• 제목/요약/키워드: AGE-R

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Importance of an Integrated Assessment of Functional Disability and Work Ability in Workers Affected by Low Back Pain

  • Fabrizio Russo;Cristina Di Tecco;Simone Russo;Giorgia Petrucci;Gianluca Vadala;Vincenzo Denaro;Sergio Iavicoli
    • Safety and Health at Work
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    • 제15권1호
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    • pp.66-72
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    • 2024
  • Background: This study examines the relationship between functional disability and work ability in workers affected by low back pain (LBP) through an analysis of correlations between the Oswestry Disability Index (ODI) and Work Ability Index (WAI). The role of personal and work factors on functional disability/work ability levels has also been studied. LBP is the most common musculoskeletal problem and a major disabling health problem worldwide. Its etiology is multifactorial. Multidisciplinary approaches may help reduce the burden of pain and disability and improve job continuity and reintegration at work. Methods: A cohort of 264 patients affected by LBP from an Italian outpatient clinic were included in a clinical diagnostic/therapeutic trial aiming at rehabilitation and return to work through an integrated investigation protocol. Data were collected during the first medical examination using anamnestic and clinical tools. The final sample is composed of 252 patients, 57.1% man, 44.0 % blue collars, 46.4% with the high school degree, 45.6% married. Results: WAI and ODI reported a negative and fair correlation (r = -0.454; p = .000). Workers with acute LBP symptoms have a higher probability of severe disability than those with chronic LBP symptoms. White collars without depressive symptoms reported higher work ability - even in chronic disability conditions-than those with depressive symptoms. Conclusion: The study found that ODI and WAI have a convergent validity and this suggests that the two tools measure capture distinctive aspects of disability related to personal, environmental, and occupational characteristics. The most important and modifiable prognostic factors found for ODI and WAI were depressive symptoms, workday absence, and intensity of back pain. The study also found a mild association between age and ODI. The study's findings highlight the importance of using a multidisciplinary approach to manage and prevent disability due to LBP.

산욕 초기 여성의 간호 요구에 관한 연구 (A Study on the Women's Need during early Postpartum)

  • 유은광;이미영;김진희;신추경;유순재;지수경
    • 여성건강간호학회지
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    • 제6권3호
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    • pp.439-452
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    • 2000
  • This study sought to figure out women's needs during early postpartum for developing adequate nursing intervention toward postpartal women's healthy adaptation. A convenience sample of 89 women who are in the early postpartal period and admitted in a university hospital located in Seoul, Korea was studied from July 1, 1999 to August 13. 1999. 1. The age group of 26-30 years was 52.8% and the level of education above high school 91%. 67.6% of women had no job, 62.9% had experienced one time of delivery, and 52.8% had no experience of abortion. 2. 31.5% of women received prenatal education, 44.9% only postpartal education. 77.5% of women planned breast-feeding, and 53.9% of women had an experience of breast-feeding during hospital stay. For the feeling of confidence related to the self-care, 27% only expressed 'yes. I have' and 59.5% 'just a little bit'. For the feeling of confidence related to the baby rearing, 29.2% only expressed 'yes. I have' and 60.7% 'just a little bit'. 3. The rate of postpartal women's mother as a preferred non-professional care giver was the highest, 75.3%. The rate of the style of Sanhujori highly preferred and planned at this time was at postpartal women's maiden home or her home with mother, 58.4%, 47.7% respectively. It shows that women still wish to have traditional Sanhuiori at home. 4. The mean of nursing need of postpartal women was 4.25% and it means that universally the degree of nursing need during postpartum is still high. General nursing need (4.29) was higher than that of traditional Sanhujori (4.09), however, the need of Sanhujori is still high. 5. Specifically, the degree of nursing need according to the category of needs was 'educational need for baby rearing,' 4.43; 'emotional-psychological care', 4.41; 'environmental care,' 4.31; 'self-care,' 4.14; and 'physical care,' 3.85 in rank. The educational need core of the specific method about Sanhuiori (4.35) was second to the highest among 15 items of self-care. 6. The related factors to the degree of nursing need were age to physical care; educational level, plan of breast feeding and experience of breast feeding during hospital stay to emotional-psychological care; and the feeling of confidence in baby rearing to environmental care. 7. There was highly positive correlation between the degree of traditional Sanhujori need and general care need(r=.77). This result strongly reflects that there is a necessity of professional care givers' capability to consider the integrative care reflecting the socio-cultural need for women's healthy adaptation during postpartum. It provides a challenge to the professional care givers to research further on the effects of Sanhuiori on the health status, health recovery after abortion or delivery from the various aspects through the cross-sectional and longitudinal research for the refinement of the reality of Sanhuiori not only as cultural phenomenon but as an inseparable factor influencing on women's postpartal healthy adaptation and for the appropriateness of intervention and quality of care for desirable health outcome.

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영아에서 경련을 동반한 저칼슘혈증에 관한 연구 (Hypocalcemic Convulsion in Formula Feeding Young Infants)

  • 김미정;고철우;구자훈
    • Childhood Kidney Diseases
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    • 제2권1호
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    • pp.14-19
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    • 1998
  • 목적 : 최근 6개월 이하의 영아에서 저칼슘혈증의 임상 경험의 예가 증가하여 이의 원인, 증세, 치료 및 임상 경과를 알아보기 위하여 본 연구를 시행하였다. 방법 : 1994년 2월 부터 1991년 4월까지 경북대학교 병원 소아과에 경련을 주소로 내원하였던 환아 중 그 원인이 저칼슘혈증으로 확인되었던 11예를 대상으로 하였다. 이들은 모두 6개월 이하였으며 평균 $2.2{\pm}1.1$개월이었다. 이들 환아의 병력지를 통하여 후향적으로 각종 검사를 분석하였다. 결과 : 이 환아들의 저칼슘혈증의 원인으로는 비타민 D 결핍이 8예였고, 무기인의 과다한 섭취가 3예였다. 경련의 양상은 전신성 간-근대성이 9예였고 부분 근대성이 2례였다. 경련의 지속시간은 30초에서 20분까지 다양하였으며, 경련의 횟수는 평균 6.5회였다. $Bonky^{(R)}$, 칼슘 단독 또는 병합 요법 후 혈청 칼슘은 치료 전 $6.3{\pm}0.9$ mg/dL서 치료 후 $9.9{\pm}1.7$ mg/dL로 통계학적으로 의미있게 증가하였고(P=0.0008), 혈청 ALP는 치료 전 $1,418{\pm}864$ U/L에서 치료후 $772{\pm}503$ UL로 통계학적으로 의미있게 감소하였다(P=0.0112). 입원 당시 iPTH은 $176.7{\pm}129$ pg/mL로 증가되어 있었고 3명의 환아에서 치료 이후 추후 검사상 정상 범위로 회복 되었다. 모든 환아에서 치료 전$25(OH)D_3$는 감소되어 있었으며 평균 $3.9{\pm}2.7$ ng/mL였고, 치료 후 1예에서 정상으로 회복되었다. $1,25(OH)_{2}D_{3}$는 6예 중 2예에서 감소되어 있었다. 결론 : 최근 비타민 D가 보강된 것으로 알려진 조제 분유 영양아에서 발생된 경련을 동반한 저칼슘혈증의 원인은 상당수에서 비타민 D 결핍이었으며 $1,25(OH)_{2}D_{3}$의 단기간 투여로 성공적으로 치료되었으며, 조제 분유 영양아에서도 저칼슘혈증의 원인으로 비타민 D 결핍을 반드시 생각해야 한다고 사료 된다.

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초기 자궁 경부암에서 치료전 예후 인자 (Pretreatment prognostic Factors in Early Stage Caricinoma of the Uterine Cervix)

  • 김미숙;하성환
    • Radiation Oncology Journal
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    • 제10권1호
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    • pp.59-67
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    • 1992
  • 1979년 3월 부터 1986년 12월까지 초기 자궁 경부암으로 서울대학교병원 치료방사선과에서 방사선 치료를 받은 124명의 환자를 대상으로 치료 결과 및 예후에 영향을 미치는 인자에 대하여 분석하였다. 병기 IB(35명)에서 5년 국소 치료율, 5년 무병 생존율 및 5년 생존율은 각각 $79.0\%$, $76.4\%$, $81.8\%$였다. 병기 IIA(89명)에서는 $78.0\%$, $66.8\%$, $72.1\%$였다. 나이, ECOG수행상태, 임신 횟수, 당뇨또는 고혈압의 여부, 병리조직학적 소견, 종양의 크기, 종양의 침투 양상, 전산화단층 촬영 소견 및 혈액 검사소견에 대한 후향적 분석을 단변수 분석과 다변수분석을 이용하여 5년 국소 치료율, 5년 무병생존율, 5년 생존율에 따라 실시하였다. 단변수 분석상 종양의 크기와 전산하단층 촬영상 직장 침윤이 5년 국소 치료율, 5년 무병 생존율 및 5년 생존율에 의미 있는 예후 인자이었다. 전산화 단층촬영상 자궁강 결합 조직 침범이 5년 국소치료율, 5년 무병 생존율에 의미가 있었다. 혈색소치가 5년 무병 생존율 및 5년 생존율에 의미가 있었다. 병리 소견과 환자의 나이가 5년 국소치료율에 의미가 있었다. 전산화 단층촬영결과를 제외한 다변수 분석결과에서 종양의 크기가 5년 국소치료율과 5년 생존율에 의미가 있었다. 혈색소치가 5년 무병생존율에 의미가 있었다. 전산화 단층촬영결과를 포함한 다변수 분석결과에설 병리소견이 5년 국소치료율과 5년 무병생존율에 의미가 있었다. 혈색소치와 전산화단층촬영상 직장침윤이 5년 국소치료율에 의미가 있었다.를 나타냈으나 통계학적으로 유의한 차이는 없었다. 결론적으로 선양 낭포암의 수술후 방사선치료에 있어서 60 Gy이상의 방사선양과 $64cm^2$이상의 field size로 치료함으로써 좀 더 좋은 국소치유율을 얻을 수 있었으며 환자의 생존율을 높이기 위해서는 좀 더 효과적인 항암제의 개발이 시급하다 하겠다.시에 비하여 심하지 않았으며 치료에 잘 적응하였다. 본 연구에서 DDP가 비교적 적은 합병증을 동반한 의미있는 방사선 민감제임을 확인하였으며 치료효과를 증대시키기 위하여 DDP와 방사선치료의 적절한 투여 계획을 결정하는 전향적 연구가 필요하다고 생각한다.C$-$43^{\circ}C$까지 잘 가온될 수 있음을 입증 하였다. 또한 폐의 온열요법시 종격동은 보다 높은 온도에 도달함으로 종격동의 열손상에 대한 고려가 필요함을 시사한다.r=0.990)로 각각 표시되었으며 각 간의 기울기에 대한 유의차는 없었다.18. 혈청중 LH와 total protein과의 상관계수는 +0.947이다. 19. 혈청중 FSH와 total protein과의 상관계수는 +0.709이다. 20. 혈청중 FSH와 triglycerides와의 상관계수는 +0.549이다. 21. 혈청중 estradiol-$17{\beta}$와 triglycerides와의 상관계수는 +0.673이다. 22. positive feedback mechanism에 의해서 LH, FSH와 estradiol-$17{\beta}$는 간을 자극시켜 albumin, total protein 및 triglycerides를 분필시킴으로서 난황형성(vitellosenesis)에 관여하는 것으로 나타났다.

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대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
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    • 제2권1호
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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Growth Performance, Carcass Yield, and Quality and Chemical Traits of Meat from Commercial Korean Native Ducks with 2-Way Crossbreeding

  • Heoa, K.N.;Hong, E.C.;Kim, C.D.;Kim, H.K.;Lee, M.J.;Choo, H.J.;Choi, H.C.;Mushtaq, M.M.H.;Parvin, R.;Kim, J.H.
    • Asian-Australasian Journal of Animal Sciences
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    • 제28권3호
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    • pp.382-390
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    • 2015
  • This work was conducted to investigate the performance and meat characteristics of commercial Korean native duck (KND). A total of 180 1-d-old ducklings of 2-way crossbreds from A and B lines (from National Institute of Animal Science) were used in this work and divided into 4 groups (3 replicates/group, 15 birds/replicate). The four groups were 4 crossbreds as AA (A line [♀]${\times}$A line [♂]), AB (A line [♀]${\times}$B line [♂]), BB (Pure line B strains) and BA (B strains [♀]${\times}$A strain [♂]). Ducks were fed diets based on corn-soybean meal for 0 to 3 wk (22.4% crude protein [CP], 2,945 kcal/kg metabolizable energy [ME]) and 3 to 8 wk (18.4% CP, 3,047 kcal/kg ME). As a result of this study, average body weight of 4 crossbreds were 625, 1,617, 2,466, and 2,836 g at 2, 4, 6, and 8 weeks, respectively, and significantly increased over the period of time (p<0.05). Body weight of BB group was greater than other crossbreds at the age of 6 weeks (p<0.05). There was a significant difference in weekly body weight gains (p<0.05), which were 573, 991, 850, and 371 g at 2, 4, 6, and 8 weeks old, respectively. Uniformity of 4 crossbreds was 84.9%, 80.5%, and 72.5% at 6, 7, and 8 weeks, respectively, and there was no difference among crossbreds. Body weight gain of BB crossbred was highest among crossbreds (p<0.05). Weekly feed intake significantly increased with weeks as 669, 1,839, 2,812, and 3,381 g at 2, 4, 6, and 8 weeks respectively (p<0.05). Feed intakes of AA and BB crossbreds were higher at 2 to 4 weeks old than others and that of BB crossbred was highest at 4 to 6 weeks old (p<0.05). Weekly feed conversion ratios were 1.17, 1.86, 3.32, and 9.37 at 0 to 2, 2 to 4, 4 to 6, and 6 to 8 weeks old, respectively, and it increased with age (p<0.05). There was no significant difference in feed conversion ratio among crossbreds. Carcass yields of 4 crossbreds were 73.6%, 71.6%, 73.5%, and 71.7%, respectively, so there was no significant difference among crossbreds. There was no difference in wing, neck, breast and leg ratios among crossbreds. However, back ratios of 4 crossbreds were 17.6%, 18.0%, 15.8%, and 17.6%, respectively, and back ratio of BB was the highest among crossbreds. Finally, these results may provide the basic data on the production, carcass quality, fatty acid and amino acid composition of commercial KND with 2-way crossbreeding.

소아 감염성 흉막삼출의 원인 분석 (A clinical study on the etiology of parapneumonic effusion in children)

  • 염정숙;배원태;박은실;서지현;임재영;박찬후;우향옥;윤희상
    • Clinical and Experimental Pediatrics
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    • 제49권1호
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    • pp.56-63
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    • 2006
  • 목 적 : 흉막삼출을 동반한 폐렴에서 빠른 원인병원체의 판단으로 조기진단과 적절한 치료로 후유증 발생을 최소화하는데 도움을 주는 자료를 얻기 위해 최근 경험한 감염성 흉막삼출의 원인병원체, 연도별 발생빈도 변화, 연령별 빈도 및 후유증 발생률을 알아보고자 하였다. 방 법 : 1987년부터 2004년까지 17년간 경상대학교병원 소아과에 폐렴으로 입원한 환아 중 감염성 흉막삼출을 보인 86례를 대상자로 이들의 병록기록지를 후향적으로 조사하였다. 결 과 : 총 대상자의 남녀 비율은 1.45 : 1(남 : 여=51 : 35명)로 남아가 많았으며, 평균 연령은 5.64세(${\pm}4.43$)이었다. 발생빈도의 변화를 연도별로 분류해 보았을 때 평균 발생률은 감소를 보이지만 통계학적으로 의미 있는 변화를 보이지 않았다(r=-0.25, P=0.30). 총 대상자 86례 중 원인체가 밝혀진 경우는 57례(66.3%)로 결핵 7례(8.2%), 비결핵 세균성 14례(16.3%), 미코플라스마 34례(39.5%), 기타 감염성 흉막삼출 2례(2.3%)였다. 나머지 29례(33.7%)는 원인불명 감염성 흉막삼출이었다. 비결핵 세균성 흉막삼출 14례를 병원균 별로 분류하면 황색포도알균이 5례(5.8%)로 가장 많았고, 폐렴사슬알균이 3례(3.5%), 녹농균 3례(3.5%), 기타 포도알균 2례(2.3%), 폐렴막대균 1례(1.2%)로 밝혀졌다. 미코플라스마 폐렴은 혈청검사를 통한 진단이 비교적 용이하고 후유증 동반율이 매우 낮고, 비결핵 세균성 흉막삼출에서 흉막액의 소견은 높은 백혈구수와 함께 중성구 우세를 보이며, 산도와 당이 매우 낮게 측정되고, 단백과 LDH가 매우 높게 나오는 특징을 보였다. 결핵성 흉막삼출 환자 1례에서 흉막비후의 후유증을 남겼는데, 결핵성 흉막삼출은 흉막액에 높은 백혈구수에 림프구와 중성구의 우세가 비슷하고, 단백과 LDH가 높게 나오는 특징을 보였다. 결 론 : 이에 연구자들은 폐렴의 초기에 흉막유출이 동반되었는지를 빨리 파악하고, 환아의 연령도 고려하여 병인을 추정하여, 흉막삼출액의 빠른 분석을 통한 치료적 접근이 사망률과 이환율을 줄일 수 있는 것이라 본다.

초음파를 이용한 견관절 관절강내 주사의 정확성과 임상적 결과: 유착성 관절낭염 환자의 견봉 쇄골 접근법 (Accuracy and Clinical Outcomes of Ultrasound-guided Glenohumeral joint Injection: Acromioclavicular Approach in Patients with Adhesive Capsulitis)

  • 이상훈;황석민
    • 대한정형외과 초음파학회지
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    • 제5권1호
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    • pp.9-14
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    • 2012
  • 목적: 유착성 관절낭염 환자에서 초음파를 이용한 관절와 상완 관절강 내 스테로이드 주사를 시행한 후 주사요법의 정확성이 임상적 결과에 미치는 영향을 평가하고자 하였다. 대상 및 방법: 임상적으로 유착성 관절낭염으로 진단받은 환자들 중 외상이 없고, 약물 치료 및 물리 치료를 받았으나 만족할 만한 호전을 보이지 않은 환자를 대상으로 하였다. 환자들은 총 33명으로 남자 15명, 여자 18명으로 평균 연령은 55.1세(42~72세)였다. 이를 대상으로 견봉 쇄골 접근법을 통해 스테로이드 칵테일 10 ml(triamcinolone 1 ml(40 mg/ml), lidocaine 4 ml(2%), normal saline 5 ml)와 조영제 5 ml ($Telebrix^{(R)}$, Guerbet, France)를 주입하였으며, 이후 바로 방사선 촬영을 시행하여 주사의 견관절 관절강 내 주입 여부를 확인하였다. 또한 조영제가 관절강내로 정확히 들어간 경우, 부분적으로 들어간 경우 그리고 조영제가 관절강 바깥으로 들어간 경우로 3군으로 분류하여 각각의 군에서 주사요법 전, 후 수동적 운동범위 및 VAS score를 이용한 통증 완화 정도를 분석하였다. 결과: 총 33례 중 25례(76%)에서 조영제가 정확히 관절강 내로 주입되었음을 확인하였다. 6례(18%)에서는 관절강에 부분적으로 조영제가 관찰되었고, 2례(6%)에서는 조영제가 관절강 바깥에서 관찰되었다. 조영제가 관절강내로 정확히 들어간 군은 시행 전 굴곡은 평균 111도(80~140도), 외회전은 48도(0~90도)였고, 시술 후 굴곡은 평균 134도(90~150도), 외회전은 70도(30~90도)로 호전되었다(p<0.01). 그리고 조영제가 관절강내로 부분적으로 들어간 군은 시행 전 굴곡은 평균 120도(90~150도), 외회전은 70도(10~90도)였고, 시술 후 굴곡은 평균 139(135~140도)도, 외회전은 78도(50~90도)로 호전된 결과가 관찰되었다(p<0.01). 조영제가 관절강 바깥으로 들어간 군은 환자수의 부족으로 통계적으로 의미를 갖지 않았다. 시술 전, 후 VAS 점수의 변화는 조영제가 관절강 내로 정확히 들어간 군은 7.1점(3~9점)에서 2.6점(0~5점)으로 호전되었고(p<0.01), 부분적으로 들어간 군은 7.5점(7~9점)에서 3.3점(2~4점)으로 호전되었고(p<0.01), 관절강 바깥으로 들어간 군은 7.5점에서 2점으로 호전되었다. 또한 당뇨 환자군과 비 당뇨 환자군을 비교한 결과 임상적 결과에 통계적으로 유의한 차이가 없이 모두 호전되었다. 결론: 유착성 관절낭염 환자에서 초음파 하에 견봉 쇄골 접근법을 통한 견관절 관절강 내 스테로이드 주사는 기존의 방법들보다 좋은 정확도(94%)를 보고하였으며, 이 중 관절강 바깥으로 새어나간 군과 새어나가지 않은 군 간에는 임상적으로 유의한 차이가 발견되지 않았다.

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신생아집중간호단위 환경과 저체중출생아의 반응에 대한 연구 (A Study on the Environment for Lowbirth Weight Infants in Neonatal Intensive Care Unit in the United States)

  • 한경자
    • Child Health Nursing Research
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    • 제4권2호
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    • pp.159-176
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    • 1998
  • In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

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경인 지역 소아의 A형 간염 항체 보유율 (Prevalence of Antibodies to Hepatitis A in the Healthy Children in Inchon-Kyunggi Prefecture)

  • 권영세;홍영진;최연호;김순기;손병관;강문수;배수환;홍광선
    • Pediatric Infection and Vaccine
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    • 제5권2호
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    • pp.239-244
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    • 1998
  • 목 적 : A형 간염은 수년동안 거의 발생 보고가 없었으나 최근 경인지역에서 A형 간염 발생이 증가하였다고 보고되고 있으며, 소아에서도 대전에서 집단 발생이 보고된 바가 있다. 이는 사회경제적으로 발전하고 주거환경이 좋아지면서 소아에서의 A형 간염에 대한 항체 보유율이 낮아진 결과, 감염원에 노출된 연장아와 성인에서 현증 감염이 증가된 것으로 추측된다. 이에 저자들은 경인 지역에서 건강한 소아의 A형 간염 항체 보유율을 조사하여 A형 간염의 역학적 특성을 이해하는데 도움이 되고자 이 연구를 시행하였다. 방 법 : 경인 지역의 l세 76명의 유아와 3세 78명 및 5세 58명의 유아원생과 11세, 13세, 15세, 17세의 초중고생 각각 100명씩을 채혈하였고 혈청을 분리하여 $-80^{\circ}C$에 보관하였다가 Abbott사의 AxSYM$^{(R)}$ HAVAB(Microparticle Enzyme Immunoassay : MEIA)를 이용하여 anti-HAV를 측정하였다. 결 과 : 1) 전부 612명을 검사하였고 남아 316, 여아 296명으로 남녀의 비는 1.1 : 1이었다. 2) 1세군에서는 10.5%(남아 6례, 여아 2 례)에서 anti-HAV가 양성이었고, 3, 5, 11, 13세 군에서는 전부 anti-HAV가 음성이었으며, 15세 군에는 6%(남학생 4례, 여학생 2례)에서 anti-HAV가 양성이었고, 17세 군에서는 11 %(남학생 7례, 여학생 4례)에서 양성이었으며 남녀간의 차이는 없었다. 결 론 : 경인 지역의 유아 및 학동기 소아에서 A형 간염 항체가 거의 형성되어 있지 않으므로 감염자와의 접촉이나 오염된 음식들을 통해 학동기 소아에서의 현증 환자 발생의 위험이 있어, A형 간염에 대한 관심을 가지고 진료에 임하는 것이 필요하며 예방 방법에 대한 지침이 만들어져야 될 것으로 생각된다.

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