• 대한영양사협회학술지
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• 제20권3호
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• pp.183-198
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• 2014

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.

• 대한임상독성학회지
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• 제17권1호
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• pp.21-27
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• 2019

Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

• 한국토양비료학회지
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• 제17권3호
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• pp.224-231
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• 1984

누수(漏水)와 양분용탈(養分溶脫)이 심한 사질답(砂質畓)(강서통(江西統))에 산적토(山赤土), 점질(粘質) 및 미사질해이토(微砂質海泥土)와 영일만(迎日灣)의 제삼기층토양(第三紀層土壤)을 객토처리(客土處理)하여 토양개량효과(土壤改良效果) 및 벼 생육(生育)에 미치는 영향(影響)을 2개년간(個年間) ('80~'81)에 걸쳐 비교(比較)하여 본 결과(結果)는 다음과 같다. (1) 수량(收量)은 1, 2년차(年次) 공히 비슷한 경향(傾向)이었으며 점질해이토구(粘質海泥土區)와 제삼기층토(第三紀層土) 처리(處理區)에서 가장 높았다. (2) 2년차(年次)에서 전생육기간(全生育其間)동안 객토(客土)의 잔효(殘效)에 의하여 건물중(乾物重) 및 무기성분(無機成分) 흡수량(吸收量)은 증가(增加)하는 경향(傾向)이며 특히 점질해이토구(粘質海泥土區)와 제삼기층토구(第三紀層土區)가 현저(顯著)하였다. (3) 시험(試驗) 후(後) 토양(土壤)의 양(陽)이온치환용량(置換容量), 유효규산(有效珪酸), 치환성양(置換性陽)이온 및 황성철함량(活性鐵含量)이 증가(增加)되었으며 제삼기층토구(第三紀層土區)에서 양(陽)이온 치환용량(置換容量)이 가장 높았다. 또 입단함량(粒團含量)과 소성지수(塑性指數)는 증대(增大)되었으며 제삼기층토구(第三紀層土區)와 점질해이토구(粘質海泥土區)에서 투수계수(透水係數)가 현저(顯著)히 적어졌다.

• Journal of Hospice and Palliative Care
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• 제21권3호
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• pp.84-91
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• 2018

목적: 본 연구는 국내 2차 병원의 암환자 치료 실태에 대해 알아보고자 하였다. 방법: 국내 한 2차종합병원에서 2009년 1월 1일부터 2017년 9월 31일까지 입원치료 받은 암환자를 대상으로 전자의무기록을 후향적으로 분석하였다. 결과: 연구 대상자는 총 223명이었다. 2차 병원 입원 이유로는 3차 병원에서의 수술, 항암화학요법, 방사선치료 후의 지지요법 위한 경우가 69명으로 가장 많았고, 다음으로 기타 지지치료 위한 입원(58명), 증상 조절 위한 입원(53명), 2차 병원 입원 중 암이 진단된 경우(27명), 적극적 항암치료를 하지 않기로 한 후 전원 된 경우(16명) 순이었다. 퇴원 시 타 기관으로 전원 된 환자 75명 중 3차 병원으로 전원 된 환자들이 50명으로 가장 많았고 다음으로 요양병원(10명), 호스피스병원(8명), 요양원(4명), 2차 병원(2명) 순이었다. 암 외 동반질환을 가진 환자가 120명(53.8%)이었다. 타 진료과로 협의진료 의뢰된 경우 암 관련 의뢰보다 암 외 다른 질환으로 의뢰된 경우가 더 많았다. 심폐소생술금지에 동의한 경우는 73명이었다. 결론: 암환자 치료를 위해 의료기관 간 협력체계 확립이 필요하며, 암 외 동반질환 치료 등 종합적인 관리가 필요하다.

• 수도
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• 통권17호
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• pp.16-23
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• 1979

• 수도
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• 통권19호
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• pp.2-8
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• 1979

• 의료법학
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• 제22권4호
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• pp.89-115
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• 2021

우리나라의 의료전달체계는 의료법과 국민건강보험법에 근거하고 있으며, 한정된 의료자원을 효율적으로 운영하기 위하여 질환의 중증도에 따라 의료기관을 이용하도록 구분되어 있다. 상급종합병원에서 이미 중증 질환에 대한 치료가 이루어져 병원급 의료기관으로 전원 또는 자택으로 퇴원이 가능한 경우 의료기관에서 환자에 대하여 의료계약을 해지할 수 있는지가 문제된다. 우리나라 법원의 입장으로는 해당 의료기관에서 더 이상의 입원치료가 불필요한 경우 의료기관의 의료계약 해지권을 인정하는 판결과 그러한 경우에도 의료기관의 의료계약 해지권을 부정하는 판결이 병존하고 있다. 한편 미국 판결 중에는 급성 치료를 담당하는 의료기관에서 입원 중인 환자에게 더 이상 급성 치료가 필요하지 않는 경우에 전문간호시설 등으로 전원을 인정하는 판결들이 있다. 의료자원이 한정되어 있고 의료기관의 계약 해지권이 제한된 취지가 국민의 생명권, 건강권에 대한 위험을 방지하기 위한 목적임을 고려할 때 해당 의료기관에서 치료가 종결되어 환자에게 더 이상 신체적 위해가 없음이 확인된 경우에는 다시 원칙으로 돌아가 의료기관의 계약 해지권을 인정할 필요가 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1659-1665
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• 2014

The present study conducted with 100 oral cancer patients at a private tertiary care hospital in Delhidemonstrated that stage III cancer was associated with longer use of tobacco and poor oral hygiene. There was also statistically significant association (p<.05) between consumption of tobacco and alcohol. More than 60% treatment expenditure was on surgery followed by accommodation (9%) and investigations (8%). The effect of tobacco was well known among patients as 76% of the patients knew that common cancer in tobacco chewer is 'oral cancer', 22% of the patients however responded that they did not know which cancer is common in tobacco chewers. 58% said that they learnt about ill effects of tobacco from media while 24% said they learnt from family and friends. Out of 78 tobacco users, 60 (77%) said that they never received help to quit tobacco while 18(23%) have received help to quit.

• 임상간호연구
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• 제23권2호
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• pp.202-210
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• 2017

Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.1
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• pp.298.1-298.1
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• 2003

The aim of this study was to investigate the protective effect of acanthoic acid on liver injury induced by either tertiary-butyl hydroperoxide (tBH) or carbon tetrachloride in vitro and in vivo. Acanthoic acid, (-)-pimara-9(11),15-diene-19-oic acid, is a diterpene isolated from the root bark of Acanthopanax koreanum. In in vitro study, the cellular leakage of lactate dehydrogenase (LDH) with 1.5 mM tBH for 1 j, were significantly inhibited by treatment with acanthoic acid(25 and 5mg/mL). (omitted)