• Journal of Preventive Medicine and Public Health
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• 제38권1호
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• pp.1-8
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• 2005

Objectives : To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections(URI). Methods : We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. Results : We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR=2.400, 95% CI=1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR=6.773, 95% CI=1.816-25.254). Conclusion : These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.

• 한국건설관리학회논문집
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• 제16권2호
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• pp.86-96
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• 2015

2000년대 PF(Project Financing)의 적극 활용을 통해 부동산개발 및 PF 시장이 급성장하였지만, 이후 세계금융위기의 여파로 부동산 경기 침체로 인해 상당수의 개발사업이 정상적으로 추진되지 못하게 되었다. 이러한 현상은 철저한 사업성 분석 없이 무리하게 사업을 추진한 것이 근본적인 원인으로 판단된다. 이에 본 연구에서는 부동산개발사업의 무분별한 추진을 억제하고 객관적인 평가가 가능하도록 기존 부동산개발사업 평가체계의 문제점을 짚어보고 이를 보완할 수 있는 부동산개발사업의 평가항목 및 평가기준 등을 평가수요 및 사업유형 등 사업의 성격에 맞게 적용할 수 있는 전반적인 평가체계를 제안하였다. 본 연구에서 제안한 부동산 평가체계 및 운영방안을 통해 부동산 평가체계를 제도화하여 표준화함으로써, 보다 일관성 있는 평가가 가능할 것으로 기대되며, 아울러 평가자료의 통일적 축적이 가능하게 될 것으로 기대된다.

• 한국임상수의학회지
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• 제25권1호
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• pp.52-57
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• 2008

An intact male, 3-year old, Sapsari, weighing 29 kg with a history of respiratory distress, anorexia, abdominal distension, and depression for 1 day was referred. Radiographic findings included a C-shaped soft tissue mass in the mid-abdominal cavity and loss of serosal detail. Ultrasonographs showed splenomegaly with hypoechoic coarse parenchyma, loss of venous flow in the dilated splenic veins, and thrombi. Based on image findings, acute isolated splenic torsion was diagnosed. Splenectomy and prophylactic gastropexy was performed. Another case was a spayed female, 8-year old, Shih-tzu, weighing 3.7 kg with a history of intermittent abdominal pain and a palpable abdominal mass for 1 year. Radiographic findings showed splenomegaly characterized by a soft tissue round mass. Ultrasonographs revealed displaced splenic hilum and absence of venous flow in the dilated splenic vein. Chronic isolated splenic torsion was diagnosed and also splenectomy and gastropexy was performed. Two dogs were recovered normally after surgery without any complications. Acute form of isolated splenic torsion showed acute systemic clinical signs, severe C-shaped splenomegaly on radiographs, and loss of all of splenic venous flow, perivenous hyperechoic triangle sign, and thrombi on ultrasonographs. Chronic form of isolated splenic torsion showed chronic obscure clinical signs, moderate splenomegaly on radiographs, and partial loss of splenic venous flow on ultrasonographs.

• Korean Journal of Acupuncture
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• 제22권4호
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• pp.117-127
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• 2005

Objective : This study was undertaken to determine if Plantaginis Semen herbal acupuncture(PSA) has a protective effect on glycerol-induced acute renal failure in rats. Methods : Rats were dehydrated for 24hr and then injected with 4 ml/kg of 50% glycerol in each hindlimb muscle. In experiments for PSA effect, rats were received 0.1 ml of PSA extraction in both sides of corresponding $Sh\grave{e}nsh\bar{u}(BL_{23})$ of human body for 3 days after injection of glycerol. The experimental group were divided into the normal group, the control group, the sample 1,2,3 group. Results : Glycerol injection decreased glomerular filtration rate and increased urine volume, serum creatinine, BUN level and fractional excretion of $Na^+,\;K^+\;and\;Cl^-$. These results show that glycerol injection bring about acute renal failure. PSA significantly increased glomerular filtration rate and significantly decreased serum creatinine, BUN level and fractional excretion of $Na^+,\;and\;Cl^-$ as compared with control group. Conclusion : These results suggest that PSA can be used in prevention and treatment for acute renal failure. However, the precise mechanisms of PSA protection remain to be determined.

• Korean Journal of Acupuncture
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• 제22권3호
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• pp.105-117
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• 2005

Objective : This study was undertaken to determine if Juglandis Semen herbal acupuncture(Ja) has a protective effect against glycerol-induced acute renal failure in rats. Methods : Rats were dehydrated for 24hr and then injected with 5 ml/kg of 50 % glycerol, one-half of dose in each hindlimb muscle. In experiments for Ja effect, rats received 0.1 ml of Ja extraction in both sides of corresponding $Sh\grave{e}nsh\bar{u}(BL_{23})$ of human body and non-acupuncture points(the root of tail) for 3 days after injection of glycerol. The experimental group were divided into the Normal group, the Control group, the Ja to $Sh\grave{e}nsh\bar{u}(BL_{23})$ group(Ja-AS), the Ja to non-acupuncture points group(Ja-AN). Results : There were significant decrease of urine volume, BUN, fractional glucose excretion, fractional phosphate excretion, total protein level in Ja-AS as compared with the control group. Conclusion : This suggests that Ja-AS could be used in prevention and treatment of acute renal failure. However, the precise mechanisms of Ja protection remain to be determined.

• Journal of Acupuncture Research
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• 제18권2호
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• pp.111-122
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• 2001

Objectives ; This study was undertaken to determine if Salviae Radix herb-acupuncture (SRA) exerts protective effect against alterations in membrane transport function in rabbits with mercury chloride (Hg)-induced acute renal failure. Methods and Results ; The administration of Hg at a subcutaneous single dose of 10mg/kg caused a reduction in GFR to 9.4% of the basal value and an increase in fractional Na+ excretion to 10-fold, indicating generation of acute renal failure. When animals were acupunctured with $0.5m{\ell}$ of SRA extract (0.1%) in both sides of Shinsu(BL23) for 7 days prod to Hg administration, such changes were significantly attenuated. The fractional excretion of glucose and phosphate was increased to approximately 132-fold and 7-fold, respectively, in rabbits treated with Hg alone, but the fractional excretion of glucose was increased to 26-fold and that of phosphate was not different from the basal value in SRA-pretreated rabbits. Uptakes of glucose and phosphate in purified isolated brush-border membrane and $Na^+-K^+$-ATPase activity in microsomal fraction were inhibited in rabbits treated with Hg alone, suggesting that impairment in proximal reabsorption of glucose and phosphate is resulted from a direct damage of membrane transport carriers and disruption of the normal $Na^+$ gradient. Conclusions ; Such changes were prevented by SRA. Uptakes of organic ions, PAH and TEA, in renal cortical slices were inhibited by the administration of Hg, which was prevented by SRA. Pretreatment of an antioxidant DPPD attenuated the increase in the fractional excretion of glucose and phosphate induced by the administration of Hg.

• 대한지역사회영양학회지
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• 제7권4호
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• pp.578-584
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• 2002

This study was designed to investigate the association between the period of engraftment and the nutritional status of patient s undergoing bone marrow transplantation for acute myelogenous leukemia (AML). Nutritional status was evaluated by body mass index (BMI), percentage of ideal body weight (PIBW), percentage of weight loss, and serum albumin, total protein (T protein), hemoglobin (HGB) and hematocrit (HCT) levels on the day prior to transplantation and on the day of bone marrow transplantation. The periods of engraftment were determined by absolute neutrophil counts (ANC) above $500/mm^3$ from the day of bone marrow transplantation. The study subjects were 80 patients (55 males, 25 females) with acute myelogenous leukemia admitted to the University Hospital in Seoul. The result of this study is as follows : Tie nutritional status values of the majority of patients on the day prior to transplantation were in the normal range except for HGB and HCT ; however, during hospitalization, all of the levels of the nutritional status values were significantly decreased. The periods of engraftment of the abnormal group according to their BMI, PIBW, HGB and HCT levels on the day of bone marrow transplantation showed no difference when compared to the normal group. However, the periods of engraftment of the abnormal group, according to the percentage of weight loss, albumin, and T protein levels were significantly decreased when compared to the normal group. Therefore, the nutritional status of patients at the time of transplant had a noticeable influence on the periods of engraftment. Our results suggested that nutritional status is a critical factor of engraftment in BMT during pre-transplant and post-transplant. Futhermore, we recommend that the process of nutritional preparation for the transplant should initiate immediately after the transplant decision has been made.

• Tuberculosis and Respiratory Diseases
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• 제45권4호
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• pp.888-895
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• 1998

Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum, accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features that make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria, hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.281-286
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• 1985

소장 평활근육종은 매우 드물고 특이증상이 없으므로 원인 모를 위장관 출혈, 장폐쇄, 종물촉지, 빈혈, 복통 및 오한 등이 동반될 때 한 번은 고려하여 조기진단으로 환자의 사망율을 줄여야 할 것으로 사료된다. 최근들어 우리 나라에서도 그 증례보고가 늘어나고 본원에서도 2예를 경험한 바 이를 요약하면 1) 2예 모두 33세 남자였다 2) 발생부위는 공장 1예, 회장 1예였다 3) 주소는 1예에서는 복부통증을 동반한 종물촉지였고 다른 l 예에서는 천공에 의한 급성복막염 증상이었다. 4) 실험치상 CEA가 1예에서는 3.37에서 11.65ng/ml로 증가하였고, 다른 1예에서는 1.83 ng/ml였다. 혈색소는 술전 8.1gm%, 9.5gm%로 나타났다. Benzidine 잠혈반응은 둘 다 양성(++)였다. 5) 수술은 1예에서는 광범위 절제술 실시후 약 13개월만에 재발하여 재 수술하여 조직 검사를 다시 시행한 후 화학요법(VAC) 치료후 현재까지 외래에서 정기검진을 하고 있으며, 나머지 l예에서는 광범위 절제술후 15일만에 자진 퇴원하여 결과관철이 되지 못하고 있다.

• 한국항만경제학회지
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• 제27권4호
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• pp.145-164
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• 2011

최근 동북아시아지역의 교역규모가 급성장함에 따라 동북아시아 경제권이 세계경제에서 점유하는 비중이 점차 늘어나고 있다. 이러한 대륙 국가들과의 주요 연결로서 가장 큰 구심점 역할을 하고 있는 것이 Trans Siberian Railway(TSR) 등이라고 할 수 있다. TSR 이용의 경우 국내 도로운송과 부산항과 극동 러시아 항만간 해상운송, 대륙횡단철도, 최종목적지 도착이후의 도로운송을 포함하고 있어 항공운송을 제외한 복합운송의 전 영역에 걸쳐 있으며 최근 들어 국내 철도 화물운송을 활성화시켜 대륙횡단철도와 연계하여 운영하는 것에 대한 방안도 활발하게 논의되고 있다. 따라서 본 연구는 첫째, 러시아 및 중앙아시아향(向) 화물 운송의 선봉장 역할을 하고 있는 우리나라 TSR Service Operator들의 특징 및 역할을 파악하고 둘째, TSR Service Operator의 SWOT 분석으로 대변되는 대내 외적인 환경 분석과 우리나라 TSR Service Operator의 현황을 분석하고 셋째, 이를 바탕으로 우리나라 TSR Service Operator가 지속적인 경쟁우위를 확보하고 유지할 수 있는 발전 방향을 제시하는데 그 목적이 있다.