• 디지털융복합연구
• /
• 제10권11호
• /
• pp.493-502
• /
• 2012

본 연구는 진료비 삭감율에 영향을 미치는 의료기관의 운영요인과 환경요인이 무엇인지 알아보기 위한 연구로 삭감율을 최초 삭감율과 최종 삭감율로 구분하고, 진료비는 입원과 외래로 구분하여 조사 연구 하였다. 연구의 자료는 전국 병원급 이상 독립된 보험심사부서의 부서장을 대상으로 직접 설문조사를 통해 얻어진 205부의 설문지를 최종 분석 자료로 이용하였다. 본 연구의 결과는 다음과 같다. 진료비 최초 삭감율과 최종 삭감율에 대한 집단 간의 차이를 분석한 결과 입원의 의료기관 운영요인은 보유 병상, 총 진료과, 보험심사 인력, 총 직원수에 유의한 결과를 보였으며, 외래는 의무기록 운영형태, 보유병상, 총 진료과, 보험심사인력, 총 직원수에 유의한 결과를 보였다. 진료비 삭감율에 영향을 미치는 의료기관의 운영요인은 최초 삭감과 최종 삭감이 동일하게 입원은 병상수가 높을수록, 외래는 전자의무기록을 시행할수록 유의한 결과를 보였다. 진료비 삭감율에 영향을 미치는 의료기관의 환경요인은 최초 삭감과 최종 삭감이 동일하게 입원은 업무협조가 잘 될수록, 지표관리를 시행할수록, 시간외 수당이 지급될수록 유의한 결과를 보였다. 외래의 경우 진료비 최초 삭감은 지표관리를 시행할수록, 진료비 관련 위원회를 구성하여 운영할수록 유의한 결과를 보였으며, 최종 삭감은 업무협조가 잘 될수록, 지표관리를 시행할수록, 시간외수당이 지급될수록 유의한 결과를 보였다.

• 식물분류학회지
• /
• 제46권1호
• /
• pp.83-116
• /
• 2016

본 연구는 욕지도의 관속식물상과 식생을 밝히기 위하여 2015년 3월부터 2016년 1월까지 총 6회에 걸쳐 21일간 현지조사를 실시하였다. 관속식물은 113과 354속 487종 4아종 50변종 4품종 2교잡종의 총 547분류군으로 정리되었다. 이 중 기존의 조사에서는 발견되지 않았으나 본 연구에서 처음으로 밝혀진 분류군은 314분류군이었다. 한반도 고유종 8분류군, IUCN 평가기준에 따른 적색목록식물 6분류군, 식물구계학적 특정식물 86분류군이 조사되었다. 본 조사지에서 다른 지역에 비해 특이적으로 분포하는 식물은 99분류군이며, 이 중 남방계식물은 97분류군, 제한분포 식물은 2분류군이 확인되었다. 귀화식물은 74분류군이 발견되었다. 욕지도의 산림식생은 곰솔군락과 사방오리군락이 주를 이루는 것으로 나타났다. 군락의 수직구조는 안정적이었으며, DBH-class 분석 결과 교목층의 우점종이 유지될 것으로 나타났다. 간벌과 같은 교란인자가 제거되면 초본과 목본종의 구성은 현재와 다른 양상이 나타날 것으로 보인다.

• 건축역사연구
• /
• 제21권5호
• /
• pp.33-46
• /
• 2012

The purpose of this study lies on reinterpreting the geography books in Joseon dynasty as records of the cities and consequently suggesting directions for further urban research. Geography books of Joseon dynasty are valuable references to understand the national policy, and imply that the focus of the contents is on the system. Especially, military system is an important concept to understand city type in that period, relationships between cities, selection of location, etc. The results of review are as following: First, military system is not a permanent fixture and therefore reflects changes in urban policies along with the history. The system suggests valuable clues on urban development as it is state-run, and closely associated with national land development. Second, counties and prefectures under jurisdiction of district called Eupchi(邑治) had cities as important as or even more important than local government such as Yeong-a(營衙), Jinbo(鎭堡), Yeok(驛: administrative cities). Such special regions need to be studied as other type of cities in Joseon dynasty by defining their architectural characteristics and roles. Third, the relationship of cities such as Eupch, Yeong-a, and Jinbo, was reorganized according to the local military system. Eupchi, administrative city, along with Yeong-a and Jinbo evolved into a military city as it became systematically organized. The characteristics of Yeok needs to be reconsidered in the context of such new inter-city relationship. Fourth, considerations which should be reviewed in the geography based on this concept can be mainly classified into architecture and landscape. This will also lay the foundation, and suggest new directions for further research for Eupchi, Yeong-a, Jinbo, and Yeok. Fifth, description of the geography looks simple at first sight, but with thorough understating on the system, there are chances to interpret objective reasoning of position and landscape in the overall flow of region, area, etc. Bongsu(烽燧), signal-fire, can be an object of comparison with geographical features and position. Furthermore, advantageous position is a historical and geographical element showing the major context of the region.

• Advances in pediatric surgery
• /
• 제16권2호
• /
• pp.134-142
• /
• 2010

Malignant ovarian tumors in children are very rare, and consist of about 1 % of all childhood malignant tumors. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with malignant ovarian tumors. We retrospectively reviewed the medical records of children under 15 years of age with malignant ovarian tumors who had been treated surgically at Asan Medical Center between 1989 and March 2009. There were 32 patients, ranged in age at surgery from 2 to 15 years (mean; 10.4 years). The median follow-up period was 64.7 months (from 1 month to 188 months). Pathologic diagnosis were; immature teratoma (n=10), mixed germ cell tumor (n=10), and dysgerminoma (n=6). Tumor stage was classified by the staging system of the International Federation of Gynecology and Obstetrics (FIGO). The number of patients in stage I, II, III, and IV were 24 (75 %), 2 (6.2 %), 4 (12.5 %), and 2 (6.1 %), respectively. The tumor recurred in 4 patients. Seven patients of group 1 did not receive postoperative adjuvant chemotherapy, and in three of them, the tumor recurred. Twenty-five patients (group 2) underwent postoperative adjuvant chemotherapy, and there was only one recurrence. One patient who did not receive postoperative adjuvant chemotherapy and expired 10 months after operation because of tumor recurrence and distant metastasis. The overall 5-year event free survival (EFS) was 84.2 %: group 1 in 44.4 %, and group 2 in 95.7 %. Tumor recurrence was related to the postoperative adjuvant chemotherapy (p=0.004). In conclusion, proper surgical procedures with relevant postoperative adjuvant chemotherapy might improve clinical results in children with malignant ovarian tumors.

• 대한의료기공학회지
• /
• 제18권1호
• /
• pp.1-26
• /
• 2018

The objective of this study is to verify the effects of Moosim-Gi-Gong Doinbeop on low back pain targeting low back pain patients hospitalized in Korean medicine hospitals. For the study, 44 adult female and male patients hospitalized with low back pain at M Korean Medicine Hospital and H Korean Medicine Hospital located in Gimpo, Gyeonggi Province were recruited. The subjects had a temperature difference between left and right 湧泉(KI1) of over 0.5℃ through infrared thermographic imaging, and 23 of them were classified in the control group for retrospective analysis based on the test records. Infrared thermographic imaging, X-ray pelvic AP view - standing position, a sit-and-reach test and a VAS survey were employed for detection, and IBM SPSS Statistics 24 for the statistical process. The results were rounded down to three decimal places as in an average±standard deviation, and the significance level was 0.05 to be evaluated significant if p<0.05. The result of the study is as follows: 1. In the comparison between before and after conducting Moosim-Gi-Gong Doinbeop, the meaningful difference was shown in the experimental group in all indicators. But Indicators except for the temperature difference between right and left 湧泉(KI1)(difference between before and after) and In displaced pelvic correction indicators on the X-ray showed a significant difference in the control group. 2. As for the variation widths of the experimental group and the control group, the former showed significant temperature differences between 印堂(EX-HN3) and 關元(CV4) and right and left 湧泉(KI1); difference variations of anteflexion; and changes in PI and In displacement on the X-ray. 3. As for changes in the experimental group according to demographic characteristics, gender, age and degree of obesity did not show significant differences in all indicators. However, those who experienced back pain for more than six months in the experimental group showed the biggest body temperature differences between 印堂(EX-HN3) and 關元(CV4), while other indicators had no significant difference. As a result, patients who received Korean medicine treatment showed relieved back pain and improvement in pelvic correction and sports activity; however, those who got Moosim-Gi-Gong Doinbeop together showed more clearer improvement effects in pelvic correction and sports activity.

• 복식
• /
• 제43권
• /
• pp.243-258
• /
• 1999

This is a study of CHOK-DU-RI(族頭里) a black crown-like headpiece worn by woman on formal occasion in Chosun Dynasty and has succeeded until now. CHOK-DU-RI was originated by BOKTAK worn by Mongolian noblewomen and inflowed to the last period of Koryo dynasty under occupation of Yuan. The documentary records of O-JU-YON-MUN-CHSNG-JON-SAN-KO( by Lee Kyu-kung CHUNG-JANG-KWAN-JON-SUH by Lee Tock-mu and KO-SA-TONG by choe Nam-sun verify CHOK-DU-RI is a custom of mongolian fusion that was affected by KO-KO of Yuan and was formed. Ko-Ko is the same as BOKTAK. It is assumed KO-KO is a borrowed name as its transcription varies. The name was given according to its appearance which is certified by the record CHANGCHUN-CHIN-IN-SEO-BANG-YU-RAM-KI. It says that it can be simply named KO-KO as its edge is alike ad goose or a duck. In addition KO-Ko was called CHOGTAI in case of being added a camel fur that is JUGDUR. CHOGTAI similarily pronounced with CHOK-DU-RI which of being added a camel fur that is JUGDUR, CHOGTAI similarily pronounced with CHOK-DU-RI which provd CHOK-DU-RI was originated in Mongol. The shape of BOKTAK is very high and wided toward the top with the top with the angle getting more pointed and a feather stuck on the side. But its height got lower and its size smaller as it did gradually Koreanized to a CHOK-DU-RI. The use of CHOK-DU-RI has been settled since the last period of Chosun Dynasty. It came to stay as a popular custom when King Young-jo and Jong-jo wanting to do away with the corrupt practice of KA-CHE encouraged women at that time to do their hairs with CHOK-DU-RI instead of KA-CHE. It is as follows the classification of CHOK-DU-RI. First classified by a use group is divided into ceremonial use such as the seven treasures CHOK-DU-RI and jeweled CHOK-DU-RI. Hereby it is assumed that CHOK-DU-RI was used regardless of fortune. Secondly it varies by its type of frame. There are SOM CHOK-DU-RI OHT CHOK-DU-RI and O-YOM CHOK-DU-RI a kind of SOM CHOK-DU-Ri formed a base of O-YOM-MO-RI. The third group by jeweling has WHE-BONG CHOK-DU-RI and TA-BONG-CHOK-DU-RI JEwele CHOk-DU-RI can be still seen being commercially lent and worn by the brides at nuptical ceremonies performed in tradition of fashion and when worn bya bride as she gives her parents to her parents-in-law.

• 약학회지
• /
• 제58권2호
• /
• pp.141-149
• /
• 2014

Background: Oriental lifestyle for treating diseases has been developed and well-accepted for a long time among Koreans. Sasang Constitution theory, originated from Korean traditional medicine, suggests that medication treatment should be differentiated by each patient's body classification (So-yang [SY], So-eum [SE], Tae-yang [TY], and Tae-eum [TE]), in contrary to western medicine's theory that medication should be applied equally by disease indication without such classification. However, the pharmacotherapeutic outcomes of these theories have not been compared to date. In this study, we aimed to compare the two theories by evaluating blood pressure (BP), which is lowered as a therapeutic outcome, among hypertensive patients taking angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs), two most commonly used antihypertensive classes in Korea. Methods: From April 2006 to June 2012, we retrospectively collected data on hypertensive patients with Sasang Constitution classification at Kyunghee University Hospital at Gangdong, one of the East-West collaborative medical centers in Korea. We collected information on age, gender, underlying diseases, antihypertensive drugs (ARB, CCB, ARB+CCB), and BP by reviewing the electronic medical records. We excluded patients with missing blood pressure at baseline or follow-up, or those who had a change in their antihypertensive drug class during follow-up. Results: We selected a total of 573 patients (SY: 165, SE: 158, TY: 0, TE: 250). Baseline BPs were on average 139.0/82.0 mmHg for SY, 137.8/78.5 mmHg for SE, and 138.7/79.2 mmHg for TE. In all three groups, CCBs were the most prescribed, followed by combination therapy with ARB+CCB, then ARBs. BP reduction after 1 month of initial medication was significantly different among the drug classes, but not in Sasang constitutional classification (ARB [SY: -12.4/-4.7, SE: -12.3/-2.5, TE: -8.6/-1.8], CCB [SY: -12.3/-5.4, SE: -13.0/-2.3, TE: -10.8/-6.0], ARB+CCB [SY: -15.6/-6.7, SE: -18.4/-8.1, TE: -20.2/-6.7], drug [$P{\leq}0.05$/P>0.05], constitutional type [P>0.05/P>0.05]). Conclusion: We observed significant differences in reduction of blood pressure by classes of drugs (ARB+CCB>CCB>ARB) but not by Sasang constitutional classification. Therefore, current approach of antihypertensive pharmacotherapy assisted by Western medicine is appropriate for treatment of hypertension. However, further larger scale or prospective studies are required in order to confirm these results.

• 임상간호연구
• /
• 제26권2호
• /
• pp.207-216
• /
• 2020

Purpose: The purpose of this study was to investigate the motor subtypes of delirium in patients in a Surgical Intensive Care Unit (SICU), and identify the factors related to the characteristics of patients according to the motor subtypes of delirium. Methods: Data were collected in the SICU of a tertiary hospital in ^⁎ city from October 2018 to June 2019. Delirium was detected using the Confusion Assessment Method for the ICU (CAM-ICU) and motor subtypes of delirium were measured with the Delirium Motor Subtype Scale (DMSS)-4. Patients' characteristics were obtained by using the electronic medical records. Descriptive statistics were used to analyze the data. Results: Among 1,112 patients, 172 patients showed delirium (15.5%). After excluding dementia patients and patients refusing to participate in the study, 126 patients included in the final analysis. Delirium patients were classified as hyperactive delirium (32.5%), hypoactive delirium (42.9%), mixed delirium (11.9%), and non-motor subtype delirium (12.7%). Conclusion: The study results suggest that hypoactive delirium is the most prevalent motor subtype of delirium in SICU. More application of ventilators, more administration of sedatives, more use of catheters, and higher nursing severity were reported for hypoactive delirium cases than hyperactive ones. Therefore, it is necessary to assess early the motor subtypes of delirium using structured tools and develop appropriate nursing interventions suitable for each subtype of delirium.

• 대한예방한의학회지
• /
• 제12권2호
• /
• pp.61-72
• /
• 2008

Objectives : The aim of this study was to evaluate effects of herbal medicine and other associated factors for abnormal liver function tests(especially total bilirubin, AST, ALT, and ${\gamma}$GT) levels in outpatients at an oriental medical clinic. Methods : A cross-sectional study based on clinical records was conducted on 504 patients at one Oriental medical clinic in Seoul, Korea. They were tested a liver function tests for screening and 497 patients ranging from the age of 4 to 74 were chosen for the study. Patients with basal liver disease or DM were excluded during the screening process. Patients were classified into case(abnormal) and control(normal) groups by normal liver function test references. Results and Conclusions : In this study, Significant correlations for abnormal total bilirubin levels was age, for abnormal AST was gender, for abnormal ALT were gender, smoking, marriage status, and job, for abnormal ${\gamma}$GT were age, gender, obesity, alcohol, smoking, marriage status, and job using the Chi-square test(p<0.05). There was no significant correlations for abnormal LFTs by using herbal medication history, and intake duration. After controlling other covariates, logistic regression analysis showed that the significant associated factors for abnormal total bilirubin levels were age(odds ratio[OR]=0.87, 95% confidence intervals [CI]=0.87-0.99). For abnormal AST levels was obesity(OR=2.45, CI=1.2-4.9), for abnormal ALT levels were age(OR=1.01, CI=0.99-1.03), male gender(OR=3.31, CI=1.62-6.76), and obesity(OR=3.71 CI=2.28-6.08). For abnormal ${\gamma}$GT levels were male gender(OR=4.83 CI=1.34-17.43), obesity(OR=3.29, CI=1.74-6.22), alcohol (OR=2.51, CI=1.19-5.28), and smoking(OR=2.29, CI=1.16-4.50). Herbal medication history was not as a risk factor for all abnormal liver function tests. Therefore, people who are male, obese, alcohol drinker and smoker will have higher liver function test levels. But intake of herbal medication or the duration of intake may not be the risk factor for abnormal liver function test results.

• Journal of Animal Science and Technology
• /
• 제50권3호
• /
• pp.309-314
• /
• 2008

본 연구의 목적은 경주로 상태가 더러브렛 경주마의 주파기록에 미치는 영향을 구명하기 위하여 수행되었으며, 이용된 자료는 한국마사회로부터 수집한 8,189두의 주파기록 총 148,865개로 얻어진 결과는 다음과 같다. 경주로의 상태는 경주로의 수분함량에 따라 건조, 양호, 다습, 포화 그리고 불량 주로로 분류하였으며, 각 경주로 상태의 빈도는 전체 빈도에 대하여 40.7%, 34.4%, 14.4%, 8.7% 그리고 1.8%로서 건조 주로의 빈도가 가장 높게 나타난 반면 포화 및 불량 주로의 빈도는 낮게 나타났다. 대체적으로 봄과 겨울에는 건조 주로가 여름에는 불량 주로의 빈도가 증가하며, 가을에는 양호 주로의 빈도가 높은 것으로 나타났다. 경주거리별 주파기록에 대한 수분함량의 회귀계수는 －0.068 ~ －0.162초의 범위를 나타내었다. 모든 경주거리에서 주파기록은 불량 주로에서 가장 우수하였으며, 경주거리별로 불량 주로와 건조 주로 사이의 기록차이는 －1.47 ~ －3.41초의 범위를 나타내었다.