• 대한간호학회지
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• 제27권2호
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• pp.433-443
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• 1997

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objective information for patients undergoing cardiac catheterization : 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms -coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor or nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%. and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.

• 한국안광학회지
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• 제17권3호
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• pp.285-291
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• 2012

목적: VDT 작업이 조절기능에 주는 영향을 알아보고자 하였다. 방법: 조절기능 이상과 전신 및 안질환이 없고 교정수술을 받은 경험이 없는 대학생 48명(남 16명, 여 32명)을 대상으로 VDT 작업 전과 2시간 작업 후의 굴절력, 조절래그, 조절용이성, 상대조절력과 최대조절력, 순목 횟수 값을 측정하였다. 원거리 굴절교정 도수를 착용한 상태에서 모든 검사를 실시하였고 VDT 증후군의 자각증상에 관련된 항목에 대해 설문조사를 실시하였다. 결과: 2시간동안 VDT 작업 후의 굴절력변화는 0.23 D 증가하였고, 조절래그 변화량은 우안에서는 $0.17{\pm}0.42D$, 좌안에서는 $0.23{\pm}0.47D$(t=2.26, p=0.03) 만큼 증가하였고 통계적으로 유의한 차이를 나타내었다. 조절용이성과 상대조절력과 조절력은 VDT 작업 후에 모두 감소하는 경향을 보였으나, 순목 횟수는 증가하는 양상을 보였다. VDT 작업 후 안정피로가 33.4%, 어깨통증이 33.3%의 자각증상을 보였다. 결론: 2시간 VDT 작업 시간에 따라 조절래그는 증가하였고, 전반적인 조절기능의 능력이 감소하는 경향을 보였으며, 시각적 부담을 주는 증상으로는 안정피로가 가장 높은 자각도를 보였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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• pp.253-260
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• 2015

Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods: Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results: The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion: A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.199-202
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• 2011

Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

• 동의생리병리학회지
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• 제24권6호
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• pp.983-988
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• 2010

The present study aims to investigate a possible mechanism of electroacupuncture (EA) in the spinal dorsal horn that may underlie N-methyl-D-aspartate (NMDA) receptor-associated extracellular signal-regulated kinase (ERK) mitogen-activated protein kinase (MAPK) signaling pathways. The hot plate latency of the ipsilateral hindpaw of EA-treated rats was significantly decreased compared with complete Freund's adjuvant (CFA)-injected ones. The expressions of NR1 and NR2B subuint mRNA of NMDA receptor in the whole L4-5 segments are decreased by CFA treatment, but NR2B subunit was significantly recovered by EA treatment. When we detected the expression of ERK, there were no significant difference between normal and CFA-treated rats with EA or NMDA receptor antagonist MK801. But phosphorylated ERK expressions were markedly induced by CFA, but these inductions were significantly modulated by EA treatment. Although hosphorylation of ERK was also arrested by MK801, these inductions of CFA-injected rats was markedly inhibited only by co-treatment with EA and MK801. Phosphorylated cAMP response element-binding protein (CREB), ERK-related transcriptional factor, showed a significant increase in CFA-treated rats and this increase was slightly inhibited by EA and MK801 treatments. But immunoreaction for phosphorylated CREB were significantly increased by CFA treatment in the superficial laminae of the dorsal horn and these inductions were significantly arrested by co-treatment of EA and MK801. Consequently, the hyperalgesia induced by CFA are associated NMDA receptor and EA and MK801 may showed anti-hyperalgesia via same mechanism for inhibition of ERK and CREB phosphorylation in the dorsal horn.

• 한국산업보건학회지
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• 제29권4호
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• pp.550-561
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• 2019

Objectives: The purpose of this study is to provide basic data for the improvement of the working environment for health prevention and related countermeasures for shift workers. This study was conducted based on the Fifth Korean Working Conditions Survey (KWCS), which analyzed the health effects of shift work forces and compared them with preceding studies. Methods: By analyzing secondary rates using raw data from the 5th KWCS, 4,870 (9.7%) of the 50,184 total study subjects were divided into shift work and 45,314 (90.3%) non-shift work groups based on the response to shift status. Variables that could affect work health issues were identified and corrected. A cross-analysis was conducted to examine demographic characteristics (gender, age, and education level) of the workers and occupation characteristics (monthly net earnings, employment type, occupation, working period up to now, workplace scale, type of work system, and weekly working hours). In order to find the work health issue ratio between the shift and non-shift work groups, logistic regression was analyzed and the association with health problems according to shift type by gender was looked at through cross-analysis. Results: According to the surveys conducted from the 1st KWCS (2006) to the 5th KWCS (2017), the proportion of shift workers continued to increase. Also, muscular pains in the lower limbs (hips, legs, knees, feet, etc.) (OR=1.135, 95%CI 1.031-1.251), headaches, eyestrain (OR=1.580, 95% CI 1.428-1.748), anxiety (OR=1.715, 95% CI 1.402-2.099), difficulty falling asleep (OR=1.391), and other problems (OR=7.392) were reported. In addition, back pain, muscular pains in shoulders, neck and/or upper limbs, muscular pains in lower limbs (hips, legs, knees, feet, etc.), headaches, eyestrain, depression, anxiety, overall fatigue resulted in significant results for both male and female shift workers. Depression and anxiety were higher in female shift/circulation compared to males. Conclusions: The social nets for the health and safety of shift workers should be explored in a variety of ways, including management and supervision of shift sites, attempts to reorganize and improve the shift system, development of workers' health recovery programs, promotion, systematic treatment, and compensation systems.

• Tuberculosis and Respiratory Diseases
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• 제65권4호
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• pp.334-338
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• 2008

흉막의 고립성 섬유성 종양은 주로 흉막통, 호흡곤란, 기침 등의 증상으로 발현하거나 무증상으로 발견되는 경우가 대부분이다. 본 증례의 환자는 흉막의 고립성 섬유성 종양의 거대한 종괴 영향에 의한 압박증상과 동반된 폐렴, 패혈 쇼크와 급성 호흡곤란의 진행으로 매우 치명적인 임상 양상을 보였으며, 기계환기법과 항생제, 승압제 등의 치료 후에 종양절제술로 호전되었다. 저자들은 흉막의 고립성 섬유성 종양으로 인한 치명적인 임상 경과를 보인 증례 1예를 경험하였기에 문헌고찰과 함께 보고한다.

• 한국임상수의학회지
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• 제24권1호
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• pp.32-34
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• 2007

3개월 령, 35kg의 수컷 볼조이가 간헐적인 좌측 전지 파행을 주 증상으로 내원 하였다. 1년 전 심한 운동 후 간헐적인 파행 및 동통을 호소하였으며, 증상은 계속 악화되었다. 신체 검사 상에서 좌측 두갈래근의 촉진과 견관절의 굴곡 및 신장 시에 통증을 호소하였다. 일반방사선 검사에서 좌측 견관절의 결절사이고랑에서 골증식체와 관절주위변성이 관찰되었다. 관절 조영상에서는 좌측 두갈래근 힘줄에 거칠고 불규칙한 영상을 확인할 수 있었다. 활액 검사 상에서는 퇴행성 관절 질환 소견이 보였다. 이상의 검사들을 바탕으로 두갈래근 힘줄 윤활막염으로도 진단하고, 내과적 치료를 실시하였다. 무균적으로methylprednisolone acetate 40mg을 관절낭 내로 주사하고, 3주간 엄격한 운동 제한을 실시하였다. 3주 후 내원 시 두갈래근 힘줄의 통증은 완전히 소실되었으나 퇴행성 관절염에 의한 경등도의 파행이 존재하여 NSAIDs의 투여를 실시하였다. 장기적인 예후의 관찰이 필요할 것으로 생각되며, 원발질환의 재발 시에는 2차 약물치료 또는 힘줄 절단술(힘줄 고정술, 힘줄박리술)등 을 통한 수술적인 치료가 고려될 수 있다.

• 정신신체의학
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• 제5권1호
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• pp.3-11
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• 1997

In becoming parents, the marital partners enter into a new developmental phase. The conception of the child is an act of mutual creativity during which the boundaries between the self and another were temporarily obliterated more completely than at any time since infancy. The infant is a physical fusion of the parents, and their personalities unite within the child. for many women, creativity as a mother becomes a central matter that provides meaning and balance to their lives. The husband usually has strong desires for an offspring and can be transformed by it. The child can profoundly affect one or both parents, and the influences are reciprocal-a child's needs or specific difficulties uncover a parent's inadequacy. following the child's development, each transition into a new developmental phase requires an adaptation by the parents, and one or another of these required adaptations may disturb a parent's equilibirium. And the personality changes, emotional difficulties, and regressions of a spouse that occur in response to some phase of parenthood can upset the marriage. Not only do children identify with parents, but parents also identify with their children. The parents take pleasure in child's joy and suffer with the child's pain more than in almost any other relationship. certain respects e parents lives again in the child. Through the process of identification the child can also provide one of the two parents with the opportunity to experience intimately the way in which a person of the opposite gender grows up. Parenthood also provides the opportunity to be loved, admired, and needed simply because one is a parent and, as such, a central and necessary object in the young child's life. The many potentialities for emotional satisfactions from parenthood manage to outweigh the tribulations and sacrifices that are required. The child also exerts an indirect effect through changing the parent's position in the society, for new sets of relationships are established as the parents are drawn to other couples with children of the same age, and for a new impetus toward economic and social mobility often possesses the parents. frequently the couple's relatedness to their own parents improves and grows firmer once again. Parenthood, the satisfactions it provides and the demands it makes, varies as life progresses : and changes with the parent's interests, needs, and age as well as with the children's maturation. There are phases in the child's life that the parents are reluctant to have pass, whereas they tolerate others largely through knowing that they will soon be over. The changing lives of the children provide many satisfactions that offset the tribulations, uncertainties, and regrets. The parents change. The young father, who was just starting on his carrier whom the first child was born, settles into a life pattern. He becomes secure with increasing achievement and interacts differently with the youngest child and provides a different model for him than for the oldest. The mother may have less time for a second or third child than for her first, but she may also be more assured in her handling of them. The birth of a baby when the parents art in their late thirties will find them Less capable of physical exertion with the child and less tolerant of annoyances, but they are less apt to be annoyed. Eventually the children min and leave home, but the couple do not cease to be parents.

• The Korean Journal of Physiology and Pharmacology
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• 제11권3호
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• pp.97-106
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• 2007

The present study was attempted to investigate the effect of nicorandil, which is an ATP-sensitive potassium ($K_{ATP}$) channel opener, on secretion of catecholamines (CA) evoked by cholinergic stimulation and membrane depolarization from the isolated perfused rat adrenal glands. The perfusion of nicorandil ($0.3{\sim}3.0mM$) into an adrenal vein for 90 min produced relatively dose-and time-dependent inhibition in CA secretion evoked by ACh (5.32 mM), high $k^+$ (a direct membrane depolarizer, 56 mM), DMPP (a selective neuronal nicotinic receptor agonist, $100{\mu}M$ for 2 min), McN-A-343 (a selective muscarinic $M_1$ receptor agonist, $100{\mu}M$ for 4 min), Bay-K-8644 (an activator of L-type dihydropyridine $Ca^{2+}$ channels, $10{\mu}M$ for 4 min) and cyclopiazonic acid (an activator of cytoplasmic $Ca^{2+}$-ATPase, $10{\mu}M$ for 4 min). In adrenal glands simultaneously preloaded with nicorandil (1.0 mM) and glibenclamide (a nonspecific $K_{ATP}$-channel blocker, 1.0 mM), the CA secretory responses evoked by ACh, high potassium, DMPP, McN-A-343, Bay-K-8644 and cyclopiazonic acid were recovered to the considerable extent of the control release in comparison with that of nicorandil-treatment only. Taken together, the present study demonstrates that nicorandil inhibits the adrenal CA secretion in response to stimulation of cholinergic (both nicotinic and muscarinic) receptors as well as by membrane depolarization from the isolated perfused rat adrenal glands. It seems that this inhibitory effect of nicorandil may be mediated by inhibiting both $Ca^{2+}$ influx and the $Ca^{2+}$ release from intracellular store through activation of $K_{ATP}$ channels in the rat adrenomedullary chromaffin cells. These results suggest that nicorandil-sensitive $K_{ATP}$ channels may play an inhibitory role in the regulation of the rat adrenomedullary CA secretion.