• Archives of Plastic Surgery
• /
• 제33권5호
• /
• pp.669-671
• /
• 2006

Purpose: Congenital insensitivity to pain with anhidrosis(CIPA) is a rare form of autosomal recessive peripheral sensory neuropathy. Patients with CIPA show loss of pain sensation, which leads to corneal ulcers and opacities, self-mutilation of the tongue and fingertips, as well as fractures with subsequent joint deformities and chronic osteomyelitis. The purpose of this report is to highlight the fact that pressure sores also are a potential complication of CIPA. Methods: This case report describes a patient presenting with pressure sores resulting from CIPA. A 5-year-old boy was referred to our department for the treatment of a $5{\times}5cm$ sacral pressure sore as a result of a hip spica cast applied for the treatment of a left hip joint dislocation. He had a history suggesting CIPA such as multiple bony fractures, mental retardation, recurrent hyperpyrexia, anhidrosis, and clubbing fingers due to oral mutilation. A microscopic examination of the sural nerve showed mainly large myelinated fibers, a few small myelinated fibers and an almost complete loss of unmyelinated fibers. After wound preparation for two weeks, the exposed bone was covered with two local advancement flaps. Results: Two weeks later, complete wound healing was achieved. A 16-month follow-up showed no recurrence. However, the patient presented with a new pressure sore on the left knee due to orthosis for the treatment of the left hip joint dislocation. Conclusion: The early diagnosis of CIPA and special care of pressure sores are important for preventing and treating pressure sores resulting from CIPA.

• 정신신체의학
• /
• 제26권1호
• /
• pp.9-18
• /
• 2018

연구목적 청소년의 내재화장애는 겉으로 표출되지 않으므로 의료서비스 이용을 결정하는 부모나 교사가 그 증상을 인지하기 어렵고 청소년 자신도 정신의학적 개입을 기피하는 경향이 있어 치료 기회를 놓치기 쉽다. 본 연구는 내재화장애 청소년의 정신병리를 자기보고식 강점난점설문지(SDQ-SR)와 MMPI-A를 사용하여 조사하고, 이 두 검사도구가 내재화장애를 진단평가하는데 상호보완성이 있는지를 규명하고자 시행되었다. 방 법 청소년 외래환자(13~17세) 91명을 임상진단에 따라 두 집단으로 나누었으며, 내재화장애집단 44명과 그 외 임상진단을 가진 비교집단 47명이 완성한 SDQ-SR과 MMPI-A 자료가 내재화장애 진단을 어느 정도로 예측할 수 있는지 분석하였다. 결 과 로지스틱 회귀분석 결과, SDQ-SR의 정서증상 소척도가 1점 상승할 때 내재화장애의 진단예측력은 2.27배 증가하였다. 또한 ROC 곡선분석에서, SDQ-SR 정서장애 소척도의 절단점수를 4점으로 했을 때 내재화장애진단의 민감도와 특이도가 각각 88.94와 78.72로 나타났다. MMPI-A에서는 A-anx 절단점수가 56이었을 때 민감도와 특이도는 각각 77.27과 74.47이었다. 그러나 이 두 검사도구 소척도들의 어떠한 조합도 SDQ-SR 정서증상 소척도가 갖는 진단예측력을 더 높이지는 못했다. 결 론 본 연구에서는 청소년의 내재화장애를 진단하는데 SDQ-SR의 정서증상과 MMPI-A의 A-anx, A-aln, A 및 INTR가 중요한 소척도임을 알 수 있었으나 이를 확정하기 위해서는 정상대조군을 포함한 대규모의 연구가 필요하다.

• 한국의료질향상학회지
• /
• 제2권1호
• /
• pp.68-84
• /
• 1995

Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

• 한국산학기술학회논문지
• /
• 제18권2호
• /
• pp.631-638
• /
• 2017

4차 산업혁명의 도래로 우리 삶의 방식과 산업 구조가 IT 기반 자동화를 넘어 지능화 단계로 진화하면서 다양한 분야에서 소프트웨어 역량을 갖춘 인재를 요구하고 있다. 이러한 요구를 반영하여 최근 초중등뿐만 아니라 대학에서도 비전공자에 대한 소프트웨어 기초 교육을 강화하고 있다. 본 연구에서는 관련 연구를 통해 비전공자의 소프트웨어 교육 목표를 컴퓨팅 사고 기반의 일반적인 문제해결능력과 자신의 학문 영역에서 소프트웨어 융합 역량을 향상시키고자 함에 두고, 이러한 목표를 달성하고자 창작로봇을 이용한 비전공자의 소프트웨어 융합 교육에 대한 방안을 제안하였다. 다양한 전공의 학생들로 구성되는 핵심교양 교과목 수강생 91명을 대상으로 창작로봇 과정과 컴퓨팅 사고 및 융합 요소와의 관련성에 기초하여 수업을 설계하고 13주 동안 연구를 수행하였다. 창작로봇을 통한 소프트웨어 융합 교육의 효과를 알아보기 위해, 수업 전사전 진단 조사를 토대로 수업 후 학생들의 학습 성과, 창작로봇 활동 과정에 대한 만족도, 타 학문에 대한 인식의 변화를 관찰하였다. 연구의 결과, 학생들은 학습내용의 이해도, 다 학제적 협력학습에 대한 전반적인 만족도, 타 학문에 대한 이해도, 창작로봇 활동을 통한 문제해결능력에 대한 자기 평가 등 12개 문항에서 수업 전과 비교하여 자신의 능력이 향상되었다고 응답하였다.

• 한국콘텐츠학회논문지
• /
• 제18권10호
• /
• pp.194-202
• /
• 2018

본 연구는 한국 루터교회 내의 평신도 의식과 신앙성숙을 위한 기독교 상담, 교회 내 프로그램의 영향을 분석하고, 그 결과를 바탕으로한 교회성장요소를 제공하고자 한다. 연구대상은 한국 루터교단에 소속되어 있는 ${\bigcirc}{\bigcirc}$교회에 출석하는 평신도를 대상으로 하였으며, 총 83부의 설문을 분석에 사용하였다. 연구도구로는 한국교회성장연구소의 교회건강 진단을 위한 NCD 평신도 설문지를 사용하였으며 신뢰도 Cronbach's ${\alpha}$는 0. 91 이었다. 종속변수에 해당하는 교회발전과 성장은 교회발전 성장, 교회발전 목표, 교회발전 조직으로 측정하였고, 독립변수인 교회프로그램과 기독교상담에 대해서는 지도자, 의례, 공동체, 사역/프로그램, 개인적 믿음/가치관으로 측정하였다. 회수된 설문은 교회발전과 성장과의 상관성을 검증을 위해 상관성 검증을 실시하였고, 교회발전과 성장에 영향을 미치는 요인을 검증하기 위해 다중회귀분석을 실시하였다. 본 연구결과를 볼 때 상담을 포함한 교회 내 사역 프로그램, 교우와의 관계, 공동체 활동 및 상호소통 등이 영적성장 및 자기성장과 높은 상관관계로 나타났다. 그러므로 지속적인 교회성장을 위해서는 상담사역을 중심으로 한 교회 내 공동체 프로그램의 중요성이 필요하다고 여겨진다.

• Journal of Oral Medicine and Pain
• /
• 제37권1호
• /
• pp.9-17
• /
• 2012

편평태선은 피부와 점막에 발생하는 만성 염증성 질환으로써 신체 여러 부위에 침범하여 매우 다양한 임상소견을 나타낸다. 아직 정확한 원인은 밝혀지지 않았으나 피부나 점막에서 유도된 항원변화에 대한 상피와 결체조직 사이의 세포매개성 면역반응에 의한 것으로 알려져 있다. 중년 여성에서 호발하고, 증상의 악화와 완화가 번갈아 일어나는 것이 이 질환의 특징으로, 정신적 스트레스, 유전적 요인, 환경적 요인, 약물 등의 여러 요소가 증상의 악화에 관여하는 것으로 추정된다. 피부 편평태선 환자의 60-70%에서 구강 편평태선이 동반되고, 구강 편평태선 환자의 2/3 가량이 단독병소로써 나타난다. 이번 연구에서는 정서적 스트레스가 구강 편평태선을 악화시키는데 있어 어떤 영향을 미치는지 평가하고자 한다. 임상검사 혹은 조직검사 결과 구강 편평태선으로 진단된 환자 30명과 치과대학 학생들의 부모들 중 구강 편평태선의 증상 및 병력이 없는 30명을 대상으로 하였다. 스트레스 상황의 평가를 위해서는 한국적 문화에 맞게 적절하게 변형한 Holmes와 Rahe의 사회적 재적응 평정척도 설문지(SRRS)를 이용하였다. 분석결과 구강 편평태선 환자들이 대조군에 비해 최근 1년 동안 더 많은 수의 스트레스성 사건들을 경험한 것으로 나타났다.

• 농업과학연구
• /
• 제37권3호
• /
• pp.393-398
• /
• 2010

Early pregnancy diagnosis of bovine is an essential component for efficient reproductive plan in farms because long term of non-pregnancy results in economic losses by failure of offspring production and low milk yield in dairy cattle. The major steroid hormones related with reproduction are known to be progesterone and estrogen in bovine pregnancy. To evaluate detection level of hormones in milk, plasma and milk progestrone and estrogen of Holstein cows was analyzed during artificial insemination (AI) and embryo transfer (ET). Progesterone concentration at 21 days postestrus was significantly different in plasma and milk between pregnant and non-pregnant cows. Estrogen concentration at estrus was higher in pregnant recipients than that in non-pregnant recipients. To analyze correlation between hormone levels and conception rates in Holstein, the conception and return rates were checked following AI, and the returned cows were on the track of pregnancy after consecutive AI. Pregnant cows following first AI were considered as high conception group while pregnant cows following third AI were rated as low conception group. Proportion of high and low conception groups in this study was 78.2% and 9.1%, respectively. Hormone analysis indicated that high conception group had higher estrogen level during estrus than low conception group ($26.45{\pm}3.32$ vs $19.017{\pm}2.97$). Progesterone level was not different between high and low conception groups during estrus but increased significantly after 21 days postestrus (21 day: $4.95{\pm}1.12$ vs $0.95{\pm}0.23$, 35 day: $12.47{\pm}3.82$ vs $2.41{\pm}1.21$). In conclusion, the pattern of progesterone and estrogen secretion in Holstein milk samples could be a good candidate for early pregnancy detection and selection of recipients during ET.

• 가정∙방문간호학회지
• /
• 제3권
• /
• pp.86-97
• /
• 1996

The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

• 가정∙방문간호학회지
• /
• 제8권2호
• /
• pp.135-147
• /
• 2001

The aim of this descriptive study was to identify the impact of chronic illness on children and their families. Mothers of 177 children with chronic disease were recruited from aged one to 17 years hospitalizing the pediatric nursing unit at one university hospital. 28 questions. a self-complete maternal questionnaire developed by researchers based on literatures and 'The Impact of Childhood Illness Scale' (Hoare & Russell, 1995) assess four aspects of the child's and family's lifestyle with two dimensions for each question. the frequency of the problem and its importance of concern that it cause. In the data analysis. Pearson correlation coefficients and analysis of variance were used to test any association and a statistical comparisons. between individual variables and the impact on child's and family's lifestyle. The results were as follows: 1) There were the higher mean scores on the importance dimension than on the frequency dimension on total impact on child's and family's lifestyle. On the importance dimension. mothers had much higher levels of concern about impact on child's development and adjustment among subscales. On the frequency dimension, mothers had much higher levels of concern about impact on the family daily living on subscales. 2) The impact on child's and family's lifestyle related on individual variables were: (1) On the importance dimension. there was statistically significant low in the impact on child's development and adjustment among subscales in older parent group compared with it of younger parent group. (2) On the frequency dimension. there were statistically significant high in the impact on child's development and adjustment among subscales in the children with leukemia or cancer compared with it of the other children who had another chronic illnesses. And there were statistically significant high in the impact on child's development and adjustment among subscales in less than high school educated mothers compared with it of mothers who was educated college level. (3) On the frequency dimension. There were statistically significant high in the impact on family's daily living among subscales and total impact on child's and family's lifestyle in female children. (4) There was positive correlation between impact on parents daily living and frequency of child's hospitalization on the frequency dimension. but there was negative correlation between the two variables on the importance dimension. (5) There was positive correlation between impact of chronic illness and its treatment and duration of child's hospitalization on the frequency dimension. In conclusion. these results were reflected by the high level of concerns about impact on child's development and adjustment although mothers had frequently responded about the impact on the family daily living. We suggest consistent intervening program that help the family empowering to make children live with and adjust to their chronic illnesses from the point of diagnosis and after discharge from the hospital. We also suggest these results can be utilized as a useful data in the practice of home health nursing for children who have chronic illnesses and their families.

• Tuberculosis and Respiratory Diseases
• /
• 제46권2호
• /
• pp.266-272
• /
• 1999

콕시디오이데스진균증 토착 지역인 미국 애리조나 피닉스 지역을 여행한 과거력이 있는 국내 거주 75세 여자 환자에서 무증상의 고립성 폐결절로 악성종양을 의심하여 폐절제술을 시행한 결과 콕시디오이도마로 진단된 1예를 국내에서 처음 경험하였기에 보고 하는 바이다.