• 제목/요약/키워드: Traditional Korean Medicine Education

검색결과 295건 처리시간 0.029초

Melittin induces autophagy to alleviate chronic renal failure in 5/6-nephrectomized rats and angiotensin II-induced damage in podocytes

  • Yufan Zhang;Huaping Xu;Hongwei Qiao;Ya Zhao;Minmin Jiang
    • Nutrition Research and Practice
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    • 제18권2호
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    • pp.210-222
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    • 2024
  • BACKGROUND/OBJECTIVES: Chronic renal failure (CRF) is a complex pathological condition that lacks a cure. Certain Chinese medicines, such as melittin, a major component in bee venom, have shown efficacy in treating CRF patients. On the other hand, the mechanisms underlying the therapeutic effects of melittin are unclear. MATERIALS/METHODS: A 5/6 nephrectomy model (5/6 Nx) of renal failure was established on rats for in vivo assays, and mouse podocyte clone 5 (MPC5) mouse podocyte cells were treated with angiotensin II (AngII) to establish an in vitro podocyte damage model. The 24-h urine protein, serum creatinine, and blood urea nitrogen levels were evaluated after one, 2, and 4 weeks. Hematoxylin and eosin staining, Masson staining, and periodic acid-Schiff staining were used to examine the pathological changes in kidney tissues. A cell counting kit 8 assay was used to assess the cell viability. Reverse transcription polymerase chain reaction and Western blot were used to assess the mRNA and protein levels in the cells, respectively. RESULTS: In the rat 5/6 Nx, melittin reduced the 24-h urinary protein excretion and the serum creatinine and blood urea nitrogen levels. Furthermore, the renal pathology was improved in the melittin-treated 5/6 Nx rats. Melittin promoted podocin, nephrin, Beclin 1, and the LC3II/LC3I ratio and inhibited phosphorylated mammalian target of rapamycin (mTOR)/mTOR in 5/6 Nx-induced rats and AngII-induced MPC5 mouse podocyte cells. Moreover, inhibiting autophagy with 3-MA weakened the effects of melittin on podocin, nephrin, and the LC3II/LC3I ratio in podocytes. CONCLUSION: Melittin may offer protection against kidney injury, probably by regulating podocyte autophagy. These results provide the theoretical basis for applying melittin in CRF therapy.

아침대체 편의식 개발을 위한 전통음식의 조리방법과 문헌고찰 I(1400년대${\sim}$1945년대 고 조리서 속 미음과 미수, 고음류 분석) (Literary Investigation and Traditional Food Cooking Methods for the Development of a Breakfast Food Substitutefood I (Analysis of Mieum, Misu, and Goeum During $1400's{\sim}1945's$))

  • 복혜자
    • 한국식품조리과학회지
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    • 제23권6호
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    • pp.987-1002
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    • 2007
  • 조선시대 고조리서와 고문헌고찰을 통한 전통음식인 미음, 미수, 고음류의 조리방법은 다음과 같다. 미음류는 쌀과 잡곡류를 섞어 조리한 미음류 7종류와 견과류에 잡곡류와 한약재료 등을 섞어 조리한 미음류는 3종류이었다. 약초 등 한약 재료에 육류, 조류, 어패류 등을 섞어 조리한 미음류는 7종류로 총 17종류의 미음과 미수, 고음류 등이 분류되었다. 세부적인 조리방법은 다음과 같다. (1) 곡류를 이용한 미음으로 쌀과 조 등은 오랫동안 끓여 즙을 내 체에 받혀 소금간을 하였고, 율무, 수수 등은 수비한 가루를 끓이거나 물에 타 먹었다. (2) 인삼 등 한약재료 등은 오래 동안 끓여 성분이 용출되면 체에 밭여 액즙을 사용하였고 고기, 뼈, 어패류 등도 함께 오랫동안 푹 끓여 체에 받혀 즙으로 만들어 수시로 음료 마시듯이 이용하였다. 갈분, 율무 등은 수비한 가루로 묽게 끓였다. (3) 고기와 어패류를 이용한 미음으로는 고기와 어패류를 함께 푹 끓여 체에 받힌 후 묵은 간장으로 간을 하였으며, 뼈, 양, 도가니 등은 함께 만화로 오랫동안 끓여 체에 밭여 즙으로 짜거나 찹쌀이나 멥쌀로 함께 끓여 섞기도 하였다. 현대인들의 바쁜 일상에 일하면서 공부하면서 바로 먹을 수 있는 식사대체음식이 요구되는바 이에 전통음식이었던 미음, 미수, 고음류의 문헌고찰과 조리방법을 1차적인 연구로 시도하였다. 또한 고 조리서 속 전통음식을 재현한 문헌을 제시하였고 조리방법도 비교하였으며 전통음식을 조리과학적으로 실험한 연구동향을 살펴보았다. 후속 연구로 전통음식을 조리과학적인 실험연구로 전체적인 성분과 조리후의 영양 손실과 잔존여부, 실온상태에서의 보존료가 첨가되지 않은 기간동안의 부패 여부 등과 조리후의 항산화성 등을 실험하고 조리후의 관능평가를 거친 후 상품으로서의 식사대체음식 개발을 위한 기초연구자료로 삼고자 한다.

지역사회개발(地域社會開發)과 기생충(寄生虫) (Community development and parasite control)

  • 임한종
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.10-21
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    • 1976
  • The traditional application of night soil to vegetable gardens and rice paddies results in a most wide spread condition of parasitism, with a variety of helminths found in Korea. In addition to the above fact, the peculiar habit of the consumption of raw vegetables, fish, crustaceans and mammals provides a means of infestations of helminths. During the last sixty years numerous reports were found on the prevalence of helminths amongst the Korean population in different parts of the country, and it was generally recognized that ascariasis, hookworm disease, filariasis, clonorchiasis and paragonimiasis constitute the important helminthic disease in Korea. In practical measures of parasite control activities the main measures are summarized as mass-treatment, night-soil disposal and transmission control. Among the three, the mass-treatment has been commonly applied, however, no reduction of transmission has been obtained by treatment of a population. Therefore, the ultimate eradication of parasites will depend upon the application of comprehensive environmental sanitation measures. The basic environmental measures will be concerned with (a) the safe disposal of human excreta, (b) the provision of adequate and safe water supplies in such a way as to promote a higher standard of personal hygiene in the population, and (c) the prevention of food contamination by faecal material. Additional environmental measures will deal with the improvement of housing and housing hygiene and with general community development. Community development means social and cultural as well as economic development. The control measures on the parasitic endemic diseases, such as clonorchiasis and paragonimiasis are the good examples for community health development in Korea. The control of Clonorchis and Paragonimus infections are theoretically very simple, as the infection can only invade the human body by way of encysted metacercaria which are taken into the body when eating passive intermediate hosts(fishes, crabs and crayfishes). Although prophylactic measures in the case of the infections deal with above merely consist the fishes in cooking or submerging in hot water before eating them, it is exceedingly difficult to carry out such simple measures in face of century old traditions, to which the relatively primitive population clings with great tenacity. There is no one universally applicable method of control. The choice of methods must be dictated by the nature of the environment. the habit and custom of the people. the pattern of transmission and the resources of the country. There must exist a well organized public health infrastructure. Since a control programme is of necessity on a longterm basis and continuity in its implementation is essential. An investigation should be made on the prevalence of the diseases and its relationships to irrigation engineering, freshwater ecology, agricultural methods, hydro-electric schemes, and the development of communities in affected areas. In conclusion, however. the control of clonorchiasis and paragonimiasis in Korea is not an impossible task. A combination of efforts with major emphasis on health education and mass chemotherapy coupled with governmental aid in enforcing legislative public health measures could reduce the diseases. Health education in particular attempts following four things: (a) It supplies a person with enough general knowledge about a disease to make the preventive measures. (b) It makes a person feel sufficiently about the importance of his own health to make him alter his behavior and adopt these preventive measure. (c) It makes him concerned for the health others. (d) It tries to make him feel so strongly about the first three that be supports and even initiates preventive action by the community. Educational efforts should be directed primarily toward school children because it is during the early years that most persons become infected, and also because children are less entrenched in their food habits so that, the educational process should be involved at various levels in successive changes of knowledge, attitude, beha viour, habit and custom of their lives. The most parasitic endemic diseases are related to community diseases. In caring for a sick community. the first stage is to gather epidemiological data, the next is to make inferences from it-to make the community diagnosis. The third is to prescribe community treatment or community health action part of a community health action programme. The community health action is the sum of the steps decided upon to remedy the critical features revealed by the community diagnosis. Action takes various forms; health education is the most important.

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보건소장의 한방진료에 대한 태도와 관련 요인 분석 (A study on the current status of oriental medical care services in health centers and implications for its expansion)

  • 류규수;김문수
    • 보건교육건강증진학회지
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    • 제18권2호
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    • pp.157-168
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    • 2001
  • Currently the oriental medical care services in the health centers is getting popularity because of their unique aspects which western medicine can not cover. This study was conducted to speculate the current status of oriental medical care services in health centers and possibility of how to effectively provide the oriental medical care services(or traditional medical care services) in health centers. For the study, the survey questionnaires were distributed to all 269 health centers and 138(51.3%) of them were collected. Eight of the collected were inadequate for the analysis and 130 of 269 questionnaires were finally chosen for the study. The SPSS/PC WIN 8.0 was used for the statistical analysis. The results are as follows. First, 91 out of 130 sample health centers(70%) are providing oriental medical care services. The results show that the willingness of the directors and the public awareness in community are the most important factors to provide oriental medical care services in health centers. In contrast, the lack of cooperative efforts between western and oriental medical doctors and the lack of government supports are considered as factors that intervene the oriental medical care services in health centers. About 80% of the sample health centers respond that the government supports is needed for oriental medical care services in health centers. Second, it was asked to the directors of 39 health centers which do not provide oriental medical care services regarding their future plan to include the services. About 70% of health centers respond that no plan is available now. They acknowledge that the demand on the services is the most important factor to consider the oriental services as their future medical services. Third, 69.2% of the oriental medical doctors in health centers are public health doctor. 95.6% of the sample health centers have space for the oriental medical care services in their facilities and some health centers provide the services through the private clinics nearby facilities. Finally, the surveyors consider both budgetary constraints and difficulty in recruiting doctors as barriers for the effective oriental medical care services in health centers. Finally, t-test and LSD were employed to find out the difference among several groups. The analysis shows statistically significant difference among groups about their recognition on health care policy, health care system, and effectiveness of oriental medical care services. To be conclude, the study shows the necessity of oriental medical care services in health centers. To do so, the government supports, cooperative efforts between oriental and western medical doctors, and providing job security for doctors should proceed to provide effective oriental medical care services in health centers.

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건강식품에 대한 소비자 인식 연구 (II) -건강식품에 관한 소비자 의식구조- (A Survey on the Consumer Attitude Toward Health Food in Korea (II) -Consumer Perception on Health Foods-)

  • 이은주;노승옥;이철호
    • 한국식생활문화학회지
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    • 제11권4호
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    • pp.487-495
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    • 1996
  • 건강식품 및 원료의 유효성분 및 위해요소 조사분석에 관한 연구의 기초조사로 건강식품에 대한 소비자의 의식조사를 실시하였다. 건강식품에 관한 이용실태 조사와 건강식품에 대한 객관적 지식정도 조사로 구성된 설문지를 이용하여 서울, 경기 지역에 거주하는 방문 및 협조가 가능한 20세 이상의 일반 소비자 1000명을 대상으로 1995년 10월부터 96년 2월에 걸쳐 직접 방문하고 설문지를 배부하여 설명한 후 조사대상자가 직접 기입하게 하는 방법으로 조사하였다. 882부를 회수(회수율 88%)하였으나 이중 불완전한 응답 23부를 제외한 859부(유효회수율 86%)를 SAS프로그램을 이용하여 통계처리하였다. 조사대상자의 사회경제적 여건에 대하여는 단순빈도와 백분율을 구하였고 교차표를 이용하여 결혼 여부, 월수입, 교육정도 등의 사회 경제적 여건과의 통계적 연관성을 파악하였다. 건강식품에 관한 이용실태 조사결과로는 응답자의 58.8%가 건강식품을 사용한 경험이 있었으며 68.2%는 건강식품의 효능을 믿는다고 응답하고 있어 건강식품에 대한 관심도가 매우 큰 것으로 나타났다. 건강식품에 대한 가장 큰 기대효과는 전체적 건강유지에 도움을 주는 것(59.8%)이라고 응답하였으며 가장 큰 부정적 견해로는 과대선전(52.1%)이라고 응답하였다. 건강식품에 대한 정보 선택 경로로는 주로 친지의 권유나 소개(30.6%)로 이용하고 있었으며 우리나라 식품법에서 건강보조식품의 등록관리사실은 63.7%가 모르고 있다고 응답하여 응답자의 과반수 이상이 건강식품의 행정적 관리사실에 무지한 것으로 나타났다. 건강식품의 등록관리 사실을 알고 있는 건강식품의 종류로는 로얄제리(22.7%), 스쿠알렌(16.0%), 정제어유(15.1%), 유산균(10.6%), 알로에(8.8%)순으로 나타났다. 건강식품과 약품(또는 한약)과의 차별인식 조사결과에서는 응답자의 84.2%가 건강식품과 한약이 다르다고 생각하면서도 가장 잘 알고있는 건강식품의 종류와 약품(또는 한약)의 종류를 묻는 두 문항에 모두 인삼(22.7%, 41.7%)을 가장 많이 응답하여 전체적으로 건강식품과 약품의 구별을 제대로 하지 못하는 것으로 나타나 이를 위한 계몽과 교육이 시급함을 알 수 있었다.

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당귀(Angelica spp.)의 기원분석에 관한 분자생물학적 연구 현황 및 향후과제 (Current status on the development of molecular markers for differentiation of the origin of Angelica spp.)

  • 이신우;이수진;한은희;신의철;조계만;김윤희
    • Journal of Plant Biotechnology
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    • 제44권1호
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    • pp.12-18
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    • 2017
  • 당귀는 우리나라를 포함하여 중국과 일본 등 아시아국가에서 유용하게 이용되는 한약재이다. 그러나 국가마다 그 기원을 달리하기 때문에 혼 오용이 심하고 국제시장에서 혼란을 불러일으킬 소지가 다분하다. 따라서 오래전부터 형태학적, 세포유전학적 분석과 지표성분을 이용한 화학적 판별 마커의 개발에 관한 연구가 많이 진행되어 왔다. 또한 최근에는 다양한 재배환경과 수확 후 가공 및 처리방법에도 비교적 안전한 유전자 단편의 염기서열 비교분석을 통한 분자생물학적 기술을 적용한 판별기술의 개발에 관한 연구결과 들이 발표되고 있다. 그러나 아직까지 이들 기술의 실용화를 통한 현장 적용에는 한계가 있으며 보다 많은 후속연구가 수행되어야 한다. 이에 본 논문에서는 현재까지의 연구결과를 바탕으로 얻어진 문제점을 논하고 향후 필요한 추가 연구 과제들에 관하여 기술하였다.

고려.조선시대의 수학과 사회 (Mathematics and Society in Koryo and Chosun)

  • 정지호
    • 한국수학교육학회지시리즈A:수학교육
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    • 제24권2호
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    • pp.48-73
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    • 1986
  • Though the tradition of Korean mathematics since the ancient time up to the 'Enlightenment Period' in the late 19th century had been under the influence of the Chinese mathematics, it strove to develop its own independent of Chinese. However, the fact that it couldn't succeed to form the independent Korean mathematics in spite of many chances under the reign of Kings Sejong, Youngjo, and Joungjo was mainly due to the use of Chinese characters by Koreans. Han-gul (Korean characters) invented by King Sejong had not been used widely as it was called and despised Un-mun and Koreans still used Chinese characters as the only 'true letters' (Jin-suh). The correlation between characters and culture was such that, if Koreans used Han-gul as their official letters, we may have different picture of Korean mathematics. It is quite interesting to note that the mathematics in the 'Enlightenment Period' changed rather smoothly into the Western mathematics at the time when Han-gul was used officially with Chinese characters. In Koryo, the mathematics existed only as a part of the Confucian refinement, not as the object of sincere study. The mathematics in Koryo inherited that of the Unified Shilla without any remarkable development of its own, and the mathematicians were the Inner Officials isolated from the outside world who maintained their positions as specialists amid the turbulence of political changes. They formed a kind of Guild, their posts becoming patrimony. The mathematics in Koryo significant in that they paved the way for that of Chosun through a few books of mathematics such as 'Sanhak-Kyemong', 'Yanghwi-Sanpup' and 'Sangmyung-Sanpup'. King Sejong was quite phenomenal in his policy of promotion of mathematics. King himself was deeply interested in the study, createing an atmosphere in which all the high ranking officials and scholars highly valued mathematics. The sudden development of mathematic culture was mainly due to the personality and capacity of king who took anyone with the mathematic talent into government service regardless of his birth and against the strong opposition of the conservative officials. However, King's view of mathematics never resulted in the true development of mathematics perse and he used it only as an official technique in the tradition way. Korean mathematics in King Sejong's reign was based upon both the natural philosophy in China and the unique geo-political reality of Korean peninsula. The reason why the mathematic culture failed to develop continually against those social background was that the mathematicians were not allowed to play the vital role in that culture, they being only the instrument for the personality or politics of the king. While the learned scholar class sometimes played the important role for the development of the mathematic culture, they often as not became an adamant barrier to it. As the society in Chosun needed the function of mathematics acutely, the mathematicians formed the settled class called Jung-in (Middle-Man). Jung-in was a unique class in Chosun and we can't find its equivalent in China or Japan. These Jung-in mathematician officials lacked tendency to publish their study, since their society was strictly exclusive and their knowledge was very limited. Though they were relatively low class, these mathematicians played very important role in Chosun society. In 'Sil-Hak (the Practical Learning) period' which began in the late 16th century, especially in the reigns of Kings Youngjo and Jungjo, which was called the Renaissance of Chosun, the ambitious policy for the development of science and technology called for. the rapid increase of he number of such technocrats as mathematics, astronomy and medicine. Amid these social changes, the Jung-in mathematicians inevitably became quite ambitious and proud. They tried to explore deeply into mathematics perse beyond the narrow limit of knowledge required for their office. Thus, in this period the mathematics developed rapidly, undergoing very important changes. The characteristic features of the mathematics in this period were: Jung-in mathematicians' active study an publication, the mathematic studies by the renowned scholars of Sil-Hak, joint works by these two classes, their approach to the Western mathematics and their effort to develop Korean mathematics. Toward the 'Enlightenment Period' in the late 19th century, the Western mathematics experienced great difficulty to take its roots in the Peninsula which had been under the strong influence of Confucian ideology and traditional Korean mathematic system. However, with King Kojong's ordinance in 1895, the traditional Korean mathematics influenced by Chinese disappeared from the history of Korean mathematics, as the school system was hanged into the Western style and the Western mathematics was adopted as the only mathematics to be taught at the Schools of various levels. Thus the 'Enlightenment Period' is the period in which Korean mathematics shifted from Chinese into European.

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간호진단 프로토콜(Protocol)의 임상적용 효과에 관한 연구 (The Effects of Clinical Application of a Nursing Diagnosis Protocol)

  • 이향련;조미영;조결자;김윤희;김귀분;김광주;문희자;박신애;강현숙
    • 대한간호학회지
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    • 제19권1호
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    • pp.40-62
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    • 1989
  • This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t=.54, df=58, p=.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t=1.93, df=154, p=.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t=6.40, df=79.90, p=.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t=1.79, df=118, p=.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t=-2.6, df=13.22, p=.02, t=2.41, df=23.85, p=.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F=5.17, df=3/153, p=.00, t= -2.39, df=154, p=,01, f=5.91, df=2/153, p=.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

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보식용 지황의 플러그 육묘 재배를 위한 적정성 평가 (Appropriateness Evaluation of Plug Seedling Cultivation for Replanting of Rehmannia glutinosa (Gaertn.) Libosch. ex Steud)

  • 이상훈;강승욱;이소희;구성철;허목;김미란;이우문;박민수;김연복;한종원
    • 한국약용작물학회지
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    • 제27권3호
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    • pp.202-207
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    • 2019
  • Background: Rehmannia glutinosa is a perennial herb belonging to the family Scrophulariaceae and is used in traditional oriental medicine. This study was conducted to evaluate the appropriateness of plug-seedling cultivation for replanting of R. glutinosa. Methods and Results: The seed rhizomes of Rehmannia glutinosa 'Jihwang 1' were harvested in the middle of March, 2018. Direct seedling cultivation was conducted after air curing for 3 days. The seedlings for transplanting were cultivated for 30 (30D), 45 (45D), and 60 days (60D). The mat formation rates of the 30D, 45D and 60D treatment seedling were 81.3%, 100%, and 100%, respectively. Of the tree treatment groups, flowering occurred only in the 45D and 60D treatment groups, and their flowering rates were $7.3{\pm}3.06%$ and $13.3{\pm}1.15%$, respectively. The agronomic characteristics and active components of the three treatment groups were evaluated in comparison with the DS1 (directly seeded group, control) and DS2 (directly seeded group, replanting) groups. As a result, the leaf length and leaf width of the 30D seedlings were higher than other treatment groups, but the number of leaves per plant was statistically the same. In addition, root diameter and yield of the 30D seedling were statistically the same as DS1. Moreover the catalpol contents of 30D, 45D, DS1 and DS2 group seedlings were 2.23%, 1.86%, 2.50% and 2.08%, respectively. Conclusions: Taken together, these findings suggest it is feasible to use the plug-seedling cultivation method for replanting of R. glutinosa. seedlings. However, further evaluation of the economic aspect is needed.

우리나라 전문간호사제도 개선방안에 관한 연구 (A Study on the Establishment of Clinical Nurse Specialist)

  • 변영순;김영임;송미숙
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.130-146
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    • 1994
  • Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

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