• Journal of the Society of Cosmetic Scientists of Korea
• /
• v.30 no.2
• /
• pp.263-278
• /
• 2004

Ursolic acid (UA) and Oleanolic acid (ONA), known as urson, micromerol and malol, are pentacyclic triterpenoid compounds which naturally occur in a large number of vegetarian foods, medicinal herbs, and plants. They may occur in their free acid form or as aglycones for triterpenoid saponins, which are comprised of a triterpenoid aglycone, linked to one or more sugar moieties. Therefore UA and ONA are similar in pharmacological activity. Lately scientific research, which led to the identification of UA and ONA, revealed that several pharmacological effects, such as antitumor, hepato-protective, anti-inflammatory, anticarcinogenic, antimicrobial, and anti-hyperlipidemic could be attributed to UA and ONA. Here, we introduced the effect of UA and ONA on acutely barrier disrupted and normal hairless mouse skin. To evaluate the effects of UA and ONA on epidermal permeability barrier recovery, both flanks of 8-12 week-old hairless mice were topically treated with either 0.01-0.1mg/mL UA or 0.1-1mg/mL ONA after tape stripping, and TEWL (transepidermal water loss) was measured. The recovery rate increased in those UA or ONA treated groups (0.1mg/mL UA and 0.5mg/mL ONA) at 6h more than 20% compared to vehicle treated group (p < 0.05). Here, we introduced the effects of UA and ONA on acute barrier disruption and normal epidermal permeability barrier function. For verifying the effects of UA and ONA on normal epidermal barrier, hydration and TEWL were measured for 1 and 3 weeks after UA and ONA applications (2mg/mL per day). We also investigated the features of epidermis and dermis using electron microscopy (EM) and light microscopy (LM). Both samples increased hydration compared to vehicle group from 1 week without TEWL alteration (p < 0.005). EM examination using RuO4 and OsO4 fixation revealed that secretion and numbers of lamellar bodies and complete formation of lipid bilayers were most prominent (ONA=UA > vehicle). LM finding showed that thickness of stratum corneum (SC) was slightly increased and especially epidermal thickening and flattening was observed (UA > ONA > vehicle). We also observed that UA and ONA stimulate epidermal keratinocyte differentiation via PPAR Protein expression of involucrin, loricrin, and filaggrin increased at least 2 and 3 fold in HaCaT cells treated with either ONA (10${\mu}$M) or UA (10${\mu}$M) for 24 h respectively. This result suggested that the UA and ONA can improve epidermal permeability barrier function and induce the epidermal keratinocyte differentiation via PPAR Using Masson-trichrome and elastic fiber staining, we observed collagen thickening and elastic fiber elongation by UA and ONA treatments. In vitro results of collagen and elastin synthesis and elastase inhibitory activity measurements were also confirmed in vivo findings. These data suggested that the effects of UA and ONA related to not only epidermal permeability barrier functions but also dermal collagen and elastic fiber synthesis. Taken together, UA and ONA can be relevant candidates to improve epidermal and dermal functions and pertinent agents for cosmeseutical applications.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.4
• /
• pp.569-583
• /
• 1995

Background: The expression of the adhesion molecules on the cell surface is important in the movement of cells and the modulation of immune response. DILD starts as an alveolitis and progresses to pulmonary fibrosis. So adhesion molecules in these patients is expected to be increased. There are several reports about adhesion molecules in DILD in terms of the percentage of positive cells in immuno-stain, in which the interpretation is subjective and the data were variable. Methods: So we measured the relative median fluorescence intensity(RMFI) which is the ratio of the FI emitted by bound primary monoclonal antibody to FI emitted by isotypic control antibody of the cells in BALF of 28 patients with DILD(IPF:10, collagen disease:7, sarcoidosis:9, hypersensitivity pneumonitis:2) and 9 healthy control. Results: RMFI of the ICAM-1 on AM($3.30{\pm}1.16$) and lymphocyte($5.39{\pm}.70$) of DILD were increased significantly than normal control($0.93{\pm}0.18$, $1.06{\pm}0.21$, respectively, p=0.001, P=0.003). RMFI of the CD18 on lymphocyte was also higher($24.9{\pm}14.9$) than normal($4.59{\pm}3.77$, p=0.0023). And there was a correlation between RMFI of ICAM on AM and the % of AM(r=-0.66, p=0.0001) and lymphocyte(r=0.447, p=0.0116) in BALF. Also RMFI of ICAM on lymphocyte had a significant (r=0.593, p=0.075) correlation with the % of IL-2R(+) lymphocyte in BALF. The soluble ICAM(sICAM) in serum was also significantly elevated in DILD($499.7{\pm}222.2\;ng/ml$) compred to normal($199.0{\pm}38.9$) (p=0.00097) and sICAM in BAL fluid was also significantly higher than normal control group($41.8{\pm}23.0\;ng/ml$ vs $20.1{\pm}13.6\;ng/ml$). There was a Significant correlation between sICAM level in serum and the expression of ICAM-l on AM(r=0.554, p=0.0259).Conclusion: These data suggest that in DILD the expression of adhesion molecules is increased in the AM and BAL lymphocytes with elevated serum sICAM, and these parameter may be useful in determining disease activity.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.6
• /
• pp.1296-1307
• /
• 1997

Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

• Journal of Ginseng Research
• /
• v.26 no.3
• /
• pp.111-131
• /
• 2002

Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

• Korean Journal of Food Science and Technology
• /
• v.8 no.2
• /
• pp.95-106
• /
• 1976

In order to investigate chemical components and mineral of ginseng cultivated in Korea and to establish an appropriate extraction method, the present work was carried out with Raw ginseng(SC), White ginseng(SB) and Ginseng tail(SA). The results determined could be summarized as follows : 1. Among the proximate components, moisture content of SC, SB and SA were 66.37%, 12.61% and 12.20% respectively. The content of crude ash in SA was the highest value of three kinds of ginseng root: SA 6.04%, SB 3.52% and SC 1.56%. The crude protein of Dried ginseng root(SA and SB) was about 12-14%, which was more than two times compared with that of SC(6.30%) The content of pure protein seemed to be in similar tendency with that of crude protein in three kinds of ginseng root: 2.26% in SC, 5.94% in SB and 5.76% in SA. There was no significant difference in the content of fat among the kinds of ginseng root. $(1.1{\sim}2.5%)$ 2. The highest Ginseng extract was obtained by use of Continuous extractor which is a modified Soxhlet apparatus for 60 hours extraction with 60-80% ethanol. 3. Ginseng and the above-mentioned ginseng extract (Ginseng tail extract: SAE, White Ginseng extract : SBE, Raw Ginseng extract: SCE) were analyzed by volumetric method for the determination of Chlorine and Calcium, by colorimetric method for that of Iron and Phosphorus, by Atomic Absorption Spectrophotometer for that of Zinc, Copper and Manganese. The results were as follows : 1. The content of phosphorus in SA, SB and SC were 1.818%, 1.362%, 0.713% respectively and phosphorus content in three kinds of extract were in low level (SAE: 0.03%, SBE: 0.063%, SCE: 0.036%) 2. In the Calcium content, SA, SB and SC were 0.147%, 0.238%, 0.126% and the Calcium contents of Ginseng extracts were 0.023%, 0.011% and 0.016%. The extraction ratio of Calcium from SA was the highest value (15.6%), while that in the case of SB was 4.6%. 3. The Chlorine content of SA was 0.11%, this was slightly higher than others(SB: 0.07%, SC: 0.09%) and extraction ratio of SA and SB were 36.4%, 67.1% while that of SC was 84.4%. 4. The Iron content of SA, SB and SC were 125ppm, 32.5ppm and 20ppm but extraction ratio was extremely low (SAE: 1.33%, SBE: 0.83%, SCE: 1.08%), 5. The Manganese content of SA, SB and SC were 62.5ppm, 25.0ppm and 5.0ppm respectively but the Manganese content of extract could not determined, Copper content of SA, SB and SC were 15.0ppm, 20.0ppm and those of extract were 7.5ppm, 6.5ppm, 4.5ppm while those of extraction ratio were 50%, 32.5% and 90% respectively, Zinc was abundant in Ginseng compared with other herbs, (SA: 45.5ppm, SB: 27.5ppm and SC: 5.5ppm) and the extracted amount were 4.5ppm, 1.25ppm 1.50ppm respectively.

• Journal of Genetic Medicine
• /
• v.8 no.2
• /
• pp.89-99
• /
• 2011

Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

• Journal of the Korean Society of Environmental Restoration Technology
• /
• v.14 no.4
• /
• pp.1-10
• /
• 2011

This study was conducted to compare the growth of Zoysia japonica depending on different soil treatments in Saemangeum sea dike, which is filled with dredged soil. Zoysia japonica was planted using sod-pitching method on the control plot. On plots which were treated with forest soil and soil improvement, Zoysia japonica seeds were sprayed mechanically. Sixteen months after planting, coverage rate, leaf length, leaf width, and root length were measured and analyzed. Also, three Zoysia japonica samples per plot were collected to analyze nutrient contents. Coverage rate was 100% in B treatment plot(dredged soil+$40kg/m^3$ soil improvement+forest soil), in C treatment plots (dredged soil+$60kg/m^3$ soil improvement+forest soil), and D treatment plots (dredged soil+$60kg/m^3$ soil improvement), while only 43% of the soil surface was covered with Zoysia japonica on control plots. The width of the leaf on C treatment plots (3.79mm) was the highest followed by D treatment (3.49mm), B treatment (2.40mm) and control plots (1.97mm). Leaf and root length of D treatment was 30.18cm and 13.18cm, which were highest among different treatments. The leaf length of D treatment was highest followed by C, B, and A treatments. The root length of D treatment was highest followed by C, A, and B treatments. The nitrogen and phosphate contents of the above ground part of Zoysia japonica were highest in C treatment, followed by D, B, and A treatments. The nitrogen and phosphate contents of the underground part of Zoysia japonica were highest in D treatment, followed by C, A, and B treatments. C and D treatments showed the best results in every aspect of grass growth. The results of this study could be used to identify the cost effective way to improve soil quality for soil surface fixation on reclaimed areas using grass species.

• KOREAN JOURNAL OF CROP SCIENCE
• /
• v.26 no.1
• /
• pp.69-89
• /
• 1981

Stevia (Stevia rebaudiana Bertoni) is a perennial herb widely distributed in the mountainous area of Paraguay. It belongs to the family Compositae and contains 6 to 12 percent stevioside in the leaves. Stevioside is a glucoside having similar sweetening character to surgar and the degree of sweetness is approximately 300 times of sugar. Since Korea does not produce any sugar crops, and the synthetic sweetenings are potentially hazardous for health, it is rather urgent to develop an economical new sweetener. Consequently, the current experiments are conducted to establish cultural practices of stevia, a new sweetening herbs, introduced into Korea in 1973 and the results are summarized as followings: 1. Days from transplanting of cuttings to the flower bud formation of 6 stevia lines were similar among daylengths of 8, 10 and 12 hours, but it was much greater at daylengths of 14 or 24 hour and varietal differences were noticable. All lines were photosensitive, but a line, 77013, was the most sensitive and 77067 and Suweon 2 were less sensitive to daylength. 2. Critical daylength of all lines seemed to be approximately 12 hours. Growth of plants was severely retarded at daylengths less than 12 hours. 3. Cutting were responded to short daylength before rooting. Number of days from transplanting to flower bud formation of 40-day old cuttings in the nursery bed was 20 days and it was delayed as duration of nursery were shorter. 4. Number of days from emergence to flower bud formation was shortest at short day treatment from 20 days after emergence. It was became longer as initiation of short day treatment was earlier or later than 20 days. 5. Plant height, number of branches, and top dry weight of stevia were reduced as cutting date was delayed from March 20 to May 20. The highest yield of dry leaf was obtained at nursery duration of 40-50 days in march 20 cutting, 30-40 days in April 20 cutting, and 30 days in May 20 cutting. 6. An asymptotic relationship was observed between plant population and leaf dry weight. Yield of dry leaf increased rapidly as plant population increased from 5,000 to 10,000 plants/10a with a reduced increasing rate from 10,000 to 20,000 plants/l0a, and levelled off at the plant population higher than 20,000 plants/l0a. 7. Stevia was adaptable in Suweon, Chengju, Mokpo and Jeju and drought was one of the main factors reducing yield of dry leaf. Yield of dry leaf was reduced significantly (approximately 30%) at June 20 transplanting compared to optimum transplanting. 8. Yield of dry leaf was higher in a vinyl house compared to unprotected control at long daylength or natural daylength except at short day treatment at March 20. Higher temperature ill a vinyl house does not have benefital effects at April 20 transplanting. 9. The highest content of stevioside was noted at the upper leaves of the plant but the lowest was measured at the plant parts of 20cm above ground. Leaf dry weight and stevioside yield was mainly contributed by the plant parts of 60 to 120cm above ground but the varietal differences were also significant. 10. Delayed harvest by the time of flower bud formation increased leaf dry weight remarkably. However, there were insignificant changes of yield as harvests were made at any time after flower bud formation. Content of stevioside was highest at the time of flower bud formation and earlier or later harvest than this time was low in its content. The optimum harvesting time determined by leaf dry weight and stevioside content was the periods from flower bud formation to right before flowering that would be the period from September 10 to September 15 in Suweon area. 11. Stevioside and rebaudioside content in the leaves of Stevia varieties were ranged from 5.4% to 14.3% and 1.5% to 8.3% respectively. However, no definit relationships between stevioside and rebaudioside were observed in these particular experiments.

• Korean Journal of Veterinary Research
• /
• v.36 no.4
• /
• pp.783-794
• /
• 1996

It has been suggested that ion transport systems are intimately involved in mediating the effects of growth regulatory factors on the growth of a number of different types of animal cells in vivo. The functional importance of the apical membrane $Na^+/H^+$ antiporter in the renal proximal tubule is evidenced by estimates that this transporter mediates the reabsorption of approximately one third of the filtered load of sodium and the bulk of the secretion of hydrogen ions. This study was designed to investigate the pathway utilized by IGF-I in regulating sodium transport in primary cultured renal proximal tubule cells. Results were as follows : 1. $Na^+$ was observed to accumulate in the primary cells as a function of time. Raising the concentration of extracellular NaCl induced an decrease in $Na^+$ uptake compared with control cells in a dose dependent manner. The rate of $Na^+$ uptake into the primary cells was about two times higher in the absence of NaCl($40.11{\pm}1.76pmole\;Na^+/mg\;protein/min$) than in the presence of 140mM NaCl($17.82{\pm}0.94pmole\;Na^+/mg\;protein/min$) at the 30 minute uptake. 2. $Na^+$ uptake was inhibited by IAA($1{\times}10^{-4}M$) or valinomycin($5{\times}10^{-6}M$) treatment($50.51{\pm}4.04$ and $57.65{\pm}2.27$ of that of control, respectively). $Na^+$ uptake by the primary proximal tubule cells was significantly increased by ouabain($5{\times}10^{-5}M$) treatment($140.23{\pm}3.37%$ of that of control). When actinomycin D($1{\times}10^{-7}M$) or cycloheximide($4{\times}10^{-5}M$) was applied, $Na^+$ uptake was decreased to $90.21{\pm}2.39%$ or $89.64{\pm}3.69%$ of control in IGF-I($1{\times}10^{-5}M$) treated cells, respectively. 3. Extracellular cAMP decreased $Na^+$ uptake in a dose-dependent manner($10^{-8}-10^{-4}M$). IBMX($5{\times}10^{-5}M$) also inhibited $Na^+$ uptake. Treatment of cells with pertussis toxin(50pg/ml) or cholera toxin($1{\mu}g/ml$) inhibited $Na^+$ uptake. Extracellular PMA decreased $Na^+$ uptake in a dose-dependent manner(1-100ng/ml). 100 ng/ml PMA concentration significantly inhibited $Na^+$ uptake in IGF-I treated cells. However, staurosporine($1{\times}10^{-7}M$) had no effect on $Na^+$ uptake. When PMA and staurosporine were added together, the inhibition of $Na^+$ uptake was not observed. In conclusion, sodium uptake in primary cultured rabbit renal proximal tubule cells was dependent on membrane potentials and intracellular energy levels. IGF-I stimulates sodium uptake through mechanisms that involve some degree of de novo protein and/or RNA synthesis, and cAMP and/or PKC pathway mediating the action mechanisms of IGF-I.

• The Korean Nurse
• /
• v.20 no.4 s.112
• /
• pp.39-49
• /
• 1981

기존 간호 영역 내 간호는 질적으로, 양적으로 급격히 팽창 확대되어 가고 있다. 많은 나라에서 건강관리체계가 부적절하게 분배되어 있으며 따라서 많은 사람들이 적절한 건강관리를 제공받지 못하고 있어 수준 높은 양질의 건강관리를 전체적으로 확대시키는 것이 시급하다. 혹 건강관리의 혜택을 받는다고 해도 이들 역시 보다 더 양질의 인간적인 간호를 요하고 있는 실정이다. 간호는 또한 간호영역 자체 내에서도 급격히 확대되어가고 있다. 예를들면, 미국같은 선진국가의 건강간호사(Nurse practitioner)는 간호전문직의 새로운 직종으로 건강관리체계에서 독자적인 실무자로 그 두각을 나타내고 있다. 의사의 심한 부족난으로 고심하는 발전도상에 있는 나라들에서는 간호원들에게 전통적인 간호기능 뿐 아니라 건강관리체계에서 보다 많은 역할을 수행하도록 기대하며 일선지방의 건강센터(Health center) 직종에 많은 간호원을 투입하고 있다. 가령 우리 한국정부에서 최근에 시도한 무의촌지역에서 졸업간호원들이 건강관리를 제공할 수 있도록 한 법적 조치는 이러한 구체적인 예라고 할 수 있다. 기존 간호영역내외의 이런 급격한 변화는 Melvin Toffler가 말한 대로 ''미래의 충격''을 초래하게 되었다. 따라서 이러한 역동적인 변화는 간호전문직에 대하여 몇가지 질문을 던져준다. 첫째, 미래사회에서 간호영역의 특성은 무엇인가? 둘째, 이러한 새로운 영역에서 요구되는 간호원을 길러내기 위해 간호교육자는 어떤 역할을 수행해야 하는가? 셋째 내일의 간호원을 양성하는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가 등이다. 1. 미래사회에서 간호영역의 특성은 무엇인가? 미래의 간호원은 다음에 열거하는 여러가지 요인으로 인하여 지금까지의 것과는 판이한 환경에서 일하게 될 것이다. 1) 건강관리를 제공하는 과정에서 컴퓨터화되고 자동화된 기계 및 기구 등 새로운 기술을 많이 사용할 것이다. 2) 1차건강관리가 대부분 간호원에 의해 제공될 것이다. 3) 내일의 건강관리는 소비자 주축의 것이 될 것이다. 4) 간호영역내에 많은 새로운 전문분야들이 생길 것이다. 5) 미래의 건강관리체계는 사회적인 변화와 이의 요구에 더 민감한 반응을 하게 될 것이다. 6) 건강관리체계의 강조점이 의료진료에서 건강관리로 바뀔 것이다. 7) 건강관리체계에서의 간호원의 역할은 의료적인 진단과 치료계획의 기능에서 크게 탈피하여 병원내외에서 보다 더 독특한 실무형태로 발전될 것이다. 이러한 변화와 더불어 미래 간호영역에서 보다 효과적인 간호를 수행하기 위해 미래 간호원들은 지금까지의 간호원보다 더 광범위하고 깊은 교육과 훈련을 받아야 한다. 보다 발전된 기술환경에서 전인적인 접근을 하기위해 신체과학이나 의학뿐 아니라 행동과학 $\cdot$ 경영과학 등에 이르기까지 다양한 훈련을 받아야 할 필요가 있다. 또한 행동양상면에서 전문직인 답게 보다 진취적이고 표현적이며 자동적이고 응용과학적인 역할을 수행하도록 훈련을 받아야 한다. 그리하여 간호원은 효과적인 의사결정자$\cdot$문제해결자$\cdot$능숙한 실무자일 뿐 아니라 소비자의 건강요구를 예리하게 관찰하고 이 요구에 효과적인 존재를 발전시켜 나가는 연구자가 되어야 한다. 2. 미래의 간호교육자는 어떤 역할을 수행해야 하는가? 간호교육은 전문직으로서의 실무를 제공하기 위한 기초석이다. 이는 간호교육자야말로 미래사회에서 국민의 건강요구를 충족시키기는 능력있는 간호원을 공급하는 일에 전무해야 함을 시사해준다. 그러면 이러한 일을 달성하기 위해 간호교육자는 무엇을 해야 하는가? 우선 간호교육자는 두가지 측면에서 이 일을 수정해야 된다고 본다. 그 하나는 간호교육기관에서의 측면이고 다른 하나는 간호교육자 개인적인 측면엣서이다. 우선 간호교육기관에서 간호교육자는 1) 미래사회에서 요구되는 간호원을 교육시키기 위한 프로그램을 제공해야 한다. 2) 효과적인 교과과정의 발전과 수정보완을 계속적으로 진행시켜야 한다. 3) 잘된 교과과정에 따라 적절한 훈련을 철저히 시켜야 한다. 4) 간호교육자 자신이 미래의 예측된 현상을 오늘의 교육과정에 포함시킬 수 있는 자신감과 창의력을 가지고 모델이 되어야 한다. 5) 연구 및 학생들의 학습에 영향을 미치는 중요한 의사결정에 학생들을 참여시키도록 해야한다. 간호교육자 개인적인 측면에서는 교육자 자신들이 능력있고 신빙성있으며 간호의 이론$\cdot$실무$\cdot$연구면에 걸친 권위와 자동성$\cdot$독창성, 그리고 인간을 진정으로 이해하려는 자질을 갖추도록 계속 노력해야 한다. 3. 미래의 간호원을 양성하는 능력있는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가? 내일의 도전을 충족시킬 수 있는 능력있는 간호교육자를 준비시키기 위한 실질적이고 현실적인 전략을 논함에 있어 우리나라의 실정을 참조하겠다. 전문직 간호교육자를 준비하는데 세가지 방법을 통해 할 수 있다고 생각한다. 첫째는 간호원 훈련수준을 전문직 실무를 수행할 수 있는 단계로 면허를 높이는 것이고, 둘째는 훈련수준을 더 향상시키기 위하여 학사 및 석사간호교육과정을 발전시키고 확대하는 것이며, 셋째는 현존하는 간호교육 프로그램의 질을 높이는 것이다. 첫째와 둘째방법은 정부의 관할이 직접 개입되는 방법이기 때문에 여기서는 생략하고 현존하는 교과과정을 발전시키고 그 질을 향상시키는 것에 대해서만 언급하고자 한다. 미래의 여러가지 도전에 부응할 수 있는 교육자를 준비시키는 교육과정의 발전을 두가지 면에서 추진시킬 수 있다고 본다. 첫째는 국제간의 교류를 통하여 idea 및 경험을 나눔으로서 교육과정의 질을 높일 수 있다. 서로 다른 나라의 간호교육자들이 정기적으로 모여 생각과 경험을 교환하고 연구하므로서 보다 체계적이고 효과적인 발전체인(chain)이 형성되는 것이다. ICN같은 국제적인 조직에 의해 이러한 모임을 시도하는 것인 가치있는 기회라고 생각한다. 국가간 또는 국제적인 간호교육자 훈련을 위한 교육과정의 교환은 한 나라안에서 그 idea를 확산시키는데 효과적인 영향을 미칠 수 있다. 충분한 간호교육전문가를 갖춘 간호교육기관이 새로운 교육과정을 개발하여 그렇지 못한 기관과의 연차적인 conference를 가지므로 확산시킬 수도 있으며 이런 방법은 경제적인 면에서도 효과적일 뿐만 아니라 그 나라 그 문화상황에 적합한 교과과정 개발에도 효과적일 수 있다. 간호교육자를 준비시키는 둘째전략은 현존간호교육자들이 간호이론과 실무$\cdot$연구를 통합하고 발전시키는데 있어서 당면하는 여러가지 요인-전인적인 간호에 적절한 과목을 이수하지 못하고 임상실무경험의 부족등-을 보충하는 방법이다. 이런 실제적인 문제를 잠정적으로 해결하기 위하여 1) 몇몇 대학에서 방학중에 계속교육 프로그램을 개발하여 현직 간호교육자들에게 필요하고 적절한 과목을 이수하도록 한다. 따라서 임상실무교육도 이때 실시할 수 있다. 2) 대학원과정 간호교육프로그램의 입학자의 자격에 2$\~$3년의 실무경험을 포함시키도록 한다. 결론적으로 교수와 학생간의 진정한 동반자관계는 자격을 구비한 능력있는 교수의 실천적인 모델을 통하여서 가능하게 이루어 질수 있다고 믿는 바이다.