간호사가 인식한 이차 피해 경험이 삼차 피해 경험에 미치는 영향과 이차 피해 지지의 다중 매개효과

김은미,김순애,김지인,이주리,나선경,Kim, Eun-Mi,Kim, Sun-Aee,Kim, Ji-In,Lee, Ju-Ry,Na, Sun-Gyoung 한국의료질향상학회 2017 한국의료질향상학회지 Vol.23 No.2

Purpose: Nurse's second victim experiences could influence organizational negative work-related outcome. The purpose of this study was to investigate the casual relationship between nurses' second victim experience and third victim experience and multiple mediation effects of second victim supports. Methods: A cross-sectional, self-report survey (the Second Victim Experience and Support Tool) was conducted with 305 nurses working in a general hospital. Data were collected from October 20 to November 25, 2016 and analyzed using SPSS Win version 23.0. Results: The nurses' perceived second victim experience was $3.24{\pm}0.61$ and the third victim experience was $3.12{\pm}0.92$. Nurses' second victim experience was found to have a direct effect on increasing third victim experience and indirect effect of colleague support as mediator (p<.05). However, institutional support and supervisor support had not a partial and indirect effect on third victim experience. Conclusion:This study is one of the first to connect second victim experience to third victim experience in South Korea. This study broadens the understanding of the negative effects of a second victim experience influence third victim experience. When involvement in patient safety events, the important role of colleague support in limiting nurse's third victim experience have been acknowledged. This study reinforces the efforts health care leaders are making to develop interventional programs to colleague support their staff as they recover from adverse event involvement.

간전이 위암환자의 치료 결과 및 예후

김은미,김세원,김상운,이경희,현명수,박원규,장재천,송선교,Kim, Eun-Mi,Kim, Se-Won,Kim, Sang-Woon,Lee, Kyung-Hee,Hyun, Myung-Soo,Park, Won-Kyu,Chang, Jae-Chun,Song, Sun-Kyo 대한위암학회 2006 대한위암학회지 Vol.6 No.4

목적: 간전이 위암환자들을 대상으로 치료 결과를 알아보고 생존 분석을 통해 예후를 확인하고자 하였다. 대상 및 방법: 1990년 3월부터 2006년 3월까지 영남대학교 영남의료원 내과 및 외과에 내원한 위암환자 중 간전이가 발견된 85예(동시성 62예, 이시성 23예)를 대상으로 후향적 연구를 시행하였다. 임상병리학적 인자와 위절제술, 간전이병소 절제술 및 항암화학요법 등 치료 관련 인자들에 대해 생존분석을 실시하였다. 결과: 간전이 위암환자들의 중앙생존기간은 11개월(동시성 11개월, 이시성 17개월)이었다. 동시성 간전이군의 경우 위절제율은 24.1%, 간전이병소 절제율은 16.1%였다. 간외 전이 동반율은 23.5%였고 생존기간에 차이가 있었다(P<0.05). 간전이 병소 절제 및 위절제군, 위절제군, 비절제군의 중앙생존기간은 각각 60개월 이상, 10개월 및 9개월이었다(Fig. 1, P<0.05). 이시성 간전이군의 경우 위암절제 후 무병생존기간의 중앙치는 8개월이었으며 초기병기와 간전이 빈도 사이에는 차이가 없었다. 동시성 간전이군에서는 단변량 분석 결과 간외 전이, 위절제술, 간전이 병소 절제술, 외과적 절제 형태 및 항암화학요법에 대한 반응이 유의하였고 다변량 분석 결과 간전이병소 절제술, 항암화학요법에 대한 반응 및 간외 전이가 독립적 예후인자였고, 이시성 간전이군에서는 간외 전이, 항암화학요법에 대한 반응 및 원발암 세포의 분화도가 유의하였고 간외 전이가 독립적 예후인자였다. 결론: 간전이 위암환자에서 예후는 간전이 병소의 절제, 원발 병소의 절제, 간외 전이 유무 및 항암화학요법에 대한 반응여부에 의해 결정되므로 치료에 있어 간외 전이가 없는 경우 보다 적극적인 절제 노력과 항암화학요법이 생존율 향상에 기여할 것으로 판단된다. Purpose: This study was conducted to evaluate the treatment outcomes and the prognosis for gastric cancer patients with hepatic metastasis. Materials and Methods: This retrospective study was based on the medical records of 85 gastric cancer patients with hepatic metastasis (62 synchronous and, 23 metachronous) who received chemotherapy with or without resectional therapy from March 1990 to March 2006. The survival rate was analyzed according to clinicopathologic factors and therapeutic factors, such as whether or not a gastrectomy, a hepatic resection, and/or chemotherapy had been performed. Results: The median survival of gastric cancer patients with hepatic metastasis was 11 months (synchronous: 11 months and metachronous: 17 months). The rates of gastrectomies and hepatic resections in the synchronous group were 24.1% and 16.1%, respectively A 23.5% prevalence of extra-hepatic metastasis was observed. The median survivals of patients who underwent a gastrectomy with a hepatic resection, a gastrectomy alone, and non-surgical treatment were 60, 18, and 9 months, respectively (P<0.05). The disease-free median survival of the metachronous group was 8 ($3{\sim}39$) months. There was no difference in initial pathologic stage and frequency of hepatic metastasis after the gastrectomy in the metachronous group. In the synchronous group, extra-hepatic metastasis, a gastrectomy as the operative procedure, a hepatic resection as the operative procedure and the response to chemotherapy were statistically significant in the univariate analysis, and a hepatic resection as the operative procedure, the response to chemotherapy, and extra-hepatic metastasis were independant prognostic factors identified by the multivariate analysis. In the metachronous group, extra-hepatic metastasis, the response to chemotherapy and differentiation were statistically significant in the univariate analysis, and extra-hepatic metastasis was an independent prognostic factor identified by the multivariate analysis. Conclusion: An aggressive surgical therapy and effective chemotherapy are necessary in the treatment of gastric cancer patients with hepatic metastasis. (J Korean Gastric Cancer Assoc 2006;6:237-243)

각국의 식생활 교육.정책

김은미,Kim, Eun-Mi 한국식품연구원 2009 食品技術 Vol.22 No.3

뇌동맥류 파열로 인한 지주막하 출혈 환자에서 중재적 치료 후 조절되지 않은 두통 치험 1례

김은미,김기태,Kim, Eun-mi,Kim, Ki-tae 대한한방내과학회 2021 大韓韓方內科學會誌 Vol.42 No.2

Subarachnoid hemorrhage (SAH) is a disease that causes bleeding in the subarachnoid space; 70%-80% of nontraumatic subarachnoid hemorrhages are caused by saccular aneurysms. If the patient has already experienced a ruptured aneurysm that causes subarachnoid bleeding, rebleeding can result in a high mortality rate and serious sequelae. Therefore, if the patient can undergo surgical or interventional treatment, it should always be performed. This patient was diagnosed with acute aneurysmal subarachnoid hemorrhage and hydrocephalus. The patient was hospitalized for uncontrolled headache and vertigo after aneurysm coil embolization and ventriculoperitoneal shunting. The patient was treated with Yangkyuksanwha-tang and acupuncture and was observed with a symptom checklist for 25 days. Headache improved, from a visual analog scale (VAS) score of 7 to 0. Vertigo also improved, from a numeric rating scale (NRS) of 6 to 2, and the vertigo pattern changed from rotational to nonrotational. This case suggests that Korean medicine treatment is helpful in managing subarachnoid hemorrhage sequelae.

V+대동여지도 (주)엠아이케이21 - (주)엠아이케이21 디스플레이 사업의 미래는 우리가 이끈다

김은미,Kim, Eun-Mi 벤처기업협회 2009 벤처다이제스트 Vol.127 No.-

몇 년 전까지만 해도 볼록한 브라운관과 자그마한 흑백 모니터로 세상을 마주하던 인류는 기술의 급성장을 거듭해 이제는 손가락 하나로 세상을 움직이고 있다. TV에 이어 PDP와 MP3 휴대전화에 이르기까지 디스플레이 산업은 지속적으로 발전하고 있으며 시장 또한 거대화 되어가고 있다. 이러한 시장변화에 대응해 차별화 된 디스플레이 기기의 개발과 보급에 필요한 영상신호 발생기 및 분배기 등을 개발한 경남 창원의 (주)엠아이케이21을 소개한다.

V+Incubator AC미디어 - 만화로 안되는게 어딨니? 뉴미디어 PR시대 개척하는 AC미디어

김은미,Kim, Eun-Mi 벤처기업협회 2009 벤처다이제스트 Vol.127 No.-

YOU TUBE, 판도라TV 등 요즘 전 세계적으로 많은 네티즌이 UCC(User Creative Contents)에 열광하고 있다. UCC로 '떴다'하면 웬만한 연예인이 부럽지 않을 정도로 유명세를 얻는 요즘 세상. 만화와 애니메이션으로 UCC를 한 단계 업그레이드 시킨 AC미디어(대표 김진수, www.acmedia.kr)가 뉴미디어 시대의 한 획을 긋겠다며 도전장을 내밀었다.

마약남용자 11명의 타액 중 메스암페타민의 분석

김은미,이주선,최혜영,최화경,정희선,Kim, Eun-Mi,Lee, Ju-Seon,Choi, Hye-Young,Choi, Hwa-Kyung,Chung, Hee-Sun 대한약학회 2008 약학회지 Vol.52 No.6

A qualitative and quantitative analytical method was developed for detection of methamphetamine (MA) and its main metabolite amphetamine (AM) in oral fluid. Oral fluids of eleven drug abusers were provided by Police, specimens were collected by stimulation with a cotton swab treated with 20 mg of citric acid ($Salivette^{(R)}$; Sarstedt, USA). As the preliminary test, oral fluid samples were screened for amphetamines by Fluorescence Polarization Immunoassay (TDxFLx, Abbott Co.). Extraction for MA was performed using solid-phase extraction (SPE) by $RapidTrace^{TM}$ (Zymark, USA) with mixed mode cation exchange cartridge, CLEAN $SCREEN^{(R)}$ (130 mg/3 ml, UCT) after dilution with phosphate buffer. Samples were evaporated and derivatized by pentafluoropropionic acid anhydride (PFPA). Quantitation of MA and AM was performed by gas chromatography-mass spectrometry (GC-MS) using selective ion monitoring (SIM), the quantitation ions were m/z 204 (MA), 208 (MA-$D_5$), 190 (AM) and 194 (AM-$D_5$). The selectivity, linearity of calibration, limit of detection (LOD) and quantification (LOQ) within- and between day precision, accuracy and recoveries were examined as parts of the method validation. All oral fluid samples gave positive results to immunoassay for MA (cut-off level, 50 ng/ml as d-amphetamine). Concentrations of MA and AM by GC-MS in eleven samples were ranged 104.2${\sim}$4603.3 ng/ml and 32.4${\sim}$268.6 ng/ml, respectively. Extracted calibration curves of MA and AM were linear over the two concentration range of 1${\sim}$100 and 50${\sim}$1000 ng/ml with correlation coefficient of above 0.999. LOQ of MA and AM was 1 and 3 ng/ml, respectively. The intraand inter-day run precisions (CV) for MA and AM were less than 10%, and the accuracies (bias) for MA and AM were also less than 10% at the two different concentrations 5 and 100 ng/ml at low calibration range, 50 and 1000 ng/ml at high calibration range. The absolute recoveries of MA and AM at low and high calibration ranges were more than 82% and 75%, respectively. In this study the qualitative and quantitative analytical method of MA in oral fluid was established. Oral fluid testing may detect drug use in past hours because of its shorter detection window than urine, and be useful in post-accident situations. So oral fluids will be most useful for testing drug abuse in the driving under the influence of drug (DUID) as the alternative specimens of urine.

Kernel Relaxation과 동적 모멘트를 조합한 Support Vector Machine의 학습 성능 향상

김은미,이배호,Kim, Eun-Mi,Lee, Bae-Ho 한국정보처리학회 2002 정보처리학회논문지B Vol.9 No.6

This paper proposes learning performance improvement of support vector machine using the kernel relaxation and the dynamic momentum. The dynamic momentum is reflected to different momentum according to current state. While static momentum is equally influenced on the whole, the proposed dynamic momentum algorithm can control to the convergence rate and performance according to the change of the dynamic momentum by training. The proposed algorithm has been applied to the kernel relaxation as the new sequential learning method of support vector machine presented recently. The proposed algorithm has been applied to the SONAR data which is used to the standard classification problems for evaluating neural network. The simulation results of proposed algorithm have better the convergence rate and performance than those using kernel relaxation and static momentum, respectively. 본 논문에서는 커널완화법과 동적모멘트를 이용한 support vector machines의 학습성능 개선을 제안하였다. 제안된 학습 방법은 기존의 정적모멘트와는 달리 수렴 정도에 따라 현재의 학습에 과거의 학습 속성을 반영하는 동적모멘트 방법이다. 기존의 정적 상수로 정의된 모멘트가 전체 학습에 동등하게 영향을 주는 반면 제안된 동적모멘트를 이용한 학습방법은 학습 수행에 따라 동적으로 모멘트를 변경함으로써 수렴속도와 학습 성능을 효과적으로 제어할 수 있다. 제안된 학습법을 support vector machine의 새로운 순차 학습 방법인 커널완화법에 적용하였다. 신경망 분류기 표준 평가 데이터인 SONAR 데이터를 이용하여 실험한 곁과 동적모멘트를 이용한 방법이 수렴속도와 학습 성능면에서 기존의 커널완화법과 정적모멘트를 이용한 학습법에 비해 향상된 성능을 보이는 것을 확인하였다.

V+동아리 (주)유비온 레저동아리 'COT' - 생활속 작은 일탈을 꿈꾼다 (주)유비온 레저동아리 'COT'

김은미,Kim, Eun-Mi 벤처기업협회 2009 벤처다이제스트 Vol.127 No.-

매일 아침 정해진 시간에 출근해 일하고, 퇴근하는 따분한 일상. 일상의 대부분을 회사생활속에서 스트레스의 해소는 물론, 직원 간의 끈끈한 정이 있는 작은 일탈은 약이 된다. 평생교육 및 성인자격증 콘텐츠를 인터넷 등을 통해 서비스하는 이러닝 산업의 선두주자, (주)유비온의 레저동아리 'COT'는 일탈을 꿈꾸는 유비온들의 휴식공간이 되어주는 사내동호회다.

국내외 산업동향 - 국내식자재 산업동향과 식품안전관리시스템

김은미,Kim, Eun Mi 한국식품연구원 2013 食品技術 Vol.26 No.3