• Journal of Chest Surgery
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• 제53권5호
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• pp.250-257
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• 2020

Background: Lung adenocarcinoma (LUAD) with ground-glass opacity (GGO) can become aggravated, but the reasons for this aggravation are not fully understood. The goal of this study was to analyze the genetic features and causes of progression of GGO LUAD. Methods: LUAD tumor samples and normal tissues were analyzed using an Illumina HiSeq 4000 system. After the tumor mutational burden (TMB) was calculated, the identified mutations were classified as those found only in GGO LUAD, those present only in nonGGO LUAD, and those common to both tissue types. Ten high-frequency genes were selected from each domain, after which protein interaction network analysis was conducted. Results: Overall, 227 mutations in GGO LUAD, 212 in non-GGO LUAD, and 48 that were common to both tumor types were found. The TMB was 8.8 in GGO and 7.8 in non-GGO samples. In GGO LUAD, mutations of FCGBP and SFTPA1 were identified. FOXQ1, IRF5, and MAGEC1 mutations were common to both types, and CDC27 and NOTCH4 mutations were identified in the non-GGO LUAD. Protein interaction network analysis indicated that IRF5 (common to both tissue types) and CDC27 (found in the non-GGO LUAD) had significant biological functions related to the cell cycle and proliferation. Conclusion: In conclusion, GGO LUAD exhibited a higher TMB than non-GGO LUAD. No clinically meaningful mutations were found to be specific to GGO LUAD, but mutations involved in the epithelial-mesenchymal transition or cell cycle were found in both tumor types and in non-GGO tissue alone. These findings could explain the non-invasiveness of GGO-type LUAD.

• 디지털융복합연구
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• 제10권5호
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• pp.289-299
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• 2012

본 연구는 경남지역 손상환자의 타 지역 의료이용과 관련된 요인을 규명하여 의료의 접근성을 높이기 위한 기초자료를 제시하고자 하였다. 질병관리본부의 2008년 퇴원손상환자조사 8,225건의 자료 뿐 아니라, 인구센서스 및 보건의료자원 실태조사자료를 이용하였으며, 분석방법은 빈도분석, 교차분석, 로지스틱 회귀분석을 실시하였다. 분석결과 첫째, 손상환자의 의료이용은 대도시 중심으로 집중화 현상이 뚜렷하였다. 둘째, 군지역의 손상환자 타 지역 이용률이 시 지역에 비해 높았다. 본 연구를 통하여 의료기관 및 병상수를 공급하는 일 뿐만 아니라 지방에서의 의료의 질적 수준을 올리는 정책과 의료의 접근성을 위해 군지역의 손상환자를 위한 대책이 요구된다.

• Journal of Preventive Medicine and Public Health
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• 제7권1호
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• pp.153-162
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• 1974

To find a basic study for manpower of physicians and medical care systems in Busan, author has studied towards 1,069 doctors who had taken the regular report in 1973, residing in Busan City. The survey was conducted from July 1 to August 31, 1973 and the findings & results obtained through the study for distributions, characteristics, employment of doctors and some medical system were summarized as follows; 1. The ratio between doctor and populations in Busan City was 1:1,887. 2. The doctors who graduated from Susan Medical College were 438 as the most proportion (40.9%). 3. Sex distribution of doctors revealed male 970, female 99 and those belonging to the 30-39 age group were as the most proportion (41.0%). 4. The doctors who had faith in Christianity were the highest (22.3%), 5. By the opening year of clinics, there was increasing tendency after 1950, especially during 1970-1973. 6. At that time of investigation, the doctors who had private clinics were 673 (67.3%) and nonemployees were 27 (2.5%) 7. The total Medical Specialists in Busan were 519, and among them the Internal Medicine Specialists were the highest proportion (16.2%). 8. The clinics employing the disqualified nurse-aids were 237 (22.2%). 9. Most of doctors (81.8%) had opposed attitude to the establishment of new medical colleges. 10. More than half of the doctors (59.8%) agreed to the functional division between Physicians and Pharmacists. 11. The ratio of agreement to the practical application of public medical insurances was 68.7%. 12. The opinion by opening hospital-clinics at Myeon for administrative measures for doctorless rural area was the highest proportion. 13. The doctors who replied as low state of confidence of the citizens to the doctors-themselves were 691 (64.6%).

• 대한간호학회지
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• 제27권4호
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• pp.912-922
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• 1997

The purpose of this study was to examine the effect of supportive nursing on stress reaction of breast cancer patients undergoing chemotherapy. The nonequivalent control group pre-test/post-test design was used for this experimental study. The subjects were 32 patients who were receiving chemotherapy after mastectomies at K hospital in Taegu from June, 1994 to June 1995. Among 32 subjects, 16 were placed in the experimental group and 16 in the control group. The experimental and control groups were tested for general characteristics, trait anxiety, health locus of control, family support, state anxiety, hopelessness, physical stress, and anxiety behavior. Collected data was analized by means of a chisquare test and a t-test for the comparative analysis of the general characteristics and homogeneity of subjects. ANOVA, and MANOVA were used for testing the hypothesis. Reliability of the tools were analyzed using the Pearson Correlation coefficient. The results of this study were as follows : 1. The hypothesis : The stress reaction of the experimental group which took supportive nursing was lower than the stress reaction of the control group : this was supported statistically. The main variable influenced in stress reaction was hopelessness. Supportive nursing for breast cancer patients, who are receiving chemotherapy, was especially effective in the reduction of hopelessness compared to state anxiety, physical stress, and anxiety behavior. 2. An analysis of the difference on stress reaction, according to the frequency of supportive nursing between the control and experimental group, showed the level of hopelessness of the experimental group was lower than the control group after four supportive meeting sessions. But there was no statistical difference in state anxiety, physical stress, and anxiety behavior. In conclusion, this study supported utilization of supportive care as well as demonstrating the effectiveness of the System-Developmental Stress Model developed by Chrisman and Riehl-Sisca.

• 전자공학회논문지
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• 제50권10호
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• pp.116-123
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• 2013

모바일 헬스케어 서비스에서 생체 정보의 신뢰성 있는 전송은 매우 중요하다. 본 논문에서는, 6LoWPAN의 멀티 홉 무선네트워크의 모바일 헬스 케어 모니터링 서비스에서 신뢰성 있는 생체 정보 전송 기술을 제안한다. 또한, IEEE 11073-20601 프로토콜을 확장하였으며 IPv6 네트워크를 사용한 6LoWPAN 기반의 6LoWPAN 멀티-홉 무선 센서네트워크에서 생체 정보를 안정적으로 전송하기 위하여 신뢰성 있는 경로 구축 방법을 제안한다. 6LoWPAN은 IPv6 패킷을 전송하기 위하여 MAC계층의 상위 계층에 적응 계층을 올려 센서 네트워크에 부합하는 점 등으로 인해 현재 가능성을 인정받고 있다. 본 논문에서는 6LoWPAN의 센서들이 소형이고 저가이며 배터리를 사용할 수 있음을 고려하고 모바일 헬스케어 응용환경에 적합한 네트워크 시스템인 만큼 신뢰성 있고 전력 소비 및 알고리즘 수행의 복잡도를 최소화하는 라우팅 절차 및 알고리즘을 제시한다. 본 논문에서 제안된 방법의 우수성을 증명하기 위하여 NS-3을 사용하여 AODV 프로토콜과 성능을 비교하였다.

• 의료법학
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• 제7권2호
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• pp.311-330
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• 2006

As issues of education, employment and so on, the medical issue is one of the hot spots of society in China today. The health system reform which was pushed ahead after China's Revolution and open to the outside world hasn't received great progress. Many actual problems haven't been solved, for example it is difficult and expensive to see a doctor. With the development of the economy and society, the citizen's legal consciousness has gradually risen. They make a claim for better medical service. At the same time, the number of the disputes of medical care arises annually. China has sped up the opening of service trade for fulfilling promises of entry the WTO since 2001. China has already opened many service trade fields, including medical field. From the domestic perspective, there are many problems in domestic medical department. From the international perspective, China's present medical level falls behind the world advanced medical level. Under this background, it is a bold act for China to open the medical service field to foreign investors. Today, a huge medical service market is developed in China. However, the government's investment to medical devices and the financing channels is limited. Therefore, it is inevitable that individuals, social organizations and foreign investors invest to the medical market. In view of the situation, Chinese government issued a series of relevant laws and rules. In recent years, many multinational companies, consortiums, charitable institutions, enterprises and individuals establish various medical institutions in China. But there are rare research in the actuality and legal subject of foreign investment to Chinese medical market. Hence, it is necessary to realize the actuality of foreign investment to Chinese medical market, to familiar with the elements and procedure of establishing foreign joint and cooperative medical institution. Meanwhile, analyzing the existing problems and posing the legal subject have important theoretic and practical value.

• 의료법학
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• 제11권2호
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• pp.181-208
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• 2010

Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

• 대한간호학회지
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• 제41권4호
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• pp.568-579
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• 2011

Purpose: The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009. Methods: During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility. Conclusion: The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.

• 한국콘텐츠학회논문지
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• 제11권7호
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• pp.259-274
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• 2011

이 연구는 2004년 KTX의 도입 이후 증가하고 있는 서울 지역 의료기관으로의 원거리 의료 이용 현상의 특성 및 그 영향 요인을 분석하였다. 설문조사를 통해 KTX로 서울지역 의료기관을 이용한 경험이 있는 203명에 대한 자료를 확보하여 이들을 대상으로 분석하였다. 분석 결과 최신 설비 및 의료장비의 보유 여부, 의료진의 수준 등이 원거리 의료 이용의 가장 중요한 이유로 나타났고, 질병 치료의 방문 목적, 40세 이상 연령, 전문대졸 이하 등의 요인이 서울지역 의료기관에서의 입원서비스 이용 가능성을 유의하게 높였다. 이는 지방 소재 상급종합병원의 중증질환 진료능력 제고와 이를 위한 정부 지원의 필요성, 그리고 의료 기관 인증 및 가감지급평가사업 결과 공시의 강화를 통한 합리적인 의료기관 선택 유도의 필요성을 시사한다.

• 종양간호연구
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• 제11권1호
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• pp.74-82
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• 2011

Purpose: This study was performed to systematically review the recently published nursing intervention studies. Methods: The literature was identified through the Korean Education and Research Information Service (KERIS), the Korean Information Service System (KISS), and National Assembly Library websites. Key words such as breast cancer, nursing, and intervention were used. The factors analyzed are as follows: 1) the characteristics of studies and study populations, 2) the classification of interventions, 3) outcome indicators and their effects, and 4) effective interventions. Results: Thirty two studies were included. Seventeen studies used a single intervention such as aerobic dance, TaiChi, foot massage, aromatherapy, or a stress-reduction method. Fifteen studies used combined interventions, including education, exercise, counseling, support, yoga or meditation. The data on 47 outcome indicators and their effects were segregated into psycho/spiritual outcomes, stress coping, physical outcomes, cardiorespiratory function, symptom management, arm and shoulder functions, fatigue, and quality of life. Some interventions had positive effects on stress, fatigue, and functions of shoulder. Conclusion: Various interventions are available for breast cancer patients, and some have had positive effects. However, more studies are required to develop evidence-based practice guidelines for nursing interventions.