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신숙희,이복순,신인화,김효정,장연수,이행자,신수산나 병원간호사회 1998 임상간호연구 Vol.3 No.2
Recording a patient' s water intake and discharge is a nursing job which provides basic data about the body' s fluid balance. It helps to determine the electrolyte balance which is important to any patient' s diagnosis. It also helps to assess any fluid loss or overload. and leads to the early recognition of any serious functional problems, However in korea there is no adequate standard table for calculating the amounts of oral fluid intake as objective data which are really available in practice. This study will try to deliver consistent information by minimizing measurement mistakes. The goal is to develop a standard table by which we can measure a patient's water intake and discharge and also to develop measurable amounts of oral intake and to present their fluid content. The research will consist of three steps : 1) the item developing process 2) the fluid content developing process 3) the testing process. The first step, the process of developing items for measuring the amount of oral intake, will be accomplished by analyzing data about food gathered from a survey of nurses. The second step, the process of developing an item's fluid content, will be accomplished by testing, a survey and by reference to records. In the final step, the developed items of oral intake of food and their fluid content will be verified in clinical application by nurses. As a result of this research, a standard table of the amount of oral intake will be developed for 5 items which will be divided by main meal, fruit, a beverage, a milk product, and liquid food. and the weigh and fluid content will be given for each item. This standard table developed by our research team will offer the correct measurement of these items. It will present the fluid content of the items which have previously been measured differently by nurse and organization. It will then combine the items and this provide a tool to assess fluid balance.
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신숙희,Shin, Sook Hee 대한핵의학기술학회 2014 핵의학 기술 Vol.18 No.2
일상생활에서 경험하는 다양한 사건들은 모두 스트레스인자로 작용하여 이에 대한 대처가 부적절하면 인체의 항상성이 파괴되어 정신 및 신체질환의 발생에 영향을 주며 인체의 면역반응에 부정적인 영향을 주어 질병에 대한 대처능력을 떨어뜨려 다양한 만성질환에 대한 감수성을 높일 수 있다. 스트레스에서 내분비학적 및 생화학적 반응을 이용하는 근거는 신체 대부분의 시스템이 스트레스 중 변화하고 이런 변화를 나타내는 생물학적 지표가 스트레스와 관련된다는 근거에 의해 신체적 반응에 대한 생화학적 반응으로서 스트레스 호르몬인 코티졸 측정과 생리적인 스트레스반응으로서 여러 가지의 생리신호 중에 혈압(blood pressure)과 심박변이도(heart rate variability, HRV)를 측정하여 스트레스 반응 수준을 측정하여 상관관계를 분석하였다. 전체 94명의 피실험 대상자의 혈청 코티졸의 농도는 평균 11.22 ng/mL 이었고 최저 3.6ng/mL에서 최고 23.3 ng/mL의 분포를 나타냈다. 남녀 집단을 나누어 분석하면 남자가 13.71 ng/mL 으로 여자 10.47 ng/mL 보다 유의하게 높았다(p<0.05). 생리신호 중 혈압을 남녀 집단으로 구분하여 분석한 결과 수축기혈압 평균이 남자가 133 mmHg으로 여자 117 mmHg보다 통계적으로 유의하게 높았다(p<0.05).확장기 혈압의 평균은 남자가 81mmHg로 여자의 76.4 mmHg 보다 높았으나 유의하지 않았다. 심박변이도 중 교감신경 활동을 보여주는 LF/HF ratio 비도 남자가 3.09 로 여자 1.77 보다 유의하게 높게 나타났다(p<0.05). Purpose The physiological and biochemical responses of healthy men and women to life stress were measured in order to investigate the correlation between these two responses under the normal situation. Materials and Methods The population of the research is some randomly chosen health college students located in Daejeon City during the period from August to September 2014, and the sample of 94 students. Heart rate variability (HRV), blood pressure (BP) were selected as physiological stress indices and serum cortisol level was used as a biochemical stress biomaker. The data which is collected used SPSS19.0 programs and frequency and percentage and T-test, correlation. Results Male showed the significant higher value of serum cortisol level (p<0.05), BP (p<0.05), and LF/HF ratio of HRV (p<0.05) than female. The difference of BP between correlated significantly with serum cortisol level (p<0.05). The LF/HF ratio of HRV also correlated significantly with serum cortisol level (p<0.05) Conclusion We suggest that LF/HF ratio of HRV and BP may be good indices for the assessment of life stress.
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경항문 내시경 미세수술 후 부가적 치료 여부의 결정: 36명의 고위험군 직장암 환자에 대한 임상적 경험
신숙희,한상아,박치민,윤성현,이우용,최동욱,전호경 대한대장항문학회 2005 Annals of Coloproctolgy Vol.21 No.6
Purpose: Local excision, including transanal endoscopic microsurgery (TEM), has become an alternative to the classic radical operation for early rectal cancer. However, radical resection for rectal cancer is necessary for advanced tumor, poor differentiation, a narrow resection margin, and positive lymphovascular invasion. This study presents the factors related to recurrence in patients who required secondary radical surgery after TEM, but did not undergo the operation. Methods: From November 1994 to December 2004, 167 patients underwent TEM for rectal cancer. Thirty-six of those patients were included in this study. Inclusion criteria were poor differentiation, a mucinous carcinoma, invasion to a proper muscle layer, lymphovascular invasion, and a positive resection margin. Results: Twelve of the 36 patients underwent a secondary radical operation, but 24 of them did not due to poor general condition or refusal. One of 12 patients (8.3%) who underwent a secondary radical operation had a systemic recurrence. Five of 24 patients (20.8%) who did not receive surgery had recurrences; 3 of 5 were local recurrence, and the others were distant metastases. Among the 24 patients who did not undergo a secondary radical operation, there were no recurrences in 2 cases of poor differentiation or mucinous carcinoma and in 2 cases of positive resection margin. There were 2 cases of recurrences in the 7 patients (25.0%) who had lymphovascular invasion, 1 case in the 1 patient (100%) who had a T3 lesion, 3 cases in the 17 patients (12.5%) who had T2 lesions. Conclusions: In high-risk patients, TEM followed by radical surgery is most beneficial in preventing local recurrence. A radical operation is strongly recommended especially if pathologic results after TEM shows T3 lesions or lymphovascular invasion.
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