인슐린 비의존형 당뇨병성 케톤산증 환자의 마취경험 : 증례보고 A case report

강규식,김난설,김지은 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

The most serious acute complication of DM is diabetic ketoacidosis (DKA). Medical and surgical illnesses account for 50% of episodes of DKA. Infection, myocardial infarction, cerebral vascular accidents, gastrointestinal bleeding, trauma, pancreatitis, and burns are the most common medical causes. The mortality rate from DKA has been reduced to less than 5%. Patients with insulin-dependent diabetes mellitus (IDDM) are more prone to DKA than those with noninsulin-dependent diabetes mellitus (NIDDM). Older diabetics account for approximately 75% of patients who present with DKA. The signs and symptoms of DKA result from hyperglycemia or ketoacidosis. We report a case of anesthetic management of a patient with noninsuline-dependent diabetic ketoacidosis after trauma.

법랑질 인공우식병소에서 APF gel과 CPP-ACP 제제의 재광화 효과

강지선,이난영,이상호 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

많은 연구에서 불소 이온을 이용한 치아우식증의 예방 및 재광화 효과에 대해 밝힌 바 있다. 불소는 치아우식을 예방하고 재광화를 촉진하는 대표적 인 성분이다. 하지만 불소를 이용한 재광화는 하부의 탈회 병소를 충분히 광화시키지 못하며 다공성으로 인해 불완전한 광화를 보인다. 또한 그 적용 과정에서 과량이 섭취되었을 경우에 발생할 수 있는 독성도 고려해야 한다. 한편 CPP-ACP(Casein Phosphopeptides-Amorphous Calcium Phosphate)는 초기의 우식병소를 재광화 시키며 우유 단백질인 casein으로부터 추출한 성분으로 섭취되어도 인체에 무해하다. 본 연구의 목적은 APF gel과 CPP-ACP 제제의 재광화 효과를 비교해 보고자 하는 것이다. 본 실험에서는 법랑질 인공우식 병소에 Acidulated Phosphate Fluoride(APF) gel과 CPP-ACP 제제를 각 도포 방법에 따라 적용하였다. 14일 후, 표면미세경도를 측정하고 편광 현미경 하에서 재광화 병소를 관찰하여 다음과 같은 결과를 얻었다. 1. 실험 전후 표면미세경도를 측정하여 비교한 결과, 모든 군에서 실험 후에 표면미세경도가 증가하였다(P<0.05). 2. CPP-ACP 제제를 도포한 군에서 불소를 도포한 군에 비해 표면미세경도 증가 폭이 유의하게 컸다(P<0.05). 3. 편광현미경 하에서 관찰한 결과 불소도포 군은 불규칙하고 얇은 재광화 층을, CPP-ACP제제를 도포한 군은 균일하고두터운 재광화 층을 보였다. Many operations have been carried out using the fluohde ion to prevent and reverse dental caries, It certainlyencourages remineralization and also prevents dental caries. However, the remineralization developed by these means is superficial only leaving lower levels of demineralized lesion with a degree of porosity and incomplete mineralization. We must consider its toxic effects when it isingested for overdose. The CPP-ACP paste is able to remineralize the incipient lesion and has no harmful effectswhen it is ingested, because it was made form casein which is from the protein of milk. The purpose of this article is to compare the remineralization effects between APF gel and the CPP-ACPpaste. we applicated the APF gel and CPP-ACP paste on the artificial enamel carious lesion. After 14 days. we measured the surface microhardness and observed the reminei-alized lesion under polarized light microscope. The results were as follows: 1. The surface microhardness ofgroup III was the highest. followed by gi'oup II. and I(p<0.05). 2. The surface microhardness ofgroup III was significantly higher than those ofgroup I, and II(p<0.05). 3. We could observe thin and irregular remineralization layer ofgroup II, and regular and moderate remineral-ization layer ofgroup III under polihzed light microscope.

공변량 구조분석을 이용한 국내 간호연구의 동향

임난영,강현숙,이성은,서연옥,권영은 대한간호학회 2001 Journal of Korean Academy of Nursing Vol.31 No.2

This study was conducted by analyzing all 33 articles based on the LISREL, published from January 1991 to March 1999 in Korea. The analyses consisted of the publication date of articles, principal dependent variables, subjects of the research. adequacy of sampling, adequacy of research purposes and results. accordance between theoretical model and hypothetical model. fit measures, theoretical base of model modification, and adequacy of conclusion. The results were as follows : ? The thesis of 33 articles in total were outnumbered as 25 (75.8%) to 8 (24.2%) research articles. As for a sex classification of the subjects, 45.5% of the research were conducted around a female group of subjects. while 54.5% were done for both sex, The range of the sample size was 105 to 803, and the average was 259 subjects. ? A single theoretical variable was measured for each measurement variable, any difference between variables was hardly found in 8 articles (24.2%), and 19 articles (57.6%) did not consider any measurement error. To analyze if the representative has been considered while collecting the data. most data were collected by a convenient sampling. Seven articles (21.2%) were seen with a sign of a representative. Questionnaires were used in a majority (31 articles) of the data collecting process. Only 2 articles (6.1%) were measured with a physiologic index simultaneously. 14 articles (42.2%) were centered on theory development, 10 articles on theory synthesis. and 9 articles on theory test. The research purposes and results were consistent in 25 articles (75.5%) and 8 articles (24.2%) were inconsistent. The quality of life and health promotion behavior were the concepts most frequently studied as a dependent variable. and 7 articles centered on them. In applied theories a health promotion model was used on 4articles (12.1%), while role theory and stress-coping models were in 3 articles respectively. The articles were analyzed to see if the hypothetical model was elaborated and tested by the theoretical model. Twenty-five articles proved to be rationale for the inconsistencies. Also, 56.5% proposed hypotheses were supported among the subject articles. and 30 articles (90.0%) suggested a revised model. Path coefficient (17 articles) and theoretical adequacy (17 articles) were the standards mostly used. In conclusion. the principal factors were obtained from the research are to be considered as the principes of LISREL application. First. a model has to be established on a theoretical base rather than empirical results dependent on the data. The results are also required to be globally interpreted. Secondly. at least 200 samples are necessary to satisfy the need. Third. more than 3 measurement variables are to be adjusted to a single theoretical variable: the measurement errors must be suggested as well. Finally. normal distribution characteristics of the data and the estimation method need to be reported. Based on the research result. the follows are suggested: ? Systematic criteria on the LISREL application and procedure need to be developed ? Agreement form is required to report the results of research using the LISREL

간흡충: 충체 및 대사성 항원의 특성분석 (1)항원투여 마우스 비장조직에 대한 면역조직화학적 연구

송강원,주난영,류장근,양용석 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 1996 Journal of biomedical laboratory sciences Vol.2 No.2

저자들은 마우스를 실험모델로 하여 간흡충의 항원을 투여 했을 때 비장조직에 대한 CD3, CD4 및 CD8 모노클로날 항체의 반응 여부를 알아보고자 하였다. 즉, 간흡충에 대한 세포면역학적인 특성을 규명고자 하였으며 특히 비장 조직에 대한 phenotype을 관찰한 결과 다음과 같은 결과를 얻었다. 간흡충의 조항원을 면역증강제와 함께 복강 투여한 다음 일정 기간 후에 비장조직을 Avidin-biotin complex 면역조직염색을 실시한 결과 CD3에서 강한 양성 반응을 나타냈고 CD4와 CD8에서는 약한 반응을 나타냈다. 조직부위를 보면 피막, 혈관, 임파관, 백수부위와 림프구 및 대식세포의 세포막에서 양성반응을 보였다. The authors inquired into what reactions comprise the response of mice(as a model) CD3, CD4 and CD8 monoclonal antibodies in spleen tissue when injected intraperitoneally by antigens of Clonorchis sinensis. The author is objective was focused on investigating the property of cellular immunity for liver fluke. In particular, the results of having examined the phenotype of the tissue of spleen were revealed as follows: a certain length of time after having been intraperitoneally injected with antigens of Clonorchis sinensis and Freund's adjuvant, the tissue of spleen was embedded and immunohistochemically stained by the avidin-biotin complex method. A strong reaction in response to CD3, while a feeble reaction resulted from CD4 and CD8. The tissue region showed a positive reaction to all antibodies, especially from capsules, vascular areas, white pulps and membrane of blood cells.

월출산국립공원 수질특성에 관한 연구

최형일,김난희,강영주,채희정,김연풍,조도호,설동화 조선대학교 환경공해연구소 2007 環境公害硏究 Vol.20 No.1

Because mountain streams have narrow widths and steep slopes compared to streams and lakes, hours of immobility are considerably short, and the quality of mountain streams has been greatly influenced by rainfall, land-use, components of the streambed and types of forests. During the summer when heavy rainfall occurs, eroded earth and sand flow into mountain streams and cause temporarily high turbidity. It is also the cause of eutrophication, which is frequently found in downstream. As evaluation standards for the quality of mountain streams were not established in Korea, this quality was evaluated by examining some items based on quality standards for drinkable water and research on the influences of pollution in mountain streams, which showed that these were seldom in downstream water systems. Mountain streams within Wolchulsan National Park flow into a reservoir and when characteristics of mountain streams from forests and rainfall that flow into mountain streams through forest ecosystems were studied, results of measuring its changes are as follows. Monthly changes of pH were low between April and August and higher starting October, and the EC was measured higher in the winter and the spring and tended to be low starting April. The EC on the 19th of May and the 23rd of October and the concentration of floating materials and COD_(Mn) were observed to be higher due to the influence of rainfall on the 19th of May and the 22nd of October, and it was judged that the washing out of dried deposits attached to the water pipe and the leaching of woods were influenced by rainfall. It is considered that real-time monitoring of water quality for a long time and water quality conditions during and after rainfall should be examined for ensuring basic data of water quality and evaluating characteristics and seasonableness of mountain streams, which may be greatly changed by artificial influence in the future.

간호사의 임상 실무 경험

서문자,손행미,강현숙,권성복,김주현,박영숙,이은희,임난영,조경숙,지성애 성인간호학회 2002 성인간호학회지 Vol.14 No.4

purpose: This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea. Method: Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription. Result: The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients. Conclusion: Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.

간흡충 피낭유충에서 Alkaline Phosphatase 및 Acid Phosphatase의 특성

양용식,송강원,주난영 연세대학교 보건과학연구소 1997 보건과학논집 Vol.7 No.-

철도교통소음의 수평·수직적 전달 및 감쇠 특성

최형일,정원삼,김난희,강영주,위환 조선대학교 환경공해연구소 2006 環境公害硏究 Vol.19 No.1

This study has been conducted to achieve the following objectives: First, in order to understand the horizontal propagation and attenuation characteristics for the railroad traffic noise, we selected actively developed areas within 100 meters away from the road to measure the level of traffic noise near a road. To measure the noise near a railroad, we selected areas within 100 meters away from the railroad and then selected Saemaul-ho and Mugoongwha-ho as the subjects for our experiment, In this way, we analyzed the horizontal propagation and attenuation characteristics for the traffic noise occurring in diversified areas. Second, in order to understand the vertical propagation and attenuation characteristics for the railroad traffic noise, we measured and analyzed the distributional characteristics of vertical sound pressure levels on each floor of multi-storied apartment buildings according to changes of traffic load and types, and the existence or nonexistence of soundproof walls. For the case of the railroad traffic noise, we also selected Samaul-ho and Mugoongwha-ho as the subjects for our experiment, and we measured and analyzed the different noise levels on each floor of multi-storied apartment buildings from the soundproof wall. The results of Horizontal propagation and attenuation characteristics for the railroad traffic noise are as follows: In cases of the flat land, cutting land, and bridge area, as distance increases, the sound pressure level steadily decreases. The cutting land has an especially high distance decrease compared to the other areas, and the sound pressure level for the bridge area is higher than that of the flat land with a measurement of 9.7~17.5㏈(A). Vertical propagation and attenuation characteristics for the railroad traffic noise are as follows: The amount of sound pressure level decrease is 13.9~15.4㏈(A) for Samaul-ho and 10.9~11.5㏈(A) for Mugoongwha-ho when measuring the vertical sound pressure levels at heights lower than 4.5m, which indicates a fairly large decrease. At 6m, the amount of decrease is 7.3㏈(A) for Samaul-ho and 5.0㏈(A) for Mugoongwha-ho, which indicates a small decrease.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

만성 신장질환자의 혈액투석 중 부작용에 대한 일반투석과 profiling 투석법의 비교

강해숙,강현주,강의정,유난영,김아름,공진화,양영옥 병원간호사회 2007 임상간호연구 Vol.13 No.1

Purpose: The purpose of this study was to evaluate adverse reactions during hemodialysis with gradient ultrafiltration and high sodium dialysate could be reduced as compared to conventional hemodialysis. Method: Thirteen outpatients who had been on hemodialysis three times in a week for more than 6 months were recruited. he data were collected for 8 weeks from July 3 through August 26, 2006. Patients received conventional hemodialysis for the first four weeks, and then received profiling dialysis of gradient ultrafiltration & high sodium dialysate for the second four weeks. The collected data were analyzed with mean, standard deviation, paired t-test at significant level of .05. Result: The incident frequency of hypotension during sodium profiling hemodialysis was reduced, compared to conventional hemodialysis(t=1.210, p=.020). At the same time, the number of nursing interventions during sodium profiling hemodialysis was reduced significantly. Although systolic and diastolic blood pressure measured after profiling hemodialysis and conventional hemodialysis were not significantly different, the levels of systolic and diastolic BP were increased and concentration level of sodium was increased from 138.0±2.2mEq/L in conventional hemodialysis(the first four weeks) to 140±2.9mEq/L in profiling hemodialysis(the second four weeks) with t=-1.627, p=.114. Conclusion: Due to the reduced number of adverse reactions and nursing interventions in profiling hemodialysis, we can expect an increase in patient's compliance toward hemodialysis. This study suggest that profiling hemodialysis would be more efficient hemodialysis and more effective nursing interventions in occurrence of adverse reactions. However, because of the limited number of cases of this study, the effectiveness of profiling hemodialysis is yet to be determined.