NIHSS 활용을 통한 뇌졸중 환자 간호의 질향상 전략

박경현,송경애,공혜성,나화주,유수경,박소영,김상희,최혜림,배희준,한문구,양미화 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로활용하고 있지만 아직 간호현장에서는보편적으로사용하지 않고있다. 이에 뇌졸중환자간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중환자 간호의 질을보다 향상시키기 위하여 본활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를향상시키기 위한 프로그램을 개발·적용한다. 둘째, 간호사가급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬수있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과치료를위한의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 「NIHSS 간호사 교육 프로그램」을 마련하였다.

DJ-1 deficiency impairs synaptic vesicle endocytosis and reavailability at nerve terminals

Kyung, Jae Won,Kim, Jin-Mo,Lee, Wongyoung,Ha, Tae-Young,Cha, Seon-Heui,Chung, Kyung-Hwun,Choi, Dong-Joo,Jou, Ilo,Song, Woo Keun,Joe, Eun-Hye,Kim, Sung Hyun,Park, Sang Myun National Academy of Sciences 2018 Proceedings of the National Academy of Sciences Vol.115 No.7

<P>Mutations in DJ-1 (PARK7) are a known cause of early-onset autosomal recessive Parkinson's disease (PD). Accumulating evidence indicates that abnormalities of synaptic vesicle trafficking underlie the pathophysiological mechanism of PD. In the present study, we explored whether DJ-1 is involved in CNS synaptic function. DJ-1 deficiency impaired synaptic vesicle endocytosis and reavailability without inducing structural alterations in synapses. Familial mutants of DJ-1 (M26I, E64D, and L166P) were unable to rescue defective endocytosis of synaptic vesicles, whereas WT DJ-1 expression completely restored endocytic function in DJ-1 KO neurons. The defective synaptic endocytosis shown in DJ-1 KO neurons may be attributable to alterations in membrane cholesterol level. Thus, DJ-1 appears essential for synaptic vesicle endocytosis and reavailability, and impairment of this function by familial mutants of DJ-1 may be related to the pathogenesis of PD.</P>

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.

노인의 성격과 죽음태도에 관한 탐색적 연구

유경원,박상하,김혜숙,정경인 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Background and Objectives: The purpose of this study was to analyze how the personality of elderly people affects their attitude toward death. Method: For this study, we investigated 86 old men and women with over the age of 60 in C and J nursing home for the old at Gwang ju city during January 5 to March 31, 2003. As a research tool, the total 20 questions of modified Shanans assorted survey method to measure personality style were used and the reliability of this study was Cronbach's α= 0.7507. For determination of attitude of death, the total 36 questions of FODS, which has been used by Suh, Hye-Kyung were used and the reliability of this study was Cronbach's α= 0.60. Using SPSS program, the collected data were analyzed by Frequency, ANOVA and Pearson correlation coefficient, respectively. Results: In the analyze of the results of personality complying with general characteristics, there were statistically significant differences in age. It was shown that the personality of the old with the age of 61-65 is positive. There were no significant differences in thee attitude toward death complying with general characteristics. The hypothesis in this study, the correlation that the more positive personality of the old, the more positive attitude toward death was supported. Conclusion: Since the elderly people with more positive personality may have more positive attitude toward death, it is considered that the old themselves, their family and workers might help to haw positive personality for the positive attitude toward death.

저체중 또는 과체중 청소년에서 캠프 프로그램을 이용한 영양 교육효과에 관한 연구

성미경,승정자,류화춘,박재년,박동연,최미경,조경옥,최선혜,이윤신,김유경,이은주 대한지역사회영양학회 2003 대한지역사회영양학회지 Vol.8 No.4

This study was performed to evaluate the effectiveness of a nutrition education program developed for nutritionally imbalanced adolescents. A summer nutrition camp was held for 23 overweight and 16 underweight subjects. Its effectiveness with regard to was evaluated at the end of the camp and 6 months later. Nutrition knowledge, nutritional attitude, food behavior, nutrient intake, exercise habit and ideal body figures desired by the subjects. The results showed significantly higher nutrition knowledge scores at the end of the camp as compared to those obtained prior to the camp program, and these scores were maintained for at least six months. Nutrition attitude scores also improved after the education program, and these improved scores also lasted for 6 months. However, the food behavior scores measured 6 months after the education program were not significantly different from those obtained prior to the camp. Also, the exercise habit, the ideal body figures and the body figures desired by the subjects remained unchanged. When nutrient intakes of subjects were assessed before the program and 6 months later, the mean daily vitamin C intake was significantly increased after the education program. Also, the intake of iron from plant food sources increased in the overweight subjects, while less iron from animal source were consumed by the underweight subjects. Both groups tended to consume more vegetables and fruits 6 months after the education program which may have contribute to the higher vitamin C and plant-based iron intakes. These results indicate that a 4-day nutrition education camp program sustained changes in nutrition knowledge and nutrition attitude for 6 months. The increased intake of vegetables and fruits was also achieved through this education program. However, changes in dietary behavior in adolescents may require repeated education.

축구선수의 Detraining과 Retraining이 혈청지질 및 호르몬농도에 미치는 영향

정정화,박재현,채종훈,성혜련,황지인,윤미숙,노금선,윤종관,윤영학,노순덕,정경숙,박일규,김은희,박현태,박상갑 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

The purpose of this study was to investigate the effects of detraining and retraining on serum lipid and hormones in soccer players. Subjects were seven male high-school soccer players. V˙O_2max was determined for each subjects by administering a treadmill test(initial speed: 90m/min, grade: 5%, increasing speed per 3 min: 30m/min). Serum lipid(T-C, TG, HDL-C LDL-C) and hormones(epinephrine, norepinephrine, growth hormones, cortisol) were assayed pre and post detraining in 10, 20, 30 days after retraining. The repeated ANOVA was used to determine significant differences. The 0.05 level of significance was as critical level for the study. The results of the study were as follows: 1. V˙O_2max(ml/min) were 3576.3±204.2ml/min pre detraining, 3234.1±198.9 ml/min post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/min) were 3601.4±170.9 ml/min. There were significantly(p<.05) increased in retraining periods. 2. V˙O_2max(ml/kg/min) were significantly(p<.05) decreased from 62.3±2.9 ml/kg/min to 55.9±4.7 ml/kg/min in detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/kg/min) were 62.4±3.4ml/kg/min, 62.7±2.3ml.kg/min, 67.3±7.2ml/kg/min respectively. There were significantly(p<.05) increased in retraining periods. 3. T-C were significantly (p<.05) increased from 166.6±8.5mg/dl to 175.3±10.3 mg/dl in detraining. In 10, 20, 30 days after retraining, T-C were 160.1± 3.2mg/dl, 156.7±3.7mg/dl, 140.3±9.0mg/dl. There were significantly(p<.05) decreased in retraining periods. 4. HDL-C were 61.4±6.6mg/di pre detraining, 5.3±6.6mg/dl post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, HDL-C were 56.9±7.1mg/dl, 56.4±9.2mg/dl, 57.7±9.1mg/dl respectively. There were no significant difference in retraining periods. 5. The hormones(epinephrine. norepinephrine, growth hormone, cortisol) were changed as same patterns. Epinephrine were 26.0±7.0[g/ml pre detraining, 24.6±3.2pg/ml post detraining. In 10, 20, 30 days after retraining, epinephrine were 26.9±5.6pg/ml, 30.6±6.2pg/ml, 29.4±5.6pg/ml respectively. There were no significant difference in retraining periods. In conclusion, HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were decreased, T-C, LDL-C and TG were increased in detraining. But HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were increased, T-C, LDL-C and TG were decreased in retraining.

식품 기준·규격의 합리적 관리 ·운영에 관한 연구(Ⅰ) : 두부,식용유지, 전분의 분말상 원료에 관하여 Powdered marerials of Tofu, Edible oil, Starch

김희연,홍진환,박혜경,한상배,박종석,이은주,이정성,송경희,최은희,최영준,소경아,성영제,이주엽 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

본 연구는 분말상 원료(전분, 대두분)의 저장유통시 품질변화를 건전성과 안전성 측면에서 검토하여 식품의 기준 ·규격 설정f.」 합지적으로 반영하고자 하였다. 전분과 패두분의 이물을 검사하고, 2종 대두분(중국산, 미국산)을 ?0일간 IS'c와 30t에 저장하면서 성상, 수분, 산가, 과산화물가, 지방산 조성,아플라톡신 BB의 생성여부를 분석하였다. 중국산 대두분 30'』 저장군에서 50일 이후 곰팡이가 발생한 것 이외에 모든 시료에서 양호한 성상을 나타내었고, 전분과 대두닥 모든 시료에서 이물은 검출되지 않았다. 산가는 중국산과 미국산 시료간에 편차를 보여 증국산 30"C, 50일 저장시료에서 약 10배끙도 증가하였고, 과산화물가는 저장 90일후 15'E 저장군은 약 2.3배, 30'c 저장군은 3배정도 증가하였다. 대두분의 주요 지방산은 linoleic acidf18. 2), oleic acid(18 : 1), palmitic acid(16 : 0)이었으며, 3개월 저장에 따른 지방산 함량의 변화는 미미하였다. 아플라톡신 B₁은 모든 시료에서 검출되지 않았다. The objective of this study was to investigate auality changes of type raw materials(starch, soy flour) during various storage conditions. Starchflour(source of China, U.S.A) were slfred under two temperature(15'C, 30'c) forSensory evaluation, (o.reign material test, moisture content, acid value, peroxide ualue,composition, aflatorin Bi were analyzed. China soy flour(stor·ed 30'f) was contaminated by fungj on 50 days. Except for soy flour contardnated by fungi, sensory characteristics were not changed and foreign mater;als were notdetected. Acid value of China soy flour(stored at 30'C, 90 days) was about 10 times higherlevel before storage and acid value was more influenced by source(China, USA). Peroxide valuewas in proportion with the storage period slightly. The major fatty acid of soy flour waslinoleic acid(18 . 2), an(3 the change of fatty acid composition was not observed. Aflatoxlrl Blwas not detected.

서울시내 일부 고등학교 학생들에서 학업성취도가 우울 증상에 미치는 영향

박혜숙,최경희,이보은 韓國學校保健學會 2001 韓國學校保健學會誌 Vol.14 No.2

Depression is one of the most common psychologic disorder and dealt as a major public health concern. School students have heavy school work loads and stress from various evaluations representing school performance. In this study, to examine the effect of school performance and stress on depressive symptoms, we assessed the frequency of risk factors for depressive symptoms among 2,717 high school students. From April 2001 to May 2001, using a self-reported questionnaire, we collected data on the frequency of occurrence of depressive symptoms and potential risk factors for depressive symptoms. Depressive symptoms were measured using Center Epidemiologlc Studies Depression (DES-D) index. Thirty-seven percent of high school students reported having high depressive symptoms for a week Female students had a higher prevalence of depressive symptoms than males (OR=1.44, 95% CI 1.22-1.70). In a multiple logistic regression model, we found that good perceived school performance (OR=0.43, 95% CI 0.31-0.60) had a negative association with depressive symptoms. On the contrary, we also found that stress from school performance (OR=2.03, 95% CI 1.69-2.44) associated with high depressive symptoms. In conclusion, high school students had a relatively high prevalence of depressive symptoms. Students with stress from school performance had the higher risk far depressive symptoms. Key words : Depression, risk factors, prevalence, performance, youths

Inhibitory Effect of Cordycepin on Human Platelet Aggregation

박화진,--,--,--,--,--,-- THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 2004 Journal of biomedical laboratory sciences Vol.10 No.1

Cordycepin separated from Cordyceps militaris is a major physiologic active component in Cordyceps militaris. The platelet aggregation is stimulated by Ca^(2+), which is either mobilized from intracellular endoplasmic reticulum or transported from extracellular space. cGMP antagonizes the actions of Ca^(2+). Based on these facts, we have investigated the effects of cordycepin on the mobilization of Ca^(2+) and the production of cGMP on collagen (10 ㎍/ml)-induced human platelet aggregation. Cordycepin potently stimulated the human platelet aggregation induced by collagen (10 ㎍/ml) in a dose-dependent manner. Cordycepin (500 μM) inhibited also the collagen-induced human platelet aggregation in the presence both 1 mM and 2 mM of CaCl_(2). These are in accord with the results that cordycepin inhibited the Ca^(2+)-influx on collagen-induced human platelet aggregation. These results suggest that cordycepin decrease the intracellular Ca^(2+) concentration to inhibit collagen-induced human platelet aggregation. Besides, cordycepin increased the level of cGMP on collagen-induced human platelet aggregation. This result is related with the decrease of intracellular Ca^(2+) concentration, because cGMP inhibits the mobilization of Ca^(2+). In addition, cordycepin inhibited the human platelet aggregation induced by LY-83583, inhibitor of guanylate cyclase. This result suggested that cordycepin inhibit the platelet aggregation by stimulating the activity of guanylate cyclase. In conclusion, we demonstrated that cordycepin might have the antiplatelet function by inhibiting Ca^(2+)-mobilization via the stimulation of the production of cGMP.

미백보조광 조사가 치아미백의 효과에 미치는 영향

박종현,신혜진,박덕영,박세희,김진우,조경모 대한치과보존학회 2009 Restorative Dentistry & Endodontics Vol.34 No.2

The aim of this study was to evaluate the influence of light energy on the tooth whitening effect of bleaching agent in vitro. Extracted human mandibular molars were sectioned to 2 fragments(mesial distal) and lingual portions of crown were used in this study. All specimens were stained using a red wine for 24 hours and immersed in artificial saliva. Specimens divided into four groups, group 1 and 2 light-activated by LumaCool (LED, LumaLite. Inc. Spring Valley, USA) group 3 and 4 light-activated by FlipoWhite2 (Plasma acr lamp, Lokki Australia) Group 1 and 3 bleached with LumaWhite(LumaLite, Inc.. Spring Valley USA), group 2 and 4 bleached with Polaoffice(SDI, Victoria, Australia). Bleaching treatment Performed during 10 minutes every 24 hours and repeated 6 times. During bleaching treatment, distal fragments was light-activated(L) but mesial fragments was not(NL). Shade assessment employed before and after bleaching treatment using spectrophotemeter. The results of the change in shade was compared and analysed between NL and L by using paired-sample T test with 95 % level of confidence. There were no significant differences between NL and L with a few exceptions. In group 2, a^(*) value more change in L, in group 3, b^(*) value more change in L in gioup 4, a(*) value less change in L. After bleaching L^(*) value and ΔE increased in all groups and the value of a^(*) and b^(*) decreased in all groups. Within the limitation of this test conditions, the results of this study indicate that the light energy has no obvious improving impact on the tooth whitening effect of a bleaching agent. 이 연구의 목적은 미백제의 치아미백효과에 미백보조광의 빛에너지의 영향을 평가하는 것이다. 발거된 하악 대구치 치관의 설면을 실험에 사용하였고, 하나의 대구치에서 근심과 원심으로 구분되는 2개의 치아 절편을 얻었다. 모든 시편을 24시간동안 적포도주에 보관하여 착색을 유도하고, 인공타액에 보관하였다. 시편들은 미백광조사기와 미백 powder의 종류에 따라 4개의 실험군으로 나뉘었으며, 실험군은 다음과 같다. Group 1: LumaCool로 광조사를 시행, LumaWhite를 사용 Group 2: LumaCool로 광조사를 시행, Polaoffice를 사용 Group 3: FlipoWhite 2로 광조사를 시행, LumaWhite를 사용 Group 4: FlipoWhite 2로 광조사를 시행, Polaoffice를 사용 미백처치는 10분간 매 24시간마다 총 6회 시행하였고, 미백처치시 동일한 치아에서 얻어진 두 개의 시편 중 원심시편에는 미백광조사를 시행한 반면, 근심시편에는 미백광조사를 시행하지 않았다. 색조의 평가는 spectrophotometer를 사용하여 매 미백처지 전과 후에 시행하였고, 근심측과 원심측에서 얻어진 색조 변화 차이를 paired-sample T test를 이용하여 95%의 신뢰수준으로 비교하였다. 미백처치 후 모든 실험군에서 L^(*) value와 ΔE의 증가와 a^(*) value와 b^(*) value의 감소가 관찰되었다. Group 2 원심절편의 a^(*) value와 group 3 원심절편의 b^(*) value에서의 더 큰 변화와 group 4의 원심절편에서의 a^(*) value가 좀 더 적은 변화를 제외하고, 모든 실험군에서 근심절편과 원심절편사이에서 색조변화의 차이는 통계적 유의성을 보이지 않았다. 이상의 연구 결과에서 미백보조광의 빛에너지는 미백제의 치아미백 효과를 증가시키는 것에 명백한 영향을 주지 않는 것으로 평가되었다.