• 제목/요약/키워드: Modern Medicine

검색결과 856건 처리시간 0.03초

비행시차와 일중리듬 (Jet Lag and Circadian Rhythms)

  • 김인
    • 수면정신생리
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    • 제4권1호
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    • pp.57-65
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    • 1997
  • 누구나 시차가 큰 여행을 할 때 몇일 간 비행시차증이라고 불리우는 증상을 경험하게 된다. 비행시차증은 수면박탈, 비행요인, 지연요인의 복합적인 원인으로 인해 생기는 하나의 증상군이라고 말할 수 있다. 특히 빠른 시차변화로 인한 생리적 지연효과(Jet lag)는 외적 비동조화, 내적 비동조화, 그리고 수면상실의 결과를 낳는다. 인간의 수면을 조절하는 기전에 있어 일중체계가 중요하다. 즉, 평균적인 수면-각성주기는 중심체온의 주기와 내적 비동조화가 일어나더라도 수면경향, 졸리움, 자발적 수면 기간, 그리고 렘수면 경향은 중심체온의 내인성 일중주기에 따라 통제된다. 수면의 구성요소중에서 서파수면은 중심체온의 주기보다는 수면시작시간에 따라 나타나며 이전에 깨어있었던 기간이 길수록 강력하게 나타난다. 따라서 수면은 일중체계와 항상성 기전의 상호작용으로 조절된다. 비행시차 후에 변화되는 수면양상을 이해하는데 있어 일중 체계 이외에 도항상성 기전을 고려하여야한다. 수면에 대한 일중리듬체계의 영향과 수면의 항상성 과정이 비행시차후 도착지에서의 수면양상을 설 명할 수 있을 것이다. 도착지에서의 적응은 통과한 시간대 수, 여행 방향, 일주기 리듬의 부조화에 적응 할 수 있는 개인별 능력에 따라 다르다. 도착지의 시간적 단서에 빨리 노출되어 일중체계의 위상반응곡선에 의한 재동조화를 촉진시키고 수면의 항상성 과정을 고려하여 도착지의 밤 이전까지 충분히 깨어 있는 것이 Jet Lag를 극복하고 적응하는 지름길일 것이다.

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대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
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    • 제2권1호
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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기경팔맥(奇經八脈) 이론(理論)의 형성(形成)과 발전(發展)에 관한 의사학적(醫史學的) 고찰(考察) (Oriental medical historic study of formation and development about theory of Ki Kyung Pal Maek (奇經八脈))

  • 이동호
    • 대한한의학원전학회지
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    • 제10권
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    • pp.671-728
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    • 1997
  • By studying from Chun Kuk are(戰國時代) to Chung area(淸代), I could find some conclusion as follows. 1. It was Chun Kuk area(戰國時代) that was shown some signs of forthcoming activity of theory of Ki Kyung Pal Maek(奇經八脈). In that time, Hwang Jae Nae Kyung(黃帝內經) had been written. That book made a important role for foundation of theory of Ki Kyung Pal Maek(奇經八脈), but it hadn't sufficient contents in some parts. 2. The theory of the Ki Kyung Pal Maek (奇經八脈) had been developed in Jin Han area(秦漢時代), Nan Kyung(難經) had been written in the area, Nan Kyung(難經) had been the first book which had referred to name and physiology of Ki Kyung Pal Maek(奇經八脈) and it also had mentioned about course, function, and pathology of that in simple manner. 3. In Yang Jin are and Su Dang area(兩晋 및 隋唐時代), Maek Kyung(脈經) and Hwang Jae Nae Kyung Tae So(黃帝內經太素) had been written Maek Kyung(脈經) had been the first book which had referred to pathology of Ki Kyung Pal Maek(奇經八脈) by Maek Jin(脈診) in detail, and it had affected on such books like Tae Pyung Seoung Hveu bang (太平聖惠方) and Ko Kum Yeu Tong Dae Chon(古今醫統大全). Hwang Jae Nae Kyung Tae So(黃帝內經太素) had mentioned about course, function, and pathology about Ki Kyung Pal Maek(奇經八脈) in most detail at that time, and it also had referred to that of such books like Myung Dang(明堂) and Ku Khoun Kyung(九卷經) which do not exist in present. Because of these point, Hwang jae Nae Kyung Tae So(黃帝內經太素) is evaluated an important book of theory of Ki Kyung Pal Maek(奇經八脈). 4. In Song area(宋代), Seung Jae Chong Rok(聖濟總錄) had been written. Seung Jae Chong Rok(聖濟總錄) first mentioned about meeting between Ki Kyung Pal Maek(奇經八脈) and Sip I Jong Kyung(十二正經), so this book helped development of theory of Ki Kyung Pal Maek(奇經八脈) of Kum Won area(金元時代). 5. In Kum Won area(金元時代), Dong In Su Hyul Chym Ku Do Kyung(銅人腧穴針灸圖經) had been written. Dong In Su Hyul Chym Ku Do Kyung(銅人腧穴針灸圖經) made a important role of theroy of Im Meak(任脈) and Dok Meank(督脈). Sip Sa Kyung Bal Hyui(十四經發揮) was superior to other books which had been referred to theory of Ki Kyung Pal Maek(奇經八脈) at that time. Also Sip Sa Kyung Bal Hyui(十四經發揮) more mentioned about meeting between Ki Kyung Pal Maek(奇經八脈) and Sip I Jong Kyung(十二正經) than that of Seung Jae Chong Rok(聖濟總錄), so this book helped dvelopment of theory of Ki Kyung Pal Maek(奇經八脈). 6. In Myung area(明代), Ki Kyung Pal Maek Ko(奇經八脈考) that had almost accomplished theory of Ki Kyung Pal Maek(奇經八脈) had been written. Ki Kyung Pal Maek Ko(奇經八脈考) was the best book more than any other book that had been mentioned about theory of Ki Kyung Pal Maek(奇經八脈) in three ways as follows. 1) It is Ki Kyung Pal Maek Ko(奇經八脈考) that mentioned about near similar manner of modern course and physiology of Ki Kyung Pal Maek(奇經八脈). 2) Ki Kyung Pal Maek Ko(奇經八脈考) mentioned about pathology and treatment of Ki Kyung Pal Maek(奇經八脈) in detail more than any other book. 3) Ki Kyung Pal Maek Ko(奇經八脈考) emphasized on relationship between Ryun Kong(鍊功) and Ki Kyung Pal Maek(奇經八脈).

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소아정신과 환아 부모의 부부관계에 대한 연구 (A STUDY ON THE PARENTAL MARITAL RELATIONSHIP OF CHILD PSYCHIATRIC PATIENTS)

  • 임계원;홍강의;이근후
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제2권1호
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    • pp.160-175
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    • 1991
  • 본 연구의 목적은 가족의 기본이 되는 부부관계에 초점을 맞추어 부부관계와 부모자녀 관계 사이의 연관성을 알아보고자 1987년 7월부터 9월사이에 소아 정신과에서 치료받은 환아의 부모들과 일반 아동이 부모들을 대상으로 결혼 만족도 검사(Marital Satisfaction Inventory ; MSI)와 부부 적응도 척도(Dvadic Adjustment Scale ; DAS)의 두가지 설문지를 이용하였다. 환아 부모군은 환아의 진단면에 따라 정신증, 신경증, 틱, 자폐증, 정신지연의 5군으로 분류하였고 각군의 결과가 평가되었다. 1) 환아부모군은 대조군보다 결혼만족도가 낮다. 2) 환아부모군은 대조군보다 부부 적응도가 유의하게 낮다(P<0.01). 3) 환아부모군, 대조군에서 여자가 남자보다 역할개념이 더 진보적이며 환아부모군에서 역할부담이 여자에게 편중됨으로써, 양육갈등(conflict in child rearing)은 모성 우월현상과 연관됨을 시사한다. 4) 원래 가족의 고통스러운 가족력(Family History of Distress)는 결혼의 정서적 의사소통, 성생활, 자녀양육과 연관이 깊다. 5) 결혼 만족도 검사(Marital Satisfaction Inventory ; MSI)의 전반적 고통 척도(Global Distress Scale ; GDS)에 의하면 정신증, 신경증, 자폐증, 정신지체, 틱의 순서로 불만족도를 보였다. 6) 부부 적응도 척도(Dvadic Adjustment Scale ; DAS)에 의하면 정신증, 신경증, 틱, 자폐증, 정신지체의 순서로 부적응도를 보였다. 7) 틱군은 자녀양육 갈등 및 양육태도에 문제점을 시사하였고 부부관계 자체는 유의한 장애를 보이지 않았다. 위의 결과로서 부부의 부적응 및 불만족은 자녀양육 및 자녀문제와 밀접한 연관성이 있음을 시사하며 소아의 정신증과 신경증군의 발병요인은 결혼 불만족과 부적응과 관련이 깊으며 자폐증이나 정신지연군의 발병요인은 결혼 불만족과 부적응과 관련이 깊지 않음을 시사한다.

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치과기공사의 보수교육에 관한 연구(I) -보수교육 실태와 인식을 중심으로 - (A Study on the Continuing Education of Dental Technicians)

  • 문제혁
    • 대한치과기공학회지
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    • 제22권1호
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    • pp.179-198
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    • 2000
  • Since dental prosthesis is made possible only when dental technicians give themselves to the study of knowledge and the acquisition of updated skills, continuing education is of great importance in that it makes up for the efforts of dental technicians. Accordingly, continuing education relates to a system designed to contribute to the enhancement of the talents of dental technicians and the dental health of the nation. Specialized knowledge and information may work as the best weapon to preserve their jbs. This is true of this modern society where no one can expecth to survive without acquiring knowledge and information constantly for work is getting more classified and more divirsifide. This paper is dedicated to take a look at the current condition of the continuing education of dental technicians and to come up with measure to make general evaluation and to improve continuing education. This research resorts to 609 questionnaires among 6433 copies save unfaithfully responded 34 copos with 6.431 dental technicians as the subjects enrolled in the Dental technician Association. The collected questionnaires consist of 365 dental technicians living in Seoul and of 244 ones, Which account for 11.8 percent of dental technicians enrolled in the association. Because dental technicians live more in local areas than Seoul, the generalization of this survey leaves something to be desired. I have come up with the following findings. 1. 6,431 dental technicians, or 36.3 percent of an total of 14,956 licensed dental technicians, were admitted as numbers of the Dental Tachnician Association as of October 31, 1999. In the '98 continuing education. 4,141 dental technicians among 4,711 dental technicians got relevant training, and in the '99 continuing education, 4,075 technicians, or 75.9 percent of 5,365 technicians got relevant training while 1,290 technicians or 24.2 percent, fail to get relevant training. 2. The survey has it that 38.1 percent of dental technicians are ignorant of the laws on continuing education, and that technicians staying in local communities(146 persons, or 61.6%) take more part in education than those living in the capital of Korea(159 persons, or 146%), and that the older they are, the more money they earn, the more carrer they have, the higher position they hold, the more part they take in education 3. According to the survey, those who have the experience of getting training more than three times account for 52 persons(16.8%) in Seoul and 47 persons(22.4%) in local districts(p<0.01). In terms of sanctions in relation to continuing education, 26 dental technicians(4.6%) say that they have ever gotten sanctions, and 533 dental technicians(95.4%) say that they haven't. And those who were absent from continuing education(72 technicians : 13.51%) didn't get any sanction. 4. In terms of the degree of understanding continuing education, local technicians(46.8% : 110 persons) have a higher understanding of continuing education than their countparts staying in Seoul(36.0% : 130). Continuing education is not the ultimate goal itself. It should be changed to motivate those who get education to be willing to take part in contunuing education, and to help dental technicians in a practical and specific way. And the branch societies should be developde to engage in more specialized and classified expert fields. Of course, the curriculum should be so selected that the conceptions of dental technicians may be reflected to the maximum extent, and the ultimate effores should be made to effect diversity in the ways of educational methods and to perfect the preparation of continuing education on the part of instructors. Regulations should be established in relation to continuing education with a veiew to enhancing the participation of continuing education and its effectiveness. The supervision of the Ministry of Health and Welfare is of great importance in this context. The regulation of continuing education is not administrative regulation, but the expression of national will to guarantee the medical service of the nation at highest level. Therefore, it is necessary that the Ministry of Health and Welfare should change their understanding of the needs for the continuing education of dental experts, and that the expertise of government employees in charge of continuing education should be expanded. It goes without saying that the government should suppory continuing education in a financial way so as to supply the person in charge of public welfare and control the quality of national medicine.

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Gafchromic EBT2필름과 다양한 검출기를 이용하여 $3cm^2$ 이하의 소조사면에서 출력비율의 선량검증 (Dosimetric Verifications of the Output Factors in the Small Field Less Than $3cm^2$ Using the Gafchromic EBT2 Films and the Various Detectors)

  • 오세안;예지원;이레나;박헌보;김성규
    • 한국의학물리학회지:의학물리
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    • 제25권4호
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    • pp.218-224
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    • 2014
  • 소조사면의 선량검증은 고선량을 1회에 치료하는 정위적방사선수술(Stereotactic radiosurgery, SRS)과 고선량을 소분할 하여 치료하는 소분할방사선치료(hypo-fractionated radiotherapy)에서 작은 크기의 종양을 치료하기 위해서 자주 사용되기 때문에 현대의 방사선치료에서 있어서 매우 중요하다. 그러나, $3cm^2$ 이하의 소조사면에 대한 선량검증은 방사선치료에서 있어서 대단한 도전이다. 소조사면의 선량검증은 (a) 측방전자균형(lateral electronic equilibrium)의 부족, (b) 급격한 선량 기울기(steep dose gradient), (c) 선원의 부분적 차폐 때문에 어렵다. 이 연구의 목적은 6 MV 광자선의 $3cm^2$ 이하의 소조사면에서 출력비율을 다양한 검출기로 측정하고 검증하는 것이다. 출력비율은 CC13 이온함, CC01 이온함, EDGE 검출기, 열발광선량계(thermoluminescence dosimeters, TLD), Gafchromic EBT2 필름을 이용하여 $0.5{\times}0.5cm^2$, $1{\times}1cm^2$, $2{\times}2cm^2$, $3{\times}3cm^2$, $5{\times}5cm^2$, $10{\times}10cm^2$의 다양한 조사면에서 측정하였다. 출력비율의 차이는 조사면의 크기가 작아질수록 검출기간의 차이는 증가하였다. 본 연구의 결과는 $3cm^2$ 이하의 소조사면의 선량측정은 CC01 이온함, EDGE 검출기와 같은 작은 크기의 방사부부피(active volume)를 가지는 검출기를 사용해야 한다는 것을 입증하였다. 또한, $3cm^2$ 이하의 소조사면에서 EDGE 검출기의 출력비율은 Gafchromic EBT2 필름의 결과와 잘 일치하였다.