• Tuberculosis and Respiratory Diseases
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• 제39권5호
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• pp.386-391
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• 1992

연구배경 : 최근 알레르겐 흡입을 이용한 기관지유발 검사시 말초혈액 호산구수의 변화가 있음이 알려져 있고, 이는 기도 조직내로의 호산구 유입과 관련이 있음이 밝혀졌다. 그러나 히스타민나 에타콜린 흡입과 같은 비특이적 자극에 의한 기관지유발시 말초혈액 호산구수의 변화에 대한 연구는 아직 불충분하다. 이에 대해 저자들은 예비적으로 몇몇 천식 환자들을 대상으로 히스타민 기관지유발검사후 기도수축이 일어날때까지 말초혈액 호산구수를 단계적으로 측정해본 결과, 호산구수가 점차로 증가하는 환자군과 반대로 감소하는 환자군이 있음을 관찰하였다. 따라서 본연구에서는 저자들의 이러한 예비연구 결과를 재검토하고, 히스타민 기관지유발 검사중에 나타난 말초혈액 호산구수의 변화가 검사후에는 어떤 경과를 밟게 되는지를 관찰하고자 하였다. 방법 : 16명의 천식 환자를 대상으로 히스타민 기관지 유발검사를 시행함과 동시에, 검사전 및 검사후 노력성 1초 호기량($FEV_1$)이 기저치의 20% 이상 감소할때까지는 5분간격으로, 그다음에는 1시간, 2시간, 4시간, 8시간 및 48시간후에 각각 말초혈액 호산구수홀 측정하여 그 변화 경과를 관찰하였다. 결과 : 1) 히스타민 기관지유발검사중의 말초혈액 호산구수 변화를 기준으로 관찰하였을때, 11명(group I)은 기도수축 직전에 기저치보다 증가하는 양상을 보였고, 나머지 5명(group II)은 기도수축 직전에 기저치보다 감소하는 양상을 보였다. 2) Group I에 속한 환자들은 모두 기도수축 후에도 계속 호산구수가 기저치보다 증가된 상태로 유지되는 양상을 보였다. 3) Group II에 속한 환자들은 대부분 기도수축 후에도 계속 호산구수가 기저치보다 감소된 상태로 유지되는 양상을 보였다. 4) Group I과 group II간의 말초혈액 호산구수 기저치, $FEV_1$ 기저치, 히스타민 유발농도 및 혈청 IgE 양에는 의미 있는 차이가 없었다. 결론 : 히스타민 기관지유발검사후 나타나는 말초혈액 호산구수의 변화는 알레르겐 기관지유발검사시와는 다른 양상을 나타내며, 환자에 따라 계속 증가 혹은 감소되는 나름대로의 특징적인 양상을 보이는 것으로 나타났다. 아울러 조기 천식반응에도 호산구가 어느정도 관여할 것으로 추측된다.

• 지능정보연구
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• 제17권3호
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• pp.203-219
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• 2011

최근 인터넷이 가능한 컴퓨터뿐만 아니라 스마트TV, 스마트폰과 같은 장치를 통한 동영상 형태의 멀티미디어 소비가 증가함에 따라 단순히 시청만 하는 것이 아니라 동영상 콘텐츠 사용자들은 자신이 원하는 동영상 콘텐츠를 찾거나 동영상 콘텐츠에 등장하는 객체의 부가 정보를 브라우징 하고자 하는 요구가 증대되고 있다. 이러한 사용자의 요구를 충족시키기 위해서는 노동집약적인 어노테이션 작업이 불가피하다. 동영상 콘텐츠에 등장하는 객체에 직접 부가정보를 기술하는 키워드 기반 어노테이션 연구에서는 객체에 대한 관련 정보들을 어노테이션 데이터에 모두 포함시켜 대용량 데이터를 개별적으로 직접 관리해야 한다. 이러한 어노테이션 데이터를 이용하여 브라우징을 할 때, 어노테이션 데이터에 이미 포함 되어 있는 정보만 제한적으로 검색이 된다는 단점을 가지고 있다. 또한, 기존의 객체 기반 어노테이션에서는 어노테이션 작업량을 줄이기 위해 객체 검출 및 인식, 트래킹 등의 컴퓨터 비전 기술을 적용한 자동 어노테이션을 시도하고 있다. 그러나 다양한 종류의 객체를 모두 검출해내고 인식하여, 자동으로 어노테이션을 하기에는 현재까지의 기술로는 큰 어려움이 있다. 이러한 문제점들을 극복하고자 본 논문에서는 비디오 어노테이션 모듈과 브라우징 모듈로 구성되는 시스템을 제안한다. 시맨틱 데이터에 접근하기 위해 링크드 데이터를 이용하여 다수의 어노테이션을 수행하는 사용자들이 협업적으로 동영상 콘텐츠에 등장하는 객체에 대한 어노테이션을 수행 할 수 있도록 하는 어노테이션 모듈이다. 첫 번째는 어노테이션 서버에서 관리되는 어노테이션 데이터는 온톨로지 형태로 표현하여 다수의 사용자가 어노테이션 데이터를 쉽게 공유하고 확장 할 수 있도록 하였다. 특히 어노테이션 데이터는 링크드 데이터에 존재하는 객체의 URI와 동영상 콘텐츠에 등장하는 객체를 연결하기만 한다. 즉, 모든 관련 정보를 포함하고 있는 게 아니라 사용자의 요구가 있을 때, 해당 객체의 URI를 이용하여 링크드 데이터로부터 가져온다. 두 번째는 시청자들이 동영상 콘텐츠를 시청하는 중 관심 있는 객체에 대한 정보를 브라우징 하는 모듈이다. 이 모듈은 시청자의 간단한 상호작용을 통해 적절한 질의문을 자동으로 생성하고 관련 정보를 링크드 데이터로 부터 얻어 제공한다. 본 연구를 통해 시맨틱웹 환경에서 사용자의 상호작용을 통해 즉각적으로 관심 있는 객체의 부가적인 정보를 얻을 수 있도록 함으로써 향후 개선된 동영상 콘텐츠 서비스 환경이 구축 될 수 있기를 기대한다.

• 한국식품영양과학회지
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• 제46권1호
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• pp.46-55
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• 2017

본 연구에서는 한약재의 장기보존을 위한 위생처리법으로 잘 알려진 감마선 조사 처리 시 독활 추출물의 항산화 활성에 미치는 영향을 검토하였다. 천연 약용식물인 독활의 감마선 조사 처리에 따른 조사 판별 marker 확인을 위해 광자극발광법, 열발광분석법, 전자스핀공명법을 이용하여 확인시험법의 판별 특성을 확인하였다. 그 결과 광자극발광법에서 비조사구 0 kGy에서 891.00 PCs의 중간시료 수치를 나타내어 광자극발광법 단독으로는 조사 여부 판별 확인이 어려운 것을 확인할 수 있었다. 하지만 열발광분석법, 전자스핀 공명법에서는 조사구와 비조사구 간의 차이를 명확히 확인할 수 있었으며, 이를 통해 한약재인 독활은 3가지 확인 시험법을 모두 적용하여 분석하는 것이 적합한 것으로 판단되었다. 에탄올 농도별 추출에서는 50% 에탄올에서 비조사구 0 kGy와 조사구 10 kGy에서 각각 5.98 mg/g, 6.86 mg/g의 함량을 나타내었다. 항산화 활성 확인을 위해 추출물의 phenolic 농도를 $50{\sim}200{\mu}g/mL$로 조절하여 DPPH radical 소거 효과를 측정한 결과 열수와 50% 에탄올 추출물의 비조사구 0 kGy와 조사구 10 kGy $50{\sim}200{\mu}g/mL$ phenolic 농도 전 구간에서 84.04~100.00%의 매우 높은 소거효과를 나타내었으나, 감마선 조사 처리에 따른 유의적인 차이는 없었다. ABTS radical 소거 활성 측정 결과 열수와 50% 에탄올 추출물의 비조사구 0 kGy와 조사구 10 kGy $200{\mu}g/mL$ phenolic 농도에서 95% 이상의 높은 소거 효과를 나타내었다. Antioxidant protection factor(PF) 측정 결과 $100{\mu}g/mL$ phenolic 농도 처리 시 열수 추출물 비조사구 0 kGy와 조사구 10 kGy에서 각각 2.51 PF, 2.01 PF, 50% 에탄올 추출물 비조사구 0 kGy와 조사구 10 kGy는 각각 1.38 PF, 1.48 PF를 나타내었다. TBARs 저해 효과는 $50{\sim}200{\mu}g/mL$ phenolic 농도 전 구간에서 열수 추출물 비조사구 0 kGy와 조사구 10 kGy에서 65.23~83.10%를 나타냈으며, 50% 에탄올 추출물 비조사구 0 kGy와 조사구 10 kGy에서 70.67~95.81%로 농도 의존적으로 증가하는 양상을 나타냈다. 본 연구 결과 감마선 조사 처리에 따른 total phenolic compounds 함량은 열수 추출물의 경우 조사 처리 후 함량이 감소하였고, 50% 에탄올 추출물의 경우 조사 처리 후 함량이 증가하는 것을 확인할 수 있었다. 독활의 장기저장을 위해 처리한 감마선 조사 전과 후 독활 추출물의 항산화 활성 변화에는 큰 영향을 주지 않는 것으로 보이며 이는 감마선 조사법이 독활을 포함한 한약재의 장기저장을 위한 처리법으로 유용하게 이용될 수 있을 것으로 판단된다.

• Asia pacific journal of information systems
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• 제24권3호
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• pp.325-344
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• 2014

Technical support of Window XP ended in March, 8, 2014, and it makes OS(Operating System) users fall in a state of confusion. Sudden decision making of OS upgrade and replacement is not a simple problem. Firms need to change the long term capacity plan in enterprise IS management, but they are pressed for time and cost to complete it. Individuals can not help selecting the second best plan, because the following OSs of Window XP are below expectations in performances, new PC sales as the opportunities of OS upgrade decrease, and the potential risk of OS technical support ending had not announced to OS users at the point of purchase. Microsoft as the OS vendors had not presented precaution or remedy for this confusion. Rather, Microsoft announced that the technical support of the other following OSs of Wndow XP such as Window 7 would ended in two years. This conflict between OS vendor and OS users could not happen in one time, but could recur in recent future. Although studies on the ways of OS user protection policy would be needed to escape from this conflict, few prior studies had conducted this issue. This study had challenge to cautiously investigate in such OS user's reactions as the confirmation with OS user's expectation in the point of purchase, three types of justice perception on the treatment of OS vendor, psychological contract violation, satisfaction and the other betrayal behavioral intention in the case of Window XP technical support ending. By adopting the justice perception on this research, and by empirically validating the impact on OS user's reactions, I could suggest the direction of establishing OS user protection policy of OS vendor. Based on the expectation-confirmation theory, the theory of justice, literatures about psychological contract violation, and studies about consumer betrayal behaviors in the perspective of Herzberg(1968)'s dual factor theory, I developed the research model and hypothesis. Expectation-confirmation theory explain that consumers had expectation on the performance of product in the point of sale, and they could satisfied with their purchase behaviors, when the expectation could have confirmed in the point of consumption. The theory of justice in social exchange argues that treatee could be willing to accept the treatment by treater when the three types of justice as distributive, procedural, and interactional justice could be established in treatment. Literatures about psychological contract violation in human behaviors explains that contracter in a side could have the implied contract (also called 'psychological contract') which the contracter in the other side would sincerely execute the contract, and that they are willing to do vengeance behaviors when their contract had unfairly been broken. When the psychological contract of consumers had been broken, consumers feel distrust with the vendors and are willing to decrease such beneficial attitude and behavior as satisfaction, loyalty and repurchase intention. At the same time, consumers feel betrayal and are willing to increase such retributive attitude and behavior as negative word-of-mouth, complain to the vendors, complain to the third parties for consumer protection. We conducted a scenario survey in order to validate our research model at March, 2013, when is the point of news released firstly and when is the point of one year before the acture Window XP technical support ending. We collected the valid data from 238 voluntary participants who are the OS users but had not yet exposed the news of Window OSs technical support ending schedule. The subject had been allocated into two groups and one of two groups had been exposed this news. The data had been analyzed by the MANOVA and PLS. MANOVA results indicate that the OSs technical support ending could significantly decrease all three types of justice perception. PLS results indicated that it could significantly increase psychological contract violation and that this increased psychological contract violation could significantly reduce the trust and increase the perceived betrayal. Then, it could significantly reduce satisfaction, loyalty, and repurchase intention, and it also could significantly increase negative word-of-month intention, complain to the vendor intention, and complain to the third party intention. All hypothesis had been significantly approved. Consequently, OS users feel that the OSs technical support ending is not natural value added service ending, but the violation of the core OS purchase contract, that it could be the posteriori prohibition of OS user's OS usage right, and that it could induce the psychological contract violation of OS users. This study would contributions to introduce the psychological contract violation of the OS users from the OSs technical support ending in IS field, to introduce three types of justice as the antecedents of psychological contract violation, and to empirically validate the impact of psychological contract violation both on the beneficial and retributive behavioral intentions of OS users. For practice, the results of this study could contribute to make more comprehensive OS user protection policy and consumer relationship management practices of OS vendor.

• 지질공학
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• 제14권4호
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• pp.461-468
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• 2004

이 연구에서는 암반 내 절리면의 거칠기 정도에 따른 수리특성의 차이를 규명하고자 Barton(1976)이 제안한 절리면 거칠기 계수(Joint Roughness Coefficient; JRC) 등급별로 투수계수를 산정하였다. 이를 위하여 JRC등급 형태별로 고속퓨리에 변환을 이용한 스펙트럼 분석을 실시하여 각 거칠기 등급별로 영향력 이 큰 주파수 성분을 추출하였다. 스펙트럼 분석결과 낮은 JRC 등급을 갖는 절리들이 높은 등급의 절리들보다 저주파 성분이 더 강하게 구성되어 있으며, 높은 JRC등급의 절리들은 상대적으로 고주파 성분이 더 크게 차지하는 것을 알 수 있었다. 스펙트럼 성분 중에서 영향력이 큰 주파수 성분만을 이용하여 퓨리에 역변환을 실시해 JRC 등급별 절리 모델을 생성하였다. 생성된 절리 모델은 거칠기 성분을 포함한 모델로써, 균질화 해석기법을 이용하여 각 모델의 투수계수를 산정하였다. 균질화 해석법은 섭동이론을 적용한 것으로서, 미시규모(microscale) 매질특성과 거시규모(macroscale) 매질특성을 동시에 고려하여 투수계수를 계산할 수 있으므로 균열 기하양상의 국부적 영향을 고려한 투수특성을 정확히 해석할 수 있다. 균질화 해석법을 이용해 투수계수를 산정한 결과, 절리 간극이 동일한 평행판 모델을 가정한 JRC 등급별 투수계수는 $10^{-3}\~10^{-4}m/sec$의 범위에 분포한다. 반면, 전단변형이 발생한 것을 가정한 모델에서는 $10^{-4}\~10^{-5}m/sec$의 범위에 투수계수가 분포한다. 이 경우는 투수계수 분포가 일정한 변화양상을 보이지 않고 JRC등급에 따라 불규칙적인 투수계수 분포를 보인다. 동일한 크기의 간극을 갖는 경우임에도 불구하고 JRC 등급별로 투수계수의 차이가 발생하거나 전단변위에 따라 투수계수가 불규칙적으로 분포하는 것은 거칠기 변화가 투수계수의 변화에 영향을 미침을 지시하는 것으로서, 이 연구를 통해 암반내 절리 등 균열을 따른 수리특성 규명에 있어 절리면 거칠기의 영향은 반드시 고려되어야 함을 알 수 있다.

• 한국간호교육학회지
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• 제3권
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• pp.78-98
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• 1997

Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

• 여성건강간호학회지
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• 제8권2호
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• pp.232-243
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• 2002

The purpose of this study was to examine factors influencing the meaning of life for middle-aged women. The subjects for the study were 190 middle-aged women who live in Busan. Data were collected from May 25 to June 20, 1999. The instruments for this study were as follows : the meaning of life scale developed by Jung D. R(1978) ; the self-esteem scale developed by Ro, E. Y, Kwon, J. H.(1997) ; the volunteer activity scale developed by Park G. J.(1999), the marital satisfaction scale developed by Choi G. Y.(1999) ; and the health status scale developed by Kim S. Y. (1991). SPSS PC+ was utilized for data analysis. Data were analysed according to frequency and percentage, mean and standard deviation, t-test, ANOVA, Sheffe' s test and Pearson' s correlation coefficients and stepwise multiple regression. The reliability of the tools was tested by Cronbach's $\alpha$ : and it showed reliability scores of 0.88(for the meaning of life tool), 0.81(for the self-esteem tool), 0.94(for the marital satisfaction tool) and 0.78(for the health status tool). The results were as follows: 1) The scores showed that middle-aged women had a moderate level of meaning of life, with a mean of 30.31 and standard deviation of 6.24 (with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate levels of self-esteem, with a mean of 28.92 and standard deviation of 4.67 (with values ranging from 10.00 to 40.00). The scores showed that middle-aged women had a very low level of volunteer activity, with a mean of 0.87 and standard deviation of 0.93(with values ranging from 0.00 to 1.00). The scores showed that middle-aged women had a moderate level of satisfaction in their marriages, with a mean of 31.99 and standard deviation of 7.84(with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate level of health status, with a mean of 6.63 and standard deviation of 1.57(with values ranging from 3.00 to 9.00). 2) There was a statistically significant difference of the meaning of life of middle-aged women according to their religion(F=8.930, p=.000), christian ($31.94{\pm}5.96$) had more meaning th life than buddhists ($28.40{\pm}6.23$). 3) There was a statistically significant correlations between the subject' s self-esteem and the her meaning of life(r=0.477, p=0.000), the subject' s level of volunteer activity and meaning of life(r=.428, p=.000), her level of marital satisfaction and meaning of life(r=.417, p=.000), and her level of health status and meaning of life(r=.261, p=.000) among these middle-aged women. 4) Self- esteem was the highest factor influencing the level of meaning of life in middle-aged women. 40.0% of the total variance of levels of meaning of life by was dependent on self-esteem, volunteer activity, marital satisfaction and health status. In conclusion, the higher the self-esteem and levels of volunteer activity, marital satisfaction, and health status of middle-aged women, the higher the meaning of life for them. Therefore, it is necessary to elevate levels of the self-esteem and volunteer activity, marital satisfaction and health status in order to help middle-aged women have more meaning of life.

• 대한치과교정학회지
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• 제26권1호
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• pp.1-16
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• 1996

본 연구는 골격성 III 급 부정교합 환자에서 상악골 전방이동수술과 하악골 후방이동수술을 동시에 시행하였을 때 경,연조직 측모 및 연조직 후경의 변화를 관찰하고 경,연조직 변화의 상관성과 그 비율을 산출하여 교정-악교정 수술복합 치료 계획의 수립과 결과의 예측에 이용하고자 하였다. 서울대학교병원 치과진료부 교정과에 내원하여 상, 하악골의 수직적 골격 부조화는 경미하고 전후방적 골격 부조화가 심한 골격성 III급 부정교합으로 진단되어 술전 교정치료를 받고 1990년 7월부터 1995년 4월 중에 Le Fort I 골절단술 또는 Le Fort II 골절단술로 상악골을 전방이동시키는 동시에 시상분할 골절단술로 하악골을 후방이동시킨 성인 환자 25명(남자 13명, 여자 12명) 을 대상으로 수술전,후 측모두부방사선사진을 계측, 분석하여 다음과 같은 결과를 얻었다. 1. 상악골의 전방이동에 따른 상순부 연조직의 수평적 변화는 Stms를 제외하면 상관성이 높았으며 A point의 전방이동에 따라 Sn, SLS, LS 는 각각 $71\%,\;67\%,\;37\%$ 의 비율로 전방이동하였다. 2. 하악골의 후방이동에 따른 하순부 연조직의 수평적 변화는 상관성이 상당히 높았으며 ID, B point, Pog, Gn의 후방이동에 따라 LI, ILS, Pog, Gn 은 각각 $84\%,\;107\%,\;96\%,\;97\%$ 의 비율로 후방이동하였다. 3. 하악골의 후방이동에 따라 SLS, LS, Stm, LI 는 중등도의 상관성을 가지며 하방이동하였다. 4. 경조직의 전후안면고경비율과 연조직의 상,하안면고경 은 수술전후 유의한 차이가 없었으나 수술후 Stm 의 하방이동으로 하순고경에 대한 상순고경의 비율은 유의성있게 증가하였다(p<;0.001). 5. 연조직 후경은 수술후 LI-LIH 에서는 증가하고 LS-LSH 에서는 감소하였으며 LS-LSH 의 수술후 변화량과 수술전 후경은 역상관관계를 나타내었다(p<0.001).

• 가정∙방문간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• 한국직업건강간호학회지
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• 제4권호
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• pp.5-29
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• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.