• 대한간호학회지
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• 제47권1호
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• pp.14-24
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• 2017

Purpose: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. Methods: Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. Results: The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (${\beta}=.84$), hope and cognitive illness representation (${\beta}=.37$ and ${\beta}=.27$) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. Conclusion: This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• Korea-Australia Rheology Journal
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• 제17권3호
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• pp.117-123
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• 2005

Background: Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day­to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. Methods: We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemo-dialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. Results: We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy: control (P = 0.0001). Conclusions: The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.

• Journal of Pharmaceutical Investigation
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• 제39권5호
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• pp.359-366
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• 2009

In this study, paclitaxel-loaded lipid nanosuspension (PxLN) was prepared and the in vivo profiles after intravenous administration in rats were investigated. We compared the manufacturing processes depending on the temperature: PxLN-H for a hot homogenization process and PxLN-C for solidification of lipid-drug mixtures by liquid nitrogen. Both formulations showed submicron size distribution and the similar drug loading efficiency of about 70%. In vitro release of PxLNs and Taxol$^{(R)}$ performed by a dialysis diffusion method showed similar pattern for PxLN-H and Taxol$^{(R)}$, but the reduced release profile for PxLN-C. PxLN or Taxol$^{(R)}$ was intravenously administered to the rats at a dose of 5 mg/kg as paclitaxel. The drug in blood samples were assayed by the HPLC/MS/MS method. The AUC$_t$ of PxLN-H was 3.4-fold greater than that of Taxol$^{(R)}$. PxLN-H gave higher biodistribution in all tissues than did Taxol$^{(R)}$. In addition, it maintained the higher drug concentration for 12 h. This lipid nanosuspension might be a promising candidate for an alternative formulation for the parenteral delivery of poorly water-soluble paclitaxel.

• Korean Journal of Acupuncture
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• 제22권2호
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• pp.127-149
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• 2005

This study is designed to investigate the method of manufacturing herbal acupuncture through literature of oriental medicine. The findings of this study are as follows; 1. The methods of manufacturing herbal acupuncture go through the process of abstraction, purification, mixing, filtration, putting and tight sealing in the container, sterilization, quality control, printing and packing 2. There are many ways to manufacturing herbal acupuncture, for example water-alcohol precipitation, alcohol-water precipitation, liquid-liquid abstract, acid-base abstract, metal base precipitation, distillation, molecular structure, polyamide absorption, dialysis, and ion exchange, etc. And popular method is water-alcohol precipitation. This is through alcohol precipitate extracting the principal ingredients from water abstraction. This is very simple and efficient way using melting characteristics of compounds in herb to water and ethanol. 3. Sterilization of herbal acupuncture is through heating-pressure, boiling, steam flowing, low temperature, filtering, radiation, cooling, and microwaves. Nowadays filtering is commonly used. And sterilization is estimated by an examination of asepsis . 4. Herbal acupuncture must be undergo study and experiment to clinical use. The problems of herbal acupuncture are turbidity, instability, causing hemolysis, pain, and fever. So many provisions (addition, sterilization, and filtration etc.) must be prepared. 5. The theory of manufacturing herbal acupuncture is from oriental medicine, not western. So it must be corresponded to oriental medical theory, for example Gimi(氣味), Guigyung(歸經), Ingyung(引經), Bosa(補瀉), and Match of Herb. It is recommended that further study of many other sided investigations in the future.

• 근관절건강학회지
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• 제30권3호
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• pp.157-167
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• 2023

Purpose: The purpose of this study was to measure the relationship among activities of daily living, ego integrity, social support and the compliance of patient-role behavior in elderly patients receiving hemodialysis, including the effect of these variables on the compliance of patient-role behavior. Methods: A descriptive survey was conducted with 150 elderly patients over 65 years of age who were also receiving hemodialysis. Data was collected from September 28 to November 13, 2021 and analyzed using t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analysis with SPSS/WIN 26.0. Results: The results show that patient compliance had significant correlations with ego integrity (r=.63, p<.001) and social support (r=.28, p=.001). The other factors influencing patient compliance were the sub-domains of ego integrity, such as the acceptance of the past and the presence (β=.46, p<.001) and attitudes toward life (β=.26 p<.001), with an explanatory power of approximately 35.0% (F=17.21, p<.001). Conclusion: This study confirms that the ego integrity of elderly patients receiving hemodialysis has an effect on the compliance of patient role behavior. Nursing intervention programs that improve the ego integrity of elderly hemodialysis patients could help improve the compliance of patient-role behavior, which is an important factor in the disease management process.

• Applied Biological Chemistry
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• 제48권4호
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• pp.382-387
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• 2005

본 연구는 게르마늄 강화 효모의 제조 공정을 위한 최적의 조건을 잡고 제조된 게르마늄 강화 효모 내의 게르마늄의 결합 상태 확인을 목적으로 하였으며, 그 결과는 다음과 같다. 균체와 게르마늄 용액 혼합 비율 1 : 0.5(50%)로 하여 균체와 게르마늄 배양시 최적 조건인 pH 6.5, 온도 $35^{\circ}C$ 그리고 배양 시간은 20시간 배양하는 것이 높은 함량의 게르마늄을 효모 균체 내로 유입시켜 게르마늄 강화 효모를 생산하였으며, 이의 배양 과정을 통해 생산된 게르마늄 강화 효모는 배양 과정 동안의 구조적 변화에 의해 효모 내에 유입된 무기 형태인 $GeO_2$ 게르마늄과는 다른 구조를 형성하고 있었다. 또한 NMR 및 FTIR 실험을 실시한 결과 게르마늄 강화 효모의 발효 과정에 첨가한 무기 형태의 $GeO_2$가 배양 과정 동안 균체 내에서 게르마늄이 유입되는 과정에서 게르마늄이 단백질(혹은 펩타이드)과 결합하여 구조에 변화를 형성하였으며, 인공위액 안에서 투석막을 이용한 투석 전후에 따른 게르마늄 총량에서 투석 전후에 따른 차이가 나타나지 않았다. 따라서 게르마늄 강화 효모는 생합성 기법을 이용하여 게르마늄을 강화한 유기 게르마늄 생산방법으로 배양 과정을 통해 구조적으로 안전한 유기 게르마늄을 형성하여 인공위액 조건에서도 해리되지 않는 것으로 보여지며, 각종 암, 성인병의 예방과 치료, 인체 면역력의 증진 등 건강 증진을 위한 새로운 기능성 원료로의 활용이 기대되며, 이에 대한 지속적인 연구가 사료된다.

• 한국산림과학회지
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• 제35권1호
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• pp.24-32
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• 1977

아염소산염법(亞鹽素酸鹽法)에 의하여 대부분(大部分) 탈(脫) lignin된 holocellulose를 얻었다. Alkali농도별(濃度別)의 추출(抽出)에서는 5% KOH로 3회추출(回抽出)하여도 일부(一部)의 xylan이 잔존(殘存)하며 타(他)의 hemicellulose와 cellulose의 분해성물질(分解生成物)이 얻어지며, 10%와 24% KOH추출(抽出)은 그와 같이 좋은 결과(結果)가 얻어졌다. Xylan의 침전단리(沈澱單離)에 다량(多量)의 ethanol을 사용(使用)하는 상법(常法)보다는 약(約) 1/10로 농축(濃縮)하여 cellophane막(膜)에 의한 투석법(透析法)으로 소량(少量)의 ethanol이라도 회수율(回收率)과 높은 순도(純度)의 xylan이 얻어졌다. Glucornannan의 단리(單離)에 있어서 5% KOH 추출잔사(抽出殘査)는 xyJan함유량(含有量)이 많고 10%와 24% KOH 추출잔사(抽出殘査)는 그의 같은 결과(結果)이며, glucose와 mannose의 비(比)는 약(約) 1 : 1이다. Fehling용액정제(溶液精製)는 비교적(比較的) 순수(純粹)한 xylan을 얻지만, 분화분해(孵化分解), 조작(操作)의 번잡(煩雜) 및 회수율(回收率)이 낫고, 그다지 좋은 방법(方法)은 아니다. Ethanol적하법(滴下法)은 1일(日)정제(精製)라도 고수율(高收率) 및 고순도(高純度)의 xylan이 얻어지고 조작(操作)의 영역(容易)등을 고려(考慮)하여 대단히 우수한 xylan 정제법(精製法)이다. 그러나 양정제법(兩精製法)으로 arabinose잔기(殘基)를 완전(完全)히 제거(除去)할 수는 없었다. 이것은 후보(後報)에 검토(檢討)를 보고(報告)한다.

• 대한간호학회지
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• 제11권2호
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• pp.83-104
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• 1981

Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance（P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.

• 미생물학회지
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• 제45권4호
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• pp.411-415
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• 2009

비황화광물인 망간단괴에서 일부 미생물은 비효소학적 과정을 통해 간접적으로 망간(II)을 용출시킬 수 있다. 이때 환원적 용해를 일으킬 수 있는 대사산물의 생성을 위해 제공되는 탄소 및 에너지원인 glucose, sucrose, galactose 등은 생물용출 기술의 장점인 경제성을 저하시키는 원인이 되고 있다. 본 연구에서는 저렴한 탄소 및 에너지원으로 corn starch를 이용하면서 망간(II) 용출능력을 지닌 종속영양 미생물로서 Bacillus sp. MR2에 의한 망간(II)의 용출 특성을 알아보았다. 망간(II)의 용출은 MR2의 생장에 수반되어 일어났으며[25.6 g Mn(II) $kg^{-1}$ nodule $day^{-1}$], 24시간 이후에는 생성된 망간(II)의 일부가 망간단괴 입자에 다시 흡착되는 경향을 보였다. 분쇄물을 dialysis tube (MWCO 12,000)에 넣어 MR2와의 접촉을 막았을 때도 유사한 정도의 결과[24.6 g Mn(II) $kg^{-1}$ nodule $day^{-1}$]를 보여 세포와 망간단괴의 직접적 접촉이 필요 없이 세포외 분비물질에 의해 환원적 용해가 일어남을 알 수 있었다. 실험에 적용된 영향요인들의 범위에서 최적 용출조건을 분석한 결과, $25\sim35^{\circ}C$, pH 5~7, 접종밀도 1.5~2.5% (v/v), 분쇄물의 농도 2~3 g/L 및 입자크기 <75 ${\mu}m$일 때가 가장 효율이 높았다. 비록 입자의 크기가 작을수록 망간(II) 용출속도가 증가했지만 분쇄에 더 많은 에너지가 요구되므로 경제성을 고려한다면 <212 ${\mu}m$가적절한 수준으로 제시될 수 있었다. 이상의 효율적인 망간단괴의 용출 조건 규명은 기존의 물리화학적 금속 회수기술에 비해 적은 비용과 에너지가 요구되는 환경친화적 생물용출 기술의 진보에 도움을 줄 것으로 기대된다.