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Comparison of Postoperative Analgesic Efficacy of Caudal Block versus Dorsal Penile Nerve Block with Levobupivacaine for Circumcision in Children

  • Beyaz, Serbulent Gokhan
    • The Korean Journal of Pain
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    • v.24 no.1
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    • pp.31-35
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    • 2011
  • Background: Circumcision is a painful intervention frequently performed in pediatric surgery. We aim to compare the efficacy of caudal block versus dorsal penile block (DPNB) under general anesthesia for children undergoing circumcision. Methods: This study was performed between July 1, 2009 and October 16, 2009. Fifty male children American Society of Anesthesiolgists physical status classification I, aged between 3 and 12 were included in this randomized, prospective, comparative study. Anesthetic techniques were standardized for all children. Patients were randomized into 2 groups. Using 0.25% 0.5 ml/kg levobupivacain, we performed DPNB for Group 1 and caudal block for Group 2. Postoperative analgesia was evaluated for six hours with the Flacc Pain Scale for five categories; (F) Face, (L) Legs, (A) Activity, (C) Cry, and (C) Consolability. For every child, supplemental analgesic amounts, times, and probable local or systemic complications were recorded. Results: No significant difference between the groups (P > 0.05) was found in mean age, body weight, anesthesia duration, FLACC pain, and sedation scores (P > 0.05). However, on subsequent measurements, a significant decrease of pain and sedation scores was noted in both the DPNB group and the caudal block group (P < 0.001). No major complication was found when using either technique. Conclusions: DPNB and caudal block provided similar postoperative analgesic effects without major complications for children under general anesthesia.

Determination of Ignition Squence and Estimation of Injector Life Extension Technique in Liquid Rocket Engine (소형 액체 로켓 엔진에서의 점화 시퀀스 결정 및 인젝터 수명 연장 기법 평가)

  • Park, Jeong;Kim, Yong-Wook;Kim, Young-Han; Moon, Il-Yoon;Lee, Jae-Yong;Kang, Sun-Il;Chung, Yong-Gahp;Cho, Nam-Kyung;Oh, Seung-Hyup
    • Journal of the Korean Society of Combustion
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    • v.5 no.1
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    • pp.43-53
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    • 2000
  • Experimental studies on determination of the supply leading time of propellants to combustion chamber have been made to stably and efficiently guarantee the ignition process with liquid rocket engine. The propellant used is a Jet A-1 as fuel and a liquid oxygen as oxidizer. Unlike impinging FOOF type of injectors are arranged radially and the designed O/F ratio is 2.34. The present experiment program also includes the stability on the quadlet type of ignitor using the triethylalumimum as an ignition source and injector life tests. Experimental results clarifies that the propellant supply through LOx leading to combustion chamber is proper for stable ignition and combustion processes based on the fuel and oxidizer manifold pressures, combustion chamber pressure, and the variation of flame length from the nozzle exit with lapse time, and shows that the leading supply time of propellants affects the engine performance little. The effect of positioning cooling holes is remarkable to protect the injector face.

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The effect of Type 2 diabetes management using a smartphone-based blood glucose management training program (모바일 자가혈당관리 교육프로그램을 이용한 2형 당뇨병 관리 효과 분석)

  • Lee, Jung-Hwa;Jung, Jin-Hee;Sim, Kang-Hee;Choi, Hee-Sun;Lee, Jeong-Rim;Kang, Yang-Gyo;Song, Bok-Rye
    • Journal of Industrial Convergence
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    • v.20 no.9
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    • pp.59-70
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    • 2022
  • Background: Diabetes education is an important factor in blood glucose control. Reinforced education is necessary for effective diabetes education. However, it is difficult to provide reinforced diabetes education within Korea's medical environment. Therefore, we want to analyze the effect of continuous diabetes education using mobile health care that can effectively provide repeated education without having to face the patient. Methods: This study is a multicenter, randomized, controlled, pre-post design study conducted to analyze the effect of a continuous diabetes education method. A total of 109 people were registered at five hospitals in south Korea, and they were randomly assigned to the app group (34 people) who received real-time coaching and repetitive training, the logbook group (37 people) who received face-to-face training after writing a blood glucose logbook, and the general group (38 people) who received a one-time diabetes education. The study was conducted for a total of 24 weeks. Twenty-one patients withdrew their consent and failed to perform an HbA1c. A final 88 patients were analyzed. The difference in HbA1c, Self-management behavior, and Quality of life before and after education was analyzed. Results: The study involved 51 (58%) male subjects, mean age was 55.8 years and mean duration of diabetes was 7.6 years. After 24 weeks of intervention, there was no significant difference in self-care behavior and quality of life between the three groups, but the HbA1c of the app group significantly decreased after education compared to the logbook group and the general group (F=4.62, p=.013). Conclusion: It can be seen through the app group that receiving real-time education is more effective in improving blood glucose management and continuous diabetes education is important.

Reliability and Validity of the Behavioral Observation Method for Assessing Low Back Pain in Patients with Spinal Diseases (척추질환자의 요통사정을 위한 통증행위 관찰법의 신뢰도 및 타당도 검정)

  • Yoon, Ho-Soon;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.97-115
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    • 1994
  • The purpose of this study was to examine the reliability and validity of the observed behaviors of subjects who suffered from low back pain with spinal diseases, Thirty two low back pain patients admitted on the neurosurgical unit in an army hospital were compared with 30 normal controls belonged to an army unit, by means of matching the age, hight and weight. Observed pain behaviors were developed by the researcher on the bases of literature and patient observation. This tool consists of 18 behaviors seperated into two major groups : mutually exclusive and concomittent behaviors. The mutually exclusive behaviors included coding cathegories for 6. body motions assumed by the subjects during the observation session. These 6 standardized motions consisted of sitting from standing first, and serially tying down, reclining, sitting again, and then standing, 6 steps walking. Concomittent behaviors consisted of 12 observable patterns that can be observed systematically from the face, grimacing, bracing, rubbing, walking with arms fixed, support with hands on sitting or standing, guarded movement, limping, unbalaced weightbearing, stopped movement from tying position to sitting, sighing and graoning. Subjects were videotrecorded as they performed a 6-standardized sequence of motions, simultanously researcher measured the time spent performing each motion and step length. Patients were asked torate their subjective pain score on the 10 mm graphic rating scale ranging from 'no pain' to 'sever pain'. For scoring of the pain behaviors, two trained nursing officiers independently and simutanously viewwd each videorecording and checked subject 'pain behaviors at the observational item checklist. The result of the study are summarized as follows : 1. Reability of the observational tool was a=.845. 2. Spearman's rho and percentage agreement were p=.97 and 81.7 persent respectively, that indicate adequate interrater reability of this tool. 3. The sensitivity rate of the tool was .875 while specificity rate .866 for differentiating patient from the normal. 4. When difference in the objective pain indices between patient group and control were compared, there was significant difference of all indices, such as pain behavior(t=7.71, p=.0001). spent time performing motion(t=14.2, p=.0001), step length (t=-10.72, p=.0001). 5. There were differences in the objective indices the subjective pain subgroups (low, medium, high). Differences in the mean score of objective pain behavior (F=6.376. p=.005) and spent time for moyion(F=4.631, p=.018). But there were no significant differences in the step length among the subgroups(F=.667, p=.521). 6. Highly correlated pain behavior items wiyh subjective pain score were 'stopped movement from lying position to sitting', 'limping', 'support with hands on sitting or standing', 'bracing', 'guarding' and 'walking with arms fixed'. In summary, although some of rho behavior items such as sighing and groaning in this study could not be observed because of videotaped datd, the reliability and validity of the over all observation method were satifactory. Thus, the results of the present study demonstrate rye potetional utility of the tool in assessing objective pain complementing self-reported pain in low back pain patients.

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The Investigation of the Effects on Bent-up Bars within Beam-Column Joint Core with High-Strength Concrete (고강도 콘크리트 보-기둥접합부의 역학적 거동에 대한 연구 -구부림 철근을 중심으로-)

  • 이광수;오정근;신성우;최문식
    • Magazine of the Korea Concrete Institute
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    • v.3 no.2
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    • pp.123-132
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    • 1991
  • The purpose of this study was to Investigate the effects of bent - up bar Within beam - column 1lint core with High - Strength Concrete up to 800kg/$cm^2$. To achieve these objectives, 5 specimens were designed and tested under monotoric loading and reversed cyclic loadings. The primary variables were the number of bent-up bars, compressive strength of concrete and loading patterns. The results showed that the load capacity of specimen subjected to monotonic loading had more large than that of specirnn subjected to reversed cyclic loadings and the bent - up bar within joint core could prevented the crack at the joint face from propagating into the pint core but the failure was concentrated at the face of beam - column pint. Thus the study on flexural strength ratio should be accomplished before using bent - up bars within the joint core.

Water-blocking Asphyxia of N95 Medical Respirator During Hot Environment Work Tasks With Whole-body Enclosed Anti-bioaerosol Suit

  • Jintuo Zhu;Qijun Jiang;Yuxuan Ye;Xinjian He;Jiang Shao;Xinyu Li;Xijie Zhao; Huan Xu;Qi Hu
    • Safety and Health at Work
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    • v.14 no.4
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    • pp.457-466
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    • 2023
  • Background: During hot environment work tasks with whole-body enclosed anti-bioaerosol suit, the combined effect of heavy sweating and exhaled hot humid air may cause the N95 medical respirator to saturate with water/sweat (i.e., water-blocking). Methods: 32 young male subjects with different body mass indexes (BMI) in whole-body protection (N95 medical respirator + one-piece protective suit + head covering + protective face screen + gloves + shoe covers) were asked to simulate waste collecting from each isolated room in a seven-story building at 27-28℃, and the weight, inhalation resistance (Rf), and aerosol penetration of the respirator before worn and after water-blocking were analyzed. Results: All subjects reported water-blocking asphyxia of the N95 respirators within 36-67 min of the task. When water-blocking occurred, the Rf and 10-200 nm total aerosol penetration (Pt) of the respirators reached up to 1270-1810 Pa and 17.3-23.3%, respectively, which were 10 and 8 times of that before wearing. The most penetration particle size of the respirators increased from 49-65 nm before worn to 115-154 nm under water-blocking condition, and the corresponding maximum size-dependent aerosol penetration increased from 2.5-3.5% to 20-27%. With the increase of BMI, the water-blocking occurrence time firstly increased then reduced, while the Rf, Pt, and absorbed water all increased significantly. Conclusions: This study reveals respirator water-blocking and its serious negative impacts on respiratory protection. When performing moderate-to-high-load tasks with whole-body protection in a hot environment, it is recommended that respirator be replaced with a new one at least every hour to avoid water-blocking asphyxia.

An Effect on Recovery of Post-operative Bowel Movement on Nursing Intervention of Meridian Acupressure (경혈지압 간호중재가 수술후 장유동 회복에 미치는 영향)

  • Lee, Hyang-Yeon;Kim, Kwuy-Bun;Kim, Kwang-Joo;Wyang, Myung-Ja;Kim, Yoon-Hee;Kim, Il-Won;Kim, Ho-Mee
    • Journal of East-West Nursing Research
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    • v.6 no.1
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    • pp.46-54
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    • 2001
  • This study was conducted to identify the effectiveness of meridian acupressure for enhancement of post operative bowel movement to the patient with absolute bed rest who having surgery under general anesthesia. This study used a qusai experimental, nonequivalent control group post test only design. This subject were 44 patients, 22 for the experimental and 22 for the control group, who were admitted at KyungHee University hospital, neurosurgical unit A and B ward, assigned by matched sample by the name of operation who having microvascular decompression and laminectomy. Date were collected from May 1, 2001 to June 30, 2001 by auscultation, self report and by using 7 point face scale. The recovery of bowel sound were measured every 4 hours until gas out for 1 minute auscultation on lower abdomen after 4 hours having surgery. The time of gas out were measured by self report, the severity of nausea were measured every 4 hours for 7 point face scale and also the degree of satisfaction of nursing care were measured after 2 days having surgery with same scale. Data were analyzed with $X^2$, t-test, repeated measures ANOVA and ANOVA. The result of this study were as follows; 1. The experimental group which were implemented with meridian acupressure showed shorter time the recovery of bowel sound after having surgery than control group(t=-5.112, p=.0001). 2. The experimental group which were implemented with meridian acupressure showed shorter time of gas after having surgery than control group(t=-4.010, p=.0001) 3. The experimental group which were implemented with meridian acupressure showed decreased level of nausea score according to time interval than control group(F=21.995, p=.0001). 4. The experimental group which were implemented with meridian acupressure showed higher the degree of satisfaction of nursing care than control group(t=-4.010, p=.0001). These finding indicate that a meridian acupressure could be a effective nursing intervention for enhancement of post operative bowel movement to the patient with absolute bed rest who having surgery under general anesthesia.

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Optimum Conditions for Growing Gem-quality Colorless Cubic Zirconia (보석용 무색 큐빅 저코니아의 최적 육성 조건)

  • 김원사;유영문;신현숙
    • Journal of the Mineralogical Society of Korea
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    • v.14 no.2
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    • pp.99-110
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    • 2001
  • A gem-quality yttria-stabilized zirconium oxide crystals were synthesized by the skull-melting method, using the RF electrical apparatus. Principal raw materials used were $ZrO_2$and 25 wt.% $Y_2O_3$as stabilizer and 0.03~0.05 wt.% $Nd_2O_3$decolorizing agent were added to it. The single crystals were approximately 20$\times$63 mm in size with chemical composition $Zr_{0.73}$ $Y_{0.27}$ $O_{1.87}$ . The crystals are isotropic with no appreciable anisotropism under a polarizing microscope. Their refractive indices are in the range of 2.15~2.18, specific gravity 5.85, Mohs' hardness 8~8.5, and reflectivity 13.47%. The zirconia crystals were confirmed to have cubic structure with Face-centered lattice(Z=4), space group Fm3m ($CaF_2$-type structure) and unit cell parameters are a=5.157 $\AA$. The optimal growing conditions for yttria-stabilized zirconia are 50 kW, 2.94 MHz in power and to use a crucible with 105 mm $\times$ 135 mm in size. When the lowering speed of the crucible was set 16mm/hr gave the best yield, 42%. Since the refractive index(2.15~2.18) of cubic zirconia is smaller than that of diamond, the angle between crown and pavilion should be fashioned to make it smaller than $40.5^{\circ}$ to show the maximum brilliancy and fire.

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A Study on the Characteristics of Martensitic Transformation Behaviors in In-X(X=Pb,Sn) Alloys (In-X(X=Pb,Sn) 합금의 마르텐사이트변태거동 특성에 관한 연구)

  • Han, Chang-Suk;Han, Seung-Oh
    • Journal of the Korean Society for Heat Treatment
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    • v.23 no.5
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    • pp.233-238
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    • 2010
  • The phase transformations and the shape memory effect in In-rich Pb alloys and In rich-Sn alloys have been studied by means of X-ray diffractometry supplemented by metallographic observations. The alloys containing 12~15 at.%Pb transform from the ${\alpha}_2$ (fct) phase to the ${\alpha}_1$ (fct) phase by way of an intermediate phase (m phase) on cooling. The results of X-ray diffraction show that the metastable intermediate phase is observed both on cooling and heating, and has a face-centered orthorhombic (fco) structure. It is concluded that the ${\alpha}_1{\rightleftarrows}{\alpha}_2$ transformation is expressed by the ${\alpha}_1{\rightleftarrows}m{\rightleftarrows}{\alpha}_2$ transformation both on usual cooling and heating with the rate more than $8{\times}10^{-3}$ K/s. The $m{\rightleftarrows}{\alpha}_2$ transformation takes place with a mechanism involving macroscopic shear and are of diffusionless (martensitic) type. The temperature hysteresis in the two transformations is 10~13 K between the heating and cooling transformations. The alloys containing 0~11 at.%Sn are -phase solid solutions with a face centered tetragonal structure (c/a > 1) at room temperature, the axial ratio increasing continuously with tin content. The In-(11~15) at.%Sn alloys are mixtures of ${\alpha}$ and ${\beta}$ phases, the ${\beta}$ phase having a f. c. tetragonal structure (c/a < 1). The alloys containing more than 15 at.%Sn are ${\beta}$-phase solid solutions. The In-(12.9~15.0) at.%Sn alloys show a shape memory effect only when quenched to the temperature of liquid nitrogen, although their effect becomes weak and finally disappears after keeping at room temperature for a long time. The ${\beta}{\rightarrow}{\alpha}^{\prime}$ phase transformation is of the diffusionless (martensitic) type, and takes place between 330 K at 12.9 at.%Sn and 150 K at 14.5 at.%Sn. The hysteresis of transformation temperatures on heating and cooling is considerably large (29~40 K), depending on the composition. Both In-Pb and In-Sn alloys showed distinct the shape memory effects.

Characteristics of Particleboards Made from Three-months-old Domestics Bamboo (Phyllostachys nigra var henonis Stapf) (3개월생 분죽을 이용한 대나무 파티클보드의 특성)

  • Lee, Hwa Hyoung;Han, Ki Sun;Kim, Gwan Eui
    • Journal of the Korean Wood Science and Technology
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    • v.30 no.1
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    • pp.11-17
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    • 2002
  • This study was performed to determine the characteristics of particleboard made from three-months-old bamboo, (Phyllostachys nigra var henonis Stapf) grown in Damyang district, Korea. Total 60 particleboards were manufactured with 1% of liquid wax emulsion using urea-formaldehyde resin content 9%,11% and 13%, respectively. The particle boards consisted of three layers, in which face layer had the same proportion of a weight 25% of the particleboard each. And the core layer had a weight 50% of the board. The core layer and face layer had the particle dimension passing 6 mesh (3.35 mm), 12 mesh (1.70 mm), respectively. The study was carried out to determine the effect of the growing time of 3 months and 3 years on particleboard properties. The physical and mechanical properties of boards were measured and compared to the Korean standard (KS) requirements of particle boards. The results were as follows; 1. The longer the growing time, the higher the density of bamboo. Density of the upper part of bamboo showed higher than that of lower part. 2. Density and moisture content of the two particle boards did not show significant differences. Three-months-old bamboo particleboard gave higher thickness swelling than three-years-old bamboo particleboard. Bamboo particleboard passed the thickness swelling test of KS. 3. The static bending and internal bond strength of three-months-old bamboo particleboard were higher than those of three-years-old bamboo. Increase of resin contents in bamboo particleboard increased bending and internal bond strength, proportionally. Strength properties of bamboo particle board were above KS. 4. Formaldehyde emission of all the bamboo particleboards satisfied E2 level (5.0 mg/L) of KS F 3104.