만성간염환자의 삶의 질에 관한 연구

이명화,이지현,손수경 고신대학교(의대) 고신대학교 의과대학 학술지 1997 고신대학교 의과대학 학술지 Vol.12 No.1

-Abstract- This descriptive study was under taken to explore relationships between the quality of life and perceived state of health persons with chronic hepatitis to contribute theoretical understanding about these phenomenon of interest to the quality of nursing care. The subjects of this study were 100 persons with chronic hepatitis, both male and female, between 30 and 59 years of age. Data was obtained using a convenience sample technique from K Medical Center, B hospital and G hospital in Pusan from August, 1996, to November, 1996. The instruments used for this study were the quality of life scale developed by Ro, You-ja. Data was analyzed using a SPSS/PC program for ANOVA, t-test, Pearson Correlation Coefficients and Stepwise Multiple Regression. The results were as follows : 1. The mean score of the quality of life scale was 152.21. The mean scores on different dimensions were family relationships 3.44, relationships with neighbours 3.42, self-esteem 3.31, emotional life 3.14, physical state and function 3.06, economic life 3.06. 2. Higher scores on quality of life were correlated with educational level (F=2.945, p=0.05). 3. There was a significant positive correlation between the subjects perceptions of their current state of health and the quality of life score (r=0.3849, p<0.001). 4. Stepwise Multiple Regression analysis showed that 1) the perception of current health status was the main predictor and accounted for 14.99% of the total variance. 2) educational level accounted for an additional 23.6% of total variance. 5. The quality of life and the perception of their current health status of these patients with chronic hepatitis were generally lower than those of healthy adults and higher than those of cancer patients as noted in previous studies. In conclusion, the quality of life for these chronic hepatitis patients was lower than those of healthy adults and higher than those of cancer patients. The educational level was significant variable relating to quality of life of chronic hepatitis patients.

Remote health monitoring services in nursing homes

김지원,김현수,임성일,박영인,Lee Haeyoung,권수경,최영식,Sohn Linda,옥철호 고신대학교(의대) 고신대학교 의과대학 학술지 2023 고신대학교 의과대학 학술지 Vol.38 No.1

Aged people are challenged by serious complications from chronic diseases, such as mood disorder, diabetes, heart disease, and infectious diseases, which are also the most common causes of death in older people. Therefore, elderly care facilities are more important than ever. The most common causes of death in elderly care facilities were reported to be diabetes, cardiovascular disease, and pneumonia. Recently, the coronavirus disease 2019 (COVID-19) pandemic have a great impact on blind spots of safety where aged people were isolated from society. Elderly care facilities were one of the blind spots in the midst of the pandemic, where major casualties were reported from COVID-19 complications because most people had one or two mortality risk factors, such as diabetes or cardiovascular disease. Therefore, medical governance of public health center and hospital, and elderly care facility is becoming important issue of priority. Thus, remote health monitoring service by the Internet of Medical Things (IoMT) sensors is more important than ever. Recently, technological breakthroughs have enabled healthcare professionals to have easy access to patients in medical blind spots through the use of IoT sensors. These sensors can detect medically urgent situations in a timely fashion and make medical decisions for aged people in elderly care facilities. Real-time electrocardiograms and blood sugar monitoring sensors are approved by the medical insurance service. Real-time monitoring services in medical blind spots, such as elderly care facilities, has been suggested. Heart rhythm monitoring could play a role in detecting early cardiovascular disease events and monitoring blood glucose levels in the management of chronic diseases, such as diabetes, in aged people in elderly care facilities. This review presents the potential usefulness of remote monitoring with IoMT sensors in medical blind spots and clinical suggestions for applications.

Future directions of online learning environment design at medical schools: a transition towards a post-pandemic context

김세진 고신대학교(의대) 고신대학교 의과대학 학술지 2023 고신대학교 의과대학 학술지 Vol.38 No.1

Coronavirus disease 2019 (COVID-19) has had an extremely large impact on methods of teaching and learning, and the need for online learning has grown enormously during the COVID-19 pandemic. Because most professors and students adjusted their mode of teaching and learning to this new context, online learning seemed to be going well. The problem is that distance learning was abruptly adopted as an alternative method of classroom instruction. To increase the effectiveness of online learning, more consideration is needed to explore future directions of creating learning environments. Therefore, this study suggests seven design guidelines for designing learning environments at medical schools based on a theoretical background and experiences from the pandemic. Constructivism and situated learning theory are introduced as the theoretical background for learning environment design, and the basic principles of learning environment design with the paradigm shift to learner-centered classrooms and experiences using EdTech, including HyFlex learning, flipped learning, learning management systems, and interactive learning tools, were used to develop the design guidelines. Each design guideline is strategically matched with the basic principles: learner-centeredness, real-world tasks and contexts, problem-solving, new roles of professors as facilitators or tutors, collaboration, and new perspectives of evaluation and assessment.

Acute combined central and peripheral nervous system demyelination: a case report

노영은,김영미 고신대학교(의대) 고신대학교 의과대학 학술지 2018 고신대학교 의과대학 학술지 Vol.33 No.2

Guillain-Barré syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are demyelinating neurologic disorders with different target organs. Although they share similar pathogenetic mechanism, reports of simultaneous occurrence of the 2 disorders are rare. A 2 year 6 month old girl visited our hospital for fever, cough, and general weakness. Although the muscle power of extremities showed mild weakness and voiding difficulty, initial deep tendon reflex of both knees and ankles was normal. A nerve conduction study to evaluate the weakness revealed the absence of F waves. Cerebrospinal fluid analysis demonstrated pleocytosis with lymphocyte predominance and elevated protein levels. Magnetic resonance imaging showed abnormal T2 hyperintensity in pons, medulla and spinal cord. Serum anti-GD1b antibody was positive. Based on clinical findings, laboratory findings, nerve conduction study, and neuroimaging, the diagnosis of GBS and ADEM was made. This is the first case of GBS accompanied by ADEM in Korea.

섬유선종에서 발생한 침윤성 유관상피암 1예

정민정,천봉권 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.2

Fibroadenoma is a benign breast tumor that is commonly diagnosed in young women and usually not considered as meaningful premalignant lesion. But rare cases of carcnioma arising in a fibroadenoma are reported. The considered risk factors are older age than peak age of fibroadenoma, associated histologic findings, such as cyst, sclerosing adenosis, epithelial calcification or papillary aprocrine changes, family history, or proliferative diseases in adjacent to the fibroadenoma. Cellular atypia, confined to a fibroadenoma does not belong to the risk factor. Therefore, fibroadenoma in older age needs the surgical excision or continuous follow-up with regard to the individual risk factor. We report a rare case ,35-year-old woman with invasiv eductal carcinoma arising within fibroadenoma. 섬유선종은 젊은 여성에게서 흔히 나타나는 유방의 양성 종양이며, 대개는 의의있는 전암병변으로 여겨지지 않는다. 하지만, 섬유선종에서 발생한 암종의 드문 보고가 있다. 위험 인자로는 섬유선종의 호발연령보다 많은 나이, 수반된 조직학적 모습, 가족력, 주변 실질의 증식성 병변 등이 고려되며, 세포학적 이형성은 이에 속하지 않는 것으로 여겨진다. 그러므로 고령에서 발생한 섬유선종은 개인의 위험 인자에 따라 외과적 절제 또는 지속적인 추적 관찰이 필요하다. 저자들은 섬유선종에서 발생한 침윤성 유관상피암의 드문 증례를 경험하고 문헌 고찰과 함께 보고한다.

HL-60 사람 백혈병 세포로부터 topoisomerase type 1B의 동정

정인철,곽충근,조무연 고신대학교(의대) 고신대학교 의과대학 학술지 2004 고신대학교 의과대학 학술지 Vol.19 No.1

Background : DNA topoisomerases fall into two categories -type 1 and type 2. For the type 1 enzymes, the DNA strands are transiently broken on at a time; for the type 2 enzymes, by contrast, a pair of strands in a DNA double helix are transiently broken in concert by a dimeric enzyme molecule. The two types can be further divided into four subfamilies: 1A, 1B, 2A and 2B. DNA topoisomerases solve the topological problems associated with DNA replication, transcription, recombination, and chromatin remodeling by introducing temporary single- or double-strand breaks in the DNA. Camptothecin is an antitumor alkaloid that has been isolated from the Chinese tree, Camptotheca acuminata. We have developed a procedure for the simultaneous purification of type 1 and 2 topoisomerase from HL-60 human leukemia cells, and identified type 1B topoisomerase. Methods : DNA topoisomerase was purified from HL-60 human leukemia cells by a simple and fast four-step procedure : seletive ammonium sulfate precipiation, chromatography on Ultrogel A6 and DNA- cellulose, followed by ultracentrifugation on a glycerol gradient. Enzyme activity, and molecular weight were assayed by measuring the relaxation of supercoiled pUC19 DNA using agarose gell elctrophoresis and sodium dodesyl sulfate denaturing gel electrophoresis, respectively. Results Type 1 and 2 topoisomerases were isolated from extracted nucleoprotein complexes by glycerol gradient centrifugation, respectively. Human type 1B topoisomerase was purified 8.6-fold as compared to the whole cell homogenate, with 12% yield. The purified type 1 topoisomerase has a molecular weight of 100 kDa as determined by SDS polyacrylamide gel electrophoresis. The enzyme relaxes supercoiled DNA in the absence of ATP or Mg2+. Camptothecin inhibited the relaxation activity of type 1 topoisomerase in pUC19 DNA by forming a cleavable complex at various concentrations (0.4-50 uM). Conclusion : The results showed that a type 1B topoisomerase has been purified to near homogeneity from HL-60 human leukemia cells, and partial purification of type 2A from small samples was achieved by isolation of cell nuclei. Thus, the potential antitumor activity of a type 1 and 2 topoisomerase-targeted drug might be easily screened by testing the drug's ability to cause DNA cleavage in the presence of enzymes.

A double-knotted pulmonary artery catheter with large loop in the right internal jugular vein -A case report-

윤경섭,최소론,김정아,홍정인,김정호,박상융 고신대학교(의대) 고신대학교 의과대학 학술지 2018 고신대학교 의과대학 학술지 Vol.33 No.2

Knotting of a pulmonary artery catheter (PAC) is a rare, but well-known complication of pulmonary artery (PA) catheterization. We report a case of a double-knotted PAC with a large loop in a patient with hepatocellular carcinoma (HCC) undergoing liver transplantation, which has been rarely reported in the literature. A PAC was advanced under pressure wave form guidance. PAC insertion was repeatedly attempted and the PAC was inserted 80 cm deep even though PAC should be normally inserted 45 to 55 cm deep. However, since no wave change was observed, we began deflating and pulling the balloon. At the 30-cm mark, the PAC could no longer be pulled. Fluoroscopy confirmed knotting of the PAC after surgery (The loop-formed PAC was shown in right internal jugular vein); thus, it was removed. For safe PA catheterization, deep insertion or repeated attempts should be avoided when the catheter cannot be easily inserted into the pulmonary artery. If possible, the insertion of PACs can be performed more safely by monitoring the movement of the catheter under fluoroscopy or transesophageal echocardiography.

Ealrly Metabolic Suppression Therapy for Severely Increased Intracranial Pressure after Emergency Brain Decompression

김진욱,김상대,임동준,박정율 고신대학교(의대) 고신대학교 의과대학 학술지 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Objective: Patients suffering from severe traumatic brain injury or cerebral hemorrhage need to be closely monitored and be intensively managed in order to prevent irreversible neurological damage. However, progressive neurological deterioration may occur despite the rapid physiologic resuscitation after emergency brain decompression. In this study, the clinical outcome of the early metabolic suppression treatment was evaluated in patients suffering from severe cases of refractory increased intracranial pressure following emergency brain decompression. Methods: We retrospectively reviewed the charts of all patients who received early metabolic suppression therapy after emergency brain decompression between January 1, 2002 and January 1, 2007. Result: A total of 42 patients were included in this study. Twelve (29%) of these have survived. Six (50%) of the survivors showed favorable outcomes (i.e., good recovery and moderate disability) at 1 year after hospital discharge. Cerebral perfusion pressure was higher in the survivors than in the non-survivors. Conclusion: Early aggressive metabolic suppression therapy with barbiturates may be used to effectively control the intracranial pressure in a substantial number of patients with severely increased intracranial pressure even after emergency brain decompression, without adversely affecting the cerebral perfusion pressure in these patients.

교구간호 명칭에 관한 의견조사 -부산지역 일부 개신교회 목회자들을 중심으로-

이영은,강은실,황선자 고신대학교(의대) 고신대학교 의과대학 학술지 1999 고신대학교 의과대학 학술지 Vol.14 No.1

Parish nursing is an emercing nursing care delivery model that practices holistic health care. Parish nurses provide care to a faith community, emphasizing the relationship between faith and health. In Korea, educational programs and services related to parish nursing are carried out at Keimyung university, Kosin university, and Jesus junior nursing college. But it is confusion to translate parish nursing into a Korean name among nurses. The purpose of this study was to investigate an opinion about a Korean name of parish nursing with 20 pastors in Pusan. The results are as follows : 1. The majority of respondents was presbyterian pastors. 2. The average age of respondents is 54.1 year. 3. While a 45% of respondents reported that they would like to translate parish nursing into 'Gyou-ku' nursing, a 45% of respondents reported that they would like to translate parish nursing into 'Mock-heoi' nursing. The conclusion of this study was that it is necessary to investigate further studies and an open hearings on a Korean name of parish nursing of congregations and nurses as well as pastors as subjects.

고립성 골낭종의 치료

김재도,사석진,이덕희 고신대학교(의대) 고신대학교 의과대학 학술지 1997 고신대학교 의과대학 학술지 Vol.12 No.1

-Abstract- Simple bone cyst is a true benign lesion of primary intraosseous origin that almost always begins on the metaphyseal side of the epiphyseal plate of long bone in children. The pathogenesis is yet undetermined, but its clinical importance is stressed due to prone to pathologic fracture and high recurrence rate. Regardless the variable methods of treatment have been performed, but there is no an established mode of treatment. Therefore we evaluated the results according to the mode of treatment. We have studied 9 cases of simple bone cyst which where treated from Jun. 1987 to May 1995. The average duration of follow-up was 2 years. 3 cases were treated with curettage and bone graft, and 6 cases were treated with steroid injection. The clinical results were as follows: 1. Age distribution was from 4 years to 13 years (mean age 8.4 years). There were 7 boys and 2 girls. The male to female ratio was 3.5 to 1. 2. Skeletal location was proximal humerus in 5 cases, proximal femur & diatal femur, proximal radius and proximal ulna in 1 case respectively. 3. In cases of curettage and bone graft, 2 cases were healed and 1 case was recurred. Then, additional steroid injection was performed. And in 6 cases of steroid injection, 3 cases were healed, 2 cases were improved and 1 case was recurred. However, all cases were completely healed. 4. There was no difference in the results between treatment of steroid injection and curettage & bone graft. And age, sex, location and type of the cyst did not seem to influence the results of treatment. In conclusion, the steroid injection is a simple and safe procedure, and more favorable results can be expected than other surgical methods. The steroid injection should be repeated in persisting or recurrent cases, but it is highly recommended as the method of choice in the initial treatment of simple bone cyst without accompanying a pathologic fracture.