• 제목/요약/키워드: Patient Related Management

검색결과 728건 처리시간 0.027초

급성신우신염으로 입원 후 지속적인 고칼륨혈증과 정상 혈중 알도스테론 수치를 보인 25일 영아 1례 (Management of a 25-day-old Male Presenting with a First Episode of Acute Pyelonephritis, and Persistent Hyperkalemia with Normal Serum Aldosterone)

  • 강유선;최지연;이준호
    • Childhood Kidney Diseases
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    • 제18권2호
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    • pp.111-115
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    • 2014
  • 요로기형 또는 급성신우신염이 있는 어린 영아에서 신세뇨관 기능 미성숙이나 일과성 가성저알도스테론혈증에 의해 고칼륨혈증이 흔하지 않게 발생할 수 있다. 고칼륨혈증은 증세가 뚜렷하지 않지만, 골격근이나 심장기능에 치명적인 영향을 줄 수 있어 즉각적인 처치를 필요로 한다. 고칼륨혈증 치료에 fludrocortisone을 적용하는 경우는 저알도 스테론혈증에 해당하였으나, 혈중 알도스테론농도 변화없이 세뇨관의 칼륨 배설 기능 미성숙에 의한 고칼륨혈증에 대한 사례는 문헌고찰상 없었다. 본 증례에서는 급성신우신염으로 입원한 후 지속적인 고칼륨혈증과 정상 혈중알도 스테론농도를 보인 25일 영아에서 fludrocortisone로 처치한 후 양호한 경과가 관찰되어 보고하는 바이다.

하악전돌증 환자의 하악지시상분할골절단술 후 단안모화 경향과 그 결정인자에 대한 분석 (ANALYSIS OF SHORT FACE TENDENCY AND IT'S DETERMINANT FACTORS AFTER BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY OF MANDIBULAR PROGNATHISM)

  • 강지연;최희원;김경원
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권6호
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    • pp.407-420
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    • 2003
  • Purpose : The purpose of this study was to analyse the facial changes and factors contributing to then after bilateral sagittal split ramus osteotomy of mandibular prognathism. Materials and Methods : Forty patients with Class III dental and skeletal malocclusion who were treated with bilateral sagittal split ramus osteotomy were reviewed. Frontal and lateral cephalometric radiographs were taken preoperatively, immediate postoperatively and more than six months postoperatively in each patient. After tracing the cephalometric radiographs, various parameters were measured. Results : 1. Gonial angle at postoperative two days was decreased about $10.4^{\circ}$ than preoperatively and gonial angle at postoperative six months was increased about $6.8^{\circ}$ than postoperative two days. So, gonial angle at postoperative six months was decreased about $3.6^{\circ}$ than preoperative gonial angle. 2. Facial height postoperative two days was decreased about 0.8mm than preoperatively and facial height at postoperative six months was decreased about 0.7mm than postoperative two days. So, facial height at postoperative six months was decreased about 1.5mm than preoperative facial height. 3. Mandibular width postoperative two days was decreased about 1.0mm than preoperatively and mandibular width at postoperative six months was increased about 1.8mm than postoperative two days. So, mandibular width at postoperative six months was decreased about 2.8mm than preoperative mandibular width. 4. Amount of set back and mandibular plane angle were not influencing on relapse degree. Conclusion : It is thought that bilateral sagittal split ramus osteotomy in mandibular prognathic patients is effective to improve long face and steep gonial angle. More prudent operation and careful postoperative management is required to maintain stable face postoperatively. Further research for soft tissue changes and factors which are related with relapse is needed.

경추부 장애와 신경근 조절 활동 변화와의 관련성에 대한 고찰 (Literature Review on the Association Between a Cervical Dysfunction and the Change of Neuromuscular Control Activity)

  • 김선엽;이혜정
    • 대한정형도수물리치료학회지
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    • 제12권1호
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    • pp.57-67
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    • 2006
  • Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

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U-Healthcare 및 의료정보시스템의 현황과 통합의료정보시스템을 위한 운영과제 (U-Healthcare & Medical Information System of Status and Operative Challenges for Integrated Medical Information System)

  • 김보수
    • 디지털융복합연구
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    • 제9권5호
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    • pp.65-75
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    • 2011
  • 최근의 정보통신기술은 관련기술과의 융합으로 모든 시스템을 통합하는 형태로 발전하고 있다. 이런 시대의 흐름과 마찬가지로 의료산업은 근래에 많은 발전 및 응용에 관한 연구가 활발히 진행되고 있다. 의료정보시스템도 의료IT의 정보시스템들이 통합되는 방향으로 급변하게 진화해가고 있으며, 앞으로도 그 가속도는 더 할 전망이다. 따라서 본 논문에서는 국가 주도의 유비쿼터스 환경의 구축을 위한 병원 응용시스템 구축과 IT응용 서비스가 실용화하고 있는 실정에서 통합의료 정보를 위한 환자 진료의 서비스 강화를 도모하도록 통합의료정보시스템을 제안 및 설계하는 것과 동시에 통합의료정보시스템의 구축방안과 운영과제를 제시하였다.

Discomfort Analysis in Computerized Numeric Control Machine Operations

  • Muthukumar, Krishnamoorthy;Sankaranarayanasamy, Krishnasamy;Ganguli, Anindya Kumar
    • Safety and Health at Work
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    • 제3권2호
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    • pp.146-153
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    • 2012
  • Objectives: The introduction of computerized numeric control (CNC) technology in manufacturing industries has revolutionized the production process, but there are some health and safety problems associated with these machines. The present study aimed to investigate the extent of postural discomfort in CNC machine operators, and the relationship of this discomfort to the display and control panel height, with a view to validate the anthropometric recommendation for the location of the display and control panel in CNC machines. Methods: The postural discomforts associated with CNC machines were studied in 122 male operators using Corlett and Bishop's body part discomfort mapping, subject information, and discomfort level at various time intervals from starting to end of a shift. This information was collected using a questionnaire. Statistical analysis was carried out using ANOVA. Results: Neck discomfort due to the positioning of the machine displays, and shoulder and arm discomfort due to the positioning of controls were identified as common health issues in the operators of these machines. The study revealed that 45.9% of machine operators reported discomfort in the lower back, 41.8% in the neck, 22.1% in the upper-back, 53.3% in the shoulder and arm, and 21.3% of the operators reported discomfort in the leg. Conclusion: Discomfort increased with the progress of the day and was highest at the end of a shift; subject age had no effect on patient tendency to experience discomfort levels.

부식제에 의한 상부 위장관 손상의 임상양상과 위험인자 (The Clinical Characteristics and Risk Factors of Upper Digestive Lesions that are due to Ingestion of Caustic Material)

  • 김영신;최세민;김형민;윤준성;박규남
    • 대한임상독성학회지
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    • 제7권2호
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    • pp.113-120
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    • 2009
  • Purpose: Though caustic injury of the upper digestive tract can lead to severe sequelae, there are few clinical studies on this subject. This study was undertaken to evaluate the clinical characteristics, the endoscopic findings and the risk factors of the upper digestive lesions in patient with caustic ingestion injury. Methods: We retrospectively reviewed the medical records of 137 patients who ingested caustic materials and who visited to our emergency room from January, 2000 to June, 2009. Results: The most common ingested agent was sodium hypochlorite (44.5%), followed by acetic acid (19.7%), hydrochloric acid (11.7%) and lye (8.0%). Ingestion for suicidal attempt (62.0%) was more frequent than accidental ingestion (30.7%). Grade IIa injury was the most frequent finding on endoscopy of the esophagus and Grade 1 injury was the most frequent finding on endoscopy of the stomach. For the late sequelae, there were 9 cases (6.6%) of esophageal stricture and 2 cases (1.5%) of gastric outlet obstruction. The initial signs and symptoms did not correlate with the development of stricture, but leukocytosis, and grade III injury were related to the risk of developing stricture. Conclusion: Caustic injury of the upper gastrointestinal tract is frequently observed on early endoscopy and it can cause significant late sequelae such as stricture. Therefore, it is necessary to evaluate these patients with regular follow up endoscopic examinations for the management of late sequelae.

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지연 응답 모델에 기반한 성능 개선 진료정보 교류 프레임워크의 설계 (A Design of Clinical Information Exchange Framework for Performance Improvement based on Lazy Response Model)

  • 이세훈;심우호
    • 한국컴퓨터정보학회논문지
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    • 제17권9호
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    • pp.157-164
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    • 2012
  • 최근 의료서비스 환경에서 진료정보 교류는 의료의 안정성 및 질 증대, 진료업무 효율성 향상, 의료기관 운영 효율성, 환자의 편의성 증대를 가져올 수 있는 필수 의료 서비스 모델이다. 하지만 의료기관별 정보화 수준이 다양하고, 표준화된 시스템이 마련되어 있지 않으며, 기관별로 서로 상이한 정보시스템이 구축되어 있어 실질적인 진료정보 교류가 어려운 상황이다. 이 논문에서는 국내 법제도 안에서 진료정보 교류를 활성화 하기위해 관련 기술표준 및 진료정보 교류 모델에 대해 분석하였고 이중 가장 이상적인 지연 응답 모델을 기반으로 보다 나은 성능 개선을 위하여 진료정보 교류 프레임워크를 설계하였다. 성능 개선 진료정보 교류 프레임워크는 진료정보 교류 시 메타데이터 플로우와 실제 CDA 문서 플로우를 구분하여 기존 지연 응답 모델 기반 시스템과의 성능 비교 실험 결과 약 24%의 성능 향상을 얻었다.

A Study on Functional Movement Screen and Automobile Worker's Musculoskeletal Disorders

  • Shin, Eulsu;Kim, Yuchang
    • 대한인간공학회지
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    • 제35권3호
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    • pp.125-133
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    • 2016
  • Objective: The aim of this study is to figure out the level of Functional Movement Screen (FMS) of 122 automobile manufacturing workers and to set the FMS score for predicting risk of musculoskeletal disorders. Background: Although today's industrial sites have been becoming automated rapidly, the risks of work-related musculoskeletal disorders (WMSDs) have been on the rise. In the case of WMSDs, it is important to control WMSDs at the early stage. Early detection of WMSDs is very important for the successful treatment. However, the medical examination puts a great financial burden on most workers. To reduce their burden, there is one test to check the musculoskeletal functional condition and to predict the risk of injury, which is called FMS. Method: This research tested the FMS score of 122 workers at a motor company, and also conducted a questionnaire survey of individual characteristics and job characteristics. Results: For the 122 subjects, the average score of FMS is $14.63{\pm}2.27$. There is a negative correlation between FMS and their ages and BMI (p <0.05). FMS is higher when exercising regularly (p <0.05). The FMS scores of musculoskeletal disorder patients are lower than those of normal workers (p <0.05). While it is more likely to become a musculoskeletal disorder patient when FMS score is less than 14, it is more likely to become a normal worker when FMS score is more than or equal to 14. Conclusion: According to the result of FMS test, there is a score difference between individuals with musculoskeletal disorders and normal ones. FMS scores can also predict and identify workers with risk of the musculoskeletal disorders. Application: According to this study, FMS can be expected to have a positive effect on the prevention of WMSDs in worksites.

심부전 환자의 자가간호 증진을 위한 심장일지의 개발 및 효과 (Development and Effects of a Heart Health Diary for Self-Care Enhancement of Patients with Heart Failure)

  • 심재란;황선영
    • 대한간호학회지
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    • 제46권6호
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    • pp.881-893
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    • 2016
  • Purpose: The purpose of this study was to develop a heart health diary to promote self-care ability among patients with heart failure (HF), and to identify the diary's effect on self-care adherence, self-efficacy, and physical activity. Methods: A randomized control-group pretest-posttest design was adopted using block randomization. A calender-typed health diary was developed and it included a self-care checklist and education information on HF management. The experimental group were given guided counseling and education for 8 weeks and wrote a daily health diary during that period. Data were collected from the outpatient department of a tertiary medical center from February to April 2016. To verify the hypotheses, data for the experimental group (n=28) and control group (n=33) were analysed using the independent t-test with SPSS/WIN 21.0. Results: At the end of 8 weeks the experimental group had significantly higher scores for self-care adherence (t=-2.48, p =.016) and exercise related self-efficacy (t=-3.44, p =.001) compared to the control group. Conclusion: The findings show that the application of a patient-directed heart health diary is an effective nursing intervention for improving HF patients' self-care adherence and exercise self-efficacy. Strategies to promote dietary self-efficacy are necessary along with further studies including repeated research with an increasing intervention period. Healthcare providers need to encourage the utilization of a health diary for HF patients as a tool for evaluation and for implementation that leads to self-care.

텍스트네트워크분석을 활용한 국내·외 호스피스 간호 연구 주제의 비교 분석 (A Comparison of Hospice Care Research Topics between Korea and Other Countries Using Text Network Analysis)

  • 박은준;김영지;박찬숙
    • 대한간호학회지
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    • 제47권5호
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    • pp.600-612
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    • 2017
  • Purpose: This study aimed to identify and compare hospice care research topics between Korean and international nursing studies using text network analysis. Methods: The study was conducted in four steps: 1) collecting abstracts of relevant journal articles, 2) extracting and cleaning keywords (semantic morphemes) from the abstracts, 3) developing co-occurrence matrices and text-networks of keywords, and 4) analyzing network-related measures including degree centrality, closeness centrality, betweenness centrality, and clustering using the NetMiner program. Abstracts from 347 Korean and 1,926 international studies for the period of 1998-2016 were analyzed. Results: Between Korean and international studies, six of the most important core keywords-"hospice," "patient," "death," "RNs," "care," and "family"-were common, whereas "cancer" from Korean studies and "palliative care" from international studies ranked more highly. Keywords such as "attitude," "spirituality," "life," "effect," and "meaning" for Korean studies and "communication," "treatment," "USA," and "doctor" for international studies uniquely emerged as core keywords in recent studies (2011~2016). Five subtopic groups each were identified from Korean and international studies. Two common subtopics were "hospice palliative care and volunteers" and "cancer patients." Conclusion: For a better quality of hospice care in Korea, it is recommended that nursing researchers focus on study topics of patients with non-cancer disease, children and family, communication, and pain and symptom management.