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.

주기적 정성적분석을 통한 훈련목표 제공이 남자 역도 인상기술 향상에 미치는 영향

문영진,류중현,이순호 한국운동역학회 2004 한국운동역학회지 Vol.14 No.2

Y. J. MOON, J. H. RYU, S. H. LEE. Korean Journal of Sport Biomechanics, Vol. 14, No. 2, pp. 69-83, 2004. The purpose of this study is searching for technical merits and demerits of each weight lifting player through qualitative motion analysis system. Moreover, It is also analysis the repeating the establishment of exercise purpose and studying for the effect of the field adaptation. The subject of this study was five male weight lifting players who have been engaged in Korean Delegation Team. The institution of exercise target was made through two times qualitative analysis and the result of studying for the effect of the field adaptation was produced before offering feedback. Moreover, two time analysis added after offering feedback. All analysis was based on 2-D visual analysis. The results of this study are as follows: 1. Maximal barbell moving speed in starting phase was decreased after offering feedback. This result implies advancement of technical skills after offering feedback. 2. From starting posture to 앉아받기, forward and backward moving distance of hip joint was decreased after offering feedback in all subjects. This result represents advancement of technical skills after offering feedback. 3. In terms of pull phase, forward and backward moving distance of hip and shoulder joint was decreased after offering feedback in all subjects. This result represents advancement of technical skills after offering feedback. 4. In terms of pull phase, the difference of horizontal value of coordinates was decreased after offering feedback in all subjects. This result represents advancement of technical skills after offering feedback. 5. In terms of pull phase, the motion range of hip joint was decreased after offering feedback in three of five subjects and this represents advancement of technical skills after offering feedback. However, the rest of them were not variable or narrow decreasing. This result represents that feedback system could not brought tremendous effects. 6. From apex point of barbell to ? 6} =?j, the difference of barbell height was decreased after offering feedback in three of five subjects and this represents advancement of technical skills after offering feedback. However, the rest of them weren't variable or narrow increasing. This result represents that feedback system could not brought tremendous effects. 7. In terms of last-pull phase, the angular velocity of knee joint was increased after offering feedback in four of five subjects and this represents advancement of technical skills after offering feedback. However, the rest of them, only one subject, decreased. This result represents that feedback system could not brought tremendous effects. 8. In terms of last-pull, the conversional tendency of maximal extension to flextion came out all but simultaneously without offering feedback in four of five subjects. This is well-performed technique. Only one subject, however, could not use power effectively because the fact that his maximal extension came out in serial, from ankle to knee and waist means dispersion of power. In addition to, after offering feedback, only one subject made increasing the maximal extension of knee in last-pull and this result represents advancement of skills after offering feedback. However, the rest of them could not make meaningful development after offering feedback. 9. It might be assumed that searching for technical merits and demerits of each weight lifting player through qualitative motion analysis system could improve player's skill.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

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.

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.

Ender정과 Knowles핀을 이용한 노인 대퇴골 전자부 골절의 치료

문명상,우영균,선두훈,남석현 최신의학사 1992 最新醫學 Vol.35 No.11

관동맥우회술 후 발생한 급성 장간막경색 1예

문용화,김지현,강웅철,박병은,고영국,최동훈,유경종 대한내과학회 2004 대한내과학회지 Vol.66 No.3

관동맥우회술을 포함한 심장수술 후에 생기는 급성 장간막경색은 매우 드물지만 치명적인 합병증으로 발생률은 비교적 낮으나 사망률은 매우 높게 보고 되고 있다. 본 증례에서는 55세 여자 환자가 관동맥우회술을 시행받고 수술 후 1일째에 발생한 복부통증에 대해서 장간막경색증을 의심하지 못하고 수술과 연관된 비특이적 증상으로 판단하였으나 그 후 환자의 증상이 악화되면서 상장간막동맥 혈전 색전증에 의한 광범위한 급성 장괴사로 판명되었다. 관독맥우회술 후 상장간막 동맥에 생긴 혈전색전증에 의해 발생한 급성 장간막경색의 증례는 국내에 보고된 바 없고 본 증례를 통해 교육적인 경험을 하였기에 저자들은 문헌고찰과 함께 보고하는 바이다. 심폐우회술을 요하는 심장수술을 받은 환자 중 특히 급성 장간막허혈의 위험인자를 가지고 있는 환자에 대해서는 급성 장간막허혈이 생길 수 있다는 세심한 관찰이 진단이 늦어지지 않게 하는 방법이며 장간막허혈이 의심되면 즉시 적극적인 진단 및 치료적인 접근을 시도해야 하겠다. Acute mesenteric ischemia leading to massive bowel infarction following cardiac surgery particularly coronary artery bypass graft (CABG), is reported to be a very rare but serious life-threatening complication. In this case, a 55-year-old female underwent CABG and complained of abdominal pain on the first postoperative day, which was thought to be nonspecifically related to the operation wound, In the further hospital course, the patient was found to have extensive acute mesenteric infarction due to thromboembolism of superior mesenteric artery. This is a valuable educational case, since only high index of suspicion does not delay making a diagnosis especially in the patients with risk factors of acute mesenteric ischemia after cardiac surgery requiring cardiopulmonary bypass. On suspicion of acute mesenteric ischemia, an aggressive diagnostic and therapeutic approach should be performed immediately.(Korean J Med 66:317-320, 2004)

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