• Journal of Chest Surgery
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• 제41권1호
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• pp.1-11
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• 2008

배경: Damus-Kaye-Stansel (DKS) 술식은 체심실유출로 협착과 폐동맥고혈압을 완화하기 위하여 근위주폐동맥을 대동맥에 문합시키는 고식적수술이다. 본 연구는 DKS 술식의 적응증, 결과 및 결과에 영향을 주는 요인, 그리고 반월판막 기능과 DKS 경로의 장기 결과들을 알아보고자 하였다. 대상 및 방법: 1994년 5월에서 2006년 4월 사이에 본원에서 DKS 술식을 시행받은 28명의 임상기록을 토대로 후향적으로 분석하였다. 수술시 연령은 중앙값 5.3개월($13일{\sim}38.1$개월), 체중은 중앙값 5.0 kg ($2.9{\sim}13.5\;kg$)이었고, 술전 체심실 유출로 압력차는 $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$)였다. 18명은 초기고식적 수술로 폐동맥교약술을 시행하였으며, 술전 진단은 양대혈관 우심실 기시증이 9명, 심실-대혈관연결 불일치가 있는 양방실판막 좌심실유입이 6명, 그 외 기능성 단심실이 5명, Criss-cross 심장이 4명, 완전 방실중격 결손증이 3명, 그리고 좌심 저형성증후군의 이형이 1명이었다. 수술방법은 팻취를 이용한 측단문합이 14명, 고전적 측단문합이 6명, Lamberti 방법이 3명, 그 외가 5명이었으며, 양방향성 상대정맥 폐동맥 단락술을 6명에서, 폰탄수술을 2명에서 같이 시행하였다. 결과: 병원내 사망은 4명(14.3%)이었고, 평균 $62.7{\pm}38.9$개월 ($3.3{\sim}128.1$개월)의 추적관찰기간 동안 만기사망은 3명(12.5%)이었으며, 10년 누적 생존율은 $71.9{\pm}9.3%$였다. 다변량 분석에서 우심실형 단심실(위험도=13.960, p=0.006)과 일차 DKS 술식의 시행(위험도=6.767, p=0.042)이 사망의 유의한 인자였다. DKS 술식 후 4명은 단계적 양심실성 교정을, 그리고 13명은 폰탄수술까지 시행하였으며, 체심실 유출로 협착은 1명 이외에는 발생하지 않았다. 중등도 이상의 반월판막역류나, 반월판막에 대한 재수술은 없었으나, DKS경로에 의한 폐동맥협착으로 인한 재수술이 고전적 측단문합을 시행했던 1례(3.6%)에서 필요하였다. DKS경로나 반월판막에 대한 재수술의 자유도는 10년에 87.5%였다. 결론: DKS 술식은 체심실 유출로 협착을 동반한 환자군에서 유용한 방법이며, 출생직후 양심실교정이 어려웠던 일부 환자군에서 단계적 양심실 교정을 안전하게 시행할 수 있었다. 체심실유출로 협착이 심하지 않은 경우에 DKS 술식전에 폐동맥 교약술을 시행하여 폐혈관 저항을 감소시킨 후 DKS 술식의 성공률을 향상시킬 수 있었다. DKS 술식후 반월판막기능, DKS 경로와 체심실유출로협착의 완화에 대한 장기 결과는 만족할만하다.

• 한국유통학회지:유통연구
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• 제16권1호
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• pp.141-177
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• 2011

기존의 확산관련 연구들은 대부분이 구전 커뮤니케이션의 효용성에 치중하여 개인단위의 변수를 사용하는 경향이 많았다 (Iacobucci 1996; Midgley 외 1992). 반면 구전의 선행 변수로써 네트워크의 구조적 특성을 소비자의 집단문화적 성향에 기초하여 조사한 연구는 찾아보기 어렵다. 본 연구는 이같은 연구배경 하에서 네트워크의 구조적 특성과 소비자의 구전간의 관계를 연관시켜 비교문화적으로 접근하려고 하였다. 본 연구에서 추구하는 주요 목적은 한국과 중국 소비자를 대상으로 사회적 네트워크 형태에 따른 구전효과를 규명하려는 것이며, 네트워크와 구전 효과와의 관계에 영향을 미치는 조절변수로써 문화적 가치관의 역할을 검증하려고 하였다. 구체적인 연구목적은 다음과 같다. 첫째, 사회적 네트워크 관련 이론들을 바탕으로 한국과 중국 소비자들을 대상으로 네트워크의 구조적 특성들 (예: 유대강도, 중심성, 범위)이 구전의 효과 (구전 의향 및 구전 정보의 질)에 어떠한 영향을 미치는지를 규명한다. 둘째, 사회적 네트워크 특성이 구전효과에 미치는 영향에 있어서 문화적 가치 (불확실성 회피 성향, 개인주의성향)가 조절 역할을 하는지를 규명한다. 셋째, 사회적 네트워크 특성과 구전효과의 선행변수로써 소비자 개인의 혁신 성향의 역할을 규명한다. 분석 결과, 한국과 중국 소비자들은 공통적으로 네트워크 유대강도와 중심성은 구전의향에 유의한 영향을 보였으나 네트워크 범위는 두집단 모두 유의하게 나타나지 않았다. 반면, 한, 중 소비자 공통적으로 불확실성회피 성향은 네트워크범위와 상호작용을 함으로써 구전의향에 조절역할을 하는 것으로 나타났다. 마지막으로 소비자의 혁신성향은 한중 두 소비자 집단에서 공통적으로 네트워크 특성 (중심성)과 구전효과(구전정보의 질) 에 유의하게 긍정적 영향을 미치는 것으로 나타났다. 한중 양국의 네트워크 특성을 비교한 결과 한국이 중국보다 유대강도, 중심성, 범위에서 모두 유의하게 더 높은 점수를 보였으며, 불확실성회피 성향 또한 한국 소비자가 중국보다 유의하게 높은 것으로 나타났다.

• Journal of Biosystems Engineering
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• 제1권1호
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• pp.15-15
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• 1976

In analyzing the operational characteristics of a rice whitening machine, the internal radial pressure of the machine was measured using strain gage equipment. Changes in cylinder and feed screw configurations, screen type, cylinder speed and counter-pressure levels were examined to determine their impact on the quality and quantity of milled rice and the performance of the machine. The results are summarized as follows: 1. The internal radial pressure in the whitening chamber varied with the surface condition of the grain being processed. During the first or second pass through the machine, pressure was relatively low, reached a maximum after two to three passes with combinations I and II, three to six with combination III and then began to fall. 2. The pitch of the feed screw and the size of the feed gate opening which determine the rate of entry of grain into the whitening chamber, appeared to be the most important factor aff-::cting the degree of radial pressure, quality and quantity of milled rice and the efficiency of the machine. Using a feed screw with a wide pitch (4.8cm), radial pressure was relatively high and head rice recovery ratio \vere quite low. In this case capacity and machine effic?iency were much higher than obtained when using a feed screw with a narrow pitch (2.3cm). Very significant responses in radial pressure, head rice recovery rates and machine capacity were observed with changes in cylinder speed and counter-pressure levels when using the wide pitch feed screw. 3. The characteristics of the screen which surrounds the whitening chamber had an important effect on whitening efficiency. The existence of small protuberances on the original screen resulted in significant increases in both machine capacity and efficiency but without a significant decrease in head rice recovery or development of excessive radial pressure. Further work is required to determine the effects of screen surface conditions and the shape of the cylinderical steel roller on the rate of bran removal, machine efficiency and recovery rates. The size of the slotted perforations 0:1 the screen affects total milled rice recovery. The opening size on the original screen was fabricated to accommodate the round shape of Japonica rice varieties but was not suitable for the more slender Indica type. Milling Indica varieties with this screen resulted in a reduction in total milled rice recovery. 4. An increase in cylinder speed from 380 to 820 rpm produced a positive effect on head rice recovery for all machine combinations at every level of counter-pressure used in the tests. Head rice recovery was considerably lower at 380rpm using a wide screw pitch when compared to the results obtained at speeds from 600 to 820 r.p.m. The effects of cylinder speed On radial pressure, capacity and machine efficiency showed contrasting results, depending on the width of the feed screw pitch. With a narrow feed screw pitch (2.3cm), a direct proportional relationship was observed bet?ween cylinder speed and both radial pressure and machine efficiency. In contrast, using a 4.8 centimeter pitch feed roller produced a series of inverse relationships between the above variables. Based on the results of this study it is recommended when milling Indica type long grain rice varieties that the cylinder speed of the original machine be increased from 500-600 rmp up to a minimum of 800 rpm to obtain a greater abrasive effect between the grain and the screen. The pitch of the feed screw should be also reduced to decr?ease the level of internal radial pressure and to obtain higher machine efficiency and increased quality of milled rice with increased cylinder speeds. Further study on the interaction between cylinder speed and feed screw pitch is recommended. 5. An increase in the counter pressure level produced a negative effect On the head rice recovery with an increase in radial pressure, capacity, and machine efficiency over all combinations and at every level of cylinder speed. 6. Head rice recovery rates were conditioned primarily by the pressure inside the whitening chamber. According to the empirical cha racteristics curve developed in this study, the relationships of head rice recovery ($Y_h$) and machine capacity ($Y_c$/TEX>) to internal radial pressure ($X_p$) followed an inverse quadratic function and a linear function respectively: $$Y_h^\Delta=\frac{1}{{1.4383-0.2951X_p^\ast+0.1425X_p^{\ast\ast}}^2} , (R^2=0.98)$$$$Y_c^\Delta=-305.83+374.37X_p^{\ast\ast}, (R^2=0.88)$$The correlation between capacity and power consumption per unit of brown rice expressed in the following exponential function: $$Y_c^\Delta=1.63Y_c^{-0.7786^\{\ast\ast}, (R^2=0.94)$$These relationships indicate that when radial pressure increases above a certain range (1. 6 to 2.0 kg/$cm^2$ based On the results of the experiment) head ricerecovery decrea?ses in a quadratic relation with a inear increase in capacity but without any decrease in power consump tion per unit of brown rice. On the other hand, if radial pressure is below the range shown above, power consumption increases dramatically with a lin?ear decrease in capacity but without significant increases in head rice recovery. During the operation of a given whitening machine, the optimum radial pressure range or the correct capacity range should be selected by controlling the feed rate and/or counter-pressure keeping in mind the condition of the grain, particulary the hardness. It was observed that the total number of passes is related to radial pessure level, feed rate and counter-pressure level. The higher theradial pressure the fewer num?ber of pass required but with decreased head rice recovery. In particular, when using high feed rates, the total number of passes should be increased to more than three by reducing the counter-pressure level to avoid decreaseases in head rice recovery (less than 65 percent head rice recovery on the basis of brown rice) at every cylinder speed. 7. A rapid rise in grain temperature seemed to have a close relationship with the pressure generated inside the whitening chamber and, subsequently with head rice reco?very rates. The higher the rate of increase, the lower were the resulting head rice recoveries.

• Journal of Biosystems Engineering
• /
• 제1권1호
• /
• pp.17-48
• /
• 1976

In analyzing the operational characteristics of a rice whitening machine, the internal radial pressure of the machine was measured using strain gage equipment. Changes in cylinder and feed screw configurations, screen type, cylinder speed and counter-pressure levels were examined to determine their impact on the quality and quantity of milled rice and the performance of the machine. The results are summarized as follows: 1. The internal radial pressure in the whitening chamber varied with the surface condition of the grain being processed. During the first or second pass through the machine, pressure was relatively low, reached a maximum after two to three passes with combinations I and II, three to six with combination III and then began to fall. 2. The pitch of the feed screw and the size of the feed gate opening which determine the rate of entry of grain into the whitening chamber, appeared to be the most important factor aff-::cting the degree of radial pressure, quality and quantity of milled rice and the efficiency of the machine. Using a feed screw with a wide pitch (4.8cm), radial pressure was relatively high and head rice recovery ratio \vere quite low. In this case capacity and machine effic\ulcorneriency were much higher than obtained when using a feed screw with a narrow pitch (2.3cm). Very significant responses in radial pressure, head rice recovery rates and machine capacity were observed with changes in cylinder speed and counter-pressure levels when using the wide pitch feed screw. 3. The characteristics of the screen which surrounds the whitening chamber had an important effect on whitening efficiency. The existence of small protuberances on the original screen resulted in significant increases in both machine capacity and efficiency but without a significant decrease in head rice recovery or development of excessive radial pressure. Further work is required to determine the effects of screen surface conditions and the shape of the cylinderical steel roller on the rate of bran removal, machine efficiency and recovery rates. The size of the slotted perforations 0:1 the screen affects total milled rice recovery. The opening size on the original screen was fabricated to accommodate the round shape of Japonica rice varieties but was not suitable for the more slender Indica type. Milling Indica varieties with this screen resulted in a reduction in total milled rice recovery. 4. An increase in cylinder speed from 380 to 820 rpm produced a positive effect on head rice recovery for all machine combinations at every level of counter-pressure used in the tests. Head rice recovery was considerably lower at 380rpm using a wide screw pitch when compared to the results obtained at speeds from 600 to 820 r.p.m. The effects of cylinder speed On radial pressure, capacity and machine efficiency showed contrasting results, depending on the width of the feed screw pitch. With a narrow feed screw pitch (2.3cm), a direct proportional relationship was observed bet\ulcornerween cylinder speed and both radial pressure and machine efficiency. In contrast, using a 4.8 centimeter pitch feed roller produced a series of inverse relationships between the above variables. Based on the results of this study it is recommended when milling Indica type long grain rice varieties that the cylinder speed of the original machine be increased from 500-600 rmp up to a minimum of 800 rpm to obtain a greater abrasive effect between the grain and the screen. The pitch of the feed screw should be also reduced to decr\ulcornerease the level of internal radial pressure and to obtain higher machine efficiency and increased quality of milled rice with increased cylinder speeds. Further study on the interaction between cylinder speed and feed screw pitch is recommended. 5. An increase in the counter pressure level produced a negative effect On the head rice recovery with an increase in radial pressure, capacity, and machine efficiency over all combinations and at every level of cylinder speed. 6. Head rice recovery rates were conditioned primarily by the pressure inside the whitening chamber. According to the empirical cha racteristics curve developed in this study, the relationships of head rice recovery ($Y_h$) and machine capacity ($Y_c$/TEX>) to internal radial pressure ($X_p$) followed an inverse quadratic function and a linear function respectively: $$Y_h^\Delta=\frac{1}{{1.4383-0.2951X_p^\ast+0.1425X_p^{\ast\ast}}^2} , (R^2=0.98)$$ $$Y_c^\Delta=-305.83+374.37X_p^{\ast\ast}, (R^2=0.88)$$ The correlation between capacity and power consumption per unit of brown rice expressed in the following exponential function: $$Y_c^\Delta=1.63Y_c^{-0.7786^\{\ast\ast}, (R^2=0.94)$$ These relationships indicate that when radial pressure increases above a certain range (1. 6 to 2.0 kg/$cm^2$ based On the results of the experiment) head ricerecovery decrea\ulcornerses in a quadratic relation with a inear increase in capacity but without any decrease in power consump tion per unit of brown rice. On the other hand, if radial pressure is below the range shown above, power consumption increases dramatically with a lin\ulcornerear decrease in capacity but without significant increases in head rice recovery. During the operation of a given whitening machine, the optimum radial pressure range or the correct capacity range should be selected by controlling the feed rate and/or counter-pressure keeping in mind the condition of the grain, particulary the hardness. It was observed that the total number of passes is related to radial pessure level, feed rate and counter-pressure level. The higher theradial pressure the fewer num\ulcornerber of pass required but with decreased head rice recovery. In particular, when using high feed rates, the total number of passes should be increased to more than three by reducing the counter-pressure level to avoid decreaseases in head rice recovery (less than 65 percent head rice recovery on the basis of brown rice) at every cylinder speed. 7. A rapid rise in grain temperature seemed to have a close relationship with the pressure generated inside the whitening chamber and, subsequently with head rice reco\ulcornervery rates. The higher the rate of increase, the lower were the resulting head rice recoveries.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권5호
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• pp.417-422
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• 2010

Introduction: Bone density is one of the important factors for the long term success of endosseous implants. The bone density varies from site to site and from patient to patient. A preoperative evaluation of the bone density is quite useful to oral surgeons for planning dental implantation. More accurate information on the bone density will help surgeons identify suitable implant sites, thereby increase the success rate of dental implantation. This study examined the correlation between the bone density measured preoperatively by computed tomography (CT) and the implant primary stability measured by resonance frequency analysis. Furthermore, the effects of the implant sites, gender, age and generalized systemic disorder patients on the bone density and primary implant stability were examined. Materials and Methods: One hundred and fourteen patients were selected. None of the patients had undergone a tooth extraction or bone graft history in the previous year. Preoperatively, the patients underwent CT scanning to evaluate the Hounsfield unit (HU), and resonance frequency analysis (RFA) was used to evaluate the implant primary stability at the time of implant installation. All implants were 4.0 mm diameter and 11.5 mm length US II. All patients were recorded and the HU and implant stability quotient (ISQ) value were evaluated according to the sites, gender and age. Results: The highest HU values were found in the mandibular anterior site ($827.6{\pm}151.4$), followed by the mandibular molar site ($797{\pm}135.1$), mandibular premolar site ($753.8{\pm}171.2$), maxillary anterior site ($726.3{\pm}154.4$), maxillary premolar site ($656.7{\pm}173.8$) and maxillary molar site ($621.5{\pm}164.9$). The ISQ value was the highest in the mandibular premolar site ($81.5{\pm}2.4$) followed by the mandibular molar site ($80.0{\pm}5.7$), maxillary anterior site ($77.4{\pm}4.1$), mandibular anterior site ($76.4{\pm}11.9$), maxillary premolar site ($74.2{\pm}14.3$) and maxillary molar site ($73.7{\pm}7.4$). The mean HU and ISQ value were similar in females and males. (HU: P=0.331, ISQ: P=0.595) No significant difference was also found in the age group respectively. However, the correlation coefficients between the variables showed a closed correlation between the HU and ISQ value. Conclusion: These results showed close correlation between the bone density (HU) and primary stability value (ISQ) at the time of implant installation (Correlation coefficients=0.497, P<0.01). These results strengthen the hypothesis that it might be possible to predict and quantify the initial implant stability and bone density from a presurgical CT diagnosis.

• Childhood Kidney Diseases
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• 제8권2호
• /
• pp.176-185
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• 2004

목적: 급속 진행성 사구체신염은 병리조직학적으로 사구체가 광범위한 반월상을 형성하며 임상적으로는 수개월내에 급성 신부전에 빠지게 되는 신질환이다. 저자들은 이 질환의 임상 경과의 이해와 치료 방침의 결정에 도움을 주고자 소아급속 진행성 사구체 신염 환자들의 임상양상과 병리 소견을 후향적으로 고찰하였다. 방법: 1991년부터 2003년까지 소아과에 내원하여 임상 양상과 신생검 소견을 종합하여 급속 진행성 사구체 신염으로 진단 받고 추적 관찰이 가능하였던 12명을 대상으로 임상양상 및 병리소견에 대해 후향적으로 조사하였다. 신부전으로 진행한 군과 정상 신기능이 유지된 군으로 나누어 임상-병리학적 지표들을 비교하였다. 결과: 12명의 환자 중 남자는 4명, 여자는 8명이었다. 발병 당시 연령은 평균 11세 5개월이었고 경과 관찰 기간은 평균 25개월이었다. 신조직 검사 결과에 따라 분류하면 면역복합체 매개성 사구체 신염인 경우가 10예(83%), 무면역 침착 사구체 신염이 2예(17%)였고 항사구체 기저막 항체 신염인 경우는 없었다. 모든 환자가 경구 스테로이드 투여를 받았고 10명(83.3%)에서 methylprednisolone pulse therapy를 시행하였고 이중 8명(65.7%)은 cyclophosphamide 병합 투여도 시행하였고 4명(33.3%)은 혈장교환을 병행하였다. 경과 관찰하는 동안 1예에서 정상 신기능으로 회복되었고 7예는 정상 신기능은 유지되나 신증후군 범위 이하의 단백뇨가 지속되는 부분 회복을 보였다. 2예에서는 지속되는 단백뇨와 혈청 크레아티닌 상승을 보이는 만성 신부전 상태를 보였고 2예에서는 말기 신질환으로 진행하였다. 진단시 높은 혈청 크레아티닌과 낮은 헤모글로빈 수치를 보인 경우와 나이가 어린 경우 예후가 불량하였다. 결론: 소아에서 급속 진행성 사구체신염은 면역 복합체 신염이 대부분을 차지하고 조기 진단과 적극적인 치료를 시행하였을 때 대부분의 환자에서 신기능의 호전이 관찰되었다. 이 질환의 임상 경과와 치료 방침의 확립을 위하여 다기관의 전향적 연구가 필요하다.

• 대한가정학회지
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• 제27권2호
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• pp.133-148
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• 1989

This study attempts of analyze empirically the living status of the elderly in Korea by finding out the problems of it in the family and by clarifying the influences of the family environmental variables and the values on the adjustment of the aged. To carryout the aim of this study, the causes and the patterns of the problems for the aged had been found out through the review of literature. Based on them the questionnaire was prepared including the questions of the values, family environmental vriables as well as the degree of satisfaction of thier liver and the extent of life interchange. The former variables were taken as independent and the latter were taken as dependent variables, so that the relationship between the two variables could be exemplified. The 400 aged over 60 living in Seoul and the other cities were selected through the purposive sampling and interviewed. The answers of the 376 respondents, 94% of the sample, were analyzed for this study. The following results have been found out through the various statistical analysis such as frequency distribution, chi-square test, pearson's correlation, analysis of variance and cluster analysis. At first, the results from the examination of the frequency distribution regarding the living status of the aged are; I) sixteen percent of the respondents living with their married offspring were receiving economical support, though they pointed out the problems of the extended family are the inconveniences with their children (60%) and simpleness (20%) of their livers. It seems that the aged in Korea are poor and have negative opinion on the relationship with their offspring even if they live in the same house. Secondly, it has been found out that the family environmental variables, especially such as sex, occupation, residence, education, level, living ability and the family type, play and important role not only on the degree of satisfaction of their liver but also on the extent of interchange of their lives. However, the variables such as religion and whether the spouse is alive or not do not play and important role. Thirdly, the reported main reasons of their delightness were healthy life (1.87%), the well-being of their offspring (2.08%), the spouse's long life (3.38%), religious activity (5.05%), the hobby activity (4.31%) and the participation in the social activity (5.05%). While, they mainly concern about the illness (1.98%), offspring (2.00%), econmic difficulties (3.39%), inharmonious home (3.81%) and the despicable treatment (3.81%). The respondents wer classified into two groups, they are dependent and independent, using cluster analysis. Health, social activity, offspiring, religion, couple's long life among the factors which lead them to be delighted were turned out to be statistically signhificant at 0.01 significance level between the two groups. As far as their worrisome matters are concerned, health and economic difficulties were significantly different between the two groups. Fourthly, regarding the life interchange, it has been proved that there is a statistically significant differences betwwen the two groups in the economic and the emotional satisfaction, help for ordinary life, status in the family, subjective and objective relationship with offspring, but not in economic dependency and the activity status. Fifthly, it has been noted that there is a high correlation between the degree of life's satisfaction and the extent of life interchange. On the basis of the results mentioned above, it could be concluded taht; i) The majority of the aged in Korea are not economically active, and thus they live with their married offspring even of they have a negative opinion on the subjective relationship with them. This can be pointed out as the main problem of the aged and thus it needs to be studied further. ii) the environmental variables such as age, sex education level, family type and occuption (which can not be changed by their effrot) turned out to give an important effect on the extent of the life interchange among the aged. iii) The respondents who are identified as independent group have a higher degree of life satisfaction and family status than the group identified as defendent. Thus, it can be inferred that it is possible for them to adjust their life by making an effort to modify themselves. iv) The high correlation between the extent of life interchange and the degree of life satisfaction indicates that the elderly themselves can adjust in order to obtain the higher degree of life satisfaction. Therefore, the following suggestions are derived from this study. First of all, the aged should try to be psychologically independent. Second, they need to control themselves in order to achieve self-assurance. Third, the community have to prepare a program of self-development for the aged. Fourth, the social welfare policy that can solve the problem of illness and poverty of the elderly should be introduced, so that their minimum requirements can be satisfied.

• 한국지구과학회지
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• 제24권5호
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• pp.378-392
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• 2003

본 연구는 제7차 과학 교육과정에 대한 지구과학 교사들의 관심도와 활용도에 대한 조사연구로서 과학교육과정에 대한 관심도에 대한 고등학교 지구과학 교사들은 단계 0의 지각적 관심이 상대적 강도 98%로 가장 높은 정점을 이루고 있어 대부분의 선행연구의 결과와 같이 교사들이 교육과정에 대해 무관심한 것으로 나타났다. 과학교육과정에 대한 활용도에 대한 고등학교 지구과학 교사들의 과학 교육과정에 대한 영역별 활용도를 분석한 결과는 교사들이 교육과정을 거의 활용하지 않는 수준(I수준)이 1.69%, 지구과학 교육과정에 대한 정보를 갖고 활용하려는 준비가 되어 있는 수준(II수준)이 17.80%, 지구과학 교육과정을 반성적 사고없이 교사중심적으로 활용하는 수준(III수준)이 43.97%이었으며, 교육과정을 완전히 이해하고 수용하여 안정적으로 활용하는 교사수준(IV수준)이 31.86%, 장기적 결과를 생각하며 동료들과 협력하여 더 나은 방안을 탐색하는 수준(V수준)이 4.69%로 나타났다. 전체적인 활용수준은 기계적 활용수준(3단계)으로 나타났고 수업목표 영역(평균 3.28)과 내용 영역(평균 3.28)의 활용도가 비교적 높게 나타났으며, 성격 및 이념 영역(평균 3.24), 수업자료 영역(3.18), 평가 영역(3.18), 수업방법 영역(평균 3.12)의 순으로 나타났다. 경력에 따른 지구과학 교사들의 과학 교육과정에 대한 관심도는 0${\sim}$4년, 15${\sim}$19년, 20년 이상, 5${\sim}$9년 경력의 교사 집단 순이며 10${\sim}$14년 경력의 교사 집단이 교육과정에 대한 관심도가 가장 낮은 것으로 나타났다.

• 가정간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• Journal of Korean Medical Science
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• 제33권49호
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• pp.323.1-323.12
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• 2018

Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.