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

노인 낮병원의 심리사회적 치료 프로그램이 노인의 신경인지기능과 우울 증상에 미치는 효과

유계준,송정은,오병훈,안석균,이홍식,오희철,구은형,황혜숙,이은철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

노인에게 있어서 신경인지기능의 저하와 우울 증상은 가장 흔한 장애이며 신체적, 정신적인 면에 많은 영향을 미치고 있다. 또한 이러한 장애중 비임상군에서 심리사회적 치료개입의 효과가 보고되고 있다. 이러한 측면에서 지역사회에서 노인에게 제공되는 심리사회적 치료개입의 중요성이 높아지고 있다. 이전의 연구에서는 대상이 특정 집단이거나, 비교군이 없거나, 치료효과에 대한 추적 관찰이 이루어지지 않는 등의 제한점이 있었으며, 현재 국내의 노인 낮병원은 소수에 불과하고 이러한 낮병원의 치료효과에 대한 연구는 거의 없는 실정이다. 따라서 본 연구는 지역사회 정신보건센터에서 운영하는 노인 낮병원에 참가하는 노인들을 대상으로 낮병원의 심리사회적 프로그램이 노인들의 신경인지기능과 우울 증상에 미치는 효과와 이에 대한 유지 효과의 유무를 알아보고자 하였다. 경기도 광주군 정신보건센터의 노인 낮병원에 참여한 노인을 치료군으로, 치료를 거부하거나 치료 중 탈락한 노인을 비교군으로 하여 10주간의 낮병원 치료전후와 치료종결 후 10주에 신경인지기능은 한국형 간이 정신상태검사(이하 MMSE-K)로, 우울 증상은 단축형노인우울척도(이하 SGDS)로 평가하여 두 군을 비교하였고 치료군의 치료 직후와 치료종결 후 10주를 비교하였다. 연구결과 노인 낮병원의 심리사회적 치료가 시간에 따른 SGDS점수 변화에 통계학적으로 유의한 영향을 미쳤으며, MMSE-K점수 변화에는 통계학적으로 유의한 영향을 미치지 않았다. 또한 10주 추시가 가능했던 치료군 중 약 43%가 10주 후 SGDS가 증가하여 호전되었던 우울증상의 악화를 보였다. 본 연구 결과 노인 낮병원의 심리사회적 치료 프로그램 개입은 노인에게 있어서 우울 증상을 호전시키며 신경인지 기능에는 직접적인 영향을 미치지 않는 것을 알 수 있었다. 또한 상당수에서 심리사회적 치료 개입으로 인한 우울 증상의 호전이 유지되지 않음을 알 수 있었다. 이는 노인우울증상의 치료에 낮병원의 심리사회적 치료 프로그램이 효과적일 수 있음과 치료 후 이를 유지하기 위한 부가적인 치료개입의 필요성을 시사한다. Cognitive impairment and depression are the most common symptoms affecting the elderly on physical and mental states. Studies have shown that these symptoms in mild cases are improved by psychosocial intervention, emphasizing the importance of therapeutic intervention provided in the community. The purpose of this study was to investigate whether the psychosocial program at a geriatric day care service has any therapeutic effect on the cognitive function and depressive symptoms in the elderly and whether such effect can be maintained. The experimental group was composed of 37 elderly patients attending the day care service at the mental health center located in Kwangju county, Kyonggi province. The control group was composed of 22 elderly patients who either refused intervention or who dropped out of the program. Cognitive function was assessed with the Korean version of the Mini-Mental State Exam(MMSE-K), and depressive symptoms were assessed with the Short-form Geriatric Depression Scale(SGDS). The experimental group and the control group were compared on the score of on each test, which was administered before and after the program and 10 weeks after discontinuation of program. In the experimental group, the scores acquired immediately after the program and at 10 weeks of follow-up were also compared. The results showed that psychosocial intervention at a geriatric day care service was significantly associated with the change in SGDS scores dependent on time but not significantly associated with the change in MMSE-K scores. In the experimental group whose follow-up assessment was possible, it was further shown that 43% of patients had increased SGDS scores 10 weeks after the program ended, indicating that depressive symptoms had worsened. This study suggests that psychosocial therapeutic intervention in the geriatric day care service improve depressive symptoms but not cognitive functions in the elderly. In addition, for a considerable percentage of subjects in the experimental group, the improvements in depressive symptoms were not sustained after the intervention was withdrawn. These findings proposes a need of strengthening therapeutic intervention to maintain such effect.

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.

분자역학적 방법을 이용한 부산시내 대형건물 냉각탑수의 레지오넬라균의 형별 분류

김정만,정석훈,서대영,박은희,송은주,최재철,이은엽,장철훈 대한임상미샐물학회 2004 Annals of clinical microbiology Vol.7 No.1

갑상선 유두암이 병발된 가족성 대장 용종증 1예

백종현,소창배,이은영,이지숙,신은경,박은호,서정아,양재홍,송준영,박선자,박요한,최영식 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome, typically characterized by multiple colorectal adenomas and increased incidence of colorectal carcinomas if it is not treated. Moreover, a variety of extracolonic manifestation are seen. The prevalence of thyroid tumors developing in patients with FAP is about 1∼2%. Generally, papillary thyroid cancer indicates low mortality but ,however, as people get older, the cancer becomes more aggressive. So, the operation is required. Recently we experienced a case of FAP, presenting with papillary thyroid carcinoma, and reported with a brief review of literatures.

대동맥 판막 치환술 후 반복되는 Acinetobacter baumannii 균혈증의 원인이 된 대동맥염 1예

정용필,김성철,송은희,장은영,김은경,김윤지,성흥섭,김미나,최상호,우준희,김양수 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

감염성 대동맥염은 흔하지 않지만 매우 위중한 질병으로 Salmonella so.와 S. aureus가 주된 원인균이다. 아직까지 병원내 감염의 주요 원인균인 Acinetobacter baumannii에 의한 감염성 대동맥염은 보고된 바가 없었다. 저자들은 대동맥 판막 치환술을 시행받은 76세 남자 환자에서 적절한 항생제 투여에도 반복되는 A. baumannii 균혈증의 원인이 감염성 대동맥염으로 진단되었던 1예를 경험하였기에 보고하는 바이다. Infectious aortitis is an uncommon yet, life threatening disease. Early surgical treatment and prolonged antibiotic therapy is crucial to survival. Salmonella sp. and Staphylococcus aureus are the most common organisms isolated. There is no case report of infectious aortitis caused by Acinetobacter baumannii, which has recently emerged as a major cause of health care-associated infections. Here, we describe a 76-year-old male with infectious aortitis who experienced recurrent bacteremia due to A. baumannii in spite of adequate antimicrobial therapy after aortic valve replacement.

AAC를 이용한 PECS(사진 교환 의사소통 체계) 중재가 정신지체아동의 사물요구하기 수행에 미치는 효과

송은주 국립특수교육원 2002 특수교육연구 Vol.9 No.1

본 연구는 구어사용에 제한을 받은 중도정신지체아동에게 AAC를 이용한 PECS 중재을 사용하였을 때, 정신지체아동의 의사소통기능 중 사물요구하기 기능의 습득 및 일반화와 유지가 이루어지는지를 살펴보고, 더불어 PECS체계가 적절한 사물요구하기 뿐만 아니라 발화하기에도 영향을 미치는지 알아보고자 하였다. 본 연구는 표현언어가 1세 미만인 중도정신지체 아동 네 명을 대상으로 대상자간 중다 간헐기초선 설계로 기초선, 중재, 일반화, 유지단계로 실시하였다. 본 연구결과 첫째, AAC를 이용한 PECS중재에서 중도정신지체아동들의 적절한 사물요구하기 수행이 습득 및 유지, 일반화되었고 둘째 AAC를 이용한 PECS중재로 아동들의 발화하기의 습득이 향상되었다. 이에 본 연구의 결과가 갖는 교육적 시사점 및 제한점을 논의하고 앞으로의 연구에 대해 제언하였다. The purpose of this study is to investigate the effects of PECS intervention using AAC(Augmntative and Alternative Communication) in requesting objects of young children with mental retardation. Four young children with mental retardation who were in nonverbal language and showed few conventional forms of requesting objects participated in this study. Using Multiple probe design across subjects, The percentage of requesting objects was measured. The following questions were addressed : (1) The acquisition, generalization and maintenance of reasonable requesting objects with PECS intervention using AAC (2) The increase of verbal language in requestion function through PECS intervention using AAC (3) The generalization to new objets, adults and place of reasonable requesting objects. The results of this study were as follows : First, Through PECS intervention using AAC in requesting objects of young children with mental retardation, the level of advanced performance in requestion objects was increased. Second, The level of verbal language with PECS intervention using AAC was increased. Third, The increased level of advanced performance in requesting objects was generalized to new objects, adults, and place. The results from this investigation suggest that PECS intervention using AAC is effective in requesting objects of young children with mental retardation

어린이 김치 표준화에 대한 연구(1) : 어린이 김치의 담금법 개발 Development of the Preparation of Kimchi for the Children

송영옥,전영수,권명자,빈성미,김은희,문정원,김명 부산대학교 가정대학 1995 家政大學硏究報告 Vol.21 No.-

The purpose of this study is reporting the results of first trial for the standardization of children's kimchi in terms of brining standardization, development for the recipe ad pannel test for the children's kimchi. In order to develop the standard recipe for children's kimchi, our research team have visited kimchi factories, temples and houses located in Pusan and Kyung-Sang Nam Do province. Three kinds of chinese cabbage kimchi (hamyang, haeundae, and jinrae kimchi named by region where we collected) which got the top three highest score in panel testing was selected. The original recipes of these kimchi were sightly modified to prepared the kimchi at laboratory. Among three of them, hamyang kimchi which contained dried anchovy power was selected as a model kimchi for development of the children's kimchi recipe. We find out that the optimal salt concentration of brined cabbage and kimchi for the children's kimchi (sliced style kimchi, approximately 2.5X3cm a piece) that showed the hightest pennel score were approximately 1.5% and 2.0%, respectively. The salt concentration of brined cabbage became 1.5, 1.43, and 1.60% after 60 min at 10% brining solution, 45 min at 12% and 30 min at 15%, respectively. The developed recipe used for the children's kimchi at our team is as follows. The major ingredients used for the preparation of kimchi is brined sliced chinese cabbage (salt concentration is 1.5%) 1kg galic 11g, ginger 5.0g, red pepper powder 20.0g, fermented anchovy juice 25.0g, fermented shrimp juice 5.0g dried anchovy and sea weed extracts 30.0g, anchovy power 2.4g glutinious rice gel 40.0g, starch syrup, 10.0g, and apple juice 22.5g. The total acceptability test of developed children's kimchi (test kimchi) was carried out with 84 of 6th grade student during lunch time at elementary school in Pusan where has a school lunch program. Sixty nine percent of student answered test kimchi is very good, 25% of them said it is fair, and only 6% of students answered they didn't like test kimchil. However, for the kimchi supplied from school at lunch, 52% students answered the kimchi is good, 26% of them said it is fair, and 22% of them said they don't like school supplied kimchi. This result tells us that the test kimchi is better than school supplied kimchi and the test kimchi can be developed further as a children's kimchi.

중증 두부 손상 환자의 예후 인자에 대한 임상 분석 : Clinical Prognostic Factors

송준석,하은주,이종수,이승재,박효일 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.2

A clinical analysis was carried out retrospectively with 54 cases of severe head injured patients(Glasgow Coma Scale score 3 to 8) in identify prognostic factors. Unawareness for over 1 month, abnormal pupillary reaction, abnormal motor response pattern, and diffuse head injury with basal cisternal compression prove to be the most reliable predictors. Individual predictions of outcome provide a powerful tool for assessing the relative efficacy of alternative treatments.

뇌 경막하 축농

송준석,하은주,이종수,이승재,박효일 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12

Subdural empyema is relatively uncommon condition. characterized by purulent collection in the subdural space. Having presented a fulminating clinical course with very high morbidity and mortality. it is conconsidered as a neurosurgical emergency. In recent years, the mortality of subdural empyema has significantly diminished due to rapid diagnosis, aggressive antibiotic therapy and timely surgical intervention. The condition remains a diagnostic challenge ; CT scanning cannot be relied upon although the use of intravenous contrast and more modem scanner has improved the diagnostic yield. MRI offers earlier and more accurate diagnosis of computed tomographically suspected lesion. We report cases of subdural empyemas. which were diagnosed with MR and operaton. We treated one case successfully and the other postoperative case unsuccessfully owing to a delayed diagnosis.