• Journal of Yeungnam Medical Science
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• 제6권1호
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• pp.21-29
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• 1989

1986년 3월부터 1989년 2월까지 영남대학병원 소아과에 폐렴으로 진단받고 입원한 315명 중 M. pneumoniae에 의한 폐렴으로 진단된 환아 71명을 대상으로 임상적 고찰 결과 다음과 같은 결론을 얻었다. 1. M. pneumoniae에 의한 폐렴은 전체 폐렴 환아중 22.5%에 해당하였으며, 그 중 5-9세 사이가 31.7%로 가장 많았다. 또한 M. pneumoniae에 의한 폐렴의 연령별로는 5-9세 사이가 53.5%로 가장 많았다. 2. 월별 분포는 10월에서 1월 사이가 59.2%로 늦가을 및 겨울에 높은 발생빈도를 보였다. 3. 성별 발생빈도는 1.3대 1로 남아에서 다소 높았다. 4. 임상 증상으로는 기침이 98.6%로 가장 많았으며 발열 49.3%, 콧물 19.7% 동의 빈도를 보였으며 입원전 기침을 한 기간은 개개 21주 이내였다. 5. 이학적 소견으로는 수포음이 95.7%로 가장 많았으며 인후발적이 43.7%, 천명음이 18.3%에서 나타났다. 6. 혈액 검사상 백혈구 수는 47.9%에서 정상 범위였으며 혈구 침강 속도(57.7%) 및 CRP 양성(87.3%)이 많았다. 7. 방사선 소견상 간질성 폐렴과 소엽성 폐렴이 각각 45.5%, 39.4%로 대부분을 차지하고, 대엽성 폐렴이 15.5%였고, 늑막 삼출이 5.6%에서 나타났다. 8. 동반질환 또는 합병증으로는 중이염 4례(5.6%), 간염 3례(4.2%), 급성사구체 신염, 기관지 천식, 부비동염이 각각 2례(2.8%)에서 동반되었고 1례에서는 혈소판 감소증이 있었다.

• The Korean Journal of Physiology and Pharmacology
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• 제26권6호
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• pp.427-438
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• 2022

Pyroptosis, a form of cell death associated with inflammation, is known to be involved in diabetic nephropathy (DN), and discoid domain receptor 1 (DDR1), an inflammatory regulatory protein, is reported to be associated with diabetes. However, the mechanism underlying DDR1 regulation and pyroptosis in DN remains unknown. We aimed to investigate the effect of DDR1 on renal tubular epithelial cell pyroptosis and the mechanism underlying DN. In this study, we used high glucose (HG)-treated HK-2 cells and rats with a single intraperitoneal injection of streptozotocin as DN models. Subsequently, the expression of pyroptosis-related proteins (cleaved caspase-1, GSDMD-N, Interleukin-1β [IL-1β], and interleukin-18 [IL-18]), DDR1, phosphorylated NF-κB (p-NF-κB), and NLR family pyrin domain-containing 3 (NLRP3) inflammasomes were determined through Western blotting. IL-1β and IL-18 levels were determined using ELISA. The rate of pyroptosis was assessed by propidium iodide (PI) staining. The results revealed upregulated expression of pyroptosisrelated proteins and increased concentration of IL-1β and IL-18, accompanied by DDR1, p-NF-κB, and NLRP3 upregulation in DN rat kidney tissues and HG-treated HK-2 cells. Moreover, DDR1 knockdown in the background of HG treatment resulted in inhibited expression of pyroptosis-related proteins and attenuation of IL-1β and IL-18 production and PI-positive cell frequency via the NF-κB/NLRP3 pathway in HK-2 cells. However, NLRP3 overexpression reversed the effect of DDR1 knockdown on pyroptosis. In conclusion, we demonstrated that DDR1 may be associated with pyroptosis, and DDR1 knockdown inhibited HG-induced renal tubular epithelial cell pyroptosis. The NF-κB/NLRP3 pathway is probably involved in the underlying mechanism of these findings.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.10.1-10
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• 1982

최근의 후두미세수술 (Laryngo-microsurgery)의 보편화와 이에 따른 음성외과학(phonosurgery)의 발달로 종전까지 성대결절이나 성대폴립등의 양성종양 절제나 반회신경 마비등예에서 진단된 성문간격 (glottic chink)을 $Teflon^{{\circledR}}$ injection등으로 치료해오던 후두경술(Laryngoscopy)하에서의 수술적 조작이 그 한계와 범위를 넘어서서 이제는 우리 나라에 있어서도 후두의 기능외과적인 측면에서 음성을 개선하려는 시도가 고조되고 있으며 특히 성대마비나 변성기발성장애 (Mutational dysphonia), 성대위축 (Vocal cord atrophy), 운동기능 항진성발성장애 (Hyperkinetic dysphonia), 성대구증(Sulcus vocalis)등을 위한 음성개선수술이 실시되고 있음은 우리나라의 음성외과학의 발전이라는 견지에서도 매우 기꺼운 일이다. 이러한 뜻에서 내시경술을 통해서 성대에 직접 수술적 조작을 가하지않고서도 성문외적으로 후두구조를 수술하여 성대의 위치와 물리적 성질을 변화시킴으로서 음성을 개선하려는 갑상연골성형술 (thyroplasty)이 성행되고 있음을 강조하고싶다. Isshiki(1974)는 이러한 thyroplasty 를 4종류로 분류하였으며 편측성 성대마비의 경우 I 형 thyroplasty (lateral compression of vocal cord) 와 IV형 thyroplasty (Lengthening of vocal cord) 가 효과적인 수술방법인데 이들 수술의 장점은 국소마취하에서 환자의 목소리를 들어가면서 lateral compression의 정도를 조정해서 시술할 수 있다는것과 갑상연골내측 연골막 밖에서 의 조작으로서 후두내 출혈이나 호흡곤란등의 위험성이 전혀 없다는 것이다. 본 교실에서는 1981 년 9월부터 1982년 3월까지 7개월간에 경험한 편측성 성대마비 7예에 대하여 국소마취하에서 thyroplasty를 시행하여 약간의 지견을 얻었기에 보고하는 바이다. 수술에 앞서서 모든 환자에게 미리 공기역학검사, 청각심리적검사, 스트로보스콥검사(stroboscopy) 및 음향분석(Sound spectrographic analysis) 을 실시하였으며 thyroplasty 시행 2 개월후에 상기한 검사를 다시 시행해서 수술전후의 음성을 비교관찰하여 다음과 같은 성적을 얻었다. 1) 공기역학검사상 최장발성지속시간 (Maximum phonation time)은 58 % 증가되었으며 이에따른 발성시호기유율 (Phonation quotient)과 평균호기유율(Mean flow rate)은 각각 58 %, 54 %로 감소되었다. 2) 청각심리적검사에서 애성의 정도가 호전되었으며 스트로보스콥검사에서도 발성시 성문간격의 개선을 보았다. 3) 음향분석도상에서 성대 진동의 주기성 (Periodicity)이 회복되었으며 특히 고주파역에서의 잡음분포가 감소되었다.

• 동의생리병리학회지
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• 제32권4호
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• pp.232-246
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• 2018

The purpose of this research is to contribute to clinical researches on neck pain and cervical spondylosis by reviewing the latest research trends and evaluation tools through the analyses of clinical studies on neck pain and cervical spondylosis over the last 5 years. 70 papers satisfying the selection conditions among the RCT papers that had been searched as "neck pain" or "cervical spondylosis" at Pubmed(https://www.ncbi.nlm.nih.gov/pubmed) from March 2011 to February 2016 were targeted. Papers were numbered in order of their publication dates and analyzed by classifying their contents into 1) pain classification, 2) treatment type, 3) treatment duration, 4) treatment time, 5) number of participants, 6) evaluation tools and methods of research, and 7) evaluation duration. 55 papers targeted chronic neck pain, 6 papers acute and subacute neck pain, and 2 papers subacute and chronic neck pain. In comparison by intervention, 43 papers corresponded to physical therapy, 3 papers to acupuncture, 1 to herbal fomentation, 5 to medication, and 18 papers corresponded to multilateral comparisons comparing the efficacy by various interventions. In research period, there were 50 papers based on treatment period, 16 papers based on the number of treatments, and 4 papers based on different periods depending on each group. In treatment duration, the cases from 1 month or more to less than 3 months were most, followed by the cases of less than 1 month, and the cases from 3 months or more to less than 6 months. In treatment frequency, the number of treatments of the treatment group was the same as that of the control group in 51 papers, and many treatments were conducted by the methods of acupuncture, manual therapy, and injection therapy in cases of once or twice of treatments, and physical therapy and electroacupuncture corresponded mainly to the cases from 3 times or more to less than 10 times of treatments, and retrospective observation and exercise programs corresponded mainly to the cases of more than 30 times of treatments. In the number of subjects of the researches, the cases from 50 or more to less than 100 were most, followed by the cases from 20 or more to less than 50. There were 7 evaluation tools cited 10 times or more: VAS, NRS, PPT, NDI, NPQ, CROM, and SF-36. In evaluation period, 37 papers evaluated only during the treatment period, and 33 papers conducted follow-up. In follow-up period, the cases of less than 3 months were most, followed by the cases from 6 months or more to less than 1 year, and the cases from 3 months or more to less than 6 months. When planning clinical researches on cervical pain in the future, appropriate intervention methods, frequency and duration of treatment, period of follow-up, appropriate number of subjects and selection of evaluation tools for objective validity will have to be considered. In addition, randomization, double-blind, etc. will have to be considered for researches with high basis level.

• 자원환경지질
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• 제46권6호
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• pp.485-494
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• 2013

주입된 $CO_2$가 환경에 영향을 미치지 않고 지하에서 안정적으로 저장되어 있는지를 총체적으로 모니터링 하는 주입 및 주입 후 관리 (Monitoring, Mitigation and Verification, MMV) 기술은 이산화탄소 지중저장 분야에서 경제적 및 환경적으로 매우 중요한 역할을 하고 있다. 특히, 해외 대규모 지중저장 프로젝트 사례를 보았을 때 주입한 $CO_2$의 거동을 가장 효율적으로 모니터링할 수 있는 방법 중의 하나로 탄성파를 이용한 시간 경과 (Time-lapse) 모니터링 기술이 그 핵심으로 떠오르고 있다. 이 연구에서는 캐나다 Estevan에 위치한 Aquistore 이산화탄소 주입 현장의 3차원 베이스라인 (baseline) 탄성파 자료를 수집하고 분석하여 국내 지중저장 탄성파 모니터링 실증화를 위한 기초 연구를 수행하였다. 이산화탄소 주요 저장 대상층은 탄성파 도달 시간 1,800 ~ 1,900 ms 깊이의 Winnipeg 와 Deadwood 사암층이다. Aquistore 탄성파 자료에 대한 에너지, 유사도(similarity)를 도출하고 주파수를 분해하여 $CO_2$ 주입 대상층의 특성을 규명하였다. 그 결과 등시선도 1,800 ms의 연구지역 북측, 1,850 ms의 남측에 탄성파 에너지가 큰 영역이 집중적으로 분포함을 확인할 수 있었고, 탄성파 에너지 속성을 도시하여 반사계수가 큰 사질 퇴적양상이 우세한 영역을 구분할 수 있었다. 또한 탄성파 기록의 유사도를 도출하여 두 개의 주요한 구조선이 북서-남동 방향으로 지중저장 대상층을 절단함을 확인하였다. 탄성파자료의 주파수를 성분별로 분해하고 5, 20 및 40 Hz 성분을 분석한 결과 연구지역의 중앙에서 동서 방향으로 발달하는 균질한 퇴적 양상이 구체화되었다. 베이스라인 자료의 경우 추가적으로 인위적인 잡음을 제거하고 층서 해석 결과를 통합하여 이산화탄소 지중저장 영역을 묘사한다면 시간경과 모니터링 자료와의 효율적인 대비가 가능할 것이다.

• Investigative Magnetic Resonance Imaging
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• 제8권1호
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• pp.32-41
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• 2004

목적 : MnPC의 자기이완성질을 살펴보고, 토끼의 간에 이식한 VX2 암종을 이용해 자기공명영상에서 간의 조영증강형태를 관찰하고자하였다. 또한 간세포 특이성 조영제 사용 시와 비교하여 MnPC의 조직특이성 조영제로서의 가능성을 탐색해 보고자 하였다. 대상 및 방법 : 조영제 합성시 상자성 원소의 배위자로 phthalocyanine(PC)를 선택하였다. 2.01 g (5.2 mmol)의 phthalocyanine을 0.37g(1.4 mmol)의 manganese chloride와 $310^{\circ}C$에서 36시간동안 반응시킨 후 혼합물을 크로마토그래피 (CHC13: CH3OH=98:2, volume ratio)로 정제하여 2000 달톤의 분자량을 갖는 1.04 g $(46\%)$의 MnPC를 얻었다. 자기이완율은 MnPC를 0.1 mmol로 희석시켜 1.5 T (64 MHz)에서 측정하였다. VX2 암종은 토끼의 간실질 내에 종양세포 부유액을 주입해 실험적으로 유발시켰다. 모든 영상은 1.5 T MR장비에서 무릎관절코일을 사용하여 획득하였다. 본 연구에서 새로 개발된 거대분자 자기공명영상 조영제인 MnPC (4m-mol/kg)와 간세포 특이성 조영제인 Mn-DPDP (0.01 mmol/kg)가 사용되었으며 이들 조영제는 토끼의 이정맥을 통해 주입되었다. T1 강조영상은 스핀에코 (TR/TE=516/14 msec)와 고속다면회손경사회복 (TR/TE=80/4 m-sec, flip angle $60^{\circ}$)을 사용하여 얻었고, T2 강조영상의 획득을 위해서는 고속스핀에코 (TR/TE=1200/85 m-sec)를 사용하였다. 결과 MnPC의 1.5T (64MHz)에서의 자기이완율은 $R1=7.28\;mM^{-1}S^{-1}$, $R2=55.56\;mM^{-1}S^{-1}$ 이었고, MnPC의 높은 T2 자기이완율은 T2 강조영상에서의 정상 간실질의 신호강도를 감소시켜 간실질과 VX2 암종의 구분을 쉽게 하였다. MnPC 주입시 T1 강조영상에서는 간세포 특이성 조영제의 주입시보다 종양의 경계가 명확하였고, 조영증강은 주입후 최소한시간 이상 높게 유지되었다. 결론 : MnPC가 간세포로 흡수되어 담관으로 배설된다는 사실은 Mn-DPDP와 유사한 특성이며 이는 MnPC가 새로운 간특이성 조영제임을 확인시켜 준다. 또한 MnPC의 R2값이 기존의 조영제에 비해 매우 크다는 사실은 T1 조영제로서 뿐만 아니라 T2 조영제로서의 사용 가능성을 보여준다. 이러한 사실들을 좀더 정확하게 뒷받침하기 위해서는 임상적으로 사용되기 이전에 생체 내 그리고 시험관내 연구가 더 필요하며 다른 동물모델에서의 추가적인 연구가 요구된다.

• 한국응급구조학회지
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• 제15권3호
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

• 한국방사선학회논문지
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• 제15권4호
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• pp.463-472
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• 2021

산부인과 초음파 검사에서 골반 장기를 관찰하기 위해 고주파수의 경질 탐촉자를 이용한 검사의 수요가 증가하고 있다. 하지만 임상에서는 경질 탐촉자의 정도관리가 제대로 시행되고 있지 않으며 평가 기준이 확립되지 않은 실정이다. 따라서 현재 사용되고 있는 산부인과용 초음파 장치 20대를 대상으로 58개의 경질 탐촉자와 20개의 곡면 탐촉자를 ATS-539 표준팬텀에 적용하여 각각의 영상을 획득 한 후 정량과 정성적으로 측정하였다. 정량측정은 종측정, 횡측정, 국소영역, 정성측정은 불응영역, 축방향/외측방향 분해능, 예민도, 기능적 해상도, 회색조와 동적범위를 실시하였다. 정량적 통계 분석 결과 횡측정, 국소영역에서 두 탐촉자 간 유의한 차이가 있었으며,(p<0.05) 정성적 비교 분석 결과 예민도, 기능적 해상도에서 차이점을 확인 할 수 있었다. 이는 탐촉자 간 갖는 주파수의 차이와 탐촉자의 주사 기하학의 차이로 발생 한 것으로 사료된다. 위와 같은 실험 결과를 토대로 횡 거리 평가의 허용 범위는 10%(±8 mm)으로 상향, 예민도의 허용 범위는 삼사분위(75%) 수준인 12 cm깊이인 6개까지 관찰, 기능적 해상도의 평가의 허용 범위는 삼사분위(75%) 수준인 6개(12cm), 6개(12cm), 11개(11cm), 9개(9cm), 6개(6cm)까지 관찰, 회색조와 동적범위의 표적의 깊이를 4cm 깊이의 50%인 2 cm 깊이에서도 측정이 가능하게 표적을 추가하는 것이 타당하다고 사료된다. 연구 결과를 통해 산부인과용 경질 탐촉자의 정도관리 평가 기준을 제시하였으며 본 연구가 향후 경질 탐촉자 전용 팬텀 제작을 위한 기초자료로 활용될 것으로 기대한다.

• 재활간호학회지
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• 제2권2호
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• pp.257-270
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• 1999

The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.