• 한국임상약학회지
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• 제11권1호
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• pp.1-6
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• 2001

This research is conducted to evaluate the clinical and economic benefits from therapeutic drug monitoring(TDM) service on vancomycin in a tertiary general hospital. Total 99 pairs of steady state peak and trough concentrations of vancomycin were obtained from 73 patients. To see the clinical benefits, the appropriateness of vancomycin dosing before TDM was evaluated. In 72 pairs of vancomycin blood concentrations obtained prior to TDM consultation, $47.2\%$ of the cases had reached within therapeutic range. Serum vancomycin levels in patients with $40{\leq}CLcr<60$ (ml/min) were higher and than the levels in patients with 40>CLcr and $60{\leq}CLcr$ (ml/min). Dose reduction rate in patients with creatinine clearance $40{\leq}CLcr<60$ (ml/min) were also significantly higher than those of compared groups ($61.5\%$, p=0.0138). Serum vancomycin concentrations were re-obtained from 21 patients who received modified dose through TDM service. Ninety percent (19/21cases) of them were within the target therapeutic range. For the evaluation of economic benefits from TDM consultation, estimated cost savings were calculated in those patients. The total drug saving were 586 vials in 21 patients. The calculated mean cost saving from the drugs was 314,570 won (range: $11,273\sim473,466)$ per patient. The study revealed that TDM service for vancomycin is necessary because empirical dosing is not effective for obtaining therapeutic drug level, especially patients with mild renal insufficiencies. The cost saving from TDM is also beneficial for the patients.

• 의학교육논단
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• 제24권2호
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• pp.156-171
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• 2022

The purpose of this study was to establish a model for constructing longitudinal data for medical school, and to structure cohort and longitudinal data using data from Yonsei University College of Medicine (YUCM) according to the established input-environment-output (I-E-O) model. The study was conducted according to the following procedure. First, the data that YUCM has collected was reviewed through data analysis and interviews with the person in charge of each questionnaire. Second, the opinions of experts on the validity of the I-E-O model were collected through the first expert consultation, and as a result, a model was established for each stage of medical education based on the I-E-O model. Finally, in order to further materialize and refine the previously established model for each stage of medical education, secondary expert consultation was conducted. As a result, the survey areas and time period for collecting longitudinal data were organized according to the model for each stage of medical education, and an example of the YUCM cohort constructed according to the established model for each stage of medical education was presented. The results derived from this study constitute a basic step toward building data from universities in longitudinal form, and if longitudinal data are actually constructed through this method, they could be used as an important basis for determining major policies or reorganizing the curricula of universities. These research results have implications in terms of the management and utilization of existing survey data, the composition of cohorts, and longitudinal studies for many medical schools that are conducting surveys in various areas targeting students, such as lecture evaluation and satisfaction surveys.

• 종양간호연구
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• 제4권2호
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• pp.110-123
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• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

• 대한방사선기술학회지:방사선기술과학
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• 제20권1호
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• pp.43-49
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• 1997

Purpose of this paper is to extend help for clinical application in balloon cholangiography on patients who have undergone endoscopic sphincterotomy, impacted stones of intrahepatic duct, and missed bile duct because of other diseases in operating endoscopic retrograde cholangiopancreatography. This study was done for the patients who had clinical signs of biliary diseases from January to December In 1996. We studied 45 patients who had endoscopic sphincterotomy, re-examination after interventional treatment of the endoscopic retrograde cholangiopancreatography, and uncertain diagnosis due to common bile duct and intrahepatic duct those are not filled with contrast media. Balloon cholangiography was performed in case of uncertain diagnosis while operating endoscopic retrograde cholangiopancreatography. First of all, we insert balloon catheter Into the working channel of treatment jejunofiberscope and remove treatment Jejunofiberscope after ballooning, and lastly take biliary tract X-ray after Injection and changing position of patient. The results of this study were as follows. (1) In classification of diseases, stones of gall bladder, those of common bile duct, and those of intrahepatic duct were 30 cases, fistula was 1 case. (2) In total cases of 45, only diagnosis were 25 cases, interventional treatment were 20 cases. (3) In case of interventional treatment, endoscopic sphincterotomy and endoscopic nasobiliary drainage, and stone removal were about the same, 7, 7, 6 respectively. Balloon cholangiography will be useful to prevent patients from having repeated and unnecessary studies for the cases above explained. It is considered that this study will be useful for clinical application in terms of reducing medical expenses, pain while examination, and consultation hours.

• 토지주택연구
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• 제8권2호
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• pp.73-82
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• 2017

Although Changdong Sanggye area has been developed during 1980s as a new city for the supply of low-income housing, currently it was degraded to a bed town located outside Seoul. However, Changdong Sanggye area is designated as the center of a metropolitan area in '2030 Seoul City Basic Plan' due to a variety of potential factors such as a traffic center for linking metropolitan areas, location of 15 universities, and neighboring natural environment like Jungnang stream and Buckhan mountain. The purpose of urban regeneration plan is to create a new CBD of Changdong Sanggye which is the center of vocational and cultural lives of 3.2 million people in the northeastern metropolitan area. To achieve the purpose, 12 unit projects and 24 sub-unit projects are set up based on the three major goals and core strategies. An enterprise project team of northeastern area was newly founded and then a dedicated organization was established by the Seoul government in 2015 in order to integrate separated urban regeneration related functions. In the Seoul government an administrative council and a project promotion council are operated for consultation and coordination between the administrative divisions and government projects for urban regeneration. Through the success in Changdong Sanggye regeneration project, they are expected to have economic effects such as job creation and increase in tax revenue and to re-vitalize the area as a new economic center in northeastern Seoul having amenities and cultural facilities and waterfront parks.

• 기본간호학회지
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• 제4권2호
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• pp.245-265
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• 1997

The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

• 벤처창업연구
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• 제18권2호
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• pp.67-79
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• 2023

이탈률은 사용자가 방문한 후 별다른 요청 없이 바로 이탈한 비율이며 본 연구를 통해 웹사이트의 어떤 속성이 이탈률에 영향을 미치는지 알아보고자 하였다. 웹사이트 평가항목은 선행연구를 통하여 다양한 업종의 벤처기업에 공통으로 적용할 수 있도록 사용성과 정보, 서비스상호작용, 기술 등 총 4가지 항목과 27개 평가속성으로 정의하였다. 연구 결과 이탈률에 영향을 미치는 웹사이트 속성은 판별분석과 의사결정나무분석에 의해 6개가 유의한 것으로 검증되었다. 본 연구를 통한 벤처기업 웹사이트의 이탈률을 줄이기 위한 제안은 다음과 같다. 첫째, 웹사이트의 경로명을 필수로 표시하고 풀다운 메뉴 기능을 추가하여 다른 페이지로의 이동이 용이하도록 한다. 둘째, 사용자의 관심을 끌 만한 핵심 콘텐츠를 배너 형태로 노출하고 서브 페이지에서도 내부링크 배너를 적재적소에 배치하는 것이 좋다. 셋째, 외부링크는 현재 페이지를 바로 이탈하지 않도록 새 창으로 연동하여 재유입이 가능하도록 해야 한다. 마지막으로 담당자 연락처와 상담기능은 고객과의 소통을 위한 직접 정보로서 노출이 권장되지만 개별 응대가 어려울 경우에는 상담기능만이라도 필수로 추가해야 한다. 이러한 제안들은 웹사이트의 개발과 운영, 마케팅 등 여러 분야에서 실무적으로 도움이 될 것으로 기대된다. 다만 특수한 경우에는 높은 이탈률이 정상적일 수도 있으므로 상황에 맞게 고려되어야 한다.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.89-92
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• 2011

Purpose: Electrical burn of scalp is uncommon. Much more, chronically exposed dura in unstable burn scar is quite exceptional. Hence, we report a case of chronically exposed dura following electrical burn. Methods: A 63-year-old man presented with an about 40 years history of an ulcerative lesion arising from electrical burn scar with 'squeeze like sensation' around wound. Wound was about $6{\times}8$ cm. Area in the center was $3{\times}3$ cm nonviable dura without sequestrum. Tangential excision with an intraoperative neurosurgical consultation and transposition flap under general anesthesia was done. Intraoperative biopsy was done. The wound was diagnosed as chronic osteomyelitis, not Marjolin ulcer. Flap was taken successfully. But after 5 days, infectious discharge had been appeared during 2 weeks, despite irrigation and drainage. As flap was re-evaluated, we could see remnant necrotic dura. After that, latissimus dorsi muscle free flap with meshed split thickness skin graft was transferred without excision of necrotic dura. Results: Flap was taken successfully. Follow-up at 10 weeks has been uneventful, with good and stable coverage of the wound. Conclusion: It is true that complete excision of devitalized tissue with sagittal sinus obliteration is prerequisite to flap taken. But necrotic dura was tangentially excised instead of total dura excision, because, posterior two-thirds of the sagittal sinus was involved underneath. Muscle is rich in blood vessels and decrease the recipient-site bacterial count effectively. In this case, muscle flap with skin graft without total dura excision is an alternative treatment.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2006년도 추계학술대회 논문집
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• pp.1029-1036
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• 2006

South and North Koreas are putting forth efforts to overcome the distrust and animosity of the past 50 years to open an era of harmony and cooperation where the two halves can work together for mutual benefits. As part of those efforts, both parties are working now to reconnect the railways between the North and the South that remained broken for the past 60 years. In addition, the restoration of Trans-Korean railway paves the way for the "Silk Road Railway" which links European continent to Asian regions and Pacific Rim. The restoration project acts as a conduit for cooperation within in the Northeast Asian continent, hence, an important tool for facilitating peace and prosperity within the Northeast Asian region. Notably, the Railway project is regarded as the cardinal future-oriented peace building project for cultivating constructive, cooperative relations (Trans-Korean Railway and Trans-Asian Railway works) by stimulating human resources and commodity flows through railroad transportations. Northeast Asian region takes on a similar instance to the unification of European continent through its astounding development in railroad transportation, i.e., the international re-construction of Railroad lines will act as a catalyst to link Eurasian areas into one regional community for cooperation and peace. At present, the government is creating a momentum to bind trans-Eurasian railroad works and an initiative for "Northeast Asia Railroad networks and consultative organization". The South Korean administration paves the way to develop railroad network within South-North Korean, Russia and Eurasian region. It also fosters railroad cooperation with China for people and goods transports. To achieve such objectives, the project requires wide publicity and cross-border cooperation from concerned countries. The blueprint would have to be drafted up for Northeast Asian railroad train demonstration runs, Northeast Asian transportation agreements, with a bid to promote constitute Northeast Asian Railroad Consultation body. Moreover, the government would also have to prepare both, a draft of the linkage and the mandated standardized proposal.

• 보건교육건강증진학회지
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• 제26권3호
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• pp.25-34
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• 2009

Objectives: This study has longitudinally analyzed male smokers in order to find out the trend rate of re-smoking after smoking cessation. Methods: The study was conducted with 800 male smokers who were provided with smoking cessation services for 3 years at public health centers from July 16, 2005 to July 15, 2008. Results: The results can be summarized as follows: First, the success rate of smoking cessation for at least 6 months during 3-year period was 54.4%. The failure rate of smoking cessation at the second year was 47.5% and the third 27.2%, which indicates that the failure rate diminishes as the period of smoking cessation extends. Second, the success rate of smoking cessation at the first trial was 35.0%, the second 24.3%, and the third 16.4%. The success rate diminished as the number of trial increased. Third, the continuation rate of smoking cessation for a year was 18.3%, for 2 years 13.4%. For the success group, the continuation rate of smoking cessation for a year was 52.5%, for 2 years 38.2%. For the failure group, the rate for a year was 21.5%. Fourth, in this longitudinal analysis, the most crucial variables that affect the success rate of smoking cessation are total number of consultation and the past experience of successful smoking cessation. Conclusion: This study shows that success of smoking cessation and the continuance of smoking cessation are both difficult, and that the past experience of smoking cessation plays an important role determining the present success of smoking cessation and continuance of smoking cessation. Thus, it is necessary to divide people into success group and failure group based on the results of the past experience of smoking cessation when they consult at smoking cessation clinics at public health centers. Further, in order to increase the continuation rate of smoking cessation, this study suggests that we need to consider ways to take care of those who successfully abstained from smoking for 6 months.