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어머니와 영아의 수면문제가 영아의 문제행동 및 어린이집 적응에 미치는 영향에서 모아애착의 매개효과
배정인(Jung In Bae) 한국열린유아교육학회 2014 열린유아교육연구 Vol.19 No.4
본 연구는 영아의 사회부적응적 행동을 발생시키는 경로와 선행요인에 대해 탐색하고자 한 것으로 어머니수면문제와 영아수면문제가 영아문제행동 및 어린이집 적응에 영향을 미치는지, 여기서 모아애착의 매개효과가 나타나는지 살펴보고자 하였다· 이를 위해 서울지역 어린이집에 재원중인 영아의 부모 및 교사를 대상으로 설문조사를 실시하였으며 상관관계분석과 회귀분석, 구조모형 분석을 통해 본 연구의 가설을 검증하였다· 연구결과 첫째, 어머니수면문제는 모아애착을 매개로 영아문제행동을 증가시키고 있었고 둘째, 영아수면문제 역시 모아애착을 매개로 영아문제행동을 증가시키고 있었다· 셋째, 영아수면문제가 낮을수록 어린이집 적응이 높았으나 여기에서 모아애착의 매개효과는 나타나지 않았다· 마지막으로 어머니수면문제는 영아수면문제에 영향을 미쳐 어린이집 적응 및 모아애착을 통한 영아문제행동에 관여하고 있음을 알 수 있었다· 일련의 연구결과들은 후속연구를 위한 이론적 대안을 제시하며 또한 영아의 사회부적응 문제를 감소시키기 위한 사회적·정책적 대안마련의 필요성을 시사한다. This study examines the mediation effects of mother attachment between mother sleep problems, infant sleep problems and infant problem behaviors, adaptation in child care centers. The study surveys the mothers and teachers of infants’ who attended child care centers. This study also conducts a correlation analysis, regression analysis, and structural equation model analysis. Results show that, first, mother sleep problems increased infant problem behaviors; second, infant sleep problems increased mother attachment. Third, infant sleep problems increase adaptation in child care centers but no mother attachment mediation effects are found. Lastly, mother sleep problems influence infant sleep problems, infant sleep problems increased mother attachment, mother attachment increased infant problem behaviors. This study suggests that theoretical basis for a follow-up study and social and political alternatives to help decrease infant social-maladjustment action.
임상연구 : 후두경을 이용한 이중관 기관지 튜브 삽관 시 심혈관계 반응을 억제하는 Remifentanil의 적정 용량
신형용 ( Hyoung Yong Shin ),서보병 ( Bo Byoung Seo ),이용철 ( Yong Cheol Lee ),김진모 ( Jin Mo Kim ),김애라 ( Ae Ra Kim ),장영호 ( Young Ho Jang ),배정인 ( Jung In Bae ),홍지희 ( Ji Hee Hong ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
Background: The purpose of the present study was to determine the optimal dose of bolus remifentanil to attenuate hemodynamic changes to laryngoscopic double-lumen endobronchial intubation. Methods: A total of 80 ASA I or II patients requiring double-lumen endobronchial intubation were randomly assigned to receive normal saline (NS) or one of the three different doses (0.5μg/kg (group R0.5), 1.0μg/kg (group R1.0) or 2.0μg/kg (group R2.0)) of remifentanil. Study drugs for each group were administered over 30 seconds after induction of anesthesia with thiopental sodium and rocuronium. Laryngoscopic endobronchial intubation was carried out 90 seconds after the administration of study drug. Arterial blood pressure and heart rate were recorded at preanesthetic baseline, preintubation, postintubation, and every one minute during the initial 5 minute period after intubation. Results: Mean arterial pressure at postintubation period increased significantly compared to baseline value in group NS, R0.5, and R1.0, but there were no significant changes in group R2.0. Heart rate showed significant increase in comparison to baseline value at every postintubation period in group NS, R0.5, R1.0, with no significant changes in group R2.0. Conclusions: We suggest that 2.0μg/kg of remifentanil attenuate the hemodynamic changes to double-lumen endobronchial intubation without adverse effect. (Korean J Anesthesiol 2007; 53: 48~53)
실험연구 : 상복강 대동맥 교차차단 및 재관류 시 Fenoldopam 투여가 허혈성 신 손상에 미치는 영향
유진균 ( Jin Gyun Yoo ),박혜령 ( Hye Ryoung Park ),이용철 ( Yong Cheol Lee ),김진모 ( Jin Mo Kim ),장영호 ( Young Ho Jang ),김애라 ( Ae Ra Kim ),배정인 ( Jung In Bae ),홍지희 ( Ji Hee Hong ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.2
Background: The overall rate of renal complication after surgery on the suprarenal aorta remains high. In this study, the changes in renal blood flow (RBF), urinary oxygen tension (PuO2), renal vascular resistance (RVR), and urinary volume following fenoldopam administration were investigated in supraceliac aortic cross-clamping and unclamping animal model. Methods: Twelve dogs were divided into two groups; control group (n = 6), fenodopam group (n = 6). After brachial, femoral, and pulmonary arterial catheterization, midline abdominal incision was made. For the aortic cross-clamping the supraceliac aorta was exposed. A doppler flowmeter probe was placed around right renal artery. A ureteral catheter was positioned at the right renal pelvis to measure urine volume and urinary oxygen tension (PuO2). In fenoldopam group, 0.5μg/kg/min of fenoldopam was administered immediately before suprarenal aortic reperfusion. Systemic hemodynamics, renal blood flow, renal vascular resistance, PuO2, and urine volume were compared between two groups. Results: The systemic hemodynamics were not significantly different between the two groups throughout the experiment. After aortic reperfusion, the RVR significantly increased in control group, but the RVR in fenoldopam group remained to baseline level. The urine output, RBF, and PuO2 significantly increased in fenoldopam group compared to control group. BUN and serum creatinine were not different between the two groups. Conclusions: High dose of fenoldopam administration reverse ischemic renal insufficiency after supraceliac aortic cross clamping. (Korean J Anesthesiol 2007; 52: 202~11)
실험연구 : 실험견에서 간혈류 차단 및 재관류 시 소량의 Nitroglycerin과 Dopamine 투여에 의한 신장 혈류 및 실시간 국소 신관류의 변화
한성욱 ( Seong Wook Han ),엄진원 ( Jin Won Uhm ),장영호 ( Young Ho Jang ),김애라 ( Ae Ra Kim ),김진모 ( Jin Mo Kim ),배정인 ( Jung In Bae ),정정길 ( Jung Kil Chung ),전재규 ( Jae Kyu Cheun ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.44 No.6
Nalbuphine HCL (Nubain)을 이용한 균형마취
배정인 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.2
Nalbuphine hydrochloride을 사용하여 균형마취를 시행한 20례의 환자 중 남녀는 각각 8례, 12례이며 연령은 평균 49±6.8세였다. 수술시간은 평균 207±33.0분이며 회복시간은 평균 247±34.8분이였고 평균 동맥압은 술전 93.6±7.8 mmHg, 피부절개시 116.2±18.0 mmHg, 술후 95.1±14.8 mmHg였다. 수술을 시행한 환자는 위 절제술 12례, 난관절제술 2례, 담낭 절제술 6례였다. 동맥혈 가스분석치를 비교하면 술전 PH는 7.39±0.03 PaCO₂는 42.9±2.8 mmHg, PaO₂는 91.9±6.42 mmHg이고 술후 PH는 7.35±0.02, PaCO₂는 41.4±1.2 mmHg, PaCO₂는 93.8±3.91 mmHg이였다. 호습수는 술전 평균 1.±1.8회/분, 술후 평균 19±1.4회/분이였다. 합병증은 구역질 및 구토, 두통, 발한, 구내건조 및 호흡저하는 1례도 없었다. 이상의 결과로 nalbuphine hydrochloride를 사용하여 균형마취를 시행한 결과 nabuphine hydrochloride는 심혈관계에 미치는 영향이 적고 호흡저하가 적은 약제이며 마취종료 후 의식회복이 빨랐으며 약 자체의 독성이 적고 효력이 강해서 술후 통증을 호소하지 않는 약이다. 또한 부작용이 적고 약값이 비싸지 않기 때문에 균형마취시 사용하기에 적당한 약제라고 사료된다. Nalbuphine hydrochloride produces agonistic analgesic effects at the kappa-receptor and antagonistic effects at the mu-receptor. The aim of this study was to evaluate the hemodynamic effects of nalbuphine hydrochloride during balanced anesthesia. 20 patients, American Society of Anesthesiologists physical status ⅠandⅡ, were scheduled for elective surgery. All patients were administered nalbuphine hydrochloride and glycopyrrolate IM 60 min. for premedication. Induction was established with pentothal sodium and succinylcholine after preoxygenation. 1.0 ㎎/㎏ of nalbuphine hydrochloride, and non-depolarizing muscle relaxant were administered for maintenance. The mean age of the patients was 49±6.8 years and there were eight men and twelve women. The duration of the operation and recovery time were 207±3.3 min. and 247±34.8 min. respectively. The mean arterial pressure was 93.6±7.8 mmHg preoperatively, 116.2±18.0 mmHg intraoperatively, 95.1±14.8 mmHg postoperatively. The arterial blood gases were analysed for the evaluation of ventilatory function. The PaCO₂ was 412.9±2.8 mmHg preoperatively, 41.1±1.2 mmHg postoperatively. The PaO₂was 91.9±6.42 mmHg preoperatively, 93.8±3.91 mmHg postoperatively, pH was 7.39±0.03 preoperatively, 7.35±0.02 postoperatively. There were no statistically significant differences regarding vital signs, arterial blood gas analysis and respiratory rate measured at preoperative, intraoperative, and postoperative states. Taken these all together, we conclude that nalbuphine hydrochloride is the safe drug for balanced anesthesia because of its cardiovascular stability, no respiratory disturbance, tolerable postoperative pain, rapid recovery of consciousness, few side effects, drug toxicity and low cost of drug.