한국의학사 강의 개발과 강의 사례 연구

이현숙 ( Hyun Sook Lee ) 연세대학교 의과대학 의사학과 의학사연구소 2013 연세의사학 Vol.16 No.1

This research will explore how to develop and teach Korean medical history in Korean universities. In 2009-2010, I participated in a project called “Developing the Module of the Korean Medical History,” which was funded by the Korean Research Foundation. For this project, done at Yonsei Medical College, five specialists worked together to develop the module: Yeo In-sok (Director of the project, Contemporary period), Lee Hyun-sook (Ancient period and the Goryeo dynasty), Kim Seong-su (Joseon dynasty), Sihn Kyu-whan (Modern 1: the late 19th century and early 20th century), and Park Yun-jaeoe (Colonial period). One of the results of this project was the publication of the book History of Medicine in Korea. As a case study, I analyzed the results of my experiences teaching Korean medical history to graduate students in medical college in 2010 and freshmen in nursing college in 2013. In the graduated school of medical college, all of the five members gave lectures, however, it seems like too many lecturers for five students in eight classes. I could not give any previous reading material and assignment. It means we need more time to teach properly. In 2013, I taught Korean medical history by myself as the Korean History class in a nursing college. I invited Prof. Kim and Sihn as a guest teacher. According to my survey of the nursing college`s freshmen students, my students selected the forensic medicine of the Joseon dynasty and the military medicine of Silla Unification War in the 7th Century as the best subjects. The next favorite subjects were the comparison of the Modernization and Exploitation theories in colonial Korea, as well as Ancient Medicine, specifically trephination and skull modification. They selected these because the visual media, made by KBS, about the forensic medicine of the Joseon dynasty and about the artificial cranial deformation of the Gaya, which we had watched in the class. From this, I discovered that watching visual images was the most efficient method of learning for the class. Another assignment I gave to my classes concerned the military medicine of ancient Korea, and my students were responsible for reading my article “Military Medicine of the Silla Unification War,” summarizing the article, and recording their thoughts and impressions. This subject was also a favorite. I determined that self-study was a very efficient way to develop students` ideas and passions. The results of the survey about the comparison of the Modernization and Exploitation theories revealed that my students supported the Exploitation theory more than the Modernization theory. In the 1st class, 17 students supported the Modernization theory, while 49 students subscribed to the Exploitation theory in the Colonial medicine. On the other hand, only 7 students agreed with the Modernization theory at the 2nd class, while 55 students supported the Exploitation theory. I believe this is the result of the influence of Prof. Sihn, who had provided a special lecture to my students as a supporter of the Exploitation theory. I also recognized that my way of questioning had influenced the answers of the students. In the question of the 1st class, I had explained the Modernization theory at first, and then I had them choose “agree” or “disagree” and explain their answer. In the 2nd class, on the contrary, I introduced the Exploitation theory in advance and had them select “agree” or “disagree.” The 2nd class might have been influenced by the method of questioning, and they selected the Exploitation theory as an easier answer. Most of the nursing college`s students were content learning about the history of Korean medicine as a Korean history class. The text book History of Medicine in Korea played a considerable role in guiding my students, even though it has many weaknesses. In conclusion, the history of Korean medicine is a good subject for teaching Korean history at a university, and it also develops the identification of medical college students.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

승무 좌우치기 동작 중 숙련도와 류파에 따른 어깨 각도, 각속도 및 근활성도의 비교

홍경아(Hong, Kyung-A),김현숙(Kim, Hyun-Sook),이만균(Lee, Man-Gyoon) 한국체육과학회 2013 한국체육과학회지 Vol.22 No.6

This study was designed to compare joint angle, angular velocity, and EMG activity of shoulder during "Joa-u-chigi" according to skill level and style of "Seungmu". Ten skilled and ten unskilled Korean dancers participated in the study. Dependent variables were compared according to skill level as well as between skilled dances of both styles. Main results were as follows: 1) In "Mae-Bang Lee" style, the amount of changes in angle and angular velocity were greater in skilled than unskilled. In addition, EMG activity of trapezius was greater at P1 and P3 in skilled than unskilled. 2) In "Young-Sook Han" style, angle and angular velocity of shoulder were not changed from middle of P1 to end of P2 in unskilled, indicating that their shoulder was not moved properly. 3) The movement of "Young-Sook Han" style started with greater angle of shoulder than "Mae-Bang Lee" style. Range of changes in angular velocity of "Young-Sook Han" style was greater than "Mae-Bang Lee" style throughout the movement. Conclusion was that the movement of shoulder during "Joa-u-chigi" was performed with more balanced manner as well as in smoother and stronger fashion in skilled than unskilled in both styles. These results would be expected to be applied well in the field of education as a very meaningful information.

일부 사업장 건강증진사업 실태조사 및 요인분석

이경화,이원철,이강숙,홍현숙,송연이 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.2

For the purpose of access the health promotion activities in 138 worksite which had more than 50 workers, we surveyed the questionnaire on May and September 1998. The results of survey were as follows: 1.59 companies(45.1%) were conducting the health promotion activities. Most of them were manufacturing and located Kyung-sang province and had nurses as a health manager. 2.Companies operating the health promotion activities had significant higher degree of satisfaction and usage of welfare facilities than non-operating companies. 3.The level of knowledge for regulations, professional skills, and performance related health promotion was low in all companies. Top manager's interest and will for investment to health promotion was significant lower in non-operating companies. 4.The reasons why the health promotion program was not operated, were low budget, top manager's indifference, lack of information, work overloading, no human resource, an insufficient governmental support in order. 5.The most necessary items for program were education and promotion, budget, and governmental support. Needed personnel were nurses, fitness trainner, and necessary program were health management, exercise, nutrition, and stress counselling. For comparing before and after IMF, amount of budget was decreased. In conclusion, this study suggested that major barriers to conduct health promotion activities were lack of budget, lower interest of top managers, and insufficient professional information, therefore detail health promotion program would be developed and supported by government.

근로자 건강증진전략을 위한 행동변화에 대한 요구도 평가

이강숙,임현우,구정완,홍현숙,이정민,이원철,박정일,맹광호,M, O'Donnel 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the stage of behavior change for health promotion strategy in workplace Methods : Questionnaire survey was carried out for 309 workers who employed in H Electronics company in Kyong-in area from September to October 1998. Results : According to need assessment of four step such as precontemplation stage, contemplation stage, action stage, maintenance stage which were to change of behavior for health promotion, the percent for quitting smoking were observed 48.8%, 43.1%, 8.1%, 0%, and for the restriction of drinking were 29.8%, 10.6%, 9.3%, 5.3%; for fitness 11.1%, 31.0%, 37.3%, 20.6% in male 26.6%, 27.8%, 26.6%, 19.0% in female, for regular diet 26.1%, 19.8%, 38.7%, 15.3% in male, 27.8%, 22.2%, 40.0%, 10.0% in female and for stress management 5.8%, 10.6%, 8.7%, 75.0% in male, 13.6%, 22.7%, 19.7%, 44.0% in female. In heavy smoker(p=0.017) and heavy drinker,(p=0.021) the percent of precontemplation stage was significantly higher than in lower drinker and light smoker. Conclusions : This study suggested that company support for health promotion in workplace was and workers of high risk group for smoking and drinking were in precontemplation stage. So before conducting the health promotion program, health risk appraisal and need assessment for stage of behavior change should be taken for the efficient health promotion strategy.

중증 재생불량성빈혈에서 타인 혹은 HLA 불일치 혈연간 골수이식을 위한 cyclophosphamide와 antithymocyte globulin전처치 요법

이정희,이제환,김신,설미이,이정신,김우건,김상희,지현숙,박찬정,이규형 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: Cyclophosphamide와 ATG의 전처치 요법은 HLA가 일치하는 형제간 골수이식에서는 매우 효과적인 것으로 알려져 있으나, 타인 혹은 HLA 불일치 혈연간 골수이식에서는 전처치 요법으로서 불충분한 것으로 보고되었는데, 주요 문제는 착상 부전이었다. 우리나라를 포함하는 극동아시아 지역의 국가들에서 발표되는 보고에 의하면 타인이식을 포함하여 골수이식 후 착상 부전과 이식편대숙주질환의 발생이 서구 국가들로부터의 보고에서보다 적은 것으로 알려져 있다. 저자 등은 6예의 중증 재생불량성빈혈 환자들에서 질병 초기에 Cyclophosphamide와 ATG만을 이용하여 전처치를 한 후에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행하였다. 방법: 1999년 5월부터 2000년 4월까지 서울중앙병원에서 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 성인 중증 재생불량성빈혈 환자들을 대상으로 하였다. 골수이식을 위한 전처치 요법으로 cyclophosphamide (50 mg/kg/d x 4)와 ATG (30 mg/kg/d x 3)를 투여하였는데, 골수이식 전에 ATG에 대하여 과민 반응을 보였던 한 예 (UPN 120)에서는 ATG 대신에 fludarabine (30 mg/m2/d x 3)을 투여하였다. 이식편대숙주질환의 예방을 위하여 cyclosporine과 methotrexate를 투여하였다. 결과: 연구 기간 중에 모두 6예가 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받았는데, 5예는 타인으로부터 골수를 공여 받았으며, 1예는 HLA의 표현형이 하나의 유전자좌에서 일치하지 않는 형제로부터 골수를 공여 받았다. 타인 골수이식을 받은 5예 중에서 3예의 공여자는 HLA의 표현형이 일치하였으며, 1예는 하나의 유전자좌가 major mismatch였고, 1예는 하나의 유전자좌가 minor mismatch였다. 추적기간의 중앙값은 406일 (범위, 328-643일)인데, 6예 모두에서 착상된 상태를 유지하면서 생존해있다. 2예에서 3도의 급성 이식편대숙주질환과 전신성 만성 이식편대숙주질환이 발생하였다. 결론: Cyclophosphamide와 ATG의 전처치 요법은 재생불량성빈혈의 초기에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 한국인 환자들에서 충분히 착상을 가져올 수 있는 요법으로 생각된다. 비록 본 연구의 대상 환자 수가 적지만 결과는 매우 고무적이다. HLA가 일치하는 형제가 없는 중증 재생불량성빈혈 환자의 경우에 타인 골수 공여자에 대한 검색을 조기에 시행해야 하며, 타인 혹은 HLA 불일치 혈연간 골수이식을 질병 초기에 적극적으로 고려해야 할 것으로 생각된다. Background: Cyclophosphamide (CY) and ATG regimen was reported to be insufficient for alternative donor BMT in SAA patients due to high incidence of graft rejection. The rates of graft rejection and GVHD after allogeneic BMT including unrelated donor transplants seemed to be lower in reports from Asian countries of Far East. We applied CY/ATG regimen to six patients with early stage of SAA transplanted with marrow from alternative donors other than HLA-identical siblings. Methods: Three patients were transplanted from HLA-phenotypically identical unrelated donors, two from one-locus mismatched unrelated donors, and one from an one-locus mismatched sibling donor. Four patients received no previous therapy for SAA, and two received one course of immunosuppressive therapy with ATG. Preparative regimen was CY (200 mg/kg) plus ATG (90 mg/kg) in all patients except one who had had an anaphylactic reaction to ATG prior to BMT and received fludarabine (90 mg/m2) in place of ATG. Cyclosporine plus methotrexate were given for GVHD prophylaxis. Results: All six patients engrafted and all are alive with durable engraftment at a median follow-up of 406 days (range, 328 to 643). Two patients developed grade III acute GVHD and extensive chronic GVHD. Conclusions: CY/ATG regimen may be sufficient in Korean patients with early stage of SAA transplanted with marrow from alternative donors. Although the number of patients in present study is small, results are encouraging. Stem cell transplantation using alternative donors may be considered at early stage of aplastic anemia.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

대학생들의 떡에 대한 기호도 및 이용현황

이현옥,노숙령,김기숙,이숙영,이복희,박미정 중앙대학교 생활과학연구소 2002 생활과학논집 Vol.15 No.-

The survey study was conducted to investigate the rice cake consumption pattern including the frequency of intake and the degree of preference and the area of improvement for Korean rice cake among college students. About the motive for purchases of rice cake, 'taste is good(43.3%)' was the highest, and 'eat as a snack' the next (42.9%). The reason which does not eat the rice cake frequently was uncomfortable to eat (24.1%), insipid(21.4%), not variously assorted(17.9%) in the order named. The college students surveyed were eating rice cake as a snack mainly. They wanted the rice cake to be charmed and be in pretty shape, and fusion style for gift. And they wanted to be rice cake more sweetened and cool taste like ice cream. Therefore, traditional rice cake is required for further research for the development of product which is more acceptable for the young adults.

콩아이스크림의 상품화를 위한 고정화 효소의 이용

이숙영,이현옥,노숙령,김기숙,이복희,박미정 중앙대학교 생활과학연구소 2002 생활과학논집 Vol.15 No.-

The study was to investigate the functional properties of soy protein isolate hydrolyzed by immobilized α-chymotrypsin and the quality characteristics of soy ice cream made by the soy protein isolate treated with immobilized α-chymotrypsin. Up to the hydrolysis rate of 22.9%, treatement by immobilized α-chymotrypsin costed more time than that of α-chymotrypsin. Foam and emulsion capacity were decreased by the number of repetitive usage. Apparent viscosity and overrun of soy ice cream treated with immobilized α-chymotrypsin and α-chymotrypsin were shown similar tendency. In the sensory characteristics, soy ice cream by enzyme treatment was evaluated as much acceptable than untreacted soy ice cream in the item of beany flavor, icy feel and overall quality. For efficient use of immobilized α-chymotrypsin industrially, α-chymotrypsin immobilized on glass beads can be reused for about 11 times more than α-chymotrypsin.

항암화학요법 관련 오심과 구토 완화를 위한 비약물요법에 관한 연구동향

소향숙,최자윤,조인숙,김영재,김지영,김애숙,김옥미,김춘심,김현오,설영애,안정옥,이애리,이영자 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. Method: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. Result: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group: 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. Conclusion: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.