의료 인력의 확보가 환자 입원일수에 미치는 영향

고유경,이한주,김미원 한국간호과학회 간호행정학회 2011 간호행정학회지 Vol.17 No.3

Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients

명시적 수업 모형을 적용한 중학생의 과학탐구기능 교수・학습 자료 개발

고 유 미 정 은 영 부산대학교 사범대학 과학교육연구소 2014 교사교육연구 Vol.53 No.1

In addition to learning scientific knowledge, students also improve their scientific thinking skills through scientific inquiry. Therefore, improving students' science process skills is an important goal for science education. This study developed and evaluated 7 teaching materials to teach middle school students' science process skills based on an explicit instructional model. The teaching materials were composed of 3 levels applying explicit instruction; ‘explanation and demonstration’, ‘guided practice’ and ‘independent practice’. For easy application to an actual class in school, the topics of these materials were based on the 2009 revised science curriculum. These topics included: ‘Observing lily and celery', ‘Formulating a hypothesis on the experiment of transpiration’, ‘Transforming the experiment data of photosynthesis to table and graph’ and ‘Analyzing the graph of photosynthesis in different circumstances’ in the ‘Photosynthesis’ unit, ‘Controling variables in the experiment of digestion of saliva’ in the ‘Digestion-Respiration- Circulation-Excretion’ unit, ‘Recognizing the problems related to the sense of human body’ in the ‘Stimulus and Response’ unit, and ‘Classifying organisms’ in the ‘Genetics and Evolution’ unit. The majority of the teachers responded that they would like to apply these materials to their classes because all the materials would help students improve their science process skills, and would be appropriate to apply in an actual class. However, they voiced some concern that some of the materials might be a bit too difficult for middle school students to perform. These materials can be used as complements to inquiry activities in the science textbook to help improve students’ science process skills 과학 탐구는 과학을 하는 방법으로 새로운 지식을 만드는 방법일 뿐 아니라 과학적 사고력을 증진시키며, 이는 과학적 소양을 함양하는 데 필수적이다. 본 연구에서는 관찰, 분류, 문제 인식, 가설 설정, 변인 통제, 자료 변환, 자료 해석 기능을 교수・학습하기 위한 자료를 각각 개발하였다. 이 자료들은 명시적 수업 모형을 적용하여 ‘설명 및 시범’, ‘안내된 연습’, ‘독립적 연습’의 3단계로 구성하였고, 자료의 주제는 2009 개정 과학과 교육과정의 생명과학 영역의 내용과 탐구활동을 토대로 선정하여 중학교 과학 수업에서 쉽게 활용할 수 있게 하였다. ‘광합성’ 단원에서는 ‘백합과 샐러리 관찰하기’, ‘증산 작용 실험에 관한 가설 설정하기’, ‘광합성 실험 결과를 표와 그래프로 표현하기’, ‘여러 가지 환경요인에 따른 광합성량을 나타낸 그래프 해석하기’의 4 개의 자료를 개발하였고, ‘소화・순환・호흡・배설’ 단원에서는 ‘침의 소화 실험에 대해 변인 통제하기’를, ‘자극과 반응’ 단원에서는 ‘우리 몸의 감각에 관련된 문제 인식하기’를, 그리고 ‘유전과 진화’ 단원에서는 ‘생물 분류하기’를 개발하였다. 이 자료들에 대해서 중학교 과학 교사 14명의 의견을 조사한 결과, 대부분의 교사들이7개의 자료 모두 중학생의 과학탐구능력을 향상시키는 데 도움을 줄 것이고, 학교 수업에 적용하기에 적절하며, 이 자료들을 자신의 수업에 적용할 의사가 있다고 응답하였다. 다만 내용 수준에 대해서는 일부 자료가 중학생의 수준에 비해 어렵다는 의견이 있었다. 본 연구에서 개발한 과학탐구기능 교수・학습 자료는 학교 현장에서 교과서 탐구 활동을 보완하여 학생들의 과학탐구능력을 향상시키는 데 도움을 줄 것으로 기대된다.

제2형 당뇨병 동물모델인 OLETF 쥐에서 장기간 라미프릴 투여가 내당능 및 췌도 베타세포에 미치는 효과

고승현,윤건호,김명미,안유배,송기호,유순집,손현식,차봉연,이광우,손호영,강성구 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:최근 소개된 HOPE(Heart Outcomes Prevention Evaluation)study의 결과에 의하면, 심혈관질환이나 이에 대한 위험인자가 1가지 이상인 9,541명을 대상으로 안지오텐신 전환효소 억제제의 일종인 라미프릴을 투여하여 사망율과 뇌졸증, 심부전, 당뇨병 합병증이 개선되었을 뿐 아니라 다른 항고혈압제에 비해 새롭게 당뇨병으로 진단되는 환자가 줄었음을 보고한바 있다. 이에 저자들은 라미프릴(ramipril)을 제2형 당뇨병 동물모델에 장기간 투여함으로써 당뇨병을 예방하거나 고혈당 상태 또는 인슐린 감수성을 개선시킬수 있는지를 알아보고자 하였다. 방법:생후 24주된 체중 400∼450g의 OLETF와 LETO 쥐를 대상으로 6개월간 라미프릴 경구투여 하였고 혈압, 24시간 단백뇨 및 인슐린 내성검사를 시행하였다. 6개월 이후로는 8주간 투여군과 대조군의 체중을 비슷하게 맞추어 내당능 상태를 평가하였고 이후 다시 8주간 고농도 포도당을 투여하였다. 경구당부하검사를 시행한 후 희생시켜 조직표본을 만들어 guinea pig anti­human insulin 항체로 염색후 DAB로 발색하여 point count 법으로 베타세포를 정량하였고, 면역염색으로 췌도의 변화와 섬유화의 정도를 관찰하였다. 결과:라미프릴을 6개월간 투여하였을 때 OLETF 쥐에서 1)체중 증가가 적었으며 2)경구 당부하검사시 포도당하 면적은 의미있게 감소하였고 3)인슐린 내성검사상 Kitt가 증가되는 경향을 보였으며 4)수축기, 이완기 혈압과 24시간 단백뇨양이 의미있게 감소하였고 5)체중을 맞추면 내당능 상태가 비슷해졌다가 고농도 포도당 주입시 다시 포도당하 면적이 대조군에서 더 증가되었다. 라미프릴 투여군에서 췌도변형 및 파괴와 탈과립, 췌도내 섬유화가 감소하였다. 결론:본 실험에서는 인슐린 비의존성 당뇨병 동물 모델인 OLETF 쥐에서 당뇨병 발생 이전 단계부터 장기간 라미프릴을 투여할 경우 체중증가가 적었고, 투여군과 대조군의 체중을 맞추었을 때는 내당능상태의 차이가 없아가 고혈당 투여시 다시 투여군과 대조군에서 의미있는 차이를 보였다. 라미프릴 투여가 베타세포의 기능면에서 이로운 효과를 보일 것으로 생각되었다. 따라서 비만한 환자에서 안지오텐신 전환효소 억제제의 장기투여는 단백뇨 감소, 혈압강하 효과 이외에 체중증가의 억제 및 당뇨병 발생을 억제할 가능성을 시사한다. Background : In a Heart Outcomes Prevention Evaluation HOPE study, ramipril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, significantly reduced the death rates the number of myocardial infarctions, strokes, heart failure as well as the risk of complications related to diabetes and of diabetes itself. However, it is known that ACE inhibitors improve glucose tolerance or insulin sensitivity or reduce the incidence of diabetes. Methods : 24 week-old OLETF (Otsuka Long Evans Tokushima Fatty) rats weighing 400 ~ 450 g were used in this study. 4 groups of rats were examined in parallel for 40 weeks. The OLETF rats were randomized for treatment with an aqueous solution of ramipril (5 mg/Kg) daily [OL (RMP), n=10)] and with saline [OL (CON), n=10)]. The LETO rats were also randomized in the same was as the OLETF rats (LT(RMP), n=10, LT (CON), n=10). The blood glucose level, body weight, systolic and diastolic blood pressure was assessed every month. At 3 and 6 months, the 24hrs urinary protein concentration was measured, and as insulin tolerance test and oral glucose tolerance test were conducted in all experimental groups. After 6 months, the body·weight was matched for 2 months in each corresponding group. Subsequently, a 15% sucrose loading was done for 2 months. After the glucose tolerance test, the pancreas was excised and immuno histochemical staining was conducted for insulin to quantify the beta cell mass by a point-counting method. In addition, the islet morphology was evaluated in the pancreas. Results : Ramipril treatment for a period of 6 months improved the 2hr blood glucose level, the area under the glucose curve in the oral glucose tolerance test, insulin sensitivity in addition to lowering significantly systolic and diastolic blood pressure and 24hrs urinary protein level significantly in OLETF rats. Of note, a lower weight gain was observed in both the ramipril-treated animals at 6 months. After weight matching, the AUC g and 2hr blood glucose level values were similar between the corresponding groups, but a 15% sucrose loading worsened the AUC g value. Histologically, the islets were less disorganized and the extent of fibrosis was lower in the ramipril-treated OLETF rats in the trichrome stain. Conclusion : Long-term treatment of ramipril, a long acting angiotensin-converting enzyme inhibitor may be useful for suppressing weight gain and proteinuria in addition to having a protective effect on the islet to harmful stimuli such as hyperglycemia (J Kor Diabetes Asso 25:469~482, 2001).

동종 조혈모세포이식 후 발생한 크립토콕쿠스 척추염 1예

고윤호,임동준,이성수,조유경,이동건,최정현,김유진,민창기,김동욱,박정미,김춘추,신완식 대한감염학회 2001 감염 Vol.33 No.4

Skeletal cryptococcosis is an uncommon infection. Cryptococcus is a common cause of meningitis and infects 7∼10% of patients with AIDS. As well as AIDS, the infection may be seen in association with leukemia, lymphoma, Hodgkin's disease, sarcoidosis, tuberculosis and diabetes, also in patients on steroid medication. But there is no case report of skeletal cryptococcosis following allogeneic hematopoietic stem cell transplantation. A 40-year-old woman was admitted to the hospital because of low back pain. She had chronic myelogenous leukemia for 2 years and underwent allogeneic hematopoietic stem cell transplantation 8 months ago. She have been treated with steroid and cyclosporine orally because of chronic graft versus host disease. On examination she was afebrile and had posterior lower lumbar tenderness. But, she had no reduced strength of low extremities. Open biopsy was underwent. Histology demonstrated budding, round-to-oval, refractile yeast-like organisms within debris. The results of a lumbar puncture were unremarkable and cerebrospinal fluid culture failed to grow bacteria and yeast. The patient was treated with amphotericin B (1 gram) and AmBisome□ (2.8 gram) over 6 weeks. Three months after cessation of therapy, the patient was doing well.(Korean J Infect Dis 33:298∼301, 2001)

항결핵 치료과정에서 호전되었다가 악화된 뇌 결핵종 1예 보고

이대훈,유진홍,강미자,김홍기,김선화,고동훈,천지성,유원종 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.3

In spite of nationmide tuberculosis control program, tuberculosis is still prevalent in Korea. Accordingly, tuberculous meningitis also poses one of the main trouble some problems. Recently, We experienced a perplexing case of tuberculous menin-gitis and tubercdoma in a 24-year old female patient. She was admitted to our hospital owing to meningeal irritation sign, aphasia, VI nerve palsy, and ,fever. CSF analysis showed a finding consistent with that of presumptive tuberculous meningitis.. Initial MRI of the brain revealed a large mass(tuhercu1oma) on left parieto-temporal area. Antitubeculous regimen(1soniazid (INH), rifampin(RMP), ethambutol(EMB), pyrazinamide(PZA)} of meningeal dose was given immediately, and her symptoms and signs were dramatically disappeared with a few days after treatment. She was discharged with improved condition and under maintenance treatment of tuberculosis. Follow-up one year after treatment. revealed that the previous lesion was nearly diminished. She showed no symptom at all until she recognized a total blindness of sudden onset on her left eye a t the 18th month of treatment. Brain MRI checked at that time showed multiple masses of tuberculoma scattered over the brain base and one of them invaded left optic nerve. In our opinion, the cause of relapse in this patient might he explained by the selection and ultimate replication of a minor population of resistant strain. Although such relapse is an extremely rare event, we think that we should always pay attention to this possible resistance problem every time we meet patients with tuberculous meningitis.

연구논문 : 과학영재교육원 학생들의 과학 통합 탐구 능력

정은영 ( Eun Young Jeong ),권이영 ( Yi Young Kwon ),양주성 ( Joo Sung Yang ),고유미 ( Yu Mi Ko ) 경북대학교 과학교육연구소 2013 科學敎育硏究誌 Vol.37 No.3

과학영재교육원 학생들이 성공적으로 과학 탐구를 수행하기 위해서는 문제 인식, 가설 설정, 탐구 설계, 결론 도출 등의 과학 통합 탐구 능력이 요구된다. 이 연구에서는 김유향(2013)이 개발한 ‘과학 탐구 사고력 측정을 위한 서술형 평가도구’를 사용하여 과학영재교육원 학생들의 과학 통합 탐구 능력을 평가 요소별, 성별, 이수 과정별, 전공 분야별로 비교하였다. 이 평가도구는 탐구 사고력의 주요 요소들인 탐구 문제 도출, 변인 추출, 가설 설정, 실험 설계, 자료 변환, 자료 해석, 결론 도출, 일반화, 평가에 관한 문항이 각 2개씩 총 18문항으로 구성되어 있다. 이 평가도구를 2013년 현재 C 대학교 부설 과학영재교육원에 다니고 있는 학생들 중 102명 학생들(초등과학반 15명, 중등과학심화Ⅰ반 58명, 중등과학심화Ⅱ반 29명)을 대상으로 시행하였다. 그 결과, 과학 통합 탐구 능력의 요소 중 가설 설정, 변인 추출의 점수는 상대적으로 높았고, 자료 변환, 자료 해석, 평가의 점수는 상대적으로 낮았다. ‘자료 변환’에 해당하는 선 그래프 그리기 문항과 ‘평가’에 해당하는 실험 설계의 개선점 찾기 문항의 정답률은 약 40 %로 상대적으로 낮게 나타 났다. 영재교육을 받은 단계별로 비교하면 과학 통합 탐구 능력의 요소들 중 일반화의 경우 유의미한 차이가 있었다. 남학생과 여학생의 점수 차이는 유의미하지 않았다. 이 연구에서 사용한 평가도구가 생물 분야의 소재를 다루고 있어 생물 분야의 영재 학생들과 다른 분야(물리, 화학, 지구과학)의 영재 학생들과 비교한 결과, 유의미한 차이가 없었다. 과학영재교육원 학생들의 과학 통합 탐구 능력 향상을 위하여 자료 변환, 자료 해석, 평가에 관한 교수·학습을 강화하고, 과학 탐구와 관련된 구체적인 교수·학습 자료를 개발할 필요가 있다. The purpose of this study was to investigate science integrated process skill of the students in science education center for the gifted. In order to do this, ``free-response test for the assessment of science process skills`` developed by Yu-Hyang Kim(2013) was administered to 102 students(15 in elementary school science class, 58 in middle school science classⅠ, and 29 in middle school science classⅡ) who attend the program of science education center for the gifted in C university. The assessment tool measured 9 skills ; formulating inquiry questions, recognizing variables, formulating hypotheses, designing experiment, transforming data, interpreting data, drawing conclusions, formulating generalizations, and evaluating the designed experiments. As a result, the students in science education center for the gifted had relatively high scores in the area of ``formulating hypotheses`` and ``recognizing variables``, but they had relatively low scores in the area of ``transforming data``, ``interpreting data``, and ``evaluating the designed experiments``. The 2 items` percentage of correct answers were below 40% ; one is about a drawing a line graph in ``transforming data``, and the other requires finding improvements of the experimental design in ``evaluation``. There was no significant difference between boys`` scores and girls`s one, and between the scores of students in the field of biology and those of students in the other fields(physics, chemistry, and earth science) in science integrated process skills. And there was significant difference according to the periods receiving the gifted education in ``formulating generalizations``. The teaching and learning has to focus on improving science integrated process skills in the program of science education center for the gifted and teaching and learning materials needs to be developed.

[PE-0057] Genetic Diversity and Genome-wide Association Study of Korean Soybean Landraces(Glycine max(L.) Merr.)

Yu-Mi Choi(Yu-Mi Choi),XiaoHan Wang(XiaoHan Wang),Hye-Myeong Yoon(Hye-Myeong Yoon),On-Sook Hur(On-Sook Hur),Na-Young Ro(Na-Young Ro),Ho-Cheol Ko(Ho-Cheol Ko),Jung-Yoon Yi(Jung-Yoon Yi) 한국육종학회 2022 한국육종학회 공동학술발표집 Vol.2022 No.-

Differences in Cotyledon Color and Harvest Period Affect the Contents of Major Isoflavones and Anthocyanins in Black Soybeans

( Yu-mi Choi ),( Hyemyeong Yoon ),( Myoung-jae Shin ),( Yoonjung Lee ),( Sukyeung Lee ),( On Sook Hur ),( Na Young Ro ),( Ho-cheol Ko ),( Jeongyoon Yi ),( Sang Hoon Lee ),( Heon-woong Kim ),( Yu Jin H 한국육종학회 2021 Plant Breeding and Biotechnology Vol.9 No.1

Several environmental and genetic factors affect the isoflavone and anthocyanin contents in soybeans. This study aimed to assess the influences of cotyledon color and harvest period on the contents of five major isoflavones and three major anthocyanins in 323 black soybean landraces grown in Korea. In all the soybeans, malonylgenistin, malonyldaidzin and cyanidin-3-O-glucoside were the foremost components. The total isoflavone (TIC) and total anthocyanin (TAC) contents were in the ranges of 491.29-1998.39 μg/g and 452.60-2789.37 mg/100 g on dry weight basis, respectively. Both the average TIC and TAC were higher in green cotyledon soybeans (1493.93 μg/g and 1656.05 mg/100 g, respectively) than in yellow cotyledon soybeans (1423.09 μg/g and 1489.30 mg/100 g, respectively). With respect to the harvest period, the average TIC was in the order of Late-October (1517.31 μg/g) > Mid-October (1454.54 μg/g) > Early-October (1340.95 μg/g). Moreover, the average TAC decreased in the order of Late-October (1765.76 mg/100 g) > Mid-October (1503.93 mg/100 g) > Early-October (1350.91 mg/100 g). In general, cotyledon color appeared to cause a significant variation on TAC (P < 0.05) but not on TIC, whereas the harvest period appeared to cause significant variations on both the TAC and TIC. Among the 323 landraces, 20 were identified to contain high TIC ( > 1800 μg/g) and TAC (> 2000 mg/100 g) in their seeds and hence, could be considered as important sources of dietary isoflavones and anthocyanins. Besides, they possibly provide a wide spectrum of options if considered during the development of improved soybean genotypes.

Outside Directors` Expertise and Earnings Management

Yu Mi Ko,Ji Hwan Lee,Bong Jin Kim 한국경영학회 2010 한국경영학회 통합학술발표논문집 Vol.2010 No.08

A fatal case of acute pulmonary embolism caused by right ventricular masses of acute lymphoblastic lymphoma-leukemia in a 13 year old girl

Yu Mi Ko,Soo Hyun Lee,허준,구홍회,양지혁 대한소아청소년과학회 2012 Clinical and Experimental Pediatrics (CEP) Vol.55 No.7

We report a case of a 13-year-old girl with acute lymphoblastic lymphoma-leukemia, who presented with a cardiac metastasis in the right ventricle, resulting in a pulmonary embolism. At the time of her leukemia diagnosis, a cardiac mass was incidentally found. The differential diagnosis for this unusual cardiac mass included cardiac tumor,metastasis, vegetation, and thrombus. Empirical treatment was initiated,including anticoagulation and antibiotics. She underwent plasmapheresis and was administered oral prednisolone for her leukemia. Five days later, she experienced sudden hemodynamic collapse and required extracorporeal membrane oxygenation insertion and emergency surgery. These interventions proved futile, and the patient died. Pathology revealed that the cardiac mass comprised an aggregation of small, round, necrotic cells consistent with leukemia. This is the first known case of acute lymphoblastic leukemia presenting as a right ventricular mass, with consequent fatal acute pulmonary embolism. Acardiac mass in a child with acute leukemia merits investigation to rule out every possible etiology, including vegetation, thrombus, and even a mass of leukemic cells, which could result in the fatal complication of pulmonary embolism.