• 성인간호학회지
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• 제12권1호
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• pp.52-63
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• 2000

In Korea, most of the patients with chronic liver diseases have been using some kind of alternative therapies at home. however, the question is why do people turn to alternative therapy and how the patients are able to use the alternative therapies widely, though the effects have not been proven scientifically. Therefore, it is necessary to explore the process of the patients' experiences using the alternative therapies. The 16 participants were from internalmedical departments in hospital and the permission was received to participate in this study from the subjects. The data were collected with interviews and participants observations, analyzed by the grounded theory methodology of Strauss and Corbin(1990). With the analysis of the data, 15 categories were generated such as psychological pressures, barriers of role performances, distrusts of western medicine, blind obediences to the treatments, attitudes towards alternative therapies, supportive systems, obstacles to taking alternative therapies, financial burdens, collecting informations, pursuing alternative modalities, efforting diversities, analyzing by themselves, managing the body, accepting the disease, and ambivalence. The paradigm model was developed to identify the relationships of categories. The central phenomenon of the experiences of seeking alternative therapies was named jagi momdasrim. The central concept of jagi momdasrim is a mind-set to desire to wellness and to take more responsibility for one's own healing by pursuing alternate healing modalities rather than the western medical system. The process of jagi momdasrim evolved several stages such as seeking, finding, struggling, overcoming, fulfilling, and governing the diseases. Four patterns of taking alternative therapies were found as follows: the bulsin-chujong-hyung, the suyoung-hyung, the yangdari-gulchiki-hyung, the chamjae-hyung. In conclusion, the phenomenon of alternative therapies as consumer-driven force to heal the chronic liver diseases of the patients could be explained as an adaptive behavior through the process of jagi momdasrim. However, since most of the participants practicing some kind of alternative therapies had no evidences of its effects and never tried to consult with their medical doctors about alternative therapies, we should approach more actively. Therefore, it is recommended for nurses to listen and watch the patients behaviors of using alternative therapies and find out how to educate the patients about the proper and safe way to take the alternative therapies.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8725-8734
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• 2014

The transforming growth factor-${\beta}1$ (TGF-${\beta}1$) gene 29 T/C polymorphism is thought to be associated with breast cancer risk. However, reports are largely conflicting and underpowered. We therefore conducted a meta-analysis of all available case-control studies relating the TGF-${\beta}1$ 29T/C polymorphism to the risk of developing breast cancer by including a total of 31 articles involving 24,021 cases and 31,820 controls. Pooled ORs were generated for the allele contrasts, with additive genetic, dominant genetic and recessive genetic models. Subgroup analysis was also performed by ethnicity for the TGF-${\beta}1$ 29T/C polymorphism. No association was found in the overall analysis (C vs T: OR=1.028, 95% CI=0.949-1.114, p-value 0.500; CC vs TC: OR= 1.022, 95% CI=0.963-1.085, p-value 0.478; CC vs TT: OR= 1.054, 95% CI=0.898-1.236, p-value 0.522; CC vs TT+ TC: OR= 1.031, 95% CI=0.946-1.124, p-value 0.482; TT vs CC+TC: OR= 0.945, 95% CI=0.827-1.080, p-value 0.403). Similarly, in the subgroup analysis by ethnicity, no association was found in Caucasian (C vs T: OR= 1.041, 95% CI=0.932-1.162, p-value 0.475; CC vs TC: OR= 1.031, 95% CI=0.951-1.118, p-value 0.464; CC vs TT: OR= 1.081, 95% CI=0.865-1.351, p-value 0.493; CC vs TT+TC: OR= 1.047, 95% CI=0.929-1.180, p-value 0.453; TT vs CC+TC: OR= 0.929, 95% CI=0.775-1.114, p-value 0.429;) and Asian populations (C vs T: OR= 1.004, 95% CI=0.908-1.111, p-value 0.931; CC vs TC: OR= 0.991, 95% CI=0.896-1.097, p-value 0.865; CC vs TT: OR= 1.015, 95% CI=0.848-1.214, p-value 0.871; CC vs TT+TC: OR= 1.000, 95% CI=0.909-1.101, p-value 0.994; TT vs CC+TC: OR= 0.967, 95% CI=0.808-1.159, p-value 0.720;). No evidence of publication bias was detected during the analysis. No significant association with breast cancer risk was demonstrated overall or on subgroup (Caucasian and Asian) analysis. It can be concluded that TGF-${\beta}1$ 29T/C polymorphism does not play a role in breast cancer susceptibility in overall or ethnicity-specific manner.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.407-417
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• 1999

Objective: Mammalian follicle cells are the most important somatic cells which help oocytes grow, mature and ovulate and thus are believed to provide oocytes with various functional and structural components. In the present study we have examined whether cumulus or granulosa cells might playa role in establishing the plasma membrane structure of mouse oocytes during meiotic maturation. Design: In particular the differential resistances of mouse oocytes against chymotrypsin treatment were examined following culture with or without cumulus or granulosa cells, or in these cell-conditioned media. Results: When mouse denuded oocytes, freed from their surrounding cumulus cells, were cultured in vitro for $17{\sim}18hr$ and then treated with 1% chymotrypsin, half of the oocytes underwent degeneration within 37.5 min ($t_{50}=37.5{\pm}7.5min$) after the treatment. In contrast cumulus-enclosed oocytes showed $t_{50}=207.0$. Similarly, when oocytes were co-cultured with cumulus cells which were not associated with the oocytes but present in the same medium, the $t_{50}$ of co-cultured oocytes was $177.5{\pm}13.1min$. Furthermore, when oocytes were cultured in the cumulus cell-conditioned medium, $t_{50}$ of these oocytes was $190.0{\pm}10.8min$ whereas $t_{50}$ of the oocytes cultured in M16 alone was $25.5{\pm}2.9min$. Granulosa cell-conditioned medium also increased the resistance of oocytes against chymotrypsin treatment such that $t_{50}$ of oocytes cultured in granulosa cell-conditioned medium was $152.5{\pm}19.0min$ while that of oocytes cultured in M16 alone was $70.0{\pm}8.2min$. To see what molecular components of follicle cell-conditioned medium are involved in the above effects, the granulosa cell-conditioned medium was separated into two fractions by using Microcon-10 membrane filter having a 10 kDa cut-off range. When denuded oocytes were cultured in medium containing the retentate, $t_{50}$ of the oocytes was $70.0{\pm}10.5min$. In contrast, $t_{50}$ of the denuded oocytes cultured in medium containing the filtrate was $142.0{\pm}26.5min$. $T_{50}$ of denuded oocytes cultured in medium containing both retentate and filtrate was $188.0{\pm}13.6min$. However, $t_{50}$ of denuded oocytes cultured in M16 alone was $70.0{\pm}11.0min$ and that of oocytes cultured in whole granulosa cell-conditioned medium was $156.0{\pm}27.9min$. When surface membrane proteins of oocytes were electrophoretically analyzed, no difference was found between the protein profiles of oocytes cultured in M16 alone and of those cultured in the filtrate. Conclusions: Based upon these results, it is concluded that mouse follicle cells secrete a factor(s) which enhance the resistance of mouse oocytes against a proteolytic enzyme treatment. The factor appears to be a small molecules having a molecular weight less than 10 kDa.

• 한국임상약학회지
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• 제23권4호
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• pp.307-315
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• 2013

Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections caused by gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroduced into the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularly Pseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settings as a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidney injury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This study retrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenous colistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 and excluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of the colistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classified with risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patients included in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKI occurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI ($1.92{\pm}0.86mg/dL$ vs. $1.12{\pm}0.46mg/dL$ p=0.001), maximum BUN also increased ($64.2{\pm}28.7mg/dL$ vs. $48.4{\pm}24.9mg/dL$ p=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI ($34.5{\pm}18.6ml/min$ vs. $64.4{\pm}33.7ml/min$ p=0.185). The patients with AKI had significantly longer duration of colistimethate therapy ($21.1{\pm}17.0$ days vs. $13.0{\pm}11.5$ days, p=0.020) and larger cumulative doses of colistimethate ($6465.9{\pm}4717.0mg$ vs. $4438.1{\pm}3426.7mg$, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethate in critically ill patients was high and serious. Drug monitoring program should be performed to shorten duration of therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.

• 한국정보전자통신기술학회논문지
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• 제14권5호
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• pp.394-402
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• 2021

고령사회의 진입과 인간의 평균 수명이 연장되고, 여성의 사회적 진출 및 남성들의 외모에 대한 관심증가, 미디어 매체를 통한 K-문화가 전 세계적으로 관심을 받으면서 자연스럽게 관심은 K-Bueaty에 집중되고 있다. 최근, 의료관광 분야의 점유를 보면 성형 및 피부과와 같은 피부미용 의료관광의 경우 중국, 일본 등 아시아뿐만 아니라 북미, 유럽 등에서 인기를 누리고 있다. 사람의 노화를 가장 먼저 외면적으로 확인할 수 있는 부위는 바로 얼굴의 피부 주름이다. 깨끗하고 주름이 없으면서 탄력성 있는 건강한 피부는 대부분의 사람들이 원하는 바람이다. 대표적으로 집속형초음파자극(HIFU:High Intensity Focused Ultrasound)와 저주파, 고주파(RF:Radio Frequency), 미세전류를 이용한 갈바닉 테라피, 급속 냉각을 이용한 크라이오 테라피 등 피부의 컨디션과 상태에 따라 관리하는 방식이 달라지며, 같은 기전을 이용한 의료기기 및 피부미용 기기의 시술 역시 출력 및 자극 부위 등에 따라 시술의 효과가 차이가 난다. 본 연구는 수많은 피부미용 의료기기 및 미용기기 중 마이크로니들을 이용한 침습형 고주파 피부 의료기기를 개발하고자 국제규격인 IEC 60601-2(의료기기개별기준규격)및 MFDS(Ministry of Food and Drug Safety : 식품의약품안전처)에서 고시한 고주파 자극기 기준 규격을 준수한 고주파 출력 장치를 설계 및 개발하였다. 회로 설계는 Class-A Topology를 이용한 증폭장치(AMP:Amplifier)와 Half-Bridge Topology를 이용한 전원장치로 이루어져 있다. 개발된 고주파 출력 장치를 측정한 결과 평균 63.86%의 효율을 얻었으며, 최대출력은 116.7W, 50.67dBm으로 측정되었다.

• 지역사회간호학회지
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• 제7권1호
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• pp.154-169
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• 1996

Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.

• Genomics & Informatics
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• 제8권3호
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• pp.108-115
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• 2010

Hypertension is the most prevalent disease worldwide and is itself a risk factor for cerebral, cardiac, and renal diseases. The inconsistency of candidate genes suggested by previous genomewide association studies (GWASs) may be due to not only differences in study design and genetic or environmental background but also the difference in the power of analysis between continuous traits and discrete traits. We analyzed 352,228 single nucleotide polymorphisms (SNPs) in 8842 unrelated Koreans obtained from Ansan and Ansung cohorts. We performed a series of GWA analyses using three different phenotype models; young hypertensive cases (278 subjects) versus elderly normotensive controls (680 subjects); the upper 25% (2211 hypertensive cases) versus the lower 25% of the SBP distribution (2211 hypotensive controls); and finally SBP and DBP as continuous traits (8842 subjects). The numbers of young hypertensive cases and elderly normotensive controls were not large enough to achieve genomewide significance. The model comparing the upper 25% subjects to the lower 25% of subjects showed a power that was approximate to that of QTL analysis. Two neighboring SNPs of the ATP2B1 gene, rs17249754 (SBP, p=$2.53^{-10}$; DBP, p=$1.28{\times}10^{-8}$) and rs7136259 (SBP, p=$1.30{\times}10^{-9}$; DBP, p=$6.41{\times}10^{-8}$), were associated with both SBP and DBP. Interestingly, a SNP of the RPL6 gene, rs11066280, revealed a significant genomewide association with SBP in men only (p=$3.85{\times}10^{-8}$), and four SNPs located near the MAN2A1 gene showed a strong association with DBP only in elderly men aged 60-70 years (e.g., rs6421827, p=$4.86{\times}10^{-8}$). However, we did not observe any gene variant attaining genomewide significance consistently in the three phenotype models except for the ATP2B1 gene variants. In general, the association signal with blood pressure was stronger in women than in men. Genes identified in GWASs are expected to open the way for prevention, early diagnosis, and personalized treatment of hypertension.

• 간호행정학회지
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• 제6권1호
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• pp.135-146
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• 2000

The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

• 한국문헌정보학회지
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• 제28권
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• pp.287-299
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• 1995

지금까지 국내 연구자들이 SCI 학술지에 발표한 의학논문의 수가 아주 미미하기 때문에 전 세계 학자들이 발표한 SCI 전체논문 중 한국논문이 차지하는 비중은 지극히 낮은 것으로 보인다. 따라서, 본 연구에서는 1980년부터 1990년 사이에 국내에 있는 의학 관련기관의 연구자들이 SCI 학술지에 발표한 논문이 SCI 전체 논문 중 차지하는 비중(Percentage Contribution from Korea to SCI Database)을 47개 의학분야별로 조사하였다. 또한. 본 연구에서는 "국제적으로 영향력 있는 학술연구 활동실적(i.e., Mainstream Productivity)"이 타 분야보다 뛰어난 한국의 의학분야를 밝히기 위하여. SCI 학술지에 발표된 모든 한국 의학논문 중 한 분야의 논문이 자치하는 몫(Percentage Share)을 SCI 전체 논문 중 그 분야의 논문이 차지하는 몫으로 나누어 그 상대적 크기를 분석함으로써, 우리나라 학자들의 Mainstream Productivity Ratio(R)를 각 분야별로 측정하였다. (R=1은 SCI 의학 학술지에 발표된 모든 논문 중에서 어떤한 분야의 논문이 차지하는 비율만큼 한국에서도 그 분야의 논문이 SCI 학술지에 투고되었다는 의미이다.) 1980년에서 1990년 사이에 한국 학자들에 의하여 SCI에 발표된 의학논문이 SCI 전체 의학논문 중에서 차지하는 비율은 $0.051\%$였다. 각 의학 분야별로는, Biotechnology & applied microbiology의 기여도가 $0.8\%$를 차지하여 한국 최고를 기록하였다. 전 세계 문헌의 $1\%$ 이상을 생산한 의학 분야는 없었다. 전 세계 문헌의 $0.1\%$ 이상을 SCI 학술지에 게재한 의학분야는 47개 중 6개인데, 위에 언급한 Biotechnology & applied microbiology를 제외하면 $0.1\%$에서 $0.2\%$ 사이의 기여도를 보였다. 최다 편수의 논문을 낸 Pharmacology 8l Pharmacy$(0.075\%)$나 두 번째로 논문수가 많았던 Biochemisty & molecular biology$(0.054\%)$의 기여도는 $0.1\%$에 미치지 못하였다. 조사대상이 된 47개 의학분야 중 27개 분야에서 예상된 것보다 상대적으로 적은수(R<1)의 한국 논문이 SCI 학술지에 게재되었다. Mainstream Productivity Ratio가 3보다 큰 분야는 4개인데, 그 중 Biotechnology & applied microbiology는 R=15.63으로 아주 월등한 논문 발표실적을 올렸다. Dermatology & venereal diseases(3.02)와 Engineering, biomedical(3.75)도 국제적으로 영향력 있는 학술지에 논문 발표실적이 뛰어난 의학분야이다.

• 대한영양사협회학술지
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• 제20권3호
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• pp.183-198
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• 2014

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.