• Title/Summary/Keyword: 15,000임상도

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Effects on Unplanned Extubation, Oral Mucosa, and Facial Skin Integrity of New Method to Secure Endotracheal Tube (새로운 기관튜브 고정기구 적용이 비계획적 발관과 구강·안면 피부 통합성에 미치는 효과)

  • Kim, Jung Sook;Lee, Eun Sook;Park, Jin Hyang
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.49-59
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    • 2009
  • Purpose: Examination was done of the effects on unplanned extubation, oral mucosa, and facial skin integrity in patients with oral intubation secured with a new method using Multifix Endo II. Methods: A prospective quasai-experimental design was used. Data were collected during a 3-week EICU admission period between Jun. 1 and Nov. 30. Two hundreds seventeen (conventional taping group: 105, Multifix Endo II group: 112) orally intubated adults were enrolled in the study at the EICU of the C University Hospital. Results: The incidence of unplanned extubation (${\chi}^2=11.580$, p=0.03) and scores for the facial skin integrity impairment of the Mutifix Endo II group (t=5.28, p=.000) were significantly lower than those of the conventional taping group even though the scores for oral mucosa impairment were not different. The nurse's evaluation of the clinical effectiveness of the two methods including convenience, comfort, safety, and satisfaction were also higher for the new securement method compared to the conventional taping group. Conclusion: The securement method using Mutifix Endo II was more effective than the conventional method in the prevention of unplanned extubation and maintenance facial skin integrity.

Self-perceived Stigma, Self-efficacy and Quality of Life in Psychiatric Outpatients (정신과 외래 환자가 지각하는 낙인과 자기효능감 및 삶의 만족도에 관한 연구)

  • Sung, Ki Hye
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.127-138
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    • 2009
  • Purpose: The purpose of this study was to explore self-reported perceived stigma, self-efficacy, and quality of life among psychiatric outpatients Methods: In the present study, researchers analyzed the survey responses of 195 patients recruited in the S hospital psychiatry outpatient clinic. The measurement tools used in this study were the "Devaluation & Discrimination" scale to determine perceptions of stigmatization, general and social efficacy scales to measure self-efficacy, and the "General Well-Being Index" to measure quality of life in psychiatric outpatient. Statistical analysis included means with standard deviation, t-test, ANOVA and Pearson correlation coefficients to identify relationships between the variables. Results: There was a significant difference in self-perceived stigma and quality of life in psychiatric outpatients (r=-.233, p=.001) and a negative correlation between self-efficacy and quality of life (r=-.424, p=.000). Correlation analysis results support the hypothesis that higher self-perceived stigma scores were related to reduced quality of life among patients with schizophrenia (r=-.231, p=.021), while there was a positive correlation between self-perceived stigma scores and self-efficacy scores among patients with bipolar disorder (r=.362, p=.013). Conclusion: The findings suggest that nursing imtervention strategies should include education programs to reduce stigmatization and enhance self-efficacy and quality of life among patients with chronic psychiatric illnesses.

Development of early diagnosis system for the detection of diabetic foot using photoplethysmograph (PPG를 이용한 당뇨병 환자의 족부질환의 조기진단 시스템 개발)

  • Kim Jin-Tae;Kim Sung-Woo;Hong Hyun-Ki;Im Jae-Joong;Kim Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.43 no.3 s.309
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    • pp.60-66
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    • 2006
  • The purpose of this study was to suggest a new detection method for early diagnosing diabetic neuropathic foot by obtaining a ratio of toe to finger blood flow using photoplethysmography(PPG) and Laser Doppler(LD). Nerve conduction velocity (NCV) has been routinely used for diagnosing neuropathic foot, but it applies strong electric stimulus to peripheries resulting in stress and pain. The blood flow ratio of 50 neuropathic diabetes($0.96{\pm}0.20$) was significantly higher than that of 64 normal person($0.46{\pm}0.15$)(p<0.000). It also showed that toe temperature of neuropathic diabetes($30.5{\pm}1.4^{\circ}C$) was significantly higher than that of normal group($29.3{\pm}2.0^{\circ}C$)(p<0.000). The optimal boundary value of the blood flow ratio was found to be 0.678 and the sensitivity and specificity of this proposed method resulted in 95.3% and 95.3% respectively. Lastly, there were no neuropathic diabetes whose temperature difference between finger and toe was higher than $4.5\;^{\circ}C$.

Salmonellosis in children: Analysis of 72 Salmonella-positive culture cases during the last 10 years (소아의 살모넬라 감염증: 최근 10년동안 살모넬라 배양 양성인 72례에 대한 분석)

  • Noh, Sung Hoon;Yu, Ka Young;Kim, Jung Soo;Hwang, Pyoung Han;Jo, Dae Sun
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.791-797
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    • 2009
  • Purpose : We aimed to investigate the clinical manifestations of and antibiotic resistance in culture-proven childhood salmonellosis. Methods : Clinical manifestations and laboratory data of and antibiotic use in subjects with culture-proven childhood salmonellosis, who were treated at the Chonbuk National University Hospital between September 1998 and August 2008, were analyzed retrospectively. Patients with underlying diseases or concomitant illnesses were excluded. Results : We assessed a total of 72 patients. There were 68 stool culture-positive cases, 7 blood culture-positive cases, and 3 both stool culture- and blood culture-positive cases. Salmonella group D was the most frequent pathogen in stool (63.9%) and blood (71.4%) cultures. Salmonella typhi was isolated in 1 case. Of the 72 patients, 45 (62.5%) were male children, of which 29 (40.3%) were aged <3 years. The patients most commonly presented with diarrhea (90.2%) and fever (83.3%). Leukocytosis (leukocyte count, >$15,000/{\mu}L$) and leukopenia (leukocyte count, <$4,000/{\mu}L$) were detected in 8.3% and 5.6% of the patients, respectively. Elevated serum C-reactive protein concentration (>5 mg/dL) and erythrocyte sedimentation rate (>20 mm/h) were observed in 88.9% and 58.3% of the patients, respectively. Fifty-two (85.2%) of 61 patients who had undergone antibiotic treatment received a third-generation cephalosporin as definitive antibiotic therapy. Multidrug resistance rate was 40.0 % in the first 5 years of the study and 71.4% in the last 5 years. No fatalities occurred in this series. Conclusion : Children with culture-proven salmonellosis showed relatively benign clinical outcomes. Appropriate antibiotic treatment of <2 weeks is probably adequate for those without a suppurative focus of infection. The incidence of antibiotic resistant isolates was recently seen to increase.

Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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Hepatitis Complicated with Mycoplasma pneumoniae Infection (Mycoplasma pneumoniae 폐렴에 합병된 간염)

  • Lee, Jin-Tae;Kim, Hee-Sup;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.207-212
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    • 2001
  • Purpose: Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has not been studied yet until now in Korea. Methods: We performed the prospective study of 19 cases that had AST and ALT>50 IU/L respectively without evidence of hepatitis A, B, C, cytomegalovirus, and Ebstein-Barr virus infections amongst 143 patients with M. pneumoniae pneumonia who were admitted to the Department of Pediatrics, Seoul Red Cross Hospital from Jan. 1999 to Dec. 2000. Results: 1) Hepatitis occurred in 13.3% of Mycoplasma pneumoniae infection, especially in fall and winter times. The average age was 4.86 years and male to female ratio was 2.2:1. 2) Vomiting was developed in 21.1%, diarrhea in 36.8%, and hepatomegaly in 21.1%, respectively. And leukocytosis was noted in 21.1%, eosinophilia in 15.4%, anemia in 10.5%, and thrombocytosis in 5.3%, respectively. The average level of C-reactive protein was $6.34{\pm}4.82$ mg/dl. 3) There was no hyperbilirubinemia, but hypoalbuminemia was detected in 42.1%. The average serum levels of AST and ALT were $214.05{\pm}183.22$ IU/L and $284.16{\pm}286.84$ IU/L, respectively. 4) Chest radiology showed lobar or lobular consolidation in 73.7%, bronchial infiltration in 26.3%, and pleural effusion in 31.6%. 5) The average length of hospitalization was 7.9 days, and the average length of normalization of serum transaminases was 8.8 days. All patients recovered within 2 weeks completely. Conclusion: The prognosis of M. pneumoniae hepatitis is good. However, its incidence is not so low that liver function should be considerately checked in case of M. pneumoniae infection.

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Effects of Steroids and HCG on in vitro Maturation and Ovulation of Oocyte in Banded Catfish, Pseudobagrus fulvidraco (동자개 (Pseudobagrus fulvidraco)의 난모세포 성숙과 배란에 대한 스테로이드와 HCG의 in vitro효과)

  • LIM Sang-Koo;BAEK Hea-Ja;HAN Chang-Hee
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.30 no.2
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    • pp.203-210
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    • 1997
  • The aim of this study was to determine the effect of steroids and human chorionic gonadotropin (HCG) on in vitro maturation and ovulation of oocyte in Pseudobagrus fulvidraco. Oocytes were incubated in the media Leibovitz L15 supplemented with the various concentration of $17\alpha,\;20\beta-dihydroxy-4-pregnen-3-one(17\alpha20{\beta}OHP),\;17\alpha-hydroxyprogesterone(17{\alpha}OHP),\;progesterone(P_4),\;estradiol-17\beta(E_2)and\;HCG$. After 60 hours incubation, the maturation ability of oocyte was assessed by the appearance of germinal vesicle breakdown (GVBD). GVBD was significantly enhanced by the addition of $17\alpha20{\beta}OHP,\;17{\alpha}OHP,\;P_4\;and\;HCD(P<0.05)$. The highest CVBD was observed when $17\alpha20{\beta}OHP$ and HCG were supplemented to media. When oocytes were cultured for 16 hours in media containing $10\~1,000\;ng/ml\;17\alpha20{\beta}OHP,\;17{\alpha}OHP\;and\;P_4$, the rate of GVBD in oocytes cultured in the medium supplemented with 100 ng/ml $17\alpha20{\beta}OHP(65\%)$ was significantly higher than that with $17{\alpha}OHP\;(40\%)\;and\;P_4(35\%)$. The efforts of $17\alpha20{\beta}OHP$ and HCG on GVBD were assessed by various concentration of these hormones. When oocytes were cultured for 60 hours in various media containing $1\~1,000\;ng/ml\;17{\alpha}20{\beta}OHP\;or\;5\~1,000\;IU/ml$ HCG, the GVBD of oocytes was significantly increased in the medium with $10\~100\;ng/ml\;17\alpha20{\beta}OHP$ and 500 IU/ml HCT. When oocytes were cultured in the various media supplemented with $1\~1,000\;ng/ml\;17\alpha20{\beta}OHP\;or\;5\~1,000\;IU/ml$ HCG for 60 hours, the media with $1\~100\;ng/ml\;17\alpha20{\beta}OHP\;or\;50\~1,000IU/ml$ HCG significantly increased in the rate of ovulation. However supplementation with $1,000\;ng/ml\;17\alpha20{\beta}OHP$or 5 IU/ml HCG did not improve the rate of ovulation compared to controls. This results indicate that supplementation of steroid and HCG except $E_2$ can improve the in vitro maturation and ovulation of oocyte in P. fulvidrac; HCG and $17\alpha20{\beta}OHP$ may be more effective than other steroids on oocyte maturation and ovulation in P. fulvidraco.

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전자부품의 냉각을 위한 자연대류 상관 관계식의 평가

  • 이재헌
    • Journal of the KSME
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    • v.27 no.6
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    • pp.504-514
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    • 1987
  • 복잡한 전자부품의 조립시에 필요한 열적 디자인에 관한 정보는 오래전부터 실험을 통하여 얻어지고 있다. 실험적 데이터를 이용하여 무차원 파라미터로 표시된 실험결과는 꼭 같지는 않지만 현상적으로는 비슷한 상황에 응용될 수 있다. 여기서는 학술문헌에 나타나 있는 자연대류에 관한 실험적인 상관관계식들과 프레임에 수직으로 꽂혀있는 균일가열 전자회로기판의 모델에서 얻어진 무차원 자료들을 비교하고자 한다. 대부분의 자료들은 수정채널 Rayleigh수(Ra")가 15~100범위에 속하며, 이러한 범위는 부품이 조밀하게 배치된 기관이 서로 좁은 채널을 이루고 있으며, 동시에 상당한 전력을 소비하고 있는 경우에 해당한다. Wirt와 Stutzman, Bar-Cohen과 Rohsenow의 일반상관관계식은 AT'||'&'||'T Bell 연구소에서 개발된 전자기기를 이용하여 수집한 실험데이터를 잘 표현하고 있으며 10 < Ra" <1,000범위에서 추천될 수 있다. 두개의 유사한 상관관계식과 비교할 때 상당히 좋은 예측을 보였으며 또한 Sparrow와 Gregg의 연구결과와도 잘 일치하므로 Ra" < 10인 경우에 Aung의 완전발달층류의 채널유동방식, Ra" > 1,000인 경우에는 Aung등의 단일 수직평판 근사식이 추천될 수 있다. Coyne의 알고리즘에 의한 계산치는 10

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Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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A Clinical Study of Acute Colonic Diverticulitis in Children (소아에서 발생한 급성 대장 게실염의 임상적 고찰)

  • Sim, Jae Hoon;Song, Keum Ho;Sim, Yun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang;Lee, Hae Ran;Lee, Kwan Seop
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1095-1100
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    • 2003
  • Purpose : Children with acute colonic diverticulitis(ACD), can be misdiagnosed with acute appendicitis. Methods : We reviewed 15 cases of ACD during five years, from January 1998 to June 2002 retrospectively. Results : Most patients(80%) with ACD in children presented with right lower quadrant pain. The primary diagnosis on admission was mostly acute appendicitis(87%), and all ACD in children occurred in the right colon. Fourteen patients were managed by conservative treatment including antibiotics. A follow-up study was performed in 15 patients. There were symptomatic recurrences in two patients, but no significant complication was noted. The frequency of ACD was 11.7 per 1000 acute appendicitis. Conclusion : ACD in children can mostly be cured by conservative treatment. It is prudent to choose the management through the diagnostic work up, including abdominal sonography and computed tomography, because there was no significant difference of clinical findings between ACD and acute appendicitis.