의사를 위한 호스피스 교육 프로그램의 개발 - 2004 호스피스.완화의료 시범사업을 중심으로 -

김수현,신상원,정미경,이순남,이소우,이경식,최윤선,Kim, Su-Hyun,Shin, Sang-Won,Chong, Mi-Kyong,Lee, Soon-Nam,Lee, So-Woo,Lee, Kyung-Shik,Choi, Youn-Seon 한국호스피스완화의료학회 2006 한국호스피스.완화의료학회지 Vol.9 No.2

목적: 2004년 호스피스 완화의료 시범사업을 실시하면서 의사를 대상으로 한 사업을 위하여 호스피스 완화의료에 관한 교육 프로그램을 개발하고 이를 기초로 교육을 실시하고 성과를 분석하였다. 방법: 교육 분과위원회에서 3차례의 회의를 통해 교육 요구도(총 79문항) 설문지를 개발한 후 125개 전국 호스피스 관련 기관에 종사하는 의사를 대상으로 우편을 이용하여 설문지를 발송하였다. 교육 중요도는 호스피스 전문가 27명에게 이메일을 통하여 조사하였다. 결과: 교육 요구도 및 중요도 조사 결과, 다양한 문헌 검토 및 외국의 호스피스 완화의료 관련 교육과정을 기초로 호스피스 완화의료 교육 프로그램이 개발되었으며 교육 시간은 총 36시간(이론 21, 실습 15시간)이었다. 이를 토대로 1일 교육 코스를 전국에서 4회에 걸쳐 시행하였으며 47명의 의사가 참여하였다. 교육 이수 후 참가자들은 교육 과정이 향후 업무에 도움이 된 정도는 항목마다 $3.0{\sim}3.6$점, 교과 강사의 적절성은 $3.1{\sim}3.3$점으로 평가하였다(1: 전혀 아니다 ${\sim}4$: 매우 그렇다). 전반적인 만족도는 100점 중 80점이었다. 결론: 개발된 교육 프로그램은 전체적으로는 운영되지 않았으며 일부만 시험교육으로 운영하였다. 대상자들은 대체로 만족하였으나 강의보다는 사례, 토론 중심의 교육 및 주제별 심화교육을 원하였다. 향후 지속적인 요구도 조사와 프로그램 개발 및 시행이 필요하다. Purpose: The purpose of this study was to develop education program for physicians who work at hospice palliative care settings in Korea, to practice abridged education program extracted from the full contents of the proposed education, and to improve the quality of hospice palliative care service. Methods: To develop the education program, questionnaire for hospice education need assessment (total 79 items) was distributed to 125 organizations practicing hospice service via mail and the data was collected from 1 Sep. to 10 Oct. 2004. Another questionnaire for hospice education importance assessment was asked to the palliative specialists from Sep. 23 to 17 Oct. 2004. Based on the analysis of the questionnaires, and reviewing various references and actual hospice palliative education programs of other countries, the education programs were developed. Results: Ore-day-Hospice education 2004 was conducted based on the suggested education program, and it was practiced four times on a national basis (2 times in Seoul, and once in Busan and Gwangju, respectively). 47 physicians attended the education program. The education program lasted about 7 hours, comprising 5 hours of common lectures for all attendants regardless of their professions and 2 hours of specific seminar for physicians only. Attendants positively responded to the contents of the education program. But they pointed out that the program should be offered on weekday and it should be more in-depth and more discussion based lesson. Conclusion: The suggested education program was not fully conducted yet. After practicing the abridged education program, more in-depth and discussion oriented rather than lecture-based education were suggested. It may be argued that the proposed education, which requires much longer period education, should also reflect the evaluation of the 1-day education program to successfully implement the proposed education program.

우리나라 長壽者의 生活 및 意識調査에 관한 硏究 - Ⅴ. 過去의 健康疾病 및 苦痛에 대한 態度 -

최진호(Jin-Ho Choi),변재형(Jae-Hyeung Pyeun),최재수(Jae-Sue Choi),임채환(Chae-Hwan Rhim),김수현(Soo-Hyun Kim),김정한(Jeung-Han Kim),이병호(Byeung-Ho Lee),우순임(Soon-Im Woo),최선남(Sun-Nam Choi),변대석(Dae-Seok Byun),김무남(Mu-Nam Ki 한국식품영양과학회 1987 한국식품영양과학회지 Vol.16 No.4

우리나라 長壽者의 生活 및 意識調査硏究의 一環으로 長壽者의 過去의 健康, 疾病 및 苦痛에 대한 對處態度 등을 調査ㆍ比較한 結果는 다음과 같다.<br/> 1. 更年期(40~60歲)의 健康狀態가 『대단히 건강했다.』가 71.0%로 가장 많고, 그 다음이 『건강이 보통이었다』가 21.6%로서, 전체 장수자의 91.6%가 보통이상의 건강상태를 유지했다.<br/> 2. 老年期에 접어든 후 疾病이나 負傷을 당한 經驗이 『없었다』고 대답한 경우가 74.7%로 대부분을 차지한 반면 『있었다』고 대답한 경우는 22.6%에 불과했다.<br/> 3. 疾病이나 負傷이 『있었다』고 한 경우의 內譯을 比較하여 보면 『消火器疾患』이 32.6%로 가장 많고, 그 다음이 『腦率中ㆍ高血壓』 14.0%, 『心臟病』 14.0%, 『呼吸器疾患』 12.8%의 순으로 되어 있었다.<br/> 4. 苦痛에 대한 經驗을 調査하여 본 結果, 苦痛이 『없었다』가 55.7%, 『있었다』가 44.3%로 거의 비슷한 傾向이었고, 苦痛에 대한 經驗內譯을 보면 『가정생활』이 85.1%로 대부분을 차지한 반면 『사업』 등은 10.1%에 불과해서 가정생활에 많은 문제가 있었음을 알 수 있었다.<br/> 5. 苦痛에 대한 對處態度롤 比較하여 보면 빨리 『잊을려고 努力했다』가 51.2%로 가장 많았고 그 다음이 『계속 걱정을 했다』(33.3%), 『걱정을 하지 않았다』(7.1%)의 순이었다.<br/> 6. 長壽한 사람들의 初經年齡은 『16~18歲』가 38.8%로 가장 많고, 그 다음이 『19歲이후』가 25.2%로서 전체 장수자의 64.0%가 16세이상에서 初經이 나타났으며, 閉經年齡은 『41~43歲』가 36.4%로 가장 많고, 그 다음이 『44~46歲』가 28.5%로서 전체 장수자의 64.9%가 46歲이하에서 閉經現象이 나타났다. 따라서 장수한 사람들의 初經年齡은 현재보다 4~5年 늦은 반면 閉經年齡은 현재보다 4~5年 빨랐음을 알 수 있었다. The present study was designed to be link a part of the research on the investigation on daily life and consciousness of the longevous people in Korea, and to investigate the health conditions, and the attitude on disease and suffering of longevous people in the past.<br/> 1. By the health conditions of longevous people between 40 and 60 years, "very good" showed the highest figure of 71.0%, followed by "ordinary" (21.6%). Consequently it is found that 92.6% of total longevous people surveyed maintained the good health conditions above ordinary.<br/> 2. Of the experiences of disease and/or injury after 60 years of longevous people, "never" showed the highest figure of 74.7%, while "had" showed the only 22.6% of total longevous people surveyed.<br/> 3. Of the details of disease and/or injury after 60 years of longevous people, "digestive disease" showed the highest figure of 32.6 %, followed by "apoplexia cerebri & hypertensions" (14.0%) and "heart disease" (14.0%), and followed by "respiratory disease" (12.8%).<br/> 4. Of the experiences of suffering between 40 and 60 years of longevous people, "never" showed 55.7% of total longevous people surveyed, while the frequency of suffering decreased in the order of "once" (22.7%), "2 times" (15.8%) and "3 times" (4.7%). By the details of suffering between 40 and 60 years of longevous people, "family life" showed the highest figure of 85.1%. followed by "business" (10.1%).<br/> 5. By the attitude on suffering of longevous people, "tried to forget soon" showed the highest figure of 51.2%, followed by "continuous worried" (33.3%). and followed by "not worried" (7.2%).

우리나라 長壽者의 生活 및 意識調査에 관한 硏究 - Ⅴ. 過去의 健康疾病 및 苦痛에 대한 態度 -

최진호(Jin-Ho Choi),변재형(Jae-Hyeung Pyeun),임채환(Chae-Hwan Rhim),양종순(Jong-Soon Yang),김수현(Soo-Hyun Kim),김정한(Jeung-Han Kim),이병호(Byeong-Ho Lee),우순임(Soon-Im Woo),최선남(Sun-Nam Choe),변대석(Dae-Seok Byun),김무남(Mu-Nam 군산대학교 수산과학연구소 1994 군산대학교 수산과학연구소 연구논문집 Vol.1 No.-

The present study was designed to be link a part of the research on the investigation on daily life and consciousness of the longevous people in Korea, and to investigate the health conditions, and the attitude on disease and suffering of longevous people in the past. 1. By the health conditions of longevous people between 40 and 60 years, ""very good"" showed the highest figure of 71.0%, followed by ""ordinary"" (21.6%). Consequently it is found that 92.6% of total longevous people surveyed maintained the good health conditions above ordinary. 2. Of the experiences of disease and/or injury after 60 years of longevous people, ""never"" showed the highest figure of 74.7%, while ""had"" showed the only 22.6% of total longevous people surveyed. 3. Of the details of disease and/or injury after 60 years of longevous people. ""digestive disease"" showed the highest figure of 32.6%. followed by ""apoplexia cerebri & hypertensions""(14.0%) and ""heart disease""(14.0%), and followed by ""respiratory disease""(12.3%). 4. Of the experiences of suffering between 40 and 60 years of longevous people, ""never"" showed 53.7% of total longevous people surveyed, while the frequency of suffering decreased in the order of ""once""(22.7%), ""2 times""(15.8%) and ""3 times""(4.7%). By the details of suffering between 40 and 60 years of longevous people. ""family life"" showed the highest figure of 85.1%, followed by ""business""(10.1%). 5. By the attitude on suffering of longevous people, ""tried to forget soon"" showed the highest figure of 54.2%, followed by ""continuous worried""(23.3%), and followed by ""not worried""(7.2%).

대한내과학회가 드리는“안전한 약물 복용 지침”

김수현 ( Su Hyun Kim ),정혜경 ( Hye-kyung Jung ),신인순 ( Ein-soon Shin ),이진서 ( Jin Seo Lee ),류연주 ( Yon Ju Ryu ),홍경섭 ( Kyoung Sup Hong ),방수미 ( Soo Mee Bang ),장윤석 ( Yoon-seok Chang ),김찬규 ( Chan Kyu Kim ),이병완 ( 대한내과학회 2021 대한내과학회지 Vol.96 No.3

목적: 우리나라는 약제를 의사 처방전이 있어야 살 수 있는 전문의약품과 처방전 없이 살 수 있는 일반의약품으로 분류한다. 약제 부작용을 최소화하고 약물 남용을 피하려면 약제에 대한 환자 교육이 중요하다. 노령 인구가 증가함에 따라 다양한 동반 질환을 가진 인구가 증가하여 여러 가지 약물 복용이 증가하고 있어 이로 인한 부작용의 위험도 증가하고 있다. 방법: 대한내과학회 표준진료지침위원회에서 내과 분과별 전문가와 개원의, 진료 지침 개발 방법론 전문가들이 모여 “안전한 약물 복용 지침” 개발 소위원회를 구성하고 개발사업을 진행하였다. 결과: 본 지침의 주요 내용은 1) 안전하고 효과적인 약물복용법, 2) 진통제(아세트아미노펜과 비스테로이드 소염제)의 올바른 사용, 3) 약물 오남용을 막기 위한 안정제와 수면제의 올바른 사용, 4) 여러 가지 약물 복용의 주의사항이다. 결론: 환자와 간병인이 일반적으로 사용되는 진통제, 기분 안정제, 수면제 및 다약제를 포함하여 약물 사용에 대한 일반적인 원칙과 예방 조치를 이해하기 위해 개발된 지침이다. 또한 의사, 간호사 및 의료 종사자가 환자와 간병인을 교육하기 위한 교육 자료로도 사용될 수 있다. Background/Aims: In Korea, medications are available by prescription from a physician, or can be purchased over-the-counter (OTC) without a prescription. Education regarding both prescribed and OTC drugs is important to minimize side effects and avoid drug abuse. The risk of side effects due to polypharmacy is increasing due to the growing number of elderly patients with comorbidities. Methods: There are various clinical guidelines for physicians, but it is difficult for patients and their caregivers to find published guidelines regarding drug use. In this regard, experts from nine subspecialties of internal medicine, geriatric medicine, and guideline development methodology formed a working group to develop guidelines for safe drug use under the Clinical Practice Guidelines Committee of the Korean Association of Internal Medicine. Results: The main contents of this guideline are 1) safe and effective drug administration, 2) the proper use of analgesics (acetaminophen and nonsteroidal anti-inflammatory drugs), 3) the proper use of tranquilizers and sleeping pills to prevent drug abuse, 4) points to be aware of when taking multiple medications. Conclusions: The guidelines were developed for patients and their caregivers to understand the general principles and precautions for drug use, including commonly used painkillers, mood stabilizers, sleeping pills, and polypharmacy. These guidelines could also be used as educational materials for physicians, nurses, and healthcare workers to educate patients and their caregivers. (Korean J Med 2021;96:225-235)

만성신부전 : 만성 싸이클로스포린 독성모델에서 크레메진의 효과

김수현 ( Su Hyun Kim ),기정연 ( Jung Yeon Ghee ),송현국 ( Hyun Kuk Song ),윤혜은 ( Hye Eun Yoon ),최범순 ( Bum Soon Choi ),오동진 ( Dong Jin Oh ),양철우 ( Chul Woo Yang ),김용수 ( Yong Soo Kim ),유석희 ( Suk Hee Yu ),김석영 ( Suk 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1

백내장 수술 후 발생한 Agrobacterium radiobacter 안내염 1 례

김수현(Soo Hyun Kim),김준순(Joon Soon Kim) 대한안과학회 2001 대한안과학회지 Vol.42 No.7

이식 : 신장이식에서 BKV DNA PCR 검사법의 활용

김수현 ( Su Hyun Kim ),윤혜은 ( Hye Eun Yoon ),오은지 ( Eun Jee Oh ),박순철 ( Sun Cheol Park ),최범순 ( Bum Soon Choi ),오동진 ( Dong Jin Oh ),양철우 ( Chul Woo Yang ),김용수 ( Yong Soo Kim ),문인성 ( In Sung Moon ),유석희 ( Suk H 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1

임상연구 : 소아에서 사시 교정 수술 후 Ondansetron과 Dexamethasone의 병용투여가 구토 예방에 미치는 효과

김순임 ( Soon Im Kim ),이정석 ( Jeong Seok Lee ),김수현 ( Soo Hyun Kim ),옥시영 ( Si Young Ok ),김선종 ( Sun Chong Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.3

Background: Postoperative vomiting (POV) is a common complication after pediatric strabismus surgery. The aim of this study was to evaluate the prophylactic antiemetic effects of a combination of ondansetron with dexamethasone after strabismus surgery in children. Methods: In this prospective, randomized, double-blind, placebo-controlled study, 126 healthy children, aged 3-10 years, who underwent strabismus surgery under general anesthesia using sevoflurane were examined. The patients were divided randomly into three groups: Patients who received 100μg/kg ondansetron with 100 μg/kg dexamethasone (OD group, n = 42); 100μg/kg ondansetron (O group, n = 42); and saline as placebo (P group, n = 42) after the induction of anesthesia. The incidence of vomiting, the patient`s distress due to vomiting, the need for rescue antiemetics and parental satisfaction during the first 24 h after surgery were evaluated. Results: The incidence of vomiting in group OD (5%) and group O (17%) during the first 24 h after surgery were significantly lower than in group P (40%) (P < 0.001, P < 0.05, respectively). The level of distress of the patients in group OD during the first 6 h after surgery was significantly lower than in group P (P < 0.05). The parents in group OD were more satisfied than those in group P (P < 0.05). However, the incidence of vomiting, patient`s distress, need for rescue antiemetics, and parental satisfaction were comparable between groups OD and group D. Conclusions: A combination of ondansetron with dexamethasone and ondansetron alone were equally effective in preventing vomiting after strabismus surgery in children. However the combination of ondansetron with dexamerhasone, but not ondamsetrone alone, is more effective in reducing the level of patient`s distress and incresing the level of parental satisfaction than the placebo. (Korean J Anesthesiol 2006; 51: 324~9)

신장 이식 환자의 만성 C형 간염에서 인터페론 치료 효과와 합병증

김용균 ( Yong Kyun Kim ),윤혜은 ( Hye Eun Yoon ),김수현 ( Su Hyun Kim ),최범순 ( Bum Soon Choi ),배시현 ( Si Hyun Bae ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon ),양철우 ( Chul Woo Yang ),김용수 ( Yong Soo Kim ),김석영 ( 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.6

Purpose : Chronic hepatitis C is a common cause of liver disease in kidney transplant (KT) recipients and lessens the chances of patients and graft survival. We evaluated the efficacy and safety of IFN-αatherapy in KT recipients with chronic hepatitis C. Methods : Ten KT recipients with chronic hepatitis C treated with recombinant IFN-α were enrolled. the patients had stable graft function, serum alanine aminotransferase (ALT) and positive HCV viremia were raised at the start of treatment. Eight patients received IFN alpha 3 million units three times weekly and 3 of them in combination with ribavirin in dose of 600mg daily. Two patients received pegylated INF-αa90 μg once weekly. Results : In 7 patients serum ALT levels were normalized and in 6 patients HCV-RNA became negative at the end of treatment. Five patients had sustained remission (persistently negative HCV-RNA) at the end of the follow-up. One patient relapsed at 15 months after discontinuation of INF. During the course of INF therapy one patient died due to sepsis with bowel perforation. Three patients developed graft dysfunction. In all of them graft function returned with discontinuing of INF and steroid therapy. In of three patients on INF plus ribavirin, hemolytic anemia was developed. After discontinuing of ribavirin hemolytic anemia was recovered and they were treated with INF alone. Conclusion : IFN-α therapy results in good biochemical response and virological clearance in KT recipients with chronic hepatitis C, but in about one third of the patients, the treatment had to do stopped prematurely due to graft dysfunction.

VANET환경에서 BloomFilter를 이용한 메시지 일괄검증 기법

김수현 ( Su-hyun Kim ),이임영 ( Im-yeong Lee ),박두순 ( Doo-soon Park ) 한국정보처리학회 2011 한국정보처리학회 학술대회논문집 Vol.18 No.2

VANET(Vehicular Ad-hoc Network)는 MANET(Mobile Ad-hoc Network)의 한 형태로, 다수의 차량들이 무선통신을 이용하여 차량 간 통신 또는 차량과 RSU(Road Side Unit)사이의 통신을 제공하는 차세대 네트워킹 기술이다. VANET환경에서 기존의 그룹 서명 방식을 이용한 메시지 서명 및 검증이 이루어진다면, 통신 차량이 많아질수록 오버헤드가 발생하는 단점을 지니고 있다. 이에 따라, 본 논문에서는 다수의 차량 간 통신 시에 보다 효율적인 메시지 검증을 위해 Bloom Filter를 이용한 메시지 일괄 검증 기법을 제안한다.