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      • KCI등재
      • KCI등재후보

        기관내관 소독방법 개선에 따른 간호업무 시간단축 및 비용 절감 효과

        이행선,김해리나,김은숙,김보람,성선숙 한국의료QA학회 2008 한국의료질향상학회지 Vol.14 No.1

        Background: The purposeof innercannula is to protect the upperair wayand permitair to pass freely, in addition, to provideendotrachealsuction, artificial respiration and to maintain adequate oxygensaturation. The tubeneeds to be sterilizedformaintenanceand cleannessof air wayand forprevention of bronchospasm. However, it has been reportedthat there is no guideline forsterilization and manyhospitalsconducttheirown sterilization methods, forexample, oncea day(13's generalhospital), three timesa day(TheCatholic University of Korea STMary's hospital) or evenno cleansing. Consequently, the QI team of our hospitalsuggested the SOP(standard operatingprocedure) of sterilization and evaluate cost and timeeffect in nursing. Method: 1) Benchmarking of 13's neurosurgery departmentof generalhospital in Seoul 2) Investigation of test recordsof sputumculture from patientswith intubation for tracheotomy 3) Checkof resultsof 02 Sat. monitoring to confirm of maintainingopenedair way Result : 1) Improvement of process: decrease of excess sterilization of inner cannula (from 3 timesa day to oncea day) 2) Costeffects: saving over10 million wonper oneyear 3) Providing better nursing: time effects (30 mina day) permit to conductmorenursing activities Conclusion: Itcan get Costand timeeffectsin nursing withimproved sterilization methodof innercannula It needs to do researchon improvement of the monthly exchangeprotocol of outercannula and providesupportingdata forthe properexchangeschedule. The resultof additionalmicroorganism detection frompatients withnewprocessneeds to be evaluated furthermore.

      • Lutembacher 증후군 환자 증례 보고

        김성범,서정주,곽철훈,김상민,이보라,민선경,황은구,김용인,조욱현,최석구 인제대학교 2008 仁濟醫學 Vol.29 No.-

        Lutembacher's syndrome is rare combination of mitral stenosis (MS) and atrial septal defect (ASD). The hemodynamic interplay between the MS and ASD leads to wide variation of clinical presentation. Here we describe a 43-year-old female with Lutembacher's syndrome and tricuspid regurgitation with pulmonary hypertension, who underwent direct closure of ASD and tricuspid valvuloplasty successfully. We also reviewed other literatures in an effort to increase awareness of this condition.

      • KCI등재

        디지털 측방두부규격방사선사진과 MDCT의 3차원 재구성 영상을 이용한 합성측방두부규격방사선사진의 계측치 비교 및 머리 위치가 미치는 효과

        김미자,최보람,허경회,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.3

        Purpose : To investigate the reproducibilities and compare the measurements in digital and MDCT-synthesized cephalometric radiograph, and to investigate the effect of head position on the measurement during imaging with MDCT. Materials and Methods : Twenty-two dry skulls (combined with mandible) were used in this study. Conventional digital cephalometric radiograph was taken in standard position, and MDCT was taken in standard position and two rotated position (10°left rotation and 10°right tilting). MDCT data were imported in OnDemand?? and lateral cephalometric radiograph were synthesized from 3D virtual models. Two types of rotated MDCT data were synthesized with default mode and with corrected mode using both ear rods. For all six images, sixteen angular and eleven linear measurements were made in V-Ceph?? three times. Reproducibility of measurements was assessed using repeated measures ANOVA and ICC. Linear and angular measurements were compared between digital and five MDCTsynthesized images by Student t-test. Results : All measurements in six types of cephalometric radiograph were not statistically different under ICC examination. Measurements were not different between digital and MDCT-synthesized images (P> .05). Measurements in MDCT-synthesized image in 10°left rotation or 10°right tilting position showed possibility of difference from digital image in some measurements, and possibility of improvement via realignment of head position using both ear rods. Conclusion : MDCT-synthesized cephalometric radiograph can substitute conventional cephalometric radiograph. The error on head position during imaging with MDCT have possibility that can produce measurement errors with MDCT-synthesized image, and these position error can be corrected by realignment of the head position using both ear rods. (Korean J Oral Maxillofac Radiol 2009; 39 : 133-47)

      • 인장력을 받는 ㄷ형강 고력볼트 접합부의 감소계수 U값에 관한 연구

        김진숙,표영석,나승욱,신영록,김보영,최문식 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

        The purpose of this paper is to examine the influence of reduction coefficient according to the limit state design of steel structures in the bolted joints of tension members. It was carried out the tensile testing about high strength bolted connections performed in structural steel channels. Considered parameters are the number and row of bolts, the connection length, connection eccentricity of the specimen. The test results showed that failures generally came (a) classic net section, (b) block shear failures. We found that the professional factor, obtained by calculating the test failure load divided by the nominal specification strength, is lower than 1.00. We thought that the reason was the moment produced by eccentric loading depends upon the connection geometry as well as the rotational stiffness of the connection.

      • 신경회로망을 바탕으로 한 확률적 최적화 실험계획법

        김보경,이석훈 충남대학교 1991 忠南科學硏究誌 Vol.18 No.1

        This paper studies the schemes to apply the Simulated Annealing algorithm that is used as an optimization stchnique for neural Network as a technique for finding the optimal design of experiments and compares this implemented results with those of Branch and Bound algorithm which completely gurarantees the optimality in order to evaluate their performance. In this comparison, D-optimality is used as a criterion for optimization.

      • KCI등재후보

        구진상괴사성 결핵진 3례

        손보성,송준영,정재봉,김병천,이상숙,류영욱,이규석 啓明大學校 醫科大學 1994 계명의대학술지 Vol.13 No.4

        Papulonecrotic tuberculid is an eruption of necrotizing papules, particularly affecting the extremities and occurring in more or less symmetrical crops, and responding to antituberculosis therapy. Individual lesions heal with scarring. Histologically, vascular involvement is seen in early lesions. Late lesions are divided into two forms. In superficial forms, wedge shaped area of necrosis forms in epidermis and upper dermis. Epithelial and lymphoid cells gather around its periphery. In deep forms, with no epidermal change, granulomatous changes surrounded by well defined palisading histiocyte and lymphoid, epithelioid cells are seen. In mid-dermis and perivascular area, vessel shows vasculitis. In the first case, leukocytoclastic vasculitis and early granuloma formation were seen. In the second case, palisading granuloma formation was seen. In the third case, tuberculoid granuloma formation was seen. We report three cases of papulonecrotic tuberculid showing three different stages of histological finding, in individual cases.

      • KCI등재

        혈관신경성부종의 문헌적 고찰 및 증례 보고

        서보영,임재석,김 온,김성문 大韓顎顔面成形外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.1

        Angioneurotic edema is rarely seen in dental practice and manifested by acute attacks of swelling of the extremities, face, airway, or abdominal visera, occuring spontaneously and suddenly or secondary to trauma. Two types are recognized : hereditary and nonhereditary. Prophylatic therapy may be used by fresh frozen plasma or antifibrinolytic agents in hereditary type. Good supportive care for acute attacks, together with a knowledge of course of the disease, can prevent asphyxiation from airway obstruction. A case of acute angioneurotic edema of the facial area in a 19-year-old man is presented in conjunction with a review of the literature. Angioneurotic edema attacks him acutely after the extraction of the lower, right 3rd molar.

      • Thermocouple을 이용한 Buchanan Plugger 표면의 온도상승 분석

        조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 전남대학교 치의학연구소 2003 구강과학 Vol.15 No.4

        This study was performed to confirm the actual temperature rise on the surface of Buchanan plugger by evaluating the temperature rise on the surface of it, the peak temperature of pluggers of various size using thermocouple. The heat carrier system 'System B Heatsource' (Model 1005, Analytic Technologies, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200 which Dr. Buchanan's "Continuous wave of condensation" technique recommended on digital display and the power level on it was set to 10. The touch mode was used. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 ㎜ increments from the tip to the 4 ㎜ length of shank. Each thermocouple was secured with cyanoacrylate adhesive and orthodontic resin block. The two wire leads of each thermocouple were connected to the appropriate channels of Data Logger. This was configured to simultaneously record input from the five thermocouples. The heat control spring was touched for 1, 2, 3, 4 and 5 seconds, and the temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01. Ten trials was determined for each plugger. The average of temperature rise and standard deviation was calculated for each size of plugger. The data were statistically analyzed by one-way ANOVA to determine their significance. The results as follows. 1. The position at which the temperature peaked was approximately at 1∼2㎜ far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F type and followed by, in descending order, FM type, M type. ML type showed the lowest peak temperature (p<0.01). This results suggest that the actual temperature on the surface of the pluggers does not correlate well with the temperature set on digital display. Heat concentrates around the tip. The larger plugger reveals lower temperature rise relatively.

      • KCI등재후보

        열전대(thermocouple)를 이용한 Buchanan Plugger 표면의 온도상승 분석

        조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.4

        This study was performed to evaluate the actual temperature rise on the surface of Buchanan plugger using thermocouple. The heat carrier system 'System B Heatsource'(Model 1005, Analytic Technologies, Redmond, WA, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200℃ on digital display and the power level on it was set to 10. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 mm increments from the tip to the 4 mm length of shank. The heat control spring was touched for 5 seconds, and temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01 using Data Logger. The data were statistically analyzed by one-way ANOVA. The results were as follows. 1. The position at which the temperature peaked was approximately at 1~2 mm far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F plugger and followed by, in descending order, FM plugger, M plugger. ML plugger showed the lowest peak temperature (p<0.01). 3. The temperature on the pluggers was decreased with the increase of touching time. This results suggest that the actual temperature on the surface of the pluggers dose not correlate well with the temperature set on digital display. Heat concentrates around the up. The larger plugger reveals lower temperature rise relatively.

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