• 여성건강간호학회지
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• 제12권2호
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• pp.87-96
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• 2006

Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

• Journal of Periodontal and Implant Science
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• 제26권4호
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• pp.859-872
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• 1996

The purpose of this study was to evaluate the effect of low concentrative ${\beta}-APN$ on the periodontal ligament and relationship between lathyrintic bodies and osteoclast cells near the by alveolar bone. Mandibles including teeth and periodontiums of 24 Sprague-Dawley rat was used. ${\beta}-APN$ 0.2g/kg/day soluted in mineral water was administrated for 5 days before sacrifice in experimental group. 3 rats on each day was sacrificed on 1, 3, 7, 11 days after stop administration ${\beta}-APN$. Histologic examination and the activity of osteoclasts by tartrate resistant acid phosphatase was observed. The results were as follows : 1. In experimental group, the The small foci of lathyrintic bodies surrounded by palisading fibroblasts were seen obviously on 1, 3 days and decreased after 7 days. On 11 days, fibroblasts of periodontal ligament similar to control group. 2. The lathyrintic bodies were seen in the middle zone of periodontal ligament of pressured area like furcation area, alveolar crest, bone resorption area than tensioned area of apposition area. 3. In experimental group of 1, 3 days, lathyrintic bodies were much seen in the area that osteoclasts was much distributed area. After 7 days, experimental group was seen the control group. In conclusion, rathyrintic bodies were formed by low concentrative ${\beta}-APN$ chiefly on the pressured area like furcation area, alveolar crest, bone resorption area than tensioned area of apposition side in periodontal tissue and concerned with osteoclast cells.

• Clinical and Experimental Pediatrics
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• 제58권9호
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• pp.341-346
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• 2015

Purpose: To evaluate the practical applications of the diagnosis algorithms recommended by the American Academy of Pediatrics urinary tract infection (UTI) guideline. Methods: We retrospectively reviewed the medical records of febrile UTI patients aged between 2 and 24 months. The patients were divided into 3 groups: group I (patients with positive urine culture and urinalysis findings), group II (those with positive urine culture but negative urinalysis findings), and group III (those with negative urine culture but positive urinalysis findings). Clinical, laboratory, and imaging results were analyzed and compared between the groups. Results: A total of 300 children were enrolled. The serum C-reactive protein level was lower in children in group II than in those in groups I and III (P<0.05). Children in group I showed a higher frequency of hydronephrosis than those in groups II and III (P<0.05). However, the frequencies of acute pyelonephritis (APN), vesicoureteral reflux (VUR), renal scar, and UTI recurrence were not different between the groups. In group I, recurrence of UTI and presence of APN were associated with the incidence of VUR (recurrence vs. no recurrence: 40% vs.11.4%; APN vs. no APN: 23.3% vs. 9.2%; P<0.05). The incidence of VUR and APN was not related to the presence of hydronephrosis. Conclusion: UTI in febrile children cannot be ruled out solely on the basis of positive urinalysis or urine culture findings. Recurrence of UTI and presence of APN may be reasonable indicators of the presence of VUR.

• Journal of Korean Medical Science
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• 제33권49호
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• pp.310.1-310.11
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• 2018

Background: Acute pyelonephritis (APN) is one of the most common community-acquired bacterial infections. Recent increases of antimicrobial resistance in urinary pathogens might have changed the other epidemiologic characteristics of APN. The objective of this study was to describe the current epidemiology of APN in Korea, using the entire population. Methods: From the claims database of the Health Insurance Review and Assessment Service in Korea, the patients with International Classification of Diseases, 10th Revision codes N10 (acute tubulo-interstitial nephritis) or N12 (tubulo-interstitial nephritis, neither acute nor chronic) as the primary discharge diagnosis during 2010-2014 were analyzed, with two or more claims during a 14-day period considered as a single episode. Results: The annual incidence rate of APN per 10,000 persons was 39.1 and was on the increase year to year (35.6 in 2010; 36.7 in 2011; 38.9 in 2012; 40.1 in 2013; 43.8 in 2014, P = 0.004). The increasing trend was observed in both inpatients (P = 0.014) and outpatients (P = 0.004); in both men (P = 0.042) and women (P = 0.003); and those aged under 55 years (P = 0.014) and 55 years or higher (P = 0.003). Eleven times more women were diagnosed and treated with APN than men (men vs. women, 6.5 vs. 71.3), and one of every 4.1 patients was hospitalized (inpatients vs. outpatients, 9.6 vs. 29.4). The recurrence rate was 15.8%, and the median duration from a sporadic episode (i.e., no episode in the preceding 12 months) to the first recurrence was 44 days. The recurrence probability increased with the number of previous recurrences. The average medical cost per inpatient episode was USD 1,144, which was 12.9 times higher than that per outpatient episode (USD 89). Conclusion: The epidemiology of APN in Korea has been changing with an increasing incidence rate.

• Biomolecules & Therapeutics
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• 제31권4호
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• pp.411-416
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• 2023

Methamphetamine (METH) is a powerful neurotoxic psychostimulant affecting dopamine transporter (DAT) activity and leading to continuous excess extracellular dopamine levels. Despite recent advances in the knowledge on neurobiological mechanisms underlying METH abuse, there are few effective pharmacotherapies to prevent METH abuse leading to brain damage and neuropsychiatric deficits. α-Pinene (APN) is one of the major monoterpenes derived from pine essential oils and has diverse biological properties including anti-nociceptive, anti-anxiolytic, antioxidant, and anti-inflammatory actions. In the present study, we investigated the therapeutic potential of APN in a METH abuse mice model. METH (1 mg/kg/day, i.p.) was injected into C57BL/6 mice for four alternative days, and a conditioned place preference (CPP) test was performed. The METH-administered group exhibited increased sensitivity to place preference and significantly decreased levels of dopamine-related markers such as dopamine 2 receptor (D2R) and tyrosine hydroxylase in the striatum of the mice. Moreover, METH caused apoptotic cell death by induction of inflammation and oxidative stress. Conversely, APN treatment (3 and 10 mg/kg, i.p.) significantly reduced METH-mediated place preference and restored the levels of D2R and tyrosine hydroxylase in the striatum. APN increased the anti-apoptotic Bcl-2 to pro-apoptotic Bax ratio and decreased the expression of inflammatory protein Iba-1. METH-induced lipid peroxidation was effectively mitigated by APN by up-regulation of antioxidant enzymes such as manganese-superoxide dismutase and glutamylcysteine synthase via activation of nuclear factor-erythroid 2-related factor 2. These results suggest that APN may have protective potential and be considered as a promising therapeutic agent for METH-induced drug addiction and neuronal damage.

• 대한간호학회지
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• 제53권1호
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• pp.39-54
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• 2023

Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

• 중환자간호학회지
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• 제16권3호
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• pp.48-61
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• 2023

Purpose : This study aimed to identify and describe the leadership experience of advanced practice nurses (APN). Methods : Data were collected through five focus group interviews in 2022 with a total of 24 APNs in groups of 4-6 participants. All interviews were recorded, transcribed, and data were analyzed using qualitative content analysis. Results : Nine categories emerged from three main themes. First, "Roles of APN leadership" comprised a trusted clinical expert, a moderator for the entire team, a resource person for nurturing the next generation, and a change agent for improving clinical practice. Second, "Facilitators and barriers to APN leadership" included ambiguity of APN role, support system, and institutional backing. Third, "Strategies for strengthening APN leadership competencies" comprised systematic leadership education and speaking up for APNs. Conclusion : APNs are passionate about their expertise and practice, but lack the legal and organizational authority and support to provide successive leadership. Systematic education including leadership and organizational advocacy will enable APN to provide leadership that benefits patients, institutions, and the wider healthcare system.

• 대한안전경영과학회지
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• 제16권1호
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• pp.239-250
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• 2014

The purpose of this research is to implement and develop the Economic Cost Driver Size(ECDS) extended model to determine the optimal cash driver size with measurement complexity cost and allocation fail cost. ECDS model can be used to seek both measurement accuracy and time efficiency of the Activity-Base Costing (ABC). The study also develops Activity Priority Number (APN) to evaluate the importance of nonvalue-added activities improvement and to determine the representative cost driver of value-added activities when applying ECDS model. APN consists of Severity Priority Number (SPN), Undetectablitiy Priority Number (UPN) and Occurrence Priority Number (OPN). APN can be obtained from lower-stream activity, current activity, upper-stream activity in terms of hierarchical dependency of SIPOC (Supplier, Input, Process, Output, and Customer). In order to seek both efficiency of invested capital and reduction of overhead cost, the paper proposes the integrated ABC and Economic Value Added (EVA) model using redesigned ABC-based statement of comprehensive income and EVA-based statement of financial position. For a better understanding of the proposed ABC-EVA integrated model, numerical examples are demonstrated in this paper. Cost drivers of ABC and capital drivers of EVA in the proposed model can be used to reduce activity overhead cost from ABC-based statement of comprehensive income and to lessen activity capital charge from EVA-based statement of financial position.

• 간호행정학회지
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• 제13권4호
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• pp.553-561
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• 2007

Purpose: This study aimed to assess needs of training programs for APN practice courses and continuing education programs for APNs to provide baseline data to improve APN education and practice. Methods: A total of 98 questionnaires were distributed to professors in 38 nursing institutions and 64 (65.3%) were returned. Data collection was performed in November and December, 2007 through email. Results: Professors in charge of geriatric and home care nurse practitioner programs constituted 43.7% of the study participants. Forty-one percent answered that they were satisfied with the practice programs they currently have operated, while 36.5% responded to have difficulty in appointment of institutions for practice programs and 56.3% had problems in assignment of preceptorship. In case of developing training programs for APN practice courses, 58.7% answered that they are willing to participate, and 90.6% felt needs for development of continuing education programs for APNs. Regarding liability insurance for APN students, only 11.5% provided insurance policy. Conclusion: The study results indicated that standardized training programs are needed to assure quality of APN education, and continuing education programs are required to provide opportunities for APNs to improve competencies.

• Clinical and Experimental Pediatrics
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• 제59권3호
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• pp.139-144
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• 2016

Purpose: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). Methods: We retrospectively evaluated 298 pediatric patients ($age{\leq}36months$) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. Results: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). Conclusion: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.