기관지 방선균증의 임상 1례

이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

관절염 환자의 민속요법이용 형태

은영,강현숙,이은옥,이인숙,이종수 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

This sty was undertaken to explore the utilization patterns of medical treatment and herb medicine in patients with arthrits. The data were collected from 995 patients who were registered either in a center of rheumatology or resided in community with arthritis. The data were analyzed by percentile, t-test and chi-square test using SAS PC program. The results of this study were as follows; 1. According to characteristics of sample-population, mean age was 57.7 years, duration of arthritis 9.7 years and mean duration of pain 2.4 hours per day at present. 2. First diagnosis was identified at department of orthopedic surgery or local clinic. But 85.2% of patients have transferred to the center of reumatology currently. But ironically over 70% of patients experienced the herb treatment and herb treatment had hern medicine simultaneous with medical treatment. This indicated that they were shopping around of treatment during the first one year. 3. Mean cost of medical treatment was 67,400 won, while they payed to herb medicine as much as two or three times. The utilization rate of herb medicine was 36.5% of patients per one year. Costs of herb-treatment were 182,000 Won and herb medicine was 36.6% of patients per one year. Costs of herb -treatment were 182,000 Won and herb medicine 149,100 Won. 4. Eighty point six percent of patients were experienced herb medicine during life-time. One hundred and seventy four kinds herb medicine were found to be used by patients, most of which were nutrients, muscle relaxants, andtiphlogistics and analgesics. Thirty two point six percent of users recognized that herb medicine were effective but 51.7% did not. In conclusion, arthritis patients have been experienced various kinds of drug and remedies for treatment. And they wasted their limited medical and economical resources on these unresonable remedies. Therefore, they should be guided for wise decision about treatment. Futher studies in nursing will be required to explore the value system of patients about herb medicine, the determinant factors of shopping-around patterns of treatment, and the coping mechanism for chronic pain or aggravating symptom.

기악가들의 근골격계 문제에 관한 조사 연구 : 관현악단 단원을 대상으로

이은남,이은옥,이인숙 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

This study was undertaken to identify the musuloskeletal problems and their contributing factors in instrumental musicians in Korea. The data were collected from March 31, 1996 from 304 symphony orchestra members in various areas. The data were analyzed for percentile, t-test, chi-squre using SPSS PC?? program. The results of this study were as follows: 1. Two hundred and fifteen musicians(70.7%) reported experience of various symptoms among 304instrumental musicians. One hundred eighty seven cases reported the present symptoms. 2. The prevalence rate of each woodwind players, string players, and percussionist and keyboard players is 47%, 34.2%, and 17% respectively. 3. Pain, tenderness and stiffness were the most common symptoms, while paresthesia and motor dysfunction were rare. This indicates that most players had muscle tendinous overuse, while small number of players had nerve entrapment and motor dysfunction. 4. In past and present symptoms, they experienced more symptoms mainly in right shoulder, wrist, and fingers than left side in string players, while woodwind players experienced symptoms in both siders of shoulders, wrists, fingers, and knee joints. In the percussionist and keyboard players, right elbow, shoulders, wrists, fingers, and knee joints. In the percussionist and keyboard players, right elbow, wrist, and fingers were more involved than left side. 5. The major contributing factors of the symptoms were playing posture, playing technique, total duration of playing, and period of each practice. 6. The most frequent modalities for treatment of the sympotms were acupuncture or moxibustion, other alternative therapy such as heat compress, massage. 7. There was significant difference in periods of career as teaching, private lesson and membership of orchestra between group of having symptoms and group of no symptoms. Through this study it was found that the musculoskeletal problems are common in the instrument players in Korea and the major contributing factors were playing posture, playing technique, total duration of playing and the period of each practice. Therefore, preventive measures and treatment for early symptoms are necessary for the instrument players, while modalities for prevention and health promotion should be emphasized to the school health nurses who works at high schools.

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.

자기 효능의 개념 분석

서순림,이은남,박송자,양영희,이동숙,최은옥,구미옥,김인자,이인숙,김성재,박영임,이은옥 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

Today human needs for health promotion and maintenance are increasing. The nursing progression has a great responsibility for helping clients to practice good health behavior. self efficacy was found to be potent predictor in initiating and maintaining the health-related behavior. Therefore, the concept is important in nursig intervention for change of health behavior. The purpose of this paper was to analyze and clarify the meaning of the concept, self efficacy. This study used Walder & Avant's process of concept analysis. Critical attributes of self efficacy were : 1) positive perception of his won capability; 2) intrapersonal strength; 3) possibility of being learned; 4) individuality; 5) specificity; 6) generalizability. Antecedents of self efficacy consist of those facts that 1) new situation occurs; 2) individuals have needs to change the new situation; 3) there are some required actions in new situation. Consequences occurring as a result of self efficacy consist of those facts that 1) individual initiates the of failure; 5) cope with the situation; 6) controls the situation; 7) the level of self efficacy is enhanced; 8) the level of self-esteem is enhanced.

Sarcomatoid Carcinoma Arising from Mature Cystic Teratoma

Ho-Chang Lee1, Seung-Myoung Son, Yong-Moon Lee, Ji Hae Koo, Song-Yi Choi, Ok-Jun Lee, Eun-Hwan Jeong 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.2

Malignant transformation of mature cystic teratoma (MCT) is rare. Sarcomatoid carcinoma is a neoplasm comprising malignant mesenchymal cells and a conventional carcinomatous area. Here, we report on a case of sarcomatoid carcinoma arising from an MCT in the left ovary of a 45-year-old female. A unilocular cyst consistent with MCT was observed; however, a nodule within the cyst was confirmed from the resected ovary. Microscopically, the nodule showed both squamous cell carcinoma and pleomorphic sarcomatous components admixing with each other. Lining epithelial cells at the periphery of the main tumor showed squamous metaplasia. When a sarcomatous component is observed in the ovary tumor, it is important to find a squamous cell component, either benign or malignant.

하루 콩단백질 25g 섭취를 위한 메뉴작성 및 영양성분 분석

한재숙,김정애,서봉순,이연정,서향순,조연숙,한경필,이신정,오옥희,우경자,조은자,구성자,김수진,李承彦,南出隆久 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.2

The purpose of this study was to develop menus for daily intake of 25g soybean protein and to analyse nutrients of these foods. Analytical values were compared to the theoretical one using the food composition table and recommended dietary allowances for Koreans (7th revision). The results are as follows. 1. Soybean curd residue stew, Soybean curd, Kimchi saute, and hard boiled soybean and lotus root were selected for the menu for January, of which the content of soy bean protein(SBP) was 33.1g, soybean stew, soybean curd and soybean sprout saute, and Italian deep fried soybean curd were for February, of which the content of SBP was 35.0g. The content of SBP in soybean paste soup with soybean curd, fried soybean curd and fried soybean curd roll, the menu for March, was 24.9g. That of April were soybean curd gratin with soymilk, soybean curd and ham with garlic dressing and the content of SBP was 26.3g. That of May were soybean porridge, soybean flour cake with honey (Dasik), soybean sprout soup and the content of SBP was 26.7g. That of June were soymilk, pan-fried soybean curd, steamed soybean curd with chicken and the content of SBP was 28.4g. That of July were noodle with soymilk, mapatofu, soybean curd salad and the content of SBP was 24.7g. That of August were soybean sprout with mustard dressing, Tossed green pepper with raw soybean flour, Tofu and Kimchi stew, soybean curd steak and the content of SBP was 26.2g. That of September were Chinese cabbage soup with raw soybean flour, sweet and sour tofu and the content of SBP was 23.2g. That of Oct. were Fermented soybean stew, soybean pan cake and the content of SBP was 24.3g. That of November were not-pressed soybean curd casserole, pan-fried mashed soybean curd with egg, stir frying deep-fried soybean curd with vegetables and the content of SBP was 22.4g. That of December were soybean curd and mushroom casserole, fried soybean curd and vegetables, hard boiled soybean curd and the content of SBP was 28.9g. 2. The ratio of the analytical value over theoretical value (A/B%) of one serving in kcal, carbohydrate, protein, fat, ash and dietary fiber were 57.7~107.7%, 42.9~131.9%, 79.2~118.3%, 54.5~100%, 40.7~80.8% and 42.1~113.2%, respectively. 3. The ratio of A/B% of one serving in Ca, K, Na, P and Fe were 44.1~93.6%, 59.0~153.1%, 53.1~117.7% 64.6%~138.8 and 33.8~77.3%, respectively. That in Fe was the lowest among minerals. 4. The ratio of analytical value over Korean R.D.A(A/C%) in Ca was relatively higher (22.0~85.9%) than that in kcal(18~63%). 5. The ratio of A/C% in Fe was 25.1~64.3% and lower than that in Ca and protein in general.

초등학교 영어수업에서 멀티미디어 자료 적용범위에 따른 영어학습의 효관에 관한 연구

이동한,이건옥,제은주 부산교육대학교 교육대학원 1999 논문집 Vol.1 No.-

The purpose of this study is to investigate appropriate proportion of multimediarized environment for the elementary English classroom. For this study, 100% multimediarized English lesson was provided to 4th grade students at Nae-San elementary school and 50% multimediarized English lesson was given to 4th grade students at Min-An elementary school for 4 months from september to december in 1998. To Nae-San, whole class was progressed only by various multimedia materials without direct interaction between the teacher and students from the beginning to the end of lesson. For Min-An, the English lesson was performed with multimedia materials, activities with teacher: one half of the lesson was done by the use of multimedia materials and the other half was done by interaction between the teacher and students. The study result shows that there was no significant difference between Nae-San and Min-An elementary school students performed better than that of Nae-San elementary school students. The result of this study shows that students who have class with 50% multimedia is better than students who have studied with 100% multimedia environment in the point of speaking. In the conclusion, this paper suggests that the language teaching method with 50% multimedia including variable game activities and apposite materials is more effective than that of 100% multimedia.

유아의 사회·정서 능력과 또래인기도의 관계

이경옥,여은진 덕성여자대학교 2006 德成女大論文集 Vol.35 No.-

본 연구에서는 성별에 따른 유아의 사회·정서 능력과 또래인기도의 차이를 살펴보고, 또래인기도와 사회·정서능력과의 관계를 검토하였다. 이를 위하여, 만 5세 유아 82명을 대상으로 정서지능, 정서지식, 사회적 능력, 대인간 문제해결 전략, 또래인기도에 대한 자료를 수집하였다. 분석결과, 유아의 정서지능, 사회적 능력, 또래인기도는 성별에 따라 차이가 없는 것으로 나타났으며, 정서 지식의 경우 여아가 남아보다 높았고 대인간 문제해결전략 중 친사회적 전략은 남아가 더 높은 것으로 나타났다. 또한 사회·정서 능력과 또래인기도의 관계를 분석한 결과, 교사가 평가한 유아의 정서지능과 사회적 능력은 또래인기도와 높은 정적 상관관계를 나타내었으나 유아면접에서 얻어진 유아의 정서 지식과 대인간 문제해결 전략은 또래인기도와 상관관계가 없는 것으로 나타났다. 특히 정서지능 하위영역 중 또래관계와 사회적 능력 하위영역 중 사교성이 또래인기도와 높은 상관이 있는 것으로 나타났다. 반면 유아의 대인간 문제해결 전략 중 친사회적 전략은 교사가 평가한 유아의 정서지능 및 사회적 능력과 유의한 상관을 나타내었으나 또래인기도와는 상관이 없는 것으로 나타났다. 전반적으로 교사가 평가한 유아의 사회·정서능력이 유아간의 또래인기도를 이해하는데 적절함을 알 수 있었다. This study investigated association between young children's peer popularity and their social and emotional competence. Participants were 82 children from two child care centers and one kindergarten from a metropolitan area of Korea. The mean age of children was 74.65 months(SD=3.79). The results indicated that there were no significant differences between girls and boys; girls were slightly higher than boys on emotional knowledge, while boys were slightly higher than girls on prosocial problem-solving strategy. Peer popularity was positively related to emotional intelligence, social competence, but not related to emotional knowledge and interpersonal problem-solving strategies. The results indicated that emotional intelligence and social competence answered by teachers were important predictors of peer popularity of young children.

意味辨別法으로 測定한 敎師像에 관한 一硏究

李恩玉,李學柱 울산대학교 1985 연구논문집 Vol.16 No.2

本 硏究는 大學生이 갖는 敎師像을 意味 辨別法으로 測定·分析하기 위하여 40쌍의 대칭되는 形容詞間項을 사용하였다. 標集은 서울과 지방에서 4개 대학을 선정, 모두 579명으로부터 資料를 募集하였고. 資料는 全體, 性別, 系列別로 平均, 標準偏差를 算出하고, t-檢證 및 要因分析 하였으며 그 結果는 다음과 같다. 1. 全體的으로 大學生이 갖는 敎師像은 肯定的이나, 그 지지정도는 多小 中立的이어서 鮮明하지 않다. 部分的으로 活動, 力能次元에서는 否定的인 경향도 나타내고 있다. 가장 肯定的인 반응을 보인 문항은 '중요하다', '自尊心이 강하다', '精神的', '깨끗하다' 등이었고, 가장 否定的인 반응을 보인 문항은 '소심하다', '보수적이다', '방어적', '고지식하다' 등이었다. 2. 大學生의 性別에 따른 敎師像은 男學生이 女學生에 비해 훨씬 强하게 肯定皓일 경향을 나타내고 있다. 이런 경향은 '순진하다', '깨끗하다', '옳다', '똑똑하다', '헌신적이다'라는문항에서 두드러지게 나타났다. 3. 大學生의 系列別에 따른 敎師像은 非師範系가 師範系 學生에 비해 다소 肯定인 경향을 나타내고 있다. 이런 경향은 '깨끗하다', '새롭다', '의욕적'이라는 문항에서 나타나고 있다. 4. 大學生이 갖는 敎師像의 栗因構造는 "進取性"과 "誠實性"이 대부분을 차지하고 있는데, 이중 진취성에는 부정적인 경향을, 성실성에는 긍정적인 경향을 나타내고 있다. 以上의 結果를 토대로 볼때, 大學生에게 비쳐진 敎師의 이미지는 全般的으로는 肯定的이나, 倫理·道德的인 側面에서는 보다 肯定的 方向에서, 活動·力能面에서는 多小 否定的일 方向에서 知覺되고 있으며, 이런 경향은 男學生이나 比師範系 學生보다는 女學生, 師範系 學生에게서 더욱 두드러지게 나타나므로, 漸增하고 있는 敎職의 女性化 추세에 비추어 現行의 師範·敎職敎育에서 이에 대한 적절한 對策 마련이 있어야 할 것이다. This study is an attempt to measure college students' image on "teacher", and to determine the factor structure of the image. This study used a semantic differential scale that was constructed with 40 bipolar adjective items. The scale was administered to 579 college students. Mean scores were computed for every adjective pair for the male group, the female group, the teacher-training course students, non-teacher-training course students and the combined group. This analysis showed a tendency that 1) the college students, generally, had positive images on "teacher". Only on 7 items, they showed negative tendencies such as "narrow-minded, " "conservative" , "defensive" , "simple-minded" etc. The most positive responses were "important", "self-respectful", "spiritual", "clean" act. 2) Significance tests for the sex difference showed that the male students had more strongly positive images on 16 items and more negative images on 1 item on teacher than the female students. That is, the male students' images on "teacher" were more incline toward "pure", "clean", "right", "clever", "self-sacrificing", and less toward "talkative". 3) Significance tests for the course difference showed that the non-teacher-training course students had more positive images on 7 items and more negative images on 2 items on teacher than the teacher-training course students. That is, the non-teacher-training course students' images on ."teacher" were more inclined toward "clean", "new", "willingly" and less toward "difficult" , "talkative". And the data were subjected to factor analysis. Using a criterion of eigenvalue greater than, 1, followed by the varimax rotation, 9 factors were selected. The common variance of 56.5% in the meaning or image of "teacher" were calculated for all these 9 factors. Items that had factor score coefficient of .10 or greater on a single factor were arbitrarilly selected to represent that factor. The 9 factors have been named "Progressiveness", "Sincerity", "Nobility", "Self-Fulfilment", "Sagacity" , "Quickness" , "Complexity" , "Faithfulness" . Among the factors, the 1st factor (Progressiveness) accounted for 25.6% of the common variance, 55% of the common variance accounted for 9 factors. This implies that "Progressiveness" dimension is the most important for assessment of the "teacher" image. But the students showed negative tendency in 1st dimension. The 2nd factor (Sincerity) accounted for 7.7% of the common variance, 14.2% of the common variance accounted for 9 factors. In 2nd dimension, the students showed positive tendency. The results imply that students have image on "teacher" who was "negative", "narrow-minded", "conservative", "defensive", "simple-minded", "weak", but "selfsacrificing", "sincere", "responsible", "clean", "believable"