• PNF and Movement
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• 제12권3호
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• pp.143-150
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• 2014

Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.

• Clinical Pain
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• 제19권2호
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• pp.116-119
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• 2020

Cervical transforaminal epidural steroid injection (TFESI) is commonly performed to provide relief of pain caused by radiculopathy. Intra-arterial injection of particulate steroid or direct needle injury can lead to spinal artery embolism or thrombosis. Also there is a possibility of vascular spasm. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI with non-particulate steroid in Korea. A 47-year-old female patient underwent C7 TFESI at local pain clinic. Injected materials were dexamethasone and mepivacaine. Right after the intervention, she felt muscle weakness and decreased sensation. On physical examination, she had decreased sensation from C4 to T2 dermatome in light touch and pin-prick test. Proprioception and vibration were intact. The motor grades of upper extremities were grade 1. Cervical and thoracic spine MRI was checked. Diffusion-weighted image and apparent diffusion coefficient image showed long extension of spinal cord infarction from C2 to T1 level.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권1호
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• pp.9-17
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• 2023

Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.210-216
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• 2023

Purpose: This preliminary retrospective cohort study analyzed the relationship between the parameters provided by sonorheometry device Quantra and the coagulation values obtained from standard venous blood samples in patients admitted in intensive care unit (ICU). Methods: We reviewed medical charts of 13 ICU adult patients in whom at least one coagulation study with Quantra was performed. The relationship between Quantra and laboratory data was analyzed with the Spearman rank correlation coefficient (rho). The 95% confidence interval (CI) was computed. A P-value <0.05 was considered statistically significant. Results: We collected 28 data pairs. Statistically significant moderate correlations were found for the following parameters: clot time (CT) and activated partial thromboplastin time (rho=0.516; 95% CI, 0.123-0.904; P=0.009; clot stiffness (CS) and the international normalized ratio (INR; rho=0.418; 95% CI, 0.042-0.787; P=0.039); INR and platelet contribution to CS (rho=0.459; 95% CI, 0.077-0.836; P=0.022); platelet count and platelet contribution to CS (PCS; rho=0.498; 95% CI, 0.166-0.825; P=0.008); and fibrinogen and fibrinogen contribution to CS (FCS; rho=0.620; 95% CI, 0.081-0.881; P=0.001). Conclusions: Quantra can provide useful information regarding coagulation status, showing modest correlations with the parameters obtained from laboratory tests. During diffuse bleeding, CT and FCS values can guide the proper administration of clotting factors and fibrinogens. However, the correlation of INR with CS and PCS can cause misinterpretation. Further studies are needed to clarify the relationship between Quantra parameters and laboratory tests in the critical care setting and the role of sonorheometry in guiding targeted therapies and improving outcomes.

• 한국병원경영학회지
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• 제28권4호
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• pp.23-32
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• 2023

Purposes: Caregivers are placed in a poor working environment because there is no special legal basis or definition in the current medical system, and they have difficulty in supplying manpower due to frequent job change and retirement. Therefore, this study aimed to find out the effect on job consciousness, job stress, job satisfaction, and turnover intention of caregivers in nursing hospitals for the elderly. Methodology: In this study, a survey was conducted from May 2nd to 16th, 2022, targeting caregivers with more than 6 months of work experience working at 10 nursing hospitals in D City. Data were collected through convenience sampling, and a self-administered questionnaire method was used, in which subjects filled out a questionnaire. A total of 240 questionnaires were distributed, and 220 copies were considered for the final analysis after excluding non-response or inappropriate questionnaires for data use. Data analysis used t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis, and the main results are as follows. Findings: Job stress and job satisfaction showed a significant correlation with the level of turnover intention, and were also found to be major determinants. On the other hand, among the occupational characteristics of the study subjects, employment type, job motivation, service period, number of patients, injury experience, and license status showed a significant difference from turnover intention. Conclusion: As a result of the above research, in order to prevent job turnover and retirement by improving job stress and job satisfaction of caregivers engaged in nursing hospitals, it is necessary not only to legalize caregivers, but also to secure an appropriate level of caregivers for nursing hospitals and improve specific treatment for caregivers. Ultimately, a policy alternative that can provide quality nursing service is required.

• 대한의용생체공학회:의공학회지
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• 제24권2호
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• pp.133-140
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• 2003

본 연구에서는 보행훈련 전후에 실시된 보행속도 측정 결과와 누운 자세에서 능동적 발목 배굴시의 근전도 활동 측정 결과를 비교하였다. 9명의 불완전 척수손상 환자들이 3개월 동안 하루 20분 주 5회로 이루어진 체중부하 감소장치 및 트레드밀을 이용한 보행훈련 (STAT supper-ted treadmill ambulation training)에 참가하였다. 보행속도 실험과 능동운동 실험은 보행훈련 시작 및 종료된 시점의 동일한 날, 혹은 같은 주에 실시되었다. 환자의 능동운동시의 표면근전도 값을 측정하였고. 동일한 운동시 열명의 건강한 피실험자들로부터 측정된 근전도값을 기준값으로 비교하는데 사용하였다 하지 열곳의 근육에서 측정된 표면근전도 값은 반응벡터 (response vector)라고 명명되었고 크기 및 근육 제어 분포 패턴을 관찰하는데 사용되었다. 척수손상 환자들의 보행속도는 0.47$\pm$0.35 m/s에서 0.68$\pm$0.52 m/s로 유의한 증가를 보였다. 근전도 해석결과에서는 우측 발목관절 배굴시에 근전도의 증가를 보인 6인의 환자들의 값은 109.7$\pm$148.5 $\mu\textrm{V}$에서 145.9 $\pm$ 180.7 $\mu\textrm{V}$ 로 증가하였으나 유의한 수준은 아니었다 (p〈0.055). 또한 좌측 발목의 배굴에서 측정된 근전도에서는 단 2명만이 상관계수와 근전도 증가를 보였다 보행훈련 후의 환자들의 근육 활동의 변화는 개개인의 상태에 따라 매우 다양하게 변하였고. 보행훈련 후의 상태는 보행훈련 전의 상태에 매우 의존적임을 알 수 있었다 정량적인 해석을 위해 새로 도입된 반응벡터의 사용은 척수손상 환자들의 보행훈련 전후에 환자의 상태를 평가. 예측, 혹은 훈련의 방향 설정시에 유용하게 사용될 수 있는 가능성을 보여주었다.ne(chloroform)와 toluene 등이 가장 자주 검출되는 성분이었다. 대부분의 aromatic hydrocarbons, alkyl benzenes및 다른 유기용매 성분은 검출농도 이하이다.한 대사적인 문제와 생활 양식에 의한 영향이 클 것으로 추정된다. 그러므로 BMI가 높은 노인들에게 부족되고 있는 영양소에 대한 연구가 이루어져야 할 것이다. 특히 비타민 A, E B 복합체는 노인성 질병과 관련하여 그 기능이 규명되어야 할 영양소이다. 이는 항산화효소의 증가에 의한 지질 과산화물 생성삼소와 PGE$_2$및 TXA$_2$등의 유의적인 감소가 유선암세포의 증식을 억제하는 인자로 작용할 수 있는 가능성을 시사하였다. 또한 지방산 투여 에 따른 과산화물 생성과 항산화 시스템이 유선암 세포에서는 상호기전적으로 작용하지 않았으나 이는 농도와 배양시간에 따른 CLA의 항암효과가 in vivo 실험에서 재검증 할 필요가 있음을 시사한다. 또한 장시간의 세포배양 실험시 PGE$_2$는 반감기가 짧고 다른 대사물로 쉽게 전환되는 불안전한 물질이므로 새로운 측정방법의 개발이 필요하겠다. 더욱이 CLA에 의한 항암효과가 정확히 어떤 기전에 의한 것인지 보다 깊이 있는 연구가 필요하지만 본 연구에서 얻은 에이코사노이드 대사의 변화 등은 유선암 예방 연구에 기초적인 자료가 될 것으로 생각된다.들어가 면서 점차 감소하여 대조군과 유사한 양상을 나타내었으나, 전체적으로 대조군보다 높은 수치를 나타내었다. 반면에 5, 10 $\mu\textrm{g}$ L$^{-1}$의 농도에 노출된 세포는 초기에 매우 낮은 탄소동화율을 보였으며, 5 $\mu\textrm{g}$ L$^{-1}$의 농도에 노출시킨 세포의 경우 12일째부터 단위세포 당 탄소동화율이 매우 크게 증가하였다. 본 연구의

• 한국작물학회지
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• 제47권6호
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• pp.409-412
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• 2002

본 시험에서는 원형 포트에 재배한 맥류(피맥 2품종, 과맥 2품종)의 염(NaCl, $MgSO_4$ )을 도별(0, 60, 120, 180mM)로 출수기에 10일 동안 처리하여 출수기의 내염성 정도와 이에 수반된 몇 가지 대사물질의 변화와 수량구성요소의 변이를 조사하여 재배법개선, 그리고 내염성이 큰 품종육성을 위한 기초자료를 얻고자 수행하였다. 염류간의 비교에서 수수, 간장, 일수립수, 그리고 수량에 있어서는 유의성이 없었으며 건경중과 천립중에서는 염종류간 차이가 있어서 유의성이 인정되었는데 $MgSO_4$ 보다 NaCl에서 높았다. 지엽의 조사에서는 엽록소와 유리 proline이 유의성이 있었는데, 엽록소는 NaCl 보다 $MgSO_4$ 에서 높았으나 유리 proline 축적은 $MgSO_4$ 보다 NaCl에서 높았다. 농도간 비교에서는 모든 조사항목이 유의성이 있어서 농도간의 차이가 나타났는데 중실수량을 포함한 모든 항목이 전반적으로 저농도에서 높고 고농도일수록 낮았다. 지엽의 조사항목에서도 모두 유의성이 인정되었는데 농도증가에 따라 생건비는 증가하는 경향이지만 상대팽압도와 엽록소는 상당히 감소하는 경향이었다. 그리고 유리 proline 함량은 대조적으로 농도증가에 따라 축적량이 증가되었는데 대조에 비하여 많으면 10배까지 증가되었다. 종합적으로 볼 때 생식생장기의 생육단계에서 유리 proline축적이 많으며 수량구성요소와 종실수량의 감소가 적은 백동이나 동보리1호가 상대적으로 내염성이 높게 나타났으나, 출수기의 염 stress는 생육장해가 커 수량감소를 초래하므로 이시기의 관리가 중요하다고 하겠다포장 출수기, 성숙기는 결빙방지 단백질의 농도, 광합성의 광저해에 대한 내성, 포장 내동성과 고도의 정의 상관을, 등숙기간은 각 형질들과 부의 상관을 보였다. was "glossy and smooth" in all cases and preference about the texture was high. The Doenjang with added P. japonica Powder had a saltier taste and the Doenjang with P. japonica Powder had the least sweet taste. In the flavor and overall Preference, the Doenjang with P. japonica powder was the lowestEX>로 측정되었고, 계사내 지붕의 표면 온도는 최고 $29^{\circ}C$가 측정되었다. 계사 내 표면 온도 및 닭의 표면 온도는 계사내 공기온도의 영향을 많이 받는 것으로 나타났다.ill in a good agreement with those predicted by Rohsenow's formula, which was based on nucleate boiling. For the condenser, the wall temperatures were practically uniform, and the measured values of condensation heat transfer coefficient were 1.7 times higher than the predicted values obtained from Nusselt's film condensation theory on tilted

• 대한간호학회지
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• 제29권4호
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• pp.929-939
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• 1999

The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

• 대한정형외과학회지
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• 제56권3호
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• pp.208-214
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• 2021

목적: 급성 골다공증성 요추 골절 환자에서 척추 변형의 진행을 예측할 수 있는 여러 인자들 중 척추의 자기공명영상 촬영에서 척추 주변 근육의 정량적 분석을 통해 척추 기립근 및 다열근의 감소와 후만각의 변형의 상관관계를 알아보고자 한다. 대상 및 방법: 이 연구는 2007년 1월부터 2018년 3월까지 단일 분절의 급성 요추 골절로 진단되어 보존적 치료 중인 환자를 대상으로 하였다. 다열근 및 척추 기립근의 감소는 지방으로 변성된 비율을 통해 확인하였고 이는 진단 당시 촬영한 요추 자기공명영상 촬영을 사용하여 측정되었으며, 지방으로 변성된 비율은 총 지방 침윤율로 정의하였다. 1년 추적 관찰에서 요추의 측면 방사선 사진에 기초하여 추체 압박률, 콥스각 및 쐐기각을 측정하였다. 피어슨 상관 계수를 분석하여 통계적 유의성을 확인하였다. 결과: 연구 대상은 129명으로 30명은 남자, 99명은 여자를 대상으로 하였다. 평균 연령은 71.28±9.55세, 평균 BMD 점수는 -3.53±0.79 g/cm², 평균 지방 침윤율은 15.20%±11.99%였다. 지방침투율은 수상 당시 나이(R=0.373, p<0.001)와 양의 상관 관계가 있었지만, BMD 점수(R=-0.252, p=0.004)와는 음의 상관 관계를 보였다. 1년 후 추적관찰하여 확인한 결과에서 지방 침윤율은 추체 압박률(R=0.369, p<0.001) 및 콥스각(R=0.386, p<0.001)과 양의 상관 관계를 보였다. 요추 골절이 아래 분절로 내려 갈수록 추체 압박률(R=-0.191, p=0.030) 및 후만각(R=-0.428, p<0.001)은 감소하는 경향이 있었다. 결론: 급성 골다공증 요추 골절 환자에서 지방 침윤율은 보존적 치료를 위한 중요한 예측 인자가 될 수 있다. 지방 침윤율이 높은 환자의 예후는 환자 교육 과정에서 설명을 해야 하며 단기 외래 환자 후속 조치를 통해 환자를 면밀한 모니터링이 필요하다.

• Journal of Chest Surgery
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• 제13권4호
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• pp.321-337
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• 1980

The increasing use of cardioplegic solution for the reduction of ischemic tissue injury requires that all cardiplegic solution be carefully assessed for any protective or damaging properties. This study describes functional, enzymatic and structural assessment of the efficiency of three cardioplegic solutions (Young & GIK, Bretschneider, and $K^{+}$ Albumin solution) in a Modified Isolated Rat Heart Model of cardiopulmonary bypass and ischemic arrest. Isolated rat heart were subjected to a 2-minute period of coronary infusion with a cold cardioplegic or a noncardioplegic solution immediately before and also at the midpoint of a 60-minute period of hypothermic ($10{\pm}1$. C) ischemic cardiac arrest. The results of this study were as follow: 1. Spontaneous heart beat after ischemic arrest occured 16 seconds later after Langendorff reperfusion in the Young & GIK group (n=6), and 40 second later in the Bretschneider group (n=6) and 6 minute later in the $K^{+}$ Albumin group (n=6), and 16 minute later in the control group (non-cardioplegia). A good recovery state of spontaneous heart beat was shown in the Young & GIK and Bretschneider groups. 2. The percentage of recorveries of heart function at 30 minute after postischemic working heart perfusion were : heart rate $91.6{\pm}3.1$% (P<0.01)m oeaj airtuc oressyre $83{\pm}3$% (P<0.01), coronary flow $70{\pm}8$% (P<0.05) and aortic flow flow rate $39{\pm}9.3$% (P<0.05) in the Young & GIK group. This percentage of recoveries of the Young & GIK group was significantly greater than the control group. In the Bretschneider group, the percentage of recoveries were : heart rate $87.8{\pm}7.5$%(P<0.05), peak aortic pressure $71{\pm}2.3$% (P<0.05) and aortic flow rate $33.2{\pm}6.6$%(P<0.05). hte percentage of recoveries were significantly greater than in the control group. In the $K^{+}$ Albumin group, recoveries of heart function were poor. 3. Total CPK leakage was $131.2{\pm}12.75$IU/30 min/gm. dry weight in the control group, $50.65{\pm}12.75$IU in the Young & GIK gruop, $69.40{\pm}32.21$Iu in Bretschneider group, and $103.65{\pm}15.47$IU in the $K^{+}$ Albumin group during the 30 minute postischemic Langendorff reperfusion. Total CPK leakage was significantly less (P<0.001) in the Young & GIK group, than in the control group. 4. Direct correlatin between percentage recovery of aortic flow rate and total amount of CPK leakage from Myocardium was noticed.(Correlation Coefficient r = 0.76, P<0.001). 5. Mild perivascular edema was the only finding of light microscopic study of myocardium after 60 minute ischemic arrest with cold cardioplegic solutions and hypothermla.