국내에서 분리된 Extended-Spectrum β-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의 빈도 및 유형

홍성근,김선주,정성훈,장철훈,조성란,안지영,신종희,이혜수,송원근,어영,염종화,용동은,이경원,정윤섭 대한임상미샐물학회 2003 Annals of clinical microbiology Vol.6 No.2

국내의 치매관련 간호연구논문 분석

김혜영,홍춘실,오경옥,이선영,정현숙,이지혜,남미라 충남대학교 간호과학연구소 2002 충남대 간호학술지 Vol.5 No.1

The purpose of this study was to analyze the trends of korean nursing research on dementia and to suggest the direction of future research. A total of 52 nursing research articles published from 1992 to 2001 were selected for this study. These articles were analyzed in a systematic way including time and source of publication, design of research, type of subjects, variable and tool of measurement, intervention outcome of experimental research, and theme of qualitative research. The results were as follows : 1. The nursing research about dementia has appeared since 1992 and increased rapidly since 1998. 2. Eighteen of 52 studies were composed of dissertation of graduate school, and the research designs were mostly quantitative. There were 36 nonexperimental research, 11 experimental research, and 5 qualitative research designs. 3. The subjects of studies were mostly the caregivers of dementia patients as 33 of 52 studies. 4. Most measurement instruments used for research were developed by researcher him/herself, or redesigned and translated into korean as the original foreign version was used. 5. In correlational research, the trend was to study physical conditions in relation to activities of daily living and functional status in dementia patients and psychological conditions in relation to burden, quality of life, depression, and stress in their families. 6. 2 methodological research were development of assessment tool of dementia patients in community, and assessment of burden of caregiver. 7. In experimental research, subjects were all dementia patients, and interventions were music therapy(5), light therapy(2), education program, cognitive stimulation training, validation therapy, hand massage, reminiscence, horticultural therapy, and art therapy. 8. Theme of qualitative research was all caring experience of family. There were 3 phenomenologic methodology, l ethnography and l case study. Based on these findings, the following recommendations were made: 1. It' s necessary to develop a reliable and valid instrument to measure the characteristics of dementia patients and family caregivers of dementia patients. 2. Experimental study should be repeated to prove the effect of intervention for dementia patients and their family.

의료이용통계 일치도에 관한 연구

강성홍,남문희,임지혜 인제대학교 2009 仁濟論叢 Vol.24 No.1

This study was aimed to investigate medical utilization statistics of type and it’s reliability. Second objective is to suggest methods to improγe reliability of patient survey statistics. We collected patient survey data, health insurance data, discharge summary data in 2005 and reliability of medical utilization statistics analyzed using rate of diagnosis. We found correspondence rate of diagnosis among health insurance statistics, patient survey statistics, discharge injury survey statistics was not high. The rate of Mental and behavioral disorders was 5.0% in health insurance statistics, was 2.4% in patient survey statistics, was 1.3% in discharge injury survey statistics. The rate of diseases of the respiratory system was 10.3% in health insurance statistics, was 8.5% in patient survey statistics, was 12.1% in discharge injury survey statistics. Based on these results, to improvement reliability of medical utilization statistics, this study suggest public health statistics system building, performance of patient survey four times yearly, securing expert.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

알부민이 첨가된 시험관내 약역학 감염모델을 이용한 폐렴알균 치료에서 Ceftriaxone 일일 1회 요법

허지안,전혜선,박선희,최수미,김시현,이동건,최정현,유진홍,신완식 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

배경 : Penicillin 내성 폐렴알균이 증가하는 지역에서 대안 중의 하나로 사용되는 ceftriaxone (CTR)의 적절한 용법, 용량을 파악하는 것이 중요하다. 본 연구는 임상에서 분리된 폐렴알균을 대상으로 시험관내 약역학 감염모델을 이용하여 알부민이 첨가된 경우와 첨가되지 않은 경우 CTR의 일일 1회 요법의 효과를 비교해 보고자 하였다. 재료 및 방법 : Penicillin 감수성(SM24), 중간내성(SM47), 내성(SM60)주를 대상으로 2-구획 시험관내 약역학 감염모델을 적용하였다. CTR 주입은 2 g씩 24시간마다로 사람의 약동학을 모의하였다. 알부민은 모델에서 4g/ dL가 유지되도록 하였다. 살균효과는 0, 2, 4, 6, 24, 30, 48시간째 집락수 변화로 측정하였다. 결과 : 모든 균주에서 알부민이 첨가되지 않은 경우 6시간 이내에 살균력이 관찰되었다. 최저억제농도 및 알부민 첨가유무에 관계없이 3주 모두 24시간째 살균력이 관찰되었고, 48시간째는 모두 측정한계 이하의 집락수로 감소하였다. 전 실험과정에서 CTR에 대한 내성주는 출현하지 않았다. 결론 : CTR의 일일 1회 요법은 알부민이 첨가되었을 때, 감수성, 중간내성, 내성주 모두에서 살균력 발현이 지연되었으나 최종효과는 알부민이 없을 때와 다르지 않았다. 앞으로 알부민 결합효과와 관련된 기초적인 추가 연구가 필요할 것으로 생각된다. Background : During the era of increasing penicillin resistant Streptococcus pneumoniae, it is important to have knowledge about adequate dosage and dosing interval of ceftriaxone (CTR). We examined efficacies of once-daily CTR and compared results in an in vitro pharmacodynamic infection model (IVPDIM) supplemented with albumin and those without albumin. Methods : Using three clinically isolated S. pneumoniae that were susceptible (SM24), intermediate (SM47) and resistant (SM60) against CTR, we utilized a two-compartment IVPDIM. CTR 2 g was administered intravenously every 24 h. Human albumin was added with concentration of 4 g/dL. Samples were removed at multiple time points over a 48-h period to determine the colony counts. Results : In SM24 and SM60, bactericidal effects were observed within 6 hours in groups without albumin. The number of colonies during 1st 6 hours were more decreased in albumin-free groups than in albumin-supplemented groups (P<0.05). In SM47, similar results were found during 1st 6 hours (P=0.03). But, regrowth was observed in albumin supplemented group at 30 h. Irrespective of results of minimal inhibitory concentrations and albumin supplementation, bactericidal effects were shown at 24 h in all 3 strains. All groups were decreased below the detection limit at 48 h. Development of resistance was not detected throughout the entire study period in either strain. Conclusions : Although extents of killing in albumin supplemented broth of once-daily CTR dosing were delayed in all 3 strains compared with those of albumin free broth, final efficacies were not different between the two groups.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

도시 쉼터 노숙자의 정신장애 유병율과 삶의 질

한오수,홍진표,하지혜,이철,김창윤,이동우,박종익 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 외환위기 이후에 급증한 노숙자 문제는 경제적인 상황의 호전에도 불구하고 만성화하는 경향을 보이고 있다. 쉼터의 노숙자를 대상으로 정신질환의 유병율과 삶의 질에 대한 조사를 시행하였다. 방 법 : 2000년 3월에 서울의 대표적인 쉼터에 거주하는 노숙자220명을 대상으로 인구학적 자료에 대한 설문조사를 한 뒤 Structured Clinical for DSM-Ⅳ(SCID-I)을 이용하여 AxisⅠ의 주요 정신질환을 진단하였다. 또 SmithKline Beecham Quality of Life Scale(SBQOL)를 사용하여 삶의 질정도를 평가하였다. 결 과 : DSM-Ⅳ AxisⅠ의 정신질환 중 기분장애, 정신병적 장애, 물질 사용 장애에 대한 진단 평가 결과 상기정신질환의 전체 평생 유병율은 73.6%, 현재 유병율은 59.1%이었다. 알코올 의존과 남용의 평생 유병율은 59.5%로 가장 높았고, 기분장애와 장애가 각각 39.5%, 3.6%이었다. 삶의 질은 노숙의 기간이나 실직 기간과 유의한 관계가 없었고, 자신이 지각한 건강상태, 자살과거력, 우울장애 유무와 통계적으로 유의하게 상관관계가 있었다(p<0.01). 결 론 : 노숙자에서 정신질환 중 알코올 장애의 유병율이 가장 높았으며, 우울장애가 있는 경우에 삶의 질이 저하되는 것으로 나타났다. Objectives : Homeless people surged after financial crisis tend to be chronic despite late economic recovery. So we tried to estimate prevalence of mental illness and quality of life of the homeless population living in shelter. Method : The study subjects were 220 homeless peoples who stayed at a shelter in Seoul around March 2000. Questionnaires on sociodemographic data were administered to the subjects, and then diagnoses of major DSM-Ⅳ Axis I mental disorders were made using Structured Clinical Interview for DSM-Ⅳ Axis I Disorders(SCID). And quality of life(QOL) was evaluated by SmithKline Beecham Quality of Life(SBQOL). Results : The lifetime prevalence of major DSM-Ⅳ mental disorders(mood disorders, psychotic disorder, and substance use disorder) of 220 homeless people was 73.6%, and current prevalence was 59.1%. The lifetime prevalence of alcohol dependence and abuse was highest, 59.5% and those of mood disorder and psychotic disorder were 39.5%, 3.6% respectively. Quality of life was not significantly correlated with duration of homelessness and unemploy-ment but marital status, self perceive health status, suicidal attempt history were significant factors. The quality of life in the people with mood disorders were estimated to be lower than those with any other diseases(p<0.01). Conclusion : Alcoholism was the most prevalent mental disorder in homeless people and mood disorder was negatively related to the quality of life scale.

자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

한국판 Neuropsychiatric Inventory로 본 치매 단계에 따른 행동ㆍ정신증상 특징

오병훈,차경렬,홍창형,김지혜 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : This study aimed to compare the behavioral psychological symptoms of dementia by stages and to suggest the proper management treatment plan. Methods : We examined behaviral psychological symptoms in 17 dementia patients with mild stage (CDR=0.5, 1), 18 de-mentia patients with moderate stage (CDR=2) and 24 dementia patients with severe stage (CDR=3, 4). We compared the prevalence and the composite scores (frequency x seventy) of each behavioral domain in K-NPI among three groups. The MMSE-K, GDS, Barthel ADL were also administrated to evaluate the general cognitive function, seventy of the patients and activity of daily living. Results : The most common behavioral disturbances were apathy/indifference, depression/dysphoria, and aberrant motor behavior. The mean composite score of aberrant motor behavior increased by stages of dementia severity with statistical significance. The total score of the K-NPI increased with severer stages of dementia the result didn't show statistical significance. The K-NPI score showed the positive correlation with CDR, GDS and the negative correlation with MMSE-K, B-ADL. But, there was no statistically significant correlation. Conclusion : Behavioral and Psychological Symptoms of Dementia (BPSD) change by the stages of dementia. The practical guideline for BPSD management according to dementia stage is needed. Re-evaluation and new therapeutic inter-vention must be considered by the stages of dementia.

주상병 일치도에 관한 연구 : 1개 중소병원을 중심으로

서영숙,김유미,남문희,강성홍,임지혜 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.1

Background : The principal diagnosis has been used in many different fields such as hospital statistics, medical research, insurance claim, national health statistics and so on. Some principal diagnoses have a relatively low level of reliability in the medium-sized hospitals. The purpose of this study is to identify the reliability level of principal diagnoses and to suggest ways to improve reliability of the principal diagnosis. Method : Data were collected from a medium-sized hospital located in Pusan. The discharge summaries on 323 patients who were discharged in January, 2008 and the outpatient summaries on 251 patients who visited the hospital on March 28, 2008 were collected, and descriptive analysis was performed using SPSS version 12.0K. Result : The findings are the followings: (1) the diagnostic consistency rate between medical records and doctors’ was 92.0%; (2) the diagnostic consistency rate between medical records and insurance claims was 86.1%; (3) the diagnostic consistency rate between doctors’ diagnoses and insurance claims was 80.2%. The evidence seems to indicate that some principal diagnoses have reliability problems in the medium-sized hospitals. Conclusion : The results of this study suggest the followings: (1) employees should be trained and supervision of hospital activities are needed; (2) network systems should be constructed for each department; (3) professions need to be fostered (4) doctors’ awareness of medical records should be changed.