• Title/Summary/Keyword: 임상에서의 문제점

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Reseach on Transcultural Nursing (횡문화 간호에 관한 연구)

  • Shin, Kyng-Rim
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.454-463
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    • 1992
  • 세계가 일일 생활권화 됨과 더불어 국제교류가 활발해지므로써 횡문화 간호 연구는 전문직 간호(Professional Nursing)에 있어서 매우 중요한 부분을 차지하고 있음을 많은 문헌을 통해서 알 수 있다(Brink, 1976 : Leininger, 1977 : Roberston & Boyle, 1987). 횡문화 간호연구는 서로 다른 문화적 배경을 가진 사람들을 잘 이해하고 그들의 건강을 돌봄에 있어서 더욱 효과적이고, 안전한 간호를 할 수 있을 뿐만 아니라 간호이론 개발, 간호모형(Model) 개발에 있어서도 매우 중요한 역할을 한다고 믿는다. 본 연구는 1984년에서 1987년 사이에 전문적 간호연구지에 실린 10편의 횡문화 간호연구와 관련된 논문들을 발췌하여 간호지식체의 본질적인 과정인 비판적 문헌고찰을 통해 각 논문들을 비교 분석 한 것으로써, 미래의 간호연구를 위한 간호실무, 간호교육, 간호연구 방법 및 간호 행정면에서 그 적용성을 높여줄 것이다. 비판적 문헌고찰을 위한 기준은 Burns와 Grove(1987)의 방법을 참고하여 아래와 같이 선정하였다. 1. 분석대상 : 목적, 가설 진술, 문헌고찰, 표본조사, 방법론적 논점, 결과 해석 2. 이론적 틀의 유도 흑은 통합 3. 발전적인 간호수행을 위한 중요성, 적용성 및 제언 이상의 내용으로 비교 분석을 해본 결과 1984년에서 1987년 사이에 발표된 횡문화 간호에 관한 논문들의 주제는 주로 여성을 대상으로 한 건강돌봄, 자가간호, 건강신념, 수유, 임신 그리고 간호사와 소수민족 노인과의 의사소통 양상 등으로 나누어 볼 수 있었다. 이론적 틀은 주로 사회학, 정신심리학, 인류학 이론으로부터 도출되었고, 오직 두 편만이 간호 이른에 틀을 둔 것으로 나타났다. 1. 10개의 논문의 가설과 목적의 분석에 있어서 4편의 논문은 목적과 가설이 구체적으로 진술되어 있었고, 나머지 6편은 목적이 전반적으로 진술되어 있었으며 가설도 구체적이지 않았다. 이러한 제한점은 각 논문의 연구자가 문헌고찰을 충분히 하지 못하고 단지 수편의 논문만을 제시 한 데서 비롯되었다고 분석 해 볼 수 있겠다. 2. 문헌고찰 부분에서는 각각의 연구주제를 지지해줄 수 있는 문헌들이 충분히 고찰되지 못하였고, 이론적배경 또한 횡문화 이론과의 관련성이 적었다. 또한 횡 문화 연구에 기초가 되는 연구대상자의 사회 인구학적 특성과 역사적 배경은 잘 나타났으나, 이론적 연구와 경험적 연구 간에 괴리가 있었다. 3. 표본추출방법은 문화에 기반을 둔 대상자를 선정한다는 점에서 한계성 이 있었다. 4. 방법론적 이유로는 대상자와의 면담시간이 구체적으로 기술되지 않았으며, 고유한 언어를 통역하는 과정에서 의미론적 문제에 대한 고려가 부족하였다. 면접과 기록과정에서 보면 자료의 기록과정과 분류 및 분석과정이 명시되어 있지 않았다. 참여관찰과 면접방법을 사용시 이에 대한 자세한 기술이 되어 있지 않았다. 5. 연구결과의 적용 및 이에 대한 논의는 상당히 제한되어 있었는데, 수편의 연구만이 방법론 문제점과 앞으로의 연구분야에 대한 전망을 제시하였으며, 특이한 것은 어 떤 연구자도 이른 개발을 위한 적용 및 임상실무적 차원에서 간호에 대한 제언을 하지 않았다.

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Comparison of Push-out Bond Strengths According to Relining Procedure and Cement Type on Fiber Post (Fiber post의 Relining 방법과 시멘트 유형에 따른 Push-out Bond Strength의 비교)

  • Kang, Hyun-Young;Cho, So-Yeun;Yu, Mi-Kyung;Lee, Kwang-Won;Kim, Kyoung-A
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.253-265
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    • 2011
  • When restoring endodontically treated teeth is the mismatch between fiber post size and post space diameter, the resin cement layer is excessively thick in post space and voids are likely to form in it, thus predisposing to de-bonding. The method to overcome this problem is to reline the fiber post with composite resin. This individual anatomic post improves the adaptation of post to root walls and decreases the resin cement thickness. The purpose of this in vivo study was to evaluate the push-out bond strength of fiber post according to relining procedure and luting agents type used for simplicity of clinical procedure. Forty-two extracted teeth were divides into six groups.(n=7) A1: relined fiber post cemented with Luxacore/all-bons 2, A2: non-relined fiber post cemented with Luxacore/all-bond2, B1: relinind fiber post cemented with Calibra/XP-bond, B2: non-relined fiber post cemented with Calibra/XP-bond, C1: relined fiber post cemented with RelyX Unicem, C2: non-relined fiber post cemented with RelyX Unicem Push-out bond strength was affected by interaction between relining procedure and luting agent type. Relined fiber post presented higher push-out bond strength value than non-relined fiber post and statically significant differences(p<0.05) Cementation with RelyX Unicem showed significantly higher bond strength than other luting agents(p<0.05).

ORTHODONTIC TRACTION OF IMPACTED MANDIBULAR SECOND PRIMARY MOLAR (매복된 하악 제2유구치의 교정적 견인)

  • Kim, Min-Jung;Lee, Sang-Ho;Lee, Nan-Young;Jang, Hyang-Gil
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.303-308
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    • 2011
  • Tooth impaction refers to situations in which the eruption is inhibited by some physical barriers in eruptive path and the tooth remains unerupted beyond the normal time of eruption. The etiology of impacted tooth is controversial, but ankylosis has been suggested probably as a leading role. Impacted primary molars may cause several problems such as space loss, tipping of adjacent teeth, supra-eruption of the antagonists, dislocation of succeeding premolar, cystic change and infection. As one of conventional treatments of impacted primary molars, early tooth extraction or surgical extraction following space regaining when there is space loss has been suggested. However, when they are in normal formation and not ankylosed, orthodontic traction following surgical exposure can be the choice of treatment. In this case, a 3-year-old boy was referred to the department of pediatric dentistry for the unerupted mandibular right second primary molar. After surgical removal of gingiva on the occlusal surface, orthodontic traction was performed. After treatment, we could get normal alignment of primary teeth and the opportunity for normal development of permanent teeth.

TREATMENT OF IMPACTED CANINE : CASE REPORTS (매복견치의 치료: 증례보고)

  • Ahn, Byung-Duk;Kim, Young-Jae;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.151-158
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    • 2008
  • Upper and lower cuspids are very important teeth in point of function as well as esthetic. However, failure of eruption of the canine sometimes happens and is frequently encountered clinical problems. Upper cuspids are more frequently impacted as compared with lower cuspis and palatally impaction is more frequent event than labially impaction. Impaction of the mandibular canine is unusual event, especially crossing the midline (transmigration) is very rare. Because of, in most cases, there is no signs and symptoms, impacted teeth can be detected by periodic radiograph examination. The etiology of impaction is unclear and multifactorial. The treatment of impacted canine is influenced by presence of obstacles, location and direction of impaction, space for alignment and development of root. There are several treatment options; (1) Surgical removal and/or observation, (2) Window opening and orthodontic traction, (3) Autotransplantation. The first patient (impaction of upper right cuspid) is treated with window opening and orthodontic traction. The second patient (bilaterally impaction of lower cuspids) is treated with autotransplantation, because of transmigration.

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AMELOGENESIS IMPERFECTA: A CASE REPORT (법랑질 형성부전증 환아의 치험례)

  • Park, Hee-Suk;Kim, Tae-Wan;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.562-570
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    • 2008
  • Amelogenesis imperfecta is a group of hereditary defects of enamel, unassociated with any other generalized defects. It is classified into 14 subtypes according to different clinical and genetic features. According to its clinical features, it is classified into hypoplastic type, hypocalcified type and hypomaturation type. However, these features tend to co-exist often. Dental features associated with amelogenesis imperfecta include quantitative and qualitative enamel deficiencies, pulpal calcification, root malformations, abnormal eruption, impaction of permanent teeth, progressive resorption of root and crown, congenital missing teeth and anterior and posterior open bite occlusions. The first case patient is a 16 month-old child with discoloration of deciduous teeth. All of her deciduous and permanent dentition has shown amelogenesis imperfecta. The restorational, orthodontic and recent prosthodontic treatments have been completed. Another patient is a 9 year and 3 month-old child with amelogenesis imperfecta in both deciduous and permanent dentition. The restoration has been done and the prosthodontic treatment is planned after the completion of growth. Above cases indicate that amelogenesis imperfecta occurs both in deciduous and permanent dentition, and it requires the long term treatment and care.

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Estimation of the Central Aortic Pulse using Transfer Function and Improvement of an Augmentation Point Detection Algorithm (전달함수를 이용한 대동맥 맥파 추정 및 증강점 검출 알고리즘 개선에 관한 연구)

  • Im, Jae-Joong
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.45 no.3
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    • pp.68-79
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    • 2008
  • Aortic AIx(augmentation index) has been used to measure aortic stiffness quantitatively and even to evaluate ventricular load. However, in order to calculate aortic AIx catheters should be inserted to the subjects' artery, which hampers its clinical usage. To overcome such limitation, aortic AIx has been indirectly calculated by estimating aortic pressure wave from the peripheral arterial pulse by applying transfer functions. In this study, central aortic pressure waves using Millar catheter and radial artery pulse waves using tonometry pressure sensor were measured to establish transfer functions for an estimation of central aortic pressure waves from radial artery pulse waves. Also, an algorithm which detects augmentation point for the calculation of AIx were developed. Developed algorithm for the detection of augmentation point gradually increases the differential order to detect inflection point rather than detects the distinctive point that appears after a specific time. Transfer functions were established using 10th order ARX model and were verified for the stability of the transfer function through residual analysis. Evaluation of an algorithm for the detection of augmentation point were performed by comparing the augmentation points obtained from developed algorithm with the known augmentation points synthesized in various conditions. In addition, developed algorithm for the AIx is proved to provide more accurate results than the ones developed by previous studies. The significance of the study was in two folds. Firstly, the results could provide the basis for the measurement of aortic stiffness using easily-measurable radial artery pulse waves, and secondly, extension of the study may enable the early diagnosis of various vascular diseases.

Application of the convergence-confinement method of tunnel design to rock masses (암반 터널에서의 시공단계를 고려한 암반-지보 거동특성 곡선적용에 관한 연구)

  • Lee, Du-Wha;Choo, Seok-Yean;Lim, Sang-Bin;Park, Young-Jin;Ahn, Sung-Joo
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.4 no.2
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    • pp.143-153
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    • 2002
  • Convergence Confinement Method (CCM) makes a more simple judgement in a ground-support reaction than numerical method. Also this method is good for the applicability of construction feedback and the analysis of field measurement. However, there has been little research with respect to the application of CCM in tunnel construction. One of the problems in CCM is a decision of the time to support installation. To decide a reasonable supporting installation time, support characteristic curve and displacement characteristic curve considering construction stage are proposed. In addition, to predict displacement distribution ratio and load distribution ratio, the time dependent support reaction curve is used. Finally, through a comparison of the result between CCM and numerical analysis, the trust of this study is proved and the practical application is proposed to control resonable tunnel construction management.

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Frictional resistance of different ceramic brackets and their relationship to the second order angulation between bracket slot and wire (세라믹 브라켓의 종류 및 브라켓 슬롯과 와이어 각도에 따른 마찰 저항 차이)

  • Choi, Yoon-Jeong;Park, Young-Chel
    • The korean journal of orthodontics
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    • v.36 no.3 s.116
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    • pp.207-217
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    • 2006
  • Although ceramic brackets have been used widely for improved esthetics during treatment, ceramic brackets have some inherent problems; brittleness, attrition of the opposing teeth and high frictional resistance. This study was performed to understand the frictional resistance of the ceramic brackets, as well as to be a helpful reference for finding the solutions to the problem of frictional resistance. Three different kinds of brackets were used; metal bracket, polycrystalline ceramic brackets with a metal slot to reduce the high frictional resistance and monocrystalline ceramic brackets. The brackets were tested with a $.019{\times}.025$ stainless steel wire with a second order angulation of $0^{\circ}\;and\;10^{\circ}$, and the static and kinetic frictional forces were measured on the universal testing machine. The results of this study showed that the ceramic brackets, especially the monocrystalline ceramic bracket without a metal slot, generated higher frictional resistance than the metal bracket, and the frictional resistance was increased as the angulation between the bracket slot and the wire increased. Therefore, the development of the ceramic bracket with reduced frictional resistance and the prevention of excessive crown tipping during orthodontic treatment will lead to the simultaneous attainment of more efficient and improved esthetic treatment goals.

In Vitro Antitumor Activity and Nephrotoxicity of the Novel Platinum(II) Coordination Complex Containing Cis-dach/Diphosphine (새로운 Platinum(II)Complex ([Pt(II)(cis-dach)(DPPP)].$(NO_3)_2$의 항암효과 및 신독성)

  • Jung, Jee-Chang;Yim, Sung-Vin;Park, Seung-Joon;Chung, Joo-Ho;Ko, Kye-Chang;Chang, Sung-Goo;Rho, Young-Soo
    • The Korean Journal of Pharmacology
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    • v.32 no.1
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    • pp.93-102
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    • 1996
  • Platinum coordination complexes are currently one of the most compounds used in the treatment of solid tumors. However, its use is limited by severe side effects such as nephrotoxicity. Our platinum-based drug discovery program is aimed at developing drugs capable of diminishing toxicity and broadening the clinical spectrum of activity of cisplatin. We synthesized new Pt(II) complex analogue containing 1,2-diaminocyclohexane (dach) as carrier ligand and 1,3-bis(diphenyl phosphino)propane (DPPP) as a leaving group. Furthermore, nitrate was added to improve the solubility. A new series of PC-1 [Pt(cis-dach) (DPPP)]. $2NO_3_2$ was synthesized and characterized by their elemental analysis and by various spectroscopic techniques [infrared (IR), $^{13}carbon$ nuclear magnetic resonance (NMR)]. PC-1 was demonstrated acceptable antitumor activity aganist SKOV -3, OVCAR-3 human ovarian adenocarcinomacells and significant activity as compared with that of cisplatin. The toxicity of PC-1 was found quite less than that of cisplatin using MTT, $[^3H]thymidine$ uptake and glucose consumption tests in rabbit proximal tubule cells, human kidney cortical cells and human renal cortical tissues. Based on these results, this novel platinum compound represent a valuable lead in the development of a new anticancer chemotherapeutic agent capable of improving antitumor activity and low toxicity.

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Open Source-Based Surgical Navigation for Fracture Reduction of Lower Limb (오픈소스 기반 수술항법장치의 하지 골절수술 응용검토)

  • Joung, Sanghyun;Park, Jaeyeong;Park, Chul-Woo;Oh, Chang-Wug;Park, Il Hyung
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.38 no.5
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    • pp.497-503
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    • 2014
  • Minimally invasive intramedullary nail insertion or plate osteosynthesis has shown good results for the treatment of long bone fractures. However, directly seeing the fracture site is impossible; surgeons can only confirm bone fragments through a fluoroscopic imaging system. The narrow field of view of the equipment causes malalignment of the fracture reduction, and radiation exposure to medical staff is inevitable. This paper suggests two methods to solve these problems: surgical navigation using 3D models reconstructed from computed tomography (CT) images to show the real positions of bone fragments and estimating the rotational angle of proximal bone fragments from 2D fluoroscopic images. The suggested methods were implemented using open-source code or software and evaluated using a model bone. The registration error was about 2 mm with surgical navigation, and the rotation estimation software could discern differences of $2.5^{\circ}$ within a range of $15^{\circ}$ through a comparison with the image of a normal bone.