• 한국보건간호학회지
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• 제12권2호
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• pp.122-135
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• 1998

This study was carried out to understand the nursing needs of postpartum women during the postpartum period. The goal of study was to obtain data needed to develop maternal education programs and to improve the nursing quality for postpartum women. A cross-sectional survey design was employed in this study. The subjects were 101 postpartum women who had delivery at 2 general hospitals in Chung-Buk. Korea. Data were collected from Sep. 29 to Nov. 28. 1997 by means of a structured questionnaire. The instrument used for this study was the one which was consisted of revised Maternal Concerns Questionnaire (MCQ) developed by Bull (1979). The data were analyzed through the SPSS/PC+ program by use of frequency, t-test and ANOVA. The results of the study were as follows; 1) The mean score of concerns about 'self' was 2.98 for primipara and 2.80 for multipara but was not statistically significant difference. Among the items of concerns 'for self', 'Being good mothers' was the highest (primipara 3.93. multipara 3.75). 2) The mean score of concerns about 'baby' was 3.64 for primipara and 3.53 for multipara but was not statistically significant difference. Among the items of concerns 'for baby', 'Normal growth and development' was the highest (primipara 3.91. multipara 3.90). 3) The mean score of concerns about 'husband' was 3.33 for primipara and 3.06 for multipara and was statistically significant difference (t=2.11. p=0.03). Among the items of concerns 'for husband', 'Husband being a good father' was the highest (primipara 3.87, multipara 3.77). 4) The mean score of concerns about 'family' was 2.65 for primipara and 2.80 for multipara but was not statistically significant. Among the items of concerns 'for family', 'Change in the family's lifestyle' was the highest(primipara 3.01, multipara 2.93, t=-1.99, p=0.04). 5) The mean score of concerns about 'community' was 2.48 for primipara and 2.42 for multipara but was not statistically significant. Among the items of concerns 'for community'. 'Getting to health care facilities' was the highest (primipara 2.48, multipara 2.42). 6) On considering the relationship between the postpartum women's nursing needs and their general characteristics, 'regularly antenatal care' was statistically significant (t=2.29. p=0.02). In conclusion, recognition of maternal concerns can be used by nurses to identify nursing diagnoses and to develop care plans that reflect the patient's priorities.

• 한국의학물리학회지:의학물리
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• 제20권3호
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• pp.174-179
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• 2009

사이버나이프 로봇 방사선 수술 시스템은 환자를 치료하는 동안 환자의 내부 기준 마커를 이용하여 종양의 위치를 실시간으로 추적 할 수 있는 시스템이다. 최근 폐종양 치료의 경우 기준 마커의 삽입 없이 폐종양의 밀도 차이를 이용하여 실시간 종양 추적을 할 수 있는 폐종양추적시스템이 개발되어 치료에 적용되고 있다. 최근 개발되어 국내 최초 도입된 폐종양 추적치료시스템의 위치 추적 정확도의 분석은 동적흉부 팬톰과 GafChromic film을 이용하였다. 폐종양추적시스템을 이용하여 종양의 위치 추적 정확도는 평균 오차 $0.85{\pm}0.22$ mm로 분석되었다. 기준마커 삽입 없이 폐종양추적시스템을 이용하여 폐종양 치료에 매우 유용한 것으로 판단되었다.

• 여성건강간호학회지
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• 제4권2호
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• pp.187-202
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• 1998

This study was carried out to identify the difference between educational needs and levels of satisfaction of primigravida during the antepartum period. The goal of the study was to obtain data needed to develope educational programs and to improve the nursing quality for antepartal clients. The subjects were 106 primigravida who attend antenatal clinic at 3 general hospitals in the Seoul area. The data was gathered using a questionnaire which, consist of 71 items, was developed by the researcher from May 4 to June 3, 1998. Results found are as follows : 1. The characteristics of subjects : The majority of subjects were aged 25-29 years(73.6%), college graduates(61.3%), jobless(68.9%), had no religion(38.7%), attended antenatal clinic regularly(91.5%), duration of pregnancy was 38-39 weeks(49.06%), pregnancy was planned(67%), and 42.5% have had some sort of prenatal education. 2. Over all level of educational needs was relatively high(Mn. 3.97) but the level of satisfaction was of average level(Mn. 3.01). Therefore, differences between the level of educational needs and satisfaction was significant(P=.0001). 3. The educational needs by category, the highest need was on birth preparation(Mn. 4.18), self care of the mother and infant care(Mn 4.10), health maintenance and promotion(Mn. 3.79), the lowest was care of discomfort(Mn 3.66). The level of satisfaction was higher on postpartum self care(Mn 3.15), but the lowest was infant care(Mn 2.84). Differences between educational needs and satisfaction by categories was significant(P=.0001). 4. Relationship between educational needs and levels of satisfaction among primigravida of different characteristics were as follows : 1) Educational needs of minor discomforts area were significantly high among age of 25-29(P=.0108), and over 35 years of age, was satisfied on preparation of labor & delivery, postpartum self care (P=.036, .02). 2) With regard to different level of education, middle school graduates had higher educational needs on discomfort care and postpartum self care(P=.0014, .014). College graduates have had higher educational needs on health maintenance(P=.008) and were more satisfied on preparation of birth(P=.0025) 3) With regard to whether pregnancy was planned or not, no difference was found on educational needs. But the levels of satisfaction was significantly higher in the group of planned pregnancy(discomfort care P=.0454, birth preparation P=.0256, postpartum self care P=.0092). 4) with regard to antenatal education, those who have had some sort of antenatal education, educational needs on birth preparation(P=.0345) was significantly high. And also the levels of satisfaction were significantly higher on every category(P=.0004-.0001). 5) No difference was found on educational needs or level of satisfaction by Job, religions, regularity of antenatal care and complication of pregnancy.

• 보건행정학회지
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• 제13권1호
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• pp.98-115
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• 2003

Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4％ of KDRGs had a CV of charges from tertiary care hospitals less than 100％ and 95.43％ of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80％ for non-outlier claims from tertiary care hospitals, 51.98％ for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

• Journal of Radiation Protection and Research
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• 제36권1호
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• pp.28-34
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• 2011

세기조절방사선치료(Intensity Modulated Radiotherapy, IMRT)의 정도관리를 위해서 독립적인 방법으로 선량검증을 하는 것은 중요하다. 독립적 선량검증을 위해 팬톰과 이온전리함을 이용한 측정 방법이 보편적으로 이루어지지만 많은 시간과 노력이 요구된다. 본 연구에서는 세기조절방사선치료 시 시간에 따른 다엽콜리메이터의 움직임을 기록한 dynalog 파일을 이용하여 치료계획에서 도출된 총 실제 플루언스와 실제 치료 시의 모니터유닛(monitor unit, MU) 공간분포를 비교함으로써 간편한 세기조절방사선치료 정도관리 기술을 개발하였다. DICOM RT plan 파일로부터 총 실제 플루언스를 추출하고 MATLAB 코드를 이용하여 실제 치료 시 MU 공간분포를 dynalog 파일로부터 계산하였다. 개발된 방법의 효용성을 검증하기 위해 단계별조사기법과 동적조사기법으로 치료 받은 각 5명의 환자 데이터를 후향적으로 분석하였다. 분석 방법은 상용프로그램(Verisoft 3.1, PTW, German)에서 제공하는 감마인덱스를 사용하였다. 분석 결과 실제 치료 시의 MU 공간분포와 치료계획 상의 MU 공간분포 일치도가 평균 $97.8{\pm}1.33$%로 높은 일치도를 나타냈다. MU 공간분포 재구성의 정확도는 동적조사기법보다 단계별조사기법이 평균 1.4% 높았다. 본 연구에서 개발된 기술을 통해 세기조절방사선치료의 선량검증을 효과적으로 수행할 수 있다. 또한 분할치료 시 선량보정에 적용함으로써 맞춤형치료(adaptive radiotherapy)를 위한 기초자료로 사용될 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5681-5686
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• 2015

Background: Pancreatic cancer ranks fourth in deaths caused by cancers throughout the world. Gemcitabine chemotherapy is the primary method of treatment of advanced pancreatic cancer, and in asco2014, it is still firstline chemotherapy. Howeve,r gemcitabine+fluorouracil regimens are also licensed and widely used worldwide. Clinical trials are the best way to evaluate drug efficacy. In this study, we performed a systematic review and a meta-analysis of randomized controlled trials (RCTs) to assess whether gemcitabine+fluoropyrimidine combination therapy improves the prognosis of unresectable pancreatic cancer compared with gemcitabine treatment alone. Materials and Methods: A quantitative up-to-date meta-analysis was undertaken to investigate the efficacy of gemcitabine-based combination treatment compared with gemcitabine monotherapy for locally advanced or metastatic pancreatic cancer. Inclusion was limited to high-quality randomized clinical trials. Results: A total of 12 studies were included in the present analysis, with a total of 3,038 patients recruited. The studies were divided into three subgroups including 5-FU / CAP / S-1 combined with gemcitabine. For the primary endpoint of overall survival (OS), gemcitabine-based combination therapy demonstrated significantly better outcome (HR, 0.88; 95% CI, 0.81-0.95) than gemcitabine monotherapy. The analysis of progression free survival (PFS) also provided a significant result for the combined therapy in a total of 8 trials (2,130 patients) (HR, 0.74; 95% CI, 0.63-0.86). With subgroup analysis according to the method of dosing delivery, we found that in the injection group with 3 trials (889 patients), a negative result was found (HR, 0.93; 95% CI, 0.77-1.12); while a positive result was observed in the oral group with 9 trials (2,149 patients) (HR, 0.87; 95% CI, 0.80-0.95). Conclusions: Gemcitabine combination therapy provides a modest improvement of survival, but is associated with more toxicity compared with gemcitabine monotherapy.

• 한국의학물리학회지:의학물리
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• 제29권3호
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• pp.92-100
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• 2018

The manufacturer of a linear accelerator (LINAC) has reported that the target melting phenomenon could be caused by a non-recommended output setting and the excessive use of monitor unit (MU) with intensity-modulated radiation therapy (IMRT). Due to these reasons, we observed an unexpected beam interruption during the treatment of a patient in our institution. The target status was inspected and a replacement of the target was determined. After the target replacement, the beam profile was adjusted to the machine commissioning beam data, and the absolute doses-to-water for 6 MV and 10 MV photon beams were calibrated according to American Association of Physicists in Medicine (AAPM) Task Group (TG)-51 protocol. To verify the beam data after target replacement, the beam flatness, symmetry, output factor, and percent depth dose (PDD) were measured and compared with the commissioning data. The difference between the referenced and measured data for flatness and symmetry exhibited a coincidence within 0.3% for both 6 MV and 10 MV, and the difference of the PDD at 10 cm depth ($PDD_{10}$) was also within 0.3% for both photon energies. Also, patient-specific quality assurances (QAs) were performed with gamma analysis using a 2-D diode and ion chamber array detector for eight patients. The average gamma passing rates for all patients for the relative dose distribution was $99.1%{\pm}1.0%$, and those for absolute dose distribution was $97.2%{\pm}2.7%$, which means the gamma analysis results were all clinically acceptable. In this study, we recommend that the beam characteristics, such as beam profile, depth dose, and output factors, should be examined. Further, patient-specific QAs should be performed to verify the changes in the overall beam delivery system when a target replacement is inevitable; although it is more important to check the beam output in a daily routine.

• 한국통신학회논문지
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• 제31권5B호
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• pp.430-441
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• 2006

다양한 A/V 기기 및 홈 네트워크 보급으로 말미암아, 현재의 홈 네트워크는 향후 엔터테인먼트 네트워크로 발전할 것으로 예상된다. 또한 홈 네트워크 내에서 접할 미디어 콘텐츠의 요구 대역폭 및 사용량 또한 증가될 것으로 예상된다. 엑세스 네트워크의 초고속화 및 홈 기반 네트워크의 고속화가 진행되고 있지만, 미디어 콘텐츠의 고용량화 및 콘텐츠 양의 증가로 말미암아 홈 기반 네트워크의 고속화만으로는 홈 네트워크 내에서의 품질이 보장되는 미디어 콘텐츠의 공유를 보장하는데 어려움이 있다. 또한 홈 엔터테인먼트 네트워크 내에서의 네트워크 트래픽 뿐 아니라, 화상 회의 및 전화 등과 같은 애플리케이션의 발달로 인하여 외부 인터넷과의 통신으로 인해 발생되는 트래픽이 예상된다. 미디어 콘텐츠의 특성상 실시간의 전송을 요구하는 것이 대부분이기 때문에, 사용자들이 원하는 미디어 콘텐츠를 원하는 장소 및 기기로 품질이 보장되는 상태로 전송하는 것은 가장 기본적이면서도 핵심적인 요구사항이다. 현재 홈 엔터테인먼트 네트워크를 위해 많은 미들웨어들이 제시되고 있지만, 이들 미들웨어 프로토콜들은 기본적인 수준의 기기 발견 및 제어의 기능만을 제공하고 있으며, 품질이 보장되는 미디어 콘텐츠의 공유 지원을 위해 제시되는 미들웨어 또한 사용자들이 원하는 수준의 서비스를 제공하기에는 아직 많은 한계점들을 가지고 있다. 따라서 본 연구에서는 UPnP에 기초하여 홈 네트워크 내에서 품질이 보장되는 미디어 콘텐츠의 전송을 위한 방법을 제시한다. 제안된 방법은 홈 네트워크 표준 미들웨어 프로토콜인 UPnP와 호환이 되며, UPnP치 추가적인 기능으로 UPnP와 함께 이용될 수 있다. 본 연구에서는 제안된 방법의 검증을 위해서 VideoLAN이라는 프로그램을 사용한다. 제안된 방법의 기능을 지원할 수 있도록 VideoLAN을 수정하였고, 다양한 시나리오 환경에서 그 기능을 검증한다.

• 한국통신학회논문지
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• 제41권5호
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• pp.555-564
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• 2016

본 논문은 무인로봇을 활용하는 군 정찰 환경에서 발생하는 트래픽 속성을 고려한 슬롯 할당 기법을 제안한다. 전장 지역을 탐지하고 적으로부터의 위협을 사전에 확인하기 위해 사람을 투입하는 것 대신 점차 무인로봇이 그 역할을 대신할 것으로 예상된다. 관제센터가 무인로봇을 조종하기 위해 전송하는 제어메시지의 경우, 한 번의 오작동이 큰 비극을 낳을 수 있기 때문에 고 신뢰성이 요구된다. 또한 각 무인로봇들이 감시정찰을 위해 관제센터로 전송하는 정찰용 멀티미디어 데이터의 경우, 실시간으로 끊김없는 영상을 제공하는 것이 중요하다. 본 논문에서는 이러한 무인로봇 환경의 요구사항을 고려하여 효과적인 데이터 전송을 보장하기 위해 per-path 기반의 중앙집중식 TDMA 슬롯 할당 기법을 제안하였다. 관제센터가 트래픽 방향을 기반으로 중앙집중식으로 슬롯을 할당함으로써 무인로봇들 간의 슬롯 할당 충돌을 감소시키고 전송 지연을 감소시킨다. 본 제안 기법은 ns-3 시뮬레이터를 활용하여 성능을 검증하였고 TDMA기반의 비교 알고리즘보다 높은 패킷 전송 성공률을 보였으며 다운링크 트래픽 전송 시나리오에서 비교 알고리즘에 비해 짧은 지연 시간을 보였다.

• 한국산학기술학회논문지
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• 제14권6호
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• pp.2639-2644
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• 2013

휴대폰 사용자의 폭발적인 증가와 제품의 빠른 교체주기로 인하여 이동통신사 간의 마케팅 경쟁이 매장으로 확산되면서 매장을 새롭게 단장하는 리뉴얼 주기가 짧아지고 있다, 주요 이동통신사가 간판을 포함한 매장 리뉴얼은 소비자에게 자사의 브랜드 아이덴티티를 강하게 심기 위한 목적으로 추진되고 있다. 소비자들은 매장이 단순히 값싸고 질 좋은 제품을 판매만 하는 것이 아니라, 매장, 제품, 서비스에 대해 느끼고 수용할 수 있도록 고객 체험을 제공할 것을 바라고 있다. 특히 이동통신사 대리점의 경쟁이 치열해 매장수가 많이 늘어나는 추세를 보이고 최근에는 리뉴얼 시 단순 CI(Corporate Identity) 교체에 의미를 두기보다 매장의 인테리어에서 익스테리어까지 통합된 이미지로 바꾸는 SI(Store Identity) 개념을 적용해 매장들을 바꾸고 있다. 인테리어,Sign 등의 비주얼 요소를 일관성 있게 설계 및 디자인하여 매장 내, 외부에 적용하여 소비자에게 호의적인 매장 이미지를 심어주고 궁극적으로 매출액 증대에 큰 영향을 미치게 하는 요소라 할 수 있다. 이러한 활동은 기업이 Identity관리를 통해 이미지를 컨트롤 할 수 있으며 마케팅 측면에 매우 중요한 요소라 할 수 있다. 본 논문에서는 국내 이동통신사와 해외 이동통신사의 SI를 비교분석하고 효과적인 SI의 방향을 제언하는데 목적을 둔다.