여성노인의 구술생애사를 통해 본 돌봄 윤리의 재구성

신경아(Kyung A Shin) 계명대학교 여성학연구소 2011 젠더와 문화 Vol.4 No.2

이 글은 최근 한국사회에서 진행 중인 노인 돌봄의 탈가족화 맥락에서 여성노인들이 자신의 경험을 어떻게 해석하는지 살펴보고 있다. 연구방법으로는 구술생애사를 선택하였으며, 노인 3명과 그들을 돌보는 가족 며느리나 딸 과의 인터뷰를 병행하였다. 인터뷰는 연구참여자들의 집을 방문하여 이루어졌는데, 자연스러운 일상적 상황 속에서 연구가 수행될 때 가장 좋은 결과를 가져올 수 있다는 문화기술지적 방법론의 규칙을 따르기 위해서였다. 세 명의 노인의 구술은 '분노하는 어머니와 벗어나고 싶은 며느리'(여정순씨), '외로운 어머니와 시어머니에 대한 기억을 갖지 못한 며느리'(이순영씨), 자식세대에 적응하려는 어머니와 보이지 않는 며느리'(권영경씨)로 각각 정의될 수 있지만, 세 사례에서 공통된 사실은 소통과 공감의 부재였다. 이 중 이순영씨는 가부장적 가족관습 속에서 자신과 며느리의 위치가 갖는 동질성을 인식하고 며느리 돌봄에 대한 기대 역시 여성에게 지워진 차별적 의무라는 사실을 깨닫고 있었다. 이러한 사례가 암시하는 것은 노인 돌봄의 탈가족화 조건 속에서 돌봄의 두 주체 시어머니와 며느리 가 소통하기 위해서는 가부장적 가족 내 여성의 위치에 대한 이해라는 젠더적 관점이 필요하다는 사실이다. Gender is a key factor in elder care. This is because most of the care givers as well as the care takers are women. This study looks into what old women have experienced in the social transformation of elder care and how they feel being faced with such rapid change in Korea. In order to collect oral histories, 3 elderly women were interviewed, while their daughter or daughter in law participated in separate interviews. The analysis of the interview data shows the lack of communication and sympathetic understanding between the care giver and the cared. The case of Yeo Jung sun can be defined as 'an angry mother and her daughter in law hoping to be free from the burden of care'. The case of Kwon Young kyung shows 'an adaptable mother as a result of her daughter in law being absent'. Lee Sun young's narrative described 'a lonely mother whose daughter in law'. Nevertheless, Lee Sun young has made a great effort to understand her daughter in law by using insightful interpretation within the framework of the patriarchal family relationship. Her story proves the fact that for communication between the cared for elder and her care giver, gender perspectives are needed to allow us see through the eyes of women within the patriarchal family and understand their positions.

Difference of The Cardiac Structure and Function Depending on Obesity Level of Healthy Adults

Kyung-A Shin(신경아),Seung-Bok Hong 대한의생명과학회 2011 Biomedical Science Letters Vol.17 No.2

The purpose of this study was to find out any difference and correlation between the cardiac structure and its function according to the level of obesity as evaluated by waist measurement and BMI (body mass index) in healthy adults. For research subjects, the study selected a final 519 subjects excluding 198 subjects aged 55 or over out of 717 subjects who received echocardiography through a medical checkup at J General Hospital. For the criteria for obesity, men were defined as being obese in case their waist measurement was over 90 ㎝, whereas women were defined as being obese in case their waist measurement was over 80 ㎝. Also, regarding the BMI criteria, in case a person’s BMI was 30 ㎏/㎡, the subject was classified as belonging to an obese group, and in case a person’s BMI was between 25 ㎏/㎡ and 30 ㎏/㎡, the subject was classified as belonging to an overweight group. Concerning the evaluation of cardiac structure and function, they were evaluated using two-dimensional, M-mode, doppler echocardiography. According to the stage of obesity in accordance with waist measurement and BMI, the cardiac structure showed both eccentric and centripetal changes, and the cardiac function was also discovered to show differences according to the stage of obesity. In addition, also in the overweight group, which is a prior stage to obesity, out of the criteria for obesity classification according to BMI, there were differences in the cardiac structure and function. Also, both the waist measurement and BMI were found to have a correlation with cardiac structure and diastolic function. Consequently, cardiac structure and function are correlated with BMI and waist measurement, which are anthropometrical variables, and obesity is assumed to induce not only structural change but also functional change of the heart.

임상병리(학)과의 임상실습 교육내용 표준화를 위한 기초연구

신경아(Kyung A Shin),이준호(Jun Ho Lee) 한국보건기초의학회 2022 한국보건기초의학회지 Vol.15 No.1

This study is a basic study for standardization of clinical practice education contents of the department of biomedical laboratory science. Therefore, the importance of clinical practice education contents was evaluated. The survey was conducted from February 22 to May 27, 2021. 160 professors and 150 clinical experts from each field participated in the survey. The Mann-Whitney U test was conducted to analyze the difference in importance of clinical practice education contents between professors and clinical experts. As a result, 60 items of professors and 27 items of clinical experts were found to have an importance of 4.5 or higher among a total of 184 clinical practice education contents. The education contents that show a significant difference in importance between professors and clinical experts were 9 items (36.0%) in clinical chemistry, 8 items (30.8%) in hematology, 2 items (5.7%) in transfusion, 14 items (56.0%) in clinical physiology, and 9 items (56.3%) in histocytology. In the field of histocytology, there were the most differences in importance between professors and clinical experts. However, there were no items showing differences in importance between professors and clinical experts in the fields of clinical microbiology, immunoserology, and molecular biology. Therefore, it is necessary to prepare guidelines for standardization of clinical practice that reflect the opinions of professors and clinical experts

초 울트라마라톤대회(622 km) 경기가 심장마커와 근손상마커에 미치는 영향

신경아 ( Kyung-a Shin ),박용범 ( Yongbum Park ),김영주 ( Young-joo Kim ) 대한스포츠의학회 2018 대한스포츠의학회지 Vol.36 No.3

Purpose: Changes in serum biomarkers of cardiac and muscle damage have been studied in ultra-marathon runners for distances up to 308 km. We investigated these biomarker changes following a 622-km super-ultramarathon race. Methods: A group of men with a mean age of 52.7±4.8 years participated. Blood samples were obtained pre-race, during the race, and post-race, to analyze the aforementioned biomarkers. Results: Creatine kinase and creatine kinase-MB (CK-MB) levels increased during the race, and both steadily declined post-race with CK-MB declining at a slower rate. Lactic acid dehydrogenase levels overall were increased over pre-race levels. White blood cell counts increased during the race. Red blood cell decreased from pre-race to 300 km and 622 km. Platelet increased only in the recovery period. High-sensitivity C-reactive protein levels were increased throughout the race and at day 3 compared to pre-race levels. Cardiac troponin I (cTnI) levels increased during the race. N-terminal pro b-type natriuretic peptide (NT-proBNP) levels increased during the race. Conclusion: The rise in cTnI was not clinically significant, and highly elevated NT-proBNP levels during the race indicates that myocardial burden rose linearly as running distance increased. However, no clinical risk was found as most of the markers returned to normal range during the recovery.

중환자실에 근무하는 의료인의 전비강에서 PBP2a Rapid Kit와 직접 Coagulase 검사를 이용한 Methicillin-resistant Staphylococcus aureus의 검출

홍승복 ( Seung-bok Hong ),신경아 ( Kyung-a Shin ),손재철 ( Jae-cheol Son ),신경섭 ( Seob-kyeong Shin ) 대한임상검사과학회 2010 대한임상검사과학회지(KJCLS) Vol.42 No.2

We evaluated the performance of a novel screening test, PBP2a MRSA rapid kit (Dinona Inc., Iksan, Korea), for methicillin-resistant Staphylococcus aureus (MRSA) based on a immunochromatographic assay. The test is able to detect penicillin-binding protein 2a (PBP2a) using the nasal specimens from health care workers. The nasal specimens were obtained from 69 healthcare workers and were incubated in enrichment broth followed eight hours incubatin in BHI with cefoxitin 4 μg/mL. These broth were tested by PBP2a Rapid Kit. The enrichment broths were also directly tested for tube coagulase using the conventional identification method. 19 of 22 MRSA showed positive results by PBP2a rapid test and direct coagulase test (the sensitivity for detection of MRSA, 86.36%). While, 8 of 47 non-MRSA showed false positive results for the two tests. All of the 8 non-MRSA which showed false positive were co-colonizing isolates with MRCNS and MSSA. In addition, 46 of 49 methicillin-resistant staphylococci (MRS) showed positive results for PBP2a MRSA rapid kit (the sensitivity for detection of MRS, 93.8%), and all of 20 non-MRS showed negative results (specificity, 100%). The combination of PBP2a MRSA rapid kit and direct coagulase test showed the good sensitivity for detection of MRSA from anterior nares but frequently showed false positive results from the co-colonizing carrier with MRCNS and MSSA.

대사적으로 건강한 비만남성에서 간 효소의 임상적 의의

신경아,Shin, Kyung-A 대한임상검사과학회 2017 대한임상검사과학회지(KJCLS) Vol.49 No.3

Increased hepatic enzymes are associated with insulin resistance, metabolic complications, and type 2 diabetes mellitus. Metabolically healthy obese (MHO) phenotype is not accompanied by metabolic complications and maintains insulin sensitivity, despite excessive body fat. The purpose of this study was to evaluate the clinical implications of hepatic enzymes in MHO men. The diagnostic criteria for MHO were based on NCEP-ATP III and obesity in adults was defined using WHO Asian-Pacific criteria. We used the data from 9,683 obese men aged between 20 and 70 years. The subjects were divided into three groups according to the diagnostic criteria: The metabolically healthy non-obese (MHNO, N=2,878), metabolically healthy obese (MHO, N=5,427), and metabolically abnormal obese (MAO, N=1,378). Obesity criteria were classified according to the standards set forth by WHO Asia-Pacific Criteria. AST, ALT, and GGT were significantly lower in the MHO group than in the MAO group (p<0.001, respectively). However, the hepatic enzyme levels were higher in the MHO group than in the MHNO group (p<0.001). Liver enzymes were associated with metabolic syndrome risk factors. Waist circumference, fasting glucose, total cholesterol, triglyceride, and HDL-C were risk factors for metabolic syndrome affecting liver enzymes. In conclusion, hepatic enzymes were found to predict metabolic abnormalities in metabolically healthy obese men.

수술용 최대혈액신청량(MSBOS)의 설정

신경아 ( Kyung A Shin ),최종태 ( Jong Tai Choi ),김현수 ( Hyun Soo Kim ) 대한임상검사과학회 2004 대한임상검사과학회지(KJCLS) Vol.36 No.2

The aim of our study is to determine maximum surgical blood order schedule (MSBOS) in each surgical operation through analyzing usage of blood products at Bundang Jesaeng General Hospital. We investigated the amount of transfused red cells for each operation and calculated crossmatching-to-transfusion ratio (C/T ratio) and MSBOS. This was accomplished by referring to the Laboratory Information System program during 1 year from January through December 2003. Coronary artery bypass surgery and decompressive craniectomy showed the highest MSBOS in our hospital. The average C/T ratio was 3.2 and excessive reservations for blood products have been made for many operations. From this study, guidelines for the optimal blood ordering for each surgery were suggested.

울트라 마라톤(100 km)에서 삼투압 농도와 전해질 대사의 생화학적 요인 변화에 대한 안전성 평가

신경아 ( Kyung A Shin ),김영주 ( Young Joo Kim ) 대한임상검사과학회 2016 대한임상검사과학회지(KJCLS) Vol.48 No.2

본 연구는 22명의 남자 아마추어 선수를 대상으로 100 km 울트라 마라톤에서의 전해질 대사 반응의 안전성을 평가하기 위해 실시하였다. 대상자의 평균 연령은 50.91±4.77세, VO2max는 48.19±6.43 mL/kg/min, 그리고 평균 경기 완주시간은 829.64±89.31분이었다. 혈액검사에 포함된 전해질 지표로는 칼슘, 무기인, 마그네슘, 소디움, 포타슘, 염소, 총이산화탄소, 음이온차이, 혈장량 변화와 삼투압 농도를 경기 전, 50 km 지점, 경기 종료 직후 측정하였다. 본 연구결과 소디움 농도는 경기 전보다 50 km 지점에서 감소하였고 50 km 지점보다 100 km 지점에서 감소하였으나, 고나트륨혈증 및 저나트륨혈증은 나타나지 않았다. 100 km 울트라 마라톤 경기에서 다른 모든 전해질 지표들의 거리별 변화는 참고범위 내에서 이루어졌으며, 혈장량 변화는 나타나지 않았다. 결론적으로 아마추어 지구력 선수들의 전해질 대사에 있어서 경기중 통계적인 차이는 있었으나 임상적으로 의미 있는 삼투압 농도와 전해질의 변화는 나타나지 않았으며 안전한 경기로 나타났다. This study was conducted to investigate the electrolyte metabolic responses to a 100 km ultra-marathon in 22 male amateur runners. Their average age was 50.91±4.77 years old and their VO2max value was 48.19±6.43 mL/kg/min. The participants completed the race with a mean finishing time of 205.55±19.61 minute. Electrolyte parameters based on blood tests including calcium, inorganic phosphorus, magnesium, sodium, potassium, chloride, total carbon dioxide, anion gap, plasma volume change and osmolality were measured pre-race, at 50 km, and at 100 km (post-race). Only slight changes in sodium level with no cases of hypernatremia or hyponatremia were observed. Additionally, all the electrolyte parameters changes were within the normal range and plasma volumes were unchanged. Overall, amateur marathon runners are not at risk to develop clinically significant electrolyte or osmolality changes during a 100 km ultra-marathon.

복부비만 고령여성의 대사증후군 위험요인과 고감도 C-반응성 단백의 관련성

신경아 ( Kyung-a Shin ) 대한임상검사과학회 2017 대한임상검사과학회지(KJCLS) Vol.49 No.2

이 연구에서는 복부비만을 가진 고령여성을 대상으로 대사증후군 동반 유무에 따른 대사증후군 위험요인과 hs-CRP와의 관련성에 대해 알아보고자 하였다. 대사증후군 진단은 AHA/NHLBI (American Heart Association/National Heart, Lung and Blood Institute) 2005년 기준에 따라 5가지 기준 중3개 이상 해당되는 경우 대사증후군 진단군(MetS, N=77), 2개이하의 위험요인에 해당하는 경우 대조군(Absent, N=97)으로 분류하였다. hs-CRP 농도는 대사증후군 위험요인과 밀접한 관련이 있으며, 특히 복부비만(r=0.190, p=0.014), 공복혈당(r=0.240, p=0.002), HDL-콜레스테롤(r=-0.164, p=0.035)과 연관이 있음을 확인할 수 있었다. 또한 대조군보다 대사증후군 진단군에서 hs-CRP가 높게 나타났으며(p=0.007), 복부비만 상태일지라도 높은 혈당(p=0.006)과 낮은 HDL-콜레스테롤혈증(p=0.010)의 위험요인이 있는군에서 hs-CRP가 높았다. 결론적으로 복부비만이 있더라도 대사증후군 위험요인의 동반유무에 따라 염증관련 위험도가 달라짐을 알 수 있었다. High sensitive C-reactive protein (hs-CRP) has been associated with metabolic syndrome (MetS) and its risk factors. This study aimed to evaluate the association between hs-CRP and the risk factors of MetS in elderly women with abdominal obesity. The diagnosis of MetS followed the AHA/NHLBI criteria, and abdominal obesity was defined using the WHO Asian-Pacific criteria. We used the data from 174 elderly women, with an average age of 74 years. They were classified into two groups: The absent group (N=97) and the MetS group (N=77). Hs-CRP was significantly higher in the MetS group (p=0.007). Hs-CRP had a positive correlation with abdominal obesity (r=0.190, p=0.014) and fasting blood glucose (r=0.240, p=0.002), while having a negative correlation with HDL cholesterol (r=-0.164, p=0.035). Moreover, hs-CRP was higher in the group with risk of high fasting blood glucose (p=0.006) and low HDL-cholesterol (p=0.010), even in elderly women with abdominal obesity.

한국 성인의 혈청 요산 수치와 인슐린저항성 및 대사증후군 구성요소간의 연관성

신경아,김은재,Shin, Kyung-A,Kim, Eun Jae 중소기업융합학회 2020 융합정보논문지 Vol.10 No.11

본 연구는 한국 성인의 성별에 따른 혈청 요산 수치와 인슐린저항성 및 대사증후군 구성요소간의 관련성을 확인하고자 하였다. 2018년 6월에서 2020년 5월 사이에 경기지역 종합병원에서 건강검진을 받았던 20세 이상 남성 2,365명, 여성 2,063명 총 4,428명을 대상으로 단면연구를 시행하였다. 연구결과 남녀 모두 정상군보다 대사증후군 진단군에서 요산치가 높았으며, 고요산혈증군에서 대사증후군과 그 구성요소의 발병률은 정상군보다 높았다. 고요산혈증은 남성에서 혈압상승(p=0.006)과 고중성지방혈증(p<0.001), 여성에서 대사증후군(p=0.012)과 낮은 HDL-콜레스테롤(p<0.001) 발병 위험을 높이는 요인으로 나타났다. 따라서 남성과 여성 모두에서 고요산혈증은 대사증후군 및 그 구성요소와 관련이 있었으며, 특히 여성에서 대사증후군 발병의 독립적인 예측인자임을 확인하였다. The purpose of this study was to investigate the relationship between serum uric acid levels, insulin resistance and components of metabolic syndrome. It was conducted on 4,428 adults over the age of 20 who had undergone health checkups at a general hospital in Gyeonggi-do from June 2018 to May 2020. As a result of the study, uric acid levels were higher in the metabolic syndrome subjects than normal subjects in both men and women. and the incidence of metabolic syndrome and its components was higher in the hyperuricemia group than in the normal group. Hyperuricemia was found to increase the risk of elevated blood pressure(p=0.006) and hypertriglyceridemia(p<0.001) in men and metabolic syndrome(p=0.012) and low HDL-cholesterol(p<0.001) in women. Thus, in both men and women, hyperuricemia was associated with metabolic syndrome and its components, and it was confirmed that it was an independent predictor of the onset of metabolic syndrome in women.