혈액투석시 Double Lumen Silicone Rubber Catheter ( = Permcath ) 사용의 임상적 경험

차대룡(Dae Ryong Cha),김선숙(Sun Sook Kim),이영호(Young Ho Lee),권영주(Young Joo Kwon),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim),선경(Kung Sun),김정숙(Jung Sook Kim),함인귀(In Gui Ham),김미경(Mi Kyung Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.4

N/A Background: Repeated, long-term access of the vascular system is a prerequisite for successful extended care of the patients with end stage renal disease (=ESRD) treated with hemodialysis. Despite recent technical advances in percutaneous venous cannulation, vascular access remains a major problem in patients requiring acute Hemodialysis. Although the subclavian cannula has gained a large clinical acceptance in recent years, it carries specific risks such as hemothorax, pneumothorax, venus stenosis, thrombus formation and infection. Recently, a double-lumen, central venous catheter made of Silicone Rubber (=Perm cath) has developed for use as a vascular access device, This device is particularly useful in patients who have exhausted other vascular access sites or who have severe cardiovascular disease. Methods: A total of 23 dual-lumen silicone rubber catheters were placed through the internal jugular vein in 23 patients as a vascular access at our institution during the period of April, 1992 through November, 1992. The perm-cath (Hemocath, Quinton, Seattle) is 36 Cm long and each lumen has an internal diameter of 2 mm. Implantation of the catheters occurred in the operating room and under strict aseptic conditions through the right internal jugular vein. A 10 cm subcutaneous tunnel was then created, which extended from the in-cison to a point 2 cm above the ipsilateral clavicle. The catheter was passed out through the upper portion of the subcutaneous tunnel with the Dacron cuff placed 2 cm from the lower end of the tunnel, acting as both an anchor and a barrier to infection. The tip of the catheter was inserted through an internal jngular vein terminating in the right atrium under EKG monitoring. Each lumen of the catheter was filled with 1000 units of heparin sodium (1.5 ml in venous line, 1.5 ml in arterial line) and capped. Results : The mean duration of catheter use was 24±16 days (8 to 119 days), and the complication of perm-cath occurred in 3 cases such as venous thrombosis in 1 case, catheter exit site infection in 1 case, and exit site hematoma in 1 case. During hemodialysis, blood flow rate ranged from 190 to 313ml/min (mean:235±26ml/ min), and venous retrun pressure ranged from 20 to 150 mmHg(mean:65±16mmHg). Total 14 catheters were removed during treatment and the causes of catheter removal were patient death in 8 cases, venous thrombosis 1, recovery from acute rena1 failure 2, fistula maturation 2, infection 1. Conclusion: Internal jugular vein cannulation with silastic catheter which offers a new percutaneous method was provided safe and reliable as the temporary central vein access. The catheters are well tolerated by the patients and have the advantages of immediate use after placement, high blood flow rates, no repetitive venipuncture, and no cardiac dysfunction. Permcath is particulary useful in patients who have exhausted other vascular access site, severe cardiovascular disease, and terrified by repetitive venipuncture. Though our initial experience has been favorable, there will be needed to evaluate the outcome of permcath over longer period of time.

익산시와 서울시 여고생의 식습관 및 영양 섭취 상태에 관한 연구

김인숙,이윤희,김희주 한국조리과학회 2005 한국식품조리과학회지 Vol.21 No.2

This study was carried out to investigate the dietary behaviors and nutrient intake of high school girls in Iksan and Seoul cities. The subjects consisted of 122 students in Iksan city, and 136 students in Seoul city. The proportion of subjects who eat meals irregularly was higher in Iksan (98.4%) than in Seoul (80.9%). The proportion of subjects who skip meals was also higher in Iksan (61.5%) than in Seoul (56.6%), and most of them (69.7%) skipped breakfast, even though they thought that it was the most important meal (86.4%). The subjects vended to overeat at lunch (41.9%) and dinner (55.4%). The main reasons that the subjects skipped a meal were a lack of time (50.7%) and poor appetites (23.7%).Most of the subjects (57.4%) had tried to control their body weight by taking drugs (40.5%), doing exercise (34.5%), and controlling their diet (25%). The average intake of nutrients and energy was significantly higher (P<0.05, P<0.01) in Iksan than in Seoul. The intake was below the RDA recommendations except for phosphorus in Iksan, but was above it except for calcium, iron, and vitamin B2,in Seoul. The indexes of nutritional quality (INQ) of calcium (0.5), iron (0.6), vitamin A (0.8), vitamin B2 (0.7), niacin (0.9), and vitamin C (0.9) were under 1.0 but those of protein (1.0), phosphorus (1.2) and thiamin (1.0) were over 1,0. The INQ of the other nutrients, except protein and vitamin C,was significantly higher in Seoul than in Iksan.

원발성 위장관 임파종의 임상적 고찰

윤진우,한지숙,고윤웅,박인서,최응재,주승행,김태승 大韓血液學會 1983 大韓血液學會誌 Vol.18 No.2

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.

익산지역 초등학교 고학년의 비만지표별 비만도와 식습관에 대한 연구

주은정,김인숙,김영순,서은아 대한지역사회영양학회 2001 대한지역사회영양학회지 Vol.6 No.1

The purpose of this study is to determine the prevalence of obesity and to examine the eating habits of elementary school students in Iksan city. The study was carried out on 292 students(male : 151, female : 141) in May of 1997. The average height and weight of the subjects were 141 cm and 37 kg in males and 142 cm and 36 kg in females, which were similar to the average of Chonbuk. A Weight/Length Index(WLI), Broca Index, Ro¨hrer Index(RI), Body Mass Index(BMI) and Waist Hip Ratio(WHR) were used as an obesity index to classify degree of obesity, WLI, Broca Index and RI were proper for judging child obesity and strict judgments were conducted in the order of RI, WLI and Broca Index. The subjects were classified as 30.8% underweight, 43.5% normal, 8.2% overweight and 17.5% obese by WLI and there were significant differences between height (p < 0.05) and weight(p < 0.01) according to obesity degree among the four groups. 50.3% of the boys and 55.3% of the girls ate regularly, and the main reason they didn't eat breakfast(78.4%) was due to lack of time. The frequency of snacks were 1-2 times a week(40.4%), fruits(40.4%) from market and supermarket(68.2%). According to the survey 84.6%, 77.4%, 78.1%, 69.9%, 59.9% and 86.6% of subjects didn't eat meat, fish, soysauce, instant food, sugar and seaweed respectively. Seaweed, meat, and soysauce showed low preferences. 69.5% and 74.7% of the subjects drink milk and ate kimchi respectively. By analyzing eating habits according to the degree of obesity, the rate of skipping breakfast(p < 0.01), and eating meat or fish(p < 0.05) were high in the overweight and obese groups of girls. In the boys case, the rate of not eating food in sugar(p < 0.05) was high in the obese group. Obese children need to correct their eating habits. This reasserts the importance of nutrition education in children through teachers, parents, and dietitions. The findings of this study may be applied to nutrition education to ensure better physical fitness for children.

韓·美·日 老人住宅硏究의 방향

신경주,조재순,곽인숙,최정신 漢陽大學校 韓國生活科學硏究所 1995 韓國 生活 科學 硏究 Vol.- No.13

The purpose of this research was to trace the trends in the research subjects related to housing for the elderly in Korea, U.S.A, and Japan. One hundred sixty eight researches were selected from six research journals besides Masters' and Ph. D theses published in Korea, 164 from five research journals and three research subject-lists in Japan, and 124 from three research journals in U.S.A. There were some common research areas of the elderly housing among the three countries such as facilities required for the elderly housing, general issues of the elderly housing, etc. There was some differences in the research areas. For instance, intergenerational coresidence was mainly studied in Korea. The results showed that housing policies as well as research methods related to the elderly housing are beginning areas and must be further developed to meet the rising needs of housing for the elderly in Korea.

공단지역 및 청정지역 식물 잎권의 잎표면세균 및 내산성세균의 분포

안종훈,방숙진,한남정,송왕영,황소영,이인수,박성주 대전대학교 이과대학 기초과학연구소 1997 自然科學 Vol.- No.-

산성강하물의 영향을 받는 대천공단지역과 영향을 받지 않는 청정지역인 대전 계족산 자연휴양림에서 자라는 밤나무(Castanea crenat)의 잎표면에서 서식하는 총세균수, 생존세균수, 종속영양세균수, 내산성세균수를 1996년 8월부터 1997년 8월까지 5회에 걸쳐 조사하였다. 공단지역 잎표면 평균 총세균수, 생존세균수 및 종속영양세균수는 각각 9.9×10^(5) cell/㎠, 1.6×10⁴cell/㎠, 7.1×10³cell/㎠,로서 청정지역에 비하여 각각 1.5배, 2배, 2.6배 정도로 관찰되었다. MPN법으로 측정한 pH 5.6애서의 잎표면 내산성세를수는 공단지역 3.3×10⁴, 청정지역 3.4×10⁴MON/㎠로 거의 같았고, pH 4.0에서의 내산성세균수는 공단지역애서 1.9×10^-(-1)MPN/㎠인 반면 청정지역에서는 전혀 검출되지 않았다. pH 3.0에서의 내산성 잎표면세균수는 공단지역과 청정지역의 잎권 어느 곳에서도 검출되지 않았다. 한편 계절별 잎표면세균수의 분포는 대체로 잎이 나기 시작하여 크기가 가장 작은 5월에 최대를, 그리고 낙엽이 지는 11월에 최소를 나타내었다. 이런 결과는 공단지역의 대기오염물질의 침적이 주변의 식물 잎표면 세균수를 감소시키지는 않으며, 특히 산성강하물의 영향으로 내산성세균수가 증가함을 보여주고 있다. Total, direct viable count, and acid-tolerant epiphytic bacterial population sizes were quantified on leaves of chestnut tree (Castanea crenata S. et Z.) near Taejon Industrial Estate affected by acid precipitation and deposition as well as in the clean natural forest area, Mt. Kyejok, in Taejon city from August 1996 to August 1997. Geometric mean numbers of total, direct viable count, and acid-tolerant epiphytic bacteria were 9.9×10^(5) cell/㎠, 1.6×10^(6)cell/㎠, and 7.1×10³cfu/㎠ respecfvely, being 1.5, 2, and 2.6 times those in the clean area. Acid-to-lerant epiphytic bfcterial numbers at pH 5.6 by MPN method were 3.3×10" in the industrial area, about the same as the number,3.4×104 MPNicni, of the clean area. Acid-tolerant bacterial number at pH 4.0 was 1.9×10^(-1)MPN/㎠ in the industrial area, whereas none was detected in the clean area. Acid-tolerant bacteria at pH 3.0 were not detected at all in the industrial area as well as in the clean area. Epiphytic bacterial population sizes were generally the greatest in May when leaves are emerged and grew but the lowest in November when defoliation occurs. These results showed that air pollutant deposition on leaves did not cause a deuease of epiphytic bacteria at least and acid deposition on leaves did cause an increase of acid-tolerant bacteria.

베체트병에서 비스테로이드성 소염진통제에 의해 발생한 대량 소장출혈 1예

강인숙,류연주,장지은,정성애,이지수,조영주,이경은,이지희 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

Bechet's disease(BD) is a chronic inflammatoroy condition involving several organs inclu-ding gastrointestinal tract. Gastrointestinal tracts involvement in BD has been identified throughout the entire alimentary tract and commonly accompanies ulcerative lesions in the small and large bowel. It is debatable whether BD could be included among seronegative spondyloarthropathy (SPA).SPA usually occurs without overt sign of intestinal inflammation, but significant number of patients have asymptomatic intestinal inflammation, usually affecting ileum. Since most patients with SPA in-cluding BD are treated with NSAIDS. However, NSAID may play a role in aggravation or provo-cation of intestinal inflammation. Special attention to asymptomatic intestinal inflammation is needed, especially when NSAIDs are used for management of arthritic symptom in SpA. We experienced a case of BD which was complicated by a massive small bowel bleeding precipitated by NSAID use. 저자들은 베체트병 환자에서 비스테로이드성 소염진통제 사용 후 발생한 대량 소장 출혈의 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

백서 간세포 핵소체 인산단백질 B23의 진화론적인 특성 규명

이혜정,윤상인,박주인,정진숙,김영대,김정만,곽종영,김인후 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.1

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.