• 제목/요약/키워드: the accounting standard

검색결과 203건 처리시간 0.021초

호흡조절방사선치료를 위한 피부움직임과 종양움직임 차이 평가 (Evaluation of Difference between Skin Motion and Tumor Motion for Respiration Gated Radiotherapy)

  • 권경태;임상욱;박성호;권수일;신성수;이상욱;안승도;김종훈;최은경
    • 한국의학물리학회지:의학물리
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    • 제19권1호
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    • pp.14-20
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    • 2008
  • 본 연구는 호흡조절방사선치료(Respiration gated radiotherapy)를 위해 종양의 실제 움직임과 호흡조절감시장치로 측정한 피부움직임과의 차이를 분석하여 호흡조절방사선치료 시 발생 가능한 오차를 예측하고자 하였다. 호흡에 따른 종양의 움직임을 알아보기 위해 본원에서 2007년1월 10일부터 2월 28일까지 횡경막 주위의 종양 움직임이 큰 폐부위 환자8명, 복부부위 환자 2명에 대해 투시검사기와 호흡조절감시장치를 이용하여 종양의 움직임 영상 및 복부에 위치시킨 적외선 반사장치의 움직임을 측정하였으며, 이 두 측정값의 차이를 정량적으로 비교 평가하였다. 투시검사기에서 종양의 움직임은 $1.3{\sim}3.5cm$ 종축방향(craniocaudal direction)으로 측정되었으며, 호흡조절감시장치는 $0.43{\sim}2.19cm$ 종축방향(craniocaudal direction)의 움직임이 측정되었다. 두 측정값의 비는 $1.31{\sim}5.56$으로 나타났으며 정규화 한 두 값의 표준편차는 $0.08{\sim}0.87cm$ (평균 0.204 cm)로 나타났다. 위상차가 존재한 patient 3를 제외하면 평균 0.13 cm, 최대 0.23 cm의 차이를 보이고 있다. 호흡조절감시장치로 종양의 움직임을 예측할 경우 0.23 cm 차이 이내에서 잘 예측됨을 말 수 있었고, 이 결과로 호흡조절방사선치료 시 0.2cm 정도 오차범위 내에서 치료가 가능할 것으로 예측된다. 다만 위상차이가 있는 환자는 호흡조절방사선치료를 적용하지 않는 것이 바람직하다고 생각된다.

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신갈호의 어류군집 특징 및 어구별 채집 효과 분석 (Fish Community Characteristics and the Influence of Fish Sampling Gears in Lake Singal, South Korea)

  • 고명훈;한미숙;최광식;곽인실;박영석
    • 한국환경생태학회지
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    • 제38권3호
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    • pp.263-276
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    • 2024
  • 신갈호의 어류군집 특징 및 어구별 채집 효과를 밝히기 위해 2020년 8월부터 2021년 10월까지 조사를 실시하였다. 채집 어구는 호소에서 일반적으로 사용되고 있는 족대와 투망, 자망, 정치망을 사용하였다. 조사결과, 조사기간 동안 채집된 어류는 7과 18종 3,501개체, 생체량 117,670g이었다. 개체수비 우점종은 참붕어(Pseudorasbora parva, 29.9%), 아우점종은 피라미(Zacco platypus, 25.1%), 다음으로 배스(Micropterus salmoides, 19.3%), 붕어(Carassius auratus, 9.1%), 밀어(Rhinogobius brunneus, 6.1%), 블루길(Lepomis macrochirus, 4.2%) 등의 순으로 우세하였으며, 생체량비 우점종은 붕어(45.1%), 아우점종은 잉어(Cyprinus carpio, 17.4%), 그 다음으로 배스(14.3%), 피라미(7.7%), 떡붕어(C. cuvieri, 7.4%), 참붕어(3.9%) 등의 순으로 우세하였다. 출현종 중 한국고유종은 몰개(Squalidus japonicus coreanus), 점줄종개(Cobitis nalbanti), 얼록동사리(Odontobutis interrupta) 3종이었으며, 외래어종은 배스, 블루길, 떡붕어, 향어(Cyprinus carpio nudus type) 4종으로 이중 배스와 블루길은 생태계교란 생물로 지정된 종이다. 주요종의 평균 체장과 체중을 조사한 결과, 우점종인 참붕어는 체장 60±24.1mm, 체중 4.4±3.42g이었고, 아우점종인 피라미는 체장 82±17.6mm, 체중 10.4±7.27g, 우세종 배스는 체장 96±25.1mm, 체중 24.9±96.02g, 붕어는 체장 125±77.3mm, 체중 168±336.5g이었다. 어구별 조사결과, 족대로 채집된 어류는 3과 8종 302개체 생체량 1,269g, 투망으로 채집된 어류는 4과 11종 948개체 생체량 31,343g, 자망으로 채집된 어류는 4과 13종 682개체 생체량 69,695g, 정치망으로 채집된 어류는 7과 15종 1,569개체, 생체량 15,362g으로 나타났다. 어구별 조사결과를 요약하면, 정치망은 종수와 개체수가, 삼중자망은 생체량이 가장 많았으며, 투망은 연안지대의 종수와 개체수를 채집하는데 강점이 있었으며, 족대는 종수와 개체수, 생체량 모두 가장 적었으나 연안지대의 저서성 소형어류를 채집하는데 강점을 보였다.

일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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