• Journal of Korean Academy of Nursing
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• v.28 no.4
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• pp.1047-1059
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• 1998

Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.275-289
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• 2013

This study was conducted to investigate and analyze the dental patients' awareness and understanding about TMDs. Among the total number of 243 patients who had visited the department of dentistry of Busan Paik Hospital, Inje University or Hanvit dental hospital in Ulsan metropolitan city and participated in the survey, 195 patients who filled in all parts of the questionnaire were selected as the subjects. The results were as follows. 1. The subjects who were aware of the term, "TMDs" were 17.4%. The group with total education period of 12 years and over was significantly more aware of "TMD"(82.4%, p<0.01) than the other group. The subjects who were aware of the term, "jaw joint disease" were 81.0%. 30 to 49 age group(45.6%, p<0.05) and the group with total education period of 12 years and over(60.1%, p<0.01) were significantly more aware of "jaw joint disease" than other groups. 2. More than half of the subjects chose "overuse of the jaws" as the concept of jaw joint disease(50.6%). 3. TV, radio(41.4%) was the most frequent source of awareness about jaw joint disease followed by family and friends(20.2%), hospitals and health professionals(18.2%), internet(15.7%) and newspapers, magazines(4.5%). Among the respondents who were aware of jaw joint disease through TV, radio, 30 to 49 age group showed significantly higher percentage(52.4%, p<0.05) than other age groups. Among the respondents who were aware of jaw joint disease through internet, 18 to 29 age group showed significantly higher percentage(61.3%, p<0.01) than other age groups. Among the respondents who were aware of jaw joint disease from hospitals and health professionals, the group with total education period of 12 years and over showed significantly higher percentage(75.0%, p<0.05) than the other group. 4. Noise during mouth opening and closing(26.9%), mouth opening difficulty(25.1%) and jaw pain(13.7%) were the most frequently responded sign and symptoms of jaw joint disease. For the causes of jaw joint disease, enjoying hard food chewing(19.5%), occlusal discrepancy(19.0%) and chewing with one side only(18.5%) were responded in sequence. TMJ surgery(28%) was the most frequently responded treatment method for jaw joint disease, followed by occlusal appliance therapy(23.9%) and physical therapy(14.6%). For preventive method of jaw joint disease, avoid eating hard food(21.1%), avoid opening mouth wide(17.0%) and simultaneous using of molar of both side when chewing food(15.4%) were chosen frequently.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.101-107
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• 2010

Purpose : In evaluation of patients, laboratory results are crucial in determination of a treatment plan. Obtaining venous blood from infants and children is a difficult procedure. Substitution of a capillary blood sample for a venous blood sample has been suggested. However, there are few studies showing mutual correlation between C-reactive protein (CRP) results in capillary and venous blood. This study was designed to determine whether the result of the capillary sample is the same as the result of the venous blood sample. Methods : After informed consent, a pair of venous and fingertip capillary blood samples were simultaneously collected from 100 children. The LC-178CRPTM was used for analysis of capillary blood and the Hitachi 7180 automatic hematology analyzer was used for analysis of venous blood. We compared CRP of both venous and capillary blood samples. Results were analyzed by crosstabulation analysis, simple regression analysis and the Bland Altman Plot method. Results : A close correlation (90.63%) was observed between capillary and venous blood analyzed by crosstabulation analysis. CRP results were similar between the two groups and showed a high coefficient correlation ($\beta$=1.3434, $R^2$=0.9888, P<0.0001) when analyzed by a simple regression model. The average value in venous blood was also higher compared to capillary blood. According to Bland Altman Plot analysis, lab results were measured at a 95% confidence interval. Conclusion : CRP results from capillary blood showed close correlation with venous blood sampling. At present, venous blood sampling is the preferred method. However, due to difficulty in venous blood sampling, capillary sampling could be considered as an alternative technique for use with children.

• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.32 no.1 s.55
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• pp.45-51
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• 2006

In the field of makeup cosmetics, especially, powder-based foundations such as two-way cake, pact and face powder, the quality of which is known to be strongly influenced by the properties of powder, surface treatment technology is widely used as a method to improve the various characteristics of powder texture, wear properties, dispersion ability and so on. The two-way cake or pressed-powder foundation is one of the familiar makeup products in Asian market for deep covering and finishing purpose. In spite of the relent progress in surface modification method such as composition of powders with different characteristics and application of a diversity of coating ingredient (metal soap, amino acid, silicone and fluorine), this product possess a technical difficulty to enhance both of the adhesion power and spreadability on the skin in addition to potential claim of consumer about heavy or thick feeling. This article is covering the preparation and coating method of nano-vesicle that mimic the double-layered lipid lamellar structure existing between the corneocytes of the stratum corneum in the skin for the purpose of improving both of two important physical characteristic of two-way cake, spreadability and adhering force to skin, and obtining better affinity to skin. Nano-vesicle was prepared using the high-pressure emulsifying process of lecithin, pseudo ceramide, butylene glycol and tocopheryl acetate. This nano-sized emulsion was added to powder-dispersed aqueous phase together with bivalent metal salt solution and then the filtering and drying procedure was followed to yield the nano-vesicle coated powder. The amount of nano-vesicle coated on the powder was able to regulated by the concentration of metal salt and this novel powder showed the lower friction coefficient, more uniform condition of application and higher adhesive powder comparing with the alkyl silane treated powder from the test result of spreadability and wear properties using friction meter and air jet method. Two-wav cake containing newly developed coated powder with nano-vesicle showed the similar advantages in the frictional and adhesive characteristics.

• Pediatric Infection and Vaccine
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• v.10 no.2
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• pp.186-192
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• 2003

Purposes : Recently, acute gastroenteritis broke out among the neonates transferred from postpartum care centers located in Seoul, and Gyeounggi area. Thus, we researched the cause, progress and characters of the disease by analyzing the cases from 9 hospitals in Seoul and Gyeounggi area. Methods : We conducted retrospective study of 33 neonates transferred from postpartum care centers from October 2001 to July 2002 : we divided the neonates into 2 groups. The severe group had any of following 5 conditions : blood pH <7.20, respiratory difficulty, mechanical ventilation, shock, and disseminated intravascular coagulation. And the rest were classified into the moderate group. Results : The severe group was significantly more aged than the moderate group(P= 0.005). Weight loss was significantly severe in the severe group(P=0.0512). In blood gas analysis, bicarbonate was less in the severe group than the moderate group(P=0.032). In the virus examination, rotavirus was detected in 7 cases, and astrovirus was detected in 1 case. In the severe group, 4 neonates were dead. Conclusion : In acute gastroenteritis of neonates, early diagnosis and treatment are important. Thus, the legislation of postpartum care center is needed, and the medical specialists should be stationed in postpartum care center. We assume that the severe group had severe conditions because they were treated comparatively late. However, to find out the cause of the disease and to cope with it, the nationwide epidemiologic study on acute gastrenteritis of neonates is needed.

• Journal of Music and Human Behavior
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• v.4 no.1
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• pp.21-30
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• 2007

Unlike other common forms of speech disorder, such as phonological disorder or dysphonia, stuttering has not been studied within the context of music therapy. Most cases of stuttering display no difficulty in singing, and fluency within the musical structure does not translate to fluency in speech. Hence, musical approach has been generally considered to be ineffective to the treatment of stuttering. However, the fundamentals of music therapy assume its extensive application in treating variety of speech disorders, including the case of stuttering. Presented in this paper are the case studies designed to validate the efficacy of music therapy as a remedy for stuttering. This study enrolled 6 children with stuttering and conducted 20 individual sessions over a period of 10 weeks. The sessions focused on the Melodic Intonation Therapy, Reinforcement of speech rhythm, song writing and singing. Musical elements were structured to enhance the verbal expression and rhythmic senses, as well as to facilitate the initiation of verbal communication. The result is as follows. First, it was noticed that the disfluency had been decreased in before and after of the music therapy in every child although the result was somewhat different depending the child. The overall result of the investigation shows the significant difference statistically. And categorically speaking, the significant difference was checked in the frequency of the stuttering. In the steps of the session, the increase and decrease was happened repeatedly, and then after it was decreased little by little. Secondly, the Communication Attitude was decreased in before and after of the music therapy, and also there was significant difference statistically. although the avoidance behavior was decreased in before and after of the music therapy, the increase and the decrease was repeated irregularly in the steps of session. All the results described above shows that music therapy gives positive effect to decrease in disfluency of stuttering child and also to develop the Communication Attitude. And new possibility and effectiveness can be proposed in the musical approach to the stuttering.

• Journal of Distribution Research
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• v.15 no.5
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• pp.237-255
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• 2010

The Korean Pharmacist Law has limited the sales of medicine to pharmacies. This has caused difficulty in purchasing medicine late at night or on holidays, which has limited the range of customers' selections and accelerated customers' discomfort, accordingly. Also, the rapid progress of aging has quickly boosted medical expenses for seniors, and has served as a factor that aggravates the budget of national medical insurance. Meanwhile, advanced countries, including the USA and Japan, have allowed the sales of general medicine, of which the safety and efficacy have been tested, in general retail stores such as convenience stores or super markets from the perspective of supporting self-medication. In particular, Japan, which has a strong tendency of pursuing safety in the world, diversified sales channels for general medicine in order to control quickly rising medical expenses. As a result, Japan has achieved the effect of easing various regulations as follows in the economic and social fields. First, the increasing distribution channels of general medicine from pharmacies to general retail stores provoked a potential demand, which also expanded related markets. Second, the competition between sales channels resulted in the reduction of the price of medicine. Third, the growing sales channels of medicine have extended the options of consumers and, subsequently, the convenience in the use of consumers has increased. Fourth, the creation of a competitive environment owing to the diversification of sales channels has accelerated an effort to enhance corporate competitiveness. Fifth, the foundation of enhancing the financial soundness of medical expenses has been prepared through the formation of a self-medication environment. In 2000, the Korean population aged 65 or over exceeded 7%, and it is anticipated to be over 14% by 2018; thus, the increase of national medical expenses will be sped up. As a way of being prepared for the era of aging, we, just as other advanced countries, need to create a self-treatment environment by diversifying the sellers of general medicine, and, thus, reduce spending on personal medical expenses, enhance the financial soundness of national medical insurance, and, further, promote the welfare of consumers.

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.69-78
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• 1998

Purpose : The risk of severe tuberculous disease such as meningitis or miliary tuberculosis increases as younger is the child at the time of infection. Therefore, the early diagnosis and prompt treatment is mandatory for infants with tuberculosis. This study was undertaken to describe the epidemiology, clinical and radiographic manifestations, and response to therapy in infants with tuberculous disease. Methods : Medical records of 29 infants with tuberculosis diagnosed at the Seoul National University Children's Hospital from July, 1985, to April, 1997, were reviewed, retrospectively. A case of tuberculosis was confirmed if M. tuberculosis was isolated from any body site or if there was histologic proof of tuberculosis. Otherwise, the diagnoses were individualized considering history of contact with contagious adult case, clinical manifestations, chest X-ray findings, result of a Mantoux test reaction with 5 tuberculin unit of PPD, and the response to therapy. Results : The mean age at diagnosis was $7.00{\pm}2.65$ months (range, 3 to 12 months). Twelve cases had isolated pulmonary diseases, and the rest had pulmonary disease and meningitis, 5 cases; pulmonary disease and cervical lymphadenitis, 3; isolated meningitis, 3; and miliary tuberculosis, 6. Source case was identified in 19 cases, 7 of which were detected with retrograde manner. Twenty seven of 29 were symptomatic at their initial visit. The presenting symptoms were mainly respiratory or neurologic, and respiratory difficulty was accompanied in 7 cases. Physical examination revealed wheezing in 7 cases and decreased breath sounds in 9. Hepatomegaly or hepatosplenomegaly were frequent. Chest radiographs showed lung parenchymal disease with hilar lymphadenopathy in 18 cases, and focal or generalized emphysematous change in 7 cases. Conclusion : Most of the infants with tuberculosis are symptomatic at diagnosis, and many of infants with intrathoracic tuberculosis presented with symptoms of bronchial obstruction. When tuberculosis is suspected in an infant, the adult source case should be vigorously investigated to aid in diagnosis and for the prevention of further transmission of tuberculous disease. Almost half of infant tuberculosis are preventable if prophylaxis were given when adult cases were diagnosed.

• Journal of radiological science and technology
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• v.35 no.4
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• pp.299-308
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• 2012

To perform patient dose surveys in major interventional radiography procedures as a mean of inter-institutional comparison and of establishing reference dose levels with the ultimate goal of optimizing patient doses in the field of interventional radiography. We reviewed international patient dose survey data in the literature and measured patient dose in major interventional radiography procedures (TACE, AVF, PTBD, TFCA, GDC embolization). ESD(Entrance Skin Dose) was measured using TLD chips attached to the patient skin and ED(Effective Dose) was calculated using angiography unit-derived DAP. A survey of patient dose in interventional radiography procedures were also performed with a questionnaire for interventional radiologists and we proposed a guideline for optimizing patient doses in the field of interventional radiology. The patient dose survey data in interventional radiography procedures were very rare in literature compared with those in diagnostic radiography procedures. In TACE, the mean ED was 25.43 mSv and the mean ESD was 511.75 mGy. The mean ED of TACE was not high, but the cumulative dose should be checked, due to longer procedure TACE. In TFCA, the mean ED was 22.6 mSv and it was relatively high compared with data of other countries. In GDC embolization, the mean ED was not available, because GDC embolization was performed with old Image-Intensifier-type unit and there has no unit-installed ionization chamber. Also, the mean ESD of GDC embolization was up to 2,264 mGy and further studies are needed to calculate the net ED of GDC embolization. Patient dose occurred during interventional radiography procedures are high related with the difficulty of the procedure, fluoroscopy time, the number of angiographies and the treatment protocol. Therefore, continuous education and efforts should be made to optimize the patient dose in the field of interventional radiology.