포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.

한국전통 식품의 원료인 메주와 누룩에서 분리된 접합균에 대한 연구

유기원,성창근,이상선,유진영 충남대학교 생물공학연구소 1998 생물공학연구지 Vol.6 No.-

The fungal isolates of Mucorales, directly collected from Korean traditional raw materials of Nuruk (raw material for Korean rice wine) and Meju (raw material for Korean soysauces), were compared with those of Rhizopus oryzae purchased. The fungal isolates of Rhizopus, Mucor, and Absidia mostly identified as based on the morphological observations, were evaluated with the PCR-polymorphic bands. The PCR-polymorphic bands of the genomic DNA reacted with the primers of OPD series tenmer were various, but showed averaged 4 to 6 in the agarose-electrophoresis. The dissimilarity coefficient (DC) between two isolates were compared by the cluster analysis, dendrogams and polar ordinations. The isolates of R. oryzae known showed several groupings within the lower value of DC and were divided to two groups of amylo-process and other fungi with other purposes. The isolates unidentified were identified by the DC made of this results. Taxonomy of these isolates made by the morphological observations were consistent with those resulted above in most case but not in all aspects. More works were needed with the isolates known for detail informations of Mucorales.

외상 환자에서 의식소실 유무와 외상후 스트레스 장애의 유병율, 증상 양상, 우울 및 불안에 관한 연구

이유진,연규월,우행원,김영철,임원정 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.4

연구목적 : 본 연구에서는 의식 소실 유무에 따른 외상후 스트레스 장애 유병율 및 증상, 우울, 불안 증상을 알아보기 위해 외상을 당한 환자를 의식 소실이 있었던 환자군과 의식 소실이 없었던 환자군으로 구분하여 두 집단의 외상후 스트레스 장애의 유병율, 증상 및 불안 정도를 비교해보고자 하였다. 방 법 : 사고를 당하고 1달 이상 경과한 환자 120명(남자 69명, 여자 51명)을 대상으로 하였다. 대상군을 의식 소실 유무에 따라 소실군과 비소실군으로 구분하고 사회인구학적 변수, 사고 당시 의식 소실의 유무, 의식 소실 시간, 사고의 종류, 사고에 대한 기억, 사고의 심각도, 손상 심각도 점수(Injury Severity Score)를 조사하여비교하였다. 또한 외상후 스트레스 장애 척도(Clinician Adminstered PTSD Scale), Beck의 우울증 척도(Beck Depression Inventory), 상태 특성 불안처도- Ⅰ, Ⅱ(State Trait Anxiety Inventory- Ⅰ, Ⅱ)를 이용하여 조사하여 두 군 사이의 외상후 스트레스 장애유병율 및 증상, 우울, 불안 정도를 비교하였다. 결 과 : 통 연구 대상자 120명중 의식 소실이 있었던 환자군(소실군)은 56명(46.7%)이었고 의식 소실이 없었던 환자군(비소실군)은 64명(53.3%)이었다. 총 대상자 120명중 30명(25%)이 외상후 스트레스 장애로 진단되었으며 소실군 56명중 17명(30.4%)이 비소실군 64명중 13명(20.3%0이 각각 외상후 스트레스 장애로 진단되었으나 두 군간의 차이는 통계적으로 유의하지 않았다(x^2=1.607, P>0.05). 외상후 스트레스 장애 증상 척도에서는 소실군에서 사고에 대한 기억 상실, 흥미 상실, 이탈, 감정 둔마, 수면자애, 예민함, 집중력 감소 증상의 빈도가 유의하게 높았다(P<0.05). 비소실군에서느 반복적인 회상과 놀람 반응 빈도가 유의하게 높았다(p<0.05). Beck의 우울증 척도 점수는 소실군에서 38.8±8.8, 비소실군에서 31.0±7.9로 의식 소실을 보고한 환자군의 점수가 유의하게 높았으며(t=-3.16, 0<0.05) 상태 특성 불안 척도-I, II는 소실군에서 각각 44.5±3.3, 44.6±3.9, 비소실군에서 각각 42.9±3.0, 42.3±3.4로 소실군의 점수가 유의하게 높았다(t=-2.75, p<0.05, t=-3.38, p<0.05). 결 론 : 사고 당시 의식 소실이 없었던 환자군과 비교하여 외상후 스트레스장애가 비슷한 빈도로 진단되며 의식 소실이 외상후 스트레스 장애의 발생에 유의한 영향을 미침은 물론 불안 및 우울에도 유의한 영향을 미친다고 할 수 있다. Objectives :This study investigated PTSD prevalence, symptoms, depressed mood and anxiety, comparing two groups of the patients in trauma ; one who had experienced the loss of consciousness(group "A" here after) and the other group of patients who had not(group "B" here after). Method : subjects were 120 patients(age18-66) who had received trauma(traffic accident, fall down) more than 1 month. Before they consisted of 56 patients who had experienced the loss of the consciousness(46.7%) and 64 who had not(53.3%). Men were 69 and women were 51. Clinician administered PTSD Scale, Beck Depression Inventory, State Trait Anxiety Inventory-I, II were administered. The factors such as sociodemographic variables, unconsciousness at the time of trauma, memory about tranmatic accidents were considered. Result : Out of 120 subjects, 30 patients(25%) were diagnosed as PTSD : 17 from 56(30.4%) and 13 from 64(20.3%) were found in the group "A" and "B" respectively. Prevalence of PTSD was higher in the group "A" showed significant difference between two groups(x^2=1.607,p>0.05). The CAPS of group "A" showed significantly high frequency in the loss of interest, detachment, restricted affect, sleep difficulty, irritability/anger. concentration difficulty(p<0.05), while the group "B" scored high in intrusive recall and increased startle. The scores of BDI, STAI-I, II were significantly higher in the group "A"(t=-3.16, p<0.05)(t=-2.75, p<0.05, t=-3.38, p<0.05). Conclusion : PTSD was mre frequent and depressed mood and anxiety appeared more often in the group qho experienced the loss of consciousness. Thus the loss of the consciousness at the time of trauma prones of the aevelopment PTSD and symptom of aepression and anxiety.

유치 상아세관에 관한 주사전자현미경적 관찰

김유희,김영진,정경원 大韓小兒齒科學會 1995 大韓小兒齒科學會誌 Vol.22 No.1

유치 상아세관의 형태학적 특징을 관찰하기 위하여 정상탈락기의 유전치, 조기발거한 유전치, 정상탈락기의 유구치와 대조군으로 저기발거한 영구소구치 각 10개를 대상으로 치관부 상아질을 주사전자현미경적 관찰을 통해 치수측, 중앙부, 법랑상아경계부근의 각 부위별 상아세관의 직경과 단위면적당 수를 측정하여 각 군내에서의 부위별 차이와 각 부위에서의 각 군간의 차이을 비교평가하여 다음과 같은 결론을 얻었다. 1. 정상탈락기의 유전치, 조기발거한 유전치, 정상탈락기 유구치, 조기발거한 영구 소구치 각 군내에서의 부위별 상아세관의 직경은 치수측에서 법랑상아경계부근으로 갈수록 작게 나타났다.(p<0.01). 2. 각 군간의 부위별 상아세관의 직경은 조기발거한 영구소구치군이 모든 부위에서 다른 세 군에 비해 크게 나타났다.(p<0.05). 3. 치수측과 중앙부에서 상아세관의 직경은 정상탈락기의 유구치군이 정상탈락기의 유전치군과 조기탈락한 유전치군에 비해 크게 나타났다(p<0.01). 4. 정상탈락기 유전치, 조기발거한 유전치, 정상탈락기 유구치, 조기발거한 영구 소구치에서 부위별 단위면적당 상아세관의 수는 치수측에서 법랑상아경계부근으로 갈수록 작게 나타났다(p<0.01). 5. 각 군의 상아질 치수측, 중앙부, 법랑상아경계부근에서 단위면적당 상아세관 수의 차이는 없었다(p<0.05). The purpose of this study was to evaluate number and diameter of tubules in pulp side, middle side, dentinoenamel junction side of coronal dentin of normal exfoliated anterior primary teeth, early extracted anterior primary teeth, normal exfoliated posterior primary teeth and early extracted permanent premolar. Numbers of sample were 10 teeth in each group. The diameter and number of tubules were counted and measured in ×4000 magnified screen of scanning electron microscope. The comparison of diameter and number of tubules at three level in each group was done. The results of this study were as follow. When the diameters of tubules at three levels were compared, the diameters of tubules were graduately decreased from pulp side close to dentinoenamel juntion side in all groups. At pulp sidem middle side and dentnoenamel junction side, when the diameters of tubules of each group were compared, the diameters of tubules of early extracted permanent premolar were greater than other groups. At pulp side, the diameters of tubules of normal exfoliated posterior primary teeth were greater than that of other two primary teeth groups. When the number of tubules at three levels were compared, the number of tubules were graduately decreased from pulp side close to dentinoinamel junction side in all groups. A pulp side, middle side and dentinoenamel junction side, when the number of tubules of each group were compared, no significant difference was in each group.

GT rotary file을 이용한 근관성형법과 충전방법의 비교

강유미,진정희,유미경,이세준,이광원 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.5

The purpose of this study was to compare the shaping time of two shaping methods and the leakage of three different obturation techniques. Ninty three canaled human molar teeth were used. which were randomly divided into two groups of forty teeth each and ten control teeth. After working length determination. the one group was prepared crowndown technique using rotary root canal instruments of GT rotary files .12/20, .10/20, .08/20 and .06/20 taper(Maillefer Instrument SA. Switzerland). The other group was instrumented with Gates Gildden burs(#1, #2 and #3) to coronal preparation and GT rotary files .08/20 and .06/20 taper to apical preparation. Shaping time was measured. After root canals were instrumented, they were divided to three subgroups and obturated as follows: Subgroup 1, obturated with single cone method : Subgroup 2, obturated with lateral condensation : Subgroup 3, obturated with continuous wave technique. Three subgroups were obturated using non-standardized gutta-percha cone(Diadent, Korea, 06 or .08 taper) and AH-26(Dentsply DeTrey, Germany) as a root canal cement. Ten unobturated teeth served as positive and negative controls. After immersion in 2% methylene blue solution for 1 month, the teeth were washed during 24h. The teeth were determineralized in 10% nitric aciid and dehydrated by immersion in 80, 90 and 100% ethyl alcohol. The teeth were finally cleared and stored in 100% methylsalicylate, and apical dye penetration was evaluated under stereomicroscope(Leica M420, LC, U.S.A) at (×) 8.75 magnification. Liner measurement of dye penetration was assessed with the use of digitalized image analysing system (analySIS, GmbH, Germany), The data were analysed statistically using independent T-test and Two-way ANOVA and Tukey test. The result were as follows: 1. In canal prepared with GT^Trotary file, shaphing time taked more than the group of using Gates Gildden drill to coronal preparation without statistical significant (p>0.05). 2. The group of single cone obturation using canal preparation of GT^TM rotary files showed significantly more apical leakage than those of lateral condensation and continuous wave technique regardless of shaping method (p<0.05). 3. The group of single cone obturation using canal preparation of GT^TM rotary files and Gates Gildden drill showed significantly more apical leakage than those of continuous wave technique regardless of shaping method (p<0.05). 4. Regardless of shaping method. The group of continuous wave obturation showed less apical leakage than those of lateral condensation without statistical significance (p>0.05). 5. The group of single cone obturation using canal preparation of GT^TM rotary files and Gates Gildden drill showed more apical leakage than the group of lateral condensation using sane shaping method without statistical significance (p>0.05).

한국어판 표출감정평가척도의 신뢰도와 타당도

김진훈,김대호,강유미,박성혁,이창훈,장동원 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.2

Objectives : The present study was designed to assess the reliability and validity of Korean version ofFamily Questionnaire (FQ-K), a briefquestionnaire measuring expressed emotion (EE). Methods : A sample of 84 first-order relatives ofschizophrenics completed the FQ-K and the data were analyzed for intemal consistency and factor structure. Additionally non-random subset of participants (n=34) refilled FQ-K after two weeks for test-retest reliability and naturalistic follow-up data of 36 were obtained for any re-hospitalization events to assess predictive validity. Results : Intemal consistency of FQ-K was good (Cronbach's alpha=.819) and pimcipal component factor analysis revealedthe two-factor structure (criticism and emotional overinvolvement) identical to previously reported for the FQ. The FQ-K also showed reasonable test-retest reliability and excellent predictive validity was indicated in that outcome of re-hospitalization was superior for low expressed emotion patients at six-month naturalistic follow-up. Conclusion : The Korean version of FQ Proved to be a reliable and valid instrument measuring expressed emotion in relatives of Korean patients with schizophrenia.

ESO 기법을 이용한 컴플라이언트 메커니즘 설계

이원구,박재용,김상락,유진식,한석영 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

A compliant mechanism is a mechanism that produces its motion by the flexibility of some or all of its members when the input forces are applied. Whereas the topology optimization based on homogenization and SIMP parameterization has been successfully applied for compliant mechanism design, an ESO approach has not been considered yet for the optimization of these types of systems. This work presents a modified version of the evolutionary structural optimization (ESO) Procedure for its application in topology optimization of compliant mechanisms, It will be shown that an additive version of this method must be adopted in order to achieve the optimum design, since the traditional ESO method's element removal technique is not efficient in this case. The methodology is based on a mutual energy concept for formulation of flexibility and the ESO method. A multi-objective optimization problem is formulated as an application of compliant mechanism design. The procedure has tested in several numerical applications and benchmark examples to illustrate and validate the approach.

한국무예의 발전동향과 과제 및 전망

서충진,강유원,김이수 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

Where is the Oriental martial arts going in these days? Can it be separated with sports or physical education to get its own region? To get a solution from these questions, there are three parts of studies of the possible trends on Korean martial arts such as the actual conditions on educating coach of martial arts, the research about thesis of martial arts, and the actual conditions of related journals. For the conclusion, the following five solutions could be shown. At first, there should be a general modification on processing of educating the martial arts coach. 1. Expanding the items of martial arts can raise the level of coach's educating quality based on the curriculum, the contents, and the variety programs. 2. Martial arts sports, ordinary martial arts, and traditional martial arts must be unifiable and simple to develope its problems. 3. the importance of traditional martial arts and the qualified test of its coach must have a mutual preservation and maintenance through being related with each other between martial arts' each items. Second, it's necessary to train the martial arts with required elements of the recognition, the theory, the existence and the philosophy. Third, it's necessary to take shape of pyramidical structure through the long term policy of training martial arts. Forth, variety events of martial arts should be held regularly from the government. At last, it's necessary to expand the martial arts region and make variety activities from related academies or institutes.

레진 시멘트를 이용한 레진 파이버 강화 레진포스트의 치근 상아질에 대한 미세인장결합강도

김진우,유미경,이세준,이광원 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.1

Object The purpose of this study were to evaluate the microtensile bond strength of resin fiber reinforced post to radicular dentin using resin cement according to various dentin surface treatment and to observe the interface between post and root dentin under SEM. Material and Method A total 16 extracted human single rooted teeth were used. A lingual access was made using a #245 carbide bur in a high-speed handpiece with copious air water spray. The post space was mechanically enlarged using H-file(up to #60) and Gates Glidden bures(#3). This was followed by refining of the canal space using the calbrating drill set provided in ER Dentinpost(GEBR, BRASSELER GmbH&Co. KG). The 16 teeth were randomly distrubuted into 4 group of 4 teeth. Group 1 teeth had their post space prepared using 10% phosphoric acid as root canal surface treatment agent during 20s. The canal was then rinsed with saline and dried with paper point. Group 2 teeth had their post space prepared using 3% NaOCI as root canal surface treatment agent during 30min. The canal was then rinsed with saline and dried with paper point. Group 3 teeth had their post space prepared using 17% EDTA as root canal surface treatment agent during 1min. The canal was then rinsed with saline and dried with paper point. Group 4 teeth had their post space prepared using 17% EDTA as root canal surface treatment agent during 1 min. After rinsing with saline, the canal was rinced 10ml of 3% NaOCI for 30min. After drying with paper point, the post(ER Dentinpost, GEBR, BRASSELER GmbH&Co. KG) was placed in the treated canals using resin cement. Once the canal was filled with resin cement(Super bond C&B sunmedical co. Ltd.), a lentulo was inserted to the depth of the canal to ensure proper coating of the root canal wall. After 24 hours, acrylic resin blocks(10·15·50mm) were made. The resin block was serially sectioned vertically into stick of 1·1mm. Twenty sticks were prepared from each group. After that, tensile bond strengths for each stick was measured with Microtensile Tester. Failure pattern of the specimen at the interface between post and dentin were observed under SEM. Results 1. Tensile bond strengths(meen±SD) were expressed with ascending order as follows ; group 4, 12.52±6.60 ; group 1, 7.63±5.83 ; group 2, 4.13±2.31 ; group 3, 3.31±1.44. 2. Tensile bond strengths of Group 4 treated with 17% EDTA +3%NaOCI were significant higher than those of group 1, 2 and 3 (p<0.05). 3. Tensile bond strengths of Group 1 treated with 10% phosphoric acid were significant higher than those of group 2 (p<0.05). Tensile bond strengths of Group 4 treated with 17% EDTA +3% NaOCI was significant higher than those of other groups.

학령전기 아동의 글씨 쓰기에 영향을 미치는 요인에 관한 연구

김원진,왕군철,김두리,최인영,허진아,최유정,장문영 대한감각통합치료학회 2011 대한감각통합치료학회지 Vol.9 No.1

목적 : 학령전기 아동의 글씨 쓰기 명료도 및 속도와 지각-운동 기술의 상관관계를 확인하고, 글씨 쓰기에 가장 영 향을 주는 요인을 알아보고자 하였다. 연구방법 : 덴버 발달 선별 검사를 통하여 정상 발달로 선별된 23명의 학령 전기 아동(평균 연령=68.61개월, SD=2.04)을 대상으로 글씨 쓰기 명료도 및 속도 측정을 위하여 한글 자모 쓰기 검사지를 사용하여 자음과 모음을 쓰도록 하였다. 시지각과 시각-운동 통합 수행 능력 측정을 위하여 시지각 발달 검사를 사용하였고, 소운동 협응 수행 능력 측정을 위하여 Grooved pegboard test를 사용하였다. 결과 : 글씨 쓰기 명료도와 전반적인 시지각, 비운동성 시지각, 시각-운동 통합, 우세손 소동작 협응의 상관관계는 없었으며, 글씨 쓰기의 속도는 전반적 시지각과 우세손 소동작 협응 항목에서 유의한 상관관계를 보였다. 회귀 분 석 결과 글씨 쓰기 속도에 가장 큰 영향을 주는 요인은 전반적 시지각 항목이었다. 결론 : 만 5~6세 학령 전기 아동의 전반적 시지각 능력의 발달을 향상시키기 위한 중재를 제공하는 것이 글씨 쓰기 의 속도 능력을 향상 시킬 수 있다는 것을 알 수 있다. Objective : This study investigated the relationships of handwriting legibility and perceptual-motor skills, and handwriting speed and perceptual-motor skills. And identified the predictors that most affect the handwriting of preschool children. Methods : Twenty-three typically developing preschool aged children (mean age: 68.61 months, SD=2.04) were selected through the Korean-Denver Developmental Screening Test-2(K-DDST-2). The children were tested with regard to handwriting legibility, visual perception, visual-motor integration and fine-motor coordination. Results : First, a significant relationship was not found among handwriting legibility, visual perception, visualmotor integration and fine-motor coordination. Second, a significant relationship was found among handwriting speed, visual perception and fine-motor coordination. Third, stepwise multiple regression analyses showed that general visual perception were significant predictors for handwriting speed. Conclusion : Occupational therapists should evaluate children's visual perception levels utilizing a standardized test, and focus on general visual perception in order to improve handwriting skill(speed). Also, occupational therapists are expected to play an important role in the management and treatment of children's handwriting skills.