• 제목/요약/키워드: Wonju

검색결과 5,035건 처리시간 0.029초

The Effects of Bronchoscope Diameter on the Diagnostic Yield of Transbronchial Lung Biopsy of Peripheral Pulmonary Nodules

  • Lee, Nakwon;Kim, Sang-Ha;Kwon, Woocheol;Lee, Myoung Kyu;Yong, Suk Joong;Shin, Kye Chul;Jung, Ye-Ryung;Choi, Yeun Seoung;Choi, Jiwon;Choi, Ji Sun;Lee, Won Yeon
    • Tuberculosis and Respiratory Diseases
    • /
    • 제77권6호
    • /
    • pp.251-257
    • /
    • 2014
  • Background: Transbronchial lung biopsy (TBLB) is a valuable diagnostic tool for peripheral pulmonary lesions. The diagnostic yield of TBLB reportedly ranges from 41%-60%. Many studies demonstrated the various factors that influence the yield of TBLB, including size, location, and distance from the carina or pleura. However, no study has evaluated the effects of the bronchoscope diameter. We evaluated whether the bronchoscope diameter affected the diagnostic yield of TBLB. Methods: We reviewed records from 178 patients who underwent TBLB using bronchoscopes of two different diameters (5.7 mm, thick outer diameter, Olympus BF-200; 4.9 mm, thin, BF-260). The fluoroscopic guidance rates, yield of TBLB and flexible bronchoscopy (FB) were compared between the two groups. Additionally, we compared the results of the procedures with respect to diagnosis, distance from the pleura, and size of the lesion. Results: The results of fluoroscopic guidance, TBLB, and FB yield using thin diameter bronchoscope were significantly better than those obtained with a thick diameter bronchoscope (p=0.021, p=0.036, and p=0.010, respectively). Particularly, when the distance from the pleura was ${\leq}10mm$, success rates for fluoroscopic guidance and FB with thin bronchoscope were higher (p=0.013 and p=0.033, respectively), as compared to with thick bronchoscope. Conclusion: A thinner diameter bronchoscope increased the yield of bronchoscopy, and bronchial washing in conjunction with TBLB was useful in the diagnosis of peripheral pulmonary nodules.

속립성 결핵과 감별이 필요했던 가속형 규폐증 1례 (A Case of Accelerated Silicosis Mimicking Miliary Pulmonary Tuberculosis)

  • 김광현;김상하;권우철;이명규;최훈;이낙원;홍태원;용석중;신계철;정순희;리원연
    • Tuberculosis and Respiratory Diseases
    • /
    • 제59권6호
    • /
    • pp.684-689
    • /
    • 2005
  • 규폐증은 유리규산에 노출될 수 있는 다양한 작업장에서 발생할 수 있는 질환으로 호흡성 분진의 축적에 의한 폐실질의 병리학적 변화를 가져오는 대부분 만성적인 경과를 보이는 질환이다. 하지만 드문 경우에 노출된 분진의 강도와 노출기간에 따라 임상양상이 급격하게 진행되는 경우가 있을 수 있다. 저자들은 진폐증으로 진단하였던 환자가 약 2개월 동안의 급격한 방사선학적 소견의 진행을 보여, 속립성 결핵과의 감별을 위해 시행한 경기관지 폐생검을 통하여 진단하였던 가속형 규폐증 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

  • Lee, Myoung Kyu;Lee, Won Yeon;Yong, Suk Joong;Shin, Kye Chul;Kim, Chong Whan;Lee, Ji-Ho;Jung, Saehyun;Jung, Ye-Ryung;Kim, Hyun Sik;Yu, Tae-Sun;Kim, Sang-Ha
    • Tuberculosis and Respiratory Diseases
    • /
    • 제73권2호
    • /
    • pp.93-99
    • /
    • 2012
  • Background: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients. Methods: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months. Results: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly. Conclusion: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.

부식제 중독 환자에서 시간에 따른 내시경 합병증 비교 (Comparing the Possible Complications of Endoscopy Dependent on Time in Caustic Poisoned Patients)

  • 최진걸;김오현;김현;이동건;고진;김태훈;차경철;이강현;황성오;차용성
    • 대한임상독성학회지
    • /
    • 제12권2호
    • /
    • pp.70-76
    • /
    • 2014
  • Purpose: Endoscopy has been recommended as a primary procedure for determining the extent of damage and prognosis in patients with caustic ingestions. Endoscopy within the first 24 hours has been suggested, however, such immediate endoscopy is not always possible. Therefore, we wanted to determine complications and possible delayed sequelae after the endoscopy performed dependent on time, including less than 24 hours and more than 24 hours, after ingestion of relatively high toxic caustic agents. Methods: From January 2005 to May 2013, 105 consecutive patients were diagnosed with caustic poisoning in the emergency department of the Wonju Severance Christian Hospital. Out of 95 patients who underwent endoscopy, while excluding 49 patients who ingested sodium hypochlorite and 15 patients due to insufficient data, 41 patients were ultimately included. We compared general characteristics, complications related to endoscopy, late sequelae, total admission length, and mortality between two groups. Results: Twenty eight patients (68.3%) were diagnosed with acid ingestion. Median endoscopy time was 17.8 (IQR 9.7-36.9) hours and performed in 16 patients (39%) after 24 hours. There were no complications, such as perforation and bleeding in either endoscopy within 24 hours group or endoscopy after 24 hours group. In addition, no difference in ingested materials, endoscopy grade, or late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group. Conclusion: No difference in complications and late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group when endoscopy was performed based on a clinician's assessment.

  • PDF

간호학생을 위한 응급상황관리 시뮬레이션 실습 교과목 개발 및 적합성 평가 (Development and Applicability Evaluation of an Emergent Care Management Simulation Practicum for Nursing Students)

  • 허혜경;박소미;신윤희;임영미;김기연;김기경;최향옥;최지혜
    • 한국간호교육학회지
    • /
    • 제19권2호
    • /
    • pp.228-240
    • /
    • 2013
  • Purpose: This study was to evaluate the applicability of an emergent care management simulation practicum which is for enhancing nursing students' emergent care management competency based on the Nursing Education Simulation Model. Methods: One group pre-post experimental design was conducted for evaluation of the applicability of the simulation practicum. A convenient sample of 60 senior nursing students was participated. The simulation practicum was provided for 26 hours per student at the end of the first semester of senior year. Educational practices in simulation scale, simulation design scale and learning outcomes were measured. Higher positive correlations between variables represent applicability. Descriptive analysis, paired t-test and Pearson correlation coefficient were used for data analyses. Results: Among contractual components of nursing education simulation model, educational practices in simulation and simulation design (r=.80, p<.010), learning outcomes (r=.71-.28, p<.050), simulation design and learning outcomes (r=.72-.30, p<.050) were significantly correlated. Critical thinking (t=-3.63, p<.050) and problem solving competence (t=-2.55, p<.050) were significantly increased by this simulation practicum. It represents the applicability of an emergent care management simulation practicum. Conclusion: This emergent care management simulation practicum was appropriate to enhance the nursing students' emergent care management coping competency.

악성종양 노인환자에서 치근단 절제술 시 즉시 고무배농법의 효과 : 증례보고 (EFFECT OF IMMEDIATE RUBBER DRAINAGE ON THE DENTAL APICOECTOMY IN GERIATRIC CANCER PATIENTS : REPORT OF CASES)

  • 유재하;한상권;정원균;노희진;김영남;장선옥;전현선;김종배;남기영
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제30권6호
    • /
    • pp.536-539
    • /
    • 2004
  • The apicoectomy is an operation in which the root apex is removed and the adjacent periapical pathologic tissue is curetted. In this operation, there are several factors that may lead to the surgical wound infection, such as, local, systemic, environmental, endogenous and surgical factor. The systemic medical and surgical factor that may compromise patients defense are more important cause of the wound infection. The postoperative infection is likely to occur owing to poor systemic condition(especially geriatric cancer patient with operation, radiotherapy and chemotherapy), postoperative accumulation of hematoma & seroma and other contaminated factors. So, the authors established the immediate rubber drainage into the sutured wound of dental apicoectomy for the prevention of postoperative infection. The results are more favorable without the wound infection in total 31 cases of the dentistry of Dong San Medical Center & Wonju Christian Hospital.

Detection of MecA Gene in Clinical Isolates of Staphylococcus aureus by Multiplex-PCR, and Antimicrobial Susceptibility of MRSA

  • Lee, Hyean-Woo;Yoon, Joon-Ho;Sohn, Joon-Hyung;Lee, Kyoung-Ho;Yeh, Byung-Il;Park, Deok-Woo;Kim, Hyun-Won;Choi, Jong-Whan
    • Journal of Microbiology and Biotechnology
    • /
    • 제13권3호
    • /
    • pp.354-359
    • /
    • 2003
  • Multiplex-PCR protocols were designed in order to make a rapid identification of MRSA. MecA, femB, and 165 rRNA genes were amplified for making a detection of MRSA. The incidence of MRSA in the clinical isolates of Staphylococcus aureus was examined by using a multiplex-PCR assay. The mecA gene was detected in 266 strains out of 336 clinical isolates of S. aureus, thus the incidence of MRSA was approximately 76.5%. The MRSAs of 247 strains (96.1%) showed resistance to more than eight species of the antimicrobial agents tested. The isolates of MRSA showed 27 different antimicrobial-resistant patterns. The results indicate that many different MRSA strains having high multidrug resistance are actually prevalent in Korea. Also, VISA was screened from the MRSA. Two strains were grown on the BHI agar plate supplemented with $8\;\mu\textrm{g}/ml$ of vancomycin at a frequency of $1/10^8$ colony forming units or higher.

갑상선절제술을 받은 중년여성과 받지 않은 중년여성의 신체상, 우울, 갱년기 증상 비교 (Comparisons of Body Image, Depression, and Climacteric Symptoms among Middle-Aged Women with and without Thyroidectomy)

  • 윤병숙;백지은;이준상;박미정;임영미
    • 임상간호연구
    • /
    • 제14권3호
    • /
    • pp.5-14
    • /
    • 2008
  • Purpose: The purpose of this study was to compare body image, depression, and climacteric symptoms among middle-aged women with and without thyroidectomy. Method: The research design was a comparative descriptive study using a self-report questionnaire. A total of 102 women aged 40~59 years were recruited using a convenient sampling method. A total of 52 women out of 102 were within a year after thyroidectomy due to benign disease. The rest of the subjects were healthy women without any previous diseases in thyroid. The instruments included Body Image Concern Inventory, Climacteric symptoms, and Center for Epidemiological Studies Depression Scale. The data were analyzed by descriptive statistics, t-test, $x^2$-test, one-way ANOVA, and correlation analysis. Results: There were no significantly differences in age, education, menstruation states between women with and without thyroidectomy. The demographic characteristics of two groups were homogeneous. There were significantly statistical differences in body image (t= 8.456, p=.000), and depression (t=3.142, p=.002) between the groups. There was, however, no significantly differences of climacteric symptoms. In addition, in women with thyroidectomy, no significant associations were found among body image, depression, and climacteric symptoms. Conclusion: The findings demonstrated the need to develop an effective nursing intervention to increase body image and to reduce depression in middle-aged women after thyroidectomy.

  • PDF