• 제목/요약/키워드: 임상에서의 문제점

Search Result 427, Processing Time 0.031 seconds

Regional Citrate Anticoagulatinln for Continuous Renal Replacement Therapy in Children (소아의 지속적 신대체요법에서 Citrate 항응고요법의 경험)

  • Hahn Hye-Won;Park Young-Seo
    • Childhood Kidney Diseases
    • /
    • v.9 no.1
    • /
    • pp.76-82
    • /
    • 2005
  • Purpose : Regional anticoagulation with trisodium citrate for continuous renal replacement therapy(CRRT) is an effective and safe method, with lower bleeding risk. However it is not widely used because of complex current protocols used to prevent anticipated metabolic derangements. We evaluated simplified regional anticoagulation protocols with ACD-A(R) solution and commercially available calcium-containing dialysis solution. Methods : The medical records of twenty-eight patients who underwent CRRT were reviewed. Hemofilter life span according to the anticoagulation method used was compared, and laboratory findings at Pre- and 48 hours post-CRRT initiation were compared in the citrate-based CRRT group. Results : Of the twenty-eight Patients, five patients underwent citrate-based CRRT Hemofilter life span was 1.60 $\pm$ 0.72 days, showing no significant differences with the hemofilter life span in the heparin based and LMWH based CRRT group. No patients experienced hemorrhagic complications. PT, aPTT, sodium, t$CO_{2}$, iCa levels showed no difference in pre- and post-CRRT. Total calcium levels were increased. At the recommended postfilter iCa level, j.e., 0.25-0.39 mmol/L, all five patients needed increased amount of citrate infusion, and Ca infusion requirement was decreased. Conclusion : Simplified regional citrate anticoagulation with calcium-containing dialysate is an effective and safe method, and is not associated with increased hemofilter clotting. However, increased postfilter iCa level is recommended.

  • PDF

Hygienic status of Korean hospital foodservice (국내 의료기관의 급식위생 현황분석)

  • 김정원;김동연;곽동경;서희재
    • Korean journal of food and cookery science
    • /
    • v.17 no.2
    • /
    • pp.105-116
    • /
    • 2001
  • The current status of Korean hospitals on foodservice hygiene was evaluated by a survey in the March of 2000 from 96 hospitals in terms of general sanitation management, education and training, and from 35 hospitals on the observance of hygienic practices in the whole stages of foodservice, personal hygiene, and kitchen equipment and facility hygiene. The questionnaire was filled directly by the dietitian working in the subject hospital. The status of general sanitation management was satisfactory overall; however, the record-keeping or documentation of the practices was the weak point which needs to be improved. only 4% of the subjects appeared to have implemented HACCP for the hospital foodservice. Comparison of the hospitals in their observance rate of hygienic practice by the type of hospital, the location of hospital, the number of bed, and the separation of dietitian's duties as clinical nutrition and foodservice showed characteristic trends among the groups. General hospitals often showed better scores than tertiary hospitals in their observance rates. As the location of hospital moved from large cities to small towns, the observance rate for hygienic practice decreased. Hospitals with entrusted foodservice system showed better scores in hygienic practice than those with owner-operated one in the stage of planning and equipment/facility hygiene (p<0.05). And the scores of the hospitals having dietitian's duties separated into clinical and food services were higher than the ones with un-separated duties. Detailed information obtained in this study would serve for the development of guidelines or programs to improve the hygienic level of Korean hospital foodservice.

  • PDF

A Study on the Nonpoint Source Pollution Management Guideline for Golf Course Construction (골프장 개발에 따른 비점오염 관리를 위한 지침마련에 대한 연구)

  • Im, Sang-Jun;Kim, Sang-Min;Kang, Moon-Seong
    • Journal of agriculture & life science
    • /
    • v.43 no.3
    • /
    • pp.55-62
    • /
    • 2009
  • The objective of this study is to establish the management guideline for golf course construction nonpoint source pollution reduction. For this, the characteristics of nonpoint source pollution from golf course construction and current management status were investigated. Investigated results showed that before and after monitoring for golf course construction sites are necessary as well as during the construction. It is important to focus on erosion and sediment control during the construction. To reduce a nonpoint source pollution from golf course construction, it is necessary to analyze the nonpoint source pollution movement through effective monitoring system and make a effective pollution reduction strategy considering construction stages, origin of the pollution and diverse management practices.

Factors Influencing Nursing Practices of Physical Restraint Use among Nurses working in Long-term Care Hospitals (요양병원 간호사의 신체적 억제대 사용과 관련된 간호실무에 영향을 미치는 요인)

  • Ha, Sun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.3
    • /
    • pp.526-534
    • /
    • 2019
  • This study was undertaken to identify knowledge, attitude, perception and nursing practice toward use of physical restraints, among nurses in long-term care hospitals. We further explored the impact of factors associated with nursing practice toward use of physical restraints. This was a cross-sectional descriptive study in which self-administered questionnaires were collected from 128 nurses working at 11 long-term care hospitals. Descriptive statistics, including t-test, one-way ANOVA, Welch's test, Pearson correlation coefficients and multiple regression, were applied to analyze the data collected. Our results reveal that the participants possess moderate levels of knowledge, attitude, perception and nursing practice toward use of physical restraints. Significant positive correlations were observed between nursing practice and knowledge. Multiple regression analysis showed that the factors significantly related to nursing practice and use of physical restraint were knowledge (${\beta}=0.27$, p=0.002) and attitude (${\beta}=-0.17$, p=0.044), having a total explained variance of 9.0%. The findings from this study suggest that knowledge is the strongest predictor on nursing practice toward use of physical restraints. Thus, we propose that developing and applying evidence-based educational intervention programs to reduce the use of physical restraints in long-term care hospitals are required.

Reconsideration and Conservational Scientific Diagnosis of Silla Stone Monument in Bongpyeong-ri, Uljin (울진 봉평리 신라비의 재판독과 보존과학적 진단)

  • Jo, Young-hoon;Lee, Chan-hee;Shim, Hyun-yong
    • Korean Journal of Heritage: History & Science
    • /
    • v.46 no.3
    • /
    • pp.48-67
    • /
    • 2013
  • This study was focused on the recognition of historical values and the establishment of conservation schemes for a Silla stone monument in Bongpyeong-ri, Uljin by combining the humanistic investigation of inscription reinterpretation and the scientific conservational diagnosis of deterioration. According to the investigation of inscription, a total of 13 letters were reconsidered compared to the preceding researches. Thus, the meaning and interpretation of previous inscription was partially changed. This monument is composed of gneissose leucogranite and the most suitable site as provenance of the stone would be the Jukbyeon seashore (2.1km). The site shows similar color, size and composition of minerals, gneissose structure and magnetic susceptibility as the Bongpyeong stone monument. This monument developed a structural crack (crack index 0.4) and a microcrack (crack index 2.0) along the gneissose structure. The horizontal strength is weaker than the vertical strength. Therefore, the cracks should be reinforced and treated. However, consolidating is not urgently needed because the total weathering grade by ultrasonic velocity shows the stage of moderate weathering(3,403m/s, 0.32). Also, the major problems of chemical deterioration are blackening (85.2%) with soil, iron oxide,rubbing mark, and salt crystals (17.3%) from the sea. Therefore, the contaminants and the salt crystals should be removed using pressure spray and pulp paper, while the application of poultice should be examined through clinical tests.

Social Psychological Characteristics of Juvenile Offenders (소년범죄자의 사회심리적 성격특성)

  • Koh, Jae-Won
    • The Journal of the Korea Contents Association
    • /
    • v.21 no.10
    • /
    • pp.702-711
    • /
    • 2021
  • In order to examine the type of PAI profile for criminally charged juvenile offenders, the study sought to find out personality types and behavioral characteristics of 251 juvenile offenders and 173 ordinary adolescents from 2018-2020. Looking at the overall profiles of juvenile offenders and ordinary adolescents, we found differences in Infrequency(INF), Mania(MAN), Antisocial Features(ANT), Alcohol problems(ALC), Drug problems(DRG), Aggression (AGG), and Dominance(DOM) and Warmth(WRM). Based on these results, we perform clustering as factors Antisocial features(ANT), Aggression(AGG), and Dominance (DOM) with an average difference of more than five points. It was classified as Cluster 1 with a high percentage of adolescents and Cluster 2 with a high percentage of juvenile offenders, and Cluster 1 was named as a defense group because it showed a similar model to the profile of ordinary adolescents. The profile type of cluster 2 was named externalization, which can be represented as an externalization group. The results were similar to previous studies, and the profile type of juvenile offenders has higher overall clinical scale than that of ordinary adolescents, indicating behavioral problems. Continued research on juvenile offenders could lead to understanding of youth as well as juvenile offenders.

The Developing Trend of Cardiovacular Drug Coated Balloon Catheter (심장혈관용 약물코팅풍선카테터의 개발 동향)

  • Park, Junghun;Jo, Won-Il;Byeon, Dae-Heung;Kang, So Young;Nam, Choong-hyun;Seo, Kyoung-Woo;Park, Jun-Kyu
    • Applied Chemistry for Engineering
    • /
    • v.33 no.5
    • /
    • pp.545-550
    • /
    • 2022
  • As a result of the rapid entry into an aging society and westernized eating habits, the number of heart disease patients caused by angina pectoris, myocardial infarction, and high blood pressure has increased by more than 100,000 over five years. Heart disease has consistently ranked second in the cause of death in Korea over the past eight years, and medical expenses consumed annually reach 6 trillion won. While various treatments are being proposed for more patients, drug-coated balloon catheters have been developed and gradually commercialized to solve the disadvantages of stent implantation such as restenosis and increased risk of bleeding due to long-term double antiplatelet medication. In Korea, it began to use a drug-coated balloon catheter with the first release of it called "SeQuent Please (Bibrown Korea)" in 2010. Its demand increased gradually as insurance benefits were applied in 2012. Drug-coated balloon angioplasty is increasing in use not only in Korea but also around the world, especially in the Asia-Pacific region, including Japan. Until now, the demand for domestic products is increasing, and if the efficiency in vivo and clinical trials is proven in the future, it is expected to be an effective procedure compared to high-risk stent implantation.

Sleep Disordered Breathing in Children (어린이의 수면호흡장애)

  • Yeonmi, Yang
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.49 no.4
    • /
    • pp.357-367
    • /
    • 2022
  • Sleep disordered breathing (SDB) is a disease characterized by repeated hypopnea and apnea during sleep due to complete or partial obstruction of upper airway. The prevalence of pediatric SDB is approximately 12 - 15%, and the most common age group is preschool children aged 3 - 5 years. Children show more varied presentations, from snoring and frequent arousals to enuresis and hyperactivity. The main cause of pediatric SDB is obstruction of the upper airway related to enlarged tonsils and adenoids. If SDB is left untreated, it can cause complications such as learning difficulties, cognitive impairment, behavioral problems, cardiovascular disease, metabolic syndrome, and poor growth. Pediatric dentists are in a special position to identify children at risk for SDB. Pediatric dentists recognize clinical features related to SDB, and they should screen for SDB by using the pediatric sleep questionnaire (PSQ), lateral cephalometry radiograph, and portable sleep monitoring test and refer to sleep specialists. As a therapeutic approach, maxillary arch expansion treatment, mandible advancement device, and lingual frenectomy can be performed. Pediatric dentists should recognize that prolonged mouth breathing, lower tongue posture, and ankyloglossia can cause abnormal facial skeletal growth patterns and sleep problems. Pediatric dentists should be able to prevent these problems through early intervention.

Analysis of Research Trends in New Drug Development with Artificial Intelligence Using Text Mining (텍스트 마이닝을 이용한 인공지능 활용 신약 개발 연구 동향 분석)

  • Jae Woo Nam;Young Jun Kim
    • Journal of Life Science
    • /
    • v.33 no.8
    • /
    • pp.663-679
    • /
    • 2023
  • This review analyzes research trends related to new drug development using artificial intelligence from 2010 to 2022. This analysis organized the abstracts of 2,421 studies into a corpus, and words with high frequency and high connection centrality were extracted through preprocessing. The analysis revealed a similar word frequency trend between 2010 and 2019 to that between 2020 and 2022. In terms of the research method, many studies using machine learning were conducted from 2010 to 2020, and since 2021, research using deep learning has been increasing. Through these studies, we investigated the trends in research on artificial intelligence utilization by field and the strengths, problems, and challenges of related research. We found that since 2021, the application of artificial intelligence has been expanding, such as research using artificial intelligence for drug rearrangement, using computers to develop anticancer drugs, and applying artificial intelligence to clinical trials. This article briefly presents the prospects of new drug development research using artificial intelligence. If the reliability and safety of bio and medical data are ensured, and the development of the above artificial intelligence technology continues, it is judged that the direction of new drug development using artificial intelligence will proceed to personalized medicine and precision medicine, so we encourage efforts in that field.

Development and Validation of AI Image Segmentation Model for CT Image-Based Sarcopenia Diagnosis (CT 영상 기반 근감소증 진단을 위한 AI 영상분할 모델 개발 및 검증)

  • Lee Chung-Sub;Lim Dong-Wook;Noh Si-Hyeong;Kim Tae-Hoon;Ko Yousun;Kim Kyung Won;Jeong Chang-Won
    • KIPS Transactions on Computer and Communication Systems
    • /
    • v.12 no.3
    • /
    • pp.119-126
    • /
    • 2023
  • Sarcopenia is not well known enough to be classified as a disease in 2021 in Korea, but it is recognized as a social problem in developed countries that have entered an aging society. The diagnosis of sarcopenia follows the international standard guidelines presented by the European Working Group for Sarcopenia in Older People (EWGSOP) and the d Asian Working Group for Sarcopenia (AWGS). Recently, it is recommended to evaluate muscle function by using physical performance evaluation, walking speed measurement, and standing test in addition to absolute muscle mass as a diagnostic method. As a representative method for measuring muscle mass, the body composition analysis method using DEXA has been formally implemented in clinical practice. In addition, various studies for measuring muscle mass using abdominal images of MRI or CT are being actively conducted. In this paper, we develop an AI image segmentation model based on abdominal images of CT with a relatively short imaging time for the diagnosis of sarcopenia and describe the multicenter validation. We developed an artificial intelligence model using U-Net that can automatically segment muscle, subcutaneous fat, and visceral fat by selecting the L3 region from the CT image. Also, to evaluate the performance of the model, internal verification was performed by calculating the intersection over union (IOU) of the partitioned area, and the results of external verification using data from other hospitals are shown. Based on the verification results, we tried to review and supplement the problems and solutions.