위암환자에서의 자매염색분체의 교환

박찬상,김대광 대한해부학회 1999 Anatomy & Cell Biology Vol.32 No.5

재가시설 요양보호사의 직무만족도에 영향을 미치는 요인: Herzberg의 동기-위생이론을 중심으로

박찬상,고광신 교회사회사업학회 2012 교회와 사회복지 Vol.0 No.19

본 연구는 Herzberg(1959)의 동기-위생이론(motivation-hygiene theory)을 바탕으로 재가시설 요양보호사의 직무만족도에 영향을 미치는 내·외재적 요인을 검증하였다. 분석결과, 첫째, 조사대상자들은 주로 요양보호사 자격증 취득이유에 대하여 답하기를 ‘보람을 찾기 위해서’라고 하였다. 둘째, 요양보호사들의 주요변인에 대한 특성에서 내재적 요인이 외재적 요인보다 더 높았다. 셋째, 상관관계에서는 인간관계와 감독기술을 제외한 모든 요인들이 직무만족에 긍정적으로 작용하는 것으로 나타났다. 넷째, 직무만족도에 영향을 미치는 요인은 일반적 특성 및 근무특성 변인 가운데 월수입이, 내재적 요인을 투입하였을 때는 성취와 성장가능성이, 그리고 외재적 요인을 투입하였을 경우에는 월수입과 직업안정이, 그리고 전체 변인을 투입하였을 경우 성취만이 직무만족도에 영향을 미치는 것으로 나타났다. 이러한 연구결과를 바탕으로 직무만족도를 높이기 위한 일반적 및 교회사회사업적 제언을 하였다.

QA를 통한 응급실 진료시간 단축

박찬상,최우익,이동필,안영호,조준 대한응급의학회 1997 대한응급의학회지 Vol.8 No.2

In modern medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time in the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meeting among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours(from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree(p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.

재가시설 요양보호사의 직무만족도에 영향을 미치는 요인: Herzberg의 동기-위생이론을 중심으로

박찬상 ( Chan Sang Park ),고광신 ( Kwang Shin Ko ) 한국교회사회사업학회 2012 교회와 사회복지 Vol.19 No.-

버섯 중독 환자에 대한 임상적 고찰

박찬상,조준,최우익,안영호,유병대,이동필 대한응급의학회 1998 대한응급의학회지 Vol.9 No.2

Background: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. Methods: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. Results: Mean age of the patients was 40.0years and the ratio of male to female was 1:0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea, except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1 %) Conclucion : The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are dischrged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.

외상성 고관절 탈구의 예후에 영향을 주는 요인

박찬상,조준,유병대,서영조,이명갑,이동필 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : Incidence of traumatic hip dislocation have been increased with development of transportation. Traumatic hip dislocation demands early recognition as an emergency and prompt reduction. So we designed this study to determine what kinds of factors affect the prognosis of the patient. Methods ; Eighty five patients who admitted emergency department of our hospital with the traumatic hip dislocation were enrolled in this study. Cause of injury, type of dislocation, method of reduction, the time from dislocation to reduction, age, gender and associated patellar injury were evaluated by retrospective chart reviews. Results : Average age of excellent good group(E&G) is 28±17.8 and fair and poor group(F&P) is 39±18.6, so the older the age the more poor prognosis.(P<0.05). The time to take reduction of E&G group is 18±8.2 hours and F&P group is 25±12.6 hours, so the faster the better prognosis.(P<0.05) We classify the type of hip dislocation by Thompson and Epstein method, type Ⅰ to type Ⅴ. The prognosis of type Ⅰ is better than type Ⅴ(P<0.05). Fifty five case were associated with patellar injury and they had poor prognosis than the other cases that were not associated with knee joint injury. Conclusion : In traumatic dislocated hip patients, the prognosis was poor in old age, delay in reduction, higher type of dislocation and associated with knee joint injury.

Sister Chromatid Exchange Frequencies in Stomach Cancer Patients

박찬상(Chan-Sang Park),김대광(Dae-Kwang Kim) 대한해부학회 1999 Anatomy & Cell Biology Vol.32 No.5

위암환자의 말초혈액에서의 자매염색분체교환 (sister chromatid exchange, SCE)에 대한 보고는 매우 드물기 때문에 한국에서 흔한 위암에서의 SCE 빈도에 대한 조사를 하였다. 12명의 위암환자의 말초혈액을 수술전에 채취하여 30개의 중기세포를 관찰하였으며, 대조군으로 10명의 건장한 사람의 말초혈액 세포를 이용하였다. 위암환자의 평균 SCE 빈도는 7.0107±1.5720, 대조군에서는 5.8267±0.7646로 각각 나타나서 위암환자의 빈도가 대조군의 것보다도 의미있게 높게 나타났다 (p<0.035). 이 결과로 종양의 한 소인으로 추정되는 염색체 불안정성이 위암환자에게서 나타난다고 할 수 있다. This study was made to show the effect of stomach cancer on chromosome by sister chromatid exchange (SCE) analysis, because very few studies have reported. Metaphase preparation from peripheral blood lymphocytes of 12 patients were harvested before operation, along with those of 10 healthy control subjects. Mean SCE frequency in the stomach cancer patients was 7.0107±1.5720 as compared with 5.8267±0.7646 in controls. SCE values of patients with stomach cancer were significantly higher than those of control (p<0.035). This results suggest that patients with stomach cancer show a degree of chromosomal instability that might be related to a predisposition to neoplasia.

노인의 건강상태 만족도의 영향요인

박찬상(Chan-Sang Park),황선영(Sun-Young Hwang) 한국정책개발학회 2015 정책개발연구 Vol.15 No.1

본 연구는 노년기의 건강약화를 스트레스 사건으로 규정하고 개인적, 가족적, 사회적 자원이 노인의 건강상태 만족도에 미치는 영향을 규명하는 것을 주목적으로 한다.『2011년도 노인생활실태조사』자료를 이용하여 65세 이상 노인의 건강상태 만족도 결정요인에 대해 분석하고자 한다. Ordered Logit 모형을 이용한 건강상태 만족도 결정요인은 분석결과 ADL, 우울, 흡연, 소득, 교육수준, 사회활동과 사회적서비스인지도 등으로 나타났다. 또한 유의한 상호작용으로는 ADL과 배우자 건강, 우울과 교육수준, 우울과 배우자의 건강여부, 우울과 사회활동으로 나타났다. 본 연구는 분석결과를 바탕으로 건강약화를 경험하는 노인들의 심리적 압박감을 완화시킬 수 있는 사회복지적 개입 방안에 대한 정책적 제언을 함으로써 노후의 건강상태 만족도를 향상시킬 수 있는 대안을 제시하고자 하였다. In this study, we regulate health weakness of the elderly people as a stressor and focus on investigating whether personal, familial and social resources have direct or indirect effect on health satisfaction of elderly people. Based on『2011 research on the actual condition of elderly people』, we will analyse the determinants of health satisfaction of the elderly people aged 65 or over. Analysis result of determinants of health satisfaction by using Ordered Logit model, it appeared as ADL, depression, smoking, income, education, social activities and social service level and so on. Also, similar interaction appeared as ADL and spouse's health, depression and education, depression and spouse's health, depression and social activities. This study suggests an alternative that can improve health satisfaction of the elderly people by giving political proposal for social welfare intervention plan relieving mental pressure of the elderly people who are experiencing health weakness.

골반골절의 분류, 동반손상 및 혈역학적 변화

조준,박찬상,유병대,이동필 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.3

In general, pelvic fracture carries higher mortality especially from motor veicle accident, we have retrospectively reviewed charts and radiographs of 185 patients in order to identify clinical finding, kinds of fracture, hemodynamic changes and associated injuries in patients with pelvic fractures. We attempted to classify pelvic fractures according Young classification. The following results were obtained; 1. On age and sex distribution, the pelvic fractures showed peak incidence between 2nd decade and 5th decade. Male was affected more frequently than female, the ratio being male to female, 2.6 to 1. 2. The mechamisn of injury was motor veicle accident in 155(83.8%), fall in 25(13.5%), others in 5(2.7%). 3. The associated injuries of pelvic fractures: extremity, thoracic, urinary system, intraperitoneal and head injury. 4. Of the 185 cases of the pelvic fractures, simple pelvic fractures are 101 cases(54.6%), lateral compression in 39(21.1%), anteroposterior compression in 18(9.7%), vertical shearing in 17(9.2%), mixed pattern in 10(5.4%). 5. Retroperitoneal hematoma and urinary tracts injuries were the most common associated in mixed pattern. 6. The incidence of hemodynamically unstable fractures were 19.8% in simple pelvic fracture but, as expected was higher in major pelvic ring disruptions except to acetabular fracture(52.4%) 7. Mortality rates were 5.9% in all pelvic fractures but 10.7% in major pelvic ring disruptions except to acetabular fractures. Prognostic factor in pelvic fractures were the amount of hemorrhage and associated injuries, therefore early diagnosis and management are essential to reduce the mortality in pelvic fracture.

증상발현 24시간이내 사망한 급성심근경색증 환자의 위험인자

조준,박찬상,이동필 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : Recently, the incidence of acute myocardial infaction has been gradually increasing as prolongation of life spans and improvements of diet and life styles in Korea. The rate of mortality and sudden death is higher than other diseases. The purpose of this study is to evaluate factors which can affect on the mortality of AMI during initial 24 hrs. Methods : A retrospective clinical study was done on 364 consecutive patients with AMI who had been presented to Keimyung University Dong-sang Medical Center from January 1990 to May 1997(M:F ratio=254:110). The subjects were divided two groups. The Group Ⅰ was patients who had expired during the initial 24 hrs periodof AMI(47 patients, 13%), the Group Ⅱ was pateints who had survived (317 patients, 87%). We compared clinical features, EKG, laboratory results in both groups and tried to analyse the vulnarable factors. Results : The results were as follows; 1) The mean age in Group Ⅰ (64.4 yearly) was older than in Group Ⅱ(61.3 yearly) and female gender was also higher in Group Ⅰ. The mean systolic/diastolic blood pressures of the Group Ⅰ(103/61mmHg) were lower than those of the Group Ⅱ(123/75mmHg). 2) The chest pain and mental change were noted more frequently in Group Ⅰ than in Group Ⅱ and the dyspnea was less frequent in Group Ⅰ than Group Ⅱ. 3) The higher grades of Killip classification was significantly more frequent in Group Ⅰ than in Group Ⅱ. 4) The mean onset to drug time for thrombolytics in Group Ⅰ and Group Ⅱ were 14.1 hrs and 6.6 hrs. 5) The mortality rate of the Group Ⅰ and the Group Ⅱ were respectivly 13%, 6.6%. The most common causes of death were cardiogenic shock and ventricular arrhythmia. Conclusion : The mortality rate of initial 24 hrs of onset as form of sudden death was higher than post-24hrs group(66.2%). The factors for the higher mortality group were old age and female gender, and they were unstable in vital signs, higher Killip classifications. Therefore, these groups demand more rapid and aggressive approach than the other groups.