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김창엽,김광호,임병묵,Kim Chang-Yup,Kim Kwang-Ho,Lim Byung-Mook 대한예방한의학회 2002 대한예방한의학회지 Vol.6 No.2
The study aims to investigate the process of professional socialization of oriental medical students, to analyze influencing factors on it, and to compare the results with those of western medical students. Professional socialization, in the context of this study, means the process through which a layperson becomes a profession equipped with professional identity and values. A survey using specially designed questionnaire was carried out in 1999. The data were collected from 11 oriental medical colleges for 2,656 students. A total of 2,597 cases was finally included in the statistical analysis. Analysis of factors related to professional value found that oriental medical students thought highly of human-oriented factors, followed by science and status, and this trend remained unchanged as they moved on to qualification. Among professionalism related items, those involved in professional regulation and dominance factors showed high scores, while showing low scores on items related to bio-ethics and autonomy factors. Unlike items of professional value, those of professionalism showed a notable difference in attitude statistically by schooling level. The average scores of factors for professionalism increased with increasing schooling years. This trend proved that oriental medical students acquired professional norms and attitudes through their educational period. Multiple regression analysis with the factors related to professional value and professionalism as dependent variables found that independent variables had some impact on science, status, and clinical autonomy, but no impact on human, policy autonomy, and professional regulation factors. In conclusion, with increasing schooling years, professional norms and attitudes of oriental medical students were also strengthened. And, in spite of the differences in general propensity, they have a base consciousness in common with western medical students. The difference of mind-set and attitudes related to professionalism in the two groups, however, considering the necessity of future cooperative relations, indicated that a common curriculum between both schools is needed, and the education of social medicine should be strengthened in oriental medical colleges.
응급실에 내원한 패혈증 환자들에서 CT 조영제의 사용은 급성 신부전과 연관성이 있는가?
김창엽,이재훈 대한응급의학회 2012 대한응급의학회지 Vol.23 No.3
Purpose: Computed tomography (CT) with contrast media (CM) is often performed on patients with elevated serum creatinine (sCr), however, due to the risk of contrast induced nephropathy (CIN), the confirmatory use of intravenous contrast CT is not routine. This aim of this study was to differentiate between pre-renal acute kidney injury (AKI) due to severe sepsis and CIN. Methods: Of 330 patients with sepsis who presented to an emergency center in a tertiary care hospital and who underwent CT from January 2009 until May 2010, 232 were enrolled in this study. A group of 115 septic patients with CM and a group of 117 septic patients without CM were analyzed. Results: When considering the change according to difference in initial sCr, the 2~3 day increase of serum creatinine (sCr) observed in both groups did not differ significantly (p=0.236). Use of CM and the amount of iodine showed no significant association with AKI within a period of three days (p=0.64 and p=0.558, respectively). Regardless of the use of CM, elevated sCr at the time of hospital presentation was likely to lead to elevated sCr at day 2-3 (odds ratio 4,p=0.034). Conclusion: CIN can be confused with other causes, particularly renal failure due to sepsis. The effect of performing intravenous contrast CT on the kidney may be less than thought. The risk of checking intravenous contrast CT,which was delayed for prevention of renal impairment in patients with elevated sCr, should be reconsidered.