중환자에서 동맥혈 가스분석 횟수와 그로인한 실혈량에 대한 연구

이석열,전철우,정영수,오희숙,마분란,이정미,정혜영,이만복,이길노 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background : Arterial blood gas analysis is the most comon exam in intensive care unit. In this study, the frequency of blood gas analysis and the amount of blood loss after Blood Gas Analysis in Intensive Care Unit were observed. Methods : From November 1999 to February 2000, 115 patients admitted to intensive care unit at Soonchunhyang university Kumi hospital were studied prospectively for the frequency of blood gas analysis and the amount of blood loss after blood gas analysis in Intensive Care Unit. Results : The mean value of frequency of blood gas analysis was 6.41±6.49 and the mean value of amount of blood loss after blood gas analysis was 0.78ml. This was lower than that of other foreign reports. The patients with ventilator therapy above 24 hours showed higher frequency of blood gas analysis than that of not applied ventilator patients. Pulse oxymetry was applied to all patients and the frequency of blood gas analysis was decreased due to the use of strict pulse oxymetry. Conclusion : Doctors and nurses in intensive care unit keep in mind that adequate blood sampling is needed for the decrease of blood loss. Education and protocol for the decrease of blood loss after arterial blood gas analysis may be necessary.

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.

New polymorphic microsatellite markers in the Korean mi-iuy croaker, $Miichthys$ $miiuy$, and their application to the genetic characterization of wild and farmed populations

An, Hye-Suck,Kim, Eun-Mi,Lee, Jang-Wook,Kim, Dae-Jung,Kim, Yi-Cheong The Korean Society for Integrative Biology 2012 Animal cells and systems Vol.16 No.1

Eighteen new polymorphic microsatellite markers were developed for the Korean mi-iuy croaker ($Miichthys$ $miiuy$, Perciformes, Sciaenidae), and allelic variability was compared between a wild population in Mokpo, Korea, and a hatchery population in Tongyeong, Korea. All loci were amplified readily and demonstrated allelic variability, with the number of alleles ranging from 5 to 37 in the wild population, and from 4 to 12 in the farmed population. The average observed and expected heterozygosities were estimated, respectively, to be 0.74 and 0.78 in the hatchery population samples, and 0.79 and 0.86 in the wild samples. These results indicate lower genetic variability in the hatchery population compared with the wild population, and significant genetic differentiation between the wild population and the hatchery samples ($F_{ST}$=0.058, P<0.001). These microsatellite loci may be valuable for future population genetic studies, monitoring changes in the genetic variation within stocks in a commercial breeding program, conservation genetics, and molecular assisted selective breeding of the mi-iuy croaker in the future.

일 도농복합지역 저소득층 노인의 건강문제 분석 : 보건소 방문간호사업 대상자 중심으로

고일선,,이태화,이경자,이정렬,임미혜,천의영,주윤미,이계철 노인간호학회 2005 노인간호학회지 Vol.7 No.2

Purpose: The purpose of this study was to analyze the health problems of low-income aged with chronic illness living in urban-rural composite area. Method: The sample consisted of 440 aged who were receiving home care services from a public health center. MDS-HC was applied to analyze the health problems of the aged. Data were collected through a face- to-face interview by six trained interviewers from June 28 to July 15, 2004. Result: Subjects had average number of 8 health problems in both urban and rural area. Lack of preventive health care measure, pain, and visual function were the most frequent health problem. The rural aged had more pain, bowel management problems, compared to the urban aged having more urinary incontinence and indwelling catheter. There were many health problems related to falls and pressure ulcers with middle-old aged in urban, and old-old aged in rural area. Conclusion: The results of this study showed strategies for care intervention of low-income elderly to put in practice. Therefore, tailored-service for each subject should be provided.

한국비서자격시험의 개선점과 비교연구

남자현,이미정,이미영,이아영,정해금,최유정,이미숙,전인선,정혜림 이화여자대학교 법정대학 비서학과 1997 비서학연구 Vol.- No.17

소하천의 수질개선을 위한 자연정화공정 개발에 관한 연구

이혜미,오종민 경희대학교 환경연구소 2001 環境硏究 論文集 Vol.10 No.-

This study was performed to application of Porous concrete blocks and aquatic plants to water purification in small urban stream. This study was investigated the ability of water purification according to the variety of environment, epiphytic algae and aquatic plants. When the Porous concrete was used as contact media, the average removal efficiency of SS, BOD and COD were SS(85-95%), COD(50-60%), BOD(65-75%) respectively. Also when the Porous concrete and aquatic plants was used the average removal efficiency of SS and BOD were SS(90-95%), BOD(70-80%) respectively. In result, average removal efficiency of total nitrogen(T-N) with the Porous concrete and aquatic plants was about 40-50%. Average removal efficiency of total phosphorus(T-P) with the Porous concrete and aquatic plants was about 60-70%.

2-구획 인공 모세혈관 모델을 이용한 Pseudomonas aeruginosa 임상균주에 대한 Panipenem의 효과

이동건,전혜선,최수미,최정현,유진홍,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.4

목적 : Panipenem은 일본에서 개발된 카바페넴계 항생제로 광범위한 항균력을 나타낸다고 보고되고 있지만 P. aeruginosa에 대해서는 아직 논란이 있다. 본 연구에서는 임상에서 분리된 P. aeruginosa 균주를 대상으로 사람의 약역학을 모의할 수 있는 시험관내 역동 모델을 이용하여 panipenem (PAPM)과 imipenem (IMPM)의 효과를 비교하고 Muller-Hinton broth (MHB)와 basic amino acid 함량이 적은 배지(Minimum Broth Davis, MBD)에 효과의 차이가 있는지 확인하고자 하였다. 재료 및 방법 : 혈액에서 분리된 P. aeruginosa SGP14 균주를 대상으로 하였다. 사람의 약동학을 모의할 수 있는 2-구획 인공 모세혈관 모델(two-compartment model)을 제작하였고, 세균이 peripheral compartment에서 반감기에 따라 농도가 변하고 있는 항생제에 노출되고, 접종한 세균의 수는 희석되지 않게 하였다. PAPM과 IMPM의 용량은 500mg씩 하루 2회를 모의하도록 하였고 2일간 실험하였다. Panipenem, imipenem의 반감기는 사람의 약역학과 같이 10시간에 맞추었다. 항생제 투여 간격은 panipenem, imipenem 모두 12시간으로 하였고 각 항생제의 최고 및 최저농도는 사람에 투여했을 때의 혈중농도에 맞추었다(panipenem 각각 45.6, 0 ug/mL, imipenem 각각 33.0, 0 ug/mL). 배지는 MHB와 MBD를 사용하였고 4군으로 나누어 실험하였다. [PAPM (MHB), PAPM (MBD), IMPM (MHB), IMPM (MBD)] peripheral compartment에서 0, 1, 2, 4, 6, 8, 12, 24, 32, 48시간에 맞춰 샘플을 하였고 집락수 (cfu/mL)를 측정하였다. 결과 : SGP14에 대한 PMPM, IMPM의 MIC는 각각 64, 2 ug/mL이었다. PAPM (MHB)는 2시간이 지나면서 다시 자라기 시작하여 32시간째부터는 항생제를 사용하지 않은 대조군과 같은 곡선을 보였다. 12시간까지의 집락수 변화는 4가지 실험군에서 군간 의미있는 차이를 보이지 않았지만(P=0073) 군내의 PAPM (MHB)가 PAPM(MBD), IMPM (MBD)와 비교하여 집락수 변화가 유의하게 작았다. 또한 48시간까지의 집락수 변화는 PAPM(MBD)이 가장 많았고, 그 다음이 IMPM (MHB), IMPM(MBD)였으며, PAPM(MHB) 순이었다(P=000). 48시간까지 집락수 변화는 IMPM (MHB)와 IMPM (MBD)사이에 차이가 없었다. 결론 : 사람의 혈청내 basic amino acid 농도와 PAPM의 농도를 모의하도록 한 2-구획 인공 모세혈관 모델에서 PAPM은 IMPM과 비교하여 P. aeruginosa에 대해 비슷하거나(12시간째) 더 나은 살균력을 보였다(48시간째). 추후 본 실험의 결과와 실제 임상에서의 P. aeruginosa에 대한 panipenem의 효과를 비교해보는 것이 필요하겠다. Background : Panipenem (PAPM) is a new carbapenem which has an enhanced broad spectrum activity against both gram-positive and negative organisms. However, its activities in vitro against Pseudomonas aeruginosa are still under controversy. The aim of this study was to compare the activity of PAPM with those of imipenem (IMPM) against clinical isolates of P. aeruginosa using in vitro kinetic model and to evaluate the differences according to the quantity of basic amino acid in media. Materials and methods : Using a clinical isolate of P. aeruginosa (SGP14) from blood, an in vitro 2-compartment artificial capillary model based on a dialyzer unit was prepared. Antibiotics were given as a bolus q12 hrs for 48 hrs. Simulated doses and frequencies of PAPM and IMPM were 500 mg q12 hrs as approved by Korea Food and Drug Administration. Muller-Hinton broth (MHB) and minimal broth Davis (MBD) were used as culture media and we divided the experiments into 4 groups [PAPM (MHB), PAPM (MBD), IMPM (MHB), IMPM (MBD)]. At 0, 1, 2, 4, 6, 8, 12, 24, 32, and 48 h, samples were removed from peripheral compartment and viable bacterial counts were measured. Results : The susceptibility of PAPM and IMPM for SGP14 were 64 and 2 ug/mL in MHB and 4 and 2 ug/mL in MBD, respectively. Up until 12 hours, changes in bacterial colony counts were not significantly different (P=0.073) for each group. However among the four groups, PAPM (MHB) showed the least changes compared with PMPM (MBD), IMPM (MBD). The largest decrement of colony during 48 hours was observed with PMPM (MBD), followed by IMPM (MHB) or IMPM (MBD), and PAPM (MHB) in decreasing order (P=0.00). There were no differences between IMPM (MHB) and IMPM (MBD) as for the change in colony counts. Conclusions : The bactericidal activities of panipenem against the clinical isolate of P. aeruginosa was similar (at 12 h) or superior (at 48 h) to that of imipenem in an in vitro 2-compartment artificial capillary model using minimal broth to simulate human serum drug concentrations.

시험관내 심내막염 모델에서 Methicillin 내성 포도구균에 대한 Vancomycin, Arbekacin, Gentamicin 단독 혹은 병합효과

이동건,전혜선,임동석,최수미,최정현,유진홍,신완식,강문원 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

목적 : Methicillin 내성 포도구균(methicillin resistant Staphylococcus aureus, MRSA)은 병원감염의 중요한 원인균으로 vancomycin이 선택약제이다. 그러나 심내막염 등의 중증감염에서는 vancomycin의 치료실패와 함께 최근 내성균도 증가하고 있어 vancomycin을 대체할 수 있는 항균제와 보다 효과적인 항균요법의 개발이 필요하다. 본 연구에서는 사람의 환경과 유사한 시험관내 감염 모델을 적용하여 MRSA 치료를 위한 vancomycin, arbekacin, gentamicin의 단독 및 병합효과를 비교하였다. 방법 : 임상에서 분리된 MRSA 2균주(GRI 53, gentamicin 내성 : GS171, gentamicin 감수성)로 fibrin clot을 제작하여 시험관내 심내막염 모델을 만들어 vancomycin, arbekacin, gentamicin을 단독 혹은 병합주입하였다. 반감기와 최고 및 최저농도는 사람의 약동학을 기준으로 하였다. Vancomycin은 6, 12, 24시간마다 주입하거나 24시간 연속주입하였고 arbekacin은 12, 24시간마다, gentamicin은 8, 24시간마다 주입하였다. 병합주입의 경우 vancomycin은 12시간마다, gentamicin, arbekacin은 24시간마다 투여하였다. 각 투여군의 살균효과는 0, 8, 24, 32, 48, 72시간째의 fibrin clot내 집락수로 측정하였다. 결과 : GRI153에 gentamicin을 주입한 군 이외의 모든 실험군에서 대조군에 비해 의미있게 fibrin clot내 집락수가 감소하였다(P<0.001). Vancomycin과 arbekacin 단독주입군내서 8시간째의 집락수는 GRI153보다 GS171에서 의미있게 낮았고(P=0.02), GS171에 arbekacin 12시간마다 투여한 군의 집락수가 가장 낮았다(P=0.01). 72시간째 집락수는 균주의 종류나 vancomycin 혹은 arbekacin의 투여간격에 따른 차이가 없었다. GRI153에서 vancomycin과 arbekacin의 병합주입군은 24시간까지 상가작용이 있었으나 vancomycin과 gentamicin 병합주입에서는 무관작용이었고 GS171에서도 72시간 동안 무관작용을 보였다. 또한 전 실험기간 동안 내성균은 발현되지 않았다. 결론 : 시험관내 심내막염 모델에서 MRSA에 대한 arbekacin의 항균력은 vancomycin과 유사하여 단독주입이 가능함을 시사한다. Gentamicin 내성균주의 경우 두가지 항균제의 병합주입으로 24시간까지 상가작용을 보이고 있으나 임상에 적용하기 위해서는 추가연구가 필요할 것으로 생각된다. Background : Glycopeptide has been used for the one-and-only treatment of choice in methicillin resistant Staphylococcus aureus (MRSA) infection, but its exclusive use for the MRSA infection has led to the increased risk of glycopeptide-resistance. To find an alternative (s), we employed an in vitro infective endocarditis model (IVIEM) to compare the efficacy of vancomycin (VCM). arbekacin (ABK), and gentamicin (GM) alone or in combination. Methods : Using two strains of clinically isolated MRSA, one GM susceptible (GS171) and the other GM resistant (GR153), fibrin clots were prepared and suspended in IVIEM. Antibiotics were added as a bolus to simulate human pharmacokinetics of regimens, including q 6 h, q 12 h, q 24 h, or continuous infusion with VCM, q 12h or q 24 h with ABK, and q 8 h or q 24 h with GM. In cases of combination, regimens were VCM q 12 h plus ABK q 24 h, and VCM q 12 h plus GM q 24 h. Fibrin clots were removed from each model at 0, 8, 24, 32, 48. and 72 h, and the bacterial densities (in CFU/g) were determined. Results : At 8 hour, the colony counts of GS171 were lower than those of GR153 (P=0.02), and the lowest with the ABK q12h against GS171 (P=0.01). At 72 hour, monotherapy with ABK or VCM produced same degree of bacterial reductions in IVIEM, regardless of dosing frequency or GM-resistance. In the case of GM-resistance, combination of VCM and ABK did show additive effect until 24 hours, although VCM and GM showed no indifference during all the experiments. Development of resistance during experiment was not observed with any regimens. Conclusions : Our data suggest that ABK monotherapy could be used as an alternative to VCM even in the treatment of GM-resistant staphylococcal endocarditis. Further studies will clinical trials are warranted to evaluate the additive effect of VCM and ABK.

다공성 하천구조물을 이용한 2차 처리수의 수질개선 효과

이혜미,오종민,최이송 경희대학교 환경연구소 2002 環境硏究 論文集 Vol.11 No.-

This study was performed to application of porous hydraulic structures(porous weir and porous river bed materials) to water purification in small and middle stream. This study was investigated the ability of water purification according to the variety of environmental conditions, periphytons and material of hydraulic structures. When the ordinary hydraulic structure was used as contact d a , the average removal efficiency of SS, BOD and COD were SS(48.4%), BOD(25.2%), COD(12.0%) respectively. Also when the porous hydraulic structure was used as contact media, the average removal efficiency of SS, BOD, COD and T-P were SS(83.0%), BOD(62.1%), COD(45.9%), T-P(32.3%) respectively. Judging from our results, porous concrete applied to the weir from took a great role of removal efficiencies of BOD, COD(low concentration range of organic materials) and T-P

해고사유 및 시기의 서면통지규정과 관련한 해고의 정당성 검토 : 대법원 2011. 10. 27. 선고 2011다42324 판결을 중심으로

이혜미 이화여자대학교 법학전문대학원 2012 Ewha Law Review Vol.2 No.2

본 판결에서는 원고에 대한 피고의 징계해고가 부당해고인지 여부에 관하여 실체적 정당성과 절차적 정당성의 두 측면에서 다투어졌다. 근로기준법 제23조 제1항은 사용자가 근로자에게 해고를 비롯한 불이익한 처분을 할 경우에는 ‘정당한 이유’가 있어야 한다고 하고 있는데 우리 판례는 해고가 정당하려면 절차적 정당성과 실체적 정당성을 모두 갖추어야 한다고 하고 있다. 절차적 정당성과 관련하여 2007. 7. 1. 부터 해고의 시기, 사유의 서면통지 제도(근로기준법 제27조)가 새롭게 도입되었는데, 본 판결에서는 해고사유를 서면으로 통지하는 경우 해고사유를 어느 정도로 구체적으로 기재하여야 하는지 여부가 핵심적 쟁점이 되었다. 근로기준법 제27조 제1항은 ‘해고의 사유를 서면으로 통지할 것’만 규정하고 있고, 해고사유를 어느 정도로 특정하여야 하는지는 규정하고 있지 않아서 문제된 것인데, 대상판결은 “해고의 서면통지시 ‘해고사유’는 근로자가 자신의 어떤 행위가 해고사유에 해당하는지를 인식할 수 있도록 해고사유에 해당하는 근로자의 구체적인 비위행위를 명시하여야 하고, 그렇지 않고 단순히 징계사유의 조항만을 나열한 것은 제27조 제1항에 위반한 해고로 무효”라고 판시하였다. 근로기준법 제27조의 도입 취지가 해고사유 등의 서면통지를 통해 사용자로 하여금 근로자를 해고하는 데 신중을 기하게 함과 아울러, 해고의 존부 및 시기와 그 사유를 명확하게 하여 사후에 이를 둘러싼 분쟁이 적정하고 용이하게 해결될 수 있도록 하고, 근로자에게도 해고에 적절히 대응할 수 있게 하기 위한 것이라는 점에서 대상판결의 판시는 타당하다. 대상판결은 해고의 서면통지 요건의 해석을 명확히 하고, 기존의 해고사유의 구체성에 대한 학계의 논란도 잠식시킬 수 있게 되었다는 점에서 큰 의의를 갖는다. This Note reviews a court decision where a ex-employee argued for wrongful dismissal. In this decision, the court revealed standards that determine whether a particular dismissal is justifiable or not. Korean Labor Standards Act Article 23 states that a dismissal should have justifiable reasons. The reviewed court decision states that dismissal must satisfy both substantial and procedural justification standards. In 2007, Korean Labor Standards Act was revised to introduce a new system, Written Notice of Reason for Dismissal. However, it failed to stipulate how detailed such reasons for dismissal should be. This court decided that a written notice of reason for dismissal should state specific actions by the employee that called for dismissal, and that enumeration of Articles that state causes for disciplinary action is not enough thus violation of Article 27 Clause 1. When considering the background for introduction of the new system, such decision is an adequate interpretation of the article. This decision is worthwhile in that it will be able to terminate the long academic controversy on justifiable causes for dismissal.