• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.569-584
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• 1993

This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC＋ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2315-2321
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• 2013

This study attempt to develope and suggest a new, minimize side effects process for calculate a time to peak enhancement of contrast level by using blood flow instead of current mathematical process. We conducted a studies 127 patients who performed the CE MRA by using test-contrast inject way. We used measurements of a contrast inflow time and time to peak enhancement of contrast level of each cerebrovascular branch for similarity of witch cerebrovascular branch calculate a time to peak enhancement of contrast level by using blood flow in image compared with calculation a time to peak enhancement of contrast level by using current mathematical process after contrast enhancement. In this study, confidence interval were used if the variable is continuous variable; there is differences between 4 groups exist but in group 1, there is no difference with time in peak enhancement of contrast level by using mathematical method to inflow time in sinus sigmoideus. it was significant statistically, in addition there was significant low heterogeneity in Bland Altman plot. Thus, apply a new calculate a time to peak enhancement of contrast level by using blood flow method will minimize damage caused by side effect, maintain quality of image, easy and fast access. It should provide a space for the exchange of current calculate a time to peak enhancement of contrast level by using mathematical process.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.5
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• pp.1126-1132
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• 2009

We carried out this study to reduce the gaps between medical institutes and between medical personnels and help to improve medical service quality, by classifying diagnoses and related intervention through the development of standard nursing intervention and by computerizing protocols. We considered two processes: one is the development process of home nursing standard intervention, and the other is the process of computerizing its related protocols. For the former, research covered analysis of home health care practices, development of client assessment protocol, of patients diagnosis protocols, and of patients intervention protocol. For the latter, strategies for home health care information systems should be set up and it constituted four research contents of analysis, design, management and evaluation of the systems. We also trained and educated home nurses who work at home health service center, by making them use the manual of home health care information systems at a certain city of P. In this study, therefore, we developed elements of standard home health care mediation so that they could be included in the forms of home health information note, home health progress note, and home health progress summary, home health discharge summary. Because standard home health care intervention has been developed, it became easier to exchange information between different home heath service center offices, can prevent from missing or redundant information, and contribute to standardization of hospital terminologies when EMR and HMR are developed.

• The Journal of Industrial Distribution & Business
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• v.10 no.3
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• pp.73-83
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• 2019

Purpose - This study is to clarify the structural relationship between the direct supervisor and organizational commitment and organizational citizenship behavior through mediation of the Leader-member exchange (LMX) in the hospital organization, and to confirm the mediating effect of the LMX. Through this study, we will provide basic data on the aspects of HR to enhance organizational immersion and organizational civic behavior in hospital organizations, and present suggestions on academic contribution and effective organizational operation measures. Research design, data, and methodology - This study is to investigate the relationship between authentic leadership and OC and OCB of the organization member, which is proposed to secure more active and high competitiveness in the recent changing medical environment, with multi-regression and B&K(1986) method. For this purpose, 653 employees of senior hospitals in Seoul and Kyeong-In area were surveyed using structured questionnaires. Each questionnaire was composed of 7-point scale, and each hypothesis was testified by multiple leaner regression and by BK method for testifying mediator effect. Result - As a result of the analysis, it was found that the male and non-medical staff had higher recognition level than the medical staff in the LMX, organizational commitment and organizational citizenship behavior. In the senior management or more than 5 years' experience group, organizational commitment and organizational citizenship behavior were recognized higher than the group of subordinate managers. Second, authentic leadership has a positive influence on LMX, organizational commitment and organizational citizenship behavior, and LMX has a significant positive impact on organizational commitment and organizational citizenship behavior. In addition, as a result of analyzing LMX mediating effect in the relationship of authentic leadership and organizational effectiveness by BK method, LMX had partial mediating effects between authentic leadership and organizational citizenship behavior, and between authentic leadership and organizational commitment. Conclusion - Results of the study confirmed that all the members of the hospital organization that were lacking served as positive factors for the relationships of authentic leadership and LMX, and authentic leadership and organizational effectiveness. It is expected that the hospital organization will be able to suggest such as the organizational approach to expect high organizational effectiveness centering on authentic leadership ability as psychological capital.

• Molecules and Cells
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• v.40 no.8
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• pp.567-576
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• 2017

The $Na^+/H^+$ exchanger is responsible for maintaining the acidic tumor microenvironment through its promotion of the reabsorption of extracellular $Na^+$ and the extrusion of intracellular $H^+$. The resultant increase in the extracellular acidity contributes to the chemoresistance of malignant tumors. In this study, the chemosensitizing effects of cariporide, a potent $Na^+/H^+-exchange$ inhibitor, were evaluated in human malignant mesothelioma H-2452 cells preadapted with lactic acid. A higher basal level of phosphorylated (p)-AKT protein was found in the acid-tolerable H-2452AcT cells compared with their parental acid-sensitive H-2452 cells. When introduced in H-2452AcT cells with a concentration that shows only a slight toxicity in H-2452 cells, cariporide exhibited growth-suppressive and apoptosis-promoting activities, as demonstrated by an increase in the cells with pyknotic and fragmented nuclei, annexin V-PE(+) staining, a $sub-G_0/G_1$ peak, and a $G_2/M$ phase-transition delay in the cell cycle. Preceding these changes, a cariporide-induced p-AKT down-regulation, a p53 up-regulation, an ROS accumulation, and the depolarization of the mitochondrial-membrane potential were observed. A pretreatment with the phosphatidylinositol-3-kinase (PI3K) inhibitor LY294002 markedly augmented the DNA damage caused by the cariporide, as indicated by a much greater extent of comet tails and a tail moment with increased levels of the p-histone H2A.X, $p-ATM^{Ser1981}$, $p-ATR^{Ser428}$, $p-CHK1^{Ser345}$, and $p-CHK2^{Thr68}$, as well as a series of pro-apoptotic events. The data suggest that an inhibition of the PI3K/AKT signaling is necessary to enhance the cytotoxicity toward the acidtolerable H-2452AcT cells, and it underlines the significance of proton-pump targeting as a potential therapeutic strategy to overcome the acidic-microenvironment-associated chemotherapeutic resistance.

• The Journal of the Korea Contents Association
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• v.19 no.5
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• pp.331-341
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• 2019

The purpose of this analysis is to examine the effects of health expenditure on income inequality on household income after the financial crisis by using the household income survey form 1996 to 2016. The main results are as follows. First, after the financial crisis, the gross income inequality of households has been changing steadily, though there has been a slight change in each year. Second, high-income earners spend more on health care expenditure by income level. Therefore, unequal levels are maintained. Third, the Gini coefficient of income excluding health care expenditure was calculated. The results of the analysis are larger than the Gini coefficient of total income. Income inequality is intensified by the expenditure of health care expenditure of households. The inequality of household income due to health care expenditure has been increasing steadily since the financial crisis. Efforts such as strengthening the protection of health insurance have been continuously carried out for the purpose of reducing the burden of the national medical expenses. However, it does not contribute to resolving income inequality. In the future, it will be necessary to provide a more selective medical support system to reduce the medical expenditure of the low income class.

• The Korean Society of Law and Medicine
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• v.23 no.3
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• pp.47-87
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• 2022

Due to the COVID-19 pandemic, non-face-to-face treatment was temporarily permitted. A lot of consensus has been formed on the need to continuous non-face-to-face treatment. However, the current 「Medical Service Act」 only permits telemedicine between doctors and medical personnel. On the other hand, as a result of legal interpretation, there is an opinion that non-face-to-face treatment is allowed. But considering the overall legal system, non-face-to-face treatment is not allowed. Nevertheless, we have to consider the reality such as the development of science and technology and the outbreak of infectious diseases. Therefore, it is not advisable to allow face-to-face treatment only. Ultimately, it is necessary to find ways to ensure that non-foce-to-face treatment can be performed in a safe and effective manner. And it should be institutionalized. This is strategically necessary and important. Therefore, we must look over ahead legal issues to be discussed. First of all, the scope, the target disease and the subject of implement have to be clear. Also, structurally, the standards of facilities and equipment must be prepared for non-face-to-face treatment to be implemented. Functionally, communication and information exchange between doctors and patients should be well conducted. In addition, the information protection management system that occurs in the process of non-face-to-face treatment should be materialized. Lastly, the issue of responsibility and cost of non-face-to-face treatment should be decided in detail. When these problems materialize, it can be expected that a safe non-face-to-face treatment environment will be established.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.269-276
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• 2001

Objectives : To evaluate the internal burden and hazardous effects associated with smoking in middle and high school students. Methods : We analysed urinary cotinine(U-cotinine) concentrations and the frequency of Sister Chromatid Exchanges (SCE). A comparison was done of U-cotinine concentrations and the frequency of SCE in peripheral lymphocytes across school levels (middle vs. high) and smoking types (direct: daily & occasional smoking, indirect; usual indirect & non-smoking), in 122 males. Results : The middle school student group comprised 6.8% daily smokers, 15.9% occasional smokers, 40.9% daily indirect smokers, and 35.4% nonsmokers, while the high school student group comprised 18.0%, 20.5%, 35.7%, and 21.8%, respectively. The U-cotinine concentration and the frequency of SCE among the middle school students were $79.11{\mu}g/l$ and 2.0 per cell, respectively, which were significantly lower than the $146.85{\mu}g/l$ (p=0.078) and 2.6 per cell (p=0.005) of the high school students. Among the 40 direct smokers, these two biomarkers were $236.66{\mu}g/l$ and 2.59 per cell, significantly higher than the $67.33{\mu}g/l$ (p=0.0001) and 2.1 per cell (p=0.003) among indirect smoking groups. The variation in individual U-cotinine concentration ranged widely in both the indirect and direct smoking groups. Conclusion : Urinary cotinine concentrations and the frequency of Sister Chromatid Exchange seem to objectively and effectively evaluate student exposure whether it was direct or indirect smoking. Consequently, these biomarkers may be useful in monitoring the objective efficacy of anti-smoking programs in adolescent populations.

• Journal of Environmental Science International
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• v.19 no.12
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• pp.1343-1354
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• 2010

The purpose of the study was to analyze the persistence of HCH in atmosphere, soil, sediment and water of the western and southern regions of Korea. The samples from the western region were collected from Anmyeon Island, and the samples from the southern region were collected from Kimhae and Busan. The concentration of HCH isomers in atmosphere showed the pattern of $\alpha$-HCH>$\gamma$-HCH>$\beta$-HCH. The regions with high HCH concentration in the atmosphere are the regions that have been highly exposed to HCH used in the past, and the areas that have been influenced by the long range transport. The HCH that persists in the soil, water and sediment evaporates into the atmosphere, showing the characteristics of Air-Surface exchange. When the regional concentration distributions are compared, the concentration of HCH was higher in the atmosphere of a plain and the cities near the plain, than the urban areas. In this study, the ratio of $\alpha/\beta$-HCH was used as an indicator for estimating the source of Technical HCH and Lindane. According to the result, the contribution of Lindane was high in Kimhae plain and Kimhae urban areas. However, in Busan, the contribution of Technical HCH was higher than Lindane. In case of Anmyeon Island, the western region of Korea had high contribution from Tehcnical HCH. In soil and sediment, $\beta$-HCH was dominant. In water, $\gamma$-HCH was dominant among other isomers. Such results are due to $\gamma$-HCH inLindane. Furthermore, the source of $\gamma$-HCH in urban areas is assumed to be the use of medicine, medical supplies and other living supplies. Based on the results of this study, the management of HCH, a newly list up emerging POPs, should be strengthened by further research on sources, fate, persistency, accumulation and exposures and etc. to the risk assessments.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.559-568
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• 2020

Epidermal growth factor (EGF) is a hormone protein that affects cell growth and proliferation, and has various medical applications. In the present study, the gene of human EGF was codon-optimized with E. coli and the expression vector was constructed by cloning into pRSET. In order to obtain the recombinant human EGF in an active form rather than an inclusion body, chaperone co-expression was attempted along with codon optimization, for the first time. The expressed human EGF was isolated in the pure form by performing Ion Exchange Chromatography in two consecutive runs. ELISA analysis showed that the activity of purified EGF was greater than 99%, which is similar to commercially available EGF. Cell proliferation test confirmed that the recombinant human EGF has the ability to promote cell proliferation of human skin fibroblasts. The human EGF expression system of this study gives a significant amount of protein, and does not require the renaturation step and the additional chromatographic system to remove a fusion contaminant, thereby providing a very useful alternative to conventional expression systems for the preparation of recombinant human EGF.