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.

분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

WMT를 이용한 인터넷 방송국 구축

김홍식,이영진,조재영,주영훈,박주연,송선아 인제대학교 기초과학연구소 2000 자연과학 Vol.4 No.-

WMT(Windosw Media Technologies)는 Microsoft에서 만든 인터넷 또는 인트라넷상에서 고품질의 오디오/비디오를 실시간으로 전송하여 주는 멀티미디어 스트리밍 기술이다. WMT는 대부분의 로컬 및 스트리밍 멀티미디어 파일 형식을 지원하기 때문에 개발자들은 어떤 웹 어플리케이션이나 사이트에라도 오디오와 비디오 방송을 구축할 수 있다. WMT에 포함된 Windows Media Encoder, Windows Media On Demand Producer등을 이용하고 전용서버를 설치하여 on-Demand방송이나 실시간 인터넷 방송을 구축할 수 있다. WMT is the multimedia streaming technology which transfer the audio and video on Internet or Intranet. Because WMT supports almost styles of local and streaming multimedia file, some developers build the radio and video broadcasting system at any web applications and sites. This paper shows the method of develop the realtime internet broadcastion system with WMT.

복식 전자궁적출술에 관한 임상적 고찰

황성연,김창홍,김홍곤 圓光大學校 醫科學硏究所 1997 圓光醫科學 Vol.13 No.1-2

Hysterectomy is one of the most common surgical procedures performed; after cesarean delivery, it is the second most frequently performed major surgical procedure in the U.S. This study was attempted to analysis 440 consecutive abdominal hysterectomies, especially concerned with its indication and complication, from January 1, 1995 to December 31, 1996 at the department of Obstetrics and Gynecology, Wonkwang University hospital. The results were summarized as follows: 1. The most common age distribution was 40 to 49 years with 41.4 years of mean age. 2. There couldn't be found any relationship between the indication of surgery and the parity. 3. The most common symptom and sign was lower abdominal pain(52.0 %) and followed by hypermenorrhea(31.3 %) and palpable mass(18.4 %). 4. 29.8 % of all cases was anemic in preoperative check of hemoglobin level, and in 14.3 % of all cases, correction of level was necessary. 5. The uterine myoma was most commonly indicated for Total abdominal hysterectomy (66.8 %) and cervical carcinoma was 7.7 % of all cases. 6. Majority of cases were received abdominal hysterectomies, including 25 cases of radical hysterectomies with pelvic lymphadenectomy. 7. Leiomyoma was the most common postoperative pathologic findings(69.1 %) and followed by adenomyosis(58.4 %). 8. Overall complication rate of abdominal hysterectomy was 21.5 %, which included febrile morbidity of 15.5 %, anemia of 14.1 % and upper respiratory tract infection of 6.1 %.

자궁근종의 임상 및 병리학적 연구

황성연,홍성진,김창홍,김흥곤 圓光大學校 醫科學硏究所 1997 圓光醫科學 Vol.13 No.1-2

Uterine myoma is the most common solid pelvic tumor in women. Nevertheless, etiology and symptomatology remain poorly understood, and management is inconsistent. In an effort to improve understanding of these aspects of uterine myoma, we have reviewed and analysed the data results obtained from myoma patients at department of obstetrics and gynecology, Wonkwang university hospital during the years 1995 to 1996. The following results have been obtained. 1. During the period the incidence of uterine myoma among 1,116 cases of major gynecologic surgery was 27.2 %. 2. Myoma was observed most frequently in the age group 40 to 49 years and the mean age was 43.6 years. 3. The intramural type was observed in 200 cases (65.8 %), mixed type in 53 cases (17.4 %), subserous type in 29 cases (9.5 %) and submucous type in 22 cases (7.3 %) respectively. 4. The symptoms commonly found in decreasing order were abnormal uterine bleeding (57.3 %), pain or pressure symptoms (53.3 %) and palpable mass (22.4 %). 5. Hypermenorrhea was observed in 96 cases (31.6 %) and there were significant correlations between the presence of hypermenorrhea and the type of myoma, associated adenomyosis. ( p< 0.05 ) 6. There were no significant correlations between the dysmenorrhea and the type of myoma, associated adenomyosis. ( p > 0.05 ) 7. Abnormal electrocardiographic findings were noticed in 18.8 %. 8. Mean hemoglobin level were 10.2 gm/㎗ and less than 10 gm/㎗ was found in 26.6 % and transfusion was performed in 20.8 %. 9. The most frequently associated disease in uterine myoma was adenomyosis seen in 43.4 %. 10. The secondary pathologic changes in uterine myoma were found in 5.0 % and the most common change was hyaline degeneration (3.0 %). 11. The infertility was observed in 10.2 % in which the primary infertility was 6.3 % and secondary 3.9 % respectively. 12. Total abdominal hysterectomy was performed in 84.2 % and vaginal hysterectomy in 11.8 %, myomectomy in 3.3 % respectively. 13. The postoperative complications were found in 26.6 % and the most common complication was the fever (13.8 %).

Protein microarray를 이용한 Apin-단백질의 상호작용에 관한 연구

박주철,박선화,김흥중,박종태,윤성호,김지웅,이태연,손호현 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.5

항결핵 6개월 단기요법의 성과 고찰

서지원,정연채,김남재,홍석철,김주옥,김선영,노흥규 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.1

To evaluate the effect of 6-month short term antituberculosis chemotherapy with INH, Rifampin, Ethambutol, and Pyrazinamide(2HREZ/4HRE) in the patients with pulmonary and/or extrapulmonary tuberculosis, the authors prescribed 2HREZ/4HRE regimen in 79 tuberculosis patients for 6 months with measuring the sputum staining for AFB, chest X-ray findings, recurrence rates and possible side reactions of the treatment. The result were as follow; 1. Pulmonary Tuberculosis 1) Among the 56 pulmonary tuberculosis patients who had taken 2HREZ/4HRE regimen. 32 patients showed initial positivity in sputum AFB smear stain(57.2%). Negative conversion occurred usually within 2 months after initiation of chemotherapy and the mean period of negative conversion was 1.4 months. 2) Among the 56 pulmonary tuberculosis patients, chest X-ray finding changed in 41 patients (37.21%). From these 41 patients 39 patients showed continuous improvements in chest X-ray finding, though 3 patients showed initial aggravation in spite of continuous medication. The remainder 2 cases aggravated due to the failure of treatment. 3) Treatment failure occurred in 2 patients (3.57%) during the chemotherapy among 56 patients of pulmonary tuberculosis and they were infected with secondary drug-resistant strains of M. tuberculosis. 2. Extrapulmonary tuberculosis. Among 8 patients with tuberculous pleurisy and 15 patients with superficial tuberculous lymphadenitis, there were no evidence of treatment failure after completion of antituberculosis chemotherapy for 6 months with 2HREZ/4HRE regimen. 3. Follow-up study was performed from 6 months to 50 months after completion of antituberculosis chemotherapy and the relapse was not noted in both pulmonary and extrapulmonary tuberculosis patients group during this period. 4. Serum AST/ALT elevated in 9 patients(11.4%) during the treatment and this occurred usually within 3 months after the initiation of antituberculosis chemotherapy. However treatment interruption occurred in 2 patients (2.5%) due to the development of hepatitisone due to drug-induced hapatitis and the other due to type B viral hepatitis. In conclusion, we could find this 2HREZ/4HRE 6-months short-term antituberculosis regimen is effective and could be recommanded as a promising regimen for the treatment of tuberculosis.

急性骨髓性 白血症에서의 試驗管內 集落細胞 形成에 관한 연구

고석만,조덕연,박철신,강원권,김민범,김삼용,노흥규 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1 No.1

To evaluate the in vitro granulocyte-macrophage colony formation in acute myeloblastic leukemia and the prognostic implications of these results, the author performed the in vitro agar culture of bone marrow cells in 10 patients with acute myeloblastic leukemia (AML) and 5 control subjects. Culture medium was composed of 20% fetal calf serum(FCS), 50% Iscove's medium, 0.3% agar, 10% colony stimulation factor (CSF), and 2×105 cells/ml. Human placental conditioned medium (HPCM) and phytohemagglutinin-leukocyte conditioned medium (PHA-LCM) were used as colony stimulating factor. Colony counting was done on 7th day of culture. Colony was defined as containg 20 or more cells, and cluster was defined as containing 3 - 19 cells. The results were as followings, 1. In control subjects, the number of clusters formed was 3-47/2×10^(5) cells (20±19)and that of colonies was 5-24/2×10^(5) cells (14±9) when stimulated with HPCM. When stimulated with PHA-LCM, the number of clusters formed 5-39/2×10^(5) cells(18±16) and that of colonies was 6-13/2×10^(5) cells (9±3). 2. In AML patients, 3 groups were recognized according to pattern of colony formation : 1) non-forming 2) cluster forming 3) both cluster and colony forming. Of 10 cases, 5 cases were 'non-forming', 2 cases were 'cluster forming'; and 3cases wer cluster and 'colony forming'; 3. All 5 cases 'non-forming' cases, one of 2 cases of 'cluster forming'; and none of 3 cases of 'cluster and colony forming' achieved complete remission. So, there was significant difference in remission rate in the different growth types. These results suggest that granulopoiesis in AML patients is impaired and the pattern of in vitro CFU-L(colony forming unit-leukemia) formation has prognostic significance.

대장수술 후에 발생한 급성신부전의 위험인자

이혜미,황창재,김재황,김흥대,박대팔,서일숙,송선옥,김세연,이덕희,지대림 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

연구 배경 : 급성 신부전은 술 후 발생할 수 있는 합병증 중에서 사망률은 큰 영향을 줄 수 있으므로 이 연구를 통해 위험인자를 알아보려고 한다. 재료 및 방법 : 2004년 1월부터 2006년 12월까지 3년간 영남대학교 의과대학 부속병원에서 대장 수술을 받은 570명의 환자들을 대상으로 하였다. 환자들의 성별과 연령, 미국 마취과학회 신체등급, 동반질환, 수술의 종류, 응급수술의 여부, 수술 시간, 재수술의 여부, 술 중의 투약 상황, 술 후에 자가 통증 조절기에 사용한 약제, 술 중에 저혈압의 유무, 수혈 여부, 술 후 기계적 환기를 시행한 경우를 비교하였다. 결과 : 비교 결과에서 성별과 수술의 종류, 응급 수술의 여부, 개복여부 등에는 유의한 차이를 보이지 않았다. 반면 환자의 나이와 수술 시간, 재수술의 여부, 술중에 이뇨제 등을 사용한 경우, 술 중에 저혈압의 유무, 술 후에 기계적 환기를 시행한 경우 등에는 유의한 차이를 보였다. 결론 : 이상의 결과로 급성신부전의 원인은 어느 한 가지라고 하기 보다는 위험인자에 얼마나 노출되어 있는가가 결정하는 것 같고, 그 원인들이 모여서 상승효과를 내는 것 같다. 그러므로 수술 전부터 많은 위험에 노출된 환자는 술 중 더 적극적인 감시를 시행하여 수술 후의 합병증 발생을 줄이는 노력을 기울여야 하겠다. Background : Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. Materials and Methods : Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. Results : The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). Conclusion : Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.