茯?湯의 痛痺에 미치는 影響 및 HPLC에 依한 防風類의 pattern 分析

金惠璘,金光湖 慶熙大學校韓醫科大學韓醫學硏究所 1984 慶熙韓醫大論文集 Vol.7 No.-

단일 3차 의료기관에서 외상환자에 대한 대량수혈 프로토콜 적용 분석

김혜린,유동원,김혜림,신경화,이현지,장철훈,김형회 대한수혈학회 2018 大韓輸血學會誌 Vol.29 No.3

Background: Massive hemorrhage due to trauma is one of the major causes of death in trauma patients, and the quick supply of appropriate blood products is critical in order to reduce the mortality rate. We introduced a massive transfusion protocol (MTP) for safe and rapid transfusion of trauma patients. Using records collected since its adoption, we compared the characteristics of MTP applied group (MTP group) and MTP not applied group (non-MTP group) to determine whether there is an indicator for predicting patients to be treated with MTP. Methods: We retrospectively reviewed the electronic medical records and laboratory findings of patients who received massive transfusions in the trauma emergency room of a single tertiary hospital from February to August 2018. We analyzed various laboratory test results, the amount and ratio of the transfused blood products, and the time required for blood products to be released for the MTP group and the non-MTP group. Results: Of the 54 trauma patients who received massive transfusions, 31 were in the MTP group and 22 in the non-MTP group. There was no significant difference in initial vital signs (except blood pressure) and laboratory test results. Also there was no difference in the amount and ratio of blood products, but the time required for blood product release was shorter in the MTP group. Conclusion: There was no significant difference in clinical findings such as initial vital signs and laboratory test results between the MTP and non-MTP groups, but required blood products were prepared and released more quickly for the MTP group.

Development of Deuterated Carbenic Ir(III) Complexes for the Solution- and Vacuum-Processed Deep-Blue Phosphorescent Organic Light-Emitting Diodes

김혜린,진성호,박호열,이지은,엠디 알 아민,Manigandan Thippan,제갈영순 한국고분자학회 2023 한국고분자학회 학술대회 연구논문 초록집 Vol.48 No.1

Understanding Senior Tourists’ Well-Being: The Moderating Effect of Travel Patterns

김혜린 강원대학교 경영경제연구소 2018 Asia-Pacific Journal of Business Vol.9 No.4

Retiring from work is a major personal and professional transition and has a major influenceon one’s life. Tourism researchers have been aware of the importance of seniors’ tourism andleisure activities to enhance their well-being. The study examines the effect of tourismexperience on leisure life domain, which in turn influences overall quality of life. Moreover,the moderating effect of travel patterns is also tested. A final sample of 328 was used fordata analysis including Structural equation modeling (SEM) and multi-group analysis to testthe hypotheses. The findings revealed that tourism experience positively influences satisfactionwith leisure life domain and overall quality of life. Findings also indicated that there aremoderating effects of the travel patterns on the relationship between satisfaction with leisurelife domains and overall quality of life. The study also provided managerial implications fortourism marketers and destination managers.

Comparative effectiveness of cycling of tumor necrosis factor-a (TNF-a) inhibitors versus switching to non-TNF biologics in rheumatoid arthritis patients with inadequate response to TNF-a inhibitor using a Bayesian approach

김혜린,이민영,박선영,박선경,변지혜,권성홍,이의경 대한약학회 2014 Archives of Pharmacal Research Vol.37 No.5

Alternative tumor necrosis factor-a (TNF-a)inhibitors and non-TNF biologics are available as treatmentoptions for rheumatoid arthritis patients who exhibit inadequateresponse to TNF-a inhibitor (TNF-IR patients). Theseagents have considerable efficacy compared with placebo,but head-to-head comparisons among these agents have notbeen performed. The objective of this study was to useBayesian approach to compare the effectiveness of cyclingTNF-a inhibitors versus switching to non-TNF biologics inTNF-IR patients. A systematic review was conducted usingMEDLINE and Cochrane library. Key endpoints were theAmerican College of Rheumatology (ACR) responses of20/50/70 and the health assessment questionnaire (HAQ)score change at six months. Bayesian outcomes were calculatedas the probability that OR is greater than one andHAQ score change difference is less than zero. Comparedwith TNF-a inhibitors, non-TNF biologics were associatedwith higher ACR response rates; in ACR20, the OR was1.639 for abatacept [P(OR[1) = 90.7 %], 1.871 for rituximab[P(OR[1) = 96.2 %] and 3.52 for tocilizumab[P(OR[1) = 99.9 %]. Similar trends were shown in theHAQ change comparison; the median differences (MD)were -0.259 for abatacept [P(MD\0) = 100 %], -0.160for rituximab [P(MD\0) = 98.2 %], and -0.200 for tocilizumab[P(MD\0) = 99.3 %]. In conclusion, switchingto non-TNF biologics was more effective than cycling TNFainhibitor in TNF-IR patients.

부르노 무나리(Bruno Munari)의 어린이를 위한 작업에 관한 연구 ― 놀이 개념을 중심으로

김혜린,이헌국 사단법인 한국조형디자인협회 2008 조형디자인연구 Vol.11 No.1

Bruno Munari who is the artist and designer did the diversity of works includinging the fine arts, design, architecture, writing, various design for children and the art education activity. Picaso says Munari is??Leonardo da Vinci of today?? which is the remark showing his sparkling concept and an creative expression method. He leaded the center of the Italian design and especially the preceding viewpoint about education for children was unique and experimental which is investigated deeply Nowadays. After his working of the first picture book for children in 1945 he designed the instruments of education combined play and maded practice the original work shop program of art playing. He observed the creativity of children and showed interest in play instruments of education enthusiastically because he thought man after growing who was exclusive to accept new method or thinking. The works for children by Bruno Munari is ??I libri Munari??composed 10 books in 1945 and various picture books, instruments of education series for play of 11 type 12 kinds, the toy cat ll gatto Meo, 1949, a little monkey Zizi, one of product designs for children. I libri Munari were designed for cure of the inside of children that were an epoch making presentation to change the way on making picture books for children for example pop-up style, reorganization with other sizes flip forms, using the various sizes of folding paper, binding by the stapler, dynamic composition, variety scales etc. Since then the series works of picture books for children were done by various attempt on breaking the common sense. Bruno Munari's achievement on his variety works are summarized as follows. First, the joyful studying by play showing through his works for children enhances their shaping sense and has learning effect naturally. Second, his works for children by leading a stimulus of sences can does mental development for children. Third, the constitution process by exciting children's curiosity leading play of his works for children promotes children's creativity. Forth, physical participation through I Laboratori program can achieve physical cultivation for children. Fifth, Abitacolo, L'abtacolo chiuso, one of his works for children can give a space for their own and it is composed of two stories that can be open or fold if they want. Sixth, he expanded boundary of making picture book for children for example exceptional page composing, using the original material, pop up style, punching etc. As mentioned above Bruno Munari's various works for children is background on humanism and that because of approachable method by play can formative desirable human nature of children. He approched the comprehensive method and unique not to following the existing way and worked on child centered not on adult. It needs more an in-depth study and revaluation on Bruno Munari's philosophy of design about the education of children.

산업안전보건법상 사용사업주 책임 - 사용사업주의 파견근로자에 대한 책임을 중심으로 -

김혜린 전북대학교 부설법학연구소 2019 法學硏究 Vol.59 No.-

Obwohl die Begriffe des Arbeitgebers und des Arbeitnehmers nach dem Gesetz über die Arbeitsbedingungen(Labor Standards Act) grundsätzlich auch für das Arbeitsschutzgesetz gelten, sind die Pflichten für den Arbeitsschutz durch die gesetzlichen Regelungen dem entleihenden Unternehmen auferlegt. Diese rechtspolitische Entscheidung vom Gesetzgeber, nämlich, dass dem Entleiher die Verantwortung für den Arbeitsschutz übertragen ist, lsst sich wohl als sinnvoll bewerten, wenn man die Verwirklichungsstruktur der Arbeitsverhältnisse bei einer Arbeitnehmerüberlassung betrachtet: In der Regel nutzt der Entleiher die Arbeitskraft des Leiharbeitnehmers und übt ihm gegenüber auch das Weisungsrecht aus. Außerdem wird die Leistung eines Leiharbeitnehmers normalerweise im Betrieb des Entleihers erbracht. Noch dazu befinden sich viele verleihende Unternehmen tatsächlich in der finanziellen schwachen Lage. Trotz dieser Besonderheiten der Arbeitsverhältnisse bei der Arbeitnehmerüberlassung gibt es allerdings auch die Situationen, in denen das Weisungsrecht von dem Entleiher und das von dem Verleiher parallel existieren können, wie beispielsweise im Falle dessen, dass das Weisungsrecht vom Verleiharbeitgeber auch bei der Arbeitnehmerüberlassung noch auszuüben parat ist. In diesem Fall kann die gesetzliche Regelung von Arbeitsschutzgesetz nur als einen Befreiungsgrund für den Verleiharbeitgeber fungieren. Um diesem Verdacht entkommen zu können, ist es notwendig, die Mitverantwortung von Ver-und Entleiharbeitgeber für den Arbeitsschutz zu verdeutlichen und klar zu regeln. Erwähnt ist es ferner von der Notwendigkeit einer neuen gesetzlichen Regelung über den privatrechtlichen Haftungsgrund, da das Arbeitsschutzgesetz hauptsächlich mit öffentlich-rechtlichen Schutzvorschriften geregelt ist und ihm ein Haftungsgrund beim Verstoß des Arbeitsgebers gegen die Fürsorgepflicht für die Sicherheit und Gesundheit des Arbeitnehmers fehlt. 산업안전보건법은 근로기준법상 근로자, 사용자 개념을 준용함에도 불구하고, 파견법은 제35조를 통해 파견 중인 근로자의 안전·보건에 대한 책임을 사용사업주에게 부담하도록 규정하고 있다. 이는 일반적으로 파견근로자의 노동에 대한 이용과 지배가 사용사업주의 업무 영역 내에서 이루어지고, 위험에 대한 지배도 사용사업주에게 있다는 점에 근거한 것이다. 그러나 사용사업주가 파견근로자에 대하여 산업안전보건과 관련하여 책임을 부담하는 근거에 대해서는 별도의 규정이 존재하지 않을 뿐만 아니라 파견법과 산안법은 사용사업주와 파견근로자의 법률관계에 대하여 명시적으로 설명하고 있지 않다. 따라서 사용사업주의 파견근로자에 대한 안전배려의무를 계약책임으로 판단한 평화산업사건에서의 판례의 법리는 주목을 받게 된다. 그러나 이 법리를 파견근로관계의 모든 유형에 적용하는 것은 적합하지 않을 수 있다는 결론에 이르게 되어 이를 명확히 하기 위해서 산안법 내지는 판견법에 안전배려의무에 대한 근거 규정을 마련할 것을 제안한다. 또한 파견근로자 뿐만 아니라 노무를 제공하는 자는 기본권 보호의무의 대상이 되는 자유권적 기본권으로 신체의 자유에 대한 기본권의 향유자로 국가에 대한 보호청구권을 향유하고 있다는 점을 명심할 필요가 있다.

자기조직화지도기법을 이용한 여름철 동시 열 극한에 대한 증가 추세 및 메커니즘 분석

김혜린,이명인,이준리 한국기상학회 2023 한국기상학회 학술대회 논문집 Vol.2023 No.4

환자표본자료를 이용한 간이식 환자의 의료이용 특성 및 의료비용 분석

김혜린 한국임상약학회 2018 한국임상약학회지 Vol.28 No.1

Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was 90,066±36,959 thousand KRW and 10,557±9,668 thousand KRW for LT and post-LT patients, respectively. Especially, LT patients’ costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being 35,983±18,115 thousand KRW, 28,246±9,408 thousand KRW, and 12,131±6,604 thousand KRW, respectively. For inpatients, the average number of hospitalized days was 63.5±66.0 days for LT patients and 22.3±35.1 days for post-LT patients. Conclusion: Compared to postLT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

우리나라와 일본의 병원약사와 관련된 업무에 대한 수가 비교

김혜린,김민혜,박혜경 한국병원약사회 2021 병원약사회지 Vol.38 No.1

Background : Currently, the pharmacists at hospitals in Korea provide professional and diverse pharmaceutical care services. However, the service fee covered by national health insurance (NHI) is limited to the traditional dispensing and managing of medication. In Japan, with a similar health insurance system to Korea, health insurance fees for pharmaceutical care services are rewarded in various types. We aimed to compare the unit price and types of reimbursement activity covered by NHI between Korea and Japan. Methods : The 2020 medical fee tables from NHI in Korea and Japan were examined and the unit price and condition were extracted for analysis. The insurance fee of Japan was converted into Korean won using the Purchasing-Power-Parities (PPP) exchange rate. We set various cases for comparison (1-day dispensing for peroral and external use medication and aseptic compounding) in inpatient and outpatient settings. Results : In Japan, various fees were awarded for pharmacists’ clinical pharmaceutical care activities besides traditional dispensing and promoting participation in multidisciplinary team activities. Compared to Japan, the level of health insurance fees in Korea was 70–73%, 47–57%, and 19–31% for 1-day dispensing to inpatients, outpatients, and discharge patients, respectively. For aseptic compounding for three-drug chemotherapy regimens and parenteral nutrition, the levels were estimated at 103–116% and 122%, respectively. Conclusion : The hospital pharmacists’ services fees in Korea were lower than those in Japan for traditional dispensing activities. There were more types of health insurance fees in Japan, and the terms and conditions that must be met to be awarded were very specific.