• Tuberculosis and Respiratory Diseases
• /
• 제62권5호
• /
• pp.437-440
• /
• 2007

기관절개술은 가장 오래된 수술기술 중의 하나로 상기도 폐쇄의 경감, 장기간의 기계호흡유지, 보조적 기계호흡시에 기도 저항의 감소 등의 목적으로 시행할 수 있다. 기관절개술에 따른 초기합병증으로는 기흉, 피하조직기종, 절개부위 출혈, 종격동 기종, 흡인, 기관절개 관 전위 등을 들 수 있다. 수술에 따른 피하조직기종과 기흉은 0.9-5%에서 보고되었다. 본 증례에서는 기관절개술 직후에 피하조직기종과 양측 폐에서 발생한 긴장성 기흉을 경험하였기에 보고하는 바이다.

• 대한임상독성학회지
• /
• 제6권1호
• /
• pp.32-36
• /
• 2008

Purpose: The major complication of acute organophosphate (OP) poisoning is respiratory failure as a result of cholinergic toxicity. Many clinicians find it difficult to predict the optimal time to initiate mechanical ventilation (MV) weaning, and as a result have tended to provide a prolonged ventilator support period. The purpose of this study is to determine any clinical predictors based on patients characteristics and laboratory findings to assist in the optimal timing of mechanical ventilator weaning. Methods: We reviewed medical and intensive care records of 44 patients with acute OP poisoning who required mechanical ventilation admitted to medical intensive care unit between July 1998 and June 2007. Patient information regarding the poisoning, clinical data and demographic features, APACHE II score, laboratory data, and serial cholinesterase (chE) levels were collected. Base on the time period of MV, the patients were divided into two groups: early group (wean time < 7 days, n = 28) and delayed group (${\geq}$ 7 days, n = 16). Patients were assessed for any clinical characteristics and predictors associated with the MV weaning period. Results: During the study period, 44 patients were enrolled in this study. We obtained the sensitivity and specificity values of predictors in the late weaning group. APACHE II score and a reciprocal convert of hypoxic index but specificity (83.8%) is only APACHE II score. Also, the chE concentration (rho = -0.517, p = 0.026) and APACHE II score (rho = 0.827, p < 0.001) correlated with a longer mechanical ventilation duration. Conclusion: In patients with acute OP poisoning who required mechanical ventilation, the APACHE II scoring system on a point scale of less than 17 and decrements in cholinesterase levels on 1-3 days were good predictors of delayed MV weaning.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제16권2호
• /
• pp.95-103
• /
• 2013

Purpose: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. Methods: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. Results: The mean score of the IDA group was $7.8{\pm}2.6$ points, which was significantly higher than that of the control group ($5.6{\pm}2.1$) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. Conclusion: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.

• Asian-Australasian Journal of Animal Sciences
• /
• 제22권11호
• /
• pp.1540-1546
• /
• 2009

One hundred and forty-four piglets with an average birth weight of 1,672${\pm}$13.4 g were used to evaluate different feeding strategies for piglets reared from birth on a dummy sow. A 3${\times}$2 factorial experiment compared three nursing frequencies (1, 3 or 6 h intervals) and two feeding regimes (milk only, or milk combined with access to creep feed and water). The piglets which were nursed at one hour intervals had the lightest body weights at all days, and the poorest combined milk and creep feed dry matter conversion efficiency to piglet body weight gain in the second week. Piglets which were nursed at 3 h intervals had the heaviest body weight at day 15 and 22, but those nursed at 6 h intervals achieved similar body weight by days 29 (milk withdrawal) and 36. Piglets offered creep feed were observed to wean themselves before cessation of milk availability, and the timing of this self-weaning depended on the nursing frequency. The piglets nursed at one hour intervals weaned themselves between day 22 and day 29, those nursed at 3 h intervals weaned themselves between day 15 and day 22, whilst those nursed at 6 h intervals weaned themselves between day 8 and day 15. The piglets which were nursed at 6 h intervals had the highest total dry matter intake in weeks 3 and 4 when fed with milk, creep feed and water but not when fed milk only. They consequently had the poorest dry matter conversion efficiency in the fourth week and overall when fed with milk, creep feed and water, but not when fed milk only. It is concluded that the optimal management routine under these conditions is a 3 h nursing cycle with provision of supplementary creep feed and water.

• Child Health Nursing Research
• /
• 제8권1호
• /
• pp.55-66
• /
• 2002

It is an important task to give adequate nutritions to infants and to wean properly for rapid growth. This study was conducted to survey on doing the weaning activities of the first-time mother. This study was to provide basic data of health teaching and nursing intervention for the promotion of ideal weaning activities. Survey was done from January to February in 2001. Total 444 mothers who have first-time baby under twelve month old were interviewed in five community health center around contry (Seoul, Choung-ju, Asan, Cheon-an, Jeju). The results are summarized as follows; Starting time of weaning was common in four month old(40.4%). Most common daily weaning times by age showed once(under 3 months), twice(4 to 7 months), three times(8 to 12 months). The younger, the more commercial weaning products(p<0.01). Education level showed relatively positive relation with home-made weaning food(p<0.05). Items showed low scores in 4 to 7 months group were starting new food item, waiting at least one week interval to new food, feeding by milk bottle, allowing grasping spoon, consulting pediatrician for problems after weaning, starting from morning, regular schedule. Items showed low scores in 8 to 12 months group were feeding whole egg rather than yolk only up to 12 months, keeping weaning interval were increased, feeding by milk bottle, trying various cooking method, not giving commerical cooking and instant food and unproper raw milk feeding. In weaning activities by general factors, mother age, health status, marriage duration, monthly income were statistically significant (p<0.05). To improve good weening activities, targetting on low maternal age and poor health status, and low income group, developing teaching materials and training program for items showed low scores and proper weaning time, type of easy home-made food and easy cooking method should be provided. Further study on effect of nursing intervention to improve weaning activities are needed.

• Journal of Chest Surgery
• /
• 제39권6호
• /
• pp.490-494
• /
• 2006

말기 폐질환 환자에서 폐이식은 가장 효과적인 치료이나 원발성 이식부전은 아직도 이식 후 합병증과 사망률 증가의 주 요인이 된다. 폐기종으로 진단된 52세 남자 환자가 지속적 호흡기 치료 및 기관절개 상태에서 좌측 폐이식 수술을 시행 받았다. 본 환자는 이식술 후 발생한 원발성 이식부전으로 호흡기 발관이 불가하여 재이식이 결정되었다. 환자는 인공심폐기 하에 순차적으로 양측 폐이식 수술을 시행 받았으며 현재 퇴원하여 건강하게 일상생활을 하고 있다. 폐이식 수술 후에 발생하는 이식부전이 있으면 가급적 빠른 시일 내에 재이식 수술을 시행하는 것이 예후에 중요하다.

• Journal of Chest Surgery
• /
• 제43권3호
• /
• pp.304-307
• /
• 2010

대동맥 축착증 및 심한 대동맥 협착을 가진 생후 5일의 환자가 대동맥 협착을 해결하려는 중재적 시술 도중 유도 카테터에 의한 우측 경동맥 손상으로 인한 출혈 및 심낭 내 탐폰으로 인한 심정지가 발생하여 심폐소생술 후 체외막성산화기 보조를 받았다. 환자의 체중은 2.4 kg이었다. 1일 후 수술적 완전 교정술을 시행하였으나, 수술 직후 심한 심기능 저하로 인하여 양심실 보조 장치로 순환 보조를 하였고, 3일 후 양심실 보조 장치 이탈에 성공하였다. 이후 환자는 일반적인 치료 후 특별한 문제없이 퇴원하였다.

• 한국통신학회논문지
• /
• 제36권8A호
• /
• pp.712-722
• /
• 2011

Wireless body area network (WBAN)은 인체 주변 영역에서의 통신서비스를 제공한다. WBAN 서비스는 인체 내부에 이식된 의료 응용을 위한 MICS 주파수 대역과 의료 응용과 consumer electronics (CE) 응용 분야 모두를 제공할 수 있는 ISM 주파수 대역에서의 서비스로 이루어지기 때문에 WBAN을 위한 MAC 프로토콜은 의료 응용과 CE 응용간의 상이한 특징과 유연성 (flexibility)을 고려하여 설계되어야 한다. 본 논문에서는 WBAN MAC 프로토콜의 요구사항을 확인하고, WBAN의 요구사항을 만족하는 WBAN MAC 프로토콜을 제안한다. WBAN의 다양한 응용을 위한 전송 유연성을 제공하기 위해서 동적 CFP(Contention Free Period) 할당(Dynamic CFP Allocation)을 제안한다. 또한, 경쟁 기반의 긴급 의료 데이터를 발생하는 의료 응용과 때때로 대량의 데이터를 발생하는 CE 응용을 지원하기 위해서 OCDP(opportunistic contention decision period) 구간과 4-mode Opportunity period를 제안하고, 제안한 방안을 이용하여 Inactive period와 Opportunity period를 일시적으로 전환하여 사용할 수 있는 기법을 제안한다. 다양한 시뮬레이션 결과 IEEE 802.15.4 MAC 프로토콜과 제안하는 WBAN MAC 프로토콜을 비교하였을 때, WBAN 환경에서의 전송 처리량, CFP 이용율, 전송지연 측면에서 증가된 성능 결과를 얻을 수 있었다.

• Pediatric Infection and Vaccine
• /
• 제25권2호
• /
• pp.101-106
• /
• 2018

6세 남아가 인플루엔자 A 바이러스 감염 이후 급성 호흡부전 상태에서 내원하였다. 기관 삽관 이후 인공 호흡 및 산화 질소공급에도 호흡성 산증 및 저산소증의 호전이 없어 내원 9시간 이후 체외막 산소 공급을 이용하여 호흡 보조를 시행하였다. 내원 12시간 이후 기관지경을 이용하여 우측 중간 기관지부터 상엽 구멍을 막고 있는 단단한 점액 마개를 제거하였다. 이후 환자는 신경계와 호흡기계 후유증 없이 퇴원하였다. 저자들은 플라스틱 기관지염으로 인한 급성 호흡 부전 상태의 환자에서 신속한 체외막 산소 공급 및 기관지경술의 처치를 시행함으로써 후유증 없이 치료한 사례를 보고한다.

• Journal of Trauma and Injury
• /
• 제27권4호
• /
• pp.229-232
• /
• 2014

A 55 year-old man hit a vehicle while riding a bicycle. He was diagnosed as left hemopneumothorax, multiple rib fracture, cerebral hemorrhage, and skull fracture. Initially he suffered from hypoxia requiring 100% oxygen with a mechanical ventilator. Finally he became hypotensive. Venovenous extracorporeal membrane oxygenation (ECMO) was initiated to support patient's gas exchange. Because hypotension and left ventricular dysfuction persisted, we converted the mode of support to veno-arterio-venous ECMO. Over four days of intensive care, we could wean off ECMO. The patient went to rehabilitation facility after 45 days of hospitalization. Although trauma and bleeding are considered as relative contraindication of ECMO, careful decision making and management may enable us to use ECMO for trauma-related refractory heart and/or lung failure.