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Validity of Nursing Diagnoses Related to Difficulty in Respiratory Function (호흡기능장애와 관련된 간호진단의 타당도 조사)

  • 김조자;이원희;유지수;허혜경;김창희;홍성경
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.569-584
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    • 1993
  • This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC+ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

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Petrochemistry and Geologic Structure of Icheon Granitic Gneiss around Samcheog Area, Korea (삼척지역 이천화강편마암의 암석화학과 지질구조)

  • Cheong Won-Seok;Cheong Sang-Won;Na Ki-Chang
    • The Journal of the Petrological Society of Korea
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    • v.15 no.1 s.43
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    • pp.25-38
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    • 2006
  • Metamophic rocks of Samcheog area, northeastern Yeongnam massif, was studied petrochemically. This area includes Precambrian Hosanri Formation (schists and gneisses) and granitoid (Icheon granitic gneiss, leucocratic granite and Hongjesa granite), Cambrian sedimentary rocks, and Cretaceous sedimentary and acidic volcanic rocks. Hosanri formation is composed of quartz+plagioclase+K-feldspar+biotite+muscovite+granet${\pm}$cordierite${\pm}$sillimanite. Mineral assemblage of biotite granitic gneiss, which is massive granodioritic rock with weak foliation, is similar to Hosanri formation. According to mineral assemblages, metamorphic rocks of studied area can be divided into two metamorphic zones (garnet and sillimanite zones). From Icheonri area, major, trace and rare earth element data of biotite granitic gneiss and luecocratic granite suggest that source rock is politic rocks of Hosanri formation and source magma was formed by anatexis and experienced fractionation of plagioclase. Trace element diagram show collisional environment such as syn-collisional, volcanic arc granite. Orientation of faults in study area have three maximum concentrations, $N54^{\circ}\;W/77^{\circ}\;SW,\;N49^{\circ}\;W/81^{\circ}\;NE\;and\;N10^{\circ}\;W/38^{\circ}\;NE$. Structure analysis suggests that faults in study area ware formed by uplift and compression. Faulting age is guessed after Tertiary because some shear joints is developed in dikes to intrusive Cretaceous acidic volcanic rock. Hosanri formation and Icheon granitic gneiss had experienced similar deformation history because they have maximum concentration to foliations, $N89^{\circ}\;E/55^{\circ}\;SE\;and\;N80^{\circ}\;E/45^{\circ}\;SE$, respectively.

The Changes of Cerebral Metabolic Parameters, Serum Levels of Neuron-Specific Enolase and S-100$\beta$ Protein During Retrograde Cerebral Perfusion Under Profound Hypothermic Total Circulatory Arrest (초저체온하 완전순환정지 시에 이용되는 역행성 뇌관류의 시간에 따른 뇌대사 지표, 혈청 내 neuron-specific enolase, 및 S-100 베타단백의 변화)

  • 김경환
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.653-661
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    • 2001
  • Background: Retrograde cerebral perfusion(RCP) is one of the methods used for brain protection during aortic arch surgery. The author previously published the data, however, for the safety of it, there still remains many controversies. The author performed RCP and checked various parameters to clarify the possibility of early detection of cerebral injury. Material and Method: The author used pigs(Landrace species) weighing 25 to 30kg and performed RCP for 120 minutes. After weaning of cardiopulmonary bypass, we observed pigs for another 120 minutes. Rectal temperature, jugular venous oxygen saturation, central venous pressure were continuously monitored, and the hemodynamic values, histological changes, and serum levels of neuron-specific enolose(NSE) and S100$\beta$ protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. Result: Flow rates(ml/min) during RCP were 224.3$\pm$87.5(20min), 227.1$\pm$111.0(40min), 221.4$\pm$119.5(60min), 230.0$\pm$136.5(80min), 234.3$\pm$146.1(100min), and 184.3$\pm$50.5(120min). Serum levels of NSE did not increase after retrograde cerebral perfusion. Serum levels of S100$\beta$ protein(ng/ml) were 0.12$\pm$0.07(induction of anesthesia), 0.12$\pm$0.07(soon after CPB), 0.19$\pm$0.12(20min after CPB), 0.25$\pm$0.06(RCP 20min), 0.29$\pm$0.08(RCP 40min), 0.41$\pm$0.05(60min), 0.49$\pm$0.03(RCP 80min), 0.51$\pm$0.10(RCP 100min), 0.46$\pm$0.11(RCP 120min), 0.52$\pm$0.15(CPBoff 60min), 0.62$\pm$0.15(60min after rewarming), 0.76$\pm$0.17(CPBoff 30min), 0.81$\pm$0.20(CPBoff 60min), 0.84$\pm$0.23(CPBoff 90min) and 0.94$\pm$0.33(CPBoff 120min). The levels of S100$\beta$ after RCP were significantly higher than thosebefore RCP(p<0.05). The author could observe the mitochondrial swellings using transmission electron microscopy in neocortex, basal ganglia and hippocampus(CA1 region). Conclusion: The author observed the increase of serum S100$\beta$ after 120 minutes of RCP. The correlation between its level and brain injury is still unclear. The results should be reevaluated with longterm survival model also considering the confounding factors like cardiopulmonary bypass.

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The Morphologic Changes of Parvalbumin- Immunoreactive Interneurons of the Dentate Gyrus in Kainate-Treated Mouse Hippocampal Slice Culture Epilepsy Model (Kainic Acid로 처리한 해마박편배양 마우스 간질모델에서 치아이랑 Parvalbumin 면역 반응성 사이신경세포의 형태학적 변화)

  • Chung, Hee Sun;Shin, Mi-Young;Kim, Young-Hoon;Lee, In-Goo;Whang, Kyung-Tai;Kim, Myung-Suk
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1551-1558
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    • 2002
  • Purpose : Loss of hippocampal interneurons in dentate gyrus has been reported in patients with severe temporal lobe epilepsy and in animals treated with kainic acid(KA). Interneurons contain $Ca^{2+}$- binding protein parvalbumin(PV). The effects of kainic acid on parvalbumin-immunoreactive (PV-IR) interneurons in dentate gyrus were investigated in organotypic hippocampal slice cultures. Methods : Cultured hippocampal slices from postnatal day nine C57/BL6 mice were exposed to $10{\mu}M$ KA, and were observed at 0, 8, 24, 48, 72 hours after a one hour KA exposure. Neuronal injury was determined by morphologic changes of PV-IR interneuron in dentate gyrus. Results : Transient(1 hour) exposure of hippocampal explant cultures to KA produced marked varicosities in dendrites of PV-IR interneuron in dentate gyrus and the shaft of interbeaded dendrite is often much thinner than those in control. The presence of varicosities in dendrites was reversible with KA washout. The dendrites of KA treated explants were no longer beaded at 8, 24, 48 and 72 hours after KA exposure. The number of cells in PV-IR interneurons in dentate gyrus was decreased at 0, 8 hours after exposure. But there was no significant difference in 24, 48 and 72 hours recovery group compared with control group. Conclusion : The results suggested that loss of PV-IR interneurons in dentate gyrus is transient, and is not accompanied by PV-IR interneuronal cell death.

Effects of Green Manure on Soil Properties and Grain Yield of Sorghum (Sorghum bicolor Moench) (수수 재배 시 풋거름작물 이용이 토양특성 변화와 수수의 수량에 미치는 영향)

  • Kim, Sung-Kook;Jung, Gun-Ho;Shin, Sung-Hyu;Kim, Min-Tae;Kim, Chung-Guk;Shim, Kang-Bo
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.61 no.4
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    • pp.290-296
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    • 2016
  • Green manure has been used as alternative to chemical fertilizer. To evaluate the effect of green manure on the chemical properties of top-soil and sorghum yield, hairy vetch (Vicia villosa Roth, HV), manure barley (MB), and a mixture of hairy vetch and manure barley (HV+MB) were incorporated into the soil at a rate of $100kg-N\;N\;ha-1$ before the sorghum was transplanted. Total biomass of sorghum grown in the HV, MB, and HV+MB treatments was 13.1, 31.6, and $25.2t\;ha^{-1}$, respectively, and the nitrogen production of the treatments was 81, 74, and $145kg\;ha^{-1}$, respectively. The SPAD value of the uppermost leaf of sorghum plants grown in the soils with HV, MB, or HV+MB were very similar until heading stage; however, at maturity, the SPAD value of sorghum cultivated in the soils with HV was lower than that of sorghum in the soils with MB or HV+MB. This could be because the nitrogen release from HV was too rapid to supply nitrogen to sorghum during the later stage of grain filling. Compared with chemical fertilizers, the incorporation of green manure increased the pH, exchangeable cations ($K^+$, $Mg{^{+}^{+}}$, and $Ca{^{+}^{+}}$), and total nitrogen in soil postharvest, indicating an improvement in soil chemical properties. Total carbon content increased in soil with green manure incorporated, but decreased in the chemical fertilized soil, suggesting that sorghum cultivation using green manure may sequester carbon in soils. The yield of sorghum cultivated with green manure was not different from the yield of sorghum cultivated with chemical fertilizers. These results suggest that the mixture of hairy vetch and manure barley can be a useful chemical fertilizer alternative in sorghum cultivation.

Effects of Heat-stress on Rumen Bacterial Diversity and Composition of Holstein Cows (고온 스트레스 영향에 따른 홀스타인종 젖소의 반추위내 미생물 균총 변화)

  • Kim, Dong Hyeon;Kim, Myung Hoo;Kim, Sang Bum;Ha, Seung Min;Son, Jun Kyu;Lee, Ji Hwan;Hur, Tai Young;Lee, Jae Yeong;Park, Ji Hoo;Choi, Hee Chul;Lee, Hyun Jeong;Park, Beom Young;Ki, Kwang Seok;Kim, Eun Tae
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.39 no.4
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    • pp.227-234
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    • 2019
  • This study was performed to investigate the effect of heat-stressed environment on rumen microbial diversity in Holstein cows. Rectal temperature and respiration rate were measured and rumen fluid was collected under normal environment (NE; Temperature humidity index (THI)=64.6) and heat-stressed environment (HE; THI=87.2) from 10 Holstein cows (60±17.7 months, 717±64.4 kg) fed on the basis of dairy feeding management in National Institute of Animal Science. The rumen bacteria diversity was analyzed by using the Illumina HiSeqTM 4000 platform. The rectal temperature and respiratory rate were increased by 1.5℃ and 53 breaths/min in HE compared to that in NE, respectively. In this study, HE exposure induced significant changes of ruminal microbe. At phylum level, Fibrobacteres were increased in HE. At genus level, Ruminococcaceae bacterium P7 and YAD3003, Butyrivibrio sp. AE2032, Erysipelotrichaceae bacterium NK3D112, Bifidobacterium pseudolongum, Lachnospiraceae bacterium FE2018, XBB2008, and AC2029, Eubacterium celulosolvens, Clostridium hathewayi, and Butyrivibrio hungatei were decreased in HE, while Choristoneura murinana nucleopolyhedrovirus, Calothrix parasitica, Nostoc sp. KVJ20, Anabaena sp. ATCC 33047, Fibrobacter sp. UWB13 and sp. UWB5, Lachnospiraceae bacterium G41, and Xanthomonas arboricola were increased in HE. In conclusion, HE might have an effect to change the rumen microbial community in Holstein cows.

Study on Waxy Corn X. Analysis on Botanical Characteristics, Physicochemical Properties Related to Table Qualities of the Developed Waxy Corn Hybrids (찰옥수수 연구 X. 육성된 찰옥수수 교잡종의 식물학적 특성 및 식미관련 이화학적 형질)

  • Lee, Moon-Sub;Bok, Tae-Gyu;Choi, Yun-Pyo;Hong, Bom-Young;Jo, Yang-Hee;Lee, Hee-Bong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.56 no.1
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    • pp.8-13
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    • 2011
  • This study was carried out to compare botanical characteristics, physicochemical properties related to table quality and feed values and develop a new variety among 12 developed waxy com hybrids. These materials were produced in 2008 and cultivated in 2009 at Com Breeding and Genetics Farm of Coll. of Agri. & Life Sci., Chungnam Nat'l Univ. Botanical characteristics of used waxy com hybrids showed large difference among hybrids; stem height, ear height and ear length. In physical properties, range of kernel sugar content among used hybrids appeared 16.1 to 13.0brix(%). CNU08H-15, CNU08H-35 and CNU08H-h39 among these were highly appeared as 15 above and pericarp thickness of Yeonongchal was very thick as $46.0{\mu}m$, while CNU08H-39 among hybrids showed the thinnest as $23.0{\mu}m$ compared to other hybrids. Protein content as a indicator of table quality was the highest in Ilmichal among hybrids, while that of CNU08H-39 was the lowest, while amylopectin content was the highest as 94.5%, From experimental results, Daehakchal Gold 1, CNU08H-h121 and CNU08H-39 including check Yeonyoungchal were highly evaluated as new hybrid in thinner pericarp, high amylopectin and chewiness.

Growth Characteristic and Nutrient Uptake of Water Plants in Constructed Wetlands for Treating Livestock Wastewater (인공습지를 이용한 축산폐수처리장에서 수생식물의 생육특성과 영양염류 흡수특성)

  • Park, Jong-Hwan;Seo, Dong-Cheol;Kim, Seong-Heon;Lee, Choong-Heon;Choi, Jeong-Ho;Lee, Sang-Won;Lee, Dong-Jin;Ha, Yeong-Rae;Cho, Ju-Sik;Heo, Jong-Soo
    • Korean Journal of Environmental Agriculture
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    • v.31 no.4
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    • pp.351-358
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    • 2012
  • BACKGROUND: Constructed wetlands for wastewater treatment are vegetated by wetland plants. Wetland plants are an important component of wetlands, and the plants have several roles in relation to the livestock wastewater treatment processes. The objectives of this study were to investigate the growth characteristics and nutrient absorption of water plants in constructed wetlands for treating livestock wastewater. METHODS AND RESULTS: In this study, livestock wastewater treatment plant by constructed wetlands consisted of $1^{st}$ water plant filtration bed, $2^{nd}$ activated sludge bed, $3^{rd}$ vertical flow(VF), $4^{th}$ horizontal flow(HF) and $5^{th}$ HF beds. Phragmites communis TRINIUS(PHRCO) was transplanted in $3^{rd}$ VF bed, Iris pseudoacorus L(IRIPS) was transplanted in $4^{th}$ HF bed and PHRCO, IRIPS and Typha orientalis PRESEL(THYOR) were transplanted in $5^{th}$ HF. Growth of water plants in constructed wetlands were the highest in October. The IRIPS growth was higher than other plant as 264 g/plant in October. The absorption of nitrogen and phosphorus by IRIS were 3.38 g/plant and 0.634 g/plant, respectively. The absorption of K, Ca, Mg, Na, Fe, Mn, Cu and Zn by water plants were higher in the order of IRIPS > THYOR > PHRCO. CONCLUSION(S): The absorption of nutrients by water plants were higher on the order of IRIPS > THYOR > PHRCO in constructed wetlands for treating livestock wastewater.

Physicochemical Properties of Organic Milk and Conventional Milk from Chungnam and Jeonbuk, Korea (한국 충남 및 전북에서 생산된 유기우유와 일반우유의 이화학적 특성에 관한 연구)

  • Ki, Kwang Seok;Lim, Dong Hyun;Park, Seong Min;Lim, Hyun Joo;Park, Su Bum;Kim, Tae Il;Jeong, Seok Geun;Baek, Kwang Soo;Kwon, Eung Gi;Lee, Se Young
    • Korean Journal of Food Science and Technology
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    • v.47 no.3
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    • pp.359-363
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    • 2015
  • This study was conducted to investigate the differences in the physicochemical properties of organic and conventional milk from Chungnam and Jeonbuk, Korea. The milk was collected from 10 organic and 10 conventional milk farms in February, March and August, and then analyzed for milk composition, minerals and fatty acids. Organic milk showed lower fat (p<0.01) and total solid (p<0.05), but higher phosphorous (p<0.01) content than conventional milk. However, there was no difference in the content of lactose or the somatic cell count. Organic milk showed lower (p<0.01) stearic acid and total saturated fatty acid content, but higher (p<0.01) total, mono-, and poly-unsaturated fatty acid content. These results showed that organic and conventional milks differ mainly in their fat and unsaturated fatty acid content. Due to increasing consumer interest in food safety and health, organic milk, which contains more beneficial fatty acids, might be preferred over conventional milk.

The Correlativity of Ulva lactuca Fractions, LPS, Enzymatic Activity and the Evaluation of Water Fraction (갈파래 분획, LPS, 효소활성의 상관성과 수층분획의 가치평가)

  • Nam, Chun-Suk;Kang, Kum-Suk;Ha, Jong-Myung;Lee, Sang-Hyeon;Lee, Jae-Hwa;Lee, Dong-Geun;Jang, Jeong-Su;Kang, Hwan-Yul;Ha, Bae-Jin
    • Journal of Life Science
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    • v.16 no.6
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    • pp.984-988
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    • 2006
  • Lipopolysaccharide(LPS) was posttreated after the 14 day-pretreatment of Ulva lactuca fractions(ULF), and their correlativity to enzymatic activity alteration was investigated in the liver of rats. ULF was intraperitoneally administered into rats at dose of $1m{\ell}/kg$ of 100 mg/kg concentration for 14 days. On the day 15, $1m{\ell}/kg$ of LPS was injected. The corelativity was examined by measuring the changed values of superoxide dismutase(SOD) in mitochondrial fraction and catalase(CAT), glutathione peroxidase(GPx) in liver homogenate. The results showed that LPS treatment decreased the high values of SOD, CAT, GPx to the low values, but ULF pretreatment increased the low values of SOD, CAT, GPx to the high values. It was suggested that ULF, LPS and antioxidative enzymes like SOD, CAT, GPx had the corelativity of the high-low-high pattern and that the ULF pretreatment played the proper preventive role in the protection against the LPS treatment-induced enzymatic inactivity in the water fraction.