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검색결과 6,182건 처리시간 0.034초

부분유방방사선치료(Accelerated Partial Breast Irradiation) 환자의 장액종(Seroma) 체적 변화에 대한 연구 (Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation)

  • 김대호;손상준;문준기;서석진;이제희
    • 대한방사선치료학회지
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    • 제28권1호
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    • pp.65-75
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    • 2016
  • 목 적 : 유방보존술 이후 부분 유방 방사선 치료를 시행한 환자들의 치료 전후 장액종의 체적 변화를 분석하여 방사선 치료 효과 향상에 기여하고자 한다. 대상 및 방법 : 본원에서 ViewRay MRIdian System을 이용하여 부분유방방사선 치료를 시행한 환자 20명을 대상으로 하였다. 대상 환자들의 수술시 제거된 검체 크기를 구하고, 장액종의 체적 변화를 주(week)단위로 획득하였다. 획득한 체적을 바탕으로 나이, 수술 후 첫 치료시작까지의 기간, 체질량지수(BMI), 수술시 적출된 검체 크기 등을 기준으로 하여 비교하였다. 그리고 부분 유방 방사선 치료의 특정용적을 구하기 위해 PTV(=seroma volume + margin)를 기준으로 ViewRay MRIdian RTP System을 이용하여 분석하였다. 결 과 : 모의치료 MRI 촬영 후 첫 치료 시까지 1주일간 나타난 장액종의 체적 변화는 0~5%가 8명, 5~10%가 2명, 10~15%가 3명, 15~20%가 2명, 그리고 20% 이상이 5명 이었다. 가장 큰 변화를 보인 2명의 환자 중, A환자는 기존 치료계획에서 처방선량 100%의 용적이 213.08 cc, PTV는 181.93 cc, 장액종의 체적은 15.3 cc였으나, 보정치료계획에서 장액종의 체적이 5.3 cc로 65.36% 감소하면서, 처방선량 100%의 용적은 205.83 cc, PTV는 102.54 cc로 각각 3.4%, 43.6% 감소하였다. B환자는 장액종의 체적이 20.2 cc에서 11.6 cc로 42.57% 감소하였고, 이로 인해 처방선량 100%용적은 8.1%, PTV는 40% 감소하였다. 결 론 : 장액종의 체적 변화는 고령일수록, 수술 후 치료가 시작되는 기간이 짧을수록, 검체의 크기가 100 cc이하 일수록 큰 것을 확인하였다. 부분유방방사선치료 환자의 경우 전체유방방사선치료의 환자보다 체적 변화에 따른 Dose conformity가 더욱 민감하므로, 지속적인 관찰을 통해 각 환자의 장액종 체적 변화에 따른 보정치료계획을 수립하여 치료하는 것이 바람직하다고 사료된다.

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정전협정 60년, NLL과 서북 도서 (60 Years since the Armistice Treaty, the NLL and the North-Western Islands)

  • 제성호
    • Strategy21
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    • 통권31호
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    • pp.27-56
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    • 2013
  • The United Nations Command (UNC) and the communist North failed to reach an agreement on where the maritime demarcation line should be drawn in the process of signing a truce after the Korean War because of the starkly different positions on the boundary of their territorial waters. As a result, the Armistice Treaty was signed on July 1953 without clarification about the maritime border. In the following month, Commander of the UNC unilaterally declared the Northern Limit Line (NLL) as a complementing measure to the Armistice. Referring to this, North Korea and its followers in South Korea wrongfully argue that the NLL is a "ghost line" that was established not based on the international law. However, one should note that the waters south of the NLL has always been under South Korea's jurisdiction since Korea's independence from Japan on August 15, 1945. There is no need to ask North Korea's approval for declaring the territorial waters that had already been under our sovereign jurisdiction. We do not need North Korea's approval just as we do not need Japan's approval with regard to our sovereign right over Dokdo. The legal status of the NLL may be explained with the following three characteristics. First, the NLL is a de facto maritime borderline that defines the territorial waters under the respective jurisdiction of the two divided countries. Second, the NLL in the West Sea also serves as a de facto military demarcation line at sea that can be likened to the border on the ground. Third, as a contacting line where the sea areas controlled by the two Koreas meet, the NLL is a maritime non-aggression line that was established on the legal basis of the 'acquiescence' element stipulated by the Inter-Korea Basic Agreement (article 11) and the Supplement on the Non-aggression principle (article 10). Particularly from the perspective of the domestic law, the NLL should be understood as a boundary defining areas controlled by temporarily divided states (not two different states) because the problem exists between a legitimate central government (South Korea) and an anti-government group (North Korea). In this sense, the NLL problem should be viewed not in terms of territorial preservation or expansion. Rather, it should be understood as a matter of national identity related to territorial sovereignty and national pride. North Korea's continuous efforts to problematize the NLL may be part of its strategy to nullify the Armistice Treaty. In other words, North Korea tries to take away the basis of the NLL by abrogating the Armistice Treaty and creating a condition in which the United Nations Command can be dissolved. By doing so, North Korea may be able to start the process for the peace treaty with the United States and reestablish a maritime line of its interest. So, North Korea's rationale behind making the NLL a disputed line is to deny the effectiveness of the NLL and ask for the establishment of a new legal boundary. Such an effort should be understood as part of a strategy to make the NLL question a political and military dispute (the similar motivation can be found in Japan's effort to make Dokdo a disputed Island). Therefore, the South Korean government should not accommodate such hidden intentions and strategy of North Korea. The NLL has been the de facto maritime border (that defines our territorial waters) and military demarcation line at sea that we have defended with a lot of sacrifice for the last sixty years. This is the line that our government and the military must defend in the future as we have done so far. Our commitment to the defense of the NLL is not only a matter of national policy protecting territorial sovereignty and jurisdiction; it is also our responsibility for those who were fallen while defending the North-Western Islands and the NLL.

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유기주석화합물이 웅성생식세포주에 미치는 영향 (Mechanisms of Tributyltin-induced Leydig Cell Apoptosis)

  • Lee, Kyung-Jin;Kim, Deok-Song;Ra, Myung-Suk;Wui, Seong-Uk;Im, Wook-Bin;Park, Hueng-Sik;Lee, Jong-Bin
    • Environmental Analysis Health and Toxicology
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    • 제18권2호
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    • pp.89-94
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    • 2003
  • 본 연구는 환경 호르몬으로. 분류된 67종 중의 하나인, 선저 도료나 어망, 어구 및 방오페인트 재료로 사용되어지고 유기주석화합물(tributyltin)을 사용하여 설치류의 웅성생식세포에서 세포자연사를 일으키는 작용기작을 조사하였다 먼저 흰쥐의 레이딕 세포주인 R2C에 유기주석화합물을 농도별(1∼500 nM)로 처리한 후 DNA fragment현상을 전기영동법을 통하여 조사하였다. 그 결과 유기주석화합물을 처리한 군들에서 대조군에 비하여 세포자연사현상이 농도 의존적으로 증가하였다. 유기주석화합물이 세포 내 칼슘이온(Ca$^2$$^{+}$)및 유해 산소종(reactive oxygen species)에 미치는 영향을 조사해본 결과 유기주석화합물 처리시 세포 내 칼슘이온 및 유해 산소종이 시간에 의존적으로 크게 증가하였다. 또한 칼슘 킬레이터인 BAPTA를 전 처리한 경우 유기주석화합물에 의해 유도된 칼슘이온 및 유해 산소종이 대조군에 비해 유의성 있게 감소하였다. 이러한 세포자연사 과정이 미토콘드리아의 cytochromec방출에 의한 과정인지를 화인하기 위해 세포질 내 cytochrome c양을 western blot법을 사용하여 확인해 본 결과 유기주석화합물처리 시간 및 농도에 따라 증가하며, 이 또한 BAPTA를 전처리 한 경우 대조군에 비하여 유의성 있게 감소하였다. 또한 유기주석화합물이 세포자연사 유발 시 caspase-3 효소 활성과의 관계를 확인하기 위해 ELISA법을 사용하여 확인해 본 결과 유기주석화합물 처리 농도에 의존적으로 증가하였으며, caspase-3효소 억제자로 잘 알려진 Z-DEVD FMK을 전 처리한 경우 유기주석화합물을 처리한 군에 비해 세포자연사율이 크게 감소하였다. 이러한 결과들을 종합해 볼 때 유기주석화합물은 세포 내 칼슘이온의 증가를 일으키고, 그로 인하여 세포질 내 유해산소종 및 cytochrome c의 양이 증가함으로써 세포자연사 다음 단계인 caspase효소 활성의 증가를 통하여 흰쥐의 레이딕 세포주인 R2C의 세포자연사를 일으킬 것이라 추론할 수 있다.

측두하악장애 치료결과의 예측에서 사회심리학적 요인의 영향 (Sociopsychological Factors related to Prediction of Treatment Outcome of the Temporomandibular Disorders)

  • 여인식;한경수;김윤희
    • Journal of Oral Medicine and Pain
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    • 제30권4호
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    • pp.433-446
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    • 2005
  • 본 연구는 측두하악장애 환자를 대상으로 하여 초진 시 주소의 심한 정도와 임상적 진찰소견의 상이함, 그리고 설문지를 이용한 사회심리학적 상태의 차이 등이 향후 진행되는 치료과정을 통해 증상의 실제 감소정도와 그에 소요되는 치료기간에 미치는 영향을 규명하고자 시행되었다. 측두하악장애 환자 268명을 대상으로 최대개구량, 수평피개량, 수직피개량, 촉진점수, 전치부 개교합, 수조작시 턱의 뻣뻣함(rigidity), 그리고 하악운동시 운동의 부조화(jerk)나 개구제한 등을 조사하고, 대상자의 사회심리학적 상태를 평가하기 위하여 사회재적응평가척도(SRRS), 병원불안우울척도(HAD scale), 피츠버그 수면지수(PSQI), 그리고 간이정신진단검사(SCL-90R) 등 설문지를 이용하였으며, 증상변화에 대한 대상자의 주관적 평가를 관찰하기 위하여 가시상사척도(VAS)를 이용하였다. 조사된 치료기간은 내원한 전 기간인 전체 치료기간(total treatment duration)과 증상이 실제로 경감된 활동적 치료기간(active symptom relieving duration)이며, 활동적 치료기간은 치료지수(treatment index, TI)의 산출에 이용되었다. 본 연구의 결론은 다음과 같다. 1. 임상적 진찰 및 설문지 조사를 통해 분석된 40여 항목 중 남녀 간에 차이를 보인 항목은 최대개구량, 촉진점수, 하악운동시 턱의 부조화, 수면장애, 전체 치료기간 등이었으며, 전반적으로 설문지 조사항목에서 그 차이가 더 적었다. 또한 전체 대상자에서 간이정신진단검사의 각 항목척도와 다른 설문지의 총점 간 상관관계를 상호 비교할 때 사회재적응평가척도나 피츠버그 수면지수에 비해 병원불안우울척도의 총점이 더 높은 상관계수를 나타내었다. 2. 각 주소증상 별로 치료지수에 따라 세 군으로 구분하여 비교한 결과 통증의 경우 치료지수가 낮거나 중간인 군이 높은 군에 비해 치료개시 시점의 통증은 심했으나 종료시점에서는 오히려 더 약하게 나타났으며, 이러한 양상은 기능장애와 관절잡음을 주소로 한 경우에서도 유사하여 치료지수가 낮은 군에서 높은 군에 비해 치료개시 당시의 증상은 심했으나 종료 시에는 오히려 낮아진 양상을 보였다. 활동적 치료기간 역시 치료지수가 낮은 군에서 중간이나 높은 지수의 군에 비해 유의하게 짧은 것으로 나타났다. 3. 증상이 경감되는 활동적 치료기간을 예측한 회귀방정식의 산출 결과 전체적으로 볼 때 최대개구량을 제외한 나머지 요인들 모두 대상자가 스스로 기록하는 가시상사척도상의 주관적 증상의 정도 및 설문지, 특히 간이정신진단검사의 척도항목으로 밝혀져 측두하악장애의 치료결과에는 각 개인의 사회심리학적 상태가 더 많은 영향을 미치는 것으로 판단되었다.

티머시 우점초지에서 예취빈도와 최종예취시기가 목초의 재생 및 생산성에 미치는 영향 (Effects of cutting Frequency and the Last cutting Date on Regrowth and Production in Timothy-dominated Sward)

  • 신재순;이병석;신기준;이효원
    • 한국초지조사료학회지
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    • 제6권2호
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    • pp.84-90
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    • 1986
  • 본(本) 시험(試驗)은 고랭지(高冷地) Timothy 우점초지에서 목초(牧草)의 적정(適正) 예취회수(刈取回數)와 최종(最終) 예취시기(刈取時期)를 구명(究明)하고자 DM 생산량(生産量), 월동후(越冬後) 초기생육특성(初期生育特性), 다음해 1차수량(次收量) 조단백질(粗蛋白質) 및 조섬유(粗纖維) 생산량(生産量)을 조사(調査)하고 그들간(間)의 상관관계(相關關係)를 분석(分析)한 결과(結果)를 요약(要約)하면 다음과 같다. 1. 초기생육(初期生育)이 개시(開始)되는 시기(時期)는 예취회수(刈取回數)가 증가(增加)함에 따라 빨라지는 경향(傾向)이었으나 유의차(有意差)가 없었으며 최종예취일(最終刈取日)에 따른 영향은 일정하지 않았다. 2. 예취회수(刈取回數)가 증가(增加)함에 따라 건물생산량(乾物生産量)은 감소하였으나 최종예취일(最終刈取日)에 따른 차이(差異)는 없었다. 3. 월동후 1 차수량(次收量)은 예취회수(刈取回數)에 따라 현저히 감소하였으나 최종예취일(最終刈取日)에 따른 차이(差異)는 뚜렷하지 않았다. 4. 조단백질(粗蛋白質) 생산량(生産量)은 예취회수(刈取回數)가 증가(增加)할수록 많아졌으나 건물율(乾物率)은 낮아지는 경향이었고 조섬유(粗纖維) 생산량(生産量)은 일정하지 않았다. 5. 건물수량(乾物收量)과 건물율(乾物率)($\gamma=0.78$) 및 다음해 1차수량(次收量)($\gamma=0.82$)간(間)과 건물율(乾物率)과 다음해 1차수량(次收量)($\gamma=0.83$)간(間)에는 정(正)의 상관(相關)이 있었고(p<0.01), 조단백질(粗蛋白質) 생산량(生産量)과 건물율(乾物率)($\gamma=-0.67$) 및 다음해 1차수량(次收量)($\gamma=-0.68$)간(間)에는 부(負)의 상관(相關)이었다(p<0.01). 6. 이상(以上)의 결과(結果)를 종합(綜合)해 볼 때 건물생산(乾物生産)에 있어서는 년간(年間) 예취회수(刈取回數)는 3회(回)호 하고 최종예취일(最終刈取日)은 9월(月) 30일(日)로 하는 것이 적당(適當)하다고 생각되며 조단백질(粗蛋白質) 수량(收量)을 고려한다면 4회(回) 예취(刈取)에 최종예취일(最終刈取日)은 9월(月) 30일(日)로 하는 것이 좋다고 사료(思料)된다.

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한국.중국.일본 여성의 색조대장문화 (A Study on Make-up Culture of Korea, China and Japan)

  • 박보영;황춘섭
    • 복식
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    • 제39권
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    • pp.217-237
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    • 1998
  • The present research is to study the make-up culture of Korea and its neighboring countries such as China and Japan during the period from the prehistoric age to the 19th cen-tury. The research was made by documents analysis. The results are summerised as follows : (1) A man has a basic instinct to beautify himself. There was not a significant difference between the make-up behavior of men and women in its primal stage. It was by the start of farming and the division of labor that made the make-up behavior as a feminine culture. The difference of sexual role caused the con-ceptual difference between manly beauty and womanly beauty. It was very natural for women to regard the make-up as the best way for showing their feminine beauty. In Korea, China and Japan, there were vari-ous kinds of primal actions such as tattooing, body-painting, and tooth make-up which were used in the purpose of body protection, incantation, ornament, and so on. Ass their ornamental purpose was becoming more important, these primal actions became the basis of the feminine make-up culture. Nowadays make-up, having mental and emo-tional function, is helpful to increasing self-satisfaction, promoting good personal relation-ship, and attracting attention from the other sex. It also has other functions of showing social status, wealth, age, sex, courage, power, and so on. (2) The representative make-up product used widely in the three countries was Boon (powder) which decides the overall color of face. The key point in the production of Boon was to increase its power of adsorption. The invention of Yunboon (power mixed with lead) solved this major problem of Boon. Yeonji which decides the color of cheek was the mixture of Boon and the powder of Honghwa (a kind of red-colored flower or tree). Mimook (eyebrow pencil) was developed to match up with the various and changing currencies of penciling eyebrows in each nation and times, Yeonji and Joosa (red sand) were used as Jinji (lip stick). The predominant color of Jinji was red. As miscellaneous methods of partial make-up, there were Kon-ji used in a wedding cer-emony in korea, Aek-hwang, Hwa-jeon, Sa-hong, and Myun-yup in China, and Chi-heuk, a peculial method of partial make-up in japan. (3) There were various factors which decided the characteristics of make-up culture usually reflects international atmosphere, the form of government, economic situation, re-ligious and social ideology, aesthetic sense, symbolizing meanings of colors, and so on. The up and down of an influentian country was one of the major factors which decided the characteristics of the make-up culture of its neighboring countries. When a country took a liberal form of government, it had diverse and splendid tendencies in its make-up culture. The better a nation's economic situation is, the more abandant and various its make-up culture is, and sometimes, the more eccentric and decadents it was. In the field of make-up production, the three countries had their own characteristics. But, as a whole, China was the leading nation who spread the culture and products of make-up to Korea and Japan. Though the Chinese make-up culture and products were usually spread to Japan through Korean, there was some evidence of direct exchanges between China and Japan through its dispatches of Kyun-Tang-Sa(Japanese delegation to the Tang Dynasty). While religion had a positive influence on the development of make-up culture by introducing new methods of make-up, Confucianism exercised strict control over the make-up cul-ture. The currencies in arts and changes of esthetic sense introduced new methods and booms to the make-up culture. Literature made people pay increasing attentions to the countenances of women and changed the standards of esthetic sense. We can find out that the social status of woman was also reflected in the make-up culture. As the social status of women became higher, the feminine make-up culture also developed more then ever. As mentioned above, the make-up cultures of the three countries reflected their social values, esthetic senses, and emotional feelings. Through their cultural exchanges, the three countries could develop various make-up products and methods.

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전남지역 왕우렁이(Pomacea canaliculata: Ampullariidae)의 발생생태 및 피해 (Occurrence and Damage of Golden Apple Snail (Pomacea canaliculata : Ampullariidae) in Jeonnam Province of South Korea)

  • 김도익;김선곤;최경주;강범용;박종대;김정준;최동로;박형만
    • 한국응용곤충학회지
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    • 제46권1호
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    • pp.109-115
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    • 2007
  • 전남지역 담수직파재배지에서 발생하여 피해를 주고 있는 왕우렁이의 발생상황, 특성 및 피해를 조사한 결과는 다음과 같다. 왕우렁이는 2003년 10월까지는 밀도가 높았으나 11월부터 밀도가 급격히 떨어져 월동에 들어가기 시작하였으며 4월 중순부터 월동에서 깨어나기 시작하였다. 물이 없는 본답에서는 거의 발견할 수 없었으며 본답에서는 6월부터, 수로에서는 5월부터 밀도가 증가하기 시작하였다. 왕우렁이는 벼유묘 8.4cm의 길이를 섭식하는데 235.2초가 소요되며, 이때 한번 섭식을 하면 벼 유묘 지상부가 2.5cm밖에 남지 않아 회복되지 못하였다. 왕우렁이의 밀도가 높을수록 벼 피해는 컸으며 포트당 20마리인 경우 24시간만에 100%의 섭식률을 보였다. 왕우렁이는 논 중앙보다는 논둑 주변에 더 많이 분포하였으며 산란된 난괴 역시 논둑주변에 더 많았다. 겨울을 난후 개체의 크기는 대부분 소형유체(25mm 이하)였으나 물이 지속적으로 고여 있고 흙이 부드러운 수로의 개체들은 대형이었다. 월동 중인 왕우렁이를 채집하여 양식종과 비교한 결과 유리온실이나 비닐하우스에 보관하여도 바로 섭식하지 않았으며 생존율도 양식종보다 낮았다. 온도가 급격히 변화하면 왕우렁이는 활동을 정지하고 온도가 상승하면 다시 활동하기 시작하였다. 그러나 $-3^{\circ}C$ 정도까지 내려가면 거의 모든 개체가 생존하지 못하였다. 왕우렁이에 의한 피해는 담수직파시 20%로 높았고, 기계이앙 재배논에서 피해는 낮았으며 피해를 받은 이후 회복되었다. 왕우렁이를 담수직파 벼에 투입하였을때 파종직후에 5.6%의 피해율을 보였으며 늦게 방사할수록 피해율은 적었다.

합리성의 추구와 수학교육 (The Persuit of Rationality and the Mathematics Education)

  • 강완
    • 한국수학교육학회지시리즈A:수학교육
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    • 제24권2호
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    • pp.105-116
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    • 1986
  • For any thought and knowledge, its growth and development has close relation with the society where it is developed and grow. As Feuerbach says, the birth of spirit needs an existence of two human beings, i. e. the social background, as well as the birth of body does. But, at the educational viewpoint, the spread and the growth of such a thought or knowledge that influence favorably the development of a society must be also considered. We would discuss the goal and the function of mathematics education in relation with the prosperity of a technological civilization. But, the goal and the function are not unrelated with the spiritual culture which is basis of the technological civilization. Most societies of today can be called open democratic societies or societies which are at least standing such. The concept of rationality in such societies is a methodological principle which completes the democratic society. At the same time, it is asserted as an educational value concept which explains comprehensively the standpoint and the attitude of one who is educated in such a society. Especially, we can considered the cultivation of a mathematical thinking or a logical thinking in the goal of mathematics education as a concept which is included in such an educational value concept. The use of the concept of rationality depends on various viewpoints and criterions. We can analyze the concept of rationality at two aspects, one is the aspect of human behavior and the other is that of human belief or knowledge. Generally speaking, the rationality in human behavior means a problem solving power or a reasoning power as an instrument, i. e. the human economical cast of mind. But, the conceptual condition like this cannot include value concept. On the other hand, the rationality in human knowledge is related with the problem of rationality in human belief. For any statement which represents a certain sort of knowledge, its universal validity cannot be assured. The statements of value judgment which represent the philosophical knowledge cannot but relate to the argument on the rationality in human belief, because their finality do not easily turn out to be true or false. The positive statements in science also relate to the argument on the rationality in human belief, because there are no necessary relations between the proposition which states the all-pervasive rule and the proposition which is induced from the results of observation. Especially, the logical statement in logic or mathematics resolves itself into a question of the rationality in human belief after all, because all the logical proposition have their logical propriety in a certain deductive system which must start from some axioms, and the selection and construction of an axiomatic system cannot but depend on the belief of a man himself. Thus, we can conclude that a question of the rationality in knowledge or belief is a question of the rationality both in the content of belief or knowledge and in the process where one holds his own belief. And the rationality of both the content and the process is namely an deal form of a human ability and attitude in one's rational behavior. Considering the advancement of mathematical knowledge, we can say that mathematics is a good example which reflects such a human rationality, i. e. the human ability and attitude. By this property of mathematics itself, mathematics is deeply rooted as a good. subject which as needed in moulding the ability and attitude of a rational person who contributes to the development of the open democratic society he belongs to. But, it is needed to analyze the practicing and pursuing the rationality especially in mathematics education. Mathematics teacher must aim the rationality of process where the mathematical belief is maintained. In fact, there is no problem in the rationality of content as long the mathematics teacher does not draw mathematical conclusions without bases. But, in the mathematical activities he presents in his class, mathematics teacher must be able to show hem together with what even his own belief on the efficiency and propriety of mathematical activites can be altered and advanced by a new thinking or new experiences.

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3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구 (Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital)

  • 유호신
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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선천성 결손치에 관한 임상적 연구 (A CLINICAL STUDY OF CONGENITAL MISSING TEETH)

  • 정해경;양연미;김재곤;백병주;정진우;김하나;김미아
    • 대한소아치과학회지
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    • 제36권2호
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    • pp.245-252
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    • 2009
  • 치아의 선천성 결손은 치배의 발육이 시작되지 못하여 치아의 증식, 분화가 일어나지 못함으로서 발생하는 흔한 치아의 발육 이상이다. 이 연구의 목적은 선천성 결손치의 발생률, 결손치의 수, 발생부위와 결손치 환자에게서 나타난 다른 치아이상의 발생여부를 조사하는 것이다. 본 연구는 2006년 7월부터 2008년 6월까지 전북대학교 소아치과에 내원하여 파노라마를 촬영한 1,520명의 환자(2.9$\sim$17세)를 대상으로 제 3 대구치를 제외한 선천성 결손치의 분포를 조사하여 다음과 같은 결과를 얻었다. 1. 전체 1,520명 중 총 8.88%에서 결손치가 관찰되었으며, 남자가 9.05%,여자가 8.64%에서 결손치가 관찰되었다. 2.총 350개의 영구 결손치 중 하악 제 2소구치가 22.3%로 가장 발생률이 높았고, 하악 측절치, 상악 제 2소구치 하악 중절치, 상악 측절치 순이었다. 또한 총 18개의 유치 결손치 중 하악 유측절치가 가장 높은 발생률(50%)을 보였다. 3. 1개의 영구치 결손치를 가지는 환자는 43.3%, 2개는 34.3% 3개는 6.7%, 4개는 1.5%, 5개는 3.7% 6개 이상은 10.4%이었다. 또한 유치 결손치의 수는 1개는 86.7%, 2개는 13.3%이었다. 4. 결손치가 있는 환자 중 과잉치를 가지는 환자는 18명(13.3%)이 있었으며, 왜소치, 이소맹출, 융합치 등의 치아이상을 지닌 환자도 관찰되었다.

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