• 제목/요약/키워드: Respiratory Assessment

검색결과 394건 처리시간 0.028초

$^{31}P$ 자기 공명분석법을 이용한 만성 폐질환 환자에서의 골격근대사 이상에 관한 연구 (Assessment of Abnormality in Skeletal Muscle Metabolism in Patients with Chronic Lung Desease by $^{31}P$ Magnetic Resonance Spectroscopy)

  • 조원경;김동순;임태환;임채만;이상도;고윤석;김우성;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제44권3호
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    • pp.583-591
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    • 1997
  • 연구배경 : 만성폐질환 환자들의 운동 능력 감소의 한 기전으로 제시되고 있는 골격근의 기능 저하는 질환의 병태생리에 기인하는 만성적인 저산소증으로 야기되는 산소성 인산화과정의 장애로 인한 근육 대사과정의 변화가 주요 원인으로 알려져 있다. 그러나 저산소증은 없으나 운동시 호흡곤란을 호소하며 운동능력의 감소를 나타내는 만성폐질환 환자들에서도 이러한 근육 대사 과정의 변화가 나타나는지에 대해서는 연구된 바 없다. 이에 저자들은 $^{31}P$ MRS를 이용하여 이들에서 전박 골격근의 대사 변화를 비슷한 연령의 정상인의 대사와 비교 관찰하므로써, 이들에서도 운동 능력 감소의 한기전으로서 역시 골격근의 대사 변화가 관여할 가능성을 알아보고자 하였다. 연구방법 : 6 명의 만성폐쇄성폐질환 남자 환자 및 1명의 폐유육종증 남자 환자와 5명의 비슷한 연령의 건강한 성인 남자들의 전박근을 대상으로 $^{31}P$ MRS 검사를 실시하였다. 환자군의 평균 연령은 $56.7{\pm}12.1$세였으며 대조군의 평균 연령은 $51.6{\pm}13.6$세였다. 각 대상인의 전박 골격근을 대상으로 $^{31}P$ MRS검사를 안정시, 운동시 및 20분간의 회복시에 걸쳐 시행하였으며, 검사 중 계산된 세포내 산소성인산화 능력을 반영하는 Pi/PCr(inorganic phosphate/phosphocreatine)의 비와 세포내 pH(pHi)의 변화를 양군간에 비교하였다. 결 과 : 안정시 골격근 세포내 pHi는 양군간에 차이가 없었으나, 운동시작 2분후 pHi는 환자군이 $6.82{\pm}0.1$, 대조군이 $6.97{\pm}0.05$로 환자군에서 유의하게 낮았다. 그러나 극심한 피로상태에서 pHi는 환자군이 $6.70{\pm}0.10$, 대조군이 $6.78{\pm}0.09$로 환자군이 낮은 경향을 보였으나 통계적으로 유의한 차이는 없었다. 근육세포 내 산소성인산화 능력이 지표인 Pi/PCr은 안정시, 운동중 및 극심한 피로상태에서 모두 양군간에 통계적으로 유의한 차이는 없었다. 회복시 초기 4분간에 걸쳐 관찰한 Pi/PCr의 회복 및 pHi가 안정시 50%수준으로 회복되는데는 시간은 양군간에 차이가 없었으며, 운동지속 시간도 유의한 차이는 없었다.

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마황용량에 따른 이상반응에 관한 예비연구: 무작위배정이중맹검시험 (Adverse Effects of Ma-huang according to Dose : A Randomized Double-Blind Placebo-Controlled Pilot Study)

  • 형례창;이태호;손동혁;여진주;양창섭;서의석;장인수
    • 대한한방내과학회지
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    • 제27권1호
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    • pp.188-196
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    • 2006
  • Background: Ma-huang (Ephedra sinica) has been widely used to treat respiratory disease in oriental medicine for over a hundred years. Ma-huang preparations contain approximately 1.25% ephedrine alkaloids. Recently, the ephedra alkaloids have received much press lately due to adverse effects in those using whole extracts as 'dietary supplements' for weight loss or athletic performance enhancement, and these reports are troubling given the increasing use of Ma-huang by the general public. The purpose of this report is to determine the proper dosage to minimize adverse effects and maximize the potential curative value. Objectives : The object of this study was to find an effective yet low risk dosage of Ma-huang. Methods : The study was designed as a double-blind randomized placebo-controlled trial. The subjects of this study were 26 adults between 20 to 40 of age who agreed to participate in this study. They were allocated through randomization into three groups. Each group took three opaque capsules three times a day. A group (N=9) took one Ma-huang capsule and two placebo capsules, B group (N=8) took two Ma-huang capsules and one placebo capsule, C group (N=9) took three Ma-huang capsules. The total trial periods was two days. To compare the adverse effects of Ma-huang according to dosage, blood pressure and pulse were checked, and other adverse effects were assessed using a morning questionnaire, patient's global assessment scale and Wong-Baker faces pain rating. Results : The following result were obtained: 1. After taking 18 g of Ma-huang per day, pulse rate had a significant increase. 2. After taking more than 6 g of Ma-huang per day, palpitation would be increased significantly. 3. After taking more than 18 g of Ma-huang per day, tiredness would be increased significantly. Conclusion: According to the results, 12 g of Ma-huang per day will minimize adverse effects and maximize the potential curative value.

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외상성 뇌손상 후유증으로 인한 좌 우 Alpha파 비대칭성이 유발된 청소년의 Alpha파 비대칭 뉴로피드백 훈련 1례 (A Case of Alpha Wave Asymmetric Neurofeedback Training of Adolescents having Left and Right Alpha Wave Asymmetry Caused by Traumatic Brain Injury Sequela)

  • 정문주;원희욱;채은영
    • 한국산학기술학회논문지
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    • 제18권8호
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    • pp.171-180
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    • 2017
  • 본 연구의 목적은 외상성 뇌손상 후유증이 삶의 질을 결정할 수 있는 주요한 요인이기 때문에, 후유증을 호전시킬 수 있는 효과적인 훈련 방법을 찾는데 있다. 이를 위해 본 연구에서는 어린 시절 외상성 뇌손상을 경험하고 인지 학습과정서적인 부분에 어려움이 있는 청소년을 대상으로 하여 뉴로피드백 훈련을 실시하였다. 환아 평가는 K-WAIS-IV 지능검사와 QEEG 뇌파 분석을 사용하였다. 뉴로 피드백 훈련은 T3 알파파 보상, T4의 알파파 억제 훈련을 주 3회 30분씩, 총 36회를 훈련하였다. 또한 뉴로피드백 훈련과 함께 호흡 명상도 환아 스스로 실시할 수 있도록 하였다. 그 결과 숙면을 취하고 시험불안의 감소, 기말고사 성적의 만족 등의 안정적인 상태를 보였다. 본 연구는 유년기 두뇌 외상으로 인하여 가시적으로 드러나지 않는 기질적, 심인성 문제들이 존재할 가능성과 이를 발견할 수 있는 다양한 도구의 활용에 대해 발견했다. 또한 유년기 외상성 뇌손상의 경우 뇌 훈련과 명상을 통하여 호전될 수 있다는 결과를 나타냈다. 이는 뇌과학의 측면에서 심신 치료에 도움이 되는 융합적 방법을 제시하였다는데 그 의의가 있다.

Exposure and Toxicity Assessment of Ultrafine Particles from Nearby Traffic in Urban Air in Seoul, Korea

  • Yang, Ji-Yeon;Kim, Jin-Yong;Jang, Ji-Young;Lee, Gun-Woo;Kim, Soo-Hwan;Shin, Dong-Chun;Lim, Young-Wook
    • Environmental Analysis Health and Toxicology
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    • 제28권
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    • pp.7.1-7.9
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    • 2013
  • Objectives We investigated the particle mass size distribution and chemical properties of air pollution particulate matter (PM) in the urban area and its capacity to induce cytotoxicity in human bronchial epithelial (BEAS-2B) cells. Methods To characterize the mass size distributions and chemical concentrations associated with urban PM, PM samples were collected by a 10-stage Micro-Orifice Uniform Deposit Impactor close to nearby traffic in an urban area from December 2007 to December 2009. PM samples for in vitro cytotoxicity testing were collected by a mini-volume air sampler with $PM_{10}$ and $PM_{2.5}$ inlets. Results The PM size distributions were bi-modal, peaking at 0.18 to 0.32 and 1.8 to $3.2{\mu}m$. The mass concentrations of the metals in fine particles (0.1 to $1.8{\mu}m$) accounted for 45.6 to 80.4% of the mass concentrations of metals in $PM_{10}$. The mass proportions of fine particles of the pollutants related to traffic emission, lead (80.4%), cadmium (69.0%), and chromium (63.8%) were higher than those of other metals. Iron was the dominant transition metal in the particles, accounting for 64.3% of the $PM_{10}$ mass in all the samples. We observed PM concentration-dependent cytotoxic effects on BEAS-2B cells. Conclusions We found that exposure to $PM_{2.5}$ and $PM_{10}$ from a nearby traffic area induced significant increases in protein expression of inflammatory cytokines (IL-6 and IL-8). The cell death rate and release of cytokines in response to the $PM_{2.5}$ treatment were higher than those with $PM_{10}$. The combined results support the hypothesis that ultrafine particles from vehicular sources can induce inflammatory responses related to environmental respiratory injury.

산업간호사의 의료행위 직무지침서 활용 및 의료행위직무 수행실태 (A Survey on the Occupational Health Nursing Activities for primary care)

  • 윤순녕;김순례;김영임;송영숙;안정혜;전경자;조동란;김정희
    • 한국직업건강간호학회지
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    • 제9권1호
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    • pp.5-17
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    • 2000
  • The occupational health nursing guideline for primary care was developed by the Korean Academic Society of occupational health nursing and the organization for occupational health nurses (currently known as the Korean Association of Occupational Health Nurses) in 1993. Since then, there have been many changes in the health care environment and job performance of occupational health nurses. Appropriate revisions are necessary of the guidelinea based on this background. The purpose of this study was to describe the use of the occupational health nursing guideline for primary care and to analyze the characteristics of primary care activities by occupational health nurses. The questionnaire was mailed to 150 occupational health nurses(OHNs) with the response rate of 64%. The results can be summarized as follows; 1. 65.6% of OHNs have been using the guideline for primary care and 75.9% of them agreed that the guideline was be helpful for their job. 2. Common symptom care, emergency care and chronic illness care were more frequently implemented than occupational disease care by OHNs. In manufacturing industries, emergency care was more frequently implemented than chronic illness care in contrast to the service industries. 3. Most frequent common symptoms treated by OHNs were indigestion, diarrhea, abdominal pain, headache, and coughing. In the case of chronic illness, OHNs more frequently treated diseases of the gastro-intestinal system, skin and sensory organs, and the respiratory system. Emergency care for bruises, burn, and abrasions was more frequently provided. VDT syndrome was the most common occupational disease cared by OHNs in manufacturing and service industries. 4. OHNs prescribed the medicine for external application more frequently than internal medicine. Remedy for colds, analgesics, vitamins, and digestives were more frequently used. From these results, we suggest that the guideline should be revised to emphasize the activities consisting problem finding such as health assessment, physical examinations, monitoring and screening, and to renew the drug list in the range of over- the counter medication (OTC). In the future, the guideline will include the strategies for the role as the case manager.

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재원환자의 질환군에 따른 가정간호 요구도 (Needs of Home Care Nursing Services for Hospital Patients)

  • 한성숙;김순례;이소영;권은하
    • 지역사회간호학회지
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    • 제18권1호
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    • pp.165-176
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    • 2007
  • Purpose: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. Method: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. Results: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. Conclusion: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.

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일 가정간호 실습교육 평가 연구 (An Evaluation Study on Home Care Clinical Practicum)

  • 강규숙;김조자;서미혜;백희정
    • 가정∙방문간호학회지
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    • 제6권
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    • pp.78-87
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    • 1999
  • From 1990 to 1997 Home Care Education Programs have been offered at 11 Home Care Education Institutes. But there have been no revisions in the program. Especially in the clinical practicum, the Ministry of Health and Welfare proposed 248 hours as 'Family Nursing and Practice'. But each of institutes has developed their own program, and the clinical practicum is very different. Institutions for home care practice have been very limited and even now only 40 hospitals started home care in the second demonstration project. A few community-based institutions have also been offering home care services. This study was conducted to analyze home care clinical practicum offered at Y university, and plan for a revised home care clinical practicum. Y university clinical practicum was revised to include 'visits to community institutions', 'laboratory practice', 'hospital practice', 'discharge planning and home care practice', and 'home care specialty practice'. The results of the evaluation and plan for a revision are as follows: 'Visits to community institutions' is a practice that helps the students understand community resources which are available to home care nurses, and as an orientation to institutions for practice. 'Laboratory practice' is to used to improve nursing skills that are applicable to home care. Problems that the students identified in the laboratory practice were 'lack of opportunity for individual practice', and 'inadequate theoretical preparation for practice'. To address these problems the basic nursing skills laboratory was open and could be used freely by the home care students, and practice could be done after the theoretical lectures. 'Hospital practice' is a practicum in which the students apply nursing skills to patients and to obtain assessment skills for discharge planning. Using a preceptorship, five days for hospital practice should be offered. 'Discharge planning and home care practice' was done at Wonju Christian Hospital. This institute is too far away that this practice should be provided at different institutions as soon as it is possible to contract with home care institutions. Patients groups in different home care institutions are very different, so the 'Home care specialty practice' should be done after analyzing patient groups and choosing specialty areas. These areas are' care of patients with respiratory dysfunction', 'care of patients with neurologic dysfunction', 'care of cancer patients', 'care of patients on dialysis', and 'wound care'. This practice should be offered with a preceptorship, so preceptors, clinical directors, and students should meet for home visit orientation.

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공간패널모형을 이용한 국내 초미세먼지 농도에 대한 분석 (Spatial panel analysis for PM2.5 concentrations in Korea)

  • 이종현;김영민;김용구
    • Journal of the Korean Data and Information Science Society
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    • 제28권3호
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    • pp.473-481
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    • 2017
  • 초미세먼지 (particulate matter 2.5, $PM_{2.5}$)는 분진의 입경이 2.5 이하의 보다 작은 크기의 미세한 입자들을 말하는데, 미세먼지와 달리 대기 중에서 제거가 어렵고 기도나 코 점막에서 걸러지지 않으며, 호흡 시 폐포까지 직접 침투하기 때문에 장기간 노출될 경우, 폐 기능 감소, COPD (chronic obstructive pulmonary disease) 증가, 폐암 발생증가가 있다고 알려져 있다. 현재 국내외에서 초미세먼지에 대해 다양한 연구가 이루어지고 있는데, 초미세먼지의 농도는 기상인자 (풍속, 강우량, 일사량 등)에 영향을 받는 것으로 알려져 있으며, 이산화질소, 오존, 이산화황, 미세먼지 등 대기물질의 농도에도 영향을 받는 것으로 알려져 있다. 특히 우리나라는 점차 증가하고 있는 자동차 수나 오염원으로 인한 초미세먼지외에도 중국으로부터 유입되는 초미세먼지 또한 고려되어야 하는 대상이므로 기상인자 중 풍향과 풍속 또한 어느 정도 큰 영향을 미칠 것으로 판단되며 인접 지역에 대한 영양 또한 고려되어야 할 것이다. 본 연구에서는 초미세먼지 농도에 영향을 미치는 유의한 대기물질 및 기상자료와 초미세먼지 농도의 지역적 특성을 고려한 공간자기상관 행렬에 기초한 공간패널모형을 소개하였고 이를 서울 25개 구에서 관측된 초미세먼지 자료에 적용하였다. 또한 초미세먼지와 대기오염물질의 농도를 통해 서울시에서 발생한 호흡기 질환 환자 수를 분석하여 그의 위해성을 확인하였다.

마황 단기복용이 사상체질인의 불안에 미치는 영향 : 이중맹검 임상시험 (Short-Term Effects of Mahuang on State-Trait Anxiety According to Sasang Constitution Classification : A Double-Blind Randomized Controlled Trial)

  • 형례창;양창섭;이태호;김락형;곽민정;서의석;장인수
    • 대한한방내과학회지
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    • 제28권1호
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    • pp.106-114
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    • 2007
  • Background : Mahuang (Ephedrae Herba, Ephedra sinica $S_{TAPE}$) has been widely used to treat respiratory disease in Asian over the past thousand years. The main ingredient of Mahuang is ephedrine, whose affects on the autonomic nervous system induce some adverse effects like vasoconstriction, hypertension, tachycardia, miosis, insomnia, dizziness, headache, etc. Although there were lots of reports about adverse effects of Mahuang, there were no clinical studies which evaluated the adverse effects of Mahuang on the autonomic nervous system by objective numerical value in the past decade. Objectives : The purpose of this report was to provide an objective assessment of state-trait anxiety that is caused by Mahuang, and to identify anxiety of Mahuang according to different Sasang constitution classifications. Methods : The study design was a double-blind randomized placebo-controlled trial. The subjects of this study were 79 adults aged between 20 to 40 who agreed to participate. Because 8 adults dropped out, a total of 71 subjects entered the study. They were allocated through randomization to a Mahuang group (N=50) and placebo group (N=21). Each group took three opaque capsules (every opaque capsule containing 2g of Mahuang or none) twice a day. To compare the state and trait anxiety before and after taking Mahuang, we checked the anxiety by using STAI-KYZ. Results : The following results were obtained. Short-term administration of Mahuang significantly increased state-anxiety, but in the placebo group, there were no significant changes in state-anxiety. In the Mahuang group except females, there was more significant increase in state-anxiety of Soeumin than Soyangin and Taeumin in the 2nd measurement. Conclusion : It is suggested that the ingestion of Mahuang can increase sympathetic activity and induce anxiety. There was a significant difference among Sasang constitution classification. Especially, the response is stronger in Soeumin than other constitutions. If we use Mahuang according to the Sasang constitution classification in clinic, we could not only minimize the anxiety but maximize the potential curative value.

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팔꿈치관절 CT검사에서 환자 자세 및 호흡에 따른 화질평가 (Quality Assessment for Elbow CT scan by positioning and respiratory control)

  • 임종천;박상현;이인재
    • 전자공학회논문지
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    • 제54권7호
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    • pp.110-114
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    • 2017
  • 팔꿈치관절 CT 검사 시에 골절 등으로 인해 부득이하게 팔을 거상하지 못할 때에 주로 선 감약이 많이 되는 복부 장기 및 요추에 중복된 상태로 검사하여 영상의 질이 저하되는 경우가 많다. 그로 인해, 판독에 많은 어려움이 있으며 선량 증가로 인해 환자의 피폭이 많아지고 있다. 본 실험에서는 복부 장기와의 중복을 피하고 상대적으로 선 감약이 적은 폐야와 중복되어 광자량을 증가시켜 영상의 질 향상을 도모하고자 하였다. 실험 방법은 환자의 오른쪽 팔꿈치관절을 대상으로 하여 환자를 바로 누운 자세에서 팔꿈치관절을 L2-3 level에 위치시킨 방법과 바로 누운 자세에서 왼쪽으로 30도 정도 돌려서 폐야와 중첩하고 완전한 흡기 상태에서 비교하여 진행하였다. 16, 128채널 각각 5회씩 측정하여 나온 데이터를 Image J 프로그램을 이용하여 평균값 및 표준편차를 구한 뒤 신호 대 잡음 비(SNR), 대조도 대 잡음 비(CNR), 평균대 표준편차 비(MSR)를 각각 측정하여 평가를 시행하였다. SPSS 프로그램을 이용하여 CNR, MSR을 통계 분석하였고 각각의 인자가 향상된 결과를 얻을 수 있었다. 따라서 팔꿈치관절 CT 검사 시 환자의 자세와 흡기를 통하여 검사하는 방법은 피폭선량을 최소화하고, 영상의 질을 향상하는 방법으로서 의의가 있었다고 생각한다.