간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

Cholelithiasis complicated with biliary sludge and urolithiasis in a dog

Seung-gon Lee,Dong-gun Kim,Joon-seok Lee,Ho-hyun Kwak,Hyun-sook Nam,Heung-myong Woo*, In-Chul Park**, Changbaig Hyun1,In-chul Park,Chang-baig Hyun 한국임상수의학회 2006 한국임상수의학회지 Vol.23 No.3

A 10-year-old intact female Miniature Schnauzer dog was referred with the primary complaint of persistentanorexia, remittent fever, vomiting and abdominal pain. Hemogram suggested a chronic inflammatory disease. Serumbiochemistry showed moderate hepatobiliary cellular damage with severe cholestasis. Abdominal radiography andultrasonography revealed hepatomegaly, choleliths and sludges in gall bladder and small stones in urinary bladder. Basedcholecystectomy and cystectomy, choleliths and uroliths were removed from gall bladder and urinary bladder,respectively. The clinical condition was dramatically improved after surgery.

치근단 미완성 치아의 자가치아이식

정지숙,박호원,이주현,서현우 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

자가치아이식이란 자신의 치아를 구강 내의 한 위치에서 다른 발치와나 외과적으로 형성된 치조와로 이동시키는 술식이다. 통상적으로 이 술식은 상실되거나 보존하기 힘든 제1대구치를 다른 치아로 대체하거나, 매복된 견치를 악궁의 정상 위치로 이동시키거나, 전치부와 같이 심미적으로 중요한 부위의 상실된 치아를 소구치로 대체하는 경우에 많이 사용된다. 자가치아이식을 성공적으로 수행하기 위해서는 세심한 수술 기법과 더불어 적절한 증례 선택이 중요한데, 이식할 치아는 치근 발육이 1/2~3/4 정도 이루어진 미성숙 치아가 유리하고 근단공이 넓을수록 치수 재혈관화의 가능성도 높아져 이후의 근관 치료의 필요성도 줄일 수 있다. 본 증례들은 소아에서 치근단 미완성 치아의 자가치아이식을 통해 임상적, 방사선학적으로 양호한 치유 결과를 얻었고, 별도의 근관 치료 없이 양호한 치수 치유 결과를 보였기에 보고하는 바이다. Autogenous tooth transplantation can be defined as the surgical movement of a tooth from one position in the mouth to another in the same individual. The most common reasons for tooth transplantation include replacement of a missing first molar, transplantation of impacted canines to their normal positions in the arch, and transplantation of premolars in areas of missing teeth, especially in the anterior area of the mouth. The key to successful tooth transplantation is proper selection of graft with adequate root development as well as the design of surgical operation. Root development stage with half to three-quarter-developed roots increase the success rate of autotransplantation. We report the cases of successful autotransplantation which resulted in ideal healing of periodontal ligament, gingiva and alveolar bone. All transplanted teeth presented immature root formation at the moment of the procedure. After surgical procedure, we can observe good healing pattern without endodontic problem.

이탈리안 라이그래스의 성숙종자 유래 캘러스로부터 효율적인 식물체 재분화

우현숙,이상훈,이동기,김진수,원성혜,이병현 Plant molecular biology and biotechnology research 2004 Plant molecular biology and biotechnology research Vol.2004 No.-

As an initial step for future genetic manipulations to improve forage characteristics of Italian ryegrass (Lolium multiflorum Lam.), an efficient tissue culture system was established and the factors affecting plant regeneration were evaluated. MS medium containing 5 ㎎/L 2,4-D was optimal for embryogenic callus induction from mature seed and had a strong effect on successive plant regeneration. The plant regeneration frequency was observed at above 70% when embryogenic calli induced were transferred to N6 medium supplemented with 1 ㎎/L 2,4-D and 5 ㎎/L BA. Among several basic media tested, MS and M6 medium were optimal for callus induction and plant regeneration, respectively. Genotype was an important factor in plant regenerability. 'Jeanne' showed the highest regeneration frequency of 73%. A short tissue culture period and high-frequency regeneration system established in this study will be useful for molecular breeding of Italian ryegrass through genetic transformation.

근로자 건강증진전략을 위한 행동변화에 대한 요구도 평가

이강숙,임현우,구정완,홍현숙,이정민,이원철,박정일,맹광호,M, O'Donnel 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the stage of behavior change for health promotion strategy in workplace Methods : Questionnaire survey was carried out for 309 workers who employed in H Electronics company in Kyong-in area from September to October 1998. Results : According to need assessment of four step such as precontemplation stage, contemplation stage, action stage, maintenance stage which were to change of behavior for health promotion, the percent for quitting smoking were observed 48.8%, 43.1%, 8.1%, 0%, and for the restriction of drinking were 29.8%, 10.6%, 9.3%, 5.3%; for fitness 11.1%, 31.0%, 37.3%, 20.6% in male 26.6%, 27.8%, 26.6%, 19.0% in female, for regular diet 26.1%, 19.8%, 38.7%, 15.3% in male, 27.8%, 22.2%, 40.0%, 10.0% in female and for stress management 5.8%, 10.6%, 8.7%, 75.0% in male, 13.6%, 22.7%, 19.7%, 44.0% in female. In heavy smoker(p=0.017) and heavy drinker,(p=0.021) the percent of precontemplation stage was significantly higher than in lower drinker and light smoker. Conclusions : This study suggested that company support for health promotion in workplace was and workers of high risk group for smoking and drinking were in precontemplation stage. So before conducting the health promotion program, health risk appraisal and need assessment for stage of behavior change should be taken for the efficient health promotion strategy.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

Encephalomyocarditis Virus 표면항원의 단일항체생산 세포주의 크론과 이의 면역학 및 생화학적 연구(I)

윤장현,이숙영,김우제,윤지원,고광삼 朝鮮大學校 附設 醫學硏究所 1986 The Medical Journal of Chosun University Vol.11 No.1

To determine the immunological and biochemical properties of monoclonal antibody against encephalomyocardins viral surface antigen, Balb/c female mice were immuunized with the purified viral surface protein of D-variant of encephalomyocarditis virus and then fused with niyeloma cells(NS-l). Sixteen monocloiial antibody-producing hybridoma cell lines were selected from non-producing hybridoma cell lines. Among them, three hybridoma cell lines produced IgG2b and other thirteen hybridoma cell lines produced IgG1. Two hybridoma cell lines, EDH-S-23 and EDH-S-24, Produced IgG2b and showed highest neutralization titer, 236. The antigenic specificity of these monoclonal antibodies was specific to D-variant of encephalomyocarditis virus. VIoreover, the monoclonal antibody showed specifically the curring effect on diabetes mellitus of mice, which was induced by the D-variant of encephalomyocarditis virus.

메추리알의 저장성 향상에 대한 세척 및 저장 조건의 효과

차보숙,김학현,엄권용,김우정 한국산업식품공학회 2003 산업 식품공학 Vol.7 No.4

메추리알의 저장성 향상을 위하여 세척수의 온도와 pH, 세척후의 mineral oil coating, 저장중 공기의 상대습도(RH)와 CO₂의 영향을 비교하였다. 메추리알의 품질특성은 난황계수, Haugh unit, 중량감소를 측정하였다. 그 결과 세척수 온도 50℃와 pH 11.0의 KOH 용액이 수돗물이나 pH 3.5의 lactic acid 용액으로 세척한 것보다 저장성 향상에 효과가 있었다. 환경기체조건을 상대습도 70%와 3.0% CO₂ 농도로 조절한 것은 상대습도 80%와 2.0% CO₂의 조건보다 저장 기간을 50% 이상 연장 시켰다. 또한 mineral oil로 coating 처리할 경우 50℃에서 알칼리 용액으로 세척한 후 상대습도 70% 및 3.0% CO₂ 조건에서 저장하는 것보다 54% 가량 저장성 향상에 효과가 있었다. 이러한 조건에서 저장온도를 4℃로 낮출 경우 3개월 이상의 저장이 가능하였으며 선정된 세척 및 환경기체 조건은 저장 중 메추리알의 무게의 감소도 크게 낮춰 주었으며, 특히 mineral oil coating은 무처리구와 비교할 때 2.5배 이상 무게감소를 억제하는데 효과적임을 알 수 있었다. Effects of pH and temperature of the washing water, mineral oil coating, and PH and CO₂consentration for storage were investigated to extend the shelf-life of quail eggs. The quality characteristics of quail eggs measured were yolk index(YI), Haugh unit(HU) and weight loss. The results showed that KOH-adjusted washing water of pH 11.0 at 50℃ were effective on the improvement of storage stability of the eggs. Comtrolled atmosphere of RH 70.0% and 3.0% CO₂resulted in prolonged shelf-life by 50% when it was compared to the condition RH 80.0% and 2.0% CO₂. Coating the eggs with mineral oil extended futher the shelf-life up to 54%. combined treatments of washing at 50℃ and pH 11.0, coating with mineral oil, and controlling the atmosphere at RH 70.0% and 3.0% CO₂ extended the shelf-life more than 4 monts during storage at 4℃. The wight loss of the eggs during storage was significantly reduced by the storage at above condition and treatment particularly storing at 4℃.

조직학적 진단된 chronic necrotizing pulmonary aspergillosis 2예

김연숙,정숙인,기현균,김춘관,김신우,한정호,김성민,백경란,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

CNPA는 기존의 폐질환 및 폐절제술로 인해 국소방어기전에 저하가 있거나 비특이적 전신면역상태저하를 갖고 있는 환자들에게서 주로 발생하는 만성적인 공동성 폐질환이다. 현재까지 우리나라에서는 CNPA의 보고가 없는 상태이고, 저자들은 최근 조직학적으로 진단된 CNPA 2예를 경험하였기에 보고하는 바이다. 저자들이 경험한 CNPA 환자들은 만성알코올 중독 및 기관지확장증과 같은 기저질환과 폐절제술을 받은 병력이 있었다. Aspergillus가 폐실질을 침윤하고 있는 조직소견과 조직배양에서 Aspergillus가 검출되어 조직학적 진단이 가능하였고, amphotericin B의 정주요법 및 경구 itraconazole 투여와 폐절제술 등으로 성공적으로 치료되었다. 아직 많은 임상의들에게는 낯선 질환인 CNPA의 치료성적은 환자의 동반질환 및 CNPA 자체의 중증도, 진단과 치료 시작의 지연 등에 의해 크게 좌우되므로 만성적으로 진행하는 공동성 폐병변을 갖고 있는 환자에게서 CNPA를 감별하는 것이 중요하다. Chronic necrotizing pulmonary aspergillosis (CNPA) is a chronic cavitary form of pulmonary aspergillosis. Dozens of CNPA cases have been reported in patients with systemic immunologic dysfunction or altered local defense mechanism from preexisting pulmonary disease. Review of literatures revealed that no CNPA cases have been reported in Korea yet. We experienced two cases of CNPA proven by lung biopsy. A 53-year-old alcoholic male in poor nutritional state was admitted with generalized weakness and weight loss. Chest CT revealed a cavitary nodule surrounded with ground-glass attenuation. CT-guided fine needle aspiration and biopsy was done. The biopsy specimen demonstrated dichotomously branching septated hyphae consistent with those of Aspergillus sp. Another case was a 39-year-old man with bronchiectasis who was admitted with persistent hemoptysis. He had a past history of pulmonary tuberculosis. A parahilar lesion with intracavitary soft tissue mass was incidentally detected in high-resolution GT. Left lingular segmentectomy was done due to uncontrolled hemoptysis and CNPA was histologically diagnosed. Both patients were successfully treated with intravenous amphotericin B followed by oral itraconazole. Even though CNPA is unfamiliar to most clinicians, it should be included in differential diagnoses of chronic progressive cavitary pulmonary lesion, especially in patients with immunologic dysfunction.