• 보건행정학회지
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• 제19권2호
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• pp.21-35
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• 2009

Limited studies examined Medical Aid recipients' perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.

• 한국인터넷방송통신학회논문지
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• 제17권6호
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• pp.97-103
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• 2017

고품질의 소프트웨어를 개발하기 위해서는 개발 초기단계에 정확한 요구사항 정의 및 분석이 필요하다. 그러나 대부분의 자연어 기반의 요구사항 문장 표현은 부정확성과 이해도 어려운 실정이다. 또한 요구사항은 같은 의미를 가진 객체나 용어들이 중복 식별된다. 이를 해결하기 위해 고객 요구사항을 언어학적 및 의미적 문맥 분석을 통한 효율적인 요구사항 분석 방법이 필요하다. 본 논문에서는 요구공학 언어학자인 Fillmore의 의미론적 분석 방법을 요구공학에 접목하고, 의미론적 분석 개선 방안을 제안한다. 이 방법은 자연어 기반의 요구사항을 Goal Oriented Use Case Modeling 통해 쉽게 읽고 이해 가능한 요구 사항 분석이 기대된다.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.80-88
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• 2022

Background: Although it is known that inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Thus, the aim of this study was to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among patients with chronic respiratory diseases. Methods: Nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15, 2021 were obtained from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The positivity of SARS-CoV-2 infection was retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test. Results: Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. A multivariate analysis showed no significant increase in infection with ICS use (odds ratio, 0.84; 95% confidence interval, 0.66-1.03). Moreover, there were no associations between the positivity of infection and the dose or type of ICS prescribed. Conclusion: Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect this positivity.

• Journal of Chest Surgery
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• 제20권2호
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• pp.241-250
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• 1987

We scrutinized the preoperative electrocardiographic and hemodynamic findings in adult atrial septal defects older than 15 years, and then followed up the postoperative electrocardiographic changes sequentially. In preoperative electrocardiographs, the mean PR interval [0.17 sec] was prolonged than normal adults [M;0.13,F;0.15], and the mean QRS axis [93.1*] was deviated to rightward than normal [M;63.7*,F;64.4*], and 122 cases of all 159 patients [77.8%] were in RAD quadrant. The QRS morphology was classified into three groups; a] crista supraventricularis hypertrophy, 25 cases, b] right ventricular outflow tract hypertrophy, 89 cases, c] right ventricular hypertrophy, 44 cases, and normal rs pattern, 1 case. Comparing the QP/QS, Pp/Ps, Rp/Rs in these three groups, Qp/Qs increased a] 2.65 to b] 2.97 and decreased b] 2.97 to c] 2.55, Pp/Ps increased a] 0.27 to b] 0.35 to c] 0.44, and Rp/Rs increased a] 0.1 to b] 0.14 to c] 0.2. In comparing the atrial fibrillation with sinus rhythm, the patient`s mean age was increased [26.4 to 45.7], the mean Qp/Qs was decreased [2.97 to 2.7], the mean Pp/Ps was increased [0.35 to 0.46], the mean Rp/Rs increased [0.14 to 0.2], and the QRS morphology was RVOT hypertrophy;7 cases, RVH;2 cases in all 11 cases. Therefore, the atrial fibrillation was appeared in progressed status. Increasing the mean pulmonary arterial pressure, size of the R` wave in Vl lead increased, and the QRS morphology tended to become severe patterns. Postoperatively, the PR interval shortened and QRS axis tended to normal axis quadrant, and size of R` wave decreased sequentially, atrial fibrillation disappeared in 4 cases. Conclusively, by use of the conventional surface electrocardiography, we could anticipate the hemodynamic changes and the prognosis at outpatient department.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.119-124
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• 2007

Purpose: We reconstructed the skin defect of lower legs exposing muscles, tendons and bone with fasciocutaneous sural artery flap and report our cases. Materials and Methods: Between March 2005 and September 2006, 8 cases of skin defect were reconstructed with fasciocutaneous sural artery flap. Defect site were 4 case of ankle and foot and 4 cases of lower leg. The average defect size was $4{\times}4\;cm^2$. There were 5 men and 3 women and mean age was 52.2 years. We evaluated the viability of flap, postoperative complication, healing time, patient's satisfaction. Results: There was no flap failure in 8 cases. But recurrent discharge in 2 cases was healed through several times adequate debridement and delayed suture without complication. Flap edema may be due to venous congestion was healed through leg elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence in follow up period. Cosmetic results as judged by patients were that 5 cases are good and 3 cases are fair. Conclusion: Sural artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Sural artery flap is useful method for the skin defect of lower legs because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

• 사상체질의학회지
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• 제20권2호
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• pp.21-29
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• 2008

1. Objectives and Methods It has been examined 703 papers of Sasang Constitution Society published from 1989 to 2007. Among them, the study methods have been classified focused on 332 papers related to clinical research and the method of constitution diagnosis and subjects have been researched to research the reality of the clinical research of Sasang Constitutional Medicine. 2. Results 1. The rest studies are the most which can not be classified by existing study method among 332 clinical studies. 2. The study of patient control group is 17 cases and the clinical experiment is one case, so highly well-grounded studies have not been performed. 3. The most method of constitution diagnosis is the constitution diagnosis by experts and by QSCC. 4. The number of constitution diagnosis method performed in the research institution is within 2. They are 254 cases(89.5%). 5. The studies which utilize more than 3 constitution methods are 22 cases and the studies that use medical rash are 7cases(31.8) 6. The 215 cases that subjects are less than 100 are the most and 100${\sim}$500 subjects are 71 cases. 500${\sim}$10000 subjects are 33 cases and more than 1000 subjects are 15 cases. 3. Conclusions Therefore, it is needed to increase the rate of highly well-grounded studies and set the standard criteria by providing constitution diagnosis guideline.

• Journal of Chest Surgery
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• 제18권4호
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• pp.635-642
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• 1985

Double outlet left ventricle [DOLV] is a rare cardiac anomaly in which both great arteries arise entirely, or predominantly above the morphologically left ventricle. About 100 cases of DOLV have been reported in the literatures by 1984. We have experienced eight cases of DOLV at Seoul National University Hospital during the period from October 1981 to July 1905. Ages of the patients were ranged from 12 months to 24 years old, and chief complaints on admission were frequent URI and DOE in 5 cases and cyanosis in other 3 cases. In all eight patients, Cardiac catheterization and cineangiography were performed but pre-operative diagnoses were incorrect except one case [VSD in 2 cases, DORV in 2cases, c-TGA in 2 cases and TOF in one case] We have performed total corrective surgery in seven patients. In case I, patch closure of VSD aligning aorta and pulmonary artery with LV, ligation of proximal pulmonary artery and the use of external valved conduit from RV to PA have been employed. In other 6 cases, intraventricular repair using boomerang shaped Dacron patch with correction of associated anomalies were employed. In remaining one patient who had coexistent PDA and coarctation of aorta, we have performed coarctoplasty and PDA ligation initially and the patient is waiting for subsequent total corrective procedure. In seven patients whom we have performed total corrective surgery, there is one hospital mortality due to right heart failure and one complication of complete heart block necessitating permanent pacemaker implantation. All survivors are doing well in follow up period of 9 months to 4 years. To our knowledge, this is the first report of surgical experiences for DOLV in the Korean literature.

• 한국주거학회논문집
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• 제21권4호
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• pp.11-22
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• 2010

In the urban area where rapid suburbanization trend continues, the role of mixed use building is controversial. It is argued that the mixed use building is an effective tool to recover residential function of urban core(urban regeneration). It is also argued that the building is a cause of serious urban problems, such as congestion, public service shortages. The fundamental purpose of this study is to examine the role of mixed use building in terms of urban growth management in Seoul. For this purpose, data of mixed use building from 1981 to 2007 are collected and analysed. The results show that most of mixed use buildings are located in either sub-centers or population losing areas, rather than traditional urban core. Therefore, it is hard to accept that the two controversial arguments. The mixed use building noncore areas in most cases. However, it dose help to increase population inflow in non-core areas. it is difficult to accept the public service assertion which states that super-high rise mixed use building causes public service congestion, because the building is built in population losing or demand decreasing area. Based on these findings this study suggests some policy alternatives such as urban service boundary or concurrency program to management urban growth.

• 교육시설 논문지
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• 제21권4호
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• pp.3-10
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• 2014

The opportunity, provided for a direction planning mixed-use facilities for secondary schoo, is the purpose of this paper. Mixed-use facilities are an important issue in school building as it seeks to revive the facilities for local residents in school zone. The latest works of mixed-use facilities in secondary school, however, which are evaluated as well reflected the patterns of education and local community, are still deficient in that communicational elements in secondary school are inadequate. The cases of this paper, which are grown up as an educational building with mixed-use facilities opened to the local residents, are suitable to offer the design method for the future secondary school with mixed-use facilities. This paper reviews an assessment of its success in mixed-use facilities for secondary school as a public building for both of local residents and students and concludes with the establishment of design method for the future school; extraction of the factors contributing to development of mixed-use facilities in school area and proposal of design method; implementation of renewal of mixed-use facilities including educational program and spaces for the creation of identity.

• 지능정보연구
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• 제17권4호
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• pp.255-277
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• 2011

PSS(Product Service System) 시스템은 제품과 서비스가 하나로 통합되어 고객에게 차별화된 가치를 제공하고, 기업이 경쟁력을 가지고 지속적인 성장을 할 수 있게 지원하는 시스템이다. 본 논문에서는 PSS 시스템으로 성공한 Amazon의 Kindle과 Apple의 iPod, 실패한 Microsoft의 Zune과 Sony의 e-book reader를 채택하여 중다 사례연구 방법론을 통해 성공요인과 실패요인을 도출하고자 한다. 이를 위하여, 사례 분석을 통해 가설을 도출하고, 연관 문헌연구와의 비교 및 분석을 통하여 PSS 시스템에서 상업적으로 성공하기 위한 전략적 시사점을 제시하였다.