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이미헌,박형숙,하재현 한국성인간호학회 2017 성인간호학회지 Vol.29 No.6
Purpose: The purpose of this study was to understand and describe the adjustment experiences of nurses to an oriental medical unit. Methods: Fourteen nurses who worked or were working in oriental medical units participated.Data were collected through in-depth interviews from April to December, 2013. Analyses of the transcribed interviews were done using Corbin and Strauss’s grounded theory. Results: Through the constant comparative analysis method, the central phenomenon was identified as ‘constant mental fluctuation’. Nurses reported their adjustment to an oriental medical unit through four stages. The stages were described as ‘the discouraged’ stage, ‘the conflicted’ stage, ‘the restructuring’ stage and lastly ‘the coexistence’ stage. Conclusion: As the participants reported the process of adjusting, they reported continuous constant conflicts and struggles with the oriental medical doctors, the nursing department, patients and their guardians and lastly with themselves. The process of becoming integrated into an oriental medical unit is a complex study and should be studied further in terms of whether this process is the same or different adjusting to other units.
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골수로의 원격전이를 동반한 위장의 저등위 점막연관성 림프조직림프종 2 예
이미헌(Mi Hun Lee),정훈용(Hoon Yong Jung),강경훈(Gyung Hun Kang),장혜숙(Hye Sook Jang),명승재(Seung Jae Myung),양석균(Suk Gyun Yang),홍원선(Won Sun Hong),김진호(Jin Ho Kim),민영일(Young Il Min) 대한소화기학회 2000 대한소화기학회지 Vol.36 No.5
Extranodal mucosa-associated lymphoid tissue (MALT) lymphoma constitutes most of the low-grade gastric lymphoma and almost 50% of all gastric lymphoma. The specific recirculation pattern might explain the tendencies of MALT lymphomas to remain localized and to recur preferentially within the gastrointestinal tract. It was known that the rate of gastric MALT lymphoma with bone marrow involvement was low, as less than 10%. We have experienced two patients who presented with nonspecific abdominal pain and dyspepsia. They were diagnosed to have gastric low-grade MALT lymphoma with bone marrow involvement at the time of presentation. The endoscopic findings showed irregular ulcerations. Microscopically, there was monotonous lymphoid infiltration with lymphoepithelial lesions which were consistent with low grade MALT lymphoma. Both patients showed H. pylori-associated chronic gastritis. The results of their bone marrow biopsy showed focal infiltration of neoplastic lymphoid cells. We report two cases of primary gastric low-grade MALT lymphoma with the bone marrow involvement.
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Water Jet Peening에 의한 SUS 304의 경도에 관한 연구
이미헌(Lee Mi-Heon),서병훈(Seo Byung-Hun),나승한(Na Seunghan),정성균(Cheong Seong Kyun),이명호(Lee Myeong-Ho) 한국철도학회 2009 한국철도학회 학술발표대회논문집 Vol.2009 No.11월
Material properties of the metal surface can be changed by Water Jet Peening, which uses highly pressurized water. The effect of water jet peening(WJP) on the hardness of SUS 304 is investigated in this study. The specimen was cut into 40 × 40 × 10 ㎜ and polished on one side. Two different methods were used to investigate the change of hardness on the surface of SUS 304. Water Jet Peening(WJP) and Water Cavitation Peening(WCP) methods were used to examine the difference of hardness. The distance between specimen and nozzle was also changed as an important parameter. The hardness data were examined by 40 micro meter interval. The results show that the hardness distribution is different depending on peening methods and peening distance. Water Jet Peening seems to be a good method to increase the hardness of metal surface and further research work on WJP is necessary to increase the practicality.
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주진우,이미헌,김일,Ju, Jin-Woo,Lee, Mee-Heon,Kim, Il 대한미생물학회 1986 大韓微生物學會誌 Vol.21 No.3
Authors studies on the isolation of non-sucrose fermentation Vibrio species such as V. parahaemolyticus, V. vulnificus and V. damsela from sea water, shellfishes and various algae at Ulleung island in the east of Korea on summer in 1985. Authors carried out test for isolated strains to biochemical characteristics, halophilism, hemolysis and serological reaction. The results obtained were as follows: 1. Strains isolated from total specimens were 25 strains of V. parahaemolyticus, 2 strains of V. vulnificus and 1 strain of V. damsela, respectively. 2. Isolated frequency of Vibrio species from sea water and marine products was lower than on specimens in the southern sea of Korea from 1980 to 1985. 3. On hemolysis reaction on blood agar media using human and rabbit erythrocytes, 14 strains among 25 strains of V. parahaemolyticus isolated were positive, and V. vulnificus and V. damsela were positive, respectively. 4. The distributions of serotypes of V. parahaemolyticus isolated were from O1 group to O10 group, and from K 10 to K 69. The results of K serotypes were as follows ; serotype K 10 and K 33 were 2 strains, serotype K 59 and K 69 were 1 strain, respectively. And 2 strains of V. vulnificus isolated were not agglutinated by antiserum of V. vulnificus. Therefore, the probability is that 2 strains of V. vulnificus isolated were other serotypes distributed on sea weater and marine products of Ulleung island of Korea.
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김일,주진우,이미헌 대한미생물학회 1986 大韓微生物學會誌 Vol.21 No.3
Authors studies on the isolation of non-sucrose fermentation Vibrio species such as V. parahaemolyticus, V. vulnificus and V. damsela from sea water, shellfishes and various algae at Ulleung island in the east of Korea on summer in 1985. Authors carried out test for isolated strains to biochemical characteristics, halophilism, hemolysis and serological reaction. The results obtained were as follows: 1. Strains isolated from total specimens were 25 strains of V. parahaemolyticus, 2strains of V. vulnipcus and 1 strain of V. damsela, respectively. 2. Isolated frequency of Vibrio species from sea water and marine products was lower than on specimens in the southern sea of Korea from 1980 to 1985. 3. On hemolysis reaction on blood agar media using human and rabbit erythrocytes, 14 strains among 25 strams of V. parahaemolyticus isolated were positive, and V, vulnificus and V. damsela were positive, respectively. 4. The distributions of serotypes of V. parahaemolyticus isolated were from Ol group to 010 group, and from K10 to K 69. The results of K serotypes were as follows;serotype K 10 and K 33 were 2 strains, serotype K 59 and K 69 were 1 strain, respectively. And 2 strains of V. vulnificus isol ated were not agglutinated by antiserum of V. vulnijicus. Therefore, the probability is that 2strains of V vulnificus isolated were other serotypes distributed on sea weater and marine products of Ulleung island of Korea.
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김인식,도윤경,이미헌,이승엽,김현수,백효종,이상문,박종훈,김익수,손경락 대한간학회 2003 Clinical and Molecular Hepatology(대한간학회지) Vol.9 No.3(S)
배경/목적: 원발성 간세포암의 육종성 변이는 병리학적 그리고 임상적으로 드물지 않게 보고되어져 왔다. 더욱이 간세포암의 육종성 변이는 간동맥 색전술이나 항암치료를 받은 후에 발생할 수 있다고 보고되었다. 반면에 간내담도암의 육종성 변이는 매우 드문 예로, 연자 등은 과거 간동맥 색전술이나 항암치료의 과거력 없이 발생된 간내 종괴를 주소로 내원한 환자에서 수술로 진단된 간내담도암의 육종성 변이 1예를 경험 하였기에 보고하는 바이다. 증례: 71세 남자로 2개월간의 미열과 우상복부 불편감 및 체중감소(4kg/1개월)를 주소로 내원하였다. 과거력상 특이소견은 없었고, 신체검진상 혈압 120/80 mmHg, 체온 37.5℃, 맥박 70회/분, 호흡수 18회/분이었고, 이학적검진상 우측 최하늑골의 정중 쇄골선 하방으로 10cm, 검상돌기 최하단 하방으로 8cm 정도의 매우 큰 딱딱하고 표면은 매끄러운 간종괴 소견이 있었다. 검사실소견은 말초혈액검사상 백혈구 8,990/μL, 혈색소 12.1 g/dL, 혈소판 484,000/?이었고, 혈청 생화학검사상 AST 39 IU/L, ALT 24 IU/L, total protein 5.9 g/dL, albumin 3.0 g/dL, total bilirubin 0.5 mg/dL, ALP 329 IU/L, LDH 465 IU/L였으며 prothrombin time은 정상의 166%였다. B형간염항원표지자는 음성이었고 α-fetoprotein은 1.5 ng/μL로 정상범위였으며 CA 19-9와 CEA도 11.0 ng/μL와 7.8 ng/μL로 정상 범위였다. 방사선검사상 복부 CT촬영에서 비조영증가영상상 16×12 cm 크기의 내부에 연부조직음영을 보이고 분엽상 형태를 보이는 저음영의 종괴가 간의 우엽에서 위치하고 있었다. 조영증강영상상 동맥기에 내부의 고형성 부분의 조영이 증가되었고 조영증강의 중격형성을 보였다. 문맥기와 정맥기에는 내부에 고형성 부분의 조영이 더욱 증가되었다. MRCP상 T1강조영상에서 낮은 신호강도를 보이고 내부에 중등도 신호강도의 종괴가 보였다. 조영증강 T1강조영상에서는 내부에 조영이 잘되는 고형성 부분이 보였다. T2 강조영상에서 T1에서 낮은신호강도를 보이던 부분은 높은 신호강도로 보이고 내부에 중등도 신호강도의 병변이 보였다. 그리고 담도의 확장소견은 보이지 않았다. 환자는 분엽절제술(제5, 6, 7구역)과 담낭절제술을 시행하였는데, 수술조직의 육안상 18×16×15cm 크기의 1600g의 무게를 가진 경계가 명확한 고형성 종괴로 내부에 괴사와 낭성변화의 단면을 보였다. 조직학적 소견상 종괴는 분화가 좋은 선암종과 다형성의 육종으로 구성되어 있었는데 육종 부위는 비정형성이 심한 핵을 가진 방추형의 세포로 되어있으며 종양세포 사이에 종양성 유골(osteoid)이 흔히 관찰되는 것으로 미루어 보아 골육종으로 진단되었다. 그리고 선암종과 육종은 서로 이행하는 부위가 존재하였다. 조직구축학적 검사상 선암종은 종괴 단면의 0.6% 나머지는 전부 골육종이 차지하였으며 괴사는 36%에서 나타났다. 면역조직화학염색상 선암종 부분은 high molecular & low molecular cytokeratin 및 CEA염색에 양성이었고, 육종 부분에도 cytokeratin에 대한 면역염색에서 부분적으로 양성으로 관찰되어 육종을 이루는 세포들의 상피세포 기원을 시사하는 소견으로 생각하였다. 환자는 수술후 미열과 우상복부 통증은 호전되어 현재 보존치료로 일반상태 호전을 기다리며 외래 추적관찰 중이다.
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