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신혈관성 고혈압 및 장골동맥 폐쇄에 대한 수술 (Surgical Treatment for Renovascular Hypertension and Iliac Artery Occlusion)

  • 류경민;류재욱;박성식;강태수;김석곤;서필원
    • Journal of Chest Surgery
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    • 제40권8호
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    • pp.582-586
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    • 2007
  • 48세 남자 환자가 조절되지 않는 고혈압 및 좌측 하지통증을 주소로 내원하였다. 컴퓨터 단층 혈관조영술에서 동맥경화에 의한 양쪽 신장동맥 폐쇄와 좌측 총장골동맥 폐쇄가 관찰되었으며, 2개월간의 내과적 치료로도 호전되지 않아 수술을 시행하였다. 수술은 8 mm 인공도관을 이용하여 대동맥-양측 신동맥간 우회수술 및 대동맥-좌측 대퇴동맥간 우회수술을 시행하였다. 수술 후 10개월간 1종류의 항고혈압제(안지오텐신 수용체 억제제)와 항응고제만 사용하면서 정상적인 혈압을 유지하고 있다. 수술을 통한 신혈관성 고혈압의 치료는 중재적 시술기법 및 약물치료의 발달 및 최근 감소하는 경향이나, 광범위한 동맥경화가 동반된 경우에는 수술치료가 필요하다. 본 증례는 광범위한 동맥경화에 의한 신혈관성 고혈압 및 좌측장골동맥 폐쇄 환자에 대한 수술치료로 좋은 결과를 얻었기에 보고하는 바이다.

미국, 한국, 중국 일간지의 '9.11 테러' 뉴스보도 비교분석 (An Analysis of the 9.11 Terror Attack News Reports on the Daily Newspapers in the U.S., Korea, and China)

  • 유세경;김미라
    • 한국언론정보학보
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    • 제18권
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    • pp.165-198
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    • 2002
  • 9.11 테러참사 사건에 대한 미국, 중국, 한국의 주요일간지 보도 비교분석 결과 자국의 이데올로기와 외교적 이해관계가 국제 분쟁에 관한 뉴스 프레임에 영향을 미치고 있다는 사실이 확인되었다. 뉴스 프레임은 양적, 질적인 측면에서 모두 차이를 보였는데, 기사량에서 미국의 <뉴욕 타임즈>, 한국의 <조선일보>는 9.11 테러사건 발생직후 신문의 거의 전 지면을 할애한 반면(382건, 192건) 중국의 인민일보는 단 32건의 기사만을 보도함으로써 이번 사건을 상대적으로 축소 보도하였다. 뉴스 내용에서도 <뉴욕 타임즈>와 <조선일보>는 9.11 테러와 아프간 공습을 미국 정부의 공식적인 시각대로 '인류 평화를 위협하는 악의 전쟁행위' 그에 따른 '필연적인 미국의 군사보복과 응징'의 틀을 통해 미국의 아프간에 대한 무력 공격을 정당화시킨 반면, 중국의 <인민일보>의 경우에는 9.11 테러와 관련해서는 중립적 시각에서 사실보도만을 하고, 미국의 공습과 관련해서는 무고한 아프간 민간인들의 회생과 고통을 부각함으로써 현저하게 다른 뉴스 프레임을 견지한 것으로 나타났다. 이야기 구성방식에서는 세 나라의 일간지 모두 특정 사건 중심으로 에피소드를 전핸 일화 중심적 뉴스틀을 사용한 것으로 나타났다.

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내로우 스쿼트 운동이 내반슬 성인의 무릎 사이 거리와 보행 시 무릎 관절의 생체역학에 미치는 즉각적인 영향 (The Immediately Effect of Narrow Squats on the Knee Joint Biomechanics During a Gait and Distance Between the Knees of Person With Genu-varum)

  • 한석규;김택훈;노정석;최흥식;이준영
    • 한국전문물리치료학회지
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    • 제25권3호
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    • pp.19-26
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    • 2018
  • Background: Genu varum is also known as bow leg. It is a deformity wherein there is lateral bowing of the legs at the knee. it does give rise to pain, and persistent bowing can often give rise to discomfort in knees, hips and ankles. Objects: This study investigated the effect of narrow squats on the knee joint during a gait and distance between the knees of person with genu varum. Methods: This study analyzed 23 patient with genu varum that grade III, 12 narrow squat group and 11 genenal squat group in motion analysis laboratory. The subjects of experiment took gait before and after intervention, the range of joint motion, moment of knee joint adduction, power, distance of the knees were measured. And in order to make an analysis between groups, an paiered t-test and independent t-test was carried out. For statistical significance testing, it was decided that significance level ${\alpha}$ be .05. Results: It was shown that the group of narrow squat exercise significantly decreased in distance of knees (p<.05),In moment of adduction of knee joint, it was shown to significantly decrease in two groups (p<.05), was significantly decreased in adduction, abduction, and rotation (p<.05). In relation of peak-knee adduction moment and valgus angle, there was significant decrease in narrow squat group (p<.05). Conclusion: When the above result of study were examined, a narrow squat exercise given to the genu varum patients significantly decreased the distance between the knees, range of knee adduction and abduction, knee adduction moment, knee power. And stability gains through the decrease of excursion of knee medial part be effective for the correction of genu varum deformation.

정신과 병동 간호사와 일반병동 간호사의 스트레스 반응양상에 대한 비교연구 (Comparative Study on the Stress Response of Nurses Working on Pscychiatric Wards to that of Nurses Working on General Wards)

  • 김영자
    • 대한간호학회지
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    • 제25권3호
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    • pp.399-418
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    • 1995
  • The purpose of this study was to investigate the stress response of nurses working on psychiatric wards (psychiatric nurses) compared with that of nurses working on general wards (general nurses) in order to provide assessment data for intervention of the stress response. The Symptoms of Stress Inventory was used to measure the stress response. Data were collected by a direct survey method using a questionnaire and were collected from March first to March 30, 1995. A sample of 200 nurses working in three psychiatric hospitals and psychiatric wards in four university hospitals in Seoul and Kangwon province were selected and 200 nurses working on general wards from two general hospitals in Seoul were also selected for a total sample of 400 nurses. Nurses who had experienced more than one of the major life events in the last two years were excluded from the total number in the samples, so the final sample was 161 psychiatric nurses, and 169 general nurses. The Scores for the total stress response, scores of the SOS subscales, stress response by sociodemographic characteristics of the nurses working on the psychiatric wards were compared with those of nurses working on the general ward. The results of this investigation are as follows 1. The mean total SOS score for the psychiatric nurse was 0.81 (SD=0.48) and that of the general nurses was 0.90(SD=0.53). 2. The Mean score for peripheral manifestation, con tral-neurological symptoms, gastrointestinal symptoms, muscle tension, habitual patterns, de-pression, anxiety, anger and cognitive disorganization for the general nurses showed a tendency to be higher than those of the psychiatric nurses. Mean score for cardiopulmonary symptoms for the general nurses was significantly higher than that of the psychiatric nurses. 3. The mean scores for the sixteen SOS items for the general nurses was significantly higher than for the psychiatric nurses. The 16 items were flushing of the face, sweating excessively even in cold weather, thumping of the heart, rapid breathing, dry mouth, a choking lump in the throat, hoarseness, muscle tension in hands or arm, muscle tension in leg, working tiring one out completely, severe aches a핀 Pain make it diffi-cult to do the work, severe nervous exhaustion, worrying about health, feeling weak and faint, so upset that one wants to hit something, unable to keep thoughts from running through one's mind. The mean score of only 505 item were significantly higher for the psychiatric nurses. 4. Stress responses between psychiatric nurses and general nurses were significantly different according to the following demographic characteristics : marriage, duration of work, position, accommodation, planning to move into another working site, working ward, education in psychiatric nursing.

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Assessment of the quality of life in maxillectomy patients: A longitudinal study

  • Kumar, Pradeep;Alvi, Habib Ahmad;Rao, Jitendra;Singh, Balendra Pratap;Jurel, Sunit Kumar;Kumar, Lakshya;Aggarwal, Himanshi
    • The Journal of Advanced Prosthodontics
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    • 제5권1호
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    • pp.29-35
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    • 2013
  • PURPOSE. To longitudinally assess the quality of life in maxillectomy patients rehabilitated with obturator prosthesis. MATERIALS AND METHODS. Thirty-six subjects were enrolled in the span of 16 months, out of which six were dropouts. Subjects (age group 20-60 years) with maxillary defects, irrespective of the cause, planned for definite obturator prosthesis, were recruited. The Hindi version of European Organization for Research and Treatment of Cancer, Head and Neck version 1 of Quality of Life Questionnaire was used before surgical intervention and one month after definitive obturator. Questionnaire includes 35 questions related to the patient's physical health, well being, psychological status, social relation and environmental conditions. The data were processed with statistical package for social science (SPSS). Probability level of P<.05 was considered statistically significant. RESULTS. The quality of life after rehabilitation with obturator prosthesis was 81.48% (${\pm}13.64$) on average. On item-level, maximum mean scores were obtained for items problem with teeth ($1.87{\pm}0.94$), pain in mouth ($1.80{\pm}0.92$), trouble in eating ($1.70{\pm}0.88$), trouble in talking to other people ($1.60{\pm}1.22$), problems in swallowing solid food ($1.57{\pm}1.22$) and bothering appearance ($1.53{\pm}1.04$); while minimum scores were obtained for the items coughing ($1.17{\pm}0.38$), hoarseness of voice ($1.17{\pm}0.53$), painful throat ($1.13{\pm}0.43$), trouble in having social contacts with friends ($1.10{\pm}0.40$) and trouble having physical contacts with family or friends ($1.10{\pm}0.31$). CONCLUSION. Obturator prosthesis is a highly positive and non-invasive approach to improve the quality of life of patients with maxillectomy defects.

복합운동이 과체중 및 비만청소년의 신체구성, 혈중지질 및 BDNF에 미치는 영향 (Effects of Combined Exercise on Body Composition, Blood Lipids, and BDNF in Obese Adolescents)

  • 신석민;김철형
    • 생명과학회지
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    • 제22권9호
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    • pp.1231-1236
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    • 2012
  • 비만은 여러 가지 질환을 유발하는데 이중에서도 뇌신경세포의 활성 및 생성에도 부정적인 영향을 미치는 것으로 보고되고 있어 이에 대한 추가적인 연구가 필요하다. 본 연구는 과체중 및 비만 청소년의 BDNF 개선을 위한 운동 효과를 검증하고자 12주 복합운동에 따른 신체구성, 혈중지질, BDNF의 변화를 분석하였다. 이를 위해 과체중 및 비만 청소년 18명을 복합운동군 9명, 대조군 9명으로 무선표집하여 연구를 진행하였다. 연구 결과 통계적으로 집단간 차이를 보이며 체중(p<0.01), BMI (p<0.05), 체지방률(p<0.05), 체지방량(p<0.01)이 감소하고, 제지방률(p<0.05)이 증가하였다. 또한 TC와 LDL-C의 평균은 운동군이 대조군보다 더 많은 감소 경향을 나타내었고, HDL-C는 두 집단 모두 감소하는 경향을 보였으나 모두 집단간 차이는 나타나지 않았다. 또한 BDNF의 평균은 운동군이 대조군보다 더 많은 증가 경향을 나타내었으나 집단간 차이는 나타나지 않았다. 본 연구를 통하여 12주 복합운동 프로그램은 과체중 및 비만 남자 청소년의 체중, BMI, 체지방률, 체지방량, 제지방률은 개선시킬 수 있으나 혈중 지질 및 BDNF의 변화에는 영향을 미치지 못하는 것을 알 수 있었다. 본 연구를 통하여 12주 복합운동 프로그램은 과체중 및 비만 남자 청소년의 체중, BMI, 체지방률, 체지방량, 제지방률은 개선시킬 수 있으나 혈중 지질 및 BDNF의 변화에는 영향을 미치지 못하는 것을 알 수 있었다.

류마티스 관절염 환자의 적응 예측모형 -Roy이론과 Lazarus 및 Folkman 이론의 명제 합성- (The Prediction Model of Adaptation in Patients with Rheumatoid Arthritis - Propositional Synthesis of Roy's and Lazarus & Folkman's Theory -)

  • 김인자;서문자
    • 근관절건강학회지
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    • 제4권2호
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    • pp.197-220
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    • 1997
  • The lack of a comprehensive theory describing the mechanism of adaptation scientifically has been one of the limiting factors for the development of nursing intervention of patients with chronic illness. Since Roy's theory provides the general conceptual framework depicting adaptation process with structural stimuli and control mechanism, it is appropriate to understand the process of adaptation. But in Roy's theory, the propositions about cognator and regulator as control mechanisms are not clearly defined. For this reason, most of the previous researches applying the Roy's theory have disregarded the study of cognator and regulator. For the patients with chronic illness such as rheumatoid arthritis, it was reported that adaptation states were different for the same stimuli due to the difference of the control mechanism. Moreover in nursing it is important to identify the control mechanism which can be and must be intervened by nurses. It was the Lazarus and Folkman's theory that proposed the control mechanism. They suggested that individual differences in the reaction against the perceived stress are due to the difference in appraisal and coping. Therefore, the synthesis of Roy's and Lazarus and Folkman's propositions might help to clearly understand the mechanism of adaptation. From this point, a theoretical framework has been developed and tested. The subjects were the 297 patients who had been diagnosed rheumatoid arthritis and attended the outpatient clinic. A hypothetical prediction model of adaptation was tested by the covariance structure analysis with PC-LISREL 7.13. As a result, the overall fit was good($x^2$=78.83, p=0.00 ; GFI=0.96 : AGFI=0.90 ; RMR=0.04) for the hypothetical model. In the final model added GA(5, 1), the overall fit was increased ($x^2$=57.82, p=0.003 ; GFI=0.97 ; AGFI=0.93 : RMR=0.036). Except the fact that illness symptoms affected physical adaptation directly, it was supported that focal and contextual stimuli affected physical and psychosocial adaptation through appraisal and coping. Therefore, it was asserted that the synthesis of two theory's propositions was appropriate. So this model would be useful for the theoretical framework in the nursing practice. And this study synthesizing and testing the theory might contribute to establish nursing's scientific base.

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노인물리치료를 위한 저항트레이닝 처방에 대한 탐색 (An Exploration on Prescription of Resistance Training for Geriatric Physical Therapy)

  • 신홍철;정동혁
    • The Journal of Korean Physical Therapy
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    • 제15권1호
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    • pp.61-81
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    • 2003
  • There can be little dissension that the ultimate goal of all physical therapy interventions with the elderly is to restore or maintain the highest level of function possible for the individual. Whenever physical therapists take on this challenge, they assist elders in maintaining their identities as competent adults. Advancing age is associated with profound changes in body composition, including increased fat mass, decreased fat-free mass(particularly muscle), decreased total body water and decreased bone density. Along with these changes in body compositions, and perhaps as a direct result of them, elderly people have lower energy needs, reduced strength and functional capacity and a greatly increased risk for such diseases as noninsulin-dependent diabetes mellitus and osteoporosis. Resistance training is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density. In the past couple of decades, many studies have examined the effects of Resistance training on risk factors for age-related diseases or disabilities. We have explored the positive and negative aspects of older adults' participation in resistance training programs. The benefits to older adults are reported to be increased strength, endurance, muscle capacity, and flexibility; more energy; and improved self-image and confidence. The negative aspects include some pain or stiffness and other nonspecific problems. The positive and negative aspects of resistance training are therefore very similar to those in younger populations. Scientific investigations over the past 10 years have demonstrated that resistance training can be safely and successfully implemented in older populations. Even the frail and very sick elderly can benefit and improve their quality of life. Proper design and progression of a resistance training program for older adults is vital to optimal benefits from resistance exercise. The results of data provided by this research on resistance training for health shows that there is enough existing evidence to conclude that resistance training, particularly when incorporated into a comprehensive fitness program, can offer substantial health benefits which can be obtained by persons of all ages. These benefits, including improvements in functional capacity, translate into an improved quality of life.

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북한이탈주민의 남한사회 적응 경험 (Experience of Adaptation of North Korean Defectors in the South Korean Society)

  • 김미영;변은경
    • 한국산학기술학회논문지
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    • 제20권2호
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    • pp.593-604
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    • 2019
  • 본 연구는 북한이탈주민을 대상으로 남한사회 적응 경험을 포괄적이고 심층적으로 파악하기 위하여 시도된 현상학적 연구이다. 자료수집은 2016년 7월부터 2017년 6월까지로 하였고, 북한이탈주민 10명을 대상으로 그들의 남한사회 삶의 적응 경험을 인터뷰를 통해 이루어졌다. 수집된 자료는 Colaizzi 방법으로 분석하였다. 연구 참여자는 총 10명으로 남성 5명, 여성 5명이었고, 나이는 40대가 5명, 50대가 5명으로 나타났다. 결혼상태는 미혼이 4명, 기혼 6명으로 나타났다. 연구 참여자로 부터 얻은 원자료에서 남한사회 삶의 적응 경험을 분석한 결과 180개의 본질적인 의미단위를 추출하였고, 본질적인 의미단위에서 19개의 주제와 6개의 주제모음, 4개의 범주로 구조화할 수 있었다. 4개의 범주는 '다른 세상 마주하기', '이방인으로 살기', '적응하기', '자아실현하기'였다. 6개의 주제모음은 '새로운 세상을 만남', '심리적인 고통', '현실의 벽', '남한사회에 표류', '남한 사람이 되어감', '주체적인 삶'으로 도출되었다. 본 연구를 바탕으로 북한이탈주민의 남한사회 적응 경험에 대한 반복연구와 남한사회에서 적응을 도울 수 있는 중재 프로그램 개발과 그 효과를 확인하는 연구가 필요하다.

소아암 환아와 가족을 위한 가족희망파트너사업의 효과에 대한 질적 평가 (Qualitative Evaluation of Effectiveness of 'Family Hope Partner Project' for Pediatric Cancer Patients and their Families)

  • 김선희
    • 한국가족복지학
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    • 제55호
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    • pp.59-90
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    • 2017
  • 본 연구는 소아암 환아와 가족을 위해 한국백혈병소아암협회에서 실시된 '가족희망파트너사업' 의 총체적인 효과를 규명하고 이들에 대한 지원의 실증적 기초자료를 마련하는데 그 목적이있다. 이를 위해 본 연구는 '가족희망파트너사업'을 통해 1년 이상 서비스를 이용 중인 보호자6명, 소아암 아동 5명을 2016년 6~7월까지 인터뷰하였으며, 수집된 자료는 질적분석 과정을거쳐 해석되었다. 본 연구의 결과는 다음과 같다. 소아암 환아와 가족은 '혹독한 아픔의 장벽' 과 '소용돌이치는 불안과 소진'에 직면해있었는데, '가족희망파트너사업'을 통해 연계된 '회복과 성장의 디딤돌이 되어준 참 스승'으로 말미암아 다차원적인 효과를 경험하게 되었다. 즉'환아의 전반적인 재활 지원', '가족관계의 향상', '사회적 관계에 대한 해갈(解渴)', '압박에서의 해방'이라는 긍정적인 효과들을 체험하게 되었다. 본 연구는 '가족희망파트너사업'의 다차원적인 효과를 심층적으로 확증하였으며, 한국백혈병소아암협회에 의해서 소아암 환아와 가족을 위해 국내외적으로 최초로 시도된 '가족희망파트너사업'의 방향성을 모색하였다는데 의의가있다.