• 제목/요약/키워드: Lung sound

검색결과 53건 처리시간 0.031초

고양이 심근비대증에 병발한 안장색전증의 중재치료 증례 (Interventional Approaches for Treatment of Saddle Embolus in Two Cats with Hypertrophic Cardiomyopathy)

  • 강민희;박희명
    • 한국임상수의학회지
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    • 제31권4호
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    • pp.298-302
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    • 2014
  • 8년령의 중성화된 잡종 수컷 고양이 (증례 1)와 3년령의 중성화된 샴 수컷 고양이 (증례 2)가 뒷다리 마비, 지속적인 개구호흡, 그리고 객혈 등을 주증으로 내원하였다. 심잡음 (증례 1)과 분마성심음 (증례 2)이 좌측 심저부에서 청진되었으며, 방사선 검사상 증례 1의 경우 폐포패턴을 동반한 심한 공기연하증이, 증례 2에서는 확연한 심비대가 확인되었다. 심초음파 검사에서 두 마리 고양이 모두에서 좌심실과 심실중격의 구심성 비대와 좌심방의 확장이 확인되었다. 심장 초음파를 포함한 검사를 바탕으로 본 환축은 고양이 심근비대증으로 진단되었으며, 신체검사와 복부 초음파 검사를 통하여 병발한 안장색전증을 확인하였다. 일반적인 치료를 통한 환축의 예후가 불량한 점을 감안하여, 직접적인 혈관내 혈전용해술이 시도되었다. 혈관조영술을 통하여 혈전의 위치와 크기를 확인 할 수 있었으나, 광범위한 색전증으로 인하여 중재적 시술을 이용한 혈전용해는 성공적이지 못했다.

Relevance of Dental Health Capacity and Pulmonary Function Status in Adults

  • Song, Kwui-Sook;Ryu, Da-Young;Kim, In-Ja
    • 치위생과학회지
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    • 제17권5호
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    • pp.454-461
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    • 2017
  • The purpose of this study was to confirm the relevance of dental health capacity and pulmonary function status. The subjects of this study were adults aged 40 years and older, who participated in pulmonary function and oral examinations. The data used for this study were raw data from the sixth Korea National Health and Nutrition Examination Survey (2013~2015). Statistical analysis was performed by analysis of complex sample survey data. The results were as follows: First, restrictive and obstructive patterns were more prevalent among males than females. They were even worse in older subjects. Approximately 67% of smokers had obstructive pattern. Second, there was a relevance between dental health capacity and pulmonary function status. The functioning teeth index, number of present teeth, and number of sound teeth (ST), which are indicators of dental health, declined with decreased pulmonary function. The number of missing teeth (MT) increased as the pulmonary function deteriorated (p<0.05). Third, the relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience was statistically significant in the tissue health (T-health) index and ST among non-smokers. The relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience was statistically significant (p<0.05) for the T-health index, ST, and MT among smokers. However, there was no relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience and adjusting confounding variables. In conclusion, there was a relevance between dental health capacity and pulmonary function status after confounding variables were adjusted. However, there was no relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience and adjusting confounding variables.

건강문제에 관한 의견조사 -우리나라 학부모의 인식도를 중심으로- (Health Concern Survey of Parents of School Children)

  • 김명호;백종현;이경자
    • Journal of Preventive Medicine and Public Health
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    • 제19권1호
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    • pp.100-122
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    • 1986
  • Obtaining an available information on health concerns of parents of school-age children and furthermore developing the sound policy for the public on health education, this study was conducted during Nov.-Dec. 1985 in the four selected areas; Seoul, large, middle and small city, and farming and fishery villages for 3,337 parents of schoolchildren in Korea. In this study, parents complected a questionnaire containing 34 items related to health concerns(e.g. drinking alcohol, air pollution, cancer, etc. see Table 4 and Fig. 2). For each health items, respondents were asked to indicate a choice between three levels of concern; 'Very high concern,' 'Moderate concern,' 'Little concern', and 'No opinion'. An analysis of responses indicated that most of the top ten health concerns identified by parents as cancer, abortions among high school students, medical malpractice, water pollution, traffic accidents, air pollution, suicide of parents and homicide of offspring, heart disease, venereal diseases, and high blood pressure in that order. Those health problems about which respondents were least concerned were more closely related to the individual, such as drinking alcohol, smoking, tooth decay, gum disease, underweight, overweight. Of greater concern were more such as water pollution, abortions among high school students, air pollution, accidents, medical malpractice. For cancer, heart disease, high blood pressure, various accidents, environmental pollution, parents showed high concern, however, for health issues which contributed as causative influences such as lung cancer from smoking and liver cirrhosis and traffic accidents from drinking alcohol showed less concern. Relationship between parent's residential areas, educational level and sex distribution and health concern showed little difference, however, for these issues parents identified as relatively high concern. Most parents stowed more concern in sex-related of family-related health issues such as abortions among high school students, suicide of parents and homicide of offspring.

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구개열 환자의 비인강폐쇄 기능에 대한 공기역학적 연구 (An Aerodynamic Study of Velopharyngeal Closure Function in Cleft Palate Patients)

  • 안태섭;양상일;신효근
    • 음성과학
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    • 제1권
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    • pp.237-259
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    • 1997
  • Cleft Palate speech appears to have hyper/hyponasality with velopharyngeal insufficiency and articulation disorders. Previous studies on Cleft Palate speech have shown that speech tends to have lower airflow and air pressure. To examine the aerodynamic characteristics of Cleft Palate speech, Aerophone II Voice function Analyzer was used. We measured sound pressure level, airflow, air pressure and glottal power. Three Cleft Palate adults and five normal adults participated in this experiment. The test words are composed of: (1) the sustained vowel /o/ (2) /CiCi/, where C is one of three different stop consonants in Korean (3) /bimi/. Subjects were asked to produce /bimi/ five times without opening their lips. All the data was statistically tested by t-test for Cleft Palate patients before operation groups and control groups and paired t-test for Cleft Palate patients before and after operation groups. The results were as follow: (1) Cleft Palate patients generally speak with incomplete oral closure and lower oral air pressure. As a result, the SPL of Cleft Palate before operation is 3 dB lower than control groups. (2) Airflow of Cleft Palate in phonation and articulation is lower than that of control groups. However, it increased after operation. Lung volume and mean airflow in phonation are significantly increased (p<0.05). (3) Although velopharyngeal function (velar opening rate) of Cleft Palate is poor in comparison with control groups, it was recovered after operation. In this event maximum flow rate and mean airflow rate are significantly increased (p<0.05). (4) Air pressure of Cleft Palate in speech is lower than that of control groups. In general, the air pressure of Cleft Palate increased after operation. In this event air pressure of glottalized consonant is significantly increased (p<0.04). (5) Glottal Power(mean power, mean efficient and mean resistant) of Cleft Palate patients is lower than that of control groups. But mean efficient and mean resistant of Cleft Palate patients increased significantly (p<0.05) after operation.

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복부수술 환자의 조기운동에 대한 외과병동 간호사의 중요도-수행도 분석 (Importance-Performance Analysis about Early Mobilization after Abdominal Surgery Patients in Surgical Ward Nurses)

  • 김보은;최혜란
    • 디지털융복합연구
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    • 제19권12호
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    • pp.567-575
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    • 2021
  • 본 연구는 중요도-수행도 분석을 통해 복부수술 환자의 조기운동에 대한 외과병동 간호사의 중요도 인식 및 수행 정도를 확인하기 위함이다. 연구대상은 외과병동에서 근무하는 간호사 162명을 대상으로 자가보고 설문지를 이용하여 2021년 3월 8일부터 22일까지 자료를 수집하였다. 수집된 자료는 SPSS/WIN 25.0를 이용하여 기술통계, independent t-test, paired t-test, one-way ANOVA로 분석하였으며 중요도와 수행도는 IPA분석 기법을 사용하였다. 조기운동은 폐합병증 예방운동과 조기이상으로 구분하였다. 연구결과, 집중이 필요한 영역은 흡인위험성 확인, 개선이 필요한 영역은 구강간호, 호흡음 청진, 진동/타진, 필요시 흡인, 강화운동 영역이었다. 따라서 임상에서 조기운동의 중요도 및 수행도의 격차를 줄일 수 있는 방안을 마련하여야 하겠다.

성문상부암종에서 성문상 후두부분절제술과 경부청소술의 치료성적 (Treatment Outcome of Supraglottic Partial Laryngectomy and Neck Dissection for Supraglottic Carcinoma)

  • 태경;민현정;송미나;신광수;이승환;김경래;이형석
    • 대한두경부종양학회지
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    • 제23권1호
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    • pp.15-20
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    • 2007
  • Background and Objectives:Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods:Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results:Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions:Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.

어린이집 실내·외 석면노출 가능성 조사에 관한 연구 (A Survey on Asbestos Exposure Possibility in Indoor and Outdoor Environments of Childcare Centers)

  • 박화미;손병훈
    • 한국산업보건학회지
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    • 제24권2호
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    • pp.122-129
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    • 2014
  • Objectives: Because of its properties such as resistance to heat, chemicals and corrosion; tensile strength; sound absorption; and affordable price, asbestos has been widely used as a building material, fire resistant and retardant, thermal and heat insulator, soundproofing material, and electrical insulation. Since the prolonged inhalation of asbestos can cause serious illnesses such as lung cancer, mesothelioma, and asbestosis after an incubation period of 20 to 40 years, the mineral was classified as a Group 1 carcinogen by the International Agency for Research on Cancer, an intergovernmental agency forming part of the World Health Organization. Children and infants are more at risk than are adults if they are exposed to carcinogens, due to aweaker immunity that has not yet been fully developed. Most childcare centers are operated all day and children tend to spend a great amount of time in the centers. This is why it is important for them to be systematically isolated from environments that may expose them to asbestos. Materials: In order to understand both indoor and outdoor hazards to which children may have been exposed, the study focused on actual surveys of asbestos used in childcare centers, paying special attention to slate-roofed buildings in the vicinity of the centers. Results: A survey of a total of 211 childcare centers showed that the buildings of 18.1% of the centers contained asbestos, with 60.53% of the material being found in classroom ceilings. "Tex" was the most used material for ceilings, making up 89.47% of all ceilings. An outdoor survey showed that childcare centers in Daegu Metropolitan City had an average of 143 slate-roof buildings within a distance of 1km. Conclusions: Buildings housing mainly toddlers, children, teenagers and others more vulnerable to the toxicity of asbestos are not subject to asbestos investigation by law. A legal and practical basis for asbestos control is required for such buildings. In particular, housing materials which contain asbestos in day care centers require asbestos control. GIS should be used to identify the location of buildings with slate roofing materials in the vicinity of daycare centers in order to gauge toxicity of exposure to asbestos caused by potential asbestos friability possibility in outdoor conditions.

동맥관 개존증의 임상적 고찰 (A retrospective clinical study of isolated patent ductus arteriosus)

  • 곽영태
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.593-606
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    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

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폐렴간균 폐렴에 의해 유발된 상대정맥 증후군 1예 (A Case of Superior Vena Cava Syndrome Caused by Klebsiella Pneumonia)

  • 김주영;임채만;김선희;추윤호;고윤석;김우성;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제41권1호
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    • pp.58-62
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    • 1994
  • 저자들은 폐렴간균 폐렴에 의한 우상엽의 용적 증가로 인하여 유발된 상대정맥 증후군 1예를 임상 경험한후 medline검색상 SVCS의 유발 원인으로서 폐렴간균 폐렴은 최초의 증례로 사료되므로 이에 보고하는 바이다.

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호흡기능장애와 관련된 간호진단의 타당도 조사 (Validity of Nursing Diagnoses Related to Difficulty in Respiratory Function)

  • 김조자;이원희;유지수;허혜경;김창희;홍성경
    • 대한간호학회지
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    • 제23권4호
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    • pp.569-584
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    • 1993
  • This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC+ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

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