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.

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.

국소 Pimecrolimus로 치료한 형질세포 입술염

신혜원 ( Hye Won Shin ),강명승 ( Myung Seung Kang ),고주연 ( Joo Yeon Ko ),노영석 ( Young Suck Ro ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.8

Plasma cell cheilitis is a rare, idiopathic, benign inflammatory disease of lips, characterized by dense plasma cell infiltrates in the upper dermis. It presents as erythematous patches with erosion usually on the lower lip of elderly people. Although, various therapeutic options, including topical steroids, intralesional injection of glucocorticoids, oral nystatin and topical antibiotics have been tried, none of them is promising. A 68-year-old woman presented with a 4-month history of erosive patches with crusts on her lower lip, which was resistant to topical corticosteroids. A histopathologic examination revealed dense inflammatory cell infiltration mainly consisting of plasma cells in the dermis, consistent with plasma cell cheilitis. She was treated with topical pimecrolimus and after 2 weeks of application, the lesion started to get better. After 7 weeks it had almost disappeared. Herein, we present a case of plasma cell cheilitis treated with topical application of pimecrolimus. (Korean J Dermatol 2008;46(8):1061~1064)

고등학교 경제 교과서의 금융 단원 분석

신혜원 ( Hye Won Shin ),장경호 ( Kyung Ho Jang ) 한국사회과교육학회 2014 시민교육연구 Vol.46 No.4

본 연구에서는 2009년 개정교육과정 이후 고등학교 「경제」교과서에 편제된 금융 단원의 교육과정이 교과서와 어떻게 부합하는가를 확인하고, 각 교과서에서 다루는 내용의 범위와 설명의 차이를 분석한다. 연구 결과 우선, 교육과정 성취 기준과 해설서의 내용이 대부분 교과서에 반영되어 있어 금융 단원의 교육과정과 교과서는 부합성이 높은 것으로 나타났다. 다음으로, 교과서가 설명하고 있는 금융 단원의 내용은 개념의 수에서 큰 차이를 보였다. 다만, 2009년 개정교육과정에 비해 2011년에 개정된 교육과정에 따른 교과서에서 그 차이는 줄어들었다. 마지막으로, 교과서마다 금융 개념의 범위와 설명 방식에는 큰 차이를 보였다. 특히, 수입과 지출, 생애 주기와 재무 계획 등에 대한 설명에서 일부 교과서가 오류를 범하고 있었다. This study intends to analyze whether the contents of finance chapter in high school economics textbooks is well aligned with the national curriculum since its revision in 2009. We also investigate the differences of scopes and contents of finance chapter. The results of this study are as follows. First, the curriculum is formally aligned with textbooks. Second, there exist significant differences in the number of concepts in the finance chapter of each textbook. However, the differences become less significant in the revised textbooks. Third, there are still remaining differences in the scopes and contents of finance chapter. In particular, the differences are signifiant in the way of explaining income, expenditure, financial commodities, and the life-cycle hypothesis.

연장입양아 가족의 부모-자녀 애착증진 프로그램 개발 및 효과연구

신혜원 ( Hye Won Shin ),정익중 ( Ick Joong Chung ),민성혜 ( Sung Hye Min ),권지성 ( Ji Sung Kwon ) 대한가정학회 2011 Human Ecology Research(HER) Vol.49 No.2

The purpose of this study was to develop and evaluate an attachment improvement program for families adopting an older child. The objectives and contents of this program reflected on the experiences of adopted parents and the characteristics of older-age adoptee children with attachment disruption. The program consisted of three components: parent-child relationship building, parenting skills enhancement for adopted parents, and negative emotions mediation for the older-age adoptees. The subjects of program were eight parent-child dyads. Differences between pre- and post-test data showed statistically significant improvements in the quality of parent-child relationships, communication levels with parents, and the parents` autonomic levels. There was also a reduction in the children`s social problems. The implications of this study were discussed in terms of improving parent-child attachments in families adopting an older child.

음낭에 발생한 사마귀모양암

신혜원 ( Hye Won Shin ),김영훈 ( Young Hoon Kim ),고주연 ( Joo Yeon Ko ),노영석 ( Young Suck Ro ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.3

Verrucous carcinoma is a low grade, locally aggressive variant of squamous cell carcinoma, which usually occurs on the oropharynx, genitalia and sole. Verrucous carcinoma of the anogenital area, also known as a Buschke-Loewenstein tumor, most frequently arises on the glans penis and prepuce. However, there are few case reports of verrucous carcinoma arising on the scrotum. A 61-year-old man presented with a well-circumscribed, 3×4 cm sized, round, verrucous mass on the scrotum which developed 2 years ago. He had had diabetes mellitus for 9 years, but had not been treated. A biopsy specimen taken from the tumor revealed the typical finding of verrucous carcinoma. (Korean J Dermatol 2008;46(3):374∼377)

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.

대응 짝 비열등성 임상시험에서 모의실험을 통한 ITT군과 PP군의 비교

신혜원 ( Hye Won Shin ),이준영 ( Jun Eyoung Lee ),안형진 ( Hyong Gin An ) 한국보건정보통계학회 (구 한국보건통계학회) 2011 보건정보통계학회지 Vol.36 No.2

Objectives: This research tries to evaluate proper analysis sets for matched-pair noninferiority clinical trials based on Sanchez and Chen`s work (2006). Methods: We evaluate intention-to-treat (ITT) with last observation carried forward (LOCF), ITT with mixed model for repeated measures (MIVIRM) and per-protocol (PP) using simulation study wit various scenarios. Results: From the simulation study, it is found that LOCF is simple and convenient to handle missing data, but it should be used with caution because it can result in biased effect estimation and lack of control on Type I error. On the other hand, ITT-MMERM has more control over Type Tenor and bias compared with ITT-LOCF and PP. Conclusions: In matched-pair noninferiority clinical trials, ITT with consideration of MMRM can be recommended for the primary analysis.

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.

사물인터넷(IoT) 환경에서의 개인정보보호에 관한 규범적 고찰

신혜원 ( Shin Hye-won ),지성우 ( Ji Seong-woo ) 제주대학교 법과정책연구소 2016 法과 政策 Vol.22 No.2

사물인터넷은 주변 기술과 융합되어 하나의 생태계를 구성하며, 인터넷을 기반으로 한 융합의 중심에서 실제 생활영역으로 적용되면서 다양한 경제적 가치, 효율성 증대, 편의성 증대 등을 현실화할 것이란 기대가 높아지고 있다. 하지만 기술발전에 따른 편의성과 산업적으로 발생하는 많은 이익들이 밝은 미래만을 보여주는 것은 아니다. 기술의 발전 뒤에 사회는 해킹의 위협과 보안문제, 개인정보 침해문제 등 수 많은 위험에 직면해 있다. 정보기술의 발달로 자신의 개인정보가 노출된 정보주체는 원치 않는 광고와 스팸 등 기업 마케팅의 표적이 되었고 나아가 신용카드나 은행계좌의 불법도용으로 직접적인 재산적 침해가 발생하고 있다. 온라인 활동 증가, 광대역 연결의 확산, e커머스를 포함한 온라인 금융거래 증가, 컴퓨터보다 상대적으로 보안이 취약한 모바일 기기의 급속한 도입 등으로 인해 개인정보보안 위협은 지속적으로 증가할 것이다. 사물인터넷 시대에는 기기를 통해 수집된 정보에 의하여 특정 개인을 자동적으로 식별하고 개인의 습관, 위치, 관심사, 취향 등의 정보까지 파악할 수 있으며, 이용자 자신이 인지하지 못하는 상황에서 자신의 정보가 관찰ㆍ축적ㆍ공유될 수 있고 보건 및 의료분야 등의 민감한 정보가 수집ㆍ공유될 수 있다. 해킹사건이 잇따라 발생하며 여전히 개인정보 유출에 무방비하게 노출되어 있는 우리에게 사물인터넷의 밝은 미래만이 존재할 것인지에 대해서는 진지한 고민이 수반되어야 하며, 산업 활성화에 따른 이익을 따지기에 앞서 이용자의 정보보호를 위한 실질적인 보호방안과 진지한 법적성찰이 필요하다. Internet of everything (IoT) has evolved from the individual and closed form within specific organizations or companies to an ‘Everything as a Service’, forming a kind of ecosystem by combining with surrounding technology, and ass it is applied to the actual living territory at the center of internet- based convergence, various economical value, increase in efficiency and increase in convenience are expected to become real. But because of this, individual’s all behaviors and information may be collected involuntarily through objects, and cause serious problems regarding the protection and security of privacy or personal information using big data. In other words, it is directly applied to all objects in the real life and extends the threats in cyber space to real life, individuals are facing the threat of personal information invasion or privacy invasion in the midst of the development of IoT that connects all objects and those objects to humans. To people that are defenselessly exposed to the leakage of personal information due to continuous hacking incidents, a serious consideration on whether there is only a bright future in IoT or not should be accompanied, and before calculating the profit due to revitalization of industry, practical protection plans and serious legal consideration for the protection of user information are needed.