임상병리(학)과의 임상실습 교육내용 표준화를 위한 기초연구

신경아(Kyung A Shin),이준호(Jun Ho Lee) 한국보건기초의학회 2022 한국보건기초의학회지 Vol.15 No.1

This study is a basic study for standardization of clinical practice education contents of the department of biomedical laboratory science. Therefore, the importance of clinical practice education contents was evaluated. The survey was conducted from February 22 to May 27, 2021. 160 professors and 150 clinical experts from each field participated in the survey. The Mann-Whitney U test was conducted to analyze the difference in importance of clinical practice education contents between professors and clinical experts. As a result, 60 items of professors and 27 items of clinical experts were found to have an importance of 4.5 or higher among a total of 184 clinical practice education contents. The education contents that show a significant difference in importance between professors and clinical experts were 9 items (36.0%) in clinical chemistry, 8 items (30.8%) in hematology, 2 items (5.7%) in transfusion, 14 items (56.0%) in clinical physiology, and 9 items (56.3%) in histocytology. In the field of histocytology, there were the most differences in importance between professors and clinical experts. However, there were no items showing differences in importance between professors and clinical experts in the fields of clinical microbiology, immunoserology, and molecular biology. Therefore, it is necessary to prepare guidelines for standardization of clinical practice that reflect the opinions of professors and clinical experts

Difference of The Cardiac Structure and Function Depending on Obesity Level of Healthy Adults

Kyung-A Shin(신경아),Seung-Bok Hong 대한의생명과학회 2011 Biomedical Science Letters Vol.17 No.2

The purpose of this study was to find out any difference and correlation between the cardiac structure and its function according to the level of obesity as evaluated by waist measurement and BMI (body mass index) in healthy adults. For research subjects, the study selected a final 519 subjects excluding 198 subjects aged 55 or over out of 717 subjects who received echocardiography through a medical checkup at J General Hospital. For the criteria for obesity, men were defined as being obese in case their waist measurement was over 90 ㎝, whereas women were defined as being obese in case their waist measurement was over 80 ㎝. Also, regarding the BMI criteria, in case a person’s BMI was 30 ㎏/㎡, the subject was classified as belonging to an obese group, and in case a person’s BMI was between 25 ㎏/㎡ and 30 ㎏/㎡, the subject was classified as belonging to an overweight group. Concerning the evaluation of cardiac structure and function, they were evaluated using two-dimensional, M-mode, doppler echocardiography. According to the stage of obesity in accordance with waist measurement and BMI, the cardiac structure showed both eccentric and centripetal changes, and the cardiac function was also discovered to show differences according to the stage of obesity. In addition, also in the overweight group, which is a prior stage to obesity, out of the criteria for obesity classification according to BMI, there were differences in the cardiac structure and function. Also, both the waist measurement and BMI were found to have a correlation with cardiac structure and diastolic function. Consequently, cardiac structure and function are correlated with BMI and waist measurement, which are anthropometrical variables, and obesity is assumed to induce not only structural change but also functional change of the heart.

여성노인의 구술생애사를 통해 본 돌봄 윤리의 재구성

신경아(Kyung A Shin) 계명대학교 여성학연구소 2011 젠더와 문화 Vol.4 No.2

이 글은 최근 한국사회에서 진행 중인 노인 돌봄의 탈가족화 맥락에서 여성노인들이 자신의 경험을 어떻게 해석하는지 살펴보고 있다. 연구방법으로는 구술생애사를 선택하였으며, 노인 3명과 그들을 돌보는 가족 며느리나 딸 과의 인터뷰를 병행하였다. 인터뷰는 연구참여자들의 집을 방문하여 이루어졌는데, 자연스러운 일상적 상황 속에서 연구가 수행될 때 가장 좋은 결과를 가져올 수 있다는 문화기술지적 방법론의 규칙을 따르기 위해서였다. 세 명의 노인의 구술은 '분노하는 어머니와 벗어나고 싶은 며느리'(여정순씨), '외로운 어머니와 시어머니에 대한 기억을 갖지 못한 며느리'(이순영씨), 자식세대에 적응하려는 어머니와 보이지 않는 며느리'(권영경씨)로 각각 정의될 수 있지만, 세 사례에서 공통된 사실은 소통과 공감의 부재였다. 이 중 이순영씨는 가부장적 가족관습 속에서 자신과 며느리의 위치가 갖는 동질성을 인식하고 며느리 돌봄에 대한 기대 역시 여성에게 지워진 차별적 의무라는 사실을 깨닫고 있었다. 이러한 사례가 암시하는 것은 노인 돌봄의 탈가족화 조건 속에서 돌봄의 두 주체 시어머니와 며느리 가 소통하기 위해서는 가부장적 가족 내 여성의 위치에 대한 이해라는 젠더적 관점이 필요하다는 사실이다. Gender is a key factor in elder care. This is because most of the care givers as well as the care takers are women. This study looks into what old women have experienced in the social transformation of elder care and how they feel being faced with such rapid change in Korea. In order to collect oral histories, 3 elderly women were interviewed, while their daughter or daughter in law participated in separate interviews. The analysis of the interview data shows the lack of communication and sympathetic understanding between the care giver and the cared. The case of Yeo Jung sun can be defined as 'an angry mother and her daughter in law hoping to be free from the burden of care'. The case of Kwon Young kyung shows 'an adaptable mother as a result of her daughter in law being absent'. Lee Sun young's narrative described 'a lonely mother whose daughter in law'. Nevertheless, Lee Sun young has made a great effort to understand her daughter in law by using insightful interpretation within the framework of the patriarchal family relationship. Her story proves the fact that for communication between the cared for elder and her care giver, gender perspectives are needed to allow us see through the eyes of women within the patriarchal family and understand their positions.

초 울트라마라톤대회(622 km) 경기가 심장마커와 근손상마커에 미치는 영향

신경아 ( Kyung-a Shin ),박용범 ( Yongbum Park ),김영주 ( Young-joo Kim ) 대한스포츠의학회 2018 대한스포츠의학회지 Vol.36 No.3

Purpose: Changes in serum biomarkers of cardiac and muscle damage have been studied in ultra-marathon runners for distances up to 308 km. We investigated these biomarker changes following a 622-km super-ultramarathon race. Methods: A group of men with a mean age of 52.7±4.8 years participated. Blood samples were obtained pre-race, during the race, and post-race, to analyze the aforementioned biomarkers. Results: Creatine kinase and creatine kinase-MB (CK-MB) levels increased during the race, and both steadily declined post-race with CK-MB declining at a slower rate. Lactic acid dehydrogenase levels overall were increased over pre-race levels. White blood cell counts increased during the race. Red blood cell decreased from pre-race to 300 km and 622 km. Platelet increased only in the recovery period. High-sensitivity C-reactive protein levels were increased throughout the race and at day 3 compared to pre-race levels. Cardiac troponin I (cTnI) levels increased during the race. N-terminal pro b-type natriuretic peptide (NT-proBNP) levels increased during the race. Conclusion: The rise in cTnI was not clinically significant, and highly elevated NT-proBNP levels during the race indicates that myocardial burden rose linearly as running distance increased. However, no clinical risk was found as most of the markers returned to normal range during the recovery.

중환자실에 근무하는 의료인의 전비강에서 PBP2a Rapid Kit와 직접 Coagulase 검사를 이용한 Methicillin-resistant Staphylococcus aureus의 검출

홍승복 ( Seung-bok Hong ),신경아 ( Kyung-a Shin ),손재철 ( Jae-cheol Son ),신경섭 ( Seob-kyeong Shin ) 대한임상검사과학회 2010 대한임상검사과학회지(KJCLS) Vol.42 No.2

We evaluated the performance of a novel screening test, PBP2a MRSA rapid kit (Dinona Inc., Iksan, Korea), for methicillin-resistant Staphylococcus aureus (MRSA) based on a immunochromatographic assay. The test is able to detect penicillin-binding protein 2a (PBP2a) using the nasal specimens from health care workers. The nasal specimens were obtained from 69 healthcare workers and were incubated in enrichment broth followed eight hours incubatin in BHI with cefoxitin 4 μg/mL. These broth were tested by PBP2a Rapid Kit. The enrichment broths were also directly tested for tube coagulase using the conventional identification method. 19 of 22 MRSA showed positive results by PBP2a rapid test and direct coagulase test (the sensitivity for detection of MRSA, 86.36%). While, 8 of 47 non-MRSA showed false positive results for the two tests. All of the 8 non-MRSA which showed false positive were co-colonizing isolates with MRCNS and MSSA. In addition, 46 of 49 methicillin-resistant staphylococci (MRS) showed positive results for PBP2a MRSA rapid kit (the sensitivity for detection of MRS, 93.8%), and all of 20 non-MRS showed negative results (specificity, 100%). The combination of PBP2a MRSA rapid kit and direct coagulase test showed the good sensitivity for detection of MRSA from anterior nares but frequently showed false positive results from the co-colonizing carrier with MRCNS and MSSA.

한국성인의 대사증후군 예방을 위한 운동부하 검사시 각 단계별 심근부담률의 적정 임계점

신경아,Shin, Kyung-A 대한임상검사과학회 2018 대한임상검사과학회지(KJCLS) Vol.50 No.2

심근부담률은 심근산소소비량을 간접적으로 측정하는 지표로 심박수와 수축기 혈압의 곱으로 나타내며, 심근이 받는 부담을 나타낸다. 본 연구는 한국성인을 대상으로 트레드밀 운동부하 검사시 대사증후군에 따른 심근부담률의 적정 수준을 제시함으로써 대사증후군 유병률을 낮추기 위한 심근부담률의 목표치를 설정하여 그 기준을 제시하고자 하였다. 대사증후군 진단은 National Cholesterol Education Program (NCEP)의 Adult Treatment Panel (ATP) III에서 제시한 5가지 진단기준 중 3개 이상 충족하는 경우 대사증후군 진단군(MetS, N=25), 1~2개의 기준에 해당하는 경우를 대사증후군 전단계군(Pre-MetS, N=106), 5개의 진단기준에 해당하지 않는 경우는 대사증후군 위험요인이 없는군(Non-MetS, N=65)으로 분류하였다. 운동부하검사는 Bruce 프로토콜에 따라 시행하였다. 심근부담률은(심박수${\times}$수축기 혈압)${\div}1,000$으로 구하였다. 본 연구결과 대사증후군 진단군에서 도달한 일량이 낮음에도 불구하고 최대 수축기 혈압이 높은 것으로 나타났다. 또한 대사증후군에 따른 운동부하 검사시 심근부담률의 최적 임계점은 운동부하검사 1단계에서는 $12.56mmHg{\times}beats/min{\times}10^{-3}$, 운동부하검사 2단계는 $16.94mmHg{\times}beats/min{\times}10^{-3}$, 운동부하검사 3단계에서는 $21.11mmHg{\times}beats/min{\times}10^{-3}$로 나타났다. The rate pressure product (RPP) is expressed as a product of the heart rate and systolic blood pressure as an index indirectly measuring the myocardial oxygen consumption, and it indicates the burden on the myocardium. The aim of this study was to determine the optimal level of RPP for preventing metabolic syndrome in a treadmill exercise test in Korean adults. Metabolic syndrome was the diagnosis of the third executive summary report on the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. According to the criteria, the metabolic syndrome diagnosis group (MetS, N=25), pre-metabolic syndrome group (Pre-MetS, N=106), and non-risk factor group (Non-MetS, N=65) were classified. The exercise stress test was performed based on the Bruce protocol. The RPP was calculated as (heart rate${\times}$systolic blood pressure)${\div}1,000$. The results showed that the maximum systolic blood pressure was high despite the low daily dose reached in the diagnostic group of metabolic syndrome. The optimal threshold of the RPP at the time of the exercise treadmill test for a metabolic syndrome prediction was $12.56mmHg{\times}beats/min{\times}10^{-3}$ in the first stage of the exercise stress test. The second stage of the exercise test was $16.94mmHg{\times}beats/min{\times}10^{-3}$, and at the third stage of the exercise test was $21.11mmHg{\times}beats/min{\times}10^{-3}$.

학교 건축물의 모형실험을 통한 국내지진에 대한 내진보강에 관한 연구

신혜민(Shin, Hye-Min),전아현(Jun, A-Hyun),최혜지(Chio, Hye-ji),팽지영(Paeng, Ji-Yeong),유민지(Yu, Min-ji),이재경(Lee, Jae-gyoung),이현지(Lee, Hyeon-Ji),신경재(Shin, Kyung-Jae) 대한건축학회 2017 대한건축학회 학술발표대회 논문집 Vol.37 No.2

The purpose of this study is to develop various seismic reinforcement through shaking table test and nonlinear analysis of the school building. After the Gyeongju 9.12 earthquake, the government has set a policy to extend the scope of the mandatory seismic design on new buildings and public buildings, and to expand the seismic reinforcement of public buildings with low rate of seismic design. 86% of elementary, middle, and high school buildings surveyed in Korea were found to be vulnerable to earthquakes. Therefore, it is necessary to strengthen the seismic reinforcement of the school buildings that should be used as a disaster evacuation facility.

한국 성인남성의 안정시 심박수와대사증후군 위험요인의 연관성

신경아(Shin, Kyung-A) 한국웰니스학회 2015 한국웰니스학회지 Vol.10 No.4

안정시 심박수는 자율신경계 반응지표이다. 안정시 심박수와 대사증후군의 증가는 심혈관질환 이환율과 사망률의 위험요인이다. 본 연구는 한국 성인남성을 대상으로 안정시 심박수와 대사증후군 위험요인간의 관련성에 대해 알아보고자 하였다. 2010년 1 월부터 2012년 12월까지 J 종합병원 건강검진센터에서 종합건강검진을 실시한 20세 이상 80세 이하의 남성 14,252명을 대상으로하였다. 대사증후군은 미국심장학회에서 제시한 American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI, 2005)의 진단 기준에 따랐으며, 3개 이상의 위험요인을 가진 경우 대사증후군으로 진단하였다. 안정시 심박수는 대사증후군 위험요인과 관련이 있으며, 대사증후군 위험요인의 개수가 증가할수록 안정시 심박수는 직선적으로 증가하였다(각각 p<.001). 또한 염증지표인 고감도 C-반응단백질 및 백혈구수, 인슐린은 안정시 심박수가 가장 낮은 그룹에 비해 가장 높은 그룹에서 높게 나타났으며, 안정시 심박수가 증가함에 따라 대사증후군 유병률은 증가하였다(각각 p<.001). 결론적으로 안정시 심박수는 각각의 대사증후군 위험요인과 관련이 있으며, 안정시 심박수가 증가할수록 대사증후군 발병위험이 높았다. Resting heart rate is a recognized marker of autonomic nervous system response. Increased resting heart rate and metabolic syndrome are risk factors for cardiovascular morbidity and mortality. The author examined the cross-sectional association between resting heart rate and components of the metabolic syndrome in the Korean men. The study subjects were 14,252 males between 20-80 years who visited the health promotion center at a J General Hospital from January 2010 to December 2012. According to the American heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criterion, subjects with 3 or more risk factors were diagnosed with metabolic syndrome. The resting heart rate was correlated with metabolic syndrome risk factors and resting heart rate develops clustering of risk factors (respectively p<.001). Inflammatory markers in high sensitivity C-reactive protein and white blood cell counts and insulin were higher in the highest quartile than in the lowest quartile, the prevalence of metabolic syndrome increased with the in increase in resting heart rate (respectively p<.001). Resting heart rate was correlated with metabolic syndrome risk factors. The prevalence of metabolic syndrome increased linearly with the increase in resting heart rate.

수술용 최대혈액신청량(MSBOS)의 설정

신경아 ( Kyung A Shin ),최종태 ( Jong Tai Choi ),김현수 ( Hyun Soo Kim ) 대한임상검사과학회 2004 대한임상검사과학회지(KJCLS) Vol.36 No.2

The aim of our study is to determine maximum surgical blood order schedule (MSBOS) in each surgical operation through analyzing usage of blood products at Bundang Jesaeng General Hospital. We investigated the amount of transfused red cells for each operation and calculated crossmatching-to-transfusion ratio (C/T ratio) and MSBOS. This was accomplished by referring to the Laboratory Information System program during 1 year from January through December 2003. Coronary artery bypass surgery and decompressive craniectomy showed the highest MSBOS in our hospital. The average C/T ratio was 3.2 and excessive reservations for blood products have been made for many operations. From this study, guidelines for the optimal blood ordering for each surgery were suggested.

임상실습에 대한 임상병리(학)과 학생들의 만족도 조사를 바탕으로 임상실습 만족이 전공 만족도에 미치는 영향

신경아,김효신,이선경,Shin, Kyung A,Kim, Hyo Shin,Lee, Sun Kyung 대한임상검사과학회 2019 대한임상검사과학회지(KJCLS) Vol.51 No.2

This study examined the satisfaction of clinical laboratory science students practiced in clinical practice. In addition, the satisfaction of clinical practice and the satisfaction of the clinical practicum affecting the major satisfaction were investigated. From February 20, 2019 to March 10, 2019, a questionnaire survey was conducted on clinical laboratory science students who performed clinical practice in eight weeks of 2018. A total of 344 people were selected for the final analysis data. The questionnaire was comprised of 46 items, which consisted of three items of the general characteristics and 43 items of the clinical practice satisfaction. The satisfaction level of the clinical practice evaluation part was lowest in average 3.88 points. Male students were more satisfied with clinical practice than female students. The satisfaction level was higher in the group with more than the average degree of satisfaction than the group with less than the average. The factors that affect the satisfaction of clinical practice and the degree of satisfaction with majors are the satisfaction with the clinical practice time and satisfaction with interpersonal relationships. 이 연구는 임상실습을 실시한 임상병리(학)과 학생을 대상으로 임상실습에 대한 만족도를 조사하였으며, 전공 만족도에 따른 임상실습 만족도 차이와 전공 만족도에 영향을 미치는 임상실습 만족도 요인을 확인하였다. 2018년 8주의 동계 임상실습을 수행한 4년제 2개교, 3년제 7개교 임상병리(학)과 학생을 대상으로 2019년 2월 20일부터 2019년 3월 10일까지 설문조사를 실시하였다. 총 344명을 최종 분석 자료로 선정하였다. 설문지는 총 46문항으로 대상자의 일반적 특성 3문항, 임상실습 만족도에 관한 문항 43문항으로 구성되었다. 임상실습에 대한 영역별 만족도 중 임상실습 평가부분의 만족도가 5점 만점에 평균 3.88점으로 가장 낮았다. 또한 여학생보다 남학생의 임상실습 만족도가 높았으며, 임상병리(학)과 전공 만족도가 보통 이하인 군보다 보통을 초과한 군에서 높은 만족도를 보였다. 임상병리(학)과 전공 만족도에 영향을 미치는 임상실습 만족도 요인으로는 임상실습 시간에 대한 만족도와 대인관계에 대한 만족도가 영향을 미치는 것으로 나타났다.