• 기본간호학회지
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• 제9권2호
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• pp.237-245
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• 2002

Purpose: This study was to examine the changes in cold discomfort according to the type of blanket used after surgery. Methods : Women scheduled for Cesarean Section were divided into two groups. After the surgery, 30 patients were covered with a warming blanket which was set at $40^{\circ}C$ by the warmer and the other 30 patients were covered with an ordinary blanket. Both group's cold discomfort was measured at 5 time points using a mercury thermometer, shivering scale. and subjective thermal sensation scale. Data were analyzed by using mean scores with t-test, paired t-test using the SPSS/WIN program. Result: At 30 min after being covered with the blanket, the axillary temperature had returned to the pre-operation temperature in both groups. At 45 min after being covered with the blanket, the women in the warming blanket group had no further shivering but for those in the ordinary blanket group shivering continued. At 45 min after being covered with the blanket, the women in the warming blanket group had returned to the condition before surgery, but those in the ordinary blanket group continued to complain of cold sensation. Conclusion: This study suggests that use of a warming blanket helps to relieve cold discomfort following surgery. This study is also expected to enhance understanding of the Importance of subjective data by exploring the difference between subjective complaints and objective data about cold discomfort.

• 임상간호연구
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• 제24권2호
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• pp.227-234
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• 2018

Purpose: This study compared the temporal artery temperature (TAT) measured by infrared temporal artery thermometers to the axillary temperature (AT) measured by standard mercury-in-glass thermometers, and evaluated accuracy of the TAT measurement for clinical practice. Methods: A total of 247 adult inpatients in general wards in a tertiary medical center located in Seoul participated in the study. The TAT was measured within one minute after the AT measurement. Data were analyzed using descriptive statistics, paired t-test, Pearson correlation coefficient, linear regression, and the Bland-Altman plot. Results: There was a significant difference in mean temperature between AT and TAT, $36.89^{\circ}C$ (SD=0.70) versus $37.35^{\circ}C$ (SD=0.72). The Bland-Altman plots demonstrated the difference between the AT and TAT as -1.29 to +0.33. The specificity and sensitivity of the TAT in detecting fever were high. The positive predictive values were 57.5% and 71.0% when the AT were higher than $38.0^{\circ}C$ and the TAT fever cutoff levels were $38.0^{\circ}C$ and $38.3^{\circ}C$ respectively. Conclusion: TAT and AT were highly correlated and agreeable, indicating that TAT is as accurate as AT. The findings suggested that TAT measurement can be used in clinical practice. For accurate communication between medical personnel, medical institutions need to provide guidelines for temperature measurement, especially for the use of thermometer and measurement sites.

• 대한간호학회지
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• 제30권2호
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• pp.488-497
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• 2000

The purpose of this study was to explore the effect of a postpartum massage program on stress response in the Cesarean section mothers. The study focused on evaluating the effect of postpartum massage program on mood, anxiety, skin temperature and concentration of saliva and breast milk immunoglobulin A in the Cesarean section mothers. This study was designed as a nonequivalent control group pretest-posttest quasi-experimental study. Twenty-eight Cesarean section mothers were selected as experimental group, whereas twenty- seven were control group. The postpartum massage program consisted of 20 minutes of warm-up, massage and ending phases and used once a day. During each program, there were 4 minutes of warm-up, 14 minutes of massage on back, axillary and breasts, and 2 minutes of ending. Massage were used for the experimental group by the same investigator 20 times per minute. The massage technique used were efflurage, petrissage, accupressure, kneading and vibration. Skin temperature was monitored with YSI Tele-thermometer(Simpson electric Co., USA) before and after massage program. The concentration of immunoglobulin A in saliva and breast milk was analyzed by immunoturbididimeter assay(Cobas INTEGRA, Swiss) before and after massage program. Also at this time mood and anxiety were measured by self-report. The data were analyzed using SPSS version 7.5 and hypothesis was tested with ANCOVA analysis and Pearson coefficient correlation. The results were as follows : 1) Score of mood increased significantly after use of postpartum massage program. 2) Level of anxiety decreased significantly after use of postpartum massage program. 3) Skin temperature increased significantly after use of postpartum massage program. 4) Concentration of saliva immunoglobulin A increased significantly after use of postpartum massage program. 5) Concentration of breast milk immunoglobulin A did not change significantly after use of postpartum massage program. 6) After use of postpartum massage program, there was significant correlation between psychological stress response and physiological stress response.The results suggest that postpartum massage program can be effective nursing intervention to reduce stress response in the postpartum mothers under stress.

• 한국산학기술학회논문지
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• 제21권10호
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• pp.127-136
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• 2020

목적: 본 연구는 국소적 냉 요법 중 가장 일반적으로 적용하는 냉 젤 팩과 얼음 팩을 적용 한 후와 수동적 재가온 후의 생리적 변화를 확인하여 냉 요법의 적용시간과 간격에 대한 근거를 마련하고자 합니다. 방법: 무작위 비교군 반복측정 실험연구로 건강한 성인 22명을 냉 젤 팩과 얼음 팩 그룹에 무작위 배정하여 30분 동안 냉요법을 적용한 후 40분 동안 수동 재가온을 실시했습니다. 오른쪽 액와에 냉요법이 적용되는 동안 5분 간격으로 총 15회, 조직과 말초의 산소포화도, 말초혈류, 피부온도, 체온을 측정하였습니다. 결과: 냉 젤 팩 군에서 StO₂는 냉 요법 전 69.43%였고, 냉 젤 팩 적용 30분 후 61.06% 였으며 얼음 팩 군에서 StO₂는 냉 요법 전 67.66%였고, 얼음 팩 적용 30분 후 64.80%로 크게 줄었습니다.(p <.001) 냉 젤 팩 군에서 피부온도는 냉 요법 전 33.57℃였고, 냉 젤 팩 적용 30분 후 29.15℃ 였으며 얼음 팩 군에서 피부온도는 냉 요법 전 32.64℃였고, 얼음 팩 적용 30분 후 28.90℃로 크게 줄었습니다.(p <.001) 40분 재가온 후에는 피부 온도만이 완전히 회복되었습다. 냉 젤 팩과 얼음 팩 그룹 간에는 큰 차이가 없었습니다. 결론: 액와에 국소적 냉 요법을 적용할 때는 30분 적용 후 적어도 40분 이상의 수동적 재가온을 위한 시간을 갖도록 해야 할 것입니다.

• Journal of Chest Surgery
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• 제44권3호
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• pp.215-219
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• 2011

Background: Selective antegrade perfusion via axillary artery cannulation along with circulatory arrest under deep hypothermia has became a recent trend for performing surgery on the ascending aorta and aortic arch and when direct aortic cannulation is not feasible. The authors of this study tried using moderate hypothermia with right brachial and femoral artery perfusion to complement the pitfalls of single axillary artery cannulation and deep hypothermia. Materials and Methods: A retrospective analysis was performed on 36 patients who received ascending aorta or aortic arch replacement between July 2005 and May 2010. The adverse outcomes included operative mortality, permanent neurologic dysfunction and temporary neurologic dysfunction. Results: Of these 36 patients, 32 (88%) were treated as emergencies. The mean age of the patients was 61.9 years (ranging from 29 to 79 years) and there were 19 males and 17 females. The principal diagnoses for the operation were acute type A aortic dissection (31, 86%) and aneurysmal disease without aortic dissection (5, 14%). The performed operations were ascending aorta replacement (9, 25%), ascending aorta and hemiarch replacement (13, 36%), ascending aorta and total arch replacement (13, 36%) and total arch replacement only (1, 3%). The mean cardiopulmonary bypass time was $209.4{\pm}85.1$ minutes, and the circulatory arrest with selective antegrade perfusion time was $36.1{\pm}24.2$ minutes. The lowest core temperature was $24{\pm}2.1^{\circ}C$. There were five deaths within 30 post-op days (mortality: 13.8%). Two patients (5.5%) had minor neurologic dysfunction and six patients, including three patients who had preoperative cerebral infarction or unconsciousness, had major neurologic dysfunction (16.6%). Conclusion: When direct aortic cannulation is not feasible for ascending aorta and aortic arch replacement, the right brachial and femoral artery can be used as arterial perfusion routes with the patient under moderate hypothermia. This technique resulted in acceptable outcomes.

• Journal of Chest Surgery
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• 제30권2호
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• pp.125-130
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• 1997

저체온 심폐바이패스후에 환자를 적절히 재가온시키지 못하면 수술직후 중환자실에서 종종 후하강 (afterdrop)현상이 발생할 수있다. 후하강이 생기면 전해질 장애, 부정맥, 혈역학적 불안정을 일으킬 수 있을뿐 아니라 전율에 의해 산소소모량을 크게 증가시킴으로서 수술 직후 불안정한 심근에 악영향을 미칠 수 있다. 따라서 본 연구는 소아 심장수술환자에서 적정 재가온 종료 온도를 찾기 위한 노력의 일환으로 50명의 환자들을 직장 온도를 기준으로 섭씨 35.5도에서 재가온을 종료한 군과 37도에서 재가온을 종료한 군으로 나눈뒤 두 군 사이에 후하강의 발생 여부를 비교 분석하였다. 그리고 후하강의 여부와 함께 심박수, 수축기 및 확장기 혈압 등 활력 증후도 함께 측정하였다. 그밖에 체온측정 장소에 따른 온도 의 차이를 관찰하기 위 해 심폐바이패스 중에는 직장 온도와 함께 식도 온도를 그리고 중환실에서는 직장 온도와 함께 액와 온도를 각각 측정하였다. 환자들은 전례에서 롤러 펌프에 의한 비박동성 관류를 시행 받았으며 산화기로는 막형 또는 기포형 산화기가 사용되었다. 두군의 환자들은 연령, 성별, 체표면적, 심폐바이패스 시간, 재가온 시간 등에서 유의한 차이가 없었다. 관찰 결과 두군의 환자들에서 모두 회복실에 도착한후 16시간후 까지 측정한 직장 온도에서 후하강은 없었으며 두군간 시간대별 직장 체온의 차이도 관찰되지 않았다. 두군간 심박수와 수축기 및 확장기 혈압에서도 유의한 차이는 발견되지 않았다. 그리고 재가온 종료시 식도 온도는 직장 온도에 비해 높게 측정되었으며 중환자실에서 측정한 액와 온도는 직장 온도보다 항상 낮게 측정되었다. 전율은 전례에서 관찰되지 않았다. 결론적으로 본 실험 결과는 소아에서는 직장 온도를 기준으로 적어도 섭씨 35.5도 이상에서 재가온을 종료하면 후하강이 일어나기 어렵다는 것을 의미하고 있다. 8례(11%),술후 일과성 신경학적 합병증이 7례 (9%),술후 일과성 정신과적 합병증이 6례 (8%), 급성 신부전이 3례 (4%),술후 출혈 및 폐렴이 각각 2례 (3%), 창상 감염과 십이지장 궤양 천공이 각각 1례 (1 %)이었다. 역행성심정 지액을 이용한 심근 보호법은 고위험도의 허혈성 심질환 환자에서의 관상동맥 우회술에서 수술 위험도를 최소화할 수 있는 유용한 심근 보호법이라고 생각된다.처리구를 무작위로 할당하여 배양하였으며, 또한 740개의 정상수정란도 같은 반복수로 배양을 실시하였다. 미세주입한 수정란은 8일 후 11.6%(26/255) 및 5.2% (14/267)가 대조구 및 G418 처리구에서 배반포기까지 발달하였으며 정상수정란은 27.2% (151/740)가 배반포기 배까지 발달하였다. 미세주입후 대조구에서는 23.1$\pm$2.6/70.7$\pm$4.7 (32.7%)의 할구가 $\beta$-Gal 활력을 보였고, 반면에 100$\mu\textrm{g}$/ml G418 처리구에서는 40.3$\pm$4.1/48.8$\pm$7.5 (82.6%)가 $\beta$-Gal 활력을 보였다. 비록 mosaic 형태로 외래유전자가 발현되었지만 대조구에서 87.0% (26/30개) 배반포기가 $\beta$-Gal 활력을 보인 반면, G418 처리구에서는 모든 배반포기가 $\beta$-Gal 활력을 보였다 (P<0.05). 그러나 대조구 및 G418 처리구의 ICM colony에서는 영양배엽과 내배엽을 제외한 epiblast에서는 확인되지 않았다. 그러나 이 결과로부터 $\beta$-actin promoter/lacZ gene이

• Clinical and Experimental Pediatrics
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• 제48권8호
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• pp.820-825
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• 2005

목 적 : 감염과 질병상태의 유용한 인자인 열의 존재와 정도를 좀더 손쉽고 정확하게 확인하기 위해, 고막체온계 및 이마체온계의 정확성과 유용성을 평가하고자 하였다. 방 법 : 2004년 1월 1일부터 12월 31일 까지 중앙대학교 부속 병원에 입원하여 치료받았던 환아 중 무작위로 1,050명을 선출하여 대상으로 하였으며, 수은 체온계, 고막 체온계(BRAUN IRT $3020^{(R)}$) 및 이마 체온계(HubDIC $DOTORY^{(R)}$)로 동시에 체온을 측정하였고 이를 비교, 분석하여 상관관계를 조사하였다. 결 과 : 고막 체온계와 이마 체온계의 측정치는 각각 표준 검사인 수은 체온계의 측정치와 유의한 상관관계 및 상호 교환성을 가졌으며, 양측 고막 간, 그리고 고막 체온계와 이마 체온계 사이에서도 유의한 상관관계를 보였다. 발열에 대한 고막 체온계의 민감도는 오른쪽과 왼쪽에서 각각 81.1%, 82.4%였고, 양성 예측률은 각각 81.8%, 73.6%였다. 이마 체온계의 민감도는 83.3%였으며, 양성 예측률은 74.4%였다. 결 론 : 고막 체온계(BRAUN IRT $3020^{(R)}$) 및 이마형 체온계(HubDIC $DOTORY^{(R)}$)가 액와형 수은체온계와 통계적으로 유의한 상관성 및 일치성을 보이며(P<0.05), 또한 발열에 대한 민감도 및 양성 예측률이 매우 높아 일상의 가정에서나 병원에서 진료목적으로, 연구 목적으로 체온 측정하는 데 유용하게 사용될 수 있을 것으로 본다.

• 사상체질의학회지
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• 제19권2호
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• pp.179-186
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• 2007

1. Objectives In this case report, We report a case of advanced non-seminomatous germ tell tumor(NSGCT) of the testis to retroperitoneal lymph node. We successfully managed with sasang medical treatment. 2. Methods We treated a man with NSGCT of testis with retroperitoneal lymph node metastasis. We evaluated pain grade by VAS(visual analogue scale). and fever grade by body temperature(by axillary thermometer) 3. Results Pain and fever were improved with the Sasang constitutional medicine. 4. Conclusions Cancer pain and fever was markedly improved by Sasang Constitutional management. Further studies are needed to evaluate the cause of the improvement.

• Journal of Chest Surgery
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• 제28권7호
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• pp.684-688
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• 1995

Hyperhidrosis, one of the abnormalities in autonomic nervous system, has been treated with dermatologic principles or thoracic sympathectomy via conventional axillary thoracotomy or dorsal spinal approach. But these techniques were rather ineffective or invasive. Recently, VATS is widely applied in thoracic surgical area, and hyperhidrosis is not the exception of these cases.From May 1993 to August 1994, 30 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic [T2, T3 sympathectomy with thoracoscopic surgery at Seoul National University Hospital. There were 20 men and 10 women and the mean age was 23.0 years.Mean operating time was 115 min and there was no thoracotomy conversion. Operative complications were anesthetic overdose in 1, Horner`s syndrome in 1, and small amount of residual pneumothorax in 6. Mean postoperative hospital stay was 2.3 days [range from 1 to 4 days and postoperative analgesics were required in 17 cases with a single dose.Sweating amount was measured in 12 patients, showing significantly decreased amount from 284.5 mg preoperatively to 18.9 mg postoperatively in 5 minutes [p=0.004 . There was no recurrence during mean 6 months follow up. Twenty two patients [73.3 % complained moderate compensatory hyperhidrosis on the trunk.In conclusion, all patients were greatly satisfied with those results including no more palmar sweating, less pain, better cosmetics, short hospital stay. In addition, recent use of sweating amount measurement and intraoperative temperature monitoring could make this technique more accurate, so we easily applied thoracoscopic sympathectomy with minimal risk.

• Urogenital Tract Infection
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• 제13권3호
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• pp.66-71
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• 2018

Purpose: To determine the appropriate regimen of antibiotic prophylaxis for the prevention of bacterial infections in patients receiving percutaneous nephrolithotomy (PCNL). Materials and Methods: Forty patients, who planned to undergo PCNL from October 2015 to August 2017, were assigned randomly into two groups. Patients in the single-dose group (n=20) were administered an intravenous single dose of 2 g ceftriaxone 30 minutes before PCNL, whereas those in the three-days regimen group (n=20) were administered a preoperative intravenous single dose of 2 g ceftriaxone and an additional postoperative oral cefpodoxime proxetil (100 mg twice a day) for three days. The incidences of infectious complications in the two groups, such as pyrexia, systemic inflammatory response syndrome (SIRS), and sepsis, were compared. Results: Fever (axillary temperature >$38.0^{\circ}C$) did not develop in any of the patients in the single-dose group but developed in one patient (5.0%) in the three-day regimen group due to pneumonia (p=0.3). SIRS developed in a total of eight patients (20.0%), four patients from each group. None of the patients in either group developed sepsis after PCNL. Conclusions: The three-day prophylactic antibiotic regimen did not demonstrate better efficacy for the prevention of bacterial infections in patients with PCNL compared to the single-dose prophylactic antibiotic regimen.