혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

規模에 대한 報酬와 生産性의 景氣循環性

鄭郁泳,朴喜玉 관동대학교 기업경영연구소 1999 경영논집 Vol.18 No.-

문화인류학의 발전과 교육에 미친 영향

정옥희 교양교육혁신연구센터 2018 지식과 교양 Vol.- No.2

본 연구는 문화와 개인의 관계에 둘러싼 논쟁으로 이루어진 인류학의 발전을 탐구한다. 문화와 개인의 관계를 초점으로 문화와 퍼스넬리티론이 심리 인류학으로 발전되고, 신진화 주의와 문화유물론을 주장한 마르크스 철학의 영향은 문화인류학의 토대가 되어 문화상대주의 관점으로 이어지는 일련의 과정을 살펴봄으로써 교육 이론에 미친 영향을 발견할 수 있다. 문화인류학은 교육학의 발전과 함께 문화 상대 주의적 관점에서 인간에 대한 이해를 문화 속에서 들여다보게 함으로써 교육을 인류학적 관점에서 탐구하고자 한 교육인류학의 태동을 가져왔음을 알게 해준다. 문화인류학의 발전이 교육에 미친 영향 관계를 탐색하는 것은 그동안 문화에 관한 당연한 믿음 속에서 선택된 지식과 정보가 교육으로 이행되는가에 대한 통찰을 제공한다. 개인과 문화의 관계 속에서 그동안 당연시 여겼던 문화적 믿음을 낯설게 함으로써 교육의 방향을 인류학적 관점에서 거시적으로 바라보는 계기가 될 수 있다.

미혼모의 특성

정경순,노명희,김옥란 김천과학대학 2004 김천과학대학 논문집 Vol.30 No.-

This study was conducted to search for characteristics of unwed mother. The subjects were residing 160 unwed mothers in welfare facilities located in Seoul, Gyeonggi, Jeonnam and Daegu. The data were collected from August 2002 to February 2003. The major findings were as follows. ·The subjects were under 20 years(50.6%), under high school graduate(52.2%), having both parents(60%). ·Among the subjects, 74.4% were to choose the adoption, 83.3% were the time of first sexual relation under 15years, 55% were not of former pregnancy experience, 50% had experience of abortion in former pregnancy. ·First sexual relation was acted natually(50%) but after sexual relation, 49.4% was feeling of repent ·Attitude of sexual relation was represented outstandingly that sexual relation may be a consider expression of love. ·Among the subjects, the reason of noncompliance of contraception were because of unknown to method of contraceptions(21.9%). We need to develop educational programe to improve compliance and knowledge of contraception of unwed mother.

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.

이성대상포진의 증상에 따른 안면신경마비의 정도와 예후

신시옥,송창근,이동욱,최영석,진흥률,신정우,윤희석 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

연구목적: 이성대상포진에 동반되는 안면신경마비는 Bell's palsy와는 달리 예후가 더 나쁘고 그 마비가 완전히 회복되지 않는 경우가 더 많다.본 연구에서는 이성대상포진에서 발현되는 증상들의 유무가 치료 전 안면신경마비의 정도 및 치료 후 예후와 상관관계가 있는지를 관찰하여 예후의 예측인자에 대해 분석하였다. 재료 및 방법: 지난 1992년 1월부터 1999년 6월까지 이성대상포진으로 진단받고 본원에 입원하여 고용량 부신피질호르몬제와 항바이러스제인 acyclovir의 병합투여로 동일한 치료를 받은 30명의 환자를 대상으로 후향적으로 의무기록을 분석 및 고찰하였으며, 치료 전 안면마비의 정도와 치료 후 마비의 회복 정도를 이통, 이명, 난청, 현훈 등의 증상의 유무와 치료 시작 시기, 그리고 안면신경의 electroneuronography(ENoG) 값에 따라 비교하였다. 결과: 이성대상포진수포가 안면신경마비 보다 먼저 발현된 경우에 안면신경마비의 치료 전 grade가 통계적으로 유의하게 좋았다(p<0.05).이통, 청력손실, 그리고 현훈의 유무에 따른 안면신경마비의 정도는 상관관계가 없었고 예후에도 차이가 없었다.이명의 유무에 따른 치료 전 안면신경마비의 정도는 상관관계가 없었으나 치료 후 완전회복율은 이명이 있었던 군에서 통계적으로 유의하게 높았다(p=0.003<0.05).완전회복군과 불완전회복군 사이의 치료 전 ENoG의 수치는 통계적으로 유의하게 예후와 상관이 있었다(p=0.037<0.05). 결론: 좀더 많은 수의 환자를 연구에 포함하여 증상에 따른 예후의 차이를 연구하는 것이 필 요하며 또한 ENoG 값이 10%에서 40% 사이인 환자들의 치료 방법에 대한 고려와 이성대상포진수포가 안면신경마비보다 먼저 생긴 환자에서 치료 전 마비정도가 경미했던 이유에 대한 연구가 필요할 것으로 생각된다. Purpose: Herpes zoster oticus generally has a poor prognosis, leaving many patients with permanent facial nerve dysfunction, compare to Bell's palsy.Acyclovir and prednisolone have been widely used for the treatment of herpes zoster oticus.This retrospective study was conducted to suggest the prognostic factors according to various symptoms. Materials and Methods : Clinical studies were retrospectively performed on 30 patients with herpes zoster oticus who were treated with acyclovir and prednisolone in the Chungbuk National University Hospital between 1991 and 1999.The authors analyze the pre-treatment grade and prognosis of facial nerve palsy according to symptoms(the existence of otalgia, tinnitus, hearing loss, and vertigo), the treatment onset, and electroneuronography ( ENoG ). Results : Of thirty patients who have been diagnosed as herpes zoster oticus, there is no significant difference in the pre-treatment grade of facial nerve palsy according to the existence of vesicle, otalgia, tinnitus, vertigo, and hearing loss.Of 25 patients who have facial nerve palsy, the recovery from the palsy is complete in 14 patients(56%).There is no significant difference in the pre-treatment grade of facial nerve palsy according to the existence of otalgia, tinnitus, vertigo, and hearing loss.The pre-treatment grade of facial palsy is better when the vesicles precede facial in the group with tinnitus than without tinnitus.A significant difference of the prognosis according to the onset of treatment and other symptoms are not found.ENoG is better in the group that facial nerve palsy is completely recovered than incomplete recovery group. Conclusion : Reliable prognostic factor according to symptoms is not found, ENoG is the only prognostic factor.

TV Show Program에 나타난 연예인의 의복연출이 대학생의 구매행동에 미치는 영향

박옥련,정희진 慶星大學校 1998 論文集 Vol.19 No.1

The purpose of this study was to know the effect on entertaiers' fashion in TV show programs on the trend of purchasing behavior of a new generation. Specific point in this study are 1) to examine entertainers' fashion and purchasing behavior 2) to examine the impact of TV show program affecting the purchasing behavior such as the purchasing motivation and obtaining fashion information source 3) to survey the attitude of accepting the fashion in TV show program and to survey an analysis of the rate of clothes in real life and 4) to analysis the relation ship between entertainers' fashion in TV show program and the clothes preference, the degree of purchasing clothes, the wearing preference and purchase preference. This study paralleled the theoretical study with empirical study through the survey information. The questionnaire was distributed to 600 University students who are attending in Pusan, and finally 561 data sets were used for statistical analysis. To survey the influence of fashion in TV show program on University student there were presentations of photo and films of three domestic broadcasting companies (KBS, MBC, SBS), which University students prefer. For an analysis of data, frequency distribution, mean, standard deviation, percentage, F-test, T-test, through SPSS+. The result of the study were as follows; First, University students effected on entertainers' fashion is proved to have a tendency to copy entertainers' fashion. Female students showed higher information source than male. Second, clothing preference degree showed higher purchasing preference degree in entertainers' fashion. Third, in case of their receiving attitude on entertainers' fashion in TV show program, the higher a program is rated on TV, the higher the level, the more mean pocket money, and the mean clothing expenditure were, the higher positive clothing preference degree the clothing purchasing degree, and the wearing preference degree they had. Finally, the correlation of wearing preference degree and purchasing preference degree showed higher for both male and female.

임상간호사의 사회심리적 건강과 건강지각, 건강관련 행위

김정희,현미열,김영순,김정실,남상옥,송만숙,이라주,이정화 한국간호과학회 간호행정학회 2010 간호행정학회지 Vol.16 No.1

Purpose: The purpose of this study was to investigate the relationships among psycho-social well-being, and health perception and behavior in clinical nurses. Methods: The data were collected from 362 nurses employed at five general hospitals. A self-reported questionnaire was used to assess demographics and job characteristics, health perception and behavior, depression, and psycho-social stress. The data were analysed using Cronbach's alpha, descriptive statistics, t-test, and ANOVA. Results: While nurses perceived themselves to be in good health, represented by a high mean for health perceptions, actual health behavior was poor as the mean for health behavior was low. Forty two percents of the subjects were categorized as having major depression and high-stress levels. There were statistically significant differences in psycho-social well-being according to age, marital status, years of employment, and monthly salary. Also, there were significant differences in psycho-social well-being according to health perception, regular meals and exercise, sufficient sleep, job related injury and accident, and absences for ill. Conclusion: In order to prevent depression and improve psycho-social well-being among clinical nurses, organizational support and health management needs to be focused on high-risk nurses. Furthermore, it is essential to consider the health perception and behavior of clinical nurses.

쌍태임신중 일측태아 사망 5 예에 대한 임상적 고찰

신정옥,심일구,이항재,김희범 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

Objective : Our purpose of this study was to evaluated the incidence of twin pregnancy with one fetal demise, predisposing factors and the maternal complications and perinatal outcomes. Patients : From January 1993 to December 1997, 5 twin pregnancy with single fetal demise after 28 weeks gestation by gestational age were observed in Soonchunhyang Kumi Hospital. Results : 1. The incidence of one fetal demise was 3.01% in twin pregnancy. 2. Maternal disseminated intravascular coagulation has not been demonstrated. 3. The predisposing factors of twin pregnancy with single fetal demise are umbilical cord torsion (40%), congenital anomaly(20%) and unknown(40%). 4. According to chorionicity, it seems that the perinatal mortality rate of monochorionic group was higher than dichorionic. Conclusion : This study suggests that monochorionic placentation is associated with increased risks of twin pregnancy with single fetal demise. But it may be partially explained due to small numbers of cases in this study.

폐결핵 환자의 우울 상태

홍정표,최선희,조만종,이성주,박종,김기순,김양옥 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.1

The main purpose of this study is to identify and evaluate the depressive states for the patients with chronic pulmonary tuberculosis. A questionnaire(Self-rating Depression Scale, SDS) survey was performed toward 57 pulmonary tuberculosis patients with initial treatment who started chemotherapy and 53 pulmonary tuberculosis patients with retreatment, admitted to one tuberculosis-centered hospital and two general hospital. Fifty three healthy persons as control group were investigated with the same questionnaire for comparison. The survey was performed from July to August 1996. The results are as follws : 1. The patients had significantly high scores in the depression than control and the patient with retreatment showed significantly high scores in the depression than the patient with initia1treatment(P<0.01). 2. The depressive levels of the patients were associated with duration of admission and the expectancy of recovery (P<0.05). 3. The percentage of the subjects with 40 or more scores tentatively classifiable as psychologically depressed was 67.1% of the total subjects, 48.4% of the control groups, 75.0% of the patient with initial treatment and 84.1% of the patient with retreatment. Because patient with pulmonary tuberculosis with initial treatment showed higher depression scores than normal persons, and patients with retreatment due to failure of initial treatment showed higher depression scores than initial treatment, it is necessary to give attention to depression of the patients during treatment of pulmonary tuberculosis.