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Predicting hospital bankruptcy in Korea (병원도산 예측에 관한 연구)

  • Lee, Moo-Sik;Seo, Young-Joon
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.490-502
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    • 1998
  • This study purports to find the predictor of hospital bankruptcy in Korea and to examine the predictive power of the discriminant function model of hospital bankruptcy. Data on 17 financial and 4 non-financial indicators of 31 bankrupt and 31 profitable hospitals of 1, 2, and 3 years before bankruptcy were obtained from the hospital performance databank of Korea Institute of Health Services Management. Significant variables were identified through mean comparison of each indicator between bankrupt and profitable hospitals, and the discriminant function model of hospital bankruptcy was developed. The major findings are as follows 1. As for profitability indicators, net worth to total assets, operating profit to total capital, operating profit ratio to gross revenues, normal profit to total assets, normal profit to gross revenues, net profit to total assets were significantly different in mean comparison test in 1, 2, and 3 years before hospital bankruptcy. With regard to liquidity indicators, current ratio and quick ratio were significant in 1 year before bankruptcy. For activity indicators, patients receivable turnover was significant in 2 and 3 years before bankruptcy and added value per adjusted inpatient days was significant in 3 years before bankruptcy. 2. The discriminant function in 1, 2, and 3 years before bankruptcy were; $Z=-0.0166{\times}quick$ ratio-$0.1356{\times}normal$ profit to total assets-$1.545{\times}total$ assets turnrounds in 1 year before bankruptcy, $Z=-0.0119{\times}quick$ ratio-$0.1433{\times}operating$ profit to total assets-$0.0227{\times}value$ added to total assets in 2 years before bankruptcy, and $Z=-0.3533{\times}net$ profit to total assets-$0.1336{\times}patients$ receivables turn-rounds-$0.04301{\times}added$ value per adjusted $patient+0.00119{\times}average$ daily inpatient census in 3 years before bankruptcy. 3. The discriminant function's discriminant power in 1, 2, and 3 years before bankruptcy was 77.42, 79.03, 82.25% respectively.

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암의 발생기작

  • 임영희
    • Proceedings of the Korean Journal of Food and Nutrition Conference
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    • 1997.06b
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    • pp.8-10
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    • 1997
  • 종양은 아직 그 발생 원인과 기작이 정확히 밝혀져 있지 않으므로 정확한 정의를 내리는 것은 어려우나 일반적으로 종양이란 정상 세포가 갖고 있는 세포 분열의 특이성을 상실하여 일어나는 조직의 자율적인 과잉 성장을 말한다. 이와 같은 세포의 비정상적인 증식에 의한 종양을 임상 및 병리 형태학적으로 양서 종양과 악성종양으로 분류한다. 양성 종양을 일으키는 종양 세포는 정상 세포와 비슷할 뿐 아니라 그 주변 세포들과 확실한 경계를 이루고 있으며 증식도 느리며 다른 부위로의 전이가 없다. 이에 반해 악성종양은 일반적으로 증식도 빠르고 이형의 세포로서 주변의 조직으로 확산, 전이될 뿐만 아니라 최종적으로 숙주인 개체를 사망시킨다. 악성종양은 다시 상피 조직에서 유례한 암, 비상피 조직에서 유래된 육종, 백혈구에서 유래된 백혈병 등으로 구별하지만 그의 본질은 거의 같으며 모든 악성종양은 통속적으로 암이라고 불리운다. 종양의 발생원인으로 크게 3가지로 나눌 수 있는데 화학물질, 바이러스 및 유전적 요인에 의한 것으로 알려졌다. 최초의 발암물질로 알려진 benzopyrene에 의한 발암 등 연구에 의해 화학적 발암원들은 직접 발암 물질로 작용하는 것이 아니라, 일단 체내에서 대사된 후 이들 대사 산물일 DNA 등에 작용함으로써 발암이 유도 되는 것으로 밝혀졌다. 이와 같이 화학적 변화를 거친 후에야 DNA에 영향을 미치는 것외에 다른 화학물질들은 또 다른 기작을 통해 암을 유발하는데 쥐의 피부에 benzopyrene을 한 번 처리하면 암을 유발하지 않으나 여기에 phorbol ester를 처리하면 높은 빈도로 암이 형성된다. 여기서 benzopyrene과 같이 세포의 DNA에 돌연변이를 일으키는 작용을 하는 발암물질을 발암개시제라 하고 phorbol ester처럼 그 자체로는 발암능이 없으나 발암개시제에 노출된 세포에 영향을 미쳐 발암능을 크게 강화시켜 주는 것을 발암촉진제라고 한다. 암은 세포증식 제어계에 DNA가 이상을 일으킨 현상을 말하는 데 이와 같은 DNA의 변형된 유전정보에 의해 암과 관련된 단백질을 합성하므로 이 DNA를 암유전자라 부르며 바이러스에서 유래된 것을 V-one 그리고 세포에서 유래된 것을 c-one이라 한다. 암유전자는 본래 암을 형성하기 위한 것이 아니라 증식제어 유전자로서 변이나 비정상으로 활성화 됨으로써 암을 유발시키므로 proto-oncogene이라 부른다. 또한 고등동물의 유전자 중에는 세포성장을 억제하는 유전자들이 있으며 이들은 세포의 성장 생존 분화를 조절하는 것으로 생각되고 있다. 따라서 이들 유전자는 세포의 암변형을 억제하는 기능을 가지고 있다. 이들 유전자의 이상으로 세포성장 억제기능이 상실되면 세포의 과잉 성장이 초래되면 결과적으로 암으로 유발하는 것으로 추측되고 있다. 최근의 연구에 의하면 암세포에서 암억제 유전자의 이상과 암유전자의 활성화가 함께 발견 되면서 정상세포가 암으로 변형되는 과정에는 암억제 유전자의 이상과 암유전자의 활성화가 동시에 관여한 가능성이 높은 것으로 알려져 있다. 정상 세포가 암을 유발하기 위해서는 발암의 다단계설에서와 같이 여러 단계의 변과가 필요한데 여러 가지 요인에 의해 정상세포의 염색체가 변화되어 정상세포들이 가지고 있는 세포분열의 특이성을 상실하고 증식이 빠르고 저항력이 강한 세포가 선택 되어지고 비정상 서ㅔ포으 과잉 분여러에 의해 종양이 형성되며 이어서 혈관의 신생을 촉진하는 맥관형성, 전이 등이 과정을 거쳐 신체의 다른 부위로 전이된다. 20세기 초까지는 암은 노화와 함께 자연발생적으로 일어나는 피할 수 없는 질병으로 여겨졌으며 그 치료도 조기에 발견된 암환자에게 외과적인 치료를 하는 것이 최선의 방법 이었다. 그러나 현재에는 암환자의 80% 이상이 환경적 요인에 의해 암이 발생 된다고 믿어지고 있다. 과거 치료에 중점을 둔 것에서 점차 예방의 가능성과 그 방법의 모색에 관심을 갖게 되었으며 치료적인 면에서도 외과적 수술 이외에 방사선 치료, 항암제의 투여 등 약물요법, 면역요법의 이용 이외에 더 나아가 gene theraph 및 tumor vaccines 개발에 대한 관심도 증가되고 있다. 국제암연구협회에서는 인간에게 발암이 가능한 물질의 종류를 정기적으로 발표하고 있는데 지금까지 발암 가능성이 높다고 널리 알려진 위험요인을 크게 나누어 보면 다음과 같다. 흡연, 음주, 식이요인, 호르몬 및 기타 요인으로 약물, 자외선 등을 들 수 있는데 현재까지 이들 요인에 의한 발암 기작이 완전히 규명된 것은 아니지만 이들에 의한 발암의 확률이 높다는 것은 사실이므로 이 위험요인에 노출되는 것을 방지함으로써 암발생을 예방할 수 있을 것이다. 암발생의 예방법으로는 암발생 자체를 예방하는 것과 이미 발생한 암환자를 조기 발견하고 치료하는 방법이 있을 수 있다. 현재까지의 여러 연구 결과들을 보면 유전적인 요인을 제외한 대부분의 발암 위험인자들은 개개인의 생활습관과 밀접히 관련되어 있음을 알 수 있다. 이를 바탕으로 1992년 대한 암협회에서는 '암 예방 14개 권장 사항'을 발표하여 국민 홍보활동을 하고 있는데 그 내용의 반 이상이 식생활 습관과 관련되어 있을 정도이므로 암예방에 있어서의 식품의 역할이 매우 크다 할 수 있다. 따라서 건전한 생활습관과 더불어 적절한 식품의 섭취는 암예방을 위한 기본이 될 것이다.

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SUITABILITY OF SHELLFISHES FOR PROCESSING 3. Suitability of Pacific oyster for processing (패류의 가공적성 3. 굴의 가공적성)

  • LEE Eung-Ho;CHUNG Seung-Yong;KIM Soo-Hyeun;RYU Byeong-Ho;HA Jin-Hwan;OH Hoo-Gyu;SUNG Nak-Ju;YANG Syng-Tack
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.8 no.2
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    • pp.90-100
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    • 1975
  • The estimation of the pre-processing condition of oyster is of great importance for distributors and processors. This study was attempted to establish the basic data for evaluating the processing suitability of oyster, which is the most important shellfish for domestic use and export. The data were analysed by measuring the condition index, chemical composition and heavy metal content of oysters. In order to eliminate the manual work that has to be done on a tightly closed oyster shell and avoid shrinkage in the oyster meat which is attendant on the steaming process, chemical means to open oyster were examined. finding the method of pretreatment of polyphosphate for frozen oysters were attempted to improve the product quality. The prevention of undesirable color change of the canned oyster meat is another problem to solve. The important results are as follows : 1. The ratio of meat volume and meat weight to the holding capacity by shells may be useful as an index to measure the condition index of oysters. 2. As a whole, monthly changes of moisture and fat content in oysters were reversely correlated. Protein content slightly decreased from April and rapidly decreased in July, and again rapidly increased in August but from September to November decreased slightly. In April, the content of glycogen was 4 percent. From this period to September, glycogen was rapidly decreased. From July to September, it was only 0. 7 to 1 percent but increased from October. There were little seasonal changes in pH value. The pH value of oyster meat was 6.0 to 6.2. The crude ash content was slightly decreased from June to August. 3. The range of monthly change of heavy metal content are as follows: Total mercury was 0 to 0.019 ppm, cadmium was 0.026 to 0.053 ppm, copper was 0.111 to 0.594 ppm, and lead_was 0.061 to 0.581 ppm. 4. By the results of condition index, chemical composition and heavy metal content of oysters, the suitable harvest season as raw materials for processing was the end of December to the end of May of next year. 5. The pretreatment of 10 percent polyphosphate in 5 percent salt solution of oyster meat appeared effective to reduce thawing drip during cold storage. 6. The pretreatment of $Na_2EDTA$ and BHA did not show the color prevention effect to the canned oyster meat during storage. 7. Magnesium chloride affected to open the valves of oysters.

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Site Monitoring System of Earthquake, Fault and Slope for Nuclear Power Plant Sites (원자력발전소의 부지감시시스템의 운영과 활용)

  • Park, Donghee;Cho, Sung-il;Lee, Yong Hee;Choi, Weon Hack;Lee, Dong Hun;Kim, Hak-sung
    • Economic and Environmental Geology
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    • v.51 no.2
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    • pp.185-201
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    • 2018
  • Nuclear power plants(NPP) are constructed and operated to ensure safety against natural disasters and man-made disasters in all processes including site selection, site survey, design, construction, and operation. This paper will introduce a series of efforts conducted in Korea Hydro and Nuclear Power Co. Ltd., to assure the safety of nuclear power plant against earthquakes and other natural hazards. In particular, the present status of the earthquake, fault, and slope safety monitoring system for nuclear power plants is introduced. A earthquake observatory network for the NPP sites has been built up for nuclear safety and providing adequate seismic design standards for NPP sites by monitoring seismicity in and around NPPs since 1999. The Eupcheon Fault Monitoring System, composed of a strainmeter, seismometer, creepmeter, Global Positioning System, and groundwater meter, was installed to assess the safety of the Wolsung Nuclear Power Plant against earthquakes by monitoring the short- and long-term behavioral characteristics of the Eupcheon fault. Through the analysis of measured data, it was verified that the Eupcheon fault is a relatively stable fault that is not affected by earthquakes occurring around the southeastern part of the Korean peninsula. In addition, it was confirmed that the fault monitoring system could be very useful for seismic safety analysis and earthquake prediction study on the fault. K-SLOPE System for systematic slope monitoring was successfully developed for monitoring of the slope at nuclear power plants. Several kinds of monitoring devices including an inclinometer, tiltmeter, tension-wire, and precipitation gauge were installed on the NPP slope. A macro deformation analysis using terrestrial LiDAR (Light Detection And Ranging) was performed for overall slope deformation evaluation.

Health Promotion Behavior, Health Problems, Perceived Health Status and Farmers' Syndrome of Rural Residents (농촌주민의 건강증진행위, 건강문제, 지각된 건강상태 및 농부증)

  • Park, Jeong-Sook;Kwon, Sang-Min;Oh, Yun-Jung
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.47-57
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    • 2009
  • Objectives: The purpose of this study was to identify the health promotion behavior, health problem, perceived health status and farmers' syndrome of rural residents. Methods: The subjects of this study were 637 adults of 19 primary health care post extracted from 1.875 primary health care post in Korea by quota sampling method. The collected data were analyzed by descriptive statistics, Pearson's correlation. Results: The average score of health promotion behavior was 2.23. In the sub-scales, the highest degree of performance was 'nutrition', followed by 'spiritual growth' and the lowest degree of performance was 'physical activity'. The most prevalent health problem was ailments in 'musculoskeletal system', followed by 'fatigue', 'eyes and ears', 'cardiovascular system'. The mean score of perceived health status was 8.54. The prevalence of farmers' syndrome was 98.4%. Health promotion behavior showed a significant positive correlation health status and perceived health status showed a significant negative farmers' syndrome. Conclusions: With the above findings, rural residents' physical activity is less than urban residents', and the rural resident's score of perceived health status, musculoskeletal system and fatigue are lower than urban residents'. The farmers' syndrome of the rural people is high. A tailored health promotion program for rural community is needed to develop in the consideration of these findings.

Effects of the Planetarium Lesson on Students' Understanding of Astronomical Concepts (천체투영관 수업이 학생들의 천문 개념 이해에 미치는 효과)

  • Kim, Wansoo;Shim, Hyunjin
    • Journal of Science Education
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    • v.42 no.1
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    • pp.49-65
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    • 2018
  • Astronomy is the subject that can easily draw students' interest in studying science, therefore plays an important role in developing scientific core competence. However, it is difficult to develop spatial thinking that is required in understanding astronomical concepts through the classroom lessons. Planetarium, along with the science museum, is one of the most representative informal educational institution where astronomical concepts can be taught beyond time and space constraints. In this study, we developed the astronomy education program that is operated in the planetarium and applied the program to the elementary, middle and high-school students to investigate the effects of the planetarium lesson compared to the classroom lesson. The duration of this research was about 8 months, and the number of the students involved is 761, including participants of the 1 night and 2 days camps in the Daegu National Science Museum. The newly developed planetarium lesson is comparable to the previous classroom lesson of which topics are cardinal points, constellation, and the rotation of the earth. Test items were developed to evaluate the understanding of the astronomical concepts. The study was conducted based on the pre- and post-test with non-equivalent groups design comparing classroom and planetarium lessons. The results of this study are as follows. First, planetarium lesson is more effective for understanding astronomical concepts such as the cardinal points, earth's rotation, and the constellation than classroom lesson. Second, planetarium has a positive effect irrespective of gender and previous knowledge. Third, planetarium for high school students has the same effect as additional observation activities followed by the classroom instruction. Therefore, planetarium can be used as an alternative, effective tool when night observation is not available. In summary, planetarium is an effective tool that helps students to understand the astronomical concepts.

NEAR REAL-TIME ESTIMATION OF GEOMAGNETIC LOCAL K INDEX FROM GYEONGZU MAGNETOMETER (경주 지자기관측소 자료를 이용한 준실시간 K 지수 산출에 관한 연구)

  • Choi, K.C.;Cho, K.S.;Moon, Y.J.;Kim, K.H.;Lee, D.Y.;Park, Y.D.;Lim, M.T.;Park, Y.S.;Lim, H.R.
    • Journal of Astronomy and Space Sciences
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    • v.22 no.4
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    • pp.431-440
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    • 2005
  • Local K-index is an indicator representing local geomagnetic activity in every 3 hour. For estimation of the local K-index, a reasonable determination of solar quiet curve (undisturbed daily variation of geomagnetic field) is quiet essential. To derive the solar quiet curve, the FMI method, which is one of representative algorithms, uses horizontal components (H and D) of 3 days magnetometer data from the previous day to the next day for a specific day. However, this method is not applicable to real time forecast since it always requires the next day data. In this study, we have devised a new method to estimate local K-index in near real-time by modifying the FMI method. The new method selects a recent quiet day whose $K_p$ indices, reported by NOAA/SEC are all lower than 3, and replace the previous day and the next day data by the recent quiet day data. We estimated 2,672 local K indices from Gyeongzu magnetometer in 2003, and then compared the indices with those from the conventional FMI method. We also compared the K indices with those from Kakioka observatory. As a result, we found that (1) K indices from the new method are nearly consistent with those of the conventional FMI method with a very high correlation (R=0.96); (2) onr local K indices also have a relatively high correlation (R=0.81) with those from Kakioka station. Our results show that the new method can be used for near real-time estimation of local K indices from Gyeongzu magnetometer.

On decrease program of Radioactive Wastewater and Sewages in High Dose Radioiodine Therapy Ward (고용량 방사성옥소 치료병실의 오.폐수 저감화를 위한 연구)

  • Ryu, Jae-Kwang;Jung, Woo-Young;Shin, Sang-Ki;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.19-26
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    • 2008
  • Purpose: In general, We discharged radioactive wastewater and sewages less than $8.1{\times}10^{-13}$ Ci/ml in a exclusive water-purifier tank. Our hospital operating three exclusive water-purifier tank for radioactive wastewater and sewages of 60 tons capacity respectively. In order to meet the criteria it need a enough decay more than 125 days per each exclusive tank. However, recently we fell into the serious situation that decay period was decreased remarkably, owing to the wastewater amount increased rapidly by enlarge the therapy ward. For that reason, in this article, I'd like to say the way that reducing of radioactive wastewater and sewages rationally. Materials and Methods: From January, 2006 to October, four hundred and two cases were analyzed. They were all hospitalized during 3 days and 2 nights. We calculated the average amount of water used (include toilet water used, shower water used, washstand water used, $\cdots$), each exclusive water-purifier tank's decay period, as well as try to search the increased factors about water-purifier tank inflow flux by re-analysis of the procedure of radioisotope therapy step by step. Results: We could increase each exclusive water-purifier tank's decay period from 84 days to 130 days through the improvement about following cause: (1) Improvement of conventional toilet stool for excessive water waste $\rightarrow$ Replacement of water saving style toilet stool (2) Prevention of unnecessary shower and wash (3) Stop the diuretics taking during hospitalization (4) Analysis of relationship between water intakes and residual dose of body (5) Education about outside toilet utilization before the administration (6) Changed each water-purifier tank's maximum level from85% to 90% Conclusion: The originality of our efforts are not only software but hardware performance improvements. Incidentally the side of software's are change of therapy procedures and protocols, the side of hardware's are replacement of water saving style toilet stool and change of each water-purifier tank's maximum level. Thus even if a long lapse of time, problem such as return to the former conditions may not happen. Besides, We expect that our trials become a new reasonable model in similar situation.

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Influence of the Increase of Dissolved $CO_2$ Concentration on the Marine Organisms and Ecosystems (해수중 용존 $CO_2$ 농도 증가가 해양생물 및 해양생태계에 미치는 영향: 국내외 사례 연구)

  • Lee, Jung-Suk;Lee, Kyu-Tae;Kim, Chan-Kook;Park, Gun-Ho;Lee, Jong-Hyeon;Park, Young-Gyu;Gang, Seong-Gil
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.9 no.4
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    • pp.243-252
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    • 2006
  • Influence of the increasing carbon dioxide concentration in seawater on various marine organisms is assessed in this article with regard to the impacts of anthropogenic $CO_2$ introduced into surface or deep oceans. Recent proposals to sequester $CO_2$ in deep oceans arouse the concerns of adverse effects of increased $CO_2$ concentration on deep-sea organisms. Atmospheric introduction of $CO_2$ into the ocean can also acidify the surface water, thereby the population of some sensitive organisms including coral reefs, cocolithophorids and sea urchins will be reduced considerably in near future (e.g. in 2100 unless the increasing trend of $CO_2$ emission is actively regulated). We exposed bioluminescent bacteria and benthic amphipods to varying concentrations of $CO_2$ and also pH for a short period. The ${\sim}l.5$ unit decrease of pH adversely affected test organisms. However, amphipods were not influenced by decreasing pH when HCl was used for the seawater acidification. In this article, we reviewed the biological adverse effects of $CO_2$ on various marine organisms studied so for. Theses results will be useful to predict the potential risks of the increase of $CO_2$ concentrations in seawater due to the increase of atmospheric $CO_2$ emission and/or sequestration of $CO_2$ in deep oceans.

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Limited Lateral Retinacular Release for Treatment of Painful Bipartite Patella (통증이 있는 이분슬개골의 제한적인 외측 지대 유리술 치료)

  • Yi Seung Rim;Hahn Sung Ho;Yang Bo Kyu;Chung Shun Wook;Ha Jung Hyun;Ahn Young Joon;Chung Byung June;Jeon Do Hwan;Bin Sung Woo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.60-65
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    • 2004
  • Purpose: The purpose of this study was to evaluate the results of limited vastus lateralis release for treatment of painful bipartite patella. Materials and Methods: From Jan. 1995 to Jun. 2002, we performed limited lateral retinacular release in 14 patients(16 cases) for treatment of painful bipartite patella. All patients were men and mean age was 22.3 years old. The opeative techique was that insertion of the vastus lateralis to the painful patellar fragment is detached subperiosteally. We evaluated the clinical results by degree of pain and level of activity. Also we analyzed the radiologic findings by measuring fragment tilting angle and gap between fragments. The mean follow up period was 14 months. Results: At final follow up, all of the patients showed pain relief and can be returned to more than recreational sports activity after the operation. On radiologic findings, fragment tilting angle and gap between fragments were reduced at statistically significant level. Conclusion: The limited lateral retinacular release for treatment of painful bipartite patella is one of good methods which is less invasive and shows good results in clinical and radiologic findings.

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