• 지역사회간호학회지
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• 제7권2호
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• pp.410-419
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• 1996

This study was reviewed from 1000 articles related to family planning from 1970 to 1990 and 20 articles associated with natural family planning from 1980 until the present. The purpose of natural family planning(NFP) is to identify the time ovulation of women themselves, to have intercourse with periodic abstinence, and to deliver a healthy child. The ultimate goal of NFP is to promote the family's health. The NFP method is described as periodic abstinence of intercourse to avoid pregnancy by identifying the ovulation time in the menstration cycle. Clinical symptoms and signs of reflection underlying changes in Estrogen and Progesterone are the change of basal body temperature, the change of cervical mucus and cervix, abdominal pain and breast tenderness. The types of NFP are the calender rthythm method, basal body temperature methods, cervical mucus method, symptothermal method, cyclo-thermal method and home based ovulation test kits. Recently the cyclo-thermal method involved. It is calendar rhythm method applied to B.B.T. For the cervical mucus method, when the estrogen level in the blood concentration is increased, the mucus begins to excrete, the amount of moist mucus increases while the mucus is clear, slippery, and smooth. For 3 days, this timing can be considered contraception. Fertility is at a maximum on the day mucus appears, abstinence for 3 days is a type of contraception. Sexual intercourse on a maximum day of mucus maximizes pregnancy potential. But, the contraception depends on the practice of a perfect rule. For basal body temperature methods, at ovulation time, the temperature increases $0.2^{\circ}C-0.5^{\circ}C$. Through the review of literature a high temperature above $0.2^{\circ}C$ for 3 days indicates that the previous 6 day period was ovulation and fertilization. The Symptothermal method is used to determine the prediction of ovulation through the observation of mucus excretion, high temperature, the change of cervical mucus, low abdominal pain, vaginal discharge, and breast change. Home based ovulation test kits are cervico-vaginal fluid aspiration, test a digital electric thermometer, body fluid(blood, saliva, urine) test kits, They are on the market. However, research on the contraception method is still in progress. For pregnancy it is still too early to use home based ovulation test kits because of deficit of reliability and simplicity more research on the technology is needed. It is suggested that NFP methods be included in nursing curriculum in order to educate NFP users how to effectively use NFP methods. Furthermore, this study has implications for the dissemination of NFP methods in terms of Korean policies of family planning and the support of community welfare agences.

• 한국산학기술학회논문지
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• 제17권3호
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• pp.464-472
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• 2016

본 연구는 간호대학생들을 대상으로 인유두종바이러스(HPV) 예방접종에 영향을 미치는 요인을 조사하였다. 연구대상은 G광역시에 소재하는 3개 대학의 간호학생 604명이었다. 자료수집은 2015년 6월부터 10월까지 이루어졌으며, SPSS 21.0 program을 이용하여 분석하였다. 대상자 가운데 HPV 예방접종군은 14.7%, 비접종군은 85.3%로 나타났다. 예방접종여부와 연령, 학년, 성별, 용돈, 예방접종에 대해 들어본 경험은 통계적으로 연관이 있었다(p<.001). 대상자의 암 예방행위 점수는 평균 7.22점, 건강신념은 평균 24.71점이었다. 예방접종군의 결정요인은 '부모님 또는 주변인의 권유'가 가장 많았고, 비접종군의 장애요인은 '관심이 없어서'가 가장 많았다. HPV 예방접종에 영향을 미치는 유의한 요인은 학년, 용돈, 예방접종에 대해 들어본 경험, HPV 예방접종 관련 건강신념이었다. 특히 HPV 예방접종에 대해 들어본 경험이 없는 대상자 보다 경험이 있는 대상자의 예방접종률이 높았다(OR=8.59, p<.001). 본 연구의 결과는 간호대학생들의 HPV 예방접종에 대한 제한된 지식에 기여할 수 있을 것이다. 또한 예방접종률 증진을 위한 기초자료로써 유용하게 활용될 것으로 사료된다.

• 한국의학물리학회지:의학물리
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• 제15권2호
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• pp.63-69
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• 2004

고선량률 근접치료는 저선량률 근접치료와 비교하여 짧은 시간에 많은 선량이 조사되며, 치료를 위한 최적화가 물리적 요인, 방사선 파라미터, 최적화 알고리즘 같은 여러 복잡한 요인들과 연관되어 있으므로 정확한 선량 전달을 위해서는 정확한 검증 과정을 필요로 한다. 본 연구에서는 앞선 연구에서 제작하였던 선량 검증용 팬톰의 단점을 보완하고 CT나 MRI 시스템에서도 이용할 수 있는 구조를 추가시켜 고선량률 근접 치료의 위치 및 선량 검증을 위한 새로운 자궁경부암용 팬톰을 개발하였다. 또한, 개발된 팬톰을 이용하여 고선량률 근접치료에서의 기존의 필름에 기반한 orthogonal 방법의 위치 확인에 대한 점증을 수행하였다. 위치 확인에 대한 철증은 CT 시스템에서의 좌표를 비교, 분석함으로써 수행되었다. 제작된 팬톰은 자궁경부암 환자를 대상으로 환자의 해부학적 구조를 모사하여 제작하였기 때문에 방광과 직장을 모사한 구와 원기둥의 구조물을 포함하고 있으며, C-arm과 CT 영상을 정확하게 획득하기 위한 localizer를 포함하고 있다. 또한, C-arm 및 CT 좌표 비교 수행을 위하여 알고리즘에 기반한 재구성 프로그램을 직접 IDL 5.5를 이용, window 환경에서 개발하였다. 좌표 비교를 수행한 결과, CT의 좌표가 정확한 좌표라고 가정했을 때 필름에 기반한 방법은 모든 점에서 1.0 mm 이내에서 일치함을 확인할 수 있었다. 본 연구를 바탕으로 우리는 현재 사용하고 있는 Plato (Nucletron, Netherlands) 근접치료 기기의 위치 확인 알고리즘에 대한 검증을 자체적으로 수행할 수 있었다. 이번 연구에서 새롭게 제작된 팬톰과 소프트웨어는 근접치료의 Qual Assurance (OA) 분야에서 효율적이고 강력한 QA 도구로 자리 잡을 수 있을 것으로 기대된다.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.801-813
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• 1998

우리 나라의 주요사망원인에 해당하는 암질환을 대상으로 YLD를 측정하여 주요암질환간 질병부담의 우선 순위 측정하고 이의 활용범위를 알아보고자 수행한 본 연구에서 다음과 같은 결과를 얻었다. 우리 나라 남성의 암으로 인한 질병부담의 우선 순위 위암(4081.4년), 간암(3104.2년), 대장 및 직장암(3086.2년), 식도암(1511.9년), 폐암(1166.7년), 췌장암(1093.8년), 방광암(665.6년), 전립선암(421.7년), 백혈병(397.2년), 임파선암(259.7년)으로 계산되었다. 여성의 경우 암으로 인한 질병부담의 우선 순위 위암(2707.1년), 식도암(1536.7년), 간암(1468.5년), 자궁암(1311.8년), 난소암(974.3년), 췌장암(763.5년), 유방암(724.5년), 폐암(689.9년), 백혈병(351.3년), 임파선암(241.1년)로 계산되었다. 이러한 결과는 본 연구에 사용한 연구재료 및 연구 방법의 불완전성에도 불구하고 향후 보건의료정책의 우선순위결정, 즉 한정된 자원을 보다 더 효율적으로 활용하는데 보다 구체적인 정보를 계량적으로 제공해 줄 수 있다는 점에서 중요한 의의를 갖는다고 하겠다.

• The Korean Journal of Pain
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• 제14권1호
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• pp.61-67
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• 2001

Background: Usually, lumbar epidural block is performed on the $L_{3-4}$ interspace. This study was designed to evaluate the analgesic efficacy and shortening of labor duration comparing the $L_{1-2}$ and $L_{3-4}$ interspace epidural blocks in nulliparous normal vaginal deliveries and then investigates side effects following the blocks. Methods: Eighty healthy nulliparous women were divided into two groups, $L_{1-2}$ (n = 40) and $L_{3-4}$ (n = 40). Epidural blocks, lumbar epidural block were performed at the $L_{1-2}$ and $L_{3-4}$ interspace with a catheter advancing 3 cm cephalad. The initial dose of 12 ml (0.167% bupivacaine, fentanyl $50{\mu}g$ and clonidine $75{\mu}g$) was injected epidurally at 4 cm dilatation of cervix and severe pain of labor. If a visual analogue scale (VAS) score was more than 4 points, an additional dose was administered epidurally using the same volume as the above mentioned, but with the exception that the bupivacaine was diluted to 0.1 percentage. The maternal blood pressure, pulse rate, respiration rate and fetal heart rate were measured at 10 min intervals for the first 30 min, at 15 min interval for the next 30 min and at 30 min interval for the last one hour following the blocks. The duration of the first (active) and second stages of labor was counted and the neonatal Apgar score was recorded at one and five min after delivery. The degree of motor block, pruritus, nausea and vomiting were also noted. Results: The patients in group $L_{1-2}$ had lower pain scores than group $L_{3-4}$ at 5, 20, 30, 60 mins. The duration of 1st and 2nd labor stage in the $L_{3-4}$ epidural block were $272{\pm}33.5$ min, $49.2{\pm}27.4$ min respectively but those in the $L_{1-2}$ epidural block were $253.5{\pm}32.5$ min, $37.3{\pm}22.3$ min, respectively. Conclusions: We concluded the analgesic efficacy and shortening of labor duration in $L_{1-2}$ epidural block was better than those in $L_{3-4}$ epidural block. Maternal hemodynamic change, motor block. pruritus, nausea, vomiting and Apgar score showed no significant differences between the two groups.

• 대한임상검사과학회지
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• 제39권3호
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• pp.210-216
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• 2007

There is increasing evidence that stromal reaction in cancer has an important diagnostic and prognostic significance. The aim of our study is to analyze the relation between the increase in mast cell number and the expression CD34 and alpha-smooth muscle actin (${\alpha}$-SMA) in the stroma of cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). We investigated a total of 29 CIN (1,2,3) and 21 SCC (microinvasive and invasive) specimens and compared the distribution of $CD34^+$ stromal cells, ${\alpha}-SMA^+$ cells, transforming growth factor-${\beta}1$ $(TGF-{\beta}1)^+$ cells, and the density of mast cells using immunohistochemistry with antibodies against CD34, ${\alpha}$-SMA, TGF-${\beta}1$, and c-Kit (CD117) respectively. Computerized image analysis was to evaluate the positive area (%) and density of the respective immunoreactive cells. In CIN $CD34^+$ cells were abundant in the stroma but no ${\alpha}-SMA^+$ cells were identified except the wall of blood vessels. $CD34^+$ cells were progressively decreased along the continuum from CIN 2 to microinvasive SCC and not observed in the stroma of invasive SCC. Whereas ${\alpha}-SMA^+$ cells were only observed in the stroma of microinvasive and invasive SCC. We found more intense TGF-${\beta}1$ expression in the increased mast cells in the stroma of invasive SCCs than that in the stroma of CIN. These results indicate that disappearance of $CD34^+$ stromal cells and appearance of ${\alpha}-SMA^+$ cells are associated with the stromal change of CIN to SCC and the transformation of $CD34^+$ stromal cells into ${\alpha}-SMA^+$ cells is mediated by TGF-${\beta}1$ secretions in the stromal mast cell of SCC.

• Journal of Animal Science and Technology
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• 제56권3호
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• pp.8.1-8.6
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• 2014

Background: Artificial insemination (AI) can serve as a powerful tool to the sheep owners for making rapid genetic progress of their flock. The AI in sheep is mostly performed using fresh semen with two reasons i) lambing rate following trans-cervical AI with frozen semen is limited by the inability of frozen-thawed sperm to transit the cervix and ii) the need of circumventing the cervical barrier through laparoscope aided intrauterine AI. Therefore, AI with frozen-thawed semen is not as widespread in sheep as it is in other domestic species. However, to get maximum benefits through the use of AI, frozen-thawed semen is a prerequisite because instead of high fertility, the short shelf life of fresh semen coupled with a limitation on the number of insemination doses achievable per unit time restricts the widespread use of individual sires. Therefore, in order to enhance lambing rate, a total of 240 trans-cervical artificial inseminations with frozen-thawed semen were performed in Bharat Merino ewes during autumn season either once in the evening (G-I, 10 h after onset of estrus, n = 100) or twice (G-II, 14 h and 22 h after onset of estrus, n = 140) i.e. once in the morning and again in the evening. Results: The pregnancy rate (proportion of pregnant ewes confirmed by ultrasonography at day 40) and lambing rate (proportion of ewes lambed) were higher in G-II as compared to G-I (26.4 vs 20% and 19.3 vs 10%, respectively). The difference in lambing rates was statistically (P < 0.05) significant. The depth of insemination within cervico-uterine tract had no significant effect on pregnancy and lambing rates. Conclusions: The results indicate that lambing rate in sheep following TCAI with frozen-thawed semen was significantly influenced by time of inseminations. Two inseminations after 14 and 22 h of onset of estrus enhanced the lambing rates of Bharat Merino sheep as compare to single insemination after 10 h of onset of estrus. The TCAI technique with frozen-thawed ram semen is promising and may serve as a valuable tool for genetic improvement of sheep breeds. Research efforts are going on worldwide to overcome the poor fertility following TCAI with frozen-thawed semen.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10193-10198
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• 2015

Background: Cancer is a major cause of mortality in developing countries and correct and valid information about the epidemiology of this disease is the first step in the planning of health care in each region. The aim of this study was to determine the relative frequency, mean age and sex ratio of the most 10 common non-skin cancers in the world and Iran, among patients referred to an oncology clinic. Materials and Methods: This descriptive study was conducted in Mashhad, north east of Iran. The data obtained from the records of patients referred to the private oncology center between the years of 1985-2012". According to the latest report of GLOBOCAN study commonest malignancies included were lung, breast, colorectal, prostate, stomach, liver, cervix, esophageal, bladder cancers and Non-Hodgkin lymphoma. Results: A total of 4,606 cases were analyzed. The mean age was $55.5{\pm}13.8years$ (male: $59.5{\pm}13.9$, female: $52.6{\pm}12.9$). Overall, breast cancer (1,264 cases, relative frequency of 27.4%) was the most prevalent cancer; however the mean ages of diagnosis were not significantly different between 5-year time period divisions (p=0.290). The most common cancer in men was esophageal cancer (26.3%).The lowest mean age was related to women diagnosed with breast cancer ($48.5{\pm}11.8$) and men with non-Hodgkins lymphoma ($48.4{\pm}17.8$). There were statistically significant differences between the mean age of men and women with gastric (p=0.003) and esophageal cancers (p<0.001). Male to female sex ratios in our study for bladder, lung and stomach cancers were 6.57, 2.60 and 2.50 respectively. Conclusions: The results showed that breast cancer tends to be found in younger female patients and bladder cancer appears more often in men. Screening in target population in addition to early diagnosis may reduce death and disability.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6639-6641
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• 2014

Background: To evaluate the clinical significance of atypical squamous cells of undetermined significance (ASCUS) in PAP test in post-menopausal women and compare with reproductive age women. Materials and Methods: A total of 367 patients who referred to our gynecologic oncology clinic were included to the study between September 2012 and August 2013. Data for 164 post-menopausal (group 1) and 203 pre-menopausal (group 2) women with ASCUS cytology were evaluated retrospectively. Immediate colposcopy and endocervical curettage was performed for both groups and conization for all women with a result suggestive of CIN2-3. Histopathological results and demographic features of patients were compared between the two groups. Results: Mean age of the patients was $54.6{\pm}6.5$ years in group 1 and $38{\pm}6.6$ years in group 2. Some 14 (8.5%) of post-menopausal women and 36 (17.7%) of pre-menopausal women were current smokers (p=011). Totals of 38 (23.2%) post-menopausal and 64 (31.5%) pre-menopausal women were assessed for HPV-DNA. High risk HPV was detected in 7 (4.3%) and 21 (10.3%), respectively (p=0.029). Final histopathological results recorded were normal cervix, low grade cervical intra-epithelial neoplasia (CIN 1), and high grade cervical intra-epithelial neoplasia (CIN2-3). In group 1 results were 84.8%, 12.2% and 1.8%, respectively, and in group 2 were 71.9%, 23.2% and 4.9%. There were no cases of micro invasive or invasive cervical carcinoma in either group. Two cases were detected as endometrial carcinoma in the menopausal group (1.2%). Conclusions: In current study we found that preinvasive lesions were statistically significantly higher in pre-menopausal women than post-menopausal women with ASCUS. Cervicitis was more common in menopausal women. Therefore, we think that in case of ASCUS in a post-menopausal woman there is no need for radical management.

• 대한방사선치료학회지
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• 제18권2호
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• pp.119-125
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• 2006

목 적: 본 연구에서는 근접치료 시 선량기준점에서 선량을 정확히 분석하고자 근접방사선치료용 다목적 팬텀(Multi Purpose Brachytherapy Phantom, MPBP)을 제작하여 그 유용성을 평가하고자 하였다. 대상 및 방법: 자체 제작된 근접방사선치료용 다목적 팬텀(MPBP)에서 다기능삽입구(Multi Function Applicator, MFA)를 이용하여 치료 시와 동일한 조건을 재현한 후 열형광선량계(TLD)를 이용하여 전산화 치료계획 장치에서 계산된 좌표와 동일한 기준점에서 선량을 측정하였다. 측정 대상은 근접방사선 치료환자 중 탄뎀(tandem)과 난형체(ovoid)를 사용한 자궁경부암 환자 4명을 대상으로 환자 당 5회씩 총 20회 A point와 B point 그리고 방광에서 선량을 측정하였다. 결 과: MPBP에서 TLD의 측정 결과는 A Point에서 측정한 환자의 상대오차가 각각 -3.2%, -0.2%, 0%, 3.8%를 보였고, B point에서는 -1.4%, -1.4%, 2.4%, 4.0%를 보였다. 그리고 방광에서는 1.3%, 2%, 5.4%, 7.15%의 상대오차를 나타내었다. 결 론: 자체 제작된 근접치료용 다목적 팬텀(MPBP)은 다기능삽입구(MFA)를 사용하여 치료 시와 동일한 조건에서 선량측정의 재현성을 이룰 수 있었고, A, B point지점과 방광의 선량을 정확히 분석할 수 있었다. 따라서 본 연구에서 제작된 근접방사선치료용 다목적 팬텀은 기준점 선량분석에 매우 유용한 것으로 판단된다.