• 제목/요약/키워드: 임상 경과

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상악 전치부 임플란트 식립에 의한 열개 및 천공형 골결손 발생 시 조직 접착제를 이용한 골유도 재생술: 증례보고 (Guided Bone Regeneration using Fibrin Glue in Dehiscence or Fenestration Defects Occurred by Maxillary Anterior Implants: Case Report)

  • 지영덕;선화경
    • 구강회복응용과학지
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    • 제28권3호
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    • pp.277-290
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    • 2012
  • 최근 치과 임플란트는 구강 내 무치악 부위의 보편적인 수복 방법으로 임상가 뿐만 아니라 환자들에게도 널리 인식되어 있다. 외상, 만성 치주염 등 다양한 원인에 의해 상악 전치부는 발치 후 급속한 순측 골흡수가 진행될 수 있다. 그로 인해 협소한 순구개 폭경을 가진 상악 전치부 치조제 상에 임프란트 식립 시 열개 및 천공형 골결손이 발생할 수 있다. 이 경우 골유도 재생술을 사용하여 상악 전치부 치조제를 증강시킬 수 있다. 골유도 재생술시 골이식재에 조직 접착제를 혼합하여 기계적 및 생물학적 이점을 얻을 수 있다. 본 증례에서는 순설 폭경이 얇은 상악 전치부 치조제 상에 임플란트 식립에 의한 열개 및 천공형 골결손 발생시 자가골을 제외한 동종골, 이종골, 그리고 합성골 입자형 골이식재 등을 다양하게 조합한 후 조직 접착제와 혼합하여 골유도 재생술을 진행하였다. 모든 증례에서 양호한 치조제 증강을 보였음에 보고하는 바이다.

간호역량 규명을 위한 문헌 분석 (An Identification Study on Core Nursing Competency)

  • 박영임;김정아;고자경;정명실;방경숙;최명애;유미수;장혜영
    • 한국간호교육학회지
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    • 제19권4호
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    • pp.663-674
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    • 2013
  • Purpose: This study was to scrutinize not merely the nomenclature of clinical competency suggested in nursing literature but also what core clinical competency nursing students should be focused on for improving competency-based curriculum. Methods: A comprehensive review on 69 domestic and 89 foreign related literature was conducted. After reviewing the full text of a total of 158 articles, only 23 articles with measurement tools were selected for scrutinizing while 135 articles with obscure definitions of clinical competency were excluded. Results: Clinical competencies including 120 concepts were identified. Those concepts were categorized as 30 clinical competencies according to their similarities. Seven core clinical competencies including 1)nursing knowledge, 2)nursing skill, 3)interpersonal skill/cooperation, 4)problem-solving, 5)professionalism, 6)nursing management/leadership and 7)research ability were derived from the 30 clinical competencies through the categorizing process. Conclusion: Teaching & learning strategies should focus on the integration of nursing theories and clinical practices based on competency-based curriculum considering the 7 core clinical competencies. Nonetheless, they include somewhat abstract concepts and some were not concrete enough to be applied to the nursing curriculum. Thus, further research is needed in order to develop consensus-driven clinical competencies and competency modeling which can suggest the interrelation between the core competencies.

급성 호산구성 폐렴 1예 (A Case of Acute Eosinophilic Pneumonia)

  • 이기훈;조철호;고광곤;문태훈;장동섭;박찬섭;김진주;김준미
    • Tuberculosis and Respiratory Diseases
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    • 제42권1호
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    • pp.99-104
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    • 1995
  • 만성 호산구성 폐렴은 잘 알려진 질환이나 급성 호산구성 폐렴은 아직 잘 정의되어 있지 않은 상태로 최근 보고 예가 증가하는 추세이며 급성 호산구성 폐렴의 진단 기준에 대한 모형들도 제시되고 있다. 급성 호산구성 폐렴은 일반적으로 만성 호산구성 폐렴과는 달리 1개월내의 빠른 임상 경과와 스테로이드에 대한 빠른 반응, 치료후 재발이 없는 것등을 특징으로 한다. 저자등은 평소 건강하던 중 호흡곤란, 기침, 발열등의 급성 호흡기계 증상으로 내원하여 흉부 X-선상 양측 폐야 전체에 결절성 혼탁과 감염의 증거없이 말초 혈액상 호산구 증다증을 보인 환자에서 기관지 폐포 세척술과 경기관지 폐생검으로 확진된 급성 호산구성 폐렴 1예를 보고하는 바이다.

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후하악부 절개를 통한 하악골 관절돌기 골절의 치료 후 임상경과에 대한 고찰 (Consideration of Clinical Progress after Open Reduction with Retromandibular Approach in Treatment of Mandibular Condyle Fractures)

  • 김한구;권남호;배태희;김우섭
    • 대한두개안면성형외과학회지
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    • 제9권1호
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    • pp.17-22
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    • 2008
  • Purpose: For several decades, open reduction has been a controversial issue in mandibular condyle fracture. The authors have successfully used the open reduction and internal fixation with retromandibular approach and have found it to be satisfactory for mandibular condyle fracture. Methods: A total of 10 patients with mandibular condyle fracture underwent open surgical treatment using retromandibular approach. The incision for the retromandibular approach was carried below the ear lobe and the facial nerve branches were identified. Dissection was continued until the fracture site was exposed and internal fixation was performed with miniplate following intermaxillary fixation. The average period of joint immobilization was 1 weeks and the arch bars were removed in 3 weeks on average. The preoperative and postoperative panoramic view and three-dimensional computed tomography were compared. During the follow up period, we evaluated the presence of malocclusion, chin deviation, trismus, pain, click sound, facial nerve palsy, hypertrophic scar and skin fistula. Results: According to the radiographic findings, the fractured condyle was reducted satisfactorily in all patients without any symptoms of facial palsy. During the follow up period ranged form 6 to 12 months, all clinical symptoms were improved except in one case with chin deviation and malocclusion. Conclusion: Using open reduction and internal fixation of mandibular condyle fracture with retromandibular approach, all results were satisfactory with good functional outcomes and minimal complication. We concluded that the open surgical treatment should be considered as the first choice for mandibular condyle fracture management.

대장내시경 전처치 융합관리프로그램의 효과 (The Effect of Bowel Preparation Convergence Program for Colonoscopy)

  • 강원숙;김주성
    • 한국융합학회논문지
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    • 제9권1호
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    • pp.473-483
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    • 2018
  • 본 연구목적은 대장내시경 전처치 융합관리프로그램의 효과를 확인하기 위함이다. 비동등성 대조군 시차설계에 따라 대장내시경 검진예정자 75명을 연구대상으로 하였다. 실험군에게는 동영상교육, 걷기운동 및 전화상담모니터링으로 구성한 대장내시경 전처치 융합관리프로그램을 적용하였다. 자료는 구조화된 질문지와 대장내시경 관찰을 통해 수집하였으며 SPSS 21.0 program을 이용하여 분석하였다. 연구결과 실험군의 대장정결제 복용이행도와 검사만족도는 대조군보다 높았고(p=.002; p=.001), 검사난이도와 검사불편감은 유의하게 낮았다(p=.002; p=.001). 대장정결도와 검진소요시간에는 두 집단 간 유의한 차이가 있었으나 식이요법이행도는 차이가 없었다((p<.001; p=.001; p=.108). 따라서 대장내시경 전처치 융합관리프로그램은 대장내시경검사를 위한 효과적인 간호중재방안으로 활용될 수 있으며 향후 임상실무에서 다양한 진단적 검사를 위한 융합중재개발이 요구된다.

간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발 (Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process)

  • 조용애;은영;구미옥;김경숙;곽미경;김정혜;이선희;박동아;노화경
    • 임상간호연구
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    • 제21권2호
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    • pp.154-168
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    • 2015
  • Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

급성 경·요추 염좌로 진단된 교통사고 환자에서 귀비탕(歸脾湯)과 당귀수산(當歸鬚散)의 효과에 대한 임상 연구 (Clinical Study of the Effects of Gwibi-tang and Danggwisusan on Traffic Accident Patients with Acute Cervicolumbar Disorder)

  • 박정오;정훈;허동석
    • 한방재활의학과학회지
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    • 제25권3호
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    • pp.81-90
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    • 2015
  • Objectives This study was designed to compare the effects Gwibi-tang herbal-medication with Danggwisusan herbal-medication for patients with acute cervical and lumbar sprains due to a traffic accident. Methods This study was carried out on 119 acute cervical & lumbar sprain patients by traffic accident. We divided these patients into 2 groups. Group A was treated with Gwibi-tang and Group B was treated with Danggwisusan three times a day for three days. Each patient was treated with acupuncture, physical therapy and two types of herbal-medication. We measured the numerical rating scale (NRS) at two time points : pre-treatment (Tx). and post-Tx. Results 1. The NRS scores significantly decreased after treatment in all patients. 2. The changed NRS scores of nuchal pain showed a borderline significant difference between Group A and Group B (p=0.067). 3. In sub-group analysis, Gwibi-tang showed a greater effect on NRS scores of lumbago pain in female patients (p=0.068) and patients under 30s (p=0.054) compared to Danggwisusan. Conclusions In this study, both types of herbal-medication; Gwibi-tang and Danggwisusan were highly effective on acute cervical and lumbar sprain patients. Especially Gwibi-tang (Group A) was more effective than Danggwisusan (Group B) in reducing the initial nuchal pain. Also Gwibi-tang was more effective for lumbago pain in female and patients under 30s.

하악골에 발생한 근섬유종 (MYOFIBROMA OF THE MANDIBLE)

  • 윤정훈;김수관;이상호
    • 대한소아치과학회지
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    • 제30권1호
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    • pp.10-14
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    • 2003
  • 근유종은 소아에 주로 발생하는 다발성 종양으로 처음에 기술되었지만, 단독으로 발생하는 경우가 더 많고, 어느 연령층에서나 발생한다. 성인과 소아형 모두 비슷한 임상적 특성과 병리조직학적 특징을 갖는다. 이 증례는 9세 남아의 하악에 경계가 명확한 단방성의 방사선 투과성 병소로, 병리조직학적으로 방추형 세포들이 다발을 이루며 증식하며, 일부에는 혈관주피종과 유사한 부위가 관찰되었다. 면역조직화학적으로 종양세포는 vimentin과 smooth muscle actin에 양성, S-100, desmin, cytokeratin AE1/3에 음성이었다. 이 증례에서와 같이 소아에서 단방성 방사선 투과상의 고형성 종괴로 나타나는 경우 근섬유종을 감별진단에 포함시켜야 한다고 생각된다. 환자는 수술 1년이 경과한 현재까지 재발의 소견은 없지만 재발한 경우도 보고되어 있어 철저한 추적 관찰이 필요하며, 현재 #43, 44 치아의 맹출을 유도하는 중에 있다.

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결핵성 뇌수막염에 동반된 뇌성 염분소실증후군(Cerebral salt wasting syndrome) 1예 (A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis)

  • 이자영;이은실;이재형;임은주;김형수;장지선;김현규;김두만;박용범;이재영;모은경
    • Tuberculosis and Respiratory Diseases
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    • 제59권3호
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    • pp.306-310
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    • 2005
  • 저자들은 결핵성 뇌수막염을 가진 31세 남자환자에서 심한 다뇨와 저나트륨혈증, 저혈압, 요중 염분소실이 동반되어 있어 CSWS로 진단하고 항결핵제 투여와 식염수, 염류코르티코이드의 투여 후 임상적 호전을 보인 증례 1예를 경험하였기에 보고하는 바이다.

교통사고 소아환자 121례를 통한 임상적 고찰 (The Clinical Study on 121 Traffic Accident Child Patients)

  • 조민서;한재경;김윤희
    • 대한한방소아과학회지
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    • 제26권2호
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    • pp.35-46
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    • 2012
  • Objectives The purpose of this study was to find out the characteristics of children patients who had been treated in the Oriental Medical Hospital due to traffic accidents. Methods The study was carried out with 121 children patients who visited the Oriental Medical Hospital from April 2011 to March 2012 and was analyzed by reviewing the patients' charts. Results In the distribution of sex the ratio between boys and girls were similar, but regarding the age, 0~6 year-old group was more than that of 7~15 year-old group. In the traffic accident patterns, 87.6% of the entire children patients were injured by car crash. The highest type in the collision between cars was rear-ending impact. The most patients (48.8%) visited our hospital for oriental medical treatment in less than 3 days after the traffic accident. The number of the first visitors in the Oriental Medical Hospital were 77 (63.6%) and those who visited other western hospitals before and were 44 (36.4%). The most frequent duration of admission and treatment in OPD was less than 7 days. Sleeping disorders (37.1%) were diagnosed the highest in 0~6 year-old group and C-spine sprain (49.0%) was diagnosed the highest at 0~7 years-old group. Herb medications were prescribed to relieve anxiety for 0~6 year-old group and for 7~15 year-old group, those were prescribed to activate blood eliminating phlegm and to normalize Qi flow. The highest effective treatment period was less than 7 days. Conclusions This data suggested that the oriental medical care could be more effective in treating children victims of traffic accidents by confirming many different symptoms depending on the age.