• 임상간호연구
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• 제20권3호
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• pp.313-325
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• 2014

Purpose: This study aimed to develop the protocol of kangaroo care for premature infants and to evaluate its effects including physiologic responses of premature infants, their parents'anxiety, and neonatal nurses'perception regarding the kangaroo care. Methods: Kangaroo care protocol was developed through a literature review and validation of an expert group. The developed kangaroo care protocol was tested with 27 preterm infants, 24 parents, and 60 nurses in one neonatal intensive care unit in S hospital. Data were collected from December 2012 to February 2013 and analyzed by descriptive statistics and t-test using the SPSS/Win statistical program. Results: Physiologic responses including heart rate, respiration rate, oxygen saturation, body temperature among premature infants received the kangaroo care were maintained within normal limit. The anxiety levels of the parents who provided kangaroo care for their infants were significantly decreased as it was compared before and after care (t=3.43, p=.002). There were no significant differences in nurses'perceptions about kangaroo care before and after the application of the protocol. Conclusion: The developed kangaroo care protocol is proved to be effective and can be used safely in nursing practice.

• Nutrition Research and Practice
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• 제17권6호
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• pp.1043-1055
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• 2023

BACKGROUND/OBJECTIVES: The fruit of Cydonia oblonga Miller (COM) is used traditionally in Mediterranean region medicine to prevent or treat obesity, but its mechanism of action is still unclear. Beyond a demonstrated anti-obesity effect, the fruit was tested for the mechanism of adipogenesis in 3T3-L1 preadipocytes. MATERIALS/METHODS: 3T3-L1 preadipocytes were cultured for 8 days with COM fruit extract (COME) at different concentrations (0-600 ㎍/mL) with adipocyte differentiation medium. The cell viability was measured using an MTT assay; triglyceride (TG) was stained with Oil Red O. The expression levels of the adipogenesis-related genes and protein expression were analyzed by reverse transcription polymerase chain reaction and Western blotting, respectively. RESULTS: COME inhibited intracellular TG accumulation during adipogenesis. A COME treatment in 3T3-L1 cells induced upregulation of the adenosine monophosphate-activated protein kinase (AMPK)α phosphorylation and downregulation of the adipogenic transcription factors, such as sterol regulatory element-binding protein 1c, peroxisome proliferator-activated receptor γ, and CCAAT/enhancer binding protein α. The COME treatment reduced the mRNA expression of fatty acyl synthetase, adenosine triphosphate-citrate lyase, adipocyte protein 2, and lipoprotein lipase. It increased the mRNA expression of hormone-sensitive lipase and carnitine palmitoyltransferase I in 3T3-L1 cells. CONCLUSIONS: COME inhibits adipogenesis via the AMPK signaling pathways. COME may be used to prevent and treat obesity.

• 한국의료질향상학회지
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• 제19권2호
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• pp.36-46
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• 2013

Objectives: The purpose of this study is to find a way to effectively introduce accreditation for ambulatory health care organization by identifying the physicians' attitude for accreditation and characteristics that affect thei r attitude. Methods: A web survey was conducted from February 15 to March 4, 2011 for 183 physicians who work in ambulatory health care organizations throughout the nation. Self-reported questionnaire was used for this study. SPSS WIN(version 12.0) was utilized for statistical analysis. Results: Physician's attitude towards accreditation for ambulatory health care organization was positive(25.7%), moderate(39.3%), and negative(35.0%). Clinics that practice as a group or which treat more patients per day showed more positive attitude(p<0.05). The result of ordinal regression analysis indicates the groups with daily patients over 100 showed 36.3 times more positive attitude than the one under 75(p<0.05). Conclusion: The accreditation for ambulatory health care organization has not been throughly discussed yet. Many physicians did not have knowledge about accreditation. Clinics that see more patients per day had more positive attitude for accreditation. It indicates the cost may play important role in voluntary participation in accreditation.

• Journal of Hospice and Palliative Care
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• 제21권2호
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• pp.51-57
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• 2018

목적: 임종기 환자의 연명의료 결정은 환자와 가족, 의료진에게 당면과제이나 실제 의료현장에서 합의된 연명의료 제한의 정의와 시기는 결정하기 어려운 실정이다. 이에 본 연구는 단일 의료기관에서 심폐소생술 금지 동의 후 사망한 환자를 조사하여 임종기환자의 연명의료의 실태를 확인하여 보고자 한다. 방법: 2016년 1월부터 2016년 12월까지 한 대학병원에서 '회복불능 예상 환자 제한 치료 동의서(DNR 동의서)'에 동의 후 사망한 환자의 의무기록을 후향적으로 분석하였다. 결과: 전체 대상환자의 DNR 동의 후 사망까지 기간은 중앙값 2일(1일 미만~51일)이었다. 전체 사망의 45.3%(170명)은 암환자였으며, 54.6%(205명)은 비 암환자로 주요 사망원인은 뇌혈관계(19.2%), 호흡기계(14.7%)가 많았고, 순환기계(6.7%), 감염(6.4%), 신장질환(5.1%), 간질환(2.7%) 등이었다. 암환자군과 비 암환자군을 비교했을 때 DNR 동의 후 사망까지 기간의 중앙값은 암환자에서 3일(range 1일 미만~51), 비 암환자에서 2일(range 1일 미만~50)로 통계적 차이는 없었다(P=0.629). 대상 환자 중 205명은 DNR 동의 전기계호흡 등 특수 연명의료를 시행받았으며 특수 연명의료 유보군(170명)과 비교하였을 때, 특수 연명의료 시행군의 76.1%가 비 암성질환이었으며, 특수 연명의료 유보군의 71.1%가 암질환이었다(P<0.05). 결론: DNR 동의 후 사망한 환자 대부분이 임종에 임박하여 연명의료를 결정하였으며 DNR 동의 후 사망한 환자의 절반 이상이 비 암환자였으나 연명의료를 받던 중에 중단 또는 유보로 결정되는 경우가 더 많았다. 바람직한 연명의료 결정을 위해 의료진은 말기 환자 및 가족과 좀 더 빠른 시점에서 이에 대한 논의가 필요하겠다.

• 농촌의학ㆍ지역보건
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• 제29권1호
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• pp.91-100
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• 2004

시대의 변천에 따라 보건진료원의 업무활동 내용의 변화를 전라북도내에 근무하는 보건진료원을 대상으로 비교 분석한 결과는 다음과 같다. 1) 보건진료원의 수는 1989년 255명에서 2000년 224명으로 감소하였다. 2) 보건진료원의 일반적 특성은 1989년에 비하여 2000년에 연령, 기혼자, 근무경력이 증가하였다. 3) 보건진료원의 시간별 업무량은 1989년과 2000년 모두 진료업무가 가장 높았고, 1989년에 비해 2000년에는 모성보건, 영 유아보건, 가족계획, 진료업무, 결핵관리가 현저히 감소하였으며, 2000년에는 업무시간에 지역사회보건정보수집이 새롭게 추가된 것으로 조사되었다. 4) 1일 평균 진료환자 수 및 주민과의 친밀도는 1989년보다 2000년에 증가하였다. 근무에 대한 만족도는 1989년에 보통이다, 괜찮은 직업이라 생각한다, 보람을 느끼고 있다 라고 응답한 경우가 36.6%, 37.4%, 17.6% 이었던 반면에 2000년에는 11.6%, 22.6%, 56.8%로 보람을 느끼고 있다 고 응답한 경우가 증가하였다. 5) 지역사회의 실정을 감안할 때 가장 필요한 업무라고 응답 한 경우 진료업무가 57.7%이었으며, 보건교육이 31.4%, 지역사회보건정보수집이 10.9%순으로 나타났다. 또한 불필요한 업무로는 가족계획이 68.8%로 가장 높았고, 결핵관리 11.1 %, 영 유아보건 6.3%, 모성보건 5.6%순으로 조사되었다. 6) 보건진료소 이용도 감소 시 가장 바람직한 방안으로는 새로운 보건기능을 수행하는 기관으로 전환이 79.0% 이었으며, 기타(가정방문, 만성질환 및 노인환자 건강관리)가 12.3%로 조사되었다. 이상의 결과로 보아 보건진료원은 본인의 직능에 대하여 지역사회주민의 접근성 및 친밀도가 높고 직업에 대한 만족도가 높은 것으로 인식하고 있으며, 업무는 시대의 변화에 따라 감소하는 추세이고, 지역주민의 보건진료소 이용 감소 시 보건진료원은 새로운 보건기능을 수행하는 기관으로 전환을 원하고 있는 것으로 조사되었다. 그러므로 보건진료소의 현 실태를 정확히 인식하고, 보건진료원의 장점, 즉 지역사회에 대한 높은 접근성과 친밀도 및 전문성을 도대로 공공보건사업 기능이 강화된 새로운 역할을 모색함이 바람직하다고 판단된다.

• Nutrition Research and Practice
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• 제17권6호
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• pp.1113-1127
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• 2023

BACKGROUND/OBJECTIVES: Excessive alcohol consumption has harmful health effects, including alcohol hangovers and alcohol-related liver disease. Therefore, methods to accelerate the alcohol metabolism are needed. Laurus nobilis is a spice, flavoring agent, and traditional herbal medicine against various diseases. This study examined whether the standardized aqueous extract of L. nobilis leaves (LN) accelerates the alcohol metabolism and protects against liver damage in single-ethanol binge Sprague-Dawley (SD) rats. MATERIALS/METHODS: LN was administered orally to SD rats 1 h before ethanol administration (3 g/kg body weight [BW]) at 100 and 300 mg/kg BW. Blood samples were collected 0.5, 1, 2, and 4 h after ethanol administration. The livers were excised 1 h after ethanol administration to determine the hepatic enzyme activity. The alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH), superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities in the liver tissue were measured. RESULTS: LN decreased the serum ethanol and acetaldehyde levels in ethanol-administered rats. LN increased the hepatic ADH and ALDH activities but decreased the alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase activities in the ethanol-administered rats. In addition, LN inhibited lipid peroxidation and increased the activities of SOD and GPx. CONCLUSIONS: LN modulates the mediators of various etiological effects of excessive alcohol consumption and enhances the alcohol metabolism and antioxidant activity, making it a potential candidate for hangover treatments.

• Nutrition Research and Practice
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• 제18권2호
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• pp.210-222
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• 2024

BACKGROUND/OBJECTIVES: Chronic renal failure (CRF) is a complex pathological condition that lacks a cure. Certain Chinese medicines, such as melittin, a major component in bee venom, have shown efficacy in treating CRF patients. On the other hand, the mechanisms underlying the therapeutic effects of melittin are unclear. MATERIALS/METHODS: A 5/6 nephrectomy model (5/6 Nx) of renal failure was established on rats for in vivo assays, and mouse podocyte clone 5 (MPC5) mouse podocyte cells were treated with angiotensin II (AngII) to establish an in vitro podocyte damage model. The 24-h urine protein, serum creatinine, and blood urea nitrogen levels were evaluated after one, 2, and 4 weeks. Hematoxylin and eosin staining, Masson staining, and periodic acid-Schiff staining were used to examine the pathological changes in kidney tissues. A cell counting kit 8 assay was used to assess the cell viability. Reverse transcription polymerase chain reaction and Western blot were used to assess the mRNA and protein levels in the cells, respectively. RESULTS: In the rat 5/6 Nx, melittin reduced the 24-h urinary protein excretion and the serum creatinine and blood urea nitrogen levels. Furthermore, the renal pathology was improved in the melittin-treated 5/6 Nx rats. Melittin promoted podocin, nephrin, Beclin 1, and the LC3II/LC3I ratio and inhibited phosphorylated mammalian target of rapamycin (mTOR)/mTOR in 5/6 Nx-induced rats and AngII-induced MPC5 mouse podocyte cells. Moreover, inhibiting autophagy with 3-MA weakened the effects of melittin on podocin, nephrin, and the LC3II/LC3I ratio in podocytes. CONCLUSION: Melittin may offer protection against kidney injury, probably by regulating podocyte autophagy. These results provide the theoretical basis for applying melittin in CRF therapy.

• 수면정신생리
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• 제28권2호
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• pp.70-77
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• 2021

목 적 : 본 연구의 목적은 불면증 환자의 주관적 수면인식과 관련 있는 임상적, 객관적 요인들을 알아보고 임상에서 불면증 환자의 이해와 평가 및 치료에 도움을 주기 위함이다. 방 법 : 109명의 불면증 환자들을 대상으로, 수면다원검사 결과와 자가보고 설문지를 후향적으로 분석하였다. 주관적 수면인식은 아침자가보고 설문지의 주관적 총 수면시간(subjective total sleep time, subjective TST), 입면 잠복시간(subjective sleep onset time; subjective SOL), 각성횟수, 아침 개운함 정도로 측정하였으며, 주관적-객관적 수면차이를 계산하였다. 임상적 특징은 Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS)를 측정하였다. 변수들 사이의 관련성을 알아보기 위하여 상관분석을 시행하였다. 결 과 : 109명의 불면증 대상자(남성 = 72명, 나이 43.49 ± 15.32세)를 분석한 결과, 주관적 총 수면시간(subjective TST)은 수면다원검사에서의 입면 후 각성시간(wake after sleep onset, WASO) (p < 0.001), N1 수면(p = 0.039), PSQI (p < 0.001), BDI (p = 0.014)와 유의한 음의 상관관계를 보였다. 수면차이는 PSQI (p = 0.018)와 유의한 음의 상관관계가 있었다. 아침 개운함 정도는 PSQI (p = 0.019), BDI (p < 0.001)와 유의한 음의 상관관계가 있었다. 결 론 : 불면증 환자에서 주관적 수면인식은 수면다원검사의 입면 후 각성시간(WASO), N1 수면과 관련성이 있었으며, 우울감과 평소 수면의 질과 관련성이 있었다. 불면증 환자에서 다양한 객관적 수면변수, 평소 수면의 질 및 우울감이 주관적 수면인식에 영향을 미치므로, 이를 고려하여 환자를 평가 및 치료해야 하겠다.

• 가정∙방문간호학회지
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• 제8권2호
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• pp.109-120
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• 2001

This study has been done in order to help the people understand the cancer patients and provide the basic materials for the care of cancer patients by deeply understanding the living experience of the practice of alternative therapy for cancer patients. Data were collected with several in depth interviews and observations. Collected datas were analyzed by using phenomenological method of study by Giorgi (1970). The trial experience of alternative therapy for cancer patients has been classified into the one of having concerns, following, being infatuated, and coming out by pushing, and the experience of having concerns appeared as the meaning of the limit of modern medicine, despair, loneliness. hope, emotional support. dissolution of the feeling of uneasiness. the feeling of burden of the medical expense, self-treating, the subject of treatment. and indifference while the experience of following appeared as the meaning of blind following, temptation, going outside to look for something, wandering. following unconditionally, advise of the professionals, mistaken belief. self-abandonment, powerlessness. disconnection of dialogue with the medical staff. elevation of immunity, strengthening the physical power, absence of the source of examined information, clinging, self-responsibility. the experience of being infatuated appeared as the meaning of thorough trial. affirmative experience. devotion. diverse efforts, faithful trial. affirmative self-suggestion. change of the style of life. the feeling of burden of expense, being envious, bitter feeling toward the family, considering family, family discords, and difficulty of enforcement. The experience of coming out by pushing appeared as the meaning of waiting. self-reflection. maintaining the distance. cutting attachment, throwing the greed away, coming out by pushing. being thoughtful. accepting disease. individual difference of physical quality, and ambivalence. But they return to the experience of being concerned all over again in case of recurrence or metastasis of the disease even though they come out of such stage, and they always have ambivalence even in the condition with no recurrence and metastasis. In conclusion, the trial of alternative therapy for cancer patients could be explained as the adaptive behavior to the disease which is difficult to be cured. the cancer. The cancer patients are exposed to the side effects and harm without the examined information resources. Therefore the nurse should well aware of the alternative therapy and be able to do the appropriative management through the open communication with the patients who are under the trial of alternative therapy.

• Nutrition Research and Practice
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• 제17권2호
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• pp.206-217
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• 2023

BACKGROUND/OBJECTIVES: The immunomodulatory effect of Platycodon grandiflorum (PG) has been reported, but studies on its mechanism are still lacking. This study was undertaken to confirm whether the hydrolyzed and fermented PG extract (HFPGE) obtained by adding hydrolysis and fermentation to the extraction process has an immune-enhancing effect in the in vivo system. MATERIALS/METHODS: Five-week-old BALB/c mice were divided into 4 groups: normal control group (NOR), control group (CON), 150 mg/kg body weight (BW)/day HFPGE-treated group (T150), and 300 mg/kg BW/day HFPGE-treated group (T300). The mice were administered HFPGE for 4 weeks and intraperitoneally injected with cyclophosphamide (CPA, 80 mg/kg BW/day) on day 6, 7, and 8, respectively, to induce immunosuppression. The levels of immunoglobulins (Igs) and cytokines were measured in the serum. In splenocytes, proliferation and cytokine levels were measured. RESULTS: Serum IgA, IgG, and IgM levels were observed to decrease after CPA treatment, which was recovered by HFPGE administration. The levels of serum interleukin (IL)-12, tumor necrosis factor (TNF)-α, IL-8, and transforming growth factor (TGF)-β were also decreased after exposure to CPA but increased after HFPGE administration. Decreased splenocyte proliferation was seen in CPA-treated mice, but was observed to increase in the T150 and T300 groups as compared to the NOR group. Compared to the CON group, splenocyte proliferation stimulated with concanavalin A (ConA) or lipopolysaccharide (LPS) in the HFPGE-treated groups was significantly increased. The cytokines secreted by ConA-stimulated splenocytes (IL-2, IL-12, interferon-γ, TNF-α) were increased in the T150 and T300 groups, and cytokines secreted by LPS-stimulated splenocytes (IL-4, IL-8, TGF-β) were also increased by HFPGE administration. CONCLUSION: These results suggest that HFPGE stimulates the immunity in immunosuppressed conditions, thereby enhancing the immune response. Therefore, it is expected that HFPGE has the potential to be used as functional food and medicine for immune recovery in various immunocompromised situations.