern patients increased (p=0.000). Additionally, as the degree of obesity increased, the proportion of patients with excess differentiation increased (p=0.002). The PDS (Postprandial distress syndrome) symptom type was significantly more frequent in the underweight and normal groups than in the overweight and obese groups, and the EPS (Epigastric pain syndrome) symptom type was more frequent in the overweight and obese groups. Regardless of the type of pattern identification, the most frequently used prescriptions were Naesowhajung-tang, Hanshin Naeso-san, and Sojeokgunbi-hwan granule. Conclusion: This study analyzed the medical records of patients with FD to elucidate the use of Korean medicine treatments. Our study is meaningful in that we found that the distribution of pattern identification and symptom patterns are linked to the degree of obesity in FD patients and identified the tendency for herbal medicine treatments to be prescribed in clinical practice.

신생아 호흡곤란 증후군에서 동맥관 개존 동반유무에 따른 임상적 경과 비교 (Comparison of Clinical Courses According to the Existence of Patent Ductus Arteriosus in Respiratory Distress Syndrome)

  • 성주희;이현주;홍현기;배종우;최용묵
    • Clinical and Experimental Pediatrics
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    • 제46권11호
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    • pp.1080-1084
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    • 2003
  • 목 적 : 저자들은 RDS 환아의 임상 경과 중에서 PDA가 동반되는 군과 동반되지 않은 군을 비교하여, 이들의 주산기 병력의 특성, 임상 양상과 경과를 비교 관찰하여 두 군 사이에 차이점이 있는지를 검토함으로서, 향후 RDS 환아의 관리에서 PDA 동반에 따른 효율적인 관리의 정보를 얻기 위하여 본 연구를 실시하였다. 방 법 : 2000년 1월부터 2002년 12월까지 경희대학교병원 신생아 집중치료실에서 신생아 RDS로 진단되어 치료한 총 83례를 대상으로 하였다. 총 83례 중에서 PDA를 동반한 군(A군)은 17례, PDA를 동반하지 않은 군(B군)은 66례였다. PDA는 울혈성 심부전의 임상증상을 보이거나, 청진상 심잡음이 들리며, 방사선 소견상에서 폐부종이 심해지거나 CT ratio가 증가되는 경우에 심초음파를 하여 진단하였다. 후향적 방법으로 증례들의 임상 기록지를 검토하여, 두 군 사이의 임상적 양상과 경과의 차이점을 분석하였다. 결 과: A군에서 B군에 비해 재태기간이 짧고 출생 체중이 낮아 미숙의 정도가 심할수록 PDA의 발생 빈도가 높았다. 주산기 가사의 빈도는 A군에서 의미있게 높았다. 만성 폐질환, 뇌실 내출혈, 괴사성 장염, 미숙아 망막증, 구루병, 패혈증, 담즙성 황달의 빈도가 B군에 비하여 A군에서 높았다. 결 론 : 두 군의 주산기 병력의 특성은 유의한 차이를 보임을 알 수 있었고 만성 폐질환 등의 합병증의 발생이 유의한 차이를 보였으나 후자의 경우 재태기간을 포함한 여러 인자를 고려하여야 하므로 앞으로 더 많은 연구가 이루어져야 한다고 사료된다.

ROME III에 의한 국내 대학생의 과민성 장 증후군의 유병률, 증상유형 및 위험요인 (The Prevalence, Subtypes and Risk Factors of Irritable Bowel Syndrome by ROME III among Korean University Students)

  • 박미정;이경숙;정재심;김주현;최정안;신기수;최명애
    • Journal of Korean Biological Nursing Science
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    • 제13권1호
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    • pp.61-71
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    • 2011
  • Purpose: The purpose of the present study was to investigate the prevalence, subtypes and risk factors of irritable bowel syndrome by ROME-III among Korean university students. Methods: This study was descriptive survey research. The sampls were 796 and variables were measured by structured questionaire. Rome-III criteria was used for diagnosis of IBS. The gathered data were analyzed with %, $x^2$-test, t-test, logistic regression by SPSS win 17.0. Results: The students with IBS were 61 (7.7%) and the most of the subtype was IBS-M (42.6%). Meal (times/day), breakfast, stress, quality of sleep, neuroticism, bodily pain, general health, social function, role emotional restriction, mental health, somatization, obcessive-compulsive state, depression, anxiety, hostility, global severity index, positive symptom distress index, positive symptom were significantly different between IBS group and non-IBS group. The prevalence of IBS was low in the higher score of role emotional in general health state. There were more 2 times students who had score of the obsessive-compulsive in psychological health over the 50 than below the 50 in IBS group. Conclusion: 7.7% of students were diagnosed by Rome-III criteria and the most of the sybtype was IBS-M. The risk factors of IBS were role emotional restriction, obsessive-compulsive state.

유방암 환자의 자기초월감 증진을 위한 자조집단과정 개발 및 운영 효과 (Effects of the Self-help Group Program for Promoting Self-Transcendence in Women with Breast Cancer)

  • 권인각;박은영;함윤희;류성숙;이은옥
    • 종양간호연구
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    • 제1권2호
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    • pp.217-228
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    • 2001
  • Cancer survivor's self-help group may promote psychosocial adjustment in cancer patients. Self-transcendence has been shown to be related with crisis and adjustment in women with breast cancer. The purpose of this study is to determine the effectiveness of self-transcendence promoting program to facilitate self-transcendence, physical, and emotional well-being in women with breast cancer. Thirty patients who received mastectomy were recruited, but 9 subjects of experimental group and 14 subjects of control group participated in this study. Subjects of experimental group attended the self-help group for self-transcendence once a week for 6 weeks. Each session of program was proceeded for 2hours and the program contained activities for promoting self-transcendence, stress management, communication skill, exercise and relaxation, symptom management, and family support. Data were collected by self-reporting questionnaires within seven days after mastectomy and after the program was finished in experimental group, within 7 days after mastectomy and after 3 months in control group. Self-transcendence was assessed using the self-transcendence scale (STS) developed by Reed. Physical well being was assessed using Symptom distress scale (SDS) developed by McCorkle and Young and emotional well being was assessed using Profile of mood states (POMS). As a result, no significant differences were found between both groups in changes of self-transcendence, emotional well-being, and physical well-being. Self-transcendence score was significantly decreased in control group (p =0.16). But that of experimental group showed no decrease. In conclusions, when the self-transcendence promoting program is provided to the patients with breast cancer, it can be helpful for promoting self- transcendence. For the further study, repeated research with appropriate sample size and more intensive nursing intervention to promote self-transcendence is suggested. And reassessment after 6 months is recommended for testing long term effects of the program.

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