• 한국병원경영학회지
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• 제7권3호
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• pp.63-83
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• 2002

This study is to survey the materials purchasing and inventory management status and the characteristics and opinions of the staff in charge of purchasing and inventory of the general hospitals in Busan area in order to contribute to the rationalization of its management through the grasp of actual situation and the presentation of desirable improvement plan for the materials purchasing and inventory management. The status of medical institute had been surveyed by the purchasing/ administration managers of total 26 general hospitals, and the purchasing/ management questionnaires had been commenced with 86 staff of the 26 hospitals. Its major survey results, after the analysis of 24 medical institute statuses (return rate of 92.30%) and 60 staff questionnaires (return rate of 69.76%), are as follows. First, post-purchasing evaluation system is not used actively, orders are being placed by phone or fax, and general merchandise is being purchased through free contracts in most of the hospitals participated in the survey. Second, as per the materials supplying methods, the requisition and delivery system is currently the most popular in the hospitals surveyed, however, both the requisition and delivery system and the par level transfer system are the most desired in the hospitals of more than 500 beds, and the par level transfer system is the most desired in the hospitals under 500 beds for the materials supplying system in the future. Third, as per the inventory management system that is desired the most in the future, the SPD and JIT types are preferred in the hospitals of more than 500 beds, the stockless strategy is preferred in the hospitals under 500 beds, the senior staff above section chief grade prefer the stockless strategy, and the junior staff prefer the ABC classification and SPD types. Fourth, The necessity of purchasing staff's training for the materials management is highly recognized but the effectiveness is not so much acknowledged, which is because such a training is thought to be so superficial and formal that it is not helpful much in the actual field. When summarizing the survey results as above, the materials purchasing and management system is differed for each group of hospitals according to the size of beds, and the more scientific management system is largely required by the general hospitals in Busan city. They also hope the introduction of joint purchasing system, materials management by the bar-code system, and positive execution of the market survey and training of the relevant staff for the management of purchasing affairs. So the more systematic purchasing and inventory management is regarded to be necessary through the introduction of scientific and specialized education of materials management, market survey, and post-purchasing evaluation system also through the computerization of materials purchasing and inventory management as soon as possible.

• 한국사회복지학
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• 제68권2호
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• pp.213-232
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• 2016

본 연구는 청소년들이 지각하는 스트레스 프로파일을 탐색하고, 프로파일에 나타난 집단별 특성변인의 영향을 알아보는데 목적이 있다. 한국청소년정책연구원의 '한국 아동 청소년 인권실태조사(2013)' 횡단자료를 이용하여 전국의 초등학교 4학년에서 고등학교 3학년에 재학 중인 9,521명의 청소년들을 대상으로 스트레스 유형에 대한 프로파일분석을 실시하였다. 분석 결과, 적합도 지수와 잠재계층 분류율에 따라 2개 계층 유형이 선택되었다. 1유형은 모두 낮은 수준으로 나타나 저위험집단으로, 2유형은 모두 높은 수준으로 나타나 상대적 위험집단으로 명명하였다. 청소년들의 스트레스 특성을 예측하기 위해 저위험집단을 기준으로 이항로지스틱회귀분석을 실시한 결과, 여학생이 남학생에 비해, 주관적 건강상태와 행복 정도가 낮을수록, 가출경험이 있을수록, 학업성적 수준과 가정의 경제적 사정이 낮을수록 상대적 위험집단에 속할 가능성이 높게 나타났다. 그러나 중학생은 가출경험과 학업성적수준에서, 고등학생은 학업성적수준에서 집단 간 차이가 유의미하지 않게 나타났다. 초등학생, 중학생, 고등학생, 전체 청소년에서 모두 저위험집단에 비해 상대적 위험집단에 속할 가능성에 가장 큰 영향을 미치는 것은 행복정도로 분석되었다. 본 연구의 시사점, 제한점, 후속연구의 방향을 제시하였다.

• 대한지리학회지
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• 제49권4호
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• pp.615-632
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• 2014

본 연구는 서답형 문항의 채점에서 평가의 객관성, 타당성, 신뢰성을 보장하기 위해 가장 중요한 주제의 하나인 블러핑 문제를 탐구한 것이다. 먼저 연구자는 블러핑의 개념과 주요 유형을 선행 연구를 바탕으로 이론적 수준에서 정리하였다. 다음으로, 한국지리 교과의 주요 용어를 사례로 학습자의 블러핑 전략과 유형을 실증적으로 분석해 보았다. 기존의 연구 보고와 비교할 때, 본 연구에서 밝혀진 전체 학생들의 평균적 블러핑율은 상당히 낮은 것으로 나타났다. 그러나, 남녀 학생의 블러핑율이 유사하다는 점, 최고 성적 집단의 블러핑율이 가장 낮았다는 점은 기존의 연구 보고와 유사하였다. 블러핑의 실제 유형은 크게 '발문의 반복 서술형', '기존 지식 편중형', '추상적 개념 활용형', '채점자 공감 유도형'의 네 가지로 구분되었다. 분석 결과를 토대로 보다 타당성과 신뢰성이 있는 서답형 문항 채점을 위해 몇 가지 시사점 및 과제를 다음과 같이 제안하였다. 첫째, 블러핑과 학생들의 성별 및 학령, 학습 성적 및 지적 수준, 학습자의 학습 스타일 등과의 관계에 대해 지속적인 연구가 필요하다. 둘째, 블러핑 유형과 사례 분석 내용이 포함된 서답형 문항 채점 매뉴얼 개발 보급 및 채점 관련 연수가 확대되어야 한다. 셋째, 일반적인 블러핑 유형 외에 지리 영역의 특수한 블러핑 유형을 탐구하는 실증적인 후속 연구가 요구된다.

• Journal of Gastric Cancer
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• 제18권1호
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• pp.30-36
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• 2018

Purpose: We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS). Materials and Methods: We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial. Results: Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial. Conclusions: The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.347-358
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• 1993

The purpose of this study is to analyze the relationship between the blood pressure level and their sexual maturity and physical growth in the children at puberty. For this purpose, we estimated the blood pressure, physical growth and sexual maturity of the boys of 335 and girls of 373 who are in the middle schools which are located in Kangwha County, Kyungki-Do. Both systolic and diastolic pressure were measured twice. Such physical growth as height, body weight, skin fold thickness, waist circumference, hip circumference and arm circumference were measured. The sexual maturity was estimated according to the classification of Tanner's 5-phase-sexual-maturity : in boys, their pubic hair development phase : in girls, their pubic hair and breast development phase and the menstrual experience. In the phase of the pubic hair development, the boy's sexual maturity was distributed into this; the 1 st 56.4%, the 2nd 29.3%, the 3rd 9.9%, the 4th 4.1% and the 5th 0.3%. While the girls sexual maturity was distributed into this the 1st 20.5%, the 2nd 34.9%, the 3rd 30.6% the 4th 12.6% and the 5th 1.3% in the phase of the pubic hair development, and the 1st 0.8%, the 2nd 13.7%, the 3rd 36.2%, the 4th 18.8% and the 5th 30.5% in the phase of the breast development. This indicated that the girls sexual maturity was higher than those of the boys. The girls menstrual experience rate accounted to the 58.2%. In order to see the relationship between the children's sexual maturity and blood pressure level, we regress blood pressure level on physical growth (i.e., height, BMI) and sexual maturity. Sexual maturity in treates as dummy variables. As the resulf of this analysis, the boys' sexual maturity has nothing to do with the blood pressure either systolic or diastolic. But the girl's systolic pressure was statistically significant ; the 9% of the physical growth, the 5% of the pubic hair development and the 4% of the breast development in sexual maturity was explained. In the girls' diastolic pressure, only their pubic hair development was statistically significant ; the 7% of the physical growth and the 7% of the pubic hair development in the diastolic was explained and the 5% of the physical growth in the diastolic Korotokoff phase IV and the 2% of the pubic hair development in the diastic Korotokoff phase was explained, especially, the girls exprienced menstruation, their systolic and diastolic pressure were significantly high (P<0.01). Conclusively, in the first grade children attending middle schools who are in the early process of the sexual development, the sexual maturity was not related to blood pressure level, on the other hand, the blood pressure level of the girls who are more sexual development than those of the boys' have something to do with sexual maturity and physical growth.

• Journal of Chest Surgery
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• 제12권3호
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• 제12권3호
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• pp.289-296
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• 대한두경부종양학회지
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• 제15권1호
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• pp.22-28
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• 1999

Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

• 대한임상검사과학회지
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• 제39권2호
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• pp.128-135
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• 2007

This study was designed to investigate the correlation between the expression rate of p53 and p21 proteins by immunohistochemical staining and tumor prognostic factors including the tumor size, histological differentiation and Dukes' stage of tumor prognostic factors in colon cancer, and to acquire necessary data for the presumption of diagnosis, treatment and prognosis of colon cancer patients. From January 2000 to January 2003 at Hanyang University Guri Hospital, the paraffin blocks of 35 patients diagnosed with colon cancer whose pathologic reports were possible to review were selected. Harris hematoxylin & eosin (H&E) staining and immunohistochemical staining by ABC (Avidin Biotin Conjugate) method were performed. The histological differentiation grade and stage were classified according to the classification of the World Health Organization (WHO) and modified Dukes's stage from H&E staining. The expression rate of p53 and p21 proteins were analyzed by immunohistochemical staining. The results was analyzed statistically by SPSS (Windows version 8.0). As a result, the expression rate of p53 protein was 11.4% (4 cases) in clear differentiation, 48.6% (17 cases) in moderate differentiation, and 17.1% (6 cases) in poor differentiation. In other words, the poorer the differentiation, the higher the expression rate of p53 protein (p<0.05). The expression rate of p21 was 17.1% (6 cases) in clear differentiation, 40.0%(14 cases) in moderate differentiation, and 8.6% (3 cases) in poor differentiation, According to the progression of histological malignant degeneration, the expression rate of p21 protein decreased distinctively (p<0.05). However, the correlation between the two above mentioned proteins and the tumor-size and Dukes' stage was not of statistical significance. In the comparison of the expression rate of p53 protein with that of p21 protein, in 10 cases, p53 protein expression was positive while p21 protein expression was negative, and in 6 cases, p53 protein expression was negative whereas p21 protein expression was positive. Consequently a statistically significant inverse correlation between the expression rate of p53 protein and that of p21 protein was observed (p<0.05). In conclusion, we found a significant correlation between histological differentiation and the expression rate of p53 and p21 proteins (p<0.05), and a significant inverse correlation between the expression rate of p53 protein and that of p21 protein (p<0.05). Also, it could be confirmed that the over expression of p53 and p21 proteins is closely associated with the occurrence of colon cancer and its progress. Therefore, it is thought that this study may be greatly beneficial to the presumption of diagnosis, treatment and prognosis of colon cancer patients.

• 한국작물학회지
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• 제42권3호
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• pp.357-366
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• 1997

우리 나라에서 재배되고 있는 주요 벼품종들의 입형을 조사하여 입형에 따른 품종군을 구분하고 도정율과 발의 상품가치를 높히고자 1995년 경기도 여주군 가남면 건국대학교 농과대학 실습농장에서 47개의 주요 품종을 재배, 수확하여 실험한 결과를 요약하면 다음과 같다. 1. 공시품중의 현미 장폭비는 1.57∼2.25범위로서 통일형 품종을 제외하면 장폭비가 모두 2.0이하의 단원형에 속하였다. 2. 단립(장폭비 2.0이하)에 속하는 품종들의 평균 장폭비는 1.77, 변이계수는 4.79％로서 입형의 균일도에 차이가 심하였다. 3. 현미의 장폭비에 의하여 1군은 1.75이하, 2군은 1.76∼l.80, 3군은 1.81∼l.90, 4군은 1.91∼2.00, 5군은 2.01 이상으로 5등급하면 현재 분류방법보다 더 균일한 입형을 가진 품종군으로 분류할 수 있었다. 4. 1군과 2군에 속하는 품종들은 도정시 체눈의 크기가 1.7mm(001체)를 사용하는 것이 도정율과 쌀알의 균일도를 높일 수 있으며 3군과 4군에 속하는 품종들은 체눈의 크기가 2.0mm를 사용하는 것이 좋았다. 5. 쌀의 이화학적 및 취반특성은 품종 고유의 특성으로 위에서 분류한 등급간에는 뚜렷한 차이가 없으며 일반적으로 1군에 속하는 품종들이 밥맛이 좋다고 평가되었다.