• 제목/요약/키워드: Feeding tube

검색결과 209건 처리시간 0.023초

빔튜브파단 냉각재상실사고시 원자로냉각수 보충방법 변경이 리스크에 미치는 영향 (Effect of Change of Reactor Coolant Injection Method on Risk at Loss of Coolant Accident due to Beam Tube Rupture)

  • 이윤환;이병희;장승철
    • 한국안전학회지
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    • 제37권4호
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    • pp.129-138
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    • 2022
  • A new method for injecting cooling water into the Korean research reactor (KRR) in the event of beam tube rupture is proposed in this paper. Moreover, the research evaluates the risk to the reactor core in terms of core damage frequency (CDF). The proposed method maintains the cooling water in the chimney at a certain level in the tank to prevent nuclear fuel damage solely by gravitational coolant feeding from the emergency water supply system (EWSS). This technique does not require sump recirculation operations described in the current procedure for resolving beam tube accidents. The reduction in the risk to the core in the event of beam tube rupture that can be achieved by the proposed change in the cooling water injection design is quantified as follows. 1) The total CDF of the KRR for the proposed design change is approximately 4.17E-06/yr, which is 8.4% lower than the CDF of the current design (4.55E-06/yr). 2) The CDF for beam tube rupture is 7.10E-08/yr, which represents an 84.1% decrease compared with that of the current design (4.49E-07/yr). In addition to this quantitative reduction in risk, the modified cooling water injection design maintains a supply of pure coolant to the EWSS tank. This means that the reactor does not require decontamination after an accident. Thermal hydraulic analysis proves that the water level in the reactor pool does not cause damage to the nuclear fuel cladding after beam tube rupture. This is because the amount of water in the chimney can be regulated by the EWSS function. The EWSS supplies emergency water to the reactor core to compensate for the evaporation of coolant in the core, thus allowing water to cover the fuel assemblies in the reactor core over a sufficient amount of time.

비위관영양환자의 폐흡인 조기확인을 위한 포도당 검사지[glucose test strips] 방법의 임상적 유용성 (Clinical Implications of the Glucose Test Strip Method for Early Detection of Pulmonary Aspiration in Nasogastric Tube- Fed Patients)

  • 김화순
    • 대한간호학회지
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    • 제34권7호
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    • pp.1215-1223
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    • 2004
  • Purpose: This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients. Method: The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria. Result: The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35mg/dl and were lower than those concentrations found in tube fed patients (32.75mg/dl). The mean glucose concentration of the aspiration group was 45.60mg/dl and the glucose concentration of the non aspiration group was 19.93mg/dl. The difference was statistically significant (t=2.163, p=.038). More subjects in the no aspiration group ($73\%$) than the aspiration group ($56\%$) had glucose concentrations below 20mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups. Conclusion: The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

경관급식 유동액의 점도와 삼투압이 체외에서 비장관 튜브를 통한 흐름속도에 미치는 영향 (The Effects of viscosity and Osmolality of Enteral Solution on Flow Rates Through Nasogastric Tubes in Vitro)

  • 한경희
    • Journal of Nutrition and Health
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    • 제26권6호
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    • pp.793-803
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    • 1993
  • This study was designed to measure viscosity, osmolality and in vitro flow rates via nasogastric tubes for 6 types of commercially available and 9 hospital-blenderized enteral solutions and to examine the effect of viscosity and osmolaility of enteral formula on the flow rates in gravity drip administration. Each solution was infused through 18, 16, 14, 12 French sizes of silicone rubber tube. Flow rates were measured six times at $25^{\circ}C$ using formula bags and drip sets hung at a uniform height on a intravenous drip stand with tube uniformly positioned in collecting container. Viscosity ranged widely from 16.0 to 195.5 cps with mean, 64.61$\pm$64.42 for hospital-blenderized formula while mean viscosity of commercial formula was 7.60$\pm$4.84 cps. Mean osmolality of commercial formula and hospital-blenderized formula were 370$\pm$100.80, 540.33$\pm$89.37 mOsm/kg respectively. There was negative relationship between viscosity of formula and flow rates through tubes but no significant relationship between flow rates and osmolalty. Some of hospital-blenderized formula was too viscous to be infused througth tube with gravity drip administration and the recipe of formula requires to be modiifed. On the other hand, commercial formula with the low viscosity flows too rapidly with large bore size tubes. Smaller size of tube must be selected for hyperosmolar solution to decrease possible side effects associated with tube feeding. Two kinds of regression equations for flow rates obtained according to viscosity and tube sizes were also presented for the purpose of practical uses. In conclusion, this study emphasizes that viscosity of fomula, osmolality, patient's tolerance and comfort, caloric density should be considered in the selection of tubes for gravify drip administration.

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후천성 비종양성 기관식도루;수술 치험1례 (A Case Report of Acquired Nonmalignant Tracheoesophageal Fistula)

  • 윤정섭
    • Journal of Chest Surgery
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    • 제25권8호
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    • pp.800-805
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    • 1992
  • Acquired, nonmalignant tracheoesophageal fistula is an uncommom and difficult problem to manage. The most commom cause is a complication of endotracheal or tracheostomy tubes. Most are diagnosed while patients still require mechanical ventilation. The principle of treatment is two stage operation. First, new tracheostomy tube is placed so that the baloon is below the fistula, and gastrostomy and feeding jejunostomy are made for the drainage and feeding. Finally after weaning from the mechanical ventilation, tracheal resection and reconstruction are made, and the esophageal defect is closed in two layers and a viable strap muscle interposed into the two suture site to prevent recurrence. Recently, we experienced a case of acquired nonmalignant tracheoesophageal fistula which was developed during mechanical ventilation. She was successfully treated with the above two stage operation.

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Effects of Dysphagia Treatment Applied to Infants with Pierre Robin Syndrome - Single Subject Research Design

  • Kim, Mikyung;Kim, Deokju
    • International Journal of Advanced Culture Technology
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    • 제8권1호
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    • pp.1-12
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    • 2020
  • Pierre Robin syndrome is characterized by micrognathia, glossoptosis, and cleft palate. Infants with Pierre Robin syndrome causes feeding difficulty, upper airway obstruction, and other symptoms. This study aims to examine the effects of applying dysphagia treatment to infants with Pierre Robin syndrome. The study participant was an infant who was born four weeks premature and referred for dysphagia treatment approximately 100 days after birth. At the initial assessment, the infant showed oral sensory sensitivity, a high level of facial and masticatory muscle tension, and a low stability of the chin and cheeks with almost no normal "sucking-swallowing-breathing" pattern. We set the baseline period and intervention period using the AB design. During the baseline period, non-nutritive sucking training using a rubber nipple was conducted without implementing an oral stimulation intervention. During the intervention period, non-nutritive sucking training and an oral stimulation intervention were performed. After the intervention period, the infant's daily oral intake and oral intake per time significantly increased compared to that during the baseline period. We observed that the oral intake time of the infant decreased during the intervention period compared to that in the baseline period, which indicated an improvement in control over the chin, tongue, and lip movements, a change in muscular tension, and stabilization of the "sucking-swallowing-breathing" pattern. We provided dysphagia treatment before breastfeeding, it was positive effects such as normal development of the infant, transition from tube feeding to bottle feeding, and enhancement of overall oral motor function.

연하장애 환자의 삶의 질 영향 요인 (Factors Influencing Swallowing-related Quality of Life in Patients with Dysphagia)

  • 김주연
    • 한국산학기술학회논문지
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    • 제17권11호
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    • pp.421-431
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    • 2016
  • 본 연구는 연하장애 환자의 삶의 질 향상을 목적으로 연하장애 환자의 우울, 사회적 고립감, 생의 의미와 삶의 질수준을 파악하고, 삶의 질의 영향요인을 확인하고자 시도되었다. 연구대상은 서울, 인천, 경기 지역에 소재한 종합병원과 재활병원 등 8개 기관에서 뇌졸중, 퇴행성 신경계 질환으로 인하여 연하장애가 발생한 환자 총87명을 대상으로 하였다. 자료수집기간은 2015년 2월부터 4월까지였으며, 연구도구는 CES-D, RULS, PIL, SWAL-QOL을 사용하였다. 수집된 자료는 SPSS 22.0 통계프로그램을 이용하여 기술통계, t-test, ANOVA, Pearson's correlation, Stepwise multiple regression으로 분석하였다. 연구 결과 우울이 있는 군은 대상자의 20.7%였고, 보통 이상의 사회적 고립감을 느끼는 군 92.0%, 실존적 공허상태에 있는 군이 64.4% 였다. 즉, 대다수의 대상자들이 사회적 고립감을 경험하고 실존적 공허상태에 있었으며, 삶의 질의 평균 점수는 158.89(35.97)점이었다. 연하장애 환자의 삶의 질 영향요인을 확인한 결과, 경관급식의 경우가 정상식이보다 삶의 질이 유의하게 낮았고(${\beta}=-0.57$, p<.001), 생의 의미가 낮아 실존적 공허상태에 있는 경우(${\beta}=0.19$ p=.014)가 삶의 질이 낮았다. 30-49세의 연령은 80세 이상보다 삶의 질이 높았으며(${\beta}=0.26$, p=.001), 대학교 수준 이상의 교육수준이 무학에 비해 삶의 질이 높았다(${\beta}=0.17$, p=.032). 이 중 연하장애 환자의 삶의 질에 가장 많은 영향을 주는 변수는 경관급식이었고 (${\beta}=-0.57$, p<.001), 이러한 4개의 변수는 연하장애 환자의 삶의 질에 대해 50.7%(F=28.84 p=.031)의 설명력을 나타냈다. 그러므로 연하장애 환자의 삶의 질을 높이기 위해 생의 의미를 높일 수 있는 중재 프로그램의 개발과 함께, 경관급식 환자의 삶의 질이나 정서 상태를 확인할 수 있는 후속연구가 필요하다.

고장력강 관재 액압성형 공정 설계 (Hydroforming Process Design of High-Strength Steel Tube)

  • 김기정;김헌영;고형규;신명호
    • 한국소성가공학회:학술대회논문집
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    • 한국소성가공학회 2009년도 추계학술대회 논문집
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    • pp.202-205
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    • 2009
  • Tubular torsion beam of high strength steel is going about in an automotive rear axle due to the advantages of light weight and efficient rear packaging capability. High strength tubular beam can be manufactured by the hydroforming in order to ensure dimensional accuracy, while a conventional stamping has been used for steel tubular beam. Internal pressure, feeding and their combination are the key factors of controlling the process. Based on the numerical simulation and try-outs, the optimized hydroforming process conditions for the high strength tubular beam were suggested.

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알루미늄 튜브의 열처리 조건에 따른 액압 성형성 연구 (Effects of Heat Treatment on Hydroformability of Aluminum Tubes)

  • 이문용;손성만;조완제;이상용
    • 한국소성가공학회:학술대회논문집
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    • 한국소성가공학회 2001년도 추계학술대회 논문집
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    • pp.364-367
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    • 2001
  • Recently social demands of fuel economy and environmental regulation require the development of light materials and new manufacturing technologies. In this point, aluminum tube hydroforming, which is satisfied with good strength-to-weight ratio and recyclability, is new innovative concept. but, up to now the level of that is relatively low. In this paper, we studied formability of different aluminum tubes in different heat treatments under internal pressure and axial feeding, and mechanical properties of aluminum tubes before and after hydroforming.

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선천성 낭포성 유선종 기형 (Congenital Cystic Adenomatoid Malformation(CCAM))

  • 김수원
    • Journal of Chest Surgery
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    • 제21권6호
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    • pp.1084-1094
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    • 1988
  • Conservative management of 3 iatrogenic perforations of intrathoracic esophagus was reviewed. The primary disorders were achalasia in 2 patients and congenital tracheoesophageal fistula in 1 patient. Perforation occurred after treatment of the primary disorders in the distal esophagus in 2 patients and mid-thoracic esophagus in 1 patient. All the perforations appeared late after the previous treatments and the inflammation spread to mediastinum and pleural cavity in all the 3 patients. Conservative management of esophageal perforation was carried out with intraluminal drainage from the perforated site of esophagus[insertion of Levin`s tube and continuous suction], pleural drainage and feeding of liquid diet through gastrostomy tube with Fowler`s position. The patients revealed spontaneous closure of perforated sites about 3 to 4 weeks after this conservative management without open thoracotomy. This result suggests that this conservative management may be accepted as therapeutic method in the thoracic esophageal perforations regardless of cause and time of the perforation.

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관재 하이드로포밍시 공정인자 영향도에 관한 연구 (A Study on the Effects of the Process Parameters for the Tube Hydroforming Process)

  • 김봉준;김정운;문영훈
    • 한국소성가공학회:학술대회논문집
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    • 한국소성가공학회 2001년도 춘계학술대회 논문집
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    • pp.49-53
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    • 2001
  • Recently hydroforming process became a process which is increasingly applied in the automotive industry. As the hydroforming process is a new technology, there is no abundant data to assist manufacturing the products. To investigate the effects of process parameters on the tube hydroforming process, simple bulging, circular bulging and Tee-fitting tests are performed. The optimal leading path to escape the failure modes(bursting, wrinkling) is determined and the effects of the process parameters, the internal pressure and axial feeding on the product quality, such as thickness distribution, forming height and branch dome shape are investigated.

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