• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8489-8493
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• 2014

Objective: To verify the basic preoperative evaluation in the discrimination between benign and malignant adnexal masses in our clinical practice. Materials and Methods: Data were collected on the records of 636 women with adnexal masses who had undergone surgery either by open or endoscopic approaches. Those with obvious signs of malignancy, any history of cancer, emergency surgeries without basic evaluation were excluded. The preoperative features by age, ultrasound and serum Ca125 level were compared with final histopathological diagnosis at the four departments of the institution. These are the general gynecology (Group 1: exploratory laparotomy), the gynecologic endoscopy (Group 2: laparoscopy and adnexectomy), the gynecological oncology (Group 3: staging laparotomy) and the gynecologic endocrinology and infertility (Group 4: laparoscopy and cystectomy). Results: There were simple and complex cyst rates of 22.3% and 77.2%, respectively. There were 86.3% benign, 4.1% (n:20) borderline ovarian tumor (BOT) and 6.4% (n:48) malignant lesions. There were 3 BOT and 9 ovarian cancers in Group 1 and one BOT and two ovarian cancer in the Group 2. During the surgery, 15 BOT (75%) and 37 ovarian cancer (77%) were detected in the Group 3, only one BOT was encountered in the Group 4. The risk of rate of unsuspected borderline or focally invasive ovarian cancer significantly increased by age, size, complex morphology and Ca125 (95% CI, OR=2.72, OR=6.60, OR=6.66 and OR=4.69, respectively). Conclusions: Basic preoperative evaluation by comprehensive ultrasound imaging combined with age and Ca125 level has proved highly accurate for prediction of unexpected malignancies. Neither novel markers nor new imaging techniques provide better information that allow clinicians to assess the feasibility of the planned surgery; consequently, the risk of inadvertent cyst rupture during laparoscopy may be significantly decreased in selected cases.

• 대한교통학회지
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• 제25권6호
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• pp.43-53
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• 2007

기존의 소방도로는 법적 용어가 아닌 편의상 지칭하는 명칭으로 도로교통법이나 지방경찰청장 고시 등에 의한 주 정차 단속구간이 아니다. 이러한 이유로 화재 등 긴급 상황 발생시 소방차량의 현장접근이 늦어져 재산 및 인명 피해가 확대되는 일이 빈번히 발생하고 있다. 본 연구에서는 기존의 애매했던 소방통로의 개념을 보완하고 새롭게 소방통로의 개념을 정립하고자 새로운 용어인 방재경로라는 개념을 도입하였다. 소방차량의 제원 및 지역 특성을 고려한 방재경로 선정기법을 제안하고, 효과적인 운영을 위한 법적 근거 및 지속적인 관리/감독을 위한 전담 관리 부서를 제안하였으며, 서울시 한개 동을 대상으로 한 화재발생 가상시나리오에서는 방재경로를 통한 소방차의 신속한 접근으로 피해가 감소될 수 있는 것으로 나타났다. 방재경로 확보는 각종 재난으로부터 시민을 보다 신속하고 안전하게 보호하기 위한 방안으로서 화재 등 긴급 상황 시 시민의 안전 확보뿐만 아니라, 해당 도로의 주 정차 금지로 인한 도로의 혼잡완화로 향후 시민의 큰 호응을 얻을 수 있을 것으로 판단된다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권4호
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• pp.47-60
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• 2019

Purpose: Regional public hospitals have implemented functional reinforcement projects, and the facilities to accommodate them have increased in size. Nevertheless users in hospital are concerned about space shortage and area imbalances. Therefore I will trace the factors and trends that influence the size, and derive the relationship between these and the uses' critical opinion. Methods: Among the indicators for determining the size of medical facilities, the number of beds and total floor area are the essential indicators that directly affect the composition of space and allocation of area inside the medical facility. The purpose of this study is to investigate the change and the factors of change on the these two indicators in regional public hospitals and analyze the trend of changes. Results: In accordance with support undertaking, regional public hospitals have been increased the number of chronic-based beds and expanded additional facilities such as O.P.D specialized centers, emergency centers and funeral homes for reflecting the needs of the regions and times. However, as a result of analyzing the area, regional public hospitals are growing in size mainly on the ward and O.P.D is only expanded the scope of functional reinforcement division but total area level of O.P.D is lower than the recent level. In addition, the levels of D&T, Supply, mechanical/electrical equipment area related to medical support and control environment quality are very low. This is because the functional reinforcement projects have been done without concerning diagnose the whole facility. Implications: If functional reinforcement projects are conducted, to cope with problems of space shortage and imbalance of area, it is judged that an architectural planning that comprehensively analyzes existing facilities and related departments should be included.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.284-291
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• 2015

The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.

• 한국융합학회논문지
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• 제7권5호
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• pp.89-96
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• 2016

본 연구는 여대생의 생활 스트레스와 보건실 이용 만족도를 알아보기 위한 서술적 조사연구이다. 2014년 10월 29일부터 11월 11일까지 일 광역시 여대생 203명을 대상으로 자료를 수집하여 SPSS/WIN 프로그램을 사용, t-test와 ANOVA 및 Scheffe 사후검증을 실시하였다. 본 연구에서 여대생의 생활 스트레스는 학업스트레스가 가장 높았고 그 다음은 취업 스트레스였으며, 교우 스트레스가 가장 낮게 나타났다. 전공계열에 따라서는 자연과학계열이 보건계열보다 취업스트레스가 높았고, 보건계열이 인문사회계열보다 학업스트레스가 높았다. 음주를 하는 군이 이성 스트레스가 높았고, 식사시간과 식사습관에 따라서 하부 영역에 차이를 보였다. 교내 보건실을 이용하는 동기는 약품이용 및 응급처치가 가장 많았고, 그 다음이 체지방 측정이었으며 가장 만족스러운 항목에서는 무료투약, 응급처치, 비만프로그램 순으로 나타나 이용자 특성을 반영한 보건실의 융합적 관리가 필요할 것으로 사료된다.

• 한국융합학회논문지
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• 제11권11호
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• pp.345-352
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• 2020

일본은 2007년 「긴급의사확보대책」을 통해 의료취약지의 의사재배치와 특정 진료과 편재해소를 위한 인력수급을 위해 힘을 기울이고 있다. 특히 지역 의사인력 확보방안에서 단기적 대안으로는 기존의 의사인력을 지역으로 유인하는 방안과 지역임상연수를 활성화 하여 임상연수를 받기위해 대도시로 의사가 유입되는 것을 방지하기 위한 방안이 있으며, 장기적 대안으로는 지역정원제도와 자치의과대학을 통해 의료취약지에서 근무할 인력을 양성하는 등 다각도에서 해소 방안을 찾아 가고 있다. 우리나라에서 최근 지속되고 있는 의사증원 및 공공인력정책에 대한 정부와 의협 간의 갈등을 심각하게 인식하고, 지역에서 근무할 의사인력을 안정적으로 확보할 수 있는 대안을 모색하기 위해 유사한 진통을 겪었던 일본의 사례를 벤치마킹하여, 정책적인 시사점을 제시하고자 한다.

• Ocean and Polar Research
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• 제30권1호
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• pp.89-107
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• 2008

Marine environment is subject serious destruction because of frequent accidents during exploration of marine resources and overseas transport. Also, as many industrial enterprises discharge high volume of wastes and contamination, marine pollution has become a serious threat to people (especially in China). China is quickly becoming a world economic leader of the 21st century. Rapid industrialization and social changes have raised the standard of living of millions of the Chinese, mainly in the areas of East and South East coast. The process of industrialization, however, is often followed by deterioration of the marine environment and rarely turned around until a country has increased its standard of living. Solving these array of problems will take decades and currently the government is addressing minor specific issues only. Fortunately, the Chinese government has enacted a number of marine pollution control laws. On 25 December 1999, the 13th Session of the Ninth Standing Commettee of the National People's Congress passed the amended the Marine Environment Protection Law of the People's Republic of China. This Law establishes rights and responsibilities of the relevant departments concerning marine environment management and provides for two new chapters on "Marine Environment Supervision" and "Marine Ecological Protection", along with "Supervision of Pollution Prevention for Marine Construction Projects", "Marine Ecological Protection" and "Marine Environment Pollution Prevention for Marine Construction Projects". Also, the Law was amended with provisions for integrated pollution discharge control system and oil spillage emergency response plan and enhanced legal responsibilities. Chinese government recognizes that international and national experience can be useful for China to prevent further ecological degradation of the marine environment.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.223-227
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• 2020

Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients. Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6-91 years). The average ISS was 22.01 points (range, 16-75 points). Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission. Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

• 한국간호교육학회지
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• 제26권4호
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• pp.393-401
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• 2020

Purpose: This study aimed to identify attitude and knowledge level on post-traumatic stress disorder (PTSD) among nursing and paramedic students. Methods: A questionnaire survey was conducted from December 1st to 20th in 2019. A total of 210 students participated from two universities in Korea. Data were analyzed using descriptive statistics, t-tests and one-way analysis of variance. Results: Students were positive about the government's spending on PTSD treatment (91.4%), and professional training (92.4%). PTSD patients were considered to be more dangerous (68.1%) and violent (42.4%) than the general population. There were no significant differences in attitude and general knowledge on PTSD between nursing and paramedic students. However, general knowledge on PTSD differed according to education experience on PTSD (t=2.04, p=.043). Knowledge scores for PTSD treatment differed significantly according to the academic major (t=2.02, p=.044), and education experience on PTSD (t=2.87, p=.005). Conclusions: The results of this study indicate nursing and paramedic students lack knowledge on PTSD. Therefore, developing curriculum regarding PTSD-related contents in undergraduate and continuing education in both departments is needed to provide better quality health care to people with PTSD.

• 한국항만경제학회지
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• 제35권3호
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• pp.73-92
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• 2019

전 세계적으로 재난과 위기 상황이 확산되고 있으며 중국의 쓰촨성 지진과 동일본 대지진과 같이 동북아시아 지역에서도 재난도 증가하는 추세이다. 본 연구는 유엔 세계식량계획 산하의 인도적 물류센터(UNHRD)를 동북아시아의 한국 유치를 제안하는 목적이다. 관련 선행 연구가 국내에는 없지만, 유엔 시설 유치에 대한 국가의 무형적인 이익, 가치와 물류 관련 경제적 효과를 중심으로 연구하며, 유치 효과는 우리나라 기업들의 다양한 인도적 지원 물류 산업 분야로의 진출과 유엔 관련 비즈니스 확대로 예상된다. 유엔조달연감과 대한민국 해외 긴급구호 자료들을 활용하여 관련 유엔기구의 현황을 우선 분석하고 한국의 유치 환경에 대한 SWOT 분석을 통하여 세부 유치 전략을 도출하고자 한다. 한국의 유엔 물류센터 유치 방안으로서는 인도적 지원 관련 국내외 NGO 전문가 협력체계 구축과 홍보, 정부 부처와 지자체 공동 유치 제안, 지속적인 정보 수집과 한국 유치에 관한 타당성 논리개발 등 장기적인 관점에서 유엔의 해당 기관과 긴밀하게 협력하여 전략적으로 추진하는 것이 필요하다.