Non-functional Pituitary Adenoma Detected on 18F-fluorodeoxyglucose Positron Emission Tomography (18F-FDG-PET) in a Patient with Mucosa-associated Lymphoid Tissue Lymphoma

Magnetic resonance imaging (MRI) is the modality of choice for the detection and characterization of a pituitary adenoma. Uptake of 18F-fluorodeoxyglucose (FDG) by intrasellar tumors, including pituitary adenomas, has been reported in several previous studies. We report a case where a pituitary adenoma was detected on FDG-positron emission tomography(PET), but the tumor was not detected with the use of sellar MRI. A 31-year-old woman was referred to the clinic due to a focal increase of FDG uptake at the pituitary fossa seen on whole body FDG-PET. The patient was receiving chemotherapy due to a recurred B-cell lymphoma of the mucosa-associated lymphoid tissue type. Subsequently, sellar MRI was performed, and images showed a small non-enhancing heterogenous cystic lesion in the midline of the pituitary gland, radiologically suggestive of a Rathke`s cleft cyst. However, sellar MRI failed to identify a lesion consistent with a pituitary tumor that corresponded to the site of increased FDG uptake detected by the use of PET, despite the inclusion of a dynamic contrast enhanced sequence. Despite the negative findings of the MRI examination, basal and stimulated levels of the GnRH free α-subunit were profoundly increased. Therefore, we suspected the presence of a non-functional pituitary tumor in addition to a Rathke`s cleft cyst, rather than pituitary involvement of a lymphoma, based on the hormone levels and PET scan findings.ope

Clinical Meaning of Postprandial Insulin Secretory Function in Korean Type 2 Diabetes Mellitus

Background: Impaired pancreatic beta-cell responsiveness is associated with type 2 diabetes mellitus. Postprandial insulin deficiency is closely related with fasting plasma glucose, HbA1c and insulin responses to meals, but most studies examining postprandial beta-cell responsiveness have been limited by the small number of type 2 diabetic patients examined. The aim of this study was to evaluate fasting and postprandial insulin secretions in relation to the duration of diabetes, BMI and glycemic control in a large number of patients with variable disease durations. Methods: We evaluated the fasting plasma glucose, insulin, C-peptide, HbA1c, BMI, postprandial 2 hour glucose, insulin and C-peptide in 1,170(male 662, female 508, age 54.6+/-1.6 years, duration of diabetes 5.2+/-6.3 years, BMI 25.4+/-3.3kg/m(2)) type 2 diabetic patients. The delta C-peptide, delta insulin, fasting(M0) and postprandial(M1) pancreatic beta-cell responsiveness were also calculated. The subjects were divided into three groups according to their duration of diabetes, BMI, and fasting and postprandial C-peptide levels. After adjusting for age, sex and BMI, the correlation of diabetes and HbA1c were correlated parameters. Results: In the group of patients whose duration of diabetes was longer than 10 years, the BMI, fasting, postprandial and delta C-peptide, and M0 and M1 were significantly lower, but age, fasting and postprandial glucose, as well as HbA1c were significantly higher than those in the other groups. There were no significant differences in the fasting and postprandial glucose and HbA1c according to their fasting C-peptide tertiles. However, in the group of patients with the highest postprandial C-peptide tertile, the fasting and postprandial glucose and HbA1c were significantly lower than those in the other groups. The duration of diabetes, after adjustment of age, sex and BMI, was negatively correlated with the fasting, postprandial and delta C-peptide, M0 and M1, but was positively correlated with the fasting and postprandial 2 hour glucose and HbA1c. The HbA1c after adjustment of age, sex and BMI, was positively correlated with duration of diabetes, and fasting and postprandial glucose, but was negatively correlated with fasting postprandial and delta C-peptide, M0 and M1. Conclusion: Although the fasting and postprandial insulin secretions were decreased with duration of diabetes, the decrease in the postprandial insulin secretion was more prominent. The postprandial pancreatic responsiveness may be a more important factor in predicting glycemic control in Korean type 2 diabetic patients than the fasting pancreatic responsiveness.ope

Balsamic Vinegar Improves High Fat-Induced Beta Cell Dysfunction via Beta Cell ABCA1

BACKGROUND: The aim of this study was to investigate the effects of balsamic vinegar on β-cell dysfunction. METHODS: In this study, 28-week-old Otsuka Long-Evans Tokushima Fatty (OLETF) rats were fed a normal chow diet or a high-fat diet (HFD) and were provided with tap water or dilute balsamic vinegar for 4 weeks. Oral glucose tolerance tests and histopathological analyses were performed thereafter. RESULTS: In rats fed both the both chow diet and the HFD, the rats given balsamic vinegar showed increased insulin staining in islets compared with tap water administered rats. Balsamic vinegar administration also increased β-cell ATP-binding cassette transporter subfamily A member 1 (ABCA1) expression in islets and decreased cholesterol levels. CONCLUSION: These findings provide the first evidence for an anti-diabetic effect of balsamic vinegar through improvement of β-cell function via increasing β-cell ABCA1 expression.ope

A Case of Multiple Endocrine Neoplasia Type 1 with Mutation of MENIN Gene

Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominantly inherited syndrome, characterized by the combined occurrence of tumors of the parathyroid glands, endocrine pancreas, and anterior pituitary gland. The MENIN gene, which is a kind of tumor suppressor gene, is located at the chromosomal locus 11q13. It consists of one untranslated exon and nine exons encoding the menin protein. We report a case of a 22-yearss-old woman with MEN type 1, who was proven to have a mutation in the MENIN gene. The patient was admitted because of repeated hypoglycemia. The fasting plasma glucose level was 32 mg/dL. Seventy two hours fasting test showed an the insulin/glucose ratio as 0.33. Endoscopic ultrasonography detected multiple masses on the pancreas. The arterial-stimulated venous sampling (ASVS) with calcium showed sudden step up of insulin at the head and tail portions of the pancreas. The sellar MRI showed a pituitary mass that produced prolactin. Instead of a pathologic diagnosis from operational specimen, the genetic analysis revealed a mutation in the MENIN 1 gene (exon 2, 200~201insAGCCC).ope

Adiponectin Gene Polymorphism and Carotid Artery Intima-Media thickness in Type 2 Diabetes

Background: The aim of this study was to examine the association between the common polymorphisms of the adiponectin gene(ACDC) and the intima-media thickness(IMT) of the common carotid arteries in type 2 diabetic patients. Methods: The B mode ultrasound examination of carotid artery was performed on 133 type 2 diabetic patients. The carotid IMT was calculated using the Intimascope computer program. The SNP45 and SNP276 of the ACDC were examined. Results: There was no significant difference in the carotid IMT among the SNP45 genotypes(0.66+/-0.18mm for TT, 0.71+/-0.12mm for TG and 0.64+/-0.15mm for GG, P=NS). Subjects carrying the SNP276 GG genotype had a markedly lower serum adiponectin concentration than those carrying the TT genotype(3.35+/-2.00microgram/mL vs. 4.98+/-2.24microgram/mL, P=0.029) The carotid IMT was significantly higher in patients with the SNP276 GG genotype than those with the TT genotype (0.70+/-0.17mm vs. 0.59+/-0.13mm, P=0.032). Patients with the +45GG/+276GG genotype combination showed significantly higher mean carotid IMT than the other genotype combinations(0.78+/-0.09mm vs. 0.71+/-0.15mm, P=0.013) Conclusions: These results suggest that the adiponectin gene, SNP276 is associated with the carotid IMT in type 2 diabetic patients. Further studies are will be needed to confirm these genotypephenotype associations.ope

A Comparative Study on the Establishment and Execution of the Informalization Policy in Korea

☞ 이 논문은 저자가 원문공개에 동의하지 않은 논문으로, 도서관 내에서만 열람이 가능하며, 인쇄 및 저장은 불가합니다.오늘날 세계는 정보와 지식이 개인, 사회는 물론이고 국가의 미래를 죄우하는 핵심요소로 등장하였으며 세계 각국은 정보와 지식의 활용을 최대한 촉진하기 위하여 정치, 경제, 사회, 문화의 전 영역에 걸쳐 근본적인 구조변화를 추진해 오고 있다. 그리고 이러한 산업사회로부터 정보사회로의 패러다임의 변화가 국가의 주된 정책을 산업정책에서 정보화정책으로 바뀌게 만들었다. 즉 정보화정책은 이제 모든 정책에 영향을 미치는 국가의 전반적인 기반정책이고 종합정책이다. 여기에서 정보화정책은 국가경제를 유지·발전시키면서 경제성장과 신규고용을 창출해 내는 산업경제적 측면과 경제성장과정에서 파생된 사회문제를 해결하는 유용한 정책수단으로, 더 나아가 국민의 삶의 질을 향상시키기 위한 국가적 노력의 일환으로 국가의 정보화를 위해 추진되는 종합정책이다. 이에 우리나라는 1996년 국가정보화종합계획으로서 '정보화촉진기본계획'을 수립하게 되었다. 이 계획은 21세기 세계일류국가로 도약하기 위한 최고의 국가전략으로 정보화를 설정한 것으로, 고도정보사회를 실현하기 위한 단계별 목표와 중단기적 추진과제들을 담고 있다. 따라서 본 연구에서는 우리나라의 정보화정책을 핵심적으로 보여주고 있는 3차례에 걸친 정보화촉진기본계획에 구체적인 내용을 파악하여 우리나라의 정보화정책의 방향이 어떻게 변화되고 있는지를 살펴보고 이를 몇몇 요소들로 비교분석하고자 하였다. 분석의 결과를 요약하면 다음과 같다. 우선 수립배경을 측면을 분석해 보면 각각의 기본계획은 선진국으로의 도약과 지식정보사회의 진입을 위한 노력에서 공통된 배경을 찾아볼 수 있다. 그러나 1차의 경우는 분야별로 사업을 추진하기 때문에 특히 지역정보화를 따로 언급하고 있지만 2,3차의 경우는 단계별 사업을 추진하기 때문에 지역화를 특별히 언급하지는 않고 있다. 그 다음으로는 목표를 살펴보면 각 기본계획은 단계별로 정보이용 활성화단게, 정보활용 확산단계, 정보활용 극대화 등으로 각기 다른 목표를 가지고 있으며, 정부의 추진방향, 정보인프라의 구축수준, 국제적 위치에 대한 목표에 있어서도 그 단계에서 추구하는 목표는 조금씩 달라진다. 이러한 목표는 그 전 단계 기본계획의 추진실적과도 상당한 관계가 있어 실적에 따라서도 달라질 수 있을 것으로 본다. 세 번째는 기본계획의 특징분석이다. 우리는 여기에서의 가장 중요한 것은 주도대상의 주체이다. 앞에서도 언급했듯이 우리나라의 경우 다른 선진국과 달리 1차 기본계획 단계에서는 정보화기반 조성을 위해 정부주도의 계획을 추진하였다. 그러나 이후 2,3차 계획에서는 정보화의 기반이 조성되어 어느 정도 수준의 민간 참여를 이끌어낼 수 있었으며 점차적으로 확대되고 있는 실정이다. 또한 사업형태에 있어서의 특징은 1차의 경우는 분야별로 그 목표를 정해 세부사업을 추진하였으나 2,3차에서는 그 성격을 단게별 사업으로 바꿔서 추진하고 있다. 네 번째로 중점과제를 보면 1차 기본계획은 기반조성을 기본으로 해서 전자정부 구현, 기업의 경쟁력 강화, 정보통신산업 육성 등을 주요 과제로 선정하여 추진하였으며 2차 기본계획은 1차의 기반 조성을 바탕으로 인터네 보급, 전국민의 정보화교육, 행정정보화, 지식기반산업 활성화 등을 추진하였다. 그리고 현재 추진중인 3차 기본계획은 국민의 정보활용을 극대화시키고 산업정보화와 민원서비스의 개선, IT 전문인력 양성 등을 주요 내용으로 한다. 마지막으로 기본계획의 추진실적은 몇 개의 항목들로 비교 분석하였다. 각 기본게획에서 계속적으로 추진하고 있는 사업을 중심으로 변별력이 있는 요소들을 선정하였으며 정부의 전자결재율, 공공전달 비율, 인터넷 뱅킹 이용자수, 정보통신산업 수출액, 초고속 인터넷 이용가수, 인터넷 이용자, 이동전화 가입자 등이 그것이다. 그러나 3차 기본계획의 경우 현재 추진중인 사업이므로 추진실적 부분에서는 제외되었다. 본 연구에서는 지금까지의 3차례에 걸친 정보화촉진기본계획의 내용을 비교분석해 보았다는 것에서 그 의의를 찾을 수 있으며, 이후 3차 정보화촉진기본계획이 추진이 완료 될 때에는 더 다양하고 정확한 자료로 심도깊은 많은 연구가 이루어지리라 기대한다.제 1 장 서론 1 제 1 절 연구목적 1 제 2 절 연구범위와 연구방법 2 1. 연구범위 2 2. 연구방법 3 제 2 장 정보화정책에 대한 이론적 배경 4 제 1 절 정보화정책의 의의 4 1. 정보화정책의 개념 4 2. 정보화정책의 분류 6 제 2 절 연구의 분석틀 9 제 3 장 우리나라 및 각국의 정보화정책 11 제 1 절 각국의 정보화정책 개관 11 1. 미국의 정보화정책 11 2. 캐나다의 정보화 정책 15 3. EU의 정보화 정책 20 4. 일본의 정보화정책 23 5. 싱가포르의 정보화정책 25 제 2 절 우리나라의 정보화정책 현황 28 제 3 절 정보화촉진기본계획의 수립 31 1. 정보화촉진기본법의 제정 31 2. 수립배경과 의의 35 3. 목표와 추진전략 36 4. 기본원칙 38 제 4 장 정보화촉진기본계획의 비교 분석 40 제 1 절 제 1 차 정보화촉진기본계획 40 1. 수립배경 40 2. 목표 41 3. 특징 41 4. 중점과제 42 5. 추진실적 55 제 2 절 제 2 차 정보화촉진기본계획 (CYBER KOREA 21) 60 1. 수립배경 61 2. 목표 61 3. 특징 63 4. 중점과제 63 5. 추진 실적 73 제 3 절 제 3 차 정보화촉진기본계획 76 1. 수립배경 76 2. 목표 77 3. 특징 77 4. 중점과제 78 제 4 절 정보화촉진기본계획의 비교분석 83 1. 수립배경 분석 83 2. 목표 분석 83 3. 특징 분석 84 4. 중점과제 분석 85 5. 추진실적 분석 86 제 5 장 결론 88 제 1 절 연구결과의 요약 88 제 2 절 연구의 한계 90 참고문헌 91 Abstract 9

A Study of Johannes Brahms’ “Cello Sonata No. 1 in e minor, Opus 38”

본 논문의 목적은 브람스(Johannes Brahms, 1833-1898)의 생애와 배경을 통해 Cello Sonata No. 1, Op. 38 작곡 당시의 브람스의 작품 배경에 대하여 연구하고 곡을 분석하여 악곡의 구조적인 면과 전개방식을 통해 곡의 흐름을 이해하고 이를 통해 연주의 다채로운 해석과 표현의 실질적인 도움을 얻고자 한다. 브람스는 19세기 낭만시대를 대표하는 작곡가인 동시에 고전주의 경향이 큰 작곡가이다. 그는 낭만주의시대에 나타났던 급격한 감정주의나 그 당시 유행했던 표제음악, 교향시의 형식에 따르지 않고 주로 교향곡이나 실내악곡을 작곡하였다. 브람스는 고전적 구조와 함께 서정성을 입혀 하나의 음악으로 융합시키려고 노력했다. 이렇듯 브람스는 고전주의를 지키고자 하는 고집으로 낭만시대 안에서 자신만의 독창적인 음악을 하나의 장르로 만들어 냈다. Cello Sonata No.1 Op.38은 1865년에 작곡되었으며 브람스의 신고전주의적 경향이 뚜렷하게 보이는 작품이다. 고전적 형식을 중요시 하면서 그 틀 안에서 다양한 전조, 반음계적 선법, 그리고 넓은 도약으로 서정적인 낭만주의적 음악을 결합하여 표현한 작품이다. 이 곡은 3개의 악장으로 이루어져 있으며 제 1악장은 Sonata형식으로 조성적, 구조적면에서는 이전시대 보다 발전된 모습을 보이며 고전시대의 Sonata 양식을 유지한다. 제 2악장은 Menuetto-Trio 형식으로 복합 3부분형식으로 작곡되어 있으며 Da capo를 사용해 곡의 통일감을 형성해 준다. 3악장은 대선율로 사용되는 한 주제를 가지고 전위하거나 역행시키는 등 형태를 변화시킴으로서 Fugue의 기법을 사용하였다. ;The purpose of this essay is to study the context of Cello Sonata No. 1, Op. 38 based on Johannes Brahms’s life and background. By analyzing the structure of this piece, we could understand its flow and the various interpretations of the performance, which could prove to be helpful. J.Brahms was, with his deep roots in Classicism, a leading composer during the Romantic era of the 19th century. He composed symphony and chamber pieces despite the trends for excessive romanticism, program music or symphonic poems that were popular back then. He tried to blend the classical structure and lyricism. This way, J.Brahms maintained classicism and developed his unique style into a known musical genre in the Romantic era. Cello Sonata No.1 Op.38 was composed in 1865 by J.Brahms, and his neoclassical trend is obvious in the piece. While he placed emphasis on the classical format, he also applied the lyrical romanticism using modulation, semi-negative line method, and wide leaps. The piece is composed of three movements. The first movement in a sonata form shows huge structural development compared to that of the previous era, all the while keeping its classical sonata form. The second movement in the Menuetto-Trio form is composed in composite three-part format and demonstrates the unity of music using Da Capo. The third movement uses Fugue technique, exhibiting the diversity via avant-garde or retrogression of a topic in the counter line.Ⅰ. 서론 1 Ⅱ. J. Brahms의 생애와 음악적 특징 2 A. J. Brahms의 생애 2 B. J. Brahms의 음악적 특징 5 Ⅲ. J. Brahms Cello Sonata No.1 Op. 38 분석 8 A. 1악장 9 B. 2악장 29 C. 3악장 38 Ⅳ. 결론 52 참고문헌 54 Abstract 5

Effect of pH cycling and fluoride varnish on root surfaces

학위논문(석사) --서울대학교 대학원 :치의학과(치과보존학 전공),2010.2.Maste

한국 청소년 차별경험이 건강에 미치는 영향

학위논문 (석사)-- 서울대학교 대학원 : 보건학과(보건정책관리학전공), 2011.8. 조병희.Maste

Effects of on&offline education program aimed at promoting father-infant interaction

학위논문 (박사) -- 서울대학교 대학원 : 간호대학 간호학과, 2021. 2. 방경숙.본 연구의 목적은 부아 상호작용 증진을 위한 영아 아버지를 위한 온 오프라인 교육 프로그램을 개발하고 그 효과를 검증하는 것이다. 블렌디 드 러닝 모형에 따라 프로그램을 개발하였다. 본 프로그램은 가정방문, 구두 및 서면 피드백, 온라인 강의, 가정방문, 구두 및 서면 피드백 단계 에 따라 매주 1회씩 5주간 총 5회기의 내용으로 구성되었다. 본 연구의 이론적 기틀은 Kathryn Barnard (1978)의 ‘아동건강가정 상호작용 이론’에서 돌봄제공자, 환경, 아동이 교차하는 상호작용 영역에 초점을 두고 있으며, 환경적 측면에서 교육 프로그램을 통해 사회적 자 원을 제공함으로써 돌봄제공자와 아동 영역에 사회적 지지를 제공하고, 결과지표로써 영아발달의 지식 증가와 부아상호작용, 부아애착의 증진을 확인하고자 했다. 개발된 프로그램의 효과를 평가하기 위해 비동등성 대조군 전후 설계 에 의한 유사실험연구를 수행하였다. 연구 대상자는 서울시 자치구 세 곳에 거주하면서 서울아기 건강 첫걸음 사업 보편방문에 참여했던 가정 의 영아기 자녀(생후 2～6개월)를 둔 아버지들 중에서 편의모집방법에 의해 선정된 실험군 18명과 대조군 18명이었고, 사후조사까지 완료한 최 종 연구참여자는 실험군 15명, 대조군 17명이었다. 실험군에게는 본 연구 에서 개발된 5주간의 부아 상호작용 증진 교육 온오프라인 교육 프로그 램을 적용하였다. 수집된 자료는 사전 동질성 확인 후 일반화 추정 방정 식 분석을 통해 가설을 검증하였고, 실험군을 대상으로 취합한 만족도 조사결과는 내용분석을 통해 정리하였다. 부아 상호작용 증진 온오프라인 교육 프로그램에 참여했던 실험군의 아버지와 대조군의 아버지의 프로그램 실시 전후 부아 상호작용 점수 변화량, 특히 돌봄제공자 측면의 점수변화량에는 유의미한 차이가 있었다 (p=.072). 그러나 영아발달지식, 부아애착은 그룹과 시간에 따른 변화량 이 통계적으로 유의하지 않았다. 본 프로그램을 통해 영아 아버지를 대상으로 한 부아 상호작용 증진 온오프라인 교육 프로그램이 아버지의 영아 신호에 대한 민감성을 높이고 인지발달을 촉진하는 환경을 조성할 수 있는 능력을 함양시킨다 는 점을 확인하였다. 본 연구를 통해 가정 내 돌봄제공자를 위한 돌봄의 질을 향상시키기 위한 교육의 일환으로 정확한 영아발달지식을 바탕으로 부아 상호작용을 개선해 나갈 수 있는 방안을 제시하였다. 온라인 교육 과 오프라인 교육을 안배하여 교육의 효과를 높이는 동시에 일과 양육을 병행하는 아버지들의 프로그램 참여를 독려하기 위하여 개별적인 스케쥴 을 허용하고, 개별적인 상담과 피드백이 이루어질 수 있도록 온라인 커 뮤니티와 전화상담을 활용하였다는 점에서 의의가 있다. 본 프로그램은 아버지뿐만 아니라 어머니, 조부모, 아이돌보미를 포함한 타인돌봄제공 자, 정상아, 질환 아동 등 각기 다른 상황의 대상에게 적용가능하다는 점 에서 폭넓게 활용이 가능할 것으로 보인다. 추후 아버지들의 직접 참여 의 기회를 확충하고, 토론 등을 통해 비슷한 처지의 아버지들 간 경험을 공유하는 프로그램의 보완 및 후속연구가 필요함을 제언하는 바이다.The purpose of this study was to develop an on·off-line education program for fathers of infants to enhance parental interaction and to verify the program's effectiveness. The program was composed of five sessions. The sessions were comprised of home visit, oral and written feedback, online lectures, home visit, and final oral and written feedback and all of them were done in the mentioned order. The theoretical framework of this study was focused on the interaction domain where the care provider, environment, and children interacted within Kathryn Barnard(1978)'s Child Health Family Interaction theory. Especially, from an environmental perspective, this research attempted to confrim the educational program provided social support for fathers of infants by figuring out whether the program increased the knowledge of infant development, father-infant interactions and attachment as outcome indicators. In order to evaluate the effect of the developed program, a quasi-experimental study was conducted by using a nonequivalent control group pre-post test design. The subjects of this study consisted of experimental groups and control groups where each group was composed of 18 people. They were selected by the convenience sampling method and they were fathers with infant children (2-6 months of age) residing in three autonomous districts of Seoul who participated in the universal visit as part of the Seoul Healthy First Step Project. The number of the final study participants who completed the follow-up investigation composed of 15 people in the experimental group and 17 people in the control group. To the experimental group the on·off-line father-infant interaction enhancement education program was applied. The collected data were hypothesized through the analysis of the generalized estimating equation(GEE) after confirmation of preliminary homogineity, and the results of the satisfaction surveys collected from the experimental group were organized through content analysis. There was a significant difference in the change of father-infant interaction scores of the experimental group, especially in the caregiver aspect (p=.075). However, the changes between the groups and times were not statistically significant when it came to infant development knowledge and infant-father attachment. Through this program, it was confirmed that father-infant interaction promoting education that targeted fathers of infants enhances the father's sensitivity to infant signals and fosters the ability to create an environment that promotes infants’ cognitive development. This study proposed possible strategies improving father-infant interactions by making sure that they have accurate knowledge regarding infant development so that the quality of care of the caregivers at home can be improved. This program is meaningful in that it did not only try to increase the effectiveness of education by using both on and off-line education, but also it tried to encourage working fathers to participate by taking into account of their schedules through individual counseling and feedback gathering by using the means of online community and phone counseling. This program can be applied to various caregivers and infants in diverse situations including mothers, grandparents, babysitters, and children with diseases. It is suggested that future opportunities for improving the program by expanding the fathers’ direct participations and by encouraging knowledge-sharing among fathers who are in similar circumstances although follow-up studies are needed in this regard.Ⅰ. 서 론 ··················································································1 1. 연구의 필요성 ················································································1 2. 연구의 목적 ····················································································3 3. 용어의 정의 ····················································································4 Ⅱ. 문헌고찰 ············································································6 1. 아버지의 영아돌봄 ········································································6 2. 아버지 역할 중재프로그램 ··························································13 3. 부아 상호작용과 애착 ··································································18 Ⅲ. 이론적 배경 ·····································································21 1. 연구의 이론적 기틀 ··································································21 2. 연구가설 ······················································································23 Ⅳ. 연구방법 ···········································································24 1. 연구설계 ······················································································24 2. 연구대상 ······················································································26 3. 연구도구 ······················································································27 4. 프로그램 개발 ············································································30 5. 자료수집 및 절차 ······································································39 6. 자료분석방법 ··············································································42 7. 연구자의 준비 ············································································43 8. 연구의 윤리적 고려 ····························································44 V. 연구결과 ···········································································45 1. 프로그램 운영 ············································································45 2. 프로그램의 효과평가 ································································50 VI. 논의 ··················································································63 1. 프로그램의 적용 ········································································63 2. 프로그램의 효과 ·········································································66 3. 연구의 제한점 ············································································71 4. 간호학적 의의 ············································································73 참고문헌 ·················································································74 부록 ·························································································93 Abstract ················································································127Docto