우리나라 시 · 군 · 구 지역보건의료계획의 비전(Vision) 문구 분석

안치영(Chi-Young Ahn),김현수(Hyun-Soo Kim),김원빈(Won-bin Kim),오창훈(Chang-hoon Oh),홍지영(Jee-Young Hong),김은영(Eun-Young Kim),이무식(Moo-Sik Lee) 한국농촌의학 지역보건학회 2017 농촌의학·지역보건 Vol.42 No.1

지역보건의료계획서에서 비전은 각 지역의 보건의료계획을 나타내는 핵심요소임에도 불구하고 작성방법에 대한 구체적인 지침이 부재하여 각 지역의 비전은 매우 다양하게 표현되어 있다. 이에 이 연구에서는 제6기 지역보건의료계획에서 제시한 비전 문구를 보건소 유형별, 권역별로 분석하였다. 전국 229개 지역의 제6기 지역보건의료계획서의 비전 문구와 이와 관련된 미션, 전략체계도, 중장기 추진과제 등을 대상으로 하였다. 지역을 권역별 4개, 읍·면·동 구성에 따른 보건소 유형을 4개로 분류하였고, 각 지역 비전의 글자 수, 문장 평가, 단어 빈도, 문구 평가를 빈도분석과 카이제곱검정, 일원배치분산분석을 이용하여 분석하였다. 비전의 글자 수가 17자 이하인 보건소가 172개소(75.1%)였고, 보건소 유형별로 유의한 차이가 있었다(p<0.05). 문구에 대한 수사표현에서 비유법(37.1%)이, 한글 외에 표현 언어 사용에서는 특수문자(43.2%)가 많았으며, 보건소 유형별로 유의한 차이가 있었다(p<0.01). 비전에 사용된 단어들은 ‘건강’, ‘행복’, ‘함께’, ‘군민’ 또는 ‘시민’, ‘도시’, ‘100세’ 등이었다. 문구평가 점수에서는 특·광역시 및 수도권에서 가장 높았으며, 보건소 유형 및 권역별로 유의한 차이를 보였다(p<0.05). 보건소 유형별로 과정 및 평가 영역, 공유가능성 등에서 유의한 차이가 있었다(p<0.01). 방향성은 충청권, 수도권 순으로 권역별로 유의한 차이가 있었으며(p<0.01), 미래지향성 및 공유가능성은 영남권이 가장 높아 권역별로 유의한 차이가 있었다(p<0.01). 비전은 지역보건의료계획에 가장 중요 요소 중 하나이다. 이 연구는 지역사회 특성별로 비전의 설정이 다름을 확인하였으며, 이러한 결과를 통하여 지역보건의료계획 등 보건소 비전 수립시 참고가 될 수 있는 기초적인 자료가 될 것으로 판단된다. Objectives: In this study, we analyzed vision statements of the 6th community health plan of local government in Korea. Methods: We examined vision statements letters, missions and strategy plans, and long-term missions of 6th community health plans of 229 local government in Korea. We also analyzed the numbers of vision letters, sentence examination, word frequency, each vision statement with frequency analysis, chi-square test, and one-way ANOVA. Results: Among 229 local government, 172(75.1%) of local government had the number of letters (Korean) less than 17 of vision statements, and there were a significant differences according to type of community health centers (p<0.05). Figuration (37.1%) were the most used in an expression of vision statement sentence, and special characters (43.2%) were the most used language except Korean. The most commonly used words of vision statement in order of frequency were ‘health’, ‘happiness’, ‘with’, ‘citizen’, ‘city’, ‘100 years old’ etc. Chungcheong provinces and Daejeon metropolitan city had a highest score in directionality on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Gyeongsang provinces, Ulsan, Daegu, and Busan metropolitan cities had a highest score in future orientation and sharing possibilities on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Conclusions: Vision is one of the most important component of community health plan. We need more detailed ‘vision statement guideline’ and the community health care centers of local government should effort to make more clear and complete their vision.

Correction: Rewritable full-color computer-generated holograms based on color-selective diffractive optical components including phase-change materials

Hwang, Chi-Young,Kim, Gi Heon,Yang, Jong-Heon,Hwang, Chi-Sun,Cho, Seong M.,Lee, Won-Jae,Pi, Jae-Eun,Choi, Ji Hun,Choi, Kyunghee,Kim, Hee-Ok,Lee, Seung-Yeol,Kim, Yong-Hae The Royal Society of Chemistry 2018 Nanoscale Vol.10 No.47

<P>Correction for ‘Rewritable full-color computer-generated holograms based on color-selective diffractive optical components including phase-change materials’ by Chi-Young Hwang <I>et al.</I>, <I>Nanoscale</I>, 2018, DOI: 10.1039/c8nr04471f.</P>

물리치료(학)과 학생들이 지각한 물리치료사의 이미지와 자아존중감과의 관련성 분석

김은애 ( Eun Ae Kim ),이건철 ( Geon Cheol Lee ),배원식 ( Won Sik Bae ),김지혁 ( Chi Hyok Kim ) 대한물리의학회 2013 대한물리의학회지 Vol.8 No.1

PURPOSE: The purpose of this study is to look into relationship between image of physiotherapist and self-esteem of physiotherapy students and desirable image of physiotherapists offer to establish basic materials. METHODS: The subjects of this study are consist of 603 students of department of Physical therapy university and college in Busan and Kim-hae. Data are collected from June 9 to July 9 in 2011 by structured questionnaires. RESULTS: The result are as follows. 1. at the physiotherapist image score, the highest score question is Physiotherapist is specialist(3.45) and the lowest score question is Physiotherapist is treated samely with doctor(2.15). 2. at the self-esteem score, the highest score question is I think that I am at least as valuable as others(3.37) and the lowest score question is I can be poorly sometimes(2.81). 3. at the static results of physiotherapist image score gap by general characteristics, there are significantly different in gender(t=2.27, p=.02), similar profession distinction(t=4.30, p=.00), major satisfaction(t=5.74, p=.00), school system (t=-2.54, p=.01). 4. at the static results of self-esteem score gap by general characteristics, there are significantly different in years (f=5.14, p=.00), gender(t=4.09, p=.00), religion(f=2.87, p=.04), similar profession distinction(t=3.97, p=.00), major satisfaction(t=4.26, p=.00). 5. at the static results of good reputation of physiotherapists increase self-esteem of physiotherapy students score question are significantly different(r=0.53, p=.00). CONCLUSION: Accordingly, these results of this study that there is a very correlation between image of physiotherapist and self-esteem of physiotherapy students. Therefore, good reputation of physiotherapists increase self-esteem of physiotherapy students.

물리치료사의 직무유형이 직무만족도와 조직몰입도에 미치는 영향 : 부산지역을 중심으로

김성구 ( Seong Gu Kim ),노정운 ( Jung Woon No ),박민규 ( Ming Yu Park ),하용목 ( Yong Mok Ha ),김지혁 ( Chi Hyok Kim ),배원식 ( Won Sik Bae ) 대한통합의학회 2014 대한통합의학회지 Vol.2 No.4

Purpose : The purpose of this survey was to investigate the effect on job satisfaction and organizational commitment according to the job types of Pusan area physical therapists figuring out structural causality between job satisfaction and organizational commitment. Method : This survey was conducted through structured questionnaire for the physical therapists working in Pusan area, and data from 217 therapists were utilized in the final analysis. Data collection was deployment questionnaire using Google Docs (online survey), The SPSS 21.0 program was used according to for research purposes independent t-test was used for individual and job characteristics, was used according to job types and job satisfaction and organizational commitment are logistic regression analysis, correlation analysis and chi-square test. Result : The results of this study were as follows. 1. Overall job satisfaction according to the job types was appeared musculoskeletal physical therapist more 4 times. 2. Job types according to the organizational commitment did not make direct effect. Conclusion : Number of musculoskeletal physical therapist than neurological physical therapist was fewer and there were many per day treatment of patients, but overall job satisfaction was appeared that is higher. This is thought that job types affects more than working environment.

위암 환자의 예후인자로서 림프관 정맥 및 신경 침범의 의의

김치호,장석원,강수환,김상운,송선교,Kim Chi-Ho,Jang Seok-Won,Kang Su-Hwan,Kim Sang-Woon,Song Sun-Kyo 대한위암학회 2005 대한위암학회지 Vol.5 No.2

목적: 표준화된 술식으로 위절제술을 시행한 위암 환자를 대상으로 임상병리학적 특성, 특히 암세포의 림프관, 정맥 및 신경 침범 유무가 환자의 예후에 미치는 영향을 확인 하고자 하였다. 대상 및 방법: 1995년 1월부터 1999년 12월까진 만 5년간 영남대학교 의과대학 부속병원 외과에서 위암으로 진단되어 위절제를 시행받은 1,018명의 의무기록을 토대로 후향적 연구를 시행하였다. 통계는 chi-dquare test를 이용하고 예후 인자들은 Cox proportional hazards regression model을 사용한 다변량 분석을 통해 분석하였다. 생존율은 Kaplan-Meier 방법으로 5년 생존율을 구하고 log-rank test로 검정하였다. 유의 수준은 P < 0.05를 기준으로 하였다. 통계처리는 SPSS for Windows (Version 10.0, SPSS lnc, USA) 프로그램을 이용하였다. 결과: 각 임상병리학적 특성에 대한 단변량 분석 결과, 환자의 연령, 종양의 크기 및 위치, Borrmann형, 조직 분화도, 위절제술의 범위, 암의 위벽 침윤도, 림프절 전이 정도, 병기, 원격 전이 유무, 수술의 근치도 등이 유의하였으며, 이상의 유의한 인다들을 다변량 분석한 결과 암의 위벽 침윤도, 림프절 전이, 림프관 침범, 신경 침범 및 수술의 근치도가 독립적 예후 인자로서 유의하였다. 결론: 기존의 TNM 병기 분류법이 병의 진행 상태를 객관적으로 표현할 수 있고 기본적인 예후 인자로서 역할을 하지만, 병리조직학적 검사 소견에서 림프관 및 신경 침범 유무를 확인하는 것은 위암의 예후 판정에 추가적인 정보를 제공할 수 있을 것으로 기대한다. Purpose: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. Materials and Methods: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. Results: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. Conclusion: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.

Analysis of lawsuit cases in the Department of Surgery in Korea

Ji Yun Jung,김소윤,Dong Gyu Kim,Choong Bai Kim,Kyong-Choun Chi,강원경,Won Lee 대한외과학회 2018 Annals of Surgical Treatment and Research(ASRT) Vol.94 No.3

Purpose: The aim of this study is to prepare medical staff in order to prevent medical malpractice litigation through analysis of litigation cases related to the department of surgery in Korea. Methods: A total of 94 litigation cases related to the department of surgery, where a certain amount of payment was ordered to the defendant between 2005 through 2010, were analyzed. We examined time of occurrence, amount claimed and awarded in damages, plaintiff claims, and court opinion. Results: An average of 3.2 years was spent from the date of the incident occurring to the end of the litigation procedures. The average amount awarded in judgments for damages was 59,708,983 ± 67,307,264 (range, 1,700,000–365,201,482) Korean won. Cases were found involving the following opinion of the court: violation of duty of care (49 cases), violation of informed consent (7 cases), violation of duty of care and informed consent (5 cases), and settlement, reconciliation, and others (32 cases). By analyzing defendants’ negligence in court opinions, diagnosis (30.8%) was the most common, followed by post-operation management (27.7%). Conclusion: Physicians have to conduct treatment and surgery based on exact diagnosis and be careful to observe patients’ conditions and symptoms after surgery. It is essential to identify the current status and characteristics of medical litigation for reducing further litigation and improving patient safety. In order to create a safe medical environment, national efforts should be made not only by individuals but also at the national level.

주요 우울증에서 Interleukin-10 유전자의 제한효소 절편길이 다형성

전태연,배치운,이정태,박원명,김광수,Jun, Taeyoun,Pae, Chi-Un,Lee, Chung Tai,Bahk, Won-Myong,Kim, Kwang-Soo 대한생물정신의학회 2000 생물정신의학 Vol.7 No.2

Objective : Major depression is known to have immunologic dysfunctions, the recent studies revealed that cytokines including IL-6 and IL-$1{\beta}$ were increased in patients with major depression. Since molecular genetic methods have been progressed, this study was to investigate the relationship between major depression and immunologic aspects by analyzing polymorphism of IL-10 gene. Method : 92 patients with major depression were included and data of 146 normal controls obtained from the Catholic Hemopoietic Stem Cell Information Bank of Korea were used in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by Mae III After that procedure, we obtained and assessed RFLP of two alleles, IL-10T and IL-10C. All data were analyzed by ${\chi}^2$ test. Results : 1) There were no significant difference in genotype frequencies of $IL-10^*T/T$, $IL-10^*T/C$, and $IL-10^*C/C$ between major depression patients group and control group. 2) There were no significant difference in allelic frequencies of $IL-10^*T$ and $IL-10^*C$ between major depression patients group and control group. Conclusion : We did not verified the differences in frequencies of $IL-10^*T/^*IL-10^*C$ gene between the major depression patients group and control group, respectively. But the results of this study do not declare that the IL-10 gene has no association with major depression. We do suggest that further systematic studies including various clinical variables should be conducted.

영양불량환자의 중증도 적용 향상을 위한 영양지원팀 협의진료체계 개선활동의 중요성

권국환 ( Kuk Hwan Kwon ),이형순 ( Hyung Soon Lee ),유지형 ( Jee Hyoung Yoo ),지수나 ( Soo Na Chi ),박현희 ( Hyun Hee Park ),김소원 ( So Won Kim ),김경란 ( Kyung Ran Kim ),윤난희 ( Nan Hee Yun ),라경택 ( Kyoung Taek Ra ),송현정 ( H 한국정맥경장영양학회 2018 한국정맥경장영양학회지 Vol.10 No.1

Purpose: The grade of complexity in the diagnosis related group (DRG) payment system is influenced by the secondary diagnosis of specific complication and comorbidity level, in which moderate or severe malnutrition is included. This study examined an existing proportion of patients with malnutrition who were supposed to be qualified for the complexity level and devised quality improvement measures to increase the proportion of qualifying complexity payments. Methods: The goal of the activities was to increase the rate of complexity payment claims for patients with malnutrition (%). Cases ineligible for the DRG payment system and cases with no diagnosis of malnutrition were excluded. We established a collaborative system between the nutrition support team and departments related to each improvement factor (i.e., patient care, medical records, insurance review, and medical information). Results: Before implementing the activities, this study investigated the current level of complexity payment claims for malnutrition patients who were discharged within a specific period (June 1, 2015∼August 31, 2015). The results showed that complexity payment claims were filed in 10.00% (2 of the 20 malnutrition cases). After the activities, the rate of complexity payment claims for the patients with malnutrition within the study period (June 1, 2016∼August 31, 2016) was 46.43% (26 out of 56), showing an approximately 364% increase from the pre activity rate. This change was statistically significant according to the chi-square test on Microsoft Excel 2010 (P<0.01). Conclusion: Collaborative efforts by the related departments enabled the smooth implementation of each activity. In addition, moderate or severe malnutrition was revealed to be a variable in the complexity-specific payment system. In the future, hospital-wide awareness and effort are crucial to promot the steady practice of these activities and expand their implementation.

Medium Optimization and Application of Affinity Column Chromatography for Trypsin Production from Recombinant Streptomyces Griseus

Won Jae Chi,Ju Hyun Song,Eun A. Oh,Seong Whan Park,Yong Keun Chang,Eung Soo Kim,Soon Kwang Hong 한국미생물 · 생명공학회 2009 Journal of microbiology and biotechnology Vol.19 No.10

Identification of Neuron - killing Factor on Bombyx mori Nervous System

Kim, Mi-Kyung,Choi, Chi-Won,Yun, Chi-Young,Kim, Hak-Ryul 한국곤충학회 2001 Entomological Research Vol.31 No.3

Approximately half of the neurons in the abdominal nervous system of the Bombyx mori die after adult eclosion. Two physiological signals regulate post-eclosion neuronal death in adult moths. The one is a steroid hormone, 20-hydroxyecdysone, and the other is a neural signal originated in nervous system. The neural signal is transmitted from the fused pterothoracic ganglion to abdominal ganglion A3 via the intersegmental connectives. In order to characterize the signal of neural origin, in vitro culture system was developed. Treatments of 20-hydroxyecdysone and drugs revealed the delay or the blockage of neuronal cell death in B. mori nervous system. Aqueous extracts of pterothoracic ganglia were prepared and applied to cultured ventral nerve cords. These extracts showed a potent activity in killing neurons. The active component of the extract was heat-stable and trypsin-sensitive. Size fraction studies suggested that the active component has a molecular mass below 30,000Da.