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Professional Nursing Quality Assurance (전문직 간호의 질적보장)

  • Kim, Hea-Sook
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.248-259
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    • 1992
  • 질적 보장은 전문직 종사자에 의하여 수혜받는 대상자를 보호하기 위하여 전적으로 필요한 프로그램이다. 이러한 질적보장을 통하여 전문직의 자율성과 책임을 튼튼히 할 수 있는 의무는 전문직 종사자 모두의 관심사가 되어야 한다. 미국에 있어서 질적 간호에 대한 관심은 이제 새로운 이유가 아니다. Beyers(1988)는 건강체계 지도자 사이에 가장 중요한 문제로 강조하는 것이 수혜자의 이용의 용이성(Access), 숫가(Cost) 그리고 질적인 제공(Quality)이 라고 피력 하였다. 미국 건강사업 평가자와 조정자(Regulator)들은 질(Quality)을 위한 자율적인 프로그램에 많은 에너지를 투입하여 전반적인 건강사업 즉 의료계의 질보장, 더 나아가서는 간호의 질을 향상 시키기 위한 많은 프로그램을 분석 연구한다. 이 논문은 간호에 있어서 질적 보장을 위한 내용으로 주요점은 질적 보장에 사용되는 용어, 역사적 배경, 질적 보장을 강조하는 이유, 질적 보장제도의 개발, 질 사정(euali assessment)과 질적 보장에 있어서 간호 전문직 개입을 차례대로 설명하였다. 구미의 경우 1970년대부터 간호직에 있어서는 질적보장제도개발에 우선순위를 두게되어 미 간호협회에서는 Professional Standards Review Organizations (PSRO)에 근거하여 간호실무를 위한 표준을 내어놓았다. 질적보장을 위한 평가방법으로 구조, 과정, 결과 그리고 수혜자가 간호계획을 세우는데 사정에 참여하는 방법 등 4가지를 간략하게 설명하였다. 질적 보장을 향상시키기 위해서는 전문직과 공공의료기간이 서로 협동체가 되어 중추역할을 해야함을 강조하고 이렇게 서로 협력하므로써만이 비로서 우리의 목적을 성취할 수 있다고 생각된다.구 등이 이용된다. $^{166}$ Ho, $^{198}$ Au, $^{32}$P, $^{90}$ Y, $^{169}$ Er, $^{186}$ Rc, $^{131}$ I, $^{211}$ At 등 의 방사성 핵종의 교질, 미소구 또는 단세포군 항체표지 형태로 직접 종양내 또는 공동이나 체강에 투여하는 치료법이 있다. 류마치스 관절염의 슬관절에 $^{165}$ Dy colloid를 주사하는 $^{166}$ Ho-MAA도 활발히 이용되고 있다. and computed groundwater levels. 본 논문에서는 가파른 산사면에서 산사태의 발생을 예측하기 위한 수문학적 인 지하수 흐름 모델을 개발하였다. 이 모델은 물리적인 개념에 기본하였으며, Lumped-parameter를 이용하였다. 개발된 지하수 흐름 모델은 두 모델을 조합하여 구성되어 있으며, 비포화대 흐름을 위해서는 수정된 abcd 모델을, 포화대 흐름에 대해서는 시간 지체 효과를 고려할 수 있는 선형 저수지 모델을 이용하였다. 지하수 흐름 모델은 토층의 두께, 산사면의 경사각, 포화투수계수, 잠재 증발산 량과 같은 불확실한 상수들과 a, b, c, 그리고 K와 같은 자유모델변수들을 가진다. 자유모델변수들은 유입-유출 자료들로부터 평가할 수 있으며, 이를 위해서 본 논문에서는 Gauss-Newton 방법을 이용한 Bard 알고리즘을 사용하였다. 서울 구로구 시흥동 산사태 발생 지역의 산사면에 대하여 개발된 모델을 적용하여 예제 해석을 수행함으로써, 지하수 흐름 모델이 산사태 발생

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Antimicrobial Activity of Elfvingia applanata Extract Alone and in Combination with Naringenin (Elfvingia applanata 엑스의 항균력 및 Naringenin과의 병용효과)

  • Cheon, Jun-Hee;Lee, Sun-Ok;Rym, Kyo-Hwan;Eo, Seong-Kug;Lee, Chong-Kil;Han, Seong-Sun
    • The Korean Journal of Mycology
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    • v.23 no.2 s.73
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    • pp.153-160
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    • 1995
  • As part of our search for less toxic antimicrobial agents from natural resources, the antimicrobial activity of Elfvingia applanata $(P_{ers.})\;K_{arst.}$ extract was examined alone and in combination with naringenin. EA, the aqueous extract from the carpophores of E. applanata, was lyophilized and a dark brownish powder was obtained. Antimicrobial activity of EA was tested in vitro against nineteen strains of bacteria and eleven strains of fungi by serial broth dilution method, and expressed by minimal inhibitory concentration (MIC). Among nineteen strains of bacteria tested, the antimicrobial activity of EA was the most potent against Proteus vulgaris showing MIC of 1.125 mg/ml. EA also inhibited the growth of the selected fungi at higher concentrations ranging from 7.5 mg/ml to 15.0 mg/ml. To investigate the effect of antimicrobial combinations of EA with naringenin, the fractional inhibitory concentration index (FICI) was determined by checkerboard assay for each strain. The antimicrobial combinations of EA with naringenin resulted in partial synergism against Staphylococcus aureus only, and showed additive effect in two strains including Klebsiella pneumoniae and Salmonella typhi. Antagonism was not found.

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An Example of Test on Differences of Pulse Waveform Characteristics at Cun, Guan and Chi (촌, 관, 척 위치의 맥파 특징 차이 검정에 대한 1례)

  • Lee, Jeon;Lee, Yu-Jung;Jeon, Young-Ju;Lee, Hae-Jung;Ryu, Hyun-Hee;Kim, Jong-Yeol
    • Korean Journal of Oriental Medicine
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    • v.14 no.2
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    • pp.107-112
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    • 2008
  • Although the pulse diagnosis position, Guan is apart from Cun or Chi by only $10{\sim}20$ mm at most, traditional medical doctors applies different indent pressures and even they states different pulse images are felt at Cun, Guan and Chi, To support their clinical behaviors, in this study, we tested statistically whether there are differences in pulse waveform measured at these three positions with SphygmoCor system used world widely, A 30 years old female subject without any evidence of cardiovascular diseases was involved in this experiment. Radial pulse waves were recorded at three different positions on left lower arm 10 times at three positions-Cun, Guan and Chi. With ANOVA, we tested whether, among three different positions. there are any differences in 12 parameters of radial pulse waveform and in estimated AIx(Augmentation Index) as an arterial stiffness index extracted from radial pulse waveform. As results, differences in optimal indent pressure h0 were observed at different measuring positions(P<0.001) but not significantly different. And pulse pressure his were found to be different(Chi$22.60{\pm}3.06%,\;18.60{\pm}3.37%\;and\;26.4{\pm}5.02%$ respectively. Consequently. AIx at Gwan seems to be lowest and that at Chi seems to be highest. So. we assert the AIx at Chi is likely to be overestimated. In further studies. we want to examine what make differences in these parameters between measuring positions. And it also seems to be worthy to investigate the relationship between the depth of radial artery and AIx. And, ultimately, we need to determine the best measuring process including measuring position, hold-down pressure, signal quality validation and so on. so to achieve the optimal waveform which represents subject's health condition for both western medicine and traditional medicine.

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Anti-inflammatory Effects of Illicium verum Hook. f. via Suppression of NFκB Pathway (NF-κB 억제를 통한 대회향(大茴香)의 항염증효능)

  • Keum, Soo Yeon;Park, Sang Mi;Jegal, Kyung Hwan;Hwangbo, Min;Cho, Il Je;Park, Chung A;Kim, Sang Chan;Jee, Seon Young
    • Herbal Formula Science
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    • v.24 no.4
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    • pp.243-257
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    • 2016
  • Objectives : Illicium verum Hook. f. has been known to possess antimicrobial, antioxidant, antifungal, anti-inflammatory, insecticidal, analgesic, sedative, convulsive activities, it has been rarely conducted to evaluate the immuno-biological activity. The present study was examined to evaluate the anti-inflammatory effects of the Illicium verum Hook. f. water extracts (IVE) in vivo and in vitro. Methods : Cell viability was measured by MTT assay. The relative levels of NO were measured with Griess reagent. iNOS, COX-2, $NF-{\kappa}B$ and target proteins were detected by immunoblot analysis, and levels of cytokines were analyzed by ELISA kit. Anti-edema effect was determined in the carrageenan (CA)-induced paw edema model in rats. Results : All dosages of IVE used in MTT assay had no significant cytotoxicity. The increases of NO production and iNOS expression were detected in LPS-treated cells compared with control. However, these increases were attenuated by treatment with IVE. Also, IVE reduced the elevated production of $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 by LPS. IVE inhibited the $p-I{\kappa}B$ and translocation of $NF-{\kappa}B$ to nuclear. Furthermore, IVE significantly inhibited the increases of hind paw swelling, skin thicknesses and inflammatory cell infiltrations induced by CA injection. Therefore, IVE will be favorably inhibited the acute edematous inflammations. Conclusion : These results provide evidences that anti-inflammatory effect of IVE is partly due to the reduction of some inflammatory mediators by suppression of $NF-{\kappa}B$ pathway.

An Analysis of the Surface Anatomical Location of the Posterior-inferior Margin of the Sacroiliac Joint (천장관절 후하연의 표면해부학적 위치 분석)

  • Cho, Kwang Yeon;Kim, Bum Su;Kim, Won Oak;Yoon, Duck Mi;Yoon, Kyung Bong
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.47-51
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    • 2009
  • Background: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. Methods: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. Results: The oblique angle was $5.4{\pm}2.9^{\circ}$. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were $3.8{\pm}0.8cm$ and $0.9{\pm}0.6cm$, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were $3.4{\pm}0.7cm$ and $3.9{\pm}0.6cm$, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). Conclusions: The measurements in this study can be used as a reference standards for the blind SIJ block.

Role of Adenosine and Protein Kinase C in the Anti-ischemic Process of Ischemic Preconditioning in Rat Heart (허혈전처치의 허혈심장 보호과정에서 Adenosine 및 Protein Kinase C의 역할)

  • You, Ho-Jin;Park, Jong-Wan;Kim, Myung-Suk
    • The Korean Journal of Pharmacology
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    • v.32 no.1
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    • pp.31-37
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    • 1996
  • The protective effect of 'ischemic preconditioning (IP)'on ischemia-reperfusion injury of heart has been reported in various animal species, but the mechanism is unclear. In an attempt to elucidate the mechanism of IP, we examined the effects of blockers against adenosine and protein kinase C in preconditioned heart of rat. The hearts perfused with oxygen-saturated Krebs-Henseleit solution by Langendorff method were exposed to 30 min global ischemia followed by 20 min reperfusion. IP was performed with three episodes of 5 min ischcmia and 5 min reperfusion just before ischemia-reperfusion. IP prevented the depression of contractile function and the myocardial contracture in the ischemic-reperfused heart and reduced the release of lactate dehydrogenase during the reperfusion period. Polymyxin B, chelerythrine and colchicine, PKC inhibitors, attenuated almost completely the anti-ischemic effect of IP, while adenosine receptor antagonists did not. These results indicate that PKC may be a crucial intracellular mediator in anti-ischemic action of IP in ischemic-reperfused rat heart, while adenosine may not be involved in the mechanism of IP.

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Fluoxetine Modulates Corticostriatal Synaptic Transmission through Postsynaptic Mechanism

  • Cho, Hyeong-Seok;Choi, Se-Joon;Kim, Ki-Jung;Lee, Hyun-Ho;Cho, Young-Jin;Kim, Seong-Yun;Sung, Ki-Wug
    • The Korean Journal of Physiology and Pharmacology
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    • v.10 no.1
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    • pp.31-38
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    • 2006
  • Fluoxetine, widely used for the treatment of depression, is known to be a selective serotonin reuptake inhibitor (SSRI), however, there are also reports that fluoxetine has direct effects on several receptors. Employing whole-cell patch clamp techniques in rat brain slice, we studied the effects of fluoxetine on corticostriatal synaptic transmission by measuring the change in spontaneous excitatory postsynaptic currents (sEPSC). Acute treatment of rat brain slice with fluoxetine ($10{\mu}M$) significantly decreased the amplitude of sEPSC ($8.1{\pm}3.3$%, n=7), but did not alter its frequency ($99.1{\pm}4.7$%, n=7). Serotonin ($10{\mu}M$) also significantly decreased the amplitude ($81.2{\pm}3.9$%, n=4) of sEPSC, but did not affect its frequency ($105.8{\pm}8.0$, n=4). The effect of fluoxetine was found to have the same trend as that of serotonin. We also found that the inhibitory effect of fluoxetine on sEPSC amplitude ($93.0{\pm}1.9$%, n=8) was significantly blocked, but not serotonin ($84.3{\pm}1.6$%, n=4), when the brain slice was incubated with p-chloroamphetamine ($10{\mu}M$), which depletes serotonin from the axon terminals and blocks its reuptake. These results suggest that fluoxetine inhibits corticostriatal synaptic transmission through postsynaptic, and that these effects are exerted through both serotonin dependent and independent mechanism.

The Effects of the Mixture of Fetal Bovine Serum and Poly-glycolic acid in Rabbit Calvarial Model (Poly-glycolic Acid(PGA)와 우태아 혈청(Fetal bovine serum, FBS)의 혼합물이 가토에서 골형성에 미치는 영향)

  • Sung, Yong Duck;Kim, Yong Ha;Moon, Young Mi;Kim, Kap Joong;Kim, Yeon Jung;Choi, Sik Young
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.298-304
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    • 2007
  • Purpose: This study was undertaken to investigate the osteogenic induction potential of PGA & FBS mixture on a calvarial defect in the rabbit. Methods: Twenty New zealand white rabbit, weighing from 3.5-4kg were allocated into each of the three groups. Four 8 mm sized bone defects were made on the parietal bone by drilling. In group I, the bony defects were implanted with $50{\mu}m$ thickness film containing mixture of PGA and FBS. In group II, with PGA only film, & in group III, the bony defects were left with no implants. Results were evaluated by using morphologic change, radiographic study, biochemical study and histologic examination at 1 week (group I n=7, group II n=7, group III n=14), 2 weeks (group I n=6, group II n=6, group III n=12) and 3 weeks (group I n=7, group II n=7, group III n=14) following implantation. Results: In the morphologic & radiographic study, the formation and corticalization of callus were observed earlier in group I than in groups II and III (p < 0.05). In histological examination, group I showed more abundant and faster new bone formation than in group II and III. In biochemical analysis, group I displayed more activity than in group II and III. Group I also showed more abundant osteopontin, osteocalcin than groups II and III. Conclusion: In conclusion, the results demonstrate that the mixture of PGA and FBS has an effect on osteoblastic formation in the rabbit model. It is considered that further evaluation of long term results on resorption, immunologic tissue reaction and response of applied mixture in the human model will be needed.

Fucoidan Increases Phagocytic Capacity and Oxidative Burst Activity of Canine Peripheral Blood Polymorphonuclear Cells Through TNF-${\alpha}$ from Peripheral Blood Mononulear Cells (Fucoidan에 의한 개 말초혈액 단핵구세포에서 생산된 TNF-${\alpha}$의 다형핵백혈구에 대한 탐식능과 순간산소과소비력의 증가효과)

  • Kim, Soo-Hyun;Kang, Ji-Houn;Yang, Mhan-Pyo
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.183-189
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    • 2011
  • The objective of this study was to examine the effect of fucoidan on the phagocytic capapcity and oxidative burst activity (OBA) of canine peripheral blood polymorphonuclear cells (PMNs). The phagocytic capacity and OBA of PMNs were evaluated simultaneously by using a flow cytometer. Fucoidan itself did not cause any direct effect on the phagocytic capacity and OBA of PMNs. However, the phagocytic capacity and OBA of PMNs were enhanced by the culture supernatant from PBMCs treated with fucoidan. The phagocytic capacity and OBA of PMNs were also increased by treatment with recombinant canine (rc) tumor necrosis factor (TNF)-${\alpha}$. The ability of the culture supernatant from fucoidan-treated PBMCs to stimulate the phagocytic capacity and OBA of PMNs was inhibited by addition of anti-rc TNF-${\alpha}$ polyclonal antibody (PAb) prior to the culture. The amount of TNF-${\alpha}$ in the culture supematant from PBMCs was shown to increase upon treatment of fucoidan as compared with that of vehicle-treated PBMCs culture supematant. The level of TNF-${\alpha}$ mRNA expression in PBMCs was also up-regulated by the fucoidan treatment. These results suggest that fucoidan has an immunoenhancing effect on the phagocytic capacity and OBA of canine PMNs, which is mainly mediated by TNF-${\alpha}$ released from fucoidan-stimulated PBMCs.

Effect of Mixed Extract for Elimination of Hangover on Ethanol Pharmacokinetics in Rats (랫드에서 한방 혼합 추출물이 Ethanol의 약물동태학적 거동에 미치는 영향)

  • Jeon Tae Won;Lee Eun Sil;Lee Young Sun;Han Ok Kyung;Kim Hyun Young;Kim Kwang Joong;Kim Hyo Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.547-552
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    • 2002
  • To investigate an efficacy of mixed extract with Ginseng radix, Puerariae lobata, Puerariae radix, Rubi pructus, Gomi pructus, Hoelen, Dried orange peel and Parvum comus cervi etc., on the hangover elimination, 12 hr-fasted male Sprague-Dawley rats weighing 150-200 g were given mixed extract (5 mL/kg, p.o.) and administered ethanol at a dose of 3 g/kg bw (25% in distilled water) orally 30 min postdosing. Blood was collected from caudal artery at 0.25, 0.5, 1, 2, 4, 6, 8, 10, and 12hr and then the animals were sacrificed at 24hr after the ethanol treatment. In these experiments, liver function indices, such as alanine aminotransferase and alkaline phosphatase activities, showed unaltered results in all treated groups compared with the normal group. The pharmacokinetics of ethanol after oral administration of mixed extract were also evaluated. From 0 min to 12hr, the administration of mixed extract showed 14% reduction of the area under the serum concentrations-versus-time curves (AUC) compared with the control group. The activities of alcohol dehydrogenase and aldehyde dehydrogenase measured at 24hr postdosing were also not altered by the administration of mixed extract compared with the control group. These studies demonstrate that oral administration of mixed extract, prepared by traditional prescription, decreases the ethanol concentration in serum and reduces AUC, suggesting that the mixed extract is effective for elimination of ethanol-induced hangover.