• Journal of Chest Surgery
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• 제10권1호
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• pp.98-105
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• 1977

A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

• 대한간호학회지
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• 제5권1호
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• pp.17-30
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• 1975

The concept and definition of nursing and her role have been changing in accordance with the socio-cultural factors of the initial society. At present, nursing is conceptualized as a health care profession assisting man to restore, maintain and promote health by providing knowledge, wilt strength and resources through various processes of interaction. Man′s behavior, of individual and group activities for health inclusive, is driven by the initial man′s value orientation. The purpose of this study is to investigate the value orientation regarding health of rural health center milieu in order to give data for; 1. the planning for the delivery of community nursing service, 2. the health education plan at all level of nursing care activities, and 3. the planning of curriculum for nursing education. A hundred opinion leaders among the labor population residing in rural areas (P-group), hundred and six professional nurses at rural health centers (N-group) were indirectly interviewed through questionaries. And ninety five of N-group were interviewed likewise of their perceptions of P-group (NP-group) from July 15, to October 15, 1974. The result is as follows: 1. Maintenance of health is revealed to be the most valued component for man′s happiness in all the three groups. (P-group: 7.30 S. D.=1.31), (N-group :7.84 S. D. =49), and (NP-group : 5.93 S. D. =2.28) 2. The average value score of the maintenance of health revealed significant difference by P〈.001 level between each of the three groups. (Between N-group and P-group : T= -4.07 P and NP ; T=-6.93, N and NP: T=-9.35) 3. Basic health maintenance activities necessary for maintenance and promotion of personal health were moderately valued by all the three groups, P-group ; 3.74 (S. D. =.43) , N-group: 3.52 (S. D. =.34), NP-group: 3.07 (S. D. :.55) Among the 8 categories of basic health maintenance activities, "food intake" was highly valued by P-group (mean value score; 4.00 S. D=.51) , "exercise and rest" and "personal cleanliness" was highly valued by both P-group (4.02, 4.08) and N-group (4.08, 4.22). 4. The mean value score of basic health maintenance activities revealed significant difference by P〈.001 level between each of the three groups (between P-group and N-group: T=-4, 07, N-and NP: T=-6.93, P and NP T=-9.35) 5. Among the 30 questionaries, dynamic activities for health maintenance were more valued in comparison to passive activities in an tile three groups. 6. In N-group, correlation between the value of basic health maintenance activities and the personal health status personal revealed moderate significance. Correlation between the value of basic health maintenance activities and the age revealed low significance. 7. In group, correlation between the value of basic health maintenance activities and; perception of personal health status revealed non significance, between the age and sex revealed low sign affiance, and between the educational status revealed moderate significance. Recommendations are as follows ; 1. The efforts towards alteration of value orientation concerning health in general in community nursing practice de focussed be that of family Planning. 2. In order to prepare professional nurses competent in understanding individual and group, social science and behavioral science be strength ended in planning nursing curriculum. 3. Milieu of nursing experience during nursing education be Planned to begin at simple nursing problem and move towards complex, f. e. home care towards health crisis situation in order to achieve dynamic role mastery.

• 가정간호학회지
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• 제8권2호
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• pp.121-134
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• 2001

The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

• 성인간호학회지
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• 제12권4호
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• pp.606-618
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• 2000

The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.

• 항공우주정책ㆍ법학회지
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• 제21권1호
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• pp.135-167
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• 2006

유럽연합의 통합과정에서 대두되는 EU와 제3국과의 항공교섭 상에서 기존의 EU회원국가들이 체결하고 있는 제3국과의 양국간 항공협정의 처리에 관한 문제가 대두하고 있다. 2004년 4월 29일의 유럽재판소의 판결기준에 대한 국제항공 공법적 차원에서 기존의 국제항공질서의 변화를 모색할 필요성이 강력하게 등장하게 된다. 이러한 점에서 특히 미국과의 기존의 양자관계를 다자관계로 변경하여야 하는 문제가 중요하다. 한국과도 향후 협상에 중요한 참고사항이 될 것이다. 이러한 점에서 특히 유럽연합과 미국의 기존의 양자관계에서 다자간 관계로 변형시켜 나가는 문제가 향후 국제항공질서에 커다란 영향을 미칠 것으로 보인다. 이러한 관점에서 새로운 방향전환을 위한 국제항공질서를 재정립할 대안모색을 해 본다. 결론적으로 대안모색으로서는 첫째, 기존의 시카고 협약에서 설정된 하늘에 대한 자유에 추가적인 질서형성을 위해 양국간 협정의 표본인 Bermuda I, II에 대체할 수 있는 어떤 다자간 제3의 Bermuda III와 같은 국제항공질서를 설정해야 한다. 둘째, 새로운 다자간 협정에 적용되어야 할 하늘의 자유는 양측의 자유만을 최대한 보장하는 형태가 아닌 양측의 주장을 조절하는 구체적인 것이 되어야 한다. 셋째, 또한 새로운 다자간 국제항공질서는 단순한 지역적 경계를 넘어서 전 지구적 문제로 접근한다는 점에서 최근 사회과학 연구에서 등장하는 복잡계이론을 도입할 필요가 있다. 이와 같은 대안모색에서 필요한 사항들을 점검하고 입장차를 줄여 나가는 방향으로 정리되어야 할 것으로 본다.

• Journal of Chest Surgery
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• 제36권7호
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• pp.497-503
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• 2003

폐 국균종은 폐결핵 등 만성 폐질환으로 인하여 파괴된 폐조직에 국균이 2차적으로 기생하여 발생하는데, 치명적 각혈 등의 증상이 발생할 수 있기 때문에 상당수 증례에서 수술적 치료를 필요로 한다. 이에 최근 10년 간의 수술적 경험을 고찰하고자 한다. 대상 및 방법: 1992년 8월부터 2002년 7월까지 폐절제술 후 병리학적으로 폐 국균종으로 확진된 31명의 환자를 대상으로 호발연령 및 성비율, 주소, 술전검사, 술식의 종류, 지저질환, 술 후 합병증 등을 분석 검토하였다. 결과: 호발연령은 30대와 40대(64.5%)이었으며, 술 전 주요증상은 객혈이었다(27명, 87.1%). 31명 모두에서 술 전 항결핵제 투여경력이 있었으며 19명(61.3%)에서 단순 흉부 방사선 사진상 연부조직 음영이 있는 큰 공동이 관찰되었고 흉부 전산화 단층촬영에서는 31명 모두에서 관찰되었다. 국균객담검사상 37.9%, 혈청 면역 확산 검사상 83.3%의 양성률을 보였다. 폐상엽이 19예(61.3%)로 호발부위였으며 대부분에서 폐엽절제술을 시행하였다. 술 후 병리조직검사상 전 예에서 결핵과 동반되어 있었다. 주요 합병증으로는 농흉 3예(9.7%), 지속적인 공기 누출 2예(6.45%), 사강 2예(6.45%), 술 후 출혈 1예(3.23%) 등이었다. 술 후 사망은 1예(3.23%)로 양측성 폐 국균종에서 수술한 반대쪽의 대량출혈로 사망하였다. 결론: 성비, 나이, 임상증상, 폐결핵과의 연관성, 병변부위 및 수술방법, 합병증 등에 대해서 과거 1963년부터 1992년까지 수술받은 80예와 비교하여 볼 때 큰 차이는 없었다. 진단 기법상 혈청검사는 술 전 아주 높은 양성률을 나타내었고 흉부전산화단층촬영의 높은 진단율은 폐 국균종의 진단과 수술에 매우 중요하다고 사료된다. 복합형 폐 국균종의 경우 흉막유착과 폐문의 경화, 잔존폐의 불완전한 확장 때문에 수술에 어려움이 있어 많은 시간 약물요법과 기관지 동맥 색전술 등의 내과적 치료를 선호하게 되는 데 이와 더불어 공동절개술 등의 비교적 비침습적인 수술방법도 추천되며 최근 합병증의 감소와 더불어 단순형 폐 국균종은 조기에 수술을 적극적으로 고려함이 요구된다.

• Asia Marketing Journal
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• 제12권2호
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• pp.111-133
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• 2010

투자상품의 확산, 고령화 등으로 인한 금융니즈 다양화와 자본시장법 시행으로 인한 금융회사간 치열한 경쟁으로 인해 금융산업 내에서 마케팅의 역할이 더욱 중요해지고 있다. 그러나, 지금까지 다른 산업에 비해 금융산업의 마케팅 연구는 상대적으로 부족하였다. 본 연구는 향후 구체적인 금융마케팅 연구들이 진행되기에 앞서 국내 금융마케팅 연구들을 정리하고, 국내 금융회사 마케팅 담당자를 In-depth 인터뷰하여 실제 국내 금융 마케팅 현황을 조사하였다. 이를 통해 향후 금융마케팅 연구에 필요한 시사점을 얻고자 하였다. 분석 결과, 다른 산업의 마케팅과 다른 금융 마케팅만의 고유 특징에 대한 이론적인 연구가 부족하였고, 금융산업 내에서 은행, 증권, 보험, 카드 산업 간의 마케팅 특징 차이에 대한 연구도 부족하였음을 알 수 있었다. 소비자행동 관점에서 금융고객의 의사결정 과정에 관한 연구도 부족하였다. 또한, 우리나라의 금융회사의 마케팅 현황은 외형적으로 어느 정도 성숙 단계에 접어들었다고 볼 수 있으나, 실제 업무는 여전히 과거의 영업지원, 혹은 프로모션 및 CRM 데이터 분석 등 단기적인 부분에 치중되어 있었다. 그리고, 은행, 증권, 보험, 카드 회사 등 각 세부 금융산업별 마케팅 담당자들이 중요하게 생각하는 금융마케팅의 키워드와 문제 인식 정도도 서로 다름을 알 수 있었다. 본 연구는 이러한 분석 결과를 바탕으로 향후 금융마케팅 연구를 위한 시사점과 함께 6가지의 연구명제를 제안하였다.