간호사고와 관련판례에 대한 임상간호사의 지각

정지연(Ji Yun Jeong),이명하(Myung Ha Lee) 한국간호행정학회 1999 간호행정학회지 Vol.5 No.3

제2형 당뇨병환자에서 유산소 운동 강도에 따른 인슐린저항성의 변화

구윤희 ( Yun Hyi Ku ),구보경 ( Bo Kyung Koo ),안희정 ( Hee Jung Ahn ),정지연 ( Ji Yun Jeong ),석희금 ( Hee Geum Seok ),김호철 ( Ho Chul Kim ),한경아 ( Kyung Ah Han ),민경완 ( Kyung Wan Min ) 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.5

연구배경: 운동은 주로 동맥경화증 및 인슐린저항성으로부터 보호하는 작용을 통해 사망률을 감소시키는 데에 도움이 되는 것으로 알려져 있다. 이번 연구에서는 제2형 당뇨병환자에서 어떤 강도의 운동이 염증을 완화하고, 내피 세포 기능을 개선시키며 인슐린저항성을 호전시키는 데에 더욱 도움이 되는지 알아보고자 하였다. 방법: 총 59명의 비만한 여성 2형 당뇨병환자가 대조군(CG, N=18), 중강도 운동군(MEG, N=17), 고강도 운동군(VEG, N=14)으로 randomly 배정되어, 가속계로 모니터하며 12주간 운동 요법을 시행하였다. 연구시작시점, 12주 운동 종료 시점, 연구시작으로부터 1년 시점에 체중, 전산화 단층 촬영을 이용하여 복부지방, 피하지방, 내장지방을 측정하였으며, 혈장 hs-CRP, IL-6, 인슐린감수성을 측정하였다. 결과: 평균 연령은 54±7세, 체질량지수는 26.9±2.5 kg/m2이었다. 운동 요법 동안 두 운동군은 운동 칼로리로 각각 488.6±111.9 kcal/day, 518.8±104.1 kcal/day를 사용하였다. 체질량지수, 복부지방, 피하지방은 두 운동군에서(ΔBMI: -1.1±0.7, -0.8±0.5, ΔTF: -4,647±3,613 mm2, -2,577±2,872 mm2, ΔSF: -2,057±2,021 mm2, -1,141±1,825 mm2, respectively) 대조군에 비해 유의하게 감소하였으나(P<0.01), hs-CRP, IL-6 및 FMD는 변화 없었다. 인슐린감수성은 고강도 운동군에서만 감소하였으며, 내장지방은 중강도 운동군에서만 감소하였다. 1년 추적관찰 결과, 이러한 차이는 모두 소실되는 경향을 보였다. 결론: 제2형 당뇨병환자에서 체중 및 체지방 감소를 동반한 고강도 운동은 3개월간의 intervention을 통해 전신 염증수치나 내피 세포 기능의 변화 없이 인슐린감수성 개선 효과를 나타냈다. Background: Exercise offers protection against atherosclerosis and insulin resistance. We evaluated the benefits of exercise at different levels of intensity for ameliorating inflammation, endothelial dysfunction, and insulin resistance in a sample of type 2 diabetic subjects. Methods: Fifty-nine overweight women with type 2 diabetes were randomly assigned to control (CG, N=18), moderate-intensity exercise (MEG, N=17), and vigorous-intensity exercise (VEG, N=14) groups. Patients in the two experimental groups completed a 12-week exercise program, with their exercise activities monitored by accelerometers. We assessed the patients` body weights, total abdominal fat (TF), subcutaneous fat (SF) and visceral fat (VF) via computed tomography, measurements of plasma levels of hs-C-reactive protein (hs-CRP) and interleukin-6 (IL-6), assessment of endothelial function by brachial artery flow-mediated dilation (FMD), and evaluation of insulin sensitivity by insulin tolerance tests, at baseline, at the end of the 12-week interventions, and one year after initiation of the study. Results: At baseline, the average age of all subjects was 54±7 years, and average body mass index (BMI) was 26.9±2.5 kg/m2. During the intervention, patients in the MEG and VEG groups expended comparable amounts of activity-related calories (488.6±111.9 kcal/day, 518.8±104.1 kcal/day, respectively). Although BMI, TF, and SF decreased similarly in the MEG and VEG groups (ΔBMI: -1.1±0.7, -0.8±0.5, ΔTF: -4,647±3,613 mm2, -2,577±2,872 mm2, ΔSF: -2,057±2,021 mm2, -1,141±1,825 mm2, respectively), compared to control (P<0.01), hs-CRP, IL-6, and FMD remained constant in both exercise groups even after completion of the 12-week exercise intervention. Insulin sensitivity improved only in patients subjected to vigorous exercise (VEG). Visceral fat loss was observed only in patients subjected to moderate exercise (MEG). At one-year follow up, these values had all returned to baseline. Conclusion: Exercise vigorous enough to result in significant weight and fat reduction did not ameliorate inflammation and endothelial dysfunction as measured at the end of a 12-week exercise intervention, nor did it result in sustained improvements in insulin sensitivity in type 2 diabetic subjects. (Korean Diabetes J 33:401-411, 2009)

직자(直刺), 영수(迎隨) 및 염전수기법(捻轉手技法)에 따라 시행한 경거(經渠)${\cdot}$복류(復溜) 침자(鍼刺)가 중대뇌동맥(中大腦動脈) 폐새(閉塞)에 의하여 유발(誘發)된 국소(局所) 뇌허혈(腦虛血) 백서(白鼠) hippocampus의 항세포자멸사(抗細胞自滅死) 및 복경보호(福

윤대환,변정윤,최찬헌,백진웅,정지연,정연진,나창수,Youn, Dae-Hwan,Byun, Jeng-Yun,Choi, Chan-Hun,Baek, Jin-Ung,Jeong, Ji-Yeon,Jung, Yeon-Jin,Na, Chang-Su 경락경혈학회 2007 Korean Journal of Acupuncture Vol.24 No.3

Objectives : Aims of this study is to investigate the effects of $LU8{\cdot}KI7$ in rat induced by experimental focal ischemia. Materials and methods : The focal ischemia was induced by intraluminal filament insertion into middle cerebral artery. The groups divided into 6groups, control; no therapy group after ischemia-induced, AT1; acupuncture therapy group at $LU8{\cdot}KI7$ after ischemia-induced, AT2; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally and the needle was twirled and rotated forward with the thumb of the right hand 9times, AT3; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally and the needle was twirled and rotated forward with the forefinger of the right hand 9times, AT4; acupuncture therapy at$LU8{\cdot}KI7$ bilaterally and the needle was inserted to the direction following the flowing route of the meridian(digital direction), AT5; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally, the needle was inserted to the direction following the flowing route of the meridian(digital direction) and the needle was twirled and rotated forward with the thumb of the right hand 9times. Acupuncture therapy was carried out 7times during 2weeks after focal ischemia-induced. The anti-apoptotic and neuroprotective effects of acupuncture are observed by Bax, Bcl-2, mGluR5, cytochrome c, Cresyl violet and ChAT-stain. Results : The intensity of Bax was decreased in AC1, AC4, AC5 group, was increased in AC2, AC3 group. The intensity of Bcl-2 was increased in AC2, AC3, AC4, AC5 group. The intensity of mGluR5 was decreased in AC1 group, was increased in AC4, AC5 group. The intensity of Cytochrome c was increased in ACI, AC2 group, was decreased in AC4, AC5 group. The density of neurons stained by Cresyl violet was increased in all group without control group. The density of ChAT was increased in AC2, ACS group. Conclusions : Our study suggests that AC5 group show anti-apoptotic and neuroprotective effects on cholinergic neuron in focal cerebral ischemia of the stroke in rats.

제2형 당뇨병환자에서 나이에 따른 최대근력의 변화

권휘련 ( Hwi Ryun Kwon ),구윤희 ( Yun Hyi Ku ),안희정 ( Hee Jung Ahn ),정지연 ( Ji Yun Jeong ),류상열 ( Sang Ryol Ryu ),구보경 ( Bo Kyung Koo ),한경아 ( Kyung Ah Han ),민경완 ( Kyung Wan Min ) 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.5

연구배경: 당뇨병환자에서 유산소 운동만으로는 근력 향상의 효과를 기대하기는 어렵다. 저항운동으로 근력 운동을 병행했을 때 근질량, 근력 및 인슐린감수성이 향상된다. 그러나 우리나라 당뇨병환자에서 저항운동의 기준이 되는 최대근력에 대한 자료가 없는 실정이다. 본 연구에서는 제 2형 당뇨병환자에서 운동 강도와 부하의 척도가 되는 최대근력의 기준 자료를 마련하고, 연령에 따라 최대근력이 어떻게 변화하는지 알아보고자 하였다. 방법: 제2형 당뇨병환자 총 266명(남: 95, 여: 171)이 연구에 참여하였다. 근력의 척도로 최대근력(1RM; KEISER, Fresno, CA, USA)을 측정하였고, 최대근력 측정을 위해 상체는 체스트 프레스(chest press), 하체는 레그 프레스(leg press)를 이용하였다. 결과: 상·하지 최대근력은 연령이 증가할수록 유의하게 감소하였다. 상지 최대근력: (남) r=-0.454, P<0.001, (여) r=-0.480, P<0.001; 하지 최대근력: (남) r=-0.569, P<0.001, (여) r=-0.452, P<0.001. 남자의 최대근력은 나이가 증가하면서 감소하는 경향을 보였지만 통계학적으로 유의한 감소는 70대부터 관찰되었고 여자는 50대부터 지속적으로 유의하게 감소하였다. 결론: 제2형 당뇨병환자에서 남·녀 모두 최대근력은 연령이 증가함에 따라 감소하는 경향을 보였다. 특히, 50대 이후부터 저항운동이 도움이 될 것으로 사료된다. Background: It is difficult to improve muscle strength with only aerobic exercise training in type 2 diabetes patients. Resistance training is effective for improving muscle mass, muscle strength and insulin sensitivity. One repetition maxima (1RM), or the maximum amount of weight a subject can lift in a single repetition, may be a useful unit for evaluating the results of resistance training in type 2 diabetic patients. This study was aimed to assess baseline values for 1RM in a sample of Korean type 2 diabetes mellitus patients that are scaled for intensity and load of exercise, and to assess the relationship of 1RM to age. Methods: A total of 266 (male: 95, female: 171) Korean patients with type 2 diabetes mellitus were included in the study sample. Maximal muscle strength was assessed by measuring 1RM for each subject (KEISER, Fresno, CA, USA). Two different exercises were used to measure 1RM: the chest press for the upper extremities, and the leg press for the lower extremities. Results: Both upper and lower values of 1RM decreased with age in men and women; upper 1RM: r=-0.454, P<0.001 in men, r=-0.480, P<0.001 in women, lower 1RM: r=-0.569, P<0.001 in men, and r=-0.452, P<0.001 in women. Values of 1RM significantly decreased in men only after the age of 70. In women, values of 1RM continuously decreased after the age of 60. Conclusion: The maximal muscle strength of individuals with type 2 diabetes decreases with age. We believe that resistance training is especially beneficial for type 2 diabetes mellitus patients after the sixth decade of life. (Korean Diabetes J 33:412-420, 2009)

직자(直刺), 영수(迎隨) 및 염전수기법(捻轉手技法)에 따라 시행한 경거(經渠),부류(復溜) 침자(鍼刺)가 중대뇌동맥(中大腦動脈) 폐색(閉塞)에 의하여 유발(誘發)된 국소(局所) 뇌허혈(腦虛血) 백서(白鼠) hippocampus의 항세포자멸사(抗細胞自滅死) 및 신경보호(神經保護)에 미치는 영향(影響)

윤대환 ( Dae Hwan Youn ),변정윤 ( Jeng Yun Byun ),최찬헌 ( Chan Hun Choi ),백진웅 ( Jin Ung Baek ),정지연 ( Ji Yeon Jeong ),정연진 ( Yeon Jin Jung ),나창수 ( Chang Su Na ) 대한경락경혈학회 2007 Korean Journal of Acupuncture Vol.24 No.3

Objectives: Aims of this study is to investigate the effects of LU8·KI7 in rat induced by experimental focal ischemia. Materials and methods: The focal ischemia was induced by intraluminal filament insertion into middle cerebral artery. The groups divided into 6groups, control; no therapy group after ischemia-induced, AT1; acupuncture therapy group at LU8·KI7 after ischemia-induced, AT2; acupuncture therapy at LU8·KI7 bilaterally and the needle was twirled and rotated forward with the thumb of the right hand 9times, AT3; acupuncture therapy at LU8·KI7 bilaterally and the needle was twirled and rotated forward with the forefinger of the right hand 9times, AT4; acupuncture therapy at LU8·KI7 bilaterally and the needle was inserted to the direction following the flowing route of the meridian(digital direction), AT5; acupuncture therapy at LU8·KI7 bilaterally, the needle was inserted to the direction following the flowing route of the meridian(digital direction) and the needle was twirled and rotated forward with the thumb of the right hand 9times. Acupuncture therapy was carried out 7times during 2weeks after focal ischemia-induced. The anti-apoptotic and neuroprotective effects of acupuncture are observed by Bax, Bcl-2, mGluR5, cytochrome c, Cresyl violet and ChAT-stain. Results: The intensity of Bax was decreased in AC1, AC4, AC5 group, was increased in AC2, AC3 group. The intensity of Bcl-2 was increased in AC2, AC3, AC4, AC5 group. The intensity of mGluR5 was decreased in AC1 group, was increased in AC4, AC5 group. The intensity of Cytochrome c was increased in AC1, AC2 group, was decreased in AC4, AC5 group. The density of neurons stained by Cresyl violet was increased in all group without control group. The density of ChAT was increased in AC2, AC5 group. Conclusions: Our study suggests that AC5 group show anti-apoptotic and neuroprotective effects on cholinergic neuron in focal cerebral ischemia of the stroke in rats.

가슴압박소생술 숙련도에 따른 구조자의 목근육 근긴장도와 근경직의 비교분석

왕중산(Joong-San Wang),김정자(Jeong-Ja Kim),정지연(Ji-Yun Jung) 한국컴퓨터정보학회 2021 韓國컴퓨터情報學會論文誌 Vol.26 No.11

이 연구의 목적은 가슴압박소생술(cardiopulmonary resuscitation, CPR)의 숙련도에 따른 목근육에 근긴장도와 근경직 차이를 확인하기 위해 실시되었다. 연구대상자는 20대 여학생 30명으로 숙련자군과 비숙련자군 각각 15명이었다. 연구결과, 숙련자군은 가슴압박 수행 후 손잡기(hand grip)의 위손쪽 아랫목근육의 근경직과 위등세모근의 근긴장도가 유의하게 감소되었다(p<.05). 비숙련자군은 가슴압박 후 양쪽 위등세모근의 근긴장도와 근경직이 모두 유의하게 감소되었지만(p<.05) 연구군 간에 유의한 차이는 없었다. 그리고, 비숙련자군은 숙련자군과 비교하여 가슴압박 수행 후 평균압박속도, 총압박횟수, 가슴압박 정확도, 가슴이완 정확도가 유의하게 낮았다(p<.05). 이 연구를 통해 가슴압박은 수행자의 목근육에 근생리학적 영향을 미치지만, CPR 숙련도에 따른 차이는 없으며, 숙련도는 CPR 정확성에 중요한 요소인 것을 확인하였다. The purpose of this study was to identify differences in the muscle tone and stiffness of neck muscles according to levels of cardiopulmonary resuscitation (CPR) skill. The subjects were 30 female students in their 20s who were divided into a skilled group (n=15) and an unskilled group (n=15). According to the results, the skilled group showed statistically significant decreases in the stiffness of the lower cervical muscle and the muscle tone of the upper trapezius on the above hand side of hand grips after CPR (p<.05). The unskilled group exhibited a statistically significant difference in both the muscle tone and stiffness of the upper trapezius muscle on both sides after CPR (p<.05). However, no statistically significant differences were found between the two groups. In addition, the non-skilled group showed statistically significant lower values than the skilled group in the mean compression rate, total number of compressions, accuracy of chest compression, and accuracy of chest relaxation (p<.05). This study confirmed that CPR has a myophysiological effect on the neck muscles of those who perform CPR. However, it found that no differences result from individual CPR skill levels that are an important element for the accuracy of CPR.