• 간호행정학회지
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• 제6권1호
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• pp.19-29
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• 2000

The purpose of this study was to analyze the relationship and the importance of relevant variables among structure, process, and outcome dimensions of nursing department in hospitals. The subject for this study was the registered nurses(N=400) working in medical, intensive care, and surgical units at 5 general hospitals with more than 500beds in Chungnam and Chungbuk. The research design was cross-sectional correlation among the variables based on their self description. The survey instrument was based on eleven structured questionnaires. The data were collected from April 26 to May 26, 1999. The SPSS/PC+ program and LISREL 8.12a program were used to analyze the data. Based on the data collected, the following results were obtained. The relationship among structural, procedural, and outcome dimensions 1. Structural dimension had a relationship with procedural dimension relating to decision-making of caregiving and working conditions, in particular, participation of the problem identification. 2. The extent of participation in decision-making had a relationship with organizational commitment and group effectiveness through the selection process among the total decision-making processes. 3. The structural dimension had a large direct effect rather than indirect effect through decision making processes on organizational commitment and group effectiveness. The relationship of structure, process, outcome dimensions was partially supported by this study. The information obtained from surveys in the field form the basis for the following recommendations for improving organizational effectiveness with in the nursing department in an hospitals. 1) Establishment of decentralized structure, environment, and culture in organizational settings would be desirable so that their members may actively participate in decision-making process. 2) Continuous education and training of nurses with theoretical Knowledge and skill of decision making, practical knowledge, and upright role perception should be highly emphasized for persons in nursing schools and in on-the-job training.

• 한국산학기술학회논문지
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• 제14권12호
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• pp.6403-6412
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• 2013

본 연구는 임상실습을 하는 간호학생들의 간호과정 스마트폰 애플리케이션의 사용의도를 조사하고, 이 프로그램의 적용효과를 평가하기 위해 시도되었다. 연구대상자는 대구 지역 일개의 간호대학 3학년 학생으로, 2012년 9월부터 2013년 9월까지 외과 병동 성인간호학 실습을 나가는 60명이다. 연구결과 간호과정 스마트폰 사용의도는 학습의 용이성, 사회적 영향, 자기효능감과 유의한 관계가 있었다. 그리고 대상자에게 적용된 간호과정 앱 애플리케이션은 급성통증에 대한 진단, 중재, 결과에 대한 목록이 가장 많았고, 프로그램 사용 만족도는 4.35점이었다. 이 연구결과를 통해 간호과정 앱은 임상실습 현장에서 간호과정 앱 사용에 대한 더 많은 기회와 교육을 제공하고, 그것의 활용에 관하여 손쉽게 적용될 수 있는 방안이 마련되어야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.228-236
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• 2020

Objective : It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry (BA) in the future. We are looking for answers to the questions; "How will the breasts look with respect to each other and what is the possibility of developing BA in the early follow-up period following the early surgical treatment and final fusion surgery of juvenile idiopathic scoliosis (JIS)?" For this reason, in this study, we aimed to evaluate the breast asymmetries of patients in the period after the final fusion. Methods : Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4.8 years (2-11) following final fusion. Results : In comparison, the mean volume of the left breast (222.4 mL [range, 104.1-330.2]) was larger than the mean volume of the right breast volume (214.5 mL [range, 95.2-326.7]) (p=0.034). The left breast was larger in 75% of the patients. BA was observed in 50% of the patients. No correlation was detected between the Cobb angle of the patient after final fusion and BA (p=0.688). Conclusion : In the late follow-up period, BA was detected in 50% of the patients with JIS who achieved final fusion after treatment with growing rod. In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7843-7847
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• 2014

Background: Although breast cancer (BC) is one of the most common malignant diseases in women, the majority of the studies describing the characteristics of BC in elderly patients have been limited to survival assessments or tumor features, without using younger BC patients as a reference group. The aim of our study was to describe and compare tumor characteristics and management patterns in elderly versus younger breast cancer patients in Turkey. Materials and Methods: We retrospectively analyzed 152 patients with invasive breast cancer who underwent surgery in our institution between 2002 and 2012. Patients were divided into 2 groups according to age at the time of diagnosis. Results: There were 62 patients in the elderly group (${\geq}65$ years) and 90 patients in the younger group (<65 years). Compared to the younger group, tumors in the elderly group were more likely to be larger (p=0.018), of lower grade (p=0.005), and hormone receptor-positive (p>0.001). There were no significant differences regarding histology, localization, lymph node involvement, or types of surgical procedures between the 2 groups. Comorbidities were more common in elderly patients (p<0.001). In addition, elderly patients were more likely to receive hormonal therapy (p<0.001) and less likely to receive radiotherapy (p=0.08) and chemotherapy (p=0.003). There was no difference in survival and locoregional recurrence rates between the groups. Conclusions: The results of this study demonstrate that breast cancer in elderly patients has more favorable tumor features, warranting less aggressive treatment regimens after surgery.

• 대한수의학회지
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• 제44권1호
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• pp.121-124
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• 2004

Horses that have been retired from racing or imported from abroad are retired as broodmares. Whether at private farms or government institutes they are bred to stallions with the aim of improving fertility and enhancing the breed. Accidental deaths as a result of surgical or obstetrical complications lead to decreased productivity and economic losses to the horse breeding industry. Intussusception of the uterine horn is a frequent complication of the equine and bovine species, but rarely seen in other species. The most common causes are thought to be tearing of the placenta which is suspended from the uterus and ovaries and the weight of the placenta. Expulsion of the embryonic membranes is also thought to be a contributing factor. If symptoms are minor and treatment affected quickly, the problem will likely resolve itself. In more severe cases the uterus will prolapse completely. This case study was observed in a Thoroughbred broodmare. After treatment of dystocia, the broodmare could not stand up. She became dehydrated, collapsed, suffered colic and was euthanised. In this case was observed serious swelling vulva and perineal region by morphology, and there was seldom ascites and unusual view in thoracic and abdominal cavity after opening abdomen. However, intussusception of uterine horn involuted left uterine horn into the uterine body was observed.

• 대한기계학회논문집A
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• 제35권8호
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• pp.883-888
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• 2011

복강경을 이용한 수술법은 입원 기간 단축 및 상처의 감소라는 장점이 있지만 수술 도구 끝단의 움직임의 제한으로 인한 수술 난이도의 증가라는 단점이 있다. 이를 숙련시키기 위해 동물을 이용하여 대체수술을 하거나, Surgery training tool set을 이용하여 조작 기술 습득을 위한 훈련을 하고 있다. 하지만 이 방법들은 사람에게서 느껴지는 촉감을 그대로 재현하지 못한다. 따라서 본 논문은 4-자유도계의 복강경 수술 의료 훈련 시뮬레이터를 통해 원활한 햅틱 피드백을 제공하였다. 햅틱 장비의 기본 요구조건인 무중력, 무마찰 상태를 만족시키기 위해 장비의 중력 및 마찰력을 측정하였다. 이를 위해 의료 시뮬레이터의 모델링을 하여 시술기에 작용하는 중력과 마찰력을 측정하고 이를 선형화 시킨후 이를 토대로 보상기를 모델링하고 이를 검증하였다.

• 한국정밀공학회지
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• 제29권2호
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• pp.222-228
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• 2012

Haptics and virtual reality are rapidly growing technologies in medical fields. Physicians and nurses can benefit from medical simulation via training and acquire surgical and clinical techniques. In this paper, the research on needle insertion force of biological tissue for haptic based intravenous injection simulator was carried out. We built the setup for needle insertion (intravenous injection) experiments and performed the experiments on live pigs. The force responses against needle insertion were measured using the experimental setup. In addition, the modeling of needle insertion force was carried out with the experimental results and numerical models via nonlinear least-squares method. The results presented in this paper indicate that the developed models can be applied not only to estimate the force feedback during intravenous injection procedure but also to improve the overall training quality of the medical simulator.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권3호
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• pp.260-266
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• 2023

Objective: Microvascular anastomosis, particularly side-to-side (STS) bypass, is a complex surgical procedure. While several suture techniques exist, none of them is superior to the others. We assessed the association between various STS bypass techniques and vessel twisting using chicken wing training models. Methods: Three suture techniques were compared over an anterior wall suture procedure. The unidirectional continuous suture (UCS) group used a downward "right-to-left" continuous suture. The reverse continuous suture (RCS) group used a downward "left-to-right" continuous suture. The interrupted suture (IS) group used the standard interrupted suture. The number of samples in each of the three groups was 30 (n=90). We compared the incidence of vessel twisting and rotation angles across groups. Results: Vessel twisting occurred in 96.7%, 56.7%, and 0% of the cases in the UCS, IS, and RCS groups, respectively. The incidence of vessel twisting differed significantly in all 3 groups (p<0.001), with an apparent trend (p=0.002). The mean rotation angles were 201°±90.6°, 102°±107.6°, and 0° in the UCS, IS, and RCS groups, respectively, which were significantly different (p<0.001). On excluding cases without twisting, the rotation angles of twisted vessels in the UCS and IS groups were 207.9°±83.7° and 180°±77.9°, respectively, which yielded a significant difference between these groups (p<0.001). Conclusions: We found that the incidence and trend of vessel twisting differed significantly across suture techniques. The RCS technique may aid in preventing vessel twisting in the STS bypass procedure.

• 한국컴퓨터그래픽스학회논문지
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• 제15권3호
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• pp.1-9
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• 2009

최근 역감, 촉감 피드백을 생성할 수 있고 3 차원 상호작용이 가능한 컴퓨터 인터페이스 기술이 발전하면서 기존의 입출력 장치에 의존하던 컴퓨터 시뮬레이션의 한계가 줄어들어 그 종류가 다양해지고 있다. 특히, 가상현실 기반 수술 시뮬레이터의 수요가 증가 하면서 사실적인 가상환경을 제공하는 방법에 관련된 연구가 활발히 진행 되고 있으며 그 중에서 가상 장기 모델의 사실적인 표현 기술은 사용자의 몰입감을 높여주는데 중요한 역할을 하기 때문에 반드시 필요한 분야이다. 가상 장기 모델의 사실성을 높이기 위해서는 사용자의 상호작용에 따라 변형되는 시각적 피드백과 알맞은 햅틱 피드백을 전달해야한다. 본 연구에서는 이 두 가지 피드백은 사람이 인지하는 방법과 시스템의 요구 사항이 다르기 때문에 보다 효과적인 시뮬레이션을 하기 위하여 서로 다른 두 모델을 구현하고 두 모델간의 동기화를 위한 기술로써 적응성 질량-스프링 모델 기법을 제안한다. 또한, 유연체 변형에 대하여 표면의 세부 형태를 보여주는 시각모델과 사용자의 상호작용에 따른 햅틱 피드백을 전달하는 햅틱 모델, 그리고 이 두개의 모델을 연동시키는 동기화 모델을 통하여 유연체의 거동을 실시간, 사실적으로 제공할 수 있는 가변형 모델 시뮬레이션 프레임워크를 설계한다.

• 대한간호학회지
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• 제20권3호
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• pp.368-380
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• 1990

A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to form a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of a standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalize patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were “PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE”. 2. The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to the condition, recording pattern, desired outcomes and nursing orders (nursing interventions). 3. The plan was used with hospitalized patients on medical - surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it is recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.