• 제목/요약/키워드: test procedures

검색결과 1,849건 처리시간 0.031초

가상현실(Virtual Reality)을 활용한 핵심간호술 훈련이 지식, 수행, 수행자신감, 자기효능감, 문제해결능력에 미치는 효과 (The Effects of Simulation Education using Virtual Reality based Core Nursing Skills Training Program on Knowledge, Nursing Practice, Self-Confidence in Performance, Self-Efficacy, and Problem Solving Ability in Nursing Students)

  • 이경미;정미란;임소연;유영미;민신홍
    • 산업융합연구
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    • 제22권5호
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    • pp.97-105
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    • 2024
  • 본 연구의 목적은 HMD 기반의 가상현실을 활용한 핵심간호술 훈련이 간호 학생의 지식, 수행도, 수행자신감, 자기효능감, 문제해결능력에 미치는 효과를 알아보고자 시행되었다. 연구 대상은 A지역 소재 1개 대학에 재학 중인 4학년 간호학생 45명이며, 가상현실 활용 핵심간호술 훈련을 적용한 실험군 21명, 마네킨 모형 사용의 고전적 방법을 활용한 대조군 24명이다. 실험군과 대조군은 핵심간호술 훈련을 마친 후, 술기가 포함된 시뮬레이션을 수행하였다. 자료 수집은 2022년 10월 3일부터 10월 28일까지 시행되었으며, 수집된 자료는 서술적 통계, t-검정(t-test)로 분석하였다. 연구 결과, 중재 이후 간호학생의 지식은 실험군이 유의하게 더 높았고(t=-2.13, p=.039), 수행자신감은 대조군이 유의하게 더 높았다(t=2.63, p=.012). 수행도, 자기효능감, 문제해결능력은 유의미한 차이가 없었다. 따라서 가상현실을 활용한 핵심간호술 훈련은 간호학생들이 실제 수행을 하기 전 지식과 수행 절차를 익히는데 유용하게 활용될 수 있으며, 마네킨 모형을 사용하는 고전적 핵심간호술 훈련은 간호 학생들의 술기 자신감 향상을 이끌어 낼 수 있을 것으로 사료된다.

Smooth versus Textured Tissue Expanders: Comparison of Outcomes and Complications in 536 Implants

  • Omar Allam;Jacob Dinis;Mariana N. Almeida;Alexandra Junn;Mohammad Ali Mozaffari;Rema Shah;Lauren Chong;Olamide Olawoyin;Sumarth Mehta;Kitae Eric Park;Tomer Avraham;Michael Alperovich
    • Archives of Plastic Surgery
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    • 제51권1호
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    • pp.42-51
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    • 2024
  • Background Increasing concerns regarding the safety of textured surface implants have resulted in surgeons transitioning from textured tissue expanders (TEs) to smooth TEs. Given this change has only recently occurred, this study evaluated outcomes between smooth and textured TEs. Methods Women who underwent two-stage breast reconstruction using TEs from 2013 to 2022 were included. TE-specific variables, perioperative information, pain scores, and complications were collected. Chi-squared, t-test, and linear regression analyses were performed. Results A total of 320 patients received a total of 384 textured and 152 smooth TEs. Note that 216 patients received bilateral reconstruction. TEs were removed in 9 cases. No significant differences existed between groups regarding comorbidities. Smooth TEs had a higher proportion of prepectoral placement (p < 0.001). Smooth TEs had less fills (3±1 vs. 4±2, p < 0.001), shorter expansion periods (60±44 vs. 90±77 days, p < 0.001), smaller expander fill volumes (390±168 vs. 478±177 mL, p < 0.001), and shorter time to exchange (80±43 vs. 104±39 days, p < 0.001). Complication rates between textured and smooth TEs were comparable. Smooth TE had a greater proportion of TE replacements (p = 0.030). On regression analysis, pain scores were more closely associated with age (p = 0.018) and TE texture (p = 0.046). Additional procedures at time of TE exchange (p < 0.001) and textured TE (p = 0.017) led to longer operative times. Conclusion As many surgeons have transitioned away from textured implants, our study shows that smooth TEs have similar outcomes to the textured alternatives.

Surgery for symptomatic hepatic hemangioma: Resection vs. enucleation, an experience over two decades

  • Nalini Kanta Ghosh;Rahul R;Ashish Singh;Somanath Malage;Supriya Sharma;Ashok Kumar;Rajneesh Kumar Singh;Anu Behari;Ashok Kumar;Rajan Saxena
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.258-263
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    • 2023
  • Backgrounds/Aims: Hemangiomas are the most common benign liver lesions; however, they are usually asymptomatic and seldom require surgery. Enucleation and resection are the most commonly performed surgical procedures for symptomatic lesions. This study aims to compare the outcomes of these two surgical techniques. Methods: A retrospective analysis of symptomatic hepatic hemangiomas (HH) operated upon between 2000 and 2021. Patients were categorized into the enucleation and resection groups. Demographic profile, intraoperative bleeding, and morbidity (Clavien-Dindo Grade) were compared. Independent t-test and chi-square tests were used for continuous and categorical variables respectively. p-value of < 0.05 was considered significant. Results: Sixteen symptomatic HH patients aged 30 to 66 years underwent surgery (enucleation = 8, resection = 8) and majority were females (n = 10 [62.5%]). Fifteen patients presented with abdominal pain, and one patient had an interval increase in the size of the lesion from 9 to 12 cm. The size of hemangiomas varied from 6 to 23 cm. The median blood loss (enucleation: 350 vs. resection: 600 mL), operative time (enucleation: 5.8 vs. resection: 7.5 hours), and postoperative hospital stay (enucleation: 6.5 vs. resection: 11 days) were greater in the resection group (statistically insignificant). In the resection group, morbidity was significantly higher (62.6% vs. 12.5%, p = 0.05), including one mortality. All patients remained asymptomatic during the follow-up. Conclusions: Enucleation was simpler with less morbidity as compared to resection in our series. However, considering the small number of patients, further studies are needed with comparable groups to confirm the superiority of enucleation over resection.

폐 국균증의 외과적 치료(제 3보) (Surgical Treatment of Pulmonary Aspergillosis (III))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • 제36권7호
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    • pp.497-503
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    • 2003
  • 폐 국균종은 폐결핵 등 만성 폐질환으로 인하여 파괴된 폐조직에 국균이 2차적으로 기생하여 발생하는데, 치명적 각혈 등의 증상이 발생할 수 있기 때문에 상당수 증례에서 수술적 치료를 필요로 한다. 이에 최근 10년 간의 수술적 경험을 고찰하고자 한다. 대상 및 방법: 1992년 8월부터 2002년 7월까지 폐절제술 후 병리학적으로 폐 국균종으로 확진된 31명의 환자를 대상으로 호발연령 및 성비율, 주소, 술전검사, 술식의 종류, 지저질환, 술 후 합병증 등을 분석 검토하였다. 결과: 호발연령은 30대와 40대(64.5%)이었으며, 술 전 주요증상은 객혈이었다(27명, 87.1%). 31명 모두에서 술 전 항결핵제 투여경력이 있었으며 19명(61.3%)에서 단순 흉부 방사선 사진상 연부조직 음영이 있는 큰 공동이 관찰되었고 흉부 전산화 단층촬영에서는 31명 모두에서 관찰되었다. 국균객담검사상 37.9%, 혈청 면역 확산 검사상 83.3%의 양성률을 보였다. 폐상엽이 19예(61.3%)로 호발부위였으며 대부분에서 폐엽절제술을 시행하였다. 술 후 병리조직검사상 전 예에서 결핵과 동반되어 있었다. 주요 합병증으로는 농흉 3예(9.7%), 지속적인 공기 누출 2예(6.45%), 사강 2예(6.45%), 술 후 출혈 1예(3.23%) 등이었다. 술 후 사망은 1예(3.23%)로 양측성 폐 국균종에서 수술한 반대쪽의 대량출혈로 사망하였다. 결론: 성비, 나이, 임상증상, 폐결핵과의 연관성, 병변부위 및 수술방법, 합병증 등에 대해서 과거 1963년부터 1992년까지 수술받은 80예와 비교하여 볼 때 큰 차이는 없었다. 진단 기법상 혈청검사는 술 전 아주 높은 양성률을 나타내었고 흉부전산화단층촬영의 높은 진단율은 폐 국균종의 진단과 수술에 매우 중요하다고 사료된다. 복합형 폐 국균종의 경우 흉막유착과 폐문의 경화, 잔존폐의 불완전한 확장 때문에 수술에 어려움이 있어 많은 시간 약물요법과 기관지 동맥 색전술 등의 내과적 치료를 선호하게 되는 데 이와 더불어 공동절개술 등의 비교적 비침습적인 수술방법도 추천되며 최근 합병증의 감소와 더불어 단순형 폐 국균종은 조기에 수술을 적극적으로 고려함이 요구된다.

표준화된 KoFlux 에디 공분산 자료 처리 방법의 변화와 개선 (Changes and Improvements of the Standardized Eddy Covariance Data Processing in KoFlux)

  • 강민석;김준;이승훈;김종호;천정화;조성식
    • 한국농림기상학회지
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    • 제20권1호
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    • pp.5-17
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    • 2018
  • KoFlux의 표준화된 에디 공분산 플럭스 자료 처리과정이 갱신되는 과정에서 그 처리 방법에 따른 결과도 조금씩 달라져 왔다. 대부분의 자료 사용자들은 자료 처리 결과의 차이와 이러한 차이가 자신들의 분석결과에 미칠 수 있는 영향에 대해 명확히 인지하지 못하고 자료를 사용하고 있는 실정이다. 본 총설에서는 KoFlux 데이터베이스를 사용하는 연구자들에게 자료처리 과정을 투명하게 정리하여 자료에 대한 신뢰성과 활용성을 확보하기 위해, 과거의 자료 처리 방법이 어떻게 변화되고 개선되었는지를 평탄하고 균질한 해남 논 관측지(HPK)와 복잡하고 비균질한 광릉 활엽수림 관측지(GDK) 자료를 처리하고 그 차이를 확인하여 문서화하였다. 관측 대상지와 관측 장비의 다양화로 인해, 기존에 무시되거나 간소화 되었던 자료 처리 과정(예, 주파수 반응 보정, 정상성 검정 등)을 다시 적용하였고, 메탄 플럭스 결측 메우기와 이산화탄소 플럭스 보정 및 배분 방법을 새롭게 개선하였다. 본 연구결과로부터 에디 공분산 플럭스 관측 자료의 품질에 주파수 반응 보정(HPK: 연적산값의 11~18%의 편향 발생, GDK: 6~10%)과 정상성 점검(HPK: 연적산값의 4~19%의 편향 발생, GDK: 9~23%)이 매우 중요하고, 결측 메우기 및 배분 과정에 있어서 우선적으로 결측을 최소화하는 것이 최선이며, 대상 플럭스의 변동을 설명할 수 있는 적절한 조절 인자의 선택이 처리방법의 선택보다 중요함을 확인 하였다. 장기 KoFlux 관측 자료의 정확성, 투명성 및 연속성 확보를 위해 위의 결과를 반영하는 자료 처리 기술 개발과 문서화를 지속적으로 추진해 나갈 것이다.

학령기 입원아동의 병원관련 공포에 관한 탐색연구 (Identification and Measurement of Hospital-Related Fears in Hospitalized School-Aged Children)

  • 문영임
    • 대한간호학회지
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    • 제25권1호
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    • pp.61-79
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    • 1995
  • When children are admitted to hospital, they have to adapt to new and unfamiliar stimuli. Children may respond with fear to stimuli such as pain or unfamiliar experiences. One goal of nursing is to help hospitalized children to adapt effectively to their hospital experience. Accordingly, nurses need to assess childrens' fears of their hospital experience to contribute to the planning of care to alleviate these fears. The problem addressed by this study was to identify and measure hospital-related fears(hereafter called HRF) in hospitalized school-aged children. The study was conceptualized with Roy's model. A descriptive qualitative approach was used first, followed by a quantitative approach. This study was conducted from November 30, 1989 to January 12, 1991. The sample consisted of 395 hospitalized school-aged children selected through an allocated sampling technique in nine general hospitals. The HRF questionnaire (three point likert scale ) was developed by a delphi technique. The data were analyzed by an SAS program. Factor analysis was used for the examination of component factors. Differences in the HRF related to demographic variables were examined by t-test, analysis of variance and the Scheffe test. The crude scores of the HRF scale were transformed into T- scores to calculate the standard scores. The results included the following : 1. Forty-four items were derived from 188 statements identifying the childrens' hospital-re-lated fears. These items clustered into 14 factors, fear of injections, operations, bodily harm others' pain, medical rounds, physical examinations, medical staff, disease process, blood and X-rays, drugs and cockroaches, tests, harsh discipline from parents or staff, being absent from school, and separation from family. The 14 factors was classified into four categories,'pain','the unfamiliar','the un-known' and 'separation'. 2. The reliability of the HRF instruments was .92(Cronbach's alpha). In the factor analysis, Cronbach's alpha coefficients for the 14 factors ranged from .84 to .86 and Cronbach's alpha coefficients for the four categories ranged from .70 to .84. Pearson correlation coefficient scores for relationships among the 14 factors ranged from ,11 to .50, and among the four categories, from ,44 to ,63, indicating their relative independence. 3. The total group HRF score ranged from 45 to 130 in a possible range of H to 132, with a mean of 74.51. The fears identified by the children were, in order, injections, harsh discipline by parents or staff, bodily harm, operations, medical staff, disease process, and medical rounds ; the least feared was others' pain. The fear item with the highest mean score was surgery and the lowest was examination by a doctor. HRF scores were higher for girls than for boys, and for grade 1 students than for grade 6 students. HRF scores were lower for children whose fathers were over 40 than for those whose fathers were in the 30 to 39 age group, and whose mothers were over 35 than for those whose mothers were in the 20 to 34 age group. HRF scores were lower when the mother rather than any other person stayed with the child. The expressed fear of pain, the unfamiliar, the un-known and of separation directs nurses' concern to the threat felt by hospitalized children to their concept of self. This study contributes to the assessment of fears of hospitalized children and of stimuli impinging on those fears. Accordingly, nursing practice will be directed to the alleviation of pain, pre-admission orientation to the hospital setting and routines, initiation of information about procedures and experiences and arrangments for mothers to stay with their children. Recommendations were made for further research in different settings and for development and testing of the instrument.

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쿠싱병에 대한 경접형동접근법의 내분비학적 결과 (Endocrinological Results of the Transsphenoidal Microsurgery for Cushing's Disease)

  • 김준수;김창진;하상수;김정훈;이정교;권병덕;홍성관;이기업;이봉재;김용재;최충곤;이호규
    • Journal of Korean Neurosurgical Society
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    • 제30권5호
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    • pp.611-621
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    • 2001
  • Objective : We analyzed the clinical and endocrinological results of the transsphenoidal microsurgery for ACTH secreting pituitary adenomas. Marerials and Methods : From October 1995 to August 2000, 18 patients underwent transsphenoidal microsurgery for Cushing's disease. We analyzed the surgical results of 17 patients, one patient who was previously operated from other hospital was excluded. Age of the patients were 18 to 61 years old(mean 37.7), male to female ratio was 1 : 3.3, and follow-up period was 3 to 50 months(mean 20.3). The selection of candidates for transsphenoidal exploration was based on endocrinologic criteria. Magnetic resonance imaging was the preferred radiologic test. Selective inferior petrosal sinus sampling of adrenocorticotropic hormone futher refined the diagnosis when endocrinologic and radiologic procedures were not definitive. Results : Results of the preoperative endocrinological test were : level of serum ACTH 29.4 to $225{\mu}g/dL$(mean $93.88{\mu}g/dL$) ; serum cortisol 11.9 to $47.5{\mu}g/dL$(mean $27.49{\mu}g/dL$) ; 24-hour urine free cortisol 235 to $1019{\mu}g/day$(mean $571.0{\mu}g/day$). Inferior petrosal sinus sampling for ACTH was performed in 11 patients and all were confirmed by Cushing's disease and we could predict the laterality of the tumor in 9 of 11 patients. We performed transsphenoidal selective adenomectomy in 5 patients, adenomectomy and subtotal hypophysectomy in 2 patients, adenomectomy and partial hypophysectomy in 9 patients, and in the remaining one patient, hemihypophysectomy followed by total hypophysectomy due to remission failure. Fifteen of 17 patients(88.2%) showed endocrinological remission. Glucocorticoid replacement therapy was performed in all the patients who showed remission for 1 to 24 months(mean 5.9 months), and 6 patients received steroid over 6 months. Conclusion : We conclude that the direct demonstration of a tumor in the pituitary gland by MRI is the most important and definitive diagnostic tool and the location of a mass should be confirmed with increased level of ACTH by the inferior petrosal sinus sampling. Transsphenoidal microsurgery is effective treatment modality for Cushing's disease and the immediate postoperative evaluation of the surgical resection of the tumor is very important. The patients should show hypocortisolism, decreased, subnormal serum ACTH and cortisol levels and 24-hours urine free cortisol. We performed 18 transsphenoidal microsurgery for Cushing's disease in 17 patients and 15 patients(88.2%) showed endocrinological remission.

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배출가스 중 응축성미세먼지 특성 연구 (A Study on the Characteristics of Condensable Fine Particles in Flue Gas)

  • 공부주;김종현;김혜리;이상보;김형천;조정화;김정훈;강대일;박정민;홍지형
    • 한국대기환경학회지
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    • 제32권5호
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    • pp.501-512
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    • 2016
  • The study evaluated methods to measure condensable fine particles in flue gases and measured particulate matter by fuel and material to get precise concentrations and quantities. As a result of the method evaluation, it is required to improve test methods for measuring Condensable Particulate Matter (CPM) emitted after the conventional Filterable Particulate Matter (FPM) measurement process. Relative Standard Deviation (RSD) based on the evaluated analysis process showed that RSD percentages of FPM and CPM were around 27.0~139.5%. As errors in the process of CPM measurement and analysis can be caused while separating and dehydrating organic and inorganic materials from condensed liquid samples, transporting samples, and titrating ammonium hydroxide in the sample, it is required to comply with the exact test procedures. As for characteristics of FPM and CPM concentrations, CPM had about 1.6~63 times higher concentrations than FPM, and CPM caused huge increase in PM mass concentrations. Also, emission concentrations and quantities varied according to the characteristics of each fuel, the size of emitting facilities, operational conditions of emitters, etc. PM in the flue gases mostly consisted of CPM (61~99%), and the result of organic/inorganic component analysis revealed that organic dusts accounted for 30~88%. High-efficiency prevention facilities also had high concentrations of CPM due to large amounts of $NO_x$, and the more fuels, the more inorganic dusts. As a result of comparison between emission coefficients by fuel and the EPA AP-42, FPM had lower result values compared to that in the US materials, and CPM had higher values than FPM. For the emission coefficients of the total PM (FPM+CPM) by industry, that of thermal power stations (bituminous coal) was 71.64 g/ton, and cement manufacturing facility (blended fuels) 18.90 g/ton. In order to estimate emission quantities and coefficients proper to the circumstances of air pollutant-emitting facilities in Korea, measurement data need to be calculated in stages by facility condition according to the CPM measurement method in the study. About 80% of PM in flue gases are CPM, and a half of which are organic dusts that are mostly unknown yet. For effective management and control of PM in flue gases, it is necessary to identify the current conditions through quantitative and qualitative analysis of harmful organic substances, and have more interest in and conduct studies on unknown materials' measurements and behaviors.

고령 환자와 신선주기 배아이식에서 임신에 실패한 환자에서 동결-융해 배아이식의 효용성 (Efficacy of Frozen-Thawed ET in Patients with Old Age or Non-Pregnant in Fresh ET Cycles)

  • 최수진;이선희;송인옥;궁미경;강인수;전진현
    • Clinical and Experimental Reproductive Medicine
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    • 제33권4호
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    • pp.237-243
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    • 2006
  • 목 적: 동결-융해 배아이식은 보조생식술에서 환자들에게 보다 많은 임신의 기회를 제공해줄 수 있는 방법으로 이용되고 있다. 본 연구에서는 예후가 좋지 않은 환자들에서 동결-융해 배아이식의 효용성을 알아보고자 하였다. 연구방법: 나이가 많은 고령 환자군 (38~44세)과 신선주기 배아이식에서 임신 실패군을 연구대상으로 하였다. 과배란 유도를 통해 채취한 난자를 일반적인 체외수정 또는 세포질내 정자주입술을 시행하여 수정을 유도하고, 잉여의 전핵 또는 난할 시기의 배아를 완만동결법으로 동결하였다. 동결보관 배아는 급속융해법으로 융해하여 호르몬요법을 시행한 환자의 자궁에 이식하였다. 신선 배아이식과 동결-융해 배아이식 과정에서의 배아 상태, 임신율, 착상률 등을 통계적인 방법으로 분석하였다. 결 과: 나이가 많은 고령군에서 신선 배아이식을 시행한 환자들과 동결-융해 배아이식을 시행한 환자들의 평균 연령은 $40.0{\pm}1.8$세 (n=206)와 $39.9{\pm}1.9$세 (n=69)로 통계적으로 유의한 차이가 없었으나, 임상적인 임신율과 착상률은 동결-융해 배아이식에서 29.0%와 11.2%로 신선 배아이식의 16.5%와 7.0%에 비해 통계적으로 유의하게 높게 나타났다. (p<0.05). 첫 번째 신선 배아이식에서 임신 실패군의 연속되는 신선 배아이식 환자군 ($31.2{\pm}2.3$, n=40)과 동결-융해 배아이식 환자군 ($31.9{\pm}3.1$, n=119)에서의 평균 연령은 차이가 없었으며, 임상적 임신율 (42.5% vs 40.3%)과 착상률 (22.6% vs 18.8%)도 유사하였다. 결 론: 본 연구에서는 동결-융해 배아이식이 고령 환자들에서 효과적으로 임신율과 착상률을 높일 수 있음을 보여주고 있다. 이러한 결과는 과배란 유도에 따른 자궁의 착상 환경 변화가 고령 환자들에서 임신율과 착상률을 저하시키는 것과 관련이 있을 것으로 생각된다.

장티브스에 관한 임상적 관찰 (Clinical review of Typhoid Fever Patients)

  • 최정신
    • 대한간호학회지
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    • 제6권1호
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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