• The Korean Journal of Physiology and Pharmacology
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• 제13권3호
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• pp.241-249
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• 2009

Although extracellular $Ca^{2+}$ entry through the voltage-dependent $Ca^{2+}$ channels plays an important role in the spontaneous phasic contractions of the pregnant rat myometrium, the role of the T-type $Ca^{2+}$ channels has yet to be fully identified. The aim of this study was to investigate the role of the T-type $Ca^{2+}$ channel in the spontaneous phasic contractions of the rat myometrium. Spontaneous phasic contractions and $[Ca^{2+}]_i$ were measured simultaneously in the longitudinal strips of female Sprague-Dawley rats late in their pregnancy (on day 18 ${\sim}$ 20 of gestation: term=22 days). The expression of T-type $Ca^{2+}$ channel mRNAs or protein levels was measured. Cumulative addition of low concentrations (< 1 ${\mu}M$) of nifedipine, a L-type $Ca^{2+}$ channel blocker, produced a decrease in the amplitude of the spontaneous $Ca^{2+}$ transients and contractions with no significant change in frequency. The mRNAs and proteins encoding two subunits (${\alpha}$ 1G, ${\alpha}$ 1H) of the T-type $Ca^{2+}$ channels were expressed in longitudinal muscle layer of rat myometrium. Cumulative addition of mibefradil, NNC 55-0396 or nickel induced a concentration-dependent inhibition of the amplitude and frequency of the spontaneous $Ca^{2+}$ transients and contractions. Mibefradil, NNC 55-0396 or nickel also attenuated the slope of rising phase of spontaneous $Ca^{2+}$ transients consistent with the reduction of the frequency. It is concluded that T-type $Ca^{2+}$ channels are expressed in the pregnant rat myometrium and may play a key role for the regulation of the frequency of spontaneous phasic contractions.

• 한국약용작물학회지
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• 제22권2호
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• pp.147-153
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• 2014

The Ponciri fructus immaturus (Poncirus trifoliata Rafinesque) has been used in oriental medicine for uterine contraction, stomachache, abdominal distension and cardiovascular diseases. Two main compounds, poncirin and naringin were successfully analyzed by high performance liquid chromatography (HPLC) and carried out method validation according to ICH guideline. A successful resolution and retention times were obtained with a $C_{18}$ reversed phase column, at an $1m{\ell}min^{-1}$ flow rate, with a gradient elution of a mixture of methanol, water and acetonitrile. Poncirin and naringin showed good linearity ($R^2$ > 0.999) in relatively wide concentration ranged. The recovery of each compound was 95.81 ~ 101.48% with R.S.D. values less than 1.0%. The application of ultrasound-assisted extraction was shown to be more efficient in extracting poncirin and naringin from Ponciri fructus immaturus. The predicted optimal poncirin and naringin yield were poncirin 2.15%, naringin 1.65% under an extraction temperature of $40^{\circ}C$, an extraction time of 10 min in a solvent of 70% methanol.

• 여성건강간호학회지
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• 제25권3호
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• pp.239-257
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• 2019

Purpose: To analyze the job of nursing unit managers working at women's hospital, using DACUM (developing a curriculum), DACUM is a method for analyzing job-focused competency. Methods: This study involved a descriptive survey. A DACUM workshop was held to define women's hospital nursing unit managers' role and identify their duties and tasks. For the workshop, a committee was formed consisting of 5 women's hospital nursing unit managers. Finally, after validation, the developed contents were made into a survey asking about nursing unit manager's duties and tasks. Results: Sixteen duties and 83 tasks were identified on the DACUM chart. The importance, difficulty, and frequency of the tasks were ranked in terms of A, B, and C, with A being the highest degree. Eight tasks received A's all in importance, difficulty, and frequency of performance. The 8 tasks were: 'taking over', 'taking care of seriously ill patients on handover', 'ward rounding', 'analyzing and resolving demands identified during handover and patient tour', 'reporting patient status during rounding', 'promoting breast-feeding', 'uterine contraction, and training for breast-feeding'. The duty with the biggest determinant coefficient (DC) was 'patients complaint management' (DC=7.09). Based on tasks, the one with the biggest DC was 'solving patient and patient guardian's complaints' (DC=7.53), followed by 'making infection control guidelines' (DC=7.5). Conclusion: When expanding the nursing staff of the hospital, women's hospitals nursing unit managers also need to use administrative functions as intermediaries to focus on the operation management of the entire hospital rather than direct nursing to suit their role.

• Tuberculosis and Respiratory Diseases
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• 제44권1호
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• pp.183-190
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• 1997

Tocolytics 임신부의 조기진통시 치료제로 많이 사용되는 약제지만 드물게는 폐부종을 일으켜 치명적일 수 있다. Tocolytics가 폐부종을 일으키는 기전은 용적증가, 교질삼투압의 감소, 심근 손상, 모세혈관 내막의 손상등에 의해 발생한다고 설명되고 있으나 아직 불확실한 상태이며 폐부종 발생의 양대 기전인 정수압적 폐부종과 투과성 폐부종의 양상이 모두 관여하는 것으로 알려져 있다. 또한 임산부가 다산부이거나 다태아 임신인 경우, 임신중 수액공급을 많이 받은 경우, 심장 질환이 동반된 경우, 감염이 동반된 경우, 동시에 steroid나 MgSO4로 치료 받은 경우등이 tocolytics 사용시 폐부종이 쉽게 발생될 수 있는 선행요인으로 작용함이 알려져왔다. 저자들은 조기진통이 있어 tocolytics인 ritodrine 치료후 정상분만하였으나 분만후 급속히 진행하는 폐부종이 발생한 30세 여자 환자를 경험하였기에 문헌고찰과 함께 보고하는 바 이다.

• 여성건강간호학회지
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• 제17권3호
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• pp.225-242
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• 2011

Purpose: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. Methods: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. Results: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. Conclusion: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.

• 대한한방부인과학회지
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• 제32권1호
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• pp.85-93
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• 2019

Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of mid-trimester oligohydramnios. Methods: It is a case report of a 31 year-old woman hospitalized for oligohydramnios at $24^{+4/7}$weeks of gestation. This patient diagnosed with special oligohydramnios had no abnormal findings such as fetal urinary abnormalities or other anomalies. Also, symptom of PPROM (preterm premature rupture of membrane) was not confirmed. The decoction, Gami-danggui-san (DG) was prescribed for the purpose of reducing unnecessary contraction of uterine muscle during pregnancy and promoting blood circulation and metabolism, thereby improving placental function and contributing to the increase of the fluid. DG decoction was administered twice a day until 19th of June, which was 10 days in total. During the treatment, level of amniotic fluid had been monitored by measuring AFI (amnioti fluid index). Results: After these conventional therapies, the amount of amniotic fluid increased steadily, and eventually reached the optimal level. AFI was found to be 3.2 on the $24^{+4/7}$ weeks, 8 on the $26^{+1/7}$ weeks, 11.5 on the $27^{+0/7}$ weeks of gestation. In the same periods, EFW (expected fetal weight) was also found to be increasing gradually: 545 g, 630, and 760 g. Conclusions: Our report implies the potential of herbal medicine as a effective therapy for oligohydramnios tratment. Further studies are needed to assess the efficacy of TKM herbal medicine and reveal the mechanisms of the decoction.

• 한국수정란이식학회지
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• 제22권3호
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• pp.161-165
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• 2007

포유류에서 옥시토신은 다양한 기능을 가지고 있는 신경뇌하수체 호르몬이다. 옥시토신은 주로 젖의 분비를 일으키고 분만 시 자궁의 수축 및 모성 행동과 관계가 있다. 모성 행동은 스트레스에 의해 억압을 받으며 옥시토신에 의해 촉진된다. 본 연구는 제왕절개의 스트레스와 자궁내 옥시투여에 따른 모성 행동의 변화를 알아보기 위해 수행되었다. 본 실험 결과, 자연 분만 예에서 스트레스를 준 개체와 스트레스를 주지 않은 개체에서 새끼의 생존율을 비교한 결과, 스트레스를 준 군에서 새끼의 생존율이 낮아 스트레스가 모성 행동에 영향을 미친다는 것을 확인하였다. 제왕절개 수술을 실시한 예에서 옥시토신을 투여한 군은 마취의 회복 후 일정 시간이 경과한 다음 새끼를 잡아먹는 식자증이 나타난 반면, 옥시토신을 투여한 군에서는 마취에서 회복한 다음 곧바로 새끼를 확인한 다음 살해하는 행동을 보였다. 결과적으로 새끼를 관리하고자 하는 모성 행동을 발현하기 위해서는 말초에 옥시토신을 투여하는 것은 의미가 없다는 것을 확인하였으며, 분만 시 모체에 대한 스트레스는 새끼의 관리에 좋지 않은 영향을 미친다는 것을 확인하였다. 또한, 본 실험은 랫드를 대상으로 제왕절개라는 새로운 스트레스의 실험적 이용, 임상적으로 제왕절개시 수행하는 자궁 내 옥시토신 투여의 임상적 평가, 그리고 제왕절개 수술을 실시한 다음 마취 회복 후 새끼를 탐색하는 모성 행동관찰의 요인을 추가한 새로운 실험이라는데 의의가 있다.

• The Korean Journal of Physiology
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• 제17권2호
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• pp.135-142
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• 1983

$PGE_2$ 및 $PGF_{2{\alpha}}$가 용혈 및 적혈구막 절편에서 $Ca^{++}$ 결합에 미치는 영향을 관찰하여 다음과 같은 결론을 얻었다. 1) $PGF_{2{\alpha}}$는 $PGE_2$와 같이 적혈구막 삼투성 취약성을 증가시키는데 대조군에서는 NaCl농도 1/18 M 용액에서 완전히 용혈되었으나 $PGE_2$ 및 $PGF_{2{\alpha}}$ 가 $10^{11}M$ 이상 포함될 경우 NaCl농도 $1/16{\sim}1/17\;M$ 에서 100 % 용혈이 일어났다. 2) 동일한 적혈구 부유액을 사용할 때 NaCl농도 1/15 M 용액에서 대조군은 $44.2{\pm}4.3%$가 용혈되나 $PGE_2$ 및 $PGF_{2{\alpha}}$가 $10^{11}M$농도로 포함되었을 때 용혈은 각기 $73.6{\pm}8.4%$ 및 $68.7{\pm}6.4%$로 대조군에 비하여 의의있게 증가하였으며 그 이상의 농도에서는 더 이상 증가를 보이지 않았다. 3) $PGE_2$ 및 $PGF_{2{\alpha}}$에 의해 증가된 용혈은 어느 $Ca^{++}$농도에서도 대조군보다 항상 일정한 정도로 증가되어 있다. 4) 적혈구막 절편에서의 $Ca^{++}$결합은 대조군이나 $PGE_2$ 및 $PGF_{2{\alpha}}$처치군 모두 incubation용액내 $Ca^{++}$농도가 증가함에 따라 곡선적으로 증가하여 $Ca^{++}$농도 5 mM에서 포화된다. 그러나 같은 농도의 $Ca^{++}$에서 비교할 때 적혈구막의 $Ca^{++}$결합은 $PGE_2$ 및 $PGF_{2{\alpha}}$ 존재시 대조군에 비하여 의의있게 증가되었다. 이상의 결과로 보아 $PGE_2$ 및 $PGF_{2{\alpha}}$가 적혈구막의 삼투성 취약성을 증가시키는 기전은 $Ca^{++}$과는 독립적으로 작용함을 알 수 있다.

• 의료법학
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• 제13권1호
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• pp.199-247
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• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.