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억제대 적용지침 개발을 통한 불필요한 억제대 적용율 감소활동
곽경선,김성은,배은경,이은숙,이은혜,최윤정,이윤경 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2
문제: 억제대 적용에 대한구체적 적용지침 없이 의례적으로 억제대를사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정상태 이거나 근력이 약하여 발관능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를볼수 없 는경우, 간호사본인의 판단이 없이 타인의 요구에 따르는등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용및 제거 지침을 마련하고자 한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 개선효과: 억제대 적용에 대한중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p= 0.005 (p <0.0히로통계적으로유의한것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든항목이 개선 활동전 에 비해 2,3차 개선 활동후에 향상한 것으로 나타났다. 개선활동전에 8.1%였던 간호 기록, 0.7%였던 간호중재, 0%였던 의사처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 갑소 및 부적절한 억제대 적용율은 유의하게 감소하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은좀더 나은 간호제공을 위하여 개발 되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은계속적으로 Feedback 되어야 할 것이다.
도시지역 일부 고등학생들의 우울과 불안에 관한 조사 연구
곽은주,송인순,정용준,조영채 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.2
This study has examined the degree of depression and anxiety among high school students in an urban area and then explored the factors influencing their depression and/or anxiety status. Self-administered questionnaires were offered to 2,381 students from ten high schools in Daejon Metropolitan City. The items for investigation included such factors as various characteristics of school and family life, daily life style, and the degree of depression and anxiety. Based on the study results, the following conclusions were made; 1. The distribution according to the depression degree has shown that 61.9% of students were normal, 32.9% of students had mild depression, 5.0% moderate depression, and 0.3% severe depression. As for anxiety, 40.2% of students were normal, while 19.1% were classified as having anxiety and 40.7% borderline anxiety. 2. As regards to the degree of depression and anxiety, it was greater in girls than boys, in 3rd graders than 1st and 2nd graders, and in the groups who have recieved lower grades in studies, who had poor relations with their friends and a low feeling of satisfaction with school life. In particular, concerning various characteristics of family life, the scores of depression and anxiety were higher in the groups whose financial conditions were poor, whose parents' interests were lower, whose degree of satisfaction with their family and school life was lower, than their counterparts. 3. According to their life styles higher scores of depression and anxiety were found in the groups whose sleeping time was inappropriate, whose breakfasts were skipped, who ate daily snacks, who didn't take regular exercises, and who had poor health habits, compared to their counterparts, respectively. 4. As for the correlation between the degree of depression and its associated variables, the higher scores of depression were in positive correlation with the groups who had lower grades in studies, poor relation with their friends, low feeling of satisfaction with school and home life, low parents' interest, poor subjective condition of health, breakfast skipping, lack of regular exercises, and lower indices of health habits. 5. As for anxiety, the higher scores of anxiety were in the positive correlation with the groups with poor relation with their friends, low feeling of satisfaction with school and family life, poor subjective condition of health, lack of regular exercises, and poor health habits. 6. The influential factors on the depression of students were selected such as subjective condition of health, sex, feeling of satisfaction with family and school life, grades in studies, relation with their friends, presence of regular exercises, degree of interest of parents, sleeping time, cigarette smoking and eating breakfast. 7. The influential factors on the anxiety state of students were selected such as subjective condition of health, feeling of satisfaction with family and school life, sex, sleeping time, regular exercises, cigarette smoking, snacking and relations with their friends. The present study results suggest that girls rather than boys, higher graders than lower ones are more vulnerable to anxiety and depression state, and besides, various characteristics of school and family life, and daily life style can be influential on students' emotional states. Therefore, better management of psychological status of students is thought to require a wide variety of measures to modify the influencing factors and to encourage social support.
All-Trans Retinoic Acid에 의한 HL-60 세포 분화유도중 H2B Histone, c-Myc 및 DNA Topoisomerase I 발현에 관한 연구
임규,박정동,최병한,이용진,김계영,이명선,장은미,김삼용,권기량,곽상태,황병두 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1
Effects of all-trans retinoic acid(retinoic acid) on DNA replication, H2B histone and DNA topoisopmerase I(Topo I) gene expression have been investigated in human promyelocytic leukemia cell line HL-60. DNA synthesis decreased at 24 hours after exposure of retinoic acid in the HL-60 cells. H2B histone mRNA rapidly reduced at 48 hours and Topo I and c-myc mRNA at 24 hours in retinoic acid-exposured HL-60 cells, respectively. The levels of c-myc, H2B histone and Topo I gene expression were reduced in proportion to the concentration of retinoic acid. The H2B histone mRNA in retinoic acid-exposured cells was elevated by cycloheximide treatment, while the level of Topo I mRNA was constant. These results suggest that regulations of H2B histone, c-myc and Topo I gene expression are different from one another, and repression of Topo I gene is closely correlated with c-myc gene during retinoic acid-induced differentiation of HL-60 cells.
Jeong, Ji Eun,Soh, Ji Eun,Kwak, Ji Hee,Jung, Hye Lim,Shim, Jae Won,Kim, Deok Soo,Park, Moon Soo,Shim, Jung Yeon The Korean Pediatric Society 2018 Clinical and Experimental Pediatrics (CEP) Vol.61 No.8
Purpose: Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. Methods: A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2-5 of the PCT levels with the lowest quintile. Results: The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ${\leq}3days$ after admission and hospital stay ${\leq}6days$. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ${\leq}3days$. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile. Conclusion: Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.
Characteristics of East Asian Passiflora virus isolates from passion fruits in Korea
Jeong-Eun Kim,Su-Bin Hong,Hyeon-Yong Choi,Mikyeong Kim,E-Seul Baek,Hae-Ryun Kwak,Min-kyeong Choi,Hyo-jeong Kim,Hyo-jeong Kim,Hyo-Jung Kang,Jong-woo Han,Heon-sub won,Ji-gwang Kim,Hyeon-ju Lee,Chang-Seo 한국농약과학회 2018 한국농약과학회 학술발표대회 논문집 Vol.2018 No.10
Kwak Mi Young,Jo Eun Young,Chin Bum Sik,Park Se Eun,Yim Jun,Lee Jung Eun,Jo Kyung Eun,Kim Yeon-Sook,Lee Jeong Eun,Yoon Young Kyung,Seo Yu Bin,Jeong Su Jin,Kang Yu Min,Joo Eun-Jeong,Yoon Jong Hyun,Kim 대한감염학회 2022 Infection and Chemotherapy Vol.54 No.2
Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients’ care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed.
Jeong Eun Ahn,Susan Taejung Kim,Hye Won Kwon,Sang Yun Lee,Gi Beom Kim,Jae Gun Kwak,Woong Han Kim,Mi Kyoung Song,Eun Jung Bae 대한심장학회 2022 Korean Circulation Journal Vol.52 No.12
Background and Objectives: Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure. However, in pediatric and congenital heart disease (CHD) patients, current adult indications cannot be directly applied because of heterogeneity in anatomy and diagnosis. Therefore, CRT responses and clinical outcomes in these patients were investigated to derive possible candidates for CRT. Methods: This study retrospectively analyzed 16 pediatric and CHD patients who underwent CRT implantation at a single center in early (0.7±0.2 year) and late (4.7±0.3 years) follow-up period after CRT. Results: The median age at CRT implantation was 2.5 (0.3–37.2) years, and median follow-up duration was 6.3 (0.1–13.6) years. Thirteen had non-transvenous CRT. Two had congenital complete atrioventricular (AV) block with previous right ventricular pacing, 5 had dilated cardiomyopathy (DCM) with left bundle branch block, and 9 had CHD. The mean ejection fraction of the systemic ventricle increased from 28.1±10.0% to 44.3±21.0% (p=0.003) in early and 51.8±16.3% (p=0.012) in late outcome. The mean functional class improved from 3.1±0.9 to 1.8±1.1 after CRT (p=0.003). Twelve patients (75%) showed improvement in ventricular function or functional class after CRT. Proportion of responders differed between patients without CHD (2/2 patients with complete AV block and 5/5 with DCM, 100%) and those with CHD (5/9, 56%), although statistical significance was not reached (p=0.088). Conclusions: CRT improved ventricular function and functional status according to the underlying condition in pediatric and CHD patients. However, further large and longer-term studies are needed to establish the guideline for the patient selection of CRT in these patients.