뇌졸중 노인을 돌보는 주간호제공자의 부담감과 예측요인 : 한방병원 입원 노인을 중심으로

유수정,김신미,이윤정,박연환 노인간호학회 2004 노인간호학회지 Vol.6 No.1

Purpose : The purpose of this study was to investigate factors influencing burden in primary caregivers caring for an elderly person who has had a stroke. Method : A convenience sample of 124 primary caregivers of elderly people with a stroke admitted to an oriental medicine hospital participated in this study. Interviews were done with a standardized questionnaire including Caregiver Burden Scale (Chang, 1995). Result: Average burden score was 93.19, indicating a moderate to severe level of burden. Time-dependent burden had the highest score of the sub-domains. For general characteristics, the factors significantly influencing caregiver burden were gender and age of the elderly person, age and educational level of the caregiver, whether living together or not, and the presence of another caregiver. Multiple regression analyses demonstrated that level of ADL of the elderly person, relationship between the elderly person and the caregiver prior to the stroke, caregivers' relation to the elderly person and primary income were significant factors in explaining variance in overall burden. Conclusion : Recognition of high levels of caregiver burden and factors influencing burden will allow us to develop different nursing strategies to decrease caregiver burden in those caring for an elderly person with a stroke.

자기효능증진 교육프로그램이 고혈압 노인의 자기효능감, 자가간호행위 및 혈압에 미치는 효과

유수정,송미순,이윤정 성인간호학회 2001 성인간호학회지 Vol.13 No.1

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various Physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior. through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly' hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1.There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2.There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3.There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. There was positive correlation between self efficacy and self care behavior depending on the measuring period. 4.There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the, program. and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.

충수돌기에 발생한 비호지킨 림프종 1예

정유경,이미숙,김윤식,이미자,전호종 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

관리형태와 표본추출방법의 효율비교 : 불량률 관리 Number of Defectives

박창순,윤유미 중앙대학교 수학통계연구소 2000 수학통계논문집 Vol.- No.7

제품의 불량률을 관리하는 산업 생산 공정에서는 불량률이 일정수준을 벗어날 따 이를 신속히 탐지할 수 있는 관리도가 필요하다. 이는 공정이 관리상태일 때 (제품의 불량률이 일정수준을 벗어나지 않을 때)는 아무런 이상신호를 주지 않고, 공정이 이상상태일 때(제품의 불량률이 일정수준을 벗어났을 때)는 가능한 한 빨리 이상신호를 줄 수 있도록 하여 불량품 생산을 줄일 수 있도록 설계되어야 한다. 이에 본 논문에서는 이렇게 관리도의 특성과 효율을 비교하기 위한 수단 으로 평균런길이를 사용하였으며 여러 가지 관리도들의 효율에 비교하는데 있어서 기존에 많이 연구되어오지 않았던 이산형 관리도중 불량률을 관리 할 수 있는 np관리도에 대하여 시도해 보았다.

소목(Caesalpinia sappan) 추출물의 Streptococcus mutans에 대한 성장, 산생성, 부착 및 비수용성 글루칸 합성 억제에 미치는 영향

유용욱,유현희,김윤정,유미선,서세정,이황,이흥수 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.2

Streptococcus mutans is known as the causative bacterial playing the most important role in forming plaque and it is being noticed as major causative bacteria of dental caries. Therefore, development of more effective, substantial and safe preventive agent against dental caries and periodontal disease is honestly required. The present study was designed to investigate the effect of chloroform extract(CE), n-butanol extract(BE),methanol extract(ME) and water extract(WE) of Caesalpinia on the growth, acid production, adhesion, and insoluble glucan synthesis of Streptococcus mutans. The CE, BE, ME and WE decreased the growth and acid production of S.mutans than that of control, especially, the ME was more effective than other extracts. The effect of CE, BE, ME and WE on the adherences to saliva-coated hydroxyapatite bead(S-HA) were evaluated. At the concentration of 2,000 ㎍/㎖, the CE showed 32% rate of bacterial adherence to S-HA, whereas, other extracts of the same concentration producedgreater than 50% rate. The CE and BE were significantly decreased the reduction rates of water insoluble glucan formation from sucrose by crude glucosyltransferase of S.mutans. Thus, the application of C. sappan can be considered a useful and a practical method for the prevention of dental caries.

심한 낙타혹(Hump)의 형성을 동반한 제 2 형 막증식성 사구체신염(Dense Deposit Disease) 1예

오희정,유민아,이영숙,김미연,김승정,강덕희,윤견일,최규복,성순희 이화여자대학교 의과대학 2004 EMJ (Ewha medical journal) Vol.27 No.1

Dense deposit disease (DDD), known as type Ⅱ MPGN, is an uncommon form of glomerulonephritis. It is an acquired primary glomerular disease, characterised by electron microscopic evidence of a continous, dense membrane deposition replacing the lamina densa. There is associated alternative pathway complement activation and a C3 nephritic factor maybe present. Patients with dense deposit disease tend to be young at clincal onset and more commonly have persistent nephrotic syndrome, gross hematuria, and acute nephritis episode and persistent depression of the serum complement level. The prognosis of dense deposit disease is worse than that of typeⅠMPGN. We experienced a patient with dense deposit disease that presenting persistent nephrotic syndrome, gross hematuria and having subepithelial hump. It is a first report of dense deposit disease having subepithelial hump in Korea, therefore we report this case with the review of relevant literatures.

Nortropinone 유도체로부터 Nortropane Spirohydantoin 유도체의 합성

정대일,박유미,박종훈,김윤영,정두희,김인식 東亞大學校 1998 東亞論叢 Vol.35 No.-

The nortropinones 11 (tropinone lla, N-isopropylnortropinone 11b, N-Carbethoxynortropinone 11c, N-furfurylnortropinone 11d, N-(p-methoxyphenyl)nortropinone 11e) were respectively synthesized by the treatment of acetonedicarboxylic acid 8 with, 2, 5-dimethoxytetrahydrofurane 9 in various amines 10 (methylamine 10a, N-isopropylamine 10b, ethylcarbamate 10c, furfurylamine 10d, p-anisidine 10e). The nortropane spirohydantoins 14 (tropane spirohydanttoin 14a, N-isopropylnortropane spirohydantoin 14b, N-Carbethoxynortropane spirohydantoin 14c, N-furfurylnortropane spirohydantion 14d, n_(p-methoxyphenyl) nortropane spirohydantoin 14e) were respectively synthesized by the treatment of synthesized nortropinones 11 (tropinone 11a 54%, N-isopropylnortropinone 11b 50%, N-Carbethoxynortropinone 11c 58%, N-furfurylnortropinone 11d 31%, N-(p-methoxyphenyl) nortropinone 11e, 70%) with potassium cyanide 12, ammonium carbonate 13.

혈전성 혈소판감소성 자반증으로 발현된 전신홍반루푸스 1예

오명근,유미라,변유미,윤찬영,권세훈,박치영,김상현 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening syndrome characterized by the classic pentad of clinical features that includes microangiopathic hemolytic anemia, thrombocytopenia, neurologic abnormalities, fever, and renal dysfunction. Early diagnosis and utilization of plasmapheresis can improve the survival rates of patients with TTP. TTP rarely may be seen in association with autoimmune disease such as systemic lupus erythematous (SLE). We report here a 42-year-old female who was presented with severe digital gangrenes, microangiopathic hemolytic anemia, thrombocytopenia, neurologic abnormalities, fever, and renal dysfunction. Her condition responded to combined therapy with high dose steroid, immunosuppressants, and plasmapheresis therapy.

Benzodiazepinone과 1,5-Benzodiazepine 유도체의 합성 연구

정대일,이용균,박유미,최태원,정일수,김인식,김윤영 東亞大學校 1997 東亞論叢 Vol.34 No.-

The reaction of o-phenylenediamine 5 with acrylic acid 11 in the presencce of P₂O5+H₃PO₄afforded benzodiazepinone 13 and pyridobenzodiazepinono 17. The reactions of o-phenylenediamine 5 with acrylic acid 11 in the presence of PPA or SiO₂afforded only benzodiazepinone 13. But the reaction of O-phenylenediamine 5 with acrylic acid 11 in the presence of acetonedicarboxylic acid 18 or acetonedicarboxylic acid 18 and PPA or acetonedicarboxylic acid 18 and SiO₂was respectively synthesized 2,4,4,-trimethyI-3H-5-hydro-1.5-benzodi-azepine 23 as new cyclic imine compound. We propose that formation of 2-(2`-imine)propyI-N-isopropylidene aniline proceed though 2-amino, N-isopropylidene aniline intermediate C and 2-(N-a-methylethyI) amino, N-isopropylidene aniline intermediate G. The reaction of o-phenylenediamine 5 with acetonedicarboxylic acid 18 in the presence of PPA or SiO₂or HCI gave 2,4,4-trimethyI-3H-5-hydro-1,5-benzodiazepine 23. Using acetone 19 instead of acetonedicarboxylic acid 18, the reaction of o-phenylenediamine 5 in the presence of PPA or SiO₂or acrylic acid 11 was synthesized 2,4,4-trimethyI-3H-5-hydro-1,5-benzodiazepine 23 as same product. And also the reaction of o-phenylenediamine 5 with acetone 19 and acrylic 11 in the presence of PPA or SiO₂was obtained 2,4,4-trimethyI-3H-5-hydro-1,5-benzodiazepine 23. In case of acetophenone 21 in stead of acceton 19, the reaction of o-phenylenediamine 5 in presence of PPA or SiO₂at 40~45℃ were obtained 2,4-diphenyI-4methyI-3H-5-hydro-1,5-benzodiazepine 24. The reaction of o-phenylenediamine 5 with crotonic acid 25 in the presence of PPA or P₂O5+H₃PO₄or SiO₂at 100~110℃ afforded respectively 4-methybenzodiazepinone 26 as 1:1 cycloadduct.

제2형 당뇨병 동물모델인 OLETF 쥐에서 장기간 라미프릴 투여가 내당능 및 췌도 베타세포에 미치는 효과

고승현,윤건호,김명미,안유배,송기호,유순집,손현식,차봉연,이광우,손호영,강성구 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:최근 소개된 HOPE(Heart Outcomes Prevention Evaluation)study의 결과에 의하면, 심혈관질환이나 이에 대한 위험인자가 1가지 이상인 9,541명을 대상으로 안지오텐신 전환효소 억제제의 일종인 라미프릴을 투여하여 사망율과 뇌졸증, 심부전, 당뇨병 합병증이 개선되었을 뿐 아니라 다른 항고혈압제에 비해 새롭게 당뇨병으로 진단되는 환자가 줄었음을 보고한바 있다. 이에 저자들은 라미프릴(ramipril)을 제2형 당뇨병 동물모델에 장기간 투여함으로써 당뇨병을 예방하거나 고혈당 상태 또는 인슐린 감수성을 개선시킬수 있는지를 알아보고자 하였다. 방법:생후 24주된 체중 400∼450g의 OLETF와 LETO 쥐를 대상으로 6개월간 라미프릴 경구투여 하였고 혈압, 24시간 단백뇨 및 인슐린 내성검사를 시행하였다. 6개월 이후로는 8주간 투여군과 대조군의 체중을 비슷하게 맞추어 내당능 상태를 평가하였고 이후 다시 8주간 고농도 포도당을 투여하였다. 경구당부하검사를 시행한 후 희생시켜 조직표본을 만들어 guinea pig anti­human insulin 항체로 염색후 DAB로 발색하여 point count 법으로 베타세포를 정량하였고, 면역염색으로 췌도의 변화와 섬유화의 정도를 관찰하였다. 결과:라미프릴을 6개월간 투여하였을 때 OLETF 쥐에서 1)체중 증가가 적었으며 2)경구 당부하검사시 포도당하 면적은 의미있게 감소하였고 3)인슐린 내성검사상 Kitt가 증가되는 경향을 보였으며 4)수축기, 이완기 혈압과 24시간 단백뇨양이 의미있게 감소하였고 5)체중을 맞추면 내당능 상태가 비슷해졌다가 고농도 포도당 주입시 다시 포도당하 면적이 대조군에서 더 증가되었다. 라미프릴 투여군에서 췌도변형 및 파괴와 탈과립, 췌도내 섬유화가 감소하였다. 결론:본 실험에서는 인슐린 비의존성 당뇨병 동물 모델인 OLETF 쥐에서 당뇨병 발생 이전 단계부터 장기간 라미프릴을 투여할 경우 체중증가가 적었고, 투여군과 대조군의 체중을 맞추었을 때는 내당능상태의 차이가 없아가 고혈당 투여시 다시 투여군과 대조군에서 의미있는 차이를 보였다. 라미프릴 투여가 베타세포의 기능면에서 이로운 효과를 보일 것으로 생각되었다. 따라서 비만한 환자에서 안지오텐신 전환효소 억제제의 장기투여는 단백뇨 감소, 혈압강하 효과 이외에 체중증가의 억제 및 당뇨병 발생을 억제할 가능성을 시사한다. Background : In a Heart Outcomes Prevention Evaluation HOPE study, ramipril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, significantly reduced the death rates the number of myocardial infarctions, strokes, heart failure as well as the risk of complications related to diabetes and of diabetes itself. However, it is known that ACE inhibitors improve glucose tolerance or insulin sensitivity or reduce the incidence of diabetes. Methods : 24 week-old OLETF (Otsuka Long Evans Tokushima Fatty) rats weighing 400 ~ 450 g were used in this study. 4 groups of rats were examined in parallel for 40 weeks. The OLETF rats were randomized for treatment with an aqueous solution of ramipril (5 mg/Kg) daily [OL (RMP), n=10)] and with saline [OL (CON), n=10)]. The LETO rats were also randomized in the same was as the OLETF rats (LT(RMP), n=10, LT (CON), n=10). The blood glucose level, body weight, systolic and diastolic blood pressure was assessed every month. At 3 and 6 months, the 24hrs urinary protein concentration was measured, and as insulin tolerance test and oral glucose tolerance test were conducted in all experimental groups. After 6 months, the body·weight was matched for 2 months in each corresponding group. Subsequently, a 15% sucrose loading was done for 2 months. After the glucose tolerance test, the pancreas was excised and immuno histochemical staining was conducted for insulin to quantify the beta cell mass by a point-counting method. In addition, the islet morphology was evaluated in the pancreas. Results : Ramipril treatment for a period of 6 months improved the 2hr blood glucose level, the area under the glucose curve in the oral glucose tolerance test, insulin sensitivity in addition to lowering significantly systolic and diastolic blood pressure and 24hrs urinary protein level significantly in OLETF rats. Of note, a lower weight gain was observed in both the ramipril-treated animals at 6 months. After weight matching, the AUC g and 2hr blood glucose level values were similar between the corresponding groups, but a 15% sucrose loading worsened the AUC g value. Histologically, the islets were less disorganized and the extent of fibrosis was lower in the ramipril-treated OLETF rats in the trichrome stain. Conclusion : Long-term treatment of ramipril, a long acting angiotensin-converting enzyme inhibitor may be useful for suppressing weight gain and proteinuria in addition to having a protective effect on the islet to harmful stimuli such as hyperglycemia (J Kor Diabetes Asso 25:469~482, 2001).