기관지 방선균증의 임상 1례

이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

관절염 환자의 민속요법이용 형태

은영,강현숙,이은옥,이인숙,이종수 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

This sty was undertaken to explore the utilization patterns of medical treatment and herb medicine in patients with arthrits. The data were collected from 995 patients who were registered either in a center of rheumatology or resided in community with arthritis. The data were analyzed by percentile, t-test and chi-square test using SAS PC program. The results of this study were as follows; 1. According to characteristics of sample-population, mean age was 57.7 years, duration of arthritis 9.7 years and mean duration of pain 2.4 hours per day at present. 2. First diagnosis was identified at department of orthopedic surgery or local clinic. But 85.2% of patients have transferred to the center of reumatology currently. But ironically over 70% of patients experienced the herb treatment and herb treatment had hern medicine simultaneous with medical treatment. This indicated that they were shopping around of treatment during the first one year. 3. Mean cost of medical treatment was 67,400 won, while they payed to herb medicine as much as two or three times. The utilization rate of herb medicine was 36.5% of patients per one year. Costs of herb-treatment were 182,000 Won and herb medicine was 36.6% of patients per one year. Costs of herb -treatment were 182,000 Won and herb medicine 149,100 Won. 4. Eighty point six percent of patients were experienced herb medicine during life-time. One hundred and seventy four kinds herb medicine were found to be used by patients, most of which were nutrients, muscle relaxants, andtiphlogistics and analgesics. Thirty two point six percent of users recognized that herb medicine were effective but 51.7% did not. In conclusion, arthritis patients have been experienced various kinds of drug and remedies for treatment. And they wasted their limited medical and economical resources on these unresonable remedies. Therefore, they should be guided for wise decision about treatment. Futher studies in nursing will be required to explore the value system of patients about herb medicine, the determinant factors of shopping-around patterns of treatment, and the coping mechanism for chronic pain or aggravating symptom.

기악가들의 근골격계 문제에 관한 조사 연구 : 관현악단 단원을 대상으로

이은남,이은옥,이인숙 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

This study was undertaken to identify the musuloskeletal problems and their contributing factors in instrumental musicians in Korea. The data were collected from March 31, 1996 from 304 symphony orchestra members in various areas. The data were analyzed for percentile, t-test, chi-squre using SPSS PC?? program. The results of this study were as follows: 1. Two hundred and fifteen musicians(70.7%) reported experience of various symptoms among 304instrumental musicians. One hundred eighty seven cases reported the present symptoms. 2. The prevalence rate of each woodwind players, string players, and percussionist and keyboard players is 47%, 34.2%, and 17% respectively. 3. Pain, tenderness and stiffness were the most common symptoms, while paresthesia and motor dysfunction were rare. This indicates that most players had muscle tendinous overuse, while small number of players had nerve entrapment and motor dysfunction. 4. In past and present symptoms, they experienced more symptoms mainly in right shoulder, wrist, and fingers than left side in string players, while woodwind players experienced symptoms in both siders of shoulders, wrists, fingers, and knee joints. In the percussionist and keyboard players, right elbow, shoulders, wrists, fingers, and knee joints. In the percussionist and keyboard players, right elbow, wrist, and fingers were more involved than left side. 5. The major contributing factors of the symptoms were playing posture, playing technique, total duration of playing, and period of each practice. 6. The most frequent modalities for treatment of the sympotms were acupuncture or moxibustion, other alternative therapy such as heat compress, massage. 7. There was significant difference in periods of career as teaching, private lesson and membership of orchestra between group of having symptoms and group of no symptoms. Through this study it was found that the musculoskeletal problems are common in the instrument players in Korea and the major contributing factors were playing posture, playing technique, total duration of playing and the period of each practice. Therefore, preventive measures and treatment for early symptoms are necessary for the instrument players, while modalities for prevention and health promotion should be emphasized to the school health nurses who works at high schools.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

Sarcomatoid Carcinoma Arising from Mature Cystic Teratoma

Ho-Chang Lee1, Seung-Myoung Son, Yong-Moon Lee, Ji Hae Koo, Song-Yi Choi, Ok-Jun Lee, Eun-Hwan Jeong 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.2

Malignant transformation of mature cystic teratoma (MCT) is rare. Sarcomatoid carcinoma is a neoplasm comprising malignant mesenchymal cells and a conventional carcinomatous area. Here, we report on a case of sarcomatoid carcinoma arising from an MCT in the left ovary of a 45-year-old female. A unilocular cyst consistent with MCT was observed; however, a nodule within the cyst was confirmed from the resected ovary. Microscopically, the nodule showed both squamous cell carcinoma and pleomorphic sarcomatous components admixing with each other. Lining epithelial cells at the periphery of the main tumor showed squamous metaplasia. When a sarcomatous component is observed in the ovary tumor, it is important to find a squamous cell component, either benign or malignant.

자기 효능의 개념 분석

서순림,이은남,박송자,양영희,이동숙,최은옥,구미옥,김인자,이인숙,김성재,박영임,이은옥 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

Today human needs for health promotion and maintenance are increasing. The nursing progression has a great responsibility for helping clients to practice good health behavior. self efficacy was found to be potent predictor in initiating and maintaining the health-related behavior. Therefore, the concept is important in nursig intervention for change of health behavior. The purpose of this paper was to analyze and clarify the meaning of the concept, self efficacy. This study used Walder & Avant's process of concept analysis. Critical attributes of self efficacy were : 1) positive perception of his won capability; 2) intrapersonal strength; 3) possibility of being learned; 4) individuality; 5) specificity; 6) generalizability. Antecedents of self efficacy consist of those facts that 1) new situation occurs; 2) individuals have needs to change the new situation; 3) there are some required actions in new situation. Consequences occurring as a result of self efficacy consist of those facts that 1) individual initiates the of failure; 5) cope with the situation; 6) controls the situation; 7) the level of self efficacy is enhanced; 8) the level of self-esteem is enhanced.

하루 콩단백질 25g 섭취를 위한 메뉴작성 및 영양성분 분석

한재숙,김정애,서봉순,이연정,서향순,조연숙,한경필,이신정,오옥희,우경자,조은자,구성자,김수진,李承彦,南出隆久 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.2

The purpose of this study was to develop menus for daily intake of 25g soybean protein and to analyse nutrients of these foods. Analytical values were compared to the theoretical one using the food composition table and recommended dietary allowances for Koreans (7th revision). The results are as follows. 1. Soybean curd residue stew, Soybean curd, Kimchi saute, and hard boiled soybean and lotus root were selected for the menu for January, of which the content of soy bean protein(SBP) was 33.1g, soybean stew, soybean curd and soybean sprout saute, and Italian deep fried soybean curd were for February, of which the content of SBP was 35.0g. The content of SBP in soybean paste soup with soybean curd, fried soybean curd and fried soybean curd roll, the menu for March, was 24.9g. That of April were soybean curd gratin with soymilk, soybean curd and ham with garlic dressing and the content of SBP was 26.3g. That of May were soybean porridge, soybean flour cake with honey (Dasik), soybean sprout soup and the content of SBP was 26.7g. That of June were soymilk, pan-fried soybean curd, steamed soybean curd with chicken and the content of SBP was 28.4g. That of July were noodle with soymilk, mapatofu, soybean curd salad and the content of SBP was 24.7g. That of August were soybean sprout with mustard dressing, Tossed green pepper with raw soybean flour, Tofu and Kimchi stew, soybean curd steak and the content of SBP was 26.2g. That of September were Chinese cabbage soup with raw soybean flour, sweet and sour tofu and the content of SBP was 23.2g. That of Oct. were Fermented soybean stew, soybean pan cake and the content of SBP was 24.3g. That of November were not-pressed soybean curd casserole, pan-fried mashed soybean curd with egg, stir frying deep-fried soybean curd with vegetables and the content of SBP was 22.4g. That of December were soybean curd and mushroom casserole, fried soybean curd and vegetables, hard boiled soybean curd and the content of SBP was 28.9g. 2. The ratio of the analytical value over theoretical value (A/B%) of one serving in kcal, carbohydrate, protein, fat, ash and dietary fiber were 57.7~107.7%, 42.9~131.9%, 79.2~118.3%, 54.5~100%, 40.7~80.8% and 42.1~113.2%, respectively. 3. The ratio of A/B% of one serving in Ca, K, Na, P and Fe were 44.1~93.6%, 59.0~153.1%, 53.1~117.7% 64.6%~138.8 and 33.8~77.3%, respectively. That in Fe was the lowest among minerals. 4. The ratio of analytical value over Korean R.D.A(A/C%) in Ca was relatively higher (22.0~85.9%) than that in kcal(18~63%). 5. The ratio of A/C% in Fe was 25.1~64.3% and lower than that in Ca and protein in general.

Halimeter를 이용한 치면세마처치 전후의 구취감소효과에 관한 연구

이은숙 ; 장종화 ; 최옥선 김천대학교 2000 김천대학교 논문집 Vol.21 No.-

The purpose of this study was attempted to analyze the halitosis concentration variation before and after oral prophylaxis through the oral examination and questionaires method as well as measuring the halitosis by Halimeter for volatile sulfer compounds, For this study. 50 patients were selected samples who had visited division of dental infirmary of Eulgy University Hospital from March 27. 2000 to June 8, 2000. The obstained results were as follows: 1. The average value for halitosis by Halimeter was 154.93±42.86ppb in men and 133.42±52.82ppb in women and average 144.18±42.83ppb(p=0.120). The value was approved increasing by age(p=0.137). 2. On toothbrushing bounds. When brushing teeth, gingiva, tongue, the halitosis concentration is lower than brushing only teeth and gingiva(p=0.001). 3. According to toothbrushing reason. Just for prevention of oral disease showed lower halitosis concentration than just for habits or halitosis removing case(p=0.000). 4. According to the toothbrushing bounds, After oral prophylaxis halitosis concentration is lower than before oral prophylaxis(p=0.000). 5. Before oral prophylaxis concentration is lower than after oral prophylaxis by ages and sex group(p=0.000)

간호전문학교 교육과정 분석

이은옥 서울大學校 1977 서울醫大學術誌 Vol.18 No.2

뇌실주위 백질연화증 발생 위험인자

이동환,서은숙,이우령,조명환,박재옥 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

The twenty newborn infants with periventricular leukomalacia(PVL) who were admitted to the neonatal intensive care unit of SoonChunHyang University Hospital from May 1, 1993 to July 30, 1997, were investigated for risk factors. Control group were the age matched 20 neonates who were admitted at the same time of study period. The results were as follows: 1) Mean gestational age was 31 week and mean birth weight 1665gm. 2) PVL's were located in the parietal region in 10 cases, fronto-occipital in 7 cases and parieto-occipital region in 3 cases. 3) Multiple logistic regression analysis for the risk factors of PVL showed that low birth weight, intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizong enterocolitis and ventilator apply were the most significant contributing factor(P<0.05). 4) In a follow-up ultrasonograptic findings, 11 among 14 neonates with localized PVL were normalized whereas, all of 6 extensive PVL had the sequale of ventriculomegaly or cerebral atrophy. 5) In a follow-up neurologic examination, the poorer sequale including spastic diplegia or quadriplegia was associated with the larger, the more extensive PVL.