사회복지시설 위탁운영에 관한 연구

조원탁,김형수 동신대학교 2004 論文集 Vol.14 No.-

This article shows the characteristics of the juridical person of social welfare to solve the problems concerning entrusting management of social welfare organization in Korea. And this paper explains the basis of law about entrusting management of social welfare organization. Finally this shows the recent amendments of social welfare law and development. In Korea, since the modern social welfare organiztion has been introduced, many institution were developed. Even though the volume became remakably bigger, the quality and equity of management was not formless, a little bit confused until now. In conclusion, when the goverment entrust the social welfare organization to the private sector, it is important for the goverment to execute a appropriate and transparant procedures to manage and achive the non-profital goal of social welfare organization.

컴퓨터를 이용한 혈액학 교육시스템의 개발

이기형,손보라,윤희석,조원덕,김승택 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

연구목적 : 전통적인 의학교육 시스템은 최근 개발되고 있는 여러 가지 영상 진단법 등 시각적 자료를 전달하는데 한계가 있으며, 이러한 한계는 모든 분야에 걸쳐서 나타나지만 특히 혈액학이나 심장학 등 시각적인 자료가 진단에 필수적인 분양에서 두드러진다고 할 수 있다.본 연구는 혈액학 교육에 사용되던 기존의 강의실 교육에 시각적 자료가 첨부된 CD-ROM을 개발하여 혈액학 교육 시스템을 개선하기 위한 것이다. 대상 및 방법 : 기존의 혈액학 교육에 있어서 필수적으로 강의 되어오던 자료를 수집하여 체계적으로 정리하였다.강의 자료에 따라서 필요한 영상 자료를 충북대학교 병원에 입원한 혈액질환 환자들의 검사 자료로부터 수집하여 컴퓨터를 기반으로 한 의학영상 처리 및 분석시스템을 통하여 이미지 파일로 변형하였다.또한 입원 환자들 중 대표적인 증례들을 수집하여 실제 임상 진료와 유사한 형태의 증례를 통한 학습을 할 수 있도록 하였다. 결과: 본 CD-ROM은 혈액학 교육에 필요한 대부분의 영역을 포함한다 각 질환의 병태생리, 진단, 임상양상, 치료 및 예후 등 전통적으로 강의되어 오던 강의록에 이미지 파일로 변형된 영상 자료를 필요한 곳마다 링크시켰다.따라서 학습자는 특별한 장치 없이 텍스트 및 영상을 한 화면에서 볼 수 있어 전통적인 교육 시스템에 비하여 시,공간적인 장점을 갖는다 할 수 있다.또한 입원 환자들로부터 수집된 증례를 통하여 실제 임상 진료와 매우 유사한 경험을 하도록하여 교육효과를 증대시켰다. 결론: 혈액학 교육에 있어서 멀티미디어적 효과를 극대화시켜 질환의 병태생리 등 강의실 교육자료뿐 아니라 진단에 필수적인 시각적 자료를 손쉽게 접할 수 있는 CD-ROM의 개발로 전통적인 강의방법이 갖는 한계를 개선시킬 수 있을 것으로 기대된다. Purpose : The traditional medical education system has its limitations in effectiveness of conveying informations in multiple modalities used in diagnosis of patients with hematologic diseases.This study was performed to develop such a multimedia system using computer based CD-ROM, which includes visual assistant systems, several hematological case studies as well as the traditional text-wise education systems. Materials and Methods: The informations about hematologic diseases were compiled and organized.The main visual data was peripheral blood smears, bone marrow data, and several laboratory results accrued from patients admitted to Chungbuk National University Hospital.Each visual data were transformed through computer-based medical image processing and analyzing system and saved as to JPEG files.Case studies were also acquired from admitted patients and the laboratory data of that patients were used unmodified as possible as. Results : The CD-ROM covers almost all kinds of hematologic diseases that must be included in ordinary medical education courses.The text part includes pathophysiology, diagnosis, clinical features, treatment and prognosis of each hematologic diseases.The essential visual data were linked to each text part and accessible with ease, by one click.Case studies were simulated to actual clinical settings and presented step by step from diagnoses to treatments. Conclusion: A multimedia approach for the study of hematologic diseases has been developed and available in CO-ROM format.This system has advantage over traditional education system in conveying all kinds of visual data which is essential in educating hematologic disorders.

Long/Short 훈련심볼을 이용하는 개선된 채널추정기법에 의한 IEEE 802.11a 무선 LAN 시스템의 성능 개선

곽재민,정해원,조성준,이형호 한국항행학회 2002 韓國航行學會論文誌 Vol.6 No.3

본 논문에서 IEEE 802.11a 의 규격에 따라 OFDM 무선 LAN 모뎀과 프레임 포맷을 구성하여 시뮬레이션에 의해 BER 성능을 분석하고 수정된 채널 예측 알고리즘을 적용하여 채널 예측 성능이 개선됨을 보인다. 채널 예측에 이용되는 실내 무선채널로서는 AWGN과 TDL모델을 적용한 지연확산채널을 고려한다. 우선 AWGN환경에서 규격에 제시된 전송속도 및 부호율에 따른 OFDM 무선 LAN 시스템의 성능을 분석한다. 다음으로 실내무선 채널 환경에서 채널추정이 불완전한 경우에 대해, 기존의 채널추정방식으로서 프리앰블 내의 2개의 Long 훈련 심볼을 이용하여 채널을 추정하는 경우에 대한 성능을 분석하고, 수수정된 채널 추정기법으로는 IEEE 802.11a의 프리앰블 구조를 변경하지 않으면서 Long 훈련심볼뿐만 아니라 전체 10개의 Shot 훈련심볼 중 8개의 훈련심볼들을 채널추정에 부가적으로 사용하는 방식을 채용한 경우의 성능을 분석하여 기존의 방식과 비교한다. 시뮬레이션 결과의 분석으로부터 수정된 채널 추정방식을 적용하는 경우, 규격에 정의된 프리앰블 구조의 변경없이도 잡음을 억제하는 효과를 향상시킴으로써 채널추정오차가 감소되어 채널추정성능이 개선됨을 확인하였다. In this paper, the BER performance of IEEE 802.11a OFDM WLAN system is obtained by simulation and it is shown that the proposed modified channel estimation algorithm improves the channel estimation performance of the system. The wireless channel used in channel simulation includes AWGN and delay spread channel implemented by TDL model. At first, the performance of OFDM WLAN system according to data rate and coding rate defined in standard is evaluated in AWGN channel. Then, imperfect channel estimation in indoor wireless channel is considered. After the performance of conventional channel estimation scheme using only two long training symbols is evaluated, and that of proposed modified channel estimation scheme using additional 8 short training symbol is compared with it. From the simulation results, it is shown that modified channel estimation scheme provides reduced channel estimation error and improves the channel estimation performance due to noise averaging effect with the same preamble format as defined in specification.

LC, Acute : O-061 ; Mode of cirrhosis related complication in Korean patients with liver cirrhosis -A prospective multicenter cohort study

( Hyun Young Woo ),( Jeong Won Jang ),( Sang Gyune Kim ),( Chang Hyeong Lee ),( Tae Yeob Kim ),( Won Young Tak ),( Sung Kyu Choi ),( Mong Cho1 ),( Jong Young Choi ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Cirrhosis-related complications are indications for transplantation. However, the mode of complication has not been evaluated so far. To better address this issue, we investigated the mode of cirrhosis related complication and impact of these complications on survival in prospective, multicenter, inception cohort study of subjects with liver cirrhosis presenting with the first onset of decompensated complication. Methods: In this observational study, 1515 patients with the confirmed onset time of the first decompensated complication were enrolled. The mortality risk of cirrhosis-related complications, including ascites, portal hypertensive gastrointestinal bleeding (PHGB), spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), hepatorenal syndrome (HRS), was analyzed in these cirrhotic patients. Result: As the first complication, ascites was the most frequent (53.8%), followed PHGB (36.2%), HE (7.6%), SBP (1.7%) and HRS (0.7%). During follow-up (mean 32±47 months), 484 (31.9%) experienced subsequent decompensations and the proportion of subsequent complication was consistently changed; the proportion of HE, SBP, HRS increased as time progressed. The interval between subsequent decompensative events was progressively shortened. The mortality rate according to the first complication was as follows; Ascites =PHGB> HE=SBP>HRS. The mortality rate of patients experienceing subsequent complication was significantly higher than those without subsequent complication. According to the kinds of subsequent complication, survival of HE was also higher than HRS but lower than ascites or PHGB and similar to that of SBP and this difference of survival disappeared after repeated complication. Conclusion: The mortality risk correlated with initial complication and the risk increases as the number of complication episodes is repeated. Patient`s mean age was 56±11.50 years and 72.1% was male. The cause of liver cirrhosis is hepatitis B virus (38.6%), alcohol (35.5%) and hepatitis C virus (8.9%).

갑상선 종양에서 thrombin receptor (PAR-1)의 발현 양상

박지영,목지오,김여주,박형규,김철희,변동원,서교일,유명희,조현득,오미혜,김상진 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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국산 체외 충격파 쇄석기의 음향학적 특성 평가

최민주,이종수,김성삼,조성찬,양형석,손종수,천원기 제주대학교 공과대학 첨단기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.2

In the study we measured and evaluated the acoustical property of a domestic spark gap type extracorporeal shock wave lithotripsy (ESWL). Altering the discharging medium between the electrodes of the shock wave generator (water, 1% an 10% NaCl electrolyte), we measured shock waveforms and sound pressure level (SPL). For the shock waves produced using the discharging medium, water, it was seen that the shock wave peak pressure went up to 70 MPa, and the SPL was in the range of 90 - 100 dB. As the concentration of NaCl increased in the electrolyte. the SPL did not change much and was shown to increase correlation with the discharging voltage. In the case of the discharging medium. 10% NaCl electrolyte, it was found that the shock amplitudes varied in a narrow range when being high in the concentration of NaCl and were large when being high in discharging voltages. While the stone fragmentation was in process, we measured the acoustic emission and compared their spectral properties.

자동착유시스템 설치농가의 설치 후 만족도에 관한 실태조사

기광석,김종형,정영훈,김윤호,박성재,김상범,이왕식,이현준,조원모,백광수,김현섭,권응기,김완영,여준모,Ki, Kwang-Seok,Kim, Jong-Hyeong,Jeong, Young-Hun,Kim, Yun-Ho,Park, Sung-Jai,Kim, Sang-Bum,Lee, Wang-Shik,Lee, Hyun-June,Cho, Won-Mo,Baek, Kwang- 한국축산환경학회 2011 축산시설환경학회지 Vol.17 No.1

본 시험은 국내에 도입되기 시작한 AMS에 대하여 설치 동기, 설치 후 우유생산량과우유품질, AMS 설치계기 및 설치 후 만족도, AMS 운영상 애로점 및 건의사항 등을 조사 분석하였다. 설치 계기가 무엇인가에 대한 응답비율은 노동력 부족 44%, 체험목장으로 전환 25%, 소들의 고능력화에 대응 19% 순이었으며 기타 6%였다. AMS 설치농가의 사육경력은 평균 24.9년, 평균 연령은 53.2세로 나타났으며 가족노동력만으로 경영하는 목장이 조사농가의 38%, 고용+자가노동력 형태의 목장이 63%로 나타났다. 목장의 산유능력은 두당 평균 유량은 1일 $30.9{\ell}$, 평균 유지율 3.9%, 세균수는 9.1천개/$m{\ell}$ 수준이었다. 후계자 육성에 대한 질문에 매우 그렇다라고 응답한 비율은 68%였으며, 보통 18%, 아니다와 매우 아니다라고 응답한 비율은 18%로 나타났다. 시스템 운영현황 및 애로사항을 파악하기 위하여 AMS의 프로그램 주운영자에 대한 질문에 본인 44%, 부인 6%, 자녀 또는 후계자사람이 44%, 기타 6%나 되었다. AMS 운영상 가장 어려운 점에 대한 조사결과, 기기 작동 및 복잡한 프로그램 운영이 각각 31%로 가장 많았다. 그 외 기계 에러 및 고장에 대한 애로사항이 25%이였다. 도태원인에 대하여 유방염 28%, 번식장애 20%, 발굽질환 19%, AMS에 부적합한 유두 배열 12%, 분만 후 대사성질병 7%, 노산 등 기타 14%였다. 시스템 설치 후 유지보수 계약 체결유무 및 비용에 대하여 유지보수 계약 56%, 유지 보수 계약 미체결 44%이었다. 유지보수 계약 평균 계약비용은 연간 658만원 정도였다. 시스템 설치 후 항목별 만족도에 대하여 5점 만점에 3.9점이었으며, 노동력 절감 3.7점, 업체의 A/S 3.6점, 산유량 증가 3.2점, 원유의 체세포 수 저감 2.8점이었다. 시스템 설치 시 고려사항 및 건의사항에 대하여 고가의 장비를 효율적으로 사용하기 위하여 젖소의 유방과 유두 배열이 적합하도록 젖소를 선발하는 것, 시스템을 운용할 수 있는 능력, 적합한 환경, 재정적 능력과 부지 확보, 지속적인 관찰 등이 권장되어야 할 것으로 나타났으며, 설치 업체에 대해서는 컨설팅이 체계화될 필요가 가장 높게 나타났으며 이어서 보다 저렴한 설치와 서비스의 체계화를 요구하는 결과를 보였다. The present survey was conducted to provide basic information on automatic milking system (AMS) in relation to purchase motive, milk yield and quality, customer satisfaction, difficulties of operation and customer suggestions, etc. Purchase motives of AMS were insufficient labor (44%), planning of dairy experience farm (25%), better performance of high yield cows (19%) and others (6%), respectively. Average cow performance after using AMS was 30.9l/d for milk yield, 3.9% for milk fat, 9,100/ml for bacterial counts. Sixty-eight percentage of respondents were very positive in response to AMS use for their successors but 18% were negative. The AMS operators were owner (44%), successor (44%), wife (6%) and company worker (6%), respectively. The most difficulty (31%) in using AMS was operating the system and complicated program manual. The rate of response to system error and breakdown was 25%. The reasons for culling cow after using AMS were mastitis (28%), reproduction failure (19%), incorrect teat placement (12%), metabolic disease (7%) and others (14%), respectively. Fifty-six percentages of the respondents made AMS maintenance contract and 44% did not. Average annual cost of the maintenance contract was 6,580,000 won. Average score for AMS satisfaction measurement (1 to 5 range) was 3.2 with decrease of labor cost 3.7, company A/S 3.6, increase of milk yield 3.2 and decrease of somatic cell count 2.8, respectively. Suggestions for the higher efficiency in using AMS were selecting cows with correct udder shape and teat placement, proper environment, capital and land, and attitude for continuous observation. Systematic consulting was highly required for AMS companies followed by low cost for AMS setup and systematization of A/S.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

S-130 Tenofovir versus Entecavir in Chronic hepatitis B Patients

( Hyeong Jun Cho ),( Jung Hyun Kwon ),( Young Woon Kim ),( Hae Lim Lee ),( Sung Won Lee ),( Jeong Won Jang ),( Soon Woo Nam ),( Nam Ik Han ),( Kyu Won Chung ) 대한내과학회 2016 대한내과학회 추계학술발표논문집 Vol.2016 No.1

Background: Current guidelines suggest entecavir (ETV) and tenofovir (TDF) as the first line treatment of chronic hepatitis B. We evaluated the antiviral response of the two agents in real clinical practice. Methods: A consecutive cohort study was performed. 754 treatment naive patients were enrolled and 579 patients (entecavir n=312, tenofovir n=267) tested for HBV DNA RT PCR at 24 weeks post-treatment were analyzed. Quantitative serum levels of HBsAg, HBeAg, HBV DNA were serially assessed. Virological response (VR, <20 IU/mL) was evaluated. Results: VR at weeks 12, 24, 48, 72, 96 in the ETV group were 23.3% (58/249), 48.0% (143/298), 67.0% (187/279), 76.2% (154/202), 82.3% (172/209) compared to 30.5% (60/197), 67.2% (156/232), 82.4% (155/188), 94.6% (87/92), 100% (37/37) in the TDF group, respectively. TDF achieved higher VR but the baseline HBV DNA levels were lower in the TDF group compared with the ETV group. There was no difference in the HBV DBA reduction rates between the two groups with 5.73±1.28 (log10 IU/mL) decrease in the ETV group compared to 5.77±1.50 in the TDF group at week 96 (p>0.05). HBeAg loss at week 72 was observed in 22.1% (32/145) in the ETV group compared to 29.5% (13/44) in the TDF group (p>0.05). HBeAg seroconversion was achieved in 2.8% (4/145) in the ETV group compared to 6.8% (3/44) in the TDF group at week 72 (p>0.05). The relatively higher rate of serologic response in the TDF group may be related to the lower baseline quantitative HBeAg titer in the TDF group. There was no difference in the quantitative HBeAg and HBsAg titer reduction rates between the two groups. Conclusions: Both TDF and ETV showed prominent virologic response after 96 weeks therapy. During the 96 weeks, no difference was noted in the reduction rates of quantitative HBsAg and HBeAg titers between TDF and ETV. Superior tendency was observed in the TDF group in achieving serologic response but as this study was carried out within real life clinical settings, small number of patients were followed up for more than 72 weeks in the TDF group. Therefore, long term follow up is required in future large-scale studies to accurately assess the efficacy of the two drugs.

Effect of Thickened Beverage and Swallowing Aid Jelly Used for Dysphagic Patients on the Disintegration of Orally Administered Tablets

Won Hyeong Cho,Whachun Yoo,Byoungseung Yoo 한국임상영양학회 2024 Clinical Nutrition Research Vol.13 No.2

Thickened beverages or swallowing aid jelly (SAJ), commonly used as tablet-swallowing aids for dysphagic patients, may influence the disintegration of orally administered tablets. With this in mind, we evaluated the disintegration times of therapeutic tablets immersed in thickened beverages or SAJ compared to immersion in ones without them. Thickened beverages and SAJs were prepared with various beverages (water, orange juice, and milk) using food thickeners and SAJ powders marketed in Korea. The tablet disintegration times were the same in thickened beverages and SAJs, and there was no statistically significant difference associated with the thickness levels of the thickened beverages. The disintegration times of Tylenol immersed in orange juice or milk were slightly higher compared to those immersed in water. Moreover, there was no difference in disintegration time when using the thickened beverages and SAJs. The disintegration times of Aspirin were similar in all of the thickened beverages or SAJs, and there were no differences between non-immersed and immersed tablets. These results demonstrate that the disintegration of Tylenol and Aspirin is not greatly affected by immersion in any of the thickened beverages and SAJs.