전국 응급의학과 수련병원의 응급실 병력지에 대한 분석

임태호,임훈,이종호,강형구,장문준,조광현,장석준,김승호,정상원 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: This study was designed to analyze the current emergency department(ED) medical records of teaching hospitals in Korea. Methods: The five-item questionnaires were mailed to the EDs of 40 hospitals. Among them, 27 questionnaires and 35 ED medical records were returned for reply rates of 67.5% and 87.5%, respectively. Results: 1) The actual number of data elements in the ED medical records used by each hospital varies widely. It ranges from 1 to 15 data elements with an average of 7.5 data elements. 2) Thirteen data elements, signature of nurse, checklist style in review of systems, checklist style in physical examination, neurologic examination, figure of face, Glasgow coma scale, trauma scale, treatment plan, mode of transfer, condition on transfer, documents sent with patient, condition on discharge or discharge instruction, use of pediatric chart and vaccination history are used by less than 50% of the medical records examined. 3) There was no difference in the total number of data elements or in redesign and computerization of ED medical record based on the location of the hospital, the type of hospital administration, or the number of years since the start of EM residency program. 4) There was a statistically increased number of data elements in redesigned medical records. 5) In the survey, 89% of the residents replied that medical records needed to be redesigned. With respect to uniformity, 58% of the residents disagreed. A well-designed checklist chart rather than a descriptive chart was preferred by 89% of the residents. Conclusion: The currently used ED medical records have much room for improvement. The age of the ED had little impact on the quality of ED medical records. More attention and effort in this field are needed. In addition, The Korean Society of Emergency Medicine should provide guidelines for ED medical records.

보건소 진료서비스 이용자의 만족도에 관한 연구

문영신,조우현,강임옥 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patint satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7. 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those -receiving free-care. There 'were however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients, except for the dimension on sympathy and shape.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

간호사의 임상 실무 경험

서문자,손행미,강현숙,권성복,김주현,박영숙,이은희,임난영,조경숙,지성애 성인간호학회 2002 성인간호학회지 Vol.14 No.4

purpose: This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea. Method: Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription. Result: The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients. Conclusion: Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.

차량용 브레이크 디스크와 패드의 온도 해석

신현명,임문혁 啓明大學校 産業技術硏究所 1997 産業技術硏究所 論文報告集 Vol.20 No.-

It is crucial for the safety of the passengers to design the brakes of the vehicle appropriately. One must accurately estimate the temperature increase of the brake during the braking operation and provide sufficient cooling or heat loss to maintain the stress below the allowable limit of the braking system. In this study three models were used to obtain the temperature distribution during the braking process of an actual part was investigated and compared. A two-dimensional axi-symmetric model was sufficient for obtaining the temperature distribution; however, it was found to be unsatisfactory for analyzing the stresses. In the case of the tree-dimensional portion of the model the temperature distribution turned out to be similar to the actual temperature measurement. However, under repeated braking conditions the maximum equivalent stress turned out to be greater that the yield stress; thus, the current design requires research.

Gerbera(Gerbera hybrida Hort)의 형태적 특징과 유전적 유연관계 분석

김현애,임현희,양원진,이재헌,이병영,이용문,권오창 동아대학교 농업생명과학연구소 2001 農業生命資援硏究 Vol.10 No.1

This study was conducted to analyze the morphological characteristics and genetic relationships among 24 species of Gerbera. Most of flower colors were pink. The numerical order of flower color was pink, orange, red, double-colored, and milk-white. Majority of flower types were single or semidouble flowers. A few species were double flowers. Flower diameters were from 7cm to 12cm, showed significant differences compared to other characteristics. Flower stalks were ranged from 55cm to 65cm. Only one species was the shortest as 55cm. The others were similar size as about 65cm. Main annual production yields were between 190 and 400 blossoms. Fifty seven reproducible polymorphic bands from eighty primers were used for analyses of genetic similarity. The genetic similarity of 24 collected Gerberas was largely classified into five groups. The average similarity coefficient was 0.72 ranged from 0.50 to 0.90. The highest similarity coefficient was shown between 'Sardana' with red/white flower color and double flower type, and 'Tamara' with orange flower color and double flower type as 0.90.

흰쥐 척수 손상후 Parvalbumin과 Calbindin D-28K 함유신경세포에 관한 면역세포화학적 연구

김종중,정윤영,임유택,박상수,박영란,김현곤,문정석 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2

Background and Objectives: This study was done to compared the distribution of the two calcium-binding proteins immunoreactive neurons, parvalbumin immunoreactiv (PV-IR) and calbindin D-28K immunoreactive (CB-IR) neurons in the spinal cord after transection. Materials and Methods: Twenty rats were divided into 3 groups (control, complete spinal cord injury (SCI), and right and left spinal cord hemisection). SCI was produced by cutting the spinal cord use blades 11 with scalpel handles. Results: In this experiment, CB-IR neurons were mainly found in many pyramidal cells distributed in the brain stem and spinal cord of rats. PV-IR Neurons were demonstrated in all lamina of the gray matter of the spinal cord. These immunoreactive cells had the highest density in the layer I and II of dorsal horn and several nuclei of the ventral horn of the all the segments of the spinal cord. CB-IR neuropil labeling was strongly noted in all the segments of the spinal cord. In contrast PV-IR neurons were different in distribution, size and morphology in the spinal cord. The number of PV-IR neurons were greater than in the spinal cord compared with the CB-IR neurons. CB-IR and PV-IR somata were round, oval, spindle and polygonal in shape, and were unipolar, bipolar, multipolar and horizontal in types. The diameters of the somata of the PV-IR and CB-IR neurons were 40-50 ㎛, respectively. Also dendrites of PV-IR and CB-IR neurons were densely arrayed in network.

입원 환자 영양검색 전산 프로그램 개발

안수미,윤기영,신연명,최경현,임근승,장문경,송윤미,공은희 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : About 30% of patients in the hospital are under nourishment. A large portion of people are undernourished when they are admitted to the hospital and in the majority of these, undernutrition develops further while in hospital. Patient-Generated subjective global assessment(PG-SGA), a method of nutritional assessment based on clinical judgment, has been widely used to assess the nutritional status of adults for both clinical and research purposes. Modified PG-SGA can be used as a nutrition screening tool, and a comprehensive nutrition assessment is desirable for those who are malnourished. The purpose of this study is to develop a simple, reliable and valid nutrition screening program(NSP). Methods : We applied the nutrition screening program(NSP) to adult inpatients who are at risk of malnutrition using the Modified Patient-Generated subjective global assessment(PG-SGA) and objective assessment(electrical medical record data). Results : Therefore simple and beneficial NSP is developed for patients with severe malnutrition. Using NSP. nutritional information of the severe malnutrition patient should be shared with the physicians and they should be taken care of by clinical dietitians to improve their nutritional status. Conclusion : The Modified PG-SGA and nutrition screening tool are simple, reliable and valid nutrition screening program(NSP).

Proposed Motor Scoring System in a Porcine Model of Parkinson's Disease induced by Chronic Subcutaneous Injection of MPTP

Moon, Joon Ho,Kim, Ji Ho,Im, Hyung-Jun,Lee, Dong Soo,Park, Eun Jung,Song, Kilyoung,Oh, Hyun Ju,Hyun, Su Bin,Kang, Sang Chul,Kim, Hyunil,Moon, Hyo Eun,Park, Hyung Woo,Lee, Hong Jae,Kim, Eun Ji,Kim, Seo The Korean Society for Brain and Neural Science 2014 Experimental Neurobiology Vol.23 No.3

<P>Destruction of dopaminergic neurons in the substantia nigra pars compacta (SNpc) is a common pathophysiology of Parkinson's disease (PD). Characteristics of PD patients include bradykinesia, muscle rigidity, tremor at rest and disturbances in balance. For about four decades, PD animal models have been produced by toxin-induced or gene-modified techniques. However, in mice, none of the gene-modified models showed all 4 major criteria of PD. Moreover, distinguishing between PD model pigs and normal pigs has not been well established. Therefore, we planned to produce a pig model for PD by chronic subcutaneous administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), neurotoxin. Changes in behavioral patterns of pigs were thoroughly evaluated and a new motor scoring system was established for this porcine model that was based on the Unified Parkinson's Disease Rating Scale (UPDRS) in human PD patients. In summary, this motor scoring system could be helpful to analyze the porcine PD model and to confirm the pathology prior to further examinations, such as positron emission tomography-computed tomography (PET-CT), which is expensive, and invasive immunohistochemistry (IHC) of the brain.</P>

Different prognostic factors according to left ventricular systolic function in patients with acute myocardial infarction

Im, Moon-Sun,Kim, Hack-Lyoung,Kim, Sang-Hyun,Lim, Woo-Hyun,Seo, Jae-Bin,Chung, Woo-Young,Zo, Joo-Hee,Kim, Myung-A,Park, Kyung-Woo,Koo, Bon-Kwon,Kim, Hyo-Soo,Chae, In-Ho,Cho, Dong-Ju,Ahn, Youngkeun,Jeo Elsevier 2016 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.221 No.-

<P>Background: Initial left ventricular (LV) systolic function is a main determinant of clinical outcomes in patients with acutemyocardial infarction (AMI). This study was performed to investigate whether AMI patients have different prognostic factors according to their baseline LV systolic function. Methods: A total of 12,988 patients with AMI from a nationwide database were analyzed. Major adverse cardiovascular events (MACEs) within 12 months of AMI, including death, nonfatal myocardial infarction (MI), and revascularization, were assessed. Results: Patients were stratified into two groups according to LV ejection fraction (LVEF): those with LVEF < 40% and those with LVEF >= 40%. Patients with LVEF < 40% (n = 1962, 15.1%) were older and had more unfavorable cardiovascular risk factors than those with LVEF >= 40% (n= 11,026, 84.9%). The rate of MACE was higher in patients with LVEF < 40% than in those with LVEF >= 40% (26.8% vs 11.4%, p < 0.001). Independent predictors of 12-month MACEs in patients with LVEF >= 40% were history of MI, high Killip stage, three-vessel disease, and lower renal function, which are already known as risk factors. However, diabetes mellitus (hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.17-2.40; p = 0.008), and the use of rennin-angiotensin system (RAS) blockers (HR, 0.63; 95% CI, 0.41-0.95; p = 0.029) were independent factors for 12-month MACE in patients with LVEF < 40%. Conclusions: Prognostic factors determining 12-month MACE after AMI are different according to LVEF. Management following AMI should be tailored according to their LV systolic function. (C) 2016 Elsevier Ireland Ltd. All rights reserved.</P>