백서 심근경색모델에서 시간경과와 경색의 크기에 따른 심자도의 변화

김미성(Mi Sung Kim),박영선(Young Sun Park),권순길(Sun Gil Kwon),지정훈(Jeong Hoon Ji),신종성(Jong Sung Shin),오광식(Kwang Sik Oh),양용모(Yong Mo Yang),연태진(Tae Jin Youn),김동운(Dong Woon Kim),조명찬(Myeong Chan Cho),이용호(Yong Ho 대한내과학회 2002 대한내과학회지 Vol.62 No.1

N/A Background: Magnetocardiogram (MCG), which records the changes of magnetic fields generated by the heart`s electrical activity, theoritically can provide unique data for clinical application. To date, MCG has been investigated only at a single time point after myocardial infarction (MI) with severe left ventricular dysfunction in rats. The purpose of the present study was to investigate sequential changes of MCG after MI and to evaluate effects of infarct size on MCG. Methods: Acute MI were induced by the permanent ligation of left coronary artery in 22 rats. Magnetic fields were recorded just above a rat with Nb Superconducting Quantum Interference Device (SQUID) gradiometer inside a magnetically shielded room. MCG was measured before and immediately after surgery and it was subsequently recorded at the time points of 1, 4 and 6 hours post operatively. MCG was also measured at 1, 3, 7 and 21 days after surgery. Results: Elevation of ST segment and appearance of pathological Q wave on the MCG were evident immediately after the ligation of coronary artery and persisted to 6 hours after MI. On MCG, ST segment was depressed and T wave was inverted from 1 day after MI. In rats with small-and moderate- sized MI (infarct size〈30%), ST depression returned to near the isoelectric level and Q wave disappeared from 7 days after MI. However, ST depression and Q wave were still present in rats with larger infarct (infarct size≥30%). Conclusion: Evolutional changes of MCG were well-recognized up to 21 days after MI. Furthermore, the infarct size can be expressed by the extent of Q wave and ST segment depression on MCG. Taken together, these data indicate that MCG is a helpful modality for the diagnosis, evaluation of infarct size and follow up after MI.(Korean J Med 62:42-48, 2002)

Hepatic Cirrhosis Occurring in a Young Woodchuck(Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus(WHV)

Kyu-shik Jeong,정원일,Jae-yong Chung,Mi-young An,Chae-yong Jung,Gyoung-jae Lee,Jong-soo Kang,Byeong-cheol Kang,Young-heun Jee,Bruce H Williams,Young-oh Kwon,Da-hee Jeong 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

Cirrhosis Occurring in a Young Woodchuck (Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus (WHV)Da-hee Jeong, Won-il Jeong, Jae-yong Chung, Mi-young An, Chae-yong Jung, Gyoung-jae Lee1, Jong-soo Kang1, Byeong-cheol Kang2, Young-heun Jee3, Bruce H Williams4, Young-oh Kwon5 and Kyu-shik Jeong*College of Veterinary Medicine, Kyungpook National University, Daegu 702-701, Korea1Shinwon Scientific Co., LTD, Research Institute, Suwon, Korea2Clinical Research Institute, Seoul National University, Seoul 110-744, Korea3College of Veterinary Medicine, Jeju National University, Jeju 690-756, Korea

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

요양보호사 1급 교육생의 노인에 대한 지식과 태도와의 관계

정미현,권선숙 노인간호학회 2009 노인간호학회지 Vol.11 No.1

Purpose: This study was done to identify the knowledge and attitudes of certified caregiver trainees toward elders. Method: This study used a descriptive correlational research design. The participants were 304 certified caregiver trainees in North Jeolla Province. The instrument for this study was a scale on knowledge and attitudes toward elders. The collected data were analysed using SPSS WIN 12.0. Results: The average knowledge level for the participants was 9.87±2.53, and there were three areas regarding knowledge toward elders. The social area was scored at only 32.3%, which indicates that caregivers was not familiar with elders' social lives. The average attitudes level of participants was 40.88±4.22. Among general characteristic of the participants, level of knowledge was statistically significant for age, educational level, present living conditions and subjective attitudes toward elders. Attitudes were statistically significant for educational level and subjective knowledge toward elders. Knowledge and attitudes were positively correlated. Conclusion: It is necessary to increase knowledge and positive attitudes, to provide continuing education and apply various program for certified caregiver trainees.

임상검체에서 분리된 그람 음성 세균들에 대한 Isepamicin의 시험관내 항균력

권현희,박수진,소민욱,박현구,최성호,김미나,최상호,정진용,우준희,김양수 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : The increasing incidence of multidrug-resistant gram-negative bacteria causing nosocomial infections is an important clinical problem. Isepamicin is a recently developed aminoglycoside which has been known to have potent activity against gram-negative organisms. We evaluated the in vitro activities of isepamicin and other aminoglycosides against a large number of gram-negative organisms. Materials and Methods : We tested the in vitro antimicrobial activities of isepamicin, amikacin, gentamicin, and tobramycin against 566 gram-negative organisms collected between January 2006 and June 2006 in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined and interpreted according to the recommendations of Clinical and Laboratory Standard Institute (CLSI). The breakpoint MIC used for interpretation of isepamicin was MIC≤16 ㎍/mL as susceptible, 32 ㎍/mL as intermediate, and 64 ㎍/mL as resistant. Results : The MIC_(50)/MIC_(90) of isepamicln for Escherichia coli, Klebsiella pneumon/ae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae were 1/2, 0.5/>128, 4/16, 16/>128, and 1/2 ㎍/mL, respectively. The susceptibilities for E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, and E. cloacae were 100%, 86.4%, 89.7%, 50.0%, and 96.6%, respectively. For E. coli, K. pneumoniae, P. aeruginosa, and E. cloacae, isepamicln had better in vitro activities than gentamicin and tobromycin, and had similar activities with amlkacin. For A. baumanii, all four tested aminoglycosides had similar in vitro activities. Conclusion : Isepamicin had excellent in vitro activities against gram-negative organisms, except A. baumanii. The overall in vitro activities were similar with amikacin. 목적 : 그람 음성 세균은 다양한 지역사회 및 병원 획득 감염의 원인균이다. 최근에는 병원 감염을 일으키는 그람 음성 세균에서 항균제 내성균의 출현과 확산이 큰 문제가 되고 있다. Isepamicin은 최근에 소개된 gentamicin B의 유도체로 외국에서의 연구에 의하면 그람 음성 세균들에 대한 항균력이 우수함이 보고 된 바 있다. 본 연구에서는 우리나라의 임상 균주들을 대상으로 그람 음성세균에서 isepamicin의 시험관내 항균력을 기존의 아미노배당체 제재들과 비교하여 평가하고자 하였다. 재료 및 방법 : 2006년 1월에서 6월 사이에 서울아산병원 환자에서 분리된 Escherichia coli 113 균주, Klebsiella pneumoniae 110 균주, Pseudomonas aeruginosa 117 균주, Acinetobacter baumannii 108 균주, 그리고 Enterobacter cloacae 118 균주를 대상으로 isepaimcin, amikacin, gentamicin, tobramycin에 대한 최소억제농도(minimal inhibitory concentration, MIC)를 한천 희석법(Mueller-Hinton Agar)을 이용하여 측정하였다. 감수성여부는 CLSI 기준에 따랐으며, isepamicin은 MIC≤16㎍/mL를 감수성, MIC=32 ㎍/mL를 중등도 내성, MIC≥64 ㎍/mL를 내성으로 판정하였다. 결과 : Isepamicm의 E. coli, K. pneumoniae, P. aeruginosa, A baumannii, E. cloacae에 대한 MIC_(50)/MIC_(90)은 각각 1/2, 0.5/>128, 4/16, 16/>128, 1/2 ㎍/mL였고, 항균제 감수성률은 차례대로 100%, 86.4%, 89.7%, 50.0%, 96.6%였다. 기존 아미노배당체 제재들과 비교하면 E. coli, K. pneumoniae, P. aeruginosa, E. cloacae에서는 amikacin과 비슷한 감수성률을 보였고, gentamicin과 tobramycin보다 높은 감수성률을 보였다. A baumannii의 경우 isepamicin의 감수성률이 50.0%로 비교적 낮았지만 amikacin, gentamicin, tobramycin도 각각 50.0%, 46.3%, 47.2%의 감수성률을 나타내어 4가지 항균제가 모두 비슷한 항균력을 보였다. 결론 : Isepamicin은 그람 음성 세균들에 있어 기존의 아미노배당체 제재들과 비교했을 때 amikacin과는 동등한 시험관내 항균력을 보이고 gentamicin, tobramycin보다 뛰어난 시험관내 항균력을 보여 사용이 유망한 아미노배당체 중 하나라 생각된다.

반응표면분석에 의한 단감식초 제조조건의 모니터링

정용진,서권일,이기동,윤광섭,강미정,김광수 동아시아식생활학회 1998 동아시아식생활학회지 Vol.8 No.1

To utilize deteriorated sweet persimmon effectively, response surface methodology(RSM) was used to determine the optimal vinegar fermentation conditions and monitored by a divided two stage fermentation. The optimum conditions for maximum alcohol content were obtained when the first stage (alcohol fermentation) was carried out with an initial sugar concentration of 18.5°Brix, agitation rate of 140.8 rpm, fermentation time of 127.6 hr. When sugar concentration was 14°Brix, maximum alcohol content(7.1%) was predicted at fermentation conditions of 160 rpm in agitation rate, 140 hr in fermentation time. The optimum conditions for maximum acidity were obtained when second stage(vinegar fermentation) was carried out 249.5 rpm in agitation rate, 148.8 hr in fermentation time. Predicted values at the optimum conditions were similar to experimental values.

Process 개선이 기업가치에 미치는 영향 : BSC의 적용사례를 중심으로

정미녀,권형기 관동대학교 기업경영연구소 2004 경영논집 Vol.22 No.-

본 연구는 연구대상 기업인 H기업의 현재 기업 상태를 BSC를 적용하여 진단해 보고, 변화하는 기업 환경 속에서 지속적인 성장과 발전을 위해 당기순이익 뿐만 아니라 장기적 순이익을 증가 시키려는 노력이 필요하므로 BSC의 주요 핵심인 Process 개선이 기업가치에 어떠한 영향을 미치는지를 살펴보고자 한다. H기업은 1999년 H중공업에서 분리되어 독자 경영을 이끌어 가면서 사내·외의 이해관계자들로부터 과연 부실에서 벗어나 건실 경영을 할 수 있을 거라는 의문을 야기하고 있었다. 결과적으로 당기순이익을 실현하는 것이 최대의 과제이며, 차입금이 적은 상태에서는 영업외 이익이 아닌 영업이익이 대부분 당기순이익을 반영하고 있는 상황이다. 그러므로 H기업의 process 개선이 구체적으로 어떻게 고객의 관점 그리고 더 나아가서 재무적인 관점에 공헌하는가를 살펴보았으며, 이러한 process 개선에 결정적인 제약조건을 부여하는 것이 human resource의 관점에서 야기되는 문제로 나타났다. 따라서 과연 Process. 개선이 H기업의 기업 가치를 얼마나 증진시키는가는 어떤 부분을 어떻게 개선하느냐에 따라 다른 결과를 초래하므로 BSC상에서의 Human Resource(Learning & Growth) 측면이 부각시키는 제한성을 어떻게 극복하느냐에 달린 문제라고도 볼 수 있다. 이러한 불확실성에도 불구하고 BSC를 들여다보면서 여러 가지 간접적인 효과를 가늠해 본 결과 오히려 직접적인 효과 이상으로 기업가치에 영향을 미치는 것으로 나타났다.

감과실 알코올 발효를 위한 효모의 분리

정용진,서권일,신승렬,서지형,강미정,김광수 동아시아식생활학회 1997 동아시아식생활학회지 Vol.7 No.4

To utilize abundant poor persimmon fruits effectively, it was studied on alcohol fermentation strains which were isolated and indentified from poor persimmon fruits. The strains which had exellent alcohol production ability were analysized morphogical, cultural characteristics and identified Saccharomyces cerevisiae YJK 20, Sacahroimyces kluveri DJ 97. Alcohol production ability between the isolated strains and industrial alcohol yeasts was compared in the YPD medium, persimmon extract medium. Isolated strains had high alcohol production ability in both of two medium, respectively. So it was expected that the strains, YKJ 20 and DJ 97 had good alcohol fermentation ability of persimmon fruits.

저체중출생아 어머니의 퇴원 1주일 후 교육요구도 조사 연구

권미경,최선정 관동대학교 의과학연구소 2000 關東醫大學術誌 Vol.4 No.1

This study was researched the education needs of LBW infant's mother at one week after the discharge far development of the educational program. The subjects of this study consisted of 40 mothers of LBW infant's at one week after the discharge. They were selected by convenience from 3 general hospitals and 1 pediatric hospital in Seoul, Kangnung. The data were collected during the period from January, 5 to March 15, 2000. The results of this study were as follows : 1.At one week after the discharge, the education need score of LBW infant's mother is 3.77 ±0.49 2.When each item was analyzed by the general characteristics of subject, there was significant differences according to delivery type. 3.The scores of categories are that unusual behavior is 3.97±0.55, disorder management is 3.96±0.51, attachment between mother and infant is 3.80±0.65, infant care is 3.71 ±0.62, environment is 3.55 ±0.65, feeding is 3.52 ±0.65. There were two items that represented the highest educational needs in all items. They were 'when infant has a seizure, what can I do?(4.25±0.78)' and 'when infant has a gastro-intestinal trouble, what can I do?(4.25 ±0.63)'.

정맥주입 전문간호사가 삽입한 말초삽입형 중심정맥관(PICC) 사용 결과에 대한 후향적 분석

박정윤,박광옥,백미경,김세라,권혜리,양수진 대한기초간호자연과학회 2004 Journal of korean biological nursing science Vol.6 No.1

Background : Intravenous(Ⅳ) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by Ⅳ CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the Ⅳ CNS during a 10-month period form November, 14, 2002, to October 2, 2W2. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, 2~61 days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of Ⅳ therapy.