[당선작_김형미] 검은 꼬리지느러미 심해어 외 3편

김형미 고요아침 2017 열린시학 Vol.22 No.3

당선소감_김형미

김형미 고요아침 2017 열린시학 Vol.22 No.3

개심술시 전신마취와 병용된 흉추 경막외 마취가 술중 및 술후 Stress Hormone과 심혈관계 지수변화에 미치는 영향

김형미,채병국,신정순 고려대학교 의과대학 1993 고려대 의대 잡지 Vol.30 No.1

Combined anesthesia refers to any combination of regional and general anesthesia, usually a combination of epidural and general anesthesia. Combined anesthesia has been associated with less sedation, earlier ambulation, higher pulmonary flow rates, improved oxygenation, blunting of the stress response and better pain control in the postoperative period. Currently the most commonly employed method of anesthesia for open heart surgery patients is general anesthesia supplemented with opioids and postoperative pain control with IM morphine. This study was undertaken to compare the total doses of fentanyl and vecuronium, duration of endotracheal intubation and ventilatory support, cardiovascular changes, changes in arterial blood gas, changes in cortisol and β-endorphin, and the postoperative pain score in 40 open heart surgery patients given a routine anesthetic regimen or combined anesthesia. Group A (n=20) was given general anesthesia, maintained with a nitrous oxide (2L/min)-oxygen (2L/min)-isoflurane (0.5-2.0 Vol. %) gas mixture and fentanyl (initial dose 10 ㎍/kg with additional doses as required) with routine postoperative care with IM morphine sulfate and Group B (n=20) was given light general anesthesia nitrous oxide (2L/min)-oxygen (2L/min)-isoflurane (0.2-0.5 vol. %) and a continuous epidural infusion of a combination of 0.125% bupivacaine and fentanyl (10 ㎍/ml) through an infusion pump from the start of the operation until the third postoperative day. The results were as follows ; 1. The total amount of fentanyl given to Group B was significantly lower than the amount given to Group A. 2. The duration of endotracheal intubation and ventilatory support was significantly shorter in Group B compared to Group A. 3. The heart rate was slightly higher in Group B compared to Group A, but the only significant difference was seen 30 minutes after skin incision. There was no significant difference in the systolic pressures between the two groups but comparison of the diastolic pressures before cardiopulmonary bypass (CPB) and before skin closure showed significantly higher pressures for Group B. The pulmonary artery pressure (PAP) remained stable in Group A while in Group B, the PAP gradually increased to show a significant increase on POD2. The pulmonary capillary wedge pressure (PCWP) was significantly higher in Group B compared to Group A on POD2 The cardiac output (CO) and cardiac index (CI) was stable in Group B while for Group A, there was a significant decrease from during operation to POD2. The systemic vascular resistance(SVR) showed a significant increase in Group A from during operation to POD1 and POD2 and a significant difference between Group A and Group B on POD1 and on POD2. The pulmonary vascular resistance (PVR) increased significantly from during the operation to POD2 in both Groups A and B. The stroke volume (SV) and stroke volume index(SVI) were significantly greater in Group B compared to Group A on POD2. 4. Analysis of arterial blood showed no significant difference in pH and PCO2 while the PO2 of samples taken before CPB were significantly higher in Group B compared to Group A. The bicarbonate of samples taken before skin closure was significantly lower in Group B compared to Group A. 5. Changes in serum cortisol levels showed significantly lower values before skin closure, POD2, POD3 for Group B compared to Group A. The serum β-endorphin levels were consistently lower in Group B than in Group A although not statistically significant. 6. Postoperative pain relief was evaluated as good, fair, and poor the scores for Group A were 20%, 60%, and 20% and for Group B 75%, 15%, and 10%, showing a higher percentage of good pain relief for Group B. In conclusion, the beneficial effects of combined anesthesia are a reduction in the total dose of all anesthetic agents given, a reduction in duration of endotracheal intubation and postoperative ventilatory care, minimal cardiovascular changes, attenuation of the stress response, and a better quality of postoperative pain control showing that combined anesthesia is an attractive alternative to general anesthesia for open heart surgery patients.

고혈압식

김형미 대한영양사회 1995 國民營養 Vol.174 No.-

("제3회 세계 큐레이터 워크숍"을 다녀와서) 발칸의 (古都), 문화의 신도(新都) _베오그라드

김형미 현대건축사 2004 월간 CONCEPT Vol.- No.58

Bloom의 신교육목표분류에 기초한 2015 개정 교육과정 『생명과학 I』 성취기준과 교과서 학습목표 분석

김형미,강경희 한국생물교육학회 2019 생물교육 Vol.47 No.4

The purpose of this study was to analyze the 2015 revised national curriculum 『Life science I』 achievement standards and the learning objectives in accordance with Bloom’s revised taxonomy. The subjects of this study were 2015 revised national curriculum achievement standards and eight 『Life science I』 textbooks. The results of the achievement standards analysis presented that conceptual knowledge was the most utilized. The second was factual knowledge, and the next was procedural knowledge. Analysis of the cognitive process showed that understanding was the most utilized. The analysis of textbook learning objectives showed a tendency very similar to the results of achievement standards analysis. Conceptual knowledge was the largest, and factual knowledge was presented next. In the analysis of the cognitive process, comprehension was most often presented. Achievement standards and learning objectives are very important because they present the direction of teaching- learning in the field of school education. In particular, the use of various knowledge and cognitive processes in setting achievement standards and learning objectives can be seen as essential to fostering the competencies of the subject. Therefore, efforts should be made to utilize various types of knowledge and cognitive processes in the process of constructing 『Life science I』 achievement standards and learning objectives.

A Literature Review of Functional Communication Training for Young Children

김형미 한국유아특수교육학회 2015 유아특수교육연구 Vol.15 No.4

This review is a quantitative analysis of research on Functional Communication Training (FCT) for young children. The data on 73 participants from 38 studies, published in peer-reviewed journals, were analyzed according to participant demographic characteristics, study methodology, assessment and intervention procedures, and FCT outcomes. This analysis included participants under the age of five. Most participants were male, verbal, diagnosed with developmental disabilities or autism, and engaged in aggressive behavior or destructive behavior. The results indicated that FCT treatment was effective in increasing new communication responses whereas concomitantly reducing challenging behavior. Effects of FCT intervention were maintained at follow-up or generalized to non-trained persons or settings in many of the studies. However, maintenance and generalization were assessed for less than one third of 68 participants. Social validity on FCT was measured in some of the studies. Those measured social validity reported positive feelings about or acceptability of FCT by parents and teachers.

치위생(학)과 학생이 지각한 비대면 시험의 공정성, 시험 불안 및 학교 신뢰 간의 구조적 관계

김형미,김창희,김정희 한국치위생과학회 2023 대한치위생과학회지 Vol.6 No.1

Background: This study investigated the structural relationships among justice, test anxiety, and school reliability s non-face-to-face tests of dental hygiene students. Methods: A survey was conducted with 267 dental hygiene students. The survey items included general characteristics, opinions on evaluation, the fairness of non-face-to-face tests (distributive, procedural, and interactional justice), school satisfaction, and school reliability. For statistical analysis, independent-sample t-tests, one-way ANOVA, and structural modeling analyses were performed. Results: Among factors that directly affected distributive justice and reliability towards non-face-to-face tests, the higher the interactional justice (β=0.401, p<0.001) and distributive justice (β=0.232, p=0.002) levels, the higher the school satisfaction. The higher the school satisfaction (β=0.606, p<0.001) and procedural justice (β=0.299, p<0.001) levels, the higher the perceived reliability of the school. Factors that indirectly affected school reliability included interactional justice (β=0.243, p=0.010) and distributive justice (β=0.141, p=0.010). Interactional justice (β=0.592, p=0.010) and distributive justice (β=0.208, p=0.010) were the factors affecting school satisfaction. Moreover, factors that influenced school reliability were distributive justice (β=0.56, p=0.010), interactional justice (β=0.332, p=0.010), procedural justice (β=0.229, p=0.010), and distributive justice (β=0.116, p=0.010). Conclusions: Students will trust and be satisfied with schools when schools and professors sufficiently provide information on face-to-face tests and ensure proper procedures to achieve reasonable grades as rewards for exerted time and effort. Furthermore, this study provides a reference base for developing a variety of content for fair, nonface- to-face tests, thereby allowing students to trust their schools. 연구배경: 본 연구는 치위생학과 학생들이 지각한 비대면 시험의 공정성과, 시험 불안 및 학교 신뢰간의 구조적관계를 분석하고자 한다. 연구방법: 치위생학과 학생 267명을 대상으로 설문조사를 하였다. 조사항목은 일반적 특성과 평가에 대한 의견, 비대면시험의 공정성(분배 공정성, 절차 공정성, 상호작용 공정성), 학교 만족도, 학교 신뢰도 등으로 구성하였다. 통계분석은 독립표본 t검정과 일원배치분산분석, 구조모형분석을 하였다. 연구결과: 비대면 시험에서 학교만족도와 신뢰도에 직접적인 영향을 미치는 요인은 상호작용 공정성(β=.401, p<.001)과 분배공정성(β=.232, p=.002)이 높을수록 학교에 만족하였으며, 학교 만족도(β=.606, p<.001)와 절차공정성(β=.299, p<.001)이 높을수록 학교를 신뢰하였다. 학교신뢰도에 간접적인 영향을 미치는 요인은 상호작용공정성(β=.243, p=.010), 분배공정성(β=.141, p=.010)이었다. 학교만족에 영향을 미치는 요인은 상호작용 공정성(β=.592, p=.010), 분배 공정성(β=.208, p=.010)이며, 학교 신뢰도에 영향을 미치는 요인은 학교만족도(β=.56, p=.010), 상호작용 공정성(β=.332, p=.010), 절차 공정성(β=.229, p=.010), 분배 공정성(β=.116, p=.010)이었다. 결론: 비대면 시험에 대한 정보를 학교 또는 교수들이 충분히 제공하며, 시간을 들여 노력했을 때 정당한 성적을받을 수 있도록 올바른 절차로 시행해야 학교를 신뢰하고 학교에 대해 만족할 수 있다. 학생들이 학교를 신뢰할수 있는 공정한 비대면시험을 위한 다양한 콘텐츠 개발에 기초자료를 제공하고자 한다.

부인두강 종양의 임상적 특징과 치료

김형미,홍성룡,허동구,정영호,권성근,하정훈,성명훈,김광현 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.7

Background and Objectives:Parapharyngeal space tumors are extremely rare head and neck tumors. Therefore, there are just a few reports about them. The purpose of this study was to report our experiences of parapharyngeal space (PPS) tumors regarding clinicopathological features and management. Subjects and Method:This study included 51 patients with PPS tumors which were diagnosed from January 1990 through June 2004. Medical records were reviewed retrospectively. Results:The male-tofemale ratio was close to 1:1. The mean age was 47 years (6 mo-83 Y). The most frequent presenting manifestation was asymptomatic neck mass. All patients were subjected to CT scan, while 31 patients underwent MRI in addition. Diagnostic accuracy of fine needle aspiration cytology of 28 cases matched with pathologic reports by 50%. Salivary gland neoplasms occupied the biggest parts (43.1%, 53.8%) of both benign and malignant PPS tumors. Thirteen patients (25.5%) had malignant lesions. Surgical excision was performed in 39 cases (76.5%). The transcervical (30.8%) and the transcervical-transparotid approaches (38.5%) were commonly performed surgical procedures. Overall postoperative morbidity rate was 23.1%. There were 3 recurrences (42.8%) in malignant tumors and no recurrence in benign ones after surgical excision during the mean follow-up period of 35 months (13-89 mo). Close observation, sclerotherapy and radiotherapy were only applicable for a few selected benign lesions. Conclusion:Most benign PPS tumors could be removed surgically with low complication and recurrence rates. Optimal surgical approach based on transcervical approach allows safe removal of various types of PPS tumors. (Korean J Otolaryngol2006;49:723-7)

『ICA 협동조합 원칙 안내서』 제6, 7원칙 해설

김형미 (재)아이쿱협동조합연구소 2018 생협평론 Vol.- No.29