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.

주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

Ethyoene Oxide 폭로 근로자의 말초 임파구 자매염색분체 교환에 관한 연구

황천현,박종태,장성훈,김대성,이원진,김청식,김영환 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.4

Operators of hospital sterilizers who use ethylene oxide(EtO) were studied to determine the exposure of EtO level and the frequency of sister chromatid exchanges(SCEs) from June 12 to July 20, 1997. To evaluate SCEs in the peripheral blood cells, we selected 22 workers at the central supply room of 4 university hospitals and 22 unexposed workers at the same hospitals according to match sex, age, and smoking habit and also did questionnaires. The mean air concentrations(8-hr TWA) of EtO at 4 university hospitals were less than 1 ppm. The SCE frequencies in exposed workers to EtO and controls were normally distributed. The SCE frequencies in exposed workers to EtO and controls were 6.42±0.63, 5.86±0.69, respectively and their differences were statistically significant(p=0.0093). But there were no statistically significant differences in smoking, alcohol intake, coffee drinking. Especially smokers who exposed to EtO were increased SCE statistically significant than the exposed group who did not smoke.

포도씨의 지방질 조성과 이화학적 특성

황종택,강한철,김태수,박원종 한국식품영양학회 1999 韓國食品營養學會誌 Vol.12 No.2

포도씨의 조지방질 함량을 분석한 결과 조지방질 함량은 평균 28.6%이었고, Steuben 품종이 32.0%로 가장 높았다. 지방산 조성은 리놀레인산 70.75%, 올레산 18.48%, 스테아르산 2.01%, 팔미트산 8.45%로 구성되어 있었으며 Jingyu 품종에서 스테아르산이 적었고, Fugiminori 품종은 올레산이 많았다. 중성지방질의 평균함량은 87.25%, 당지방질은 4.68%, 인지방질은 8.06%로 구성되었다. 조단백질 평균함량은 11.2%로 품종간의 차이를 나타냈으며, Neo muscat이 15.7%로 가장 높은 함량을 나타냈다. 총당은 2.35∼5.63㎍/㎎이었고 환원당 평균함량은 3.20㎍/㎎을 나타냈다. 포도씨 조지방질의 평균 검화가는 186.3㎎·KOH/g·oil이었고 Kyoho 품종이 230으로 가장 높았다. 포도씨 기름의 항산화력이 참깨보다 우수하여 DPPH 환원 능력은 평균 27%가 높았다. 그러나 180℃로 가열한 후의 포도씨와 참깨씨 조지방질들은 비슷한 산패도를 나타냈다. The possibility of grape seeds as industrial resources was tested by analyzing various chemical properties of their oils from seven different species. The range of crude oil content of the grape seeds was 26.0-32.0%, showing the highest content in Steuden. Mean individual fatty acid contents in the grape seeds were lioleic (70.75%), oleic (18.48%), stearic (2.01%), and palmitic (8.45%) acids. Stearic acid was low in Jingyu, and high oleic acid was found in Fugiminori, compared with other grape strains. Total lipids were consisted of nutral lipid (87.25%), glycolipid (4.68%), and phospholipid (8.06%). Content of crude proteins was approximatery 11.2% with some variation between strains. Total sugar content was 2.35∼5.63㎍/㎎ with reducing sugar 3.20㎍/㎎. Mean saponification value of crude oils was 186.3㎎·KOH·oil. Antioxidant activity of grape seed oils was better than that of sesame oil, resulting in the higher activity of reducing DPPH by 27%. Peroxide values, however, were similar between grape seed oils and sesame oil after heat treatment at 180℃.

원자력 사고 중 핵종의 건·습침적에 따른 농작물 오염 영향

황원태,김은한,서경석,한문희,최용호,이창우 대한방사선 방어학회 2002 방사선방어학회지 Vol.27 No.3

핵종의 지표 침적 모델의 고찰과 함께 방사성물질의 공기중 농도로부터 건침적 뿐 아니라 습침적에 따른 농작물 오염 영향을 분석, 고찰하였다. 이를 위해 방사성물질의 지표 침적량으로부터 농작물의 오염을 평가하는 기존 동적 섭식경로모델을 공기중 농도 또는 지표 침적량으로부터 평가할 수 있도록 개선하였다. 평가결과, 방사성물질의 지표 침적량은 습침적에 의한 영향이 건침적에 의한 영향보다 뚜렷이 높으나, 농작물의 오염정도는 핵종, 강우율 등에 따라 다르게 나타났다. 이러한 현상은 방사성물질의 지표 침적과 농작물에로의 차단중 어느 과정이 농작물 오염에 보다 지배적으로 작용하는가에 기인한다. Combined with deposition model onto the ground of radionuclides, the influence of radioactive contamination to agricultural products was analyzed due to wet deposition as well as dry deposition from radioactive air concentration during a nuclear emergency. The previous dynamic food chain model, in which initial input parameter is only radionuclide concentrations on the ground, was improved for the evaluating of radioactive contamination to agricultural products from either radionuclide concentrations in air or radionuclide concentrations on the ground. As the results, in case of deposition onto the ground, wet deposition was more dominant process than dry deposition. While the contamination levels of agricultural products were dependent on the a variety of factors such as radionuclides and rainfall rate. It means that the contamination levels of agricultural products are determined from which is more dominant process between deposition on the ground and interception onto agricultural plants.

RAM 및 LCC의 제조시스템의 능력에 대한 영향

황흥석,박태원 한국경영과학회 2000 한국경영과학회 학술대회논문집 Vol.- No.1

제조설비의 운영은 적절한 생산제품의 품질(신뢰도 생산단가 등)을 유지하는 조건으로 유지되어야 한다. 본 연구에서는 제조설비의 적정운영조건을 구하기 위하여 제조설비의 RAM 및 순기비용 (LCC)이 제조설비의 성능에의 영향을 분석하고 최적대안을 구하였다. 이를 위하여 우선 설비의 RAM 및 LCC 산정모델을 개발하고 이를 이용하여 제조설비의 성능에 미치는 영향을 분석하기 위한 수리모델을 제시하였다. 이를 위한 전산프로그램을 개발하고 이를 이용하여 제조시스템의 성능 분석 사례를 들어 보였다. 또한 다양한 환경에서 제조시스템의 성능을 예측하기 위하여 시스템의 복잡성이 큼 문제를 분석하는데 적절한 GMDH방법을 사용하여 추정하였다. 이를 이용한 성능예측의 실 예를 들어 본 연구의 과정을 보였다.

유전알고리즘을 이용한 모델추종형 퍼지제어기 설계

황기현,문경준,김문수,원태현 동의공업대학 1998 論文集 Vol.24 No.1

In this paper, a reference model following control system using a fuzzy logic controller (FLC) is proposed. A reference model whose response does not overshoot and has a fast rise time is designed. A FLC is designed to follow as close as possible the response of the reference model. The proposed design method has the robustness and the optimal tracking property under modeling error, disturbance and parameter perturbations. The proposed designing method is compared using a PD controller throughout the experiment. The effectiveness of the proposed designing method is verified through computer simulation and experiments for the second-order and the first-order reference model.

정신장애인의 재활의 위한 사회기술훈련의 효과성에 관한 연구

황태연,손덕순,백형의,박종원,김지현,이경화 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.2

排卵湯이 白鼠의 排卵에 미치는 影響

황태원,박재웅,위석,조한백,유심근 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

Baelantang(BLT) is used in female infertility caused by ovulation disorder. An attempt was to evaluate the influences, of BLT on the serum concentrations of FSH, LH, estradiol(E_(2)) and progesterone, the histological and optical changes of ovary, ovary weight of rats. The results of the study were as follows : 1. Blood FSH level increased experimental group as compared with control group on 7th day, which showed no efficacy. 2. Blood LH level increased in experimental group as compared with control group on 7th day and decreased 14th day, which showed no efficacy. 3. Blood E_(2) level decreased in experimental group as compared with control group on 7th day and increased 14th day, which showed no efficacy. 4. Blood progesterone level increased in experimental group as compared with control group on 7th day and decreased 14th day, which showed no efficacy. 5. In histological observations of ovary, ovulation increased in experimental group as compared control group on 7th day and on 14th day, which showed no efficacy. 6. In optically observations of ovary, weight of ovary increased in experimental group as compared with control group on 7th day and 14th day, which showed no efficacy. According to these results, BLT did not influence on the ovulation and ovary of rats.

원전 중대사고시 피폭경로 및 핵종의 방사선 피폭에 대한 상대적 중요도 해석

황원태,김은한,김병우,서경석,한문희 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.3

원자력발전소의 중대 사고시 대기로 방출된 방사성물질에 의해 피폭자가 사고후 일생동안 받게 될 전신 피폭선량의 핵종의 상대적 중요도를 방출점으로부터 거리에 따라 각 피폭결로에 대해 평가하였다. 방사능운과 지표에 침적된 방사성물지에 의한 외부피폭,호흡과 오염된 음식물섭취에 의한 내부피폭이 피폭경로로 고려되었다. 오염된 음식물섭취에 의한 영향은 우리나라 환경을 고려하여 개발된 동적 섭식경로모델 KORFOOD를 사용하여 침적시점과 침점후 시간에 따른 음식물내 방사성물질의 농도 변화를 고려하였다. 방출점으로부터 80 km까지 피폭선량을 평가한 결과, 오염된 음식물섭취에 의한 영향이 가장 놓았다. 핵종별 기여도는 방사능운에 의한 외부피폭과 호흡에 의한 내부피폭의 경우 I, 침적된 방사성물질에 의한 외부피폭의 경우 Cs에 의한 영향이 가장 높았다. 오염된 음식물섭취에 의한 내부피폭의 경우 Cs은 여름철 침적, Sr은 겨울철 침적에 보다 중요한 영향을 미쳤다. In the case of a severe accident of a nuclear power plant, the whole body does and the relative importance of the radionuclides during the lifetime of an exposed person were estimated for each exposure pathway with distances from the release point. The external exposure pathways due to immersion of radioactive could and deposition of radioactive materials on the ground, and the internal exposure pathways due to inhalation and ingestion of contaminated foodstuffs were estimated considering the variation of radioactive concentration in the foodstuffs according to deposition time and elapsed time after deposition using a dynamic ingestion pathway model applicable to Korean environment, named "KORFOOD". As the results up to 80 km from the release point, the effects due to ingestion of contaminated foodstuffs showed the highest contribution to total exposure does. The contribution of I isotopes was the highest in the case of the external does due to immersion of radioactive cloud and internal does due to inhalation. The contribution of Cs isotopes was highest in the case of the external does due to deposition of radioactive materials on the ground. In the case of the internal does due to ingestion of contaminated foodstuffs, Cs deposition in summer and Sr deposition in winter, respectively, were the most dominant radionuclide to whole body.