• Child Health Nursing Research
• /
• 제4권1호
• /
• pp.5-16
• /
• 1998

The purpose of nursing education is to prepare the professional pratictioner as nurse who will be interesteed in the health and the related aspects of community and will assume responsibility for con tributing toward the improvement of the health for the all. This means that nursing education must provide opportunities for the development of knowledge, skills, and attitudes which make this possible. Consequently, this approach has relavence for nursing education. Faculty engaged in endless debates about what is to be included, and to what de1th, and what will be given short shrift as a result. Thus, it can be seen why there is so much confusion and lack of agreement between the emphasis and objectives in nursing. This study attempted to review and identify the curriculum content of child nursing in Korea to build and develop the standard curriculum contents for national board examination for nurses and child's health needs for the coming 21st centry. The questionnaire was consisted of items for selection and organization of the knowledge components and type of unit with weigh to be attained in child nursing. Response of 34% of nursing program in university and junior college. Content analysis was done by using consensual validation of essential knowledge for curriculum content to identify what is obvious or trivial. This study pointed out that it is not yet apparent that demographic fact has greatly influenced child nursing curriculum content. In a similar vein the majority of content of child nursing devote little time and weigh to social and epidemically significant to child health. It seems to be needed that the content of child nursing may push the paradigm shift in nursing education such as health promotion and prevention for potentional roles of child and family. In conclusion, it is the time to convoke and debate for convergence of model on essential content and standarization on job analysis for national board exam for nurses in Korea.

• Journal of Korean Neurosurgical Society
• /
• 제30권sup1호
• /
• pp.85-90
• /
• 2001

Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제41권
• /
• pp.19.1-19.6
• /
• 2019

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권9호
• /
• pp.4353-4356
• /
• 2016

Purpose: To study the prevalence of CIN2+ diagnosis in women with atypical Papaniculoau (Pap) smears to suggest appropriate management option for Thai health care. Materials and Methods: Data from all patients with liquid based cytology with human papillomavirus (HPV) testing between May 2013 - May 2016 were collected from medical records. Women with atypical cervical Pap smears were recruited. Results for age, HPV testing, HPV 16, 18, 45 and other genotypes tested, colposcopic examination and histopathological assessment were all collected. Atypical smears were defined as atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot be exclude high grade squamous intraepithelial lesion (ASC-H). Results: A total of 2,144 cases were recruited. Twenty six women with ASC-US on cytology had high risk (HR) HPV detection while eight cases with ASC-H had HR-HPV (40.0% VS 72.7%, p=0.005). Among the 26 women with ASC-US cytology and positive HR-HPV, HPV type 16 (n=8, 30.8%), type 18 (n=1, 3.8%), type 45 (n=1, 3.8%) and other HPV types (n=17, 65.4%) were found. Eight women with ASC-H and positive HR-HPV demonstrated type 16 (n=6, 75%) and other HPV types (n=2, 25%). Fifty seven women with ASC-US had normal colposcopy, CIN1 and CIN2+ at percentages of 80.7 (46/57), 14.0 (8/57) and 5.3 (3/57), respectively. In the ASC-H group, 7 out of 10 women had normal colposcopy and three (30%) had CIN2+ results. Conclusions: In women with ASC-US cytology, immediate colposcopy is highly recommended. HPV testing can be performed if colposcopy is not an available option because there was high prevalence (5.3%) of CIN2+ in our findings. ASCCP recommendations for ASC-H that colposcopy should be performed on all ASC-H cases regardless of HPV result are thereby supported by the findings of this investigation.

• 한국산학기술학회논문지
• /
• 제16권9호
• /
• pp.6130-6141
• /
• 2015

본 연구는 산업장 근로자들의 건강검진결과를 토대로 BMI 변화에 따른 혈압의 변화 및 고혈압 발생비율과의 관련성을 명확하게 파악하고자 시도하였다. 조사대상은 2002년부터 20012년까지 11년간 정기건강검진을 받았던 30세부터 69세까지의 산업장 근로자 28,249명(남자 25,548명, 여자 2,701명)으로 하였다. 자료의 분석은 2002년부터 20012년까지의 BMI 구분에 따른 혈압의 평균치를 분석하였다. 또한, 기준년도(2002)로부터 10년간의 BMI의 변화량구분별로 혈압의 평균변화량을 산출하였으며, 정상혈압에서의 BMI 구분별 10년간의 고혈압의 년차별 비율을 분석하였다. 연구결과, 10년간의 평균혈압은 BMI가 저체중군에서 정상체중군, 비만군으로 갈수록 유의하게 증가하였으며, 10년간의 고혈압 발생비율도 BMI가 낮은 군에서 높은 군으로 갈수록 유의하게 증가하였다. 결론적으로 10년(2002-20012)간의 BMI의 증가는 혈압의 증가에 유의한 영향을 미치는 것으로 밝혀졌다.

• 한국방사선학회논문지
• /
• 제13권4호
• /
• pp.629-635
• /
• 2019

유방암 환자의 사회 심리적 적응 영향 요인을 수술, 방사선, 항암치료 후의 삶의 질 변화를 체계적 메타분석한 결과 방사선 치료시 삶의 질은 치료직후에 가장 낮았고 종료 후에는 점점 상승하고 있지만 종료 6개월 후에도 치료 전의 삶의 질 만큼 회복 되지 않았다. 우울증과 부작용은 치료 직후 가장 높았으며 치료 종료 후에는 다소 감소하였다. 수술요법의 경우 학력이 높을수록 심리 사회적 적응이 높았으며 검진과 보험가입이 있을 경우 심리 사회적 적응이 좋았다. 항암 화학요법의 경우 인지기능에 영향을 받아 기억력, 학습, 사고 등의 단계에서 장해를 받고 있으며 주관적 인지장애와 우울은 연관성이 있어서, 항암요법환자의 우울증의 추적관찰이 필요하다. 본 체계적 메타연구 결과 유방암환자의 3가지 치료법(수술요법, 방사선요법, 항암요법)을 시행 할 때 간호분야와 방사선 치료분야는 이러한 환자의 사회심리적 적응, 우울, 불안, 삶의 질의 경향을 인지하여 전인적 접근을 할 수 있도록 중재프로그램을 도입해야 할 것으로 생각된다.

• Journal of Chest Surgery
• /
• 제10권1호
• /
• pp.98-105
• /
• 1977

A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

• Investigative Magnetic Resonance Imaging
• /
• 제9권1호
• /
• pp.2-8
• /
• 2005

목적 : 뇌종양 및 확산텐서 영상으로 얻어진 그 주변 신경 다발을 동시에 가시화하는 소프트웨어를 구현하고 그것을 통해 뇌종양이 그 주변 신경다발에 미치는 영향에 대한 조사에의 적용 가능성을 시험해 보고자하였다. 대상 및 방법 : IDL을 기반으로 뇌종양과 그 주변 신경다발의 통합적 가시화를 구현하였다. 뇌종양을 가진 한 환자에 대한 T1 강조영상 및 확산텐서 영상을 포함하는 자기공명영상이 3.0T자기공명장치에서 획득되었다. 우리는 해부학적 정보를 위해 두개골을 제거한 뇌 영상과 구획화된 뇌종양을 위한 대조강화 T1 강조 영상을 이용하여 서피스 및 볼륨렌더링을 사용하였다. 대뇌 백질 신경 다발추적을 위해 사용되는 확산텐서영상을 위해서는 25개 방향의 확산경사 자계를 이용하는 SE-EPI방법을 사용하였다. 신경 다발추적 방법으로는 streamline과 tensorline 방법을 사용하였다. T1 강조 영상 및 확산텐서 영상의 공간적 불일치를 보정하기 위해 SPM을 이용한 정합을 수행하였다. 우리의 소프트웨어는 PC 윈도우 환경에서 작동할 수 있도록 구현되었다. 결과 : 한 명의 뇌종양 환자에 대하여 튜브 모양의 신경다발, 대뇌 백질 서피스 렌더링 , 뇌종양의 볼륨/서피스렌더링의 통합적 가시화를 성공적으로 구현하였다. 결론 : 우리의 결과는 뇌종양 및 그 주변 신경다발의 통합적 가시화의 실현 가능성을 보여주었다. 더불어 우리의 구현된 통합적 가시화는 뇌종양 부위 및 그 주변 부의의 대뇌 백질 확산 비등방성의 정량적인 분석에 사용될 수 있을 것으로 기대된다.

• 한국한의학연구원논문집
• /
• 제9권1호
• /
• pp.35-50
• /
• 2003

In Korean traditional medicine, there are 4 major diagnoses. They are 'Mang (Watching)', 'Mun (Listening)', 'Mun (Asking)', and 'Jeul (Touching)'. These ways are closely related to each other. Among the four, 'Jeul' is the most famous one because it is the final way of checking the pulse for the cure. Pulse checking has been used as an essential way of diagnosis, but there are some difficulties in doing so in the business matter. To overcome these problems the theories should be studied profoundly and heterogeneously. More importantly, these endeavors must be pursued on the basis that pulse-checking must be. done along with other diagnostic ways to diagnose more precisely and practically. Therefore, I want to study and analyze the pragmatic ways to help the business field. Wang Suk-Hua(王叔和) arranged the methods and theories of 'pulse-checking' that was used before Nea-kyung. The book is called Maek-kyung. But this is too complicated to use in the field. As a result Maek-kyul(脈訣) which is made of songs that help to memorize and practice was gain more popularity than the ${\lceil}$Maekkyung(脈經)${\rfloor}$ itself. But the songs are so simple and compact that the offsprings annotated this book again and made books consist of these annotations. Among these books ${\lceil}$Chandobangronmaekkyulgipsung(纂圖方論脈訣集成)${\rfloor}$(1349) which was written in Won(元) dynasty was imported to Cho-sun(Korea) and used as the most important book on pulse-checking. So I will study ${\lceil}$Maekkyul(脈訣)${\rfloor}$ which contains the essence of ${\lceil}$Chandobangronmaekkyulgipsung(纂圖方論脈訣集成)${\rfloor}$. And I will also study ${\lceil}$Dojumaekkyul(圖註脈訣)${\rfloor}$ and ${\lceil}$Maekkyulyouhae(脈結乳解)${\rfloor}$ as conference. The former, written by Jang-sae-hyun(張世賢), contains narrative paintings and prescriptions according to pulses. And the latter, written by Wang Bang-bu(王邦傅), contains criticism of earlies annotations along with his own theory. ${\lceil}$Chandobangronmaekkyulgipsung(纂圖方論脈訣集成)${\rfloor}$ was chosen as a text book of medical examination according to ${\lceil}$Kyungkukdaejun(經國大典)${\rfloor}$ and had been used during Cho-sun, dynasty after closely corrected by Heo Jun(許浚). It means, during Cho-sun Dynasty, everyone who wants to become doctor had studied pulse-checking through this book, and also means Cho-sun medicine emphasizes practicality. This book and the pulse-checking part of ${\lceil}$Dongeibogam(東醫寶鑑)${\rfloor}$, which published later, made the main frame of pulse-checking during Cho'sun Dynasty. As above, studing ${\lceil}$Chandobangronmaekkyulgipsung(纂圖方論脈訣集成)${\rfloor}$ which was major textbook of pulse-checking in Cho-sun, helps to study pulse checking itself as an important way of diagnosis in Korean traditional medicine. And more than that it helps us to understand. the. practical development of pulse-checking dyring Cho-sun dynasty. With these reasons I studied ${\lceil}$Chandobangronmaekkyulgipsung(纂圖方論脈訣集成)${\rfloor}$ conferring ${\lceil}$Dojumaekkyul(圖註脈訣)${\rfloor}$ and ${\lceil}$Maekkyulyouhae(脈結乳解)${\rfloor}$ to understand ${\lceil}$Maekyung(脈經)${\rfloor}$ which is practical book of pulse-checking. During so I got some achievements and I report it as. follows.

• Journal of Genetic Medicine
• /
• 제8권1호
• /
• pp.53-57
• /
• 2011

목 적: 윌슨병은 간조직에 구리의 과도한 침착으로 발병하는 상염색체 열성 유전질환이다. 지금까지 ATP7B 유전자가 유일한 원인유전자로 알려져 왔다. 그러나, 약 15%의 환자에서는 ATP7B 유전자 돌연변이가 발견되지 않는다. 본 연구는 ATP7B 유전자의 돌연변이가 발견되지 않은 윌슨병 환자를 대상으로 새로운 원인 유전자를 발견하기 위하여 시행되었다. 대상 및 방법: ATP7B 돌연변이가 발견되지 않은 12명의 윌슨병 환자를 대상으로 ATP7B 와 상호작용을 하는 것으로 알려진 ATOX1, COMMD1, GLRX, DCTN4와 ZBTB16 유전자의 전사부위와 엑손-인트론 경계부위의 염기서열을 분석하였다. 결 과: DCTN4 유전자의 12번 엑손에 존재하는 c.1084A>G(p.Thr362Ala)를 포함하는 3가지의 변이가 환자에서 발견되었다. in silico 분석을 통해 3가지 변이 중 c.1084A>G가 유일하게 단백질 기능 변화를 일으킬 것으로 예측되었다. 176명의 윌슨병 환자와 414명의 정상인을 대상으로 이 변이의 빈도를 조사한 결과, 정상인보다 윌슨병 환자에서 더 높은 빈도를 나타내었다(상대비, odds ratio [OR]=3.14, 95% 신뢰도=1.36-7.22, P=0.0094). 결 론: 본 연구의 결과는 ATP7B 와 상호작용하는 DCTN4 유전자의 c.1084A>G (p.Thr362Ala) 다형성이 윌슨병의 발병과 연관이 있음을 시사한다.