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An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory- (본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증-)

  • Park, Young-Im;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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A study on the incidence of anemia according to feeding patterns and the status of weaning diet (수유 방법에 따른 빈혈의 빈도 및 이유식이에 대한 조사)

  • Kim, Hyun-Ji;Shin, Mee-Yong;Kim, Sung-Shin;Park, Jae-Ock;Kim, Chang-Hwi
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.875-880
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    • 2009
  • Purpose : Iron-deficiency anemia remains the most common nutritional deficiency in young infants. This study aimed to survey the actual condition of feeding patterns and weaning diet and to study the association between these factors and the prevalence of anemia in infants aged over 9 months. Methods : We studied 171 infants aged 9-24 months who were hospitalized in the general ward with mild to moderate acute illnesses. The mothers answered a questionnaire about the feeding patterns and the status of the weaning diet of their infants. The infants were divided into three groups: infants who were exclusively breast-fed, those who had been given mixed feeding, and artificial milk feeders. Results : The incidence of anemia was significantly higher in exclusively breast-fed infants (23/68, 33.8%) than in the infants with mixed feeding (11/62, 17.7%) and artificial milk feeders (5/41, 12.1%). The mothers' awareness about the state of their infants󰡑 weaning diet was not related to the presence of anemia in the exclusively breast-fed infants. About 70% of the infants had started the weaning diet before age 6 months in all three groups, without any difference according to feeding patterns. Conclusion : The incidence of anemia was significantly higher in the breast-fed group than in the other infants. Many mothers of breast-fed infants with anemia also believed that their infants were taking sufficient weaning foods. Therefore, further education of the mothers about iron-rich weaning foods and the importance of iron intake during infancy is needed to prevent anemia, especially in breast-fed infants.

Pulmonary Thromboendarterectomy for Pulmonary Hypertension Caused by Chronic Pulmonary Thromboembolism (만성폐색전중으로 인한 폐동맥고혈압 환자에서 시행한 폐동맥내막절제술)

  • Song Seung-Hwan;Jun Tae-Gook;Lee Young-Tak;Sung Ki-Ick;Yang Ji-Hyuk;Choi Jin-Ho;Kim Jin-Sun;Kim Ho-Joong;Park Pyo-Won
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.626-632
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    • 2006
  • Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.

Effects of Higher Dietary Cation with or without Protected Fat and Niacin on the Milk Yield and Thermoregulatory Ability in Holsteins During Summer Heat Stress (여름철 고온스트레스 기간에 고 양이온 사료와 반추위 보호지방과 나이아신의 추가공급시 착유우의 유생산 및 체온조절에 미치는 영향)

  • 김현섭;이왕식;이현준;기광석;백광수;안병석;아주말 칸
    • Journal of Animal Science and Technology
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    • v.48 no.4
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    • pp.555-562
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    • 2006
  • The objective of this study was to evaluate the effects of dietary cation-anion difference (DCAD) with or without ruminally protected fat and niacin on the thermoregulatory ability, milk yield and milk composition of lactating dairy cows during summer in Korea. Thirty mid-lactating Holstein cows (134±12.4 DIM and 23.4±2.3kg/d of milk yield) were divided into three groups (10 animals/group). Cows were housed in a free-stall barn and were provided with forced- air ventilation (wind velocity = 4 m/s) using 41 cm diameter fans. Diet one was formulated to contain low DCAD (+15 DCAD) while the remaining two diets were higher in DCAD (+30 DCAD). One higher DCAD diet was formulated to contain by-pass fat and the second higher DCAD diet contained the niacin along with by-pass fat. The maximum ambient temperature during July was 28.5℃ which could be seen as a period of mild heat stress. As summer progressed, August was characterized as a severe heat stress condition with maximum ambient temperature (32.4℃) and THI (74.0). Dry matter, crude protein and total digestible nutrients intake was not affected by the DCAD level and supplementation of ruminally protected fat or niacin. Milk production was higher in cows fed diets supplemented with fat and niacin than those fed un-supplemented diet. No difference in milk yield was observed in cows fed diets supplemented with fat or niacin plus fat. Milk fat and rectal temperature were not affected by the DCAD level and supplementation of ruminally protected fat or niacin. However, respiration rate was decreased in cows fed diets supplemented with either fat or fat and niacin compared to those fed. The results of the present study indicated that higher DCAD (+30) and supplementation of fat along with niacin can somehow mitigate the negative effects of heat stress on milk yield and physiology of lactating Holsteins during July and August in Korea. In present study reduced respiration rate and increased milk yield in lactating cows may be attributed to the cooling effect of supplemented fat along with vasodilatory functions of niacin. (Key Words: DCAD, Heat stress, THI, milk yield, Milk fat, Holstein)

Cytotoxicity of paraquat and compensatory effects of 3-methylcholanthrene in rat lung (Paraquat의 세포독성과 흰쥐의 폐에서 3-Methylcholanthrene의 독성경감효과)

  • Rim, Yo-Sup;Kim, Doc-Soo;Han, Du-Seok;Hwang, In-Taek
    • The Korean Journal of Pesticide Science
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    • v.6 no.2
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    • pp.96-104
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    • 2002
  • This study was carried out to investigate cytotoxicity of paraquat on NIH 3T3 fibroblasts, toxicity of paraquat and compensatory effects of 3-methylcholanthrene (3-MC) on the rat lung. In order to conduct MIT [3-(4,5-Dimethylthiazol-2-yl) -2,5-diphenyl -2H-tetrazolium-bromide] and NR (Neutral red) assay, the $5.0{\times}10^4cell/ml$ of NIH 3T3 fibroblast in each well of 24 multi-dish were cultured. After 24 hours, the cells were treated with solution of paraquat (1, 25, 50 and $100{\mu}M$ respectively). After the NIH 3T3 fibroblast of all groups were cultured in same condition for 48 hours. MIT and NR assay were performed to evaluate the cytotoxicity of cell organelles. $MTT_{50}\;and\;NR_{50}$ of paraquat were $1668.97{\mu}M\;and\;1030.85{\mu}M$, respectively. These $IC_{50}$ of Paraquat were decided as a low cytotoxicity by Borenfreund and Puemer (1984). In order to observe the toxicity and compensatory effects of paraquat on the rat lung, Spraque Dawley male rats were used as experimental animals and were divided into paraquat only treated group and simultaneous application group of paraquat and 3-MC, at 30 min and 1, 3, 6, 12, 24, 48 and 96 hrs interval after each treatment. The animals were sacrificed by decapitation and their or the lungs were immediately removed, immersed in fixatives, and were processed with routine method for light microscopic study. Paraffin sections were stained with H&E and iron hematoxylin of Verhoeff. Under the light microscopy, erythrocytes were full in alveolar capillaries at 3 hrs and congested at 24 hrs after paraquat administration. The great alveolar cells (Type II cell) were increased and mitosis of great alveolar were observed in interalveolar septa. Many lymphocytes, macrophages and polymorphonuclear (PMN) cells were observed in connective tissue surrounding lung tissue and germinal center in lymph follicles of terminal bronchiole. Alveolar macrophages were increased in interalveolar septa and alveoli at 48 hrs. And observed many alveolar macrophages at 96 hrs. In iron hematoxylin stain of Verhoeff, Collagen fiber were increased in respiratory bronchiole, interalveolar septa and alveoli and breath of alveoli, and alveolar pore were broaden. But, in paraquat plus 3-MC treated group, morphological changes were mild in lung tissue. These results indicate that 3-MC has a compensatory effects against toxicity of paraquat by conjugation with oxygen.

Risk Factors Analysis and Results of the Arterial Switch Operation for Transposition of the Great Arteries with Intact Ventricular Septum (심실중격결손을 동반하지 않은 대혈관전위증 환자에서 동맥 전환술의 결과 및 위험인자 분석에 관한 연구)

  • 김용진;오삼세;이정렬;노준량;서경필
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.108-118
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    • 1999
  • Background: To evaluate the risk factor and long-term result of arterial switch operation , a retrospective study was done. Material and Method: A retrospective analysis was done to evaluate the early and long-term results on 58 patients who underwent an arterial switch operation(ASO) for transposition of the great arteries(TGA) with intact ventricular septum, between January 1988 and December 1996. Beforesurgery, 36 patients(62.1%) underwent balloon atrial septostomy, 32 patients(51.7%) received PGE1 infusion, and preparatory banding of pulmonary artery was performed on 6 patients(mean LV/RV pressure ratio 0.53$\pm$0.11). Result: The age at operation ranged from 1 to 137 days(mean 24$\pm$26 days) and the weights ranged from 1.8 to 6.8 kg (mean 3.5$\pm$0.8 kg). There were 14 early deaths(24.1%), but of the last 24 patients operated on since 1994, there were only 2 early deaths(8.3%). In the risk factor analysis, the date of operation was the only risk factor for early death(p-value < 0.01). Eight of the 14 early deaths were due to acute myocardial failure(mainly inadequate coronary blood flow). The length of follow-up ranged from 2 months to 8 years, average of 36$\pm$27 months. The follow-up included sequential noninvasive evaluations and 21 catheterizations and angiographic studies performed 5 to 32 months postoperatively with particular attention to the great vessel and coronary anastomosis, ventricular function, valvular competence, and cardiac rhythm. There were 5 late deaths(11.4%), one of thesedeaths was related to the late coronary problems, two to aspiration, one to uncontrolled chronic mediastinitis, and one to progressive aortic insufficiency and heart failure. The most frequent postoperative hemodynamic abnormality was supravalvular stenosis and the degree of pulmonary or aortic obstruction had slowly progressed in some cases, however there were no children who had to undergo a reoperation for supravalvular pulmonary or aortic stenosis. Aortic regurgitation was identified in 9 patients, which was mild in 7 and moderate in 2 and had progressed in some cases. Two patients who had an unremarkable perioperative course were identified as having coronary artery obstructions. The other late survivors were in good condition, were in sinus rhythm, and had normal LV functions. Actuarial survival rate at 8 years was 68.8%. Conclusion: We concluded that anatomic correction will be established as the optimal approach to the TGA with intact ventricular septum, though further long-term evaluations are needed.

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Morphologic Response of Gravel Beach to Typhoon Invasion - A Case Study of Gamji Beach Taejongdae in Busan (태풍 내습 시 자갈 해빈의 지형반응 - 부산 태종대 감지 해빈의 사례)

  • Lee, Young Yun;Chang, Tae Soo
    • Journal of the Korean earth science society
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    • v.41 no.1
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    • pp.19-30
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    • 2020
  • To understand the impact of typhoons on Gamji gravel beach Taejongdae in Busan, we carried out beach profiling using a VRS-GPS system and a Drone photogrammetry for the typhoons 'Kong-rey' invaded in October 2018 and 'Danas' in July 2019. In addition, grain sizes are analyzed to investigate the overall distribution pattern of gravels on the beach, and the beach topography is surveyed periodically to confirm the recovery rate of the beach. Grain-size analysis reveals that mean gravel sizes, in general, become finer from -6.2Φ to -5.4Φ towards the east in the seashore line direction. Variation in mean sizes is obviously observed in the cross-shore direction. Gravels in the swash zone are relatively fine about -4.5Φ in size and equant in shape, whereas the coarse and oblate gravels ranged from -5Φ to -6Φ are found in the berm. Gamji gravel beach particularly has two lines of berms: a lower berm situated facing beach and an upper berm about 10 m landward. After the typhoon Kong-rey passed by, about 1.4 m of severe erosion in upper berm occurred, and the berm eventually disappeared. On the backshore of the upper berm about 50 cm of erosion took place so that the elevation became lower. However, tangible erosion was not observed in the lower berm. When typhoon Danas hit, rated as mild storm, both upper and lower berm were eroded out. However, about 50 cm of deposition occurred only in the backshore. Only three days later, the new lower berm was formed, meaning that sedimentation rate must be high. This result indicates that Gamji gravel beach is recovered very fast from erosion caused by the typhoons when it is under the fair-weather condition even though beach morphology changes dramatically in a short period of time. Gravel beach is estimated to be or evaluated very resilient to typhoon erosion.

Effects of Potassium-Channel Opener on Thallium-201 Kinetics: In-vitro Study in Rat Myocyte Preparations and In-vivo Mice Biodistribution Study (K-통로개방제가 배양심근세포와 생쥐 체내의 Thallium-201역동학에 미치는 영향)

  • Lee, Jae-Tae;Kim, Eun-Ji;Ahn, Byeong-Cheol;Sohn, Kang-Kyun;Lee, Kyu-Bo;Ha, Jeoung-Hee;Kim, Chun-K.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.507-515
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    • 1996
  • Background : Potassium channel opener (K-opener) opens ATP-sensitive K'-channel located at cell membrane and induces potassium efflux from cytosol, resulting in intracellular hyperpolarization. Newly synthesized K-opener is currently examined for pharmacologic potency by means of rubidium release test from smooth muscle strip pre-incubated with Rb-86. Since in-vivo behavior of thallium is similar to that of rubidium, we hypothesized that K-opener can alter T1-201 kinetics in vivo. Purpose : This study was prepared to investigate the effects of pinacidil (one of potent K-openers) on the T1-201 uptake and clearance in cultured myocyte, and in-vivo biodistribution in mice. Methods : Spontaneous contracting myocytes were prepared to imitate in-vivo condition from 20 hearts of 3-5 days old Sprague-Dawley rat and cultured for 3-5 days before use ($5{\times}10^5$ cells/ml). Pinacidil was dissolved in 10% DMSO solution at a final concentration of 100nM or l0uM and was co-incubated with T1-201 in HBSS buffer for 20-min to evaluate its effect on cellular T1-uptake, or challenged to cell preparation pre-incubated with T1-201 for washout study. Two, 40 or $100{\mu}g$ of pinacidil was injected intravenously into ICR mice at 10 min after $5{\mu}Ci$ T1-201 injection, and organ uptake and whole body retention rate were measured at different time points. Results : Co-incubation of pinacidil with T1-201 resulted in a decrease in T1-201 uptake into cultured myocyte by 1.6 to 2.5 times, depending on pinacidil concentration and activity of T1-201 used. Pinacidil enhanced T1-201 washout by 1.6-3.1 times from myocyte preparations pre-incubated with T1-201. Pinacidil treatment appears to be resulted in mild decreases in blood and liver activity in normal mice, in contrast, renal and cardiac uptake were mildly decreased in a dose dependent manner. Whole body retention ratios of T1-201 were lower at 24 hour after injection with $100{\mu}g$ of pinacidil than control. Conclusion : These results suggest that treatment with K-opener may affect the interpretation of T1-201 myocardial images, due to decreasing thallium accumulation and enhancing washout from myocardium.

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A Convenient Radiolabeling of [$^{11}$C](R)-PK11195 Using Loop Method in Automatic Synthesis Module ($^{11}$C 표지 자동합성장치에서 루프법을 이용한 ($^{11}$C)(R)-PK11195의 간편한 합성법)

  • Lee, Hak-Jeong;Jeong, Jae-Min;Lee, Yun-Sang;Kim, Hyung-Woo;Choi, Jae-Yeon;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.337-343
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    • 2009
  • Purpose: ((R)-1-(2-chlorophenyl)-N-1-[$^{11}$C]methyl-N(1-propyl)-3-isoquinoline carboxamide ((R)-PK11195) is a specific ligand for the peripheral type benzodiazepine receptor and a marker of activated microglia, used to measure inflammation in neurologic disorders. We report here that a direct and simple radiosynthesis of [$^{11}$C](R)-PK11195 in mild condition using NaH suspension in DMF and one-step loop method. Materials and Methods: (R)-N-Desmethyl-PK11195 (1 mg) in DMSO (0.1 mL) and NaH suspension in DMF (0.1 mL) were injected into a semi-prep HPLC loop. [$^{11}$C]methyl iodide was passed through HPLC loop at room temperature. Purification was performed using semi-preparative HPLC. Aliquots eluted at 11.3 min were collected and analyzed by analytical HPLC and mass spectrometer. Results: The labeling efficiency of [$^{11}$C](R)-PK11195 was 71.8$\pm$8.5%. The specific activity was 11.8:$\pm$6.4 GBq/$\mu$mol and radiochemical purity was higher than 99.2%. The mass spectrum of the product eluted at 11.3 min showed m/z peaks at 353.1 (M+1), indicating the mass and structure of (R)-PK11195. Conclusion: By the one-step loop method with the [$^{11}$C]CH3l automated synthesis module, [$^{11}C$](R)-PK11195 could be easily prepared in high radiochemical yield using NaH suspension in DMF.

Microscopic Observation of Pellets Fabricated with Torrefied Larch and Tulip Tree Chips and Effect of Binders on the Durability of the Pellets (반탄화 낙엽송 및 백합나무 칩으로 제조한 펠릿의 현미경 관찰과 펠릿의 내구성에 대한 바인더의 영향)

  • Park, Dae-Hak;Ahn, Byung Jun;Kim, Sang Tae;Lee, Jae-Won;Han, Gyu-Seong;Yang, In
    • Korean Chemical Engineering Research
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    • v.53 no.2
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    • pp.224-230
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    • 2015
  • This study was conducted to investigate the effects of several variables on the durability of wood pellets fabricated with torrefied larch (LAR) and tulip tree (TUT) chips. Microscopic observation by scanning electron microscope-energy dispersive X-ray spectrometer was also performed to identify the surface of the wood pellets visually. In addition, torrefied-LAR and TUT pellets were fabricated with the addition of moisture, lignin, starch and protein as binders, and durabilities of the pellets were analyzed statistically. Durabilities of torrefied-LAR and TUT pellets were lower than one of non-torrefied-LAR and TUT pellets. Durabilities of both pellets fabricated with the wood chips, which were torrefied with $230^{\circ}C$ and 30 min, were the highest among all torrefaction conditions used in this study. From the microscopic observations, lignin was distributed broadly on the surface of non-torrefied wood pellets, whereas congregated partially on the surface of torrefied wood pellets. Durability of LAR pellets increased with the addition of moisture, but that of TUT pellets was reduced. Addition of binders contributed to increase the durability of LAR and TUT pellets. As a binder, lignin and protein were more effective than starch for improving the durability. In conclusion, mild torrefaction treatment, such as $230^{\circ}C$ and 30 min, might be an optimal condition to minimize the durability reduction of the LAR and TUT pellets. In addition, when torrefied woody materials with high and low specific gravities are used as a raw material for the production of durable wood pellets, it might be required to adjust moisture content and torrefaction conditions of woody materials, respectively.