위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

Effects of dietary supplementation with probiotic CS-A on performance in broiler chickens

Seong Soo Kang1*, Se Eun Kim, Ara Go, Kyung Mi Shim, Chun Sik Bae, Chang Jong Moon, Sung-Ho Kim, Jong-Choon Kim, Jin-Cheol Yoo, Seung Sik Cho 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.3

Probiotics, enzymes, organic acids, oligosaccharides, antioxidants, and other functional materials are actively being explored as alternatives to antibiotics. Probiotics include live beneficial microorganisms that colonize the intestinal tract and competitively inhibit attachment and growth of harmful microbes. Probiotics also increase feed efficiency by assisting in nutrient absorption and digestion. The current study was conducted in order to evaluate the effect of a new probiotic, CS-A, as a dietary supplement of a fermented product on growth performance, feed intake, and feed conversion efficiency in broiler chickens, and to evaluate its value as an alternative for antibiotics used as a feed additive. Antibacterial and anti-inflammatory effects of CS-A were investigated in vitro and the in vivo effects of a constant concentration of supplemented CS-A on growth rate and feed efficiency were evaluated. In addition, the safety of CS-A was assessed by examination of common symptoms and mortality. Determination of minimal inhibitory concentration revealed an excellent antibacterial effect of CS-A. Cytotoxicity was low and anti-inflammatory effects were achieved at the effective concentration of CS-A. Supplementation with 0.1% CS-A resulted in a feed efficiency score of 1.84 in broilers, compared to 2.00 in the control group. There were no adverse clinical findings, necropsy findings, hematology, and altered serum biochemistry parameters, and no mortality. Thus, it is concluded that CS-A is safe and effective as a feed additive.

두개내 동맥 병변을 보인 혈관형 베체트씨병 2예

박은미,성정준,이정주,강동화,노재규 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

신입간호학생들의 직업선호도와 간호직업에 대한 평가

전은미 , 강세원 배재대학교 자연과학연구소 2018 自然科學論文集 Vol.29 No.1

본 연구는 신입간호학생들의 직업선호도와 간호직업에 대한 평가를 알아보고자 조사되었다. 자료수집은 2018년 6월에서 10월까지 두 개 대학에서 편의표출로 시행되었다. 본 연구 결과, 간호학과 신입생들의 직업선호도 평가에서 ‘높은 임금’이 선호되었으며, 간호직업에 대한 평가에서는 ‘남을 도울 수 있는 직업’이 가장 높은 평가 점수를 보였다. 직업선호도와 간호직업 평가에서 모두 가장 낮은 점수를 보인 항목은 ‘창조하고 새로 만드는 것을 할 수 있는 직업’이었다. 간호학생과 학생들이 직업에 대한 이해를 충분히 할 수 있도록 다양한 탐색 방안을 마련하는 것이 필요하다 The purpose of this study was to investigate the occupational preference and evaluation of nursing job on new nursing students. Data collection was conducted at the two universities from June to October 2018 by convenience sampling. As a result, 'high wage' was preferred in the occupational preference. In the evaluation of nursing job, it was evaluated as 'job that can help others'. The lowest score item of both job preference and nursing job evaluation was 'job to create and to make new'. It is necessary to provide diverse approaches for nursing students to understand their profession.

여대생의 결혼관에 관한 연구

강신미,김욱련,김이화,김현주,백은주 효성여자대학교 가정대학 학도호국단 1985 家政大論集 Vol.4 No.-

In these days, Korea has undergone various changes in every social aspect throughthe process of modernization. Especially in instituional and actual aspects, the family.and marriage have been changed greatly by the rapid urbanization and iudustrializatton,.and these changes have been investigated scientifically. This paper presents marital consciousness and actual behavior of 300 woman collegestudents in Daegu, and was surveyed comparing various parts-the humanities, natural·science and the arts. As for the basic attitude of marriage, they were positive in the need of marriage,,defined marriage as the second starting point of life. Also they put the aim of marriage,on mental value. As for the dating and purity before marriage, 84 percent of respondents assented tothe dating before marriage. And they thought it proper that the duration of datingwas one year to two years. The age of the first dating and the standard of sex moralstore significant. The part of the arts tended to be open, and the part of natural sciencewere conservative. As for the standard of spouse's choice, 84 percent of respondents wanted to have theright of priority they could choose their spouses for themselves. And they thought it·proper that the age of marriage was 25-year-old to 26-year-old, and the gap of maritalage was one year to three years. Ideal spouse's characteristic, home surroundings, and marital harmony were significant. Among various marital conditions, personality tended to to emphasized, and theatmosphere of family and masculine appearance were taken serious. As for a. spouses's job, professor or research occupation was popular. Compared withthe part of the arts, the part of the humanities and natural science were positive inpredicting marital harmony. Among various marital conditions, an only son, the eldest son, and an offspring ofa concubine tended to be evaded. The type of an ideal spouse was companionship.

교내 실내 공기에서 부유 미생물의 분포

박창은,임미소,이다은,김설아,강재원 남서울대학교 2010 남서울대학교 논문집 Vol.16 No.2

The pathogenic and non-pathogenic microorganism have been isolated from the indoor airborne, the closest environment of human beings. Our purpose were to investigate the distribution of fungi and bacteria in indoor airborne sampled from 7 locations in Namseoul University for 2 months from September to October, 2010. The isolated bacteria were identified by Gram stain and biochemical test using VITEKTM system, also The fungus were identified by LPCB. The experiment on microorganism concentration of indoor air carried out and the average of total microorganism was measured. When airborne bacteria were isolated and identified. The isolation rates of Gram positive cocci, Gram positive bacilli, Gram negative bacilli, and Gram negative cocci were 38.3%, 22.4%, 2.7%, 0%, respectively. In Gram positive cocci, the most strains were identified as Micrococcus spp. In Gram positive bacilli, the most strains were identified as Bacillus spp. The frequently isolated fungi were Aspergillus sp, Penicillium sp, Alternaria sp, Rhizopus sp, Mucor sp. respectively. Further systematic studies are necessary with an emphasis on species identification. Key Words : Microorganism, Fungus, Indoor Airborne, Micrococcus, Aspergillus

간호학생의 4차 산업기술에 따른 간호직 고용 인식과 핵심역량 인식

전은미, 강세원 배재대학교 자연과학연구소 2018 自然科學論文集 Vol.29 No.1

본 연구는 간호학생들의 4차 산업기술에 따른 간호직 고용 인식과 핵심역량 인식을 파악하고자 하였다. 자료수집은 2018년 8월에서 10월까지 두 개 대학에서 편의표출로 시행되었다. 본 연구 결과 간호학생들의 4차 산업기술에 대한 이해도는 중간 이하로 나타났으며, 간호직 고용 대체 확률은 10-19% 응답비율이 가장 높았다. 간호학생들이 인지한 미래사회 변화에 필요한 중요 역량은 ‘종합적 사고력’이었다. 간호학생들의 변화하는 기술사회에 대처할 수 있는 역량을 개발하기 위해 교과-비교과 과정을 통한 다양한 방안의 모색이 필요하다. The purpose of this study was to identify the recognition of nursing employment and core competencies according to the fourth industrial technology of nursing students. Data collection was conducted at the two universities from August to October 2018. As a result, understanding of fourth industrial technology was below middle level. The probability of substituting nursing jobs was the highest in the 10-19%. The important competence required for the change of future society recognized was 'comprehensive thinking ability'. In order to develop competencies to cope with the changing technological society of nursing students, it is necessary to seek various ways through the curriculum and extra-curriculum.

선천성 대사 이상 환아에서 발생한 대사 위기의 복막 투석 치료 효과

강정혜,이동환,문철,김은미 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Purpose : We have evaluated the outcomes of peritoneal dialysis in patients with metabolic crises caused by in born error of metabolism. Methods : There are 6 patients(8 episodes, 4 males and 2 females) who had inherited inborn errors of metabolism and were admitted to the department of pediatrics, Shoonchunhyang university hospital in Seoul from December 1991 to December 1994. The technique of dialysis is discribed, in short: A Tenckhoff catheter was inserted surgically in all patients through the lateral abdominal wall. Commerically available dialysate solutions(Peritosol, Korea Green Cross Co.) was applied to 5 patients(7 cases) with hyperammonemia. In a patient with propionic acidemia, we used a special custiom made dialysate that replaces lactate by bicarbonate. Results : 1) The mean age was 5.3 months old. There were 6 patients with 8 episodes. Six cases had Ornithin transcarbamylase deficiency. The remaining cases are Multiple carboxylase deficiency and Propionic acidemia (Table 1) 2) In 7 cases with hyperammonemia, mean levels of pre and post 24hrs peritoneal dialysis serum ammonia were 1000.2±310.9 ㎍/dl and 388.8 ±156.7 ㎍/dl at 24 hours respectively. Time on serum ammonia levels reached below 300 ㎍/dl was 88.7 ±39.6 ㎍/dl hours. 3) Four out of seven cases were a recorvert of mental status. Each episode of serum ammonia mean levels was 388.8 ±156.7 ㎍/dl after 19.7 ±5.8 hours of peritoneal dialysis (Table 3). 4) Peak serum ammonia levels of the survived group reached 1356.5 ㎍/dl, higher than the expired group of 847.5 ㎍/dl and time period of starting peritoneal dialysis after onset of the survived group was 15.5 hours earlier than the expired group of 23 hours(P>0.05)(Table 4). 5) 3 out of 7 cases of hyperammonemia died. The cause if death were 3 brain edema, 1 hyperkalemla and 1 intracranlal hemorrhage. 6) In onecase with Multiple carboxylase deficiency, serum ammonia level was normalized after 12 hours of peritoneal dialysis. The reduction of serum levels of the branched amino acid was also observed. 7) In a case of Propionic acidemia with severe metabolic acidosis, the prior serum bicarbonate level was 8 mmol/L and was increased up to 18 mmol/L by peritoneal dialysis lasting 19 hours. 8) Among 8 cases, complications of peritoneal dialysis were 5 hypoalbuminemia, 4 hyoercalcemia, 4 hyperglycemia and leakage of peritoneal dialysate. Conclusions : In cases of hyperammonemia, survival rate is 57.1%. They are showed excellant efficacy of treatment of peritoneal dialysis for metabolic crises. In a case of propinic acidemia is fastly corrected by peritoneal dialysis. But unfortunally clinical manifestations is not improved. Therefore, further studies is required with treatment of severe metabolic acidic conditions.

해운대 달맞이 언덕에 있어서 바다조망경관의 역사적 변천에 관한 연구

강영조,신수안,조미나,이현주,박은희 동아대학교 건설기술연구소 2000 硏究報告 Vol.24 No.1

The purpose of this study is to clarify the historic transition of the prospects on Haeundae dalmaji hill. Dalmaji hill is well known for a character of configuration on the ground with the scene of the sea. We will infer that how did it change the prospects of Dalmaji hill's sea through the analyzing of the preset situation and location of building on the hill. (1) We investigated the stories of the building, the history, the business condition. (2) We collect the twenty four view points which is able to have seascape on the hill, being easily approaching to the road, and condition of changing the building. (3) We clarified the transition of seascape prospect and considered the characteristics of the six types from which were divided the condition of seascape prospect.

유치원의 부모교육 실태에 관한 조사연구 : 통합 진주시를 중심으로

강인언,황은미 진주여자전문대학 1995 論文集 Vol.18 No.-

The purpose of this study is to investigate the current situations of parent education of kindergarten in Chinju Area. The specific problems of the study are as follows. 1. How is the parent education executed by kindergartens? 2. What is the goal of parent education in kindergarten? 3. What is the content of parent education in kinergarten? 4. What are the patterns of parent education in kinergarten? 5. What is the administration of the parent education in kindergarten? 6. What are the effects of parent education in kindergarten? 7. What are the problems of parent education in kindergarten? 8. How is the degree of parents paticipation? 9. Is there any difference between public kindergartens and private ones in the above problems? For this study, 68 kindergartens in Chinju Area were sampled. The total subjects selected in the study were 47 kindergartens. (28 kindergartens attached to public elementary schools and 19 private kindergartens) The testing instrument used for the study was a questionaire developed by the researchers. The data were analyzed by percentage(%) and Chisquare(χ²) verification. The results of the study are as follows. There were significant differences between public kindergartens and private ones in the execution of parent education, the name of parents meeting, the person determining the membership fee, the inspecting method of kindergarten class, the type and content of interview with parents, the types of correspondence with students home, the existence of home visite programs, the areas and types participating as a assistant teacher in kindergarten, the effects of parent education and the relatioship between kindergarten and students' home.