• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1847-1850
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• 2016

Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.

• Clinical and Experimental Pediatrics
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• 제61권9호
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• pp.285-290
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• 2018

Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group. Results: Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT ($6.4{\pm}11.9ng/mL$) and C-reactive protein (CRP) level ($3.8{\pm}2.6mg/dL$), and the absolute neutrophil count (ANC) ($6,984{\pm}4,675$) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, $0.3{\pm}1.2ng/mL$; CRP, $1.3{\pm}1.6mg/dL$; ANC, $4,888{\pm}3,661$). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%. Conclusion: Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

• 한국방사선학회논문지
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• 제11권3호
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• pp.171-175
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• 2017

비파괴검사 분야에서는 작업자들의 안전을 확보하기 위해 방사선원에 대한 시스템 개발에 많은 시간과 재원을 투자하고 있으나 아직까지 사고 발생 확률은 높은 실정이다. 방사선에 대한 잠재적 사고를 미연에 방지하기 위해서는 방사선원의 위치를 직접적으로 검증하는 것이지만 아직까지 연구가 미흡한 실정이다. 이에 본 연구에서는 감마선조사기의 선원 가이드 튜브에서 방사선원의 위치를 감지할 수 있는 모니터링 시스템 개발을 위한 선행연구로써 몬테카를로 시뮬레이션을 통해 방사선 검출기에 대한 특성을 모의 추정하였다. 연구 결과, Ir-192의 감마선 에너지에 대한 방사선 검출기는 반도체 소재에 무관하게 $150{\mu}m$에서 2차 전자평형이 이루어지는 것으로 분석되었으며, 감마선 응답 특성은 $HgI_2$가 가장 우수할 것으로 기대된다. 이러한 결과는 차후 모니터링 시스템의 검출부에 위치하는 방사선 검출기의 최적화 두께를 결정하는데 기초자료로써 활용될 수 있을 것으로 기대되며, 이를 바탕으로 모니터링 시스템을 개발 시 방사선작업종사자가 위험을 쉽게 인지하여 안전을 확보할 수 있을 뿐만 아니라 잠재적인 방사선 사고에 대한 예방 및 선제적 대응이 가능함으로써 사회 안전망 구축 에 기여할 수 있을 것이다.

• 한국약용작물학회지
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• 제3권1호
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• pp.16-20
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• 1995

$1990{\sim}92$년간 남부지방 식방풍 재배시 3요소 시용랑및 피복처리가 수량 및 품질에 미치는 영향을 조사코자 시험한 결과를 요악하면 다음과 같다. 1. 3요소 시용량 시험 가. 3요소 각각 결제에 의한 수량 감수율은 질소>인산>칼리순으로 적었다. 나. 식방풍뿌리중 회분 함량과 질소 시비랑과는 부의 유의 상관관계가 있었고, 칼리 시용량과는 정의 유의적인 상관관계가 있었다. 다. 남부지방에서 식방풍 일년생 수확시 시비적량은 $N-P_2O_5-K_2O=21-13-10kg/10a$이었다. 2. 피복효과시험 가. 흑색비닐피복에서 출현율이 무피복 80%보다 6% 낮으나 수량이 7%정도 증수하므로 남부 지역에서는 흑색비닐피복재배가 좋을것으로 생각하며 투명비닐피복재배는 출현율이 낮아 수량이 25% 감수하였다. 나. 피복재료에 따른 식방풍의 품질조사결과 회분, 산불용성회분 및 엑기스 함량은 피복재료간 차이가 없었다.

• 한국산학기술학회논문지
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• 제11권7호
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• pp.2475-2482
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• 2010

본 연구에서는 해부학 실습 교육과정에 해부설명회를 도입에 따른 의학전문대학원생들의 자기평가요인(만족도, 전공 연계성, 운영 적절성, 의사소통)과 학업성취도와의 상관관계를 분석하였다. 2008학년도 1학기 해부학 실습교육을 받은 의학전문대학원생들(n=57)이 일부 수업시간을 활용하여 해부설명회에 참가하였고, 보건 의료 계통의 학부생들에게 사체를 활용하여 인체 구조에 대한 설명과 토론을 마친 후 설문지와 소감문을 작성하게 하였다. 이를 바탕으로 자기 평가 요인들을 분석하였고, 2008학년도 해부학 성적과의 상관관계를 조사하였다. 설문 대상자의 일반적 특성에 따른 자기 평가 요인을 분석한 결과, 성별, 연령, 과거 경험 유무 등의 일반적 특성과 상관없이 만족도, 전공 연계성, 운영 적절성, 언어적 및 비언어적 커뮤니케이션 모두에서 높은 수치를 나타내었다. 자기 평가 요인 중 학업성취도와 높은 상관관계를 갖는 요인은 언어적 커뮤니케이션이었다(p<0.05). 또한 언어적 커뮤니케이션은 비언어적 커뮤니케이션과도 높은 상관관계를 가졌다(r=0.673, p<0.01). 결론적으로 커뮤니케이션 기법을 활용한 해부설명회의 도입은 의전원 학생들에게 심화 학습의 기회를 제공하였고 학습동기를 유발시키며, 적극적인 학습태도를 갖게 하였다. 아울러 커뮤니케이션에 대한 중요성을 깨닫게 되었고, 타 전공자와의 상호교류를 통한 학문적 이해의 폭이 확대되었음을 확인하였다. 본 연구결과를 바탕으로 진행과정에 나타난 문제점을 보완하고 개선한다면 해부학 실습의 개선 방안으로서 해부설명회의 활용가치가 충분하다고 판단되었다.

• 대한간호
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• 제36권3호
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• pp.49-69
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• 1997

The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

• Journal of Radiation Protection and Research
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• 제47권1호
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• pp.1-7
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• 2022

Background: In Japan, new regulations that revise the dose limit for the lens of the eye (hereafter the lens), operational quantities, and measurement positions for the lens dose were enforced in April 2021. Based on the international safety standards, national guidelines, the results of the Radiation Safety Research Promotion Fund of the Nuclear Regulation Authority, and other studies, the Working Group of Radiation Protection Standardization Committee, the Japan Health Physics Society (JHPS) developed a guideline for radiation dose monitoring for the lens. Materials and Methods: The Working Group of the JHPS discussed the criteria of non-uniform exposure and the management criteria set not to exceed the dose limit for the lens. Results and Discussion: In July 2020, the JHPS guideline was published. The guideline consists of three parts: main text, explanations, and 26 examples. In the questions, the corresponding answers were prepared, and specific examples were provided to enable similar cases to be addressed. Conclusion: With the development of the guideline on radiation dose monitoring of the lens, radiation managers and workers will be able to smoothly comply with revised regulations and optimize radiation protection.

• 농촌의학ㆍ지역보건
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• 제47권2호
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• pp.99-108
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• 2022

본 연구는 19세 이상 성인들을 대상으로 B형간염 백신 접종률, 백신 접종이유 및 미접종 이유, 백신 접종 관련 요인을 파악하고자 하였다. B형간염 백신 접종률은 사후가중치를 적용 후 1차 38.0%, 2차 32.5%, 3차 26.9%로 나타났다. B형간염 백신 접종 관련 요인으로는 여자가, 저연령에서, 군부 거주자가, 직업이 있을 때, 고학력자가, 건강보험 가입자가, 배우자가 있을 때, 동거가족이 있을 때, 국가 권고 성인 예방접종을 인지하고 있을 때, 의사에게 성인 예방접종의 필요성을 설명 받은 경험이 있을 때, 본인의 성인 예방접종 기록 보관하고 있을 때, 성인 예방접종이 감염병 예방에 도움이 된다고 높게 인지하고 있을 때, 국가나 지방자치단체의 성인 예방접종 홍보 경험이 없을 때에 백신 접종률이 높게 나타났다. 결론적으로 우리나라 성인의 B형간염 백신 접종률은 양적 향상 및 질적인 측면에서의 개선을 위한 국가 정책 마련이 필요함을 발견하였다. 또한 성인의 B형간염 항체 형성률을 함께 파악하여 감염병 발생 감소나 퇴치를 위해서 국가수준의 예방접종률 목표치 선정과 함께 달성 정도 평가를 위한 정기적인 성인 예방접종률 산출이 필요하다. 더욱이 국가의 예방접종통합관리시스템을 통하여 안정적으로 성인의 예방접종 기록을 관리할 수 있도록 전산등록률 향상 방안을 마련할 필요가 있다.

• Journal of Korean Neurosurgical Society
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• 제66권5호
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• pp.573-581
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• 2023

Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.

• 한국유통학회지:유통연구
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• 제15권3호
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• pp.1-34
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• 2010

본 연구의 목적은 국내 외식 프랜차이즈 시스템에서 가맹점에 대한 가맹본부의 관계품질에 영향을 미치는 변수를 사후 지원서비스로 설정하고, 사후 지원서비스가 가맹점의 관계품질(신뢰, 만족, 몰입)과 경영성과(재무적 성과, 비재무적 성과)에 미치는 영향에 대한 포괄적인 모형을 개발하는 것이다. 제안된 모형을 검증하기 위하여 서울 및 경기 지역의 외식 프랜차이즈 가맹점 경영자 500명을 대상으로 설문 조사를 하여, 구조방정식을 통해 실증 분석하였다. 분석결과는 다음과 같다. 첫째, 사후 지원서비스 요인 중 제품범주 및 가격 요인과 정보제공 및 문제해결 능력 요인은 가맹점의 만족과 몰입에만 영향을 미치는 것으로 나타났다. 둘째, 물류지원과 슈퍼바이저 지원 요인은 신뢰와 만족에만 영향을 미치는 것으로 나타났다. 셋째, 재교육 및 훈련지원 요인은 가맹점의 신뢰와 몰입에만 영향을 미치는 것으로 나타났다. 넷째, 판매촉진 요인은 신뢰 만족, 그리고 몰입 모두에 영향을 미치는 것으로 나타났다. 다섯째, 관계품질요인들 간의 관계는 신뢰가 만족에 긍정적인 영향을 미치지만 몰입에는 직접적으로 영향을 미치지 못하고, 만족을 통해서 몰입에 긍정적인 영향을 미치는 것으로 나타났다. 여섯째, 신뢰는 재무적 성과에만 긍정적인 영향을 미치고, 만족과 몰입은 재무적 성과와 비재무적 성과 모두에 긍정적 영향을 미치는 것으로 나타났다. 마지막으로 본 연구의 결과요약과 시사점, 그리고 연구의 한계점과 향후 연구방향이 제시되었다.