• 제목/요약/키워드: high risk groups

검색결과 1,470건 처리시간 0.028초

의식불명 환자에서 경과급식에 의한 혼합형 식사와 상업용 조합식이의 효과 비교 (Comparison of Blenderized Diets and Commercial Enteral Formulas in the Unconscious Tube-fed Patients)

  • 정상섭
    • Journal of Nutrition and Health
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    • 제28권4호
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    • pp.345-354
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    • 1995
  • Blenderized diets are not recommended because of difficulties in providing a constant content of nutrients, phoblems with viscosity and osmolarity, time needed for preparation, and increased risk of contamination. To determine the possibility of substituting commercial formulas for blenderized diets, 27 unconscious patients were randomized into two different groups : blenderized diet group(n=11) and commercial formula group(n=16). Blenderized diets were composed of food sources such as rice, milk, egg, juices and others, and its energy percentage of protein, fat, and carbohydrate was 15%, 30%, and 55%, respetively. Commercial enteral formulas provided 1 kcal/ml and the energy percentage of protein, fat and carbohydrate was 25%, 20% and 55% in greenbia(G) and 20%, 20%, and 60% in Greenbia-DM(GD), repectively. In commercial formula group, five patients with diarrhea, constipation, and high blood glucose level received GD, and the other eleven patients received G. All patients received their lipuid diet for 4 weeks through 16 French rubber nasogastric tube by bolus feeding 6 times daily. The patients in commercial formula group had a similar mean daily calorie intake to the patient in blenderized diet group, 32-34kcal/kg/d and 30-35kcal/kg/d, respectively. Patients given commercial formula gained an averge of 1.7kg in weight but those given blenderized diet lost an average of 2.6kg. There was a trend toward an increase in percent ideal body weight in commercial formula group(94$\pm$5 vs 99$\pm$6%). However, blenderized diet group showed a trend toward a decrease in percent ideal body weight(106$\pm$5 vs $101\pm$6%). The initial levels of total lymphocyte counts, serum albumin and tranferrin were below the normal rante, The mean daily protein intake was significanlty higher for commercial formula group(2.0-2.1g/kg/d) than for blenderized diet group(1.1-1.3g/kg/d). Patient fed cormmercial formula for 4 weeks showed a trend toward an increase in serum albumin(8.1%) and a significant increase in serum transferrin(32.1%) without increasing the levels of blood glucose. GOT, GPT, blood urea nitrogen and serum creatinine. In the blenderized diet group, however, no significant improvement were obseved in the concentration of serum albumin and transferin, compared to initial value. There was a trend toward a decrese in the level of hemoglobin and hematocrit in blenderized deit group but no significnat change in commercial formulas goups. All patients tolerated both diets well and no significant complications were encountered. The results indicate that the commercial enteral formulas tested in this study can be an effective substitution for blenderized diet in unconscious tube-fed patients.

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급성 신우신염의 진단을 위한 영상 검사의 유용성 (The Significance of Renal Imaging Studies in the Diagnosis of Acute Pyelonephritis)

  • 한혜정;김지희;이인실;이혜선
    • Childhood Kidney Diseases
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    • 제11권2호
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    • pp.212-219
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    • 2007
  • 목 적 : 소아의 급성 신우신염은 어릴수록 증상이 비특이적이어서 진단이 어렵고 신반흔이 발생할 위험이 높으나, 조기 진단 및 적절한 치료로써 신반흔의 유병률을 줄일 수 있다. 소아의 발열성요로 감염 환아에서 급성 신우신염의 조기 진단을 위한 요로계 영상 검사를 비교함으로써, 연령별 유용성에 대해 살펴보고자 하였다. 방 법 : 발열성 요로 감염으로 진단받고, 급성기에 DMSA 스캔과 신초음파 및 배뇨중 방광 요도조영술을 시행했던 총 53명(2세 미만 34명, 2세 이상 19명)을 대상으로 하여, 두 연령군 사이에 영상검사의 민감도 및 그 연관성을 관찰하였다. 결 과 : DMSA 스캔의 신피질 결손율은 2세 미만에서 23.5%로서, 2세 이상의 63.2%에 비해 유의하게 낮았다(P<0.05). DMSA 스캔의 신피질결손은 말초 혈액 백혈구 증가와 연관이 있을 뿐, 발열 기간, ESR, CRP와는 연관이 없었고, 신초음파 이상소견 및 방광 요관 역류 유무와도 유의한 연관성 이 없었다. 결 론 : 2세 미만에서는 DMSA 스캔의 민감도가 낮아서 급성 신우신염의 진단에 어려움이 있고, DMSA 스캔만으로 방광 요관 역류의 유무를 예측할 수 없으므로 배뇨성 방광 요도 조영술을 함께 시행하는 것이 필요할 것으로 사료된다.

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광주지역 일부 대학생에서 에너지음료 섭취 실태 및 섭취 관련 제요인 특성 비교 (Consumption Behaviors of Energy Drinks and Comparison of Associated Factors Among College Students in Gwangju)

  • 서다운;김복희
    • 대한지역사회영양학회지
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    • 제23권4호
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    • pp.289-301
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    • 2018
  • Objectives: The aim of this study was to examine the current status of consumption of energy drinks among college students and investigate the effects of general environmental factors, health behavior factors, caffeine knowledge levels, and perceived stress levels on consumption of energy drinks. Methods: A survey was conducted among a total of 479 college students in Gwangju, using self-administered questionnaires. The questionnaire consisted of items about general environmental factors, health behavior, caffeine knowledge, perceived stress, and energy drink consumption behaviors. Results: 69.1% of participants experienced consumption of energy drinks, and specifically 82.8% of male students and 54.1% of female students experienced consumption of energy drinks (p<0.001). The reasons for drinking energy drinks were found to be recovery from fatigue, curiosity, taste, habit, thirst relief, and stress relief. In addition, 40.7% of participants experienced drinking energy drinks mixed with alcohol, and specifically 48.6% of male students and 27.4% of female students reported drinking energy drinks with alcohol (p<0.001). Moreover, 51.5% of participants responded that they experienced the effects of energy drinks, 31.9% reported experiencing adverse effects, and 41.1% were found to perceive the health risks. As a result of the assessment of caffeine knowledge, the participants showed a high level of knowledge of the arousal effect (77.7%) and the concentration increasing effect (70.8%) of caffeine, whereas they exhibited a low level of understanding of the health problems due to caffeine (32.6%) and adequate caffeine intake levels (24.4%). The higher levels of consumption experience of energy drinks was associated with higher body mass indexes (BMI) (p<0.01), higher academic years (p<0.01), lower levels of interest in health (p<0.05), smoking (p<0.001), alcohol consumption (p<0.05), and higher levels of perceived stress (p<0.05). Conclusions: The risk groups related to consumption of energy drinks among college students were identified as male students rather than female students, students in the third or fourth year of study associated with increased stress levels, and students with negative health behaviors. Therefore, support for diverse health and nutrition education for college students is required along with the improvement of internal and external environments of schools in order for college students to manage increased stress levels due to the schoolwork and preparation for employment and maintain positive health behaviors.

발작성 심방세동 환자의 신호평균 P파 분석 (Signal-Averaged P Wave Analysis in Patients with Paroxysmal Atrial Fibrillation)

  • 김인영;이종연;이병채;이용희;이종민;김선일;김준수
    • 대한의용생체공학회:의공학회지
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    • 제23권1호
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    • pp.1-8
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    • 2002
  • 심방세동은 가장 많이 나타나는 부정맥으로. 뇌졸중 등 심각한 합병증을 초래하는 질환이다 심방세동이 발작성으로 발생하는 경우 단시간내 불규칙적으로 발생하기 때문에 그 진단이 어렵다 본 연구에서는 발작성 심방세동 환자의 조기진단을 위하여 심실세동 등의 진단에 이용되는 신호평균 심전도를 이용한 분석방법을 사용하였다 심방세동의 징후가 있는 환자는 초기에 심방에서 심근의 전기전도가 지연된다는 이론을 근거로 심전도 P파의 길이를 진단의 기준으로 하였다. p파 길이를 정확히 측정하기 위하여 다양한 종류의 필터와 차단주파수에 대하여 분석하였으며. p파의 시작과 끝점을 판단하는 여러 방법을 시도하였다. 분석 방법의 신뢰성을 높이기 위하여 자동으로 P파 길이를 측정하는 알고리즘을 구현하였다. 구현된 알고리즘의 검증을 위해서 발작성 심방세동 이외의 병력이 없는 환자 38명과 정상인 32명을 대상으로 임상 데이터를 수집하였다. 분석 결과 30 Hz 차주파수를 가지는 LMS 필터를 사용하고. 절대치 8.75 $\mu N$를 기준으로 P파의 시작과 끝점을 측정하여 P파 길이를 계산할 때가 가장 높은 발작성 심방세동의 예측도를 가졌다. 또한 발작성 심방세동의 진단을 위한 가장 적합한 판별 값을 구하기 위하여 수신 동작 특성 곡선을 이용한 결과. 의사결정의 판별 값을 112 ms로 하는 경우 진단의 민감도 88 %. 특이도 64.4 %의 결과를 얻을 수 있었다

조혈성장인자 G-CSF 특성과 임상적 비젼 (Characteristics of Hematopoitic Growth Factor, G-CSF and Its Clinical Vision)

  • 박정혜;박정애;강석우;구태원;정경태
    • 생명과학회지
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    • 제21권11호
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    • pp.1652-1657
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    • 2011
  • 혈액세포의 분화와 성장은 20 여종 이상의 성장인자에 의해 조절된다. 혈액세포 생산에 관여하는 인자를 조혈 성장인자(hematopoitic growth factor)라고 한다. 조혈성장인자를 임상적으로 사용하기 위해 원핵생물 또는 진핵 생물 생산 시스템에서 재조합 단백질로 생산되고 있다. 그 중에서 Glranulocyte-Colony Stimulating Factor(G-CSF)는 호중구 세포 수가 감소된 암환자와 선천성 질병을 가진 환자에게 임상적 치료제로 아주 중요한 역할을 한다. 이 환자들은 충분하지 못한 호중구 세포로 말미암아 감염에 대한 위험이 아주 높으며 치사율 또한 높다. 두 종류의 재조합 G-CSF가 항암치료 후 발생하는 부작용으로 나타나는 호중구 세포 감소증 치료에 사용되고 있다. G-CSF의 중요성에 맞추어 G-CSF의 물리적 및 생물학적 기능에 대한 특성을 설명하였으며, 또한 항암치료와 G-CSF의 임상적 사용에 대한 연관성을 토론하였다. 마지막으로 두 종류의 재조합 G-CSF인 non-glycosylated G-CSF, filgrastim과 glycosylated G-CSF를 비교 설명하였으며, 이들 기존의 G-CSF에 비교되는 바이오시밀러에 대한 전망을 제시하였다.

대학생의 성 및 AIDS에 관한 의식 연구 (A Study on the University Student's Consciousness about Sex and AIDS)

  • 강병우
    • 보건교육건강증진학회지
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    • 제11권1호
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    • pp.43-56
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    • 1994
  • Although the officially confirmed incidence of the acquired immune deficiency syndrome(AIDS) has remained low thus far in Korea, the progression of the pandemic has been rapid, concerned about an eventual increase in transmission. Until a vaccine or cure is found, public information and education remain an important weapon against AIDS. For the year 2000, the current WHO projection is that there will be a cumulative total of 40 million HIV infections in man, woman and children, of which more than 90% will be in the developing countries. The incerased mortality among adults and children has raised concerns that AIDS may become so devastaing as to reverse positive population growth rates and wipe out entire population. In order to plan for the rising incidence of patient with AIDS, an assessment of AIDS-related cognition and behavior, attitude of the recognized high-risk groups is necessary. Considering that undergraduates have sexuality active and more oriented toward sexual concerns than other ages. Adolescents today are more sexually involved than in the past: The media, including films, music, and television, reinforce sexual concerns by preseating images of highly sexual adolescents. Incidence of both petting and sexual intercourse in higher and occurs at earlier ages, they are important reservoir of AIDS infection. Hence, it has become important to emymerats and describe the knowledge, attitude and behavior of them, I want.. This information will eventually guide the direction of change in public policies and education programs to meet the challenges of AIDS. The objective of this study were to identity Knowledge, Attitude, Experience of Sex and AIDS in Korea. The data were collected by survey at Korean Federation for AIDS Affairs, INC. and J university, K junior college. After October in 1993, surveyed with 507 student during their's college days in Seoul. The questionnaire was designed to provide information on sex and AIDS-related knowledge and attitudes and experience. AIDS-related knowledge was measured by using 26 questions on mode of transmission and AIDS-related attitudes were measured by 7 questions, AIDS-related experience was measured by 5 questions. There were the main dependent variables in our study, In conclusion, students during their university day need to develop AIDS-preventive education programs. Clearly, the many AIDS-prevention educational effort need to be guided by well trained health agents. Financial supports from all sectors (i.e., public and private) of our society are required to achieve that end. Further researches on AIDS-related Knowledge and Attitude and behaviors of undergraduates are needed for the development of comprehensive AIDS prevention programs.

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70세이상 환자에 대한 폐암 수술의 위험성 비교 (Comparision of Risk Factors in Lung Cancer Surgery of Above 70-Year Old Patients)

  • 장인석;심영목;김진국;김관민;유정우
    • Journal of Chest Surgery
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    • 제32권1호
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    • pp.32-37
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    • 1999
  • 배경: 폐암의 완치를 위한 가장 효과적인 치료 방법은 조기 진단과 외과적인 절제술이다. 고령의 환자군에서는 젊은 환자군에 비하여 폐암으로 진단된 경우 전신 건강 상태, 잔여 폐기능의 제한에 의하여 사용 가능한 모든 유용한 치료 방법을 최대한 이용하는 것이 불가능한 경우가 많다. 저자들은 외과적인 폐절제술을 시행한 환자군을 대상으로 후향적인 연구를 통하여 연령인자가 폐암의 병기, 조직학적 진단, 수술 방법, 합병증의 이환율과 사망률에 어떤 영향을 미치는 지 조사하였다. 대상 및 방법: 비소세포 폐암으로 진단받고 외과적인 절제술을 시행한 211명의 환자를 대상으로 하였다. 환자는 1994년 10월부터 1997년 6월까지 수술 받은 환자였다. 환자들을 인위적으로 70세 이상군(35명)과 미만군(176 명)으로 나누어 두 군을 의무기록을 참조로 비교 조사하였다. 결과: 폐암의 병기및 조직학적 진단은 두 군에서 차이가 없었다. 그러나 수술 방법, 합병증의 이환율, 사망률은 두 군 사이에 차이가 있었고, 70세 이상군에서 합병증의 이환율이 높은 것으로 나타났다(p = 0.02). 수술 방법에서 70세 이상군에서는 가능한 잔여 폐기능을 보존하는 덜 침습적인 시술이 선호되었다. 결론: 수술후 합병증의 이환율과 사망률은 70세이상 군에서 높아서 수술의 위험도가 높은 것으로 나타났다. 흉부 수술이 폐암의 완치를 목적으로 권유되어 질 수 있는 최선의 치료 방법이다. 그렇지만, 고령의 환자에서는 합병증의 이환율 및 사망률이 높게 발생한다. 따라서, 고령의 폐암 환자의 수술을 결정할 때, 수술 적응증과 수술 방법을 신중히 고려하여야 된다고 생각한다.

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Assessment of Respiratory Problems in Workers Associated with Intensive Poultry Facilities in Pakistan

  • Yasmeen, Roheela;Ali, Zulfiqar;Tyrrel, Sean;Nasir, Zaheer Ahmad
    • Safety and Health at Work
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    • 제11권1호
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    • pp.118-124
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    • 2020
  • Background: The poultry industry in Pakistan has flourished since the 1960s; however, there are scarce data regarding the impact of occupational exposure on the pulmonary health of farm workers in terms of years working in the industry. The objective of the present study was to assess the effect of poultry environment on the health of occupationally exposed poultry farmers in countries of warm climatic regions, such as Pakistan. This study will also show the effect of exposure to poultry facilities on the health of poultry farmers in the context of low-income countries with a relatively inadequate occupational exposure risk management. Materials and methods: The lung function capacity of 79 poultry workers was measured using a spirometer. Along with spirometry, a structured questionnaire was also administrated to obtain information about age, height, weight, smokers/nonsmokers, years of working experience, and pulmonary health of farm workers. The workers who were directly involved in the care and handling of birds in these intensive facilities were considered and divided into four groups based on their years of working experience: Group I (3-10 months), Group II (1-5 years), Group III (6-10 years), and Group IV (more than 11 years). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio were considered to identify lung function abnormalities. Statistical analysis was carried out using independent sample t test, Chi-square test, Pearson's correlation, and linear regression. Results: Based on the performed spirometry, 68 (86 %) of workers were found normal and healthy, whereas 11 (14 %) had a mild obstruction. Of the 11 workers with mild obstruction, the highest number with respect to the total was in Group IV (more than 11 years of working experience) followed by Group III and Group II. Most of the workers were found healthy, which seems to be because of the healthy survivor effect. For the independent sample t test, a significant difference was noticed between healthy and nonhealthy farmers, whereas Chi-square test showed a significant association with height, drugs, and working experience. Linear regression that was stratified by respiratory symptoms showed for workers with symptoms, regression models for all spirometric parameters (FVC, FEV1, and FEV1/FVC) have better predictive power or R square value than those of workers without symptoms. Conclusion: These findings suggest that lung function capacity was directly related to years of working experience. With increasing number of working years, symptoms of various respiratory problems enhanced in the poultry workers. It should be noted that most of the poultry workers were healthy and young, the rationale being that there is a high turnover rate in this profession. The mobility in this job and our finding of 86% of the healthy workers in the present study also proposed healthy worker survivor effect.

인터넷 게임 중독에 있어서 초등학생 고학년군과 중학생군 간의 정서 및 행동특성의 차이 (Internet Game Addiction and Emotional and Behavioral Characteristics in Upper Grade Elementary School Students and Middle School Students)

  • 정현;박태원;이승옥;이신후;정상근;정영철;양종철;조은정
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제21권2호
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    • pp.87-94
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    • 2010
  • Objectives : This study was aimed at investigating the relationship between internet game addiction and emotional and behavioral characteristics of students both in the 5th and 6th grade of elementary school and in middle school. Methods : Two elementary schools and two middle schools were chosen to participate. The students completed selfreport questionnaires designed by the authors, called the Internet Game Addiction Scale, Korean youth self-report (K-YSR). Results : Compared to previous studies, the rates of those in the obvious game addiction group were much lower in this study. We defined the upper 10% of internet game addiction scores as a high risk user group and the lower 10% as a control group. There were significant differences between the groups with respect to the the ages at which internet gaming began, the frequency of game play per week, and the average length of each game playing session. Significant associations were also found between the level of internet game addiction and the withdrawn and delinquency subscales of the K-YSR. However, the association between game addiction and the withdrawn subscale was found only in middle school students. Conclusion : The findings from this study suggested that withdrawn and delinquent behaviors could be predictors of internet game addiction. Results also suggested the importance of early childhood intervention for preventing the development of more severe psychopathology in early adolescence.

유전자와 생명의 사유화, 그리고 반공유재의 비극: 미국의 BRCA 인간유전자 특허 논쟁 (The Anticommons: BRCA Gene Patenting Controversy in the United States)

  • 이두갑
    • 과학기술학연구
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    • 제12권1호
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    • pp.1-43
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    • 2012
  • 이 글은 BRCA1과 BRCA2 두 인간유전자에 관련된 특허들에 대한 최근의 소송에서 제기된 인간유전자 특허의 여러 경제적, 법률적, 그리고 윤리적 쟁점들을 분석한다. 기존의 인간유전자 특허관련 연구들이 이의 법률적 논리와 윤리적 정당성에 대한 규범적인(normative) 분석에 초점을 두었다면, 이 글은 BRCA 관련 특허소송에의 기저에는 반공유재의 비극(the tragedy of the anticommons)이라 불리는 지적재산권과 경제혁신, 공공의 이익의 관계에 대한 새로운 이해가 존재하고 있음을 보일 것이다. 첫 부분에서는 2001년 미 특허청의 인간유전자 특허에 대한 정책의 형성과정에 대한 역사적인 분석을, 다음으로는 생명과학에서 지적재산권의 확대를 가져온 여러 경제적 가정들과 제도적 변화, 그리고 법적 판결들에 대한 비판적 논의를 소개할 것이다. 지적재산권의 한계와 생명의 사유화에 대한 비판을 통해서 BRCA 소송은 지적재산권의 정의와 그 범주, 그리고 이의 소유권을 둘러싼 논쟁이 공공의 이익, 과학과 의학 공동체의 창조적 지적활동과 환자들의 인권과 윤리의 문제가 복잡다단하게 얽혀있음을 보여주고 있다.

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