• 제목/요약/키워드: Physiologic factors

검색결과 107건 처리시간 0.032초

기계환기기 이탈의 성공과 관련된 생리적${\cdot}$심리적 요인에 관한 조사 연구 (A Study on the Physiological and Psychological Factors related to Successful Weaning from a Mechanical Ventilator)

  • 김조자;김화순;장연수;김은성
    • 대한간호학회지
    • /
    • 제30권4호
    • /
    • pp.995-1005
    • /
    • 2000
  • This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

  • PDF

전기 Glottography(EGG)를 이용한 후두구음역학적 특성 (The Role of the Electroglottography on the Laryngeal Articulation of Speech)

  • 홍기환;박병암;양윤수;서수영;김현기
    • 대한후두음성언어의학회지
    • /
    • 제8권1호
    • /
    • pp.18-26
    • /
    • 1997
  • There are two types of phonetic study, acoustic and physiologic, for differentiating the three manner categories of Korean stop consonants. On the physiologic studies, there are endoscopic, electromyographic(EMG), electroglottographic(EGG) and aerodynamic studies. In this study, I tried to investigate general features of Korean stops using EGG study for the open quotient of vocal fold and baseline shift during speech, and aerodynamic characteristics for e subglottal air pressure, air flow and glottal resistance at consonants. On the aerodynamic study, the glottalized and aspirated stops may be characterized by e increasing subglottal pressure comparing with lenis stop at consonants. The airflow is largest in the aspirated stops followed by lenis stops and glottalized. The glottal airway resistance (GAR) showed highest in the glottalized followed by the lenis, but lowest in e aspirated during e production of consonants, and showed highest in e aspirated, but low in the glottalized and lenis during the production of vowel. The glottal resistance at consonant showed significant difference among consonants and significant interaction between subject and types of consonant. The glottal resistance at vowel showed significant difference among consonants, and e interaction occured between subject and types of consonant. The electroglottography(EGG) has been used for investigating e functioning of e vocal folds during its vibration. The EGG should be related to the patterns of the vocal fold vibration during phonation in characterizing the temporal patterns of each vibratory cycle. The purpose of this study is to investigate the dynamic change of EGG waveforms during continuous speech. The dynamic changes of EGG waveforms fir the three-way distinction of Korean stops were characterized that the aspirated stop appears to be characterized by largest open quotient and smallest glottal contact area of the vocal folds in e initial portion of vocal fold vibration ; the lenis stop by moderate open quotient and glottal contact area ; but the glottalized stop by smallest open quotient and largest glottal contact area. There may be close relationship between the OQ(open quotient) in the initial voice onset and the glottal width at the time of consonant production, the larger glottal width just before vocal fold vibration results in the smaller OQ of the vocal fold vibration in the initial voice onset. The EGG changes of baseline shift during continuous speech production were characterized by the different patterns for the three types of Korean consonants. The small and less stiffness change of baseline shift was found for the lenis and the glottalized, and the largest and stiffest change was found for the aspirated. On the baseline shift for the initial voice onset, they showed so similar patterns with for the consonant production, larger changed in the aspirated. for the lenis and the glottalized during the initial voice onset, three subjects showed individual difference each other. I suggest at s characteristics were strongly related with articulatory activity of vocal tract for the production of consonant, especially for the aspirated stop. The suspecting factors to affect EGG waveforms are glottal width, vertical laryngeal movement and the intrapharyngeal pressure to neighboring tissue during connected spech. So the EGG may be an useful method to describe laryngeal activity to classify pulsing conditions of the larynx during speech production, and EGG research can be controls for monitoring the vocal tract articulation, although above factors to affect EGG would have played such a potentially role on vocal fold vibratory behavior obtained using consonant production.

  • PDF

건강검진행사에 참여한 노인의 생리적 건강상태 및 건강증진생활양식 (Physiologic Health Status and Health Promotion in Older Adults)

  • 강희선;박연환
    • 한국노년학
    • /
    • 제25권2호
    • /
    • pp.95-108
    • /
    • 2005
  • 본 연구의 목적은 건강검진에 참여한 노인들의 생리적 건강상태와 건강증진생활양식 정도를 확인하고 건강증진생활양식에 영향을 미치는 특성을 파악하여 향후 노인대상 건강검진 사업과 노인의 건강증진을 도모할 수 있는 중재프로그램 개발의 기초 자료로 활용하고자 함이다. 자료수집은 서울 소재 일 지하철역에서 임의표출된 60세 이상의 노인 209명을 대상으로 혈압과 혈당 측정 및 구조화된 설문지를 이용하여 이루어졌다. 연구대상 노인들은 평균 67세로 스스로 건강하다고 지각하는 경우가 39.2%이며, 71.3%가 평소에 운동을 하고 있었고, 71.8%가 평소 자신의 혈압을 알고 있었다. 노인의 44.0%가 고혈압이나 저혈압 등 혈압이상 위험 군에 속하였고, 혈당은 126mg/dl 이상인 노인이 44.5%, 200mg/dl 이상인 노인이 3.8%이었다. 노인의 건강증진생활양식 수행정도는 4점 만점에 2.75 점이었고, 6개의 하부영역 중 대인관계 영역이 3.01 점으로 가장 높았고, 영양, 스트레스 관리, 영적 성장, 신체 활동, 건강책임 영역의 순으로 낮았다. 건강증진생활양식은 운동과 평소 자신의 혈압에 대한 지식여부에 따라 차이가 있었고, 건강증진생활양식 하부영역별 차이는 다음과 같았다. 신체활동 영역은 노인의 성별, 운동, 월수입, 혈압이상; 영양 영역은 평소 자신의 혈압에 대한 지식과 혈당체크 경험; 건강책임 영역은 평소 자신의 혈압에 대한 지식, 혈당 이상; 대인관계 영역은 성별, 종교, 혈당체크경험; 영적성장 영역은 지각된 건강상태, 월수입; 그리고 스트레스관리 영역은 성별, 흡연 여부에 따라 통계적으로 유의한 차이가 있었다. 노인의 건강증진을 위해서는 본 연구에서 밝혀진 특성을 고려한 차별화된 건강증진 프로그램의 개발과 확산이 필요하다고 본다.

하부 요추 방출 골절의 수술방법 결정시 고려 요인들 (Factors in Selection of Surgical Approaches for Lower Lumbar Burst Fractures)

  • 장태안;김종문
    • Journal of Korean Neurosurgical Society
    • /
    • 제29권8호
    • /
    • pp.1055-1062
    • /
    • 2000
  • Objectives : Burst fracture of the lower lumbar spine(L3-L5) is rare and has some different features compare to that of thoracolumbar junction. Lower lumbar spine is flexible segments located deeply, and has physiologic lordosis. All of these contribute to making surgical approach difficult. Generally, lower lumbar burst fracture is managed either anteriorly or posteriorly with various fixation and fusion methods. But there is no general guideline or consensus regarding the proper approach for such lesion. We have tried to find out the influencing factors for selecting the surgical approach through the analysis of lower lumbar burst fractures treated for last 4 years(1994.3-1998.3). Method : This study includes 15 patients(male : 10, female : 5, age range 20-59 years with mean age of 36.7 years, L3 : 8 cases, L4 : 5 cases, L5 : 2 cases). Patients were classified into anterior(AO) and posterior operated(PO) groups. We investigated clinical findings, injured column, operation methods, and changes in follow-up radiologic study (kyphotic angle) to determine the considerable factors in selecting the surgical approaches. Results : There were 5 AO and 10 PO patients. Anterior operation were performed with AIF with Kaneda or Z-plate and posterior operation were done with pedicle screw fixation with PLIF with cages or posterolateral fusion. Canal compression was 46.6% in AO and 38.8% in PO. The degree of kyphotic angle correction were 10.7 degree(AO) and 8.5 degree(PO), respectively. There was no statistical difference between anterior and posterior operation group. All patients showed good surgical outcome without complications. Conclusion : Anterior operation provided good in kyphotic angle correction and firm anterior strut graft, but it difficulty arose in accessing the lesions below L4 vertebra. While posterior approach showed less correction of kyphotic angle, it required less time and provided better results for accompanied adjacent lesion and pathology such as epidural hematoma. The level of injury, canal compression, biomechanics, multiplicity, and pathology are considered to be important factors in selection of the surgical approach.

  • PDF

종합병원 간호사의 요통발생 실태와 관련요인 (A Survey on Low Back Pain of General Hospital Nurses)

  • 권영숙;김정남
    • 지역사회간호학회지
    • /
    • 제7권1호
    • /
    • pp.100-117
    • /
    • 1996
  • The purpose of the survey was to find out the prevalence rate and related factors for low back pain of nurses and to develop educational program for prevention of the low back pain. The subjects of the survey were 593 nurses of general hospitals in Tae-gu City. The survey was conducted from June 10, 1994 to October 3, 1994. The questionnaire included 34 question items concerning general characteristics, factors related to low back pain, physical nursing activities, and characteristics of low back pain. The results were as follows : 1. Among 593 of subjects, the prevalence rate of low back pain showed 62.1%. 2. In relation of health related life activities and low back pain prevalence, self-reported health state was highly significant(P=.000). 3. In relation of work environmental factors and low back pain prevalence, job satisfaction (P=.026), job stress(P=.020), and workload(P=.002) were significant. 4. In relation of physical nursing activities and low back pain prevalence, bending (P=.000), trunk twisting(P=.003), stretching(P=.006), and pulling and pushing(P=.046) were significant. 5. Physical nursing activities inducing back stress was varicant according to wards. The results of this study pointed out that the subjects' low back pain prevalence was related to the work-related physiologic and psychologic factors. Therefore, for the effective prevention of low back pain, both practicing the body mechanics and raising the morale of the nurses are needed in educational program.

  • PDF

응급의료센터에서 수혈을 시행한 성인 외상환자에서 사망 예측 인자 (Predictive Factors for Mortality among Adult Trauma Victims Transfused in an Emergency Department)

  • 이경원
    • Journal of Trauma and Injury
    • /
    • 제25권3호
    • /
    • pp.79-86
    • /
    • 2012
  • Purpose: The most common cuase of transfusion for trauma victims in an emergency department is hypovolemic shock due to injury. After an injury to an internal organ of the chest or the abdomen, transfusion is needed to supply blood products and to compensate tissue oxygen transport and bleeding. From the 1990's, there have been some reports that transfusion is one of the major factors causing multiple-organ failure. Thus, as much as possible, tranfusion has been minimized in the clinical setting. This study aims to analyze the prognostic factors for mortality among trauma victims transfused with blood products in an emergency department. Methods: We conducted this study for the year of 2010 retrospectively. The study group included adult trauma victims tranfused with blood products in our ED. The exclusion criteria were discharge against medical advice, and missing follow-up due to transfer to another facility. During the study period, 34 adult trauma victims were enrolled. We compared the clinical variables between survivors and non-survivors. Results: the mean age of the 34 victims was 58.06 years, and males account for 58.5% of the study group. The most-frequently used form transportation was ambulance(119, 55.9%), and the most common injury mechanism was mobile vehicle accidents(67.6%). The mean revised trauma score (RTS) was 5.9, and the mean injury severity score (ISS) was 47.76. The mortality rate in the ED was 58.5%, Comparison of survivors with non-survivors showed statistical differences in injury mechanism, initial SBP, DBP, RTS, ISS, and some laboratory data such as AST, ALT, pH, PO2, HCO3, glucose (p<0.05). Regression analyses showed that mortality among adult trauma victims transfused in the ED correlated with RTS. Conclusion: When an adult trauma victim is transported to the ED and needs a tranfusion, the emergency physician carefully assess the victim by using physiologic data.

자궁적출 환자가 경험하는 건강문제에 관한 조사연구 (A Study About The Health Problems of Post Hysterectomy Woman)

  • 장순복;최연순;조동숙;마계향
    • 대한간호학회지
    • /
    • 제16권2호
    • /
    • pp.53-62
    • /
    • 1986
  • The purpose of this study was to understand the pattern of health problems of post hysterectomy women by the period after their operation and to find out the related factors with health problems. A descriptive study was done using a survey methodology. The subjects were women who had undergone a hysterectomy for benign gynecological diseases at two general hospitals. They were all between one month and three year post hysterectomy as of July 15, 1985. The results are summarized as follows; 1. The percentages of the subject who were experiencing operative symptom of 1st, End and 3rd year group 53.8%, 46.2%, 37.4% respectively. The percentages of the subjects who were experiencing menopause symptom of 1st, 2nd and 3rd year group 39.0%, 35.0%, 33.7% respectively. 2. The operative factor scores of 1,2,3 year group were 20.218, 13.646, 14.030 respectively. The menopause factor scores of 1,2,3 year group were 19.055, 17.845, 17.606 respectively. 3. The sociodemographic & physiologic characteristics of the subject were as follows; the mean age of the subject was 44.47 years old, 56.2% of them were high school graduates, 73.5% had any religion, 18.3% had job, 72.6% were middle economic class, 54.3% had medical insurance, 78.4% lived in nuclei family system, the mean pregnancy number was 5.63, the mean delivery number was 2.92, 71.2% of them were diagnosed as myoma, and half of them had preserved their ovary. 4. No one factors among the 10 factors were indentified having any relation with health problem of post hysterectomy women.

  • PDF

Ultrasound-guided needle decompression and steroid injection for calcific tendinitis of the shoulder: risk factors for repeat procedures and outcome analysis

  • Kim, Su Cheol;Lee, Sang Min;Park, Gun Tae;Jang, Min Chang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
    • /
    • 제24권2호
    • /
    • pp.55-65
    • /
    • 2021
  • Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

심장 재활 프로그램에 대한 국내 연구 논문 분석 (Analyses of Studies on Cardiac Rehabilitation for Patients with Cardiovascular Disease in Korea)

  • 송영숙
    • 대한간호학회지
    • /
    • 제39권3호
    • /
    • pp.311-320
    • /
    • 2009
  • Purpose: This study was to analyze research reports published in Korea on cardiac rehabilitation for patients with cardiovascular disease. Methods: Based on inclusion criteria, 19 research reports were included in this review. Published year of selected articles was between 1996 and 2008. Nineteen studies were analyzed by guidelines of the cardiac rehabilitation programs done by the American Heart Association(AHA) and Scottish Intercollegiate Guidelines Network(SIGN). Results: The characteristics of patients were mostly of ischemic heart disease, 50-59 yr old, and male. Educational sessions were administered twice, and each lesson lasted less than 30 min. Exercise was done 3 times per week for 6 weeks. Most educational content were about risk factors, but there was no information, such as coping with feelings. Most exercise was performed as ROM, treadmill, and cycle ergometer. A large percentage of outcome indicators were health behavior, hemodynamic changes, and exercise capacity. There was more 'no effect' than 'positive effect' in trait anxiety and depression, whereas similar in physiologic domain. Conclusion: Various types of cardiac rehabilitation in Korea were performed by researchers. Therefore, we need to develop the standard protocol, to add psychosocial intervention, and to study cost effectiveness of cardiac rehabilitation.

"황제내경태소(黃帝內經太素)"의 특징(特徵) 및 양상선(楊上善)의 의학이론(醫學理論)에 대한 연구(硏究) (A Study on the Distinctive Features of "Hwangjenaegyeongtaeso(黃帝內經太素)" by Yang Sangseon and his Medical Theory)

  • 이상협;김중한
    • 대한한의학원전학회지
    • /
    • 제22권2호
    • /
    • pp.35-69
    • /
    • 2009
  • Yang Shangseon(楊上善)'s "Hwangjenaegyeongtaeso(黃帝內經太素)" was the first commentary book of "Hwangjenaegyeong(黃帝內經)", its importance often mentioned in level with Wang Bing (王冰)'s "Somun(素問)" "Yeongchu(靈樞)". The distinctive feature of Yang Sangseon(楊上善)'s commentary is that it is easy to comprehend in accordance with an organized classification, and that the explanations are simple and clear. Despite strict application of the Eumyang(陰陽, Yinyang) theory and Five phases[五行] theory throughout the text, should there be sentences which fall out of consistency with the basic theories, he added his own substantial commentary. His medical theory gives attention to the Meridian system[經絡], lays emphasis on developing the soul[神], and has a unique opinion about the Opening closing and pivot[開闔樞] theory along with the Myeongmun(命門). To explain the methods for preserving health[養生], he adopted the Nojang philosophy(老莊思想); to enrich the vitality he adopted the Buddhist philosophy(佛敎思想); and to analyze physiologic and pathogenic factors, he adopted the Confucian philosophy(儒家思想).

  • PDF