• 한국문헌정보학회지
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• 제46권3호
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• pp.233-250
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• 2012

MEDLIS 원문제공 서비스의 발전과 현황 그리고 문제점을 파악하여 개선방안을 제시하기 위하여 이용분석을 수행하였다. 2001년부터 2011년까지 축적된 트랜잭션 데이터를 분석한 결과, 이용량의 지속적 감소, 기관유형별 불균형한 기여도, 기간호에 대한 높은 의존성, 주제별 이용격차, 비교적 낮은 성공률, 다양한 실패요인이 식별되었다. 연구결과에 기초하여, 서비스 품질향상을 위한 종합목록데이터베이스의 유지 관리, 효과적 검색을 위한 기술적 지원, 기간호 공동보존 대책, 그리고 이용활성화를 위한 교육과 홍보 및 회원 확대 등을 제언하였다.

• 한국의학물리학회지:의학물리
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• 제31권3호
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• pp.71-80
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• 2020

This paper provides a brief review of the advanced technologies for carbon ion radiotherapy (CIRT), with a focus on current developments. Compared to photon beam therapy, treatment using heavy ions, especially a carbon beam, has potential advantages due to its physical and biological properties. Carbon ion beams with high linear energy transfer demonstrate high relative biological effectiveness in cell killing, particularly at the Bragg peak. With these unique properties, CIRT allows for accurate targeting and dose escalation for tumors with better sparing of adjacent normal tissues. Recently, the available CIRT technologies included fast pencil beam scanning, superconducting rotating gantry, respiratory motion management, and accurate beam modeling for the treatment planning system. These techniques provide precise treatment, operational efficiency, and patient comfort. Currently, there are 12 CIRT facilities worldwide; with technological improvements, they continue to grow in number. Ongoing technological developments include the use of multiple ion beams, effective beam delivery, accurate biological modeling, and downsizing the facility.

• 대한의용생체공학회:의공학회지
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• 제43권1호
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• pp.61-70
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• 2022

Natural and synthetic forms of calcium phosphate cement (CPC) have been widely used in bone repair and augmentation. The major challenge of injectable CPC is to deliver the cells without cell death in order to regenerate new bone. The study objective was to investigate for the potential of stem cell-laden gelatin fibers containing injectable, nanocrystalline CPC to function as a delivery system. Gelatin noddle fiber method was developed to delivered cells into nCPC. Experimental groups were prepared by mixing cells with nCPC, mixing cell-laden gelatin fibers with nCPC and mixing cell-laden gelatin fibers containing BMP-2 with nCPC. Media diffusion test was conducted after dissolving the gelatin fibers. SEM examined the generated channels and delivered cell morphology. Fibers mixed with nCPC showed physical setting and hardening within 20 min after injection and showed good shape maintenances. The gelatin fibers mixed nCPC group had several vacant channels generated from the dissolved gelatin. Particularly, proliferation and attachment of the cells were observed inside of the channels. While live cells were not observed in the cell mixed nCPC group, cells delivered with the gelatin fibers into the nCPC showed good viability and increased DNA content with culture. Cell-laden gelatin fiber was a novel method for cell delivery into nCPC without cell damages. Results also indicated the osteogenic differentiation of gelatin fiber delivered cells. We suggest that the cell-laden gelatin fibers mixed with nCPC can be used as an injectable cell delivery vehicle and the addition of BMP-2 to enhances osteogenesis.

• 한국학교ㆍ지역보건교육학회지
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• 제23권4호
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• pp.29-39
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• 2022

Objectives: The purpose of this study was to assess the incidence of delivery and puerperium complications in South Korea and analyze the correlations between the patient's characteristics and delivery and complications before and after 10 years. Methods: This study used the data from an Korean National Hospital Discharge In-depth Injury Survey. Cases of which the principal diagnosis and second diagnoses were disease classification ICD code O00-O99(Pregnancy, childbirth and the puerperium) were defined as the study subjects, and the first study group was divided as the year of discharge from 2005 to 2007, and the second study group from 2015 to 2017. Results: The number of patients discharged whose principal diagnosis or second diagnoses was O00-O99 was 21,598(Weighted 423,306) from 2005 to 2007 and 19,028(Weighted 364,384) from 2015 to 2017, which decreased by 13.9% compared to 10 years ago. The average age of discharged patients increased by about 2 years and was statistically significant (p<.0001). Factors associating spontaneous delivery, caesarean section and puerperium complication were hospitalization route, bed size, maternal age, length of hospital stay, and the year of discharge. Conclusion: Based on the results of this study, health and education policies and economic support for medical care for high-risk pregnancy and delivery management would be necessary continuously. In addition, policies to strengthen the medical system for high-risk pregnancy management in non-metropolitan areas with high fertility rates would also be needed.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2005년도 생물공학의 동향(XVI)
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• pp.580-583
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• 2005

The aim of this study was to prepare a hydrogels composed of alginate blended with a carboxymethyl scleroglucan (CMSC) and evaluate the feasibility of the hydrogels as a drug delivery system for a protein. The main advantage of the alginate/CMSC hydrogels is to improve a restricted drug release from alginate hydrogels. The CMSC was chemically synthesized with chloroacetic acid and confirmed using a FT-IR. The alginate/CMSC hydrogels were prepared at distinct compositions by crosslinking with calcium ions. The swelling ratios of these hydrogels increased significantly with increasing the content of CMSC. At pH 7.4, the swelling ratios of the hydrogels increased remarkably as compared to those at pH 1.2. In ovalbumin (OVA) release test, the amount of OVA released from the hydrogels showed higher as compared to those released at pH 1.2. In addition, the release of OVA was improved with increasing the content of CMSC. Thus, the alginate/CMSC hydrogels may be used as a potential system for oral delivery of protein drugs.

• 의료법학
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• 제21권1호
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• pp.153-185
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• 2020

불가항력 의료사고 보상사업의 근거 법률인 현행 「의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률」 제46조제1항에서는, 보건의료인이 충분한 주의의무를 다하였음에도 불구하고 불가항력적으로 발생한 '분만에 따른 의료사고'를 사업의 대상으로 정하고 있다. 또한, 동법 시행령에서 보건의료기관개설자 중 분만실적이 있는 자가 보상재원의 30%를 부담하게 규정하고 있는바, 이에 대하여 헌법재판소에서는 2015헌가13 결정을 통해 의료분쟁조정법에서 위 사업의 분담금 납부의무자의 범위와 보상재원의 분담비율을 시행령에 위임하였다고 하여 헌법에 위반되지 않는다고 결정한 바 있다. 그러나 이는 의료진으로 하여금 의료과실이 없는 분만사고에 대하여 금전적으로 보상하게 하는 것으로 과실책임주의를 배제한 것인바, 이 제도의 본질이 사회보상적 성격을 갖는 사회보장제도의 일종이라면, 보건의료개설자의 비용분담 규정을 삭제하고 국가가 비용 전부를 부담하는 방법을 고려할 수 있을 것이다. 다만, 이와 더불어 의료사고 원인분석 및 재발방지 조치 등 의료기관의 노력을 강화하기 위한 제도적 장치를 함께 검토할 필요가 있다. 더불어, 의료분쟁조정법상 보건의료개설자가 부담하여야 할 보상재원의 분담비율의 상한을 정하는 것이 포괄위임금지원칙의 취지에 부합할 것이다. 한편, 의료사고 보상심의위원회의 분담금 지급기준과 관련하여, 시행령에서 보상의 기준이 되는 재태주수, 출생체중 등을 적시하고, 그 세부기준을 의료사고 보상심의위원회에서 정함이 타당하다. 마지막으로 불가항력 의료사고 보상사업에서 보상의 회색지대를 방지하기 위함은 물론, 의료'과실'이 규범적 판단임을 고려할 때 위 동법 제48조 제1항의 규정에서 '보건의료인의 과실이 인정되지 않는다는 취지의 감정서가 제출되고'의 요건은 삭제하는 것이 바람직하며, 반드시 의료중재원 조정·중재절차가 선행되어야 하는 현행의 규정을 개선할 필요가 있을 것이다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제24권1호
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• pp.7-14
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• 2018

Purpose: This study analyzes mental healthcare delivery services and types of facilities, the status of installation and operation, and planning standard. The purpose of the study is to propose a basic data for the performance of related research and work tasks, along with an understanding of the Chinese mental healthcare facility type and support system. Furthermore, it will show a lack of current function management as the changes of mental health concept and demand for services increases, and it is intended to provide implications for the construction of mental health facilities. Methods: This study was conducted by a research on law and regulation of China's mental healthcare delivery service system and mental healthcare facility. The analyzed data are the national standard GB, the optional national standard GB/T, the building construction standard JGJ, and the report issued by the Health Planning and Development Committee. Results: At present mental healthcare facility construction in China is in the period of rapid development and it exposes the layout of medical facilities, which is not currently reasonable and the service does not reach the designated position and so on. Overall, it requires more detailed guidelines to enhance the quality of mental healthcare service. Implications: It is expected that the research of this paper will provide effective reference for future research on Chinese Mental healthcare system and facilities, and can promote construction of Chinese mental healthcare facility theory in perfect condition.

• 한국산학기술학회논문지
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• 제21권2호
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• pp.470-478
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• 2020

본 연구에서는 단일 환산지수 체계를 유형별 외래 및 입원 환산지수로 분리하기 위한 이론 모형을 설계하였다. 그리고 가상 자료를 바탕으로 외래 및 입원 환산지수와 조정계수를 산출하였다. 본 연구에서의 중요한 결론은 다음과 같다. 첫째, 외래·입원 환산지수 개념을 도입하고 설계함으로써 의원은 외래, 병원은 중한 환자 위주의 입원 기능에 집중하도록 유도할 수 있는 최소한의 인센티브 도구를 도입할 수 있다. 둘째, 환산지수를 분리함으로써 상급종합병원을 비롯한 대형병원의 외래 진료비 수입이 목표 진료비 예산 이상으로 증가하더라도 병원수익 증대에 큰 도움이 되지 않도록 보상 체계를 설계할 수 있는 방안을 도입해 자원 배분 동기를 부여할 수 있다. 셋째, 단일 환산지수보다 다양한 요소들에 대한 명시적인 계약이 가능해져 급증하는 진료비에 대한 적절한 관리 수단으로 활용할 수 있다. 마지막으로 외래 및 입원 환산지수 분리 계약은 공급자의 행위론적인 변화를 유도해 의료전달체계를 정립하는데 기여할 수 있는 정책적인 도구로 활용될 수 있을 것이다.

• 간호행정학회지
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• 제3권2호
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• pp.151-165
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• 1997

A cost analysis for hospitalized patients was performed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15, 1996. The study consisted of 148 inpatients diagnosed for lens procedures(KDRG 03900), tonsillectomy &/or adenoidectomy(KDRG 16100), Cesarean section(KDRG 37000), or vaginal delivery(KDRG 37300) without any complications. The direct or indirect nursing hours of each patients were measured. Then, direct or indirect nursing expenditures of four nursing units, operating room and delivery room were computed. Finally, the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows; 1) The average total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy, 934 minutes for appendectomy with complicated principal diagnosis, 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days, 4 days for tonsillectomy &/or adenoidectomy, 6 days for appendectomy with complicated principal diagnosis, 8 days for Cesarean section and 3 days for vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) The average nursing cost were 87,146 Won for lens procedures, 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won for Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0%, 16.0% and 22.0%, respectively, of the official price fixed by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs according to the severity of illness for those KDRGs shoud be carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the above research should be prepared in the near future.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.116-123
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• 2016

Purpose: To develop an inclusive and sustainable trauma system as the assessment of burden of injuries is very much important. The purpose of this study was to evaluate the estimates and characteristics of abdominal traumatic injuries. Methods: The data were extracted from the National Emergency Department Information System. Based on Korean Standard Classification for Disease 6th version, which is the Korean version of International Classification of Disease 10th revision, abdominal injuries were identified and abdominal surgeries were evaluated with electronic data interchange codes. Demographic factors, numbers of surgeries and clinical outcomes were also investigated. Results: From 2011 to 2014, about 24,696 patients with abdominal trauma were admitted to the hospitals annually in South Korea. The number of patients who were admitted to regional and local emergency medical centers was 8,622 (34.91%) and 15,564(63.02%), respectively. Based on National Emergency Department Information System, liver was identified as the most commonly injured abdominal solid organ (39.50%, 9,754/24,696, followed by spleen (17.57%, 4,338/24,696) and kidney (12.94%, 3,195/24,696). Conclusion: This study shows that the demand for abdominal trauma care is considerable in South Korea and most of the patients with abdominal trauma were admitted to regional or local emergency centers. The results of this study can be used as good source of information for staffs to ensure proper delivery of abdominal trauma care in trauma centers nationally.