임상연구 : 60세 이상 고혈압 환자의 척추-경막외 병용마취 시 심박수 변이도 변화

권미숙 ( Mi Suk Kwon ),백희정 ( Hee Jung Baik ),김윤진 ( Yoon Jin Kim ),김종학 ( Jong Hak Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6

Background: We evaluated the changes in heart rate variability (HRV) in elderly patients with or without hypertension before and after combined spinal-epidural anesthesia (CSE). Methods: Elderly hypertensive (group H, n = 28) and non-hypertensive patients (group C, n = 32) were recruited. We analyzed the spectral components of HRV, total power (≤ 0.4 Hz), low and high frequency power expressed as natural logarithm (LnTP, LnLF, and LnHF), normalized HF (HFnorm), normalized LF (LFnorm), and LF/HF ratio, from 5-minute electrocardiography recordings. We also measured blood pressures (systolic; SBP, diastolic; DBP, mean; MAP), heart rate (HR) and analgesia level before and after CSE. Each group was divided into two subgroups (≤ T7 [L] or ≥ T6 [H]) according to fixed analgesia level. Results: Before CSE, group H showed significantly lower LnLF than that of group C (P < 0.05). Fifteen and 10 min after CSE, decrease of SBP and increase of HR in group HH were significantly greater compared with group CL and lesser with group CH, respectively. LnTP, LnLF and LnHF in both control groups (CL and CH) were significantly decreased 15-20 min after CSE compared with pre-CSE values. LnLF and LnHF in group HH were significantly lower than those in group HL 10-15 min after CSE. But there were no significant changes of LFnorm, HFnorm and LF/HF in all four groups. Conclusions: The group H showed significantly lower LnLF than that of group C before CSE. In group HH, LnLF and LnHF were significantly lower than those in group HL 10-15 min after CSE, but the balance of the autonomic nervous system was not changed significantly. (Korean J Anesthesiol 2006; 50: 663~73)

NIC 간호중재 분류체계를 이용한 간호중재분석

권미숙(Mi Suk Kwon),박경숙(Kyung Sook Park) 한국간호행정학회 2002 간호행정학회지 Vol.8 No.4

PILOTI DESIGN에 활용된 자연소재 분석 -전국기능경기대회 출품작을 중심으로-

권미숙 ( Kwon Mi Suk ) 한국화예디자인학회 2024 한국화예디자인학 연구 Vol.50 No.0

현대 사회는 SNS의 발달로 정치도 오픈되어 있고 경제도 온라인시장으로 투명하게 오픈되어 있다. 관공서나 개인 주택에서도 담장 대신 조경으로 단장하여 개방성을 강조하고 건축물들도 유리를 많이 사용하여 내외부가 훤히 보이는 등 현대 사회는 폐쇄적이지 않고 투명하고 개방적이다. 화훼장식은 그 시대의 사회적, 문화적 환경에 따라 소비자의 요구도는 변화하는데 유리가 많은 현대의 건축물 내부에는 외관을 막지 않고 공간장식을 원하는 소비자들이 많아지고 있으며 투명하고 개방적인 화훼장식의 필요성이 증대되고 있다. PILOTI DESIGN은 바닥에서 일정 공간을 띄우고 꽃을 디자인하는 방법으로 빈 공간으로 인해 투명하고 개방된 효과가 나타나며 자연소재를 이용하면 주어진 시간 내에 다양한 테크닉과 창의적인 디자인을 표현할 수 있다. 본인은 2007~2023년 전국기능경기대회의 작품 중 꽃 월간지, 직종협의회 카페, 전국기능경기대회 출품사진 등에서 자연소재를 이용한 PILOTI DESIGN을 조사하여 절화장식, 테이블장식, 리스 등 PILOTI DESIGN에 쓰인 자연소재의 사용 빈도율과 종류, 특징 등을 조사하고 효과를 분석하였다. 그 결과 구조물과 꽃과의 연속성, 앞/뒤 공간의 연결성, 개방성, 투명성, 확장성, 스케일, 긴장감, 경량성, 공간감 등의 효과가 있으며 현대의 트렌드와 함께 한다고 할 수 있다. 본 연구를 통해 일반 꽃 작가들이 생활 속에서 다양하게 자연소재를 이용한 PILOTI DESIGN을 활용함으로써 좀 더 실용적 디자인이 되고자 하며, 자연소재의 소비 촉진으로 화훼종사자들의 소득증대에 기여할 수 있다. In modern society, politics are open with the development of SNS, and the economy is transparently open to the online market. Modern society is transparent and open, not closed, as government offices and private houses are decorated with landscaping instead of walls to emphasize openness, and buildings also use a lot of glass to see the inside and outside. Flower decoration changes the demands of consumers depending on the social and cultural environment of the time, but more and more consumers want space decoration without blocking the appearance inside modern buildings with many glass, and the need for transparent and open flower decoration is increasing. PILOTI DESIGN is a method of floating a certain space on the floor and designing flowers, which has a transparent and open effect due to empty space, and by using natural materials, various techniques and creative designs can be expressed within a given time. Among the works of the 2007-2023 National Skills Competition, I investigated PILOTI DESIGN using natural materials in flower monthly magazines, vocational council cafes, and national skills competition entry photos. I investigated the frequency, types, and characteristics of natural materials written in PILOTI DESIGN, such as cut flower decorations, table decorations, and leases, and analyzed the effects. As a result, it can be said that it has effects such as continuity between structures and flowers, connectivity between front and back spaces, openness, transparency, scalability, scale, tension, lightness, and space, and is in line with modern trends. Through this study, the general flower writers can contribute to the consumption of PILOTI DESIGN, and contribute to the consumption of natural resources.

초등학교 6학년의 교과서 비례 문제 해결에 관한 연구

권미숙 ( Mi Suk Kwon ),김남균 ( Nam Gyun Kim ) 한국수학교육학회 2009 初等 數學敎育 Vol.12 No.2

노령초산모의 임신에 관한 임상통계학적 고찰

박창수(Chang Su Park),김형선(Hyeong Seon Kim),권미숙(Mi Suk Kwon),김부철(Boo Cheol Kim),이금노(Keum Nho Lee),이영호(Young Ho Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.8

목적: 최근 현대사회에 들어서면서 노령초산모 여성이 증가함에 따라서 연령이 임신과 출산에 미치는 영향을 임상통계학적 고찰을 통하여 살펴봄으로써 향후 이들의 관리에 도움이 되고자하였다. 연구방법: 1995년부터 1998년까지 4년간 전주예수병원 산부인과에서 분만한 산모중 35세 이상 노령초산모 73명을 대상군으로 하고 동기간동안 분만한 35세이하 젊은 초산모 73명을 대조군으로 하여 임상적고찰을 하였다. 결과: 35세 노령초산모가 젊은 초산모에 비해서 불임 및 자연유산의 과거력, 산전합병증, 제왕절개술에 있어서 비교적 높은 빈도를 보였고 신생아상태에서 저체중아, 조산아가 비교적 높게 나타났으나 통계학적 의의는 없었다. 기형아는 젊은 초산모에서만 2예 있었다. 결론: 노령초산모와 젊은초산모의 비교를 통하여 나이자체가 산전합병증 및 분만방법의 결정, 신생아상태에서 좋지않은 영향을 미치게 되나 철저한 산전관리를 통하여서 비교적 양호한 결과를 얻을 수 있다. 그리고 노령임신과 선천성기형과의 연관성에 대해서는 더 많은 연구가 필요하리라고 사료된다. Objective: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. Methods: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. Results: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. Conclusion: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.

제왕절개술시 태아분만 전 사용된 마취제가 임산부의 Bispectral Index (BIS)와 신생아에 미치는 영향

권미숙,김치효,이귀용,김동연 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: The problem of psychological complications (trauma) by intraoperative awareness is a well discussed issue recently. The bispectral index (BIS) is reported to be closely related to the sedation & consciousness of anesthetics. This study was to observe the effects of ketamine injection and enflurane inhalation on the BIS, Apgar score of the neonate and blood gas analysis of umbilical cord artery and vein with general anesthesia for a Cesarean section. Methods: The subjects of the study were 30 pregnant women who received a Cesarean section with general anesthesia. Before the delivery enflurane 1.0% inhalation group (group 1, n = 10), ketamine 20 mg injected group (group 2) and both ketamine 20 mg injected and enflurane 1.0% inhalation group (group 3) were assessed by BIS, blood pressure, heart rate, induction-delivery time, Apgar score of the neonate at 1, 5 minutes and blood gas analysis of the umbilical artery and vein. Results: The BIS of all groups was over 70 after tracheal intubation and the ketamine injected group (group 2) was higher than the enflurane inhalation group (group 1) from 2 minutes after tracheal intubation. The BIS of the both ketamine 20 mg injected and enflurane 1.0% inhalation group (group 3) was lower than the ketamine injected group (group 2), 4 minutes after tracheal intubation. The Apgar score of neonates and blood gas analysis of the umbilical cord artery and vein had no significant differences between these groups. Conclusions: In the anesthetics injected before delivery in a cesarean section under general anesthetics, a small dose of ketamine can increase the BIS while a small dose of ketamine with 1.0% enflurane inhalation decreases the BIS, but in all groups the BIS was over 70 which can cause intraoperative awareness. Thus to avoid this problem, more studies are needed on the methods of anesthesia and multifactorial approaches to increase the utility of BIS monitoring. (Korean J Anesthesiol 2002; 43: 548~553)

Etomidate의 간대성 근경련에 대한 Midazolam 전투여효과

권미숙,김종학,백희정 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.4

Background: Etomidate is a rapid action sedative agent used for the induction of general anesthesia. One of the side effects of etomidate limiting its usage is myoclonus. This study was designed to determine whether a small dose of midazolam decreases the incidence of myoclonus after infusion of etomidate. Methods: Eighty ASA physical status 1 or 2, 16-60 year old patients undergoing elective surgery were randomly allocated into two groups. Group 1 (n = 40) received normal saline 0.04 ml/kg and group 2 (n = 40) received midazolam 0.04 mg/kg 3 minutes before the administration of etomidate 0.3 mg/kg. We measured and compared the incidence, severity, onset time and duration of myoclonus, and blood pressure and heart rate. Results: There were significant differences in the onset time and severity of myoclonus, but no significant differences in the incidence and duration of myolonus. Systolic blood pressure was significantly higher in group 1 than group 2 at 3 minutes after pretreatment drug administration, immediatly after etomidate administration and 3 minutes after etomidate administration. conclusions: An infusion of 0.04 mg/kg midazolam 3 minutes before etomidate decreases the severity of myoclonus and the onset of myoclonus. (Korean J Anesthesiot 2002; 43: 395~400)

폐동맥 혈전색전증과 마취에 대한 고찰

김동연,권미숙,이귀용,김치효,김유희 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Considerations of Pulmonary Thromboembolism and Anestbesia Dong Yeon Kim, M.D., Chi Hyo Kim, M.D., Guie Yong Lee, M.D. Yu Hee Kim, M.D.^*, and Mi Suk Kwon, M.D. Department of Amesthesiology, Ewha Womans University College of Medicine, Seoul, Korea ^*Department of Forensic Medicine, National Institute of Scientific Investigation (NISI) Background: Pulmonary embolism can occur in various clinical situation and its diagnosis if difficult to be made but once it happens it can be a fatal disease to cause a death. We investigated 27 autopsied cases in the recent three years at National Institute of Scientific Investigation (NISI) who received anesthesia and diagnosed as pulmonary thromboembolism as cause of death and evaluated clinial situation and mortality by reviewing medical records. Methods: Among 6848 autopsied cases in NISI from 1/1997 to 12/1999, 27 cases who were recieved anesthesia and whose cause of death were confirmed as pulmonary thromboembolism were investigated through its autopsy record, clinical record and statement. Results: The type of anesthesia of 17 cases was general anesthesia, 4 cases was local anesthesia and 6 cases was unknown. As clinical distribution, obstetric were 17 cases, orthopedic 7 cases and thoracic surgery, general surgery and urology were 1 cases. By comparing the time interval between operation and death, 7 cases of obstetric were on postoperative 1-2 days. Deep thromboembolism was observed on lower extremities by 22 cases and anatomocally heart lesion was observed by 14 cases by autopsy. Conclusions: Pulmonary thromboembolism is one of the leading causes of sudden postoperative deathe, but because reliable symptoms, signs and diagnostic methods were absent, physician have to be aware of the problem and make effort to diagnose if possible. (Korean J Anestbesiol 2001; 41: 449~449)