입원 환자 영양검색 전산 프로그램 개발

안수미,윤기영,신연명,최경현,임근승,장문경,송윤미,공은희 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : About 30% of patients in the hospital are under nourishment. A large portion of people are undernourished when they are admitted to the hospital and in the majority of these, undernutrition develops further while in hospital. Patient-Generated subjective global assessment(PG-SGA), a method of nutritional assessment based on clinical judgment, has been widely used to assess the nutritional status of adults for both clinical and research purposes. Modified PG-SGA can be used as a nutrition screening tool, and a comprehensive nutrition assessment is desirable for those who are malnourished. The purpose of this study is to develop a simple, reliable and valid nutrition screening program(NSP). Methods : We applied the nutrition screening program(NSP) to adult inpatients who are at risk of malnutrition using the Modified Patient-Generated subjective global assessment(PG-SGA) and objective assessment(electrical medical record data). Results : Therefore simple and beneficial NSP is developed for patients with severe malnutrition. Using NSP. nutritional information of the severe malnutrition patient should be shared with the physicians and they should be taken care of by clinical dietitians to improve their nutritional status. Conclusion : The Modified PG-SGA and nutrition screening tool are simple, reliable and valid nutrition screening program(NSP).

NIHSS 활용을 통한 뇌졸중 환자 간호의 질향상 전략

박경현,송경애,공혜성,나화주,유수경,박소영,김상희,최혜림,배희준,한문구,양미화 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로활용하고 있지만 아직 간호현장에서는보편적으로사용하지 않고있다. 이에 뇌졸중환자간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중환자 간호의 질을보다 향상시키기 위하여 본활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를향상시키기 위한 프로그램을 개발·적용한다. 둘째, 간호사가급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬수있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과치료를위한의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 「NIHSS 간호사 교육 프로그램」을 마련하였다.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Outcome of Midurethral sling in elderly women over 75 years old with female stress urinary incontinence

( Mi Kyung Kong ),( Soo Rim Kim ),( Yeo Jung Moon ),( Sei Kwang Kim ),( Sang Wook Bai ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

Pelvic floor disorders including urinary incontinence are common in older woman. As old population is increasing these days, we need to provide evaluation and proper treatment of stress urinary incontinence. Although there have been some controversies, aging may be one of factors of failure in Midurethral sling surgery for female stress urinary incontinence. However, there were poor reports about the effect of Midurethral sling surgery for management of urinary stress incontinence in elderly female patient. The aim of this study was to analyze and evaluate the outcome of Midurethral sling surgery in elderly female patient over 75 years versus younger women Paitents with SUI underwent Midurethral sling surgery including TOT and TVT between 2005 and 2011. Among these patients, 30 patients were over 75 years old, 468 patients were under 75 years old. Medical records were reviewed retrospectively to clarify whether Midurethral sling surgery was effective in this age group. The primary end point was subjective symptom recurrence. Cure was defined as no urinary symptom at all in any circumstances and No cure was defined as any urinary symptom or operative complication. Comparison between elderly and younger patients was performed. Total of 498 women (under 75 years old group : 468, elderly group : 30) were enrolled in the study. Median age of patient were 77.67 ± 2.23 In 30 patients over 75 years old, and 55.68 ± 9.66 In 468 patients under 75 years old. Frequency, Urethral hypermobility, cystoscopic finding, trabeculation rate were different in two groups. Concomitant pelvic organ prolapse (POP) was noted in 90% of the elderly and 50.65% of the younger women. (p value <.001) There was no significant difference in cure rate and Cure and no cure were no difference in those two age groups. (89.53% were cure and 10.47% were no cure in patients over 75 years old, 90% were cure and 10% were no cure in patients under 75 years old.) Success rate of Midurethral sling surgery in elderly women over 75 years old were not statistically different compared to patient group under 75 years old that were reported in articles. Midurethral sling surgery including TOT, TVT is a safe and effective treatment for both elderly and younger stress-incontinent women. As population of elderly women and women who have SUI symptom is now increasing, study about these groups should be assessed and further research is required to more fully understand the functional, anatomic, and physiologic outcomes after treatment for pelvic floor disorders in the older woman.

Surgical treatments for vaginal apical prolapse

( Mi Kyung Kong ),( Sang Wook Bai ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.4

Pelvic organ prolapse is a common condition, occurring in up to 11% of women in the United States. Often, pelvic organ prolapse recurs after surgery; when it recurs after hysterectomy, it frequently presents as vaginal apical prolapse. There are many different surgical treatments for vaginal apical prolapse; among them, abdominal sacral colpopexy is considered the gold standard. However, recent data reveal that other surgical procedures also result in good outcome. This review discusses the various surgical treatments for vaginal apical prolapse including their risks and benefits.

Identification of risk factors for recurrence after pelvic organ prolapse surgery

( Mi Kyung Kong ),( Sang Wook Bai ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: The aim of our study was to look at different presumed risk factors for prolapse recurrence after ASC. 방법: We performed a retrospective cohort study of the risk of recurrent prolapse after ASC at our institution from March 2005, through December 2014. All women had pelvic surgery with traditional techniques using mesh and were followed to 1 to 5years postoperatively.Our primary outcome was a composite measure defined as prolapse recurrence extending beyond the hymen or presence of bothersome bulging symptoms. We compared those subjects who met the definition of recurrence to those who did not. Statistical analysis was performed using SPSS (version 23). Univariable analysis was done using Student t test, Chi-squre and Fisher’s exact test. Multivariable logistic regression was followed to adjust for confounders. 결과: We included 160 participants at a mean follow-up of 26 months, and 16 women (10%) had a recurrent prolapse. When compared, women with and without prolapse recurrence did not show any significant difference for age, gravity, parity, vaginal parity, menopausal state and hormone replacement therapy. The two groups did not show any significant difference for family history of prolapse, previous hysterectomy status, prolapse operation history. BMI > 30 was the only significant risk factor for recurrence (p=0.02, OR 8.1, 1.6 – 40.1 95% CI). Even though some studies identified that increasing stage of preoperative descent stage increase the risk of recurrence after surgery, there was no difference between stage III and stage IV. (p=0.147, OR 0.4, 0.2 – 1.4 95% CI). In a multivariate model, we found that the risk of recurrence increase as BMI>30 with an odds ratio of 8.8 (95% CI 1.677-46.315) when controlling for age, family history, previous hysterectomy status, prolapse operation history. 결론: After ASC, obese women BMI >30 have higher prolapse recurrence compared with normal-weight women. There was no difference of recurrence between preoperative POP Q stage III and IV.

Preparation of Biocompatible Scaffold Beadsfor Cartilage Tissue Engineering

Mi-Eun KONG,Sung-Hun CHOI,Su-Jin KIM,Su-Jung KIM,Sun-Mi YOO,Joon-Serk SEO,Kyung-Ho KANG,Eun-Sun KO,Dong-Il KIM 한국생물공학회 2010 한국생물공학회 학술대회 Vol.2010 No.10

Posthysterectomy patients are as likely as patient with uterovaginal prolapse to have successful prolapse surgery

( Mi Kyung Kong ),( Sang Wook Bai ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: The aim of this study is to compare the prolapse repair success and complication rate between women with symptomatic vaginal vault prolapse (VVP) versus uterovaginal prolapse (UtVP) in patients undergoing prolapse repair with apical suspension. 방법: A retrospective cohort study comparing outcomes of VVP and UtVP participant who underwent surgical correction was performed.326 participants had symptomatic uterine prolapse of Pelvic Organ Prolapse Quantification (POP-Q) stage 3-4, they underwent ASC, VH and ICG procedures including apical repair. Anatomic assessment was based on the POP-Q system and postoperative work-up was performed after surgery. The primary outcome was treatment success at 12 months according to both objective criteria (no recurrence of any prolapse ≥ stage II, and no retreatment) and subjective criteria 결과: During the study period, 326 women were included for final analysis; 109 underwent VVP and 217 underwent UtVP apical repair. In basal characteristics, participant undergoing VVP repair were older (66.99±8.2 vs 63.16±9.9, P value 0.001), more likely to have undergone previous prolapse repair history (37.6% vs 11.1%, P value <0.0001) There was no significant difference in body mass index (BMI), parity, vaginal parity, home delivery history or difficult labor history between VVP and UtVP groups. All of 2 groups achieved a significant and comparable correction of prolapse. Postoperative point C measurements did not vary between groups (-7.7±1.5 vs -7.9±2.3, P value=0.39) The rates of postoperative complications of the 2 groups were not statistically different. And overall success was similar between groups (OR 1.3 for VVP as. UtVP, 95% CI 0.60-2.76, P value 0.55) 결론: Surgical repair success rate of VVP and UtVP were not different as measured by standardized anatomical outcomes. Both VVP and UtVP patients were restored normal pelvic anatomy. Likewise, no difference were found in complication rate.

증포 횟수별로 제조된 선식의 품질 특성 및 생리활성 성분

양경미(Kyung-Mi Yang),황경희(Kyung Hee Hwang),공현주(Hyun-Joo Kong),권지은(Ji-Eun Kwon) 한국조리학회 2021 한국조리학회지 Vol.27 No.1

증포 횟수를 달리하여 만든 선식을 첨가한 고지방식이가 비만 쥐의 혈당과 염증지표에 미치는 영향

황경희(Kyung-Hee Hwang),공현주(Hyun-Joo Kong),이언희(Eon-Hee Lee),최은미(Eun-Mi Choi),황수정(Su-Jung Hwang),장정현(Jung-Hyeon Jang),양경미(Kyung-Mi Yang) 동아시아식생활학회 2015 동아시아식생활학회지 Vol.25 No.1