입원환자 간호관리료 차등제 도입이후 간호사 확보수준의 변화

조성현,전경자,김윤미,박보현 대한간호학회 간호행정학회 2008 간호행정학회지 Vol.14 No.2

Purpose: To examine the changes in nurse staffing in hospitals after implementing the policy of differentiating inpatient nursing fees by staffing grades. Method: The study sample included 43 tertiary hospitals, 185 general hospitals, and 282 non-general hospitals that were operating in both 1999 and 2008. Nurse staffing grade was categorized from Grade 1 (highest) to 6 (lowest) in 1999 or Grade 7 in 2008, based on the nurse-to-bed ratio. Results: Tertiary hospitals at Grade 3 and Grade 4 accounted for 49% and 35%, respectively, in 2008, whereas 63% were Grade 6 in 1999. General hospitals at Grade 6 decreased from 87% to 48%. In non-general hospitals, little change was found in the staffing distribution, in that 92% still remained in Grade 6 or 7 in 2008. Forty tertiary hospitals (93%) and 45% of general hospitals improved their staffing grades, while only 7% of non-general hospitals did. Greater likelihood of improvement in staffing grades was found in general hospitals located in metropolitan areas or having 250 or more beds. Conclusion: Elaboration of the financial incentive system is needed to increase the policy impact on staffing improvement.

메탄 연소 반응 특성에 대한 팔라듐 촉매의 금속 산화물 첨가와 이원금속촉매 형성효과

조성준,윤형기,강성규 全南大學校 觸媒硏究所 2003 觸媒硏究 論文集 Vol.24 No.-

Effect of metal oxide coating and bimetallization of the palladium metal catalyst on the reversible transformation during thermal cycling in the combution was investigated with extended X-ray absorption fine structure and X-ray absorption near edge structure (EXAFS/XANES). The transformation of PdO to Pd was altered to increase its temperature by ca. 100 K with the titania and zirconia metal oxide coating, suggesting the increase of the thermal stability. The different catalytic activities of the palladium catalyst in methane combution at increased and decreased temperatures were ascribed to the different structures of the active sites, PdO and Pd. The bimetallization of the palladium catalyst with platinum removed the difference in the catalytic activities when increasing and decreasing the tmeperature. The results of the data analysis of the EXAFS indicated the formation of the bimetallic nanoparticles in which the palladium core was covered with the secondly loaded platinum.

자궁내막암의 방사선치료 성적

김재성,김준상,조문준,박승호,노흥태,남상륜 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.1

Purpose : To evaluate survival rate, treatment failure pattern and complication of endometrial carcinoma patients treated with radiation therapy Materials and Methods : From November 1989 through March 1995, twenty two patients with endometrial carcinoma were treated with radiation therapy at Chungnam National University Hospital. According to the 1988 FIGO staging system, four patients had stage I A disease, 6 stage I B, 4 stage I C, 1 stage Ⅱ A, 6 stage Ⅲ A, and 1 stage Ⅲ B. Radiation therapy was given preoperatively to 2 patients, postoperatively to 19 patients, and curatively to one patient considered to be inoperable due to valvular heart disease. Twelve patients were treated with external radiation therapy alone by conventional technique (180-200 cGy/fraction), and 6 patients with external radiotherapy plus high dose rate intracavitary radiotherapy (HDR ICR), and 4 patients with HDR ICR alone. Results : All patients were followed up for 9 to 71 months (median 21 months). The overall 5 year survival rate of all patients was 68.9%. The 5 year survival rates of stage I , Ⅱ , and Ⅲ were 87.5%, 100%, and 41.6%, respectively. Relapse rate was 9.1% (2/22), and treatment failure occurred as a distant metastasis only without local failure. Early mild complication rate was 31.8% (7/22), and late complication rate 9.1% (2/22), including one radiation colitis and one vulvar ulcer. Conclusion : Adjuvant pelvic radiation thereapy is an effective local treatment modality to prevent local relapse in patients with endometrial carcinoma not accompanying severe late complications.

그린마케팅 정책과 전략 추진 방향에 관한 연구

박상준,조재립 경희대학교 2003 環境硏究 論文集 Vol.12 No.-

Today, CEOs and the managers of the marketing department seriously consider values, quality of life, and the public interest of the society. Moreover, they recognized the need for a systematic approach to harmonize the consumer's satisfaction with the living environment. Existing marketing policy and strategy tend to focus simply focused on the customer's needs. However the 'Green Marketing' is a new approach to concentrate the market by emphasizing on environmental protection and by maintaining the balance of the ecosystem. This policy and strategy will facilitate to penetrate into the consumers who are interested in environmental issues. In this study, we will diversify the policy and strategy of green marketing, based on the basic premise of integrating environment and economy. this policy and strategy will work toward building a sustainable society by preventing pollution, saving resources and encouraging citizen participation and cooperation. For the purpose of this research, existing foreign and domestic documents were utilized in term of the theoretical aspects of green marketing's and relevant cases were analyzed in a stepwise manner.

불응성 자가면역질환에서의 자가조혈모세포이식

민도준,양동원,민창기,김완욱,이상헌,박성환,김동욱,이종욱,조철수,민우성,김범생,김호연,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: 기존의 치료에 불응하고 예후가 불량한 자가면역질환 환자들에게 최근 고용량 면역억제 및 조혈모 세포이식이 새로운 치료방법으로 대두되고 있다. 저자들은 다발성 경화증(multiple sclerosis, MS) 및 류마티스 관절염(rheumatoid arthritis, RA) 등 2명의 자가면역질환 환자들에서 자가조혈모세포 이식을 시행하였다. 방법: 말초혈액 조혈모세포 가동화를 위하여 cyclophosphamide (4 g/㎡) 및 granulocyte colony stimulating factor (10 g/kg/day)를 투여하였고, CD34+ 세포를 분리·채집 하였다, 이식 전처치로 MS 환자에서 BEAM 및 antihymocyte globulin (ATG) (3.75 mg/kg), RA 환자에서 fludarabine (180 mg/㎡), ATG (10 mg/kg)와 busulfan (8 mg/kg)을 투여하였다. 결과: 호중구 수가 500/㎕ 이상으로 회복되는 기간은 MS 환자에서 9일, RA 환자에서 15일이었다. 혈소판이 20.000/㎕ 이상으로 회복되는 가간은 RA 환자에서 9일 이었고, MS 환자에서는 혈소판 감소증이 발생하지 않았다. 비혈액학적 독성으로 MS 환자에서 WHO 1도의 오심 및 점막염이 관찰되었다. MS 환자는 이식 6개월 후까지 시력감소가 남아있었으나, 이식전에 관찰되던 감각이상 및 운동장애 등의 신경학적 이상 소견은 더 이상 관찰되지 않았다. RA 환자는 이식 1개월 후 관절 증상 및 검사소견의 호전을 보였다. 결론: 불응성 자가면역질환 환자에서 고용량 면역억제 및 조혈모세포이식은 적은 독성으로 높은 치료효과를 기대할수 있으며, 향후 이 시술의 임상적 의의를 규명하기 위하여 전향적이고 장기적인 연구가 필요할 것으로 사료된다. Background: High-dose immunosuppressive therapy followed by autologous hemathpoietic stem cell transplantation (HSCT) has been proposed as a new approach to treat severe, refractory autoimmune diseases. We describe two patients with refractory autoimmune diseases (one multiple sclerosis 〔MS〕and one rheumatoid arthritis〔RA〕) who underwent T-cell-depleted autologous peripheral bleed stem cell transplantation for the first time in Korea. Methods: We mobilized autologous stem cells with cyclophisphamide (4 g/㎡) and granulocyte colony-stimulating factor (10 ㎍/kg/day). Stem cells were enriched ex vivo using CD34-positive immunoselection and reinfused after high-dose chemotherapy with BEAM and antithymocyte globulin (ATG) (3.75 mg/kg) in MS, or fludarabine (180 mg/㎡), ATG (10 mg/kg) and busulfan (8 mg/kg) in RA. Results: The engraftment with an absolute nerutrophil count greater than 500㎕ occurred on day 9 in MS and 15 in RA, respectively. The time to nontransfused platelet count greater than 2.000/㎕ was 9 day in RA. MS patient did not show ant episode of thrombocytopenia. Regimen-related non-hematopoietic toxicity was minimal. For 6 months since HSCT, them patient with MS had been free from previously existed sensory and motor abnormalities except decreased visual acuity. Then patient with RA and only one tender joint and two mildly swollen joints with improvement in laboratory parameters at one month after HSCT. Conclusion: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of intractable autoimmune diseases. The durability of remission, however, remains to be clarified.

타임 워핑을 지원하는 효율적인 서브시퀀스 매칭 기법

박상현,김상욱,조준서,이헌길 江原大學校 産業技術硏究所 2001 産業技術硏究 Vol.21 No.A

This paper discusses an index-based subsequence matching that supports time warping in large sequence databases. Time warping enables finding sequences with similar patterns even when they are of different lengths. In earlier work, we suggested an efficient method for whole matching under time warping. This method constructs a multidimensional index on a set of feature vectors, which are invariant to time warping, from data sequences. For filtering at feature space, it also applies a lower-bound function, which consistently underestimates the time warping distance as well as satisfies the triangular inequality. In this paper, we incorporate the prefix-querying approach based on sliding windows into the earlier approach. For indexing, we extract a feature vector from every subsequence inside a sliding window and construct a multi-dimensional index using a feature vector as indexing attributes. For query precessing, we perform a series of index searches using the feature vectors of qualifying query prefixes. Our approach provides effective and scalable subsequence matching even with a large volume of a database. We also prove that our approach does not incur false dismissal. To verily the superiority of our method, we perform extensive experiments. The results reseal that our method achieves significant speedup with real-world S&P 500 stock data and with very large synthetic data.

반복적인 실신 및 실신전환자의 기립경사 검사시 뇌혈류 변화

조수진,김준수,이광호,정진상,송희정,이상철,서정돈,이원로 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

백서의 복강내에 투여한 Mitomycin-C-Polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

송규상,강대영,최정목,노승무,정경수,오정연,김진향,양준목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

To evaluate the in-vivo effects of mitomycin-C-polyglycolic acid composite(MMC-PGA) the disk: shaped composite were implanted into the peritoneal cavity of the Sprague-Dawley rats. The pathologic changes were examined at various time points up to 12 weeks. Initially the soft tissue around the inserted disks showed capillary congestion at 3 days. Inflammatory infiltrates with foreign body giant cells appeared from the 2nd week and reached peak response at 6-8 weeks. These reaction diminished prominently at 12 weeks. No specific pathologic change was found in the liver, the kidneys, and the heart. The above results suggest that the MMC-PGA composite can serve as a new device for intraperitoneal chemotherapy of various types of cancers.

효율적인 서비스 품질 측정 방법에 관한 연구

박상준,조재립 慶熙大學校 레이저 工學硏究所 2003 레이저공학 Vol.14 No.-

As many organizations are searching for ways to compete more effectively in today′s market environment. Service quality is become the most important fact to improve their competition. The objectives of this paper are to provide an overview of service Quality and to discuss how to measure it more efficiently. This study develops a conceptual ″SERVPERF″ and ″SERVQUAL″ of service quality, which identifies only performance based measurement. And Fuzzy quality measuring (FQM) using Fuzzy rule based algorithm to adept survey to date sets is proposed. Furthermore, the study examines the applicability of Fuzzy rule based measurement.

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.