Q 열에 의한 감염성 심내막염 2예

문수연,최영실,박미연,이정아,정미경,정혜숙,정두련,송재훈,백경란 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Q fever is a zoonosis caused by Coxiella burnetii, Presenting as acute and chronic illness and it has been reported worldwide. Acute Q fever is usually asymptomatic or mild and self-limiting, but infective endocarditis is one of the most serious complications of chronic Q fever and can be fatal. Known risk factors for Q fever endocarditis are valvular heart disease, immunocompromised hosts, and pregnancy. There have been some reports on Q fever in Korea but there exists no report on Q fever endocarditis. We have experienced 2 cases of Q fever with underlying valvular heart disease; both Patients came to the hospital for evaluation of prolonged fever. Although Q fever and Q fever endocarditis are rare in Korea, Q fever endocarditis should be considered in the differential diagnosis of patient with infective endocarditis when causative microorganism cannot be identified.

Benzoyl peroxide의 환경에서의 초기 위해성 평가

김미경,배희경,김수현,송상환,구현주,박광식,이문순,전성환,나진균 한국환경독성학회 2004 환경독성보건학회지 Vol.19 No.1

Benzoyl peroxide is a High Production Volume Chemical, which is produced about 1,375 tons/year in Korea as of 2001 survey. The substance is mainly used as initiators in polymerization, catalysts in hte plastics industry, bleaching agents for flour nad medication for acne vulgaris. In this study, quantitative Structure-Activity Relationships(QSAR) are used for getting adequate information on the physical-chemical properties of this chemical. And hydrolysis in water, acute toxicity to aquatic and terrestrial organisms for benzoyl peroxide were studied. The physical-chemical properties of benzoyl peroxide were estimated as followed; vapor pressure=0.00929 pa, Log K_(ow)=3.43, Henry's Law constant=3.54×10^(-6) atm-m³/mole at 25℃, the half-life of photodegradation=3days and bioconcentration factor(BCF)=92. Hydrolysis half-life of benzoyl peroxide in water was 5.2hr at pH 7 at 25℃ and according to the structure of this substance hydrolysis product was expected to benzoic acid. Benzoyl peroxide has toxic effects on the aquatic organisms. 72 hr-ErC_(50)(growth rate) for algae was 0.44mg/L, 48hr-EC_(50) for daphnia was 0.07mg/L and the 96hr-LC_(50) of acute toxicity to fish was 0.24mg/L. Acute toxicity to terrestrial organisms(earth worm) of benzoyl peroxide was low(14 day-LC_(50)=>1,000mg/kg). Although benzoyl peroxide is high toxic to aquatic organisms, the substance is not bioaccumulated because of the rapid removal by hydrolysis (half life=5.2hr at pH 7 at 25℃) and biodegradation(8.% by BOD after 21days). The toxicity observed is assumed to be due to benzoyl peroxide rather than benzoic acid, which shows much lower toxicity to aquatic organisms. One can assume that effects occur before hydrolysis takes place. From the acute toxicity value of algae, daphnia and fish, an assessment factor of 100 was used to determine the predicted no effect concentration(PNEC). The PNEC was calculated to be 0.7㎍/L based on the 48hr-EC_(50) daphnia(0.07mg/L). The substance shows high acute toxicity to aquatic organisms and some information indicates wide-dispersive use of this substance. So this substance is a candidate for further work, even if it hydrolysis rapidly and has a low bioaccumulation potential. This could lead to local concern for the aquatic environment and therefore environmental exposure assessment is recommended.

성인간호학회지 논문(1989-2000)의 내용과 경향 분석

서문자,김소선,송미순,이명선,오의금,신경림,김옥수,이숙자,이영자,오효숙,정재심,김철규 성인간호학회 2001 성인간호학회지 Vol.13 No.4

"Journal of Korean Academy of Adult Nursing" has been published since 1989 and more than 330 articles have been published up 2000. We reviewed all the articles published in this journal to analyze the contents and trend of published articles and to find out the way of improvement both in quantity and quality of studies in this area. The results are as follows : 1) Ninety percent of articles were quantitative studies. Experimental design was used in 16.1% and quasi-experimental design was adapted in 73.6% of articles. Qualitative research were 10.3% of total articles reviewed. 2) Only 5.1% of articles described theoretical framework and 73.6% of experimentally designed articles included research hypotheses. 3) Among experimental studies, only one was true experimental studie design. Eighty nine point three persent had descriptive survey method among non-experimental studies. Amog the thirty four qualitative studies, phenomenologic(73.5%), grounded theory(14.7%), and ethnographic (11.8%) design were used. 4) Most of research subject were patients and few healthy people, healthcare worker, and patient family. 5) Psychosocial data collection method which used questionnaire were 53.7% and interview. physical measurement, observation were used in 22.8%. 8.2% 5.4% of articles respectively. 6) Total number of keywords were 692, and average number of key words per article was 2.2. Health-related keyword was the most frequently used according to four metaparadigm of nursing (human, health, nursing, and environment). Environment related keyword was rarely appeared. The number and quality of nursing research in "Journal of Korean Academy of Adult Nursing" have been improved continuously. It is difficult to find out special trend or characteristics which is unique in this journal because of relatively short history of adult nursing studies. This review study was performed to analyze adult nursing studies only in the view of quantitative aspect, but it is needed to analyse qualitatively to find philosophical or theoretical trend in nursing.

입원 환자 영양검색 전산 프로그램 개발

안수미,윤기영,신연명,최경현,임근승,장문경,송윤미,공은희 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : About 30% of patients in the hospital are under nourishment. A large portion of people are undernourished when they are admitted to the hospital and in the majority of these, undernutrition develops further while in hospital. Patient-Generated subjective global assessment(PG-SGA), a method of nutritional assessment based on clinical judgment, has been widely used to assess the nutritional status of adults for both clinical and research purposes. Modified PG-SGA can be used as a nutrition screening tool, and a comprehensive nutrition assessment is desirable for those who are malnourished. The purpose of this study is to develop a simple, reliable and valid nutrition screening program(NSP). Methods : We applied the nutrition screening program(NSP) to adult inpatients who are at risk of malnutrition using the Modified Patient-Generated subjective global assessment(PG-SGA) and objective assessment(electrical medical record data). Results : Therefore simple and beneficial NSP is developed for patients with severe malnutrition. Using NSP. nutritional information of the severe malnutrition patient should be shared with the physicians and they should be taken care of by clinical dietitians to improve their nutritional status. Conclusion : The Modified PG-SGA and nutrition screening tool are simple, reliable and valid nutrition screening program(NSP).

동결온도가 해동 쇠고기의 품질에 미치는 영향

남주현,송형익,김미숙,문윤희,정인철 한국식품영양학회 1998 韓國食品營養學會誌 Vol.11 No.5

동결온도가 해동우육의 품질에 미치는 영향을 검토하였다. 해동드립감량은 -3℃ 동결이 30일째에 3.4%, -20℃ 동결이 60일째에 1.8%로 높았으며, -3℃가 -20℃보다 드립량이 많았다. 가열감량은 water bath와 pan 가열 모두 저장초기보다 동결저장중에 현저하게 높았으나, 동결온도에 의한 차이는 없었다. 염용성 단백질의 추출성은 동결기간이 경과함에 따라 감소하였고, -20℃에서 동결한 것이 -3℃에서 동결한 것보다 추출성이 높았다. 수용성 단백질의 추출은 -3℃의 경우 동결기간에 따라 현저한 변화가 없었으나, -20℃에서 동결한 것은 동결기간에 따라 증가하는 경향을 보였다. 명도(L)는 동결초기가 높았고 적색도(a)는 동결기간에 따른 변화가 없었으며, 황색도(b)는 동결초기보다 동결중에 더 높았다. Myoglobin의 변성율은 -3℃의 경우 45일째, -20℃의 경우 15일째 각각 94.4%와 94.0%로 가장 높았다. 전단력가는 동결초기보다 저장기간이 경과함에 따라 높아졌으며, 근원섬유의 소편화도는 동결저장중 현저한 변화가 없었다. pH는 -3℃와 -20℃ 모두 30일째까지 높아지다가 그 이후 낮아지는 경향을 나타내었다. This study was carried out to investigate the effects of freezing temperature on quality of thawed beef loin. In case of thaw drip loss, the freezing of -3℃ and -20℃ were higest by 3.4% to 30 days and by 1.8% to 60 days, respectively. And the thaw drip loss of -3℃ freezing was more than -20℃ freezing. The cooking loss of water bath and pan boiling were increased significantly during freezing than the beginning of freezing, but were not different -3℃ and -20℃. The salt soluble protein extractability was decreased during freezing, the -20℃ freezing was higher than -3℃ freezing. The water soluble protein extractability of -3℃ freezing was not significant different during freezing storage, that freezed at -20℃ was increased during freezing. The "L" value of the beginning of freezing was higher than during freezing, the "a" value was not different during freezing, and the "b" value during freezing was higher than the beginning of feezing. The myoglobin denatured percentaged of the -3℃ and -20℃ freezing were highest by 94.4% to 45 days and by 94.0% to 15 days, respectively. The shear force value during freezing was higher than the beginning of freezing, the myofibrillar fragmentation index was not significant different during freezing. The pH was increased to freezing 30 days, after that was decreased.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

NIHSS 활용을 통한 뇌졸중 환자 간호의 질향상 전략

박경현,송경애,공혜성,나화주,유수경,박소영,김상희,최혜림,배희준,한문구,양미화 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로활용하고 있지만 아직 간호현장에서는보편적으로사용하지 않고있다. 이에 뇌졸중환자간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중환자 간호의 질을보다 향상시키기 위하여 본활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를향상시키기 위한 프로그램을 개발·적용한다. 둘째, 간호사가급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬수있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과치료를위한의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 「NIHSS 간호사 교육 프로그램」을 마련하였다.

일부농촌지역의 농약사용실태 및 농약중독 요인 조사

이경민,송주희,장재혁,심수정,강양화,안재경,이숭호,박미영,정문호 대한보건협회 2002 대한보건연구 Vol.28 No.4

Object The usage of agricultural chemical is on the increasing. Use of pesticides has increased agricultural production. However, negative externalities from such use have increased too. Pesticide poisoning is a major public problem. The purpose if this study is to find out the relationship between keeping the safety rules or protective equipments or attending safety education or dose of pesticides use , and poisoning experience. Methods For Gu, H.M. and Pack, S.G. study , we obtained questionnaire data concerning pesticides poisoming. A person interviews on 203 were conducted in two villages in Sinmeari and woulbonri Chunchun , Kangwon province, July 2002. Result 1. 144 people(70.9%) have sprayed pesticides and the rata of experiences of pesticide poisoning was 26% among 144. Spraying time of pesticides was 1-2 hours in 63.9% of farmers. Rate of using the protective equipment was 25.7% (protective clothes), 49.3% (Mask), 48.6 (Gloves), 7.0 (Protective glasses), 64.6% (boots) respectively. 2. Chi-square and multiple logistic regression analysis showed that Duration of spraying per day (<2hr) and using of mask(protective equipment)are significantly association with poisoning experience.(x^2=5.2684 p=0.0217, CI=0.140-0.5853 OR=0.346 p=0.0211 respectively). But no association between poisoning experience and keeping safety rule, attending of safety education. 3. Spraying pesticides. Duration of spraying pesticides, reading manuals and no spraying at fatigue (keeping safety rule) are significantly association with symptom experience(x^2=14.0621 p=0.0002, x^2=7.0639 p=0.0079, CI01.395-10.950 OR=3.908 p=0.0095, CI=0.101-0.726 OR=0.271 0.0094 respectively). But no association between symptom experience and protective equipments, attending of safety education.

뇌실외 배액술 관리에 대한 이해 및 업무수행 실태

김정숙,윤미선,송소이,이지은,문경선,고지운,임분남,김경희,박경숙 중앙대학교 간호과학연구소 2001 중앙간호논문집 Vol.5 No.2

The objective of this study was to investigate the managing realities of EVD and provide a descriptive survey with the attempt to obtain basic data needed for the standardization of EVD management. For that purpose, 220 questionnaire copies were distributed to those nurses who were working with intensive care units at university hospitals, general hospitals, semi-general hospitals in Seoul, Kyongki-de and local areas. Of 158 returned questionnaire copies, 139 were used for analysis. Data were collected during the term of academic seminars of Neurosurgery Nursing Committee and KICA (Korea Intensive Care Association), ranging from Oct. 26 through 27. 2000. The tools utilized a structured questionnaire form consisting of 21 questions on general characteristics, the level of understanding, the level of work performance, standard management guidelines, etc. The data collected were analysed with frequency, percentage, mean vague, chi -square test using the SPSS 10.0 program Findings were revealed, as follows: For managing the prevention of EVD infection, aseptic technique was found to be of the most importance (48.9%),'the technique should be carried out at an operation room'(92.8%), but it was actually performed at intensive care units (over 51.5%). 'The term of antibiotics use should be less than 7 days' (81.8%), while it was actually executed for less than 7 days (49.5%). 'The proper time of quittance from it should be within less than 7 days'(74.1%) but actual quittance was executed only by 51.1%. 'Set exchange is needed' by 54.0% but actual exchange was implemented merely by 28.1%. 'The subject of management should be nurses' was reflected by 40% but actually 52.0% were carried out. As a result of hating analysed the understanding of the management of EVD by general characteristics, a significant difference was found in the necessity for set exchange by hospitals, in the time of quittance of a catheter, and in ablution items by work experience. The result of hating analysed the work performance levels of EVD management by general characteristics revealed that a significant difference in administration facilities of medicine by the classification of hospitals, especially the use of antibiotics and the quitting time of a catheter by the classification of intensive care units, and in the use of antibiotics and ablution items by the standard management guidelines.

적혈구침강속도와 급성기물질의 혈중변화에 따른 상관성과 임상적평가

이호준,김미송,장숙진,문대수,박영진 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.2

The authors determined erythrocyte sedimentation rate(ESR) and the level of acute phase reactants such as ceruloplasmin, α1-antitrypsin, haptoglobin and C-reactive protein and evaluated their correlation in 101 patients with active inflammation, chronic infection, collagen disease and neoplastic disease from Jan. 1990 to Aug. 1990 in Chosun university hospital, Shortly after the patients had been diagnosed, the tests was performed using their blood. ESR was measured by standardized Win trobe method. Ceruloplasmin, α1-antitrypsin, and haptoglobin were measured by radial immunodiffusion method. C-reactive protein was measured by turbidimethc immunoassay. The correlation of ESR and the levels of ceruloplasmin, α1-antitrypsin, haptoglobin and C-reactive protein was analysed in the control group and the disease group. The results were summarized as follows. 1. The ESR rose with each decade increase of age in most cases of the disease group. 2. The author judged that the ESR was increased when the ESR was upper than 20mm / hr. The 45 of 101 cases of the disease group showed increase of ESR. So the sensitivity of ESR to detect disease is 44.55%. 3. The difference of the level of ceruloplasmin and α1-antitrypsin of control group and that of the disease group showing normal ESR value was not statistically significant(P>0.05). 4. The difference of the level of C-reactive protein and haptoglobin of the control group and that of the disease group showing normal ESR value was statistically significant(P<0.05). 5. The difference of the level of ceruloplasmin, α1-antitrypsin and haptoglobin of the disease group showing normal ESR value and that of disease group showing high ESR value was not statistically significant (P>0.05). 6. The difference of the level of C-reactive protein of the disease group showing normal ESR value and that of the disease group showing high ESR values was statistically significant (P<0.05). 7. C-reactive protein played a major role in increasing ESR and haptoglobin played some influence also. But α1-antitrypsin and ceruloplasmin played little influence.