• 제목/요약/키워드: severe distress

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Lung Transplantation for Patients with COVID-19 Acute Respiratory Distress Syndrome

  • Cho, Woo Hyun
    • Journal of Chest Surgery
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    • 제55권4호
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    • pp.357-360
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    • 2022
  • Patients with severe coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) may exhibit pulmonary fibrosis after the viral illness resolves. Some of these patients may experience severe functional lung impairment, and thus require transplants to prevent death or maintain a tolerable quality of life. Considering the reversibility of COVID-19 ARDS, lung transplant candidates are observed for 1-2 months and must be selected very carefully before transplantation. As the short-term outcomes of such patients are comparable to those of patients with other indications for transplantation, lung transplantation should be actively considered.

재혼가정 내 모의 심리적 디스트레스의 예측요인에 관한 연구 (Determinants of Psychological Distress of Mothers in Stepfamilies)

  • 김연옥
    • 한국사회복지학
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    • 제49권
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    • pp.319-342
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    • 2002
  • The nuclear family is no longer the typical Korean Family. In recent years, stepfamilies have been of the most rapidly growing family forms in Korea. Census Bureau data show that 5.9% of marriage were in 1980, 8.0% in 1990, 10.3% in 1995, 18.0% in 2000. Especially it is remarkable that women's remarriage have been increased. In spite of the fact, the stepfamily is not an urgent issue of social welfare in Korea. The stepfamily is more vulnerable than the first-marriage family in many reasons such as vague family rules, boundary ambiguity, and stepparent role ambiguity, which provides rationale for social welfare services. This study categorizes determinants of psychological distress in remarried mothers into individual, family, and environment level and tries to prove the relationships between psychological distress and determinants. Also, it explores the degree of psychological distress in remarried mothers using Zung's Self-Rating Depression Scale. The respondents of survey research are 62 cases. The result shows relatively severe level of depression among the subjects. 46.8% of them are clinically diagnosed as mild, moderate, severe depression. Our findings suggest that the variables of marriage satisfaction, ex-wife's remarriage, role strains, marriage experience, and income are significantly associated with the level of psychological distress in remarried mothers. The most powerful predictor of psychological distress is the variable of marriage satisfaction. According to the result, it is desperately needed to pay attention to social welfare services or programs for stepfamilies.

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월경 전후기 증상 정도 및 월경고통 유형 판별요인 (A Study on the Differentiation of Women with Perimenstrual Symptom Severity and Perimenstrual Distress Patterns)

  • 박영주;유호신
    • 여성건강간호학회지
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    • 제4권1호
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    • pp.123-138
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    • 1998
  • The purpose of this study was to describe perimenstrual symptom severity levels and perimenstrual distress patterns of women. The study performed the discriminant analysis in which included seven factors : age, pariety, social support, menstrual socialization(mother's symptom, sister's symptom, and menstrual effect), attitude of sex role and depression. The subjects were 283 women that they were not pregnant or lactating, had at least one period in past three months, would understand the purpose of study and willingly accepted the participation. The data analysis was done by pc-SAS program after data collection from Nov. 20, 1997 to Dec. 18, 1997. The descriptive analysis was done to explore general characteristics of the subjects and the stepwise discriminant analysis was done to verify factors in relation to perimenstrual symptom severity levels(severe vs mild menstrual symptom group) and perimenstrual distress patterns(spasmodic vs congestive menstrual symptom group). The instruments were selected for this study from Interpersonal Support Evaluation List(ISEL) by Cohen and Hoberman(1983), Center for Epidemic Studies Depression(CES-D) by Radloff(1977), and Sex Role Attitude Scale by Yunok Suh(1995), Mother's symptom and sister's symptom measurements by Woods, Mitchell & Lentz(1995), and menstrual effect by Brooks-Gun & Ruble(1980). The major findings of this study are as follows : 1. Of the 283 women, 93 women(32.9%) were assessed to severe perimenstrual symptom group and 190 women(67.1%) were assessed to mild perimenstrual symptom group. Results from the stepwise discriminant analysis showed three factors, such as depression, menstrual effect, and age, significantly related to perimenstrual symptom severity and they explained 20% of the total variance. The linear discriminant equation included three factors related to perimenstrual symptom groups was showed(Z=1.445 depression+0.174 menstrual effect-0.054 age). The cutting score(Z) was 2.809. We classified the severe perimenstrual symptom group by more than the cutting score 2.809 and the mild perimenstrual symptom by less or equal than the cutting score 2.809. The correctedness of posterior probability from discriminant equation was 72% as two perimenstrual symptom group classifications. 2. Of the 264 women, 139 women(52.7%) were assessed to spasmodic perimenstrual distress group and women(47.3%) were assessed to congestive perimenstrual distress group. Results from the stepwise discriminant analysis showed two factors, such as depression, age, significantly related to perimenstrual distress groups and they explained 8% of the total variance. The linear discriminant equation included two factors related to perimenstrual distress group was showed(Z=-0.084 age-0.776 depression). The cutting score(Z) was -3.759. We classified the spasmodic perimenstrual distress group by more than cutting score -3.759 and the congestive perimenstrual distress group by less or equal than cutting score -3.759. The correctedness of posterior probability from discriminant equation was 65% as two perimenstrual distress group classifications.

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Sepsis and Acute Respiratory Distress Syndrome: Recent Update

  • Kim, Won-Young;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • 제79권2호
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    • pp.53-57
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    • 2016
  • Severe sepsis or septic shock is characterized by an excessive inflammatory response to infectious pathogens. Acute respiratory distress syndrome (ARDS) is a devastating complication of severe sepsis, from which patients have high mortality. Advances in treatment modalities including lung protective ventilation, prone positioning, use of neuromuscular blockade, and extracorporeal membrane oxygenation, have improved the outcome over recent decades, nevertheless, the mortality rate still remains high. Timely treatment of underlying sepsis and early identification of patients at risk of ARDS can help to decrease its development. In addition, further studies are needed regarding pathogenesis and novel therapies in order to show promising future treatments of sepsis-induced ARDS.

생후 24 시간 이내에 수술을 요하는 선천성 횡경막 탈장 및 횡경막 내번증5례 보고 (Congenital Diaphragmatic Hernia and Eventration Requiring Operation in the first 24hrs of Life - A report of 5 cases -)

  • 이철범;홍기웅;노진삼
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.175-183
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    • 1988
  • Congenital diaphragmatic hernia [CDH] is a surgical emergency in the newborn infant because it causes severe cardiorespiratory distress. Congenital diaphragmatic eventration [CDE] may also produce severe cardiorespiratory distress in the newborn infant. CDH is an anatomically simple defect that can be easily repaired by reduction of the displaced viscera from the pleural cavity and closure of the diaphragmatic defect. But these infants mortality has not been reduced and still remains very high. The barrier to survival is pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persistent fetal circulation. Between May, 1985 and Oct, 1987, 4 neonates with CDH and 1 neonate with CDE were seen in respiratory distress within 12 hrs of birth at St. Francisco general hospital. Each had severe acidosis and hypoxia. And was transferred from a local clinic. They were surgically repaired within 24 hrs of birth. Three neonates lived and two died. Two of the three neonates with CDH operated in the first 6 hrs died. The remaining two [one with CDH, the other with CDE] operated between 6hrs and 24 hrs lived. One case of mortality was combined with bilateral pulmonary hypoplasia and contralateral pneumothorax. The other one case of mortality was combined with complex syndrome of persistent fetal circulation after honeymoon period.

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성인 호흡곤란 증후군에 있어 체외막 산소화 장치를 이용한 치료 (The Treatment of Adult Respiratory Distress Syndrome (ARDS) Using Extracorporeal Membrane Oxygenation (ECMO))

  • 김고운;최은영;홍상범
    • Tuberculosis and Respiratory Diseases
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    • 제72권1호
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    • pp.1-7
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    • 2012
  • Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal $CO_2$ removal ($ECCO_2R$), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.

외상성 폐손상시 체외막형 산화기 치료 - 2 예 - (Extracorporeal Membrane Oxygenation Treatment of Traumatic Lung Injury - 2 cases -)

  • 양진성;신화균;허균;원용순
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.155-158
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    • 2011
  • Mechanical ventilation is usually the treatment of choice for severe respiratory failure associated with trauma. However, in case of severe hypoxia, mechanical ventilation may not be sufficient for gas exchange in lungs. Patients with Acute Respiratory Distress Syndrome (ARDS) undergo difficulties in oxygen and carbon dioxide exchange. Extracorporeal Membrane Oxygenation (ECMO) is the ideal therapeutic option for those patients with severe traumatic injuries. ECMO allows lungs to reserve their functions and decreases further lung injuries while increasing survival rate at the same time. We report two cases of patients with traumatic ARDS and Multiple Organ Failure including compromised heart function. The preservation of lung function was successful using ECMO therapy.

Effects of Psychological Stress and Living Environments on Perceived Hand Deformities: a Community-Based Cohort Study

  • Sunmi Song
    • Physical Therapy Rehabilitation Science
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    • 제12권1호
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    • pp.72-79
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    • 2023
  • Objective: Despite known associations between negative body image and health declines in chronic pain patients, few studies have examined longitudinal associations between psychological stress and perceived hand deformities. This study examined whether psychological distress was associated with hand deformities 4 years later and if rural and urban adults differed in the association. Design: A community-based cohort study. Methods: Community dwelling adults (mean age=51.97, 52.3% women) in a rural (n=2968) and urban area (n=2784) provided demographic data at baseline and, in the 4-year follow-up, responded to questionnaires about psychological distress. Perceived hand deformities were assessed at the 8-year follow-up. Linear regression was conducted to examine the effects of psychological distress on hand deformities and moderation by residential areas. Results: The perceived hand deformities were more likely among those with severe psychological stress, hand osteoarthritis, or any chronic disease condition (p<0.01) but less likely among those with younger age, higher education, or income (p<0.01). The regression results showed that psychological distress predicted more perceived hand deformities 4 years later even after adjusting for demographic and health covariates (p<0.01). The residential areas did not significantly moderate the association between distress and hand deformities. Conclusions: This study suggected that psychological distress may trigger later perception of hand deformities in both urband and rural adults. The findings indicate that stress management interventions that are customizable to regional contexts may be effective at preventing negative body image related health problems of community-dewelling adults.

미주한인 노인이민자와 한국노인의 동거형태와 심리적 고통에 관한 연구 (Living Arrangements and Psychological Distress among Older Korean Immigrants and older Koreans)

  • 장미야
    • 한국노년학
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    • 제39권3호
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    • pp.635-652
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    • 2019
  • 본 연구의 목적은 미주 한인노인(older Korean immigrants in the United States )과 한국에 거주하는 노인(older Koreans in South Korea)을 대상으로 동거형태(living arrangements)와 심리적 고통(psychological distress)과의 관계를 비교하기 위함이다. 이 두 나라의 노인 인구 설문조사는 60세에서 79세 사이에 해당하는 참여자(480명)로 구성되어 있으며, 인구사회학적 특성 및 동거형태와 심리적 고통과의 관계를 알아보기 위하여 위계적 다중회귀분석이 이루어졌다. 연구결과는 미주에 거주하는 '독거(living alone)' 노인의 26.4%와 '배우자와 살고 있는 노인(living with a spouse)'의 7.3%가 '심한' 심리적 고통을 겪고 있는 것으로 나타났다. 이에 반해, 한국에 거주하는 '독거'노인의 20.0%와 '배우자와 살고 있는' 노인의 20.6%가 '심한' 심리적 고통을 겪고 있음으로 나타났다. 계층적 다변량 분석은 미주 한인 독거노인과 한국거주 독거노인 모두 심리적 고통에 통계적으로 유의미한 변수가 아닌 것으로 나타났다. 흥미롭게도 배우자와 살고 있는 노인과 다른 사람(living with others)과 살고 있는 미주 한인노인의 심리적 고통에 유의미한 변수로 나타났으나 한국에 거주하는 노인은 유의미한 변수가 아니었다. 이 연구는 또한 미주 한인 독거노인과 사회적 지지에 대한 상호작용은 통계적으로 유의한 변수로 나타났다. 한국거주의 '부부와 살고 있는 노인'과 사회적지지(social support)와 네트워크(social networks)에 대한 상호작용은 통계적으로 유의미한 변수로 나타났다. 따라서 이 연구는 미국과 한국에 거주하는 노인들의 정신건강에 영향을 미치는 다양한 상황들을 탐색함으로써 기존의 문헌에 기여한다. 이러한 분석결과를 토대로 미주 한인노인과 한국 노인의 심리적 고통을 줄이기 위한 정책적 시사점을 제시하였다.

Acute Eosinophilic Pneumonia

  • Sohn, Jang Won
    • Tuberculosis and Respiratory Diseases
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    • 제74권2호
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    • pp.51-55
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    • 2013
  • Acute eosinophilic pneumonia is a severe and rapidly progressive lung disease that can cause fatal respiratory failure. Since this disease exhibits totally different clinical features to other eosinophilic lung diseases (ELD), it is not difficult to distinguish it among other ELDs. However, this can be similar to other diseases causing acute respiratory distress syndrome or severe community-acquired pneumonia, so the diagnosis can be delayed. The cause of this disease in the majority of patients is unknown, even though some cases may be caused by smoke, other patients inhaled dust or drugs. The diagnosis is established by bronchoalveolar lavage. Treatment with corticosteroids shows a rapid and dramatic positive response without recurrence.