소절개선을 이용한 심장수술의 임상고찰

김광호,김정택,이서원,김혜숙,임현경,이춘수,선경,Kim, Kwang-Ho,Kim, Joung-Taek,Lee, Seo-Won,Kim, Hae-Sook,Lim, Hyun-Kung,Lee, Choon-Soo,Sun, Kyung 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery Vol.32 No.4

Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

여성정책에 관한 남녀 국회의원의 관심 및 기여도 비교 분석 -제15대 국회 1년간 회의록을 중심으로-

박숙자 ( Sook Ja Park ),김혜숙 ( Hae Soo Kim ) 한국의회발전연구회 1999 의정연구 Vol.8 No.-

인천지역의 관광환경개선에 관한 연구

김혜숙,오수경 한국관광정책학회 2001 觀光政策學硏究 Vol.7 No.1

Korean peninsula is geographically situated as a gateway to China, Russia and Japan. Historically, Incheon has been the gateway city to Seoul, the capital city of Korea, due to its location as a port. Recent opening of the Incheon International Airport confirms more evidently that she will become the center of international traffics and exchanges, not only by traditional way but by new means. In this regard, Incheon will have a lot of potential role as a hub airport connecting all over the world in the near future, and help accelerating the globalization. Also it is just the peaceful opening period between the South and North Korea and the end of cold war around the world. This study will analyze the environment of tourism in Incheon area, find problems and help establish the development of Incheon. The result shows that many problems regarding the accommodation facility, the insufficiency of professional manpower and the tourism marketing have been brought out. To solve this kind of problems, many approaches are needed in the coming days.

자기페이스의 운동이 고령여성의 체지방 분포 및 순환계 위험요인에 미치는 영향

김현수,김혜숙,오윤선,송종일 대한비만학회 2000 The Korean journal of obesity Vol.9 No.2

It has been known that the obesity related health risk factors are associated with total adiposity as well as the regional distribution of adipose tissue. The purpose of this study was to examine the effects of self-paced aerobic plus resistance exercise program on changes in body composition, in particular abdominal fat, and lipid in thirteen older women. Subjects (65 ~ 78 year) exercised 4 time/week for 12 week. body composition was measured by the impedance method, and regional body composition was assessed by computed tomography. There was little but significant change in body weight (58.6±9.6 vs 57.3±9.6kg, p<0.05), total body fat (34.5±6.8 vs 33.0±5.9%) and subcutaneous fat area (218.3±74.4 vs 213.6±86.4 ㎠) in these subjects. Unexpectedly, visceral fat area was found to increase (115.5±42.0 vs 124.0±49.1 ㎠, p<0.05) after a self-paced exercise program in older women. There were significant changes in the systolic (p<0.01) and diastolic blood pressure (p<0.01), serum levels of total cholesterol (p<0.05) and basal glucose (p<0.05) not in triglyceride. In conclusion, although the internal abdominal adipose tissue and triglyceride did not decrease, these findings provide evidence that self-paced exercise with aerobic and resistance training is an effective intervention to change the subcutaneous fat area and to improve the coronary artery disease risk factors for older persons without diet.

간호학 교과과정 개념틀 개발 연구

조원정,김소야자,오가실,유지수,황애란,김혜숙,고일선 대한간호학회 1994 Journal of Korean Academy of Nursing Vol.24 No.3

In order to prepare for the coming twenty first Century and to meet changing societal dedmands and health needs, it is necessary to develop a new conceptual framework for curriculum the colleges of nursing. The specific objectives of this project were to ; 1) address the problem areas of the existing curriculum which were identified in the first phase of this study ; 2) develop a conceptual framework which will meet faculty, student and societal needs ; and 3) identify the content of the curriculum. In order to accomplish the objectives, the curriculum committee held 30 weekly meetings during the period of October, 1992 and December,1993. There also were two workshops with college of nursing faculty members. The Philosophy and objectives of education were revised on the basis of the essential concepts of nursing ; human being, nursing, environment, and health. From these basic concepts, six essential components were identified for the conceptual framework. These were nuring process, communication, professional roles, client, and nursing. These six components are interrelated in the curriculum. The complex interrelationship among the six components were presented on horizontal and vertical axes. Concepts related to steady improvement were put on a vertical axis. For example, concepts of client, health, and nursing are included in all levels of nursing curriculum and students are expected to retain and accumulate more complex contents as they progress in curriculum. Concepts on the horizontal axis are nursing process, communication, and professional roles. These concepts are unique to nursing and are common to any level of curriculum. Students are expected to study these concepts through all levels of the curriculum. It is expected that the objectives of the college of nursing will be accomplished when the courses and content of the curriculum are based on this conceptual framework.