• 제목/요약/키워드: Korean Medicine college

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가교화 찹쌀전분의 물리화학적 성질 및 유과제조 특성 (Physicochemical Properties of Cross-linked Waxy Rice Starches and Its Application to Yukwa)

  • 유철;최현욱;김종태;안순철;최성원;김병용;백무열
    • 한국식품과학회지
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    • 제39권5호
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    • pp.534-540
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    • 2007
  • 유과 제조 시 제조 시간을 단축할 수 있는 소재를 개발하기 위하여 찹쌀전분을 $POCl_3$와 반응시켜 가교화 찹쌀전분을 제조하고 이들의 물리화학적 특성을 연구하였다. 가교화 찹쌀전분의 치환율은 0.04-2.73으로 나타났으며, 팽윤력은 일반 찹쌀전분에 비해 약간 증가되는 경향을 보였으며 용해도는 일반 찹쌀전분보다 낮은 경향을 보였다. 등온흡습곡선은 가교화에 따른 유의적인 차이를 보이지 않았다. 전분의 pasting 특성을 검토한 결과, 호화개시온도는 가교화에 따른 변화가 없는 것으로 나타났으며, 최대점도, holding strength, final viscosity, setback은 일반 찹쌀전분보다 높아지는 결과를 나타냈다. 열적특성은 호화개시온도, 최대호화온도, 호화종결온도 그리고 호화엔탈피 모두 각 전분간에 유의적인 차이가 나타나지 않았다. X-ray회절 분석 결과로 볼 때, 가교화 찹쌀전분 및 일반 찹쌀전분 모두 A형의 결정 형태를 나타내었고, 상대적 결정화도의 차이가 나타나지 않는 것으로 보아 가교화가 찹쌀전분의 결정형영역에는 영향을 주지 않는 것으로 보여진다. 가교화 찹쌀전분을 사용하여 제조한 유과의 경우 일반 찹쌀을 장시간 침지한 후 제조한 시료와 비슷한 팽화율을 나타내었으며 시료의 변색 반응이 나타나지 않는 것으로 보아 유과 제조용 소재로서 적합한 것으로 판단되었다.

가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정∙방문간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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분무열분해(噴霧熱分解) 공정(工程)에 의한 주석(朱錫) 산화물(酸化物) 나노 분말(粉末) 제조(製造) (Preparation of Nano-Sized Tin Oxide Powder by Spray Pyrolysis Process)

  • 유재근;차광용;김명춘;한정수;장재범;이용화;김동희
    • 자원리싸이클링
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    • 제17권6호
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    • pp.79-88
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    • 2008
  • 본 연구는 폐 주석의 리싸이클링을 통한 고기능성 주석 산화물 나노 분말의 대량제조 기술개발을 위한 전 단계 연구로서 주석 염화물 용액을 원료로 하여 분무열분해 반응에 의하여 평균입도 50nm 이하의 주석 산화물 분말을 제조하였으며 반응온도의 변화에 따른 생성 입자들의 특성 변화를 파악하였다. 열분해 반응온도가 $800^{\circ}C$로부터 $850^{\circ}C$로 증가함에 따라 형성된 입자들의 평균입도는 20 nm로부터 30 nm로 증가하였다. 또한 XRD 피크의 강도도 증가하였으며 비표면적은 1/2 정도로 크게 감소하였다. 반응온도 $900^{\circ}C$의 경우에는 액적 형태는 평균입도 30 nm 정도의 나노 입자들로 구성되어 있는 반면 독립된 입자들의 경우에는 평균입도가 $80{\sim}100\;nm$로 현저하게 증가 하였으며 입자 표면이 더욱 치밀화되어 있었다. 또한 XRD 피크 강도도 현저히 증가하였으며 비표면적은 현저하게 감소하였다. 반응온도 $950^{\circ}C$의 경우에는 액적 형태의 비율 및 크기가 현저히 감소하였으며 대부분의 입자들은 독립된 형태를 유지하고 있었으며 평균입도는 약 70 nm로 $900^{\circ}C$의 경우보다 오히려 감소하였다. 또한 XRD 피크의 강도도 $900^{\circ}C$의 경우에 비하여 현저히 감소하였으며 비표면적은 2배 정도 크게 증가하였다.

원발성 폐암에서 정위적 체부 방사선치료의 빔 배열에 따른 선량분포의 비교 (Comparison of the Dose Distributions with Beam Arrangements in the Stereotactic Body Radiotherapy (SBRT) for Primary Lung Cancer)

  • 예지원
    • 한국의학물리학회지:의학물리
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    • 제25권2호
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    • pp.110-115
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    • 2014
  • 원발성 폐암의 정위적 체부 방사선치료(Stereotatic Body Radiation Therapy; SBRT)시에, 종양주위의 빔 배열을 균등하게 한 $360^{\circ}$회전각도(Equally angles; EA)와 종양주위의 빔 배열을 부분각도(Partially angles; PA)로 배열한 치료계획의 선량차이를 확인하기 위하여, 세기조절방사선치료(Intensity-modulated radiation therapy, IMRT)와 체적변조회전치료(Volumetric-modulated arc therapy, VMAT)의 종양의 선량, 동측 폐의 선량, 반대측 폐의 선량, 손상위험장기(Organ at risk, OAR)의 선량, 치료효율 등을 비교분석 하였다. 12명의 환자에서 각각 4종류($IMRT_{EA}$, $IMRT_{PA}$, $VMAT_{EA}$, $VMAT_{PA}$)의 치료계획을 생성하였으며, 처방선량은 총 선량 60 Gy, 4회 분할치료로 표적체적 95%에 대해 100% 선량이 포함되게 하였다. IMRT와 VMAT의 치료계획 평가에서 $360^{\circ}$회전각도의 빔 균등배열과 부분각도 빔 배열에서 변수중 선량일치지수, 균질성지수, 고선량 유출, $D_{2cm}$, $R_{50}$은 빔 배열에 따라 크게 차이가 나지 않았다. 또한 손상위험장기인 척수, 기관지, 식도의 최고선량은 각각의 방법에 따라 차이를 나타내었다. 특히 $HDS_{location}$에서 21.63%와 26.46%의 큰 차이를 나타내었다.

국소 진행성 직장암의 수술전 동시 화학방사선치료와 온열치료병합시 수술후 부작용 (Postoperative Complications after Preoperative Chemoradiotherapy Combined with Hyperthermia in Locally Advanced Rectal Cancer)

  • 예지원
    • 한국의학물리학회지:의학물리
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    • 제25권2호
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    • pp.89-94
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    • 2014
  • 국소 진행성 직장암 환자에서 수술 전 항암방사선동시요법으로 치료시 추가적인 고주파 온열치료 유무가 수술 후 부작용에 미치는 영향을 분석하였다. 1996년부터 2007년 사이, 본원에서 수술 전 항암방사선동시요법과 근치적 수술을 시행한 환자 205명을 대상으로 급, 만성부작용을 분석하였다. 총 방사선치료선량은 39.6 Gy에서 45 Gy였고 1회 내지 2회의 항암약물치료(5-fluorouracil, leucovorin)를 동시에 시행하였다. 88명의 환자가 주 2회, 8-MHz 고주파 온열치료기를 이용한 국소 온열치료를 시행하였다. 외과적 수술은 수술 전 치료 완결 후 4~6주 경과하여 시행하였다. 환자군의 나이 중앙값은 59세(18세~83세)이고 추적관찰기간 중앙값은 61개월(2개월~191개월)이었다. 전체 환자에서 5년 전체생존율과 무합병증 생존율은 77.4%와 73.7%였다. 각각의 조기 누출, 지연 누출, 연결부 협착, 누공, 소장폐쇄의 발생빈도는 1.0%, 2.9%, 1.5%, 5.9%, 그리고 17.1%였다. 온열치료는 모든 종류의 부작용을 증가시키지 않았다. 온열치료를 실시하지 않은 군과 온열치료군 간의 5년 무합병증 생존율은 71.8%와 76.3%였다(p=0.293). 온열치료는 수술전 항암방사선동시요법 후 근치적 수술을 시행하는 국소 진행 직장암 환자의 수술후 부작용을 증가시키지 않는다.

승모판막 대치이식술 238예 보고 (Mitral Valve Replacement : A Report of 238 cases)

  • 이영균;양기민
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.422-434
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    • 1980
  • Since 1968 up to the end of October 1980, 448 valves were replaced in 354 patients in Seoul National University Hospital. There were 238 mitral, 38 aortic, 7 tricuspid, 45 aortic with mitral, 23 tricuspid with mitral, and 3 triple valve replacement aortic mitral and tricuspid cases. Annual increase of mitral valve replacement cases and decrease of operative maortality were remarkable. Recently operative mortality of mitral valve replacement is about 5%. Sex ratio of mitral valve replacement is almost equal and there were 12 cases of pediatric patients (5%) among 238 cases, and patients under the age of 20 years were 34 (14.3%). Mitral valve replacement was done for 199 single mitral, 38 double valve and one triple valve lesions. Among 238 mitral valve replacement paients left atrial thrombus in 23(9.7%), atrial fibrillation in 132 (55.5%), and reoperation after blind mitral commissurotomy in 12(5%) cases were noted. In recent cases bioprosthetic valves, mainly lonescu-shiley valve were utilized to overcome the difficulties of postoperative late complications in anticoagnuation, especially for the rural patients and pediatric cases, in addition to the hemodynamic advantages of lonesocu valve. Among 354 patients 16 cases were congenital heart anomaly related, 5 ventricular septal defect related aortic and 4 Ebstein related tribuspid valve replacement cases. There were 2 congenital anomaly related mitral valve replacements, one for congenital mitral insufficiency of 7 years old boy and one for corrected transposition of the great vessels associated with mitral insufficiency. Among total 354 valve replacements 49 operative deaths (13.3%) were noted and in 238 mitral valve replacement 24 operative deaths occurred (10.1%). In 39 patients among 354 total valve replacements late complications were found. In 238 mitral valve replacement cases late complications were noted in 26 patients, among whom 16 cases expired. Main late complications were thrombe-embolism, subacute becteerial endocarditis, arrythmia cerebral hemorrhage due to unsatisfactory anticoagulation, and congestive heart failure in the incipient period of valve replacement were also noted. In mitral valve replacement cases long-term survival rate was 83.2% who showed marked clinical improvement. Ther were no evidences of calcification during the 2 years follow-up period for the lonescu-valve replacement cases among 19 pediatric patients. In conclusion 238 cases of mitral valve replacement were done with 24 operative deaths and 26 late complication cases among whom 16 expired. The long term survival was 83.2% of the cases. In pediatric cases in place of coumadin anticoagulation Persantin **** 75 and aspirin were administered after valve replacement. In adult cases who have difficulaties with coumadin anticoagulation and for those even with bioprosthetic heart valve replacement who needs long-term or permanent anticoagulation persantin 75 and aspirin combination regimen were administered with antisfactory results.

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담즙산과 cholesterol 및 phosphatidylcholine이 vacuolar apparatus에 미치는 영향에 관한 미세구조적 관찰 (Some Observations on the Fine Structure of Vacuolar Apparatus Affected by Dehydrocholic acid, Cholesterol and Phosphatidylcholine)

  • 신영철
    • Applied Microscopy
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    • 제26권4호
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    • pp.465-477
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    • 1996
  • 본 연구에서는 담즙산과 cholesterol 및 phospholipid가 흰쥐 간세포내 소기관에 미치는 영향을 조사하여 이들 담즙물의 수송기전을 알아 보고져 하였다. 정상군과 각 실험군에서 관찰된 Golgi장치는 거의가 cis side를 담세관으로 향하고 있었다. 각 실험군에서는 ER과 Golgi 장치 및 용해소체 등 소기관의 수적 증가, 소조의 팽대, budding 등이 관찰되었다. Dehydrocholic acid 투여군에서는 cis Golgi cistern의 선상 팽대을 많이 볼 수 있었는데 공포(vacuole)들은 담세관과 Golgi 장치사이에서 관찰되었으며 ER과 담세관 사이에서도 관찰할 수 있었다. Cholesterol 투여군과 Phosphotidylcholine 투여군에는 Golgi 장치의 모든 소조들이 팽대되어 있었으며 ER 유래의 공포와 용헤소체가 증가되어 있었는데 용해소체의 증가는 특히 cholesterol 투여군에서 현져하였다. 이상의 소견으로 미루어 담즙성분의 분비에 관여하는 주된 세포내 소기관은 ER과 Golgi 장치 및 용해소체로 추정된다. 그러나 dehydrocholic acid는 ER과 cis Golgi 소조 유래의 공포에 의해 분비되며 Cholesterol과 phosphatidylcholine은 ER에서 또는 trans Golgi 소조을 거친 후 용해소체를 통해서 배출될 것으로 추정되는데 특히 cholesterol은 용해소체를 통해서 빈번히 배출될 것으로 생각된다.

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시판 황련해독탕 Ex제제의 성분함량 모니터링 연구 (A monitoring study of marker contents in the Hwangnyeonhaedok-tang Ex preparations on the market)

  • 김은정;박혜정;김현주;김주호;안지영;이정호;김윤경
    • 대한한의학방제학회지
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    • 제16권1호
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    • pp.95-107
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    • 2008
  • Objectives : Hwangnyeonhaedok-tang(HNHDT) is the one of well-known traditional herbal formula and has been widely used for the treatment of various diseases in Korea. For the quality improvement of commercial traditional herbal formula, we investigated the quality of prepared HNHDT. Methods: We measured the contents of baicalin, berberine and geniposide in the HNHDT Ex preparations on the market by HPLC and compared with the official notice of ingredients. Results: In 3 preparations of HNHDT covered with the national health insurance(NHI), the content of baicalin was various from 32.83mg to 185.05mg, the total berberine was $12.0{\sim}50.75mg$ and geniposide was $12.57{\sim}44.84mg$. Contents of marker ingredients in NHI Preparations were below the standard and showed a large variation. In 7 non NHI Preparations of HNHDT and the standard(STD) HNHDT manufactured in laboratory, the content of baicalin was $37.16{\sim}115.69mg$, the total berberine was $5.62{\sim}28.43mg$ and geniposide was $10.98{\sim}113.47mg$. But, because composition of non-NHI preparations is different from NHI preparations, every maker's contents were up to the notice for baicalin and berberine. There was newly enforced standard regulations of geniposide in non-NHI preparations, so contents of geniposide was up to that standard only in JI and STD. Conclusions: There was a large variation of contents in the HNHDT Ex preparations on the market and the quality differences were existed between NHI and non-NHI preparations of HNHDT. Further studies for evaluation of efficacy differences and standardization of manufacturing processes are necessary.

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의무기록사의 직무만족도 및 조직몰입도 (The Level of Job Satisfaction and Organizational Commitment of Medical Record Technicians)

  • 최은미;김영훈
    • 한국병원경영학회지
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    • 제8권3호
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    • pp.72-91
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    • 2003
  • The purpose of this study is to investigate the recognition of health information managers, and to analyze the level of job satisfaction and organizational commitment of medical record technicians. The data for this study were collected through a self-administered survey with a structured questionnaire to 172 subjects from medical record technicians working in hospitals in Seoul and Gyeonggi Province as well as the faculty of medical schools across South Korea. In this analysis frequency, t-test, ANOVA, factor analysis and structural equation model were used. The main findings of this study are as follows: 1. As for recognition of the seven dimensions in the role of health information managers, the role as clinical data specialist received the most positive feedback, followed by document & repository managers, patient information coordinators, health information managers, data quality managers, security officers and research & decision support analyst. 2. The level of job satisfaction among medical information handlers and managers averaged 3.14. In terms of the factors in the work environment concerned with job satisfaction, being able to work independently and as team players reached the top among 6 factors with the average of 3.39, followed by professional position, salary & rewards, expectations for job performance and administration. 3. The average rate of organizational commitment stood at 3.09. Respondents tend to be focused on present tasks rather than future-oriented tasks. 4. The result of the analysis based on the relationship between recognition as health information managers, job satisfaction and organizational commitment found that all analysis are statistically meaningful. The more the respondents were aware of their roles as health information managers, the more they tended to be committed to their work and satisfied with their work. The more the respondents were committed to their work, the more satisfaction was seen. The effects of recognition as health information managers on organizational commitment measured 0.27 and for job satisfaction it was 0.17. The effects of organizational commitment on job satisfaction stood at 0.71. The feasibility of the model meets the standard at Chi-square value of 66.755 and the P value of 0.057. The Normed Fit Index (NFI) of 0.930 was in compliance with the standard for model feasibility and the squared multiple correlation coefficient of this model was 8% in organizational commitment and 60% in job satisfaction.

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Ras에 의해 유도된 노화세포에서 핵인 스트레스에 의한 p53 안정화 연구 (The Stability of p53 in Ras-mediated Senescent Cells in Response to Nucleolar Stress)

  • 신충렬;박길홍;이기호;김상훈
    • 생명과학회지
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    • 제19권4호
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    • pp.436-441
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    • 2009
  • B23/nucleophosmin은 핵인 단백질로서 외부 스트레스에 의해 핵인에서 핵으로 이동하게 된다. 이러한 세포 내 위치변화는 MDM2에 의한 p53단백질의 안정화에 영향을 미친다. 노화세포는 거대한 단일 핵인을 가지고 있으며, 외부 스트레스에 의해 p53 안정성이 감소한다. 그렇지만, 노화세포에서 어떠한 기전에 의해 p53의 불안정성이 증가하는 지는 아직 밝혀진 바가 없다. 따라서 본 연구에서는 노화세포에서 B23/nucleophosmin과 p53간의 상호 관련성을 조사하여 p53 안정성에 미치는 영향을 규명하고자 하였다. 본 연구에서는 IMR90세포주에 ras oncogene을 과발현시켜 노화세포를 유도하였다. 핵인 스트레스에 의해 노화세포 내 p53 단백질 발현은 감소하였으나, B23/nucleophosmin 단백질의 발현은 정상세포와 큰 차이가 없었다. 그렇지만, 두 단백질의 세포 내 위치는 노화세포에서 변화가 있었다. 즉, 정상세포와 달리, 노화세포에서는 스트레스에 의해 핵 내 p53발현이 증가하지 않았으며, B23/nucleophosmin은 핵 내로 이동하지 않고, 핵인에 그대로 머물러 있었다. 노화세포에서 MDM2와 p53간 상호결합이 안정적으로 유지된대 비하여, p53과 B23/nucleophosmin간의 상호결합은 감소하였다. 이러한 결과는 노화세포에서 핵인 스트레스에 의한 p53단백질의 안정성은 B23/nucleophosmin 결합이 감소하여 일어나는 것으로 해석된다.