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정원경,이영희 병원간호사회 2016 임상간호연구 Vol.22 No.3
Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)’s clinical practice guideline which is 'Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.' There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses' performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.
정원경,길용수,김용빈,윤경구 한국도로학회 2011 한국도로학회논문집 Vol.13 No.1
VES-LMC(very-early strength latex modified concrete) has been widely used as repair material for bridge deck overlay or rehabilitation, because it could be opened to the traffic after 3 hours of curing. However, the bright color of VES-LMC disturb driver′s sigh. A black VES-LMC, matching to asphalt concrete, was developed and applied at a filed for driver′s comfort and safety. The black VES-LMC included 2% carbon black in cement weight ratio. A series of performance evaluation for black VES-LMC was done in terms of field applicability, pavement color and temperature change. The field applicability test result showed that there were no change of workability, slump and air void, and the compressive strengthen developed more than 20MPa after 4 hours of placement. The thermal stress of black VES-LMC was smaller than that of OPC and asphalt concrete,which means the stability of black VES-LMC. The performance evaluation result showed that the black VES-LMC could prevent road icing at below zero temperatures and promote thawing at melting temperature. VES-LMC(Very-Early Strength Latex Modified Concrete)는 콘크리트의 내구성 향상에 기여하는 SB라텍스를 첨가한 신속개방형 보수보강재로서로 교면재포장 및 콘크리트포장 보수에 적용되고 있다. 그러나 VES-LMC의 밝은 색상은 운전자에게 시각적 부담을 유발하여 주행성을 저하시킬 수 있어, 심리적 안정 도모를 위해 VES-LMC의 색상을 인접한 아스팔트 포장구간과 유사한 흑색으로개발할 필요성이 대두 되었다. 따라서 본 연구에서는 흑색안료인 카본블랙을 시멘트량 대비 2% 첨가한 흑색 VES-LMC에 대한 현장적용성 및 공용성을 평가하고자 하였다. 현장 적용결과 흑색 VES-LMC는 기존 VES-LMC와 비교하여 작업성, 슬럼프, 공기량 등에는 변화가 없었으며 양생 4시간에서는 20MPa 이상을 발현하였다. 공용성 평가결과 흑색 VES-LMC는 일반콘크리트와 아스팔트포장구간에 비하여 온도응력발생량이 가장 적은 것으로 평가되었으며, 이것은 콘크리트의 안정성을 의미한다. 특히 결빙시 영하권에서도상온을 유지하여 도로결빙을 예방하고 융빙을 촉진할 수 있을 것으로 기대된다.
소아 급성림프구성백혈병 환자에서 Trimethoprim-Sulfamethoxazole과 Methotrexate 병용 투여 시 약물 부작용 평가
정원경,구현준,윤정이,강진숙 한국병원약사회 2023 병원약사회지 Vol.40 No.1
Background : As maintenance therapy for pediatric acute lymphoblastic leukemia (ALL), oral methotrexate (MTX) and mercaptopurine (6-MP) are administered to prevent relapses. In addition to these anticancer drugs, oral trimethoprim-sulfamethoxazole (TMP-SMX) is usually prescribed to reduce the risk of Pneumocystis jiroveci Pneumonia. However, concomitant use of MTX and TMP-SMX may result in an increase of toxicity of MTX. As a matter of fact, a new contraindication against the use of TMP-SMX with MTX has been announced by the Ministry of Health and Welfare in December 2020. The objective of this study was to evaluate adverse drug reactions associated with concomitant use of TMP-SMX and MTX in pediatric ALL. Methods : Sixty-five patients received a maintenance therapy between January 2016 and July 2021 at Seoul St. Mary’s Hospital. Patient’s medical records and histories from the beginning to the end of maintenance therapy were reviewed retrospectively. We analyzed each patient’s basic characteristics, incidence and severity of adverse drug reactions (myelotovicity, hepatotoxicity and nephrotoxicity), methotrexate (MTX) reduction or discontinuation according to adverse drug reactions and completion of maintenance therapy. Results : Incidence rates of chemotherapy cycles that have myelotoxicity, hepatotoxicity, and nephrotoxicity were 100%, 92.3%, and 63.1%, respectively. Majority (90.9%) of these adverse events fell into grade 1 or 2. All patients completed the maintenance therapy successfully. Conclusion : Despite recently announced contraindication against concomitant use of MTX and TMP-SMX, the maintenance therapy including both MTX and TMP-SMX for pediatric ALL patients might be safe when adverse drug reactions are carefully monitored.
정원경,김동호,권혁찬,윤경구 강원대학교 산업기술연구소 2003 産業技術硏究 Vol.23 No.A
The purpose of this paper is to analysis of initial behavior of concrete pavement with initial measurement strain gauge for concrete pavement at field, and to investigate the field test results for field applicability testing. The early-age behaviors of concrete pavement slabs were measured using the strain gauges. From the slab depths and positions, the outputs from each gauges were recorded at initial curing period The initial measurement of concrete pavement and check of crack at the joint were performed. the results could be summarized as follows. From the results of concrete strength, compressive strength and flexural strength were showed 271kgf/㎝', 43kgf/㎝' respectively. From the tests of early-age strain measurement, it was found that the strain varied at the maximum value of 150μ ε and early1 behavior of concrete slab was showed a tensile strain However. for long-term was showed a compressive strain due to dry-shrinkage.