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

EDTA와 Nd:YAG laser가 근관충전 후 치근단 미세누출에 미치는 영향

권진수,이희주,허복 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.1

The purpose of this study was to evaluate the effects of EDTA and pulsed Nd:YAG laser on apical leakage of canal obturation. Forty-eight single-rooted teeth were used in this study. The teeth were instrumented up to a size 40 K-file and irrigated with 2.5% NaOCI between each file size. And the teeth were divided into 4 groups. In group A. the root canals were irrigated with a final flush of 5ml 17% EDTA. The teeth in group C and D were irradiated by pulsed Nd:YAG laser(laser parameters were set at 1W, 100mJ, 10Hz, and 2W, 100mJ, 20Hz respectively). The results were as follows; 1. Apical leakage was observed in 50% of samples in group A, 30% of samples in group B, 20% of samples in group C, and 10% of samples in group D. 2. The teeth in group B had less leakage than group A, but there was no statistically significant differences(p>0.05). 3. The teeth in group C, D had less leakage than group A, and there was statistically significant differences(p<0.05). 4. The teeth in group C, D had less leakage than group B, but there was no statistically significant differences(p>0.05). 5. There was no significant differences in apical leakage between group C and group D(p>0.05).

급성 백혈병 환자에서 감염증의 양상 및 예후인자에 관한 연구 : 1988년∼1995년까지

정희진,김병수,신상원,김열홍,김우주,김민자,김준석,박승철,김권범 대한감염학회 1998 감염 Vol.30 No.3

목적 : 급성 백혈병의 경우 골수기능이 억제되고 항암화학요법에 따른 골수기능 저하로 감염의 위험이 증가하며 감염의 치료가 환자의 생존에 큰 영향을 미치게 된다. 이에 저자들은 1988년부터 1995년까지 고대 구로병원에 급성 백혈병으로 입원했던 환자들 중 입원 기간 내 감염이 있었던 경우를 대상으로 하여 감염의 위험인자 및 감염증의 예후를 후향적으로 분석함으로써 향후 급성 백혈병환자의 감염의 치료에 대한 지침을 얻고자 하였다. 방법 : 급성 백혈병으로 확진된 환자들 중 감염병에 이환된 경우를 대상으로 하여 각각을 미생물학적 확인감염, 임상적 확인감염, 그리고 설명 불가열로 구분하였다. 각각의 경우에서 감염 당시의 호중구 수, 호중구 감소 기간, 항암화학요법과의 연관성, 감염 병소, 배양된 검체 및 원인균, 선택적 소화관 살균법의 사용여부 및 골수회복 여부 등을 조사한 후 환자의 예후와 어떤 관계가 있는 지 조사하였다. 결과 : 연구 대상은 총 113예로 남녀비는 46:67 이었고 평균연령은 34±13세, 진단은 급성 골수성 백혈병 (AML)이 84예, 급성 림프구성 백혈병(ALL)이 29예였으며, 감염시 평균 호중구수는 663±1678/㎣이었고, 호중구 감소 기간은 평균 18±13일이었다. 감염양상은 항암화학요법과 연관된 감염이 84예로 대부분이었고 미생물학적 확인 감염이 40예로서 35%였으며, 폐렴과 원발성 패혈증이 각각 20예와 19예로 가장 많았고, 카테터 연관 감염이 7예로 나타났다. 배양된 균주는 E. coli가 10예(25%)로서 가장 많았으며, 전체적으로 E. coli, P. aeruginosa, K. pneumoniae 등의 그람음성균이 63%로 대부분을 차지하였으나 최근 그람양성구군 및 진균의 분리율이 증가하는 양상을 보였다. 감염증의 예후를 분석한 결과 진균 감염인 경우나 호중구 감소 기간이 긴 경우 사망률이 높았으며 그 중에서도 골수 기능이 회복 여부가 환자들의 생존과 통계적으로 유의한 연관이 있었다.(P=0.01). 결론 : 급성 백혈병 환자들에서의 감염은 관해유도화학요법 후 초래되는 호중구 감소와 유의한 관계가 있으며, 폐렴 및 패혈증의 임상양상을 보이는 경우가 흔하고, 원인균별로는 그람 음성균이 주류를 이루나 최근 그람 양성균 감염이 증가하는 추세를 보였다. 감염의 예후 인자로는 진균 감염인 경우나 호중구 감소 기간이 긴 경우 사망률이 높았으나 골수 기능의 회복여부가 결정적인 역할을 하는 것으로 나타나, 향후 급성 백혈병 환자의 치료에 있어 감염 빈도의 감소와 감염에서의 조속한 회복을 위해서는 골수 기능의 회복에 중점을 두어야 할 것으로 사료된다. Background : Infection is one of the most important and fatal complications in patients with acute leukemia. The characteristics of infection in acute leukemic patients are different from those in other diseases by the lack of normal inflammatory responses or distinct clinical evidence except fever. To improve the outcome of acute leukemia, it is very important to recognize the risk factors, patterns and prognostic factors of acute leukemia. Methods : We analyzed retrospectively the patterns of infection from 113 febrile patients with acute leukemia from January, 1988 to December, 1995. To determine the prognostic factors and the outcome of infection, the following variables were analyzed: the presence of neutropenia, use of chemotherapeutic agents, type and site of infections, isolated organisms, gastrointestinal decontamination, duration of neutropenia, and bone marrow recovery. Results : Out of 113 febrile patients with acute leukemia, 84 infection episodes(74%) occurred after chemotherapy. The mean duration of neutropenia was 18±13 days. The incidence of microbiologically-documented infection(MDI) was 35%(40/113). Pneumonia was the most common infection(26%), followed by primary sepsis(24%), catheter-related infection(9%). In cases of MDI, 63% were caused by gram-negative bacteria, followed by gram-positive bacteria(28%), and fungi(10%). Escherichia coli(25%) was the most common isolated in MDI. Regarding the prognostic factors in cases with infections, the recovery of bone marrow function was the only statistically significant factor(P=0.01). Conclusion : Infection has been a major cause of morbidity and mortality in acute in acute leukemic patients. To prevent infection and thereby improve the prognosis of acute leukemia, restoration of bone marrow function at early stage is important.

화상 신호를 이용한 금속표면의 미소 결함 측정에 관한 연구

이주상,윤여권,김희남 明知大學校 産業技術硏究所 1993 産業技術硏究所論文集 Vol.12 No.-

This paper reports a method of measuring surface scratch using microscope and CCD. Included are both the theory of the technique and experimental verification. The range of surface scratch which can be accurately measured by this method is also reported. The nature of this method it is anticipated that the effective automatic testing and sorting can be possible for precision machining work.

광원의 종류에 따른 복합레진의 중합거동 및 중합률에 관한 연구

류주희,이인복,유현미,김미자,석창인,권혁춘 大韓齒科保存學會 2004 Restorative Dentistry & Endodontics Vol.29 No.4

Objectives: The purpose of this study was to observe the reaction kinetics and the degree of polymerization of composite resins when cured by different light sources and to evaluate the effectiveness of the blue Light Emitting Diode Light Curing Units (LED LCUs) compared with conventional halogen LGUs. Materials and Methods: First, thermal analysis was performed by a differential scanning calorimeter(DSC). The LED LCU (Elipar Freelight, 320㎽/㎠) and the conventional halogen LCU (XL3000, 400㎽/㎠) were used in this study for curing three composite resins (SureFil, Z-250 and AEliteFLO). Second, the degree of conversion was obtained in the composite resins cured according to the above curing mode with a FTIR. Third, the measurements of depth of cure were carried out in accordance with ISO 4049 standards. Statistical analysis was performed by two-way ANOVA test at 95% levels of confidence and Duncan's procedure for multiple comparisons. Results: The heat of cure was not statistically different among the LCUs (p > 0.05). The composites cured by the LED (Exp) LCUs were statistically more slowly polymerized than by the halogen LCU and the LED (Std) LCU (p< 0.05). The composite resin groups cured by the LED (Exp) LGUs had significantly greater degree of conversion value than by the halogen LCU and the LED (Std) LCU (p = 0.0002). The composite resin groups cured by the LED (Std) LGUs showed significantly greater depth of cure value than by the halogen LCU and the LED (Exp) LGU (p < 0.05).

계장화 압입곡선의 천이거동 모델링을 통한 비등방향 2축 표면 잔류응력 분석

이윤희,정증현,박주승,권동일 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.11

Non-destructive instrumented indentation is proposed as a promising alternative of the conventional stress-measuring methods based on already-reported its sensitivity to applied stresses. In this study, we tried to expand the current indentation model on equi-biaxial stress to the characterization of general surface stress in nonequi-biaxial state. A contribution of the surface stress on indentation plasticity was theoretically extracted from the non-equi-biaxial stress matrix. And, a newly derived stress equation was expressed as a multiple of stress non-equibiaxiality and residual-stress-induced normal load. An experimental tests for confirming the model were also conducted on artificially strained API X65 steel plate, and produced the non-equi-biaxiality factor consistent with that from theoretical analysis.

만곡근관에서 수종의 File을 이용한 근관형성시 만곡도 변화에 대한 비교 연구

신주희,권오양,윤수한 大韓齒科保存學會 1997 Restorative Dentistry & Endodontics Vol.22 No.1

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

Paclitaxel 및 Apo-2L/TRAIL이 자궁경부암 세포주 아포토시스에 미치는 영향

김주영,남계현,김태희,이권해,이해혁,배동한 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.2

Objective: TRAIL(also called Apo-2L) is a member of the tumor necrosis factor(TNF) family of cytokines which induces apoptosis cell death in a variety of tumor cell lines. It mediates its apoptotic effects through one of two receptors, DR4 and DR5, which are members of the TNF receptor family, and whose cytoplasmic regions contain death domains. TNF and Fas ligand induces apoptosis in tumor cells; however, their severe toxicity toward normal tissues hampers their application to cancer therapy. We examed if paclitaxed and/or Apo-2LTRAIL induces apoptosis of cervical cancer HeLa, SiHa, ME-180, and CaSki cells. Mehods : We have demonstrated that paclitaxel and Apo-2L/TRAIL induces apoptosis of cervical cancer HeLa, SiHa, CaSki and ME-180 cell lines in a dose-dependent manner. HeLa, SiHa, ME-180 and CaSki were obtained from American Type Culture Colection. Recombinant Human TRAIL(Chmicon). DR4 and DR5 were purchased from Santa Cruz. Paclitaxel, MTT assay Kit, Acridine orange and Ethium bormide were purchased from Sigma. HeLa and SiHa were grown in DMEM. ME-180 and CaSki were grown in RPMI. Tripan blue stain and MTT assay were done for cytotoxicity. Annexin V-FITC and PI(propidium iodide) flowcytometry for apoptosis assay. DR4 and DR% were expressed by Western Blot. Fluorescent Microscopy used Acridine orange(AO) and Ethium bromide(EB). Results : Importantly, concurrent treatment of cervical cancer cells with paclitaxed and Apo-2L/TRAIL induces significantly more apoptosis than Apo-2L/TRAIL alone. Conclusion : We need further studies which reveals possible therapeutic potential in the women with cervical cancer by suing Apo-2L/TRAIL.

Pseudomonas putida SM25로부터 Protocatechuate 3,4-dioxygenase를 암호하는 pcaHG 유전자의 분자적 클로닝 및 염기서열 분석

정영희,민경희,권주영 숙명여자대학교 자연과학연구소 1998 자연과학논문집 Vol.- No.9

Pseudomonas putida SM25로부터 protocatechuate 3,4-dioxygenase 를 암호하는 pcaHG 유전자를 클로닝하기 위하여 이미 알려져 있는 primer를 제작한 후 P. putida SM25의 염색체 DNA를 주형으로 하여 PCR product인 약 1.6 kb DNA 절편을 얻었다. 이 DNA 절편을 SalI과 EcoRV로 절단한 약 1 kb DNA 절편만을 probe로 사용하여, PstI으로 절단한 염색체 DNA 전편과 Southern blot을 실시한 결과, 4.4 kb의 PstⅠ DNA 절편을 얻었다. 이 절편을 pUC19 vector에 삽입하여. 재조합 플라스미드 pYJ27을 얻었으며, 이 재조합 플라스미드의 SphI, EcoRV, Pstl,SalI, Aval 등을 사용하여 제한효소 지도를 작성하였다. Insert DNA를 서브 클로닝 하여 pcaHG 유전자를 포함하는 DNA 절편의 염기서열을 결정한 결과, pYJ27에는 1336bp 크기인 두개의 open reading frames(ORFs)가 존재하였으며 protocatechuate 3,4-dioxygenase에 해당되는 437개의 아미노산을 암호하였다. 이미 보고된 protocatechuate 3,4-dioxygenases의 DNA 염기서열을 비교한 결과, Pseudomonas putida ATCC 23975와는 94% 정도의 비교적 높은 homology를 보였다. 또한 Rhodococcus나 Acinetobacter에서는 각각 63%, 55%의 homology를 보여 주었다. Protocatechuate 3,4-dioxygenase catalyzes the conversion of protocatechuate to β-carboxymuconate through the cleavage of the aromatic ring. The genes encoding subunits of the protocatechuate 3,4-dioxygenase were designated pcaH and pcaG, respectively. The locations of the genes for the α and β subunits of protocatechuate 3,4-dioxygenase on a 4.4 kb PstI fragment cloned from the Pseudomonas putida SM25 chromosome were determined. A 1.6-kb DNA fragment from a 4.4kb recombinant DNA was cloned into pUC19 vector, pYJ27. Recombinant plasmid pYJ27 was mapped with various restriction enzymes, SalI, EcoRV, PstI, SphI, and AvaI. According to bidirectional subcloning and method of dideoxynucleotide chain termination, we determined the nucleotide sequences of the recombinant DNA fragment pYJ27 containing pcaHG gene. The deduced amino acid sequences of pcaG and pcaH were consisted 200 and 237 amino acid, respectively. The pcaG and pcaH showed about 94% homology to that of P. putida ATCC 23975 in the nucleotide sequences.