• 제목/요약/키워드: anatomy

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A Computed Tomography-Based Anatomic Comparison of Three Different Types of C7 Posterior Fixation Techniques : Pedicle, Intralaminar, and Lateral Mass Screws

  • Jang, Woo-Young;Kim, Il-Sup;Lee, Ho-Jin;Sung, Jae-Hoon;Lee, Sang-Won;Hong, Jae-Taek
    • Journal of Korean Neurosurgical Society
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    • 제50권3호
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    • pp.166-172
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    • 2011
  • Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.

티벳의학에 대한 연구 - "사부의전(四部醫典).근본의전(根本醫典)"을 중심으로 (Study on "Four Tantras", the Prime Textbook of Tibetan Medicine)

  • 장은영;윤창열
    • 대한한의학원전학회지
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    • 제11권1호
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    • pp.416-512
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    • 1998
  • The following conclusions are obtained from the studies on the chapters concerning phisiology, pathology, daily conduct, materia medica, pulse, and urinalysis from , of the "Four Tantras". 1. The theoretical basis forming the Tibetan Medicine is the substance of phlegm, bile, and wind each of which is divided into five kinds. These phisiological substances can be transformed into pathological factors when certain environment is formed. 2. In embryology, the semen of the father and menstral blood of mother is considered the most important condition in conception, and the Five factors are regarded as important. There is a detailed explanation of development of the fetus while it stays in the womb of mother during 38weeks, such as the formation of the viscera, channels, sense organs, etc. 3. There is metaphor which compares the human body with the king's palace. With the development of human anatomy, there is the detailed anatomical picture of anterior and posterior aspects of human body. And also there is the measurement of physiological constitution and the three fluids. 4. In division of the channels, they concerned the now of the blood and distribution of the nerve fibers, and each channel is connected with one another. The division of the cannel is namely embryonic channel, channel of existence, channel of connection, and the course of life principle. 5. The seven bodily constituents and three factors of phlegm, bile, and wind are important in sustaining the life of human body as well as growth and maturization, and when their equilibrium is broken, the human body is degnerated, and finally death comes. 6. The signs of death is divided into distant sign, remote sign, certain sign. and uncertain sign, and is used as a clue in diagnosis of the disease. Especially there is a mention about the mechanism of the dreams, and different dreams according to the condition of the patient. 7. In pathology, there is the cause of the disease, the environmental factors which can induce disease, the path by which disease come into the human body, the characteristics of the disease, and the kinds of disease. 8. There is a mention about the conduct, and it is divided into the daily conduct, the mental attitude, and the side-effects which can occur when one puts up with the physiological actions of the body. 9. The daily diet is divided into food and beverage. The food is divided again into grain, meat, fat, boiled food, and spiced food, and the beverage into milk, water, and wine. 10. The pulsation should be taken in lift hand to diagnose heart, small intestine, stomach, spleen, kidney, reproductive organ, and in right hand jungs, large intestine, liver, gall bladder, kidney, and bladder. In the healthy person, the pulse moves 5times in one perspiration, and the type of pulse is constant while the pulse moves 100times. But unhealthy person's pulse is different from this. The urinalysis is the unique part of Tibetan Medicine, and is important in examination of the disease. One should decide which of the three factors are dominant by the obervation of the color, amount of the steam and how long it lasts, odour, foam, and the shape of the swirl in three different states when the urine is hot, warm, and cold. One can determine the life of the patient and which viscera is the cause of the disease by the pulse, and whether the nature of the disease is hot or cold by the urinalysis. 11. The materia medica contains gemstones, minerals, plateau medication, and meat products.

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배양된 사람 치주인대세포와 골수유래간엽줄기세포의 분화에 미치는 법랑기질유도체 (Enamel Matrix Derivative, EMD)의 영향 (EFFECT OF ENAMEL MATRIX DERIVATIVE (EMD, $EMDOGAIN^{(R)}$) ON THE DIFFERENTIATION OF CULTURED HUMAN PERIODONTAL LIGAMENT CELLS AND MESENCHYMAL STEM CELLS)

  • 박상규;주성숙;권용대;최병준;김영란;이백수
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권4호
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    • pp.281-286
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    • 2009
  • Introduction: Enamel matrix derivative (EMD) is a protein which is secreted by Hertwig root sheath and plays a major role in the formation of cementum and attachment of peridontium. Several studies have shown that EMD promoted the proliferation and differentiation of preosteoblasts, osteoblasts and periodontal ligament cells in vitro: however, reports showing the inhibition of osteogenic differentiation by EMD also existed. This study was designed to simultaneously evaluate the effect of EMD on the two cell lines (human mesenchymal stem cells: hMSC, human periodontal ligament derived fibroblasts: hPDLCs) by means of quantitative analysis of some bone related matrices (Alkaline phosphatase : ALP, osteopontin ; OPN, osteocalcin ; OC). Materials and Methods: hMSCs and hPDLCs were expanded and cells in the 4${\sim}$6 passages were adopted to use. hMSc and hPDLCs were cultured during 1,2,7, and 14 days with 0, 50 and 100 ${\mu}g/ml$ of EMD, respectively. ALP activity was assessed by SensoLyte ALP kit and expressed as values of the relative optical density. Among the matrix proteins of the bony tissue, OC and OPN were assessed and quantification of these proteins was evaluated by means of human OC immunoassay kit and human OPN assay kit, respectively. Results: ALP activity maintained without EMD at $1,2^{nd}$ day. The activity increased at $7^{th}$ day but decreased at $14^{th}$ day. EMD increased the activity at $14^{th}$ day in the hPDLCs culture. In the hMSCs, rapid decrease was noted in $7^{th}$ and $14^{th}$ days without regard to EMD concentrations. Regarding the OPN synthesis in hPDLCs, marked decrease of OPN was noted after EMD application. Gradual decrease tendency of OPN was shown over time. In hMSCs, marked decrease of OPN was also noted after EMD application. Overall concentration of OPN was relatively consistent over time than that in hPDLCs. Regarding the OC synthesis, in both of hPDLCs and hMSCs, inhibition of OC formation was noted after EMD application in the early stages but EMD exerted minimal effect at the later stages. Conclusion: In this experimental condition, EMD seemed to play an inhibitory role during the differentiation of hMSCs and hPDLCs in the context of OC and OPN formation. In the periodontium, there are many kinds of cells contributing to the regeneration of oral tissue. EMD enhanced ALP activity in hPDLCs rather than in hMSCs and this may imply that EMD has a positive effect on the differentiation of cementoblasts compared with the effect on hMSCs. The result of our research was consistent with recent studies in which the authors showed the inhibitory effect of EMD in terms of the differentiation of mineral colony forming cells in vitro. This in vitro study may not stand for all the charateristics of EMD; thus, further studies involving many other bone matrices and cellular attachment will be necessary.

백서 정중구개봉합 확대후의 CGRP 면역반응 신경섬유의 변화 (Changes in CGRP-immunoreactive Nerve Fibers during Expansion of Midpalatal Suture of the Rat)

  • 김보경;박국필;경희문;권오원;성재현
    • 대한치과교정학회지
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    • 제29권1호
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    • pp.73-81
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    • 1999
  • 측방확대장치에 의한 정중구개봉합부의 확대시 교정력은 구개부의 신경요소들에 변화를 일으키면서 동통을 유발하게 되고 구개봉합부가 확대되고 그것이 유지되는 동안에 기계적 자극에 의한 구개부신경섬유의 반응성에 변화를 일으킬 것으로 생각된다. 본 연구에서는 백서 정중구개봉합부의 CGRP 면역반응 신경섬유의 교정력 적용시간에 따른 형태학적인 반응성, 밀도, 분포변화등을 관찰하고 그와 연관된 CGRP의 기능을 알아보고자 250gm내외의 Sprague-Dawley 웅성백서 상악전치에 200gm의 치아이개력이 가해지도록 활성화시킨 helical spring을 삽입하여 정상대조군과 장치 장착후 경과시간에 따라 1일, 4일, 7일, 14일 경과군으로 나누어 정중구개봉합부를 확대후 희생시켜 면역조직화학법으로 염색하여 관찰하였다. ${\cdot}$ 대조군에서 정중구개봉합부 결합조직의 CGRP 면역양성 신경섬유는 거의 관찰되지 않았다. ${\cdot}$1일군에서는 대조군에 비해 CGRP면역반응 신경섬유가 현저한 증가를 보였으며 주로 혈관 주위에 염주알 모양의 가는 신경섬유가 관찰되었다. ${\cdot}$ 4일군에서는 CGRP면역반응 신경섬유가 대조군에 비해서는 현저한 증가를 보였으나 1일군에 비해서는 크게 증가하지 않았으며 혈관의 크기가 훨씬 확장되어 관찰되었다. ${\cdot}$ 7일군에서는 특징적으로 조골양세포가 새로이 형성된 골변연을 따라 줄지어 배열되는 독특한 양상이 관찰되었고 신경섬유의 수는 4일군에 비하여 감소하고 혈관의 직경도 감소되었다. ${\cdot}$14일군에서는 CGRP면역반응 신경섬유가 7일군과 유사한 분포를 보였으며 확대에 의한 골변연의 불규칙성도 대체로 감소되었다. CGRP면역반응 신경섬유는 정중구개봉합의 확대시 초기에 일어나는 신경원성 염증반응에 주로 관련되어 증식되는 것으로 생각된다.

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파노라마방사선사진상의 이공에 관한 연구 (A RADIOGRAPHIC STUDY OF THE POSITION AND SHAPE OF MENTAL FORAMEN IN PANORAMIC RADIOGRAPHS)

  • 최갑식;배용철;김동윤;손정익
    • 치과방사선
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    • 제27권1호
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    • pp.189-201
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    • 1997
  • 22세에서 25세의 남녀 각각 100명씩 200명을 대상으로 표준 위치에서 촬영된 파노라마 방사선사진상에서 이공의 정상적 형태 및 위치를 분석하고, 다시 남녀 각각 50명씩 100명을 선별하여 두부를 10mm 전방 이동, 10mm 후방 이동, 10° 하방 이동, 그리고 10° 상방 이동시킨 후 촬영된 각각의 파노라마 방사선사진상에서 피사체의 위치 변화에 따른 이공의 형태 및 수평, 수직적 위치의 변화를 평가하여 다음과 같은 결과를 얻었다. 1. 이 공의 형 태 는 elliptic질형 (43.3%), round 또는 oval형 (42.5%), unidentified형 (7.5%), diffuse형(6.7%)의 순으로 관찰되었다. 2. 이공이 치아에 대한 수평적 위치는 제2소구치 부위(54.2%)와 제1소구치와 제2소구치 사이 (43.1%)에서 대부분 관찰되었으며, 제2소구치와 제1대구치 사이(2.7%)의 순으로 관찰되었고, 제1소구치 부위, 견치와 제1소구치 사이, 제1대구치 부위에서는 관찰되지 않았다. 3. 이공의 수직적 위치는 치근단 하방(88.2%)에서 대부분 관찰되었으며, 치근단에 접하는 경우(9.7%), 치근단과 겹쳐 나타난 경우(1.9%), 치근단에 비해 상방에 위치하는 경우(0.2%)의 순으로 관찰되었다. 4. 피사체 두부 위치의 변화에 따른 이공의 형태 변화는 표준 위치에서 나타난 결과와 비교해 볼 때 표준 위치에서 두부를 10mm전방 이동시킨 위치에서 unidentified형(9.0%)이 증가하였고, 두부를 10mm 후방 이동시 킨 위치와 피사체의 턱을 10° 상방 이동시킨 위치에서는round 또는 oval형(57.5%, 52.5%)이 각각 증가하였으며, 피사체의 턱을 10° 하방 이동시킨 위치에서는 diffuse형(3.5%)이 감소한 것 외에는 표준 위치에서 나타난 결과와 유사하였다. 5. 피사체 두부 위치의 변화에 따른 이공의 수평적 위치의 변화는 표준 위치에서 두부를 10mm 전방 이동시킨 위치에서 제1소구치와 제2소구치 사이에 위치한 경우(35.2%)가 감소한 반면 제2소구치와 제1대구치 사이에 위치한 경우(8.8%)는 더 많이 관찰되었으며, 두부를 10mm후방 이동시킨 위치와 피사체의 턱을 10° 상방 이동시킨 위치에서는 제2소구치와 제1대구치 사이에 위치한 경우(6.1%, 7.5%)가 더 많이 관찰되었으며, 피사체의 턱을 10° 하방 이동시킨 위치에서는 표준 위치에서 나타난 결과와 유사하였다. 6. 피사체 두부 위치의 변화에 따른 이공의 수직적 위치 변화는 치근단에 비해 하방에 위치한 경우가 약 90%로 대부분이었으며, 치근단에 접하는 경우, 치근단과 겹쳐 나타난 경우의 순으로 관찰되었으며, 치근단에 비해 상방에 위치하는 경우는 관찰되지 않았다.

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돌가자미 Kareius bicoloratus의 정자형성과정 중 생식세포, Cyst 상피세포 및 간질세포의 미세구조 (Ultrastructure of Germ Cells, Cyst Epithelial Cells and Interstitial Cells during Spermatogenesis of the Stone Flounder, Kareius bicoloratus)

  • 전제천;정의영;양영철
    • 한국어류학회지
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    • 제18권4호
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    • pp.311-318
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    • 2006
  • 한국 서해안에서 채집한 돌가자미 Kareius bicoloatus의 정자형성과정 중 생식세포, Cyst 상피세포 및 간질세포들의 미세구조를 전자현미경 관찰에 의해 조사하였다. 제1차 정모세포에서 연접사복합체(synaptonemal complex)들이 성숙분열 중 전기의 쌍사기에 출현하였다. 특히, 감수분열을 위한 테스토스테론 호르몬을 분비하는 세포로 알려진 간질세포(Leydig cell)들은 제1차 정모세포 및 정세포 가까이에서 뚜렷하게 출현하였다. 포상핵을 가지는 이들 간질세포들은 소엽 간 간질조직 내의 섬유모세포들에 의해 둘러싸여 출현하였다. 특히, 이들 세포들은 타원형 또는 구상의 미토콘드리아들을 가지는데, 미토콘드리아들은 관상 크리스테(cristae)를 갖는 것이 특징이다. 또한, 활면소포체와 여러 개의 공포들도 세포질 내에서 출현하였다. 성장 발달 중인 정소 내에서 정소소엽 간 간질조직에서 나타나는 잘 발달된 간질세포들(스테로이드호르몬분비세포)은 포상의 핵과 관상 크리스테를 갖는 미토콘드리아를 가지며, 활면소체를 갖는 형태적 특징을 보였다. 정자형성과정 중, 제1차, 제2차 정모세포들은 cyst 상피세포 (Sertoli cell)들에 인접하거나 부착하여 나타났다. cyst 상피세포들의 핵은 길게 신장된 타원형 또는 삼각형의 핵을 가지며 세포질 내에 여러 개의 미토콘드리아가 출현하였다. 성장 발달 중인 정소 내에서 제2차 정모세포들과 정세포 가까이에 위치한 cyst 상피세포의 세포질 내에는 지방적, 미토콘드리아 로제트(mitochondeial rosettes)들과 글리코겐 입자들이 나타났다. 특히, 후기 성장 중인 정소 내에서 cyst 상피세포의 세포질 내에는 미토콘드리아, 소포체, 작은 지방적 및 다량의 글리코겐입자들이 출현하였다. 정세포 발달(정자변태) 후기에 기부중심립이 핵막에 부착하며, 원위중심립은 편모의 기저체를 형성하고, 편모축사를 형성하였다. 정자 첨체는 다른 경골어류에서와 같이 첨체를 형성하지 않았다. 정자 두부의 길이는 대략 $3{\mu}m$ 정도이며, 미부길이는 약 $30{\mu}m$ 정도이다. 정자 미부편모의 축사(axoneme)는 주변에 9쌍의 주변이중미세관 (nine outer doublet microtubule)이 있고 중앙에 두 개의 중앙미세관(two centrial singlet microtubules)으로 구성되어 9+2구조를 나타내었다. 본 종의 정자는 체외수정 종들이 갖는 두 개의 axonemal lateral fin을 가진다. 본 연구에서 여러 단계의 생식세포들 가까이에서 출현하는 cyst 상피세포(Sertoli cell)들은 영양공급, 식세포작용, 스테로이드형성의 3가지 기능을 나타내었다. 특히, 정소 발달단계 중 퇴화 회복기에 출현하는 cyst 상피세포들의 핵은 배정 후에는 모양이 불규칙하게 나타나며, 식세포작용을 나타내는 여러 특징들이 cyst 상피세포의 세포질 내에서 나타나고 있어, cyst 상피세포들은 배정 후 방출되지 않은 생식세포들의 퇴화 흡수에 관여하는 것으로 추정된다.

정상 마우스와 rd/rd 마우스의 망막파형 비교 (Comparison of Retinal Waveform between Normal and rd/rd Mouse)

  • 예장희;서제훈;구용숙
    • 한국의학물리학회지:의학물리
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    • 제19권3호
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    • pp.157-163
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    • 2008
  • 망막색소변성(retinitis pigmentosa: RP)과 연령관련 황반변성(age-related macular Degeneration: AMD)은 망막변성으로 인해 실명에 이르는 대표적인 질환이며 망막이식장치의 개발을 통해 치료될 수 있다고 간주되고 있다. 성공적인 망막이식장치 개발을 위하여 여러 가지 선결요소가 필요하지만 그 중 한 가지가 이식장치에 인가할 전기자극을 최적화하는 것이다. 변성망막의 전기적 특성은 정상 망막과 다르리라 예측되므로 우리는 장차 개발될 망막 이식장치에 인가할 전기자극 최적화를 위한 가이드라인을 제공하기 위해 정상 망막과 변성망막의 망막파형 차이에 관한 연구를 하였다. 망막을 분리한 후 망막절편을 신경절세포 층이 다채널전극의 표면을 향하게 하여 전극에 붙인다. In-vitro 상태에서 망막 신경절세포의 전기신호를 기록하기 위해 전극 직경: $30{\mu}m$, 전극간 거리: $200{\mu}m$, 전극 임피던스 1 kHz에서 50 $k{\Omega}$인 8행 8열의 다채널전극을 사용하였다. 생후 28일된 정상마우스(C57BL/6J 종)에서는 짧은 시간대(<2 ms)의 망막 스파이크만 기록되었다. rd/rd 마우스(C3H/HeJ 종)에서는 정상적인 스파이크뿐만 아니라 약 100 ms 의 시간대를 가지는 느린 파형이 같이 기록되었다. 우리는 rd/rd 마우스에서만 관찰되는 이 느린 파형의 기전을 알아보고자 여러 가지 시냅스억제제를 사용하였다. 이 느린 파형은 rd/rd 마우스에서 양극세포로부터 신경절세포로 들어오는 흥분성입력이 정상마우스보다 강화되었기 때문에 발생한 것으로 보인다. rd/rd 마우스에서 흥분성입력이 강화되는 여러 가능성 중에서 망막변성으로 인해 수평세포로부터 양극세포로 들어오는 억제성 입력이 소실됨으로 인해 결과적으로 양극세포로부터 신경절세포로 들어오는 흥분성입력이 강화되었을 가능성이 가장 높은 것으로 보인다.

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실크피브로인을 처리한 MC3T3-E1 조골세포 조건배양액의 파골세포 분화억제효과 (Inhibitory Effect of Conditioned Medium of Silk Fibroin-Treated Osteoblasts in Osteoclast Differentiation)

  • 여주홍;박경호;주원철;이진아;이광길;우순옥;한상미;권해용;김성수;조윤희
    • 한국식품영양과학회지
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    • 제37권8호
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    • pp.992-997
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    • 2008
  • 본 연구는 MC3T3-E1 조골전구세포에 실크피브로인 처리 시 파골세포분화 관련 국소인자 중 파골세포로의 분화를 강력히 유도하는 IL-$1{\beta}$의 발현 및 파골세포로의 분화억제에 관여하는 국소인자인 OPG의 발현변화를 조골세포 조건 배양액에서 살펴보았으며, 이 조골세포 조건배양액을 RAW264.7 파골전구세포에 처리 시 파골세포로의 분화를 억제하는지를 알아보았다. 조골세포 조건배양액에서 OPG의 발현은 농도별($0.001\;mg/mL{\sim}0.1\;mg/mL$) 실크피브로인 처리 시 $86%{\sim}100%$로 양성대조군(+C)과 유의적 차이가 없었다. 그러나 IL-$1{\beta}$의 발현은 0.1 mg/mL 실크피브로인 처리 시 양성대조군(+C)의 1.8% 수준으로 그 발현을 현저히 억제 하였다. 조골세포조건배양액을 처리한 RAW264.7 세포의 파골세포로의 분화정도는 농도 의존적으로 현저히 감소 하였다. 특히, 0.1 mg/mL의 실크피브로인을 처리한 조골세포 조건배양액 처리 시 파골세포로 분화하지 않은 음성대조군(-RANKL) 수준으로 파골세포 분화를 현저히 억제한 것은 OPG의 발현 증가가 아닌 IL-$1{\beta}$의 발현 억제에 의한 것으로 사료되며, 추후 연구를 통해 관련 기전의 연구가 필요할 것으로 생각되어진다.

임상 간호원을 위한 실무교육 과정으로서의 가족계획 (Family Planning as a Part of the Nursing-Staff In - Service Education Program)

  • 전춘영
    • 대한간호학회지
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    • 제5권1호
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    • pp.112-132
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    • 1975
  • When Korean family planning services began as a part of the National Policy in 1962, the annual population growth was 3.0%. This growth rate has been decreased to 2.0% during last ten year period. And it seems imperative that all hospitals, as well as related organizations, should participate in family planning in order to contribute to achieving the National goal of 1.5% population growth by 1976, the end of the Third Five Year Economic Development Plan. Nurses should be considered the most important human resources in charge of the core of family planning services in any setting. For the family planning services in the general hospital setting, nurses as a core members contribute much as change agent, motivators, counsellors, educators etc. A nurse can work with patients and their relatives when she is equipped with relevant knowledge and skills. Fur the more family planning cannot be ignored even in hospital setting where more comprehensive nursing care is needed Thus, the general objective of this study is to provide baseline data for better programming of In-service education in family planning so that effective hospital family planning nursing services can be made a part of comprehensive nursing care contributing to the national population program and human welfare. In order to meet the general objective, this study has the following specific objectives : 1. To find out the general characteristics of the clinical nurses working in Y Hospital 2. To evaluate their attitudes and practices of family planning 3. To assess their knowledge, attitudes and practices of population and family planning as professional nurses. 4. To examine and compare data collecting methods for the planning of an In-service Educational Program 5. To explore the contents to be included in this In-service Education Program. The study population randomly selected one hundred nurses working in Y Hospital A cross-sectional survey with questionnaires developed for this study was chosen for the study method. To collect reliable data, the questionnaires were distributed to and answered by the study population in a controlled situation. X²test and t-test was employed in analyzing the data. The findings of this study are as follows: 1. Y Hospital nurses had a lower ideal number of children (X=2.02) and showed no strong preference for male children, and 74% of them expressed the desire to use permanent methods of birth control 2. of this thirty Y Hospital nurses who were married 66.7% stated they were already practicing contraceptive methods. Most of them preferred male methods of contraception. 3. According to objective evaluation about knowledge of various aspects of population and family planning, respondents from collegiate programs significantly knew better the subjects on the average than did respondents from diploma programs of nursing. 4. There was a marked difference in the results of self-evaluation and objective evaluation in their family planning knowledge. It was found that the self-evaluation family planning knowledge seemed to be unreliable. Accordingly, the objective test methods appeared to be more reliable in the evaluation of knowledge levels. 5. The subject areas needed to be included in In-service education for the Hospital family planning services in Y Hospital are 1) rhythm methods, 2) tubal-legation, 3) family planning effects of contraceptives, 4) population growth, 5) demographic traction, 6) population structure and 7) infant mortality facts. In addition, 1) various oral contraceptives, 2) basal temperature method, 3) laparoscopic female sterilization, 4) interfering factors of family planning, 5) anatomy and physiology of the female reproductive organs were additional areas to be taught to respondents from 3-year diploma schools of nursing. Demographic transition was one subject area in which the four-year graduates need further study. 6. Population problems guidance and counselling in family planning instruction in the theory and practice of contraceptives should be included in future In-service Education Programs in order to provide more effective hospital Family Planning Services, stated 77.0% of the respondents.

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간호교육 철학정립 및 교육과정 개발을 위한 기초조사 (A Preliminary Study on Setting Philosophy and Curriculum Development in Nursing Education)

  • 정연강;김윤회;양광희;한경자;한상임
    • 대한간호학회지
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    • 제18권2호
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    • pp.162-188
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    • 1988
  • The purpose of this study is to guide the direction of the Korean nursing education to analysize ⑴ the philosophy and objectives ⑵ curriculum, and ⑶ educational environment. This analysis is based on the data from 50 nursing schools (14 4-year colleges and 35 3-year colleges) The survey was conducted from Dec. 1986 through Jan. 1987 by mail. 1) Educational philosophy and objectives 10 4-year colleges and 8 3-year college program have curricular philosoph. Most popular curricular philosophies are human beings, health, nursing, nursology, nursing education, nurses role in the present and in the future. 10 nursing schools mentioned that human being is the subject to interact with : environment physically, mentally and socially. 2 schools mentioned that health is the state of functioning well physically, mentally and socially. 13 schools mentioned that the nursing is the dynamic act to maintain and to promote the highest possible level of health. 4 schools mentioned that the nursology is an applied science. 4 schools mentioned that nursing education is the process to induce the behavioural changes based on the individual ability. There is different opinion about the nurses' role between 4-year college and 3-year college. In the responses from 4-year colleges they focus on the leadership in effective changes, self-regulating and self-determining responsibilities, applying the new technology, continuing education, and participation in research to further nursing knowledge. In the responses from 3-year colleges, they focus on the education in college, primary health care nursing, direct care provider and public health education. Among 50 respondents 40 schools have educational goals which can be divided into two categories. One is to establish the moral and the other is to develop the professionalism. 2) Curriculm The analsis of curriculum is only based on the data from the 4-year colleges because the most of 3-year colleges follow the curriculum guideline set by the Ministry of Education. a) Comparison of the credits in cultural subject and in nursing major. The average required credit for graduation is 154.6 and the median credit is the range of 140-149. The average credit of cultural subjects is 43.4. In detail, the average number of credit of required course and elective courses are 24.1 and 19.3 respectively. The average credit for major subject is 111.2. In detail, the average credit for required courses and electives course are 100.9 and 10.4 respectively. In 5 colleges, students are offered even on elective course b) Comparison of the credit by class. The average earned credits are as follows : 41.1 in freshman, 400 in sophormore 38.3 in junior and 32.4 in senior. Cultural subjects are studied in early phases. c) Comparison of the compulsory and elective cultural subject by institute. The range of credit is 7-43 in compulsory cultural subjects and there are lot of differences among institutions. While all respondents require liberal arts as compulsary subjects, few respondents lists social science, natural science and behavioral science as required subjects. Social science-related subjects are frequently chosen as cultural subjects d) Distribution of creditsin cultural subjects by institute. The liberal art subjects are taught in 20 institute. English and physical education courses are taught in all instituions. The social science subjects are taught in 15 colleges and the basic Psycology and the Basic sociology are the most popular subjects. The natural science subjects are taught in 7 colleges and Biology and Chemistry are the most popular subjects among them. e) Distribution of credits in major basic courses by institute. Most of the institutes select Anatomy, Microbiology, Physiology, biochemistry and Pathology as basic major courses. f) Comparison of the required and elective courses for nursing major by institutions. Subjects and credit ranges in major are varing by institute. More than half of the respondents select the following subjects as required major subjects. (1) Adults Health Nursing and Practice (19.5 credits) (2) Mother and Child Care and Practice (8.9 credits) (3) Community Health Care and Practice (8.5 credits) (4) Psychiatric Nursing Care and Practice (8.1 credits) (5) Nursing Management and Practice (3.9 credits) (6) Fundamental of Nursing, Nursing Research and Health Assessment and Practice. Three institutions select Introduction to nursing, Rehabilitation Nursing, School Nursing, Public Health Nursing, Nursing English, Communication, Human Development as electives in nursing major. 3) Educational environment a) Nursing institution There are forty-three 3-year colleges and seventeen 4-year colleges and 81.4% of which are private b) Number of students and faculty 19.2% of the students are in 4-year colleges and 80.8% of the students are in 3-year colleges. In 4-year colleges, the number of nursing faculty members is in the other of assistant professor, instructor and professor. In 3-year colleges, the orderiis lecturer, associate professor, full time instructor and assistant professor. In 4-year colleges, 18.8 students are allocated per nursing faculty and in 3-year colleges, 33.1 students are allocated per nursing faculty. c) Clinical practices 66.7% of the 4-year colleges practice over 1201 hours in clinic and 28.5% of 3-year colleges practice over 1201 hours in clinic. In 4-year colleges, 11.5 students are allocated per nursing faculty and in 3-year colleges,17 students are allocated per nursing faculty The survey shows no difference in the procedure between 4-year colleges and 3-year colleges but 3-year colleges choose the more variety practicing site such as special hospital and community health clinic. d) Audiovisual facilities The survey shows a lot of difference in audiovisual facilities among institution and 3-year colleges are less equipped than 4-year colleges.

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