수면진정제 중독 환자에서 흡인성 폐렴 발생의 예측 인자 분석

강민진 ( Min Jin Kang ),임지용 ( Jee Yong Lim ),오상훈 ( Sang Hoon Oh ),김한준 ( Han Joon Kim ),김영민 ( Young-min Kim ) 대한임상독성학회 2015 대한임상독성학회지 Vol.13 No.2

Purpose: Drug overdose is easily found in the emergency department (ED). Sedative-hypnotics overdose causes the aspiration pneumonia in patients with decreased mental status. The purpose of this study was to investigate the risk factors of aspiration pneumonia in patients poisoned with sedative-hypnotics. Methods: One hundred seventy eight patients who were poisoned with sedative-hypnotics and who visited ED between 2009 and 2015 were included. This study was conducted retrospectively, with collection of data by review of medical records. We collected the data concerning the characteristics of patients and classified them into two groups based on the development of aspiration pneumonia. Logistic regression analysis was performed to investigate the factors for the development of aspiration pneumonia. Results: Thirty five patients had an aspiration pneumonia during their hospital stay in 178 patients. The age, amount of ingestion, Glasgow Coma Scale (GCS) score at admission, a history of hypertension and diabetes mellitus, and the hypotension at admission were significantly different between two groups in univariate analysis. The age, amount of ingestion and GCS score at admission were associated with the development of aspiration pneumonia in the multivariate logistic regression analysis (OR 1.028 (95%CI, 1.002-1.056, p=0.037), 1.026 (95%CI, 1.004-1.043, p=0.001), 0.737 (95%CI, 0.683-0.915, p=0.002)). All patients with aspiration pneumonia were discharged without a sequelae. Conclusion: The development of aspiration pneumonia in the patients of sedative-hypnotics overdose is associated with old age, amount of drug ingestion, and GCS score at admission.

일본 진료수가 결정 체계 분석을 통한 한국에의 정책적 시사점: 국민의료비 억제 기전 중심

김정덕 ( Jung Duck Kim ),강민진 ( Min Jin Kang ),김도훈 ( Do Hoon Kim ),최영순 ( Yong Soon Choi ),편동유희 ( Yuki Katagiri ) 한국사회보장학회 2015 사회보장연구 Vol.31 No.2

이 연구는 국민의료비(한국의 건강보험 총진료비 개념)를 억제하는 기전으로 작동되는 일본의 진료수가 결정 체계를 분석하여 한국의 건보재정 안정화와에 기여할 수 있는 정책적 시사점을 도출하는데 있다. 일본의 진료수가 결정 체계 분석을 통한 한국에의 정책적 시사점은 다음과 같다. 첫째, 진료수가 개정 시 약가를 일괄 인하하고 신의료기술 등 자연증가분을 포함시키지 않음으로써 ‘진료수가 개정에 따른 신규 진료비 증가분’을 최대한 억제하는 한편 자연증가분 등을 포함한 전체 진료비증가분을 국민의료비(한국의 건강보험 총진료비)증가분과 연계하여 관리하는 거시경제적 효율성을 추구하는 제도 도입을 검토할 필요가 있다. 둘째, 진료수가체계와 의료공급체계를 연계하는 정책 유인을 하는 산정 요건을 많이 운영함으로써 의료자원 배분의 효율화를 제고하는 미시경제적 효율성을 추구하는 제도 도입을 검토할 필요가 있다. Health Insurance Financing(HIF) of Korea is supposed to be unsubstantiality. Because revenue factors of HIF have been decreasing due to low fertility, whereas expenditure factors of HIF have been increasing due to aging & chronic disease. But as we had experienced controversial issue related to ‘tax increase’ at the second half of 2014, there is no alternative to financing for health insurance by raising health insurance premium. Therefore, in a given situation, the HIF spending structure reforms would be a contributory initiative. Among the aging & chronic disease - developed countries, Japan’s HIF indicators relatively had better performances than Korea through managing fee schedule revision system as a tool for health expenditure controlling mechanism. According to such a result, Korea and Japan are similar to revenue factors of HIF, Korea and Japan are different in expenditure factors of HIF. The implications for Korea through analyzing Japan’s medical fee schedule revision system as follows. First, Korea must review to introduce the strategy for driving macro-economic efficiency. Second, Korea must review to introduce the strategy for driving micro-economic efficiency.

보문 : 톱밥재배에 의한 목이의 자실체 생산

조우식 ( Woo Sik Jo ),황억금 ( Eok Keum Hwang ),강민진 ( Min Jin Kang ),최성용 ( Seong Yong Choi ) 한국균학회 2010 韓國菌學會誌 Vol.38 No.1

간호간병통합서비스 병동의 간호서비스에 대한 환자-간호사 인식도 비교

윤호순(Ho Soon Yoon),임지영(Ji Young Lim),강민진(Min Jin Kang) 한국콘텐츠학회 2017 한국콘텐츠학회논문지 Vol.17 No.3

본 연구는 Parashuraman, Zeithmal과 Berry가 개발한 SERVQUAL 모델을 이용해 간호간병통합서비스 병동을 이용한 환자와 간호사를 대상으로 간호서비스에 대한 인식도를 상호 비교함으로써 보다 환자중심의 간호서비스를 제공하고, 간호간병서비스에 대한 환자 만족도 및 간호의 질 향상을 위한 근거자료를 제시하고자 한 것이다. 이를 위하여 간호간병통합서비스 병동 간호사 192명과 환자 321명을 대상으로 간호서비스에 대한 기대-인식 차이 정도를 비교 분석하였다. 분석 결과 간호간병통합서비스 병동에서 제공된 간호서비스에 대한 환자의 만족도가 환자의 기대 정도와 간호사의 수행도에 비해 통계적으로 유의하게 높은 것으로 나타나 향후 간호간병통합서비스 제도가 환자 중심의 전인간호 실현이라는 관점에서 간호서비스 수행도를 높이는 데 기여할 수 있음을 알 수 있었다. 한편 간호사가 환자의 기대를 잘 인식하고 있어도 이에 부응하는 간호서비스를 잘 수행하지 못하고 있는 것으로 파악된 차이에 대하여는 추후 간호간병통합서비스 제도를 운영하고 있는 보건복지부와 병원 당국 그리고 간호부서간의 조정과 협력을 통하여 발전적 대안이 마련되어야 함을 알 수 있었다. 이와 같은 본 연구의 결과를 바탕으로 본 연구의 개념적 모델인 PZB의 SERVQUAL 모델을 적용하여 환자의 간호서비스에 대한 기대 수준과 만족도를 지속적으로 측정하고 평가하면서 간호서비스 질 향상을 통한 간호간병통합서비스 제도를 발전시켜나가야 할 것을 제안한다. The aim of this study was to compare perception between patient and nurse on comprehensive nursing care service using SERVQUAL model. To accomplish this goal, the 5 gaps of expectation-perception on comprehensive nursing care service was analyzed. The subjects were 192 nurses and 321 patients who admitted in comprehensive nursing care service wards. As results, patient’s satisfaction was higher than patient’s expectation and also nurse’s performance. Therefore, we found that comprehensive nursing care service would contribute to perform holistic nursing care services in the future. To develop comprehensive nursing care service system sustainably, it needs continuous measurement of patient’s expectation and satisfaction using conceptual model of this study.

Sol-Gel방법에 의해서 성장시킨PbTiO₃박막의 결정화와 물리적 성질

구영진,강민진,정원태,김태현,김상수 昌原大學校 基礎科學硏究所 2000 基礎科學硏究所論文集 Vol.12 No.-

Ferroelectric PbTiO3 thin films coated on SiO2/Si(100) and ITO glass substrates were prepared by sol-gel processing of metal alkoxide solutions and solvents. The use of sol-gel method for preparing various functional films makes it possible for the homogeneous distribution of elements at the molecular level, precise composition control, lower temperature synthesis, large surface coating and high optical quality. First of all, the XRD investigation shows that perovskite phase of polycrystalline PbTiO3 was formed by four times coating of the concentrated solution and by the heat treatment over 500, 600℃(O2 gas and air) and over 10, 20, 30 min. Surfaces of thin films were crack-free and uniform and the average grain size investigated by SEM was 0.25∼1.00 ㎛. Dielectric constant of PbTiO3/ITO glass thin film were 380 ∼ 5.25 in the region of 1 kHz∼ 10 MHz at room temperature(30℃), respectively. From the hysteresis loop of PbTiO3/ITO glass thin film, a remnant polarization of 0.382 μC/cm2 and a coercive filed of 23.85 kV/cm were obtained. At the frequency(5 kHz), C-V measurements of films in MFIS and MFM configurations showed well-behaved C-V characteristics and an injection type hysteresis. The capacitance of flat band(CFB) was 60 pF. The band gap energies of the thin films depend on the assumption of direct or indirect transition. Using one layer structure model, we calculated refractive index, extinction coefficient, absorption coefficient and band gap energy of thin film in the wavelength range of 300 to 800 nm. The band gap energy, refractive index and extinction coefficient at λ = 6325 Å of the PbTiO3 thin film were 3.7 eV, 1.96 and 0.1 respectively.

바나듐이 도핑된 강유전체 Bi₄Ti₃O_12 박막(BTV)의 성장과 특성

정원태,최은경,김현주,강민진,김상수 昌原大學校 基礎科學硏究所 2001 基礎科學硏究所論文集 Vol.13 No.-

Bi3.99Ti2.97V0.03O12 (BTV) thin films with 3 mol% vanadium doping were prepared on Pt/Ti/SiO2/Si substrate by sol-gel method. X-ray diffraction analysis indicated that single-phase lapered perovskite were obtained and preferred orientation was not observed. Under the annealing temperature at 600℃, the surface morphology of the BTV thin films had fine-rounded particles and then changed plate-like at 650℃ and 700℃. The remanent polarization (2Pr) and coercive field (2Ec) of 700℃ annealed BTV thin film were 25 μC/cm2 and 116 kV/cm, respectively. In addition, BTV thin film showed little polarization fatigue during 109 switching cycles. These improved ferroelectric properties were attributed to the increased rattling space and reduced oxygen vacancies by substitution Ti4+ ion (68 pm) with smaller V5+ ion (59 pm). The dielectric constant and loss were measured 130 and 0.03 at 10 kHz, respectively.

텅스텐(W)을 첨가한 Bi_4Ti_3O_1_2 (BTW) 박막의 미세구조 및 강유전 특성 변화

최은경,정원태,강민진,김두희,김현주,박문흠,구영건,김상수 昌原大學校 基礎科學硏究所 2002 基礎科學硏究所論文集 Vol.14 No.-

The un-doped Bi_4Ti_3O_12(BIT)and W-doped Bi_4Ti_3O_12(BTW) thin films were prepared on Pt(111)/Ti/Sio_2/Si(100) substrates by a sol-gel process amd spin caoting method. The films were analyzed by X-ray diffraction(XRD)and scanning electron microscopy(SEM). The ferroelectric hysteresis loops and the fatigue properties were obtained using a RT66A ferroelectric tester.X-ray diffraction measurements showed layered perovskite structures with a single phase in both films. The remanent polarization(2 P_r)and the coercive field(2 E_c)fo the BTW thin film were 16 u C/㎠ and 115 ㎸/㎝,respectively, with a applied field of 170 ㎸/㎝. In addition,the BTW thin film showed a low fatigue behavior up to 4.5×10^10 read/write cycles.The dielectric constant was measured 400 at 10 ㎑.