• 대한간호학회지
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• 제31권1호
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• pp.31-42
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• 2001

This study was done to evaluate the effect reducing artificial dead space on intubated children. Data were collected from July 1st, 1998 to August 31st, 1999. The subjects were selected from a pediatric intensive care unit of 'S' hospital and intubated with 3.5 mm or 4.5 mm endotracheal tube after open heart surgery. They were composed of 34 patients : 17 patients were assigned to the experimental group and the rest of them were placed in the control group. The artificial airway volume was minimized in the experimental group, and the control group maintained the artificial airway volume. ETCO2, PaCO2, SPO2 were measured as indicators of pulmonary ventilation. The tools of this study were GEM-Premier and Space-Lab patient monitors. The data were analyzed using the SPSS/PC+ program. The $\chi$2 -test was used to find general characteristics. The t-test was used to test the homogenety of the pulmonary ventilation status and mechanical ventilation setting before intervention between the two groups. Also, the paired t-test was used to examine the hypothesis. The results can be summerized as : 1. CO2 can be expelled effectively from the body in case artificial dead space was decreased. 2. As the artificial dead space was reduced, the difference between ETCO2 and PaCO2 was decreased, in other words pulmonary ventilation was improved. 3. If the artificial dead space occupied above 15 percent of tidal volume, the effect of CO2 was retention revealed in the body. 4. If the artificial dead space occupied below effect. Based on the results, the following is suggested to be applied practically : 1. A kind of the ventilator circuit acting artificial dead space should be removed from the intubated children with mechanical ventilaion. 2. The endotracheal tube should not be cut because extra-body space of the endotracheal tube did not have an effect on the dead space of the intubated children. Since the researcher could not cover this aspect in the study, they recommend the following. 1. The study should be extended to the other pulmonary disease patients for the effect of improving pulmonary ventilation. 2. Also, further studying with a more narrow interval in the extra-body space of the artificial airway will be able to explain the point of artificial dead space with proper ventilation.

• 대한통합의학회지
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• 제9권4호
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• pp.271-281
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• 2021

Purpose : This study aimed to apply muscle relaxation exercise and ultrasound therapy as an effective treatment method for tension headache patients by comparatively analyzing the muscle mechanical properties, neck disorder index, and headache impact test. Method : The subjects were classified into three groups based on the intervention received: the therapeutic ultrasound (n=15, group I), placebo therapeutic ultrasound combined with the suboccipital release (n=15, group II), and therapeutic ultrasound combined with suboccipital release (n=15, group III) groups. The intragroup and intergroup differences in muscle mechanical properties, neck disability index, and headache impact test were compared and analyzed. Result : The comparison and analyses of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the suboccipitalis and upper trapezius in groups I and III. Furthermore, statistically significant intergroup differences in the upper trapezius with a greater change in group III than in group II and suboccipitalis with greater changes in group III than in groups I and II were observed. The comparison and analyses of the changes in muscle stiffness and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius in group I and suboccipitalis in group III. Moreover, statistically significant intergroup differences in both muscles with greater changes in group III than in group II for both cases were observed. The comparison and analyses of the changes in the neck disability index and post hoc analysis revealed statistically significant intragroup decreases in all three groups and statistically significant intergroup differences with greater changes in group III than in groups I and II. The comparison and analyses of the changes in the headache impact test and post hoc analysis revealed statistically significant intragroup decreases in all three groups and a statistically significant intergroup difference with greater changes in group III than in groups I and II. Conclusion : The therapeutic ultrasound and suboccipital muscle release exercise effectively increased the flexibility of the muscles around the cervical vertebrae and reduced muscle tension and stiffness in tension-type headache patients.

• 예술인문사회 융합 멀티미디어 논문지
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• 제7권9호
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• pp.289-296
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• 2017

분노는 심장질환, 가정폭력 등에 영향을 미치며 최근 분노를 조절하지 못해 발생한 각종 범죄에 대한 언론보도가 증가하고 있다. 분노는 심각한 사회문제와 사회적비용을 발생시키기 때문에 부적절한 분노대처문제 완화를 위한 적극적인 개입방법이 필요한 현실이다. 효과적 분노대처 개입의 대안 제시를 위해 인지정서행동 통합접근, 정신역학적 접근, 심리교육적 접근, 이완요법, 인지행동-예술치료기법, 스트레스 면역법 등 다양한 방법이 연구되고 활용되고 있다. 이러한 현실에서 정보통신 기술은 이를 위한 효과적인 수단으로 활용될 가능성이 있으며 관련 연구가 다양하게 진행되고 있다. 본 연구는 분노대처 능력을 향상시키기 위한 노력의 일환으로 ICT(Information & Communication Technology)기술을 활용한 분노대처 서비스기술의 개발을 목표로 하고 있다. 즉, 분노 상황을 인지하고 분노 대처를 보다 용이하게 할 수 있도록 위치기반 서비스를 제공하여 분노를 지연하고 주변을 환기시키는 기술개발을 목표로 하고 있다. 본 연구에서는 위치정보를 이용하여 분노 상황에 직접 개입하여 분노를 완화시키는 기술에 대한 것으로서 이를 위한 기반 기술에 대한 연구이다.

• Tuberculosis and Respiratory Diseases
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• 제45권4호
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• pp.813-822
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• 1998

연구배경: 압력보조환기로 이탈시 발판 시기는 최소보조압력수준에서 시행하는 것이 추천되고 있다. 그러나 임상에서는 압력보조환기법에 의한 이탈시 기관내 관의 발관을 최소압력보조법에 도달하였다고 판단되는 경우에서도 기관내 관의 재삽관 가능성을 줄이기 위하여 때로는 T-piece 시도를 1 시간 더한 뒤 기관내 관을 제거하는 방법도 시행되고 있다. 이는 환자의 호흡예비력을 좀더 확실하게 검증할 수 있는 장점이 있는 반면, 기관내 관 자체가 높은 기도 저항을 유발하므로 환자의 호흡 일이 증대되어 오히려 이탈이 지연될 가능성도 있다. 본 저자들은 최소압력보조치에서 1 시간 T-piece 추가가 이탈에 어떤 영향을 미치는지 알아보고자하였다. 연구방법: 1997년 5월부터 1998년 3월까지 서울중앙병원 내과계 중환자실에서 이탈을 시도한 44명을 대상으로 무작위 전향적 연구를 시행하였다. 이탈 대상이 되는 환자는 모두 압력보조환기방법으로 이탈을 진행하고 압력보조수준이 최소압력보조치에 이르면 환자를 무작위로 실험군 (1시간 T-piece 시도)과 대조군(즉시 발관)으로 나누었다. 연구결과: 전체 42회 이탈의 최소압력보조치는 7.6 [${\pm}1.9$, (4-13)] cm $H_2O$였다. 1. 환자들의 기저 상태 : 두 군간 환자들의 총 기계환기 시간, APACHE III 접수, 영양지표, 분당 호흡수, 얕은 숨지수, 호흡, 일 등에서 차이가 없었다. 2. 두 군간 성공률 및 호흡역학의 차이 : 실험군이 55%, 대조군이 70%로 즉시 발관한 군이 성공률이 높으나 통계학적 차이는 없었다 (p>0.05). 재삽관률도 실험군이 18%, 대조군이 20%로 두 군간 차이가 없었다. 실험군에서 1시간 T-piece 시도후 일회호흡 용적, 분당 호흡수, 얕은 숨지수, 호흡 일에서 악화된 소견을 보였으며(P<0.05), 특히 실험군내의 실패군에서는 일회호흡용적, 호흡 일, 압력시간곱의 악화가 심하였다 (P<0.05). 3. 성공군과 실패군 분석 : 전체 성공군에서 총 기계환기 시간이 유의있게 낮았고 ($246{\pm}195$ 시간 대 $407{\pm}248$ 시간, P<0.05), 일회호흡용적은 유의하게 높았다 ($0.43{\pm}0.11$ L 대 $0.35{\pm}0.10$ L). 결 론: 이상의 결과로서 최소압력보조치에서 1 시간 T-piece 추가는 환자의 호흡 일을 증가시키며 이탈 성공률에 있어 최소압력보조치에서 즉시 발관하는 방법에 비하여 차이가 없으므로 압력보조환기 양식으로 이탈을 시도할 때는 최소압력보조치에서 즉시 발관하는 것이 나을 것으로 사료된다.

• Earthquakes and Structures
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• 제1권1호
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• pp.109-127
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• 2010

This work aims at introducing structural sensitivity analysis capabilities into existing commercial finite element software codes for the purpose of mapping retrofit strategies for a broad group of structures including heritage-type buildings. More specifically, the first stage sensitivity analysis is implemented for the standard deterministic environment, followed by stochastic structural sensitivity analysis defined for the probabilistic environment in a subsequent, second phase. It is believed that this new generation of software that will be released by the industrial partner will address the needs of a rapidly developing specialty within the engineering design profession, namely commercial retrofit and rehabilitation activities. In congested urban areas, these activities are carried out in reference to a certain percentage of the contemporary building stock that can no longer be demolished to give room for new construction because of economical, historical or cultural reasons. Furthermore, such analysis tools are becoming essential in reference to a new generation of national codes that spell out in detail how retrofit strategies ought to be implemented. More specifically, our work focuses on identifying the minimum-cost intervention on a given structure undergoing retrofit. Finally, an additional factor that arises in earthquake-prone regions across the world is the random nature of seismic activity that further complicates the task of determining the dynamic overstress that is being induced in the building stock and the additional demands placed on the supporting structural system.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.106-112
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• 2016

Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

• Journal of Korean Neurosurgical Society
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• 제63권1호
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• pp.14-25
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• 2020

Proximal flow control achieved with a balloon guide catheter (BGC) during endovascular treatment of acute ischemic stroke is reviewed in this article. In clinical practice, BGCs offer a multi-faceted approach for clot retrieval by creating proximal flow arrest, reducing embolic burden, and shortening procedure time. Evaluation of frontline thrombectomy procedures with BGCs revealed advantages of combined use over the conventional guide catheter (CGC), notably in the significant reduction of distal emboli to both the affected and previously unaffected territories. Recently, new measures of early and complete reperfusion at first thrombectomy pass have been identified as independent predictors of improved outcomes, which were consistently demonstrated with use of BGC as a safe and effective option to minimize number of passes during intervention. Prior randomized controlled trials reported the positive correlation between BGC-treated patients and a lower risk of mortality as well as shortened procedure time. While BGC use is more common in stent retriever-mediated mechanical thrombectomy, preliminary data has shown the potential benefit of device application during contact aspiration thrombectomy to achieve successful recanalization. However, the question of which major endovascular strategy reigns superior as a frontline remains to be answered. Along with clinical case assessments, BGC performance during in-vitro simulation was analyzed to further understand mechanisms for optimization of thrombectomy technique.

• 임상간호연구
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• 제22권2호
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• pp.118-131
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• 2016

Purpose: This study was conducted to develop a useful evidence-based guideline for preventing venous thromboembolism(VTE) in Korea adapting previously developed VTE guidelines. Methods: The guideline adaptation process was performed using 24 steps according to the nursing practice guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed VTE prevention guideline was consisted of 16 domains and 163 recommendations. The number of recommendations in each domain were: 4 general issues, 4 risk factors, 2 intervention at occurrence of VTE, 14 mechanical interventions, 30 pharmacological interventions, 19 VTE prevention for medical patient, 10 stroke patient, 16 cancer patient, 14 pregnancy, 6 for long distance traveller, 5 for abdominal surgery, 10 thoractic surgery, 10 orthopedic surgery, 5 neurosurgery, 4 other surgical patient, 2 urological surgery, 1 ENT surgery, 1 plastic surgery, 3 day surgery, 3 education of VTE prevention. Fourteen point three percent, 61.1%, and 24.6% of the recommendations were graded A, B, and C, respectively. Conclusion: The findings suggest that the new VTE prevention guideline can be more efficiently used to prevent VTE in hospital settings.

• 한국지능시스템학회논문지
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• 제18권5호
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• pp.599-604
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• 2008

최근 외부 개입 없이 스스로 주변 환경을 파악하고 목적지까지의 이동경로를 생성하여 자율 주행하는 지능형 시스템에 관한 연구가 활발히 진행되고 있다. 이러한 자율 주행 시스템은 기본적으로 운행 중에 사고가 발생하지 않고 안전하게 목표점까지 이동해야 한다. 본 논문에서는 레이저 변위 센서를 이용하여 노면의 왜곡(훼손된 노면, 비포장 도로, 장애물 등)을 검출하고, 영상 이진화 기법을 적용하여 위험 요소를 검출, 판단하여 주행 시스템의 안정적 운항이 가능한 경로를 생성하는 기법을 제안한다. 제안 기법의 타당성은 임의로 제작된 국부영역의 지도 데이터에 기반한 모의실험을 통하여 보인다.

• 한국전문물리치료학회지
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• 제17권1호
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• pp.53-61
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• 2010

This study investigated the relationships between Work-related musculoskeletal disorders (WMSDs), contributing factors, and the occupational stress of physical therapists. Self-reported questionnaires were given to 180 physical therapists in Gangwon Province. Variables examined included the prevalence of pain sites related to WMSDs; pain intensity; pain pattern; and job stress, which is thought to involve the physical environment; job demand; insufficient job control; interpersonal conflict; job insecurity; organizational system; reward system; and occupational culture. Among physical therapists, work-related musculoskeletal pain commonly affected the low back (30.1%), shoulder (29.3%), and wrist (12.2%). The sites of work-related musculoskeletal pain treated medically were the low back (22.8%), shoulder (19.8%), neck (12.7%), and wrist (12.1%). "Repeating the same work constantly" was suggested to be the major cause of the pain. The younger therapists were significantly more likely to feel high job stress due to the physical environment (p<.05), job demand (p<.05), and organizational system (p<.01). Women were more likely to feel greater job stress related to job demand, insufficient job control, the organization system, and job rewards. Men were more likely to feel greater job stress related to job insecurity. Weak positive relationships were observed between work-related musculoskeletal pain and job stress, which is thought to involve the physical environment; job demand; insufficient job control; interpersonal conflict; job insecurity; organizational system; reward system; and occupational culture. Physical therapists appear to be at higher risk of WMSDs because 80.1% of the physical therapists studied experienced work-related musculoskeletal pain. To reduce the risk, we need intervention strategies such as preventive education, ergonomically designed medical equipment, a psychosocial approach to work conditions, improved mechanical conditions related to therapeutic patterns, and an institutional infrastructure with sufficient personnel and scheduling.