• Asian Pacific Journal of Cancer Prevention
• /
• 제16권3호
• /
• pp.1225-1233
• /
• 2015

This study aims to clarify the psychosocial reactions of female patients with gynecological cancer undergoing chemotherapy and in the process of suffering from alopecia and to examine their nursing support. The target group comprised female patients who had received two or more cycles of chemotherapy, were suffering from alopecia, and were aged 30-65. Data were collected from semi-structured interviews, conducted from the time the patients were informed by their doctors that they might experience alopecia due to chemotherapy to the time they actually experienced alopecia and until they were able to accept the change. Inductive qualitative analysis was employed to close in on the subjective experiences of the cancer patients. The results showed the existence of six phases in the psychosocial reactions in the process of alopecia: phase one was the reaction after the doctor's explanation; phase two was the reaction when the hair starts to fall out; phase three was the reaction when the hair starts to intensely fall out; phase four was the reaction when the hair has completely fallen out; phase five was the reaction to behavior for coping with alopecia; and phase six was the reaction to change in interpersonal human relationships. The results also made it clear that there are five types of reaction patterns as follows: 1) treatment priority interpersonal relationship maintenance type; 2) alopecia agitated interpersonal relationship maintenance type; 3) alopecia agitated interpersonal relationship reduction type; 4) alopecia denial interpersonal relationship reduction type; and 5) alopecia denial treatment interruption type. It is important to find out which of the five types the patients belong to early during treatment and provide support so that nursing intervention that suits each individual can be practiced. The purpose of this study is to make clear the process in which patients receiving chemotherapy come to accept alopecia and to examine evidence-based nursing care on patients with strong mental distress from alopecia.

• 한국콘텐츠학회논문지
• /
• 제13권1호
• /
• pp.234-246
• /
• 2013

2000년 초 비영리 기관에 의해 시범적으로 도입되었던 마이크로크레딧은, 보건복지부에서 2005년부터 2008년까지 자활공동체 창업지원사업과 희망키움뱅크 사업의 형태로 추진되다가, 2009년 미소금융정책으로 결정되는 과정을 거치며 정책이 변화되는 양상을 보였다. 대표적인 변화로는 보건복지부에서 금융위원회로의 관할 부처의 변경, 복지적 접근에서 금융적 접근의 강조, 수행기관의 신설 등을 들 수 있다. 이러한 갑작스런 변화의 원인을 분석하기 위하여, 본 연구에서는 Hood(1994)와 주재현(1999)에서 제시한 분석틀을 활용하여 그 정책변동과정을 분석하였다. 분석결과, 실업률 증가와 금융환경 변화, 금융위기 등의 외적 상황의 변화, 이명박 정부의 중도 실용 추진 의지 및 마이크로크레딧 실험 성공 등의 정책 아이디어의 힘, 수동적인 개입을 보여준 이해관계의 힘, 그리고 각 부처의 정책관성에서 비롯된 내적요인들이 그 원인으로 밝혀졌다. 특히 이러한 변동의 요인 속에 드러난 다양한 이해관계자 참여의 부재는 비합리적인 방식으로 정책을 산출할 가능성을 높음을 시사해 주고 있다.

• 대한한의학원전학회지
• /
• 제26권1호
• /
• pp.27-38
• /
• 2013

Objective : This article shows that while Seishu Hanaoka(華岡靑洲) is known to have developed an effective anesthetic formula composed of traditional herbs and performed the world first partial mastectomy under a general anesthesia in 1804, anesthetic formulas very similar to those developed by him were widely recorded and deemed used in Japan and Northeast Asia before his invention. The origin of the formulas will be tracked down to compare with the several formulas broadly administered in the region. Methods : Historical literature analysis was adopted to achieve the objective. 1. Mayaku-ku (麻藥考): this book is the main medical classic by Nakagawa Syutei(中川修亭) that introduces Seishu Hanaoka, his anesthetic formulas and mastectomy. 2. Northeast medical classics: Seuideukhyobang (世醫得效方) in 1337, Uibangryuchui (醫方類聚), Uihui(宜彙) and so on. Result : Herbs such as aconitum and datura were applied as a anesthetic agent early on before the Chinese Yuan dynasty. In Korea as well, some old medical books documented such use of those herbs and relevant formulas. Conclusion : Formulas that counted as invented and employed by Seishu Hanaoka as anesthetics, in fact, had been widely known and used in the region before his era. We should pay due attention to his creativity that combined a western surgical intervention and traditional anesthetic agents and successfully performed a newly introduced surgical practice in Japan. The point is that Hanaoka took note of anesthetic herbs or formulas traditionally inherited in North-east Asian medicine and successfully applied them to the surgical procedures for breast cancer, or mastectomy and mammotomy. This history alerts us to neglected or forgotten potentials of traditional medicine in anesthetic treatment and more.

• 대한간호학회지
• /
• 제22권3호
• /
• pp.271-296
• /
• 1992

The purposes of this study were 1) to identify patterns and trends of studies of anxiety and stress and 2) to provide direction on which to base further research. Research studies of anxiety and stress were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, Monthly Nurse, and from theses and dissertations, which had been conducted for the 20 years from 1970 to 1990. The total population of the studies numbered 463. Seven studies were excluded from the analysis because of duplication, so that 252 studies of anxiety and 204 of stress were analyzed. These studies were analyzed for 1) time of publication or presentation, 2) research design, 3) characteristics of subjects used in each study, 4) types of correlated variables, and 5) types of nursing interventions. Findings obtained in the study were as follows : 1. The number of studies related to anxiety and stress has increased rapidly since the early 1980's. 2. The studies were primarily descriptive throughout the 20 years. However, correlational studies, comparative studies and experimental studies slowly increased. 3. Anxiety studies tend to be conducted more on patients and stress studies with normal subjects in non - experimental research. However, experimental studies were conducted more with patients than with normal subjects. 4. In correlational studies, the trend was to study physical conditions in relation to anxiety, and coping and adaptation in relation to stress. 5. In experimental studies, teaching and information therapy and relaxation were the most popular interventions for anxiety, and supportive care for stress. On the bases of these findings, the following recommendations were made : 1. These patterns of studies related to anxiety and stress in Korea need to be compared with studies conducted in other countries. 2. More attention is needed in terms of research design, reliability and validity of tools, and results of statistical analysis. 3. Meta -analysis should be done to analyze and integrate the results of various studies. 4. For theory testing and identification of useful intervention methods, experimintal studies with the same protocols must be conducted rather than more descriptive studies.

• 노동경제논집
• /
• 제23권2호
• /
• pp.1-37
• /
• 2000

1998~99년의 경제위기 상황에서 '경영상 이유에 의한 해고의 제한' 이 입법화되었다. 이 법은 이름 그대로 경영상 해고를 제한하기 위한 것이 아니라 계약상의 고용조정 제한을 완화시켜 노동시장 유연화를 달성하자는 취지에서 입법화되었다. 본 연구의 이론모형은 '코즈정리'의 관접에서, 이러한 공식 제약(formal constraint) 이 민간계약에 미치는 효과를 살펴본다. 즉 법의 고용보호 정도가 변화해 감에 따라 민간 주체들이 맺는 '암묵적 계약(implied contract)'의 경제효율성과 계약의 기회주의적 파기가 어떻게 변화하는가를 분석한다. 본고의 이론모형은 공식 제약의 변화가 민간 주체들의 암묵적 계약 비용을 최소화하는 방향으로 이루어지지 않는다면, 제약의 과도 혹온 과소함을 우회하기 위해 민간 주체들은 추가척인 암묵적 계약을 맺게 되고 이는 결국 계약의 경제효율성을 훼손시킬 수 있다는 합의를 제시한다. 이러한 이론모형의 합의를 한국 노동판결 자료를 통하여 검토해 본다. 사용자의 기회주의를 반영하는 대리변수로서 부당해고 사건의 원고승소율 혹은 근로자의 평균 근속연수의 시계열상 추이를 살펴봄으로써 공식 제약의 변화 이전과 이후에 기회주의적 계약파기의 변화를 실증적으로 살펴본다.

• Archives of Plastic Surgery
• /
• 제34권3호
• /
• pp.319-324
• /
• 2007

Purpose: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. Methods: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. Results: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. Conclusion: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.

• Journal of Trauma and Injury
• /
• 제26권3호
• /
• pp.207-213
• /
• 2013

Purpose: Traumatic pancreas injuries are rare conditions that result in high morbidity and mortality. Thus, early diagnosis and intervention are very important to manage pancreatic injuries. The purpose of this study is to review the management and outcomes of the pancreatic injuries in the Korean population. Methods: Original articles published from January 2001 to December 2012 and addressing the Korean population were selected by using indices such as 'pancreas injury', 'traumatic pancreas injury', and 'pancreatic trauma' to search KoreaMed and PubMed. Nine reports were selected to review the management options for surgery or endoscopic retrograde cholangio-pancreatography. We assessed the injury mechanisms, injury severities, associated injuries, types of operation, and outcomes. Results: Two hundred fifty of the 332 patients included in the 9 selected reports were men, and the mean age of all patients was 36.4 years. The main injury mechanism was traffic accidents(65.6%). Most patients had grade II or III injuries(68.9%). The most common extra-pancreatic injury site was the liver, followed by the chest and spleen. Operative management, including distal pancreatectomies(129), drainage procedures(64), pancreaticoduodenectomies(23), and others(60), was used for 276 patients. The reported mortality rate was 10.2%, and the morbidity rate ranged from 38% to 76.9%. The average length of hospital stay was 39.5 days. Risk factors for mortality were amount of transfusion, injury severity, base deficit, age, and presence of shock. Conclusion: In this study, we found neither significant data nor a consensus. If national guidelines are to be developed and established, a national data bank or registry, and nationwide data collection are required.

• 한국유기농업학회:학술대회논문집
• /
• 한국유기농학회 2009년도 하반기 학술대회
• /
• pp.284-284
• /
• 2009

EFA production systems have through necessity resulted in the development of innovative practices for weed, pest and diseases control, for example, using ducks and snails for weed control in paddy fields. These practices began to be introduced in the early 1990's and the techniques have become more popular and have been adapted to suit regional conditions. In this study, the production practices, productivity and economic performances of organic and non-chemical rice farming adopting ducks and snails for weed control were compared. In the production practices, Korean organic and non-chemical farming seem to have several concerns in terms of sustainability. It comprises lack of resistant variety use and rotational cropping system as well as high dependency upon external inputs such as organic fertilizer and farming materials for pest control. The production level of organic farming is approximately similar level but 20% higher income than non-chemical farming, while, when it was compared with conventional farming organic farming showed 20% lower productivity but 20% higher income. Organic farming shows 15% to 18% higher profits than non-chemical farming as the snail-using organic farming tends to have higher income and lower input costs than duck-using organic farming. This may encourage more farmers to convert to organic production using these techniques than simply non-chemical farming in the future. This organic conversion could be more promoted by policy intervention. However, it may result in increased supply and therefore decreased prices for organic rice in the long term unless further market demand occurs. Balanced policy measures considering production as well as marketing and consumption are urgently required for the sustainable development of organic farming.

• 한국통신학회논문지
• /
• 제27권11C호
• /
• pp.1178-1188
• /
• 2002

LLU는 신규사업자의 시내서비스 진입장벽을 낮춤으로써 음성서비스 및 광대역서비스 제공에 경쟁을 촉진할 수 있으며, 시내망 부문의 사업자간 중복투자를 방지한다는 긍정적인 측면이 있다. 그렇지만, LLU의 도입은 시내망 부문의 설비기반 경쟁을 감소시키고, 새로운 정책의 도입에 따른 직접비용과 규제비용을 발생시킨다는 점에서 부정적인 측면도 함께 공존하고 있다. 따라서 전반적인 LLU의 경제적 효과는 해당국가의 특수한 상황 및 LLU의 목적에 따라 다르게 나타날 것이다. 본 연구에 의하면 EU의 경우 대다수 회원국이 LLU를 도입하여 이미 시행하고 있으나 현재 LLU의 도입 초기에 예상했던 경제적 효과들은 기대하기 어려운 상황이다. LLU의 원활한 시행이 이루어지기 위해서는 규제문제, 합리적인 LLU 제공대가의 수준, 기술적·운영적 문제 등 LLU의 시행과정에서 발생되는 주요 이슈에 대한 신중한 검토가 요구된다.

• Journal of Chest Surgery
• /
• 제25권12호
• /
• pp.1404-1415
• /
• 1992

To understand the factors influencing Atrial fibrillation and embolism in mitral valve surgery and prevent their risk, we have reviewed our 324 patients who underwent mitral valve surgery from Fev. 1982 to May 1992. Age, disease duration, lesion type, left ventricular function and left atrial dimension were chosen as preoperative factors influencing the incidence of atrial fibrillation and embolism and their postoperative course, The number and type of replaced valve, site of atriotmy, LA obliteration, ACT and use of Defibrillator were chaser. as operative factors influencing postoperative rhythm change and postop emb-olization. The results of analyses were as follows 1. The incidence of preoperative atrial fibrillation, systemic embolism and LA throbmus was 63. 6%, 10.56% and 19.8% relatively. 2. The preoperative factors of atrial fibrillation onset was old age, prolonged symptom duration, stenotic lesion, lager LAD and lower ejection fraction. In the preoperative systemic embolism preoperative factors were old age, female, stenotic lesion. The left atrial thrombus found more commonly in patients with atrial fibrillation, old age, prolonged symptom duration, stenotic lesion and low ejection fraction. 3. The preoperative atrial fibriation persisted postoperatively in 165[50.9%] and converted to normal sinus rhythm in 50[15.4%]. The preoperative normal sinus rhythm per-eisted in 100[31%] and atrial fibrillation was occured postoperatively in 9[2.7%]. The prolonged symptom duration was the preoperative factor of persist atrial fibrillation. 4. Among 95 long term follow-up patients, atiral fibrillation was continued in 59[60%]. Conversion to normal sinus rhythm was more common significantly in left atriotomy and bileaflet valve replacement. 5. There were 12 patients who had postoperative embolism. Female, persist atrial fibrillation, no LA olbiteration and tilting disc monocusp valve were considered as possible factors influencing postoperative embolism but was impossible to analyse their statistical significance due to small sample size. So we have concluded that the patients with above risk factors need anticoagulant and early surgical intervention. Left atriotomy with minimal atrial injury, left auricular obliteration and bileaflet valve replacement may be needed to reduce postoperative atrial fibrillation persist and embolism.