• 제목/요약/키워드: fall injury

검색결과 270건 처리시간 0.038초

뇌졸중 환자의 가정간호중재 프로토콜 개발 (Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients)

  • 유지수
    • 기본간호학회지
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    • 제7권1호
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Tabebuia impertiginosa Martius ex DC(Taheebo)의 혈소판 응집 억제활성에 관한 연구 (Studies on antiplatelet activity of Tabebuia impertiginosa Martius ex DC(Taheebo))

  • 서범석;고관영;박영현;박병수;장성근
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2004년도 춘계학술대회
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    • pp.253-257
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    • 2004
  • Platelet aggregation is a complex phenomenon that probably involves several intracellular biochemical pathways. When activated, platelets change shape, aggregate and release the contents of their intracellular granules. The interactions between platelets and blood vessel walls are important in the development of thrombosis and cardiovascular diseases. When blood vessels are damaged, platelet aggregation occurs rapidly to form haemostatic Plugs or arterial thrombi at the sites of vessel injury or in regions where blood flow is disturbed. These thrombi are the source of thromboembolic complications of atherosclerosis, heart attacks, stroke, and peripheral vascular disease. Therefore, the inhibition of platelet function represents a promising approach for the prevention of thrombosis. Plants constitute a rich source of bioactive chemicals such as phenolics, terpenoids and alkaloids. Plant extracts may be an alternative to currently used medicinal source because they constitute a rich source of bioactive chemicals. This study was performed to investigate the antiplatelet activity of extract of Tabebuia impetiginosa Martius ex DC (Taheebo) and find out which fractions to this activity in rabbit platelet. Taheebo was methanol extracted and solvent fractionated in to five fractions (hexane, chloroform, ethylacetate, butanol and water). And each fractions were investigated inhibitory effects on platelet aggregation induced by various agonists using washed rabbit platelets in vitro.

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대법원 판례로 살펴본 무면허 한방의료행위의 법리 (The Legal Aspect of Supreme Court Cases on the Unlicensed Medical Practice of Korean Medicine)

  • 이해웅
    • 대한예방한의학회지
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    • 제23권1호
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    • pp.15-26
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    • 2019
  • Background and Aim : Health care and cosmetics as well as quality of life is now a matter of concern and many categories of complementary and alternative medicine fall into the territory of the medical practice of Korean medicine. Accordingly, penalties are being taken for unlicensed medical practices of Korean medicine in so called complementary and alternative medicine area. There is a possibility of violating the law for the public part because it is not clearly stipulated in the law as to what is a licensed medical practice. Materials and Method : The significance of the Medical Service Act and the Act on Special Measures for the Control of Public Health Crimes were reviewed, and the related supreme court cases were discussed upon the legal aspect of processing the unlicensed medical practice of Korean medicine. The legal information was provided from the National Law Information Center of the Ministry of Government Legislation, and the information websites of the Supreme Court and the Constitutional Court. Results : The concept of medical practice, which is essential in judging the case of unlicensed medical practice, is 'prevention and treatment of diseases through diagnosis, examination, prescribing, medication, or surgical procedures based on medical expertise', and the 'acts that may result in harm and injury of health unless performed by a medical person'. With respect to the medical practice of Korean medicine, the concept includes 'prevention and treatment of diseases using the principle of traditional Korean Medicine'. Conclusions : The concept of medical practice should be clearly stipulated in the law for the control over the unlicensed medical practices of Korean medicine. And it is important to move from the current concept of medical person-oriented medical practice emerging from the national system of healthcare control, to a concept that can accept the era of health managing-oriented medical environment and the co-governance of the healthcare providers and consumers for the future.

급성기병원에서의 간호 · 간병통합서비스 운영 전후 낙상 및 욕창 발생 변화 (Performance of Comprehensive Nursing Care Service in an Acute Care Hospital: Focusing on Accidental Falls and Pressure Injuries)

  • 남승남;류혜란;김세현;서수량;오윤희;최선미;정은진
    • 임상간호연구
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    • 제29권1호
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    • pp.56-66
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    • 2023
  • Purpose: This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. Methods: This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. Results: Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. Conclusion: It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

P.E. 필름피복(被覆) 밀식(密植) 뽕밭에서의 수종(數種) 제초제(除草劑) 처리효과(處理效果) (Effect of Several Herbicides in the Polyethylene - film Mulched Young Mulberry Field)

  • 김호락;권용웅;조용우
    • 한국잡초학회지
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    • 제5권2호
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    • pp.202-210
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    • 1985
  • 최근(最近)에 급증(急增)하고 있는 P.E. film 피복밀식(被覆密植) 뽕밭에 있어서 조성당년(造成當年) P.E. film을 피복(被覆)한 이랑과 피복(被覆)하지 않은 이랑의 잡초방제(雜草防除)를 위한 제초제(除草劑) 처리효과(處理效果)를 구명(究明)하고자 일반(一般) 뽕밭의 허가약제(許可藥劑)인 simazine 수화제(水和劑) 및 alachlor 유제(乳劑)와 함께 alachlor 입제(粒劑) 및 oxyfluorfen 유제(乳劑)를 공시(供試)하였으며, 각(各) 약제(藥劑)의 처리수준(處理水準)을 표준량(標準量)(simazine 수화제(水和劑), 150g ai/10a ; alachlor 유제(乳劑), 130g : alachlor 입제(粒劑), 200g : oxyfluorfen, 70g)과 이의 반량(半量) 및 배량(倍量)으로 하여 춘기(春期)에는 P.E. film 피복(被服)이랑과 무피복(無被覆)이랑에 처리했고, 하기(夏期)에는 무피복(無被覆)이랑에만 paraquat 49g ai/10a 혼용(混用)하여 각각(各各) 처리(處理)하고 잡초방제효과(雜草防除效果)와 뽕나무 生育 및 수량(收量)에 미치는 영향(影響)에 관하여 조사(調査)한 결과(結果)는 다음과 같이 요약(要約)된다. 1. 방임구(放任區)에 있어서의 춘기(春期) 우점잡초(優占雜草)는 무피복(無被覆)이랑에서는 갈퀴덩쿨, 망초, 며느리밑씻개, 명아주, 바랭이 등(等)이었으나 피복(被覆)이랑에서는 바랭이, 쇠비름이었다. 한편 하기무피복(夏期無被覆)이랑에서는 쇠비름, 망초, 바랭이, 쑥, 메꽃등(等)이 우생(優生)하였으나 피복(被覆)이랑에서는 뽕나무 생장(生長)에 따른 피음(被陰)으로 잡초발생(雜草發生)이 억제(抑制)되었다. 뽕나무 생육은 춘(春) 하기(夏期) 모두 손제초구에 비하여 특히 방임구(坊任區)가 불량(不良)하였으며 제초제(除草劑) 처리구(處理區)에서도 전반적(全般的)으로 약간 저조(低調)하였으며 수량(收量)에서도 같은 경향(傾向)이었다. 잡초(雜草)들은 이른 봄의 경우 피복(被覆)이랑내 잡초(雜草)들이 발생량(發生量)이 많을수록 뽕나무 생육(生育) 및 수량(收量)을 저하(低下)시키는 반면(反面) 하기(夏期)에는 무피복(無被覆)이랑내의 잡초(雜草)들이 영향(影響)을 미쳤다. 2. Alachlor 유제(乳劑) 및 simazine 수화제(水和劑) 표준사용량(標準使用量) 130g 및 150g의 제초효과(除草效果)는 춘기(春期) 무피복(無被覆)이랑에서 비교적(比較的) 양호(良好)하였으며 처리수준(處理水準) 증가(增加)에 따른 효과(效果)가 인정(認定)되었고(simazine 배량제외(倍量除外)), 반량수준(半兩水準)에서의 효과(效果)는 매우 낮았다. 그러나 춘기(春期)의 피복(被覆)이랑에서는 처리수준(處理水準)에 따른 효과(效果)의 차(差)가 뚜렷함이 없이 모두 높은 효과(效果)를 나타내어서 반량처리(半兩處理)로서도 기대효과(期待效果)가 충족(充足)되었다. 위 두 약제(藥劑)의 처리(處理) 후(後) 잔존(殘存)하는 우점잡초(優占雜草)들은 춘기(春期)의 무피복(無被覆)이랑에서는 갈퀴덩쿨, 며느리 밑씻개, 메꽃 등(等)이었으며, 피복(被覆)이랑에서는 바랭이, 띠, 쇠비름, 등(等)으로 약제간(藥劑間) 차이(差異)를 인정(認定)할 수 없었다. 하기(夏期) 무피복(無被覆) 이랑에서의 alachlor 유제(乳劑) 및 simazine 수화제(水和劑)의 제초효과(除草效果)는 방임구(坊任區)에 비하여 다소(多小) 효과적(效果的) 이었지만 처리수준(處理水準)에 따른 효과(效果)의 차이(差異)는 인정(認定)되지 않았다. 한편 하기(夏期) 무피복(無被覆)이랑에서의 우점잡초(優占雜草)는 alachlor 유제(乳劑)의 경우 쇠비름, 명아주, 며느리밑씻개 메꽃등(等)이었고, simazine 수화제(水和劑)의 경우에는 바랭이 쇠비름, 며느리밑씻개 등(等)이었다. 3. Alachlor 입제(粒劑)의 춘하기(春夏期) 피복(被覆) 및 무피복(無被覆)이랑에서의 제초효과(除草效果) 및 잔존우점잡초(殘存優占雜草)는 alachlor유제(乳劑)의 경우와 비슷한 경향(傾向)이었다. 4. Oxyfluorfen의 제초효과(除草效果)는 춘하기(春夏期)에 피복(被覆) 및 무피복(無被覆)이랑에서 모두 타약제(他藥劑)의 경우보다 지속적(持續的)인 우수(優秀)한 효과(效果)를 나타내었으며, 처리수준(處理水準)에 따른 효과(效果)의 차(差)가 있었으나 표준량(標準量)(70g ai/10a)보다 낮은 수준(水準)에서도 기대(期待)하는 효과(效果)가 인정(認定)되었다. 반면(反面) 배량구(倍量區)의 경우는 춘기(春期)에 1회(回) 처리(處理)로서 150일(日)간의 장기간(長期間)에 걸친 지속효과(持續效果)를 나타내었다. 처리(處理) 후(後) 잔존(殘存)하는 잡초(雜草)는 춘기(春期) 무피복(無被覆)이랑에서는 메꽃, 망초, 닭의 장풀 등(等)이었으며, 피복(被覆)이랑에서는 쇠비름, 바랭이 등이었고, 하기무피복(夏期無被覆)이랑에서는 쇠비름, 닭의장풀등(等)이었으나 높은 수준처리구(水準處理區)에서는 쇠뜨기의 발육(發育)도 억제(抑制)하는 강력(强力)한 제초력(除草力)을 보였다.

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하악골 골절의 임상통계학적 연구 (A CLINICAL AND STATISTICAL STUDY OF MANDIBULAR FRACTURES)

  • 박준호;허남오;전인성;신명상;노영서;윤규호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권3호
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    • pp.281-289
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    • 1994
  • This is a clinical study on 235 inpatients who sustained a total of 350 mandibular fractures and who were treated in our department during the period of Oug., 1989 through Dec., 1993. The results obtained are as follows : 1. The mumber of patients has not been increased year after year. In respect of incidence, there were the highest frequency as 67 patients(28.5%) in 1991 and the least frequency as 16 patients(6.8%) in 1989 and the highest frequency as 28 patients(11.9%) in October and the least frequncy as 12 patients(5.2%) in February. 2. The age frequency was the highest in the second decade(30.6%). The youngest patient was 8 months and the eldest patient was 80 years and mean age was 27.8 years. The ratio of men to Wemen was 4 : 1. 3. The most frequent cause was fall down as 86 patients(36.6%) and the next was fist blow 4 as 75 patients(31.9%), traffic accident as 56 patients(23.9%) in order. 4. The most common location was symphysis as 141 numbers(40.3%) and the next was condyle as 96 numbers(27.4%), angle as 94 numbers(26.8%), body as 14 numbers(4.0%) in order. The sum of fracture sites were 350 and there were 1.49 fracture sites per one patient and multiple fractures occured in 100 patients(40.5%) of the 235 patients. The ratio of Left to Right except for symphysis was 1.71 : 1. 5. Among the 333 associated injuries, facial laceration was 136(57.9%) and tooth injury was 58(24.7%) and extremity was 31(13.2%). 6. Among the 350 mandibular fractures, complications after treatment occured in 51(14.6%) and infection as 20(5.7%) was the most frequent complication. 7. In respect of treatment of mandibular fracture, close reduction was 64 patients(27.2%) and open reduction was 164 patients(69.8%) and other were 7 patients(3.0%) of all and so open reduction was the most common in type of treatment.

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Acutrak 나사를 이용한 요골두 골절의 치료 -7례 보고- (Acutrak Screw Fixation for Radial Head Fracture -7 Cases Report-)

  • 김광열;임문섭;신흥섭;최신권
    • 대한정형외과스포츠의학회지
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    • 제5권1호
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    • pp.75-80
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    • 2006
  • 목적: 해부학적 정복이 가능한 요골두 골절에 대하여 Acutrak 나사를 이용한 고정술의 치료 결과와 유용성에 대해 알아보고자 하였다. 대상 및 방법: 2001 년 5월부터 2003년 2월까지 본원에서 요골두 골절에 대해 수술한 12 예중 Acutrak 나사 고정술로 치료한 7 예를 대상으로 하였다. 추시 기간은 최소 6개월부터 최장 30개월로 평균 1.2년이었고, 평균 나이는 47세였다 손상의 원인은 낙상이 4예, 교통사고가 3예이었다. 치료 결과 평가 방법은 Mayo Clinic에서 발표한 Functional Rating index를 이용하였다 결과: Mayo Clinic의 Functional Rating Index를 이용한 기능적 평가상 우수가 2예, 양호가 5예였다 방사선학적 소견 상 모든 예에서 골유합 소견을 보였고, 부정 유합이나 나사 이완, 이소성 골형성, 감염, 외상 후 퇴행성 변화 등의 합병증은 없었고 수술 후 건측과 비교하여 운동장애도 보이지 않았다. 결론: 본원에서 시행한 요골두 골절의 Acutrak 나사 고정은 요골두 부분의 안전지대에 대한 고려없이 시행 가능하며 방사선학적 및 임상적 평가에서 만족할 만한 결과를 보였고, Acutrak 나사의 형태학적 특성상 골절의 선상 형태에 대하여 근위 요척골관절에 영향을 주지 않으며, 강한 고정력을 얻을 수 있는 술식으로 사료된다.

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말기 심부전증 환자에 대한 심장이식술의 조기 성적 (Early Results of the Heart Transplantation for End Stage Heart Failure)

  • 노준량;원태희
    • Journal of Chest Surgery
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    • 제30권9호
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    • pp.876-884
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    • 1997
  • 서울대학교병원 흉부외과에서는 1994년 3월부터 1996년 5월까지 14명의 환자에 있어서 심장이식술을 시행 하였다. 남자가 9명 여자가 5명이었으며 평균나이는 40.8 $\pm$ 12.4세 이었다. 수술전 모든 환자들은 UiID Fc III 또는 IV이었으며 술전 진단은 확장성 심근병증이 11명, 제한성 심근병증이 3명이었다. 장기 공여자의 평균연령은 24.9 $\pm$ 10.2세 이었으며 뇌사의 원인으로는 교통사고에 의한 뇌손상이 8명으로 가장 많았으며 거미막하 출혈이 2명, 이 물질에 의한 기도폐쇄, 추락사고, 뇌종양, 익사사고 등이 각각 1명이 었다. 수혜자와 공여자의 혈액형은 11명에 있어서는 일치되었고 2명에 있어서는 적합하였으나 1명의 환자에 있 어서는 부적합하였다. 11명의 환자에 있어서는 양대정맥을 직접 문합하는 방법을 사용하였으며 3명의 환자에 있어서는 우심방을 연결하는 방법을 사용하였으며 평균 이식심장 허혈시간은 157.8 $\pm$ 43.8분(94-220분) 이었다. 2명이 사망하 여 병원 사망률은 14.3%이었다. 사망원인은 우심실부전, 사이클로스포린 유발성 용혈성요독증후군, 거부반응 으로 인한 다발성 장기부전과 대동맥 문합부위 가성동맥류의 파열로 의심되는 酉\ulcorner銖汰潔駭\ulcorner 평균추적기간은 16.2 $\pm$ 9.0개월(3-28개월) 이었으며 만기사망은 1례 있었다. (8.3%) 마지막 추적당시 급성 거부반응으로 치료를 받고 있는 1명을 제외한 모든 환자들은 UnD Fc I이었다. 병원사망을 포함한 1개월 및 6개월, 2년 생존율은 각각 n.9 $\pm$ 6.9%, 85.7 $\pm$ 9.4% , 77.1 $\pm$ 11.7% 이었다. 결론적으로 심장이식술은 말기 심부전환자의 이상적인 치료법이며 앞으로 장기적인 추적검사가 필요하리라 생각된다.

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유방재건술에 사용된 식염수 보형물의 임상적 내구성과 누출 (Clinical Durability and Deflation of Saline-Filled Breast Implant in Breast Reconstruction)

  • 김일국;이준호;김용하;김태곤;이수정;강수환
    • Archives of Plastic Surgery
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    • 제38권6호
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    • pp.808-814
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    • 2011
  • Purpose: Despite wide clinical use of breast implants, there is continued concern about the lifespan of these devices. The causes of explantation were infection, deflation of implant and patient's want. The deflation of saline-filled breast implant was related to strength and durability of implant shell. The purpose of this study is to evaluate the clinical durability of saline-filled breast implant through the analysis of duration until deflation occurred, causes, incidence and influencing factors. Methods: Retrospective analyses were conducted on clinical records for 19 cases of deflation of saline-filled breast implant from 201 cases of breast reconstruction with saline-filled implant between May 1995 and June 2011. The authors had been analyzed the causes of deflation, survival duration, symptom, sign, nipple excision, volume of implant, saline filling, method of reoperation, breast cancer stage and combined capsular contracture. Results: The causes of deflation were attributed to the cases that cannot be evaluated the causes in 15 cases, fall down in 1 case, mammography in 2 cases, accidental needle injury in 1 case. Mean survival duration was 4 years and 5 months. The duration of survival was less than 1 year for 5 cases, 1 year to 10 years for 10 cases, more than 10 years for 4 cases. The volume between 201 and 250 cc of deflated breast implant was rated as high by 14.0 percent. The deflation rate of underfilled implants was 11.4 percent, adequate filled implants was 9.3 percent. None of overfilled implant was deflated. The deflation of smooth surface implant was 5 of 152 cases. Textured implant was 14 of 49 cases. The capsular contracture of non-deflated breast implant was 28 of 182 cases and that of deflated breast implant was 6 of 19 cases. Conclusion: The patients who underwent saline-filled breast implant implantation should be informed that their implant could deflate. The analysis of clinical durability and causes of deflation in breast implant was important for the prediction and prevention of reopeation. The authors could suppose the causes of deflation of saline-filled breast implant through history, duration of survival, inspection of the shell of implant.

거골 골절 및 탈구의 임상적 고찰 (Clinical Observation and Treatment of Fracture-Dislocation of Talus)

  • 이동철;김세동;정해훈
    • Journal of Yeungnam Medical Science
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    • 제9권2호
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    • pp.302-311
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    • 1992
  • 1984년 부터 1991년까지 영남대학 병원에서 치료한 거골 골절 및 탈구 환자에서 최장 8년에서 최단 1년간 원격 추시하여 다음과 같은 결론을 얻었다. 1. 평균 30세 나이로 활동기 연령군이였으며, 전부 남자이었다. 2. 손상원인은 추락사고가 대부분이었으며, 교통사고, 스포츠손상 순이었다. 3. 거골 골절 및 탈구는 Marti-Weber 방법으로 분류하였으며, Type I 1례, Type II 1례, Type III 4례, Type IV 5례이였다. 4. 치료는 관혈적 정복술 및 내고정술을 6례에서 시행하였고, 나머지 5례는 도수정북솔로 치료하였다. 5. 치료 결과에 대한 평가는 Hawkins 등급 점수표를 이용하여 약 64%의 만족도를 얻을 수 있었으나, Type IV에서 결과가 좋지 않았다. 6. 합병증으로는 무혈성 괴사가 3례, 퇴행성 관절염이 8례, 불유합이 1례로 퇴행성 관절염의 빈도가 약 70%를 차지하였고, 거골하 관절에서 대부분 발생하였다. 7. 관절의 운동범위에서 건측에 비교하여, 족관절은 약 74%에서 유지되었으며, 거골하 관절은 건측에 비해 약 43%로 감소되었다. 이상에서 거골 골절 및 탈구시에는 빠른 관혈적 정복 및 내고정을 실시하고, 술후 적극적인 재활 치료를 하여 무혈성 괴사증이나, 퇴행성 관절염의 합병증을 줄이면 이차적인 수술을 하지 않을 수 있으며, 족관절의 기능도 가능한 유지할 수 있을 것으로 사료된다.

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