• Advances in pediatric surgery
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• v.8 no.2
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• pp.143-155
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• 2002

A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.5-19
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• 1998

Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

• (The) Research of the performance art and culture
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• no.22
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• pp.287-325
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• 2011

This paper studies the time-space and appreciation of the performance culture of Gwanseo region, which is considered to have formed a characteristic culture in late Joseon period. For this purpose, 4 gasa written in hangeul (Korean alphabet), as well as 4 yeonhaeng gasa, 108 articles of Gwanseoakbu were examined. Plus, among the 9 types of yeonhaengrok (Documents of Performance culture) written in Chinese character, those parts which describe the performance traits have been analyzed. Then, 'main list of terminology' has been deduced based on the categorization according to the following points : 1) subjects of performance and appreciation 2) time and period of performance 3) space of performance 4) contents of performance 5) background and motive for performance and 6) method of performance. Through this process, various 'nouns' and 'predicate verbs' in relation to performance culture emerged, which were systemized according to types of performance elements and categories. Major terminology includes predicate verbs and symbolic verbs such as nokuihongsang,' 'baekdaehongjang,' 'jeolsaekgeumga,' 'cheonga,' 'hwaryu,' 'gamuja,' and 'tongsoja,' as well as the terms already known such as gisaeng, iwon, yangbang, akgong, and jeonak, which refer to musicians and dancers. Subjects of performance were divided into performers and listeners, categorized into concert, music, and dance, according to performance form. In the case for music, it was divided into instrumental or vocal, solo or accompanied (byeongju, self-accompaniment). In the case for vocal music, noteworthy was the inclusion of profesional artist's singing (called gwangdae or uchang). The record of 23 names of popular artists from Gwanseo region, with mention of special talents for each person, reflects the degree of activeness and artistic level of the province. Depending on the appreciating patrons, the audience were indicated as the terms including 'yugaek (party guest),' jwasang,' 'on jwaseok,' and 'sonnim (guests).' It seems that appraisal for a certain performance was very much affected by the tastes, views, and disposition of the appreciating patrons. Therefore it is interesting to observe different comparative reviews of concerts of different regions given by literary figures, offering various criticism on identical performance. In terms of performance space, it has been divided into natural or architectural space, doing justice to special performance sites such as a famous pavilion or an on-the-boat performance. Specific terms related to the scale and brightness of stage, as well as stage props and cast, based on descriptions of performance space were found. The performance space, including famous pavilions; Yeongwangjeong, Bubyeokru, Baeksangru, Wolparu, and Uigeomjeong, which are all well-known tourist sites of Gwanseo province, have been often visited by viceroys. governors, and envoys during a tour or trip. This, and the fact that full-scale performances were regularly held here, and that more than 15 different kinds of boats which were used for boat concert are mentioned, all confirm the general popularity of boat concerts at the time. Performance time, categorized by season or time of day (am/pm/night) and analyzed in terms of time of occurrence and duration, there were no special limitation as to when to have a performance. Most morning concerts were held as part of official duties for the envoys, after their meeting session, whereas evening concerts were more lengthy in duration, with a greater number of people in the audience. In the case of boat concert, samples include day-time concert and performances that began during the day and which lasted till later in the evening. Major terminology related to performance time and season includes descriptions of time of day (morning, evening, night) and mention of sunset, twilight, moonlight, stars, candles, and lamps. Such terms which reflect the flow of time contributed in making a concert more lively. Terminology for the contents of performance was mostly words like 'instrumental,' 'pungak,' or 'pungnyu.' Besides, contextual expressions gave hints as to whether there were dance, singing, ensemble, solo, and duets. Words for dance and singing used in Gwanseo province were almost identical to those used for gasa and jeongjae in the capital, Hanyang. However, many sentences reveal that performances of 'hangjangmu' of hongmunyeon, sword dance, and baettaragi were on a top-quality level. Moreover, chants in hanmun Chinese character and folk songs, which are characteristic for this region, show unique features of local musical performance. It is judged that understanding the purpose and background of a performance is important in grasping the foundation and continuity of local culture. Concerts were usually either related to official protocol for 'greeting,' 'sending-off,' 'reports,' and 'patrols' or for private enjoyment. The rituals for Gwanseo province characteristically features river crossing ceremony on the Daedong river, which has been closely documented by many. What is more, the Gwanseo region featured continued coming and goings of Pyeongan envoys and local officers, as well as ambassadors to and fro China, which required an organized and full-scale performance of music and dance. The method of performance varied from a large-scale, official ones, for which female entertainers and a great banquet in addition to musicians were required, to private gatherings that are more intimate. A performance may take the form of 'taking turns' or 'a competition,' reflecting the dynamic nature of the musical culture at the time. This study, which is deduction of terminology in relation to the time-space and appreciation culture of musical performances of Gwanseo region in late Joseon period, should be expanded in the future into research on 'the performance culture unique to Gwanseo region,' in relation to the financial and administrative aspects of the province, as well as everyday lifestyle. Furthermore, it could proceed to a more intensive research by a comparative study with related literary documents and pictorial data, which could serve as the foundation for understanding the use of space and stage, as well as the performance format characteristic to Korean traditional performing arts.

• Korean Journal of Agricultural Science
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• v.4 no.2
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• pp.254-282
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• 1977

To obtain information on the inheritance of the quantitative characters related with the vegetative and reproductive growth of rice, the $F_1$ seeds were obtained in 1974 from the all possible combinations of the diallel crosses among five leading rice varieties : Nongbaek, Tongil, Palgueng, Mangyeong and Gimmaze. The $F_1$'s including reciprocals and parents were grown under the standard cultivation method at Chungnam Provincial Office of Rural Development in 1975. The arrangement of experimental plots was randomized block design with 3 replications and 12 characters were used for the analysis. Analytical procedure for genetic components was followed the Griffing's and Hayman's methods and the results obtained are summarized as follows. 1. In all $F_1$'s of Tongil crosses, the longer duration to heading was due to dominant effect of Tongil and each $F_1$ showed high heterosis in delaying the heading time. It was assumed that non-allelic gene action besides dominant gene effect might be involed in days to heading character. However, in all $F_1$'s from the crosses among parents excluding Tongil the shorter duration was due to dominant gene action and the degree of dominance was partial, since dominance effects were not greater than the additive effect. The non-allelic gene interaction was not significant. Considering the results mentioned above, it was regarded that there were two kinds of Significantly different genetic systems in the days to heading. 2. The rate of heterosis was significantly different depending upon the parents used in the crosses. For instance, the $F_1$'s from Togil cross showed high rate of heterosis in longer culm. Compared to short culm, longer culm was due to recesive gene action and short culm was due to recesive gene action. The dominant gene effect was greater than the additive gene effect in culm length. The narrow sense of heretability was very low and the maternal effects as well as reciprocal effects were significantly recognized. 3. The lenght of the of the uppermost internode of each $F_1$ plant was a little lorger than these of respective parental means or same as those of parents having long internodes, indicating partial dominance in the direction of lengthening the uppermost internodes. The additive gene effects on the uppermost internode was greater than the dominance gene effect. The narrow as well as broad sense of heritabilities for the character of the uppermost internode were very high. There were significant maternal and reciprocal effect in the uppermost internode. 4. The gene action for the flag leaf angle was rather dominance in a way of getting narrower angle. However, in the Palgueng combinations, heterosis of $F_1$ was observed in both narrow and wide angles of the flag leaf. The dominant effects were greater than the additive effects on the flag leaf angle. There were observed also a great deal of non-allelic gene interacticn on the inheritance of the flag leaf angle. 5. Even though the dominant gene action on the length and width of flag leaf was effective in increasing the length or width of the flag leaf, there were found various degrees of hetercsis depending upon the cross combination. Over-dominant gene effect were observed in the inheritance of length of the flag leaf, while additive gene effects was found in the inheritance of the width of the flag leaf. High degree of heretabilities, either narrow or broad sense, were found in both length and width of the flag leaf. No maternal and reciprocal effect were found in both characters. 6. When Tongil was used as one parent in the cross, the length of panicle of $F_1$'s was remarkedly longer than that of parents. In other cross comination, the length of panicle of $F_1$'s was close to the parental mean values. Rather greater dominent gene effect than additive gene effect was observed in the inheritance of panicle length and the dominant gene was effective in increasing the panicle length. 7. The effect of dominant genes was effective in increasing the number of panicles. The degree of heterosis was largely dependent on the cross combination. The effect of dominant gene in the inheritance of panicle number was a little greater than that of additive genes, and the inheritance of panicle number was assumed to be due to complete dominant gene effects. Significantly high maternal and reciprocal effects were found in the character studied. 8. There were minus and plus values of heterosis in the kernel number per panicle depending upon the cross combination. The mean dominant effect was effective in increasing the kernel number per panicle, the degree of dominant effect varied with cross combination. The dominant gene effect and non-allelic gene interaction were found in the inheritance of the kernel number per panicle. 9. Genetic studies were impossible for the maturing ratio, because of environmental effects such as hazards delaying heads. The dominant gene effect was responsible for improving the maturing ratio in all the cross combinations excluding Tongil 10. The heavier 1000 grain weight was due to dominant gene effects. The additive gene effects were greater than the dominant gene effect in the 1000 grain weight, indicating that partial dominance was responsible for increasing the 1000 grain weight. The heritabilites, either narrow or broad sense of, were high for the grain weight and maternal or reciprocal effects were not recognized. 11. When Tongil was used as parent, the straw weight was showing high heterosis in the direction of increasing the weight. But in other crosses, the straw weight of $F_1$'s was lower than those of parental mean values. The direction of dominant gene effect was plus or minus depending upon the cross combinations. The degree of dominance was also depending on the cross combination, and apparently high nonallelic gene interaction was observed.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.19-26
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• 2017

Objectives: In the Lung, the VMAT rotates continuously and examines radiation. That increases the low doses to normal lung. Due to that, the incidence of radiation pneumonia among radiation side effects may increase. The cause of radiation pneumonia is the lower dose area of the lungs. The H-VMAT was applied to patients who applied to reduce radiation in the lower doses of the lungs. We wanted to assess the usefulness of the H-VMAT by comparing the radiation doses to the low dose areas of the lungs and the normal organs. Materials and Methods: A total of 26 patients who applied for a H-VMAT procedure were applied to the patient. The prescription dose applied to total dose 44 Gy from 22 divisions. For each patient, a plan was implemented with Conventional RT, VMAT and H-VMAT. Conventional RT was carried out in four to five fields each, considering the size, location, shape, and location of the PTV. In the case of a VMAT plan, the two Half ARC, three Half ARC method and the two Full ARC were planned. The H-VMAT was planned by adding two Static fields in the VMAT, taking into account the dose of the lung and the tolerance dose of the organs. Results: In the NSCLC, the lung doses $V_5$ and $V_{10}$ of the lungs except for the treatment plan volume were the lowest with $55.40{\pm}13.39%$ and $32.05{\pm}11.37%$ of H-VMAT. And, in the SCLC, the lung doses of V5 and V10 were the lowest at $64.32{\pm}16.15%$ and $35.50{\pm}9.91%$, respectively. The spinal dose of VMAT in NSCLC was $21.15{\pm}4.02Gy$, which was 7.94 Gy lower than other treatment methods. The lowest spinal dose was delivered at $19.72{\pm}1.82Gy$ for SCLC. The mean dose delivered to the esophagus was also $17.44{\pm}2.04Gy$ and $17.84{\pm}9.20Gy$ in SCLC and NSCLC, respectively. Conclusion: When comparing the value of the surrounding normal organ dose, the VMAT showed that less doses were transmitted from the heart, esophagus and spinal cord than the rest of the treatment plan. However, it was similar to VMAT in normal organs except for the spinal cord. VMAT has increased doses of some normal organs but did not exceed the tolerance dose. It showed a low value in $V_5$, $V_{10}$. When comparing Conventional RT, VMAT, and H-VMAT, If the dose to the heart, esophagus and spinal cord is lower than the tolerance dose, it is thought to reduce the incidence of radiation pneumonia by applying H-VMAT that show the benefits of low doses of the lungs.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.14 no.1
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• pp.1-14
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• 1978

To study the fluctuation of cold water in the East China Sea in summer heat budget of the Yellow Sea in winter was analysed based on the oceanographic and meteorological data compiled from 1951 to 1974. The maintain value of insolation was observed in December($160{\sim}190ly/day$), while the maximum in February ($250{\sim}260ly/day$). The range of the annual variation was found to be less than 50 ly/day. The value of the radiation term ($Q_s-Q_r-Q_h$) was remarkably small (mean 20 ly/day) in winter. It was negative value in December and January, and a positive value in February. The minimum total heat exchange from the sea ($Q_({h+c}$) was found value (471 ly/day) in February 1962, and the maximum (882 ly/day) in January 1963. The annual total heat exchange was minimum (588 ly/day) in 1962, and maximum (716 ly/day) in 1968. If the average deviation of mean water temperature at 50m depth layer were assumed to be the horizontal index ($C_h$) of colder water, $C_h$ is $C_h=\frac{{\Sigma}\limit_i\;A_i\;T_i}{{\Sigma}\limit_i\;A_i}$ where $A_i$ denotes the area of isothermal region and $T_i$ the value of deviation from mean sea water temperature. The vertical index ($C_v$) of cold water can be expressed similarly. Consequently the total index (C) of cold water equals to the sum of the two components, i.e. $C=C_h$＋$C_v$. Taking the deviation of mean sea surface temperature(T'w) in the third ten-day of Novembers in the Yellow Sea as the value of the initial condition, the following expressions are deduced : $C－T'w＝32.06 - 0.049$ $\;Q_T$ $C_h-T'w/2=12.20-0.019\;Q_T$ $C_v-T'w/2＝18.07-0.027\;Q_T$ where $Q_T$ denotes the total heat exchange of the sea. The correlation coefficients of these regression equations were found to be greater than 0.9. Heat budget was 588 ly/day in winter, and minimum water temperature of cold water was $18^{\circ}C$ in summer of 1962. The isotherm of $23^{\circ}C$ extended narrowly to southward up to $29^{\circ}N$ in summer. However, heat budget was 716 ly/day, and minimum water temperature of cold water was $12^{\circ}C$ in summer of 1968. The isotherm of $23^{\circ}C$ extended widely to southward up to $28^{\circ}30'N$ in summer. As a result of the present study, it may be concluded that the fluctuation of cold water of the East China Sea in summer can be predicted by the calculation of heat budget of the Yellow Sea in winter.

• Journal of Global Scholars of Marketing Science
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• v.19 no.3
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• pp.49-61
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• 2009

This article provides training exercises for executives into interpreting subroutine maps of executives' thinking in processing business and industrial marketing problems and opportunities. This study builds on premises that Schank proposes about learning and teaching including (1) learning occurs by experiencing and the best instruction offers learners opportunities to distill their knowledge and skills from interactive stories in the form of goal.based scenarios, team projects, and understanding stories from experts. Also, (2) telling does not lead to learning because learning requires action-training environments should emphasize active engagement with stories, cases, and projects. Each training case study includes executive exposure to decision system analysis (DSA). The training case requires the executive to write a "Briefing Report" of a DSA map. Instructions to the executive trainee in writing the briefing report include coverage in the briefing report of (1) details of the essence of the DSA map and (2) a statement of warnings and opportunities that the executive map reader interprets within the DSA map. The length maximum for a briefing report is 500 words-an arbitrary rule that works well in executive training programs. Following this introduction, section two of the article briefly summarizes relevant literature on how humans think within contexts in response to problems and opportunities. Section three illustrates the creation and interpreting of DSA maps using a training exercise in pricing a chemical product to different OEM (original equipment manufacturer) customers. Section four presents a training exercise in pricing decisions by a petroleum manufacturing firm. Section five presents a training exercise in marketing strategies by an office furniture distributer along with buying strategies by business customers. Each of the three training exercises is based on research into information processing and decision making of executives operating in marketing contexts. Section six concludes the article with suggestions for use of this training case and for developing additional training cases for honing executives' decision-making skills. Todd and Gigerenzer propose that humans use simple heuristics because they enable adaptive behavior by exploiting the structure of information in natural decision environments. "Simplicity is a virtue, rather than a curse". Bounded rationality theorists emphasize the centrality of Simon's proposition, "Human rational behavior is shaped by a scissors whose blades are the structure of the task environments and the computational capabilities of the actor". Gigerenzer's view is relevant to Simon's environmental blade and to the environmental structures in the three cases in this article, "The term environment, here, does not refer to a description of the total physical and biological environment, but only to that part important to an organism, given its needs and goals." The present article directs attention to research that combines reports on the structure of task environments with the use of adaptive toolbox heuristics of actors. The DSA mapping approach here concerns the match between strategy and an environment-the development and understanding of ecological rationality theory. Aspiration adaptation theory is central to this approach. Aspiration adaptation theory models decision making as a multi-goal problem without aggregation of the goals into a complete preference order over all decision alternatives. The three case studies in this article permit the learner to apply propositions in aspiration level rules in reaching a decision. Aspiration adaptation takes the form of a sequence of adjustment steps. An adjustment step shifts the current aspiration level to a neighboring point on an aspiration grid by a change in only one goal variable. An upward adjustment step is an increase and a downward adjustment step is a decrease of a goal variable. Creating and using aspiration adaptation levels is integral to bounded rationality theory. The present article increases understanding and expertise of both aspiration adaptation and bounded rationality theories by providing learner experiences and practice in using propositions in both theories. Practice in ranking CTSs and writing TOP gists from DSA maps serves to clarify and deepen Selten's view, "Clearly, aspiration adaptation must enter the picture as an integrated part of the search for a solution." The body of "direct research" by Mintzberg, Gladwin's ethnographic decision tree modeling, and Huff's work on mapping strategic thought are suggestions on where to look for research that considers both the structure of the environment and the computational capabilities of the actors making decisions in these environments. Such research on bounded rationality permits both further development of theory in how and why decisions are made in real life and the development of learning exercises in the use of heuristics occurring in natural environments. The exercises in the present article encourage learning skills and principles of using fast and frugal heuristics in contexts of their intended use. The exercises respond to Schank's wisdom, "In a deep sense, education isn't about knowledge or getting students to know what has happened. It is about getting them to feel what has happened. This is not easy to do. Education, as it is in schools today, is emotionless. This is a huge problem." The three cases and accompanying set of exercise questions adhere to Schank's view, "Processes are best taught by actually engaging in them, which can often mean, for mental processing, active discussion."

• Journal of Korean Academy of Nursing
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• v.4 no.3
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• pp.33-56
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• 1974

간호를 장래의 전문직으로 택하려고 공부하는 간호학생들은 완전한 성인으로서의 발달 과정중 후기 성년기에 속한다. 이시기는 자아를 발견하고 인간이 무엇을 믿으며 인간의 가치가 무엇인가를 추구하는 중요한 시기이다. 다시 말해서 어른과 어린이의 과도기에 서서 자신의 이상적 가치와 기성사회의 기존 가치를 잘 융화시켜 독립된 인간으로서 성숙하려는 노력의 시기이다. 그러므로 성년기의 갈등은 인생의 어느 시기보다도 그 정도가 심하게 나타난다. 간호학생들은 이상의 일반적인 성년기 발달의 요구 외에도 간호대학이라는 특수한 배움의 여건 때문에 좀 더 심각한 문제에 대두된다. 특히 소아과 간호대학이라는 실습환경은 여러 가지 복잡한 병실 사정으로 많은 긴장감을 주는 학습경험이다. 어린이의 간호에는 그들의 발달과정에 따른 다양한 역활이 요구된다. 또한 병원이라는 낯선 환경과 어머니를 떨어져야하는 두려움으로 불안한 어린이와 그 어린이의 불안과 두려움으로 인해 우울과 죄의식에 있는 어머니의 간호는 여러 면에서 성년기 학생들에게 긴장감을 일으키게 하는 요인이 된다. 본 연구의 문헌조사는 주로 미국 문헌에 나타난 간호 대학생들의 성년기 성숙을 위한 발달의 요구와, 소아병실의 복잡한 여건으로 발생되는 긴장감을 다루고 있다. 문헌을 기초로 하여 저자는 긴장감을 주는 간호활동을 크게 다섯 부군으로 묶었다. 1. 어린이 환자의 신체적 간호, 2. 어린이 환자나 부모와의 원만한 대화와 상호관계를 위한 간호활동 3. 소아병실에서 요구되는 다양한 간호원의 역활 4. 어린이나 부모의 간호에 대한 의뢰심 5. 간호의 가치나 이상적 간호. 연구방법으로는 49개의 폐쇄식 질문 항목을 가진 질문지를 사용하였다. 질문 항목들은 문헌연구에서 소아과 간호학 실습시 학생들이 긴장감을 느낀다고 밝혀진 내용들이 다. 학생들은 자신의 경험을 "긴장감이 없었다. ""긴장감이 있었다. ""심한 긴장감이 있었다. ""실습 중 경험이 없었다. "의 사항 중 택일을 하게 되어 있다. 연구대상으로는 모 대학교 간호대학 학생으로 산부인과 간호학 실습을 마친 후 소아과 간호학 실습 8주를 완료한 4학년 학생 42명이었다. 자료분석의 결과는 대부분의 학생들에게 소아과 간호학 실습은 긴장감을 주는 경험이 있다고 나타났다. 다음은 연구결과 주목할만한 몇 가지 사항들이다. 1. 어린이 환자의 신체적 간호는 성년기 학생들에게 긴장감을 주는 실습 경험이었다. 특별히 심하게 긴장감을 주었던 간호활동은 어린이환자의 상태가 중한 경우로, 장기간 앓는 아이, 선천성 기형이 있는 아이, 회복이 불가능하여 죽게될 아이나 사망하는 경우의 어린이 간호였다. 이 결과는 간호학의 기본과정 즉, 기초간호학이나 내 외과 간호학 실습만으로 소아과 간호학 실습을 위한 충분한 준비가 되지 못한다는 것을 뜻 할 수도 있다. 한편, 문헌연구에서 밝힌바와 같이 어리고 연약해 보이는 어린이들의 신체조건이 학생들의 간호활동을 어렵게 하는 경우도 될 수 있겠다. 2. 간호학생들의 어린이 환자와의 대화나 원만한 인간관계에서의 긴장감은 이 연구결과로 평가나 제언이 힘들다. 조사결과에서 학생들은 주로 어린이의 상태가 좋지 않은 경우에 심한 긴장감을 가졌고 일반적인 간호의 경우에는 별로 긴장감이 없었다. 이것은 질병의 상태나 화제, 이야기 할 때의 상황에 따라 긴장감의 여부가 달라질 수 있다는 결론이 되겠다. 3. 소아병실에서의 다양한 역활을 수행하는 것은 비교적 긴장감이 많이 생기는 간호활동으로 나타났다. 그러나 재미있는 사실은 학생들이 간호원으로서의 전문가적인 입장에서, 환자나 보호자를 가르칠때는 별로 문제가 없었으나 어린이 기르는 방법이나 어린이 이해면에서 좀 더 잘 안다고 생각되는 어머니가 지켜 볼때의 어린이 간호에는 긴장감을 가진다는 사실이다. 이것은 Jewett의 연구에서 밝힌바와는 상반되는 결과다. 그의 연구에서 학설들은 부모나 어머니들에 의해 전문가로서 인정받고 기대되는 경우가 제일 어려운 경험이 있다고 밝혔다. 4. 어린이 환자나 그들 부모의 간호에 대한 의뢰심은 학생들에게 심한 긴장감을 주는 경험이 있다. 특히 신체적 간호에 대해 의뢰하는 경우에는 더 심한 긴장감을 준다고 표현한다. 일반적으로 부모가 병실에 상주하는 경우에는 그들의 의뢰심이 심하며 이것은 학생들에게 감당하기 힘든 긴장과 어려움을 주게된다. 왜냐하면 성년기의 학생들은 그들 자신이 먼저 타인에게서 이해받기를 원하며 또 관용을 베풀어주기를 원하는데 그것을 남에게 주어야 하는 입장은 학생들을 긴장되게 하는 실습활동인 것이다. 5. 학생들은 그들이 배운 간호의 이상이나 가치가 실습지에서의 여러 경우와 맞지 않는 것을 보았을 때 극심한 긴장감을 갖는다고 밝혔다. 의사나 병원 행정의 사실이 자신의 이상과 맞지 않는다는 것보다는 간호원의 간호업무의 차이에서 더 비판적인 반응을 보였다. 대부분의 성년기 학생들은 그들의 이상적인 간호원상을 그들의 선배나 실무 간호원 중에서 찾으려는 시기에 그들의 간호활동이 이론과 다른 점이나 학생 자신의 소아과 간호의 가치와 다른 것을 보았을 때는 심한 반감과 긴장감을 갖게된다. 이 문제는 어린 사람이 윗 어른과 함께 동료의식을 갖고 일하기 어려운 한국적 사회구조 때문에 더 심하게 긴장감을 주는 경험인지도 모른다. 선배 간호원의 전문인으로서의 권위와 어린이 환자 보호자의 어른으로서의 권위 사이에서 자신의 이상과 가치의 추구는 용이하지 않으며 내적 갈등은 어쩔수 없는 일 일 것이다. 6. 대부분 높은 백분율의 긴장 반응은 죽음이나 환자의 사망에 관련된 간호활동 항목에서 나타났다. 이 연구의 대상 학생들은 2, 3학년에서 죽음에 대한 강의를 들었지만 이 연구 결과에 의하면 충분한 학습 경험이 주어진 것 같지 않다. 어떠한 경우의 죽음에라도 어린이 환자나 그 보호자들의 심리를 잘 이해하고 반응을 잘 관찰해서 적절한 간호를 해 줄 수 있는 다양한 방법의 학습 경험이 필요하다고 보겠다. 7. 학생들의 긴장도가 어린이 간호에 더 심한가, 보호자 간호에 더 심한가를 알기 위한 비교 결과는 비교적 비슷한 정도로 나타났다. 8. 학생들의 소아과 간호학 실습시의 긴장도는 과거의 병실 실습기간의 장, 단이나 가정에서의 어린인 간호의 경험과는 별 연관성이 없었다. 연구의 대상자가 적기 때문에 단정을 하기는 힘이 들지만 소아과 간호학 실습이 다른 병실의 실습과는 분리되어서 완전히 다르게 다루어 져야만 하며 간호교육자들의 주의 깊은 관심과 노력이 필요한 실습교육이 라 하겠다. 이상의 전반적인 고찰에 의하면 한국 성년기 간호학생들의 소아과 간호학 실습은 미국의 경우와 마찬가지로 긴장감을 주는 경험이다. 문화배경의 다른 점은 무시하고라도 Davis와 Oleson이 결론한 바와 같이 "간호대 학생은 어디를 막론하고 다 같은 성격과 문제를 가지고 있다. " 앞으로 보다 효과적인 학생들의 소아과 간호학 실습을 위한 연구를 위해 다음의 몇 가지를 본 연구의 결과를 가지고 제언한다. 1. 보다 여러 지역에서 다양한 교육 방법을 가진 학교의 학생을 대상으로 한 연구의 필요성. 2. 학생들이 실습 전 선입견이나 이미 들어서 생긴 긴장감의 개입 여부를 밝힐 수 있는 연구. 3. 학생 개인의 과거 경침이 긴장감 유발에 미치는 영향을 위한 연구 4. 이 연구의 결과를 입증할 수 있는 종단적 연구. 5. 이 연구에서 나타난 긴장감이 학습 행위에 미치는 영향을 알기 위한 관찰적 연구. 이 연구를 위해 많은 도움을 주셨던 보스턴대학의 Dr. Kennedy와 연세대학의 여러 선생님께 심심한 감사를 드립니다.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.235-245
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• 2008

Purpose: The HSV1-tk gene has been extensively studied as a type of reporter gene. In hepatocellular carcinoma (HCC), only a small proportion of patients are eligible for surgical resection and there is limitation in palliative options. Therefore, there is a need for the development of new treatment modalities and gene therapy is a leading candidate. In the present study, we investigated the usefulness of substrate, 2'-fluoro-2'-deoxy-1-${\beta}$-D-arabino-furanosyi-5-[$^{124/125}I$]iodo- uracil ([$I^{124/125}I$]FIAU) as a non-invasive imaging agent for HSV1-tk gene therapy in hepatoma model using small animal PET. Material and Methods: With the Morris hepatoma MCA cell line and MCA-tk cell line which was transduced with the HSV1-tk gene, in vitro uptake and correlation study between [$^{125}I$]FIAU uptake according to increasing numeric count of percentage of MCA-tk cell were performed. The biodistribution data and small animal PET images with [$^{124}I$]FIAU were obtained with Balb/c-nude mice bearing both MCA and MCA-tk tumors. Results:, Specific accumulation of [[$^{125}I$]FIAU was observed in MCA-tk cells but uptake was low in MCA cells. Uptake in MCA-tk cells was 15 times higher than that of MCA cells at 480 min. [$^{125}I$]FIAU uptake was linearly correlated (R2 =0.964, p =0.01) with increasing percentage of MCA-tk numeric cell count. Biodistribution results showed that [$^{125}I$]FIAU was mainly excreted via the renal system in the early phase. Ratios of MCA-tk tumor to blood acting were 10, 41, and 641 at 1 h, 4 h, and 24 h post-injection, respectively. The maximum ratio of MCA-tk to MCA tumor was 192.7 at 24 h. Ratios of MCA-tk tumor to liver were 13.8, 66.8, and 588.3 at 1 h, 4 h, and 24 h, respectively. On small animal PET, [$^{124}I$]FIAU accumulated in substantial higher levels in MCA-tk tumor and liver than MCA tumor. Conclusion: FIAU shows selective accumulation to HSV1-tk expressing hepatoma cell tumors with minimal uptake in normal liver. Therefore, radiolabelled FIAU is expected to be a useful substrate for non-invasive imaging of HSV1-tk gene therapy and therapeutic response monitoring of HCC.

• Korean Journal of Weed Science
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• v.17 no.3
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• pp.288-294
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• 1997

Field and pot expeiments were carried out to evaluate the interaction between quinclorac and bensulfuron-methyl on growth of the rice plants(Oryza sativa L. cv. Choocheongbyeo) at 20, 45, 65 days-old stages. Quinclorac and bensulfuron-methyl showed antagonistic interaction at both stages, which were detected by the Chisaka's method at isobles of 10% growth inhibition. The antagonism indices were -0.63 and -1.67 at 20 and 65 days-old seedling stages, respectively. Leaf-rolling of rice occurred when quinclorac was applied at 600g ai/ha or more at 20 days-old seedling stage, while it occured at the dose of 900g ai/ha at 65 days-old stage. Bensulfuron-methyl reduced plant height and dry weight as well as tiller production at both stages. Leaf-rolling of rice was reduced when mixture of quinclorac and bensulfuron-methyl was applied due to antagonism of the two herbicides. High temperatures increased the phytotoxicity of bensulfuron-methyl, while the phytotoxicity caused by quinclorac alone was not responsive to temperature. The antagonistic effect between quinclorac and bensulfuron-methyl increased at low temperature as tested by the Colby's method.