Preanesthetic dexmedetomidine 1 μg/kg single infusion is a simple, easy, and economic adjuvant for general anesthesia

신혜원,Hye Na Yoo,Dong Hwan Kim,Han Lee,Hyeon Ju Shin,이혜원 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.2

Background: Dexmedetomidine is an α2-adrenoreceptor agonist with sedative, analgesic and anxiolytic effects, and it has more selective α2-adrenergic effect than clonidine. We evaluate the effect of preansethetic dexmedetomidine 1 μg/kg single infusion on sedation, hemodynamics, anesthetic consumption, and recovery profiles during anesthesia. Methods: Forty-two female patients with American Society of Anesthesiologists physical status I or II undergoing gynecologic surgery with anticipated operation time of 2 h, were randomly assigned to receive dexmedetomidine 1 μg/kg (Dex group) or saline (control group) iv over 10 min before anesthetic induction. After tracheal intubation with propofol 2 mg/kg, cisatracurium 0.15 mg/kg iv, anesthesia was maintained with sevoflurane, O2 50%, N2O 50% around a BIS value of 40. Results: After study drug infusion, BIS of Dex group was lower than that of control group (93.9 ± 3.1 vs 51.5 ± 5.2, P < 0.05). Mean arterial pressure (MAP) and heart rate (HR) after intubation were increased in control group, but did not change in Dex group. During maintenance, there was no difference in MAP between groups, but HR of Dex group was lower compared to that of control group. End-tidal concentration (2.0 ± 0.5 vol% vs 1.4 ± 0.3 vol%, P < 0.05) and total cumulative consumption of sevoflurane (34.6 ± 3.8 ml vs 26.5 ± 5.3 ml, P < 0.05) were lower in Dex group than in control group. Recovery profiles, modified Aldrete score, postoperative nausea vomiting, and visual analogue pain score were not significantly different between groups. Conclusions: Preanesthetic dexmetomidine 1 μg/kg single infusion is a simple, easy, and economic general anesthetic adjuvant that maintains stable hemodynamics and decrease anesthetic consumption without the change of recovery profiles.

Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery

신혜원,Jae Hyun Ahn,Hye In Jung,Choon Hak Lim,Hye Won Shin,Hye Won Lee,Hae Ja Lim,Suk Min Yoon,Seong Ho Chang 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.6

Background: Continuous interscalene block has been known to improve postoperative analgesia after arthroscopic shoulder surgery. This was a prospective study investigating the ultrasound-guided posterior approach for placement of an interscalene catheter, clinical efficacy and complications after placement of the catheter. Methods: Forty-two patients undergoing elective arthroscopic shoulder surgery were included in this study and an interscalene catheter was inserted under the guidance of ultrasound with posterior approach. With the inplane approach, the 17 G Tuohy needle was advanced until the tip was placed between the C5 and C6 nerve roots. After a bolus injection of 20 ml of 0.2% ropivacaine, a catheter was threaded and secured. A continuous infusion of ropivacaine 0.2% 4 ml/hr with patient- controlled 5 ml boluses every hour was used over 2 days. Difficulties in placement of the catheter, clinical efficacy of analgesia and complications were recorded. All patients were monitored for 48 hours and examined by the surgeon for complications within 2 weeks of hospital discharge. Results: Easy placement of the catheter was achieved in 100% of the patients and the success rate of catheter placement during the 48 hr period was 92.9%. Postoperative analgesia was effective in 88.1% of the patients in the post anesthetic care unit. The major complications included nausea (7.1%), vomiting (4.8%), dyspnea (4.8%) and unintended vascular punctures (2.4%). Other complications such as neurologic deficits and local infection around the puncture site did not occur. Conclusions: The ultrasound-guided interscalene block with a posterior approach is associated with a success high rate in placement of the interscalene catheter and a low rate of complications. However, the small sample size limits us to draw definite conclusions. Therefore, a well-designed randomized controlled trial is required to confirm our preliminary study.

코맥 매카시의『핏빛 자오선』

신혜원(Hyewon Shin) 한국아메리카학회 2022 美國學論集 Vol.54 No.1

Blood Meridian is an intriguing text exhibiting Cormac McCarthy’s appropriation of the Western genre. The classical Western depicts the confrontations between two contending forces—the East and the West, white settlers and native Americans, and civilization and wilderness—at the backdrop of the Wild West. On the other hand, the revisionist Western of the 1960s and the 1970s casts light on the unknown histories of the victims of violent suppression and genocide during the era of American imperial wars of the nineteenth century. Blood Meridian reveals the limits of both the classical Western and the revisionist Western with regards to characters, setting and theme. Set in the frontier, as the backdrop of the American myth of the West and Manifest Destiny, the novel severely criticizes American capitalism and imperialism, describing the Glanton gang’s merciless murders. It also blurs the boundaries between civilization and barbarism through its central character, Judge Holden, who incarnates universal evil and mindless violence. While Holden’s book represents knowledge and art that kills life through its aesthetic objectification, McCarthy’s novel ironically grants Holden an eternal life as a fictional character. Insinuating the intricate relations between violence and art, McCarthy demonstrates that art, including writing, creates life and thus makes redemption and regeneration possible.

인식의 전환을 통한 분노 이해와 교육 가능성: 수업사례분석을 토대로

신혜원(Shin, Hye Won) 이화여자대학교 교육과학연구소 2017 교육과학연구 Vol.48 No.3

This study defined anger as a conscious phenomenon and identified the sources of anger from a perceived perspective. Also, the study investigated whether an educational approach to anger would bring about any change in perception. Researcher analyzed the experiences of the students who attended a class, Educational Research, using empirical methodology. The class was offered by the Department of Education at Ewha Womans University from September 6 to December 20, 201 3. The c lass focused on the phenomenon of anger and the instructor required students to verify their consciousness of anger and analyze it to transform cognition. Study results are as follows. First, participants expressed anger instead of emotions such as displeasure, disappointment, depression, and regret. They used to deny and evade anger because of negative feelings, and they ascribed the cause of anger to parental child-rearing attitudes and social atmosphere. Second, participants realized that anger is caused by individual subjective interpretation and that subjective interpretation is based on irrational beliefs. They also realized that irrational beliefs influence their own self, relationship and their lives. Finally, participants understood anger as a part of life and not something to avoid. In addition, they figured out that they can choose how to respond to anger in a given situation. They experienced cognitive transformation not only of anger but also their own selves, lives, and relationships.

하드보일드 탐정소설의 장르적 특성 연구: 레이먼드 챈들러의 『깊은 잠』

신혜원 ( Hye Won Shin ) 한국아메리카학회 2012 美國學論集 Vol.44 No.2

Having emerged as a distinct literary genre during the 1930s, hard-boiled crime fiction differs from classical detective stories such as the works of Edgar Allan Poe and Agatha Christie. Classical detective stories show how chaotic realities are scientifically explained by rational procedures so that temporarily disrupted social order may be restored in the end. On the other hand, in hard-boiled detective novels, though crimes are solved, the culprits of powerful businessmen, politicians, organized criminals go unpunished. This fictional chaos reflects the ethical uncertainty and cynicism of American society going through the corruption of the Prohibition era and the despair of the Great Depression. Raymond Chandler`s The Big Sleep (1939) exemplifies the above characteristics of hard-boiled fiction. Revealing the pessimism of the interwar-period America, his novel is not a simple "pulp fiction" but a serious modernist novel criticizing the widespread violence, corruption, and greed of the modern city. Despite the apparent darkness, Chandler creates a private-eye hero, Philip Marlowe, who voluntarily retreats from the sinful world to preserve his moral integrity. Embodying the ethos of American individualism, Marlowe is also a modern-day knight who is more loyal to his own conscience and ethical principles than to his client-his "lord." Exploring these issues, this essay examines the hard-boiled formulas used in The Big Sleep as well as the generic variants derived from classical detective stories and the medieval romance. In addition, it investigates Howard Hawks`s adaptation of the novel in his film noir classic, The Big Sleep (1946). The comparison between these two works suggests the film`s loss of the radical social criticism seen in the orignal novel. Deflected by the Hays Code and Hollywood commercialism, the film`s sanitization is most obviously illustrated by the gender relations and hypermasculinity portrayed in the movie, anticipating the postwar political conservatism.

헨리 제임스의 『새장 안에서』: 매체의 물질성과 초월의식의 한계

신혜원 ( Hyewon Shin ) 미국소설학회(구 한국호손학회) 2020 미국소설 Vol.27 No.3

This essay examines Henry James’s 1898 novella In the Cage with respect to the significance of the author’s use of the typewriter as a writing implement and his allusion to the telegraph in the story. Apart from highlighting their role in liberating the minds and expanding the consciousness of users, James also elucidates the limitations of the typewriter and telegraph as a medium. In the novella―created by dictation and typewriting―one finds numerous instances of the influence of the telegraph on the style and diction of the fiction. Similar to the author, the unnamed telegraphist in the story―by using the new medium― experiences a sense of expansion of her physical and mental capacities to a world beyond the boundaries of the self. She longs for a “wired” escape to a virtual web of possibilities to overcome social, economic, and sexual barriers. Her desire for non-verbal, pure communication intensely represents her dream to transcend social and material confinements. In this sense, despite the differences in economic and social positions, the telegraphist in In the Cage can be compared to the wealthier upper-class heroes and heroines in James’s other novels. While they are naïve idealists longing for mental liberation, they eventually awaken (sometimes fall victim) to the harsh reality of the world’s intricate web of material greed and sexual desire. Ultimately, through the telegraphist’s misinterpretation of the telegraph messages communicated between her upper-class customers, James implies that the meaning of words can neither be imposed nor exist inherently in the medium. Meaning is rather created in the context of a speech; it also depends on the relationship between sender and addressee, of which the telegraphist has no complete knowledge, except the transmitted words.

서울 성동지역 중학생에서의 여드름의 역학과 임상적 특성 및 인식도에 대한 통계적 고찰

신혜원 ( Hye Won Shin ),고주연 ( Joo Yeon Ko ),노영석 ( Young Suck Ro ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.2

Background: Acne is one of the most common dermatologic disorders of adolescence. Despite this, there have been few epidemiological studies conducted in Korea. Objective: The purpose of this study was to evaluate the prevalence, severity, and clinical characteristics of acne. In addition, the perceptions regarding acne causation, exacerbating factors, treatments, and sources of information among middle school students were investigated. Methods: In a middle school in Seoul, Korea, 629 students (all girls) in 2004 and 832 students (435 boys and 397 girls) in 2008 were asked to complete a questionnaire about the epidemiology, clinical features, and perceptions of acne. Results: In 2004, the prevalence of acne was 66.1% for girls and in 2008, the prevalence was 57.9% and 67.8% for boys and girls respectively. The severity of acne was evaluated using the Korean Acne Grading System (KAGS) and the results showed severity rates of 38.2%, 38.2% and 49.1% for grade 1, 21.6%, 15.2% and 16.1% for grade 2, 5.7%, 4.1% and 2.3% for grade 3, 0.3%, 0.2% and 0.3% for grade 4 and 0.3%, 0.2% and 0% for grade 5 for girls in 2004, and for boys and girls in 2008, respectively. In 2008, the prevalence of acne was higher in girls than boys (p=0.004); however, overall KAGS grades were higher in boys than girls (p=0.034). Additionally, an earlier onset of clinical acne was observed in girls (age 12.08) than boys (age 12.78) (p<0.001). The onset of clinical acne tended to be at a younger age in girls with an earlier onset of the first menarche (p<0.01). In both 2004 and 2008, more than 98% of the students reported their first case of acne on the face alone; however, current sites tended to involve the trunk along with the face (p=0.009, p<0.001, respectively). In 2008, the most commonly involved first site for facial acne was the forehead that over 70% of boys and girls had acne on their foreheads. The students thought high stress (64.5%, 42.0%, 51.2%), lack of sleep (33.8%, 35.7%, 40.2%), and lack of cleansing (26.6%, 35.7%, 45.7%) were the most common aggravating factors of acne for the girls in 2004, and for the boys and girls in 2008, respectively. In both 2004 and 2008, only about 10% of all acne patients had any kind of treatment for acne. Additionally, the students responded that they received information about the treatment of acne mostly from the Internet. The survey showed that `broadcasting` was the most important point to consider when choosing a hospital and `efficacy` when choosing a treatment option. Conclusion: We evaluated the epidemiological and clinical features of acne in adolescents, and learned that despite the high prevalence of acne among adolescents, only a few had actually had any treatment. Therefore, it is worthwhile to better inform middle school students about acne and the necessity for treatment to reduce acne severity and its impact on those affected. (Korean J Dermatol 2009;47(2):154∼163)

스마트폰을 이용한 한국 간호대학생 대상 간호교육의 통합적 고찰

신혜원(Shin, Hyewon),이정민(Lee, Jung Min),김신정(Kim, Shin-Jeong) 한국간호교육학회 2018 한국간호교육학회지 Vol.24 No.4

Purpose: The purpose of this study was to (a) synthesize nursing education literature using a smartphone for Korean nursing college students based on Whittemore and Knafl’s integrative five-step review method and to (b) evaluate the quality appraisal of each article using Gough’s weight of evidence. Methods: Articles published in Korea were identified through electronic search engines and scholarly websites using a combination of three search terms, including nursing student, smartphone, and education. Scientific, peer-reviewed articles in nursing education for Korean college nursing students, written in Korean or in English, and published between January 2000 and May 2018 were included in this review. Thirteen papers met the inclusion criteria and had above average ratings in quality appraisals. Results: Three characteristics related to nursing education using a smartphone were derived: (a) as a familiar media, motivating learning and enabling self-directed learning, (b) for the purpose of education or evaluation utilizing the educational movie of application, and (c) the iterative exercise of smartphone usage reinforces student learning. Conclusion: Smartphone use is an effective tool for improving nursing knowledge and skills for nursing college students in nursing education. Future research is needed to standardize smartphone applications across schools for nursing education.

동대문 패션시장의 이미지와 패션제품에 대한 외국인 소비자의 인식 -두타몰 지역을 중심으로-

신혜원 ( Hye Won Shin ),김희라 ( Hee Ra Kim ),하오선 ( Oh Sun Ha ) 한국패션비즈니스학회 2010 패션 비즈니스 Vol.14 No.2

응급실 간호사의 인권감수성과 도덕적 민감성이 노인학대 개입 의도에 미치는 영향

신혜원(Shin, Hye Won),신수진(Shin, Sujin) 한국노인간호학회 2020 노인간호학회지 Vol.22 No.3

Purpose: This study examined the effects of emergency room (ER) nurses’ human rights sensitivity and moral sensitivity on their intention to intervene in elder abuse. Methods: This study adopted a descriptive design. Data accrued from 129 ER nurses working in eight tertiary and general hospitals using a convenience sampling method. The collected data were analyzed using the SPSS 22.0 software package. Results: Gender, elder abuse-related education experience, result perception, responsibility perception (subscales of human rights sensitivity), and moral meaning (subscale of moral sensitivity) were analyzed to explain 16.0% of the intention to intervene in elder abuse. Men showed a higher intention to intervene in elder abuse (β=.19, p=.034) as well as the group experienced in elder abuse-related education (β=.20, p=.018). A higher result perception (a subscale of human rights sensitivity) (β=-.29, p=.040) and responsibility perception (β=.43, p=.002) associated with a lower intention to intervene in elder abuse. Of the moral sensibility subscales, the higher the moral meaning, the higher the intention to intervene in elder abuse (β=.25, p=.016). Conclusion: These results highlight the need to remove barriers that may prevent people from intervening in elder abuse by, for example, providing legal measures applicable to practical settings to protect the identity of those who report such cases and to induce more active intervention. It is also necessary to consider healthcare workers’ obligation to report elder abuse in educational programs and to reinforce education to build moral sensitivity to suspected elder abuse situations.