• 제목/요약/키워드: AIDS Patient

검색결과 141건 처리시간 0.025초

Optimal Scheduling of Drug Treatment for HIV Infection;Continuous Dose Control and Receding Horizon Control

  • Shim, H.;Han, S.J.;Jeong, I.S.;Huh, Y.H.;Chung, C.C.;Nam, S.W.;Seo, J.H.
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 2003년도 ICCAS
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    • pp.1951-1956
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    • 2003
  • It is known that HIV (Human Immunodeficiency Virus) infection, which causes AIDS after some latent period, is a dynamic process that can be modeled mathematically. Effects of available anti-viral drugs, which prevent HIV from infecting healthy cells, can also be included in the model. In this paper we illustrate control theory can be applied to a model of HIV infection. In particular, the drug dose is regarded as control input and the goal is to excite an immune response so that the symptom of infected patient should not be developed into AIDS. Finite horizon optimal control is employed to obtain the optimal schedule of drug dose since the model is highly nonlinear and we want maximum performance for enhancing the immune response. From the simulation studies, we find that gradual reduction of drug dose is important for the optimality. We also demonstrate the obtained open-loop optimal control is vulnerable to parameter variation of the model and measurement noise. To overcome this difficulty, we finally present nonlinear receding horizon control to incorporate feedback in the drug treatment.

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한국형 중환자간호 분류도구 개발 (Development of Korean Patient Classification System for Critical Care Nurses)

  • 유정숙;심미영;최은하
    • 임상간호연구
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    • 제21권3호
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    • pp.401-411
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    • 2015
  • Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Critical Care Nurses (KPCSC). Methods: Tertiary and general hospitals with various levels of ICU nurse staffing were included. To verify interrater reliability, data collectors and staff nurses of 15 ICUs in 11 hospitals classified 262 patients. To verify construct validity, the staff nurses classified 457 patients according to KPCSC comparing difference by medical department and type of stay in ICU. For conversion index, 195 patients from 10 ICUs in 7 hospitals were classified and nursing time was measured by 174 nurses, 7 head nurses, 18 charge nurses, 37 nurse aids and 1 secretary. Results: The developed KPCSC has 11 categories, 82 nursing activities and 115 criterias. Reliability was found to have high agreement (r=.96). Construct validity was verified by comparing differences in medical department and type of stay in ICU. According to scores, four groups in the KPCSC were identified. One score on the KPCSC indicates 6.12 minutes of nursing time. Conclusion: The findings show that the KPCSC can be used to measure new and complex nursing demands including rehabilitation and the safety of ICU patients.

안면마비 환자의 실태조사와 교정용 스프린트 개발에 관한 연구 (A Study of Survey for Facial Palsy Patients and Invention a Correction Splint to Facial Palsy)

  • 박지환
    • 대한정형도수물리치료학회지
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    • 제11권2호
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    • pp.19-25
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    • 2005
  • Purpose : Facial palsy goes together not only physical difficulties but also social life's of relationship to other people. Therefore we was devised correction splint and rehabilitation set for facial palsy proofreading. Method : This article was used by questionnaire survey that intended for 140 patients who had got facial palsied such as universities hospitals and oriental hospitals over the country in Korea. The subject matter that faced consciousness of a patient as opposed the awkward rehabilitating tool that a general matter and patient. In the object that the rehabilitation tool which now patient used through a wraps a face in only as a treatment object. Results : 1. The most chief complaints among the facial palsy patients were eating activity (41%), relationship to other people (29%), communication (20% )(Fig. 3). 2. The most needs of the facial palsy patients was aids for early treat (53%), prevented face deformity (16%) etc, (Fig. 4). 3. So we are going to make a correction splint and rehabilitation set for facial palsy, that makes common use broadly in based of medical utility (CAD. 1~7). Conclusion : We invented a correction splint and rehabilitation set for facial palsied patients in based of questionnaire survey.

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응급실 침대 위 흉부전후방향 엑스선 검사를 위한 상의고정장치 개발 (Development of the Upper Wear Fixation Device for Chest AP X-ray Imaging on the Emergency Stretcher Bed)

  • 임우택;홍동희
    • 대한방사선기술학회지:방사선기술과학
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    • 제45권3호
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    • pp.205-211
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    • 2022
  • This study aimed to provide basic data for 3D printing in the medical health field by developing upper wear fixation device (UWFD), an auxiliary device for shortening chest AP examination time on emergency room beds and non-contact with patients. The standard of hooks was modeled according to the bed frame using the Autodesk Fusion 360. It was printed with Form2 (Formlabs, Somerville, MA, USA), as SLA (stereo lithography apparatus) method, and was washed and hardened using Form Wash and Form Cure. The completed UWFD conducted an online survey on 4 items of stability, convenience, availability, preference and general characteristics. The total stability average was 3.93±0.80, the total convenience average was 3.93±0.68, the total availability average was 4.01±0.89, and the total preference average was 3.80±1.08. This study was significant in suggesting improvements in the general X-ray examination process in the emergency room by designing and making aids to easily fixing the patient's top to the frame of the emergency bed while meeting promptness and non-contact with the patient.

Nurse Substation 운영이 직접간호시간 증가에 미치는 효과 (The effects of the direct nursing care hours with establishment of the nurse substations)

  • 이정희;성영희;권인각;이순규;정연이;허성이;류성숙;김정숙
    • 간호행정학회지
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    • 제3권2호
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    • pp.61-80
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    • 1997
  • The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

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한국 병원 영양실의 환자 영양 교육 실행 현황에 관한 실태조사 (Assessment of the Dietary Consultation and Patient Education Practices in the Hospital Dietetics)

  • 옥혜운
    • Journal of Nutrition and Health
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    • 제13권1호
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    • pp.9-14
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    • 1980
  • A total of 35 hospitals throughout Korea were surveyed for the assessment of the educational function of dietitians. The current situation and the depth of practices were diagnosed in such areas as: 1. The continuing education for the hospital dietitians 2. The characteristics of patient consultation performed by the hospital dietitians 3. Systems and methods of patient instruction practiced by the dietitians, and 4. Prospectives in establishing the nutrition education center for the in-and out-patients. The major findings are: 1. Approximately half of the hospital dietitians feel positive about the practicality of their college education for the job. Extremely small number of them are on any kind of continuing education program 2) The monthly average of only 20 patients at one hospital receive diet consultation or nutrition education service from dietitians. The 50% of the consultation cases is taken up by the patients with diabetes and various circulartory diseases followed by the tube feedings, liver and renal diseases with less frequencies 3) Not even a single hospital has an office for the diet consultation and nutrition education for the in-or out-patients. Very few hospital dietetics have educational aids and/or any feedback system to evaluate the effect of the consultation. Charting is not practiced by most dietitians leaving no record of their contributions to the patient care. 4) Although the necessity of the nutrition education center in the hospital is strong1y recognized among dietitians the progress has been blocked by such obstacles as the poor system in the hospital administration in general, short in funds, lack of preparation in the dietetics and the lack of recognition both by the hospital administration and by the dietitian themselves.

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Accuracy of Freehand versus Navigated Thoracolumbar Pedicle Screw Placement in Patients with Metastatic Tumors of the Spine

  • De La Garza Ramos, Rafael;Echt, Murray;Benton, Joshua A.;Gelfand, Yaroslav;Longo, Michael;Yanamadala, Vijay;Yassari, Reza
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.777-783
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    • 2020
  • Objective : To compare the accuracy and breach rates of freehand (FH) versus navigated (NV) pedicle screws in the thoracic and lumbar spine in patients with metastatic spinal tumors. Methods : A retrospective review of adult patients who underwent pedicle screw fixation in the thoracic or lumbar spine for metastatic spinal tumors between 2012 and 2018 was conducted. Breaches were assessed based on the Gertzbein and Robbins classification and only screws placed >4 mm outside of the pedicle wall (lateral or medial) were considered breached. Results : A total of 62 patients received 547 pedicle screws (average 8 per patient) - 34 patients received 298 pedicle screws in the FH group and 28 patients received 249 screws in the NV group. There were 40/547 breaches, corresponding to a breach and accuracy rate of 7.3% and 92.7%, respectively. The breach rate was 9.7% in the FH group and 4.4% in the NV group (chi-squared test, p=0.017); this corresponded to an accuracy rate of 90.3% and 95.6%, respectively. Only one patient from the overall cohort (in the FH group) required revision surgery due to a medial breach abutting the spinal cord (1.6% of all patients; 2.9% of FH patients); no patient suffered organ, vessel, or neurological injury from screw breaches. Conclusion : Navigated pedicle screw placement in patients with metastatic spinal tumors has a significantly higher radiographic accuracy compared to the FH technique. However, the revision surgery was low and no patient suffered from clinically-relevant breach. Navigation also offers the advantage of real-time localization of spinal tumors and aids in targeting and resection of these lesions.

통증자가조절기 융합교육이 척추수술환자의 수술 후 통증관리에 미치는 효과 (Effects of Patient Controlled Analgesia Convergence Education on Postoperative Pain Management in Spinal Surgery Patients)

  • 최가영;김주성
    • 한국융합학회논문지
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    • 제9권2호
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    • pp.371-380
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    • 2018
  • 본 연구목적은 통증자가조절기(patient controlled analgesia:PCA)융합교육이 척추수술 후 통증관리에 미치는 효과를 조사하기 위함이다. 60명의 척추수술환자를 대상으로, 실험군(30명)에게 수술 전 PCA동영상, 소책자, 및 PCA실습으로 구성한 PCA융합교육을 적용하였다. 구조화된 질문지로 자료수집한 후 기술통계, ${\chi}^2-test$, Fisher's exact test, t-test 및 repeated measures ANOVA로 분석하였다. 연구결과 척추수술 후 실험군의 PCA지식태도, PCA만족도, 통증관리만족도는 대조군보다 유의하게 높았다(p<.001; p=.001; p<.001). 실험군의 수술 후 통증과 추가 진통제사용은 대조군보다 유의하게 낮았다((p<.001; p=.001). 따라서 시청각매체와 PCA실습을 접목한 PCA융합교육은 척추수술환자의 통증관리에 효과적인 실무중재임을 확인하였으며 다양한 간호실무에서 융합중재개발에 응용 가능할 것이다.

거대세포바이러스 폐렴에 동반된 미만성 폐포출혈 1예 (A Case of Diffuse Alveolar Hemorrhage Associated with Cytomegalovirus Pneumonia)

  • 조용덕;최혜숙;박명재
    • Tuberculosis and Respiratory Diseases
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    • 제64권4호
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    • pp.309-313
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    • 2008
  • 미만성 폐포출혈은 흔히 교원성질환에 동반되어 발생하나 거대세포바이러스 폐렴과 동반되어 나타날 수 있으며 병인은 아직 밝혀지지 않았다. 따라서 이 두 질환의 연관관계에 대한 연구가 필요하다. 저자들은 뇌출혈로 입원 후 장기간 치료 중이던 환자에서 거대세포바이러스 폐렴과 이에 동반된 미만성 폐포출혈 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

HIV 감염 환자에서 유리 횡복직근피부근피판을 이용한 유방재건 수술의 치험례 (A Case Report of Breast Reconstruction with Free TRAM Flap in HIV-Infected Patient)

  • 송정윤;김민호;장학;민경원
    • Archives of Plastic Surgery
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    • 제38권4호
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    • pp.539-542
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    • 2011
  • Purpose: Despite the increasing number of patients with HIV (human immunodeficiency virus) infection, surgical experience with these patients remains limited in aesthetic and reconstructive surgery. The authors performed breast reconsruction with free TRAM (Transverse Rectus Abdominis Muculocutaneous) flap in HIV infected patient firstly in Korea. Methods: A 53-years-old female with HIV positive underwent delayed breast reconstruction with free TRAM flap and 6 months lateral nipple reconstruction was performed. All procedures were performed according to the HIV infection control guidelines provided by the Korea Centers for Disease Control and Prevention. Results: There were no complications such as infection, hematoma and flap loss and symmetry of breast was achieved. Conclusion: When the operation is performed in line with the guidelines of HIV infection control, breast reconstruction with free flap is possible and can obtain successful results.