경막외척수병용마취에서 Needle Through Needle 방법과 Double Segmental 방법의 비교

권혜미 ( Hye Mi Kwon ),이원호 ( Wonho Lee ),박선아 ( Sunah Park ),정미애 ( Mi Ae Jeong ),이봉재 ( Bong Jae Lee ),전종헌 ( Jong Hun Jun ) 경희대학교 경희의료원 2016 慶熙醫學 Vol.31 No.1

Background: The combination of spinal and epidural anesthesia provides an efficient and profound anesthesia for surgery. There are needle through needle technique (NTN) and double segmental technique (DST) for combined spinal and epidural anesthesia (CSE). Some reports have differences about both techniques. We compared both techniques. Method: 87 patients were randomized to receive CSE by NTN (n=43) or DST (n=44). We measured procedure time, the numbers of attempted epidural punctures, epidural catheterizations, spinal punctures, and changes of operators. And we investigated success of spinal block and complications (the number of migrations of epidural catheter tip, headache, lumbar backache, postoperative nausea and vomiting and inadvertant dura puncture) of both techniques. Results: The number of attempted spinal punctures in NTN group is 1.4±0.9, which is smaller than 1.8±1.4 in DST group, The others are no difference significantly in NTN and DST groups. Conclusion: We find NTN and DST for CSE are no differences significantly in the technical problems and complications. We suggest the choice of NTN or DST for CSE is dependent on the skillfullness by operator.

DIS에 의한 Polyethylene Glycol 함침 알로에 베라 겔의 보습 및 경피흡수 특성

권혜미(Hye Mi Kwon),허원(Won Hur),이신영(Shin Young Lee) 한국생물공학회 2013 KSBB Journal Vol.28 No.5

This study was carried out to investigate the in vitro and in vivo moisturizing properties and percutaneous absorption of PEG-impregnated Aloe vera gel. The PEG-i-Aloe gel was obtained from dewatering and impregnation by soaking (DIS) of Aloe vera leaf slice. The moisturizing property of the obtained sample was evaluated by moisture determination using gravimetric method in desiccator under different RH% and by water sorption-desorption test on human skin. The transdermal penetration characteristics of PEG-i-Aloe gel was investigated by Franz diffusion cell in vitro transdermal absorption method. PEG-i-Aloe gel had high moisture retention ability and could significantly lead the enhancing skin hydration status as well as reducing the skin water loss due to the film formation as a skin barrier. The skin penetration rate of PEGi-Aloe gel at steady state was 9.76 μg/(h·㎠) and the quantity of the transdermal absorption was 144 μg/㎠ in 9 hr. The penetration mechanism was well fitted with Higuchi model (R² = 0.974.0.994). The results show that PEG-i-Aloe gel has the significant moisturizing effect and strong penetration of the animal skin. It could be used as the moisturizing additive in cosmetic skin products.

Bentonite 현탁액의 응집특성에 기초한 원료 알로에 베라 겔의 In situ 품질평가

권혜미 ( Hye Mi Kwon ),허원 ( Won Hur ),이신영 ( Shin Young Lee ) 한국산업식품공학회 2014 산업 식품공학 Vol.18 No.2

The glucomannan content of Aloe vera gel was measured by a novel method using a bentonite suspension that flocculates upon mixing with gels prepared by hand filleting of aloe leaf. An optimum flocculation condition was determined to be Aloe vera gel diluted in the range of 2 to 5-fold and then a bentonite suspension 1% (w/v) mixed with the gel sample in the ratio of 8:2 (v/v) to provide a mixture volume of 10 mL with the length to diameter ratio of 5. Under the conditions of these experiments, a rapid settling (<3 min) of more than 90% of the bentonite was achieved only when the aloe gel sample was properly diluted. The glucomannan concentrations in various diluted samples with the highest settling rates were identified in the range of 195.7±21.4 mg/L; thus, the results indicate that the glucomannan content may be determined from the dilution rate of the aloe gel sample that exhibits the highest settling rate. This study provides a simple, rapid, and cost-effective assay for the estimation of the glucomannan level in raw Aloe vera gel.

Defining issues test(DIT)를 이용한 의과대학 학생들의 학년별 도덕 판단력의 발달 정도

권혜미(Hye-mi Kwon),김병진(Byung-jin Kim),김성록(Sung-rok Kim),김영민(Young-min Kim),문정휘(Jung-hui Mun),박민우(Min-woo Park),방종욱(Jong-wook Bang),엄상화(Sang-hwa Urm) 한국생명윤리학회 2008 생명윤리 Vol.9 No.2

본 연구는 새로운 윤리도덕의 문제들로 인해 점점 복잡해지는 현대의료사회에서, 향후 의사가 될 의과대학생들의 도덕 판단력을 측정하고 연구하여, 발달시키는 방안을 마련하는 기초가 되고자 한다. 본 연구는 인제 의과대학생(예과1학년-본과4학년)의 도덕 판단력을 완성형 DIT를 사용하여 측정하고 이를 표준인구와 비교하고, 학년에 따른 변화와 경향성을 측정하며, 변인(연령, 성별, 종교, 형제 수, 형제 관계, 출신지역)과의 관계를 살펴보기 위한 횡단적 조사 연구이다. 의학과 1,2학년의 P 점수가 표준 집단의 P 점수 보다 유의하게 높았으며,(p<.05) 의학과 4학년의 P 점수는 표준 집단의 P 점수보다 유의하게 낮았다.(p<.05) 의학과 2학년의 5A 점수(17.03) 의학과 4학년의 5A 점수(13.65, p=.023)보다 유의하게 높았으며, 여학생의 P(%)점수와 N2 score(45.57, 43.73)는 남학생의 점수(42.44 p=.040, 40.67 p=.034)보다 유의하게 높았다. 각 단계별 평균점수에서는 4단계의 점수가 가장 높았다. 대상자들의 P(%)점수 전체 평균이 표준집단보다 조금 높았고, P점수와 N2점수에서 동일한 경향성-본과 2학년에서 가장 높고 본과4학년에서 가장 낮음-을 보였지만 통계적인 유의성은 없었다. 본과2학년과 본과4학년의 5A점수와 남녀의 P(%)점수와 N2점수 차이만 통계적으로 유의하였으며,(p<.05) 각 단계별 평균 점수에서는 4단계가 가장 높았다. 현재 의학교육을 이수하는 동안에 도덕판단력의 의미 있는 변화가 나타나지 않았다고 볼 수 있다. 그러므로 의학교육 초기단계에 의료윤리를 가르침으로써 학생들의 도덕판단력을 향상시킬 수 있도록 교육기회를 마련하고 교육효과를 지속시킬 수 있도록 하는 것이 필요하다. Objective This study is about the moral judgment in medical students. And the purpose of this study is laying the foundation for developing it. Methods In this cross-sectional research, we measured moral judgment of students in Inje college of medicine by using complete type of DIT. We compared P(%) score of medical students with that of standard population, and studied the gradual moral judgment with its tendency and relation with variables(age, sex, religion, number of siblings, birth sequence, provincial origin). Results P(%) scores of 1st and 2nd grade medical students was higher than that of standard group.(p<.05) P(%) scores of 4th grade medical students was lower than that of standard group.(p<.05) The 5A score of 2nd grade medical students(17.03) was higher than that of 4th grade medical students(13.65, p=.023), P(%) and N2 score of female(45.57, 43.73) were higher than that of male(42.44 p=.040, 40.67 p=.034). 4th stage got the highest score in total gradual average. Conclusion There is no significant change of the moral judgment during the period of medical education. Therefore, it is required to prepare an educational opportunity improving moral judgment of students by teaching medical ethics in early stage of medical education.

알로에 베라의 DIS (Dewatering & Impregnation Soaking) 공정 중 물질 전달 동역학 및 미세구조에 미치는 온도의 영향

권혜미 ( Hye Mi Kwon ),차지민 ( Ji Min Cha ),허원 ( Won Hur ),이신영 ( Shin Young Lee ) 한국산업식품공학회 2013 산업 식품공학 Vol.17 No.2

알로에의 최소공정개발 연구의 일환으로 DIS(dewatering & impregnation soaking) 공정에 미치는 온도의 효과를 조사하였다. 삼투탈수는 분자량 4000의 PEG을 삼투제로 하여 이의 40%(w/v) 용액에 두께 0.5 cm의 알로에 잎 슬라이스를 넣고 간헐적으로 교반하면서 2시간 동안 수행하였다. 서로 다른 침지온도(25-55℃)가 DIS의 성능(수분소실 및 고형분 획득)에 미치는 영향을 현미경관찰에 의한 세포조직 구조의 경시변화를 모니터링하면서 조사, 비교되었고, 동역학적으로 분석하였다. 고온(55℃) 처리에서는 저온(25 and 35℃)에서보다 더 높은 수분소실을 보였으나 세포조직의 파괴를 동반하였다. 또, 품질지표값으로서의 glucomannan 함량은 세포조직구조를 잘 유지하였던 침지온도 35℃에서 얻어졌다. 얻어진 시료의 실온건조제품을 재수화시켜 조사하고 동역학적으로 해석한 결과, 재수화 동역학은 Peleg 및 Weibull 모델로 잘 설명할 수 있었다. DIS 제품은 DIS 처리하지 않은 제품에 비해 세포구조 및 재수화성질의 향상을 주어 적정온도하에서 DIS 처리함으로써 최소공정의 알로에 제품을 얻을 수 있음을 확인하였다. To enhance the performance of the DIS (dewatering & impregnation soaking) process for Aloe vera leaf slices, the effect of temperature on DIS was investigated. DIS performance (water loss, solid gain) at various temperatures (25℃-55℃) was analyzed and changes of cell tissue structures were monitored by microscopic examination. DIS was carried out with an immersion time of 0-2 h and a thickness of Aloe vera leaf slices of 0.5 cm using poly(ethylene glycol) of 40% (w/v) with a molecular weight of 4,000 Da as a hypertonic solution. Increasing immersion temperature showed higher levels of water loss. In addition, the microscopic structures of samples treated at higher temperatures (55℃) indicated more disruption than those of samples treated at lower temperatures (25 and 35℃). The highest level of glucomannan content was observed at the 35℃ of immersion temperature. The DIS sample treated at 35℃ for 2 h without any pretreatment was air dried at room temperature, and this dried sample showed both improved cell structure and rehydration property in comparison to that of the sample prepared without DIS. Peleg and Weibull models were found to be the most accurate for describing the rehydration kinetics of aloe samples.

Taguchi 법 및 만족도 함수를 이용한 DIS 공정에 의한 알로에의 농축 최적화

권혜미 ( Hye Mi Kwon ),차지민 ( Ji Min Cha ),허원 ( Won Hur ),이신영 ( Shin Young Lee ) 한국산업식품공학회 2013 산업 식품공학 Vol.17 No.1

The optimization of dewatering and impregnation soaking (DIS) process for a concentrated Aloe vera product was investigated using Taguchi method in combination with desirability function analysis. Polyethylene glycol (PEG) as osmotic agent was adopted, and soaking temperature (T), immersion time (t), PEG concentration (C), PEG molecular weight (MW), and thickness of Aloe vera leaf slice (x) were selected as affecting variables. L_16 (4^5) orthogonal array was designed by Taguchi method with four parameters such as water loss, solid gain, glucomannan, and anthraquinone contents as objective functions. An overall quality index was transformed from individual objective functions, and was optimized finally. The optimal setting for maximum overall desirability was obtained at 55oC (T), 2 hr (t), 40% w/v (C), 0.5 cm (x), and 4,000 Da. (MW). The obtained overall desirability was 0.7842. The order of affecting factors was T>C>x>MW?x>t and the experimental results under optimum condition were similar to the prediction of an overall desirability of 0.8384. Also, it was found that the optimized DIS condition could be reproduced for a minimally processed Aloe vera product with high quality.

DIS 공정에 의한 Polyethylene Glycol 함침 알로에 베라 겔의 제조 및 특성화

권혜미(Hye Mi Kwon),허원(Won Hur),이신영(Shin Young Lee) 한국생물공학회 2013 KSBB Journal Vol.28 No.6

The novel Aloe gels were prepared with dewatering and impregnation by soaking (DIS) processing of Aloe vera leaf slice at four different temperatures (25, 35, 45 and 55℃), using dehydration solution of 40% (w/v) polyethylene glycol (PEG4000). The PEG-impregnation to Aloe vera leaf slice during DIS was observed depending on immersion temperature, and the PEG-impregnated Aloe vera gel (PEG-i-AVG) obtained was characterized using ¹H NMR, FT-IR, GPC, XRD and TGA. The PEG-i-AVG had the higher levels of Aloe bioactives (glucomannan and O-acetyl contents) and better quality indices by ¹H NMR and FT-IR spectroscopy than those of native Aloe gel. Also, the obtained Aloe gel maintained the bimodal patterns in higher molecular weight region by GPC indicating no degradation of polysaccharide from native Aloe gel. The result observed by SEM confirmed a surface modification by forming the porous structure, and TGA result exhibited better thermal stability than that of native Aloe gel. XRD result revealed that the crystalline structure in Aloe gel was led by incorporation of PEG. Significant decrease of %insolubility and high enhancement of water solubility index were observed, respectively, and highly ordered conformation such as a helix structure was also indicated by Congo red reaction. We concluded that the modification effect for enhancing function of native Aloe gel was successfully obtained by DIS process using PEG as a dehydrating agent. These results suggested that this DIS process had a high potential for developing a new minimally processed product from Aloe vera leaf.

The Effects of Joint Mobilization with Combined Exercise Therapy of Sling on Post-traumatic Adhesive Capsulitis Patient: A Case Report

권원안,김연정,권혜미,김은지,박우경,신혜원,오정익,우정희,이다혜,이은정,정은주,정재영,정현경,최보영,허은영,이재홍,Kwon, Won-An,Kim, Youn-Joung,Kwon, Hye-Mi,Kim, En-Ji,Park, Woo-Kyung,Shin, Hye-Won,Oh, Joung-Ik,Woo, Joung-Hee,Lee, Da-Hye,Lee, En-young Korea Proprioceptive Neuromuscular Facilitation As 2012 PNF and Movement Vol.10 No.2

본 연구는 43세 남성 환자의 관절가동술과 슬링을 이용한 유착성 관절낭염 환자의 치료사례를 조사하여 그 과정과 결과를 알아보고자 하였다. 어깨통증장애지수(shoulder pain and disability index) 측정과 어깨관절의 굽힘(flexion), 벌림(abduction), 바깥돌림(external rotation), 안쪽돌림(internal rotation)에 대한 관절가동범위를 측정하여 비교하였으며 견관절 주위에 비스테로이드 소염진통 주사 1회, 약물치료를 병행하며 주 3회 8주간 보존적인 물리치료인 온습포(hot pack)와 간섭파(ICT), 관절가동술, 그리고 슬링을 이용한 운동치료를 실시하였다. 결과는 관절가동술과 슬링운동치료의 적용이 유착성 관절낭염 환자의 통증을 줄이고 관절가동범위를 증진시키는데 효과가 있는 것으로 판단된다.

참여형 공간정보 웹서비스의 프레임워크 설계

최원욱(Won-Wook Choi),김경희(Kyung-Hee Kim),권혜미(Hye-Mi Kwon) 대한공간정보학회 2014 한국지형공간정보학회 학술대회 Vol.2014 No.5

본 연구는 참여기반의 공간정보 웹서비스 필요성을 인식하고, 서비스 구현을 위하여 프레임워크를 도출하기 위한 사전연구이다. Web1.0을 시작으로 VGI 지원을 위한 공간정보 웹서비스에 이르기까지 관련 연구를 분석하여 각 단계별 참조모델이 갖는 프레임워크의 진화과정을 분석하였다. 공공데이터 활용서비스의 가치사슬구조와 VGI 지원을 위한 공간정보 웹서비스의 프레임워크를 종합하여 공공 공간정보를 기반으로 참여형 공간정보 웹서비스를 제공하기 위한 프레임워크를 도출하였다.

초음파 내시경 유도 하 경식도 배액술로 치료한 종격동 침범 췌장 가성 낭종

김효정 ( Hyo Jung Kim ),김명환 ( Myung Hwan Kim ),박도현 ( Do Hyun Park ),권혜미 ( Hye Mi Kwon ),박소정 ( So Jung Park ),최은지 ( Eun Ji Choi ),최준혁 ( Joon Hyuk Choi ),김형중 ( Hyoung Jung Kim ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.3

Pancreatic pseudocyst is a common complication of acute/chronic pancreatitis, but extension of a pancreatic pseudocyst into the mediastinum is a rare occurrence. In this report, we described a case of a 62-year-old male with necrotizing pancreatitis presenting with chest pain and dysphagia caused by a mediastinal pseudocyst. Endoscopic retrograde pancreatography revealed pancreatic duct disruption and leaks. A mediastinal pseudocyst was successfully drained by endoscopic ultrasound (EUS)-guided transesophageal approach. Chest pain and dysphagia disappeared swiftly with drainage. Associated pancreatic pseudocyst at tail was managed by EUS-guided cystogastrostomy and pleural effusion was controlled by percutaneous drainage, respectively. In a follow-up period of 3 months, there has been no recurrence of symptoms and signs. Although currently EUS-guided transesophageal approach was done in the selected cases, this procedure is technically feasible, less invasive and more effective than surgical approach.