간호대학생의 임상수행능력과 핵심간호술 수행자신감이 간호전문직관에 미치는 영향

김연실,이윤정,박정애,Kim, Youn-Sil,Lee, Yun-Jeong,Park, Jung-Ae 경희대학교 동서간호학연구소 2023 동서간호학연구지 Vol.29 No.1

Purpose: This study aims to examine factors affecting nursing professionalism among nursing students. Methods: Data were collected using a structured questionnaire from July to August, 2022. The participants were a total of 266 students in the 3^rd and 4^th grades located in A and C cities. T-test, ANOVA, Scheffe' test, Pearson's correlation coefficient and multiple regression were used for data analysis using SPSS 24.0 program. Results: The average score for clinical competency was 4.05±0.59 (out of 5), confidence in essential nursing skill was 3.52±0.64 (out of 5), and nursing professionalism was 4.11±0.52 (out of 5). There was a positive correlation between clinical competency and confidence in essential nursing skills with nursing professionalism. The factors influencing nursing professionalism were clinical competency and grade, which explained 30% of nursing professionalism. Conclusion: The results of this study may be used as basic data for developing educational methods to improve nursing professionalism.

UAM 추락 시 인구 밀접 지역 지상 인명피해 분석

김연실,최인호,Kim, Youn-sil,Choi, In-ho 한국항행학회 2022 韓國航行學會論文誌 Vol.26 No.5

This study quantitatively analyzed the human casualties that can occur when a multicopter-type Urban Air Mobility (UAM) with a weight of about 1 ton and a speed of about 100 km/h falls in an urban area. Based on the population density and building database in Seoul, the population exposed to collisions in the event of a UAM crash was derived. Through the ballistic descent model, the accident impact radius of the UAM fall was calculated. In addition, the change in human casualties on the ground was analyzed when the accident impact radius increased. Finally, the ground risk map was created for Seoul, and it was confirmed that about 1 to 10 people could be injured when a UAM crash.

모성건강관리프로그램이 임부의 우울, 모성역할자신감, 분만자신감에 미치는 효과

김연실,이윤정,박규희,Kim, Youn Sil,Lee, Yun Jeong,Park, Gyu Hee 경희대학교 동서간호학연구소 2017 동서간호학연구지 Vol.23 No.2

Purpose: The purpose of this study was to investigate the effects of the maternal health care program on pregnant women's depression, maternal role self-confidence and delivery self-efficacy in a public health center. Methods: This study used a non-equivalent control group quasi-experiment design attempted to verify the effectiveness of maternal health care program. In the experimental group (39 participants), maternal health care program was applied for 120 minutes for 8 weeks, and the control group (40 participants) was provided with a booklet for maternal health care. Data collection was conducted from September 20, 2015 to November 30, 2015. Data were analyzed using ${\chi}^2-test$, Fisher's exact test and t-test. Results: The maternal health care program showed a significant effect on maternal role self-confidence and delivery self-efficacy compared to control group. Conclusion: The maternal health care program conducted at the public health center was found to be effective in improving maternal role self-confidence and delivery self-efficacy. Further development of a program to mediate the depression of the expectant mothers is needed.

PX4 기반 GPS/INS 광학 센서 융합 항법 시스템 구성 및 시뮬레이션을 통한 검증

김태균(Taegyun Kim),김동민(Dongmin Kim),김승균(Seungkeun Kim),김연실(Younsil Kim),한상혁(Sanghyuck Han) 한국항공우주학회 2020 한국항공우주학회 학술발표회 논문집 Vol.2020 No.7

도심 지역 비행을 위한 지상 인명 피해 기반 소형무인기 고장 빈도 분석

김연실(Youn-Sil Kim),배중원(Joong-Won Bae) 한국항공우주학회 2021 韓國航空宇宙學會誌 Vol.49 No.9

본 연구에서는 소형무인기(≤25kg)가 도심 지역에서 비행하고자 할 때 요구되는 고장 빈도를 무인기 추락 시 발생할 수 있는 지상 인명 피해를 기반으로 정량적으로 분석하였다. 도심 지역의 인구 밀도, 차량 교통량, 건폐율, 건물 층수 데이터 및 무인기 추락 궤적 모델링을 이용하여 특정 위치에서 무인기 추락 시 인명 피해를 계산하였고 이를 바탕으로 각 무인기 추락 위치에서 안전성 목표값을 만족하기 위한 최대 허용 가능 무인기 고장 빈도를 계산하였다. 이를 통해 각 무인기 추락 위치별 고장 빈도 요구사항을 맵 형태로 도출할 수 있었다. 최종적으로 최대 허용 가능 무인기 고장 빈도를 몇 구간으로 구분하여 각 구간별 도심 지역 비행 가능 영역을 분석하였다. 영월 지역을 대상으로 했을 때 인구 주거 지역 접근을 위해서는 최소 10<SUP>-4</SUP> (failure/flight hour) 이하의 무인기 고장 빈도가 요구됨을 확인하였다. In this paper, we quantitatively analyzed the required UAV(Unmanned Aerial Vehicle) failure rate of small UAV (≤25kg) based on the harm to human caused by UAV crash to fly over the populated area. We compute the number of harm to human when UAV falls to the ground at certain descent point by using population density, car traffic, building to land ratio, number of floors of building data of urban area and UAV descent trajectory modeling. Based on this, the maximum allowable UAV failure rate is calculated to satisfy the Target Level of Safety(TLS) for each UAV descent point. Then we can generate the failure rate requirement in the form of map. Finally, we divide UAV failure rate into few categories and analyze the possible flight area for each failure rate categories. Considering the Youngwol area, it is analyzed that the UAV failure rate of at least 10<SUP>-4</SUP> (failure/flight hour) is required to access the residential area.

연부조직육종의 수술후 방사선 치료결과

김연실(Yeon Shil Kim),장홍석(Hong Seok Jang),윤세철(Sei Chul Yoon),유미령(Mi Ryeong Ryu),강기문(Ki Moon Kang),정수미(Su Mi Chung),김훈교(Hoon Kyo Kim),강용구(Yong Koo Kang) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.4

목 적 : 최근들어 연부 조직 육종의 치료방법이 광범위 구획절제에서 사지기능을 보존하는 제한적 수술과 방사선/항암화학요법의 다병용치료로 변환되고 있으며 광범위 수술과 유사한 치료성적을 거두고 있다. 저자들은 수술후 방사선 치료를 시행한 연부 조직 육종 환자를 대상으로 치료 결과 및 실패 양상을 알아보고 관련된 예후 인자를 분석하여 수술 후 방사선치료의 역할을 알아보고자 하였다. 대상 및 방법 : 대상환자는 1983년부터 1994년까지 치료한 60명이었고 모두 추적관찰이 가능했으며 평균 추적기간은 50개월이었다. 원발병소는 상·하지가 35례(58%)로 가장 많았고 체간 12례(20%), 두경부 7례(12%)였으며 병리학적 유형에 따른 구분은 악성섬유구종 14례(23%),지방육종이 10례(17%), 악성신경섬유종 7례(12%) 등 이었다. 전체환자중 6례를 제외하고는 조직학적등급의 분석이 가능했고 grade I, II, III가 각각 27례(45%), 3례(5%), 24례(40%)였다. 수술적 절제는 19례(32%)에서 광범위절제, 36례(60%)에서 변연절제, 5례(8%)에서 국소절제를 시행하였다. 방사선치료선량은 28.8- 80Gy였고 25례에서 방사선치료와 함께 항암화학 요법을 병용하였다. 결 과 : 최종분석 시 실패 양상은 국소재발이 20례(25%), 원격전이 7례(12%), 국소재발과 원격전이를 동반한 경우가 14례(23%)였다. 원격전이한 환자는 구제치료와 상관 없이 모두 사망하였고 국소재발한 환자중 5명이 구제치료에 성공하여 무병생존하였다. 전체환자의 2년 및 5년 국소제어률은 68.0%와 48.7%로 비교적 저조한 결과를 보였다. 국소제어율에 영향을 미친 예후인자는 조직학적 유형, AJCC 병기, 조직학적 등급, 수술의 범위, 수술절연 침범 유무 및 잔존종양 정도, 림프절 전이 유무(p <0.05)였다. 전체 환자의 5년 생존률과 5년 무병생존률은 각각 60.4%, 36.6%였고 평균 생존기간은 89개월이었다. 단변량 분석에 의한 생존률에 영향을 미친 예후인자로는 조직학적 유형, AJCC 병기, 림프절 전이 유무, 조직학적 등급, 수술절연 침범 유무와 잔존 종양 정도 였다. 결 론 : 결론적으로 본 연구 결과 연부 조직 육종에서 제한적 수술과 수술 후 방사선치료로 비록 저조한 국소제어률을 보였으나 사지 절단 혹은 광범위 구획절제와 비교시 유사한 생존률을 얻었다. Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 60 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patints with median follow up duration 50 months (range 6 - 162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58%) was the most frequent site of occurrence followed by trunk (20%) and head and neck (12%). Histologically malignant fibrous histiocytoma (23%), liposarcoma (17%), malignant schwannoma (12%) constitute 52% of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42%) received chemotherapy with various regimen in the postoperative period. Results : Total 4 1 patients failed either with local recurrence or with distant metastasis. There were 29 patients(48%) of local recurrence. Four patients (7%) developed simultaneous local recurrence and distant metastasis and 8 patients (13%) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck prima ry. This feature is like ly explanation for the decreased loca l control rate . Five of 29 patients who fa iled only loca lly were salvaged by re- excis ion and/or re- irradiation and rema ined free of disease . Factors affecting loca l control include histologic type , grade, stage , extent of operation and surgica l ma rgin involvement, lymph node metastas is (p <0.05). All 21 patients who fa iled distantly are dead with progress ive disease at the time of this report. Our overall survival results are similar to those of larger series . Actuarial 5 year overall survival and disease fresurvival were 60.4 %, 36.6% respectively. Grade, stage (being close association with grade), residual disease (negative ma rgin, microscopic, gross) were significant as a predictor of survival in our series (p <0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer

김연실(Yeon-Sil Kim),윤세철(Sei-Chul Yoon),정수미(Su-Mi Chung),유미령(Mi-Ryeong Ryu),정상설(Sang-Sul Jung),최일봉(Ihl-Bohng Choi) 대한방사선종양학회 2004 Radiation Oncology Journal Vol.22 No.2

목 적: 조기 유방암에서 유방보존치료(유방보존수술+방사선치료) 혹은 유방전절제술로 치료했던 환자의 초 기 치료성적과 실패양상을 비교하고자 후향적으로 분석하였다. 대상 및 방법: 1989년 3월부터 1996년 8월까지 강남성모병원에서 AJCC병기 I, II로 치료를 받았던 유방암 환자를 대상으로 하였다. 88명은 유방전절제술을 시행하였고 85명은 유방보존술 후 방사선치료를 시행하였다. 방사선치료는 50 Gy 전 유방조사 후 원발부위에 10∼15 Gy 추가 조사하였다. 유방보존치료 환자의 34.1%, 유방전절제 환자의 45.5%에서 항암화학요법이 병용되었다. 양 치료군의 5년생존율과 5년무병생존율, 실패양상을 비교하였으며 치료실패와 연관된 위험인자를 Log-rank test를 이용하여 분석하였다. 중앙 추적기간은 63개월이었다. 결 과: 양 치료군 간에 5년생존율, 5년무병생존율의 유의한 차이(p>0.05)는 없었으며 국소재발 및 원격전이의 치료실패양상에도 차이가 없었다. 추적기간 중, 유방전절제군에서 11명(12.5%) 유방보존치료군에서 10명 (11.8%) 재발하였다. 초기 실패양상은 국소재발이 각각 6명, 5명이었고 원격전이가 각각 5명, 4명으로 차이가 없었다. 국소재발 단독의 경우 양 치료군에서 구제치료 후 대부분의 환자가 무병생존 (5/6 유방전절제술, 3/5 유방보존치료)하였다. 그러나 원격전이 환자의 경우 양 치료군 모두에서 방사선-항암화학요법의 구제치료에도 불구하고 대부분의 환자가 진행 혹은 사망하였으며 유방보존치료군의 1명의 환자만이 원격전이 후 구제치료에 성공하여 무병생존하였다. 양 치료군 간에 반대편유방암 발생률 및 다른 장기의 2차 원발암 발생률의 차이는 없었고 유방암으로 인한 사망률도 차이가 없었다. Log-rank 단변량분석에서 치료 실패와 관련된유의한 위험인자는 양 군 모두에서 N 병기, 액와 림프절 전이 숫자였으며 유방보존치료군에서는 수술절연침범유무가, 유방전절제군에서는 high nuclear grade가 치료실패와 관련된 위험인자였다(p<0.05). 결 론: 초기 분석결과 AJCC 병기 I, II 조기유방암에서 유방보존치료와 유방전절제술은 생존율뿐 아니라 치료 실패양상에도 차이가 없었으며 향후 이와 같은 결과를 확인하기 위한 장기간의 추적연구가 필요하다. Purpose: This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy in early breast cancer. Materials and Methods: We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary’s Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. In the BCT group, all patients received whole breast irradiation to a total dose of 45∼50 Gy/5∼6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1%) patients in BCT and 40 (45.5%) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19∼111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results: Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5%) in the mastectomy group and 10 patients (11.8%) in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT. Five patients failed at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of 5 BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2nd primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade in the mastectomy group were risk factors for treatment failure (p<0.05). Conclusion: Although further careful follow-up is necessary to confirm the trends evident in this series, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

The Role Radiation Therapy in the Treatment of Intracranial Glioma : Retrospective Analysis of 96 Cases

김연실(Yeon Sil Kim),강기문(Ki Mun Kang),최병옥(Byung Ock Choi),윤세철(Sei Chul Yoon),신경섭(Kyung Sub Shinn),강준기(Jun Gi Kang) 대한방사선종양학회 1993 Radiation Oncology Journal Vol.11 No.2

1983년 3월부터 1989년 12월까지 가톨릭의과대학 강남성모병원 치료방사선과에서 뇌교종으로 방사선치료를 받은 환자 90명을 대상으로 방사선치료 성적 및 생존률에 영향을 미치는 예후인자들의 후향적 분석조사를 실시하였다. 대상환자의 연령분포는 3세에서 69세였으며(중앙값 42세), 남녀비는 60:36이었고, 임상주증상은 두통 및 (67%) 운동신경 마비 (54%)였다. 조직학적 진단방법 및 수술은 생검 21명 (22%), 부분절제 21명 (22%), 아전절제 29명 (30%), 전절제 14명 (15%)이였고, 뇌간을 침습한 환자 12명중 11명은 조직검사를 시행하지 않았다. 조직학적 분류는 성상세포종이 64명 (75%)으로 가장 많았고, 회돌기교세포종이 17명 (20%), 혼합형이 4명(5%)였다. 조직학적 등급에 따른 구분은 49명이 grade I, II 종양(58%)이였으며, 30명이 grade III, IV종양(42%)이였다. 전체 96명 중 64명 (67%)이 수술과 방사선 치료를 병행하였고, 32명(33%)이 방사선단독 요법으로 치료하였으며, 25명(26%)의 환자에서 화학요법을 병행하였다. 전체환자의 평균 생존기간은 53개월이었고, 2년 및 5년 생존률이 각각 69%, 49%이였다. 조직학적 등급에 의한 생존률은 grade I 종양의 5년 생존률이 70%였고, grade II, III, IV 종양이 각각 58%, 28%, 15%였다. 연령, 조직학적 등급 및 분류, Karnofsky performance status(KPS), 침습부위, 수술적 제거여부 및 제거정도, 방사선치료선량, 방사선조사야, 화학요법 병행 여부에 따라 생존률을 분석한 결과 연령 (p=0.0121), KPS(p=0.0002), 조직학적 등급(P=0.0001), 수술적 제거 (p=0.0240)가 유의한 예후인자로 분석되었으며, 통계학적으로 유의하지는 않았지만 천막하병소가 천막상부 병소에 비해, 부분조사가 전뇌조사에 비해 높은 생존률을 보이는 매개변수로 분석되었다. Between March 1983 and December 1989, ninety-six patients with intracranial glioma were treated in the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. We retrospectively reviewed each case to evaluate variable factors influencing the treatment results and to develop an optimal therapy Policy. Median follow-up is 57 months (range: 31~133 months). Of the 96 patients, 60 (63%) were males and 36 (37%) were females. Ages ranged from 3 to 69 years (median 42 years). The most common presenting symtoms were headeche (67%) followed by cerebral motor and sensory discrepancy (54%), nausea and vomiting (34%), seizure (19%), mental change (10%) and memory and calculation impairment (8%). Eighty five (88.5%) patients all, except 11 (11.5%) brain stem lesions, were biopsy proven intracranial glioma. The distribution by histologic type was 64 astrocytomas (75%), 4 mixed oligoastrocytomas (5%), and 17 oligodendrogliomas (20%). Fourty nine patients (58% were grade I, II histology and 36 (42%) patients were grade III, IV histology. Of the 96 patients, 64 (67%) recieved postoperative RT and 32 (33%) were treated with primary radiotherapy. Gross total resection was peformed in 14 (16%) patients, subtotal resection En 29 (34%), partial resection in 21 (25%), and biopsy only in 21 (25%). Median survival time was 53 months (range 2~ 133 months), and 2- and, 5-year survival rate were 69%, 49% respectively. 5-year survival rate by histologic grade was grade I, 70%, grade II, 58%, grade III, 28%, and grade IV, 15%. Multivariated analysis demonstrate that age at diagnosis (p=0.0121), Karnofsky performance Status (KPS) (p=0.0002), histologic grade (p=0.0001), postoperative radiation therapy (p=0.0278), surgical extent (p =0.024), cerebellar location of tumor (p=0.0095) were significant prognostic factors influencing on survival.

지상 위험도 기반 무인기 운용 회랑 수용량 분석

김연실(Youn-sil Kim),배중원(Joong-Won Bae) 한국항공우주학회 2023 한국항공우주학회 학술발표회 논문집 Vol.2023 No.11

전자민주주의와 정부의 역할 변화 : 현대 정보기술(IT)의 발달은 민주관료체제의 약화를 불러오는가?

김연실(Kim Yon Sil) 한국공공정책학회 2005 공공정책연구 Vol.17 No.-

Democracy has sprung out to most political institution throughout the world and the rapid development of information technology has given bureaucracy less room for action in governmental processes and public policies. The main hypothesis was tested and examined if it was a valid argument that the role of bureaucratic processes in government has greatly been reduced through information technology. The finding suggested that, first an efficient governmental management was further explored in the rapid changes of society through technology revolution, and secondly, a cyber space was provided that the role and function of government became redefined and expanded. A further study suggests that new democracy is needed to make the government more efficient and serviceable to the people of global society.