• Journal of Preventive Medicine and Public Health
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• 제28권3호
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• pp.588-608
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• 1995

This study was intended to enhance the level of hospital personnel management through analysing job satisfaction of hospital employees in terms of structural, personal and environmental variables. The sample of this study consist of a total of 790 persons including doctors, residents, interns, pharmacists, nurses, medical engineers, office workers and manual workers who have worked for general hospitals with 200 beds, 300 beds and 800 beds respectively. The Likert's 5 scales were used for the measurement of satisfaction. The results can be summarized as follows: 1. Structural Variables The level of satisfaction on the job itself was generally low, 2.8 in Likert's 5 scales, with the order of role ambiguity(3.87), routinization(2.6), work overload (2.45) and autonomy(2.37). Hospital employees are aware of their responsibility and they regarded their work as heavy one. The compensatory satisfaction degree was 2.5 which was also low: There were in the order stability(3.1), distributive justice(2.57), pay(2.3) and promotion(1.9). Usually hospital employees showed high degree of stability, while, their satisfaction on promotion possibility is quite low due to specially differentiated structures of hospitals. The degree of satisfaction on the internal conditions of organizational culture was relatively higher as 2.92: They were co-worker's support(3.69), supervisory support(3.15), role conflict(2.64) and welfare(2.17) in order. The satisfaction on welfare as an economic condition was the lowest. 2. Personal Variables The level of satisfaction on personal variables was 3.27 which seemed to be quite high: Contribution to the hospital(3.38), attitude on job performance(3.28) and pride as a member of the hospital(3.07). They seem to believe that their work has been helpful to the performance of hospitals. 3. Environmental Variables The degree of satisfaction on these variables was 3.07 on the average which was derived from environmental factors such as family-role conflict and community support related to hospital employees' environment. The order of satisfaction for each variable is community support(3.2) and family-role conflict(2.94). They turned out to be fairly satisfied with their job in community and yet, they wanted more spare time to spend with their family.

• 대한약리학회지
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• 제29권2호
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• pp.195-202
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• 1993

스트렙토조토신으로 당뇨를 유발시킨 쥐의 심근 근장그물에서 칼슘이동이 저하됨을 볼 수 있었다. 칼슘이동의 저하는 최대칼슘 uptake의 감소와 칼슘에 대한 affinity의 감소로 나타났다. 이러한 심근 근장그물의 기능저하가 나타나는 작용기전이 심근 근장그물 단백의 산화성 손상과 관계가 있는지를 살펴보았다. 당뇨쥐에서는 glycohemoglobin과 carbonyl group의 양이 현저히 증가됨을 볼 수 있었다. 한편으로 cyclic AMP 의존성 protein kinase의 catalytic subunit에 의한 phospholamban 인산화에 의해 심근 근장고물 칼슘이동의 증가를 보였고, 이 증가는 대조군에 비하여 당뇨군에서 훨씬 현저하게 나타났다. SDS-polyacrylamide를 이용한 전기영동후 autoradiogram을 통하여 확인한 phospholamban 인산화는 당뇨군에서 진한 band로 나타남이 확인되었다. 이상의 결과로 미루어 당뇨군의 심근 근장그물 기능저하는, 기초상태에서 아마도 심근내 저하된 norephinephrine 양으로 인하여 phospholamban 인산화 정도가 적으므로 근장그물 $Ca^{2+}-ATPase$ 억제가 나타남을 제시해 주며, 근장그물 단백의 산화성 손상도 당뇨성 심근질한을 일으킬 수 있는 또 다른 요인 중의 하나로 생각된다.

• 한국시뮬레이션학회:학술대회논문집
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• 한국시뮬레이션학회 2001년도 The Seoul International Simulation Conference
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• pp.170-202
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• 2001

Simulation is used to reduce a risk involved in the new project and decision-making in an organization and to save cost and time by forecasting different situations. The objectives of this research are to acknowledge the need of simulation through the real life sample and to encourage the use of the simulation method in the future consulting project by continuously making the necessary improvements. This research analyzed the effectiveness of the simulation based on the sample use of simulation method in 1994 and 1997 for the BPR project of certification issuance process at the Supreme Court. In order to evaluate the value of the proposed simulation model, we examined the gap, which existed between the simulation result and the operational data collected by visiting the actual sites where AROS (Automated Registry Office System: automation system developed by LG-EDS Systems) is being utilized. We also identified the causes for the existing gap. According to the analysis result, (1) the gap came from the status change of thinking that the concentration of certification issuance request has eased after the computerization, (2) the gap existed in the operational process because they failed to consider the situational factors of each registry office in the simulation model, and (3) lastly the gap came from the difficulty of formulating the mathematical model for predicting the complex and diverse behavior pattern of individuals requesting the certification issuance. In order to narrow the existing gaps, we made a proposal to improve the certification issuance process where software of certification issuance vending machine was upgraded in order to help the people to use the service conveniently, more part time workers were hared when there was a overload of certification issuance request, and the quality of the certification Issuance vending machine is improved, In this research, we examined an efficient way of resource allocation based on the simulation conducted in 1994 and 1997. By reflecting changes since the simulation of 1994 and allocating the clerk and machine based on the predicted results of the simulation, we maximized the efficiency of the certification issuance process. In conclusion, this research examined the future usability of simulation method based on the analysis result and identified the key issues to consider when using the simulation method in the future consulting project.

• International Journal of Naval Architecture and Ocean Engineering
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• 제10권4호
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• pp.491-498
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• 2018

The cost evaluation for voyage route planning in an ice-covered sea is one of the major topics among ship owners. Information of the ice properties, such as ice type, concentration of ice, ice thickness, strength of ice, and speed-power relation under ice conditions are important for determining the optimal route in ice and low operational cost perspective. To determine achievable speed at any designated pack ice condition, a model test of resistance, self-propulsion, and overload test in ice and ice-free water were carried out in a KRISO ice tank and towing tank. The available net thrust for ice and an estimation of the ice resistance under any pack ice condition were also performed by I-RES. The in-house code called 'I-RES', which is an ice resistance estimation tool that applies an empirical formula, was modified for the pack ice module in this study. Careful observations of underwater videos of the ice model test made it possible to understand the physical phenomena of underneath of the hull bottom surface and determine the coverage of buoyancy. The clearing resistance of ice can be calculated by subtracting the buoyance and open water resistance form the pre-sawn ice resistance. The model test results in pack ice were compared with the calculation results to obtain a correlation factor among the pack ice resistance, ice concentration, and ship speed. The resulting correlation factors were applied to the calculation results to determine the pack ice resistance under any pack ice condition. The pack ice resistance under the arbitrary pack ice condition could be estimated because software I-RES could control all the ice properties. The available net thrust in ice, which is the over thrust that overcomes the pack ice resistance, will change the speed of a ship according to the bollard pull test results and thruster characteristics (engine & propulsion combination). The attainable speed at a certain ice concentration of pack ice was determined using the interpolation method. This paper reports a procedure to determine the attainable speed in pack ice and the sample calculation using the Araon vessel was performed to confirm the entire process. A more detailed description of the determination of the attainable speed is described. The attainable speed in 1.0 m, 90% pack ice and 540 kPa strength was 13.3 knots.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1318-1326
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• 1992

Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

• Journal of Chest Surgery
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• 제33권10호
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• pp.785-791
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• 2000

Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. Material and Method: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period Result : Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42$\pm$8.0mm and 42$\pm$8.3mm left ventricular diastolic dimensions(LVIDd) were 64$\pm$10.0mm and 56$\pm$7.4mm left ventricular end systolic volumes(LVESV) were 62$\pm$19cc (z=1.87$\pm$0.06) and 59$\pm$24cc(z=1.78$\pm$0.08) left ventricular end diastolic volumes(LVEDL) were 169$\pm$40cc(z-1.17$\pm$0.1) and 112$\pm$29cc(z=0.85$\pm$0.1) and ejection fractions(EF) were 66$\pm$6.7% and 48$\pm$12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis ($\Delta$LVEF=-13.3-4.62$\times$LVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. Conclusion ; Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.

• 대한한의학회지
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• 제23권4호
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• pp.161-168
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• 2002

Objectives: Hwangryunhaedok-tang (Huang-lian-jie-du-tang, HRHDT, 黃連解毒湯) is a traditional Korean herbal medicine that is formulated with Coptidis Rhizoma, Phellodendri Cortex, Scutellariae Radix and Gardeniae Fructus. HRHDT is cold (寒) and bitter (苦) in nature and has general properties of clearing heat and detoxifying (淸熱解毒), strengthening the stomach and settling the liver (健胃平肝), and reducing inflammation, fever and swelling. This formula can prevent and treat artherosclerosis, hyperplasia of the endothelium, cerebral fluid circulation, cerebral vascular deterioration through aging, impairment of neurotransmitters, or disruption of the functioning of the cerebral cortex following infection or trauma. The purpose of the study reported here was to determine the neuroprotective effect of HRHDT on global ischemia induced by 4-vessel occlusion in Wistar rats. Methods: HRHDT extract was lyophilized after extraction with 85% methanol and 100% water. Rats were induced to 10 minutes of forebrain ischemia by 4-vessel occlusion (4-VO) and reperfused again. HRHDT was administered with a dose of 100 mg/kg, and 500 mg/kg of 85% methanol extracts and 100 mg/kg of 100% water extracts, respectively, at 0 min and 90 min after 4-VO. Rats were killed at 7 days after ischemia and the number of CA1 pyramidal neurons was counted in hippocampal sections stained with cresyl violet. Results: Body temperature of animals showed no significant difference between saline-treated groups and HRHDT extracts-treated groups until 5 hours of reperfusion. This result indicated that neuroprotective effects of HRHDT extracts were not due to hypothermic effects. The administration of HRHDT showed a significant neuroprotective effect on hippocampal CA1 neurons at 7 days after ischemia compared to the saline-treated group (P<0.001). HRHDT methanol extracts of 100 mg/kg, 500 mg/kg and HRHDT water extracts of 100 mg/kg showed 88.5%, 98.3% and 95.1 % neuroprotection, respectively. Conclusions: The results of this study demonstrate that administration of HRHDT is highly effective in reducing neuronal damage in response to transient global cerebral ischemia. HRHDT may involve many mechanisms that might account for its high degree of efficacy. A number of factors including free radicals, glutamate, calcium overload, NO, and various cytokines have been proposed to have an important role in causing neuronal death after short periods of global ischemia. Further studies are needed to know the neuroprotective mechanisms of HRHDT.

• 한국산업보건학회지
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• 제27권4호
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• pp.352-360
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• 2017

Objectives: 본 연구의 목적은 방문요양 요양보호사들의 세부업무 영역별 특성이 근골격계통증에 미치는 영향을 알아보고, 요양보호사들의 근골격계통증을 경감시키는 방안을 마련하고자 하는 것이다. Methods: 본 연구는 P시에 위치한 C, K 재가센터 소속 요양보호사 192명을 대상으로 실시하였다. 대상자들에게 근골격계통증척도와 요양보호사의 세부업무에 대한 작업부담체크리스트를 작성하게 한 후, 수집된 자료를 SPSS 21.0 프로그램을 이용하여 분석하였다. Results: 요양보호사의 근골격계통증 자각증상 정도를 보면, 허리통증과 어깨통증의 수치가 가장 높았다. 세부업무 영역별 특성이 근골격계통증에 미치는 영향을 알아본 결과, 신체수발영역의 '식사수발하기, 이동지원하기, 목욕지원하기, 체위변경하기, 건강관리영역의 '물리치료보조하기, 욕창관리하기', 시설환경 관리영역의 '청소 및 세탁물관리'가 영향을 미치는 것으로 나타났다. Conclusion: 요양보호사들은 거동이 불편한 대상자들을 이동시키거나 체위를 변경하는 동작 등 신체적으로 무리가 가중되는 환자의 비율이 높아 신체 하중을 가장 많이 받는 허리와, 어깨의 통증을 일으킬 우려가 매우 높다. 이에, 요양보호사들에게 통증이 주로 발생할 수 있는 부위의 과부하를 줄여줄 수 있는 인체역학적 자세에 대한 교육이 필요하다. 그리고 위험한 업무에 대해서는 장비 및 인력의 지원이 제공 되어야 할 것이며, 지속적으로 다각적 차원의 사회적 지원이 필요할 것이다.

• 벤처창업연구
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• 제19권3호
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• pp.69-79
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• 2024

기업은 소비자의 불만족 요인을 적극적으로 파악하고, 예상되는 불평행동에 대하여 선제적으로 대응함으로써 소비자의 불만족을 해소하고 브랜드 로열티를 높여 재구매를 유도해야 한다. 이는 기업 규모와 무관하게 공통적으로 추구해야 하는 경영목표이다. 본 연구의 구체적인 목적은 소비자의 구매 전 기대성과와 구매 후 실제 지각성과와의 비교 여부에 따라서 불만족의 정도가 차이가 있는지, 불만족의 정도는 후속 행동인 불평행동의 유형에 영향을 미치는지, 이 과정에서 귀인행동은 조절적인 영향을 미치는지, 또한 결과의 지속성과 원인의 통제 가능성이 귀인 위치를 결정하는 요인으로 작용하는지 알아보는 것이다. 특히 벤처기업은 일반기업에 비해서 경영자의 정보처리 능력에 과부하가 걸릴 경우가 많아 의사결정에 있어서 여러 가지 비합리적인 오류를 보일 가능성이 있기 때문에 본 연구는 학문적으로나 실무적으로 중요한 의미가 있다. 분석결과, 불만족도는 부정적 불일치 그룹이 가장 높았으며, 불일치 정도가 높을수록 불만족도도 높았다. 불만족한 소비자의 귀인행동은 불만족의 정도에 조절적 영향을 미치고 있었는데, 불만족도는 외적 귀인집단이 내적 귀인집단보다 확연히 높았으며, 이는 통계적으로 유의했다. 한편, 결과의 지속성은 귀인 위치에 통계적으로 유의한 영향을 미치고 있으나 원인의 통제가능성은 그렇지 않았다. 귀인행동과 불만족의 정도는 불평행동의 유형에 영향을 미치지 않아 제한적인 영향력을 보여주었다. 본 연구는 이러한 결과들에 대한 해석과 함께 특히, 내구성 신제품을 제공하는 벤처기업에게 다양한 시사점들을 제시하고 있다.

• Journal of Chest Surgery
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• 제36권3호
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• pp.136-141
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• 2003

성인 선천성 심기형에 동반된 삼첨판막 폐쇄부전에 대한 판막륜 성형술의 중기 성적 및 잔존폐쇄부전의 위험인자를 분석하였다. 대상 및 방법： 1989년 8월부터 2001년 6월까지 총 73명의 성인환자가 선천성 심기형에 동반된 삼첨판막 폐쇄부전으로 판막륜 성형술을 받았다. 환자의 성비는 51：22로 여자가 많았고 연령은 16∼73세(평균 43세)였다. 진단은 심방중격결손(55), 심실중격결손(6), 부분 폐정맥 환류이상(4), 기타(8)의 순 이였다. 수술 전, 후 판막 폐쇄부전의 평균 혈류 속도는 각각 3.25 m/sec, 2.56 m/sec이었고, 판막 성형술의 방법은 De Vega 형(43), Kay 형(18), Ring Annuloplasty 형(12)의 순 이었다. 외래 추적기간은 2,347 patient-month (평균: 32.6개월)이었고, 이 기간 중 총 134예의 심초음파가 시행되었다. 초음파상 III/IV 이상의 잔존 판막 폐쇄 부전이 있는 경우 판막 성명술 실패로 간주하였다. 결과: 7명의 환자(9.6%)에서 판막 성명술 실패의 소견을 보였고, 이중 1명에서 삼천판막 치환술이 시행되었다. 잔존 폐쇄부전의 위험인자로는 심방 중격 결손 이외의 진단, 폐쇄부전이 우심실 압력 과부하에 의한 경우, 수술 후 높은 판막 폐쇄부전 혈류 속도 등으로 해석되었고. 판막 성형술의 방법은 잔존 폐쇄부전과 무관하였다. 결론: 선천성 심기형에 동반된 삼첨판막의 폐쇄부전이 우심실 압력 과부하에 의한 경우 판막 성형술 시 주의를 요하며, 수술 후 우심실 압부하가 소실되지 않는 경우 잔존 폐쇄부전의 위험이 높다.