• 보건행정학회지
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• 제14권4호
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• pp.88-113
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• 2004

Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system's influence on physicians' behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by $\\3,154$, days of visit per claim by 0.1 day, and amount per visit by $\\412$, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.

• 한국의료질향상학회지
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• 제1권1호
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• pp.32-43
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• 1994

The 'Pharmacy and Therapeutic Committee' decided to restrict the use of vancomycin which was categorized into restricted antimicrobials, among general, reserved and restricted antimicrobials. The committee also established prescribing guidelines of vancomycin in Seoul National University Hospital, May, 1991. Especially, the restricted antimicrobials should be used after approval by infectious disease specialist physician. A retrospective drug use evaluation (DUE) on vancomycin has been conducted to compare with the previous vancomycin DUE study in 1990. 'Criteria for DUE on vancomycin' was modified from Am J Hosp Pharm. Total 65 charts of patients were retrospectively reviewed from July 1991 to June 1992 in Seoul National University Children's Hospital. The justification of use was improved from 56% to 75% comparing with the previous study. In analyzing process indicators, several criteria including body temperature monitoring, WBC monitoring and use of concomitant antibiotics were well documented, but serum creatinine monitoring, culture and sensitivity test and level monitoring were infrequently performed, while the accepted level has been improved. Accepted level for appropriate initial dosage and duration of therapy were decreased. In outcome analysis, blood culture after discontinuing the drug was relatively well documented compared with the previous study. As the results, the approval vancomycin use was shown to be effective and rational in antibiotic therapy. And it is suggested that the above findings should be communicated to the medical staff, and a active intervention, such as feedback control, also be necessary for rational drug use.

• 기술혁신학회지
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• 제15권3호
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• pp.722-743
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• 2012

글로벌 경쟁의 가속화와 연구개발 투자의 위험성 증가에 따라 글로벌 개방형혁신에 대한 필요성이 제기되고 있는 가운데, 국제공동연구의 성과라고 할 수 있는 공동 출원 특허에 대한 품질평가를 통해 국제공동연구가 과연 효과적인지를 실증 분석하였다. 최근 들어 국제공동연구에 의한 공동출원 특허의 양은 더욱 가파르게 증가하고 있다. 1990년부터 2010년까지 21년간의 미국특허정보를 분석한 결과, 국제공동연구(international cooperative R&D)는 국내공동연구(domestic cooperative R&D)에 비해 피인용 수, 특허 패밀리 수, 청구항 수 등의 품질지표에서 모두 우수하다는 분석결과를 보여주었다. 국제공동연구에 의해 공동출원된 특허 가운데 가장 높은 품질을 보이는 산업은 IT산업으로 분석되었으며, 바이오산업, 자동차산업 등, 첨단산업 분야에서의 성과가 상대적으로 우수하다는 결과가 도출되었다. 미국특허 데이터베이스를 토대로 국제공동연구의 네트워크 분석을 수행한 결과 매개 중심성이 가장 높은 국가는 미국으로 나타났고, 독일, 영국, 캐나다, 프랑스가 그 뒤를 이었다.

• 산업경영시스템학회지
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• 제32권3호
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• pp.59-70
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• 2009

This study is the result of meta evaluation for the self evaluation of defense R&D programs in Korea by using meta evaluating indicators. The overall meta evaluation result of defense R&D programs gained 74.3 points out of 100, so it was evaluated as 'Good'. But it demonstrated that further improvement for overall system of defense R&D programs evaluation is required. And especially, it demonstrated that more alternatives are necessary in order to improve the utilizations and the feedbacks of evaluation results. The evaluation context component gained 80.2 points out of 100, so it was evaluated as 'Very Good'. The evaluation input component gained 73.1 points out of 100, so it was evaluated as 'Good'. The evaluation process component gained 74.8 points out of 100, so it was evaluated as 'Good'. And the evaluation outcome component gained 69.0 points out of 100, so it was evaluated as 'Good'. Basic model of meta evaluation was derived from the literature review and brain storming. And this meta evaluation model was determined by adopting the result of experts who performed evaluations for defense R&D programs in recent years. The reliability of components and items was verified by Cronbach's a coefficient. It was over 0.6 in evaluation components and items. And the reliability of evaluation context was 0.877, that of evaluation input was 0.755, that of evaluation process was 0.755, that of evaluation output was 0.755 respectively. From the analysis, it is attempted to identify possible problems and to find out the ways of improvements related to the self evaluation system of defense R&D programs. The ultimate objective of this study is to manage the programs effectively and improve the reliability and the objectiveness of the defense R&D programs.

• Journal of Oral Medicine and Pain
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• 제40권3호
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• pp.89-95
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• 2015

All living organisms have a biological clock that orchestrates every biological process and function, and this internal clock operates following a circadian rhythm. This biological clock is known to influence various clinical indicators such as blood pressure and body temperature. Also, the fluctuation of signs and symptoms of diseases including pain disorders are affected by circadian rhythm. It has been reported that the pain intensity of various somatic and neuropathic pain disorders show unique pain patterns that depend on the passage of time. The generation of pain patterns could be explained by extrinsic (e.g., physical activity, tactile stimulation, ambient temperature) and also intrinsic factors (neural and neuroendocrine modulation) that are related to the circadian rhythm. It is important to recognize and identify the individual pain pattern in pain therapy to approve treatment outcome. Moreover, chronotherapeutics which considers pain patterns and pharmacokinetics in context of the circadian rhythm could produce greater analgesia in response to medication. However, only a limited number of studies handle the issue of pain patterns according to circadian rhythm and chronotherapeutics in the orofacial region. The present review intends to reflect on the most recent and relevant data concerning the bidirectional relation between pain disorders of the orofacial region and circadian patterns.

• Journal of Preventive Medicine and Public Health
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• 제42권5호
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• pp.323-330
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• 2009

Objectives : The aim of this study was to investigate whether working married women in different occupational classes affected diverse health outcomes. Methods : We used data for married women aged 25-59 (N=2,273) from the 2005 National Health and Nutritional Examination Survey. Outcome measures included physical/mental and subjective/objective indicators (selfrated poor health, chronic diseases, depression, and suicidal ideation from reported results; metabolic syndrome dyslipidemia from health examination results). Agestandardized prevalence and logistic regression were employed to assess health status according to three types working groups (housewives, married women in manual jobs, married women in non-manual jobs). Sociodemographic factors (age, numbers of children under 7, education, household income) and health behaviors (health examination, sleep, rest, exercise, smoking, drinking) and a psychological factor (stress) were considered as covariates. Results : Non-manual married female workers in Korea showed better health status in all five health outcomes than housewives. The positive health effect for the non-manual group persisted in absolute (age-adjusted prevalence) and relative (odds ratio) measures, but multivariate analyses showed an insignificant association of the non-manual group with dyslipidemia. Manual female workers showed significantly higher age-adjusted prevalence of almost all health outcomes than housewives except chronic disease, but the associations disappeared after further adjustment for covariates regarding sleep, rest, and stress. Conclusions : Our results suggest that examining the health impact of work on married women requires the consideration of occupational class.

• 컴퓨터교육학회논문지
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• 제10권3호
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• pp.19-29
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• 2007

국가 경제성장에만 집중되어 추진된 정보화 정책은 기술과 사회문화 간의 불균형을 초래하고 심각한 연기능 현상을 나타냈으며, 이러한 문제들은 사이버 공간에서 개인의 정체성을 위협하고 있다. 본 연구에서는 국가 수준의 정보통신윤리 수준을 진단할 수 있는 정보통신윤리지수 모델을 개발하였다. 이를 위해 다양한 선행 연구물을 근거로 연구진의 브레인스토밍을 통해 정보통신윤리지표의 영역을 추출하였으며, 전문가와의 협의를 통해 지표로서의 타당성과 대표성을 높이고 계층분석법에 의해 가중치를 부여하였다. 또한 정보이용자와 정보사업자를 대상으로 설문조사를 통하여 수집된 설문결과를 단순평균방식으로 지수 구성요소들의 가중치 산정에 반영하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.977-980
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• 2013

Background: Endometrial cancer is common in western women, and the rates are very high; however in India, the rates are as low as 4.3 per 100,000 (Delhi). Objective: To estimate the survival of endometrial cancer patients based on age, education, family history, tobacco habit, number of pregnancies, clinical extent of disease and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India, between 1999-2002. 310 cases treated in TMH were considered as eligible entrants for the study. Five-year survival rates were estimated using actuarial and loss-adjusted (LAR) methods. Results: The proportions of patients dying above 50 years of age, non-residents and illiterates was higher than their counterparts. 54.8% of patients had some form of treatment before attending TMH. There were only 4.2% tobacco-chewers and only 6.1% had a family history of cancer. There were 25.8% who had 3-5 pregnancies (not living children) and 38.1% did not remember the pregnancy history. The 5-year overall survival rate was 92%. The five-year rates indicated better prognosis for those aged less than 50 years (97%), non-tobacco-chewers (94%), with no family history of cancer (93%), with localized disease (93%) and those treated with surgery either alone or as a combination treatment (95%). Conclusions: The present study showed that endometrial cancer patients with localized disease at diagnosis have a good outcome in India. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies now available.

• 대한두경부종양학회지
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• 제27권1호
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• pp.3-11
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• 2011

Hepatocyte growth factor(HGF) and c-Met play an important role in the control of tumor growth and invasion, and they are known to be good prognostic indicators of patient outcome. Epigallocatechin-3-gallate (EGCG) has been shown to have chemopreventive and therapeutic properties by modulating multiple signal pathways regarding the control of proliferation and invasion of cells. In this study, we evaluated the role of c-Met in EGCG-induced inhibition of invasion and apoptosis in an oral cancer cell line. In KB cells where c-Met was knocked down with siRNA, we performed invasion assay and FACS with Annexin V-FITC/PT staining. In addition, we checked the change of mitochondrial membrane potential(MMP) and the generation of reactive oxygen species(ROS). EGCG-induced inhibition of invasiveness was significantly decreased after the knock-down of c-Met. EGCG-induced apoptosis, MMP change and ROS generation was also reduced in c-Met knock-ed-down KB cells. These results suggest that c-Met is involved in EGCG-induced apoptosis and inhibition of invasiveness of oral cancer cell line.

• 보건행정학회지
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• 제29권4호
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• pp.502-512
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• 2019

Background: The purpose of this study was to identify role ambiguity of comprehensive nursing care unit nurses. Methods: A concept analysis method by Walker and Avant was used to understand role ambiguity of comprehensive nursing care unit nurses. Results: The antecedents of role ambiguity of nurses at comprehensive nursing units were shortage of nurses, unclear admission criteria, and demands for customized nursing care according to severity. Attributes include ambiguity in role delegation, patient placement ambiguity, and professional ambiguity among nursing staff. The consequences were diminished job satisfaction due to excessive workload, difficulty in resolving role ambiguity due to the lack of work analysis studies, and poor outcome of nursing indicators. Conclusion: Improvement of nationwide awareness for comprehensive nursing care unit is required. Clear division at scope of practice for nursing staff in accordance of each medical institution's characteristics is essential. Nurses at comprehensive nursing care unit should understand nature of role ambiguity that occurs as they work in large groups. Nurses should promote communications between nursing staff and they must have volition to improve status quo. An additional research of comprehensive nursing care on the causes of role ambiguity in the practice of nursing care for ward nurses is needed, and management measures should be sought at the organizational level.