• Tuberculosis and Respiratory Diseases
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• 제54권1호
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• pp.80-90
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• 2003

배경 : 본 연구에서는 세균성 리포다당질(lipopolysac-charide, LPS)로 인한 호중구성 염증이 EGFR 시스템을 통해서 배상 세포의 이형성 및 점액의 과다 분비를 유발할 것이라는 가설 하에, LPS와 MMPs 억제제(matrix metalloproteinase inhibitor, MMPI)를 투여한 후 EGFR 및 MMP-9의 발현을 연구하고자 하였다. 방법 : Pathogen-free Sprague-Dawley 를, 다양한 농도의 LPS를 투여한 군과 투여하지 않은 대조군으로 나누어 기도의 조직학적인 변화를 날짜 별로 관찰하였고, MMPI(CMT-3)를 LPS 투여 3일 전부터 매일 구강을 통해 섭식시켰다. 호중구의 침윤은 다섯 개의 고배율 시야에서 관찰된 호중구의 수로 정량화하여 비교하였고, mucus glycoconjugate에 대한 AB/PAS 염색 및 MUC5AC, EGFR, MMP-9에 대한 면역조직화학 염색 (immunohistochemical stain)을 시행하였다 결과 : LPS를 투여한 경우 기도 상피의 AB/PAS 및 MUC5AC의 염색 정도는 시간 및 용량 의존적으로 증가하였고, MMPI를 치료할 경우에 LPS로 인한 배상세포의 과형성이 유의하게 감소하였다. LPS를 주입할 경우 호중구의 침윤이 증가하였고 기도 상피에서 EGFR의 발현을 증가시켰다. MMPI로 치료할 경우 LPS로 인한 호중구의 침윤 및 EGFR의 발현 그리고 배상세포의 과형성이 현저하게 감소되었다. 결론 : Matrix metalloproteinase는 호중구성 염증 및 EGFR에 의해 발생하는 LPS에 의한 배상 세포의 과형성 및 점액 과다분비의 기전에 있어서 밀접하게 관련되고, 따라서 점액 과다분비를 특징으로 하는 세균 감염으로 인한 기도 질환의 치료에 있어서 MMPI가 잠재적인 임상적 효과가 있을 것으로 사료된다.

• 대한간호학회지
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• 제7권2호
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• pp.11-21
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• 1977

Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

• 대한두개안면성형외과학회지
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• 제10권1호
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• pp.40-43
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• 2009

Purpose: Extensive midface defect following total maxillectomy with orbital exenteration and cheek skin resection should be three dimensionally reconstructed with a large flap that have a sufficient volume of tissue and multiple skin islands. We describe our transverse rectus abdominis myocutaneous(TRAM) free flap with three skin islands which was successfully used in this situation. Methods: A 58-year-old man was performed enbloc total maxillectomy including orbital contents and wide cheek skin because of invasive maxillary squamous cell carcinoma. He was immediately reconstructed with TRAM flap that was designed not vertical but transverse fashion for providing sufficient skin area. Also, deepithelialization procedure making for multiple skin islands was done in flap insetting period when appropriate modification according to the intraoperative situation was possible. Dead space was completely obliterated by bulky muscular tissue, and three skin islands were used for lining of lateral nasal wall, palatal surface, and cheek skin restoration. Results: Postoperative course was satisfying. Maintaining of proper ipsilateral nasal airway, loss of rhinolalia and oronasal regurgitation of food particles, and restoration of cheek contour were successfully obtained. Conclusion: We report clinical experience of threedimensional reconstruction using free TRAM flap after total maxillectomy with orbital exenteration.

• 대한두경부종양학회지
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• 제32권1호
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• pp.49-52
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• 2016

The lobular capillary hemangioma (LCH) was previously known to pyogenic granuloma and is benign vascular lesion which grows rapidly on skin and mucosa. It arises from whole body, but oral and nasal cavities are most predilection sites in the head and neck area. The laryngeal LCH looks like a granulomatous lesion of posterior glottis and its common etiology are tracheal intubation and laryngopharyngeal reflux disease etc. The LCH in larynx can cause blood tinged sputum and lump sense. The lesions refractory to medical therapy or causing dyspnea may require surgical excision. A 74-year-old man who presented gradually aggravated dyspnea, lump sensation and hoarseness of one month came to our hospital. The stroboscopic examination revealed large well-margined glottic mass. It was excised with $CO_2$ laser and finally diagnosed as LCH. We present a rare unique case of glottic LCH with a review of literatures.

• 한국화재소방학회논문지
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• 제21권2호
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• pp.105-110
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• 2007

본 연구에서는 유아교육기관에서 흔히 발생될 수 있는 내 외과적인 응급상황에 대하여 유치원 교사의 기본 응급처치 수행능력에 대해 조사하였다. 연구결과 유치원 교사의 59.4%가 전반적인 응급처치방법에 대하여 올바르게 수행하고 있었으나 일부분에 있어서는 응급처치 교육이 절실하게 필요한 것으로 조사되었다. 특히 무의식 유아의 기도폐쇄는 83.2%가, 유아 인공호흡 방법은 82.1%가 잘못된 응급처치법을 숙지하고 있었다. 또한 화상 발생 시 67.4%가 응급처치 없이 바로 병원으로 간다고 응답하였고, 찰과상에 대해서도 53.7%가 잘못된 응급처치법을 숙지하고 있었다. 유아교육기관 내에서의 안전사고에 대한 교사의 책임이 부각되면서 실전에 필요한응급처치 교육프로그램 개발이 필요하다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.108-108
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• 1993

두경부영역의 림프관계의 선천성 기형은 주로 낭포성 림프관종이라고 불리던 것으로 경부에 발생하는 단발 또는 다발성의 림프로 가득찬 종괴로 나타나며, 그 자세한 발생기전에 대하여는 아직 논란이 많다. 저절로 없어지는 경우는 드물기 때문에 적절한 치료를 해 주어야 하며, 크기가 큰 경우 생후 즉시 호흡곤란, 연하곤란 등이 생겨서 위험한 상태에 빠지기도 한다. 치료로는 수술적으로 제거하는 것이 원칙이나 다발성으로 생긴 경우 그 완전제거가 어렵고, 주위조직으로의 침윤이 심한 경우에는 수술에 의한 합병증이나 재발 등이 야기될 수 있다. 최근 여러 가지 약제를 이용한 경화요법이 시도되어 왔는데, 저자들은 11명의 낭포성 림프관종을 가진 환아에서 bleomycin을 이용한 경화요법을 반복 시행하여 좋은 결과를 얻었기에 보고하고자 한다.

• 지역사회간호학회지
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• 제18권4호
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• pp.643-650
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• 2007

Purpose: This study was to obtain information regarding to agricultural accidents in farm workers in the Kyungpook area. Methods: A questionnaire survey was carried out for 528 workers from the 1st to 31st of March, 2007. Frequency, percentage, mean and chi-square test with the SPSS program were used to analyze the data. Results: The causes of agricultural accidents include falling(29.0%), overseeing(18.9%), traffic accident(17.4%), putting between machinery(11.7%), crashing(5.3%), fire (0.6%) in the order of frequency. Injuries from agricultural accidents include fracture(44.7%) cerebral bleeding (10.4%), amputation(7.0%), airway obstruction (2.3%) burn(1.9%), drug addiction(1.9%) in the order of frequency. The largest proportion of the subjects of hospital treatment were in their 50s and belonged to the group of high-level economic state. Agricultural machinery collision was the most frequent cause among the subjects of hospital treatment. Conclusion: These results suggest that carelessness can be a potential risk factor for agricultural accidents in farm workers. These findings may give useful information for developing agricultural accident prevention programs for farm workers.

• 대한의사협회지
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• 제61권12호
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• pp.715-723
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• 2018

Facial soft tissue injury due to trauma is common. Severe damage of soft tissue causes functional and cosmetic problems. In the initial evaluation of patients with facial trauma, airway maintenance and respiratory maintenance are the most important. The principles of treatment include adequate irrigation and debridement, primary closure, or secondary wound healing. Postoperative care such as taping, silicone gel sheeting, and sun screening is important to prevent scarring. The scalp and forehead are abundant in blood and can cause severe bleeding. The eyelid is very thin and has a multi-layered structure, requiring accurate suturing and reconstruction of the layers. It is advisable to determine the presence of hematoma in the ear and treat it. When the cheek area is damaged, it is necessary to identify and treat the damage of the parotid gland and the facial nerve branch. The lips should be sewn with the white roll of lip and vermillion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.538-542
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• 2010

Acute mediastinitis is a fatal infection which occurs related to connective tissue of mediastium, in the thoratic organs. Occurrence of mediastinitis due to craniocervical infection is very rare, and is defined as descending necrotizing mediastinitis. November 8th, 2008, man in his early fifties visited ER due to severe swelling on left neck area and dyspnea. Antibiotic were administered immediately, and vast amount of abscess formation on pneumomediastinum and adjacent tissues were observed via chest computed tomography. With cooperation of thoracic and cardiovascular surgery department, emergency incision and drainage with drain insertion was done to remove abscess, and control the infection. After surgery, everyday saline irrigation through drain was done during hospitalization, with continues antibiotic therapy. Descending necrotising mediastinitis is a most rare and dangerous infection which occurs on oropharyngeal area. In case of descending necrotising mediastinitis, accurate diagnosis, airway maintenance, remove of abscess by incision and drainage, aggressive antibiotic therapy and continuous saline irrigation is necessary to increase patient survivability. Also, computed tomography with contrast media is essential to figure out the size and location of the infection and abscess formation.

• 한국항공우주학회지
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• 제43권12호
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• pp.1054-1061
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• 2015

민수용 무인항공기의 활용이 확대될 것으로 기대되면서 무인항공기의 항법 정확도와 항법 무결성의 보장에 대한 문제가 중요해지고 있다. 최근 민수용 무인항공기를 대상으로 항법 정확도와 항법 무결성을 보장하는 지역보강항법시스템(Local-Area Differential Global Navigation Satellite System, LADGNSS)의 개념이 제시된 바 있다. LADGNSS는 무인항공기간의 충돌을 방지하기 위한 최소분리거리 정보를 제공하여 무인항공기의 안전을 보장한다. 최소분리거리를 산출하기 위해서는 무인항공기의 비행기술오차(Flight Technical Error)에 대한 정보가 필요한데, 이 오차는 기존 유인항공기 분야에서 평균이 0인 정규분포로 모델링 되어 왔다. 하지만 무인항공기의 경우 유인항공기와 다르게 제어/항법장비나 비행경로 등에 대한 표준이 다변화 될 것으로 예상되며 비행기술오차에 대해서 일괄적으로 평균이 0인 정규분포를 가정하는 것은 무결성 정보 산출 시 과도한 보수성을 야기할 수 있다. 본 연구에서는 비행실험을 통해 무인항공기의 비행기술오차를 수집하고, 해당 오차의 특성을 잘 묘사할 수 있는 Johnson 분포 모델을 이용해 오차를 모델링 하였다. 오차모델에 대한 적합성을 평가하기 위해서 Kolmogorov-Smirnov Test와 Anderson-Darling Test를 수행하였다.