혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

시계열 온실 환경 인자와 딸기 생육 특성간의 상관성 연구

이현규, 정동욱, 이정규, 김수아, 이동훈 忠北大學校 農業科學硏究所 2017 農業科學硏究 Vol.33 No.1

The purpose of this study is to investigate the correlation between the growth conditions of the crops and the environment of the greenhouse according to the variation of temperature inside the greenhouse. The environment sensor (i.e. temperature and humidity sensor) which were installed in the greenhouse were collected as environmental factor. The growth index of strawberry were measured to fruit length, fruit diameter, fruit weight, sugar content and yield according to the average temperature and humidity. The correlation between the environmental factors in the greenhouse and the growth index of strawberry was investigated by simple linear regression. The production of strawberry showed a slight difference in each location, but the production of strawberry was increased in the area close to the heater.

간호 학생의 임상실습 효율을 위한 기초 조사 연구

이애경,김정애,주미경,정안순,배경진,김정수,이정애,장은정 경복대학 2000 京福論叢 Vol.4 No.-

임상실습 교육은 간호이론을 실무에 적용하는 기회를 제공하는 과정으로서 임상실습이 간호교육의 중요한비중을 차지하고 있다는 것은 주지의 사실이다. 이러한 중요성에도 불구하고, 임상실습 교육에 즉각적인 해결이 어려운 많은 문제점이 있음도 이미 알고 있는 사실이다 이에 임상실습 교육의 기초 자료로 활용되고 있는 실습목록표에 대한 간호 학생들의 실습목표의 명확한 이해와 더불어 이론과 실습의 연계성을 강화시키고자 하였다. 성인간호, 모성간호, 이동간호 3개 영역 모두에서 공통적으로 기본임상간호 항목이나 기본간호술과 관련된 항목에서 직접수행의 빈도가 높았고 숙련된 기술적인 처치나 전문성을 필요로 하는 항목에서는 관찰과 수행경험이 부족한 것으로 나타났다. Clinical performance is not only the process of providing the opportunity for applying nursing theory into practice but also it is a well-known fact that clinical performance is an important part in nursing education. lnspite of this importance, it is also true that many problem with no immediate solution exist in clinical performance of nursing students. thus, through measuring and analyzing the degree of clinical experience of the nursing students, on the nursing checklist that is being used as the basic guide in clinical education, we tried to clearly understand the objectives of clinical performance and to emphasize the connection between theory and clinical performance. The results of the study showed that the frequency of directly performing tasks was high in all areas of adult health nursing, maternity nursing, and child nursing for the items of basics clinical nursing and items related with basic nursing techniques, and that the experiences of observation and execution were lacking in the items needing skilled treatment or speciality.

1996-1997년 겨울철에 유행한 인플루엔자의 임상역학적 분석 및 원인 바이러스의 분리

김수정,정규영,이용화,기창석,이남용,이상일,김지희 대한감염학회 1997 감염 Vol.29 No.4

목적: 인플루엔자는 매년 겨울 전 세계적인 유행을 일으키는 급성 호흡기 질환으로 높은 이환률과 사망율을 보인다. 국내에서도 1996-1997년 겨울철에 다수의 보고가 있었으나 아직 체계적인 감시가 이루어지고 있지 못하다. 저자들은 이 기간 동안 인플루엔자 바이러스 감염의 역학적 특성과 임상상을 연구하여 인플루엔자 감시의 기초 자료를 제공하고자 하였다. 방법: 1996년 10월부터 1997년 4월까지 삼성서울병원 임상병리과에 인플루엔자 바이러스 배양 검사가 의뢰된 모든 검체를 대상으로 인플루엔자 바이러스의 분리율과 유행 양상, 그리고 환자들의 임상상을 후향적으로 조사, 분석하였다. 결과: 총 461명의 환자로부터 525례의 검체가 의뢰되어 총 98명의 환자로부터 인플루엔자 바이러스가 분리되었다. 인플루엔자 A형은 54명의 소아 환자와 4명의 소아 환자로부터 분리되었다. 아형과 항원 특성 검사를 시행한 31례의 인플루엔자 A형 중 한 예에서 A/Wuhan/359/95 유사주로 확인되었고 12례의 인플루엔자 B형 중 5례에서 B/Guangdong/8/97 유사주로 확인되었다. 인플루엔자의 유행 양상은 3월과 4월 중순, 두 번의 인플루엔자 최고 분리 시점이 관찰되었고, 가장 많은 불리 빈도를 보인 연령층은 인플루엔자 A형의 경우 1세 미만이었고 인플루엔자 B형의 경우 3-5세였으며 폐렴이 가장 흔한 호흡기 질환이었다. 결론: 저자들은 3차 의료기관에서 분리된 인플루엔자 바이러스에 대한 역학적, 임상적 특성을 연구하였다. 지역사회에 대한 광범위한 연구가 아니므로 국내의 전반적 상황과는 차이가 있을 것으로 생각되지만 우리나라에서도 인플루엔자 바이러스의 이환률이 낮지 않을 것으로 생각되며, 보다 조직적이고 전국적인 인플루엔자 감시가 이루어져야 할 것으로 사료된다. Background: Although influenza has been a leading cause of global morbidity and mortality, we have few data regarding the epidemioloical and clinical characteristics of influenza activity in korea. Since an outbreak of influenza was recognized during winter of 1996-1997, we analysed the epidemiological and clinical features of influenza activity in the hospital seeting. Methods: All clinical specimens requested for isolation of influenza virus at Samsung Medical Center from October 1996 to April 1997 were included. Mardin-Darby canine kidney (MDCK) cell line was used for virus culture. Isolated viruses were confirmed with immunostain followed by subtyping. The demograpic and clinical characteristics of the patients were reviewed retrospectively. Results: Ninety eight influenza viruses were isolatd from 461 patients (21.3%). Influenza A and B virus were isolated from 58 (54 children and 4 adults) and 40 pediatric patients, respectively. One of 31 influenza A viruses was confirmed as A/Wuhan/359/95-like strain and 5 of 12 influenza B viruses were confiremd as B/Guangdong/8/97-like strains. Two distinctive peaks of influenza activity were recognized and the most common age of patients was less than 1 year for influenza A, and 3 to 5 years for influenza B. Common lower respiratory infections were pneumonia followed by croup, bronchiolitis and laryngitis. Conclusion: We analyzed the epidemiological and clinical features of influenza activity during winter of 1996-1997. Although this study was performed not in the community but in the hospital setting, the morbidity caused by influenza may not be low in Korea. Therefore, nationwide surveillance for influenza activity is warranted.

대학생 흡연자의 금연경험에 따른 건강신념차이

구정일,김민정,김동희,백정희,안현실,은가희,우혜령,이명희,이수현,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

It has been generally known that smoking is one of the worst factor increasing disease and mortality in human health since in 1950's and nowadays. But regardless of various proofs about social or economical problems due to smoking, current smoking rate has not been decreased in our country. Until now, most of tobacco use and its addiction researches have been focused on the adolescent or adult women smokers not on the university students. Therefore, the purpose of this study was to investigate smoking cessation of university smokers and analyze the health belief-perceived sensitivity, severity, benefits and barriers- difference, then to provide basic data for effective smoking cessation strategy for university smokers. The subjects were comprised of 181 university smokers from 15 universities in Seoul. The data were collected by structured questionaires. The questionaires were designed to measure general characteristics, smoking cessation and health belief, based on Ahn(2003)'s result on the Study of Smoking attitude, Behavior and Smoking Cessation of Adult Male and Lee(1987)'s result on Relationships Between the Health Belief Model and Smoking Habits. The data were collected from May 5 to 16. The collected data were analyzed by SPSS program. The actual number, percentiles, means, standard deviation, t-test and ANOVA were done. The result of this study were as follows; 1. The general characteristics of the subjects of this study The range of age was from 18 to 34 and the averaging age was 23. The subjects of this study were 141 males and 40 females. The religions were Christianity 25.4%(46), Buddhism 12.7%(23), Catholic 23.2%(42), no religion 37.0%(67). The residential forms were living with family 59.1%(107), cooking food for oneself 28.7%(52), dormitory 5.0%(9), boarding house 1.7%(3). Smoking starting age were university 43.1 %(78), high school 29.8%(54), middle school 14.9%(27), in the army 6.1 %(11), elementary school 1.1 %(2). 2. The smoking cessation of the subjects 80% of current smokers showed quitting smoking decision and 20% have not tried. The frequency of quitting smoking decision were from 1 to above 8 and mean was 3.06. As for smoking cessation plan, 54.7%(99) current smokers answered yes, 3.9%(7) said no, 35.4%(64) had no idea and 6.1 %(11) didn't answer. As for the reason of never quitting smoking decision, 71.42%(25 among total 35) have no need to quit smoking and the others said difficulty of smoking cessation. As for the main reason of smoking cessation decision, 54.7%(99) answered for the health, 7.2%(13) family advice, 15.5%(28) girl/boy friend's advice, 1.7%(3) to save money. As for the reason to fail smoking cessation, 56.7%(68) were will-lack, 17.5%(21) stress, 15%(18) smoking mood, 10%(12) withdrawl symptom. As for the smoking cessation method, 85.0%(125) were oneself-will, 2.7%(4) way acquired by mass-media, 2%(3) doctor's prescription, 2%(3) religion's help, 0.7%(1) smoking cessation school. As for the difficulty in smoking cessation, 42.2%(62) were drinking meeting, 23.1 %(34) no alternative of stress release, 12.2%(18) withdrawl symptom, 11.6%(17) having nothing to do, 7.5%(11) friend's encouragement. As for the most difficult cigarette to quit, 67.8%(99) were all-day smoking except the first smoking in the morning, 32.2%(47) the first smoking in the morning. 3. Health belief as for general characteristics Gender - The total point in benefits showed higher in male(28.5177) than female(26.6750). There was significant difference(t=.778, p<.05). The total point in health belief showed higher in male (105.8298) than female(l00.5000). So there was significant difference(t=.345, p<.05). Age - There was significant difference in benefits between age(10's-25.83, 20's-28.39, 30's-32.00)(F=3.73, p<.05). Smoking starting age - There was significant difference in total point of sensitivity and health belief(sensitivity F=4.00, p<.Ol, health belief F=2.843, p<.05). As for sensitivity, subjects who started smoking in the army showed the highest(33.36) and ones in high school showed the lowest(26.96). The total point in health belief showed the highest in elementary school(l19.00) and the lowest in high school(100.98). 4. Health belief as for smoking cessation There was significant difference in health belief as for smoking cessation(t=0.189, p=0.OO2). Sensitivity point showed higher in smoking quitting trial smokers(29.2) than non-trial smoker (26.9). Severity point showed higher in trial smokers (30.7) than non-trial smokers(28.9). Benefit point showed higher in trial smokers(28.6) than non-trial smokers(26.2). There was no significant difference in barriers point.

結晶學에 關한 論題(Ⅳ)

徐日煥,李珍昊,秋錦洪,李正秀,成百石,林星秀,柳保盈,朴晶蘭 충남대학교 자연과학연구소 1993 忠南科學硏究誌 Vol.20 No.1

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.

Rocuronium의 애별투여방법이 모지내전근의 이완에 미치는 영향

최영균,김승수,이원진,조광래,이상은,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 인제대학교 2009 仁濟醫學 Vol.30 No.-

Objective : There are controversies in pnmmg technique of rocuronium whether it can or can't shorten the onset time. We want to compare the effects of two different priming doses and intervals of rocuronium. Materials and Methods : After giving propofol, 50 patients were randomly assigned to 5 groups. Group I received a placebo, followed 3 min later by rocuronium 0.6 mg/kg. Priming doses and intervals of Group II, Ill, N, V were 0.06 rng/kg and 2 min, 0.12 mg/kg and 2 min, 0.06 rug/kg and 3 min, 0.12 mg/kg and 3 min, respectively. Total dose of rocuronium was 0.6mg/kg. Train of four (TOF) count or ratio and 1st twitch height of TOF (T1) were monitored with 15 secondsintervals. TOF ratio of each groups just before bolus injection, duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were compared. Results : Duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were decreased in priming groups compared to Group 1 (P < 0.01) In group V, significant depression of TOF ratio just before bolus injection was seen (P < 0.05). Conclusion : Priming technique with rocuronium is effective method to shorten the onset of neuromuscular block. But priming dose of rocuronium itself could cause hypoxia and aspiration in awake patients and should be used carefully. Priming dose of rocuronium 0.06 mg/kg and 2 minutes interval maybe relatively safe method.

Wireless pressure sensor integrated with a 3D printed polymer stent for smart health monitoring

Park, Jongsung,Kim, Ji-Kwan,Kim, Dong-Su,Shanmugasundaram, Arunkumar,Park, Su A,Kang, Sohi,Kim, Sung-Ho,Jeong, Myung Ho,Lee, Dong-Weon Elsevier 2019 Sensors and actuators. B Chemical Vol.280 No.-

<P><B>Abstract</B></P> <P>The primary objective of this study was to deploy a promising wireless pressure sensor system capable of monitoring real-time biological signals in an experimental object. MEMS-based micromachining technology was used to fabricate the proposed SU-8 wireless pressure sensor. The sensor utilizes a capacitor-inductor resonant circuit that can operate the sensor without any external power supply. The variable capacitor in the pressure sensor is designed to change the resonance frequency (130, 183 MHz) in response to applied pressure. The fabricated wireless pressure sensor was integrated into a polymer-based smart stent to minimize the discomfort of medication administration and hospital visits. A 3D bio-printing-based manufacturing technique was employed for the production of a smart polymer stent with complicated shapes. The proposed method is considerably more comfortable than the conventional metal stents fabrication process. The polymer smart stent made of the biocompatible polycaprolactone (PCL) material which can be fully absorbed by the body after a medication period. After integrating the fabricated wireless pressure sensor with the polymer smart stent, various basic experiments such as the working distance of the sensor were performed using a simple experimental setup. The biocompatibility of the proposed polymer stent and the wireless pressure sensor was also successfully confirmed using an experimental animal. The preliminary investigation results indicate that the proposed wireless sensor can be used to obtain necessary information in various parts of the human body as well as the stent.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Fabrication of SU-8 based wireless pressure sensor for battery-less operation. </LI> <LI> Manufacturing of biodegradable polymer stent using 3D printing technique. </LI> <LI> Integration of wireless pressure sensor into polymer stent for real-time blood pressure monitoring. </LI> <LI> Verification of the biocompatibility of smart stent and its operation with experimental animals. </LI> <LI> Continuous measurement of blood pressure change in animals for more than 3 months. </LI> </UL> </P>

다발성 뇌경색이 합병된 Pasteurella multocida 심내막염 1예

이남용,고재현,백경란,송재훈,천정학,김성민,이혁,김수정 대한감염학회 1997 감염 Vol.29 No.6

저자들은 평소 건강하였던 환자에서 동물과의 접촉없이 P.multocida에 의한 세균성 심내막염이 발생하여 임상 경과 중 다발성 뇌경색이 합병되었으나, 항균제 투여만으로 완치가 되었던 증례를 경험하였기에 문헌 고찰과 함께 이를 보고하는 바이다. In recent years, an increasing number of infections with Pasteurella multoida in human have been reported, causing a wide range of systemic illness. Infective endocarditis with P.multocida, however, is still quite rare. Recently we experienced a cases of P. multocida endocarditis in a 26-year old man who was admitted because of fever and headache. He denied any recent contact with animals. P. multocida was identified from blood cultures and echocardiography showed mitral regurgitation and vegetations on mitral valve area. He became stuporous on the fourth hospital day and the brain MRI showed acute cerebral infarction. He was treated with penicillin intravenously for six weeks, which successfully controlled clinical features of infections. To our knowledge, this is the first case of P. multocida endocarditis complicated with cerebral infarction in Korea.