• Journal of Trauma and Injury
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• 제33권3호
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• pp.144-152
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• 2020

Purpose: This retrospective multicenter study analyzed trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) in the Republic of Korea. Methods: This study was conducted from February 2017 to May 2018 at three regional trauma centers in the Republic of Korea. The patients were divided into two groups (cardiopulmonary resuscitation [CPR] and No-CPR) for comparative analysis based on two criteria (complication and mortality) for logistic regression analysis (LRA). Results: There were significant differences between the CPR and No-CPR groups in mortality (p=0.003) and treatment administered (p=0.016). By LRA for complications, total occlusion has significantly lesser risk than intermittent or partial occlusion in both univariate (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.00-0.36, p=0.01) and multivariate (OR 0.05, 95% CI 0.00-0.38, p=0.01) analyses. The Rescue had a higher risk than the Coda or Reliant in univariate analysis (OR 4.91, 95% CI 1.14-34.25, p=0.05); however, it was not statistically significant in multivariate analysis (OR 6.98, 95% CI 1.03-74.52, p=0.07). By LRA for mortality, the CPR group was the only variable that had a significantly higher risk of mortality than the No-CPR group in both univariate (OR 17.59, 95% CI 3.05-335.25, p=0.01), and multivariate (OR 24.92, 95% CI 3.77-520.51, p=0.01) analyses. Conclusions: This study was conducted in the early stages of REBOA implementation in the Republic of Korea and showed conflicting results from studies conducted by multiple institutions. Therefore, additional research with more accumulated data is needed.

• 대한지리학회지
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• 제46권4호
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• pp.501-517
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• 2011

본 연구에서는 원격진료 기술로 병원간 통합을 꾀하고 있는 일본의 사례를 중심으로, 원격진료의 지역화 형성 및 특성에 대해 알아보았다. 연구를 통한 결과는 다음과 같다. 첫째, 일본에서는 원격진료의 효과적인 운용을 위해, 현청, 지역 내 대학, 의사회, 지역 산업을 기반으로 하는 기업 등을 주축으로 하는 "원격진료 의원회"를 구성하여, 이를 활발한 의사 교환의 장(場)으로 이용하고 있다. 따라서 지역의 다양한 의료 종사자와 환자의 직접적인 수요를 최대한 반영하고, 조속히 맞춤형 원격진료 서비스를 제공할 수 있는 환경을 형성하였다. 둘째, 이미 형성된 긴밀한 인간관계가 원격의료의 지역화에 크게 관여하고 있다. 지역의료의 발전을 위한 정책 결정자-의사 집단 간의 관계, 의사회의 정기적인 모임과 연장자 의사 집단의 지역의료에 대한 깊은 이해 및 지원 등을 기반으로 하는 의사-의사 간의 관계, 긴 시간 신뢰를 쌓은 의사-환자 간의 관계 등은 원격진료의 발안 단계에서부터 실제적인 이용과 응용의 단계까지 두루 걸쳐 일본에서만 보여지는 지역화의 특성을 결정짓는다. 결론적으로 오프라인에서 형성된 개인적 차원의 관계(게마인샤프트)가 온라인상의 공적 차원(게젤샤프트)의 서비스로 전환되는 현상이 일본 원격진료의 지역화에서 보여지는 고유한 양식이라고 할 수 있다. 이는 하나의 현을 중심으로 하는 사회, 경제, 문화적인 특성들이 원격진료에서도 고스란히 투영되어 나타나기 때문인 것으로 파악된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.375-380
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• 2014

This study examined the incidence rates of cancer cases (averages for 2006-2010) and relationships with environmental radioactivity levels. Soil and water samples were collected from provincial and district centers of Van city and the outdoor gamma doses were determined using a portable gamma scintillation detector. Gross alpha and beta, (226)Ra, (232)Th, and (40)K activities were measured in both tap water and soil samples. Although high rates of stomach and esophagus cancers have been reported previously in Van the underlying reasons have not hitherto been defined. Incidences of cancers were highest in the Gurpmar (326.0) and Ozalp (377.1) counties (p<0.001). As to the results of the gross alpha and gross beta radioactivity measurements in the drinking water, these two counties also had high beta radionuclide levels: Gurpmar ($140mBq/dm^3$) and Ozalp ($206mBq/dm^3$). Even if within the normal range, a relation between the higher rate of the incidence of stomach and esophagus cancers with that of the higher rate of beta radionuclide activity was clear. On Spearman correlation analysis, the relation between higher beta radionuclide levels and cancer incidence was found to be statistically significant (p<0.01). According to the results of the analysis, Van residents receive an average 1.86 mSv/y annual dose from outdoor gamma radiation, ingestion of radionuclides in the drinking water, and indoor $^{222}Rn$ activity. Moreover, gross alpha and beta activities were found to be extremely high in all of the lakes around the city of Van, Turkey. Further investigations with long-term detailed environmental radiation measurements are needed regarding the relationship between cancer cases and environmental radioactivity in the city of Van.

• 한국지역지리학회지
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• 제3권2호
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• pp.163-193
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• 1997

복지사회를 지향하는 오늘날, 건강 중진에 직접 관계되는 의료시설의 접근성 문제는 주요 과제이다. 특히 삶의 질이라는 측면에서 질병의 치료 외에 건강진단, 예방과 회복, 요양 및 응급서비스의 비중이 커지고, 인구의 노령화 현상이 진전되면서 의료시설의 효율적인 입지가 주 관심사로 대두되고 있다. 의료시설은 주민의 생존과 직접 관계되는 기본적이고도 필수적인 중심시설로, 지역 주민은 균등한 혜택을 받을 수 있어야 한다. 이를 실현시키기 위해서는 기본적으로는 효율성과 평등성을 기반으로 1차 진료기관이 균등 분포해야 한다. 이에 본 연구에서는, 광주시를 사례지역으로 선정하여 의료시설의 입지와 그에 대한 주민의 효율적 이용에 관하여 분석하였다. 분석에 있어서는 통계자료와 기존의 연구 성과 외에 설문 및 현지조사 자료를 기반으로 시설 측면과 이용자 측면을 동시에 고찰하였다. 우선 의료 환경의 변화 및 의료시설의 변화 과정을 고찰하고, 이어서 의료시설의 유형별 입지 특성과 주민의 분포 특성을 고려한 지역별 의료수준을 분석하였다. 그리고 유형별 의료시설의 이용행태와 그 요인을 구명한 후, 마지막으로 장래 이용 유형의 예측과 문제지역의 추출, 나아가서는 시설의 합리적인 입지와 경영 방향을 제시하였다. 본 연구 결과는, 앞으로 신설될 의료시설의 적정 입지에 관한 기본 자료로서는 물론 지역 주민의 불평등성 해소라는 응용적 측면에서 의의를 지닌다.

• 보건의료산업학회지
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• 제7권3호
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• pp.95-109
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• 2013

The objective of this study is to assess the utilization and satisfactions about public health centers in Korea. For the analysis, the study utilize the nationwide data of 229,229 person on '2010 Community Health Survey' of Ministry of Health & Welfare. The statistical methodology used in the study is ${\chi}^2$, ANOVA, logistic regression model and multiple regression model. This study have four major findings. First, the significant affecting socio-demographic factors in utilizing public health center were gender, age, region, national basic living secured, married, income, education, job, state of health, chronic disease, unmet medical needs and utilization reason. Second, the most serviced category of health center user was vaccination both city and rural area and the next was certificate, primary care, health screening, other use, the mother and child in city area, primary care, health screening, certificate, home visiting health in rural area. Third, the significant affecting socio-demographic factors in satisfaction degree on health center service were age, region, national basic living secured, income, education, job, state of health, utilization degree and reason. Fourth, the most satisfied service of health service center was home visiting health in city area and mental health service in rural area and the next was nutritive control and the lowest satisfied service was user of certificate. The utilization and satisfaction on health center service were identified as different with residental area and user's characteristics. The politic effort are needed to support socially disadvantaged class and to narrow regional gap.

• 응용통계연구
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• 제31권2호
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• pp.287-301
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• 2018

0이 과도하게 많이 나타나는 자료는 여러 다양한 분야에서 흔히 볼 수 있다. 이러한 자료들을 분석할 때 대표적으로 영과잉 포아송 모형이 사용된다. 특히 반응변수들 사이에 상관관계가 존재할 때에는 랜덤효과를 영과잉 포아송 모형에 도입해서 분석해야 한다. 이러한 모형은 주로 빈도론자들의 접근방법으로 분석되어왔는데, 최근에는 베이지안 기법을 사용한 분석도 다양하게 발전되어 왔다. 본 논문에서는 반응변수들 사이에 상관관계가 존재하는 경우 랜덤효과가 포함된 영과잉 포아송 회귀모형을 베이지안 추론 방법을 토대로 제안하였다. 이 모형의 적합성을 판단하기 위해 모의 실험을 통해 랜덤효과를 고려하지 않은 모형과 비교 분석하였다. 또한, 실제 지역사회 건강조사 흡연 자료에 직접 응용하여 그 결과를 살펴보았다.

• KIEAE Journal
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• 제9권6호
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• pp.73-80
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• 2009

The purpose of this paper is to suggest rules and regulations about a bike parking facility, With the objective of expanding bike parking facilities for the comfort of bikers. In Korea, the requirements to establish the facility comply with several regulations like laws for the encouragement of bike usages, rules and regulations for the encouragement of bike usages, regulations of Gyeonggi Regional Corporation rules and Korea National Housing Corporation(Korea Land and Housing Corporation) and requirements for the approval of green buildings. Such rules regulate the number of parking spots depending on the number of nearby houses and the size of a parking facility. Amongst the foreign regulations about the facility is 'obligatory regulations for the establishment of a bike parking facility' in Japan. In the United States, all states apply rules about the bike facility to determine the number of bike parking spots in accordance with the number of car parking spots. Comparing Korean rules regarding the bike parking facility with those of foreign governments will give a good insight into the current situation of Korean regulations. In order to investigate the current usage of bikes, 30 houses in Goyang city, 35 schools, 16 retails shops and 20 medical centers were researched. Thereafter, a correlation test between the size of buildings and the number of bike parking spots was carried out. The result of the test indicates that there is a lack of space for bike parking. It is recommended that the bike parking facility be installed with a convenient access to a building in order to increase the rate of bike usages.

• 한국융합학회논문지
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• 제11권3호
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• pp.237-244
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• 2020

초고령사회에 진입한 일본은 의료 및 복지에 대한 수요증가에 대응하기 위해서 정부의 다양한 정책적 방안들이 논의되고 있다. 특히 개호인력 확보 및 인력양성을 위해 일본정부와 지자체가 1) 인프라 구축, 2) 개호복지사 수학자금 등 대출제도, 3)외국인 유학생 개호인력유입 등 다양한 방면으로 전문 인력 확보 대책을 추진하고 있다. 또한, 교육기관인 대학에서도 커뮤니티케어 교육연구센터를 설립하여 의료, 복지, 교육에 관한 전문인재 육성의 질적 향상을 도모하고, 직업교육을 통해 개호전문인력을 지속적으로 육성하고 있다. 한국도 급속한 고령화와 의료기술의 진보 등 보건의료를 둘러싼 환경이 크게 변화하면서 고령자에 대한 개호 수요가 증가할 것으로 전망되고 있다. 개호요구의 급증에 비해 노동 인구의 감소로 심각한 인력부족을 겪고 있는 일본의 선 경험에 비추어 보건인력 확보에 대한 정책방안의 논의가 이루어져 할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.222-234
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• 2010

Objectives: Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. Methods: The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects(2661 patients who gave written informed consent to particiate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. Results: When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. Conclusions: This study showed that needs on patient with cancer was significantly influenced by female, higher educagion, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.288-293
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• 2021

In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.