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

척수를 손상시킨 후 꼬리정맥에 주입한 사람탯줄혈액세포가 뇌줄기에 미치는 영향

김종중,정윤영,박영란,문영민,현영식,정영욱,문정석 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Background and Objectives: Stem cells are a valuable resource for treatment of many disease, but limited access to stem cells in some organs such as brain restricts their utility. Many approaches have been attempted to restore the function following brain stem injury (BSI) and spinal cord injury (SCI). The use of the human umbilical cord blood cells (hUCB) - a rich source of nonembryonic or adult stem cells - has recently been reported to ameliorate the behavioral consequences of stroke. Mateiials and Methods: Forty rats were divided into 8 groups: (1) SCI l+hUCB (infused 1 day post injury); (2) SCI 2+hUCB (infused 2 days post injury); (3) SCI 3+hUCB (infused 3 days post injury); (4) SCI 4+hUCB (infused 4 days post injury); (5) SCI 5+hUCB (mfusedt 5 days post injury); (6) SCI 6+hUCB (infused 6 days post injury); (7) LO+hUCB (laminectomy+hUCB); and (8) LO (laminectomy only). SCI was produced by compressing the spinal cord for one minute with an aneurysm clip calibrated to a closing pressure of 50 g. We report here that immunhistotochemical identification of fluorescent hUCB positive cells in the brain stem after compressed spinal cord injury using mouse anti-human mitochondria monoclonal antibody (MAB1273). Results: All SCI+hUCB (1-8) groups contained fluorescent hUCB positive cells in the all area of the brain stem. But especially a large number of fluorescent hUCB positive cells were observed in the whole area of the brain stem of the experimental 5 (SCI 5+hUCB) and 6 (SCI 6+hUCB)groups. No hUCB positive cells were found in the brain stem of group with non-injured spinal cord of these animals and group with laminectomy only. Conclusion: These results suggest that hUCB are potentially useful as a vector for treating a variety of the central nervous system disorders, and we are sure that continuous of stem cell study will give an best opportunity to treat the uncurable disorders in the future.

모체 Thyroxine 투여가 태아알코올효과를 가진 흰쥐 대뇌겉질 및 해마에서 NPY함유 신경세포의 생후 발달에 미치는 영향

김복,박상기,박영란,김종중,문정석,김주수,문영민,현영식,천관영,정윤영 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: Maternal alcohol abuse is considered to be one of the most prominent cause of neurobiological malformations in the postnatal and adult life of the offspring. In this study, we investigated the effects of maternal alcohol drinking on the postnatal development of NPY-containing neuron, and, the influence of thyroxine treatment on the cerebral cortex and hippocampus of pups of alcohol abused mother. Materials and Method: Time-pregnant rats were divided into three groups. Alcohol-fed group A received 35 calories of liquid alcohol diet daily from gestation day 6; control pair-fed group B was fed a liquid diet in dextrin replaced alcohol isocalorically: alcohol + T4 group C received 35 calories liquid alcohol diet and exogenous thyroxine subcutaneously. Results: Group C showed prominent NPY immunoreactivity in the cerebral cortex compared to group A and B at P7. In group C, NPY-containing neurons were widely distributed in the all layers of cerebral cortex after P14. Besides, numerical decrease of NPY-containing neuron as age increases was not found in group C. However, the decrease of NPY-containing neuron was clearly observed in group A compared to group C after P14. In hippocampus, group Band C were appeared similar patterns after P7. Additionally, in group C, NPY immunoreactivity was prominently appeared in CA2 and CA3 at P14 as compared to group B. Conclusions: The present results showed the increase of intensity and number of NPY-containing neurons in cerebral cortex and hippocampus of pups of exogenous T₄ supplemented alcohol-exposed dams as compared to control pair-fed and alcohol-exposed pups at P7. It presumably suggest that NPY-containing neurons might be regulated by the early postnatal growth stimulatory effect of the exogenously supplemented T₄. Therefore, the increase of NPY synthesis caused by maternal administration of exogenous thyroxine may ameliorate fetal alcohol effect, one of the ill effects as a result of the dysthyroid state following maternal alcohol abuse.

피부와 외래환자와 일반인의 진균질환 역학조사

문현주,문재동,이지범,김성진,원영호,이승철 全南大醫大 2001 전남의대학술지 Vol.37 No.4

근골격계 질환에 있어 초음파 검사의 유용성

박기영,김현리,이성문 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.6

보건소 진료서비스 이용자의 만족도에 관한 연구

문영신,조우현,강임옥 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patint satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7. 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those -receiving free-care. There 'were however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients, except for the dimension on sympathy and shape.

혈액종양 환자의 중심정맥 카테터에 대한 헤파린 관류와 생리식염수 관류의 효과 비교

문초희,연보라,김현진,은방희,배영이 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: The purpose of this study was to compare the efficacy of heparin flushing and normal saline flushing in maintaining patency of central venous catheters(CVCs), and to investigate relative risk factors of CVCs' occlusion. Method: A total of 159 patients who had been inserted with CVCs were included in the department of hemato-oncology of S hospital. The heparin group consisted of 74 patients with 10u/ml diluted heparin flushing from 23 November 2004 to 15 January 2005, and the normal saline group consisted of 85 patients with 0.9% normal saline flushing from 19 January to 31 March of 2005. Result: The heparin group was significantly different from the normal saline group in CVCs' occlusion. The normal saline group offered a much longer survival duration of CVCs' patency than the heparin group. Potential bleeding signs (PT, aPTT) had no significant differences. In multivariate analysis, 0.9% normal saline (hazard ratio 0.50), chemo port (hazard ratio 3.38), and no administration of TPN (hazard ratio 0.25) were the significant factors for occlusion of CVCs. Conclusion: For maintaining the patency of CVCs, 0.9% normal saline flushing are expected to be effective in reducing drug incompatibilities, lessening the bleeding tendency and improving cost effectiveness .

내시경적 절제로 진단된 폴립 형태의 심재성 낭종성 위염 2예

허종현,조영화,성용완,유재훈,구동영,김갑식,노지훈,문원 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Gastritis cystica profunda (GCP) is a disease characterized by hyperplastic and significant extension of cystic dilatation of the gastric mucous glands, which results in a cystic lesion in gastric submucosa. It often occurs on the part of gastroenterostomy, but can be found in the stomach without any previous surgery. GCP has variable gross finding including solitary polyps, diffuse ones, submucosal tumors, and rare giant gastric mucosal fold. It is difficult to tell GCP from a cancerous lesion by gross finding that the disease demands a necessary tissue biopsy, though GCP is commonly showed as a benign in the progress. We report a case of GCP in polypoid types diagnosed by endoscopic polypectomy.

혼파초지에서 질소시비수준과 방목율이 목초 및 육우생산에 미치는 영향

현봉수,김문철,김영호,송성언,이승협 제주대학교 농과대학 제주도축산문제연구소 1986 畜産論叢 Vol.1 No.1

Effects of N fertilizer levels and stocking rates on beef production in a mixed pastiire of orchard-grass, perennial ryegrass, tall fescue, red clover and alsike clover were studied using 3 levels of N fertilizer (50, 100 and 200 kg/ha) and 3 stocking rates (3,4 and 5 head /ha). The summarized results are the following; 1. Increasing nitrogen fertilizer on the mixed pasture increased dry matter yield and protein content(P<0.05) of the pasture species. The stocking rate did not influence either dry matter yield or protein content. 2. The percentage of pasture species increased and that of weeds decreased with increasing N fer-tilizer levels. lncreasing stocking rate from 3 to 5 heads/ha significantly influenced that of the other pastures and weeds. 3. Herhage intake per animal increased at the lower stocking rate, but total herbage intake per ha increased at the higher stocking rate, Increasing nitrogen fertilizer decreased herbage intake per animal , but slightly higher intake per animal was obserbed at 5 head stocking rate. 4. No significant difference in weight gain/ha was found among N levels and stocking rates ussd. Live weight gain per animal was greater at the higher N level and also at the louer stocking rate.

근위 대퇴정을 이용한 대퇴 전자부 골절의 치료

문영완,서동현,강신택,권덕주,지용남,이기병 대한골절학회 2003 대한골절학회지 Vol.16 No.1

목 적 : 근위 대퇴정을 이용한 고령 환자의 대퇴전자간 골절의 치료결과에 대해 보고하고자 한다. 대상 및 방법 : 2001년 4월부터 2002년 2월까지 대전자부에서 소전자에 이르는 횡선골절 및 소전자 주위 분쇄골절로 압박고 나사 고정이 용이하지 않은 전자간 골절, 일반적인 전자간 골절에 대해 근위 대퇴정을 사용해 치료한 80례 중 추시가 가능했던 71례를 대상으로 하였으며, 추시과정 중 골유합 시기, 대퇴경간각, 지연나사의 활강, 수술시간 및 출혈량, 술중 및 술후 합병증 수술시 주의사항을 조사하였다. 결 과 : 평균연령은 77.5세, 평균추시기간은 9개월이었다. Evans의 분류법으로 골절을 분류하여 안정성, 불안정성 골절은 30례, 41례였다. 평균 골 유합 시비는 13.8주였고, 대퇴경간각은 수술직후 131.9 ± 5.21˚, 129.9 ± 6.04˚ 였으며 평균지연나사의 활강은 4.21±4.13㎜였다. 수술시간은 평균 61분, 출혈량은 평균 0.67pint(134cc)였다. 술중 합병증으로는 정복 실패 1례, 원위고정나사 삽입시 피질골 골절 1례, drill bit 파손 1례가 있었으며, 술후 합병증으로는 대퇴 경간각 소실(5도이상) 12례, 경부골절의 발생이 2례, 지연나사의 관절내 돌출 1례였다. 결 론 : 대퇴골 전자부 골절의 치료로 근위 대퇴정은 정확한 삽입 위치, 삽입시의 조심스러운 확공, 지연나사의 연골하 골에 단단하게 고정시키는 등의 주의를 한다면 수술시간, 출혈량 감소 등의 술중 합병증을 줄이고, 견고한 내고정을 통한 조기 보행을 가능하게 하며, 좋은 골유합 등이 기대되므로, 특히 고령, 분쇄골절, 역행성 골절, 골다공증이 심한 경우에서 바람직한 수술방법으로 사료된다. Purpose : To evaluate the treatment results of geriatric intertochanteric fractures using a proximal femoral nail. Materials and Methods : From April 2001 to February 2002, 71 cases of the intertrochanteric fractures involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, operation time, blood loss and complications. Results : The average age was 77.5 years old, the mean duration of follow-up was 9 months and the mean duration of bone union was 13.8 weeks. The average neck-shaft angle on immediate postop. x-ray was 131.9 ± 5.21˚ and 129.9 ± 6.04˚ at last follow up and the average lag screw sliding was 4.21 ± 4.13㎜. The average operation time was 61 minutes and blood loss was 0.67 pints(134cc). Intraoperative complications were inadequate reduction in one case, difficulty in distal transfixing in one case and drill bit failure in one case and postoperative complications were loss of neck-shaft angle(more than 5 degree) in 12 cases, femur neck fracture in 2 cases and intraarticular cutting out of femur neck screw in one case. Conclusions : The use of the proximal femoral nail could be appropriate for the fixation of communited or reverse oblique intertrochanteric fracture in elderly, osteroporotic patients for early ambulation, preventing shortening and rotation deformity, and reducing operation time and blood loss.