• 대한치과기공학회지
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• 제19권1호
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• pp.21-35
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• 1997

Au 함량이 20% 미만인 Au-Ag-Pd합금의 기초합금인 Ag-Pd-Cu 3원계 합금의 시효경화 특성을 규명할 목적으로 20wt% Pd 및 20wt% Cu의 용질농도구성비가 1이 되는 3원 합금과 여기에 2wt% Au의 첨가합금에 미치는 석출상의 영향을 분석, 조사하여 아래와 같은 결론을 얻었다. Ag-20wt% Pd-20wt% Cu 3원 함금은 ${\alpha}$의 단일상에서 Ag-rich의 ${\alpha}2$상 및 PdCu규칙상에 의하여 경화반응이 진행되며 연속승온과정에서 $100{\sim}300^{\circ}C$의 경도증가와 $300{\sim}500^{\circ}C$의 경도감소의 2단계 경화특성이 얻어졌다. 연속승온시효과정은 Au첨가에 관계없이 2단계의 석출반응이 저온영역에서는 stage I, stage II로 나타나고 stage I은 고온에서의 소입에 의해 도입된 과잉공공의 이동 및 소멸에 의한 반응이고 stage II는 평형농도의 공공확산에 의한 반응에 대응하였다. 또한 본 합금의 시효석출과정은 ${\alpha}\to{\alpha}+{\alpha}2+PdCu\to{\alpha}_1+{\alpha}_2+PdCu$이고 최대 경화는 ${\alpha}_1,\;{\alpha}_2$, PdCu의 3상공존구역에서 나타났다. 이들 석출반응은 입계반응이고 반응의 진행과 함께 경도값은 상승하며 경화능에 직접적으로 기여하였다. 또한 석출상은 미세한 lamella조직의 nodule을 나타내고 이들 ${\alpha}_1,\;{\alpha}_2$ 및 PdCu상과의 미세한 혼합상의 형성이 시효경화능에 기여하는 주된 원인이 되었다. 과시효는 lamella의 조대화와 PdCu상의 ${\alpha}_2$상으로의 용해에 따른 정량적 감소에 대응하였다. 본 합금의 시효열처리 온도는 $450^{\circ}C$가 적절하며 $1{\sim}120min$ 시효시간에 걸쳐서 소정의 경화특성을 얻을 수 있었다.

• 지역사회간호학회지
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• 제10권1호
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4387-4392
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• 2013

Projection of load of cancer mortality helps in quantifying the burden of cancer and is essential for planning cancer control activities. As per our knowledge, there have not been many attempts to project the cancer mortality burden at the country level in India mainly due to lack of data on cancer mortality at the national and state level. This is an attempt to understand the magnitude of cancer mortality problem for the various calendar years from 2011 to 2026 at 5-yearly intervals. Age, sex and site-wise specific cancer mortality data along with populations covered by the registries were obtained from the report of National Cancer Registry Programme published by Indian Council of Medical Research for the period 2001-2004. Pooled age sex specific cancer mortality rates were obtained by taking weighted average of these six registries with respective registry populations as weights. The pooled mortality rates were assumed to represent the country's mortality rates. Populations of the country according to age and sex exposed to the risk of cancer mortality in different calendar years were obtained from the report of Registrar General of India providing population projections for the country for the years from 2011 to 2026. Population forecasts were combined with the pooled mortality rates to estimate the projected number of cancer mortality cases by age, sex and site of cancer at various 5-yearly periods Viz. 2011, 2016, 2021 and 2026. The projections were carried out for the various cancer-leading sites as well as for 'all sites' of cancer. The results revealed that an estimated 0.44 million died due to cancer during the year 2011, while 0.51 million and 0.60 million persons are likely to die from cancer in 2016 and 2021. In the year 2011 male mortality was estimated to be 0.23 million and female mortality to be 0.20 million. The estimated cancer mortality would increase to 0.70 million by the year 2026 as a result of change in size and composition of population. In males increase will be to 0.38 millions and in females to 0.32 millions. Among women, cancer of the breast, cervical and ovary account for 34 percent of all cancer deaths. The leading sites of cancer mortality in males are lung, oesophagus, prostrate and stomach. The above results show a need for commitment for tackling cancer by reducing risk factors and strengthening the existing screening and treatment facilities.

• 해양환경안전학회지
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• 제18권2호
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• pp.123-129
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• 2012

카보타지는 동일한 국가 내의 두 지점간 화물이나 여객을 다른 국가에 등록한 선박이나 항공기가 수송하는 것을 말한다. 카보타지규제는 경제적으로는 보호주의 측면에서, 국방의 관점에서는 국가안전보장 측면에서 정당화되어 왔으며, 미국, 일본, EU(역외(域外)국가간) 등 세계 주요국가들이 카보타지를 실시하고 있다. 우리나라는 세계 5위의 지배선단을 가진 해운국으로 성장하였으나, 선원공급 부족과 내항선선원의 고령화는 내항선박의 정상적인 운항을 저해하는 요인으로 대두되고 있다. 이에 따라 정부는 카보타지라는 기본적인 원칙을 고수하면서도 2004년부터 외국인선원들의 내항상선 승선을 허용하여 2011년 8월 현재 530명의 미얀마 및 인도네시아 부원선원이 국적 내항선박에 승선하고 있다. 우리나라 법적으로는 내항선에 외국인선원을 승선시키는 것이 가능하나, 카보타지규제를 받는 선박에 외국인선원을 승선시키는 것은 카보타지 본래의 취지를 훼손시킨다고 볼 수 있으므로, 그로 인해 발생할 수 있는 내항해운의 문제점을 해소하기 위한 조치가 필요하다. 외국인선원 승선으로 인한 문제점을 최소화하기 위해서는 첫째, 의사소통과 문화적차이를 극복할 수 있는 외국인선원 관리기법의 도입이 필요하며, 둘째, 외국인 선원의 고충상담을 위한 외국인선원지원센터의 설립이 필요하고, 셋째, 적정 관리능력을 갖춘 외국인선원관리회사를 육성하며, 넷째, 외국인선원의 근로조건 개선을 통하여 안정적인 선원공급을 가능하게 할 필요가 있다. 마지막으로 송출국가의 행정당국과의 무단이탈자 행정제재에 대한 협정체결이 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제39권2호
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• pp.141-148
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• 2006

Objectives : We wanted to evaluate the medical underutilization for benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) among Korean elderly men and we wanted to determine their associated factors. Methods : This study was conducted on 239 men with LUTS and 116 men with BPH who were compatible with the diagnostic criteria from a total of 641 participants. These participants were over 50 years old and they were randomly chosen in a community-based study for estimating the prevalence of BPH. Using a self-reported questionnaire, we surveyed the sociodemographics, health status, quality of life, lower urinary tract symptoms, medical utilization and reasons for not seeking treatment. Results : Only 27.6% of the men with LUTS and 31.0% of the men with BPH reported having visited a doctor for urinary symptoms. The reasons for not visiting a doctor were, in order of responses from the group with LUTS: 'considered the symptoms as a part of the normal ageing process', 'not enough time to visit a doctor', 'financial difficulty' and 'the symptoms were not severe or bothersome'. Regarding BPH, the responses were the same as those of the group with LUTS however, 'financial difficulty' placed second. Among the men with experience of visiting a doctor for urinary symptoms, 33.3% of those with LUTS and 28.1% of those with BPH were not treated. The most common reason in both groups was 'the symptoms were not severe to be treated'. On a multiple logistic regression analysis, the larger size household (odds ratio (OR) 3.03, 95% confidence interval (CI)=1.40-6.54) and an unsatisfactory quality of life related with urinary symptoms (OR 2.98, 95% CI=1.23-7.21) were associated with medical utilization in the group of LUTS. For BPH, the current employment status was related with the medical utilization (OR 2.80, 95% CI=1.10-7.11), in addition to the larger size household (OR 3.24, 95% CI=1.14-9.21). Conclusions : Many men with urinary symptoms do not visit a doctor. This medical underutilization for people with LUTS and BPH may be associated with economic status in Korea.

• 보건행정학회지
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• 제29권3호
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• pp.303-311
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• 2019

Background: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. Methods: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. Results: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963-0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342-0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. Conclusion: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

• 사회복지연구
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• 제42권2호
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• pp.179-203
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• 2011

본 연구의 목적은 1) 노년기 인지기능과 우울증상의 양방적 상호관계를 분석하고, 2) 이 관계에서 성별차이를 검증하는 것이다. 이는 대부분의 기존연구가 인지기능과 우울증상의 일방적 관계를 가정한 것과 달리 상호영향력을 동시에 고려하고, 나아가 노년기 정신건강에서 성별에 따른 유의한 함의를 찾기 위함이다. 분석 자료는 우리나라의 중고령자를 대표하는 한국고령자패널 자료를 활용하였고, 분석 방법은 비재귀구조방정식모델(non-recursive structural equation modeling)과 다집단분석(multi-group analysis)을 실시하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 노년기 인지기능 저하가 우울증상을 악화시키고, 우울증상의 악화가 인지기능을 저하시키는 양방적 상호관계가 나타났다. 둘째, 인지기능과 우울증상의 관계에서 성별 차이가 명확히 나타났다. 여성노인에서는 우울증상에 대한 인지기능의 영향만 유의하였고, 남성노인에서는 인지기능에 대한 우울증상의 영향만 유의하였다. 이는 노년기 인지기능과 우울증상을 이해하고 관리함에 있어 상호영향력과 성별 차이를 고려한 접근이 필요함을 시사하는 결과이다. 이상의 결과가 노년기 정신건강에 대해 갖는 이론적 실천적 함의를 논의하였다.

• 한국유통학회지:유통연구
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• 제15권5호
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• pp.237-255
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• 2010

국내 약사법에서는 약 판매를 약국에 한정하고 있다. 이로 인해 심야나 공휴일에 약 구입이 어려워 소비자 선택폭이 제한되어 소비자 불편이 가중되고 있다. 또한 급속한 고령화의 진전은 노인의료비를 급격히 증가시켜 국가 의료보험 재정을 악화시키는 요인으로 작용하고 있다. 한편 미국, 일본 등 선진국들은 자가치료(self-medication)를 지원하는 관점에서 안전성과 유효성이 검증된 일반의약품에 대해서는 편의점이나 슈퍼마켓 등 일반 소매점에서의 판매를 허용하고 있다. 특히, 세계적으로 안전추구 경향이 강한 일본은 급증하는 의료비를 억제하기 위해 일반의약품의 판매채널을 다양화하였고, 그 결과 경제, 사회분야에 다음과 같은 다양한 규제완화 효과를 얻게 되었다. 첫째, 일반의약품의 유통채널이 약국에서 일반 소매점포로까지 확대되면서 잠재수요가 유발되어 관련시장이 확대되었다. 둘째, 판매채널 간 경쟁이 촉진되면서 의약품 가격이 하락했다. 셋째, 의약품 판매채널 증가로 소비자의 선택폭이 확대되었고 소비자 이용 편리성이 증대되었다. 넷째, 판매채널 다원화로 경쟁 환경이 조성되면서 기업의 경쟁력 제고 노력을 가속화시켰다. 다섯째, 자가치료 환경조성을 통해 의료비 재정건전성 제고 기반을 마련했다. 국내 65세 이상 인구는 2000년에 7%를 넘어섰고 2018년에는 14%를 웃돌 것으로 보여 국민의료비 증가는 가속화될 전망이다. 우리도 의료선진국과 같이 고령화시대를 대비하는 차원에서 일반의약품의 판매처를 다양화하여 자가치료 환경을 조성함으로써 개인의료비 지출을 줄이고, 국가의료보험 재정건전성을 제고하며, 나아가 소비자 후생을 증진시켜나가야 할 것이다.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.100.1-100.13
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• 2018

Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.