• Title/Summary/Keyword: 자세 평가

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Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis (과도한 주간 졸림과 탈력발작을 주소로 내원한 환자에서 발견된 갑상선 중독증)

  • Chung, Jae-Kyung;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.40-44
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    • 2011
  • Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

A Study on the Efficiency of Hand-Knee Position in GB Stone Ultrasonography (담낭결석 초음파검사에서 Hand-Knee position의 효율성에 관한 연구)

  • Park, Soung-Ock;Do, Yun-Su
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.267-274
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    • 2006
  • The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.

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Professionalism raising of the escort which leads an instance analysis (사례분석을 통한 경호 전문성 제고)

  • Yu, Hyung-Chang
    • Korean Security Journal
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    • no.18
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    • pp.73-99
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    • 2009
  • There are three assassination and treatening cases in this thesis introduced as analysis data. They are shooting accidents of the U.S.A's President Reagun (1981,3.30), and the President Park Jeong Hee of South Korea(1974.8.15), assassination of the Prime Minister Lavin of Israel (1995.11.4) In March 30, 1981, there was an accident where criminal, Hinckley, fired ball cartridges right before the President Reagan got into the car to move to White House after completing the announcement of Hilton Hotel of Washington. As a result, the chest of president was shot and public information secretary and safeguard were wounded. In August, 15, pm 10:23, where the 29th 8.15 independent anniversay event was being celebrated by the people at the National theater in Jangchungdong, Seoul, the criminal Moon Sekwang fired ball cartridges, he failed to assassinate the President Park Jeong Hee of Korea, but shot the First lady Yuk Young Soo. She was wounded right part of head and died. In November 4, Saturday, pm 22:00 the Prime Minster Lavin had finished the supporting event of Middle Asia's Peace project and was taking on the car when he was killed by the criminal Amir's shooting, The accidents left very important lesson from the aspect of security analysis and it has been frequently used as a material for the education and training of safeguard organization. In Korea, as well as Presidential Security Service, national security departments have selected it as an important model for the subjects such as 'Security Analysis, 'Security Practice' and 'Security Methodology'. In the performance of security duty, security skill is the most important matter. Moreover, it has a close relationship with politics, society and culture. The purpose of this study is to analyze and reevaluate the case, which has been treated as a usual model from the aspect of security analysis, beyond its introduction. Attempted assassination of President Reagan was evaluated as a positive success example because of its rapid response of adjacent guards to evacuate Reagan, who is a guard target, within 10 seconds after the shot. When comparing it to President Kennedy Assassination of 1963, it was evaluated that guards were significantly specialized. In the study, however, it was possible to found many problems such as carelessness of guard, who is in charge of external area of event place, idle attitude for frequently used event place, confusion of wireless communication, risk of wireless security disclose, insufficient provision of compulsory record file, insufficient profiling of dangerous person and unsecured hospital and first-aid room.

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Assessment of Various Factors Influencing the Composition of Cow's Milk Produced by Organic and Conventional Methods: A Review (유기농 우유와 일반 우유의 성분에 영향을 주는 다양한 요인 평가: 총설)

  • Kim, Hong-Seok;Chon, Jung-Whan;Kim, Hyunsook;Lee, Soo-Kyung;Kim, Dong-Hyeon;Lee, Joo-Yeon;Yim, Jin-Hyuk;Song, Kwang-Young;Kim, Young-Ji;Kang, Il-Byung;Jeong, Dana;Park, Jin-Hyeong;Jang, Ho-Seok;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.1
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    • pp.21-35
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    • 2016
  • Recently, there has been a rapid increase in the sale and purchase of an array of organic products. In particular, organic milk has grown in popularity. This growth could lead to expensive, premium retail prices for various organic cow's milk products. In fact, most consumers believe that (1) dairy farming to produce organic milk is beneficial for human health and (2) organic milk products are made without the use of various antibiotics, synthetic chemicals, genetic modification, extra hormones, and so on. Several factors, including breed, diet, and stage of lactation, are known to influence the composition of milk. Therefore, this review (1) presents a research outline to compare organic and conventional milk and (2) provides a summary of individual elements that affect the composition of milk.

Microbiological Quality and Potential Pathogen Monitoring for Powdered Infant Formulas from the Local Market (영유아용 분말 조제분유의 미생물 품질분석과 위해세균 모니터링)

  • Hwang, Ji-Yeon;Lee, Ji-Youn;Park, Jong-Hyun
    • Food Science of Animal Resources
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    • v.28 no.5
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    • pp.555-561
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    • 2008
  • Ninety-nine samples of powdered infant formula in a market were collected from the local market and their contaminations for total aerobic bacteria, coliform, FAO/WHO Category A, B, and C pathogens were analyzed. Total aerobic bacteria were detected in 92 of 99 samples (93%) at levels of $1.83{\pm}0.68\;Log\;MPN/g$. These levels were below legal levels specified for infant formulas except for one sample detected by 4.5 Log CFU/g. Coliform was detected in 12 of 99 samples (12%) at levels of $1.26{\pm}1.03\;Log\;MPN/g$ whereas non-detection was required according to the specification of coliform in infant formulas. Escherichia coli was detected in 1 of 99 samples by 0.48 Log MPN/g. Salmonella and Enterobacter sakazakii among Category A weren't detected in all the samples. Enterobacteriaceae, Category B group, were detected in 25 samples of total 99 samples (25%) by $0.83{\pm}1.37\;Log\;MPN/g$. Enterobacteriaceae identified by API 20E were Escherichia vulneris, Es. hermannii, Pantoea spp., Citrobacter koseri, Klebsiella pneumoniae, En. cloaceae. Bacillus cereus among Category C was highly detected in 29 of 99 samples (29%) at levels of $0.69{\pm}0.32\;Log\;MPN/g$ with the most probable number count method, which were below legal levels for the specification of B. cereus in infant formulas. Clostridium perfringens, E. coli O157, Staphyloccus aureus, Listeria monocytogenes, Yersinia enterocolitica, and Campylobacter jejuni/coli were not detected. Contamination level of major pathogens was low and falls within the range of specification of infant formulas. However, Enterobacteriaceae and B.cereus showed the high prevalence and some Enterobacteriaceae causing disease were detected. Therefore, it is necessary to monitor the potential pathogens continually and reduce them to improve the microbial quality of non-sterilized powdered infant formulas.

Comparison of Tiletamine/Zolanzepam, Xylazine - Tiletamine/Zolazepam and Medetomidine-Tiletamine/Zolazepam Anesthesia in Dogs (개에서 Tiletamine/Zolazepam, Xylazine-Tiletamine/Zolazepam과 Medetomidine-Tiletamine/Zolazepam의 마취효과)

  • Kwon, Young-Sam;Jeong, Jae-Hoon;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.33-41
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    • 2003
  • The cardiopulmonary and anesthetic effects of tiletamine/zolazepam(TZ, 10 mg/kg IV), xylazine-tiletamine /zolazepam(XTZ, X: 1.1 mg/kg IM, TZ: 10 mg/kg IV) and medetomid-ine-tiletamine/zolazepam(MTZ, M: 30$\mu\textrm{g}$/kg IM, TZ: 10 mg/kg IV) were evaluated to 15 healthy mongrel dogs (4.16$\pm$0.65 kg). These dogs were randomly assigned to the three treatment groups(Control, XTZ, MTZ) with 5 dogs in each group. All experimental animals were premedicated with atropine(0.03 mg/kg, IM). Xylazine or medetomidine were administered to dogs in XTZ group and MTZ group 10 minutes after atropine injection. TZ was administered 20 minutes after atropine injection in all groups. The loss of pain response at pedal reflex and ear pinching tests in XTZ and MTZ groups were much longer compared with those of Control group(P < 0.01). All dogs in this study showed head rocking and hypersalivation during recovery time. Body temperature decreased progressively during experimental period in all groups, but it was not significant. After TZ injection, heart beat rate significantly increased 10 and 20 minutes in Control group, and 20 and 40 minutes in XTZ group(P < 0.05). Respiratory rate significantly decreased 0,10,20 and 40 minutes after 72 injection in XTZ and MTZ groups. In Control group, systolic arterial pressure (SAP) 20 minutes. diastolic arterial pressure(DAP) 10 minutes and mean arterial pressures (MAP) 10 and 20 minutes after 72 injection significantly decreased(P < 0.05). In XTZ group, SAP, DAP and MAP significantly decreased 20 and 40 minutes after 72 injection(P < 0.05). Thus, it was considered that XTZ and MTZ were useful in a canine surgical treatment that requires long anesthetic duration and deep analgesia.

Effects Of Environmental Factors And Individual Traits On Work Stress And Ethical Decision Making (간호사의 환경적 요소와 개인적 특성이 직무스트레스와 윤리적 의사결정에 미치는 영향)

  • Kim, Sang Mi L.;Shake ketefian
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.417-430
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    • 1993
  • 이 연구는 환경적 요소(간호사의 자율성, 조직의 표준화)와 개인의 특성(통제위, 나이, 경험. 간호역할개념, 도덕성), 직무 스트레스, 윤리적 의사결정 사이의 관계를 이론적 틀을 구성하여 테스트함으로써 그 인과관계를 탐구하였다. 본 연구를 위해 개발된 모형은 1) Katz와 Kahn의 조직에 대한 개방체계 이론(open systems theory of organization) ; 2) Kahn. Wolfe, Quinn, Snoek의 스트레스 이론 (theory of stress) : 3) Kohlberg의 도덕발달 이론(theory of moral develop-ment): 그리고 4) 여러 문헌고찰을 기초로 하였다. 본 연구의 모형은 2가지의 주요 종속변수(직무 스트레스, 윤리적 간호행위), 2가지 매개변수(간호 역할개념, 도덕성 발달정도) 그리고 여러 독립변수들(조직의 표준화, 자율성, 통제위, 교육, 나이, 경험 등)로 구성되었다. 간단히 말해, 간호사의 스트레스와 윤리적 간호행위 를 개인 자신과 환경이라는 두 요소의 결과로 간주한 것이다. 미국(2개주)의 여러 건강관리기관에 근무하는 224명의 정규 간호사를 대상으로 하였고. 가설 검증을 위하여 1) 변수간의 인과관계를 조사하기 위한 Linear Structural Relationships(LISREL)기법과 2) 나이, 경험, 교육이 변수간의 관계에 미치는 중간역할을 알아보기 위해 상관분석을 이용하였다. LISREL결과를 보면 제시된 모델이 각 내재 변수에 상당한 설명력을 가지면서 자료에 잘 맞는 것으로 나타났다. 이 연구에서 가장 뚜렷한 점으로 나타난 것은 개인의 특성보다 환경적 요소로서의 자율성이 직무스트레스와 윤리적 의사결정을 예견하는데 훨씬 중요한 변수로 부각되었다는 점이다. 또한 간호사의 전문적 역할개념과 봉사적 역할개념이 간호사의 윤리적 의사결정을 예견하는 가장 중요한 요소로 나타났다. 중간영향(moderation effect)을 보면, 젊고 경험이 적은 간호사일수록 나이가 많고 경험있는 간호사보다 환경적 요소(자율성)에 더 큰 영향을 받는다는 것을 암시하고 있다. 또한 4년제 대학 이상을 졸업한 간호사의 윤리 적 간호행 위 는 2, 3년제 를 졸업 한 간호사 보다 환경적 요소에 의해 덜 영향을 받는 것으로 나타났다. 한편 자율성의 부족은 2, 3년제 졸업 간호사보다 4년제 졸업 간호사에게 더 심한 스트레스가 되고 있음을 시사하였다. 이 연구의 결과로부터 적어도 다음과 같은 두 가지 실제적인 제언을 도출할 수 있다. 첫째, 이 연구는 환경적요소로서의 자율성이 다른 어떤 개인적인 요소보다 직무 스트레스를 예견하는 데 중요한 요소라는 것을 제시하였다. 이것은 간호행정가들에게, 간호사의 직무 스트레스를 감소시키기 위해선 “자율성”이 아주 중요히 다루어져야 한다는 것을 의미한다. 만일 간호사들의 직무스트레스가 그 개인의 복지에 큰 해가 되고 환자를 간호하는 데 직접적으로 관계된다면, 간호행정가는 그 조직의 직무체계를 다시 평가해서 일에 대한 새로운 설계가 필요한지를 파악해야 한다. 또한 이 연구는 직무를 다시 설계할 경우, 누구에게 먼저 촛점을 두고 시작해야 하는지를 밝혀주고 있다. 즉, 젊고 경험이 미숙한 간호사들에게 촛점을 두고 시작해야 하며, 작업환경의 가장 중요한 차원중의 하나인 사회적 지원(social support)을 조심스럽게 고려해 보아야 한다. 둘째, 간호사의 윤리적 간호행위를 높히기 위해 전문적 역할개념과 봉사적 역할개념이 재강조될 필요가 있다. 이 두 역할개념 들을 교육을 통하여 효과적으로 가르칠 필요가 있다고 본다. 이 두 개념들이 간호사의 바람직한 간호행 위에 영향을 미치는 가장 중요한 요소로 나타났기 때문이다. 또한, 본 연구결과에 따르면, 경험이 많을수록 일에 싫증을 느껴 바람직한 윤리적 간호행위가 감소되는 경향이 있었다. 따라서, 건강관리체제 (health care system) 안에서의 간호사의 역할이-전문직으로서의, 그리고 환자를 위한 옹호자로서의-학교와 임상에서 효과적으로 교육되어져야 한다고 본다. 간호사들의 역할에 대한 계속적인 교육이 학생은 물론 임상 간호사들에게도 실시되어져야 할 것이다. 미래연구의 방향을 제시해 보면 첫째로 연구의 일반화를 높히기 위해 더 많은 대상자를 포함시켜야 한다. 이는 여러 종류의 표본을 반드시 한번에 전부 포함시켜야 한다는 것을 의미하는 것이 아니고, 특정한 여러 표본들을 연속적으로 연구함으로서 이 목표를 성취할 수 있다고 생각한다. 둘째는 여러 construct들(윤리적 간호행위, 직무 스트레스, 간호 역할개념 등)에 대한 적절한 측정도구를 개발해야 한다. 측정도구를 개발하기 위해서는 풍부하고 세세한 통찰력을 제공하는 질적인 정보를 얻는 것이 선행되어야 한다. 셋째, 윤리적 간호행위와 직무 스트레스에 관한 연구를 증진시키기 위해 실험설계 및 종단적 연구(expel-imental, longitudinal design)가 시도될 필요가 있다. 마지막으로, 윤리적 간호행위와 직무 스트레스를 예견할 수 있는 이론적 탐구(theoretical exploration), 즉 이론정립을 위하여, 환경적 요소와 개인의 특성에 대한 자세한 정보를 제공해 줄 수 있는 질적 연구들이 요구된다.

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Development of Health Promotion Program through IUHPE - Possibilities of collaboration in East Asia - (IUHPE를 통한 건강 증진 프로그램의 발달-동아시아권의 공동연구의 가능성-)

  • Moriyama, Masaki
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.1-16
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    • 2004
  • This paper considers the possibilities of health promotion from the following perspectives; (1) IUHPE, (2) socio-cultural similarities, (3) action research, and (4) learning from our past. 1. The IUHPE values decentralized activities through regions, and countries such as Japan, Korea, Hong Kong, Taiwan and China belong to NPWP region. Since IUHPE World Conference was held in Japan in 1995, Japan used to occupy more than 60% of NPWP membership. After 2001, membership is increasing rapidly in Chinese speaking sub-region. The transnational collaboration is still in its beginning phase. 2. Confucianism is one of key points. Confucian tradition should not be seen only as obstacles but as advantages to seek a form of health promotion more acceptable in East Asia. 3. Within the new public health framework, people are expected to create and live their health. However, especially in Japan, the tendency of 'lacking of face-to-face explicit interactions' is still common at health-promotion settings as well as academic settings. Therefore, the author tried participatory approaches such as asking WlFY (interactive questions designed for subjects to review their daily life and environment) and as introducing round table interactions. So far, majority of participants welcome new trials. 4. The following social phenomena are comparatively discussed after Japanese invasion and occupation of Korea ended in 1945; ·status of oriental medicine, ·separation of dispensary services, and ·health promotion specialist as a national license. In contrast to Japanese' tendency of maintaining the status quo and postponing of substantial social change, trend toward rapid and dynamic social changes are more commonly observed in Korea. Although all of above possibilities are still in their beginning stages, they are going to offer interesting directions waiting for further challenges and accompanying researches.

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Noncondensable gas's influence in waster vapor absorption accompanying interfacial disturbance into aqueous solution of LiBr

  • Dong-Ho RIE;Keun-Oh Lee
    • Journal of the Korean Society of Safety
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    • v.7 no.2
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    • pp.63-70
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    • 1992
  • The aim of this research is to obtain a basic quantitative understanding of the effect of a noncondensable gas on the absorption of water vapor by a $H_2O$ / LiBr combination with n-octanol as the surfactant. Nonflowing aqueous solutions of LiBr (40,45,50 mass%) were exposed to saturated water vapor following the addition of an n-octanol sufactant (0.01 and 0.6 mass%). A small amount of a noncondensable gas (air) was allowed into the absorber (0.03 volume%) and its effect was analyzed by measuring the amount of water vapor absorbed. This study will aid to predict the performance of heat pump and safety operating condition when the noncondensable gas is not allowed in the absorber The results indicate that, in the presence of small amounts of a noncondensable gas, vapor absorption enhancement ratios are less than half o( those obtained under the same experimental conditions when a noncondensable gas is not present (1). The presence of a noncondensable gas causes the partial vapor pressure of air to increase at the vapor / liquid interface, which results in an instability of vapor absorption rate nd. hence, in an inhibition of interfacial disturbance.

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A Research on Park Jae-sam's Sijo with Emphasis on his Methods of Creating Poetic Images and the Process of Creating New Ideas (박재삼 시조의 이미지 구현방식과 의미화 과정 연구)

  • Son, Jin-Eun
    • Sijohaknonchong
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    • v.44
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    • pp.29-56
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    • 2016
  • The purpose of this article is to shed light on the position and the importance of sijo (Korean traditional poetic form of Three-Line Stanzas) of the Korean poet Park Jae-sam among Korean sijo writers. Even though Park Jae-sam started his career as a poet writing two sijos and a poem, he began to write more poems than sijos later on. Anyway his interest in sijo writing has continued and he has served as a judge of sijo writing contests ever since. Especially in 1985, he published a collection of sijo. And each sijo writing in this collection are composed of three-line stanzas and each stanza of three lines. And each line has a rhythmic sound with a formal word formation. This article reveals that Park Jae-sam has pursued a happy unity of form and content in his sijo writings from the collection and that he has tried his hardest to realize this goal. This article notes that for this goal he puts stress on some methods of creating poetic images and the process of creating new ideas, the unity of Koreans's unique emotion of han(恨) and a sense of eternity, transcendence through ambivalent emotions, and the structure of statement mainly made of juxtaposed metaphors. And this articles also notes that as a most sincere lyric poet in the history of sijo he is much distinguished from other Korean poets in that he depicts mainly Koreans's unique emotions and their characteristics.

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