To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom, respectively. The film density of trachea part were 0.76(${\pm}0.011$) in human, 0.97(${\pm}0.015$) in animal, 0.45(${\pm}0.016$) in phantom. The tracheobronchial bifurcation part measured 0.51(${\pm}0.006$) in human, 0.65(${\pm}0.005$) in animal, 0.65(${\pm}0.008$) in phantom. The right bronchus part measured 0.14(${\pm}0.008$) in human, 0.59(${\pm}0.014$) in animal and 0.04(${\pm}0.007$) in phantom. The left bronchus were 0.54(${\pm}0.004$) in human, 0.54(${\pm}0.008$) in animal and 0.08(${\pm}0.008$) in phantom. At the stent part were 0.54(${\pm}0.004$) in human, 0.59(${\pm}0.011$) in animal and 0.04(${\pm}0.007$) in phantom, respectively. The tracheobronchial angle of the left bronchus site were $42.6({\pm}2.07)^{\circ}$ in human, $43.4({\pm}2.40)^{\circ}$ in animal and $35({\pm}2.00)^{\circ}$ in phantom, respectively. The right bronchus site were $32.8({\pm}2.77)^{\circ}$ in human, $34.6({\pm}1.94)^{\circ}$ in animal and $50.2({\pm}1.30)^{\circ}$ in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce.
The purpose of this study was to determine the effects of aerobic rhythmical exercise program on $VO_2$ max, leg strength, grip strength, flexibility, exercise self-efficacy and quality of life in elderly. This quai-experimental study was designed as a non-equivalent control group pretest-posttest study. 36 subjects, aged between 65 and 73 years who have normal cognition. sensory function and cerebellum function participated in this study. 19 experimental group subjects participated aerobic rhythmical exercise program. Aerobic rhythmical exercise program was developed on the basis of calisthenics, stretching, aerobic exercise, Korean traditional dance and music by the author. The program consisted of approximately 1 hours of exercise, 3 times a week for 9 weeks. During 1 hours workout, there were 15 minutes of warm-up dancing, 35 minutes of conditioning dance and 10 minutes of cool-down dancing. The intensity for the conditioning phase was between $40\%\;and\;60\%$ of age adiusted maximum heart rates. The $VO_2$ max, grip strength, leg strength, flexibility, exercise self-efficacy and quality of life were measured prior to and following the experimental treatment. Data were analyzed with $x^2-test$, t-test, mean, standard deviation. percentage of change and ANCOVA test using SAS program. Results were obtained as follows. 1. The $VO_2$ max of the experimental group were significantly lower than those of the control group following the aerobic rhythmical exercise program(F=7.76, p=0.008). 2. The grip strength of the experimental group were significantly lower than those of the control group following the aerobic rhythmical exercise program(F=4.61, p=0.039). 3. The leg strength of the experimental group were significantly lower than those of the control group following the aerobic rhythmical exercise program(F=9.29, p=0.000). 4. The was no significantly difference of flexibility between experimental and control group 5. The self-efficacy of the experimental group were significantly lower than those of the control group following the aerobic rhythmical exercise program(F=43.40, p=0.000). 6. The quality of life of the experimental group were significantly lower than those of the control group following the aerobic rhythmical exercise program(F=8.91. p=0.005). The results suggest that aerobic rhythmical exercise program can improve $VO_2$ max, grip strength. leg strength. exercise self-efficacy and quality of life elderly. Thus. aerobic rhythmical exercise program was a useful nursing intervention for elderly.
The surgical hand scrub (SHS) is the single most important procedure in the prevention of post-operative wound infections and yet it remains the most violated of all infection control procedures. The purpose of this study was to gain an overview of SHS habits in operative th atre personnel and to determine knowledge and attitudes to identify whether there is a need for improvement. The subjects for this study included 79 doctors and 94 nurses working in the operative th atres of four hospitals in Incheon City and Kyungki Province. Related data were collected from July 25 to August 10, 1995 by the author. The data were analyzed using descriptive stat-istics and Chi-squre test. The results of the study are summarized as follows : 1. Nurses felt that they conducted SHS for a longer period of time than doctors did(X=20.1, P=.005). 2. Nurses and doctors had some knowledge of slip-ping rings off fingers and the length of nails, but they lacked knowledge on the duration of SHS, handwashing after an operation and on manicure. 3. There were many reasons given for insufficient SHS included : 1) because they were so busy (38%). 2) brushes were too harsh(19.7%). 3) operations were very simple(18.7%). 4) surgical latex gloves provide functional barrier(11.6%). 5) SHSs were troublesome(7.4%) 6) there were no clocks near the sinks(2.5%) and 7) the operative patients were administered antibiotics after operartion(2.1%). 4. Most of nurses and doctors considered SHS to be important in prevention against post operative infections. 5. Nurses were found to do a thorough SHS, but residents were found to neglect SHS. 6. Considering prevention against postoperative infections, most nurses and doctors considered aseptic techniques, environment-sanitary management and SHS more important than the use of antibiotics, the resistance of patients or the method of operation. 7. Half of the nurses and doctors(54.3%) considered surgical latex gloves to function well as a barrier. 8. Half of the nurses (56.4%) and doctors(51.9%) learned SHS as part of the curriculum in their school education and the rest(nurses : 95.7%, doctors : 74.7%) learned SHS as part of their In Service Education. In conclusion, these findings suggest a need to develop an educational program on surgical hand scrub and hospital infection control for surgical personnels, to install clocks near the hand scrub sinks, to consider a violation report for negligent surgical hand scrubs, and to develop a soft brush for hand scrubs in order to increase performance of the surgical hand scrub.
Lee Chang-Jin;Cho Hee-Yeon;Kang Ju- Hyung;Shin Choong-Ho;Ha Il-Soo;Cheong Hae-Il;Yang Sei-Won;Choe Yong
Childhood Kidney Diseases
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v.8
no.2
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pp.195-204
/
2004
Purpose: Hypophosphatemic rickets is a hereditary disease, characterized by hypophosphatemia due to renal phosphate wasting, impaired renal production of 1,25-dihydroxyvitamin $D_3$, rachitic bone deformities and impaired growth. The purpose of this study is to provide clinical profiles of patients with hypophosphatemic rickets in our hospital. Methods: Between July 1983 and February 2004, 56 patients were diagnosed as having hypophosphatemic rickets. The medical records of these patients were reviewed retrospectively. Clinical manifestations, family histories, laboratory data, treatment outcomes were described. Results: Fifty six patients were enrolled in this study. The average age at symptom onset and diagnosis were 20 months and 5 years respectively. Fourteen patients had family histories. The main clinical manifestations were bow legs and short stature. There was a significant negative correlation between the ages and the height z-scores at the time of diagnosis(r=-0.47, P=0.005). Initial laboratory data showed normocalcemia, hypophosphatemia, elevated serum alkaline phosphatase, decreased tubular reabsorption of phosphate and a normal range of 1,25-dihydroxyvitamin $D_3$ Radiographic examinations of bone revealed fraying, widening and cupping of the metaphyseal ends. Treatment consisted of Joulie solution and vitamin D metabolites, and resulted in improved biochemical and radiographic findings. However, height z-scores remained essentially unchanged(P=0.224). Complications of treatment were frequently observed, including hyperparathyroidism, nephrocalcinosis, and hypercalciuria. Sixteen patients had corrective osteotomy and 4 of them underwent leg lengthening together. Conclusion: There was a gap of several years between the onset of symptoms and the diagnosis. Early treatment seems to be essential to growth. For the earlier treatment, the offsprings of affected parents should be followed up closely.
Kim, Yee Hyung;Choi, Cheon Woong;Choi, Hye Sook;Park, Myung Jae;Kang, Hong Mo;Yoo, Jee-Hong
Tuberculosis and Respiratory Diseases
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v.64
no.5
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pp.356-361
/
2008
Background: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. Methods: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. Results: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. Conclusion: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.
Background: The purpose of this study was to examine the causes and pathologic process of chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph by investigating clinicopathologic findings. Method: We studied 25 adults with chronic non-productive cough over a 3-week period with a normal chest radiograph and pulmonary function tests without any other symptoms. Clinical assessment, cough score, chest and sinus radiograph, pulmonary function tests, methacholine challenge, allergic skin prick test, and bronchoscopy for bronchial biopsies were performed. Subjects were then treated with prednesolone 20 to 30 mg/day for 1 to 2 weeks. Results: The experimental group was divided into two subgroups-those infiltrated with eosinophils, and those infiltrated with lymphocytes depending on eosinophil and lymphocyte counts, both of which were respectively higher than those of the control group. Eosinophils infiltrated group had mean numbers of eosinophil of 89.8 $cells/mm^3$ while control group's mean was 0.4 $cells/mm^2$(p=0.005). Lymphocyte infiltrated group was 4 patients whose mean was 84.3 $cells/mm^2$ with 28.4 $cells/mm^2$ of control group(P=0.026). In addition, the mean thickness of the basement membrane of experimental group was $14.20{\pm}5.20{\mu}m$ in contrast of control group whose mean was $3.50{\pm}1.37{\mu}m$(P=0.001). With the methacholine challenge test, 7 of the 21 eosinophil infiltrated subjects were diagnosed with cough variant asthma ; the other 14 with eosinophilic bronchitis. Three subjects with eosinophilic bronchitis were atopic positive (21.4%) with the skin prick test In the lymphocyte dominant group, all four subjects were diagnosed with lymphocytic bronchitis. Cough score was improved after steroid treatment in 22 of 25 subjects in the experimental group (88.0%). Conclusion: These results suggest chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph was associated with airway inflammation by eosinophil and lymphocyte infiltration. The causes for chronic non-productive cough were eosinophilic bronchitis, cough variant asthma, and lymphocytic bronchitis(written in frequency). They further suggest that therapeutic treatment with steroids can provide effective symptomatic relief.
Choi, Kyong Eun;Lee, Hee Chul;Youn, So Young;Chun, Jung Mi;Shin, Son Moon;Han, Byung Hee;Lee, Yong Taek
Clinical and Experimental Pediatrics
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v.52
no.11
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pp.1273-1278
/
2009
Purpose:Congenital muscular torticollis (CMT), a common musculoskeletal disorder in infants, is characterized by the rotation and flexion deformity of the neck caused by sternocleidomastoid muscle shortening. We investigated the clinical courses and perinatal risk factors of CMT. Methods:Less than 6-month-old patients (98; M:F = 60:38) diagnosed with CMT between February 2007 and August 2008 were classified into 2 clinical subgroups, namely, SMT (sternocleidomastoid tumor) and POST (postural torticollis). All the patients were physically and neurologically examined prospectively and their cervical X-rays and ultrasonographies were obtained. Their medical histories about perinatal problems were recorded. Of the 98 patients, 45 with normal range of motion were taught passive physical exercises and 43 were referred to the Department of Rehabilitation for undergoing manual stretching therapy. Results:The mean age at initial assessment was 2.2 months (SMT: $1.4{\pm}1.0$, POST: $2.7{\pm}1.6$). SMT presented earlier than POST. All ophthalmologic examinations and cervical X-rays were normal. SMT was associated with higher incidence of caput succedaneum and cephalhematoma. POST was highly associated with plagiocephaly. Mean duration of rehabilitative physical therapy was 3.7 months (SMT: $4.6{\pm}2.5$, POST: $2.6{\pm}1.9$). POST resolved earlier than SMT. Of the 88 patients with follow-up, 87 had total resolution and only 1 had residual torticollis. Conclusion:All the patients received early treatment with passive stretching exercises. CMT was associated with perinatal problems and had various risk factors such as obstetrical problems.
Background: Workers laboring in steel industries in tropical settings with high ambient temperatures are subjected to thermally stressful environments that can create well-known risks of heat-related illnesses and limit workers' productivity. Methods: A cross-sectional study undertaken in a steel industry in a city nicknamed "Steel City" in Southern India assessed thermal stress by wet bulb globe temperature (WBGT) and level of dehydration from urine color and urine specific gravity. A structured questionnaire captured self-reported heat-related health symptoms of workers. Results: Some 90% WBGT measurements were higher than recommended threshold limit values ($27.2-41.7^{\circ}C$) for heavy and moderate workloads and radiational heat from processes were very high in blooming-mill/coke-oven ($67.6^{\circ}C$ globe temperature). Widespread heat-related health concerns were prevalent among workers, including excessive sweating, fatigue, and tiredness reported by 50% workers. Productivity loss was significantly reported high in workers with direct heat exposures compared to those with indirect heat exposures ($x^2=26.1258$, degrees of freedom = 1, p < 0.001). Change in urine color was 7.4 times higher among workers exposed to WBGTs above threshold limit values (TLVs). Conclusion: Preliminary evidence shows that high heat exposures and heavy workload adversely affect the workers' health and reduce their work capacities. Health and productivity risks in developing tropical country work settings can be further aggravated by the predicted temperature rise due to climate change, without appropriate interventions. Apart from industries enhancing welfare facilities and designing control interventions, further physiological studies with a seasonal approach and interventional studies are needed to strengthen evidence for developing comprehensive policies to protect workers employed in high heat industries.
The mutant with high productivity, X. malvacearum SNUF 560-6, was acquired from the X. malvacearum SNUF 560 with low productivity by UV-light irradiation. It was preserved is lyophilized stock culture and it was transferred to PDA slant to maintain viability fortnightly. Fermentations were started by retransfering to MY agar slant from PDA stok culture. The experiments for optimal xanthan gum production were studied in a chemically defined medium. Of the carbon and nitrogen sources tested, 0.4% sucrose medium and 10mM glutamic acid medium yielded the highest xanthan gun production respectively. The addition of 10g/l succinic acid stimulated xanthan gum production. Also 65mM $PO_4\;^{-3}\;(12.6g/l\;KH_2PO_4)$ was effective on xanthan gum production. Finally, medium 1 and medium 2 which have high xanthan gum production potencies were achieved in this stud. The components of medium 1 and medium 2 were as follows: Medium 1 : sucrose 40g/l glutamate 10mM $PO_4\;^{-3}\;54mM\;(KH_2PO_4\;12.65g/l)$ Citrate 2g/l $MgSO_4{\cdot}7H_2O\;0.2g/l$$H_3BO_3\;0.005/l$ ZnO 0.006/l $FeCl_2{\cdot}6H_2O\;0.0024g/l$$CaCO_3\;0.02g/l$ Medium 2 : $Sucrose\;40g/l\;(NH_4)_2SO_4\;2g/l$$PO_4\;^{-3}\;65mM\;(KH_2PO_4\;12.65g/l)$ Succinate 10g/l $MgSO_4{\cdot}7H_2O\;0.02g/l$$H_3BO_3\;0.06g/l$ ZnO 0.006g/l $FeCl_2{\cdot}6H_2O\;0.0024g/l$$CaCO_3\;0.02g/l$.
This study was designed to investigate the effect of one-to-one labor support on labor pain, labor stress response, childbirth experience and neonatal status for primipara by a quasi experiment (nonequivalent control group pretest-posttest design), from April 30, 1999 to February 20, 2000. The subjects of this experiment consisted of eighty two primipara with single gestation, full term, uncomplicated pregnancies. Forty one were in the experimental group and forty one in the control group. Their mean age was 25.95 years, their mean gestation period was 39.9 weeks. A caring package of one-to-one labor support had three components. Physical support consisted of massage, back pressure, touch. Emotional support was provided by a continuous nurse's presence, acceptance and encouragement. Informational support involved teaching breathing skills, relaxation skills and knowledge about the labor process. Data assessed labor pain, pulse rate and blood pressure to measure labor stress response. Also, in measuring the value of labor stress response, plasma epinephrine, plasma norepinephrine and serum cortisol were measured. In the 24 hours after birth, the data for the postpartum mother's childbirth experiences was collected. Umbilical cord arterial blood pH, one minute and five minute Apgar score were measured after birth. Data was analyzed by t-test, $x^2$-test, repeated measures ANOVA, ANCOVA with SAS Program. The results were as follows; 1. Labor pain was significantly low in the experimental group(P=.016). 2. No significant group effects were found, but significant time effects were found for plasma epinephrine, norepinephrine, serum cortisol, pulse rate and blood pressure. 3. The childbirth experience of the experimental group was significantly more positive than the control group (P = .005). 4. The umbilical cord arterial blood pH of the experimental group was significantly higher than the control group(P=.014). There was no significant difference between the two groups in neonatal one minute and five minute Apgar scores. In conclusion, these findings indicate that one-to-one labor support could be effective in decreasing labor pain, and increasing positive childbirth experiences, also increasing the neonatal umbilical cord arterial blood pH for primipara. So, one-to-one labor support could be applied as an effective nursing treatment for primipara.
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