울형성 심부전증에서 심혈관계 보상기전의 지표로서 저나트륨혈증의 의의에 관한 연구

김경환,김미경,이우형,홍사석,신길자,장일중 대한내과학회 1986 대한내과학회지 Vol.31 No.3

In patient with congestive heart failure, it is well known that the sympatho-adrenal system and the renin angiotensin system are activated to compensate for the reduction of cardiac output and the redistribution of blood flow. Although Lilly, et al. (1984) and Francis, et al. (1985) have insisted that the induction of these circulatory compensation mechanism by pastura1 changes is closely related to the concentration of plama sodium in congestive heart failure, it is still controversial. Thus, in an effort to clarify this hypothesis, present study was designed to determine the relationship between the existing sodium concentration in plasma and the changes of the plasma catecholamine concentration and renin activity during postural alterations in patients with congestive heart fai1ure and normal subjects. Ten patients with congestive heart failure who had been admitted to the Ewha Womans University Hospital from May, 1985 to July, 1985 and five normal volunteers were chosen. Patients with more than one year history of congestive heart failure belonging to class 3 or 4 as the criteria set by the New York Heart Association have been selected for this study. Among these ten patients, 5(3 males and 2 females) had low plasma sodium concentration(below 135mEq/l) and 5(3 males and 2 females) had normal plasma sodium concentration(above 135mEq/l). The observed results are as follows: 1) In the normal subjects, the observed plasma renin activity was 1,2±0.4ng/ml/hr and the concentrations of norepinephrine and epinephrine were 177.5±27 and 150.0±8pg/ml, respectively, at supine position. However, these values were increased by about 2 times by changing to upright position. 2) In patients with hyponatremic congestive heart failure, the values of plasma renin activity and catecholamine levels were significantly higher than those patients having normonatremia. 3) The increase in the plasma renin activity and catecholamin levels induced by upright position were minimal in patients with congestive heart failure having normonatremia. 4) However, in patients with hyponatremic congestive heart failure, the plasma renin activity and the levels of plasma catecholamines were not altered, or rather decreased, by the same postural changes. Based on the results, the levels of plasma sodium concentration in patients with congestive heart failure could provide an index for the induction of circulatory compensation mechaniams and may have important significance in determining the severity and prognosis of the disease. Particularly in the congestive heart failure patients with hyponatremia, as the circulatory compensation mechanism appear to be operating at maximum already, they would not be able to utilize the reflex compensation mechanism inducible with the changes of body position.

Hydroxycitrate, Carnitine 및 Capsaicin을 함유한 식이 보조제(3D-Relax Diet)의 체중 감량 효과

정은영,정경희,김미자,배윤정,장은재 동덕여자대학교 2004 생활과학연구 Vol.9 No.-

The aim of this study was to evaluate the effects of 3D-Relax Diet; a proprietary formation containing hydroxycitrate(233mg/g), carnitine(150mg/g); and capsaicin (150mg/g); on body weight, % body fat, fat mass, lean body mass, Resting Metabolic Rate(RMR), body circumference, skinfold thickness, serum glucose and lipid level. Nineteen female college students participated in this 4 weeks weight control program. All subjects were randomly assigned to the Sang sik(S) group or Sang sik & 3D-Relax(3D) group. Mean energy intake of 3D group was l,523.1±300.2 ㎉(carbohydrate: 66.3%, protein: 18.7%, fat: 15.0%) and S group consumed 1,464.8±142.1 ㎉(carbohydrate: 65.1%, protein: 19.0%, fat: 15.9%) during program. The 3D group lost 3.1±1.3 kg of body weight, 2.5±l.4 kg of fat mass, 0.6±1.2 kg of lean body mass and 16.8±183.3 ㎉/d of RMR and the S group lost 1.8±1.0 kg of body weight, 1.1±1.1 kg of fat mass, 0.8±0.3 kg of lean body mass and 19.1±181.9 ㎉/d of RMR. There was no significant differences in the loss of lean body mass and RMR between two groups, however, the total body weight and the fat mass were significantly decreased in the 3D group compared to the S group(p<0.05). The 3D group experienced a significant reduced hip size, total-cholesterol and HDL-cholesterol, however, the change of these between groups were not significantly different. There were no differences in the change of body circumference, skinfold thickness, serum glucose and lipid. These results suggest that the intake of 3D-Relax Diet(hydroxycitrate, carnitine, and capsaicin) during the weight control program decreased energy intake, fat intake and total body weight especially fat mass and those effects are presumably linked to the prevention of RMR decline and the inhibitory effects on lipogenesis.

일부 성인들의 비타민제 섭취 여부에 따른 건강 관심도와 영양지식 수준에 관한 연구 : 항산화 비타민 A, C. E를 중심으로 한

장은재,김진아,김미자 동덕여자대학교 생활과학연구소 2007 생활과학연구 Vol.12 No.-

The purpose of this study was to identify the relation to health concern level and nutritional knowledge level by status of taking vitamin supplements of adults. A self-administered questionnaire was used as a data collection from the 462 adults and the questionnaire included general characteristics of subjects, factors related to health. status of vitamin supplements habit and nutritional knowledge of antioxidant vitamins. There were higher taking rates in females over males, as with old age over youth, high education level(university) over low(high school) and high household income over low household income. BMI had insignificant between two groups, taking and Non-taking vitamin supplements. Health concern level in taking group had also statistically insignificant. Higher nutritional knowledge level was shown in females over male. But age and education level were statistically insignificant. Though there was high nutritional knowledge level with high household income rate, it was statistically insignificant as well nutritional knowledge level in taking group were higher than in non-taking group, it was statistically significant. There were no statistically significant variations between health concern level and nutritional knowledge level. The respondents' purpose of taking vitamin supplements was measured as, "sufficient supplement of nutrition and improvement health" 42.9%, "supplement of nutrition in eyes" 22.8% and "antioxidants and prevention of colds" 17.4%. The respondents' purpose of non-taking was measured as, "confidence in one's health" 32.5%, "sufficient nutrition within meals" 25.1 % and "bother" 19.7%. The respondents' motive of taking supplements was measured as, "Prescription of doctor, pharmacist and nutritionist" 35.7%, "invitation of family" 20.9%, and "mass media" 20.9%. Multi vitamins were taken by 32% of those surveyed, and vitamin C by 27.1%. In terms of the number of different kinds of vitamin supplements taken, 56.5% took one kind, 30.4% took two kinds, and 11.3% took three kinds. In terms of the frequency of consumption, 24.9% of respondents took supplements "case by case(catch a cold, drinking .etc)", 32.4% took them "regularly" and 42.7% took them occasionally. The above findings show that a group of high education level, age and household income level had a trend of high taking rate. There was an especially high taking rate within those with high nutritional knowledge. So to promote good health through a well balanced dietary life and appropriate use of nutritional supplements, improving nutritional knowledge is essential. Finally, this study suggested that nutritional education should be promoted as a basic necessity for nationwide good health.

小兒腎症候群에 關한 臨床的 觀察

金幸美,李昌浩,具滋薰,安斗洪 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.2

著者는 지난 3年間 慶北醫大 附屬病院小兒科에 入院하였던 特發性腎症候群 患兒 38名을 對象으로 臨床症狀, steroid療法에의 反應度, 豫後에 영항을 미치는 要因, 再發樣狀等을 觀祭하였으며 steroid 療法에 不良한 反應을 보인 17名에서는 經皮的腎生檢을 시행하였다. 또한 9名에서는 methylprednisolone의 "pulse" therapy, 5名에서는 cytoxan을 使用하여 아래와 같은 結果를 얻었다. 發病年齡은 3~7歲가 16名(42%)으로 가장 많았고 男兒 28各, 女兒 10名으로 男女比 約 3:1로 男兒가 많았다. 初發 및 再發時의 臨床症狀은 심한 全身浮腫이 71.1%, 腹水 및 胸腔渗出液이 65.8%, 胃腸障碍가 47.4%에서 觀察되었으며, 初期 steroid療法으로 完全寬解를 보인 경우는 14名(37.8%), 部分的寬解 17名(46%), 不良한 反應을 보인 경우는 6名(16.2%)였으며 20名(57.1%)에서 2週以內에 利尿의 招來 및 蛋白尿 消失을 보였다. 腎炎所見은 全例에 있어서 血尿 21.6%, 高血壓 10.8%. 및 窒素血症 24.3%로서 steroid 療法에 不良한 反應을 보인 患兒들에게서 높은 頻度를 나타내었으며, 1年以上 追跡觀察된 21各中 9名(43%)에서 첫 1年以內에 再發이 있었고 再發例의 約 半數에서 上氣道感染이 동반되었다. 17名에서 施行한 腎組織檢査 所見은 minimal change 8例, membranoproliferative glomeruloneph ritis 및 membranous glomerulopathy 各 3例, focal segmental sclerosis 1例 및 focal proliferative glomerulonephritis 2例로서 男女比는 13:4였다. 이 중 steroid 療法에 反應이 좋지 않았던 9各에 있어서 methylprednisolone의 "pulse" therapy를 시행한 結果 5名에게는 檢査所見의 현저한 好轉 및 再發이 없어지는 등의 成果를 얻었으며, 또한 cytoxan을 使用한 5名中 2名에서 完金寬解가 있었다. 같은 期間 동안 入院하였던 急性絲球體腎炎 患兒 54名中 6名에서 二次性腎症候群이 병발되었으며, 또한 1日 2gm/㎡ 以上의 多重의 蛋白尿는 急性絲球 體腎炎 6名 및 心不全症 2名에서 觀察되었다. A clinical observation was done on 38 children with idiopathic nephrotic syndrome, who had been admitted to our pediatric department during 2 years and 9 months period, from January 1978 to September 1980. The following results were obtained: At the beginning of illness. 42% were in the age group of 3-7 year, and male to female ratio was approximately 3:1 of male preponderance. During initial attack and subsequnt relapses, pitting edema on extremities was noticed in all cases, followed in frequency by generalized edema in 71%, ascites and/or pleural effusion in 65.8% and GI trouble in 47.4%. Response to initial continuous steroid therapy showed complete remission(group 4) in 37.8%, partial remission (group 2&3) in 46% and no response (group 1) in 16.2%. Within 2 weeks after institution of steroid therapy, both diuresis and disappearance of proteinuria were noted in 57.1%. Nephritic manifestations, eg. hematuria, hypertension & azotemia, were seen in 21.6%, 10.8%, 24.3% respectively, and the majority of children with these manifestation showed poor response to steroid therapy. Nine out of 21 patients in whom follow-up could be done over 1 year, experienced one or more relapses, giving 43% relapse rate during the 1st year, and URI was accompanied in about half of these episodes. Percutaneous renal biopsy done on 17 patients who showed steroid dependency, or no response to poor response toward steroid therapy showed the following results: Minimal change nephrotic syndrome in 8, membranous nephropathy in 3, membranoproliferative glomerulonephritis in 3, focal segmental sclerosis in 1 and focal proliferative glomerulonephritis in 2. And male to female ratio was 13:4. "Pulse therapy" with bolus dosage of methylprednisolone was tried on 9 patients, resulting in disappearance of relapse, or significant improvement in blood chemistry & urinary finding in 5. And 2 out of 5 patients in whom immunosuppressant therapy with cytoxan was given due to poor response to steroid, experienced complete remission. During the same study period, secondary nephrotic syndrome was observed in 6 out of 54 patients with acute glomerulonephritis, and heavy proteinuria alone, defined as proteinuria over 2gm/㎡ day, was seen in 6 patients with acute glomerulonephrits and 2 patients with congestive heairt failure.

유방암 수술 후 조기 운동프로그램이 어깨관절기능, 통증, 림프부종 및 일상생활 수행능력에 미치는 영향

김미옥,전창순,조영자,조의영 대한간호협회 2005 대한간호 Vol.44 No.2

Purpose : The purpose of this study was to investigate the effects of an early exercise program after mastectomy and provide the early exercise program protocol for patients who had undergone mastectomy. Method : It was conducted with the experimental design similar to the Non-Equivalent control group pre-post test. The subjects were twenty-one women who were diagnosed with breast cancer(11 in the experimental group and 10 in the control group). The subjects in the experimental group participated in early exercise program for fourteen days. The exercise program consisted of deep breathing, shoulder stretching, pose correction of upper body, promotion of physical state, ROM exercise(passive, active). Data was analysed with a χ2-test(Fisher's exact test), Mann-Whitney U test, Wilcoxon test using SPSS WIN 11.0program. Result : There were significant differences at post exercise. The experimental group showed significant increases in shoulder flexion, adduction, abduction, internal rotation, external rotation and decreased in arm circumference of operative side. Also the experimental groups relief pain, had less difficulty of shoulder function of daily living(comb hair, fasten brassiere hook, reaching the ipsilateral scapula, and contralateral scapula with fingers on the operated side, spread a blanket, lift a shopping basket). Conclusion : The results of this study suggest that, after mastectomy, the early exercise program can make a significant contribution to the return of more normal shoulder function and decrease of swelling in operative side, relief pain, recovery of activities of daily living.

간호사의 이직의도 구조모형

김창희,양승순,김연자,손연정,유미애,송주은 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to construct and test a structural equation model of nurses' turnover intention. Method: The participants were 716 nurses at 4 university hospitals. Data were collected by a self-report questionnaire in 2008 and analyzed using SPSS 12.0 and AMOS 4.0 Win program. Results: The fit indices of modified model were x²=285.928(p<.001),x²/df=1.958GFI=0.964, RMSEA=0.037, AGFI=0.944, NFI=0.947, NNFI=0.961, CFI=0.973, PNFI=0.658 and showed high compatibility with the empirical data. In the final model, job stress and satisfaction were found to have significant direct effects on nurses' turnover intention, while organizational culture and emotional labor were very important factors to have indirect effects on turnover intention via job stress and satisfaction. Nurses' turnover intention was accounted for 41.2% of covariance by these factors. Conclusions: Comprehensive nursing interventions for decreasing nurses' turnover intention should be focused on reducing job stress and increasing job satisfaction. Also, Nursing strategy for enhancing positive organizational culture and decreasing emotional labor would be helpful for decreasing nurses' turnover intention, too. Further studies are needed to prospectively conduct to verify these causal relationships with larger sample.

혈액투석환자의 건강관련 강인성,자기효능감과 이행과의 관계

서문자,장미영 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

The purpose of this study was to identify the degree of compliance, and its relationship with the health related hardiness, self efficacy of the hemodialysis patients. The data were collected from eighty nine patients on hemodialysis unit from one University hospital and two general hospitals in Seoul from August to September, 1995. The dependent variable for this study was the degree of compliance which was measured with the patients's self-report and biochemical indicators such as the interdialytic weight gain, predialysis serum potassium level and predialysis serum phosphorus level. The instruments used for data collection for this study were as follows: 1) To measure the patient's compliance, the 4-point Lidert type questionnaire was used which was developed by authors based on the literature review, pilot study and content validation by the review of their expertise. 2) The health related hardiness scale, self efficacy scale which were adopted from the previous studies used to measure the independent variables. 3) The data of biochemical indicators were collected from the patient's medical record. The reliability of the scales were ranged between Cronbach's α=.72-.87. The collected data were analyzed with SPSS pc+ program with percentage. ANOVA, Pearson's correlation, Canonical correlation analysis. The results were as follows: 2) There was significant correlation between the health related hardiness and self efficacy(r=-.280, p=.004) and between the compliance with the interdialytic weight gain(r=.346, p=.000) and predialysis phosphours level(r=.218, p=.02). A significant positive canonical correlation was found between the group of independent variables consisted of health related hardiness and self efficacy and the group of dependent variables consisting of patient's compliance and the biochemical indicators(interdialytic weight gain, predialysis derum potassium level and predialysis serum phosphorus level Rc=.444, p=.002). Health related hardness had strongly correlational structure with predialysis serum potassium level and predialysis serum phoshous level. Self efficacy had strongly correlational structure with self reported compliance and interdialytic weight gain in canonical correlational analysis. In the relationship between the group of independent variables and group of dependent variables, the main influencing factors were self efficacy and self reported compliance(canonical weight: -.887, -.695). From the above results, it can be concluded thqt; Self efficacy was found as a potent predictor of the compliance in hemodiaysis patients. These results suggest that feasibility of the cognitive approach for nursing intervention such as increasing the level of self efficacy.

양측성 다낭종신 태아의 중반기 중절 1례

손대언,송창훈,한세준,이미자,기근홍 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.2

Recently, the use of Ultrasonography as a diagnostic method in detection of fetalanomalies during pregnancy has been increased because of the safety. Many fetal genitourinary anomalies were reported as early as mid trimester by transabdomonal sonography. We experienced a case of bilateral polycystic kidney in 23th months gestatational aged fetus, diagnosed by transabdominal ultrasonography and pathologic authopsy.

중추신경계에서의 효모 가수분해물이 음식섭취조절기전에 미치는 영향

이승언,정경희,김미자,배윤정,장은재 동덕여자대학교 2004 생활과학연구 Vol.9 No.-

Saccharomyces cerevisiea, which has been known as antistress compounds, was hydrolyzed by proteinase producing SCP-20. The addition effects of SCP-20 on the food intake regulation mechanism were studied measuring the expression amount of neurotransmitters, such as NPY and NOS, which can increase food intake in hypothalamus, and CCK, which can decrease food intake by using immunohistochemistry method. The 0, 2, and 5 g/kg SCP-20 was orally administrated to the experimental animals for one week. The expression of NPY and NOS was increased in the group of 5 g/kg administrated animals while that of CCK was increased in the group of 2 g/kg administrated animals. The results of this study suggested that SCP-20 may influence the control mechanism of oral dose-dependently. Further studies are needed to elucidate the roles of SCP-20 on the changes of food intake regulation controlling neurotransmitters.

광원의 종류에 따른 복합레진의 중합거동 및 중합률에 관한 연구

류주희,이인복,유현미,김미자,석창인,권혁춘 大韓齒科保存學會 2004 Restorative Dentistry & Endodontics Vol.29 No.4

Objectives: The purpose of this study was to observe the reaction kinetics and the degree of polymerization of composite resins when cured by different light sources and to evaluate the effectiveness of the blue Light Emitting Diode Light Curing Units (LED LCUs) compared with conventional halogen LGUs. Materials and Methods: First, thermal analysis was performed by a differential scanning calorimeter(DSC). The LED LCU (Elipar Freelight, 320㎽/㎠) and the conventional halogen LCU (XL3000, 400㎽/㎠) were used in this study for curing three composite resins (SureFil, Z-250 and AEliteFLO). Second, the degree of conversion was obtained in the composite resins cured according to the above curing mode with a FTIR. Third, the measurements of depth of cure were carried out in accordance with ISO 4049 standards. Statistical analysis was performed by two-way ANOVA test at 95% levels of confidence and Duncan's procedure for multiple comparisons. Results: The heat of cure was not statistically different among the LCUs (p > 0.05). The composites cured by the LED (Exp) LCUs were statistically more slowly polymerized than by the halogen LCU and the LED (Std) LCU (p< 0.05). The composite resin groups cured by the LED (Exp) LGUs had significantly greater degree of conversion value than by the halogen LCU and the LED (Std) LCU (p = 0.0002). The composite resin groups cured by the LED (Std) LGUs showed significantly greater depth of cure value than by the halogen LCU and the LED (Exp) LGU (p < 0.05).