• 제목/요약/키워드: Terminal View

검색결과 135건 처리시간 0.02초

만성신부전에 수반된 각종 내분비기능 변화에 관한 연구 (A Study on the Abnormalities of the Various Endocrine Functions Associated with Chronic Renal Failure)

  • 홍찬표;김만우;노방수;장경식;이민형;오현관
    • 대한핵의학회지
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    • 제16권1호
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    • pp.7-14
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    • 1982
  • In an attempt to evaluate the various serum hormonal changes in terminal renal failure, the fasting $T_4,\;T_3,\;rT_3$, gastrin, secretin prolactin, and aldosterone were measured by radioimmunoassay in 12 patients with chronic renal failure, who were admitted to Chosun University Hospital from January to June, 1981. From the analysis the following results were obtained. 1. Mean values of serum hormonal concentration in 10 normal control were as follows: $T_4,\;12.93{\pm}2.00ug/ml$; $T_3,\;113.0{\pm}28.7ng/ml$; $rT_3,\;0.11{\pm}0.10ng/ml$; gastrin, $100.0{\pm}47.1pg/ml$; secretin, $32.46{\pm}11.45pg/ml$; prolactin, $11.0{\pm}3.6ng/ml$; aldosterone, $137.0{\pm}58.5pg/ml$, 2. Mean values of serum hormonal concentration in 12 chronic renal failure were as follows: $T_4,\;7.34{\pm}2.43ug/ml$; $T_3,\;71.0{\pm}19.1ng/ml$; reverse $T_3,\;0.38{\pm}0.19ng/ml$; gastrin, $162.5{\pm}40.2pg/ml$; secretin, $107.50{\pm}20.48pg/ml$; prolactin, $34.0{\pm}17.2ng/ml$; Aldosterone, $86.5{\pm}19.8pg/ml$. 3. In chronic renal failure group, serum T 4, T 3 and adosterone level were significantly lower than those of the control group, but serum $rT_3$, gastrin, secretin and prolactin were significantly higher than those of the control group. 4. In the view of the correlation between serum hormonal concentions and serum creatinine levels in patients with chronic renal failure, $rT_3$, gastrin, secretin and prolactin showed increasing tendency(positive correlations), whereas $T_4,\;T_3$ and aldosterone showed decreasing tendency (negative correlations) with increment of serum cteatinine levels. And so, we observed the negative correlation between $T_3\;and\;rT_3$.

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웹 기반 해운 선사 운영시스템 보안 요구사항 연구 (Study on security requirements for the web based operation system of a shipping company)

  • 정업;문종섭
    • 인터넷정보학회논문지
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    • 제23권1호
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    • pp.49-68
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    • 2022
  • 해운 선사의 운영시스템은 주전산기를 이용한 단말기 접속 환경 또는 클라이언트/서버 구조의 환경을 유지하고 있는 경우가 아직 많으며, 웹서버 및 웹 애플리케이션 서버를 이용한 웹 기반 환경으로의 전환을 고려하는 해운 선사가 증가하고 있다. 그런데 전환 과정에서, 기존 구성 방식과 지식을 바탕으로 웹 기반 환경의 특성 및 해운 업무의 특성을 고려하지 않고 설계를 진행하는 경우, 다양한 보안상 취약점이 실제 시스템 운영 단계에서 드러나게 되고, 이는 시스템 유지보수 비용의 증가를 초래하게 된다. 그러므로 웹 기반 환경으로의 전환 시에는, 시스템 안전성 확보 및 보안 관련 유지보수 비용 절감을 위해 설계 단계에서부터 반드시 보안을 고려한 설계가 진행되어야 한다. 본 논문에서는 다양한 위협 모델링 기법의 특성을 살펴보고, 해운 선사 운영시스템에 적합한 모델링 기법을 선정한 후, 데이터 흐름도와 STRIDE 위협 모델링 기법을 해운 선사 업무에 적용하여, 데이터 흐름도의 각 구성 요소에서 발생 가능한 보안 위협을 공격자 관점에서 도출하고, 공격 라이브러리 항목과의 매핑을 통해 도출된 위협의 타당성을 입증한다. 그리고, 이를 이용하여 공격자가 최종목표 달성을 위해 시도할 수 있는 다양한 공격 시나리오를 공격 트리로 나타내고, 보안 점검 사항과 관련 위협 및 보안 요구사항을 체크리스트로 구성한 후, 최종적으로 도출된 위협에 대응할 수 있는 23개의 보안 요구사항을 제시한다. 기존의 일반적인 보안 요구사항과는 달리, 본 논문에서 제시하는 보안 요구사항은 해운 선사의 실제 업무를 분석한 후, 여기에 위협 모델링 기법을 적용하여 도출된 해운 업무 특성을 반영한 보안 요구사항이므로, 추후 웹 기반 환경으로의 전환을 추진하는 해운 선사들의 보안 설계에 많은 도움이 될 것으로 생각한다.

어선의 안전조업을 위한 항해통신 및 어탐기의 통합시스템 구현 (Realization on the Integrated System of Navigation Communication and Fish Finder for Safety Operation of Fishing Vessel)

  • 강인숙;주인웅;김정연;최조천
    • 한국항행학회논문지
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    • 제25권6호
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    • pp.433-440
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    • 2021
  • 어선의 경계소홀에 의한 해난사고는 어선 운용자의 고령화에 따른 문제와 어선에서 협소한 조타실 내부에 설치되는 항해, 통신 및 어로장비 등 여러 개의 단말기와 모니터는 조타실의 해상시야를 방해하는 상태로 설치된다. 또한 복수의 장비에 표시되는 각각의 디스플레이 정보를 확인해야 하는 혼란으로 운용자의 정보인식 능력을 저하시키는 요인으로 작용한다. 따라서 장비들을 간결하게 통합해야 한다는 요구가 제기되어 왔으며, 통합시스템은 전자해도, 통신 및 어군탐지 등으로 다양하게 어선에서 구비해야 하는 장비와 모니터를 하나로 통합하는 것이다. 본 연구는 어선의 협소한 조타실에 설치되는 GPS 플로터, AIS, VHF- DSC, V-pass, 어군탐지기를 하나의 함체에 구성하고, 하나의 MFD (multi function display)에 의하여 운용을 간편화하는 과제이며, 항해중에 데이터통신을 자동운용하는 AIS 와 V-pass 모듈은 실증실험을 통하여 그 성능을 확인하였다. 어선에서 여러 개의 단말기를 통합하여 하나의 화면으로 모든 정보를 제공하고 운용하는 시스템은 해상안전과 어업환경을 크게 개선시킬 수 있다.

가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교 (A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients.)

  • 김용순;임영신;전춘영;이정자;박지원
    • 대한간호
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    • 제29권2호
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • 김옥겸
    • 호스피스학술지
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    • 제2권2호
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    • pp.28-48
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    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

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