• 제목/요약/키워드: clinical examination experience

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이중초음파검사상 빗장밑혈류빼앗김증후군이 관찰된 환자에서의 스텐트 삽입 후 추적 (Duplex Sonography in Subclavian Steal Syndrome Treated by Stent Insertion)

  • 한민호
    • 대한임상검사과학회지
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    • 제50권3호
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    • pp.370-374
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    • 2018
  • 빗장밑혈류빼앗김증후군은 왼쪽 근위부 빗장밑동맥이나 오른쪽 팔머리동맥에 심한 협착 혹은 폐색으로 인해 반대쪽 척추동맥으로부터 관류압이 감소된 병변쪽 빗장밑동맥으로 혈류가 역으로 유입되는 현상이 나타나게 되고, 그 결과로 척추-뇌바닥혈류부전이나 허혈성 말초동맥질환 증상이 동반되는 경우를 말한다. 빗장밑동맥을 포함한 뇌혈관 협착증에서 신경중재술을 이용한 혈류의 회복 및 방향 교정은 환자의 증상과 예후를 좋게 한다고 알려져 있다. 저자는 오른팔에 비해 왼팔 혈압이 12 mmHg 낮은 환자에서 이중초음파검사를 시행하였고, 왼쪽 척추동맥에서 빗장밑혈류빼앗김증후군의 특징적인 혈류파형이 관찰되어 혈관성형술 및 스텐트 설치술을 통해 성공적으로 치료된 증례를 보고하고자 한다. 6개월 후 추적검사에서 왼쪽 척추동맥의 혈류파형은 정상으로 회복되었고, 양팔의 혈압 차는 5 mmHg로 감소하였다.

Demographic and Clinical Characteristics of Adult Acute Myeloid Leukemia - Tertiary Care Experience

  • Sultan, Sadia;Zaheer, Hasan Abbas;Irfan, Syed Mohammed;Ashar, Sana
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.357-360
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    • 2016
  • Background: Acute myeloid leukemia (AML) is an acquired clonal frequent malignant disorder of myeloid progenitor cells. Our aim was to study demographical and clinicopathological features of adult Pakistani AML patients at presentation. Materials and Methods: In this single centre study extending from January 2010 to December 2014, data were retrieved from the patient records with a predetermined performa and analyzed with SPSS version 22. Results: Overall 125 patients were diagnosed at our institution with de novo AML during the study period. There were 76 males and 49 females (ratio 1.5:1), with an age range between 15 and 85 years and a mean age of $38.8{\pm}20.1years$. The major complaints were fever (72.8%), generalized weakness (60%), bleeding (37.6%) and dyspnea (12%). Physical examination revealed pallor in 56.8%, splenomegaly and hepatomegaly in 16% and 12.8%, respectively, and lymphodenopathy in 10.4%. The mean hemoglobin was $8.19{\pm}2.12g/dl$ with a mean MCV of $86.0{\pm}9.83fl$, a mean total leukocyte count of $43.1{\pm}68.5{\times}10^9/l$, an ANC of $3.09{\pm}6.66{\times}10^9/l$ and a mean platelet count of $62.3{\pm}78.6{\times}10^9/l$. Conclusions: AML in Pakistani patients is seen in a relatively very young population with male preponderance, compared with the west. However, clinico-pathological features appear comparable to published data.

Detection of the Carcinogenic Liver Fluke Opisthorchis viverrini Using a Mini Parasep SF Faecal Parasite Concentrator

  • Kaewpitoon, Soraya J;Rujirakul, Ratana;Tongtawee, Taweesak;Matrakul, Likit;Panpimanmas, Sukij;Wakkuwattapong, Parichart;Loyd, Ryan A;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.373-376
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    • 2016
  • The Mini Parasep SF fecal parasite concentrator (MPSFC) is a new modification of the closed concentration system, which can easily be adopted in any routine clinical pathology laboratory. Here we describe our experience with the system in diagnosing Opisthorchis viverrini. A total of 199 fecal samples was submitted for routine examination in the clinical pathology laboratory of Suranaree University of Technology hospital, Nakhon Ratchasima province, Thailand, during August to October 2015. Out of all samples examined, 10 (5.03%) were positive with intestinal parasites including O. viverrini (2.01%), followed by Strongyloided stercoralis (1.51%), Hookworm (0.5%), Taenia spp. (0.5%), and Entamoeba coli (0.5%). Regarding the distribution of intestinal parasites in relation to the methods used, and found that 4 samples (2.01%) were positive using the direct wet smear method while 10 (5.03%) were positive with the Mini Parasep SF method; the difference was statistically significant ($X^2$-test = 116.506, p-value =0.001). Mean time for processing using the Parasep system was 6.03 min/sample, the conventional direct wet smear method at 0.3 min/sample. Cost per test, conventional direct wet smear method costing less than the Parasep method at USD 0.74/sample versus USD 1.47/sample. This first report of O. viverrini detection using MPSFC indicates that Parasep concentration test is useful in the routine laboratory, increasing the yield of parasites as compared to direct microscopy, but with greater processing time and cost. Further comparisons between the Parasep concentration test and common methods for O. viverrini detection are required, particularly concerning use in epidemiological surveys.

손상된 전방십자인대의 보존적 치료 - 증례 보고 - (Conservative Treatment for Injured Anterior Cruciate Ligament - Two Cases Report -)

  • 정영복;태석기;염재광;김진수
    • 대한관절경학회지
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    • 제1권1호
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    • pp.112-115
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    • 1997
  • 저자들이 전방십자인대 파열과 함께 전방 불안정성을 보인 2례를 보존적으로 치료하여 좋은 임상적 결과를 얻은 바를 고려할 때, 급성기에 전방십자인대가 파열된 경우에도 전방십자인대를 싸고 있는 활액막이 파열되어 없어지지 않고 비교적 연속성이 잘 유지된 경우에는 보존적으로 치료함으로써 좋은 결과를 기대할 수 있을 것으로 사료되며 아울러 십자인대가 손상받았을 때 스스로 복원 능력이 있는 지에 대하여 새로운 연구가 필요하리라 사료된다.

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미국의 노인전문약사 제도에 대한 체계적 고찰: 인증, 교육 및 성과 (A Systematic Review on the Certified Geriatric Pharmacist Program of the U.S.: Certification, Education and Outcomes)

  • 남혜연;조은
    • 약학회지
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    • 제58권2호
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    • pp.129-140
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    • 2014
  • Background: As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP's performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of 'American Society of Consultant Pharmacists', 'Commission for Certification in Geriatric Pharmacy' and the selected pharmacy school samples. Articles about on the outcomes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP examination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on completion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion: Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

Clinical Experience of the Brushite Calcium Phosphate Cement for the Repair and Augmentation of Surgically Induced Cranial Defects Following the Pterional Craniotomy

  • Ji, Cheol;Ahn, Jae-Geun
    • Journal of Korean Neurosurgical Society
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    • 제47권3호
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    • pp.180-184
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    • 2010
  • Objective : To prevent temporal depression after the pterional craniotomy, this study was designed to examine the safety and aesthetic efficacy of the brushite calcium phosphate cement (CPC) in the repair and augmentation of bone defects following the pterional craniotomy. Methods : The brushite CPC was used for the repair of surgically induced cranial defects, with or without augmentation, in 17 cases of pterional approach between March, 2005 and December, 2006. The average follow-up month was 20 with range of 12-36 months. In the first 5 cases, bone defects were repaired with only brushite CPC following the contour of the original bone. In the next 12 cases, bone defects were augmented with the brushite CPC rather than original bone contour. For a stability monitoring of the implanted brushite CPC, post-implantation evaluations including serial X-ray, repeated physical examination for aesthetic efficacy, and three-dimensional computed tomography (3D-CT) were taken 1 year after the implantation. Results : The brushite CPC paste provided precise and easy contouring in restoration of the bony defect site. No adverse effects such as infection or inflammation were noticed during the follow-up periods from all patients. 3D-CT was taken 1 year subsequent to implantation showed good preservation of the brushite CPC restoration material. In the cases of the augmentation group, aesthetic outcomes were superior compared to the simple repair group. Conclusion : The results of this clinical study indicate that the brushite CPC is a biocompatible alloplastic material, which is useful for prevention of temporal depression after pterional craniotomy. Additional study is required to determine the long-term stability and effectiveness of the brushite calcium phosphate cement for the replacement of bone.

The Level of Serum Cholesterol is Negatively Associated with Lean Body Mass in Korean non-Diabetic Cancer Patients

  • Han, Ji Eun;Lee, Jun Yeup;Bu, So Young
    • Clinical Nutrition Research
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    • 제5권2호
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    • pp.126-136
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    • 2016
  • Due to poor nutrition and abnormal energy metabolism, cancer patients typically experience the loss of muscle mass. Although the diabetic conditions or dyslipidemia have been reported as a causal link of cancer but the consequence of such conditions in relation to gain or loss of skeletal muscle mass in cancer patients has not been well documented. The purpose of this study was to investigate the relationship of lean body mass and systemic parameters related to lipid metabolism in non-diabetic cancer patients using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008-2011. As results the level of serum total cholesterol (total-C) was negatively associated with both total lean body mass and appendicular lean body mass in cancer patients after adjustment for sex, physical activity, energy intake and comorbidity. The associations between consumption of dietary factors (energy, carbohydrate, protein and fat) and lean body mass were disappeared after adjusting comorbidities of cancer patients. Multivariate-adjusted linear regression analysis by quartiles of serum total-C showed that higher quartile group of total-C had significantly lower percent of lean body mass than reference group in cancer patients. The data indicate that serum lipid status can be the potential estimate of loss of skeletal muscle mass in cancer patients and be referenced in nutrition care of cancer patients under the onset of cachexia or parenteral/enteral nutrition. This data need to be confirmed with large pool of subjects and should be specified by stage of cancer or the site of cancer in future studies.

모바일 물리치료 진단 어플리케이션 개발 및 사용성 평가 (Development and Usability Evaluation of a Mobile Physical Therapeutic Diagnosis Application)

  • 이민형;김종순
    • PNF and Movement
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    • 제21권1호
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    • pp.129-137
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    • 2023
  • Purpose: The physical therapy diagnosis process requires high-level background knowledge, the ability to obtain added information from patients, accurate examination skills, and a framework for transforming thoughts into a diagnostic decision. Thus, the physical therapy diagnostic process is highly complicated and difficult work. To function as autonomous professionals, physical therapists must develop effective clinical diagnosis skills. As such, mobile application aids can help with accurate and scientific diagnoses. Therefore, this study aims to develop and evaluate the usability of a mobile application for physical therapy diagnoses. Methods: In this study, a diagnostic application was developed using App Inventor, the development environment was the Chrome web browser for Windows 10, and the mobile application was run on a Google Pixel 5. The developed application was evaluated for usability by 20 physical therapists with more than 5 years of clinical experience in the musculoskeletal physical therapy field, and a usability evaluation was conducted using a 5-point Likert scale for accuracy, convenience, satisfaction, and usability. The collected Likert scores were converted into percentages and analyzed as descriptive statistics. Results: The graphical user interface consisted of an initial screen with program guidance, 18 screens presenting the algorithm, and 12 screens presenting the estimated diagnosis based on the algorithm. As such, the usability evaluation of the developed application was as follows: accuracy 100%, convenience 90%, satisfaction 91%, and usability 88%. Conclusion: The newly developed mobile application for physical therapeutic diagnoses has a high accuracy, and it will aid in building an easy and reliable physical therapy diagnosis system.

수술전.후 재원일수에 관한 조사연구 (A Study on the Length of Stay In Hospital Before and After Operation)

  • 김미영;박경숙;김경희
    • 기본간호학회지
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    • 제4권2호
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    • pp.245-265
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    • 1997
  • The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

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간호사의 내부지향적 정책, 사회적지지 및 직무배태성이 이직의도에 미치는 영향 (Effects of Internal Oriented Policy, Social Support, and Job Embeddedness by Turnover Intention of Nurses)

  • 김중경;이선주;김원종
    • 한국산학기술학회논문지
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    • 제21권3호
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    • pp.89-95
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    • 2020
  • 본 연구는 간호사의 내부지향적 정책, 사회적지지 및 직무배태성이 이직의도에 미치는 영향에 대해 알아보기 위한 서술적 조사연구이다. 연구대상자는 연구 참여에 동의한 D광역시에 위치한 2개 대학병원 간호사들이며, 자료 수집은2018년 10월 2일부터 2019년 3월 20일 까지 실시되었다. 자료 분석은 SPSS 22.0 프로그램을 이용하였으며, 빈도와 백분율, 평균과 표준편차, 상관분석, t-test, ANOVA, Pearson's correlation, Multiple regression을 이용하였다. 연구결과 내부지향적 정책은 3.04점, 사회적지지는 상사 3.08점, 동료 3.81점, 가족 3.67점이었고, 직무배태성은 2.98점, 이직의도는 3.55점이었으며, 내부지향적 정책, 사회적지지 및 직무배태성이 높을수록 이직의도는 감소하는 것으로 나타났다. 일반적 특성에서 이직의도에 미치는 요인을 파악한 결과 임상경력과 근무부서가 유의미한 결과를 보였다. 임상경력은 높을수록 이직의도가 높았고, 근무부서는 외과병동, 내과병동, ICU, OR순으로 이직의도가 높았다. 이상의 결과를 바탕으로 간호사의 이직의도를 낮추기 위한 중재방안으로 병원 내부지향적 정책, 사회적지지 및 간호사의 직무배태성을 높이기 위한 프로그램 개발 및 교육이 적극적 이루어져야 할 것이다.