• 한국의료질향상학회지
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• 제7권2호
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• pp.204-216
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• 2000

Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

• 대한두경부종양학회지
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• 제36권1호
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• pp.1-8
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• 2020

It is well established that cancer patients are more susceptible to infection because of the immunosuppressive status caused by both disease itself and anticancer treatment, including surgery and chemoradiation. Head and neck cancer (HNC) patients are generally at high-risk for coronavirus disease 2019 (COVID-19) infection and serious adverse outcomes. Although there is an urgent need for guidance in the delivery of safe, quality oncologic care, no international consented recommendation addressed the management of HNC patients in COVID-19 due to limited data. In this review, we summarized the consideration for head and neck oncologic care in the context of the COVID-19 pandemic, based on the data and the very recent recommendations from the Korean Cancer Association and National Cancer Center. COVID-19 should be taken into consideration in the comprehensive management of HNC patients, and multidisciplinary evaluation of multilevel surgical-risks, discussion of optimized strategy, and shared-decision-making with the patient are needed to maximize both the safety from infectious pandemic and outcome of surgical and oncologic care.

• Perspectives in Nursing Science
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• 제10권1호
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• pp.32-40
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• 2013

Purpose: The purpose of this study was to examine the health care status and healthy life practices among hypertensive patients in our South Korea in a bid to provide some information on the efficient management of hypertension. Methods: The data of the fifth Korea National Health and Nutrition Examination Survey of 2011 (KNHANES V-2) was utilized to analyze the state of hypertension management of 1,932 adults who were at the Western age of 19 and up and suffered from hypertension in order to identify what factors were related to their health care status and healthy life practices. IBM SPSS/WIN Statistics 20 software was employed, and frequency analysis and a ${\chi}^2$-test were carried out. Results: According to the results of the analysis, subjective health status, depression, and suicidal thoughts were significantly related to variable income, while health status and healthy life practices were not significant in town. Furthermore Depression, alcohol dependency, and walking were significant in hypertension patients who had experienced hypertension education programs. Conclusion: This study will provide database on hypertension management. Furthermore, multidisciplinary approaches should be taken for efficient and effective care for hypertension patients.

• 한국간호교육학회지
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• 제26권4호
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• pp.383-392
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• 2020

Purpose: This study was a descriptive study to identify factors affecting the attitude toward life-sustaining treatment of nurses working at long-term care hospitals. Methods: Data were collected through structured questionnaires from August 2nd to 27th, 2019. Study participants consisted of 163 nurses who were working for at least 6 months from 7 long-term care hospitals in B and K city. Data were analyzed using t-test, ANOVA, Scheffe' test, Pearson's correlation coefficients, and hierarchical regression with SPSS WIN v 21.0. Results: There were significantly positive correlations between awareness of good death (r=.46, p<.001) and perception of patients' rights (r=.32, p<.001). The factors affecting participants' attitude toward life-sustaining treatment were awareness of good death (β=.35, p<.001) and their own view of death (β=.24, p=.001), which explained about 27.0% of the attitude toward life-sustaining treatment. Conclusion: Based on these results, it is necessary to develop nursing educational materials that can establish values for deaths, and cultivate legal and ethical knowledge related to attitude toward life-sustaining treatment. In addition, since the severity of a patient's condition varies and the characteristics of the institution vary depending on the type of hospital, a study is needed on the relevance of variables considering the hospital environment.

• 한국융합학회논문지
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• 제6권5호
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• pp.33-38
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• 2015

V2X 카 융합서비스 환경에서, 인포테인먼트 서비스와 운전자 관리 서비스 가운데 주요 서비스는 드라이버, 유지보수 관리자, 고객, 익명의 사용자의 중요한 정보를 중심으로 지원되어야 한다. 많은 소프트웨어 어플리케이션들이 운전 관리 프로그램과 계획의 특정 요구조건을 만족하기 위해 솔루션을 고려해오고 있다. 본 논문에서는 V2X 융합서비스 환경에서 클리닉 환경설정, 클리닉, 클리닉 페이지, 맴버십, 클리닉 요청 처리, 운전자 프로파일 데이터, 클리닉 맴버십 데이터 그리고 클리닉 인증을 포함한 운전자용 차량 진단을 위한 안전한 관리 시스템의 Data flow diagram을 설명하였다. STRIDE 모델 가운데 스푸핑, 탬퍼링, 부인방지, 노출, 서비스 거부, 권한 관리와 같은, ITS 진단 시스템의 보안 위협 이슈를 중심으로 고찰하였다.

• 한국직업건강간호학회지
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• 제25권1호
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• pp.1-8
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• 2016

Purpose: The 2015 Korean Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreaks resulted in 186 cases, with 8% (15 persons) of these being nurses. This study aimed to examine MERS-CoV infection status of clinical nurses and to evaluate perception for infection control. Methods: We investigated the MERS-CoV infection status of nurses using MERS-CoV press release data. We examined and analysed perception for Infection control of 121 nurses of the three MERS intensive therapeutic hospitals in July 2015. Results: One to six nurses per hospital in total 8 health care facilities were infected with MERS-CoV. They mainly had short clinical careers and were unaware of infection possibility. The personal and organizational infection control levels that nurses perceive were low and the relationship between two levels was statistically significant. Conclusion: For promoting health protection and infectious disease management competency of nurses, it is necessary to prepare institutional system for controlling infectious disease.

• 한국의상디자인학회지
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• 제2권1호
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• pp.113-121
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• 2000

The effect of Sunlight exposure on reducing the microorganism counts in the bedding materials was experimented by using 3 kinds of microorganisms(S. aureus, K. pnenmoniae and E. coli) and 3 kinds of fabrics (cotton, silk and polyester). Counts of the microorganism were examined before and after sunlight exposure. The sunlights were controlled U.V and Daylight D50 using MacBeth artificial light source. The specimens were exposed for 5 min, 10 min and 30 minutes under the $20^{\circ}C$ and 60% R.H, distance is 50cm from the light source. Results were as follows, 1. The reduction rate of the 3kinds of microorganisms was remarkably great under the U.V exposure. The U.V. exposure was very effective way to sterlize the bedding materials in the house care. 2. S. aureus was the most susceptible to U.V. exposure and the sunlight exposure. E. coli was the most resistant to the U.V and the sunlight exposure. 3. The reduction rate of the 3 kinds of fabrics was not significantly different. The polyester is more resistant than the silk and the cotton. Those were shown good reduction rate if all kinds of microorganism under the U.V and daylight.

• Tuberculosis and Respiratory Diseases
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• 제59권2호
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• pp.142-150
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• 2005

연구배경 : Peroxiredoxin (Prx) 은 최근에 알려진 항산화제로 세포의 증식과 분화, 세포사멸이나 발암과정에 관여하는 것으로 알려져 있다. 하지만, 현재까지 폐암을 비롯한 각종 질병에서의 이들 Prx단백의 역할은 잘 규명되어 있지 않다. 이에 본 연구는 폐암 조직과 정상폐조직에서 Prx 단백의 발현 양상과 분포를 연구하여 이들의 병태 생리학적인 의미를 찾아보고자 하였다. 방 법 : 아주대학교 병원에서 폐암으로 진단된 환자의 폐암조직과, 동일 환자의 정상 폐조직에서, 1 차원전기영동 (reducing 조건과 non-reducing 조건에서의 SDSPAGE) 혹은 2차원전기영동을 시행한 후 Western blot으로 Prx, Trx 및 TR의 발현 양상을 분석 하였으며, 백서의 정상 폐조직과, 환자의 폐암 조직에서 anti-Prx rabbit polyclonal 항체로 하여 면역조직화학염색법을 통해, Prx 단백의 분포를 관찰하였다. 결 과 : 면역조직화학염색법 결과 백서의 정상 폐조직에서는 Prx I, II, III 및 V 유형이, 주로 기관지상피세포, 폐포상피세포 및 폐포대식세포에서 발현되고 있음을 관찰하였다. 인체 폐암조직에서는, 정상 폐조직 부위에 비해서 Prx I 과 Prx III 유형 및 Trx단백의 발현이 선택적으로 증가되어 있고, 특히, 2차원 전기영동을 통한 프로티옴 분석에서 산화된 형태의 Prx I 과 Prx II가 증가 한 것을 비롯하여, 분자량과 등전점(pI)이 약간 변화된 형태의 Prx III가 폐암조직에 존재함을 알 수 있었다. 한편, 폐암 조직의 non-reducing 전기영동 후 Western blot에서는, monomer와 dimer 사이의 중간 크기에 해당하는 약 40 kDa과 200 kDa 이상 크기의, 항 Prx 항체와 반응하는 단백 띠 (reactive bands)가 관찰되었다. 결 론 : 폐암 조직에서 관찰되는 Prx I 과 Prx III 유형 및 Trx의 과발현 양상은, 종양 세포들이 주변의 미세 환경으로부터 겪는 여러 스트레스에 대하여 단백질을 보호하고 세포의 생명력을 유지하는데 있어 주요한 역할을 하는 것으로 사료된다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2012년도 춘계학술대회
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• pp.842-845
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• 2012

의료기기는 헬스케어 서비스를 위한 필수요소로 최근 의료와 관련된 스마트폰 애플리케이션의 증가와 함께 스마트폰과 연결되는 의료기기를 활용한 스마트 헬스케어가 대두되고 있다. 이러한 스마트 헬스케어는 현재 ISO/IEEE 11073 표준을 통해 의료기기와 게이트웨이를 연결하여 임상정보를 전송하고 게이트웨이는 HL7 CDA 표준 문서를 통해 전자 건강 기록 및 개인 건강 기록 시스템, 임상 워크플로우 및 임상 의사 결정 지원 시스템과 같은 유형의 의료 서비스 시스템과 연동하는 솔루션이다. ISO/IEEE 11073은 DIM(Domain Information Model)이라는 정보 모델을 기반으로 하며 HL7 v3인 CDA는 RIM(Reference Information Model)이 있기 때문에 상이한 인터페이스간의 매핑 매커니즘을 필요로 한다. 이에 본 논문에서는 스마트폰 환경에서 의료 응용 애플리케이션에서의 효율적인 의료기기 데이터 운용을 위해 RMIM(Refined Message Information Model) 기반의 IEEE 11073 DIM/HL7 v3 RIM 표준 인터페이스 변환 방법을 제안한다.

• Tuberculosis and Respiratory Diseases
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• 제79권2호
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• pp.91-97
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• 2016

Background: Chronic obstructive pulmonary disease (COPD) is sometimes complicated with pneumonia, but little is known about the risk factors that promote the development of pneumonia in COPD. These risk factors were evaluated in the present study. Methods: The data of 324 patients with COPD from a prospective multi-center observational cohort with obstructive lung disease were evaluated retrospectively. To identify risk factors for the development of pneumonia in COPD, the clinical and radiological data at enrollment and the time to the first episode of pneumonia were analyzed by Cox proportional hazard analysis. Results: The median follow-up time was 1,099 days and 28 patients (8.6%) developed pneumonia. The Cox analysis showed that post-bronchodilator forced expiratory volume in one second ($FEV_1$, % of predicted) and the computed tomography (CT) emphysema extent (inspiratory V950) were independent risk factors for the development of pneumonia (post-bronchodilator $FEV_1$: hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.94-1.00; p=0.048 and inspiratory V950: HR, 1.04; 95% CI, 1.01-1.07; p=0.01). Conclusion: Emphysema severity measured by CT and post-bronchodilator $FEV_1$ are important risk factors for the development of pneumonia in COPD.