• Title/Summary/Keyword: 건강효과

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Dose Planning of Forward Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer using Compensating Filters (보상여과판을 이용한 비인강암의 전방위 강도변조 방사선치료계획)

  • Chu Sung Sil;Lee Sang-wook;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.53-65
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    • 2001
  • Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

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Clinical Analysis of Influenza in Children and Rapid Antigen Detection Test on First Half of the Year 2004 in Busan (2004 상반기 부산 지역에서 유행한 인플루엔자의 임상 역학적 분석 및 인플루엔자 진단에 있어서의 신속 항원 검사법)

  • Choi, So Young;Lee, Na Young;Kim, Sung Mi;Kim, Gil Heun;Jung, Jin Hwa;Choi, Im Jung;Cho, Kyung Soon
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.158-169
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    • 2004
  • Purpose : Although influenza is one of the most important cause of acute respiratory tract infections in children, virus isolation is not popular and there are only a few clinical studies on influenza and diagnostic methods. We evaluated the epidemiological and clinical features of influenza in children and rapid antigen detection test(QuickVue influenza test) on fist half of the year 2004 in Busan. Methods : From January 2004 to June 2004, throat swab and nasal secretion were obtained and cultured for the isolation of influenza virus and tested by rapid antigen detection test(QuickVue influenza test) in children with suspected influenza infections. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Influenza viruses were isolated in 79(17.2%) out of 621 patients examined. Influenza virus was isolated mainly from March to April 2004. The ratio of male and female with influenza virus infection was 1.2 : 1 with median age of 4 years 6month. The most common clinical diagnosis of influenza virus infection was bronchitis. There was no difference between influenza A and B infection in clinical diagnosis and symptoms. All patients recovered without severe complication. The sensitivity obtained for rapid antigen detection test (QuickVue influenza test) was 93.6% and the specificity was 80.2%, the positive predictive value 40.8%, the negative predictive value 98.8%. Conclusion : With rapid antigen detection test, it is possible early detection of influenza in children. reduction in use of antimicrobial agent and early use of antiviral agent.

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A Survey on Physical Complaints Related with Farmers' Syndrome of Vinylhouse and Non-vinylhouse Farmers (비닐하우스 재배농민과 일반농민의 농부증 관련 신체증상 호소율 조사)

  • Lee, Ju-Young;Park, Jung-Han;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.258-273
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    • 1994
  • To compare the physical complaints of vinylhouse farmers with those of non-vinylhouse farmers, a personal interviews on 250 vinylhouse and 142 non-vinylhouse farmers were conducted in Sungjoo county in Kyungpook province selected by a random sampling from July 5 to July 10, 1993. Blood pressure of the subjects was also measured. Vinylhouse farmers had a higher average age, larger family size, shorter experience of farming, more working hours per day and working days per year and higher annual income than the non-vinylhouse farmers. The frequency of pesticide spray of the vinylhouse farmers was 3.4 times on the average in June 1993 as compared with 2.0 times of non-vinylhouse farmers, and 16.7 times for the vinylhouse farmers during the last one year while it was 8.3 times for the non-vinylhouse farmers in the same period. While 39.6% of vinylhouse farmers experienced pesticide intoxication symptoms such as headache, nausea, vomiting, dizziness, itching, and skin irritation, etc. during the month of June, 25.4% of non-vinylhouse farmers experienced such symptoms. The most frequent symptoms among eight symptoms that constitute the farmers' syndrome were lumbago, numbness of hand or foot, shoulder pain and dizziness regardless of sex and type of farming. Prevalence of the farmers' syndrome in male and female among vinylhouse farmers were 22.1%, 43.4%, respectively, and the prevalence in non-vinylhouse farmers was 23.2% for male and 50.7% for female. There was no statistically significant difference in the prevalence of farmers' syndrome between vinylhouse and non-vinylhouse farmers. However, the prevalence in female was about 2 times higher than that of male. When the effects of other factors were adjusted by multiple logistic regression for farmers' syndrome, the prevalence in female was 3.0 times higher than that of male. The prevalence of farmers' syndrome was increased as the age of farmers increased in both vinylhouse and non-vinylhouse farmers, and adjusted odds ratio of farmers' syndrome increased by 3% as the age increased by 1 year. Adjusted odds ratio for Farmers' syndrome in farmers who experienced pesticide intoxication during the month of June was 3.1 times higher than that of farmers who did not have such experience. While the prevalence of hypertension in male and female non-vinylhouse farmers were 22.4%, 13.7%, respectively, the prevalence in vinylhouse farmers were 13.5% for male and 12.0% for female. However, there was no association between farmers' syndrome and hypertension. It was found in this study that the vinylhouse farmers are at a high risk of pesticide intoxication, which is associated with tile common physical complaints. To reduce such risk it is necessary to develop farming methods which do not require the pesticide or may use less pesticide, a safer method of pesticide spraying, and the protective equipments which can be worn at a high temperature and have a better protective effect. Also education of farmers for the correct methods of ventilation after pesticide spraying in the vinylhouse and wearing the protective equipments may be considered as a supportive method. Since inappropriate posture at work and intensive labor may cause farmers' syndrome, it is recommended to develop farming tools which reduce physical burden and take a rest and exercise periodically during work. It is necessary to strengthen the hypertension management program of the Kyungpook province, because the prevalence of hypertension was as high as about 15%.

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Environmental Pollution in Korea and Its Control (우리나라의 환경오염 현황과 그 대책)

  • 윤명조
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.5-6
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    • 1972
  • Noise and air pollution, which accompany the development of industry and the increase of population, contribute to the deterioration of urban environment. The air pollution level of Seoul has gradually increased and the city residents are suffering from a high pollution of noise. If no measures were taken against pollution, the amount of emission of pollutant into air would be 36.7 thousand tons per year per square kilometer in 1975, three times more than that of 1970, and it would be the same level as that of United States in 1968. The main sources of air pollution in Seoul are the exhaust has from vehicles and the combustion of bunker-C oil for heating purpose. Thus, it is urgent that an exhaust gas cleaner should be instaled to every car and the fuel substituted by less sulfur-contained-oil to prevent the pollution. Transportation noise (vehicular noise and train noise) is the main component of urban noise problem. The average noise level in downtown area is about 75㏈ with maximum of 85㏈ and the vehicular homing was checked 100㏈ up and down. Therefore, the reduction of the number of bus-stop the strict regulation of homing in downtown area and a better maintenance of car should be an effective measures against noise pollution in urban areas. Within the distance of 200 metres from railroad, the train noise exceeds the limit specified by the pollution control law in Korea. Especially, the level of noise and steam-whistle of train as measured by the ISO evaluation can adversely affect the community activities of residents. To prevent environmental destruction, many developed countries have taken more positive action against worsening pollution and such an action is now urgently required in this country.

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Validity and Pertinence of Administrative Capital City Proposal (행정수도 건설안의 타당성과 시의성)

  • 김형국
    • Journal of the Korean Geographical Society
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    • v.38 no.2
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    • pp.312-323
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    • 2003
  • This writer absolutely agrees with the government that regional disequilibrium is severe enough to consider moving the administrative capital. Pursuing this course solely to establish a balanced development, however, is not a convincing enough reason. The capital city is directly related to not only the social and economic situation but, much more importantly, to the domestic political situation as well. In the mid-1970s, the proposal by the Third Republic to move the capital city temporarily was based completely on security reasons. At e time, the then opposition leader Kim, Dae-jung said that establishing a safe distance from the demilitarized zone(DMZ) reflected a typically military decision. His view was that retaining the capital city close to the DMZ would show more consideration for the will of the people to defend their own country. In fact, independent Pakistan moved its capital city from Karachi to Islamabad, situated dose to Kashmir the subject of hot territorial dispute with India. It is regrettable that no consideration has been given to the urgent political situation in the Korean peninsula, which is presently enveloped in a dense nuclear fog. As a person requires health to pursue his/her dream, a country must have security to implement a balanced territorial development. According to current urban theories, the fate of a country depends on its major cities. A negligently guarded capital city runs the risk of becoming hostage and bringing ruin to the whole country. In this vein, North Koreas undoubted main target of attack in the armed communist reunification of Korea is Seoul. For the preservation of our state, therefore, it is only right that Seoul must be shielded to prevent becoming hostage to North Korea. The location of the US Armed Forces to the north of the capital city is based on the judgment that defense of Seoul is of absolute importance. At the same time, regardless of their different standpoints, South and North Korea agree that division of the Korean people into two separate countries is abnormal. Reunification, which so far has defied all predictions, may be realized earlier than anyone expects. The day of reunification seems to be the best day for the relocation of the capital city. Building a proper capital city would take at least twenty years, and a capital city cannot be dragged from one place to another. On the day of a free and democratic reunification, a national agreement will be reached naturally to find a nationally symbolic city as in Brazil or Australia. Even if security does not pose a problem, the governments way of thinking would not greatly contribute to the balanced development of the country. The Chungcheon region, which is earmarked as the new location of the capital city, has been the greatest beneficiary of its proximity to the capital region. Not being a disadvantaged region, locating the capital city there would not help alleviate regional disparity. If it is absolutely necessary to find a candidate region at present, considering security, balanced regional development and post-reunification scenario of the future, Cheolwon area located in the middle of the Korean peninsula may be a plausible choice. Even if the transfer of capital is delayed in consideration of the present political conflict between the South and the North Koreas, there is a definite shortcut to realizing a balanced regional development. It can be found not in the geographical dispersal of the central government, but in the decentralization of power to the provinces. If the government has surplus money to build a new symbolic capital city, it is only right that it should improve, for instance, the quality of drinking water which now everyone eschews, and to help the regional subway authority whose chronic deficit state resoled in a recent disastrous accident. And it is proper to time the transfer of capital city to coincide with that of the reunification of Korea whenever Providence intends.

Comparison of Serum Cytokines($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) between Terminal Cancer Patients Treated with Vitamin C and Them without Vitamin C Therapy (Anorexia-Cachexia Syndrome을 가진 말기 암 환자에서 비타민 C 사용여부에 따른 사이토카인 변화 비교)

  • Yeom, Chang-Hwan;Suh, Sang-Youn;Cho, Kyung-Hee;Sun, Young-Gyu;Park, Yong-Gyu;Lee, Hye-Ree
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.51-57
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    • 2003
  • Purpose : Anorexia-cachexia syndrome is one of the most common symptoms and main cause of death in terminal cancer patients. This symptom is due to the enlarged cancer mass as well as tumor released cytokines. Some doctors have suggested that vitamin C was preferentially toxic to tumor cells in vitro and in vivo, and improved clinical symptoms in terminal cancer patients. Therefore, we measured cytokines in serum of terminal cancer patients to determine whether vitamin C treatment improved the anorexia-cachexia syndrome. Methods : We investigated that 49 terminal cancer patients admitted to the department of family medicine, National Health Insurance Corporation Ilsan hospital from March 1, 2002 to August 31, 2002. The study was done on 22 patients who were given 10 g/day of vitamin C infusions during 1 week and 27 patients who were not infused. We measured the cytokines levels ($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) before and after 1 week between terminal cancer patients treated vitamin C and without vitamin C. Results : Out of 49 patients, patents treated with vitamin C infusions were 22 (12 male, 10 female), and these without vitamin C were 27 (18 male, 9 female). In patients treated with vitamin C, $IL-1{\beta}\;were\;6.19{\pm}5.17$ before day and $8.76{\pm}5.72$ after 1 week, IL-6 were $3.07{\pm}8.09$ before day and $1.31{\pm}2.36$ after 1 week, and $TNF-{\alpha}\;were\;2.74{\pm}14.24$ before day and $0.50{\pm}2.00$ after 1 week. In patients treated without vitamin C, $IL-1{\beta}\;were\;2.50{\pm}3.58$ before day and $6.49{\pm}12.01$ after 1 week, IL-6 were $1.00{\pm}2.19$ before day and $17.16{\pm}81.55$ after 1 week, and $TNF-{\alpha}\;were\;1.19{\pm}2.98$ before day and $1.27{\pm}1.52$ after 1 week. The level of cytokines in patients treated with vitamin C decreased more than those without vitamin C. However, this represented no statistical value (P=0.0598 in $IL-1{\beta}$, P=0.1664 in IL-6, and P=0.5395 in $TNF-{\alpha}$). Conclusion : In terminal cancer, even if there was no statistical difference in the cytokines levels between patients treated with vitamin C and those not treated, those who were treated had a decrease all cytokines levels. Vitamin C is very safe with almost no side effects. Therefore, vitamin C treatment in terminal cancer patients can be seen as beneficial and helpful for clinical symptoms.

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Preparation of Students for Future Challenge (미래의 요구에 부응하는 미래를 위한 간호교육)

  • Kim Euisook
    • The Korean Nurse
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    • v.20 no.4 s.112
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    • pp.50-59
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    • 1981
  • 간호학생들이 당연하고 있는 문제점 미래의 간호학생들이 교육문제를 논하기 위하여는 간호학생들이 가지고 있는 문제점을 파악하고 또 이해하는 것이 우선순위가 될 것이다. 간호학생들이 문제점에 대한 연구는 한국에서 뿐아니라 미국에서도 꽤 많이 시행되어져 왔으며 특히 간호학과정에서 중간 탈락되는 중퇴자들에 대한 연구들 중에 이러한 문제점에 대해서 언급한 것이 많다. 고등학교를 졸업하고 곧 대학과정에 진학한 학생들을 대상으로 조사 보고될 Munro의 자료에 의하면 전문대학과정에서 27$\%$, 대학과정에서는 41$\%$의 간호학생들이 간호학과정에서 중간 탈락하고 있음이 보고되고 있다. 이들이 중간탈락하는 데에는 여러 가지 이유가 있으나 그 중 ''간호학에 흥미를 잃어서''가 가장 큰 이유로 보고되고 있다. 이곳 한국사회에서도 역시 비슷한 현상을 보이고 있다. 그러나 대학입시경쟁과 대학내에서의 전과가 거의 허용되지 않는 특수여건이기 때문에 학교를 중간 탈락하는 율은 미국이 보고만큼 높지는 않으나 역시 ''간호학에 흥미를 잃는다''는 것이 간호학생들의 가장 큰 문제점으로 대두되고 있다. 최근 한국에서 시행된 간호학생들에 관한 연구(표 1 참조)에 의하면 간호학생들의 학문에 대한 만족도는 조사자의 35$\~$50$\%$정도에 불과하였고 더우기 이 비율은 고학년에 올라갈수록 더욱 감소되고 있는 경향을 보이고 있다. 한국에서 시행된 어느 연구보고에 의하면 간호학에 실망했다고 생각하는 학생이 전체의 67$\%$였으며, 다른 학교로 전과를 희망한 경험이 있다는 학생이 71$\%$나 되는 것으로 보고되고 있다. 그러나 왜 흥미를 잃게 되는지 그 이유에 대하여 설명해 주는 연구는 많지 않았다. 미국의 한 저자는 간호학생들이 간호학에 흥미를 잃게 되는 원인을 간호원의 역할에 대한 이해가 정확하지 못한 것과 졸업 후 진로기회에 대한 인식부족 때문이라고 추측하고 있다. 간호학에 흥미를 잃게 되는 이유는 크게 다음의 세 가지로 분류 요약될 수 있다. 첫째, 간호학을 전공으로 택한 동기이다. 간호학의 특수성으로 인하여 학생들이 간호학을 전공으로 택한 동기도 다른 전공분야보다는 훨씬 다른 여러 종류를 보이고 있다. 즉, 종교적 이유, 다른 사람들에게 봉사할 수 있는 직업이기 때문에, 쉽게 취업을 할 수 있어서, 결혼 후에도 직업을 가질 수 있기 때문에, 외국으로 쉽게 취업할 수 있어서 등이 간호학을 선택한 이유로 보고되고 있다. 흥미나 적성에 맞다고 생각하기 때문에 간호학을 택한 학생의 수는 다른 과에 비하여 훨씬 적다. 이러한 흥미나 적성 때문이 아닌 여러 가지 다른 이유들로 인하여 간호학을 택한 경우에 특히 간호학에 쉽게 흥미를 잃어버리는 것을 볼 수 있다. 간호학에 현실적인 개념을 가지고 있는 학생들일수록 추상적이고 현실적인 개념을 가지고 있는 학생들보다 더 간호학에 지속적인 흥미를 가지며 중간에 탈락하는 율이 훨씬 적다는 것이 많은 연구에서 보고되었다. 또한 흥미나 적성 때문에 간호학을 택하였다는 학생들이 다른 과로 전과를 희망하는 율이 낮다는 것도 보고되었다. 둘째, 교과내용자체나 실습에 대한 불만족이다. 간호학에 대한 체계적인 교과내용의 결여, 과중한 과제물, 임상실습에서의 욕구불만, 실습으로 인한 부담, 지식과 실습의 차이점에 대한 갈등 등이 주요 이유로 보고되고 있다. 대부분의 연구들이 이 교과목이나 실습에 대한 불만족, 특히 실습경험에서의 갈등을 학생들이 흥미를 잃는 가장 중요한 요인이 되는 것으로 보고하고 있다. 어느 한 연구에서는 응답자의 90$\%$가 임상실습에 만족하지 못한다고 응답하였으며 그들 중의 88$\%$가 실습감독에 문제가 있다고 생각한다고 보고하였다. 셋째, 교수들에 대한 불만족이다. 대부분의 연구들이 학년이 올라가면 갈수록 교수에 대한 신뢰도가 낮아지며 또한 그에 비례하여 간호학에 대한 만족도가 낮아진다고 보고하고 있다. 교육내용에 대한 전문지식의 결여, 학생들과의 인간적인 관계의 결여, 교수법에 대한 불만족 등이 교수에 대한 불만의 주요내용으로 보고되었다. 미래의 간호에 부응할 학생교육 계속적인 사회적 변동과 더불어 급격하게 변화하고 있는 일반인들의 건강에 대한 요구도와 앞에서 기술한 문제점 등을 감안할 때 학생들에게 동기를 부여하고 간호학에 확신감을 가질 수 있도록 준비시키므로써 간호환경에서 실망하기보다는 오히려 그것을 받아들여 변화하는 사회요구에 책임감을 느낄 수 있도록 교육시키는 것이 미래의 간호학생을 준비시키는데 가장 중요한 요인이라고 할 수 있겠다. 이러한 교육을 위하여 다음의 두가지 안을 제시한다. 1. 교수와 학생간의 관계-서로의 좋은 동반자 : 교수들이 학생에게 미치는 영향, 특히 학생들의 성취도에 대한 영향에 대하여는 이미 많은 연구가 시행되었다. Tetreault(1976)가 간호학생들의 전문의식에 영향을 미치는 요인에 대하여 연구한 바에 의하면 다른 어느 것보다도 교수의 전문의식여부가 학생들의 전문의식 조성에 가장 큰 영향을 미친다고 하였다. 또한 학생들이 교수에게 신뢰감을 가지고 있을때, 교수들이 전문가로서의 행동을 하는 것을 보았을때 비로서 배움이 증가된다고 하였다. Banduras는 엄격하고 무서운 교수보다는 따뜻하고 인간적인 교수에게 학생들이 더 Role Model로서 모방하려는 경향을 나타낸다고 보고 하였다. 그러면 어떻게 학생에게 신뢰받는 교수가 될 수 있겠는가? apos;학생들의 요구에 부응할 때apos;라고 한마디로 표현할 수 있을 것이다. Lussier(1972)가 언급한 것처럼 학생들의 요구에 부응하지 못하는 교육은 Piaget이 언급한 교육의 기본 목표, 즉 개인에게 선배들이 한 것을 그대로 반복하여 시행하도록 하는 것이 아니라 새로운 것을 시도할 수 있는 능력을 가지게 하는 목표에는 도달할 수 없으며 이러한 목표는 간호학에도 가장 기본이 되어야 할 기본목표이기 때문이다. 학생들이 현재 어떤 요구를 가지고 있으며 또 어떤 생각을 하고 있는지 계속 파악하고 있는 것이 학생요구에 부응하는 교육을 할 수 있는 기본조건이 될 것이다. 의외로 많은 교수들이 학생들을 이해하고 있다고 생각하고 있으나 잘못 이해하고 있는 경우가 많다. 표 2는 현 간호학생들이 생각하고 있는 가치관과 문제점을 파악하고 또 교수가 그 가치관과 문제점을 어느 정도 파악하고 있는지 알아보기 위하여 일개 4년제 대학 200여명의 학생과 그 대학에 근무하는 18명의 교수진을 대상으로 질문한 결과를 간략하게 보고한 것이다. 또한 여기에서 학생이 보고하는 가치관, 문제점, 교수에게 바라는 점이 교수가 이해하고 있는 것과 차이가 있다는 것도 보여주고 있다. 우리가 학생들의 요구를 파악할 수 있도록 귀를 기울이고 이해하며, 그 요구에 부응하려고 노력할때 진정한 교수와 학생간의 관계가 이루어질 수 있을 것이며 이때 비로서 우리는 apos;partnershipapos;을 이룰 수 있을 것이다. 이때 간호학에 대한 실망은 줄어들 수 있을 것이며 우리도 학생들에게 전문가적인 태도를 함양시켜줄 수 있는 기회를 부여할 수 있을 것이다. 이렇게 될때 앞으로 기다리고 있는 미지의 의무에 효과적으로 또 적극적으로 대처할 수 있는 자질을 형성한 학생들을 준비해 낼 수 있을 것이다. 2. 간호모델에 의한 교과과정의 확립과 임상실습에의 적용 : 교과과정이 학생들의 모양을 만들어주는 하나의 기본틀이라고 말할 수 있다면 미래의 요구에 부응하는 학생들을 준비시키기 위하여 지금까지와는 다른 새로운 방향의 교과과정이 필요하다는 것은 재론할 필요가 없을 것이다. 이미 진취적인 간호대학에서는 guided design systems approach 또는 integrated curriculum 등의 새로운 교과과정을 시도하고 있음은 알려진 사실이다. 물론 간호모델에 준한 교과과정을 발전시키는데 대한 장점과 이에 수반되는 여러가지 새로운 문제점에 대하여 많은 논란이 있으나 모든 교과과정이 처음 시도될 때부터 완전한 것이 있을 수 없으며 시간이 지남에 따라 성숙되는 것임을 감안해 볼 때 이러한 새로운 교과과정에의 시도는 미래의 새로운 간호방향에 필수적인 사업이라고 하겠다. 이러한 교과과정을 개발하는데 몇가지 게안점을 첨부하려 한다. (1) 새로운 교과과정의 개발은 처음부터 끝까지 모든 교수진의 협력과 참여로 이루어져야 한다. (2) 비록 처음에는 어렵고 혼란이 있더라도 교과과정은 의학모델이 아닌 간호모델을 중심으로 이루어져야 한다. (3) 간호모델에서 다루어지는 개념들은 모두 직접 간호업무에 적용될 수 있는 것으로 선택되어야 한다. (4) 교과과정의 결과로 배출되는 학생들의 준비정도는 그 지역사회에 적합하여야 한다. (5) 그 지역사회의 고유한 문화적 요소가 포함되어야 한다. 아직 우리는 간호분야 내부의 갈등을 해결하지 못하고 있는 시기에 있다. 우리 내부의 문제점을 잘 해결할 수 있을때 외부와의 갈등에 잘 대처할 수 있을 것이다. 내부의 갈등을 잘 해결하기 위한 힘을 모으기 위하여는 동반자, 즉 교수와 학생, 간호교육자와 임상간호원 등이 서로 진정한 의미의 동반자 될때 가장 중요한 해결의 실마리가 될 것이다.

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Simultaneous Production System of Silkworm Dongchunghacho and Male Pupae Using Both Parent Sex-limited Larval Marking Variety (한성반문잠품종을 이용한 누에동충하초 및 숫번데기의 동시 생산체계)

  • Ji, Sang-Duk;Kim, Nam-Suk;Kang, Pil-Don;Sung, Gyoo-Byung;Hong, In-Pyo;Ryu, Kang Sun;Kim, Young-Ki;Nam, Sung-Hee;Kim, Mi-Ja;Kim, Kee-Young
    • Journal of Sericultural and Entomological Science
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    • v.50 no.2
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    • pp.101-108
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    • 2012
  • This study was conducted to confirm the mass production of male pupae and sex-limited larval marking variety as a host for synnemata production of Isaria tenupes in RDA(Rural Development Administration). Silkworm pupation, infection rate and synnemate formation of I.tenuipes were examined. Among the silkworm varieties tested, male Hansaengjam showed the highest pupation rate at 98.7%. I. tenuipes infection rate of larvae of newly-exuviated 5th instar silkworm was 83.7 ~ 90.4% in the spring rearing season and 91.7 ~ 96.6% in the autumn rearing season. Synnemata production of I. tenuipes was execellent in female Yangwonjam with an incidence rate of 99.5% followed by male Yangwonjam(99.5%) and Baegokjam(99.4%) in the spring and autumn rearing season. Synnemata living weight ranged from 0.93 ~ 1.25 g in the spring rearing season. The female Hansaengjam had the heaviest synnemata weight(1.25 g). Synnemata dry weight ranged from 0.27 ~ 0.35 g in the spring rearing season. The female Yangwonjam had the heaviest synnemata weight(0.35 g).

Studies on the Propagation of the Freshwater Prawn, Macrobrachium nipponense (De Haan) Reared in the Laboratory 2. Life History and Seedling Production (담수산 새우, Macrobrachium nipponense (De Haan)의 증${\cdot}$양식에 관한 생물학적 기초연구 2. 생활사 및 종묘생산에 관한 연구)

  • KWON Chin-Soo;LEE Bok-Kyu
    • Journal of Aquaculture
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    • v.5 no.1
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    • pp.29-67
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    • 1992
  • Life cycle and seed production of the freshwater prawn, Macrobrachium nipponense, were studied and the results are as follows : 1. Larval development : Embryos hatched out as zoea larvae of 2.06 mm in mean body length. The larvae passed through 9 zoea stages in $15{\~}20$ days and then metamorphosed into postlarvae measuring 5.68 mm in mean body length. Each zoea stage can be identified based on the shapes of the first and second antennae, exo- and endopodites of the first and second pereiopods, telson and maxillae. 2. Environmental requirements of zoea larvae : Zoea larvae grew healthy when fed with Artemia nauplii. Metamorphosing rate was $65{\~}72{\%}$ at $26{\~}28\%$ and $7.85{\~}8.28\%_{\circ}Cl.$. The relationship between the zoeal period (Y in days) and water temperature (X in $^{\circ}C$) is expressed as Y=46.0900-0.9673X. Zoeas showed best survival in a water temperature range of $26{\~}32^{\circ}C$ (optimum temperature $28^{\circ}C$), at which the metamorphosing rate into postlarvae was $54{\~}72\%$ The zoeas survived more successfully in chlorinity range of $4.12{\~}14.08{\%_{\circ}}Cl.$, (optimum chlorinity $7.6{\~}11.6\;{\%_{\circ}}Cl.$.), at which the metamorphosing rate was $42{\~}76{\%}$. The whole zoeal stages tended to be longer in proportion as the chlorinity deviated from the optimum range and particularly toward high chlorinity. Zoeas at all stages could not tolerate in the freshwater. 3. Environmental requirements of postlarvae and juveniles : Postlarvae showed normal growth at water temperatures between $24{\~}32^{\circ}C$ (optimun temperature $26{\~}28^{\circ}$. The survival rate up to the juvenile stage was $41{\~}63{\%}$. Water temperatures below $24^{\circ}C$ and above $32^{\circ}$ resulted in lower growth, and postlarvae scarcely grew at below $17^{\circ}C$. Cannibalism tended to occur more frequently under optimum range of temperatures. The range of chlorinity for normal growth of postlarvae and juveniles was from 0.00 (freshwater) to $11.24{\%_{\circ}}Cl.$, at which the survival rate was $32{\~}35\%$. The postlarvae grew more successfully in low chlorinities, and the best growth was found at $0.00\~2.21{\%_{\circ}}Cl.$. The postlarvae and juveniles showed better growth in freshwater but did not survive in normal sea water. 4. Feeding effect of diet on zoea Ilarvae : Zoea larvae were successfully survived and metamorposed into postlarvae when fed commercial artificial plankton, rotifers, and Artemia nauplii in the aquaria. However, the zoea larvae that were fed Artemia nauplii and reared in Chlorella mixed green water showed better results. The rate of metamorphosis was $68\~{\%}75$. The larvae fed cow live powder, egg powder, and Chlorella alone did not survive. 5. Diets of postlarvae, juveniles and adults : Artemia nauplii and/or copepods were good food for postlarvae. Juveniles and adults were successfully fed fish or shellfish flesh, annelids, corn grain, pelleted feed along with viscera of domestic animals or fruits. 6. Growth of postlarvae, juveniles and adults : Under favorable conditions, postlarvae molted every five or six days and attained to the juvenile stage within two months and they reached 1.78 cm in body length and 0.17 g in body weight. The juveniles grew to 3.52 cm in body length and 1.07 g in body weight in about four months. Their sexes became determinable based on the appearance of male's rudimental processes (a secondary sex character) on the endopodites of second pereiopods of males. The males commonly reached sexual maturity in seven months after attaining the postlarvae stage and they grew to 5.65 cm in body length and 3.41 g in body weight. Whereas the females attained sexual maturity within six to seven months, when they measured 4.93 cm in body length and 2.43 g in body weight. Nine or ten months after hatching, the males grew $6.62{\~}7.14$ cm in body length and $6.68{\~}8.36$ g in body weight, while females became $5.58{\~}6.08$ cm and $4.04{\~}5.54$ g. 7. Stocking density : The maximum stocking density in aquaria for successful survival and growth was $60{\~}100$ individuals/$\ell$ for zoeas in 30-days rearing (survival rate to postlarvae, $73{\~}80{\%}$) ; $100{\~}300$ individuals/$m^2$ for postlarvae of 0.57 cm in body length (survival rate for 120 days, $78{\~}85{\%}$) ; $40{\~}60$ individuals/$m^2$ for juveniles of 2.72 cm in body length (survival rate for 120 days, $63{\~}90{\%}$) : $20{\~}40$ individuals/$m^2$ for young prawns of 5.2 cm in body length (survival rate for 120 days, $62\~90{\%}$) ; and $10\~30$ individuals/$m^2$ for adults of 6.1 cm in body length (survival rate for 60 days, $73\~100{\%}$). The stocking density of juveniles, youngs and adults could be increased up to twice by providing shelters.

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The study for the roles of intratracheally administered histamine in the neutrophil-mediated acute lung injury in rats: (호중구를 매개하는 백서의 급성 폐손상의 병리가전에 있어 기도내로 투여한 히스타민의 역활에 관하여)

  • Koh, Youn-Suck;Hybertson, Brooks M.;Jepson, Eric K.;Kim, Mi-Jung;Lee, In-Chul;Lim, Chae-Man;Lee, Sang-Do;Kim, Dong-Soon;Kim, Won-Dong;Repine, John E.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.308-322
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    • 1996
  • Background : Neutrophils are considered to play critical roles in the development of acute respiratory distress syndrome. Histamine, which is distributed abundantly in lung tissue, increases the rolling of neutrophills via increase of P-selectin expression on the surface of endothelial cells and is known to have some interrelationships with IL-1, IL-8 and TNF-$\alpha$. We studied to investigate the effect of the histamine on the acute lung injury of the rats induced by intratracheal insufflation of TNF-$\alpha$ which has less potency to cause lung injury compared to IL-1 in rats. Methods : We intratracheally instilled saline or TNF(R&D, 500ng), IL-1(R&D, 50ng)or histamine of varius dose(1.1, 11 and $55\;{\mu}g/kg$) with and without TNF separately in Sprague-Dawley rats weighing 270-370 grams. We also intratracheally treated IL-1(50ng) along with histamine($55\;{\mu}g/kg$). In cases, there were synergistic effects induced by histamine on the parameters of TNF-induced acute lung injury, antihistamines(Sigma, mepyramine as a $H_1$ receptor blockade and ranitidine as a $H_2$ receptor blockade, 10 mg/kg in each)were co-administered intravenously to the rats treated TNF along with histamine($1.1\;{\mu}g/kg$) intratraeheally. Then after 5 h we measured lung lavage neutrophil numbers, lavage cytokine-induced neutrophil chemoattractants(CINC), lung myeloperoxidase activity(MPO) and lung leak. We also intratracheally insufflated TNF with/without histamine($11\;{\mu}g/kg$), then after 24 h measured lung leak in rats. Statistical analyses were done by Kruskal-Wallis nonparametric ANOVA test with Dunn's multiple comparison test or by Mann-Whitney U test. Results : We found that rats given TNF, histamine alone(11 and $55\;{\mu}g/kg$), and TNF with histamine(l.1, 11, and $55\;{\mu}g/kg$) intratracheally had increased (p<0.05) lung MPO activity compared with saline-treated control rats. TNF with histamine $11\;{\mu}g/kg$ had increased MPO activity (P=0.0251) compared with TNF-treated rats. TNF and TNF with histamine(1.1, 11, and $55\;{\mu}g/kg$) intratracheally had all increased (p<0.05) lung leak, lavage neutophil numbers and lavage CINC activities compared with saline. TNF with histamine $1.1\;{\mu}g/kg$ had increased (p=0.0367) lavage neutrophil numbers compared with TNF treated rats. But there were no additive effect of histamine with TNF compared with TNF alone in acute lung leak on 5 h and 24 h in rats. Treatment of rats with the $H_1$ and $H_2$ antagonists resulted in inhibitions of lavage neutrophil accumulations and lavage CINC activity elevations elicited by co-treated histamine in TNF-induced acute lung injury intratracheally in rats. We also found that rats given IL-1 along with histamine intratracheally did not have increase in lung leak compared with IL-1 treated rats. Conclusion : Histamine administered intratracheally did not have synergistic effects on TNF-induced acute lung leak inspite of additive effects on increase in MPO activity and lavage neutrophil numbers in rats. These observations suggest that instilling histamine intratracheally would not play synergistic roles in neutrophil-mediated acute lung injury in rats.

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