• 제목/요약/키워드: Critical illness

검색결과 130건 처리시간 0.023초

상시 근골격 모니터링과 재활을 위한 온스킨 센서 디바이스 기술 (Imperceptible On-Skin Sensor Devices for Musculoskeletal Monitoring and Rehabilitation)

  • 박찬우;구재본;진한빛;김윤정;임채현;홍찬화;김혜진
    • 전자통신동향분석
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    • 제37권2호
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    • pp.30-41
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    • 2022
  • As the society is superaging, the number of patients with movement disabilities due to musculoskeletal or nervous system illness is rapidly increasing. To improve public health and reduce medical expenses, it is essential to develop rehabilitation systems that allow patients to resume their daily-life activities. However, the existing musculoskeletal illness diagnosis and rehabilitation method is limited in terms of precision and efficiency because it is based on an empirical diagnosis and prescription without regard for individual characteristics. To overcome these limits, it is critical to design a novel concept of routine rehabilitation therapy device that is capable of inducing musculoskeletal balance by the precise analysis of musculoskeletal usage patterns via the motion and the muscle activity tracking of linked muscles. This study introduces the trend of on-skin sensor device technology for routine musculoskeletal monitoring and therapy. For on-skin rehabilitation systems, skin-adhesive and stretchable motion/posture, electromyography, pressure sensors, small-size and low-power wireless sensor interfaces, and user-friendly rehabilitation contents based on new algorithms are combined.

질적연구 진술문을 이용한 중환자실 생존자의 감성분석 (Sentiment Analysis of the Quotations of Intensive Care Unit Survivors in Qualitative Studies)

  • 강지연
    • 중환자간호학회지
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    • 제11권1호
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    • pp.1-14
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    • 2018
  • Purpose : As the intensive care unit (ICU) survival rate increases, interest in the lives of ICU survivors has also been increasing. The purpose of this study was to identify the sentiment of ICU survivors. Method : The author analyzed the quotations from previous qualitative studies related to ICU survivors; a total of 1,074 sentences comprising 429 quotations from 25 relevant studies were analyzed. A word cloud created in the R program was utilized to identify the most frequent adjectives used, and sentiment and emotional scores were calculated using the Artificial Intelligence (AI) program. Results : The 10 adjectives that appeared the most in the quotations were 'difficult', 'different', 'normal', 'able', 'hard', 'bad', 'ill', 'better', 'weak', and 'afraid', in order of decreasing occurrence. The mean sentiment score was negative ($-.31{\pm}.23$), and the three emotions with the highest score were 'sadness'($.52{\pm}.13$), 'joy'($.35{\pm}.22$), and 'fear'($.30{\pm}.25$). Conclusion : The natural language processing of AI used in this study is a relatively new method. As such, it is necessary to refine the methodology through repeated research in various nursing fields. In addition, further studies on nursing interventions that improve the coherency of ICU memory of survivors and familial support for the ICU survivors are needed.

기관지내 종괴로 발현된 폐모균증 1례 (A Case of Pulmonary Mucormycosis Presenting as an Endobronchial Mass)

  • 황정혜;안창혁;윤종욱;노길환;함형석;강은해;서지영;정만표;김호중;권오정;이종헌
    • Tuberculosis and Respiratory Diseases
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    • 제49권5호
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    • pp.633-638
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    • 2000
  • 기관지 모균증은 드문 질환으로 돌출된 종괴로 발현된 경우는 특히 드물다. 저자들은 당뇨환자에서 종괴형태로 발현되어 우측 주기관지를 폐색시키는 기관지 모균증을 발견하였다. 경직성 기관지술로 모군 종괴를 제거하여 임상적으로 호전시킨 후 적극적으로 전신적 Amphotereicin B 투여와 폐절제술을 동반하여 완치한 1예를 경험하여 이를 보고하는 바이다.

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유료 노인주거복지시설에 거주하게 된 이유에 관한 연구 (Main Reasons for Choosing to Stay in a Paid Elderly Residential Facility)

  • 이인수
    • 한국주거학회논문집
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    • 제14권2호
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    • pp.121-132
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    • 2003
  • This study has been performed to explore main reasons for staying in paid elderly residential care facilities among the residents. In this study, five males and seven females aged 65 to 82 were asked about main reasons for staying in the facilities. The answers of the qualitative interview were drawn as follows; first, some residents had suddenly decided to move into the facility due to critical life events such as bereavement, serious illness, or supporting problems. Second, some residents had taken a long period of considerations on whether staying home or in the facilities, because their health and family supports gradually diminished over the long life span. On the other hand, a few of them voluntarily chose to stay at the facilities, because they recognized supervised group activities, nutritionally well-planned meals, and health care as major inconveniences. In this study, suggestions were made as follows: first, guiding and settlement programs should be developed for the residents of the sudden events, particularly at early stage of admission. Second, intensive nursing care units should be in separation from healthy independent groups, so that the residents are relieved from stressful contacts with extremely ill patients in the residential area.

발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석 (Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor)

  • 임성용;서지영;경선영;안창혁;박정웅;이상표;정성환;함형석;안영미;임시영;고원중;정만표;김호중;권오정
    • Tuberculosis and Respiratory Diseases
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    • 제61권1호
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    • pp.34-40
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    • 2006
  • 연구배경: 발관 실패와 관련된 위험 인자를 살펴보고, 기관내 삽관의 합병증으로 인한 후두부 폐쇄와 PES로 인한 재삽관의 위험성을 발관 전에 미리 예측하기 위한 CLT 검사의 의의 및 제한점을 알아보고자 하였다. 방 법: 24시간 이상 삽관과 인공 호흡기 치료 후 발관을 시도한 34명의 연속적인 환자들을 대상으로 발관 실패군에서 성공군과 차이를 보이는 인자를 살펴보고 CLT 를 시행해서 PES와 재삽관을 예측하는 CLV, CLP의 기준값을 구하였다. 결 과: 총 34명중 발관 실패는 6명(17.6%), PES는 3명(8.8%) 이었고 PES가 있던 3명은 모두 재삽관을 받았다. 발관 실패 환자에서 삽관 기간이 길었고, SAPS II score가 컸으며, 삽관 기간은 CLV, CLP와 역상관관계를 보였다. PES 양성 환자의 평균 CLV은 $22.5{\pm}23.8ml$로 음성 환자의 $233.3{\pm}147.1ml$보다 낮았고, CLP도 양성군에서 $6.2{\pm}7.3%$로 음성군의 $44.3{\pm}24.7%$보다 유의하게 낮았다. 가장 신뢰성 있는 CLV, CLP의 기준값은 50 ml, 14.7% 였고 CLV의 민감도는 100%, 특이도 93.5%, 양성예측도 60%, 음성예측도 100% 였고, CLP의 민감도는 100%, 특이도 87.1%, 양성예측도 42.9%, 음성예측도 100% 였다. 결 론: 삽관 기간이 길고 중증 질환 환자에서 발관 실패의 가능성이 높다. CLV, CLP가 감소되어 있을 경우 PES로 인한 재삽관 위험이 높아지므로 발관 시 주의가 필요하지만 발관의 불필요한 연기나 시도 자체에 대한 기준은 아닐것으로 생각된다.

Predicting Mortality in Patients with Tuberculous Destroyed Lung Receiving Mechanical Ventilation

  • Kim, Won-Young;Kim, Mi-Hyun;Jo, Eun-Jung;Eom, Jung Seop;Mok, Jeongha;Kim, Ki Uk;Park, Hye-Kyung;Lee, Min Ki;Lee, Kwangha
    • Tuberculosis and Respiratory Diseases
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    • 제81권3호
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    • pp.247-255
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    • 2018
  • Background: Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation. Methods: Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality. A TDL on mechanical Ventilation (TDL-Vent) score was calculated by assigning points to variables according to ${\beta}$ coefficient values. Results: Data from 125 patients were reviewed. A total of 36 patients (29%) died during ICU admission. On the basis of multivariate analysis, the following factors were included in the TDL-Vent score: age ${\geq}65$ years, vasopressor use, and arterial partial pressure of oxygen/fraction of inspired oxygen ratio <180. In a second regression model, a modified score was then calculated by adding brain natriuretic peptide. For TDL-Vent scores 0 to 3, the 60-day mortality rates were 11%, 27%, 30%, and 77%, respectively (p<0.001). For modified TDL-Vent scores 0 to ${\geq}3$, the 60-day mortality rates were 0%, 21%, 33%, and 57%, respectively (p=0.001). For both the TDL-Vent score and the modified TDL-Vent score, the areas under the receiver operating characteristic curve were larger than that of other illness severity scores. Conclusion: The TDL-Vent model identifies TDL patients on mechanical ventilation with a high risk of mortality. Prospective validation studies in larger cohorts are now warranted.

기도 이물의 임상적 고찰 (A Retrospective Review of Tracheobronchial Foreign Bodies)

  • 손창영;위정욱;김수옥;오인재;박창민;김규식;김유일;임성철;임상철;김영철;박경옥
    • Tuberculosis and Respiratory Diseases
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    • 제58권6호
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    • pp.600-606
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    • 2005
  • Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

비순환기계 중환자의 예후인자로서 Cardiac Troponin I의 유용성 (Usefulness of Cardiac Troponin I as a Prognostic Marker in Noncardiac Critically Ill Patients)

  • 김휘종;함현석;조유지;김호철;이종덕;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제59권1호
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    • pp.53-61
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    • 2005
  • 배 경 : cTnI는 심근손상의 특이 표시자로서 급성관상동맥 질환에서 높은 증가는 나쁜 예후와 상관이 있다. cTnI의 증가는 여러 가지 비심장성 중증질환에서도 관찰할 수 있다. 연구자 등은 비순환기계 중환자의 예후인자로서 cTnI의 유용성을 조사하였다. 대상 및 방법 : 2003년 1월부터 2004년 7월까지 경상대학교 병원내과계 중환자실에 급성 관상동맥 증후군 이외의 중증 질환으로 입원한 215명의 환자(남:142명, 여:73명, 평균 나이:$63{\pm}2$세)를 대상으로 하였다. 환자들은 중환자실 입원 24시간 이내에 SAPS II와 SOFA점수를 산출하였고 혈청 cTnI를 측정하였다. cTnI 양성군(${\geq}0.1{\mu}g/L$)과 음성군($<0.1{\mu}g/L$) 환자의 중환자실 제 10병일째와 30병일째 사망률을 비교하였다. cTnI 양성군에서 중환자실 제 10병일째와 30병일째에 혈청 cTnI의 평균수치를 비교하였다. cTnI 양성군에서 혈청 cTnI 수치와 SAPS II와 SOFA점수와의 상관관계를 조사하였다. 결 과 : 1) cTnI양성군 환자는 120명(56%)이었고 음성군환자는 95명(44%)였다. 2) 중환자실 제 10병일째와30병일째의 사망률은 cTnI 양성군(29%, 41%)이 음성군(12%, 21%)보다 유의하게 높았다(p<0.01). 3) cTnI 양성군에서 중환자실제10병일째와 30병일째의 cTnI 평균 수치는 비생존군($4.5{\pm}9.2{\mu}g/L$, $3.5{\pm}7.9{\mu}g/L$)이 생존군($1.8{\pm}3.6{\mu}g/L$, $2.0{\pm}3.9{\mu}g/L$)보다 유의하게 높았다(p<0.05). 4) cTnI 양성군에서 cTnI 수치는 SAPS II 점수(r=0.24, p<0.001)와 SOFA 점수(r=0.30, p<0.001)와 유의한 상관관계가 있었다. 결 론 : 혈청 cTnI는 비순환기계 중환자의 유용한 예후인자가 될 수 있을 것으로 사료된다.

만성폐쇄성폐질환자 가족의 보호부담에 관한 연구 (Burden of COPD among Family Caregivers)

  • 김정화;김은경;박선형;이경애;황용일;김은지;장승훈;박성훈;이창률;이명구;이지연;김동규;정기석
    • Tuberculosis and Respiratory Diseases
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    • 제69권6호
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    • pp.434-441
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    • 2010
  • Background: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. Methods: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. Results: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. Conclusion: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

외과계 중환자의 수면질에 영향을 미치는 요인 (Factors Influencing on Quality of Sleep among Patients at Surgical Intensive Care Units)

  • 김혜순;이명희;김세영
    • 성인간호학회지
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    • 제20권3호
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    • pp.365-374
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    • 2008
  • Purpose: This study was conducted to evaluate quality of sleep and to assess the factors that influence quality of sleep in surgical ICU. Methods: The subject of the study were consisted 109 adult patients who admitted to surgical ICU. The data were collected from May 20 to December 10, 2007 by structured questionnaires. The data were analyzed with descriptive analysis, paired t-test, Pearson correlation coefficient and stepwise multiple regression. Results: The score of quality of sleep was 4.57 point. The main sleep disturbance factors related to quality of sleep in surgical ICU inpatient were sleep time, machinery alarm and noise(adjusted $R^2$=33.2). Conclusion: Based on the finding of this study, it is needed to develop a nursing intervention program that including to promote quality of sleep and to decrease machinery alarm and noise in surgical ICU.

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