• 가정간호학회지
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• 제8권2호
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• pp.121-134
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• 2001

The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

• 사상체질의학회지
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• 제23권4호
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• pp.429-444
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• 2011

1. Objective This study is aimed to present the effective classification of Soeumin symptomatology and the standardized signs for classification which can be applied for KCD, ICD and the insurance codification system. 2. Methods 1) Differentiate Soeumin symptomatology based on exterior-interior patterns, favorable-unfavorable patterns, and mild-severe-dangerous-urgent patterns. 2) Investigate the standard signs and symptoms to claasify Soeumin symptomatology based on exterior-interior patterns, favorable-unfavorable patterns, and mild-severe-dangerous-urgent patterns. 3. Results and Conclusions 1) The diagnosis criteria for Soeumin exterior-interior disease is based upon signs & symptoms of cold/heat, condition of stool, state of digestive system(such as digestion and appetite)among others. 2) The diagnosis criteria for Soeumin favorable-unfavorable disease is generally based upon whether the vital force of the spleen is damaged or not. More specifically, for the exterior disease, whether or not sweating is present. For the interior disease, whether or not dry mouth, body ache(a main symptom of the exterior state), and anxiousness are present. 3) For the Soeumin Wool-gwang disease, the diagnosis criteria of mild-severe disease is whether or not chills is present and the degree of body fever. 4) For Soeumin Mang-yang disease, the diagnosis criteria of dangerous-urgent disease is whether or not chills is, the degree of sweating and urine condition. 5) For the Soeumin Greater-Yin disease, Abdominal-pain bowel irritability pattern and Epigastric discomfort pattern are early state signs, Jaundice pattern is mild-state sign, edema & Greater-Yang disease Yin-toxin pattern are terminal state signs. 6) For the Soeumin interior disease, Abdominal-pain bowel irritability pattern and Epigastric discomfort pattern are of the dangerous state pattern, Jang-gual and Exuberant-Yin-repelling-Yang pattern are of the urgent state patterns.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권2호
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• pp.164-171
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• 2005

목 적: 건강한 만삭아로 출생한 신생아에서 상부위장관 출혈의 임상적 특징, 위내시경 소견, 연관된 위험요소 등을 알아보고자 하였다. 방 법: 2002년 1월부터 2003년 12월까지 을지의과대학교 을지병원 신생아 중환자실에 토혈 혹은 혈변을 주소로 입원하여 위내시경상 출혈성 위염 또는 궤양으로 진단된 9명의 환아들을 대상으로 산전인자, 모체인자, 분만소견, 내시경 소견, 예후 등을 후향적으로 조사하였다. 결 과: 1) 9명의 환아 중 원내 출생아는 5명(5명/3,734명)으로 발생률은 0.13%였고, 모두 적정체중 만삭아로 출생 시 가사소견은 없었다. 2) 산모들의 병력상 산전에 위염, 소화성 궤양, 제산제 복용 등의 기왕력, 위장관 질환의 가족력은 없었고, 분만과정 중 특이소견 없었다. 3) 토혈, 혈변, 반복되는 구토가 주증상이었으며, 출생 후 $4.4{\pm}3.8$일에 발생하였고, 입원 시 활력증후는 양호하였고, 혈액검사소견도 정상이었다. 내시경 검사상 출혈성 위염이 6예, 위궤양이 3예였다. 4) 모든 환아는 $H_2$ 수용체 차단제 치료와 보존적 치료을 실시하였고, 치료 시작 후 $0.9{\pm}0.3$일 이내에 임상증상은 호전되었다. $H_2$ 수용체 차단제는 $18.6{\pm}5.0$일 치료하였으며 추적관찰상 증상이 재발된 환아는 없어서 추적 내시경은 실시하지 않았다. 결 론: 만삭아에서 출혈을 동반한 상부위장관 점막질환은 대부분 예후가 양호하여 임상증상이 호전된 경우에는 추적 위내시경 검사는 불필요한 것으로 사료된다.

• 대한장애인치과학회지
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• 제14권1호
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• pp.36-40
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• 2018

CATCH 22 증후군(CATCH 22 Syndrome)은 선천성 심장기형, 비정상적인 안모, 흉선 형성부전, 구개열, 저칼슘혈증을 특징으로 하나 임상양상은 다양하게 나타난다. 본 증례는 치과 검진에 비협조적이고 다수의 치아 우식을 보이는 4세 5개월의 CATCH 22 증후군 환자를 전신마취 하에 효과적으로 치료하였기에 이를 보고하는 바이다. CATCH 22 증후군 환아는 선천적 심장기형을 동반하는 경우가 많아 의과적 자문 하에 치과 치료를 시행해야 한다. 간단한 치료의 경우 의과적 자문 하에 진정법 시행을 고려해 볼 수 있으나 불안정한 생징후를 보일 수 있어 보다 면밀한 모니터링을 요한다. CATCH22 환아의 전신상태에 대한 충분한 이해 및 술전 평가를 바탕으로 한 주의깊게 시행된 전신마취 술식은 다발성 치아우식의 치료에 있어서 보다 안전하고 효과적인 방법이 될 수 있을 것으로 사료된다.

• 대한치과마취과학회지
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• 제14권4호
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• pp.213-219
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• 2014

Background: Clinical use of propofol along with remifentanil for intravenous sedation is increasing in these days, but there are not enough researches to evaluate proper target concentration when these drugs are infused by using target controlled infusion (TCI) pump in dental treatment cases. In this study, we compared efficacy of TCI conscious sedation and target concentration of propofol when it used with or without remifentanil during conscious sedation with the help of a TCI for the surgical extraction of impacted teeth. Methods: After IRB approval, all the charts of patients who had undergone surgical extraction of impacted teeth under propofol TCI sedation for 6 months were selected and reviewed for this study. After reviewal of charts, we could divide patients in two groups. In one group (group 1), only propofol was selected for sedation and initial effect site concentration of propofol was $1{\mu}g/ml$ (n = 33), and in another group (group 2), both propofol and remifentanil was infused and initial effect site concentration of each drug was $0.6{\mu}g/ml$ and 1 ng/ml respectively (n = 25). For each group, average propofol target concentration was measured. In addition, we compared heart rate, respiratory rate, and systolic and diastolic blood pressure as well as oxygen saturation. Besides, BIS, sedation scores (OAAS/S), and subjective satisfaction scores were compared. Results: Between group 1 and 2, there were no significant differences in demographics (age, weight and height), and total sedation time. However, total infused dose and the effect site target concentration of propofol was $163.8{\pm}74.5mg$ and $1.13{\pm}0.21{\mu}g/ml$ in group 1, and $104.3{\pm}46.5mg$ and $0.72{\pm}0.26{\mu}g/ml$ in the group 2 with $1.02{\pm}0.21ng/l$ of the effect site target concentration of remifentanil, respectively. During sedation, there were no differences between overall vital sign, BIS and OAAS/S in 2 groups (P > 0.05). However, we figured out patients in group 2 had decreased pain sensation during sedation. Conclusions: Co-administration of propofol along with remifentanil via a TCI for the surgical extraction of impacted teeth may be safe and effective compared to propofol only administration.

• 성인간호학회지
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• 제12권4호
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• pp.606-618
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• 2000

The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.

• 대한기계학회논문집B
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• 제38권9호
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• pp.739-745
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• 2014

심장 질환 환자에게 약물 치료를 시행하고 있으나, 통상의 약물 치료만으로는 심장질환을 치료하기에는 부족하다. 그러나 LVAD 를 이식한다면 심장기능을 보조하여 심장 이식까지의 가교 역할로서 효과가 있다고 보고되고 있다. 본 연구에서는 선행 연구로 개발된 곡관형 LVAD 인 LibraHeart-I(LH-1)을 이용하여, 대동물(Bovine model, Holstein)과 소동물(canine model, Labrador-retriever)을 대상으로 장기간 동물실험 및 응급상황에서의 생체적합성을 평가하고자 한다. 대동물을 대상으로 실시한 장기간의 동물 실험에서 49 일 생존하였으며, 실험기간 동안 실시한 혈액 검사 및 생징후에서 특이 소견을 관찰되지 않았다. 소동물을 대상으로 한 단기간의 동물 실험에서는 외부 구동부의 동력 지원 없이도 LH-I 내에 혈액이 머무르지 않는 것으로 관찰되었다. 본 연구에서는 장기간 동물실험 및 응급상황에서의 박출 성능을 통해 선행 연구로 개발된 LH-I의 생체적합성을 검증하였다.

• 보건행정학회지
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• 제26권4호
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• pp.359-372
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• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• 한국산학기술학회논문지
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• 제10권11호
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• pp.3418-3426
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• 2009

본 연구의 목적은 비외상성 심정지 환자에게 적용하는 심폐소생술에 대한 현장업무 프로토콜의 유용성을 검증하는 것이다. 연구는 2008년 5월 1일부터 동년 6월 27일까지, 전라남도와 전라북도에 소재한 J, K대학에 재학 중인 응급구조과 학생 150명을 대상으로 하였다. 비동등성 대조군 전.후 유사 실험 설계(nonequivalent control group pretest-posttest design)를 사용하여, 실무적합성 검증을 실시하였다. 현장업무 프로토콜을 적용한 실험군과 기존의 심폐소생술을 적용한 대조군으로 나누어, 각 프로토콜 항목들의 소요시간을 비교하여 통계 분석하였다. 연구 결과, 5개항목(의식상태 평가, 기도유지, 인공호,,흡 2회 실시, 순환 확인, 심폐소생술 5주기 실시)을 제외한 나머지 18개 항목에서 3초 이상 수행시간이 단축되었다. 60초 이상의 단축을 보인 항목은 6개로, 기관삽관 튜브 고정(78.70초), 말초정맥로 확보(64.45초), 의식상태 재평가, 동공반사 확인(110.05초), 목동맥 확인(112. 55초), 활력징후 평가(85.7초)였으며, 전체시간은 110.85초가 단축되었다. 실험군과 대조군의 프로토콜 적용에 따른 사전.사후 변화에서 전체시간(t=-6.580, p=.000)은 통계학적으로 유의하게 감소한 것으로 나타났다. 따라서 비외상성 심정지 환자의 심폐소생술에 대한 현장업무 프로토콜은 정확하고 신속한 의사결정을 지원할 수 있는 지침으로 활용될 수 있으며 응급의료 서비스를 향상시킬 것으로 사료된다.

• 감성과학
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• 제20권1호
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• pp.17-30
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• 2017

하이테크놀로지를 여러 가지 다른 영역과 융합하고자 하는 노력이 다양한 연구 분야에서 시도되고 있으며, 스포츠웨어를 개발함에 있어 운동선수의 운동능력을 향상시키기 위한 분야에 이러한 첨단 기술들이 도입되고 있다. 본 연구는 스포츠 훈련에 도움이 되는 동작 센싱 스마트 스포츠웨어를 개발하기 위한 기초 연구로서, 조정 동작 시 관절의 움직임을 측정할 수 있는 동작 센서를 부착하기 위한 인체상의 최적 위치를 탐색하는 것을 목적으로 한다. 본 연구에서는 일관된 동작을 반복적으로 수행할때 관절의 변화가 큰 조정을 대상 스포츠로 선정하였으며, 조정 선수의 대표 체급인 중량급과 경량급의 피험자를 선정하여 동작에 따른 피부의 변화율을 측정하여 체급별 차이를 분석하였다. 먼저, 3차원 모션캡처 시스템을 이용하여 조정 동작 시 등, 팔꿈치, 엉덩이, 무릎 부위의 피부 변화를 촬영하고, 각 마커 간 거리의 변화율을 분석함으로써 체급에 따른 차이를 보이지 않으면서 동작에 따라 피부의 변화가 큰 부분을 인체 상에 도시하였다. 이를 바탕으로 동작 센싱용 스마트 스포츠웨어를 위한 센서 부착의 가이드라인을 제시하였다.