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연하장애가 있는 신경계 이상 환아에서 경피 내시경하 위루술 후 흡인성 폐렴의 빈도 감소
박효정(Hyo Jung Park),강지현(Ji Hyun Kang),김정미(Jung-mi Kim),추미애(Mi Ae Chu),최병호(Byung-Ho Choe),서혜은(Hye Eun Seo),권순학(Soonhak Kwon) 대한소아신경학회 2011 대한소아신경학회지 Vol.19 No.2
목적 : 스스로 먹을 수 없는 사람의 경우 타인에 의해 음식물을 공급하는 방법은 비위관을 통하거나 위루관을 통한 방법이 있다. 이중 내시경을 통한 위루술 후에 호흡기 감염의 감소 등의 유익을 확인하고자 연하장애가 있는 신경계 환아들을 대상으로 본 연구를 시행하였다. 방법 : 경북대학교병원 소아청소년과에서 1999년 1월부터 2008년 12월까지 연하장애가 있는 신경계 이상환자 중 경피 내시경하 위루술을 시행 받고 시술 후 12개월 이상 경과 관찰된 26명을 대상으로 환자들의 특성을 조사하고 기저 질환별로 분류하였으며 시술 전후에 체중과 흡인성 폐렴으로 입원하게 되는 횟수를 비교하였다. 시술 전과 시술 후 6개월 및 시술 후 6-12개월을 기간으로 정하여 비교하였다. 결과 : 총 26명(남자 14)의 시술 당시 평균 나이는 6.4±4.7 (0.9-16.9)세였다. 절반 이상인 16명의 체중이 또래에서 3 백분위수 미만이었다. 기저질환으로는 뇌성마비가 16명, 후천적 뇌손상이 4명, 척수성 근위축증이 3명, 신경계 퇴행성 질환과 선천성 근위축증이 각각 2명과 1명 이었다. 시술 전과 시술 후 6개월 및 6-12개월에 체중에는 유의한 증가가 없었다. 시술 전의 흡인성 폐렴의 빈도는 전체환자에서 6개월 간 평균 2.2회 였고 시술 후 6개월 이내에는 평균 0.35회, 6에서 12개월 이내에는 평균 0.27회로 유의한 감소가 있었다(P =0.000). 결론 : 경피 내시경하 위루술은 연하곤란을 보이는 신경질환 환아에서 흡인성 폐렴의 빈도를 감소시킬 수 있는 유용한 시술로 생각한다. Purpose : Nasogastric tube or percutaneous endoscopic gastrostomy (PEG) tube can provide a means of feeding when oral intake is not adequate. This study aimed to evaluate the benefits of PEG such as reduced respiratory complications in neurodisabled children with dysphagia. Methods : Twenty-six neurodisabled patients with dysphagia were followed-up after PEG for at least 12 months from 1999 to 2008. Medical records including characteristics, body weight, frequency of aspiration pneumonia, and grade of gastroesophageal reflux (GER) were reviewed retrospectively between the time before and after PEG. The data collected before PEG was compared with those at 0-6 months and 6-12 months after PEG. Results : The 26 (male 14) enrolled patients had a mean age on PEG of 6.4±4.7 (0.9-16.9) years. The body weight percentile of 16 out of 26 patients was under the 3rd percentile. Underlying diseases were cerebral palsy (n=16), acquired braininjury (n=4), spinal muscular atrophy (n=3), neurodegenerative disease (n=2), and congenital muscular dystrophy (n=1). Body weight was not significantly different before and after PEG. The frequency of aspiration pneumonia was 2.2 times per 6 months before PEG, compared to 0.35 times (0-6 months) and 0.27 times (6-12 months) after PEG, which showed a significant difference (P =0.000). Conclusion : The frequency of aspiration pneumonia decreased significantly by PEG in neurodisabled children with dysphagia.
박효정 ( Hyo Jung Park ) 한국정맥경장영양학회 2016 한국정맥경장영양학회지 Vol.8 No.3
Intestinal failure (IF) is a condition, in which the intestinal function or length remaining is below the minimum amount required for the absorption of sufficient nutrients and fluid to maintain normal life. The nutritional supply of IF depends on the anatomical site, length, and function of the remaining bowel. The goals of nutritional therapy for patients with IF are to achieve bowel adaptation to absorb nutrients sufficiently to live a healthy life with the current intestinal condition, and to promote the enteral autonomy to control nutrient digestion, absorption, excretion, and bowel movement. To stabilize and recover the patient`s nutrition condition after a huge bowel resection, the intestinal rehabilitation team (IRT) for individual nutritional therapy should be established. IRT carefully monitors the changes in body weight, medication use, patient`s symptoms, nutrient deficiency, hydration status, function of the remaining bowel, degree of bowel adaptation, adverse effects due to nutritional therapy, and enteral balance. To achieve intestinal adaptation and enteral autonomy through complicated and difficult nutritional intensive therapy in IF patients, it is essential to manage the patients through multidisciplinary collaboration involving physicians, pharmacists, dietitians, and nurses.
장부전 환자의 장재활 시스템 구축을 위한 질 향상 활동
박효정 ( Hyo Jung Park ),이상훈 ( Sang Hoon Lee ),윤지혜 ( Ji Hye Yoon ),김현정 ( Hyun Jung Kim ),홍슬희 ( Seul Hee Hong ),김은주 ( Eun Ju Kim ),민자경 ( Ja Kyung Min ),김현정 ( Hyun Jung Kim ),정보경 ( Bo Kyung Jung ),오채연 ( Ch 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.3
Purpose: Intestinal failure (IF) is a complex clinical condition requiring a multi-disciplinary team approach. Our objective was to set up the treatment protocols and education documents for IF patients for development of intestinal rehabilitation programs in our hospital. Methods: We compared the number of inpatients, length of hospital stay, mode of nutrition and calorie supply at discharge, and the frequency of blood transfusions before and after quality improvement of multidisciplinary activities, in order to evaluate the indirect effects of new protocols and training materials and for development of the intestinal rehabilitation system. Results: We integrated eleven protocols for treatment and monitoring and seven educational materials for patients and caregivers. We compared indirect effects before and after the quality improvement activities. The number of IF patients hospitalized was reduced from 12 to 9. The mean days of hospital stay was decreased from 322 days to 73 days, the average number of monthly blood transfusions was also reduced from 1.8 to 0.3. In addition, the percentage of patients administered enteral nutrition and calories supplied was increased at discharge. Conclusion: By integrating IF protocols and education materials for IF patients, we found possible indirect effects of intestinal rehabilitation using a multidisciplinary team approach.
Implementation and Perception of Online Peer Feedback by Korean EFL Students
박효정 ( Hyo Jung Park ),최호성 ( Ho Hsung Choe ) 21세기영어영문학회 2011 영어영문학21 Vol.24 No.3
This study examines the areas and types of feedback Korean EFL students would focus on in online peer feedback sessions and their implementation and perception of online peer feedback. Fifteen students in a two-month-long TOEFL beginner class participated in the study. They were asked to make comments on their peers` writings on the online blog after class. Most of their comments were found in the local area. In the local area the greatest frequency was observed in alternation while suggestion was the most frequently occurred in the global area. Similarly, more revisions were made in the local area than in the global area. Most of the comments which pointed out grammatical or lexical errors were implemented in their final drafts. Their perceptions of online peer feedback were investigated through interviews. In general, they found online peer feedback beneficial for the improvement of their writing abilities, but simultaneously they hesitated to give and receive peer feedback because of the possibility of incorrectness.
국내 입원한 성인 암환자의 정맥영양 사용에 대한 후향적 연구
박효정 ( Hyo Jung Park ),손유민 ( You Min Sohn ),정지은 ( Jee Eun Chung ),김정태 ( Jung Tae Kim ),양진아 ( Jin A Yang ),배혜정 ( Hye Jung Bae ),성예원 ( Ye Won Sung ),김선화 ( Sun Hwa Kim ),조지윤 ( Ji Yoon Cho ),정경미 ( Kyung Mi 한국정맥경장영양학회 2020 한국정맥경장영양학회지 Vol.12 No.2
Purpose: There have been no clinical studies on the characteristics of parenteral nutrition (PN) for adult cancer inpatients in South Korea. The published evidence describing modern PN practices in these patients is also extremely limited. Therefore in this retrospective multicenter cross-sectional study, we aimed to investigate the PN support practice in hospitalized adult cancer patients. Methods: The study included adult cancer patients hospitalized in nine hospitals in South Korea and received PN, during the period from August 1st, 2017 to October 30th, 2017. We evaluated the relevant hospital-based PN practices in this group. Results: Among the 11,580 inpatient admissions during this period, 759 cancer patients received PN (6.6%). The majority of enrolled patients (97.2%) used commercially available PN and 71.2% of these used peripheral PN formulations. The average in-hospital PN duration was 16.1±19.9 days. Patients received only 65.4±25.4% calories of the recommended target calories. The in-hospital mortality of enrolled patients was 26.1%. Conclusion: We conclude that commercial PN is the most common form of PN administered to hospitalized adult cancer patients and the overall in-hospital mortality in the patients using PN is higher in South Korea compared to other countries.
도서관의 자동 도서 관리를 위한 군집화 기반 다중경유지의 최단 경로 알고리즘 개발
강효정(Hyo Jung Kang),전은주(Eun Joo Jeon),박찬정(Chan Jung Park) 한국콘텐츠학회 2021 한국콘텐츠학회논문지 Vol.21 No.1
도서관 사서의 수많은 업무 중 도서 정리 업무는 사서가 일일이 정리해야 하는 일이기 때문에, 투입되는 인적 · 시간적 비용이 크다. 이러한 문제를 해결하기 위해 최근 인공지능 기술을 접목한 도서 정리 로봇에 관한 관심이 증가하고 있다. 본 연구에서는 도서 정리 로봇에 적용할 수 있는 다중경유지 최단 경로 알고리즘인 K-ACO 알고리즘을 제안한다. 제안하는 K-ACO 알고리즘은 하나의 로봇이 아니라 여러 대의 로봇을 가정하고 있다. 또한, K-ACO는 개미 알고리즘을 개선하여 K개의 군집을 만들고 각 군집 별 최단 경로를 제공해준다. 본 논문에서는 제안한 알고리즘의 성능 분석을 도서 정리 시간의 관점에서 실시하였다. 제안한 알고리즘인 K-ACO 알고리즘을 한 대학교 도서관에 적용하여 현재 도서 정리 알고리즘과 비교해 보았다. 시뮬레이션을 통해 제안하는 알고리즘은 도서 정리 업무를 치우치지 않고 공평하게 배분하여 궁극적으로 전체 일이 끝나는 시간을 확연히 줄일 수 있음을 알 수 있었다. 본 연구 결과를 통하여 제안한 알고리즘의 적용으로 도서 정리에 필요한 인적 · 시간적 비용을 절감하여 도서관 내 양질의 서비스 향상을 기대한다. Among the numerous duties of a librarian in a library, the work of arranging books is a job that the librarian has to do one by one. Thus, the cost of labor and time is large. In order to solve this problem, the interest in book-arranging robots based on artificial intelligence has recently increased. In this paper, we propose the K-ACO algorithm, which is the shortest path algorithm for multi-stops that can be applied to the library book arrangement robots. The proposed K-ACO algorithm assumes multiple robots rather than one robot. In addition, the K-ACO improves the ANT algorithm to create K clusters and provides the shortest path for each cluster. In this paper, the performance analysis of the proposed algorithm was carried out from the perspective of book arrangement time. The proposed algorithm, the K-ACO algorithm, was applied to a university library and compared with the current book arrangement algorithm. Through the simulation, we found that the proposed algorithm can allocate fairly, without biasing the work of arranging books, and ultimately significantly reduce the time to complete the entire work. Through the results of this study, we expect to improve quality services in the library by reducing the labor and time costs required for arranging books.