• 대한간호학회지
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• 제23권3호
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• pp.377-398
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• 1993

A survey of infant practices was conducted to provide information on which to base planned nursing interventions. The subjects were a convenience sample of 168 mothers visiting out - patients departments of five general hospitals and one public health center in Seoul for immunizations or treatment for common colds for their infants from two to 12 months of age. Data collection was carried out from July 8th to September 30th, 1991 using a questionnaire of 84 questions, 31 on the type of feeding, 22 on supplementary feeding and 21 on demographic infer mation. The results are summarized as follows : 1) The type of feeding was primarily artificial feed-ing (63.1%), followed by mixed feeding (22%) and breast feeding (14.9%) of the 59 mothers expecting during pregnancy to breast feed, 54. 2% changed artificial feeding and 30.5% went on to breast feed as they had expected. For mothers expecting to continue breast feeding over seven months. only one infant was being breast fed for over seven months. 2) For the 106 mothers using artificial feeding, 70. 8% hed attempted breast feeding, 64% of them for less than a month. Breast milk had been suppressed by for medication (38.7%) : 34.9% had used no specia] means. 3) The major reasons for replacing breast feeding with artificial feeding were the infants' demand for more milk (47.2% ) and insufficient supply of breast milk (49.3％). 4) Most mixed feeding was started at the age of one to three months (59.5%). Only 34.4% gave an artificial feeding after breast feeding : most (46%) alternated breast feeding with artificial feeding. On the whole, the motive for mixed feeding was the lack of breast milk (70.3%). 5) Many mothers (81.8%) were adding vitamin or mineral supplements to artificial milk and 51.5% were adding something to faciliate digestion. As for the method of sterilizing milk bottles and nipples, 56% had sterilized them together in boiling water from the beginning : 27% were just washing the bottles after boiling only once initially when measuring artificial milk powder, 31. 5% of the mothers over filled the measuring spoon rather than to the level. 6) The mother's occupation was related to her way of feeding. Mothers at home full time did more breast feeding than mothers employed outside the home. (x²=5.72, p=〈0.05). 7) Most mothers began supplementary food, from three to four months (48.8%) : 11.2% began later than seven months. Supplementary food was given between milk feedings by 67.2% of the mothers : 19.2% gave it before a milk feeding. Some mothers(26.4%) made their own supplementary food : 19.2% used ready - made supplementary food products for convenience. Recommendations for nursing interventions included : 1. Prenatal education about the advantages of breast feeding and breast care, and home visits after delivery for counselling related to breast feeding. Correct preparation of artificial feeding methods need to be taught in both pre & postnatal periods. In addition, specific education about supplementary feeding needed. 2. Further research is indicated about the Perceived lack of supply of breast milk and about the effectiveness of nursing interventions to Promote breast feeding.

• Child Health Nursing Research
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• 제3권2호
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• pp.178-189
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• 1997

This study was done to compare the breast-feeding primiparas' perceptions of their babies with bottle-feeding primiparas' at 2-3 days after delivery. The subjects of this study included 42 breast-feeding mothers and 56 bottle-feeding mothers. Data were collected by using the Neonatal Perception Inventory(NPI) devised by Broussard (1963) and added by Lee, Ja Hyung(1986) from December, 1996 to June, 1997. The results of this study are as follows, 1. Primiparas' perceptions of their babies according to their general characteristics. 1) There was no significant difference in mothers' perceptions according to mothers' age and whether they have a job or not. 2) There was a difference in mothers' perceptions according to their educational level (P<0.1). 2. The comparisons of breast-feeding mothers' perceptions of their babies with bottle-feeding mothers'. 1) There was no significant difference in the two groups' perceptions of other babies 2) There was no significant difference in the two groups' perceptions of their own babies. (1) Breast-feeding mothes' general perceptions of their own babies were better than bottle-feeding mothers', but there was no significant difference between the two groups. (2) Breast-feeding mothers' perceptions about the basic needs of their own babies were better than bottle-feeding mothers', and there was a significant difference between the two groups (P<0.05). (3) Breast-feeding mothers'perceptions about the sense and motor abilities of their own babies were better than bottle-feeding mothers', but there was no significant difference between the two groups. (4) Breast-feeding mothers' perceptions about the necessary care of their own babies were lower than bottle-feeding mothers', but there was no significant difference between the two groups. 3) There was no significant difference between the two groups' positive-negative perceptions of their babies (1) 69% of breast-feeding mothers and 69.9% of bottle-feeding mothers had positive perceptions about general conditions, but there was no significant difference between the two groups (2) 57.1% of breast-feeding mothers and 46.4% of bottle-feeding mothers had positive perceptions about the needs of babies, but there was no significant difference between the two groups. (3) 50% of breast -feeding mothers and 48.2% of bottle-feeding mothers had positive perceptions about the sense and motor abilities of babies, but there was no significant difference between the two groups. (4) 57.1% of breast-feeding mothers and 60.7% of bottle-feeding mothers had positive perceptions about the necessary care for babies, but there was no significant difference between the two groups. 3. 54.8% of breast-feeding mothers tried to feed their own babies on the 1st day after delivery. 83.3% of breast-feeding mothers chose the feeding method for themselves. Only 9.5% of breast-feeding mothers took recomendations for breast-feeding from nurses. 78.6% of breast-feeding mothers had no chance to learn about breast-feeding. 69% of breast-feeding mothers complained about the difficulties of breast-feeding. The most serious problems were : 'insufficient milk supply', 'lack of knowledge about feeding technique' and 'problems with nipples'.

• 사상체질의학회지
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• 제4권1호
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• pp.107-148
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• 1992

The definitions of Four Constitution (Tae-Yang-In, So-Yang-In, Tae-Eum-In, So-Eum-In) in Four-Beginning-Theory (四端論) and Distribution-Theory (擴充論) were morphologically diagrammatized. the method of measuring the five parts came from the diagrams. The five parts are the followings; Top-Line is the distance between Rt. & Lt.Shoulders. Bosom-Line is the horizontal distance passing through the Rt. & Lt.nipples. Stomach-Line is the horizontal distance passing through the Rt. & Lt. acupuncture point Bool-Yong (不容穴). Navel-Line is the horizontal distance passing through the navel. Bottom-Line is the distance between the Rt.& Lt. anterior superior iliac spines. According to it, 311 people were measured in the clinic. Through the measured numerical values, to find out the objective propriety of the morphological diagrammings and the discriminating ability of Four Constitutions by the method of measuring the five, the author tried this study and got the following results. 1. On the ground of the Internal Organs-Theory (臟腑論), the definitions of Four Constitutions were classified and diagrammatized step by step and it was possible to draw the morphological graphs satisfying the reasonable condition objectively. 2. It was found that the graphings by Mean, Standard Deviation and 95% Confidence Interval for mean of the numerical values of five measured parts and the morphological diagrammings of the definitions in Four-Beginning Theory and Distribution-Theory drove to the same figures. 3. Through the method of the Analysis of variance and the Discriminant Analysis, it was discovered that the measured numerical values of five parts could distinguish the Four Constitutions. 4. Tae-Yang-In has the longest Top-Line and the shortest Bottom-Line. The Mean head of Confidence Interval from Top to Bottom is downwardly decreased at the rate of 3.7, 1.5, 1.8, 3.4. 5. So-Yang-In has the longest Top-Line and the shortest Bottom-Line. The Mean head of confidence Interval from Top to Bottom is downwardly decreased at the rate of 2.3, 1.5, 1.5, 1.1. 6. Tae-Eum-In has the longest Navel-Line. The Mean head of Confidence Interval from Navel to Top is upwardly decreased at the rate of 0.5, 0.4, 2.5 and downwardly decreased at the rate of 2.7 between Navel and Bottom. 7. So-Eum-In has the longest Bottom-Line. The Mean head of Confidence Interval from Bottom to Top is upwardly decreased at the rate of 1.1, 1.1, 1.8, 2.3. From the above findings, it was possible to draw the morphological graphings satisfying the objectively reasonable conditions in the definitions of Four-Beginning-Theory and Distribution-Theory and it was proved that the results of the Positive Analysis, carried with the measured numerical values of five parts from the diagramming, could show the objective propriety of the morphological graphings and the discerning ability of Four Constitutions by the method of measuring the five parts.

• Archives of Plastic Surgery
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• 제45권3호
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• pp.229-238
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• 2018

Background Nipple-sparing mastectomies (NSMs) are increasingly performed to obtain the best aesthetic and psychological outcomes in breast cancer treatment. However, merely preserving the nipple-areolar complex (NAC) does not guarantee a good outcome. Darkly pigmented NACs and a tendency for poor scarring outcomes are particular challenges when treating Asian patients. Herein, we review the reconstructive outcomes following NSM at Singapore General Hospital. Methods All breasts reconstructed following NSM over an 11-year period from 2005 to 2015 were reviewed. Information was collected from the patients' records on mastectomy indications, operative details, and complications. Patient satisfaction, breast sensation, and aesthetic outcomes were evaluated in 15 patients. Sensation was quantified using the Semmes-Weinstein monofilament test. Results A total of 142 NSMs were performed in 133 patients for breast cancer (n=122, 85.9%) or risk reduction (n=20, 14.1%). Of the procedures, 114 (80.2%) were autologous reconstructions, while 27 (19.0%) were reconstructions with implants. Complications occurred in 28 breasts (19.7%), with the most common complication being NAC necrosis, which occurred in 17 breasts (12.0%). Four breasts (2.8%) had total NAC necrosis. The overall mean patient satisfaction score was 3.0 (good). The sensation scores were significantly diminished in the skin envelope, areola, and nipple of breasts that had undergone NSM compared to non-operated breasts (P<0.05). Half of the subset of 15 patients in whom aesthetic outcomes were evaluated had reduced nipple projection. Conclusions Immediate reconstruction after NSM was performed with a low complication rate in this series, predominantly through autologous reconstruction. Patients should be informed of potential drawbacks, including NAC necrosis, reduced nipple projection, and diminished sensation.

• 한국식품위생안전성학회지
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• 제32권2호
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• pp.114-122
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• 2017

본 연구에서는 식품을 용기 포장 채로 조리하는 경우 니트로사민의 함량이 증가하는 사례에서 용기 포장에서의 니트로사민이 용출되는지 확인하였다. 조리를 할 수 있는 용기 포장 31종에 대해 각 식품 유형별로 침출용매를 선택하여 단면용출시험을 진행하였다. 용출 시험을 진행한 결과, 용기 포장에서는 NDMA, NDEA, NDBA가 모두 정량 한계 미만으로만 검출되었다. 따라서 용기 포장물질에서 침출용매로의 용출은 미미하였고 침출용매가 아닌 특정 식품에 의한 차이가 있는지 확인하고자 하였다. 토마토소스를 제외한 레토르트 시료는 조리 전과 후의 유의적인 함량 차이가 없었으며 컵라면 시료의 경우는 모든 시료에서 조리 전 NDMA가 불검출되었지만 조리 후 NDMA 함량이 trace${\sim}0.93{\mu}g/kg$로 검출되었다. 컵라면의 NDMA 함량 증가 원인을 파악하기 위해 구성요소인 면, 분말스프, 건더기스프, 물을 면밀히 검토하였다. 그 결과, 면과 분말스프를 조합하여 조리한 경우에만 NDMA가 생성되었으며 폴리스티렌 제품의 경우 모든 구성요소를 함께 조리할 때보다는 NDMA 함량이 적게 검출되었다. 따라서 컵라면 시료는 면과 분말스프 내의 니트로사민 전구체가 NDMA 생성에 기여하는 것으로 추정되며 건더기스프도 NDMA 함량 증가에 기여하는 것으로 보였다. 따라서 각 구성요소 내의 전구체에 대한 검토가 필요하며 조리 중 가열에 따른 반응을 검토하는 후속연구가 필요할 것으로 추정된다.

• 대한방사선치료학회지
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• 제24권2호
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• pp.107-114
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• 2012

목 적: 기존의 광자선을 이용한 선형가속기와는 달리, 양성자 치료의 경우 물질과의 상호작용으로 발생되는 중성자를 비롯한 여러 핵종 등으로 인해 다량의 이차방사선이 생성되기 때문에 방사선 작업 종사자의 피폭은 더욱 주의 깊은 관심이 필요하다. 이에 방사선 측정 시에 널리 이용되고 있는 열형광선량계를 이용하여 방사선 작업 종사자의 피폭정도를 평가하고 이를 토대로 양성자 치료 시 방사선 피폭선량에 관한 기초 자료를 제시하고자 한다. 대상 및 방법: 본원의 양성자 치료실에서 근무한 방사선 작업 종사자를 대상으로 열형광선량계 뱃지를 이용해 피폭현황을 측정한 데이터를 비교했다. 양성자의 빔 라인 주변에서 발생하는 이차방사선의 신체부위별 피폭선량 분포를 알아보고자 신체부위(외안각, 목, 유두점, 배꼽, 등, 손목)에 가로, 세로가 각각 3 mm인 정사각형 모양의 열형광선량계를 부착하여 일일 8시간의 근무시간동안 유지하도록 하였고 총 80시간 측정하여 평균 데이터를 얻었다. 그리고 치료실 내 공간적인 방사선량의 분포를 보기 위하여 빔 사출구, PPS (Patient Positioning System), Pendant, 차폐체보관장, DIPS (Digital Image Positioning System) Console, 출입통로에 각각 열형광선랑계를 부착하고 일일 근무시간 동안의 평균 방사선량을 측정하였다. 결 과: 방사선 작업 종사자의 열형광선량계 뱃지로 측정된 피폭량을 조사한 결과 분기별 평균 0.174 mSv, 연평균 0.543 mSv로 나타났고 신체부위별로 측정한 결과에서 가장 많은 피폭량을 보인 곳은 목이였으며 가장 적은 피폭량을 보인 곳은 등(양견갑골 상각을 이은 선의 중간 지점)으로 나타났다. 작업 동선에 따른 공간적 방사선량을 알아본 결과에서는 빔 사출구 근처에서 상대적으로 높게 나타났고 거리가 멀어짐에 따라 줄어들었다. 결 론: 적은 양의 피폭일지라도 동일 장소에서 장기 근무하게 되면 피폭 누적량은 증가할 수밖에 없고 특정 부위의 누적량은 건강상의 위험을 가져다 줄 수도 있다. 그러므로 국제 방사선 방어 위원회가 권고하는 ALARA의 원칙에 따라 가능한 합리적으로 감소시킬 수 있도록 스스로 개인별 피폭관리에 철저를 기하고 피폭을 최소화시키는데 최선의 노력을 다해야 할 것이다.

• Radiation Oncology Journal
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• 제19권1호
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• pp.21-26
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• 2001

목적 : 보존적수술 후 방사선치료를 받은 유방암 환자를 대상으로 한국인에서의 조기 유방암의 보존적치료의 전반적인 미용적 결과와 유방의 대칭성 및 이에 영향을 미치는 인자들을 분석을 위하여 본 연구를 시행하였다. 대상 및 방법 : 1992년 2월부터 1997년 1월까지 조기유방암으로 보존적수술 후 서울대학교병원 치료방사선과에서 방사선치료를 시행 받은 120명의 환자를 대상으로 하였다. 대상 환자들의 추적관찰 기간은 16개월에서 74개월로 중앙값은 33개월이었다. 유방보존수술은 사분위절제술 및 액와림프절절제술 108례, 종양절제술 및 액와림프절절제술 4례, 종양절제술 2례, 전절제 생검술 4례, 피하유방절제술 및 액와림프절 절제술이 2례였다. 수술 후 방사선치료는 4 MV, 6 MV 또는 10 MV X 선을 이용하여 1 일 1.8 Gy 씩 50.4 Gy를 유방전체에 접선조사야로 조사한 후 원발부위에 7 또는 9 MeV 전자선으로 1일 2 Gy 씩 10 Gy를 추가조사하였으며 21례에서 액와림프절과 쇄골상 림프절을, 9례에서 액와림프절, 쇄골상림프절, 내유림프절을 치료범위에 포함하였다. 항암화학요법은 총 46례에서 시행하였으며, 45례에서 CMF (cyclophosphamide, methotrexate, 5-fluorouracil) 복합요법 6회를, 1례에서 CAF (cyclophosphamide, doxorublcin, 5-fluorouracil) 복합요법 12회를 시행하였다. 전반적인 미용적 결과는 유방의 부종(edema), 수축(retraction), 상승(elevation), 섬유화(fibrosis), 경화(induration) 및 피부변화 등을 고려하여 excellent, good, fair, poor 의 4 단계로 평가하였으며, 유방의 대칭성의 판정을 위하여 symmetry index를 사용하였다 전반적인 미용적 결과의 비교 및 분석을 위하여 polytomous logistic regression 방법을 사용하였고, 유방의 대칭성 평가를 위해 logistic regression 방법을 사용하였다. 결과 : 최종 추적관찰 시 전반적인 미용적 결과는 excellent가 29명$(24\%)$, good 62명$(52\%)$, fair 23명$(19\%)$, poor가 6명$(5\%)$으로 $76\%$의 환자에서 good 이상의 결과를 보였다. 단변량분석 상 종양의 크기가 2 cm 이하인 경우 (p=0.04), 림프절 전이가 없는 경우(p:0.0002), 종양 절제술 또는 전절제생검술을 시행한 경우 (p=0.02), 방사선치료의 범위에 액와림프절이 포함되지 않은 경우(p=0.0005), 항암화학요법을 시행하지 않은 경우(p=0.0001) 더 좋은 미용적 결과를 보였다. 다변량분석 상 종양절제술 또는 전절제생검만을 시행한 경우(p=0.04), 항암화학요법을 시행하지 않은 경우(p=0.0002)에 더 좋은 미용적 결과를 보였다. 유방의 대칭성에 영향을 미치는 요인으로는 단변량분석 상 종양의 크기가 2 cm 이하인 경우(p=0.0007), 림프절 전이가 없는 경우(p=0.005), 항암화학요법을 시행하지 않은 경우 (p=0.001), 방사선치료의 범위에 액와림프절이 포함되지 않은 경우(p=0.02) 에 더 좋은 유방의 대칭성을 보였으며 종양절제술 또는 전절제생검만을 시행한 경우(p=0.09) 대칭성이 높은 경향을 보였다. 다변량분석 상으로는 종양의 크기가 2 cm 이하인 경우(p=0.003), 림프절 전이가 없는 경우(p=0.007) 더 좋은 유방의 대칭성을 보였다. 결론 : 조기유방암에서의 보존적수술 및 방사선치료는 $76\%$의 환자에서 good 이상의 미용적 결과를 보였다. 또한 대상 환자 중 종양의 크기가 작은 경우, 액와림프절 전이가 없는 경우 및 수술의 범위가 작은 경우 미용적 결과가 더 우수함을 확인할 수 있었다.