외과계 집중치료실에서 입원한 환자에서 APACHE II score의 의의

이영재,이영준,박순태,하우송,정민화,권수인,조영현,권진용,최상경,손신 대한외상학회 1997 大韓外傷學會誌 Vol.10 No.1

This study attempts to evaluate the prognostic value of the APACHE II scoring system in patients of surgical intensive care unit(SICU) and to examine its usefullness in stratifying these patients according to their surgical risk and as a potential aid in making rational and objective treatment decision. The records of 161 patients admitted to the Department of Surgery, Gyeong-Sang National University Hospital between Jan. 1991 and Dec. l995 were reviewed. 1) Of a total of 161 patients, 87 were male, 74 were female, and male to female ratio was 1.71: 1. 2) This group was seen most commonly in the age group of 55-64 which occupied 30.3% of entire group. 3) The distribution of patients according to the etiology were 74 patients(46%) in trauma, 61 patients(37%) iin postop-complication, 26 patients(9%) in others. 4) The distribution of patients according to the APACHE II scores was 9 to 29 point in adm. Day and the most patients was located between 10 and 14 of 62 patient(39%). 5) The length of hospitalization was 9 days in survived patients and 8 days in non-survived patients. The length of hospitalization of 77% of patients in this study was below 10 days. 6) The death rate was 45.45%(73 patient), this patients according to APACHE II scores was 13 to 29, median 19.2 in adm. Day, the most patients was located 20 to 24(20%). Non of the survived patients had the APACHE II score of above 20 points, but all recovered patients were below 13 points. 7) The median APACHE II score in survived patients was 10.52 point at adm. Day and 6.55 point at 5 days after admission. And non-survived patients was 20.25 point at adm. Day and 30.48 point 5 days after admission(p$lt;0.001). 8) Among the patients with low APACHE II score (below 14 points), there was no mortality. But, there was mortality with APACHE II score of above l5 points. We conclude that APACHE II scoring system is useful in measuring the severity of acute disease and predicting the outcome.

절제된 정상위벽의 자기공명영상기법에 관한 연구:조직소견과의 비교

서보경,설혜영,이남준,차인호,정규병,김정혁,박철민,이지영,Seo, Bo-Gyeong,Seol, Hye-Yeong,Lee, Nam-Jun,Cha, In-Ho,Jeong, Gyu-Byeong,Kim, Jeong-Hyeok,Park, Cheol-Min,Lee, Ji-Yeong 대한영상의학회 2001 대한영상의학회지 Vol.45 No.5

목적:급속자기공명영상기법을 이용하여 절제된 정상위벽을 관찰하고,이를 조직소견과 비교 연구하여,위벽의 관찰을 위한 최적기법을 찾고자 하였다. 대상과 방법:25명 환자의 모두 41개 절제된 정상위조직을 수술후 수지(polyethylene)통에 넣고,생리식염수로 채워 자기공명영상을 시행하였다.T1강조FLASH,지방억제T1강조FLASH, T2강조TSE와 True-FISP 등 4가지 기법으로 위조직의 영상을 얻었다.자기공명영상에서는 위벽의 층수와 각층의 신호강도를 관찰하였고,이를 조직소견과 비교하였다.자기공명영상소견을 조직소견과 비교한 후 위벽 각층의 명확성과 각층간의 구분,및 전체 영상의 질에 대하여 비교하였다.4가지 기법 중 가장 좋은 방법은 3,가장 나쁜 방법은 0으로 하여 등급을 판정하였다. 결과:자기공명영상에서 위벽의 층수는 T1강조FLASH에서 2층이 41예 중 6예(14.6%),3층 31예(75.6%),및 4층 4예(9.8%)였고,지방억제T1강조FLASH에서 2층 6예(14.6%)와 3층 35예(85.4%),T2강조TSE에서 3층 24예(58.5%),4층 11예(26.8%),및 5층 6예(14.6%)였으며,True-FISP에서 1층 2예(4.9%),2층 8예(19.5%),3층 23예(56.0%),4층은 4예(9.8%), 및 5층 4예(9.8%)이었다.위벽의 신호강도는 T1강조FLASH와 지방억제T1강조FLASH에서 2층으로 보인 예는 위내강으로부터 고-중등도,3층인 경우는 고-저-고/중등도,4층인 예는 고-저-고-중등도신호강도였다.T2강조TSE에서는 3층으로 보인 예는 등도/고-저-중등도,4 층인 경우는 중등도-저-고-중등도/저,5층인 예는 저-고-저-고-저신호강도였다.자기공명 영상소견을 조직소견과 비교하였을 때 위벽이 3층으로 보인 경우 이것은 “점막층-점막하층-근층 ”에 해당하였다.관찰한 3가지 면 모두에서 T1강조FLASH,지방억제T1강조FLASH,T2강조TSE 기법이 True-FISP보다 통계적으로 유의하게 우수하였다(p=0.001).점막층의 명확성에 있어서 가장 우수한 기법은 T1강조FLASH와 지방억제T1강조FLASH이었고(p<0.05),점막하층의 명확성과 점막하층과 근층간의 구분은 T2강조TSE가 가장 우수하였다(p<0.05).전체적인 영상의 질은 T1강조FLASH와 T2강조TSE에서 가장 우수하였다(p<0.05). 결론:자기공명영상은 위벽의 각 층을 구별할 수 있는 우수한 검사로 조직소견과 높은 연관성을 보이며,전체 영상의 질,점막하층의 명확성 및 점막하층과 근층간의 구분이 T2강조TSE에서 가장 우수한다. Purpose: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Materials and Methods: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. results: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediatelow-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). Conclusion: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.

간호사의 셀프리더십과 간호업무성과간의 관계

서문경애,장성옥,조경희,김인아,이수정 대한간호학회 간호행정학회 2006 간호행정학회지 Vol.12 No.1

Purpose: This study was undertaken in order to suggest self-leadership as a way to promote organization efficiency of nursing organization. So the relation between self-leadership and outcome of nursing practice inorganization was studied. Method: The subjects of study were nurses as a population who were working for the 2 of university hospitals which have over 500 beds in Kyong Ki Province as well as who have been working for over 6 months. The data was collected by questionnaires from 215 nurses and analyzed using descriptive statistics, perason correlation coefficient, t-test and ANOVA on SAS Program. Results: Self-leadership of nurse got 3.51 grade out of 5 as a mean point. Each of the segments got 3.74 in self-compensation, 3.57 in self-expectation, 3.53 in goal-setting, 3.45 in rehearsal, 3.37 in self-criticism and 3.30 in constructive thinking in order. Independent performance of nursing practice at each items of outcome of nursing practice showed the highest correlations with the self-expectation among self-leadership segments. Constructive thinking, self-compensation, rehearsal, goal-setting were related like this in order, but self-criticism was related just a little. Dependent nursing practice has the highest correlation with the self-expectation, goal-setting, rehearsal, constructive thinking, self-compensation were similar as aboves in order, but self-criticism didn't show any similar correlations. Relationship practice has the highest correlation with the self-expectation, and goal-setting, constructive thinking, self-compensation, rehearsal were similar, while self-criticism did not show any correlations. Conclusion: In conclusion the result was obtained that self-leadership is much correlated with outcome of nursing practice. Therefore, as a way to promote efficiency of nursing organization, the constant study about self-leadership with the various aspects is needed focusing on self-management and inner motivation as a new leadership paradigm.

Ecological characteristics and trap plant attraction effect of Metcalfa pruinosa in red pepper cultivation area of Korea

Hwa-Young Seo,Gyeong-Ju Lee,In-Su Hwang,Mi-Sook Na,Yong-Seok Choi 한국응용곤충학회 2018 한국응용곤충학회 학술대회논문집 Vol.2018 No.10

Metcalfa pruinosa is the agricultural pest, first reported in Seoul, Gyeong-gi, Gyeongnam, Korea in 2009. This pests are difficult to control due to the wide range of hosts such as beans, apples, ginseng, pears, persimmon, and peaches. This study was carried out to investigate the ecological characteristics of M. pruinosa in pepper cultivation area. As a result of the density of M. pruinosa survey in Chungnam, Korea in 2018, the density of wintering-eggs, nymph, adult was the largest in Dang-jin area. And the results of the ecological characteristcs survey of M. pruinosa in red pepper cultivation area of Korea, M. pruinosa didn’t enter a red pepper field. In addition, the possibility of using three kinds of plants as attraction plants was examined in order to control environmentally friendly M. pruinosa. Among them, the greatest number of M. pruinosa nymph were attracted to Sunflower and Green perilla during nymph stage.

대장 및 직장암에 대한 임상적 고찰

고홍준,권수인,최상경,하우송 대한대장항문학회 1996 Annals of Coloproctolgy Vol.12 No.1

Evaluation for Impacts of Nitrogen Source to Groundwater Quality in Livestock Farming Area

Gyeong-Mi Lee,Sunhwa Park,Ki-In Kim,Sang-Ho Jeon,Dahee Song,Deok-hyun Kim,Tae-Seung Kim,Seong-Taek Yun,Hyen Mi Chung,Hyun-Koo Kim 한국토양비료학회 2017 한국토양비료학회지 Vol.50 No.5

We investigated 52 livestock farming complexes in Gyeong-Gi and Incheon provinces based on low, medium, and high livestock density and groundwater quality. The objective of this study was to evaluate a relationship between nitrate N concentration in groundwater and animal factors, such as livestock density and animal species. 2,200 groundwater samples for 3 years from 2012 to 2014 at Gyeong-Gi and Incheon provinces were collected and analyzed for pH, EC, DO, ORP, temperature, major anions and cations, such as NO₃-N, HCO₃<SUP>-</SUP>, PO₄<SUP>-</SUP>, SO₄<SUP>2-</SUP>, Cl<SUP>-</SUP>, NH₄-N, K<SUP>+</SUP>, Na<SUP>+</SUP>, Ca<SUP>2+</SUP>, Mg<SUP>2+</SUP>, T-N, and TOC. Average concentration of total N for generated load density was 23,973 g day<SUP>-1</SUP> km<SUP>-2</SUP> for cattle, 51,551 g day<SUP>-1</SUP> km<SUP>-2</SUP> for pig, and 52,100 g day<SUP>-1</SUP> km<SUP>-2</SUP> for poultry. For animal feeding species, average ratio for generated load over discharge load was 16.1% for cattle, 7.8% for pig, and 7.1% for poultry. Therefore, cattle feeding region is highly vulnerable for water pollution compared to pig and poultry feeding areas. The concentrations of chloride, nitrate, and total N in the groundwater samples were higher at high animal farming regions than other regions. The average concentration of nitrate, and chloride in groundwater samples was 5.0 mg L<SUP>-1</SUP>, 16.6 mg L<SUP>-1</SUP> for low livestock density, 6.9 mg L<SUP>-1</SUP>, 17.7 mg L<SUP>-1</SUP> for medium livestock density and 7.6 mg L<SUP>-1</SUP>, 22.7 mg L<SUP>-1</SUP> for high livestock density and total nitrogen (T-N) was 7.7 mg L<SUP>-1</SUP> for low livestock density, 9.4 mg L<SUP>-1</SUP> for medium livestock density, 10.7 mg L<SUP>-1</SUP> for high livestock density. In conclusion, based on this research, for managing groundwater quality near livestock farming regions, Ca-(Cl+NO₃) group from the Piper diagram is more efficient than using 19 factors for water quality standard.

구연산과 칼슘이 치아침식증의 발생에 미치는 영향

송인경,이광희,김대업,양영숙 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

산성 음료의 치아침식증 유발력을 감소시키기 위한 연구의 일환으로, 0.1%, 0.3%, 0.5%, 1.0% 구연산용백의 5분, 15분, 30분, 60분간의 사람 소구치 법랑질의 치아침식증 유발력 및 구연산용액에 첨가되는 칼슘 0.05%, 0.1%, 0.2%에 따른 치아침식증 발생 억제효과를 표면미세경도를 측정하여 연구하였다. 전체적으로 볼 때, 구연산 농도가 높을수륵, 탈회시간이 길수록, 칼슘농도가 낮을수록 탈회후 경도가 하락하였다. 탈회 5분 후 경도는 칼슘 무첨가의 경우에 76~90%이었고 칼슘 첨가에 따른 5분간의 탈회억제량은 2~l5%이었다. 탈회 15분 후 경도는 칼슘 무첨가의 경우에 65~84%이었고 칼슘 첨가에 따른 15분간의 탈회억제량은 3~l7%이었다. 탈회 30분 후 경도는 칼슘 무첨가의 경우에 53~72%이었고 칼슘 첨가에 따른 30분간의 탈회억제랑은 6~22%이었다. 탈회 60분 후 경도는 칼슘 무첨가의 경우에 43~66%이었고 칼슘 첨가에 따른 60분간의 탈회억제량은 7~l9%이었다. 탈회억제량의 분포를 전체적으로 보면, 구연산 농도에서는 1.0%에서 가장 크게 나타났고, 칼슘농도에서는 0.2%에서 가장 크게 나타났으며, 탈회시간에서는 0,1% 구연산용액에서는 탈회시간이 증가함과 더불어 탈회억제량도 함께 커지는 경향을 보였으나, 0.3% 이상의 구연산용액에서는 30분에 가장 크고 60분에 약간 감소하는 경향을 보였다 이상의 결과는 구연산에 의한 치아침식증 발생에 칼슘이 억제효과를 나타낼 수 있음을 시사한다. The purpose of study was to observe the effect of calcium and citric acid on the dental erosion of human premolar enamel. Enamel specimens were demineralized in 0.1%, 0.3%, 0.5%, or 1.0% citric acid solutions with 0.05%, 0.1%, or 0.2% calcium for 5, 15, 30, and 60 minutes, and then the surface microhardness of the enamel was measured. The hardness decreased as the concentration of citric acid and the demineralization time increased. Hardness after 5 minutes was 76~90% in case of no calcium and the inhibition of dental erosion by calcium addition was 2~15%. Hardness after 15 minutes was 65~84% in case of no calcium and the inhibition of dental erosion by calcium addition was 3~17%. Hardness after 30 minutes was 53~72% in case of no calcium and the inhibition of dental erosion by calcium addition was 6~22%. Hardness after 60 minutes was 43~66% in case of no calcium and the inhibition of dental erosion by calcium addition was 7~19%. The inhibition was the highest in 1.0% citric acid and 0.2% calcium. In 0.1% citric acid the inhibition increased as the demineralization time increased, but in 0.3% to 1.0% citric acid the inhibition was most high at 30 minutes and decreased a little at 60 minutes. These results suggest that calcium has a inhibitory effect on the citric acid induced dental erosion.

ABS AH 32鋼의 熔接金屬에서 低溫 龜裂 感受性에 미치는 豫熱效果

鄭潾相,朴景采,金庚周 경북대학교 공과대학 1987 工大硏究誌 Vol.16 No.-

It is known that the occurrence of cold cracking in welded materials is influenced by restraint, diffusible hydrogen and microstructure of weldments. The purpose of this work is to investigate effects of preheating in the same humidity of electrode as well as influences of diffusible hydrogen content. The results of obtained are as follows : Thermal cycles in welments were changed by preheating temperatures and particularly, t_8/5(cooling time from 800℃ to 500℃) and t_100(colling time from solidification to 100℃) were increased according to increase of predeating temperture. First of all. in the same humidity of dried electrode, when specimens we welded at ambient temperature, weld cracking percentages for surface and root were 100%, but when 150℃, no cracking was occurred. In the view of hardness distribution, hardness of HAZ were higher than those of base metal and weld metal and were in inverse proportion to preheating temperature and thickness of HAZ. Secondly, in the same preheating temperature, when specimens were welded in the various humidity of electrode, regardless of humidity of electrode, surface cracks were not occurred. With increasing diffusible hydrogen content, root cracking percentages increased slightly, but hardness distribution and thickness of HAZ were not changed.

Evaluation for Impacts of Nitrogen Source to Groundwater Quality in Livestock Farming Area

Lee, Gyeong-Mi,Park, Sunhwa,Kim, Ki-In,Jeon, Sang-Ho,Song, Dahee,Kim, Deok-hyun,Kim, Tae-Seung,Yun, Seong-Taek,Chung, Hyen Mi,Kim, Hyun-Koo 한국토양비료학회 2017 한국토양비료학회지 Vol.50 No.5

We investigated 52 livestock farming complexes in Gyeong-Gi and Incheon provinces based on low, medium, and high livestock density and groundwater quality. The objective of this study was to evaluate a relationship between nitrate N concentration in groundwater and animal factors, such as livestock density and animal species. 2,200 groundwater samples for 3 years from 2012 to 2014 at Gyeong-Gi and Incheon provinces were collected and analyzed for pH, EC, DO, ORP, temperature, major anions and cations, such as $NO_3-N$, ${HCO_3}^-$, ${PO_4}^-$, ${SO_4}^{2-}$, $Cl^-$, $NH_4-N$, $K^+$, $Na^+$, $Ca^{2+}$, $Mg^{2+}$, T-N, and TOC. Average concentration of total N for generated load density was $23,973g\;day^{-1}\;km^{-2}$ for cattle, $51,551g\;day^{-1}\;km^{-2}$ for pig, and $52,100g\;day^{-1}\;km^{-2}$ for poultry. For animal feeding species, average ratio for generated load over discharge load was 16.1% for cattle, 7.8% for pig, and 7.1% for poultry. Therefore, cattle feeding region is highly vulnerable for water pollution compared to pig and poultry feeding areas. The concentrations of chloride, nitrate, and total N in the groundwater samples were higher at high animal farming regions than other regions. The average concentration of nitrate, and chloride in groundwater samples was $5.0mg\;L^{-1}$, $16.6mg\;L^{-1}$ for low livestock density, $6.9mg\;L^{-1}$, $17.7mg\;L^{-1}$ for medium livestock density and $7.6mg\;L^{-1}$, $22.7mg\;L^{-1}$ for high livestock density and total nitrogen (T-N) was $7.7mg\;L^{-1}$ for low livestock density, $9.4mg\;L^{-1}$ for medium livestock density, $10.7mg\;L^{-1}$ for high livestock density. In conclusion, based on this research, for managing groundwater quality near livestock farming regions, $Ca-(Cl+NO_3)$ group from the Piper diagram is more efficient than using 19 factors for water quality standard.

Consumer Directed Services (CDS) Program in North Carolina : Reporting New Benefits of the Alternative Care Program

Yoon In Tae,Cho Jung Bae,Yoon Tae Gyeong 한국통합사례관리학회 2019 한국케어매니지먼트연구 Vol.0 No.31

NC는 지난 10년간 CDS(Consumer Directed Services)를 시범 사업으로 구현해 왔다. 다른 주에서 이전 연구에서 확인 프로그램의 뛰어난 장점에도 불구하고 노스캐롤라이나 주의 CDS는 여전히 시범 단계에 있다. 본 연구를 위하여 11명의 참가자(클라이언트)와 5명의 케어 관리자를 대상으로 심층면담 실시하였다. 본 연구의 목적으로 CDS 프로그램의 강점이 실제 존재하는지 여부를 평가하였다. 본 연구 결과에서 케어 프로그램의 새로운 많은 혜택이 있는 것으로 확인되었다. 참가자들에게 강한 우정을 제공하고 참가자들의 사회적 요구를 충족시키는 것으로 확인되었다. 전통적인 사회복지기관 중심의 케어 프로그램 보다 CDS는 클라이언트의 개인의 사생활 보호와 안정감을 제공하고 있는 것으로 나타났다. 또한 가족들과 케어복지사들에게도 CDS는 많은 이익을 주는 것으로 확인되었다. The State of NC has been implementing Consumer Directed Services (CDS) as a pilot project for a decade. In spite of outstanding advantages of the program identified by previous studies in other states, CDS in NC is still at its pilot stage. For the research project, the semi-structured in-depth interviews were conducted with 11 participants and 5 care advisors to evaluate whether the previously identified strengths of the program indeed existed. This research study shows that the 16 interviews indicate the program’s congruent benefits with the previous studies. In addition, the study identifies new benefits of the alternative care program. It offers a strong companionship to its participants and sometimes satisfies participants’ social needs. Compared to traditional agency-based home care programs, participants appreciate the sense of privacy and security that CDS has given to them. CDS also benefits family members and care advisors.