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신생아에서 Chloral Hydrate의 부작용의 빈도와 관련 인자 (Adverse Effects of Chloral Hydrate in Neonates: Frequency and Related Factors)

  • 이주영;윤영아;김순주;이현승;김소영;성인경;전정식
    • Neonatal Medicine
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    • 제18권1호
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    • pp.130-136
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    • 2011
  • 목적: Chloral hydrate는 검사 시 진정 목적으로 흔히 사용하는 약물이나 신생아에 관해서는 충분한 연구가 이루어지지 않고 있다. 이에 저자들은 신생아중환자실에서 chloral hydrate의 사용 시에 나타나는 부작용의 빈도와 그에 영향을 미치는 요소에 대해 알아보고자 한다. 또한 chloral hydrate만으로 진정이 되지 않아 추가 약물을 투여하는 경우 부작용이 증가하는지에 관해 알아보고자 한다. 방법: 2010년 3월부터 2011년 2월까지 가톨릭대학교 서울성모병원 신생아중환자실에서 검사 시 진정 목적으로 chloral hydrate를 사용한 104명을 대상으로 의무기록을 후향적으로 조사하였다. 결과: Chloral hydrate 투여 시 부작용은 41.3%에서 나타났으며 산소 포화도 감소(18.8%), 무호흡 증가(17.5%), 서맥 증가(10%), 수유량 감소(3.8%)가 있었다. Chloral hydrate 투여 시부작용은 chloral hydrate 투여 시기에 산소 투여 여부와 관련이 있었다(odds ratio [OR], 10.911: 95% confidence interval [CI], 2.082-57.178). 추가 약물 투여는 chloral hydrate 투여 시 산소 투여 여부와 관련이 있었고(OR, 4.151: 95% CI, 1.455-11.840) chloral hydrate 단독 투여 군에 비해 수유량 감소를 제외하고는 부작용에 유의한 차이가 없었다. 결론: 진정 요법이 필요한 검사 시 산소를 투여하고 있는 신생아에서 chloral hydrate의 사용은 부작용이 나타날 가능성이 높고 추가 약물 투여의 가능성이 높다. 추가 약물 투여가 필요한 경우에는 진정 유도 후 나타나는 수유량 감소에 주의하면서 진정을 유도할 수 있겠다.

임신 삼분기별 산모의 체중 증가 양상과 신생아 체중과의 상관 관계 (Maternal Weight Gain Pattern and Birth Weight)

  • 김목진;이호열;이영기;박윤기;이두진;이승호
    • Journal of Yeungnam Medical Science
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    • 제15권1호
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    • pp.135-142
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    • 1998
  • 1993년 1월부터 1996년 12월까지 영남대학교 의과대학 부속병원에서 임신 1분기부터 3분기까지 계속해서 산전 진찰을 받은 424명의 산모와 출산한 신생아를 대상으로 산전 진찰 기록지를 검토하여 임신 각 분기별 체중 증가 양상과 신생아 체중과의 상관 관계를 다중 회귀 분석법을 이용하여 조사한 결과 임신 1분기에서 산모의 체중 증가가 태어나는 신생아의 체중과 유의한 관계가 있다는 결론을 얻었다.

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간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구 (Investigation of Espoused Theories in Nursing Practice)

  • 서문자;김혜숙;이은희;박영숙;조경숙;강현숙;임난영;김주현;이소우;조복희;이명화;지성애;하양숙;손영희;권성복;김희진;추진아
    • 성인간호학회지
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    • 제13권1호
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    • pp.53-69
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    • 2001
  • As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

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Skeletal-Related Events among Breast and Prostate Cancer Patients: Towards New Treatment Initiation in Malaysia's Hospital Setting

  • Ezat, Sharifa Wan Puteh;Junid, Syed Mohamed Aljunid Syed;Khamis, Noraziani;Ahmed, Zafar;Sulong, Saperi;Nur, Amrizal Muhammad;Aizuddin, Azimatun Noor;Ismail, Fuad;Abdullah, Norlia;Zainuddin, Zulkifli Md;Kassim, Abdul Yazid Mohd;Haflah, Nor Hazla Mohamed
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.3357-3362
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    • 2013
  • The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient healthrelated quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.

간호사의 회복탄력성, 스트레스, 소진, 조직몰입과의 관계 (A Study on Relationships among Resilience, Stress, Burnout and Organizational Commitment of Hospital Nurses)

  • 류경;김종경
    • 한국콘텐츠학회논문지
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    • 제16권7호
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    • pp.439-450
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    • 2016
  • 간호사는 병원종사자 중 다양한 대상자에게 간호를 제공함과 동시에 여러 직종 간에 조정 역할을 하며 전문지식과 기술에 대한 요구 증가, 교대근무 등으로 심한 스트레스와 소진을 경험하고 이직에 대한 의도를 높이게 된다. 회복탄력성은 스트레스와 소진을 감소시키고 조직몰입을 높일 것으로 기대되어 연구가 필요한 시점이다. 본 연구는 간호사의 회복탄력성, 스트레스, 소진, 조직몰입간의 관계를 파악하여 회복탄력성이 스트레스, 소진, 조직몰입에 미치는 영향을 파악하고자 한 서술적 조사연구이다. 연구결과는 다음과 같다. 대상자의 회복탄력성은 최대 5점에서 3.38(${\pm}.38$)로 나타났으며, 스트레스는 최대 5점에서 3.73(${\pm}.50$), 소진은 최대 6점에서 2.74(${\pm}.68$), 조직몰입은 최대 7점에서 4.22(${\pm}.68$)로 나타났다. 본 연구에서 회복탄력성, 스트레스, 소진, 조직몰입의 상관분석을 실시한 결과, 회복탄력성과 스트레스, 소진 사이에는 부적 상관관계를, 회복탄력성과 조직몰입은 정적 상관관계를 보였다. 본 연구의 결과에 기초하여 간호조직에서는 간호사의 스트레스와 소진을 낮추고, 조직몰입을 증진시키기 위해 간호사의 회복탄력성에 관심을 가지고 간호사의 회복탄려성을 높이기 위한 노력으로 관련 프로그램 개발 및 적용이 필요하다.

Rutin Improves Bone Histomorphometric Values by Reduction of Osteoclastic Activity in Osteoporosis Mouse Model Induced by Bilateral Ovariectomy

  • Lee, Hye-Hwa;Jang, Jae-Won;Lee, Jung-Kil;Park, Choon-Keun
    • Journal of Korean Neurosurgical Society
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    • 제63권4호
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    • pp.433-443
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    • 2020
  • Objective : Osteoporosis is a disease of unbalanced bone metabolism that results in low bone mineral density with increased bone fragility and propensity for fractures. The increased rate of bone fracture due to osteoporosis places a significant burden on public health care expenditures. Therefore, numerous studies have been designed and performed to identify the drugs or health foods that can improve the bone quality or quantity. This study was designed to evaluate and analyze the therapeutic effects of rutin on histomorphometric values of the spine and femur in an osteoporotic mouse model induced by bilateral ovariectomy. Methods : Thirty female ICR mice (8 weeks old) underwent either a sham operation (only abdominal incision, sham group, n=10) or bilateral ovariectomy (n=20). The ovariectomized (OVX) animals were randomly divided into two groups : untreated OVX group (OVX-C, n=10), or rutin-administered group (OVX-R, n=10). The OVX-C group received weight-adjusted doses of saline vehicle and the OVX-R group received 50 mg/kg of rutin intraperitoneally, starting 1 day after surgery. At 4 and 8 weeks after surgery, serum estrogen, osteocalcin, alkaline phosphatase (ALP), and the telopeptide fragment of type I collagen C-terminus (CTX-1) were analyzed. Interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α were also analyzed. Bone histomorphometric parameters of the 4th lumbar vertebra and femur were determined by micro-computed tomography. Results : In OVX-C group, ALP, osteocalcin, CTX-1, IL-1β, IL-6, and TNF-α levels were significantly increased at 4 and 8 weeks compared to sham operation group. Rutin administration after OVX statistically significantly reduced ALP, CTX-1, IL-1β, IL-6, and TNF-α levels at 4 and 8 weeks. Rutin administration also improves bone histomorphometric parameters including trabecular bone volume fraction, trabecular thickness, and trabecular number. Trabecular separation was also decreased in OVX-R group compared to OVX-C group. Conclusion : The present study demonstrated that rutin has therapeutic effects on improving bone histomorphometric values in an OVX mouse model. The improvement in histomorphometric values may be associated with the reduction of osteoclastic activity via inhibition of IL-1β, IL-6, and TNF-α. In future studies, the mechanism for the effect of rutin on osteoporosis should be demonstrated more clearly to use rutin in human osteoporosis.

요추척추궁 절제술 환자의 표준관리지침서 개발 (Development of a Critical Pathway for Patients with Lumbar Laminectomy)

  • 박재정;박형숙
    • 성인간호학회지
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    • 제12권4호
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    • pp.517-532
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    • 2000
  • The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

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Clinicopathological Characteristics of Triple Negative Breast Cancer at a Tertiary Care Hospital in India

  • Dogra, Atika;Doval, Dinesh Chandra;Sardana, Manjula;Chedi, Subhash Kumar;Mehta, Anurag
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10577-10583
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    • 2015
  • Background: Triple-negative breast cancer (TNBC), characterized by the lack of expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2, is typically associated with a poor prognosis. The majority of TNBCs show the expression of basal markers on gene expression profiling and most authors accept TNBC as basal-like (BL) breast cancer. However, a smaller fraction lacks a BL phenotype despite being TNBC. The literature is silent on non-basal-like (NBL) type of TNBC. The present study was aimed at defining behavioral differences between BL and NBL phenotypes. Objectives: i) Identify the TNBCs and categorize them into BL and NBL breast cancer. ii) Examine the behavioral differences between two subtypes. iii) Observe the pattern of treatment failure among TNBCs. Materials and Methods: All TNBC cases during January 2009-December 2010 were retrieved. The subjects fitting the inclusion criteria of study were differentiated into BL and NBL phenotypes using surrogate immunohistochemistry with three basal markers $34{\beta}E12$, c-Kit and EGFR as per the algorithm defined by Nielsen et al. The detailed data of subjects were collated from clinical records. The comparison of clinicopathological features between two subgroups was done using statistical analyses. The pattern of treatment failure along with its association with prognostic factors was assessed. Results: TNBC constituted 18% of breast cancer cases considered in the study. The BL and NBL subtypes accounted for 81% and 19% respectively of the TNBC group. No statistically significant association was seen between prognostic parameters and two phenotypes. Among patients with treatment failure, 19% were with BL and 15% were with NBL phenotype. The mean disease free survival (DFS) in groups BL and NBL was 30.0 and 37.9 months respectively, while mean overall survival (OS) was 31.93 and 38.5 months respectively. Treatment failure was significantly associated with stage (p=.023) among prognostic factors. Conclusions: Disease stage at presentation is an important prognostic factor influencing the treatment failure and survival among TNBCs. Increasing tumor size is related to lymph node positivity. BL tumors have a more aggressive clinical course than that of NBL as shown by shorter DFS and OS, despite having no statistically significant difference between prognostic parameters. New therapeutic alternatives should be explored for patients with this subtype of breast cancer.

말초성 안면신경마비에 대한 약침병행치료 효능의 임상적 고찰 - 자하거 약침과 Sweet Bee Venom을 중심으로 - (The Clinical Research of the Effectiveness of Pharmacopuncture Complex Therapy on Peripheral Facial Paralysis - Hominis Placenta Pharmacopuncture Therapy and Sweet Bee Venom Therapy -)

  • 박재흥;장선희;이창환;구지영;전대성;안창범;김철홍;송춘호;윤현민
    • Journal of Acupuncture Research
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    • 제27권2호
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    • pp.79-87
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    • 2010
  • Objectives : The aim of this study is to investigate the effect of Hominis Placenta pharmacopuncture therapy and sweet bee venom therapy on peripheral facial paralysis. Methods : Clinical studies were done 36 patients who were treated peripheral facial paralysis to Dept. of Acupuncture and Moxibusition, of Oriental Medicine Dong-Eui University from June 15, 2009 to January 5, 2010. Subjects were randomly divided into 2 groups. : Hominis Placenta Pharmacopuncture treated group (group A, n=18), sweet bee venom treated group (group B, n=18). In group A, we treated patients with dry needle acupuncture and Hominis Placenta pharmacopuncture therapy. In group B, we treated patients with dry needle acupuncture and sweet bee venom therapy. All process of treatment were performed by double blinding method. To investigate the effectiveness of treatment applied for two groups, we used Yanagihara's unweighed grading system at before treatment, after 1week, 2weeks, 3weeks and 4weeks of treatment. Results : The Yanagihara's scores of group B were higher than those of group A, but not statistically significant. The improvement indexs of group A and group B were different, but not statistically significant. Conclusions : There were no significant differences statistically between Hominis Placenta pharmacopuncture therapy and sweet bee venom therapy on peripheral facial paralysis.

이부교대(二部交代) 근무제도(勤務制度)에 대한 임상간호사(臨床看護師)의 요구도(要求度)에 관한 연구(硏究) (A Study on the Need of Clinical Nurses about the System of 12-Hour Work Shift)

  • 강영선;문희자
    • 간호행정학회지
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    • 제1권1호
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    • pp.46-64
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    • 1995
  • The 12-hour work shift can be influenced on the nurse's job satisfaction, effective personnel administration, and quality of patient care. The purpose of this study was to explore the perception on the 12-hour work shift by nurses. A total of 516 nurses were selected by convenience sampling from six general hospitals in Seoul. Based on the literature review, the questionnaire on the need of the 12-hour work shift was designed by the investigator. The data were analyzed using descriptive statistics, ANOVA and Duncan's method as post-hoc test. The results of this study are as follows ; 1. The need of 12-hour work shift The mean needs of 12-hour work shift in the nursing practice, psychological, physical, socioeconomic, and environmental perspectives were 3.05, 2.72, 2.66, 3.08, and 4.22. 2. The need of 12-hour work shift by demographic data For the nursing practice, there was a statistically significant relationship between marital status(p=.021), satisfaction on the 8-hour work shift(p=.038), the perception on the 12-hour work shift(p=.001) and the need of 12-hour work shift. For the psychological perspectives, there was a statistically significant relationship between marital status(p=.016), the perception on the 12-hour work shift(p=.0001), and the need of 12-hour work shift. For the physical perspectives, there was a statistically significant relationship between age(p=.002), marital status(p=.005), the number of children(p=.005), the duration of job career(p=.014), the job position(p=.002), the work shift(p=.030), the perception on the 12-hour work shift(p=.0001) and the need of 12-hour work shift. For the socioeconomic perspectives, there was a statistically significant relationship between the job position(0=.002), the work shift(p=.006), the perception of the 12-hour work shift(p=.002) and the need of 12-hour work shift. For the environmental perspectives, there was a statisitically significant relationship between the traffic method(p=.05), the duration of the job career(p=.026), the perception on the 12-hour work shift(p=.309) and the need of 12-hour work shift. 3. The need of 12-hour work shift by the demographic data There was a statistically significant difference between marital status(p=.014), the number of children(p=.038), the job position(p=.007), the work shift(p=.037), and the perception on the 12-hour work shift(p=.0001) for the need of 12-hour work shift.

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