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A Follow up Study on the Acceptors of the Sterilization and Intra-uterine Device (영구불임수술 및 자궁내피임장치시술 수용자의 추후조사)

  • Woo, Im-Soo;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.39-49
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    • 1995
  • This study was attempted to investigate the acceptive status of 428 persons who had taken the vasectomy and the tubal ligation and the intra-uterine device(IUD, copper-T). It defined the complications after the contraceptive procedures and the effects of the supporting of the government for contraception. The target population was identified from the list of the 105 females taken tubal ligation, and 109 males vasectomized, 214 IUD acceptors covered by Gumi Health Center from January 1990 to December 1992. Data was collected from the target population by the questionnaire and medical records between March 1 and April 30, 1993. Among the study subjects, 56.0% of vasectomized males was between 30 and 34 years of age and the highest percentages of tubal ligation and IUD acceptors were between 25 and 29 years of age. The highest percentage of occupation of vasectomized males was officials and that of tubal ligation and IUD acceptors was in no occupational status. 81.2% of respondents were more than high school in educational level, educational level of vasectomized males was more higher than that of females. The percentage contraceptive acceptors with one or two children was 90.8% for vasectomized males, 80.1% for females with tubal ligation, and 93.9% for IUD acceptors. The most people accepted the contraception as they felt the need rather than other's persuasion. The major reasons of contraception were having the wanted children and alleviating the economic burden for the raising and the educating their children. Among the vasectomized males, 11.0% complained the side reaction and the most common symptoms were the inflammation around the wound and sexual declination. Among the tubal ligation females, 46.7% complained the side reaction and the most common symptoms were vaginal discharge, the menorrhagia, back pain and lethargy. The IUD acceptors were similar to them. The regretting rate of tubal ligation and the IUD acceptors was higher than the vasectomized males. The major reason of their regretting was the side reaction in the tubal ligation and the IUD. But the vasectomized males had the insecurity that they couldn't have their own children any more, and sexual declination. The main reason of the females accepted the tubal ligation and the IUD were the fears about toward induced abortion. The most contraceptive acceptors(83.2%) wanted to be offered by the government, but if they pay the expense in their own money, they would accept the contraception in 86.9%.

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From Trauma To growth: Posttraumatic Growth Clock (외상 후 병리에서 성장으로: 외상 후 성장 시계)

  • Lee, Hong-Seock
    • Korean Journal of Cognitive Science
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    • v.27 no.4
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    • pp.501-539
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    • 2016
  • The human mind is a self-evolving system that develops along a multidimensional hierarchical pathway in response to traumatic stimulus. In absence of trauma, a mind integrated in conflict-free state is called monistic. When the monistic mind responses to a traumatic stimulus, a response polarity forms toward stimulus polarity within the mind, turning it into a bipartite structure. Dialectical interaction between the two opposites, originating from their incompatibility, creates a new third polarity in the upper dimension. Thereby, the mind turns into a trinity structure. When the interaction among the three polarities becomes optimized, the plasticity of the mind gets maximized into the "far-from-equilibrium state," and the function of three polarities is synchronized. Through this recalibration, the mind returns back to its monistic structure. If the mind with the recurred monistic structure responds to another traumatic stimulus, this cycle of hierarchical transformation repeats itself in this cyclical and fractal growth process through synchronization of basic trinity system. Applying this concept to the process of post-traumatic growth (PTG), this paper explores how the mind transforms traumatic experiences into PTG and proposes a 'PTG Clock' that shows a fundamental sequence in the development of the human mind. The PTG Clock consists of seven hierarchical phases, and each of the first six phases has two opposite sub-phases: shocked/numbed, feared/intrusive, paranoid/avoidant, obsessional/explosive, dependent/depressive, and meaningless/searching for meaning. The seventh, the synchronization phase, completes one cycle of the mind's transformation, realizing a grand trinity system, where the mind synchronizes its biological, social, and existential dimensions. At that point, the mind becomes more susceptible to not only the stimulus of its own traumatic experience but also the pain of others. Thereby, the PTG Clock sets out on a journey to another cycle of transformation in higher dimensions. The validity of this transformational process for the PTG Clock will be examined by comparing it to Horowitz's theory of stress response syndrome.

Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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Reverse Total Shoulder Arthroplasty in Patients with Severe Rotator Cuff-Deficient Shoulder - A Minimum Three-Year Follow-up Study - (심한 회전근 개 부전을 동반한 환자에 대한 역형 견관절 전치환술 - 최소 3년 추시 결과 -)

  • Kim, Myung-Sun;Yeo, Je-Hyoung
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.73-83
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    • 2013
  • Purpose: The goal of this study is to evaluate the minimum three-year follow-up results of reverse total shoulder arthroplasty (RTSA) for glenohumeral (GH) arthritic and pseudoparalytic patients with severe rotator cuff deficiency. Materials and Methods: We evaluated 13 patients (three males and 10 females) who underwent RTSA from July 2007 to July 2010. The average follow-up duration was 54.2 months (range, 37~74 months). Clinical results were evaluated using the Visual Analog Scale (VAS) for pain, active Range of Motion (ROM): active forward flexion (aFF); active external rotation at the side (aERs); active internal rotation to the back (aIRb), American Shoulder and Elbow Surgeons (ASES) score, Korean Shoulder Score (KSS), and intraoperative and postoperative complications. Results: VAS score improved from 7.5(6~10) points to 1.5(0~4), and ROM of active forward elevation improved from $42.7(10{\sim}100)^{\circ}$ to $129.1(110{\sim}180)^{\circ}$. In addition, ASES score improved from preoperative 32.9 (11.7~46.7) points to 80.2(58.3~95.0) postoperatively, and KSS score improved from 36.8(24~47) points to 78.4 (61~92). Twelve out of 13 cases showed various degrees of scapular notching at the last follow-up. There was one case of intraoperative anterior glenoid fracture and two cases of temporary nerve injury. Revision surgery was performed in two cases for treatment of delayed postoperative deep infection. Conclusion: According to minimum three-year follow-up results, RTSA may be an effective treatment option for glenohumeral (GH) arthritic and pseudoparalytic patients. However, considering the possibility of complications related to delayed deep infection or surgeon's technique, RTSA should be judiciously and carefully indicated by expert surgeons.

THE SECOND MESIOBUCCAL CANAL OF UPPER PRIMARY MOLAR : CASE REPORT (제 2근심협측근관이 존재하는 상악유구치의 치험례)

  • Kim, Chang-Gi;Hong, Seong-Soo;Ko, Sung-Back;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.2
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    • pp.139-145
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    • 2002
  • In a primary teeth, dental caries is rapidly advanced the pulp disease, because the primary teeth have the thinner and the weaker enamel layer and the wider pulp chamber than relatively the permanent teeth. And the pulps of primary teeth are exposed during caries removal or even they are exposed by unexpected movement of the children or by trauma. For successive pulp treatment in primary teeth, it is necessary to understand completely about multiple canal morphology, variation of root canal anatomy and specific problem related to root formation and resorption of primary teeth. In upper primary molar, canal configuration of mesial root has the most variation same as upper molar. If not canal treatment is completely, most of all endodontic treatment should be failed. In a clinical case report, upper primary molars existed persistent pain or bleeding during treatment were founded the second MB canal and were performed the endodontic treatment of theirs. As a result, the upper primary molars have no symptom and good prognosis. In the examination of extracted upper primary molar, we found that 8 of 35 teeth(22.8%) in the upper primary first molars and 22 of 33 teeth(66.6%) in the upper primary second molar had the second mesiobuccal canal. It has revealed the high prevalence of two canals in mesiobuccal roots of upper primary molars. The frequency of occurrence of the second mesiobuccal canal must be taken into consideration when endodontic treatment is planned and as a possible cause of otherwise un explained failure.

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The Effects of Musculoskeletal Disorder Prevention Exercise Program Considering Agricultural Work Posture (농작업 자세를 고려한 근골격계 질환 예방 운동프로그램의 효과)

  • Park, So-Yeon;Kim, Jin-Kyung
    • The Journal of Korean society of community based occupational therapy
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    • v.3 no.1
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    • pp.1-10
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    • 2013
  • Objective : This study investigates the impact of the musculoskeletal disorder prevention exercise program designed on the basis of agricultural work posture on the balance ability, Oswestry Disability level, and Psychosocial stress of participants from one rural village in Chungnam area. Method : The exercise program was provided to 21 farmers with musculoskeletal symptoms living in one village in Chungnam area. Such program was performed once a week, 90 minutes per session, for a total of twelve weeks from July 10 to October 11, 2008, and was constructed in a way to increase flexibility and muscular strength, taking agricultural work posture into account. The balance ability, Oswestry Disability Index, and Psychosocial Well-being Index scores were analyzed based on the data of 13 of the farmers who participated in the program for more than eight times and in all of the pre- and post-assessments. Result : Thirteen participants were all women who were 70.55(${\pm}6.78$) years old on average. Most of them were engaged in general dry-filed farming. The parts where they mainly felt the pain were low back(69.2%) and knees(61.5%), and 46.2% responded 'not healthy' to the question on the overall health status. The static balance ability when standing on the right foot significantly increased from the average 9.27(${\pm}5.53$) seconds before intervention to 14.22(${\pm}5.47$) seconds after intervention(p<.05). The Oswestry Disability Index showed a significant change, decreasing from the average 19.84(${\pm}6.89$) seconds to 14.38(${\pm}7.58$) seconds(p<.05). However, there was no change in the Psychosocial Well-being Index. Conclusion : This exercise program that has been conducted for the female farmers who are mainly engaged in the dry-filed farming has contributed to the improvement of their static ability and reduction of their Oswestry Disability Index scores. It is expected that the studies on the effects of the differentiated exercise programs depending on work characteristics will make progress in the future.

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Appling Nursing Theory to Clinical Practice of Home Health Care (가정간호실무에 적용가능한 이론적틀)

  • Woo, Seon-Hye
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.11 no.1
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    • pp.5-13
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    • 2004
  • The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

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The clinical study of acne patients (面疱 患者에 對한 臨床的 硏究)

  • Chae, Byeong-yoon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.251-268
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    • 1998
  • 125 Cases of Acne were treated by Acupuncture and Herb-med treatment during a three months duration from April 1996 to February 1998 in Kyung Hee Univ. Department of Ophthal, Otolaryngology. College of Oriental Medicine. We have observed the cases and the results as follows: 1. The age of average was 24.55 age : 21.91 in males, 24.55 in females. and in these, the gulf between males and females were showed statically significant diference. In the age of onset, averag was 16.96 age and mode was 18 age and male's average was 16.96 age, minimun was 11 age, maximum 40 age and female's average was 20.14 age, minimun was 10 age, maximum 40 age. and these were showed statically significant diference between males and females. 2. In the distribution of season, winter was the most with $37.8\%$ of out patients, the rest was similar to difference of each other. but there was clear difference between males and females. 3. In the duration of history, the average was 5.10 years and male's average was 5.13 years. on the other hand female's was 5.09 years but there is no any significant difference have a resemblance with each other. 4. In blood type, O type was the most with $35.20\%$ and there was in the order of A type was $26.40\%\;B\;type\;was\;23.20\%,\;AB\;type\;was\;15.20\%$ but these were not significant difference by the chi-tend and analysis of variance with total cases, males and females. 5. In select of the preference food, patients of the prefer worm food was $42.40\%\;and\;cool\;food\;was\;38.40\%,\;tepid\;food\;was\;24\%$ but these were no significant difference by the chi-test and ANOVA of each other. 6. the state of pulse classified into 11 type and average was 7.2 times, maximum was 29 times with Hyun Sae, at the same time, the female's average was 6.73 times, maximum was 27 times and male's average was 1.5 times. The result of test with each other, these were showed statically significant difference as compared total cases with males but there were not females ones. 7. In the frequency of the major cause, oversensitiveness was the most with $34.93\%$. secondly there was in order of indigestion $30.82\%$ and menstrual irregularity and menstruation pain $23.28\%$. constipation $10.96\%$ and these showed statically significant difference as compared the females with males on the result of test for difference with each other. 8. In frequency of the symptoms, itching was the most with $31.97\%$ and there was in order of nodule $20.49\%$, pustule $18.85\%,\;papule\;15.58\%,\;flare\;13.12\%$ and also these showed statically significant difference as compared the females with males 9. for the Distribution of acne region, face was the most with $64.06\%$ and there was in order of back $14.29\%,\;upper-chest\;11.69\%,\;neck\;7.79\%$ and there was no significant difference as compared total cases with males and females. 10. Acne applied 30 prescription to 4 weeks and over and 20 weeks and over was $23.3\%$, 30 weeks and over was $16.67\%$ and average of administration duration were 4.2 weeks(male's average 5.78, maximum 96 weeks and female's average 3.85, maximum 23 weeks) maximum was 96 weeks, minimum was 1 week. 11. In the acupuncture treatment, $96.6\%$ applied to acupuncture and average was 5.44 times, maximum 46 times, minimum 1 time(male's average 4.64, female's 5.62) but these were not any significant differeence. 12. for the medication, author made a investigation and comparison between control group with treated group in order to observe for the therapeutic effect during the 1 month and 2, 3. From these results, we can see that acne was improved by the oriental treatment. in the 1 month, average of control group was 13.24 and treated group was 11.78. these showed statically significant decrease in P<0.02 as compared the treated group with control group. In the 2 months, average of control group was 13.43 and treated group was 9.03. these showed statically significant decrease in P<0.003 as compared the treated group with control group. In the 3 months, average of control group was 13.78 and treated group was 8.06. these showed statically significant decrease in P<0.008 as compared the treated group with control group.

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Morphometric Analysis of Distances between Sacral Hiatus and Conus Medullaris Using Magnetic Resonance Image in Korean Adult (자기공명영상을 이용한 한국 성인의 엉치뼈틈새와 척수원뿔 사이 거리 연구)

  • Park, Tai Soo;Hwang, Byeong-Wook;Park, Sang-Joon;Baek, Sun-Yong;Yoon, Sik
    • Anatomy & Biological Anthropology
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    • v.29 no.4
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    • pp.145-154
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    • 2016
  • The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.

The Legitimate and Eldest Son Complex in Changseongameirok (<창선감의록>의 적장자 콤플렉스)

  • Jo, Kwangkuk
    • Journal of Korean Classical Literature and Education
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    • no.38
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    • pp.65-101
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    • 2018
  • In the late Joseon Dynasty, patriarchal ideology became central to the family and the clan, and once again became acutely felt with "the familism of clan rules that centered around a legitimate and eldest son." The establishment of the family-clan system, though somewhat complex, was largely aimed at the family line of "a paternalist-a legitimate and eldest son." The trend was not limited to a particular family, but rather, was a historical and social trend. Changseonggameirok showed how to solve the family crisis by setting up a problem for the next generation's patriarch. This paper tries to explain the issue of Hwachun's complex as the legitimate and eldest son complex. First, it suggests that Hwachun's complex is as universal as the Cain complex, also known as the eldest son complex, and that Hwachun's complex is a special instance of the legitimate and eldest son complex in Changseonggameirok. Next this paper studies the aspects of Hwachun's legitimate and eldest son complex combined with Mrs. Sim's complex, as well as her daughter-in-law's complex, and eventually tracks the development of the family-clan complex. As a result, we've come to a new conclusion that the legitimate and eldest son complex was found in Changseonggameirok for the first time in Korean literary history. This paper also examines the fact that when the legitimate and eldest son complex was transferred to Hwajin, it became a family complex that Hwajin had to contend with; this paper tracks the process wherein Hwajin's filial piety solved the legitimate and eldest son complex. As a result, we realized that Hwajin's filial duty and brotherly love went beyond his feelings for Mrs. Sim and Hwachun, and supported the substantiation for "the familism of a clan that is based on rules of the legitimate and eldest son" in the course of public opinion. However the familism of these rules was not embodied in the absolute; in the royal family, for example, it was rather flexibly implemented when the characters admitted to breaking the law. In addition, this paper provides the room for a critical reading of Changseonggameirok, reflecting back on the underlying guilt and psychological pain of the characters who are affected by the particular rules, and concluding that guilt and suffering are fundamentally insoluble. This is because the two ideas, "the legitimate and eldest son complex" and "the familism of a clan rules centered on a legitimate and eldest son" are two sides of the same coin.