• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• 한국컴퓨터정보학회논문지
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• 제26권1호
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• pp.239-251
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• 2021

중국의 전통의학은 자연경험학적으로 병을 치료하고 건강을 증진시켰으나, 19세기 말부터 선진국 중심으로 자연요법에 관심이 커지면서 아로마요법을 연구하게 되었다. 본 연구는 아로마요법과 관련된 선행연구들을 검색하여 증상에 따른 에센셜오일과 신체 적용부위, 사용방법, 사용기간 등을 종합적으로 분석하였다. 연구내용은 중국연구재단 검색엔진인 CNKI(www.cnki.com)과 WANFANG DATE(www.wanfang.com)의 플랫폼에서 방향요법(芳香?法)(아로마요법)과 관련된 2000년~2019년까지의 학술지 및 학회지를 검색 및 선별하였다. 선별된 논문은 5단계 질적평가와 전문가의 평가를 통해 최종 30편의 연구논문을 분석하였다. 자료는 Excel 2013 Program을 이용하여 빈도와 백분율(%)을 구하고, 도표로 나타내었다. 아로마요법 동향분석결과 30편 모두 의학계에서 연구한 논문이다. 증상별로는 불안, 초초, 불안적 증상이 13편으로 가장 많았고, 에센셜오일 종류로는 라벤더오일, 버가못 오일이 높았고, 적용부위와 방법은 코를 이용한 흡입법으로 나타났다. 증상에 따른 에센셜오일은 초조증상/우울증/산통/수면장애/편두통/긴장/수술 후/구토증 통증/피로에서 모두 라벤더가 가장 높고, 부정적 감정증상은 오렌지, 메스꺼움은 레몬, 진저, 페파민트 오일로 나타났다. 이의 결과 아로마요법이 간호미용 및 의료미용에서 환자를 대상으로 신체 적용부위, 사용방법, 사용기간이 도출되었지만, 의료인들이 간단한 적용방법으로 흡입법과 극소적인 마사지가 높았다. 그러나 진통, 산통, 긴장 등은 단기간에 효능을 볼 수 있으나, 정신신경학적인 부분은 기간을 길게 적용한다는 표준적인 근거를 제공하였다.

• 대한방사선기술학회지:방사선기술과학
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• 제38권4호
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• pp.451-461
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• 2015

MV방사선 치료는 둘러싸여 있는 정상조직의 피폭선량을 최소화 하면서, target volume 내에 정확하게 선량을 전달하는데 있어 중요한 요인이다. 본 연구에서는 방사선 치료의 높은 정확성을 유지하기 위하여 megavoltage X-ray imaging (MVI)에서 edge block 을 사용한 digital radiography (DR) system 검출기의 modulation transfer function (MTF: 변조전달함수), the noise power spectrum (NPS: 잡음전력스펙트럼) and the detective quantum efficiency (DQE: 양자검출효율)를 측정하고자 한다. 우리는 텅스텐으로 구성된 19 (thickness) ${\times}$ 10 (length) ${\times}$ 1 (width) $cm^3$의 edge block을 사용하였으며, 다음과 같은 setting들로 pre-sampling modulation transfer function (MTF)를 계산하였다: 6-megavolt (MV) energy를 사용하고, 다양한 Radiotherapy장비인 TrueBeamTM (Varian), BEAMVIEWPLUS (Siemens), iViewGT (Elekta), ClinacR iX (Varian) 를 사용하였다. MTF결과에서 Varian TrueBeamTM flattening filter free가 MTF의 50% ($mm^{-1}$)에서 0.46, 10% ($mm^{-1}$) 에서 1.40로 가장 highest value를 보였다. Noise 분포는 Elekta iViewGT가 가장 낮은 분포를 보였다. DQE에서는 E lekt a iViewGT가 peak DQE에서 0.0026 그리고 $1mm^{-1}$ DQE 에서 0.00014로 가장 높았다. 본 연구는 Edge method를 이용하여 MTF와 DQE산출을 재현하였으며, 현재 임상에서 사용되는 DR 시스템 측정의 높은 정확성을 유지할 수 있었으며 이러한 연구는 전통적인 QA 영상화뿐만 아니라 검출기 개발 연구에 있어서 정량적인 MTF, NPS, DQE 측정에 더욱 더 효율적으로 사용될 수 있다는 것을 알 수 있다.

• 대한간호
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• 제28권3호
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• pp.52-67
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• 1989

True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

• 동의생리병리학회지
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• 제23권3호
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• pp.540-547
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• 2009

There needs disease-predictable signs in order to enable preventive diagnosis and therapy. Then traditional Chinese medicine applies various medical diagnostic equipments used in western medicine to diagnosing sub-healthy state. But such data are not originated from inherent oriental medicine, and not obtained easily in ordinary clinical practice. This paper is to provide synopsis of the ante-disease diagno-therapeutics partly and to show predictable data based on the facial shapes and signs, especially of gall bladder's versus bladder's body and masculine versus feminine shape. Ante-disease means not only the complete healthy state, but also the state unseen any symptoms in macrographically in the course of outbreak of disease. It contains two stages, first one is the former state of disease and second one is untransmitted state of disease. The patterns of ante-disease consist of latent disease, pre-disease, transmission type like senescent syndrome, abnormal reactive syndrome(變證), syndrome of transmission and transmutation. The classification with gall bladder and bladder type manifests the differences of shape, color and size of each organ in comparison of the universal and standard figures of the human being. On the other hand, the classification with masculine and feminine shape contrasts the innate sexual difference and the shape, characteristics originated from in itself. These two classification theories have their own pathologic types and syndrome types with each disease so that disease-predictable data can be constructed based on such a relationship. In addition, this diagnostic method by facial shapes and signs is able to be applied to whole stages from prenatal to present state of disease even if the cause and inducement are not clear. Ante-disease diagno-theraputic system by Gall Bladder's versus Bladder's Body and Masculine versus Feminine Shape is getting more important in the chronic and internal disease in comparison of the acute and traumatic disease. So this study is able to make up for the limit of diagnosis on ante-disease in the field of oriental medicine clinic.

• 동의생리병리학회지
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• 제24권1호
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• pp.152-157
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• 2010

The aim of this study was to investigate the effects of traditional Korean medical therapy in patients with functional dyspepsia evaluted using multi-channel electrogastrography. Before the treatment, the EGG of 14 outpatients (male 3, female 11) with functional dyspepsia were recorded and their dominant frequency(DF), percentage of gastric slow waves, percentage of Power ratio, and percentage of slow wave couplings were analysed. For 8 weeks, the patients received acupuncture treatment. After 8 weeks, EGG was rechecked and compared with the previous data. After treatment, normogastria was significantly increased in channel 1 and channel 3($53.70{\pm}18.94$% vs $72.64{\pm}15.49$% in channel 1, P<0.05; $79.74{\pm}18.09$ vs $90.86{\pm}8.86$ in channel 3, P<0.05). arrythmia was significantly decreased in channel 3($14.34{\pm}15.21$ vs $5.93{\pm}6.90$, P<0.05). The patients who had less severe decrease in EGG indexes showed improvement of those indexes through 8 weeks of outpatient care. EGG channel 3 was shown to be the most adequate standard of evaluation. But there was no significant improvement in slow wave coupling rate which is a new index of multichannel EGG.

• 대한한방내과학회지
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• 제31권3호
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• pp.425-436
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• 2010

Objectives : Hypothyroidism is a relatively common endocrinologic disease, especially among older women. Western medical doctors treat hypothyroidism with levothyroxine, however there are several side effects, including thyrotoxicosis, atrial fibrillation, osteoporosis, etc. Therefore, traditional Korean medicine(TKM) offers an appealing alternative therapy for hypothyroidism. In this study, Cuscuta Semen was used to analyze its possible effect on a hypothyroidism rat model induced by propylthiouracil(PTU). Methods : 24 two-month-old Sprague-Dawley(SD) rats were divided into 4 groups: normal (n=6), PTU-induced hypothyroidism control(n=6), hypothyroidism rat treated with Cuscuta Semen (n=6), and hypothyroidism rat treated with levothyroxine(n=6). PTU was administered for 4 weeks, Cuscuta Semen and levothyroxine was administered 2 weeks after PTU was initiated for a total duration of 2 weeks. Blood samples from all the rats were taken from their hearts and analyzed. Results : When compared to the normal group, the PTU-induced control group showed significantly lower $T_4$, $T_3$ levels and significantly higher TSH level, which is indicative of hypothyroidism. The Cuscuta Semen group had significantly higher $T_4$ and significantly lower TSH than the control group(p<0.05). There was no significant difference in biochemical labs and weight between the Cuscuta Semen and control groups. Conclusions : These results suggest that Cuscuta Semen could be effective in increasing thyroid hormone production, and be powerful enough to affect the hypothalamus-pituitary-thyroid axis. Also, no adverse effects related with Cuscuta Semen were found, suggesting that it is relatively safe to administer. In conclusion, it seems that Cuscuta Semen is a safe alternative medicine for hypothyroidism.

• 대한한방내과학회지
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• 제23권1호
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• pp.123-131
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• 2002

Objective : It is well known that modern chemotherapy against cancer has side effects to a living body, especially hemopoietic and immunologial disfunctions. However, there are no effective ways to reduce them. Recently, traditional Korean herb medicine has been reported to have some biological modifying responses. Therefore, we hypothesized that additional application of herb medicine during chemotherapy is more effective to reduce its side effects. While we were studying the effects, we have observed the inhibitory effect of Soamgudamikgitang on formation of side effects derived from Cyclophosphamide, it has been used in clinical practice at Kyung Hee Medical Center. Methods : We injected 200mg/kg of Cyclophosphamide, one time, to an experimental group, consisting of ten mice. We divided them into eight groups: normal, CPX, SAKT 2mg, SAKT 10mg, SAKT 50mg, SAKT 2mg, CPX, SAKT 10mg+CPX, SAKT 50mg+CPX. We injected Soamgudamikgitang seven days, five days, three days, and one day before we injected CPX. One day, three days, and five days after CPX injection, we injected Soamgudamikgitang again and then killed all the mice. The parameters determined in this experiment were daily body weight liver and spleen weight, RBC, WBC, and platelet for hemopoietic dysfunction and AST, ALT for hepatotoxicity, BUN, creatine for renal toxcity, lymphocyte proliferation activity and lymphocyte subsets for immunological toxcity. Results : We have found that Soamgudamikgitang has inhibitory effects on the formation of Cyclophosphamide's side effects. Significant differences between the group, which contained Cyclophosphamide, and the other group, which contains Cyclophosphamide and 2, 10, 50mg of Soamgudamikgitang respectively were observed. Platelets(2mg of Soamgudamikgitang, p<0.05 ;10mg, p<0.01 ;50mg, p<0.001), liver weight(50mg, p<0.01), spleen weight(10mg, p<0.05), AST(all groups, p<0.01), ALT(2mg, p<0.01 ;10mg, p<0.05 ;50mg, p<0.01), BUN(2mg, p<0.01 ;50mg, p<0.05). Although immunological in both lymphocyte proliferation and its subsets were not observed, which shows that Soamgudamikgitang has a strong effect on T cell activities. Conclusions : From the above results, we can expect that the combined therapy of Soamgudamikgitang and Cyclophosphamide is more effective for treating cancer patients.

• 대한한방내과학회지
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• 제26권1호
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• pp.265-274
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• 2005

Diabetic gastroparesis is a disorder in a diabetic of delayed gastric emptying in the absence of mechanical obstruction. It is estimated that about 20%-50% of diabetics suffer from gastroparesis. Clinical Sympoms include early satiety, bloating, nausea, anorexia, vomiting, abdominal pain, and weight loss. Severe gastroparesis might result in recurrent hospitalization, malnutrition, and even death, but, no exact treatment has yet been established. Electrogastrography has been known to be a simple, non-invasive, and effective method in assessing gastric motility and EGG has been used to diagnosis diabetic gastroparesis and to estimate its prognosis. Recently, two cases of diabetic gastroparesis were observed. For this cases, manual acupucture, electroacupucture, lumbar skin warming and herb medicine were applied. After application of these therapies, gastrointestinal symptoms improved and these therapeutic effects were confirmed in EGG. Moreover, blood glucose control improved, so patients were able to discontinue insulin injection and change to p.o.medication. In light of this encouraging application of oriental medicine, this is reported along with investigation of the literature.

• 생명과학회지
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• 제21권10호
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• pp.1422-1427
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• 2011

한방생약제의 항혈전 및 혈소판 응집 억제 효능을 탐색하기 위하여 하고초의 물 추출물로 혈전 용해능 활성과 혈액 응고시간 지연효과 즉 PT (prothrombin time), APTT (activated partial thromboplastin time)와 혈소판 응집억제 활성 등에 대해 항혈전 효능을 평가하였다. 혈전용해도를 측정하는 fibrin plate가 용해되어 형성된 투명환의 넓이를 측정하는 실험을 진행한 결과 혈전용해도가 농도의존적으로 효능을 나타내었다. 혈액 응고 cascade에 미치는 영향을 알아보기 위해 혈액 응고 시간 지연 및 단축 효과를 확인하고자 APTT와 PT에 미치는 영향을 조사한 결과 PT의 경우 10 mg/ml, 5 mg/ml의 경우에는 대조군보다 우수한 지연효과를 보였다. APTT의 경우에는 10 mg/ml, 5 mg/ml는 대조군과 비교하여 매우 탁월한 지연효과를 보이고, 2.5 mg/ml, 1.25 mg/ml에서도 높은 지연효과를 나타냈다. 혈소판의 응집에 따라 형성되는 두 전극 사이에 형성된 전기적 저항의 변화로 나타나는 실험을 시행한 결과 하고초의 ADP와 collagen에서 뛰어난 응집억제 활성을 보였다. 따라서 위의 항혈전 효능평가 실험결과를 볼 때 하고초를 향후에 혈전 질환의 치료제 개발에 효과적으로 이용될 수 있을 것으로 사료된다.