포스터 10 : Phlebotomy를 위한 정맥천자 시행 시 lidocaine 연고 도포군과 placebo 연고 도포군간 통증완화 비교 분석

민유선,임재명,권석운 대한임상병리사협회 2013 임상수혈검사학회 발표자료집 Vol.2013 No.-

배경(Background): 치료적 사혈요법(phlebotomy)은 환자의 전혈 또는 적혈구성분을 일정량채혈하여 제거하는 시술이며 주로 진성적혈구증가증(polycythemia vera) 및 혈색소침착증(hemochromatosis) 등의 질환을 치료하기 위해서 이용된다. 전혈 또는 적혈구를 16-18게이지(gauge)의 굵은 주사침으로 팔오금 부위의 정맥에 천자하여 환자의 체외로 제거하여야 하므로 환자들에게는 고통스러운 침습적인 처치 중 하나이다. 따라서 환자들의 고통스러운 치료과정의 신체적, 정신적인 영향을 최소화하고 통증을 관리하여 통증으로 인해 발생할 수 있는 채혈부작용과 심리적인 부담을 최소화하기 위해서 정맥천자 시 통증을 완화시키는 방법의모색이 필요하다. 방법(Methods): 2013년 5월 2일부터 9월 30일까지 치료적 사혈요법 시술을 받은 환자들중에서 본 연구의 목적을 이해하고 참여에 동의했던 40명의 환자를 대상으로 하였다. 치료적사혈요법 시행 시 40명의 대상자 중 무작위로 선정하여 20명의 연구 대상자에게는 2%lidocaine 연고를, 다른 20명의 연구 대상자에게는 placebo 연고를 천자할 부위에 도포하고, 30분 경과 후 알코올과 베타딘으로 소독한 다음 16게이지 철바늘(steel needle)로 천자하였으며, 천자 후 통증 정도를 VAS(visual analog scales)를 이용하여 측정하였다. 통계분석은 SPSSversion 21을 이용하여 paired-t test로 검정하였고 P-value가 0.05미만인 경우 유의한 차이가 있는 것으로 판정하였다. 결과(Results): 치료적 사혈요법 정맥천자를 시행 할 때 2% lidocaine 연고 피부도포군과 placebo 연고 도포군 모두에서 중재 전보다 중재 후가 유의하게 통증이 감소하였다(2%lidocaine 연고 도포군 p<0.002, placebo 연고 도포군 p<0.016). Placebo 연고 중재 후에도 유의하게 통증이 감소된 것으로 나타났다 (p<0.016). 2% lidocaine 연고 피부도포군이placebo 연고 피부도포군보다 치료적 사혈요법 정맥천자 시행 시 유의하게 통증이 감소되지않았다(p<0.186). 고찰(Discussion): 정맥천자시에 2% lidocaine 연고 피부도포와 placebo 연고 피부도포 모두에서 통증에 유의한 감소가 있는 것으로 나타남으로써 간호사의 통증이 감소한다는 설명만으로도 통증감소에 효과가 있는 것으로 생각되며, 본 연구와 선행연구를 근거로 하여 placebo연고를 도포했을 때 정맥천자 시에 확실히 통증과 불안이 감소하는 지에 대해 검정할 필요가 있다. 또한 정맥천자 시에 간호사들의 적절한 통증 중재가 환자들의 불안감소에 중요하다.

시대에 따른 한국인 머리뼈의 형태 변화

민유선,신동훈,오창석,황영일 대한체질인류학회 2012 대한체질인류학회 학술대회 연제 초록 Vol.55 No.-

일반연제 발표 : 산과학 1 ; 자간전증 태반에서 cytochrome c oxidase와 ATPase 발현에 대한 연구

민유선,이숙환,이유미,윤태기,조진호,이정노 대한산부인과학회 1999 대한산부인과학회 학술대회 Vol.84 No.-

뇌졸중 최신지견 2011: 뇌졸중 재활치료

민유선,백남종 대한뇌졸중학회 2012 Journal of stroke Vol.14 No.2

This article briefly reviews the research findings on post-stroke rehabilitative therapy mainly published in 2011. Topics on approaches for motor function recovery include the use of body-weight-supported treadmill, robotic training, virtual reality, functional electrical stimulation, intensive treatment and motor imagery. Rehabilitative strategies to improve functional recovery such as comprehensive cardiac rehabilitation, repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Also, pharmacotherapy using noradrenaline agonist reboxetine and botulinum toxin injection are discussed in this review.

손목과 손의 정상 초음파 소견

민유선 대한임상통증학회 2022 Clinical Pain Vol.21 No.1

Tendon disorders commonly cause wrist and hand disability and curtail the performance of work-related tasks. Sonography allows for cost-effective, noninvasive, and dynamic evaluation of soft tissue structures, thus representing a valuable tool for ruling out musculoskeletal disorders of the wrist and hand. Because of the complexity of the wrist joint, sonographic training and familiarity with normal and variant anatomy are needed to avoid misdiagnosis and improper treatment. The purpose of this article is to demonstrate the structures representing normal findings during sonographic evaluations of the wrist and hand. The main reviews the gross anatomy and procedures that are recommended to assess the soft tissue structures of the wrist and hand, with particular emphasis given to tendons, nerves, and ligaments. In conclusion, sonography is effective in assessing the tendons of the hand and wrist and related disorders and represents a valuable tool for diagnosis.

한국 말(馬)산업 이미지 제고를 위한 영상콘텐츠 활용 : 인간과 말의 교감을 다룬 영상 중심으로

민유선,이재영 글로벌문화콘텐츠학회 2015 글로벌문화콘텐츠학회 학술대회 Vol.2015 No.1

말은 인간의 오랜 벗이자 반려동물이며, 가축, 전쟁의 도구, 교통수단으로서 다양한 쓰임새를 지닌다. 해외 말(馬)산업은 경마, 승마, 마육, 말과 관련된 문화콘텐츠 등의 말산업으로 균형적인 발전을 해왔다. 하지만 국내 말산업은 유럽의 말산업과 비교하였을 때 초기단계이며, 경마산업에 치중되어 발전하였다. 그 결과 대다수 국민은 경마를 사행산업으로, 승마를 특수계층의 스포츠로 이분화 하면서 말산업에 대해서 부정적인 인식을 갖게 되었다 해도 과언이 아닐 것이다. 이러한 관점에서 말을 활용한 영상콘텐츠는 말에 대한 관심을 유도할 수 있고 말산업을 홍보하고 광고하는데 최고의 수단이 될 수 있다. 또한 영상콘텐츠는 인간과 말의 교감을 효과적으로 표현할 수 있고 말을 쉽게 전파할 수 있는 장점을 가진다. 따라서 국내 말산업 발전에 기여 할 수 있는 잠재력과 가능성을 가진다.

소아 급성림프구성백혈병에서 항암화학요법 후 발생하는 말초신경병증의 양상

민유선,강민구,김지윤 대한소아혈액종양학회 2017 Clinical Pediatric Hematology-Oncology Vol.24 No.2

Background: Vincristine is an antimitotic agent used for treatment of leukemia, lymphomas, and cancers. Its main side effect is a dose-related, length-dependent axonal neuropathy. Methods: We performed electrodiagnostic examinations in 18 children who had been treated with vincristine and who presented with the clinical picture of a peripheral neuropathy. Results: The mean cumulative dose of vincristine was 37.7±26.5 mg/m2. Electrodiagnostic examination showed an axonal neuropathy with a length-dependent pattern. All patients showed motor nerve abnormalities and sensory nerve abnormalities were observed in 13 patients (72.2%). The number of affected nerves was 2.67±1.1 (mean±SD) of four motor nerves and 1.5±1.4 of four sensory nerves. The mean reduction of the compound muscle action potential amplitude was 70.9±42.2% in the median nerve and 23.7±20.8% in the peroneal nerve compared to normal value. However, the mean change in the sensory nerve action potential amplitude was 139.9±78.5% in the median nerve and 246.9±169.7% in the superficial peroneal nerve. There was statistically significant difference between amplitude reduction of the compound muscle action potential and sensory nerve action potential. Conclusion: The quantitative analysis of electrophysiological motor predominance described differs from the mainly sensory neuropathy reported in adults. Incomplete myelination in motor nerve due to young age may have resulted in greater sensitivity of some nerves to neurotoxic agents.

생활체육 수영 참여자의 그릿(GRIT)이 운동 지속 의도 및 신체적 자기효능감에 미치는 영향

민유선,김현주,최종환 한국스포츠학회 2020 한국스포츠학회지 Vol.18 No.3

본 연구의 목적은 생활체육 수영 참여자의 그릿과 운동 지속 의도, 신체적 자기효능감과의 관계 및 그릿이 운동 지속 의도와 신체적 자기효능감에 미치는 영향을 규명하는 것이다. 연구대상은 생활체육 수영에 참여하는 성인 309명이었다. 그 결과는 다음과 같다. 첫째, 생활체육 수영 참여자의 그릿(흥미의 일관성, 노력의 지속성, 상황에 대한 적응성)은 운동 지속 의도와 정(+)의 상관관계가 있으며, 그릿이 운동 지속 의도에 영향을 주는 것으로 나타났다. 둘째, 생활체육 수영 참여자의 그릿(흥미의 일관성, 노력의 지속성, 상황에 대한 적응성)이 신체적 자기효능감(인지된 신체능력, 신체적 자기표 현 자신감)과 정(+)의 상관관계가 있으며, 그릿이 신체적 자기효능감(인지된 신체능력, 신체적 자기표현 자신감)에 영향 을 미친 것으로 나타났다. 따라서 그릿 수준이 높을수록 계속적으로 수영을 참여하고자 하는 지속의도를 증가시키며, 신체 적 수행과 관련된 과제를 할 수 있는 능력과 그 능력을 타인에게 평가받을 수 있는 자신감을 높이는 것을 알 수 있다. The purpose of this study is to find out how the GRIT of swimming participants affects the effect of exercise adherence intention and physical self-efficacy. The subjects of this study were 309 adults attending C swimming pool and N swimming pool located in C city in Chungbuk region. The results were as follows: First, the GRIT(consistency of interest, persistence of effort, adaptability to situations) of sports swimming participants had a positive (+) correlation with the exercise adherence intention, and it was found that grit influenced the exercise adherence intention. Second, the GRIT(consistency of interest, persistence of effort, adaptability to situations) of sports swimming participants had a positive (+) correlation with the physical self-efficacy(perceived physical ability, and physical self-presentation confidence), and it was found that grit influenced the physical self-efficacy(perceived physical ability, and physical self-presentation confidence. Therefore, it can be seen that the higher the level of grit, the greater the exercise adherence intention to participate in swimming, and the ability to perform tasks related to physical performance and the confidence to be evaluated by others.

호흡보조기를 사용하는 근위축성측삭경화증 환자 간병인의 삶의 질 및 간병 부담

민유선,김정윤,김명수,김정순,김현리,신형익 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.4

Objective: To describe the quality of life (QOL) and care burden of caregivers of ventilator-dependent amyotrophic lateral sclerosis (ALS) patients and to compare the QOL of ALS caregivers with that of dementia caregivers. Method: Ninety-one pairs of ALS patients and their caregivers were interviewed. Patients were asked to provide their age, sex, time since diagnosis, and length of ventilator use, as well as complete the ALS functional rating scale- revised (ALSFRS-R). Caregivers were asked to provide baseline demographic data including age, sex, education level, marital status, link with the patient, occupation, care time, substitute caregiver, and personal caregiver. The short form- 36 (SF-36) and burden interview (BI) were also administered to evaluate caregivers’ QOL and care burden. T-tests, ANOVA, and Pearson correlation coefficients were used for data analysis. Results: Ninety-one pairs of patients (men 69.2%, women 30.8%) and caregivers (men 24.2%, women 73.6%) completed the study. The mean SF-36 physical component summary (PCS), mental component summary (MCS), and total scores of caregivers were 131.5±13.2, 114.3±17.6, 245.8±28.2, respectively, which showed that the QOL of ventilator-dependent ALS patients was decreased. The BI score was 52.8±17.8, which meant that caregivers were heavily burdened. The SF-36 total and MCS were correlated with the BI. Care time was an important factor that influenced QOL and care burden. QOL was significantly lower for ventilator-dependent ALS caregivers than for dementia caregivers. Conclusion: This survey revealed the poor QOL and heavy burden of ventilator-dependent ALS caregivers, which necessitates social interventions including strategies about care time. (J Korean Acad Rehab Med 2010; 34: 442-450) Objective: To describe the quality of life (QOL) and care burden of caregivers of ventilator-dependent amyotrophic lateral sclerosis (ALS) patients and to compare the QOL of ALS caregivers with that of dementia caregivers. Method: Ninety-one pairs of ALS patients and their caregivers were interviewed. Patients were asked to provide their age, sex, time since diagnosis, and length of ventilator use, as well as complete the ALS functional rating scale- revised (ALSFRS-R). Caregivers were asked to provide baseline demographic data including age, sex, education level, marital status, link with the patient, occupation, care time, substitute caregiver, and personal caregiver. The short form- 36 (SF-36) and burden interview (BI) were also administered to evaluate caregivers’ QOL and care burden. T-tests, ANOVA, and Pearson correlation coefficients were used for data analysis. Results: Ninety-one pairs of patients (men 69.2%, women 30.8%) and caregivers (men 24.2%, women 73.6%) completed the study. The mean SF-36 physical component summary (PCS), mental component summary (MCS), and total scores of caregivers were 131.5±13.2, 114.3±17.6, 245.8±28.2, respectively, which showed that the QOL of ventilator-dependent ALS patients was decreased. The BI score was 52.8±17.8, which meant that caregivers were heavily burdened. The SF-36 total and MCS were correlated with the BI. Care time was an important factor that influenced QOL and care burden. QOL was significantly lower for ventilator-dependent ALS caregivers than for dementia caregivers. Conclusion: This survey revealed the poor QOL and heavy burden of ventilator-dependent ALS caregivers, which necessitates social interventions including strategies about care time. (J Korean Acad Rehab Med 2010; 34: 442-450)

치료적 혈장성분채집술과 관련된 부작용 분석

민유선,권석운,최원호,김복자,조광자,김성수 대한수혈학회 2011 大韓輸血學會誌 Vol.22 No.2

Background: Although therapeutic plasmapheresis (TP) is a useful procedure in removing pathogenic antibodies and toxic substances from the patient, adverse reactions could arise from the use of replacement fluids and anticoagulants. Comprehensive analysis on those adverse effects had been rarely reported in Korea. Methods: We retrospectively investigated the clinical records and the TP records from 3,962 TP sessions for 581 patients between January 1995 and October 2008 at Asan Medical Center, and we analyzed the adverse reactions related to TP. Results: Adverse reactions were seen in 142 patients (24.4%) in 348 TP procedures (8.8%). Citrate toxicity was most frequently seen in 83 procedures (23.9%) followed by chills in 72 procedures (20.7%), allergic reactions in 69 procedures (19.8%) and hypotension in 60 procedures (17.2%). Citrate toxicity, chills and allergic reactions were seen more frequently in the TP procedures using FFP than in the TP procedures using albumin (P=0.001). The prevalence of citrate toxicity was significantly lower in the cases where calcium gluconate was administered (P<0.001), while it was significantly higher in the patients whose hematocrit was below 28.5%(P<0.001). In terms of severity, the mild, moderate and severe adverse reactions were 36.8%, 56.3% and 6.9%,respectively. Conclusion: TP is a relatively safe method of treatment, but it is important to predict and prevent adverse reactions and to respond appropriately to these adverse reactions.