병리검사 처방오류 개선 시스템 구축

이현임,최영진,구숙희,양승주,김병로,김묘정,신일근,신미옥,서임선 한국의료QA학회 2006 한국의료질향상학회지 Vol.13 No.2

문제: 조직병리검사의 처방이 복잡하고 전문화됨에 따라 오류처방이 빈번하게 발생되고 이를 해결하기위한 프로세스가 복잡하여 부서간의 갈등과 업무의 가중, 또한 병원 수입 감소가 초래되었다. 목적: 발생된 오류처방의 유형과 발생율, 오류처방을 해결하기 위한 프로세스를 파악하여 이에 대한 문제점을 개선하여 업무의 효율성과 관련부서간의 부가업무 감소와 갈등해소, 더불어 병원수익을 향상시키는 것에 목표를 두고 활동하였다. 의료기관: 서울시에 소재한 종합병원 질 향상 활동: 조직병리검사 처방의 오류처방 발생 원인과 유형, 발생율을 조사하여 원인을 파악하고 개선을 위한 프로세스를 구축하여 질 향상을 도모하였다. 개선효과: 수술실에서 의뢰한 외과 입원환자의 일반조직병리검사 오류율은 개선 전 7.8%에서 개선 후 3.5%, 동결절편조직검사 오류율은 개선 전 28.6%에서 개선 후 0%로 이전보다 모두 개선되었다. 또한 수술실 간호사의 업무 만족도는 일반조직병리검사의 처방시 95%, 동결절편조직검사 처방시 90%로 높은 만족도를 보였다. 단 병리과의 경우 업무가 증가됨에 따라 초과근무시간이 증가하였다.

일부 성장기 학생 혈중 연농도의 성별 및 연령별 분포

임재언,강은용,최병선,서지영,홍연표,장임원,박정덕 중앙대학교 의과대학 의과학연구소 2000 中央醫大誌 Vol.25 No.2

고령화 사회를 위한 노인의 영양서비스 요구도 조사

오유진;장유경;원선임;서종려 한양대학교 2005 韓國 生活 科學 硏究 Vol.25 No.1

The survey conducted by individual interviews. Subjects were adults aged 60 and over, recruited from three elderly schools in N city in Kyung-gi province(n=95). In the survey, subjects were interviewed for general characteristics, interesting nutrition topics, preferred methods of nutrition service. Subjects were interested in topics such as ‘anything about nutrition’(41%), ‘healthy eating’(31%), ‘diet with taking medicine’(17%), and ‘nutrition counseling’(12%). As methods of nutrition service, Subjects wanted primarily to use lectures in school(27%). Nutrition education program(29%), booklets(25%) were other commonly cited methods. These results provide baseline information for developing nutrition service and methods for elderly.

Development and apoptosis of pre-implantation porcine nuclear transfer embryos activated with different combination of chemicals

Im, Gi-Sun,Seo, Jin-Sung,Hwang, In-Sun,Kim, Dong-Hoon,Kim, Se-Woong,Yang, Byoung-Chul,Yang, Boh-Suk,Lai, Liangxue,Prather, Randall S. Wiley Subscription Services, Inc., A Wiley Company 2006 Molecular reproduction and development Vol.73 No.9

<P>Artificial activation of oocytes is a pre-requisite for successful cloning by nuclear transfer (NT). This study investigated effect of different combination of activation chemicals such as electric pulse (E), thimerosal (Thi) + dithiothreitol (DTT), 6-dimethylaminopurine (6-DMAP), or cycloheximide (CH) on the developmental ability and the frequency of apoptosis of porcine NT embryos during the culture in vitro. NT embryos activated with chemicals showed significantly higher developmental rate to blastocyst stage compared to embryos activated with E alone (21.5%–26.6% vs. 15.7%, respectively). Of chemicals, Thi + DTT supported higher development to blastocyst stage as compared to 6-DMAP or CH (26.6% vs. 21.5%–23.4%, respectively). Apoptosis of NT embryos were analyzed by using a terminal deoxynucleatidyl transferase-mediated deoxyuridine 5-triphosphate nick-end labeling (TUNEL) assay. The onset of apoptosis of embryos activated E alone was on Day 4, whereas embryos activated with chemicals showed apoptosis on Day 3 post-activation NT embryos exposed to chemicals for activation had higher frequency of apoptosis compared to that of embryos exposed to E alone from Day 3 to Day 7 during the culture. In conclusion, this study shows that chemical activation after fusion could increase not only the developmental ability of porcine NT embryos but also the mean cell number with an increased ratio of inner cell mass (ICM) to trophectoderm (TE) cells. However, the chemical activation also could increase the frequency of apoptosis and induced apoptosis earlier in porcine NT embryos. Mol. Reprod. Dev. 1094–1101, 2006. © 2006 Wiley-Liss, Inc.</P>

간호리더십 교과목에 적용한 디자인씽킹 교수학습법의 효과

서임선(Seo Im Sun) 학습자중심교과교육학회 2020 학습자중심교과교육연구 Vol.20 No.17

본 연구는 간호리더십 교과목에 디자인씽킹 교수학습법을 적용하고 그 효과를 확인하고자 실시되었다. 연구는 2019년 9월 5부터 2019년 11월 15월까지 G지역 소재의 일개 대학 간호대학생에게 실시되었으며, 분석 자료는 최종 디자인씽킹 교수법을 적용한 실험군 25명과 이를 적용하지 않은 대조군 24명으로부터 수집되었다. 수집된 자료를 이용하여 두 군 간의 동질성 검정은 카이제곱 검정과 independent t-test를, 교수학습법 적용 전후 실험군과 대조군 내에서의 차이는 paired t-test로 분석하였고, 교수법 적용 후 실험군과 대조군 간의 변화 차이는 Mann Whitney U Test로 분석하였다. 디자인씽킹 교수학습법을 적용한 결과 비판적사고성향은 실험군(p=.001)과 대조군(p=.004) 모두 사후 조사에서 향상되었으나, 팀 효능감(p=.004)과 문제해결과정(p=.055)은 실험군에서만 향상된 경향을 보였다. 교수학습법 적용 후 실험군과 대조군 간의 변화 차이는 비판적사고성향(p=.018)에서만 실험군이 대조군 보다 높게 상승되었다. 디자인씽킹과 같은 창의적 문제해결 기법을 저학년에서부터 반복적으로 적용하여 미래사회에서 요구되는 핵심역량을 향상 시킬 수 있는 교수학습 전략이 필요하다. This study was conducted to identify the effect of design thinking teaching method to the Nursing Leadership course. The study was performed from September 5, 2019 to November 15, 2019 to a nursing college student in a G area. Data were collected form 25 experimental group and 24 control group using on-line questionnaires. The homogeneity test between the two groups was analyzed by the chi-square test and the independent t-test, and the difference within the two groups before and after application of the teaching-learning method was analyzed as the paired t-test. and the difference in change between the two groups after applying the teaching method was analyzed by Mann Whitney U Test. As a result of applying the design thinking teaching method, the critical thinking disposition was improved in the post-study in both the experimental group (p=.001) and the control group (p=.004), but the team efficacy (p=.004) and problem solving process (p=. 055) improved only in the experimental group. The difference in change between the two groups was higher in the experimental group than the control group only in the critical thinking disposition (p=.018). There is a need for a teaching-learning strategy that can improve the core competencies required in the future society by repeatedly applying creative problem-solving techniques such as design thinking from the lower grades.

생엽과 덖음녹차의 휘발성 향기성분 분석

이순임(Sun-Im Lee),전동복(Dong-Bok Jeon),김재성(Jae-Sung Kim),정인선(In-Sun Jung),홍영신(Young-Shin Hong),서혜영(Hye-Young Seo),박근형(Keun-Hyung Park),김경수(Kyong-Su Kim) 한국차학회 2011 한국차학회지 Vol.17 No.3

2010년 전남 보성군 ○○다원에서 재배한 녹차의 생엽과 생엽을 덖어서 제다한 덖음녹차의 휘발성 향기성분을 SDE로 추출하여 이를 농축한 후 GC/MS로 분석하였다. 생엽에서는 휘발성 향기성분 83종을 동정하였고 건시료기준 79.12 mg/kg으로 확인되었다. 풀냄새(green note)로 특정지어지는 (E)-2-hexenal이 다량 확인되었으며 linalool과 geraniol 등 monoterpene alcohol류 등이 주요 화합물로 분석되었다. 생엽의 주요 관능기적 분포는 leaf alcohol로 불리어지는 C6-alcohol 및 monoterpene alcohol류 등 alcohol류가 63%로 가장 많았고 23.3%인 aldehyde류가 다음을 차지하였으며, 이들 화합물이 생엽의 휘발성 향기성분에 영향을 끼쳤을 것으로 판단되었다. 특히 생엽에서는 지금까지 동정되지 않았던 theaspiran류가 동정되었으며 이는 osmanthus fragrance로 확인되었고 덖음 녹차에서는 동정되지 않았다. 이는 향이 진하고 독특하며 fruits, teas, 그리고 passionfruit에서 동정됨을 알 수 있었고 화장품과 식품 등에 사용되고 있다. 덖음녹차로 부터 확인된 향기성분은 총 73종으로 건시료 기준 87.40 ㎎/㎏로 확인되었다. 덖음녹차에서 확인된 주요 휘발성 향기성분으로는 4-VP와 1-ethyl-1H-pyrrole-2-carbaldehyde로 각각 총 향기성분의 6.8% 및 6.5%를 차지하였으며, benzyl alcohol, (E)-nerolidol, indole, ethyl acetate 등도 다량 분석되었다. 주요 관능기별 분포는 alcohol류가 대부분을 차지하였고 이는 주로 terpene alcohol이었다. 생엽과 덖음녹차에서 확인된 휘발성 향기성분을 비교한 결과, 생엽에서 확인된 (E)-2-hexenal과 (Z)-3-hexenol 비롯한 leaf aldehyde와 leaf alcohol 등 10여종이 덖음녹차에서는 현격하게 감소된 것으로 나타났다. 또한 ester류, ketone류 및 함질소화합물 등은 덖음녹차에서 생엽보다 많이 동정되었는데 이는 덖음과정에서의 열처리에 의한 반응생성물로 생각되었다. 덖음과정의 열에 의해 생성되는 카라멜 화합물이나 maillard product 등 한국인의 입맛에 길들여진 구수한 향기들이 확인되어, 이러한 화합물들의 변화를 고려하여 덖음과정의 조건을 수립하는데 활용함으로서 기호성 높은 차 가공 시 유익한 자료가 될 것으로 판단된다. 본 연구결과 기본 생엽과 덖음녹차의 향기성분을 기본으로 과학적 자료를 축적할 수 있었으며 가공 전 생엽의 향기성분에 대한 기초자료는 발효차나 반발효차 또는 덖음차 등 여러 유형의 가공된 다류와 비교 분석하여 기호에 맞는 차를 제다할 때 응용할 수 있는 객관적 자료를 제시하였다. Volatile flavor components from fresh and roasted leaves of Camellia sinensis L. were extracted by simultaneous steam distillation and extraction (SDE) method using the mixture of n-pentane and diethyl ether (1:1, v/v) as an extract solvent. The volatile extracts were analyzed by GC/MS. Identification of the volatile flavor components was mostly based on the RI of GC and mass spectrum of GC/MS. The total number of 83 volatile flavor components were identified in fresh leaves, and (E)-2-hexenal characterized as green note was the predominantly abundant component. Also, monoterpene alcohols such as linalool and geraniol etc. were identified as major compounds. Major functional group was alcohols including C6-alcohols and monoterpene alcohols accounting for 63%, and aldehydes followed by second functional groups. They were considered as important compounds contributing fresh leaves like flavor. But unlike roasted leaves, theaspirans which is identified in Osmanthus fragrance were detected in fresh leaves. Volatile flavor components of 73 were identified in roasted leaves of C. sinensis L., and the contents was 87.40 ㎎/㎏. 4-Vinyl phenol and 1-ethyl-1H-pyrrole-2-carbaldehyde were detected as the major volatile compounds accounting for 6.8 and 6.5%, respectively. Appreciable amounts of benzyl alcohol, (E)-nerolidol, indole and ethyl acetate were detected in roasted leaves. The major functional group was alcohols almost consisting of terpene alcohols. Leaf aldehyde such as (E)-2-hexenal and leaf alcohol such as hexanol detected in fresh leaves were significantly decreased in roasted leaves. Esters, ketones, and N-containing compounds produced during heating in roasting process were detected higher than in fresh leaves.

B형간염 바이러스 보유 환자의 질환 활성도에 따른 B형간염 지식, 자가간호수행 및 삶의 질 비교

서임선(Seo, Im Sun),송명준(Song, Myeong Jun),유양숙(Yoo, Yang-Sook),김형숙(Kim, Hyoung Suk) 한국보건간호학회 2017 韓國保健看護學會誌 Vol.31 No.2

Purpose: The hepatitis B virus is a major cause of chronic liver disease. The clinical guidelines recommend that inactive chronic hepatitis (ICH) patients also check their liver function every 6 to 12 months and manage the potential risks. This study compared the hepatitis B knowledge, self-care practice, and quality of life in patients with HBV according to the disease activity. Methods: This study was conducted in a university hospital and surveyed on 65 ICH patients and 68 progressive chronic liver disease (PCLD) patients from November in 2012 to September in 2013. Results: The knowledge of hepatitis B was lower in the group of a lately perceived HBV infection and ICH. Self-care practice was lower in the male and the patients group with a perceived HBV infection within 5 years. The “taking regular liver function test” score was lower in the ICH. Eight out of 12 Liver Disease Quality of Life instrument (LDQOL) subscales were lower in PCLD. Conclusion: The hepatitis B knowledge and self-care practice are relatively lacking in ICH and the patients group with a perceived HBV infection within 5 years. More effective education programs will be necessary to enhance the hepatitis B knowledge and self-care for patients with HBV and even for ICH.

병원 중간관리 간호사의 영적성장 체험

서임선(Im Sun Seo),용진선(Jinsun Yong) 영성과 보건복지학회 2020 영성과 보건복지 Vol.7 No.1

본 연구는 Max van Manen의 해석학적 현상학 방법을 이용하여 병원 중간 관리 간호사가 체험한 영적 성장의 본질을 탐구하고자 한다. 연구 참여자는 c대학병원에 근무 중인 중간관리 간호사로서 8주간의 영성 기반의 스트레스 완화 프로그램 (Spirituality based stress reduction Program)에 참여한 대상자 중 적절한 과제수행과 꾸준한 개인적 성장을 보여 온 13명의 참여자를 대상으로 하였다. 연구 기간은 2009년 6월부터 2011년 3월까지로 연구 자료는 참여자가 작성한 개인 일지와 체험 수기 및 참여자와의 심층 면담내용을 이용하였다. 연구 결과 병원 중간관리 간호사들이 경험한 영적 성장의 의미는 "삶을 변화시키고 싶은 갈망(Aspi rati on for changing life)", "영적 훈련(Spiritual training)", "영적 깨어남(Spiritual awakening)", "본질적 삶을 위한 고뇌(Struggling for essential life)", "영적 성숙으로 나아감(Spiritual maturing)", "평화롭게 살아감(Peaceful living)" 의 6가지로 나타났다. 결론적으로, 영적 성장에 대한 체험은 일련의 단계적 과정을 반복적으로 순환하며 나아가는 나선형적 순환 과정으로 이해할 수 있었으며 성찰과 실행을 반복하며 점진적으로 나아가게 된다 이상의 결과를 종합하면 간호사의 영적 성장은 영적 돌봄과 간호의 돌봉 예술을 실현할 수 있는 하나의 역량으로 이해될 수 있었다. 본 연구결과를 토대로 임상에서 간호사의 영적 성장을 촉진 시킬 수 있는 다양한 중재가 적용되어 간호의 돌봄 역량을 보다 강화시킬 수 있게 되기를 바란다. The purpose of this study was to explore the experience of spiritual growth in hospital middle manager nurses and research was conducted based on hermeneutic phenomenology by applying van Mana n's research method. Thirteen participants were enrolled this study and have been worked at C university hospital for an average of 147.9 months. They all completed spirituality based stress reduction program for eight-weeks and have constantly practiced holy name repetition. The study was conducted from June 2009 to March 2011, and data were collected from participant 's daily record, autobiography and semi- structured interviews. The lived experience themes of spiritual growth in middle manager nurses were extracted as "Aspiration for changing life", "Spiritual training", "Spiritual awakening", "Struggling for essential life", "Spiritual maturing", "Peaceful living". In conclusion, the experience of spiritual growth occurs as a gradually ascending spiral through repeated reflection and execution. Spiritual growth in middle manager nurses was integrated with their nursing care and have on effect competency to actualize spiritual care and "Art" of nursing . As a result of this research, it is expected that various intervention should be adapted in clinical setting to increase spiritual growth in nurses.

위암과의 감별이 어려운 Menetrier씨 병 1예

서광섭,김구영,임병욱,채선애,강남훈,유광렬,김창훈,권영우,김호정 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1

In 1988 Menetner described polyadenomes en nappe also known as hypertrophic or hyperplastic gastropathy, giant hypertrophic gastritis, and giant hypertrophy of gastric rugae. Moderate to severe hypoproteinemia and hypochlorhydria are often encountered. Radiographically and grossly, the condition can be confused with malignant lymphoma and carcinoma. Microscopically there is a striking foveolar hyperplasia accompanied by tortuosity. The glandular content is diminished, and the stroma is edematous and inflamed. Carcinoma may develop in a stomach affected by Menetnets disease, but the incidence is differently appreciate by authors.

Cortical thickness in single- versus multiple-domain amnestic mild cognitive impairment

Seo, Sang Won,Im, Kiho,Lee, Jong-Min,Kim, Yun-Hee,Kim, Sung Tae,Kim, Seong Yoon,Yang, Dong Won,Kim, Sun I.,Cho, Yoon Sun,Na, Duk L. Elsevier 2007 NeuroImage Vol.36 No.2

<P><B>Abstract</B></P><P>Amnestic mild cognitive impairment (aMCI) can be classified into single domain (S-aMCI) and multiple domain (M-aMCI) subtypes. However, there have been no studies that specifically investigate the structural differences that support this classification. In an attempt to compare regional cortical thickness in two subtypes of aMCI, we aimed to map the distribution of cortical thinning using a surface based cortical analysis of magnetic resonance imaging. The cortical thickness across the entire brain was measured in 9 patients with S-aMCI, 22 patients with M-aMCI, and 61 normal healthy subjects. Differences in the patterns of cortical thinning between S-aMCI and M-aMCI were assessed using ANCOVA on a vertex-by-vertex basis, and statistical maps of differences in cortical thickness between the groups were constructed using a surface model. Relative to controls, S-aMCI patients showed cortical thinning in the left medial temporal lobe, and M-aMCI patients showed cortical thinning in the left medial temporal lobe, precuneus, and anterior and inferior basal temporal, insular, and temporal association cortices. When the two MCI groups were directly compared, M-aMCI patients showed cortical thinning in left precuneus. Our studies suggest that M-aMCI is a transitional state between S-aMCI and Alzheimer's disease, and that the cortical thinning is evidence that the precuneus is responsible for the multiple cognitive impairments in M-aMCI.</P>