• Title/Summary/Keyword: Pressure Test

Search Result 7,892, Processing Time 0.037 seconds

A Study on Periodontal Disease and Tooth Loss in Metabolic Syndrome Patient (대사증후군 환자의 치주질환과 치아상실에 관한 연구)

  • Kang, Hyun-Joo
    • Journal of dental hygiene science
    • /
    • v.15 no.4
    • /
    • pp.445-456
    • /
    • 2015
  • The aim of this study was to identify an effective control method of metabolic syndrome (MS) and oral diseases by investigating relationship between of MS and periodontal disease, tooth loss of the adult men and woman. We analyzed and concluded as follows, using a nationwide representative sample, in 8,225 middle senior citizens based on raw data of the 5th National Nutrition Survey in 2010, 2012. The data were analyzed by descriptive statistics, chi-squared test, and logistic regression using SAS ver. 9.2 program. The results are as follows, for correlation of metabolic component to periodontal disease, it was found that in men, the periodontal disease odds ratio of the group with abnormal fasting blood glucose increased 1.27 fold (95% confidence interval [CI], 1.04~1.54), and in woman, the odds ratios of the group with abnormal high density lipoprotein cholesterol increased 1.45 fold (95% CI, 1.22~1.72) and the odds ratio of the group with abnormal obesity increased 1.44 fold (95% CI, 1.17~1.77). For correlation of MS to periodontal disease, it was found that the odds ratio of periodontal disease in the woman at-risk group increased 1.55 fold (95% CI, 1.19~2.01) and that of the group with MS increased 2.25 fold (95% CI, 1.68~3.02). For correlation of woman's metabolic component to missing teeth, it was found that the odds ratio of group with abnormal blood pressure increased 1.41 fold (95% CI, 1.10~1.82). For correlation of woman's MS to missing teeth, it was found that the odds ratio of missing teeth in the group with MS increased 1.48 fold (95% CI, 1.07~2.04). It is considered that a public health project comprising preventive and systematic disease management is necessary for controlling MS and oral disease. The findings of the study are expected to lay the foundation for the development of oral health promotion programs.

The Study of Nano-vesicle Coated Powder (나노베시클 표면처리 분체의 개발연구)

  • Son, Hong-Ha;Kwak, Taek-Jong;Kim, Kyung-Seob;Lee, Sang-Min;Lee, Cheon-Koo
    • Journal of the Society of Cosmetic Scientists of Korea
    • /
    • v.32 no.1 s.55
    • /
    • pp.45-51
    • /
    • 2006
  • In the field of makeup cosmetics, especially, powder-based foundations such as two-way cake, pact and face powder, the quality of which is known to be strongly influenced by the properties of powder, surface treatment technology is widely used as a method to improve the various characteristics of powder texture, wear properties, dispersion ability and so on. The two-way cake or pressed-powder foundation is one of the familiar makeup products in Asian market for deep covering and finishing purpose. In spite of the relent progress in surface modification method such as composition of powders with different characteristics and application of a diversity of coating ingredient (metal soap, amino acid, silicone and fluorine), this product possess a technical difficulty to enhance both of the adhesion power and spreadability on the skin in addition to potential claim of consumer about heavy or thick feeling. This article is covering the preparation and coating method of nano-vesicle that mimic the double-layered lipid lamellar structure existing between the corneocytes of the stratum corneum in the skin for the purpose of improving both of two important physical characteristic of two-way cake, spreadability and adhering force to skin, and obtining better affinity to skin. Nano-vesicle was prepared using the high-pressure emulsifying process of lecithin, pseudo ceramide, butylene glycol and tocopheryl acetate. This nano-sized emulsion was added to powder-dispersed aqueous phase together with bivalent metal salt solution and then the filtering and drying procedure was followed to yield the nano-vesicle coated powder. The amount of nano-vesicle coated on the powder was able to regulated by the concentration of metal salt and this novel powder showed the lower friction coefficient, more uniform condition of application and higher adhesive powder comparing with the alkyl silane treated powder from the test result of spreadability and wear properties using friction meter and air jet method. Two-wav cake containing newly developed coated powder with nano-vesicle showed the similar advantages in the frictional and adhesive characteristics.

Analytical studies of bovine mastitis management by standard plate counts(SPC) and somatic cell counts(SCC) (젖소 유방염 관리에 따른 세균 및 체세포수 등급 실태 조사 분석)

  • 허정호;정명호;박영호;조명희;이주홍
    • Korean Journal of Veterinary Service
    • /
    • v.21 no.3
    • /
    • pp.285-300
    • /
    • 1998
  • 1. The number of average milking cows, clinical forms of mastitis, mastitis-developing cows, and cows killed by mastitis a year were 25.7, 1.8(7%), 6.3(26%), and 2.7(10.1%)heads, respectively. The annual grade changes of standard plate counts(SPC) and somatic cell counts(SCC) showed the grade 1A of SPC diminished sharply from April to August, we think it was due to the lack of proper management in farming season and the grade 3 of SCC indirectly influenced increased in huge during August. 2. The average number of parturitions of farms was 2.3, but 50% of below 1 parturition were 22 farms(31%), 50% of above 3 parturitions were 16(23%) out of 71 farms. According to grades of the number of parturitions of milking cows per each farm, the farms' grades recording 3 parturitions and 50% were little bit excellent. 3. The actual situation research of foremilking CMT revealed 35 out of 74 farmer didn't do CMT Among them(35 out of 74 farmers), 80% did not test thanks to the troublesome process of the CMT. SCC grade 3, among farms who did foremilking CMT once or twice a month and who did not were 29% and 40% respectively and SPC grade 1A were 55% and 9%, respectively. 4. The research of actual situation on milking management let us know 29 farms(39%) did not do lastmilking, 37 farms(49%) usually did overmilking, and 34 farms(46%) did milking for 4 or 5 minutes. Grades according to average requiring times of milking showed SCC grade 1 of farms milking within 7 minutes was 11% and SPC grade 1A was 34%, on the other side, farms milking more than 7 minutes were 0% in SCC grade 1 and 13% in SPC grade 1A. Grades according to the starting time of milking after rubbing teats showed SPC grade 1A of farms starting milking at about 1 minute and over 2 minutes were 50% and 20%, respectively. 5. The research of actual situation on hygienic milking management uncovered 65 farms(88%) were using one towel which was used in washing teats and udders to wash more than 3 to 4 cows, and 53 farms(72%) were using one dried towel to dry udders not for each cow but for more than 3 to 4 cows after washing. Also, on milking turns disclosed 30 farms(40%) were milking cows in the order of incoming without isolation of a dominant group. According to grades of towels used in washing teats and udders, farms using a towel for each cow were 56% and a towel for over 3 cows were 31% in SPC grade 1A. According to using-or-not grades of dried towels after washing udders, farms using a towel for each cow were 79% and a towel for over 3 cows were 21% in SPC grade 1A. 6. Farms doing teat-dipping before milking were 7(10%), not doing teat-dipping after milking, or doing sometimes were 9(12%), and doing right after milking were 57(77%). And farms doing teat-dipping after dry cows and before delivery were 21(28a ). Farms using bethadine as an antiseptic solution were 70(95%), 40 farms(59%) diluted it with water as weak as 5 to 10 times, and on drying cows 64 farms(87%) slowly did it more than 2 days. Grade 1A of SPC of farms doing teat-dipping at every milking was 38%, farms doing occasionally or not was 33%, and farms doing it right after milking was 37% and doing after milking more than 5 cows was 20%. Grade 1A of SPC among farms diluting bethadine 5 times and diluting 5 to 10 times with water were 36% and 33%, respectively, and Grade 3 of SCC were 35% and 32%, respectively. 7. Studies on nonlactating period medical treatment, as the cows were on dry, 54 farms treated with their own hands.73 farms(98%) had bovine mastitis treated for themselves. And on applying medicines against mastitis, 55 farmers chose them on the basis of their own experience, 42 farms(57%) were treated more than 3 days. 41 farms(55%) dumped away the mastitis infected milk separately, 24 farms(32%) were feeding and milking at the same time. 8. Fifty-six farms(76%) always washed and disinfected milking machines after milking. Farms using the milking machines at low, or variable vacuum pressures, or at the vacuum pressure, set at the moment of its installation were 31(42%), and farms that did not know pulsation ratio were 27(37%). Farms changing liners when they were torn 8(11%), 58 farms(78%) said they checked milking system when there were wrong with them, 31 farms(42%) changed milking hoses when they found out problems, and 42 farms(57%) cleaned vacuum and milking systems when they felt dirty. The SPC grade 1A of farms washing and sterilizing milking machines was 38% and farms only washing was 28%.

  • PDF

A Study on Smoking Behavior and The Influencing Factors Among High School Male Students in Korea (고등학교(高等學校) 남학생(男學生)의 흡연행위(吸煙行爲)와 관련요인(關聯要因) 분석(分析))

  • Chang, Young Mee
    • Journal of the Korean Society of School Health
    • /
    • v.4 no.2
    • /
    • pp.193-215
    • /
    • 1991
  • This study is aimed at providing basic information applicable to setting up the education programs and strategies to prevent smoking among high school students by analysing smoking behavior and influencing factors. The samples consisted of 814 students, 557 parents and 362 teachers selected randomly from 8 high schools, one from each school district in Seoul. Date Analyses were made through Chi-Square test, Factor Analysis, One Way ANOVA, Multiple Regression, Correlation. SPSS/$PC^+$program was utilized. Smoking behavior (continuous smoking, re-smoking, ex-smoking, never smoking, daily smoking, occasional smoking) were used as dependent variables. Influencing factors (male students, habits, attitudes and knowledge toward smoking, home life, school life, juvenile delinquency, friendship, demographic parent's and teacher's recognition toward male students smoking) were used as in dependent variables. The major findings of the study are as follows : 1. The total smoking rate occupies 41.1% whereas the continuous smoking rate stands at 19.2%, re-smoking rate 9.5%, ex-smoking rate 12.4% and never smoking rate 58.9%. 2. The total smoking rate among high school students is significantly correlated with their monthly expenditures and type of school (p<0.001). The continuous smoking rate also shows the same tendency. As the length of butt get shorter, the current smoking rate increase. The duration of smoking is in proportion to its continuity. The major motive of smoking is curiousity whereas that re-smoking is to follow friend's behavior. The study shows that peer pressure is the most powerful factor influencing smoking behavior of students. Friends and fellow students encourage to pick up smoking and resume smoking even alter one stops smoking. 3. The correlationship between favorable attitudes toward smoking and the current smoking rate and its continuity is statistically significant(p<0.05, p<0.01, p<0.001). 4. The stability and harmony of family life and the current smoking rate show negative correlationship. The daily smoking amount of father is in proportion to the continuity of students' smoking. When parents are in favor of smoking, it is more likely that the experimental smoking rate increase the smoking rate increases, and vice versa. The more acceptable attitudes toward smoking among siblings is also one of the factors to increase the smoking rate and continuity (p<0.001). The more lenient the attitudes of parents toward their children's association with smoking friends, the higher the smoking rate. When students have difficulties in adjusting to school life, it is more likely that the current smoking rate and continuity increase. 5. The continuity of smoking and friendship are significantly correlated (p<0.05, p<0.01, p<0.001). 6. The continuity of smoking and juvenile delinquency are significantly correlated (p<0.001). 7. The difference in attitudes and smoking reasons of parents and students is significantly correlated to different smoking behavior (p<0.01, p<0.001). While smoking knowledge does not significantly influence their smoking behavior, it is noted that in the case of teachers, smoking reason (p<0.05), attitudes (p<0.001) and knowledge (p<0.05) strongly influence their smoking behavior. 8. There is a significantly correlation among the smoking reasons, attitudes and knowledge between students and parents(p<0.001). As for the correlationship between regularity and smoking amount and other influencing factors, the daily smoking amount is in proportion to depth of inhalation and duration of smoking, negative attitudes of parents unstability of family, dissatisfaction of family members, juvenile delinquency, strong smoking reasons and positive attitudes towards smoking. 9. In the case of daily smokers depth of inhalation is significantly correlated to the duration of smoking, juvenile delinquency, acceptability of parents, dissatisfaction of family members and smoking reasons. The duration of smoking motives is significantly correlated to juvenile delinquency, high acceptability of parents, strong smoking motive and positive attitudes toward smoking. 10. It is noted that 40% of parents and 30% of teachers do not recognize the significant correlationship between and the relative influencing factors mentioned above.

  • PDF

Forecasting Hourly Demand of City Gas in Korea (국내 도시가스의 시간대별 수요 예측)

  • Han, Jung-Hee;Lee, Geun-Cheol
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.17 no.2
    • /
    • pp.87-95
    • /
    • 2016
  • This study examined the characteristics of the hourly demand of city gas in Korea and proposed multiple regression models to obtain precise estimates of the hourly demand of city gas. Forecasting the hourly demand of city gas with accuracy is essential in terms of safety and cost. If underestimated, the pipeline pressure needs to be increased sharply to meet the demand, when safety matters. In the opposite case, unnecessary inventory and operation costs are incurred. Data analysis showed that the hourly demand of city gas has a very high autocorrelation and that the 24-hour demand pattern of a day follows the previous 24-hour demand pattern of the same day. That is, there is a weekly cycle pattern. In addition, some conditions that temperature affects the hourly demand level were found. That is, the absolute value of the correlation coefficient between the hourly demand and temperature is about 0.853 on average, while the absolute value of the correlation coefficient on a specific day improves to 0.861 at worst and 0.965 at best. Based on this analysis, this paper proposes a multiple regression model incorporating the hourly demand ahead of 24 hours and the hourly demand ahead of 168 hours, and another multiple regression model with temperature as an additional independent variable. To show the performance of the proposed models, computational experiments were carried out using real data of the domestic city gas demand from 2009 to 2013. The test results showed that the first regression model exhibits a forecasting accuracy of MAPE (Mean Absolute Percentage Error) around 4.5% over the past five years from 2009 to 2013, while the second regression model exhibits 5.13% of MAPE for the same period.

Relationship Between Adenosine-Induced ST Segment Depression During $^{99m}Tc$-MIBI Scintigraphy and The Severity of Coronary Artery Disease (Adenosine 부하 $^{99m}Tc$-MIBI 심근 관류스캔도중 나타나는 ST절 하강과 관상동맥 질환의 중증도와의 관계)

  • Cho, Jung-Ah;Choi, Chung-Il;Kwak, Dong-Suk;Kim, Jeong-Gyun;Bae, Sun-Kun;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Kang, Seung-Wan;Woo, Eon-Jo;Kim, Sin-Woo;Sohn, Sang-Kyun;Chae, Shung-Chull
    • The Korean Journal of Nuclear Medicine
    • /
    • v.28 no.2
    • /
    • pp.177-185
    • /
    • 1994
  • Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.

  • PDF

A Clinicopathologipal Study on the Prognosis of IgA Nephropathy in Children (소아 IgA 신병증의 예후와 관련한 임상병리학적 고찰)

  • Kwon Jae-Hun;Choi Eun-Na;Park Jee-Min;Jeung Hyeun-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
    • /
    • v.7 no.1
    • /
    • pp.23-29
    • /
    • 2003
  • Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

  • PDF

Comparison of the mental health, metabolic syndrome and nutrient intake by Gender in Problem drinkers ; Based on The Fifth(2010-2012) Korean National Health and Nutrition Examination Survey (성별에 따른 문제음주자의 정신건강, 대사증후군과 영양소 섭취; 제 5기(2010-2012) 국민건강 영양조사를 중심으로)

  • Choi, Young -Sil
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.15 no.8
    • /
    • pp.5159-5168
    • /
    • 2014
  • The study examined the relationship among metal health, metabolic syndrome and nutrient acceptance according to gender. Implemented until 2010-2012, the 5th Korean National Health and Nutrition Examination Survey, as an original document, was used for the study. The target was problem drinkers with more than 12 points under AUDIT. Regarding mental health, it was classified into stress, depression and suicidal impulse. Metabolic syndrome was defined when three causes of BMI, waist circumference, FBS, HDL and BP were out of the normal range. The nutrient intake was obtained to confirm the energy intake of nine non-nutrients (Nutrient adequacy ratio: NAR) and the proper intake of the average non-nutrient (Mean adequacy ratio: MAR). These variables were analyzed by frequency, cross analysis and multiple regression analysis through SPSS18.0. In the general features, there was a significant difference according to age, occupation and marital status. In mental health, stress, depression and suicidal impulse were examined. Metabolic syndrome was dependant on FBS, HDL and BP. The nutrient acceptance depended on calcium, vitamin A, thiamine, riboflavin, niacin, vitamin C, and MAR. Logistic regression analysis performed on the variables showed significant differences. Stress, depression, and thoughts of suicide was significantly higher in men aged 19-29 years, and women aged 30-49 years. In the case of the male, those who employed have metabolic syndrome more than those who unemployed. In terms of female, those who were belonged into the middle - low economic level have undergone with metabolic syndrome. In the part of a Mean adequacy ratio(MAR), the male who unmarried, employed, were in the middle low economic levelwere higher. In the case of the female, it was higher for those who were in the middle - low economic level. Overall, an effective way of planning the solution regarding mental health, metabolic syndrome and nutrient intake can be found by considering these features.

Flexural Properties according to Change of Polymerization Temperature of Autopolymerized Resin for Orthodontic (치과 교정용 자가중합형 Resin의 중합 온도 변화에 따른 굽힘 특성)

  • Lee, Gyu Sun
    • Journal of dental hygiene science
    • /
    • v.15 no.3
    • /
    • pp.259-264
    • /
    • 2015
  • For this experiment, specimen was manufactured by injecting polymer and monomer into silicon mold with volume ratio of 2.5:1 based on ISO 20795-2 so that average thickness, width and length of specimen would be maintained as 3.3 mm, 10.0 mm and 65.0 mm, respectively depending on spray on technique. Specimen was divided into 3 groups ($25^{\circ}C$, $40^{\circ}C$, $70^{\circ}C$) depending on polymerization temperature and 10 specimen was manufactured for each group and it was polymerized in water tank of ${\pm}1^{\circ}C$ under the setting condition of polymerization time of 15 minutes and pressure of 3 bar. After keeping specimen in distilled water of $37^{\circ}C$ for over 48 hours before experiment, flexural strength (FS) and elasticity modulus (EM) of specimen being tested by using Intron (3344; Instron; Instron). SPSS ver. 16.0 was used for analysis and post-hoc test of Scheffe was performed after using one-way ANOVA. When comparing mean value of FS of resin for orthodontics, it was represented in the range of 71.500 MPa for $25^{\circ}C$ group, 74.920 MPa for $40^{\circ}C$ group and 76.880 MPa for $70^{\circ}C$ group and difference was shown in the order of $25^{\circ}C$ group <$40^{\circ}C$ group <$70^{\circ}C$ group but such difference was not significant statistically (p=0.052). Result of EM mean value of resin for orthodontics was more polymerization temperature was high, the more was significant difference represented in the order of $25^{\circ}C$ group <$40^{\circ}C$ group <$70^{\circ}C$ group (p<0.039).

The Study on the Relationship Between the Duration of Chest Vibration prior to Endotracheal Suctioning and the Changes in Oxygen Saturation in Low-Birth-Weight Infants (저체중아에 있어 기관내 흡인전 흉부진동법의 기관과 산소포화 변화간의 관계 연구)

  • Ahn, Young-Mee
    • Journal of Korean Academy of Nursing
    • /
    • v.25 no.3
    • /
    • pp.597-607
    • /
    • 1995
  • 1960년대 이후 인공호흡기(mechanical ventilator)의 보급과 최근 의료과학의 발달, 간호의 질적 향상의 결과로 저체중출생아를 포함한 고위험 신생아의 생존율이 높아져왔다. 호흡장애증후군(RDS)은 일차적으로 폐포의 완전한 확장을 위해 필요한 계면활성물질(surfactant)의 부족, 미발달된 심폐기능에 의한 병리적 현상으로 저체중아의 가장 큰 원인이 되어왔다. RDS로 인해 인공호흡기에 의존해 있는 저체중아의 경우 적절한 산소공급과 이를 위한 호흡의 유지는 치료의 가장 큰 핵심이 되며, 이를 위한 기관내 흑은 비인두 흡인 (nasopharyngeal suction)은 신생아 중환자실(NICU)의 가장 중요한 간호행위가 되어왔다. 인공호흡기를 위한 기관삽관은 그 자체가 기도의 성모운동을 방해하고 기침반사를 억제시켜 폐 분비물의 효과적 배출을 억제하며, 특히 저체중아의 경우 조산과 관련하여 미발달된 흥곽운등과 심폐기능은 폐분비물의 이동을 저해하는 요소이다. 따라서 기도내의 분비물의 이동을 효과적으로 하여 흡인 시에 최대한의 효과를 돕기 위해 흥곽 물리요법(chest physiotheraphy : CPT)의 한 형태인 흉곽진동법 (Chest Vibration : CV)가 행해져 왔다. 그러나 저체중아를 위한CV의 임상적 적용은 그 대상의 생리적 특성, CV의 적용부위(site)와 기간(duration)에 대한 과학적 근거 없이 만성감염이나 폐질환을 가진 성인이나 cystic fibrosis환자를 위한 CV protocol을 무분별하게 채택하여 저체중아에게 행하여져 왔다 이에 본 연구자는 저체중아에 대한 CV의 안전성을 평가하고, 이에 기초하여 저체중아에게 바람직한CV의 형태를 알아보고자 본 연구를 시작하였다. 연구설계는 CV의 안전성을 평가하기 위한 실험연구이다. CV의 안전성은 RDS치료의 가장 일차적 목표인 oxygenation변화에 의해 평가될 수 있으므로, 본 실험 연구에서는 Pulse oximeter에 의해 계속적으로 측정된 산소포화 변화(oxygen saturation change)를 측정하였다. 실험대상은 미국동부에 위치한 대학병원의 NICU에 입원하여 RDS와 관련된 호흡장애로 인공호흡기에 의존해 있는 10명의 저체중아였다. 인공호흡기에 의존된 모든 저체중아는 Pulse oximeter와 심폐기능 측정기(cardiopulmonary monitor)에 의해 산소공급과 호흡상태가 계속 측정되고 있었다. 실험대상의 평균 출생시 몸무게는 평균 1,3050gm(SD=580.6)이었고, 임신월령 은 평균 28.6주(SD=3.1)였다. RDS가 그들의 일차적 진단명이었고, 그중 4명은 pneumonia, atelectasis의 합병증을 가지고 있었다. 10명중 6명은 intermittent mandatory ventilation(IMV)의 형태로, 4명은 continuous positive airway pressure(CPAP)의 형태로 인공호흡기에 의존되어 있었고 CV시의 FiO2는 평균 42.3(SD=21.2)였다. CV는 중환아용 소형진동기 (minivibrator)를 이용해 가각 10명 의 간호사에 의해 행하여 졌고, 최소 22초에서 최대 100초 동안 실시되었다. 50%의 간호사는 30초에서 40초간 CV를 실시하였으며, CV의 적용부위도, 전후 흉곽부위, 혹은 병변이 있는 좌 우측, 흑은 양쪽 흉벽 등으로 다양했고, 적용방법도 원형으로 돌려가며(circular motion), 혹은 아래에서 위로, 혹은 아무런 기준없이 간호사의 기호에 따라 다양하게 적용되었다. 산소포화의 변화는 CV가 행해지기 전.후로 5초동안 관찰되었다. 연구의 결과, 산소포화 변화는 비 모수통계(non parametric statistics)의 일종인 Matched Paired Wilcoxon test로 분석 한 결과 CV후에 3%의 감소를 보였다(P<.05). 저체중아에 있어 산소포화의 3%감소는 임상적으로 중요한 의미가 없다고 사료되어지며, 실제 흡인전의 과도호흡에 의해 CV를 행하기 이전의 산소공급수준으로 돌아 왔다. CV실시 기간과 산소포화와의 상관관계는 비 모수통계인 Spearman rho correlation coefficient를 이용하여 분석하였는데, 이 두 변수는 서로 관계가 없는 것으로 나타났다(P>.05) 또한 CV와 흡인 후에 각각의 간호사들에게 CV를 필요로 한 저체중아의 기준, 적용부위, 기간, 방법등에 대한 기준을 물었으나 대상의 특성에 따른 간호사정에 의존하기보다는 간호사 각자의 선호하는 방법이나 습관에 라 행하는 것으로 나타났다. 결론적으로 CV와 산소포화 변화와의 관계, NICU에서 관찰된 CV의 임상적 적용을 기초로 저체중아에게 안전한 CV protocol은 신생아용 소형 진동기를 이용하여, 양쪽 흉곽의 늑골하측 변연 부위(low lateral costal margin)에서 시작하여 흉골 중앙부위 방향으로 30초 동안 진동기를 적용하는 것이 좋은 것으로 나타났다. 이에 CV의 효과를 평가하기 위한 보다 과학적인 접근방법으로, CV와 흡인의 결과인 가래(sputum)에 대한 연구를 제언하는 바이다.

  • PDF