• 제목/요약/키워드: Medical Cost

검색결과 1,837건 처리시간 0.04초

자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구 (A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea)

  • 김동일
    • 대한한방부인과학회지
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    • 제19권2호
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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골관절염 환자를 위한 타이치, 타이치-자조관리 및 자조관리과정의 효과 비교 (Comparing Effects of Tai Chi Exercise, Tai Chi Self-help Program, and Self-help Management Program for Osteoarthritis Patients)

  • 조경숙;강현숙;김종임;박원숙;송라윤;안양희;임난영;이인옥;최선하;한상숙
    • 근관절건강학회지
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    • 제14권1호
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    • pp.77-84
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    • 2007
  • Purpose: The purpose of the study was to compare the effects of Tai Chi exercise, Tai Chi self help program, and self help management program on arthritic pain, stiffness, fatigue and difficulties in performing daily activities in patients with osteoarthritis. Method: The pre-post experimental design was utilized with convenient sampling at Public Health Centers. Total of 38 subjects agreed to participate in the study with the inclusion criteria of being diagnosed as osteoarthritis and no previous regular exercise. The 12 subjects were assigned to Tai Chi exercise group, 13 subjects to Tai Chi exercise combined with self help management program, and the other 13 to self help management program. Tai Chi exercise group performed exercise twice a week for one hour per each session. Tai Chi self help management group came to the class twice a week, one hour for Tai Chi exercise, and another hour for self help management program. The third group came to the class once a week for one hour to participate self help management program. At the completion of 6 week programs, 10 subjects from Tai Chi exercise, 9 from Tai Chi self help, another 10 from self help management groups completed the post-test measures. The data were analyzed by SPSSWIN 11.0. The homogeneity tests for three experimental groups were conducted by $X^2-test$, Fisher's exact test, Kruskal-Wallis test. The final analysis of the post-test measures was conducted by ANCOVA with fatigue, pain, stiffness, and difficulties in daily activities of the pretest measures as covariates. Results: The results were as follows. There were no significant differences in fatigue, pain, and difficulties of daily activities among three groups for the pretest measures. The score of arthritic stiffness was significantly different among groups after controlled for covariates, but the post-hoc tests showed no group differences. Conclusion: The nursing interventions applied for osteoarthritis patients have been previously tested to show the cost effectiveness of symptoms management of this population.

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Multiplex PCR과 Conformation Sensitive Gel Electrophoresis를 이용한 혈우병B F9 유전자 돌연변이 직접 진단법 (Direct detection of hemophilia B F9 gene mutation using multiplex PCR and conformation sensitive gel electrophoresis)

  • 유기영;김희진;이광철
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.397-407
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    • 2010
  • 목 적 : F9 유전자는 혈우병B의 병인 유전자이다. 기존의 RFLP를 이용한 연관분석은 정보제공율이 55.6%에 불과하였다. 직접 염기서열 분석법은 98%의 돌연변이를 진단할 수 있지만, 고가의 비용이 든다. 본 연구는 F9 유전자를 대상으로 돌연변이의 선별검사로써 mPCR-CSGE를 사용하고, 이후 특정 유전자 부위만을 염기서열 분석하여 mPCR-CSGE의 유용성을 확인하기 위해 고안되었다. 방 법 : 연구대상은 비혈연 관계인 27명의 혈우병B 환자였다. 직접염기서열 분석법은 독립된 다른 기관에서 시행하였고, mPCR-CSGE 선별 후 염기서열 분석법은 본 연구자의 기관에서 시행되었다. 직접 염기서열 분석법의 결과가 참고치가 되어 mPCR-CSGE 선별 후 염기서열 분석법을 정확성, 경제성, 신속성, 편이성 측면에서 비교하였다. 두가지 방법으로 진단이 되지 않는 환자에게는 MLPA를 이용하여 돌연변이를 발견하였다. 결 과 : 직접 염기서열 분석법으로 26명(96.3%)의 환자에서 돌연변이를 확인할 수 있었다. mPCR-CSGE 선별 후 염기서열 분석법으로는 23명(85.2%)의 환자에서 돌연변이를 찾아낼 수 있었다. 1명의 환자는 MLPA로써 돌연변이를 확인할 수 있었다. 27명의 환자에게 21개의 독립적인 돌연변이가 있었다. mPCR-CSGE 선별 후 염기서열 분석법은 직접 염기서열 분석법에 비해 비용은 55.7%로 줄일 수 있었으나, 실험 단계는 더욱 복잡하였고, 시간도 하루가 더 걸렸으며, 세심한 실험상의 주의가 필요하였다. 결 론 : mPCR-CSGE 선별 후 염기서열 분석법은 85.2%의 높은 돌연변이 선별력을 보이고, 직접 염기서열 분석법의 57.7%의 비용만 소모하였으나, 실험과정에 세한 주의가 요구되었으며, 노동집약적이고, 실험 시간도 하루가 더 소요되었다.

AHP를 활용한 머시닝센터의 밀링커터 선정 (Milling Cutter Selection in Machining Center Using AHP)

  • 이교선;박수용;이동형
    • 산업경영시스템학회지
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    • 제40권4호
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    • pp.164-170
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    • 2017
  • The CNC machine tool field is showing a growing trend with the recent rapid development of manufacturing industries such as semiconductors, automobiles, medical devices, various inspection and test equipment, mechanical metal processing equipment, aircraft, shipbuilding and electronic equipment. However, small and medium-sized machining companies that use CNC machine tools are experiencing difficulties in increasingly intense competition. Especially, small companies which are receiving orders from 3rd or 4th venders are very difficult in business management. In recent years, company S experienced difficulty to make product quality and delivery time due to the ignorance of the processing method when manufacturing cooling plate jig made of SUS304 material used for cell phone liquid crystal glass processing. In order to solve these problems, we redesigned the process according to the size of our company and tried to manage all processes with quantified data. In the meantime, we have found that there is a need to improve the cutter process, which accounts for most of the machining process. Therefore, we have investigated the correlation between RPM and FEED of three cutters that have been used in the past. As a result, we found that it is the most urgent problem to solve the roughing process during the cutter operation which occupies more than 70% of the total machining. In order to shorten the machining time and improve the quality in machining of SUS304 cooling plate jig, we select the main factors such as price, tool life, maintenance cost, productivity, quality, RPM, and FEED and use AHP to find the most suitable milling cutter. We also tried to solve the problem of delivery, quality and production capacity which was a big problem of S company through experiment operation with selected cutter tool. As a result, the following conclusions were drawn. First, the most efficient of the three cutters currently available in the machining center has proven to be an M-cutter. Second, although one additional facility was required, it was possible to produce the existing facilities without additional investment by supplementing the lack of production capacity due to productivity improvement. Third, the Company's difficulties in delivery and capacity shortfalls have been resolved. Fourth, annual sales increased by KRW 109 million and profits increased by KRW 32 million annually. Fifth, it can confirm the usefulness of AHP method in corporate decision making and it can be utilized in various facility investment and process improvement in the future.

실감형 가상현실 실전훈련 콘텐츠를 위한 관리 평가 시스템 개발 사례연구 (Development of Management and Evaluation System for Realistic Virtual Reality Field Training Exercise Contents : A Case Study)

  • 김종용;박동근;이필연;조준영;윤승현;박상훈
    • 한국컴퓨터그래픽스학회논문지
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    • 제26권3호
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    • pp.111-121
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    • 2020
  • 가상현실의 높은 몰입감을 활용한 실감형 훈련 콘텐츠가 산업, 교육, 의료 등 다양한 분야에서 활용되고 있다. 특히 현실에서 실시하기 힘든 고위험, 고비용이 발생하는 교육훈련을 최신 가상현실 기술을 적용하여 현실과 비슷한 환경에서 효율적이고 안전하게 체험하여 교육효과를 높일 수 있다. 본 논문은 실감형 가상훈련 콘텐츠를 체계적으로 관리하고 정의된 평가요소를 기반으로 훈련 결과를 도식화된 그림으로 가시화하는 관리 시스템을 소개한다. 관리 시스템은 콘텐츠에서 생성되는 정보를 데이터베이스에 저장하여 각 훈련생의 훈련 기록을 실용적으로 관리할 수 있다. 또한 콘텐츠 기반 시나리오 생성 방법으로 훈련 목표, 참여인원, 평가요소 등을 설정하여 하나의 콘텐츠를 여러 시나리오로 생성할 수 있다. 본 논문은 관리 시스템의 제작 방법과 그 결과를 적용 사례인 가상현실 훈련 콘텐츠 기반으로 설명한다.

불임시술의 합병증에 관한 역학적 연구 (An Epidemiological Study on the Complications caused by the Sterilization Program)

  • 홍명선
    • 지역사회간호학회지
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    • 제7권1호
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    • pp.138-153
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    • 1996
  • Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

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한방 찰색 구현을 위한 디지털 색체계의 피부색 분석에의 적용 (Application of Skin Color Analysis about Digital Color System for Oriental Medicine Observing a Person's Shape and Color Implementation)

  • 이세환;조동욱;김봉현
    • 한국통신학회논문지
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    • 제33권2C호
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    • pp.184-191
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    • 2008
  • 한의학 기반 진단 방법은 서양의학과 달리 병원에 내원하지 않고 네트웍이나 각종 통신 장비 등을 통한 질병진단이 가능하다. 특히 한의학의 뛰어난 진단 방법 중 하나인 망진 기법을 적용한 진단 기술 개발은 초고령화사회 진입에 따른 국가적 부담인 의료비 절감에 크게 기여할 수 있는 방법으로 여겨지고 있다. 이때 망진법에서 가장 중요한 것이 병색을 살피는 일 즉, 찰색인데 이를 기기로 구현할 수 있는 방법론의 개발과 적용 가능한 시스템의 구축이 가장 중요한 일이 된다. 이를 위해 본 논문에서는 망진 중 찰색 구현을 위한 연구를 행하였다. 특히 통상 인체의 주요 장기인 오장은 오색으로 병색이 안면에 나타나므로 이 오색을 구현할 수 있는 색 좌표계의 정립이 가장 중요한 일이 되며 이를 위해 색 분석을 실행하여 진단기술 개발에 있어서의 디지털 색 체계 분석을 위한 실험을 진행하였다. 끝으로 실험을 통해 찰색에 필요한 오색 추출에 맞는 디지털 색 체계를 선정하고 이를 통한 실제 피부색 분석 및 비교에 대한 실험을 수행하여 찰색 구현을 위한 디지털 색체계의 가장 적합한 색 좌표계가 어떤 것인지를 제시하고자 한다.

유비쿼터스 센서 네트워크를 위한 이벤트 처리 기법에 관한 연구 (A study on the event processing methods for ubiquitous sensor network)

  • 조양현;박용민;김현규
    • 한국컴퓨터정보학회논문지
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    • 제18권1호
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    • pp.137-147
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    • 2013
  • RFID(Radio Frequency Identification)와 WSN(Wireless Sensor Network)은 기술적 유사성과 상호 영향에도 불구하고 별개의 연구로 인식되었으며 RFID와 WSN의 기술적인 융합에 대한 연구는 미비한 수준이다. 이러한 문제점을 인식한 EPCglobal에서는 국제 표준인 EPCglobal Network를 기반으로 RFID와 WSN 기술을 효율적으로 통합/연동할 수 있는 EPC(Electronic Produce Code) 센서 네트워크를 제안하였다. 제안된 EPC 센서 네트워크는 미들웨어에서 복합 이벤트 처리(Complex Event Processing) 기법을 이용하여 RFID와 WSN을 통해 발생되는 데이터를 단일 환경에서 통합하고, 발생된 이벤트를 EPC global Network를 기반으로 연동하는 기술이다. 하지만 이러한 EPC 센서 네트워크는 미들웨어에서 복합 이벤트를 검출하기 위해 복합 이벤트를 구성하는 모든 기본 이벤트가 발생하지 못하는 경우에도 계속적인 검사를 수행하기 때문에 연산 비용이 증가되는 문제점이 있다. 이러한 EPC 센서 네트워크의 문제점들을 해결하기 위하여 본 논문에서는 미들웨어에서 복합 이벤트의 최소 조건을 정의하고 조건을 만족하는 경우에만 복합 이벤트를 검출하는 알고리즘을 제안하였다. 복합 이벤트의 최소 조건을 검사하기 위하여 인덱스 기반의 질의 색인을 사용하여 복합 이벤트를 추출한다. 제안하는 인덱스 기반의 복합 이벤트 검출 알고리즘은 기존의 검출 알고리즘과 NS2 시뮬레이션을 이용하여 성능 평가를 수행하여 복합 이벤트를 검출하는 시간에서는 기존 알고리즘과 비교하여 평균 6.8msec 적게 나타났으며, 검출에 필요한 연산수는 기존 알고리즘과 비교하여 평균 226개로 적은 연산 수를 나타내었다. 결과적으로 기존 알고리즘에 비해 복합 이벤트 검출을 위해 제안하는 알고리즘이 우수한 성능을 나타내었다.

공공보건조직에서의 방문간호사업모형개발 : 보건진료소 방문간호사업 (Development of a Home Health Care Model in the Public Health System -Visiting Health Service by Community Health Practitioners)

  • 한경자;박성애;하양숙;윤순녕;송미순
    • 대한간호학회지
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    • 제25권3호
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    • pp.472-484
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    • 1995
  • The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

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무치악 환자에서 기성 조립식 bar를 이용한 임플란트 피개의치 증례 (Implant-retained overdentures with pre-fabricated bar attachment system in edentulous patients)

  • 소나영;홍영기;하승룡
    • 대한치과보철학회지
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    • 제54권1호
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    • pp.41-48
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    • 2016
  • 치아 상실에 이어 심각한 치조골 소실을 보이는 무치악 환자들은 전통적인 방식의 총의치를 사용하는데 어려움이 많다. 이러한 문제를 보완할 수 있도록 임플란트를 이용한 피개의치가 사용되고 있다. SFI-bar$^{(R)}$는 진료실에서 직접 조정이 가능한 기성품으로 복잡한 기공과정을 필요로 하는 기존의 바 시스템보다 간결하여 시간과 비용을 절감할 수 있다. 첫 번째 증례는 55세 남자 환자로 기존 하악 임플란트-지지 피개의치가 파절되었다는 주소로 내원하였고 내구성이 있으며 통증이 없는 의치를 원하였다. 파절된 Locator$^{(R)}$ 어태치먼트를 제거 후 바를 이용한 피개의치로 치료하였다. 두 번째 증례는 파킨슨병을 앓고 있는 77세 여자 환자로 하악 치조골이 심각하게 흡수되어 의치가 자주 탈락한다는 주소로 내원하였고 통증이 없고 유지력이 있는 의치를 원하였다. 하악 전치부에 두개의 임플란트를 식립한 후 임플란트에 연결된 어댑터에 바를 연결하였다. 그 후 바에 맞는 여성부를 새로운 의치에 장착하여 치료하였다. 2년의 추적 관찰 결과 상기 환자 모두 심미적, 기능적으로 만족할만한 결과를 보였으므로 증례를 보고하고자 한다.