후두적출자의 의사소통 태도

강수균,박선희,백은아,이현혜,최경희,강은희,박은실 대구대학교 특수교육재활과학연구소 2005 특수교육재활과학연구 Vol.44 No.3

본 연구는 후두적출자의 주된 발성방법과 후두적출 경과 시기에 따른 의사소통 태도를 살펴보고자 하였다. 연구의 대상은 성인 남자 55명으로 후두암으로 인한 후두적출자들로 구성되었다. 이들에게 실시한 의사소통 태도 설문지는 Erickson의 의사소통 태도 척도-수정판(Modified Erickson Scale of Communication Attitudes: S-24)을 본 연구에 맞게 수정 보완하여 사용하였다. 본 연구의 결과는 첫째, 주된 발성방법에 따라서는 인공후두기 사용자와 식도발성자간의 의사소통 태도에 차이가 없었다. 둘째, 후두적출 경과 시기에 따라 10년 초과된 후두적출자들과 10년 이하의 후두 적출자들 간의 의사소통 태도에 차이가 없었다. 그러므로 이들의 의사소통 태도의 긍정적 태도를 증가시키기 위하여 다양한 방법을 활용하고 습득하여 이들의 의사소통 능력을 빠르게 재습득 하여 긍정적인 의사소통 능력을 가질 수 있도록 해야 한다. The purpose of this study was to determine laryngectomee's communication attitude. 55 laryngectomees, who were in the range of 40 years old to 80 years old participated in the study. Communication attitude measurements were taken by S-24(Modified Erickson Scale of Communication Attitudes). The results showed as follows: First, score of laryngectomees with artificial larynx and esophageal speakers were no significant. Second, score of laryngectomees with over 10 years after latyngectomy and 10 years after latyngectomy were no significant.

암환자의 영적간호 요구에 관한 연구

강은실 高神大學校 1991 論文集 Vol.19 No.-

The major purpose of this study was to identify the spiritual nursing care needs of cancer inpatients. Additional objectives were to determine the degree of expected spiritual nursing care, actual spiritual nursing care being received by nurses and the relationships between expected, received spiritual unrsing care and general characteristics(demographic & religious variables ) Data was collected on Jan., 1990 using a strutured questionnaire developed by Delphi technique (Choi, 1987). The collected data was analyzed using SPSS PC(+) package The results of this study were as follows; 1. Out of items which were designed to show spiritual needs of inpatients, "want nurses to introduce chaplain or pastor in local church" "want nurses to sing a hymn or use a tape recorder when I want it" "want nurses to read a Bible for me when I want it" were relatively highscored items. 2. Out of items which were designed to show the degree of satisfaction on spiritual needs, "want nurses to read a Bible for me when I want it" "want nurses to introduce chaplain or pastor in local church" "want nurses to sing a hymn or use tape recorder when I want it" "want nurses to pray for me or with me" were relatively high-scored items 3. Significant differences were find to show between spiritual needs and religion, religious career, experience of born again, hope to resureaction. 4. There was no significant relationship between the degree of satisfaction on spiritual care needs and the general characteristics of the subjects. 5. There were positive correlations between the degree of spiritual nursing care needs, the degree of satisfaction of spiritual care needs and degree of satisfaction of general nursing care.

돼지 신장세포(PK15)의 이종이식 거부반응에 대한 재조합 IL-18의 영향

최연실,김은미,김영관,박상연,심정현,윤도영,강형식,명평근 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

Various cytokines including IL-1β, IL-2, IL-4, IL-10, IL-12p40, IFN-r, and TNF-α have been recently reported to play important roles in both host and donor cell activations during xenotransplantation. Interleukin (IL)-18, a proinflammatory cytokine, can induce IL-4 and IL-13 production in T cells, NK cells, B cells, mast cells, and basophils. IL-18 has the capacity to stimulate innate immunity and both Th1-and Th2- mediated responses, but little is known to involve in the xenograft rejection. In order to investigate the role of IL-18 in xenograft rejection, we transplanted the pig kidney (PK15) cells to C57BL/6 mouse with or without intraperitoneal injection of mouse recombinatant IL-18, It was analyzed the population of T cell, B cell and NK cell in the mice transplanted with PK 15 cells and recombinant IL-18 by flow cytometry. We found that splenic CD3+ T cells were increased in mice injected PKl5 cells with recombinant IL-18. These results suggest that recombinant IL-18 is critical in the xenograft rejection by increasing T cell population of the recipients.

돼지 신장세포(PK15)의 이종이식 거부반응에 대한 재조합 IL-18의 영향

최연실,김은미,김영관,박상연,심정현,윤도영,강형식,명평근 충남대학교 생물공학연구소 2004 생물공학연구지 Vol.10 No.1

Various cytokines including IL-1β, IL-2, IL-4, IL-10, IL-12p40, IFN-γ, and TNF-α have been recently reported to play important roles in both host and donor cell activations during xenotransplantation. Interleukin (IL)-18, a proinflammatory cytokine, can induce IL-4 and IL-13 production in T cells, NK cells, B cells, mast cells, and basophils. IL-18 has the capacity to stimulate innate immunity and both Th1-and Th2- mediated responses, but little is known to involve in the xenograft rejection. In order to investigate the role of IL-18 in xenograft rejection, we transplanted the pig kidney (PK15) cells to C57BL/6 mouse with or without intraperitoneal injection of mouse recombinatant IL-18. It was analyzed the population of T cell, B cell and NK cell in the mice transplanted with PK 15 cells and recombinant IL-18 by flow cytometry. We found that splenic CD3+ T cells were increased in mice injected PK15 cells with recombinant IL-18. These results suggest that recombinant IL-18 is critical in the xenograft rejection by increasing T cell population of the recipients.

DHA의 lipoxygenation에 의한 17-H(P)DHA 의 제조 및 LC/MS/MS를 이용한 구조분석

이은실,이은주,강종성 충남대학교 약학대학 의약품개발연구소 2007 藥學論文集 Vol.22 No.-

Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are essential fatty acids and necessary for the development of brain, nerve system and retina. Recently, novel hydroxy compounds generated from DHA and EPA showing various biological activities were reported. In this study, hydroperoxy compound of DHA was prepared by incubating 15-lipoxygenase (15-LOX) and DHA, and was purified and analyzed by HPLC. The purified compound (MW 360) with the absorption maximum of 238 nm was identified as 17-hydroperoxy DHA (17-HPDHA). 17-HPDHA was reduced to a hydroxy compound by sodium borohydride and identified as 17-hydroxy DHA (HDHA) by LC/MS/MS. This method could afford to gain the commercially unavailable precursor of biologically active mediator.

연쇄알구균 감염에 의한 급성 인후염 후 반응성 관절염 1예

박은하,도연실,양정채,강미라,서현주,정숙인,손준성,기현균,오원섭,백경란,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

연쇄알구균에 의한 급성 인후염 후 발생한 반응성 관절염은 급성 류마티스열의 개정된 진단기준을 충족하지 못하면서, 지속적 혹은 재발성의 비이동성 관절염과 발열, 홍반성 결절, 일시적 간기능 이상 등을 보이면서 심장염과 무도증을 드물게 동반하는 질환이다. 따라서, 발열을 동반한 급성 관절염 환자에서 감별해야 할 질환 중의 하나이며, 심근염 예방을 위한 페니실린 요법의 적응증 및 기간에 대해서는 아직 이론이 많은 상황으로, 보다 광범위한 연구가 필요하다. 저자들은 연쇄알구균에 의한 급성 인후염 1주 후에 발생한 하지의 다발성 비이동성 관절염과 함께 결절홍반 및 일시적 간기능 이상을 보인 환자에서 PSRA로 진단하고 비스테로이드성 항염증제 및 스테로이드로 성공적인 치료를 하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Poststreptococcal reactive arthritis (PSRA) is associated with recent streptococcal infections. However, PSRA is distinct from acute rheumatic fever by its clinical manifestations: non-migrating arthritis, erythema nodosum or erythema multiforme, and transient elevation of serum transaminases. We experienced a 33-year-old man who presented with fever, arthritis of both knees and ankles, and erythema nodosums on extensor surfaces of lower legs which developed 6 days after the onset of pharyngitis symptoms. Blood and urine cultures were negative. Throat culture was negative for group A β-hemolytic streptococcus. The ASO titers increased up to 2080 IU/mL in sequential monitoring. The result of bone scan was compatible to arthritis of both knees and ankles. There were no signs or symptom of carditis. He showed clinical improvement with anti-inflammatory drugs (naproxen 1,000 mg/day and prednisolone 7.5 mg/d). PSRA should be included in the differential diagnosis of patients presenting with arthritis combined with fever.

암환자의 삶의 질 도구개발

태영숙,강은실,이명화,박금자 성인간호학회 2000 성인간호학회지 Vol.12 No.4

This study was undertaken to develop an instrument to be used for measuring the concept of duality of life of Korean patients with cancer multidimensionary and correctly. It can contribute in holistic nursing care for Korean cancer patients and also provide and validate basic data to help oncology nurses measure the outcome of nursing intervention correctly. To develop this instrument, the researchers first estabilished a conceptual framework based on the results of qualitative data analysis and indepth interview method Development of the scale was conducted using a method in which 31 items were assessed by subjects' self report using linear analogue scales. The subjects were 79 D.M. Patients. 103 patients with acute illness, and 91 cancer Patients residing in Busan, Korea. Data were collected during the period from July, 24 to August 14. 2000. This instrument consisted of 31 items with a self report stale. This instrument covered 4 dimensions of cancer patients : 1) Physical wellbeing 2) psychological wellbeing 3) social wellbeing and 4)spiritual wellbeing. Each item had a possible score of 10. The reliability of the scale was tested with Cronbach's alpha. Validity was evaluated by examining the relationships of this scale. Youn's Quality of Life Questionnare scores and the Simple Quality of Life scale. Two separate runs of multiple regression were used to predict scores on the Simple Quality of Life measuremend. Further validation was obtained by examining the correlation between the instrument subscores and Youn's Quality of Life measurement subscore for convergence of this scale. Examination of the discriminant. power of the instrument was done using ANOVA test. The results are summarized as follows : 1.The reliability of the instrument for the quality of life was 0.8321 (Cronbach's alpha.), physical wellbeing dimension 0.6343. Psychological wellbeing dimension 0.6501, spiritual wellbeing dimension 0.5883. 2.This instrument had a high correlation with Youn's Quality of Life measurement(r= 0.636) in cancer Patients, whereas it had a low correlation with Simple Quality of Life measurement(r= 0.455) in cancel patients. In the D.M. patients, the instrument correlated with both the Youn's Quality of Llfe measurement and Simple Quality of life measurement(r=0.313. r= 0.407) and in the acute stage patients. the instrument had no correlation. 3.Multiple regression of individual Items on the Simple Quality of Life scores accounted for 56.8% of the variance in the Simple Quality of Life measurement, whereas, Youn's Quality of Life measurement scores accounts for 31.7%. The correlations collected from the three group had the same patterns of variations but especially the instrument developed in this study had higher disciminant power than that of Youn's Quality of Life Measurement.

암환자가 지각한 사회적지지, 희망과 삶의 질과의 관계

태영숙,강은실,이명화,박금자 고신대학교 전인간호과학연구소 2002 전인간호과학연구 학술모음집 Vol.- No.-

The Relationship among Percieved Social Support, Hope and Quality of Life of Cancer Patients Tae, Young Sook. Kong, Eun Sil. Lee, Myung Hwa. Park, Geum Ja The purpose of this study was to investigate the relationship among percieved social support, hope and Quality of life of the cancer patients and to gain the baseline data for development of nursing intervention program for promoting quality of life in cancer patients. The design of this study was a cross sectional correlational survey. The subjects were 220 out and in-cancer patients in 5 general hospitals in Pusan The data were collected from July 2 to August 1,2001. The instruments were the Percieved social support scale(16 items, 5 point scale) had developed by Tae(1986), Hope scale(12 items, 4point scale) developed by Nowotny(1989) and Quality of life scale(31 items, 10 point scale) developed by Tae et. al(2000). The data was analyzed by the SPSS/PC+ program using frequency & percentage, item mean & standard deviation, t-test, ANOVA & Scheffe test, Pearson's correlation coefficient. The results of this study was as follows : 1) The item mean score of quality of life was 6.05±1.16 (range 0-10) .The heighest score of subarea of the quality of life was the spiritual wellbeing area (7.09±1.63) and the lowest score was social wellbeing area(5.53±1.65). The mean score of perceived social support was 52.65±10.32 (최고 1, 최저 80). The mean score of family support was32.71±6.66 (range 1- 40) and the mean score of medical team support was 19.93±5.95 (range 1- 40). The mean score of Hope was 37.02±5.64 (range 1-48). 2) There were statistically significant difference in the score of quality of life according to the life effect of religion (F=3.97, p=0.00), treatment method(F=2.94, p=0.01), area of diagnosis (F=3.48, p=0.01), stage of disease (F=13.74, p= 0.00). 3) There was significant correlation between perceived social support(r=0.44, p= 0.000 ; family support: r=0.334, p=0.000, medical support; r=0.395, p=0.000), hope(r=0.563, p= 0.000) and quality of life. In conclusion, there was a significant relationship among perceived social support, hope and quality of life. Therefore perceived social support, hope intervention programs should be developed to improve the quality of life in cancer patients.

우리나라 지역 직업성질환 감시체계의 현황과 전망

임종한,장성실,김성아,문재동,채창호,홍윤철,김수영,김진석,김영욱,한상환,이혜숙,원종욱,송동빈,하은희,강성규 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

기존의 특수건강진단과 작업환경측정을 통한 직업병 관리가 진폐증, 소음성난청 등의 소수 특정질환에 국한되고 실제 직업병 발생 규모 파악이나 신종 직업병의 발견에 한계를 보인다는 사실은 산업의학전문가들 사이에서도 공감을 이루고 있다. 미국과 영국 등에서의 직업성질환 감시체계에 대한 경험은 우리 나라의 직업성질환 감시체계 구축에도 새로운 자극제가 되면서, 1998년이후 인천, 대전, 여천, 구미, 부울경 지역에서 지역 직업성질환감시체계를 산업보건관리의 중요한 시스템으로 구축하려는 노력이 확산되고 있다. 새로이 구축되어지는 이들 지역 직업성질환 감시체계는 감시하고자 하는 대상질환, 활용 가능한 인적자원 및 자료원, 지역 의료체계의 특수성 등에 따라서 목적과 방법을 달리하면서 독특한 형태로 발전을 하고 있다. 각 지역단위 감시체계들이 그 상황에 맞게 독특한 목적과 전략들을 발전 시키면서도, 향후 발전할 국가적인 차원의 직업성질환 감시체계 구축을 위하여 직업성질환 감시의 기본 전략 등을 공유하는 등의 노력이 필요하다. 환례 정의 및 기본적인 등록 서식의 공유, 직업성질환 감시 자료원의 발굴, 공동의 정보 네트워크 및 직업성질환 감시 데이터베이스 구축 등 직업성질환 감시활동을 지원하기 위한 여러 기초 인프라 구축에 힘을 모아야 할 것이다. 우리 나라에서 직업성질환 감시체계를 성공적으로 구축하기 위해서는 수집된 자료의 질 관리를 위한 직업성질환 감시의 원칙 제정과 감시 전략의 공유 등이 필요하며, 전국적인 직업성질환 감시체계의 하부구조라고 할 수 있는 지역감시체계의 기초 토대 마련과 강화작업이 절실하게 필요하다.

의료보험 고액진료비 환자의 특성연구

문옥륜,강선희,이은표,좌용권,이현실 韓國保健行政學會 1993 보건행정학회지 Vol.3 No.1

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over Per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40 days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the eiderly patients. They have Spent 814, 126won per day on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Government should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.