응급의학 위임가능전문직무

박경혜 대한응급의학회 2022 대한응급의학회 학술대회초록집 Vol.2022 No.1

이조 창살의 조형미에 관한 연구 : 작품제작 중심으로

박경혜 이화여자대학교 대학원 1989 硏究論叢 Vol.17 No.-

출혈성 쇼크에서 하이드록시에틸 스타취(Hydroxyethyl Starch)와 7.5% 고장식염수 혼합수액 소생술이 급성 폐손상 억제에 미치는 효과

박경혜,이강현,김현,황성오 대한응급의학회 2009 大韓應急醫學會誌 Vol.20 No.3

Purpose: Acute lung injury/acute respiratory distress syndrome is common following major trauma, and is one of the most important causes of mortality and morbidity. Compared with gelatine, resuscitation with hydroxyethyl starch (HES) reduces posttrauma capillary leak. Furthermore, hypertonic saline (HTS) is known as a promising fluid resuscitation therapy with the potential to reduce lung injury caused by severe trauma. The aim of this study was to test the hypothesis that resuscitation with mixed fluids, HTS and HES, will reduce inflammation in hemorrhagic shock induced by acute lung injury compared to control (sham injury) or to either fluid alone. Methods: Spraque-Dawley (SD) rats were divided into five groups randomly: Group I were cannulated but not bled (sham); Group II bled and received Ringer’s lactated solution; Group III bled and received 7.5% HTS; Group IV bled and received HES; Group V bled and received a mixeture of HTS and HES (HTS-HES). After anesthetizing the rat, two catheters were inserted into femoral vessels: the femoral artery for monitoring blood pressure and pulse rate; the femoral vein for bleeding and fluid resuscitation. Blood sampling was done for arterial blood gas analysis (ABGA), Tumor necrosis factor-α(TNF-α), Interleukin-6 (IL-6) before shock, after fluid resuscitation and after 48 hours of survival. Bronchoalveolar lavage (BAL) and a lung histology study were conducted in surviving rats. Results: Survival rates were as follows; Group I, 80%; Group II, 100%; Group III, 70%; Group IV, 70%; Group V, 100%. There were no significant between group differences in initial ABGA, hemoglobin, or TNF-α. TNF-αlevels postresuscitation were significantly higher in group II compared to groups IV and V. After 48 hours of survival, TNF-αwas higher in groups IV and V than in group II. After survival, The IL-6 level of group V was significantly lower compared to that of the control group. IL-6 levels in BAL fluid were higher in groups IV and V than in groups I and II. Lung injury histology scores were significantly higher in groups IV and V than in the control group. Conclusion: After moderate hemorrhagic shock, lung injury is more severe in rats resuscitated with HTS-HES than in the control groups.

中學校 科學 學習 評價에 대한 現場 實態 調査 硏究

박경혜 이화여자대학교 교육대학원 1993 이화교육논총 Vol.4 No.-

비전형적인 급성충수염의 복부 전산화 단층촬영과 임상 소견의 비교

박경혜,이강현,김윤권,원호경,김선휴,장요수,김현,황성오,장용수 대한응급의학회 2006 大韓應急醫學會誌 Vol.17 No.4

Comparison of Abdominal ComputerizedTomography and Clinical Findings inAtypical AppendicitisKyung Hye Park, M.D., Kang Hyun Lee, M.D., YunKwon Kim, M.D., Ho Kyong Won, M.D., Seon HyuKim, M.D., Yong Soo Jang, M.D., Hyun Kim, M.D.,Sung Oh Hwang, M.D. Purpose: The frequency of computerized tomography (CT)for diagnosing of atypical acute appendicitis, as ordered byemergency physicians, was noted. According to abdominalCT findings, the severity of acute appendicitis is divided intosix grades that are used for diagnosis and treatment. However, whether or not the laboratory and clinical findingsof atypical acute appendicitis have a relation to the gradingof abdominal CT scans is unknown. This study was performedto evaluate the correlation between CT grades andsymptoms, signs and operative and pathologic findings ofatypical acute appendicitis. Methods: This study included 412 patients who wereadmitted and underwent an appendectomy from January2004 to June 2005. An abdominal and pelvic CT scan wasperformed in 114 patients who had atypical presentations inthe emergency room. The abdominal and pelvic CT scaleswere correlated with clinical signs, laboratory findings, andpathology reports. The CT scale for appendicitis is a sixgradescale from normal (grade 0) to periappendicealabscess (grade 5). Results: Sixty-six patients were male and 48 were female,and the mean age was 50.7±22.0 years old. On theabdominal CT, grade 0 (normal) was 3 patients (2.6%),grade 1 (probable appendicitis) 5 (4.4%), grade 2 (appendicitis)17 (14.8%), grade 3 (appendicitis with periappendicitis)47 (40.9%), grade 4 (appendicitis with rupture) 30(26.1%), and grade 5 (complicated appendicitis) 12(10.4%). There was no significant difference between CTgrades and either local tenderness or rebound tendernessin the right lower quadrant abdomen (p>0.296). Howeverincreased body temperature correlated with higher CTgrades (p=0.01). There were significant differences in theneutrophil count (p<0.001), but not the white blood cellcount (p=0.493). The severity of pathology of acute appendicitiscorrelated with the CT grade (R=0.468, p=0.004). Conclusion: There was no significant correlation of localand rebound tenderness on right lower quadrant abdomenand of white blood cell count with CT grading in appendicitis,but there was a high correlation of body temperatureand of neutrophil counts with the CT grades of appendicitisfor patients with atypical appendicitis. The CT grades ofappendicitis also correlated with the pathology.

How to Liston to English as a Second Language

박경혜 이화여자대학교 외국어교육과 1970 Foreign language teaching Vol.- No.4

가상기업의 성과요인에 관한 연구

박경혜,최세연,Park, Kyung-Hye,Choi, Se-Yeon 한국데이터전략학회 2007 Journal of information technology applications & m Vol.14 No.1

Globalization changes in market structures and consumer needs, as well as technology innovations force organizations to adopt new structures and collaborative networks to cope with rapidly changing environments. These Collaborative Networks are based on the Idea of virtual enterprise. A virtual enterprise(VE) is a temporary alliance of globally distributed independent enterprises that share core competencies and computer networks. This paper presents a proposal for a methodology to measure a key factor of success and risk First of all, we chose thirty experts' defines on virtual enterprise, fifteen are academic specialist and other fifteen are from industry. For this study we define twenty two factors determining VE's success and seventeen factors determining VE's risk using by Delphi method. And we built the influence model on virtual enterprise. A research model was established according to preceeding research and consensus on experts then the revised model of key factors on virtual enterprise. This survey was based on the Analytical Hierarchy Process (AHP). AHP is an approach to decision making that involves structuring multiple choice criteria into a hierarchy, the assessing the relative important of these criteria, comparing alternative for each criteria, and determining an overall ranking of the alternatives. A model was constructed as 3 level hierarchy. The hierarches are organizational, strategic, technical criteria. for success model on VE has 22 factors and 17 factors for risk model. They are selected by all 30 experts. 14 copies among 30 copies distributed to carry out on the Analytical Hierarchy Process (AHP). Consistency ratio confirm high validity and reliability of instrument and support theoretical model. The results of this study are summarized as follows. (1) This study presented success on VE influenced strategic criteria, and essential factor is Creating a value. Risk on VE influenced strategic criteria, and essential factor is Outcome/Distribution. (2) Its enable that ranking the criteria influence on VE. These are supported VE management and using guideline of VE.

The Anti-Inflammatory Effects of Ulinastatin in Trauma Patients with Hemorrhagic Shock

박경혜,이강현,김현,황성오 대한의학회 2010 Journal of Korean medical science Vol.25 No.1

We investigated the use of ulinastatin in association with the suppression of polymorphonuclear leukocyte elastase (PMNE), tumor necrosis factor alpha (TNF-a)and interleukin 6 (IL-6), and its effects on the prognosis of patients with traumatic hemorrhagic shock. Nineteen patients who visited the emergency department for traumatic hemorrhagic shock were enrolled. Eleven patients were randomly selected to receive a total of 300,000 IU of ulinastatin. Measurements of serum PMNE,TNF-a and IL-6 were taken before ulinastatin treatment at 24 hr, two days, three days, and seven days after admission. We compared the Systemic Inflammatory Response Syndrome scores, Multiple Organ Dysfunction Syndrome scores and Acute Physiology, age, Chronic Health Evaluation III scores of the control and ulinastatin groups. There were no significant differences in baseline values, laboratory data, treatment or mortality between the two groups. The serum PMNE levels in the ulinastatin group were lower than in the control group on the second hospitalized day. Serum TNF-a and IL-6 levels in the ulinastatin group decreased 24 hr after admission but had no significance. It is suggested that ulinastatin treatment could decrease the serum PMNE levels in trauma patients with hemorrhagic shock at 48 hr after treatment.

조지훈의 시와 신비체험

朴景惠 목원대학교 국어교육과 1991 목원어문학 Vol.10 No.-

제주시에 거주하는 60세 이상 정상인의 콜린에스테라아제 기저치

박경혜,김우정,강영준,박준혁,박주옥,김현 대한응급의학회 2012 大韓應急醫學會誌 Vol.23 No.3

Purpose: Measurement of pseudocholinesterase (PChE) is a simple test for evaluation of the severity of intoxication with organophosphate and carbamate insecticides,because they inhibit PChE; however, as demonstrated in several studies, PChE does not reflect severity and mortality. The basal level of PChE in patients who attempt suicide with insecticides could be low, because they are exposed to insecticides for a long period of time, as they are engaged in agriculture. This is part of the reason that PChE level does not reflect severity. No research on the basal level of PChE in the normal population in South Korea has been conducted. The authors of this study investigated the characteristics of residents of Jeju, Korea who have a low level of PChE. Methods: Residents of Jeju over 60 years of age were randomly enrolled. Level of PChE, demographic data, medical history, and occupation were investigated. Groups (higher level vs lower level) were divided on the basis of the median value of PChE. Mann-Whitney test, Pearson chi square,or Fisher's exact test was used for comparison between the two groups. Logistic regression was used for evaluation of factors having an effect on low level of PChE. Results: Of a total of 353 residents, 28(7.9%) residents were engaged in agriculture, and had recently used insecticide. Sixteen (4.5%) residents had lower PChE levels out of normal range (5,400~13,200 U/L), and the lower group included 177 residents. Age of residents in the lower group was older, and the level of high-density lipoprotein (HDL)was lower, compared with those of the higher group. Older age and lower HDL levels indicated a risk of lower PChE in univariate logistic regression, however, the only risk factor in multivariate logistic regression was age. Conclusion: Many potential causes of lower PChE must be considered; genetics, chronic disease, hepatic failure,liver cirrhosis, malnutrition, tumor, infection, and pregnancy. In this study, the only risk factor was age. Future investigation of genetic factors and other risk factors contributing to lower PChE level in residents under 60 years of age will be necessary.