루푸스 척수염으로 오인된 결핵성 척수염

신현주 ( Hyeon Ju Shin ),전수진 ( Su Jin Jeon ),김동규 ( Dong Kyu Kim ),안광순 ( Kwang Soon Ahn ),김현정 ( Hyeon Jung Kim ),이충원 ( Choong Won Lee ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.2

In systemic lupus erythematosus (SLE), besides immunosuppressive therapy, the immunological abnormalities such as impaired phagocytosis and deficiency of cell-mediated immunity contribute to the increased risk of infection. Most of all, the incidence of tuberculous infection is higher and the pattern tends to be more extensive and extrapulmonary than in general population. Therefore the contributory role of tuberculous infection in mortality of SLE should be emphasized, especially in areas endemic for Mycobacterium tuberculosis like Korea. When tuberculous infection involves central nervous system, it can mimic lupus myelitis, showing the clinical manifestations like paraplegia, sensory impairment and bladder dysfunction. Tuberculous myelitis should be differentiated with lupus myelitis as early as possible for proper treatment and better prognosis. We report a 52 year-old woman with SLE presented with paraplegia and urinary incontinence, who were initially suspected as lupus myelitis. But the AFB smear and culture of cerebrospinal fluid were compatible with tuberculosis myelitis.

중환자실 흡인간호 및 인공호흡기관리 표준화를 통한 인공호흡기 관련 폐렴발생 감소효과에 관한 연구

송경자,유정숙,권은옥,정은자,신현주,박옥향,옥순옥,유미,윤선희,이복남,최진아,황정해,오향순,Song, Kyung Ja,Yoo, Cheong Suk,Kwon, Eun Ok,Jung, Eun Ja,Shin, Hyeon Ju,Park, Ock Hyang,Ok, Sun Ok,Yu, Mi,Yun, Sun Hee,Lee, Bok Nam,Choi, Jin Ah,Hwan 한국의료질향상학회 2001 한국의료질향상학회지 Vol.8 No.1

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

3D/BIM 기반 화재대응시스템 개발을 위한 시각화 정보 전달 체계 구축 방안

김다희(Kim, Da-Hee),신현주(Shin, Hyeon-Ju),차희성(Cha, Hee-Sung) 대한건축학회 2022 대한건축학회논문집 Vol.38 No.1

During a fire, it is of utmost importance to provide reliable building information and secure a fire response system for proper and safe evacuation of building occupants. Every building offers different and changing fire/building information. So for buildings, it is highly recommended to upgrade to an integrated 3D/BIM linked fire response system. The purpose of this upgrade to the 3D/BIM model is not solely because of the solid design, but more so for its usability and visuals to quickly extract needed building information in an emergency. In suggesting this method, the aim is to better secure a quick response from fire personnel and provide essential building information for evacuation and rescue to save lives.

류마티스 관절염 환자에서 발생된 비장의 비호지킨 림프종

이화정 ( Hwa Jung Lee ),고진우 ( Jin Woo Koh ),박정현 ( Jung Hyeon Park ),박성남 ( Sung Nam Park ),이규 ( Kyu Lee ),신현주 ( Hyeon Ju Shin ),이충원 ( Choong Won Lee ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.4

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder of unknown etiology. Inflammation may usually extend beyond the joints and involve other organs. Clinically detectable splenomegaly is present in 5~10% of RA. Methotrexate (MTX) is a structural analog of folic acid that inhibits the enzyme dihydrofolate reductase, so cellular proliferation is reduced. MTX has been proven to be effective in treating RA and is believed to be nononcogenic at low, weekly dose employed in the patients with RA. However, recently there has been increased concern about the oncogenic potential of MTX because of several case reports describing the occurrence of non-Hodgkin`s Lymphoma (NHL) in the patients with RA treated with MTX. A 65-year-old woman with RA was treated with low dose MTX (i.e. 10 mg/week) for 3 years. Because of prolonged left upper abdominal pain and thrombocytopenia associated with huge splenomegaly, splenectomy was performed. Biopsy revealed splenic B-cell NHL. We report a case of RA with splenomegaly who developed B-cell NHL in spleen during low dose MTX therapy.

전자간호기록에 사용된 표준간호진술문의 활용실태

김은만 ( Un Man Kim ),박인숙 ( In Sook Park ),신현주 ( Hyeon Ju Shin ),안태사 ( Tae Sa Ahn ),김영아 ( Young A Kim ),오필주 ( Pil Joo Oh ),우경선 ( Kyung Shun Woo ),정은희 ( Eun Hee Jung ),주영희 ( Young Hee Joo ),조은미eunmejo,유옥수 병원간호사회 2006 임상간호연구 Vol.11 No.1

인공호흡기 적용환자에서 폐쇄형 기도흡인 전·후 과환기와 과산소 적용의 효과

신현주,김정아,권은옥,노화경,김미영,노진숙,권영옥,권정아,손희경,김세현,서미희,김선영,이영진,남지현,우정희,김명애 병원간호사회 2006 임상간호연구 Vol.12 No.2

Purpose: The purpose of this study was to identify the effects of hyperventilation and hyperoxygenation before and after endotracheal suctioning using closed-suction system on mechanically ventilated patients. Method: We selected 20 patients who were mechanically ventilated and randomly assigned into 4 groups according to the type of treatments using repeated measure. We applied 3 types of treatment, hyperventilation, hyperoxygenation, hyperventilation+hyperoxygenation, and no treatment and measured physiologic effects-SpO_(2), HR and, mena BP. Result: There were no significant differences between the group with no treatment and the group with hyperventilation, before and after endotracheal suctioning using closed-suction system(SpO_(2)(p=.693), HR(p=.970) and mean BP(p=.638)). There were no significant differences between the group with no treatment and the group with hyperoxygenation before and after endotracheal suctioning using closed-suction system(SpO_(2)(p=.693), HR(p=.970) and mean BP(p=.638)). There were no significant differences between the group with no treatment and the group with hyperventilation hyperoxygenation before and after endotracheal suctioning using closed-suction system(SpO_(2)(p=.693), HR(P=.970) and mean BP(P=.638)). Conclusion: As the results, all of the methods, hyperventilation, hyperoxygenation, and hyperventilation hyperoxygenation can be used when nurses apply endotracheal suctioning using closed-suction systems. In case of hypoxemic patients, hyperoxygenation is recommended for prevention of deoxygenation due to endotracheal suctioning using closed-suction systems.

유아교육기관 토의학습 활성화 방안 모색

윤기영,차미자,신현주 서원대학교 교육연구소 2000 敎育發展 Vol.19 No.2

In this paper, we attempt to outline the present conditions and problems on discussion learning in early childhood education center. Also, proper application of discussion method in order to develop an effective teaching - learning model in Early childhood education center. After the investigation of literature, in - depth interview was conducted with 20 kindergarten teachers were experienced discussion learning. We find that kindergarten teachers have a correct understanding of the importance of discussion learning in early childhood education center, but they have no basic concept for it on the spot. As a conclusion, we proposed three items of improvement for the better discussion learning in early childhood education center. 1.Provide of sufficient condition for discussion learning, such as space, time etc. 2.Offering a workshop for the enhancement of exprtise of teachers. 3.Developing various discussion learning model for the field.

Comparison of apical sealing ability of continuous wave of obturation technique using EndoTwinn and System B

Shin, Hyun-Ju,Park, Jeong-Kil,Hur, Bock,Kim, Hyeon-Cheol 大韓齒科保存學會 2007 Restorative Dentistry & Endodontics Vol.32 No.6

최근 continuous wave of obturation technique를 이용한 근관 충전 장비로서 옅적용뿐만 아니라 초음파 진동외 기능이 부가된 EndoTwlnn이라는 기구가 소개되었다. 이 연구의 목적은 일반적으로 널리 사용되는 System B와 새로운 기구인 EndoTwinn을 사용한 근관충전 시 근단 폐쇄 효율을 비교하기 위한 것이다. 직선형 치근을 가진 60개의 발치된 소구치와 상악 절치를 근관장 측정 후, 6% 경사의 엔진 구동형 니켈-타이타늄 파일을 이용하여 #35 파일까지 확대 및 세척하였다. SB군 (n = 20)은 System B. ET군 (n = 20)은 EndoTwinn을 이용해 충전하고, Obtura II를 이용하여 backfill하였다. 양성 대조군으로서 PC군 (n = 10)은 근관 형성 후 빈 근관으로 남겨두었다. SB, ET, PC군의 시편은 치근첨 주위 1 mm를 제외한 모든 치근면에 nail varnish을 적용하고 음성 대조군인 NSB군 (n = 5)과 NET군 (n = 5)의 시편은 치근첨을 포함한 모든 치근면에 nail varnish를 도포하였다. 각 치아의 치근첨을 메틸렌블루 용액에 2일간 담궈 보관한 후, 치근첨에서 5 mm 까지 1 mm 간격으로 절단하여 근관벽의 착색 정도를 평가하였고, 각 높이에서의 점수를 합하여 그 시편의 점수로 정하였다. 두 장비 간의 염색제 누출의 유의성 검정을 위해 student t 분석을 시행하였다. 완전히 잘려지지 않고 플러거에 가타퍼챠가 달려나오는 빈도를 비교하기 위해 카이 분석을 실행하였다. PC군은 모든 근관과 상아세관이 착색되었으며, NC군은 착색이 되지 않았다. ET군의 착색 정도가 SB군보다 유의하게 적게 나타났으며 (p < 0.05), 플러거에 가타퍼챠가 달려나오는 빈도는 유의한 차이가 없었다. 이 실험의 조건 하에서, EndoTwinn을 이용해 충전한 경우에 System B를 이용해 충전한 경우보다 근단부 밀폐 정도가 더 좋은 것으로 사료된다. The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn (the combined application of heat and ultrasonic vibration). Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta-percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final scoie of one specimen was given by summing up of the points at all levels. The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.

WMSN을 이용한 중환자분류도구의 개발과 적용

조용애,신현주,조정구,정미경,이복남,송경자 병원간호사회 2005 임상간호연구 Vol.11 No.1

Purpose: The purposes of this study are to develop critical patients classification system, to establish validity and reliability and to identify the conversion index. Method: The items of WMSCN for ICU were revised at the 256 ICUs of 45 hospitals from WMSN of Walter Reed Army Hospital. Validity through the correlation between direct nursing care hours and WMSCN score and also interrater reliability was conducted at 18 of 45 hospitals. Finally, the conversion index was identified at the 5 of 18 hospitals. Result: The WMSCN consisted of 8 categories and 82 nursing indicators. The average score of WMSCN was decreased from 124.3 to 82.2 after education of guidelines. The scores by nurses were highly correlated with head nurses'(r=.94), and also scores of the WMSCN were highly correlated with the direct nursing care hour(p=.001). Finally, the conversion index was 8.36 minutes. Conclusion: WMSCN is available to classify the nursing workload for critical care patients. The education of guidelines, repeated evaluation of validity and reliability are requisite to use WMSCN effectively. And the conversion index should be adjusted to estimate the appropriate staffing in Korea.

복와위에서 후두마스크 사용이 수술 후 인후통에 미치는 효과

최영석,이미경,임상호,김난숙,신현주,공명훈 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.5

Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation. (Korean J Anesthesiol 1998; 35: 903∼907)