The effect of interpregnancy interval on birthweight of the subsequent child was investigated for the 1,347 womens of 25 to 40 years old age who visited OBGY and Pediatric department of the general hospital in Taegu city. Questions in designed questionnaire were asked by student interviewers who were trained in nursing school. Mean birth weight by interpregnancy intervals were compared by the intervals of 6 months. Mean birth weight increased from 3,250 grams for intervals of 6 months to 3,357 grams for intervals of 25-30 months, hut the difference was not statistically significant(=0.47). Correlations between the continuous variables which were suspected as con founders and interpregnancy interval and birth weight were investigated. The coefficient of correlation between maternal age and interpregnancy interval was 0.39, between gestational period and birth weight 0.30 and between prepregnant weight and birth weight 0.16 and between birth weight of first baby and birth weight(of second baby) 0.44. But maternal age, gestational period and prepregnant weight were not considered as confounder, because they were not correlated simultaneously with birth interval and birth weight. Associations between the discrete variables which were suspected as confounders, and interpregnancy interval were investigated by Chi-square test. Associations between interpregnancy interval and educational level of mothers, types of husband's occupation, types of medical security, sex were not significant(P-values were 0.59, 0.75, 0.75, 0.82 respectively), so we did not considered these variables as confounding variables. In multiple regression analysis of birth weight, significant variables were birth weight of first baby, gestational period, sex of neonate and prepregnancy body weight of mother. Of the 1,347 births, the rate of low birth weight was 2% (27 birth). The rate for interpregnancy interval 7-12 months was highest as 3.6% and that for 13-18 months was lowest as 0.6%, but there was no regular tendency related with interpregnancy interval.
Development of digital media in education field at America, UK, Japan etc bring big progress on digital device if education. Japan bring huge progress on digital education by nationally. UK use huge a national budget at digital education development and Sweden which is advanced country of education and a welfare state. Especially UK and Sweden's digital education markets are full now aspect more high quality design. Korea which is advanced country of IT adopted digital text book 2007 with mathematics, through science and English digital text book through the state. Korea's digital text book is in a transition period. that needs case study of advanced country of education for setting design guide and educational effect to digital education media and device plan. All researches are based on LG europe design center at London. Analysis by using KJ method, survey of questionnaire, heuristic method at 4 schools in UK and Sweden. Through analytical researches want to more reality simulation at digital education, and high quality contents with digital socialization. co-work with analog, can get any where, anytime user want without any difficulty. Also interactive GUI design of digital education device to easy to access for user. When plan Digital text book content and design needs methodical design guide for target who students and environment an in-depth study of the appraisal and method. The results of the research are introduce the design plan as a basic research and giving useful design plan to make digital educational media in Korea industrial aspect.
This study analyzed the comic "Monster" based on J. Lacan's psychoanalytic theory. J. Lacan advocated a new psychoanalytic theory through S. Freud's psychoanalytic theories and socio-cultural studies. The main theory of his theoretical background is the 'desire theory' which analyzed human desires. He distinguished human desires as desires and demands and had the basic proposition that 'human desire is the desire of the other'. J. Lacan (J. Lacan) studied in depth the relationship between oneself and others, which he defined by dividing it into an imaginary system (mirror stage), a symbolic system (Oedipus complex), and a real system (desiring subject). Based on these theories, the main purpose of this study is to analyze the comic "Monster" by Naoki Urasawa focused on the desire theory of J. Lacan based on psychoanalysis to examine what new meaning could be extracted. In order to analyze the comic "Monster", the qualitative research method was used and the method of analysis was the descriptive phenomenological method devised by Giorgi (1985). Through this analytical method, the background, characters, and symbols of "Monster" were analyzed and content analysis was performed based on the theory of Giorgi (1985) and the desire theory of J. Lacan As a result of the analysis of the meaning unit and components related to the desire theory through content analysis, the contents analysis was divided into four components: identification, reproduction of desire, alienation, and unique desire and freedom. The results of this study are summarized as follows. First, on the basis of psychoanalysis, "Monster" is classified into four elements, identification of twin characters, reproduction of desire, feeling of alienation and unique desire and freedom of characters based on desire theory of J. Lacan. Second, the characters analyzed by the desire theory of J. Lacan attempted to reproduce their desires through identification and projection of twins due to their traumatic experience when they were young. Also, the characters who felt alienated in the process of reproduction made a tragic ending to complete human desire and freedom to fill in their emptiness. This result shows that desire theory of J. Lacan based on psychoanalysis can be used as a new analytical theory, a comic analysis which suggested a new meaning. The results of this study suggest that a new field of research, a comic analysis using psychological theory, needs to be created and further studies in this field are required.
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.3
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pp.381-390
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2017
The aim of this study is to develop a teamwork self-assessment tool for Korean nursing students (K-self assessment of teamwork) to evaluate the effects of simulation education, and to test the validity of the tool. As the research method, data were collected from 185 third- and fourth-year nursing students who had completed emergency simulation practice courses while attending nursing schools at two universities in K region. The collected data were analyzed using such statistical programs as SPSS/WIN 22.0 and AMOS 17.0. A test of the construct validity was conducted using confirmatory factor analysis and explanatory factor analysis. To test the criterion validity of the K-self assessment of teamwork, its correlation with the Mayo High Performance Teamwork Scale (MHPTS) was analyzed using Pearson's correlation coefficients. In addition, of the reliability items, the internal consistency was tested using Chronbach's ${\alpha}$. The results of the study are as follows: The construct validity was demonstrated through the confirmatory factor analysis and explanatory factor analysis. As regards the test of reliability, there was one item for which the reliability of its validity was increased to .937 when a (single/particular) question was removed. However, in the end, no questions were removed, because the correlation coefficient between the questions and the total score was greater than .4. The overall reliability of the K-self assessment tool of teamwork was found to be .934, confirming its reliability. The translated version of the K-self assessment of teamwork developed in this study was also demonstrated to be applicable to domestic settings, in which the teamwork of nursing students can be assessed during simulation education. The results of the use of this tool in the future will be used to assess the effects of simulation education at nursing colleges, and will become the basis of various types of educational programs aimed at improving teamwork in emergency situations.
Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.
Background: We analyzed five hundred patients who underwent either isolated or concomitant coronary artery bypass grafting(CABG) between November 1981 and June 1997. Material and Method: There were 330 males and 170 females with a mean age of 57.4$\pm$8.9 years. To evaluate the preoperative status, we performed electrocardiograghy, echocardiography, MIBI scan, Duplex sonogram, common blood test including CK and LDH and coronary angiography. Result: Preoperative clinical diagnoses were unstable angina in 282 (56.4%), stable angina in 141 (28.2%), postinfarction angina in 58 (11.6%), acute myocardial infarction in 8 (1.6%), variant angina in 7 (1.4%) and failed percutaneous transluminal coronary angioplasty in 4 (0.8%) patients. Preoperative angiographic diagnoses were three-vessel disease in 263 (52.6%), two-vessel disease in 93 (18.6%), one-vessel disease in 71 (14.2%), left main disease in 68 (13.6%), and others in 5 (1.0%) patients. Patients had various risk factors for coronary disease, and the frequency of the risk factors such as hypertension, diabetes and smoking showed increasing tendency year by year. We used saphenous vein grafts in 1143, internal thoracic artery grafts in 442, radial artery graft in 17, and gastroepiploic artery graft in 1 anastomosis. The mean number of grafts was 3.2$\pm$1.2 per patient. Concomitant operations were prosthetic valve replacement or valvuloplasty in 31, coronary endarterectomy and angioplasty in 27, left main coronary angioplasty in 13, carotid endarterectomy in 5, and neurologic problems, bleeding, and perioperative myocardial infarction. The mean follow-up period was 25$\pm$23 months and there were 5 cases of reoperation. Conclusion: We hope that the surgical results would improve with the accumulation of experience, application of new myocardial protection technique, and timely intervention of mechanical assisted devices.
Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. Material and Method: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. Result: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1 : 1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. Conclusion: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.
Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.
Yoon Sei Chul;Oho Yoon Kyung;Gil Hak Jun;Chung Su Mi;Shinn Kyung Sub;Bahk Yong Whee
Radiation Oncology Journal
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v.5
no.1
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pp.31-36
/
1987
Radiobiological and clinical evidences indicate that hyperthermia combined with ionizing radiation produces a significant improvement in therapeutic effect of cancer. In general, malignant cells are more sensitive to heat than normal cells in the heat range of $41\~45^{\circ}C$. We report the experiences obtained from 42 patients with advanced malignant neoplasms managed with 2,450MHz microwave-induced local hyperthermia and ionizing radiation at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. A clinical analysis of 42 thermoirradiated patients showed result of 11(26\%),\;15(36\%),\;11(26\%)\;and\;5(12\%)$ patients with complete response (CR), partial response (PR), minor response (MR) and no response (NR), respectively. Histologically there were $17(40.2\%)$ squamous cell carcinomas, $12(28.6\%)$ adenocarcinomas and $6(14.3\%)$ miscellaneous cancers. Eleven patients with CR consisted of five squamous cell carcinomas, five adenocarcinomas, and one chloroma. Among 15 patients with PR were five squamous cell carcinomas, five adenocarcinomas, three unknown primary tumors, and one poorly differentiated, and miscellaneous tumor each.
Pulmonary atresia with intact ventricular septum has continued to have a high surgical mortality and morbidity. This mAy attribute to the non-uniformity of the anomaly. We reviewed a total of 34 infants with pulmonary atresla and intact ventricular septum managed in this hospital between 1987 and 1995. Mean age and body weight were 57.2 (range, 3-208) days and 4.1 (range, B.3∼6.8) kg. The preoperative Z-value of the diameter of the tricuspid valve was less than -2 in 85.2% of patients and less than -4 in 33. 3% . It is well correlated w th right ventricular cavity size (n=27. r10.68, p< 0.05). Coronary artery-right ventricular fistulas were identified in 3 patients, and right ventricular dependency was suspected in 1 Over All hospital mortality was 23.5%(8/34), although it decreased to 16.6%(4124) in 1990s. Subsequent procedures were performed in 6 patients between 3 days and 58 months after Initial palliation : one bidirectional cavopulmonary shunt and 1 Fontan operation after systemic-pulmonary shunt, 3 transannular patch + atrial septal defect closure and 1 additional systemic-pulmonary shunt after polmonary valvectomy or valvotomy. Changes of Z-values of the diameter of tricuspid valve have been followed up in 11 patients between 1 and 66 months postoperatively. Z-values were increased In 5 out of 8 transannular right ventriculAr outflow tract enlargement group and in 1 out of 3 pulmonary valvectomy or valvotomy group. Our data suggest that tailoring a treatment to right ventricular cavity size and coronary anom lies may improve the surgical outcome. A Z-value of the tricuspid valve diameter could be used.
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