• 제목/요약/키워드: Korean medical class

검색결과 839건 처리시간 0.034초

구개측 미니플래이트를 이용한 양악 치아치조성 전돌환자에서의 설측 Biocreative therapy 적용 (Severe bidentoalveolar protrusion treated with lingual Biocreative therapy using palatal miniplate)

  • 정규림;정도민;박현정;김성훈
    • 대한치과교정학회지
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    • 제40권4호
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    • pp.276-287
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    • 2010
  • 본 증례보고는 심한 양악 치아치조성 전돌과 전치부 치열밀집을 보이는 23세 8개월 여자 환자를 대상으로 한 변형된 형태의 설측 교정치료법인 설측 Biocreative therapy 치료를 소개하고자 한다. 양악 제1소구치 발치 후 구개천장에 식립된 C-플래이트에 lingual sheath가 달린 보조장치를 접착하여 상악구치부에 장치부착 없이 튜브역할을 대신하게 하였으며 상악 전치부의 decrowding과 견인을 위하여 설측 교정용 브라켓을 사용하지 않고 0.022 슬롯을 가진 순측 브라켓을 치아 설면에 부착한 후 납착된 설측 레버암을 이용하여 상악 전치부의 3차원적인 견인을 시행하였으며, 견인 후 finishing 기간동안 tooth positioner를 사용하였다. 상악 구치부의 장치부착 없이도 총 치료기간은 19개월 소요되었고, 안정적인 교합관계와 안모의 개선이 이루어졌다. 장치 제거 후 13개월 유지 후에도 양호한 결과가 유지되었다.

간 스캔에서 관찰되는 폐 방사능에 관한 임상적 고찰 (Clinical Aspects of Pulmonary Radioactivity Observed in Radiocolloid Liver Scintigraphy)

  • 소영;이강욱;이헌영;이원우
    • 대한핵의학회지
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    • 제36권3호
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    • pp.185-194
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    • 2002
  • 목적: 방사성교질 간 스캔에서 폐 방사능이 관찰된 환자들의 임상적 소견을 바탕으로 간 스캔에서 폐 방사능이 관찰되는 질환의 종류를 알아보고 각 질환에 따른 폐 방사능 섭취 기전 및 환자 임상 경과를 알아보았다. 대상 및 방법: 대상 환자 총49명의 의무 기록 조사를 통하여 Tc-99m tin colloid 간 스캔에서 폐 방사능이 관찰될 당시의 주 진단명을 기준으로 대상 환자를 간 질환, 감염성 질환, 암, 허혈성 간 괴사, 기타 등 다섯 가지 질환군으로 분류하고, 각 질환군 환자들의 만성 간 질환 여부, Child-Pugh 등급, 혈청 AST, ALT수치, 추적 간 스캔 결과 및 임상 경과를 알아보았다. 결과: 총 49명중 25명에서 만성 간 질환이 있었고, 질환군별 환자수는 간 질환 23명, 감염성 질환 16명, 암 7명, 허혈성 간 괴사 2명, 기타 1명이었다. 혈청 AST, ALT 수치는 간 질환군과 허혈성 간 괴사 군 환자 모두에서 가역적 상승을 보였고, 이는 통계적으로 유의하였다(p<0.01, one-way ANOVA). 혈청 ALT 수치는 만성 간 질환이 없는 간 질환군에서 감염성 질환군에 비하여 유의하게 높았다(p<0.05). 추적 간 스캔검사가 시행된 총 17명 중 13명에서 추적 간 스캔에서 폐 방사능이 관찰되지 않았으나, 암 2명, 간과 신장의 다낭성 질환과 간 경변이 있는 독성 간염 1명 그리고 간 결핵 1명에서 추적 간 스캔에서 폐 방사능이 관찰되었다. 사망 환자는 총 12명으로 사인은 만성 간 질환 악화에 의한 간 부전 6명, 말기암 5명, 감염성 심내막염에 합병된 뇌출혈 1명이었다. 결론: 간 스캔에서 폐 방사능은 망상내피계 세포가 자극되는 심한 감염증 및 말기 암, 그리고 광범위한 간의 염증 또는 괴사를 동반하는 급, 만성 간 질환 및 허혈성 간 질환 등에서 관찰되는 것으로 판단된다.

신장이식 수혜자의 경험 (A Study on the Experience of Patients with Chronic Renal Failure who have Received a Kidney Transplant)

  • 이숙희;김경희;정혜경
    • 기본간호학회지
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    • 제6권1호
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    • pp.78-95
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    • 1999
  • The grafting of a kidney has been found to be the best medical treatment for patients who have renal insufficiency failure, but the patients still have experienced much trouble and apprehension. This study was done to further nursing theory developing for patients who have has a kidney graft from another person. The research method followed grounded theory methodology of Strauss and Corbin. The subjects were three female and four male patients. This study done befween Oct. 1997 and Mar. 1998. All of the subjects were interviewed by the author. Interview were done by the long interview technique and observation. In the process of data analysis, 'heart-boiling' was found to be the core phenomenon. The results were composed to 101 concepts. These concepts were grouped into nineteen categories, and then to twelve categories. There were 12 super-class categories as follows ; 'pain', 'heart-boiling', 'experience of dialysis', 'term of admission to a hospital', 'support of other person', 'dependence on God', 'direction', 'negative reaction', 'positive reaction', 'comfortable', 'lacking', 'acceptance'. In this process, 14 hypotheses were derived from the categories as follows ; (1) The more experience with dialysis that the patients have, the stronger the heart-boiling will tend to be. (2) The less experience with dialysis the patients have, the weaker the heart-boiling will tend to be. (3) The longer admission to hospital the patients have, the stronger the heart-boiling will be. (4) The shorter the admission to hospital the patients have, the weaker the heart-boiling will be. (5) The weaker the intense-grief is, the more positive the reaction to heart-boiling the patients wll have. (6) The stronger the intense-grief is, the more negative the reaction to heart-boiling the patients will have. (7) The stronger the support of other persons that the patients have, the more positive the reaction to heart-boiling the patients will have. (8) The weaker the support of other person that the patients have, the more negative the reaction to heart-boiling the patients will have. (9) The stronger the dependence on God that the patients have, the mure positive reaction to heart-boiling the patients will have. (10) The weaker the dependence on God that the patients have, the more negative reaction to heart-boiling the patients will have. (11) The more positive thoughts that the patients have, the more positive reaction to heart-boiling the patinets will have. (12) The more negative thoughts that the patients have, the more negative reaction to heart-boiling the patients will have. (13) The more positive reaction the patients have, the more free from heart-boiling the patients tend to be. (14) The more negative reaction the patients have, the less free from heart-boiling the patients tend to be. From the analysis of observed data and comparing each class, I concluded that there are four formula relation types between reaction of patients and heart-boiling. (1) If patients have the experience of dialysis, have a long term admission to hospital, are strong in heart-boiling, depend on God, have positive thoughts and another's strong support, they experience release by positive reaction to the intense-grief. (2) If patients have the experience of dialysis, have a short term admission to hospital, are weak in heart-boiling, do not depend on God, have negative thoughts, and have few supports from others, they experience attachment to heart-boiling though a negative reaction. (3) If patients have the experience of dialysis, have a long term admission to hospital, are strong in heart-boiling, do not depend on God, and have negative thoughts, they experience attachment to heart-boiling through negative reaction in spite of support from another. (4) If patients have the experience of dialysis, have a long term admission into hospital, are strong in heart-boiling and satisfaction is low, but they have positive thoughts, then they experience acceptance and harmony through the positive reaction to heart-boiling. The results of this study are expected to help the way nurses care for patients who have had a kidney graft from another.

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서울시 주민생활지원을 위한 공공시설의 현황 및 복합화 특성에 관한 조사연구 (Research on the Status Inquiry and Complex Characters of Public Facilities for the Community Life Style in Seoul)

  • 서귀숙
    • 한국주거학회논문집
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    • 제21권2호
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    • pp.19-30
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    • 2010
  • The aim of this research is to understand the characteristics and status of existing public facilities, in order to propose the necessary basic materials for the planning and development of improved public facilities to assist communities. Objects of this research are the public facilities provided by the Government throughout the 25gu in Seoul. The methods of this research were carried out through the home page of each facility, telephone inquiries and gujung backseo. Investigations were carried out 3 times between the periods of January-June and September in 2009. Results of the research are as follows - 1) Through the investigations of classifications and distribution status of 5 public facilities over 25gu, quantity supply problems were analyzed. 2) Building distributions of 5 public facilities were classified by types and analyzed. 3) A number of compound facilities were classified and analyzed to determine the complexities of the 5 public facilities. 4) Complex types and characteristics of public facilities in 25gu in Seoul were analyzed. Based on the results of the research, the following conclusions are drawn: 1) Public facilities throughout the 25gu in Seoul have common characteristics and functions and they are spread out evenly in each gu. This means that public facilities are standardized in Seoul. Characteristic public facilities suitable to each gu should be planned accordingly. 2) Public facilities in Seoul show a single form of one facility. Therefore, initiative plans for the complexity of facilities are required. 3) Complex public facilities in Seoul need to be the center of community life in each gu. It is necessary to take into account the diverse life styles and classified needs of residents for complex facilities. Based on the research, complex types such as public administrative+cultural facilities, culture+welfare facilities, medical+welfare facilities can be presented. These complex types should not be classified according to any particular use, but they should be commonly used by diverse generations and every social class. The inquiries of users of public facilities and the programs of each public facility are not included in this research. Thus, the reseaarch limits the proposals for complex public facilities. In the future, the characteristics of each gu in Seoul should be studied and understood, so that appropriate public facilities and their complex plans can be researched continuously and necessarily.

한국 영.유아의 대소변 가리기 훈련습성에 관한 일 연구 (STATISTICAL STUDY ON HABITUAL METHODS Of TOILET TRAINING FOR INFANT AND TODDLER)

  • 최경자
    • 대한간호학회지
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    • 제3권3호
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    • pp.119-132
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    • 1973
  • This study observed on habitual methods of toilet training for infants and toddlers in Korea thru 300 mothers at four medical institutions Ewha Woman′s University Hospital, Ewha Maternal and Child Health Center, Severance Hospital and Seoul National University Hospital) with a design to analyze beginning time, duration of period, methods employed, motives, equipments used, special terminology used for the subject training. The main purpose of this study was to generalize the proper methods of toilet training, and also to contribute a better psychological education for the mother and child. The results obtained from this study were as follows; 1. Majority of (67.3%) observed were in the age category between 30 and 40 years, and dominant numbers (64.7%) were housewives with high level of education and from middle class family background. 2. In the most cases (85%), toilet training was carried out by mothers(including wives who had a job) while more than half of mothers (53.7%) maintained their important motive for the training was "due to having high regard for cleanliness" 3. As for the time of beginning toilet training: finding indicated that starting period was decided (70%) at inconsiderate desertion of each mother. whereas, only minority group (30%) represents the cases where mother started the training when they consider tile child was physically and psychologically randy. Also greater number (77.7%) started bladder training prior to that of bowel. 4. It is noticeable that in course of training a large number of mothers (48.3%) applied strict training method when the child proper talenting, and the more rigid and strict in tile training. the more malformation of personality of the infant and toddler were seen after the training period (P<0.01). 5. Over the half of the total cases denoted (bowel 54.3%, bladder 67.7%) starting period before one year and in most cases (bowel 79.3%, bladder 729)the training was accomplished within 12 month, and therefore it was noted that earlier start(before 1 year) shortened the training period (with 12 month) . There was no significant difference between male and female infants in both starting period and duration of period in bladder training, however, in bowel training there was a tendency that female started earlier(7-12 months needed, 51.4%) than tile male (13-18 months needed, largest number 41.4%), and also in cases of female the period for needed for training were shorter than the cases of male. 6. Many a number (bowel 50.3%, bladder 97.7%) employed the method of continuous talenting at regular interval in accordance with that of child′s habit formed before training. Equipment used were various kinds, however, pieces of paper for male (45.5%) and piss pot or bedpost (42.3%) for female were common, on the other hand, "Eung-ga" for defecation (52.3%) and "Shii" for the urination (95.3%) were most standard expression that used during the training period.

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대학병원의 Formulary로 선정되어 사용 중인 원내 퀴놀론 주사제의 약물사용에 대한 평가 (Evaluation of Inpatient Use for IV Quinolones in an University Hospital Formulary)

  • 김훈희;이옥상;정선회;임성실
    • 한국임상약학회지
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    • 제22권1호
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    • pp.55-64
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    • 2012
  • The quinolones are broad-spectrum antibiotics and enhanced antimicrobial activity has extended the use of the quinolones beyond the traditional indications for quinolone antibiotics in the treatment of urinary tract infections. The quinolones are effective in a wider variety of infectious diseases, including skin and respiratory infections. Because of their excellent safety and tolerability, they have become popular alternatives to penicillin and cephalosporin derivatives in the treatment of various infections. A retrospective study was performed to evaluate efficacy and safety of IV quinolones for inpatient use. Total 117 patients who administerd quinolones for longer than 3 continuous days at community hospital from October 1st, 2008 to December 31st, 2008 were reviewed. The criterias for drug evaluation were included the validation of indication, outcome, dosage and side effects. In the results, ciprofloxacin 13 (total 93), levofloxacin 3 (total 59) and moxifloxacin 2 (total 19) cases were not met the criterias based on the culture results. Major indications were pneumonia (ciprofloxacin 16.3%, levofloxacin 67.8%, moxifloxacin 84.2%), urinary tract infection (ciprofloxacin 44.1%), skin infection (ciprofloxacin 7.5%, levofloxacin 20.3%, moxifloxacin 10.5%), intra-abdominal infection (ciprofloxacin 10.8%, moxifloxacin 5.3%), etc.. In the results of quinolone monotherapy, the frequencies were each ciprofloxacin 74.2%, levofloxacin 50.8% and moxifloxacin 47.4%. In the results of dosage validation, the validities were each ciprofloxacin 54.8%, levofloxacin 94.9% and moxifloxacin 100.0%. In the results of duration validation, the validities were each ciprofloxacin 59.1%, levofloxacin 78.0% and moxifloxacin 89.5%. Adverse drug reactions were reported for total 49 cases and those were gastrointestinal tract effects including nausea, vomiting, diarrhea and central nervous system effects including headache, dizziness. In summary, the quinolones appropriately used for hospitalized patients based on this study. A focused approach emphasizing "correct use of quinolones" may reduce development of antimicrobial resistance and maximize class efficacy. Consequently, correct use of antibiotics will contribute to decrease medical expenses for person and community.

보건진료원 직무교육 교과과정개선을 위한 연구 (A Study on Curriculum Development for CHPs)

  • 권명순
    • 한국보건간호학회지
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    • 제13권2호
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    • pp.26-44
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    • 1999
  • The study was done to improve the job training course for Community Health Practioners (CHPs) by evaluating the level of help that the training provided to the CHPs in carrying out their work and to analyze the management activities of the CHPs in order to develop a more effective CHP training program. The methodologies used in the study were a questionnaire survey. The survey results were analyzed using SPSS Windows. The study results are as follows. 1. The total average level of help from the job training(Theory. Practice and Field Practice) for carrying out the CHP work was found to be $3.04\pm.53$ (of a possible 4), which indicates a high level of help. The average for clinical practices was $3.16\pm.60$. for theory. $3.11\pm.40$ and for field practice. $2.84\pm.60$. 2. For the theory content of the job training courses. the help level was low in the area of mother and child health management/family planning with an average of $2.65\pm.62$ and in the area of health information system development with an average of $2.62\pm.83$. The reason for these deficiencies were. in order of frequency. few opportunities to apply learning. training content that was inadequate. training methodologies which were incongruent with content. improper training items and insufficient class hours. For the practice. the clinical work in rehabilitation/orthopedics departments and in ENT/Opthalmology departments had averages of $2.96\pm.86$ and $2.97\pm.80$ respectively. This low level resulted from the lack of direct experience. lack of sincerity during the practice time. lack of practice guidance. insufficient time and lack of practice equipment. in that order. For the field practice. the delivery management averaged $2.06\pm.90$ as the lowest help level. In this case 68% of respondents replied that there were no relevant reasons for this deficiency. 21% responsed that there was a lack of direct experience, 7%, a lack of practice guidance and 4.8%, insufficient time. 3. There were significant differences for several demographic variables when comparing the help level of the clinical courses (practice and Field Practice). A higher help level was reported by older nurses as compared to younger ones, experienced nurses as compared to scholarship nurses, and married over single. Also for nurses who had finished more other programs and were qualified or licensed in several areas the level was high. Although it was not statistically significant the level was higher if the work area was in a rural county, not a city, and if one had more recently completed the job training(P<,05). 4. Of the respondents 58.6% replies stated the period of job training for the CHP was adequate, but 51.7% reported that the period for theory courses was too short while an other 48.3% responded that it was sufficient. For practice locations, 50% responsed that it was good to practice in medical institutions(primary, secondary and tertiary) at the same time. While 48.3% agreed that doing theory and practice simultaneously was good, and 56.9% agreed that field practice should be done after completing theory and practice training. Hence, the development of new field practice guidelines suitable for changing environments of health management are required in place of the existing ones which were considered low in help level to the practical work of the CHPs.

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진정법을 이용한 치과 치료 시 소아 환자의 진정 후 반응에 대한 연구 (POSTSEDATION EVENTS IN PEDIATRIC PATIENTS SEDATED FOR DENTAL TREATMENT)

  • 구정은;백광우
    • 대한소아치과학회지
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    • 제36권2호
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    • pp.209-216
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    • 2009
  • Chloral Hydrate와 hydroxyzine을 경구 복용한 후 midazolam을 협점막하로 추가 투여한 진정법은 진정 심도를 깊게 해주고 안정적인 진정 상태를 유지해 준다고 보고된다. 진정 중 나타나는 반응에 대한 연구는 활발하나 퇴원 기준에 따라 환자를 귀가시킨 후 나타나는 반응에 대한 연구는 아직 부족하다. 이 연구에서는 진정법을 이용하여 치과 치료를 받은 소아 환자의 진정 후 행동 반응 및 부작용에 대해 알아보고자 한다. 이화여자대학교 목동병원 소아치과에 2005년 4월부터 2007년 12월까지 내원하여 진정법으로 치료받은 환아를 대상으로 귀가 후 24시간 이내에 전화를 이용하여 설문 조사하였다. 조사 항목은 진정 후수면 유무, 진정 후 수면 시간, 진정 후 수면 행동, 수면에서 회복 후 행동, 진정 후 구토 유무이다. 귀가 후 227명(57.8%)이 잠을 잤고 21명(6.3%)이 비정상적인 수면 행동을 보였다. 104명(31.0%)이 수면에서 회복 후 비정상적인 행동을 하였고, 10명(3.0%)이 구토 반응을 보였다. Midazolam 용량이 많으면 진정 후 잠을 잘 가능성이 크고(p<0.05), 괴로워 하면서 자거나 자다깨다를 반복할 수 있으며(p=0.055) 수면 시간도 길어질 수 있다(p=0.054). 이번 조사에서는 진정 후 수면이 많았고, 비정상적인 행동 및 구토 반응도 있었으나 우려할 만한 응급상황은 나타나지 않았다. Midazolam의 협점막하 병용 투여는 안전한 진정법으로 보이며 장기적 연구, 전향적 연구 등이 필요할 것이다.

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교정치료시 병발된 탈모증 (Alopecia : An unexpected effect of orthodontic treatment)

  • 이영준;제프 다비도비치;정규림;박영국;벨리머 맷코빅
    • 대한치과교정학회지
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    • 제29권6호
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    • pp.663-672
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    • 1999
  • 이 증례 보고는 치조성II급 1류 부정교합의 해결을 위한 통상적 교정치료 중 탈모를 보인 청소년기 환자에 대한 것이다. 22개월 간 지속된 교정치료의 결과는 성공적이었다. 그러나 치료 시작 8개월 후 환자는 완전탈모현상을 보였다. 환자에 대한 포괄적인 의학적 검사와 감별진단은 교정치료에 의하여 유발된 심리적 스트레스로 그 원인을 결론지었다. 다수 선학들의 보고에서 심리적 스트레스는 면역체계에 영향을 줌으로써 탈모를 유발할 수 있다고 지적하고 있다. 따라서 이 증례의 경우 면역체계에 대한 스트레스의 결과 두피 모낭 주위의 조직에 대한 자동면역질환과 유사한 상태가 초래됨으로써 탈모가 발생한 것으로 추정함이 타당할 것으로 생각된다. 환자의 탈모는 비타민 D의 경구 및 경피적 투여로 완전 치유되었다. 이러한 증례는 면역체계야 말로 치아주위조직의 개조를 위한 중추적 역할을 담당하며, 면역체계에 영향을 줄 수 있는 어떠한 상태도 교정치료시 탈모의 발생 등과 같은 예기치 않은 결과를 초래할 수 있음을 시사한다.

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일 지역 간호여대생과 일반여대생의 성 지식, 태도, 경험 및 교육 요구 비교 (Knowledge, Attitudes, Experiences in Sex and Needs for Sex Education of Nursing Students and Non-Nursing Students)

  • 이점숙;이가언
    • 한국학교보건학회지
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    • 제16권2호
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    • pp.45-55
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    • 2003
  • This study was focused on comparing the knowledge, attitudes and experiences in sex and the needs for sex education of nursing students and non-nursing students. The subjects of this study were 403 female students who attended 4 universities in Busan. The data was collected from November 2002 to December, and analyzed by frequency, percentage, mean, standard variance, t-test and Chi-square. The results were as follows: 1. The mean score of sex knowledge of the nursing students was 13.29 and the non-nursing students's was 11.11. There was a difference(p=0.000) between nursing and non-nursing students in sex knowledge. 2. The mean score of sex attitude of nursing and non-nursing students was 25.64, 26.65 respectively. There was no statistical difference. 3. 61.8% of the nursing students and 62.3% of the non-nursing students had experienced a relation with the opposite sex. Kissing experience was 59.9%, 61.8% and masturbation was 9.5%, 9.2% respectively. Sexual intercourse was 5.3%, 11.9% and contraception was 1.9%, 8.2% respectively. Among these experiences, sexual intercourse and contraception experience rate were different(p=0.017, p=0.002 respectively) between nursing and non-nursing students. 4. Of 19 sexual education contents, only 'the dignity of life' showed a difference. That is, more nursing students(92.9%) wanted to know about 'the dignity of life' than non-nursing students(85.7%). Among the respcndent's needs on the sexual education contents, 'Contraception' was rated first and followed by 'Sex psychology of men and women', 'Pregnancy', 'Prevention of sexual crime' and 'Sexually transmitted diseases'. Most of the respcndents(95.8%) wanted sex education introduced in the :first year of university, and presented as a special class. Specifically, 50.0% of the students wanted the education to be more realistic and systemic. With the above results, when university faculties are sexual educating to university students, they have to aware of the difference of target students. And they need to stress more realistic and specific aspect of sexual education learning rather than theoretical teaching.