기서 (寄書) : 조선총림 (朝鮮叢林)에 용상대덕 (龍象大德)을 향 (向)하야 [ ㅎ.야 ] 청년도제 (靑年徒弟)의 교육장려 (敎育奬勵)를 충고함 [ ㅎ.ㅁ ] / 보수 (寶輸) 김명희 (金明熙)

김명희 조선불교월보사 1911 朝鮮佛敎月報 Vol.2 No.-

중증외상환자의 주 손상 부위별 특성과 간호활동

김명희,김명희,박정하 기초간호학회 2013 Journal of korean biological nursing science Vol.15 No.4

오늘날 산업화와 경제성장에 따라 교통사고, 재해, 산업 재해 등의 각종사고가 증가하면서(Kim, J. J. et al., 2011) 매년 12만 5천 명의 중증외상환자가 발생하고, 이 중 1만 1천 명이 사망하고 있지만, 적절하고 신속한 치료가 이루어진다면 살릴 수 있는 중증외상환자도 3천 5백 명에 달한다(Joo, 2010). 외상환자의 예방가능 사망률은 그 나라의 전체적인 외상체계를 평가할 수 있는 지표로(Mackenzie, 1999) 미국과 일본의 중증외상환자 예방가능 사망률은 10-15% (Esposito, Sanddal, Reynolds, & Sanddal, 2003; Kunihiro, 2005)인 데 비해 국내는 33%로(Kim, 2011) 2배가 넘는 실정이다. 외상진료체계를 구축하여 외상환자의 예방가능 사망률을 줄이고 있는 외국사례를 토대로(Stewart, Lane, & Stefanits, 1995) 국내에서는 2009년 중증외상 특성화 후보센터를 지정하였고, 향후 전문외상센터를 운영할 계획이다(Central Emergency Medical Center, 2009). 현재 중증외상환자들은 권역응급의료센터에서 치료를 전담하고 있으나 입원대기 환자들이 정체되고(Chun, 2008) 치료전담 의료 인력이 부족(Lee, 2011)하여 중증외상환자의 진단, 치료 및 처치가 지연되고 있다. 외상환자는 외상초기의 적절한 치료여부에 따라 예후에 많은 영향을 받으므로(Nguyen, Rivers, & Havastad, 2000), 진단 및 치료에 소요되는 시간을 단축시켜 빠른 시간 내에 처치가 이루어지는 것이 매우 중요하다(Kim et al., 2007). 외상환자의 대부분은 다발성 외상환자들로(Kim, T. Y. et al., 2011) 복합적인 문제들을 동반하는 경우가 많기 때문에 생명유지를 위한 기본적인 처치와 동시에 손상부위에 따른 사정, 처치 및 간호활동이 이루어져야 한다. 국군간호사관학교의 외상간호교육과정(Trauma Nursing Core Course, TNCC)에 신체의 해부학적 부위에 따른 간호가 있지만, 이는 사고현장에서부터 병원에 도착하기까지의 상황에 대한 것(Korean Nurses Association, 2013)이고, 응급환자 매뉴얼의 외상환자 간호처치는 이론적이므로 임상실무현장을 반영한 병원 도착 후의 중증외상환자의 간호활동에 대한 연구가 필요하다.

중증외상환자의 치료경과 시간과 활력징후에 따른 응급처치 및 간호활동

김명희,박정하,김명희,구지은 기초간호학회 2014 Journal of korean biological nursing science Vol.16 No.3

Purpose: The aim of this study was to identify necessary emergency treatment and nursing activities for severe trauma patients according to elapsed time and vital signs. Methods: A survey was conducted with 121 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. Collected data were analyzed with descriptive statistics, applying McNemar’s test using SPSS 12.0. Results: Almost all of the subjects were men and the mean age was 46.9. Run-time for primary diagnosis, treatment decision, and leaving for the hospital room was 0.19, 4.36, and 4.21 hours, respectively, and stayover time was 9 hours. Regardless of vital signs, emergency treatments involving ambu-bagging, intubation, ventilator, and central vein catheterization insertion were offered within an hour. Central venous pressure, Foley catheter/Levin tube preparation and maintenance were performed in cases of unstable vital sign patients within an hour. Unrelated to vital signs, nursing activities for consciousness assessment, skin assesment and wound care, bed sore/fall down assesment and care, intravenous injection insertion and maintenance were conducted for all severe trauma patients within an hour. Foley catheter/Levin tube drainage care was performed for patients who had unstable vital signs within an hour. Conclusion: Emergency treatment and nursing activities for severe trauma patients were specific according to elapsed time and vital signs.

[기획특집] 2007년 신춘문예 당선자 특집 - 김명희

김명희 고요아침 2007 시조시학 Vol.- No.-

뇌혈관 환자에 대한 간호진단 적용 분석

김명희 대구보건대학 1996 대구보건대학 論文集 Vol.16 No.-

간호진단의 실무적용을 증진시키고 간호의 질을 높이기 위해 대구시내에 소재한 Y의료원 신경계 변동에 입원한 환자 102명에게 적용된 간호진단수 총 109개를 NANDA회의에서 채택된 간호진단명 105개에 준하여 분석한 결과 환자 1인당 평균1개를 사용하였으며 총 사용 NANDA 간호진단명은 9개로 대상자 102명중 가장 많이 사용된 간호 진단은 안위의 변화 44.0%, 불안 19.3%, 부적절한 개인적 대응 12.8%로서 높게 나타났다. 본 연구의 결과 적용된 간호진단의 종류 및 빈도가 매우 낮았으며 간호진단에 대한 사정도구개발의 연구와 간호사들에게 지속적인 보수교육이 강화되어야 한다고 생각한다. This research was done for the improvement of practical appliance of Ng. diagnosis and for the elevation of nursing guality(level). I analized the Ng. diagnosis with 109 diagnosis used by NANDA conference from 102 patients who were admitted for Neuro Surgery Ward of Y medical Center which is in Taegu. Ther general characteristics of the patients are as follows ; by sex, men were 57 cases(55.9%) and women were 45 cases(45.1%). In age, 26~29 were I case(1.0%), 30~39 were 10 cases(9.8%), 40~49 were 30 cases(29.4%), 50~59 were 32 cases(31.4%), 60~69 were 26 cases(25.5%), and over 70 were 3 cases (2.9%). In diagnosis of the patients, Cerebral Infarction were 52 cases(50.9%), Intracerebral Hemorrhage were 20 cases(19.6%), Subarachnoid Hemorrhage were 12 cases(11.8%), Epidural Hemorrhage were 7 cases(6.9%), Subdural Hemorrhage were 5 cases(4.9%), Aneurysm were 4 cases(3.9%), Cerebrovascular Accident were 2 cases(2.0%). I used all 109 Ng. diagnoses which means one person used about 1.0 of NANDA'S diagnoses. All used NANDA'S was 9 diagnoses. The most popular diagnoses were alteration in Comfort(44.0%), Anxiety(19,3%), Ineffective individual Coping(12.8%) in 102 cases. Bae showed ineffective air way clearance(48.4%), impaired Physical mobility, ineffective Breathing pattern, Knowledge deficit, All of them were 41.9% in her diagnosis analysis research of Open Heart Surgery Patients. Kang showed self care deficit(27.7%), skin integrity(23.4%), tissue perfusion, alteration in cerebral area(16.4%), and high risk for infection(0.6%), in her diagnosis analysis research of brain disease patients. Park(1987) showed the representative diagnosis of high risk for injury, altered nutrition less than body reguirements, knowledge dificit, sleep pattern disturbance, and fluid volume excess, in her evaluations, of the original and revealational research rate of five diagnosis in patients with CAAH or CAVH. When we consider the specifics of each patient we can determine how the Ng assessment reveals that patients problems differ according to their disease. Signs and symptoms are one thing, and nursing requests are another. As the specific response-formal analysis of 9 Ng. Diagnoses in which the most popular diagnoses were Emotion(33.4%), Exchanging(22.2%), Moving(12.0%), choosing(11.1%) Knowing(11.1%) but Communicating and Relating, Valuing, Perceiving were not applied.

Γ-Cyclodextrin Glycosyltransferase 생산균주의 분리, 동정 및 효소 생산조건

김명희,손천배,임영희,배경숙,오태광 대전대학교 이과대학 기초과학연구소 1997 自然科學 Vol.- No.-

Cyclodextrin glycosyltransferase 생산균주를 토양으로부터 분리하여 형태학적, 생화학적 그리고 균주의 세포벽 지방산 조성분석에 의해 Bacillus brevis로 동정하였고, Bacillus brevis CD162로 명명하였다. 또한 배지조성에 따른 cyclodextrin glycosyltransferase의 최적생산조건을 검토한 결과, 2.0% soluble starch, 0.75% yeast extract, 0.5% bacto peptone, 0.2% KHPO₄, 0.05% MgSO₄·7H₂O, 1.5% Na₂CO₃ (pH 10.2)의 배지 조건에서 30℃에서 96시간 배양하였을 때 가장 높은 효소생산인 0.9 unit/ml을 얻을 수 있었다.(1997년 7월 10일 접수, 1997년 11월 21일 수리) A cyclodextrin glycosyltransferase-producing bacterium was newly isolated from soil using alkaline pH medium containg 1% Na₂CO₃, The isolated strain was identified as Bacillus brevis by morphological and biochemical characteristics, and designated Bacillus brevis CD162. The strain showed the best enzyme production of 0.9 unit/ml after 96 hrs of culture at 30℃ in a medium of 2.0% soluble starch, 0.75% yeast extract, 0.5% bacto peptone, 0.2% K₂HPO₄, 0.005% MgSO₄·7H₂O and 1.5% Na₂Co₃at initial pH 10.2

牛李黨爭의 性格에 관한 硏究 II : 宦官의 兵權 掌握과 李德裕의 思想

金明姬 호남대학교 인문사회과학연구소 1998 인문사회과학연구 Vol.5 No.-

Attitudes of Korean adults english language learner and programs

김명희 경기대학교교육대학원 2000 경기교육논총 Vol.9 No.-

만성 알콜 섭취자들의 혈청내 칼슘, 인, 철, 마그네슘 햠량의 변화

김명희,김계웅 공주대학교 자원과학연구소 2000 資源科學硏究論文集 Vol.8 No.-

This study was carried out to compare serum Ca, P, Fe, Mg levels in 20 chronic alcoholics and 30 normals. Analysis for serum Ca, P, Fe, Mg of the subjects were performed by fasting venous blood sampling before anthropometry. The mean systolic blood pressure in normals and chronic alcoholics were 113.0 ± 16.9 mmHg and 125.5 ±13.4mmHg respectively. The differences between the two groups was high significant ( P < 0.01 ). Average drinking period in alcoholics was 14.1±8.8 years, alcohol intake level was 24.8±6.0% in total calories. Serum calcium level in alcoholics( 10.21±1.82mg/dl)was higher than non alcoholics(8.86±0.47mg/dl) ( p < 0.01 ). Serum phosphorus and iron levels in alcoholics were higher than non alcoholics ( P< 0.05, P< 0.01 ) but serum magnesium level was lower in alcoholics than non alcoholics ( P < 0.001 ). Because alcoholics were lived in hospital in regular period, they could eat normal diet and abstinent, and then maybe I think that serum calcium, phosphorus, iron levels are higher in alcoholics than non alcoholics. We will make plan ahead about abstinence period influenced of mineral metabolism in alcoholics.

牛.李黨爭 시기의 원진의 役割

金明姬 호남대학교 1999 호남대학교 학술논문집 Vol.20 No.1

Yuan Chen(원진:779-831), who shared the literary limelight with Po Chu-i(白居易:772-846), has been overshadowed by his friend in politics as well as in literary frame. Still Yuan Chen is known to be one of the best poet who wrote a quantity of poems lamenting upon the shadowy side of society and the life of high officials in mid-T'ang dynasty. His political career seems to be failed, because he served very short term as a minister in central government and most of his time spent as commissioner in province far out from the capital city of Ch'ang An (長安), and banishment from Ch'ang-an was regarded as punishment, because it was the hub of all cultural and political activities, where all the important decisions affecting the lives of the populace were made. After the An-Shih Rebellion which marks a key turning point in T'ang history, Ch'ang-an was sacked once more in 783 by mutinous troops. And the tivetans, who also took advantage of china's internal troubles and military weakness, revolted and marched to the capital. The bureaucrats in the court were divided in their views regarding the policies of the central government toward the outlying districts. Factions at court, divided politically and by social origin, became so strong that the entire administration was threatened. The Yuan-ho(元和) era was inaugurated in 806 under the emperor Hsien-tsung(憲宗:r.806-820), who came to the throne with eunuch and military backing. Meanwhile, under his own administration, new cliques formed around the aristocratic scholar-officials of the traditional hereditary ruling class on the one side, and newcomers or parvenus on the other. The latter, as a rule, were young intellectuals, whose backgrounds and sympathies identified them with the common people. It is to this new faction that Yuan Chen seems to have belonged, although by lineage he was a descendant of the imperial house of the Toba-Wei(拓跋魏:386-552) that ruled North China during the Southern and Northern dynasties. The so-called 'new faction' to which Yuan Chen belonged was led by Niu Seng-ju(牛僧孺:779-848) and Li Tsung-min(李宗閔:d.806), who represented the young intellectuals then rising to power through the examination system. They were more conscious of the sufferings of the people caused by official injustice and corruption, and they believed that social and political rather than military solutions were needed to remedy the nation's ills. The opposing faction was led by Li Te-yu(李德裕:787-850), son of the Chief Minister Li Chi-fu(李吉甫:758-812), who represented conservative elements with long ties of association to the imperial house and hereditary titles dating back to the founding the dynasty. The struggle for political power between these two factions, intensified by personal feuds among the party leaders, continued for almost fifty years, and weakened the bureaucratic structure upon which the empire rested and strengthened further the power of the eunuchs who had entrenched themselves in the central administration and armies. To stabilize its own position, each party tried to enlist the support of influential eunuchs. Yuan Chen began his own official career under complicated political climate and his political career fluctuated between high office and demotion and banishment, as if it had been planned long before his time. The emperor Mu-tsung (穆宗:821-824) favored him with special affection and appointed him to the position of chief minister. But party factionalism, eunuch intrigue, and power politics were too violently antagonistic at that time, and Yuan Chen could not keep the position for long, and even the emperor was unable to protect him from such enmity. Despite his brilliance as an administrator with high ideals, Yuan Chen was regarded, after all, as an 'upstart,' a parvenu. He pacifist policies antagonized the "palace guard" who believed that the authority of the central government must be restored by force. Moreover, too eager to have the clean government, he declared war against corruption and extortion wherever he found them. As a consequence of his exposure of illegal dealings and corruption in high places, he aroused the wrath of powerful political leaders and eunuch factions. Had Yuan Chen remained in the position of chief minister longer, it is possible he might have been able to accomplish some of the things he originally set out to do, and which party he had belonged to would never changed the matter. But his term in office lasted only a few months.