• Journal of Chest Surgery
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• 제56권4호
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• pp.264-271
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• 2023

Background: The optimal management strategy for aortoiliac occlusive disease (AIOD) remains debatable. This study compared early and late outcomes between direct surgical bypass and kissing stents for AIOD treatment. Methods: We retrospectively reviewed data, including age, sex, risk factors, comorbidities, symptoms, TransAtlantic Inter-Society Consensus (TASC) II classification, operation time, perioperative complications, in-hospital mortality, and length of hospital stay, from a cohort of 46 patients treated for AIOD (24 with kissing stents and 22 with direct surgical bypass) at Pusan National University Hostpital from January 2007 to December 2016. The primary, assisted primary, and secondary patency rates in both groups were compared. Results: The hospital stay (direct surgical bypass vs. kissing stents: 16.36±5.19 days vs. 9.08±10.88 days, p=0.007) and operation time (direct surgical bypass vs. kissing stents: 316.09±141.78 minutes vs. 99.54±37.95 minutes, p<0.001) were significantly shorter for kissing stents. Kaplan-Meier analysis revealed that the primary, assisted primary, and secondary patency rates in the direct surgical bypass group were 95.5%, 95.5%, and 95.5%, respectively, at 1 year; 86.4%, 86.4%, and 95.5% at 3 years; and 77.3%, 77.3%, and 95.5% at 5 years. The primary, assisted primary, and secondary patency rates in the kissing stent group were 100.0%, 100.0%, and 100.0%, respectively, at 1 year; 95.8%, 95.8%, and 100.0% at 3 years; and 95.8%, 95.8%, and 100.0% at 5 years. Conclusion: Except for special cases wherein endovascular revascularization is difficult, kissing stents are more advantageous for TASC II C and D lesions.

• Strategy21
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• 통권37호
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• pp.65-103
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• 2015

This study is an attempt to look into the future role of the ROKN and to provide a strategic way forward with a special focus on naval strategic concept and force planning. To accomplish this goal, this research takes four sequential steps for analysis: 1) assessing the role and utility of naval power of ROKN since its foundation back in 1945; 2) forecasting features of various maritime threats to influence the security of Korea in the future directly or indirectly; 3) identifying the roles to be undertaken by future ROKN; and 4) recommending Korean way of naval force planning and the operational concept of naval power. This study seeks to show that ROKN needs comprehensive role to better serve the nation with respect to national security, national prosperity and development, and future battle-space management. To safeguard the national security of Korea, it suggests three roles: 1) national guard for the peaceful unification; 2) protector of the maritime sovereignty; and 3) suppressor to maritime threats. Three more roles are highlighted for national prosperity: 1) escort of the national economy; 2) guardian for national maritime activities; and 3) contributor to the world peace. These roles need to be closely connected with the role for the battle-space management. This paper addresses the need for a dramatic shift of the central operational domain from land to maritime in the future. This will eventually offer future ROKN a leading role for developing strategic concept and force planning rather than merely a supporting one. This study finally suggests 'balanced' strategy both in concept development and force planning. A balanced force planning is a 'must' rather than an 'option' when considering a division of function between Task Fleets and Area Fleets, constructing cutting-edge conventional forces such as Aegis destroyer, CVs, or submarines, and the mix of high-profile platform and low-profile when composing future fleets. A 'balance' is also needed in operational concept. The fleet should be prepared to fulfill its missions based on two different types of force operation i.e., coercive or cooperative application of the utility of naval force. The findings and recommendations of the study are relevant today, and will be increasingly important in the future to achieve various political goals required by enhancing the utility of naval power.

• 초등상담연구
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• 제11권2호
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• pp.299-320
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• 2012

본 연구는 상보적 수업을 활용한 읽기전략 학습상담프로그램이 초등학생의 독해력, 초인지 및 자기효능감에 미치는 효과를 알아보는데 그 목적이 있다. 이를 위해 중소도시 초등학교 5학년 2개 학급을 각각 실험집단과 통제집단으로 선정하고, 실험집단에 5주 동안 총 10회기의 상보적 수업을 활용한 읽기전략 학습상담프로그램을 실시하였다. 연구의 결과는 다음과 같다. 첫째, 상보적 수업을 활용한 읽기전략 학습상담프로그램은 초등학생들의 독해력과 그 하위 요인인 사실적 이해와 감상적 이해 영역에서 유의한 효과가 있었다. 둘째, 상보적 수업을 활용한 읽기전략 학습상담프로그램은 초인지의 하위요인인 조정 영역에서 유의한 효과가 있었다. 셋째, 상보적 수업을 활용한 읽기전략 학습상담프로그램은 자기효능감에서 유의한 효과가 있었다. 새로운 읽기전략에 대한 경험과 또래집단 구성원간에 주고받는 도움과 성공 경험이 자기효능감에 긍정적인 영향을 준 것으로 볼 수 있다. 넷째, 학생의 활동보고서 및 연구자의 관찰결과와 함께 프로그램에 대한 만족도 평가를 실시한 결과에서 초등학생들이 협동학습을 통해 학습 집단에서 공동 목표를 설정하고 그 목표를 달성하기 위해서 함께 노력하여 다른 구성원에게 도움을 주고받으며 즐겁게 참여하는 것이 긍정적인 프로그램 효과에 기여하였음을 확인할 수 있었다. 이상과 같은 연구 결과를 통해 상보적 수업을 활용한 읽기전략 학습상담프로그램이 초등학생들의 독해력, 초인지, 자기효능감을 향상시키는데 긍정적인 효과가 있었다.

• 컴퓨터교육학회논문지
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• 제12권5호
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• pp.49-62
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• 2009

평생교육기관의 역할을 수행하고 있는 방송통신고등학교의 특별활동은 제반 여건의 부족과 수업 연구에 대한 부족으로 사실상 운영되지 못하고 있는 실정이다. 이에 본 연구에서는 방송고 특별활동의 효과적인 운영 방안을 탐색하기 위하여 특별활동 온라인 콘텐츠를 방송고에 시범 적용하였으며, 그 결과 수업 운영에 필요한 시사점을 도출하였다. 이러한 시사점을 바탕으로 방송고 특별활동 운영에 필요한 5가지 Blended-Learning 영역을 선정하였으며, 이 중 방송고 특별활동에 맞는 교수 학습 방법과 전략을 블랜딩한 직접교수모형을 구안하였다. 따라서 이러한 연구 결과를 바탕으로 방송고 학생의 특수성과 특별활동 내용상의 특성을 반영한 방송고 특별활동 Blended-Learning 수업 모형을 개발하였다.

• 대한간호학회지
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• 제30권1호
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• pp.18-28
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• 2000

The Purpose of this study is to extend the understanding and knowledge of menopause by comparing menopausal symptoms of married women and nuns in order to improve health and the quality of life for women. In this study a questionnaires were distributed to 116 nuns and 121 married women, from forty to fifty nine years old in Daegu metropolitan city. This study used the measurement of menopausal symptoms (Cronbach's Alpha=0.96) corrected and complemented by this student with consideration of various literature centered around menopausal symptoms, suggested by Janette M. Perz as 51 questions including 4 realms; [mental psychological factors], [physical physiological factors], [eyesight factors], and [urinary generative factors] in order to measure the degree of menopausal symptoms. The results are as follows : 1. There was a significant difference between educational background, religion, occupation, leisure time, satisfaction of marriage or ascetic life, existence of hormonal treatment, name of medical operation, and existence of counselling about menstruation as general and physiological characteristics of the nuns' group and the married women's group. 2. The menopausal symptoms of the nuns' group and the married women's group according to order in which they were presented were; 'feeling tired and lacking in energy(1.71 points)' 'vision not clear or clouded(1.69 points)', and 'be forgetful (1.57 points)' in nuns' group. 'be forgetful (1.87 points)', 'vision not clear or clouded(1.83 points)' and 'feeling tired and lacking in energy(1.76 points)' in the married women's group. The symptoms which showed the highest rank of menopausal symptoms had a maximum score of 4 points. 3. There was a statistical a significance (t=-3.9807, p<.0001) between the two groups which showed, on an average, 57.92 points in the married women's group and 43.03 points in the nuns' group from 0 to 196 of the possible points of menopausal symptoms. In difference of menopausal symptoms by menstrual aspect of the nuns' group and the married women's group, there was statistically significant difference between the two groups, showing 44.81±26.07 score in the nuns' group and 72.33±35.29 score in the married women's group as the mean score of the groups with no menstruation(t=-4.1132, p=0.0001). 4. The differences in menopausal symptoms with respect to the general and physiological characteristics of the nuns' group and the married women's group were that the nuns' group showed less menopausal symptoms on all the items than that of the married women's group. Finally, in these results, the married women's group showed higher menopausal symptoms than that of the nuns' group. Especially as the score of menopausal symptoms since the climacteric was very high it is confirmed to be a new phenomenon. Accordingly, it is considered to be necessary to carry out an indepth study of the factors related to establishing a strategy for nursing service.

• 간호행정학회지
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• 제21권3호
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• pp.243-253
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• 2015

Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

• 호스피스학술지
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• 제3권2호
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• pp.19-33
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• 2003

Cancer causes many crises to cancer patients imcluding physical dysfunction and emotional changes such as anxiety, depression as well as a threat of life, fear of death. As it develops, cancer makes people feel powerlessness due to the losses of their own positions, roles and independence. Although occupying a little proportion among all types of cancer, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking, provoke anxiety and depression after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. This study is a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research design to determine, how nursing intervention has effects on anxiety, depressing of head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher with reference to a literal review and esperts' advice. The measurement tool of anxiety was consisting of totaled 20 question items which was prepared by Spielberger and translated by Kim et al., the device of depression measurement consisting of total 20 question items which was the output of Song's translation the device of depression self-evaluation from Zung. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using x2-test and t-test. 5 hypoteses were tested using t-test. The results of the study can be summarized as follows. 1.The first hypothesis that the experimental group receiving supportive nursing intervention shows a little anxiety than the control group not receiving supportive nursing intervention was supported(t=3.817, P=.000). 2.The second hypothesis that the experimental group receiving supportive nursing intervention shows a little depression than the control group not receiving supportive nursing intervention was supported(t=8.089, P=.000). Consequently, supportive nursing intervention was found an effective nursing intervention strategy to reduce anxiety and depression of head and neck cancer patients. Providing supportive nursing intervention in nursing practice can enhance the quality of life of those cancer patients.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.472-478
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• 2001

Objectives : The authors present a retrospective analysis of 100 consecutive adult patients harboring craniopharyngiomas who underwent microsurgical resection between 1981 and 1999 to assess the long-term outcome of surgical treatment and to determine the most optimal management strategy. Methods : The extent of surgical removal was divided into four categories ; GTR(gross total removal), RSTR(radical subtotal removal), STR(subtotal removal),and PR(partial removal). The median follow-up period was 50 months(4-198). CT scan and/or MR imaging and hormonal status were evaluated to the last follow-up. Results : Visual disturbance was the most common presentation, which was improved in 42 cases and aggravated in 19 cases following the operation. Hypopituitarism was detected in 56 patients preoperatively, 82 during the immediate postoperative period, and 76 at the last follow-up. Improvement of pituitary function was not observed in any of these patients. Twenty of 100 patients showed recurrence at the mean of 27 months(3 to 196). The median progression-free survival(PFS) time of all patients was 145 months and 5-year PFS rate was 74%. Five-year PFS rate of GTR or RSTR group(71%) was significantly higher than that of STR or PR group(30%)(p=0.01). Postoperative radiation therapy significantly prolonged the PFS from 94 months in non-radiation group to 182 months(p=0.002). However, there was no statistical difference in number of patients who required hormonal replacement therapy between radiation and non-radiation group. Conclusion : Visual disturbance can be improved by early diagnosis and surgical decompression. GTR or RSTR in selected patients is considered a proper surgical strategy. Post-operative radiation therapy for residual tumors must be considered, although the ideal timing of radiation therapy is to be determined.

• 안보군사학연구
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• 통권13호
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• pp.687-738
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• 2016

To prepare for the complicated international relationship regarding Korean Peninsula after reunification, this thesis started off with the awareness that Unified Korea should build its international posture and national security at an early stage by determining its appropriate military strength for independent defense and military strategies that Unified Korea should aim. The main theme of this thesis is 'The research on appropriate military strength of the Unified Korean military'. To derive appropriate military strength of Unified Korea, this research focuses on conflict scenario and relative balance strategy based on potential threats posed by neighboring countries, and this is the part that differentiates this research from other researches. First of all, the main objective of the research is to decide appropriate military strength for Unified Korea to secure defense sufficiency. For this, this research will decide efficient military strategy that Unified Korea should aim. Than by presuming the most possible military conflict scenario, this research will judge the most appropriate military strength for Unified Korea to overcome the dispute. Second, after deciding appropriate military strength, this research will suggest how to operate presumed military strength in each armed force. The result of this thesis is as in the following. First, Unified Korea should aim 'relative balance strategy'. 'Relative balance strategy' is a military strategy which Unified Korea can independently secure defense sufficiency by maintaining relative balance when conflicts occur between neighboring countries. This strategy deters conflicts in advance by relative balance of power in certain time and place. Even if conflict occurs inevitably, this strategy secures initiative. Second, when analyzing neighboring countries interest and strategic environment after unification, the possibility of all-out war will be low in the Korean Peninsula because no other nation wants the Korean Peninsula to be subordinated to one single country. Therefore appropriate military strength of the Unified Korean military would be enough when Unified Korea can achieve relative balance in regional war or limited war. Third, Northeast Asia is a region where economic power and military strength is concentrated. Despite increasing mutual cooperation in the region, conflicts and competition to expand each countries influence is inherent. Japan is constantly enhancing their military strength as they aim for normal statehood. China is modernizing their military strength as they aspire to become global central nation. Russia is also enhancing their military strength in order to hold on to their past glory of Soviet Union as a world power. As a result, both in quality and quantity, the gap between military strength of Unified Korea and each neighboring countries is enlarged at an alarming rate. Especially in the field of air-sea power, arms race is occurring between each nation. Therefore Unified Korea should be equipped with appropriate military strength in order to achieve relative balance with each threats posed by neighboring countries. Fourth, the most possible conflicts between Unified Korea and neighboring countries could be summarized into four, which are Dokdo territorial dispute with Japan, Leodo jurisdictional dispute with China, territorial dispute concerning northern part of the Korea Peninsula with China and disputes regarding marine resources and sea routes with Russia. Based on those conflict scenarios, appropriate military strength for Unified Korea is as in the following. When conflict occurs with Japan regarding Dokdo, Japan is expected to put JMSDF Escort Flotilla 3, one out of four of its Japan Maritime Self-Defense Force Escort Fleet, which is based in Maizuru and JMSDF Maizuru District. To counterbalance this military strength, Unified Korea needs one task fleet, comprised with three task flotilla. In case of jurisdictional conflict with China concerning Leodo, China is expected to dispatch its North Sea fleet, one out of three of its naval fleet, which is in charge of the Yellow Sea. To response to this military action, Unified Korea needs one task fleet, comprised with three task flotilla. In case of territorial dispute concerning northern part of the Korean Peninsula with China, it is estimated that out of seven Military Region troops, China will dispatch two Military Region troops, including three Army Groups from Shenyang Military Region, where it faces boarder with the Korean Peninsula. To handle with this military strength, Unified Korea needs six corps size ground force strength, including three corps of ground forces, two operational reserve corps(maneuver corps), and one strategic reserve corps(maneuver corps). When conflict occurs with Russia regarding marine resources and sea routes, Russia is expected to send a warfare group of a size that includes two destroyers, which is part of the Pacific Fleet. In order to balance this strength, Unified Korea naval power requires one warfare group including two destroyers. Fifth, management direction for the Unified Korean military is as in the following. Regarding the ground force management, it would be most efficient to deploy troops in the border area with china for regional and counter-amphibious defense. For the defense except the border line with china, the most efficient form of force management would be maintaining strategic reserve corps. The naval force should achieve relative balance with neighboring countries when there is maritime dispute and build 'task fleet' which can independently handle long-range maritime mission. Of the three 'task fleet', one task fleet should be deployed at Jeju base to prepare for Dokdo territorial dispute and Leodo jurisdictional dispute. Also in case of regional conflict with china, one task fleet should be positioned at Yellow Sea and for regional conflict with Japan and Russia, one task fleet should be deployed at East Sea. Realistically, Unified Korea cannot possess an air force equal to neither Japan nor China in quantity. Therefore, although Unified Korea's air force might be inferior in quantity, they should possess the systematic level which Japan or China has. For this Unified Korea should build air base in island areas like Jeju Island or Ullenong Island to increase combat radius. Also to block off infiltration of enemy attack plane, air force needs to build and manage air bases near coastal areas. For landing operation forces, Marine Corps should be managed in the size of two divisions. For island defense force, which is in charge of Jeju Island, Ulleung Island, Dokdo Island and five northwestern boarder island defenses, it should be in the size of one brigade. Also for standing international peace keeping operation, it requires one brigade. Therefore Marine Corps should be organized into three divisions. The result of the research yields a few policy implications when building appropriate military strength for Unified Korea. First, Unified Korea requires lower number of ground troops compared to that of current ROK(Republic of Korea) force. Second, air-sea forces should be drastically reinforced. Third, appropriate military strength of the Unified Korean military should be based on current ROK military system. Forth, building appropriate military strength for Unified Korea should start from today, not after reunification. Because of this, South Korea should build a military power that can simultaneously prepare for current North Korea's provocations and future threats from neighboring countries after reunification. The core of this research is to decide appropriate military strength for Unified Korea to realize relative balance that will ensure defense sufficiency from neighboring countries threats. In other words, this research should precisely be aware of threats posed by neighboring countries and decide minimum level of military strength that could realize relative balance in conflict situation. Moreover this research will show the path for building appropriate military strength in each armed force.

• 한국사회복지학
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• 제36권
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• pp.101-127
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• 1998

본 연구에서는 재가복지서비스를 위해 인적자원을 개발하고 이러한 인적자원을 효율적으로 관리하기 위한 관리체계 모형을 제시하고자 부산지역의 청소년 직장인 주부 장애인 노인집단을 대상으로 조사를 실시하여, 조사 결과와 관련이론들을 바탕으로 재가복지서비스에 있어서 중요한 인적자원인 자원봉사자의 개발 및 관리체계 모형을 모집, 교육 및 훈련, 배치, 관리 및 지도감독, 그리고 평가의 다섯 단계로 구성하여 제시했다. 본 연구의 연구방법은 국내외의 선행연구 및 재가복지서비스와 관련되는 각종 문헌들의 검토를 통한 문헌연구와 사회조사를 통한 실증적 연구를 병행하였다. 본 연구의 결과로 제시된 모형은 자원봉사센터와 재가복지서비스를 제공하고 있는 자원봉사자 활용기관들의 상호연계 및 협력을 전제로 구성되었다. 이 좌형은 인적 자원 개발측면과 관리측면이 분리되어 있는 것이 아니라 단계별로 강조점이 다르긴 하지만 전 과정을 통해서 통합적으로 이루어지고 있다.