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ABSTRACT A Study on Folkloristics Method in Yeonam's Literature Kim, Su-hyun Advisor : Prof. Kim Su-jung, Ph.D. Department of Korean Language and Literature Graduate School of Chosun University Yeonam Park Ji-won is a literary person who mainly dealt with the life of the public although he was a high official. Being aware of the age when the people are in the middle of history, he expressed his interest in folk life through various kinds of writing including novels. Therefore, it is important in approaching to its nature to analyse his literature in the perspective of folklore. However, there have been only a few studies that analysed his literature through folklore because the study of folklore was formed by western society later than the age of Yeonam, and it was perceived that his pragmatic efforts were differentiated from the subjects for research on folk. Therefore, this study accepted the suggestion on practical science of the last Joseon worked for birth of Korean folklore and connected folklore development of western society with that of Japan to overcome the problems in the perspective that pursuit of pragmatism for the public reflected ethnicity. Specifically, the analyses of Yeonam's literature in the perspective of folklore are divided into three parts: manners and customs, folk art and food, clothing and shelter. For manners and customs, Yeonam tried to understand the meaning through acceptance and criticism of folk rather than he just introduced customs. Customs and manners are social habits and a kind of public morals to emphasize the meaning of changes rather than folk. Yeonam recorded our peculiar customs leaning to Chinese culture and successfully poured literary efforts to promote customs of Joseon. His attitude to folklore was active in saying, narratives and folk songs. The most remarkable thing is that he used a number of proverbs in his initial novels and in Yeolhailgi, a travel sketch, he used proverbs in Chinese characters for parodic effect. Being aware of the importance of folk narratives, he used long poetry to narratives to emphasize the nature of folk. In travel sketches, he collected narratives of the country, arranged them properly, and even borrowed stories on foundation of temples. Such attempt has an experimental meaning in that it was written in the period when changes in narratives were active as Pansori was formed. Yeonam recognized the value of performance art and recorded activities of Jeonkisoo of Joseon and Seolseoin of China very impressively. Even, he imposed social values to them by identifying conjuring tricks which were considered as cheating as a performance art. Meanwhile, he configurated landscape of the country in folk painting to imply the consciousness of the public. It was also artistic work based on folk. Most of his Chinese poetry represented sceneries of simple rural houses vividly like a painting and is reminiscent of folk painting which was active at that time. His prose is characterized by the painting technique of oriental painting, which indicates that his literature maintains the nature of painting. The life of food, clothing and shelter is represented everywhere in Yeonam's literature. In respect to clothing life, he presented the conditions of attire system and how to improve it. He compared Korean clothing life to Chinese, emphasizing that clothing life should be practical. Although the clothing of the masses was not described specifically in his writings, it directly showed that it was very poor and the masses were nearly barefoot. He was active in presenting problems and how to overcome them. It was recorded that he tried to distribute dyed cotton instead of silk. He considered hot pepper paste, soy paste, soy sauce and jerky as important and showed interests in favorite food such as cigarette and liquor. However, he never praised them unconditionally and was very sensible. He was actively engaged in developing medicines and recommended them. It is his literary characteristics and humanism shown in food life. His pragmatic spirit was reflected in real life through improved shelter life. He suggested that bricks and roof tiles should be used with confidence in their practical nature, and described Ondol, a Korean heating system, specifically. Yeonam observed Kang, a heating system of China, closely and judged that it is better than Ondol. Instead of advocating Chinese methods unconditionally, he presented specific premises that the method of installing a Korean underfloor heating system should be changed for better heating system, and possibilities to overcome problems of Ondol through use of bricks. His pioneering attitude towards improved shelter life was represented in his literature based on his pragmatic spirit. To examine Yeonam's literature based on the results above, there is a certain limit along with positive meaning in it. The biggest meaning is that folk base is spread in his entire literature and he did not forgive an idle attitude that the past was considered as extant cultural phenomenon. He presented appropriate criticism or directions of changes while faithfully reflecting future-oriented meaning of folk. However, there are the limits in his attitude in that his perspective was one-sided, he dealt with customs while reflecting his high position and mentioned life and culture of the public only with Chinese, not knowing Korean, characters of the masses. As a result of analysing his literature in the perspective of folklore, it was discovered that his literature pursued for practical modernity and was connected with folklore to be created later. Yeonam was a noble with consciousness of learned man, but recognized the value of folk melted in the life of the masses and tried to accept it in his literary world.
The multilateral trade negotiations (GATT, UR negotiations) and such as is promoted Doha Development Agenda (DDA) and the free trade agreement (FTA), the weakening of family farming has been accelerated by the aging of agriculture human resources function and cooperation and the role of agricultural corporation management that is based on the solidarity of family farming at the moment are increasingly expanding. However, as the management agency of agriculture, by the importance of agricultural corporation is raised, the improvement plan derivation is also important. One of the agricultural corporation major problem can be said bad management. The survey results of the agricultural corporation of the 2013 criteria was carried out, out of the corporation ten thousand 4301 companies, and is applicable to the corporation about 67% has been unhealthy after establishment. By recognizing the agricultural corporation registered as a means for the benefit of the support funds, abnormal cases that the expression management to establish a corporation for the purpose of funding the benefit itself is occurring. It is a situation that requires a thorough post-measures for the corporation, which is operated by such illegal-expedient. For this purpose, it is necessary to grasp by classifying each business segment, type of agricultural corporation that has the other management system of agriculture corporation. Because of the stability of the agricultural corporation more than anything else, efficiency on and inefficient agricultural corporation of the business conditions as well as benchmarking the efficient agricultural corporation by analyzing the factors that affect the efficiency in relation to the calculation in the analysis it is important to improve. In such a context, South Jeolla Province by agricultural company corporation 572 companies the DEA model to the subject of this study to type another business, to estimate the efficiency of the technology, efficiency of scale, the efficiency of the value of the pure technology presenting the basic materials to seek management improvement measures of agriculture company corporation, but there is its purpose. Therefore, the present paper is to understand the agricultural corporation using the Research and Statistics of the source material (2013 criteria), agricultural corporation of the efficiency of the agriculture company corporation of all southern region to another type, the basis for organizing agricultural company corporation efficiency of technology, efficiency of scale, the management improvement plan through the estimated difference of efficiency in and inefficient agriculture company corporation the efficiency of pure technology. In addition, the Jeonnam average and type another management efficiency of the business of agriculture company corporation of South Jeolla region tries to quantitative analysis by the method of the DEA, this point, has been the difference between a conventional research. 1. Refer to original article in the agricultural corporation survey of the National Statistical Office (2013 standard), it was all South regional agriculture company corporation 572 pieces of analysis. As an output variable is sales and Input costs is the number of employees, cost of sales, selling, general and administrative expenses, other expenses, was a non-operating expenses. Method of statistical processing, utilizing Deap2.1 by the DEA model. 2. 10 years of 2003 to 2013, agricultural corporation business was a tendency to increase. Agricultural corporation business in 2013 at the 2003 ratio that increased 151.4%. Agriculture company corporation has increased year-on-year 27.1 percent in 3,760 pieces. 3. Analyze the agricultural corporation by type of business, agricultural production (4,123 units), retail industry (3,655 pieces), processor (2,762 pieces), has become the order of the agricultural service industry (1,565 pieces). Compared to the previous year (2012), agricultural production increased by 8.4 percent, processor, distribution industry, agriculture, 26.6% respectively the service sector, 21.3 percent, was increased significantly and 30.7%. Looking at the agricultural production income of agricultural corporation, agricultural production import growth rate of the agriculture company corporation (28.5%) was higher as compared to the farming union corporation (7.8%). 4. When taking a look at the distribution of efficiency values for Jeollanam-do agricultural corporation, the number of effective agricultural corporation with the value of 1 among 572 Jeollanam-do agricultural corporation was 22 in technical efficiency(3.85%), 367 in pure technical efficiency(64.16%), and 25 in size efficiency(4.37%). In the meanwhile, the number of inefficient rice farm households under the value of 1 was 96.15% in the technical efficiency, 35.84% in the pure technical, 95.63% in size efficiency. 5. The economic efficiency analysis of the size of agricultural corporation can be made through one of the DEA models called Lamda value(λ) of technical efficiency model. When looking at the returns to scale of agricultural corporation, agricultural corporation was rated with 77.45% in IRS(Increasing Returns to Scale). For CRS(Constant Returns to Scale), was rated with 5.77%%. For DRS(Decreasing Returns to Scale), was rated with 16.78%. Against this backdrop, agricultural corporation which are in IRS are recommended to put effort in increasing yields to gain technical efficiency and improve size inefficiency when considering that the increase rate of yields is higher than that of increase in input. In the meanwhile, agricultural corporation which are in DRS are recommended to put effort in decreasing input factors to gain technical efficiency and improve size inefficiency when considering that the increase rate of yields is lower than that of increase in input.
Objectives: The research is aimed at identifying the necessity of the support project of Korean medical treatment in infertility by analyzing the outcome of those subject and providing data for Korean medical treatment in infertility by analyzing the medical treatment of Korean medical doctors involved in the project. Methods: 98 patients who participated in the support project of Korean medical treatment in infertility in Jeollanamdo and 57 Korean medical doctors who participated as therapists were surveyed. Patients were given four months of treatment at local Korean medical clinics and they were contacted by text messages to answer whether they were pregnant or not. After the treatment was completed, we analyzed the characteristics of the patients' group. And we sent questionnaires to doctors to answer the message. The content of the questionnaire consisted of infertility treatments, a degree of satisfaction with results, a wish for support project. These datas were analyzed by frequency, t-test, ANOVA, Multiple comparison with SPSS windows 22.0. Results: Analysis of the answer to the questionnaire obtained datas on Korean medical treatment in infertility. Most of the name of disease in western medicine and Korean medicine diagnosis devices were used by groups with less than five years of clinical careers. Also Chuna's effect was most expected by groups with less than five years of clinical careers. When asked about symptoms that must be treated for pregnancy, most of the answers were menstrual-related symptoms, coldness of hands, feet and lower abdomen, and obesity. The most important part of the effort for pregnancy was not to be stressed. The most desired thing for future support program was the introduction of husband and wife care. Conclusions: This survey by Korean medical doctors gave us reference datas for Korean medical treatment in infertility and the direction in which therapy business business should proceed.
RAGE Mac-1(αMβ2)과 결합한다는 것이 보고 되었고, RAGE와 αXβ2의 결합 특성이 조사되어 있지 않다. 이 연구에서는 αXβ2 및 αMβ2와 RAGE와의 결합 특성을 알아보고자, GST-αX I-domain 및 GST-αM I-domain을 이용해 RAGE와의 결합 여부를 확인하였고, 나아가 RAGE와의 결합에 관여하는 αX I-domain 상의 loop 및 잔기를 확인하기 위해서, αX I-domain의 점돌연변이 단백질들을 이용하여 그 결합 양상을 확인하였다. 또한 이가 양이온(cation)에 의한 RAGE와 αX I-domain의 결합 활성 정도를 비교해보았다. 이전의 Mac-1 의 I 도메인 연구에 의하면 리간드가 결합하는 부위는 주로 양으로 하전 되거나 극성 아미노 잔기에 의하여 결합이 이루어지는 것으로 나타났다. CD11 a, b, c에서 아미노산 서열은 큰 차이를 보이지만, I 도메인의 3차 구조는 매우 유사한 것으로 판명되었다. 이를 근거로 그리고 Mac-1 의 I 도메인 연구 결과를 유추하여 각 루프의 극성 잔기나 하전된 잔기를 비극성 아미노산 또는 알라닌(Alanine)으로 치환하였다. 또한 I 도메인을 가지고 있지만 피브리노겐과는 전혀 붙지 않는 α2αL I 도메인 아미노산 서열을 참고하여 제작하였다. α3β4 루프의 H201, Q202와 βDα5 루프의 E244, D249, Y250이 RAGE와 잘 결합하지 않았으나 오히려 α3α4 루프의 S199, βDα5 루프의 K251와 βFα7 루프에서는 ED298/299는 잘 결합했다. 특히 같은 α3α4에 존재하는 점돌연변이인 S199와 H201, Q202의 결합을 비교하면 세린(S)과 글루타민(Q) 모두가 극성 비전하 그룹의 아미노산임에도 불구하고 결합 정도에서 상당한 차이를 보였다. 이것은 H201, Q202가 특별히 RAGE 인지에 관여하고 있음을 추측케 한다. D249와 Y250, E244도 아스파르트산(D)과 티로신(Y), 글루탐산(E) 모두가 음으로 하전된 아미노산임에도 RAGE와의 결합에서 차이를 보여 E244, D244 Y250, K251, D252는 RAGE인지에 관여하고 K242, K243은 인지에 관여하지 않음을 추측케 한다. 게다가 같은 α3α4, βDα5 루프일지라도 아미노산 잔기들이 리간드 결합에 기여하는 바가 다름을 시사한다. αXβ2는 여러 리간드와 결합을 하는데, 어떻게 이런 multi ligand와 결합하는지 그 분자 수준에서의 이유는 밝혀지지 않았다. 지금까지의 학계의 통설은 I 도메인에서 겹쳐지기는 하지만 조금씩 다른 부위가 합쳐져서(overlapping not identical) 여러 리간드를 인식한다는 것이다(Valentin, et al., 2002; Valentin and Yakubenko, 2002). αX I-domain에서 plasminogen과 결합할 때 βDα5 loop가 중요하며, Thy-1의 경우는 α3α4 및 βDα5가 중요하고, RAGE의 경우는 마찬가지로 α3α4, βDα5가 중요하다. βDα5 loop에서도 Y250, D249가 Thy-1 결합에 중요하고, plasminogen 결합에는 K242, K243이 중요하다는 것이 밝혀졌는데, RAGE의 경우는 E244, D249, Y250이 중요하다는 것이 이번 실험으로 밝혀졌다. 이 실험 결과는 기존의 연구 결과와 달리 음으로 하전된 아미노산이 중요하고 그 사이 양으로 하전된 아미노산(K251)이 조절기능을 갖는 것으로 보인다. 이것은 RAGE상의 + 하전된 아미노산이 결합우위임을 예상하게 하여 이것은 추후 실험을 통해 확인될 수 있을 것이다. 리간드와 인테그린 결합 특성 연구는 생물학적으로 인테그린이 어떻게 리간드를 인식해서 세포 내로 신호를 전달하고, 세포의 이동, 분화 및 독특한 반응을 유발하게 하는가 하는 정보를 제공해 줄 뿐 아니라 의학적으로도 중요한 의미를 지니고 있다. 리간드 수용체 결합을 억제하면, 특히 인테그린과 ECM과의 결합을 억제하면, 백혈구가 과도하게 조직 내로 들어와 생기는 병리현상을 막을 수 있기 때문이다.
한국은 2009년 11월 25일 OECD DAC의 24번째 회원국으로 승인되면서 원조 공여국으로 활동해 왔으며, 2017년부터는 외교의 대표적 방법으로 ODA 분야에 역점을 두고 시행해 왔다. 원조 공여국 활동 10년차로 접어든 2019년에는 개발도상국의 지위마저 완전히 벗어나기에 이르렀다. 이러한 경험 속에서 한국 정부의 ODA 사업은 계속 확대되었고 보건의료 분야는 교통 분야에 이어 두 번째 규모로 비중이 높아졌다. 이에 본 연구에서는 보건의료 ODA 사업을 쌍방향적인 (신)공공외교의 수단으로 인식하고 그 성과를 학문적으로 규명하고자 하였다. 사업 성과 분석을 위해 OECD DAC의 5대 평가 기준과 보건의료 ODA 분야의 공공외교 지표 및 성과지표를 원용하여 새로운 분석 틀을 고안하였다. 이 평가틀을 미국과 한국의 보건의료 ODA 사업 사례에 적용하여 공공외교와 소프트 파워 증진의 측면에서 분석하였다. 미국의 경우 미국국제개발처(USAID)에서 수행한 캄보디아, 케냐, 우즈베키스탄의 사업을, 한국의 경우는 한국국제보건의료재단(KOFIH)에서 수행한 라오스, 캄보디아, 우즈베키스탄의 사업을 분석 대상으로 삼았다. 미국과 한국의 보건의료 ODA 사업을 분석한 결과 각국의 사업상의 특징도 확인해볼 수 있었다. 사업의 영역과 추진 방식에서 미국과 한국은 양자간 원조방식을 취하고 있는데, 미국은 보건의료의 전 영역에 걸쳐서 사업을 추진하고 국내외의 다양한 기관들과 협력하는 방식으로 수행해 왔다. 한국은 모자보건 등의 영역과 인력 교육에 중점을 두고 KOFIH와 KOICA 중심으로 수행하는 특징이 있다. 양국의 특징은 장점과 단점으로 평가할 수 있는 것이 아니고 상대적인 특수성으로 이해해야 한다. 다만 사업의 효과를 위해 상호 벤치마킹할 필요성이 있다. 본 연구에서는 공공외교의 수단으로서 보건의료 ODA가 활용될 수 있음을 확인한 결과 보건의료 ODA를 공공외교의 관점으로 이해해야 하며, 역으로 공공외교적인 시각으로 보건의료 ODA 프로그램을 기획해야 한다는 것도 자연스럽게 도출하였다. 공여국의 정부 기관이 주체가 되더라도 자원봉사자를 선발하여 SNS와 미디어를 활용한 소통 채널을 만드는 것, 보건의료 ODA 사업의 컨트롤 센터를 수원국에 건립하는 것, 다양한 인적 교류를 추진하는 것 등을 세부 사항으로 제시했다. 향후에 지향하는 (신)공공외교는 하드 파워와 소프트 파워를 적절히 결합한 스마트 파워를 활용한 쌍방향적 소통을 목적으로 한다. 보건의료 분야의 특성상 전문 인력과 기기 및 시설, 막대한 재원이 필요하여 민간이 주체가 되기는 어려울 수 있겠지만 정부 이니셔티브에서 더 발전한 정부-민관 협력 이니셔티브를 지향할 수 있을 것이다. On November 25, 2009, South Korea was approved as the 24th member of the Organization for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC). Since then, Korea has been actively engaged in aid activities as a donor country. It has also focused on the Official Development Assistance (ODA) sector as one of its representative methods of national diplomacy starting in 2017. In 2019, when the country entered its 10th year of activities as a donor country, even the status of developing countries has reached its full extinction. The South Korean government's ODA business has since continued to expand, with the health and medical sector becoming the second-largest sector after transportation. In this study, the Health ODA project is recognized as a means of interactive (new) public diplomacy and its achievements are identified academically. To analyze the Health ODA’s business performance, a new framework was devised by citing the five evaluation criteria of the OECD DAC and public diplomacy and performance indicators in the Health ODA sector. This evaluation framework was applied to the Health ODA business in the cases of the U.S. and Korea, which were then analyzed in terms of public diplomacy and soft power enhancement. Specifically, projects in Cambodia, Kenya, and Uzbekistan conducted by the U.S. Agency for International Development (USAID) and projects in Laos, Cambodia, and Uzbekistan conducted by the Korea Foundation for International Health (KOFIH) were subjected to analysis. The two countries’ characteristics should be understood as their relative specialties, rather than as merits or demerits. However, there is a need to benchmark each other in terms of the projects’ effects. Ultimately, this study confirms that Health ODA can be used as a means of public diplomacy and, moreover, that the Health ODA program should be planned from a public diplomacy perspective. In the future, (new) public diplomacy must aim towards interactive communication using smart power that combines both hard and soft power appropriately. While the nature of the health care sector makes it difficult for the private sector to become the main player—mostly due to the need for professional personnel, devices, facilities, and huge resources—it will be possible to pursue more advanced government-private partnership initiatives taking government initiatives as a starting point.
(Abstract) Background and purpose: Patients in hospital usually have a high risk of malnutrition. Without proper nutritional care, malnutrition delays the therapy process and can potentially lead to more severe complications as well as an increase in mortality rates during the hospital stay. A nutrition support team (NST) is a multi-professional team composed of physicians, nurses, pharmacists, and dietitians, whose main task is to ensure and promote proper nutrition for admitted patients. Despite the potential benefits, the effects of timely nutrition support on the nutritional status of admitted patients are not well established. This study aimed to assess the effect of the timing of NST nutritional support initiation on the nutritional status of enteral nutrition patients. Methods: Electronic medical records were retrospectively reviewed for 280 adult patients who received enteral nutrition for more than 3 days, and were referred to NST at Daegu Fatima Hospital between January 2017 and August 2018. Patients were divided into two groups: an early NST intervention group for patients referred to NST within 3 days of admission and a delayed NST intervention group for patients referred to NST after 4 days or more post-admission. Energy intake ratio, duration of tube feeding, changes in biochemical indicators related to patient nutritional status, days of hospital stay, and distribution of malnutrition were evaluated and compared between the two groups. Results: At the time of hospital admission, patients in the early NST intervention group were older on average and had fewer tube feeding-periods compared to the patients in the delayed NST intervention group. Overall, the early NST intervention group had shorter hospital stays than the delayed NST group. After NST intervention, the increase in the amount of patient’s energy intake and energy supply ratio from the first to last NST intervention was 147.3 kcal in female patients in the early NST intervention group, higher than that in female patients in the delayed NST intervention group (p =0.042). In male patients, the extent of reduction in serum albumin and hemoglobin levels between the initial and last NST intervention were significantly lower in the early NST intervention group than in the delayed NST group. In male patients, the odds ratio for patients who had malnutrition in the early NST intervention group was 0.217 (95% CI: 0.064~0.732), relative to those in the delayed NST intervention group after adjustment for hospital stay and age. In female patients, this odds ratio tended to decrease to 0.244 relative to the delayed NST intervention group (95% CI: 0.051~1.162). Conclusion: The results of this study indicate that early NST intervention may improve patients’ overall nutritional status. Sex differences in response to NST intervention need to be characterized further, and the results obtained here need to be further examined in a study with a large cohort to find those that are relevant towards developing a guideline of NST intervention. (초 록) 입원환자의 대부분은 영양불량의 위험이 높고, 이들에 대한 영양불량 관리가 제대로 이루어지지 않으면 환자의 치료 과정을 지연시키고 병원 재원기간을 길게 하며 합병증 및 사망률이 증가하게 된다. 영양집중지원팀(Nutrition support team, NST)은 의사, 간호사, 약사, 임상영양사 등으로 구성된 다 직종간 협력 체계이다. NST는 환자의 영양상태를 판정하고 환자의 상태를 개선시킬 수 있는 영양소 필요량을 파악하여 환자의 담당 의사가 적절한 영양 처방을 할 수 있도록 자문하는 역할을 한다. 본 연구의 목적은 NST의 영양관리 대상이 되는 환자들의 내원 특성, 영양지원 관련 특성, 재원기간 분포, 영양상태 분포를 환자의 성별로 구분하여 파악하고, NST 협진 조기 의뢰 여부에 따른 환자들의 영양상태 개선효과를 조사하는 것이었다. 본 연구는 후향적 연구로 2017년 1월부터 2018년 8월까지 대구 시내 모 종합병원에 내원한 환자 중 전문의에 의해 NST 협진 의뢰된 환자 280명을 대상으로 NST 조기 의뢰군(입원 3일 이내 협진 의뢰된 환자)과 NST 지연 의뢰군(입원 4일 이후 협진 의뢰된 환자)으로 분류하고, 성별로 구분하여 내원 특성, 신체계측, 생화학적 지표와 영양상태를 비교하였다. 연구 결과 남성과 여성 환자 모두 NST 조기 의뢰군이 NST 지연 의뢰군에 비하여 병원 재원기간이 유의하게 짧았다. 남성 환자의 경우 NST 조기 의뢰군은 NST 지연 의뢰군에 비하여 입원 시보다 퇴원 시 혈청 알부민(p=0.042)과 혈색소(p=0.045)의 감소폭이 적었다. 여성 환자는 NST 조기 의뢰군이 NST 지연 의뢰군에 비하여 퇴원 시 필요 에너지 대비 경장영양을 통한 에너지 공급률이 높았으며(p=0.002), 입원 시에 비하여 퇴원 시 총 림프구 수 변화가 증가하는 경향을 보였다. 환자의 재원 일수와 나이를 보정 후 퇴원 시 중증 이상 영양불량에 처할 오즈비(Odds ratio, OR)를 분석한 결과 남성 환자의 경우 NST 조기 의뢰군은 NST 지연 의뢰군보다 퇴원 시 중증 이상 영양불량에 처할 상대적 오즈비가 0.217(95% CI: 0.064~0.732)로 NST 조기 의뢰군이 NST 지연 의뢰군에 비하여 중증 이상 영양불량 발생 위험이 감소하였다. 여성 환자도 NST 조기 의뢰군이 NST 지연 의뢰군에 비해 중증 이상 영양불량 발생 위험이 감소하는 경향을 보였다(OR 0.244, 95% CI: 0.051~1.162). 이러한 결과들을 통해 NST 조기 협진 의뢰가 환자들의 영양상태에 긍정적인 변화에 기여함을 알 수 있었다. 본 연구를 통해 NST 조기 중재가 환자의 재원 일수를 감소시키고, 영양상태 관련 생화학적 지표와 영양불량 위험을 개선함을 알 수 있었다. 성별에 따른 결과 차이에 대해서는 향후 추가 연구가 필요할 것으로 판단된다. 본 연구의 결과는 NST를 구성하는 각 분야의 전문가들과 의료 서비스를 받는 환자들이 NST 협진 의뢰의 필요성 및 중요성에 대한 인식을 강화하고, NST 영양관리의 효율성을 제고하는데 기여할 수 있을 것으로 생각된다.
Many radionuclides emit multiple gamma rays or X-rays when they decay into their ground states. If two or more gamma rays (or a gamma ray and an X-ray) which are emitted in a cascade from an excited nucleus, the detector can not distinguish them and considers them as a single event because they are detected within the resolution time of the detector. As a result of them, the energy that transferred to the detector becomes the sum of the multiple events. This is known as “Cascade” or “True Coincidence” summing effect. It causes the inaccurate count rate and the erroneous results in data analysis. To date, many sophisticated efforts have been done for correcting the cascade summing-effect in HPGe detectors. The well-known methods are the Monte Carlo Simulation for the source geometry and the Peak-to-Total correction using singlet sources. In this study, We calibrated for the HPGe detectors with different efficiencies by using the reference materials that are certified by Korea Research Institute of Standards Science(KRISS). Also, we corrected the efficiency by using the KCl solution in order to correct the problem of efficiency undervaluation occurring in the energy range above 661.66 keV because of the cascade summing effect of 60Co and 88Y. In order to confirm the deviation due to the efficiency and cascade summing effect, we measured the samples for 80,000 seconds and we have identified how much the nuclide, 60Co, 134Cs and 152Eu are evaluated according to the energy range. As a result, CANBERRA’s 30% has affected by cascade summing effect a 60Co of less than 1 %, 134Cs of 12.5 %, 152Eu of 3.83 % and 40% has a 60Co of 3.33 %, 134Cs of 14.3 %, 152Eu of 7.88 %. Also, ORTEC’s 30% has a 60Co of 3.39 %, 134Cs of 14.0 %, 152Eu of 7.95 % and 40% has a 60Co of 6.48 %, 134Cs of 15.7 %, 152Eu of 9.46 %. In conclusion, we corrected peak efficiency by using 40K as a natural radionuclide and evaluated the cascade summing effect of 450mL Marinelli beaker for the HPGe detectors with different efficiency through a cross analysis sample of Korea Institute of Nuclear Safety(KINS). This method is a easier and simpler than other methods, and saves cost and time.