노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

폐경전 여성에서 혈중 성호르몬결합글로불린 농도와 산화스트레스의 연관성

최영주,오지영,홍영선,성연아 대한내분비학회 2004 Endocrinology and metabolism Vol.19 No.1

연구배경: 여성에서 남성화의 간접적인 지표인 SHBG 농도는 인슐린저항성과 관련되며, 심혈관질환의 위험을 예측할 수 있는 지표로 보고되었다. 심혈관질환의 위험인자들이 산화스트레스의 증가와 관련되며, 최근 남성 호르몬의 증가와 인슐린저항성을 특징으로 하는 다낭성난소증후군 환자에서 성호르몬과 산화스트레스가 관련된다는 연구결과가 있다. 본 연구는 SHBG와 산화스트레스의 연관성을 규명하기 위하여 시행되었다. 방법: 당뇨병, 고혈압, 심혈관질환의 과거력 및 흡연력이 없는 폐경전 여성 46명을 대상으로 하여 방사 면역계수법으로 SHBG를 측정하였으며, ox-LDL은 효소면역측정법으로, TAS 및 MDA는 분광광도계로 측정하였고, SHBG와 산화스트레스를 나타내는 지표들간의 연관성을 관찰하였다. 결과: 1. 정상내당능군과 내당능장애군간에 SHBG와 MDA 농도는 유의한 차이가 없었으며, TAS는 내당능장애군에서 정상내당군에 비해 유의하게 높았다(1.41±0.15 mmol/L, 1.30±0.17 mmol/L, p=0.034). 2. SHBG 농도는 비만군에서 비비만군에 비해 유의하게 낮았다 (56.6±34.2 nmol/L, 76.0±23.8 nmol/L, p=0.036). 3. SHBG 농도는 체질량지수 (r=-0.394, p=0.007), 당부하후혈당(r=-0.326, p=0.027), 허리둘레(r=-0.323, p=0.029), 허리 대 허벅지둘레비 (r=-0.308, p=0.037), 공복인슐린 농도 (r=-0.387, p=0.008), 내장지방면적 (r=-0.339, p=0.021)과 유의한 음의 상관관계가 있었고, 인슐린 감수성지표와는 유의한 양의 상관관계(r=0.397, p=0.008)가 있었다. 4. SHBG 농도는 MDA 농도 (r=-0.357, p=0.015) 및 ox-LDL 농도 (r=-0.367, p=0.014)와 유의한 음의 상관관계가 있었다. 5. 다중회귀분석에서 연령, 체질량지수, 당부하후혈당, 허리둘레, 공복인슐린 농도, 수축기 혈압, 고밀도지 단백콜레스테롤, 중성지방을 보정한 후 SHBG 농도는 MDA 및 ox-LDL에 유의하게 독립적으로 영향을 주었다. TAS에 영항을 주는 인자로는 공복인슐린 농도와 당부하후 혈당이 통계학적으로 유의하였고, SHBG는 유의한 관련성이 없었다. 결론: 폐경전 여성에서 SHBG의 감소는 산화스트레스의 증가와 관련되어 심혈관질환의 위험을 예견할수 있는 지표로 생각된다. Background: Low levels of sex hormone-binding globulin (SHBG), an indirect index of androgenicity, are associated with insulin resistance and cardiovascular risk factors. The risk factors of the cardiovascular disease are known to be related to oxidative stress. In recent reports, sex hormones were associated with oxidative stress in women with polycystic ovarian syndrome (PCOS), which is characterized by increased androgenicity and insulin resistance. with NGT. Methods: To investigate the relationship between sex hormones and oxidative stress, we examined the association of malondialdehyde (MDA), total antioxidant status (TAS), oxidized low density lipoprotein cholesterol (ox-LDL), and SHBG in 46 Korean premenopausal women. Results: 1. SHBG and MDA levels were not significantly different among the women with NGT and IGT. But, TAS was significantly lower (p=0.034) in the subjects with IGT than in the subjects with NGT. 2. The SHBG level was significantly lower (p=0.036) in obese women than in non-obese women. 3. The SHBG level was significantly inversely correlated with BMI (r=-0.394, p=0.007), post challenge glucose (r=-0.326, p=0.027), waist size (r=-0.323, p=0.029), waist-to-thigh ratio (WTR) (r=-0.308, p=0.037), fasting insulin level (r=-0.387, p=0.008), visceral fat area (VFA)(r=-0.339, p=0.021), and was significantly positively correlated with SI (r=0.397, p=0.008). 4. The SHBG level was significantly inversely correlated with levels of MDA (r=-0.357, p=0.015) and ox-LDL (r=-0.367, p=0.014). 5. In a multiple linear regression analysis, the SHBG level was a significant and independent factor for both MDA and ox-LDL. For TAS, the fasting insulin level and post challenge glucose were significant and independent factors. Conclusion: Increased androgenicity assessed by the decrease in serum SHBG levels is associated with the increase in MDA and ox-LDL. These results suggest that increased androgenicity in premenopausal women can contribute to the development of cardiovascular diseases via increased oxidative stress (J Kor Soc Endocrinol 19:48∼57, 2004).

고속 전철 Catenary/Pantograph계의 동특성 해석

최연선,정대현 成均館大學校 科學技術硏究所 1990 論文集 Vol.41 No.2

The vibrations in Catenary/Pantograph system should be avoided to assure the power collection in High-Speed train. Contacts between pantograph and trolley wire depend on various design parameters. To select good design parameters, analytical and numerical simulation were performed for a simplified model. The dynamic characteristics of tensioned wire subject to moving force was calculated using Laplace transform. And, a simulation program was developed to calculate the displacement of trolley wire using Euler method. The numerical results showed good agreements between two methods.

유절기 조기 상실 후 공간 상실

최병재,한연선,김성오,이종갑 大韓小兒齒科學會 2002 大韓小兒齒科學會誌 Vol.29 No.3

유치에서의 조기 상실은 부위에 따라 주된 원인이 다르다. 구치부의 조기 상실은 주로 치아우식증에 의해 일어나지만, 전치부에서 나타나는 조기 상실의 대부분은 유아가 서고 걷는 것을 배울 시기에 외상을 받아 유발되며, 다발성 우식증 등에 의해서도 일어날 수 있다. 유치의 조기 상실시 치열궁 길이 감소가 나타날 경우에는 계승 영구치의 맹출을 방해하여 영구치의 총생, 매복 및 치열궁 비대칭 등을 유발할 수 있으므로, 공간 유지에 대한 고려가 필요하다. 유구치가 조기 상실된 경우에는 인접치아의 근심 또는 원심 이동으로 공간 상실이 유발되므로, 공간유지장치의 장착이 필수적이다. 그러나, 유절치의 경우에 있어서는 치아간의 접촉이 긴밀하거나 총생이 있는 유치열이 경우와 유견치의 맹출 전에 유절치가 상실된 경우에는 공간 상실이 일어날 수 있으나, 그 이외에 치간 공간이 있는 유치열이 경우, 유견치의 맹출 후에 유절치가 상실된 경우에서는 공간의 상실이 거의 없는 것으로 알려져 있다. 따라서 유절치 조기 상실 시에는 주로 공간유지 목적보다는 심미, 발음장애, 치아결손부분으로의 혀내밀기 등의 구강습관 방지 등의 목적으로 장치의 장착이 권장되어져 왔으며, 유절치 조기 상실시 공간 상실 문제에 대한 증례보고 또한 많지 않다. 본 증례들은 연세대학교 치과대학병원 소아치과에 내원한 환자에게서 유절치의 조기 발거로 인해 장기적 관찰 결과 공간 상실이 유발되었기에 이를 통하여 유절치 조기 상실시 공간 상실 가능성에 대해 보고하고자 한다. The primary cause of missing teeth vary depending on the region. The loss of posterior teeth is mainly due to dental caries, whereas that of the anterior teeth occur primarily due to trauma at the age of standing and walk-ing and secondarily from the rampant dental caries. Particularly, reduction of the arch length in the cases of premature loss of primary teeth may compromise the eruption of succedaneous permanent teeth. This may result in crowding and impaction of the permanent teeth, and asymmetry of arch, thus a careful consideration for space maintenance should be made in such cases. Space maintainer is required in the case of premature loss of primary posterior teeth, because space loss result from the approximate and centrifugal movement of the neighboring teeth. Generally, in the case of primary in-cisor, space loss occurs when 1) tooth contact is relevant, 2) crowding in primary dentition is present, and 3) a primary incisor is lost before the eruption of primary canine. Contrarily, in the case of primary dentition with in-terdental space, space loss will not be observed, mostly when a primary incisor is lost after the eruption of pri-mary canine. Thus, using a space maintainer in cases of premature loss of primary incisor has been introduced primarily not for the purpose of space maintaining but for an aesthetic purpose, prevention of parafunctional oral habits such as tongue thrust, and of pronunciation. Additionally, few case studies have been reported of space loss in cases of premature loss of primary incisor. This study is to report cases of the space loss following the premature loss of primary incisors observed in chil-dren.

간극내 외팔보 운동의 실험해석

최연선,김경래 成均館大學校 科學技術硏究所 1995 論文集 Vol.46 No.1

Many mechenical systems experience intermittent motion of contact and separation due to the existence of clearances which may cause from manufacturing tolerances, wear, or backlash. The complex nonlinear dynamic responses within such systems can produce proper functioning or loss of performance as like wear, fretting, fatigue, as well as high noise level. In this study, the dynamic responses of a cantilever beam motion in clearance are measured with a simplified experimental set-up and the experimental results are compared with those of numerical harmonic balance method and those of numerical intergration. The results show that the cantilever motion in clearance can be modeled as a piecewise-linear oscillator, which characterizes nonlinear system. As a result, the nonlinear responses of jump phenomenon and higher harmonics are investigated experimentally and analytically. Also, the effects of the variation on system parameter were studied.

SJO¨GREN'S SYNDROME 환자에게 즉시 임프란트 술식을 행한 치험례

최정환,손동석,이지연,이윤서,안선희,이재목 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5

The old edentulous patients experience xerostomia commonly. They have considerable difficulty in wearing tissue-supported prosthesis and high risk rate of caries. One of them is Sj□gren's syndrome patient. Sj□gren's syndrome is a chronic inflammatory autoimmune disorder that results in a lymphocyte-mediated destruction of exocrine glands. We planned to place implants immediately after extraction in this case of autoimmune disease. The advantages of immediate implant placement include considerable decrease in time from tooth extraction to placement of the final prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plan. We present a case of Sj□gren's syndrome patient treated with immediate implant placement & immediate loading in anterior region and immediate implant placement in posterior region.

장구균의 동정에 대한 PCR 방법의 유용성

최연화,이영선,김홍빈,김치경,김봉수 대한감염학회 2001 감염 Vol.33 No.2

Background : Enterococci are important cause of nosocomial infections. Recently, vancomycin-resistant enterococci (VRE) has been increasingly reported as significant nosocomial pathogens. Therefore, accurate identification of enterococcal species is a prerequisite step for the appropriate antibiotic treatment and epidemiologic surveillance. We wanted to know the usefulness of PCR method compared with Vitek automatic identification system. Methods : Totally 105 isolates were identified on the species level by Vitek (GPI card and software version R06.1), methyl-α -D-glucopyranoside test, and PCR methods. Results : Among 105 enterococcal isolates, 59 were identified as E. faecium, 11 E. faecalis, 6 E. gallinarum by Vitek. But 29 isolates (28%) were unidentified. Subsequently all of these isolates were analyzed by PCR, the results of which were as follows : 17 E. faecium, 5 E. casseliflavus, 7 E. gallinarum. Two isolates identified as E. gallinarum by Vitek were reidentified as E. casseliflavus by PCR and other methods far phenotypic characterization. Conclusoin : PCR method was more accurate and sensitive than Vitek for the identification of enterococci species. (Korean J Infect Dis 33:123∼127, 2001)

모드해석에서의 경계조건 영향

최연선,박근영,배성준 成均館大學校 科學技術硏究所 1997 論文集 Vol.48 No.1

Modal analysis is a fundamental procedure to analyze the dynamic characteristics of structures or machines. Modal analysis is composed of theoretical modal analysis using finite element method and experimental modal analysis. The discrepancy between these two makes modal analysis difficult and ususally comes from misunderstandings on boundary conditions of the structure. Boundary condition effect in modal analysis is investigated theorectically and experimentally in this study for a rod and a beam. The result shows that boundary condition affects on lower modes, but can be ignored for higher modes. Boundary condition can be modeled by a spring and a damper having finite values. Using this spring and damper model, the boundary conditions of a theoretical modal analysis model can be corrected by comparing the results of experimental modal analysis.

Trichloroethylene의 대사 및 간독성에 diethyldithiocarbamate가 미치는 영향

최병선,박정덕,홍연표 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.3

목적 : 이 연구는 TCE 급성 폭로시 TCE의 대사 및 급성 독성작용과 diethyldithiocarbamate(DDTC)가 TCE의 독성 작용에 미치는 영향을 밝히기 위하여 시행하였다. 방법 : Sprague-Dawley계 수컷 쥐를 DDTC로 전처리한 군과 saline으로 처리한 군으로 나누고, 여러 농도(600, 1,200, 2,400 ㎎/㎏ body weight)의 TCE을 경구투여한 후 12시간에서 체내 각 조직의 TCE 및 TCE 대사물의 농도와 조직병리학적 변화소견을 관찰하였다. 결과 : CYP2E1 효소는 DDTC를 전처리 한 군에서 현저하게 감소하였으며, TCE만 투여한 군에서는 투여량이 증가함에 따라 CYP2E1이 유의하게 증가하여 TCE이 CYP2E1을 유도하는 것을 알 수 있었다. TCE와 TCEOH이 체내 농도는 간에서 가장 높았고, TCA의 농도는 혈액에서 가장 높게 나타났다. DDTC로 전처리한 군에서는 TCE 체내 농도가 TCE만 투여한 군보다 현저하게 높게 나타났고, TCA와 TCEOH의 농도는 현저하게 감소하여, DDTC가 TCE의 대사를 현저하게 억제함을 알 수 있었다. 조직병리학적 소견으로 볼 때, TCE 투여군에서만 간 중심소엽에 국소적인 괴사가 관찰되었고, DDTC 전처리후 TCE 투여군에서는 아무런 임상소견도 관찰할 수 없었다. 결론 : DDTC는 TCE에 의한 급성 간독성에 보호효과가 있는 것으로 나타났는데 이는 DDTC가 TCE의 대사를 억제하기 때문인 것으로 생각된다. Objectives: The purpose of this study was to evaluate the trichloroethylene(TCE)metabolism, acute toxicity, and the effects of diethyldithiocarbamate(DDTC)on the acute toxicity in TCE-intoxicated rats. Methods: TCE was administered orally at doses of 600, 1,200 and 2,400 ㎎/㎏ of DDTC. 12 hours after administration of TCE, the concentrations of TCE. trichloroacetic acid (TCA) and trichloroethanol(TCEOH) in the blood and solid organs, and the histopathological changes in each organ were examined. Results: The level of CYP2E1 markedly decreased in the DDTC-pretreated groups. The CYP2E1 content in the TCE-treated rats increased in a dose-dependent manner. The concentrations of TCE and TCEOH, than the rats pretreated with saline. These findings indicated that CYP2E1 was important in the metabolism of TCE. From the histopathological findings, centrilobular necrosis was observed in the livers of the TCE-treated rats, but no significant change was found in those rats pretreated with DDTC. Conclusions: DDTC is considered to be effective in protecting TCE-induced hepatic damage because it inhibits the TCE metabolism.