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두개인두종 수술 말기에 급격히 발생한 심각한 고나트륨혈증 -증례 보고-
박준범,박세훈,서은희,박현석,정진규 대한중환자의학회 2013 Acute and Critical Care Vol.28 No.1
Hypernatremia, defined as a rise in the serum sodium concentration to a value exceeding 145 mM/L, is a common electrolyte disorder. Diabetes insipidus is a common cause of hypernatremia, caused by impaired production or reduced responses to vasopressin. The resultant morbidity may be inconsequential, serious, or even life-threatening. However, hypernatremia rarely occurs during anesthesia and surgery. A 45-year-old female patient with craniopharyngioma was scheduled for tumor resection. Hypernatremia (serum sodium, 170 mM/L) occurred suddenly at the end of the surgery. To treat hypernatremia, 0.45% normal saline was used. Although serum sodium concentration was reduced faster than expected, the patient did not have any complications.
한국판 유아 학습행동 척도(K-LTLS)의 타당화 연구
박준범,성지현 한국아동학회 2023 아동학회지 Vol.44 No.4
Objectives: This study investigated the validity and reliability of the Learning-To-Learn Scales (LTLS) for its use in Korea. The LTLS is a seven-factor, 48-item tool for assessing the learning behaviors of preschool children. All items are rated on a 3-point Likert assessment, and teachers select from “Most often applies,” “Sometimes applies,” and “Does not apply” based on what best describes the child’s typical learning behavior. Methods: The subjects in this study were 1,396 children (3-5 years old) who were evaluated by 585 teachers living in Seoul Metropolitan City, Busan Metropolitan City, Gwangju Metropolitan City, Gangwon Province, and Gyeonggi Province. The subjects were randomly divided into an exploratory (n = 681) and confirmatory subsample (n = 715). Results: Forty-eight items of the LTLS were double-translated and revised. Exploratory factor analysis uncovered six factors of the Korean version of the Learning-To-Learn Scales (K-LTLS), and salience was found for 43 of the 48 items. Confirmatory factor analysis of the 43 items supported a 6-factor model comprising Strategic Planning, Effectiveness Motivation, Interpersonal Responsiveness in Learning, Sustained Focus in Learning, Acceptance of Novelty and Risk, and Group Learning. The six factors of the K-LTLS demonstrated criterion-related validity based on the assessment of School Readiness and proper internal consistency reliability. The analysis of differences in children’s learning behaviors based on their sex and age revealed that girls were more likely to exhibit higher learning behavior scores than boys. Additionally, 4- and 5-yearold children tended to display higher learning behavior scores than 3-year-old children. Conclusion: The K-LTLS can be an appropriate scale for assessing the learning behavior of Korean young children.
복막 투석 환자에서 도관 관련 감염 및 복막염에 대한 Mupirocin과 도관 전환술(Catheter revision)의 효과
박준범,김정미,최준혁,조규향,정항재,김영진,도준영,윤경우 영남대학교 의과대학 1999 Yeungnam University Journal of Medicine Vol.16 No.2
Background: Exit site/tunnel infection causes considerable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. Materials and Methods: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI, we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were TI symptoms (purulent discharge, abscess lesion around exit site). we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. Results: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt.mon and 1 per 21.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus (26 of 54 isolated cases, 48%), followed by the Methicillin resistant S, aureus(MRSA) (13 cases, 24%). Seven patients(5: MRSA, 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining ??quired catheter removal due to persistent MRSA infection with re-insertion at the same ??me. But, there was no more ESI in these 3 patients who were received management to ??lapse (The mean duration: 14.0 months) The rates of ESI were significantly reduced after ??sing mupirocin than before(1 per 12.7 vs 34.0 pt.mon, P<0.01). Conclusions: In summary, revision technique can be regarded as an effective method for ??efractory ESI/TI before catheter removal. Also local mupirocin ointment can play a ??gnificant role in the prevention of ESI.