자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

장기간의 에어로빅스 운동이 골형성 및 각종 호르몬과의 상관관계

김종인,김은희,김주혁,김수진,김도형,장성동 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

Selected girl mid㎗e school of 14- and 15- years-old who got 35% body fat rate and are obese, and have them aerobics exercise for 20 weeks, the conclusion on the matter of change between Osteoporosis and Hormones showed. The contents of Calcium has significant difference(p<.05) between 9.38±0.34㎎/㎗ pre-exercise and 9.34±0.29㎎/㎗ post-exercise, and the contents of Glucose has significant difference (p<.05) between 78.0±5.38㎎/㎗ pre-exercise and 81.3±5.91㎎/㎗ post-exercise. parathyroid hormone (PTH) is shown as 11.2±3.06pg/㎖ at pre-exercise arid 13.8± 4.41pg/㎖ at post-exercise, hyperparathyroidism and osteoporosis (Osteocalcin) is shown as 6.04±3.56ng/㎖ at pre-exercise and 5.29±4.92ng/㎖ at post exercise, there is no significant difference. Deoxypyridinoline is shown as like 8.18±2.43nM/mMcre pre-exercise arid 9.97±2.76nM/mMcre post-exercise, Alkaline phosphatase (ALP), which has an effect on the born disease, is shown 229.7±61.66[U/㎖ pre-exercise and 224.3±8.27 [U/㎖ post-exercise, there is significant difference(p<.0l). There is significant difference (p<.05) between Growth Hormone and Parathyroid hormone(PTH) which is bone absorption hormone, the Osteocalcin which is the mark of born-formation, there is no significant difference among the index of born formation mark, lipid, and hormones.

지역4-H조직의 내적 적합성에 관한 문화기술적 연구

김진모,김진군,전영욱,이정은,최영창,이은영 한국농업교육학회 2008 농업교육과 인적자원개발 Vol.40 No.2

이 연구의 목적은 지역4-H조직의 내적 적합성을 탐색하고 이를 기술하는데 있었다. 2006년 8월부터 10월까지 약 3개월 동안 지역4-H후원회 회장 및 임원진 3명, 지역4-H연맹 회장 1명, 학교4-H 지도교사 4명, 지역의 영농4-H회장 1명, 시·군 농업기술센터 소장 및 4-H담당자 9명을 주요 연구 참가자로 하여 심층면담을 통해 자료를 수집하였다. 수집한 자료를 분석한 결과는 다음과 같았다. 첫째, 지역4-H조직 관련자들이 인식하는 지역4-H조직의 주요성과 격차로, ① 민간4-H조직을 중심으로 한 자율적이고 독립적인 활동 부재, ② 지역4-H조직 간 다양한 종류의 협력 부재, ③ 지역사회에서 4-H활동에 대한 가치 인식 부족이 나타났다. 둘째, 지역4-H조직의 핵심 과업으로 ① 4-H의 가치 및 이념에 부합하고, 지역의 실정에 맞는 프로그램 확보, ② 지역4-H 조직 간 협력적 네트워크 확립, ③ 4-H에 대한 지역사회의 관심 및 지지 확보가 나타났다. 셋째, 지역4-H조직의 내적 부적합성으로는 ① 인원 확보의 어려움과 핵심과업에 대한 전문성 결여, ② 관료화되고 경직된 낡은 문화, ③ 조직적 자원의 축소 및 조직 간 낮은 네트워크의 수준이 도출되었다. The purpose of this study was to describe and understand internal fit in Local 4-H Organization. The main participants of this study were one leader and two members of Local 4-H Society for the support, one leader of Local 4-H Association, four School 4-H teacher, one leader of Local farm 4-H, 9 local agricultural extension workers. The data were collected through in-depth interview with them from August, 2006 to October, 2006. The Results from this study were as follow: 1. Key performance gaps of local 4-H organizations were identified: ① lack of local 4-H based activities, ② lack of various types of partnership between local 4-H organizations, ③ lack of understanding value of 4-H activities in the communities. 2. Key tasks of local 4-H organizations were identified: ① developing local 4-H programs based on 4-H's values and ideas, ② establishing the cooperative networks among local 4-H organizations, ③ ensuring the interest and support about 4-H in the communities. 3. Internal misalignments of local 4-H organizations were identified: ① difference of recruitment and lack of expertise, ② bureaucratic and rigid cultures, ③ decrease in organizational support and low level of network among organizations.

중년기 우울증 여성의 생활사건, 대처방식, 사회적 지지 및 가족관계

김동인,이진욱,김임,이선미,은헌정 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

국문초록본 연구는 중년기 우울증 여성의 생활사건 스트레스, 대처 방식, 사회적 지지, 가족 관계 등의 정신사회적 요인들을 알아보기 위한 것으로 각 변인들이 어떻게 우울과 관계가 있는지를 우울증 환자 집단과 정상인 집단으로 나누어서 비교 연구하였다. 이를 위해 35세 이상 64세 이하의 116명의 우울증 환자와 113명의 정상인을 대상으로 Beck 우울 질문지(BDI), 생활사건 질문지, 대처방식 척도, 대인관계 지지 평가척도(ISEL), 가정환경척도 등의 검사를 하였고 다음과 같은 결과를 얻었다. 1) 최고 스트레스는 환자 집단의 경우 결혼생활 스트레스(42명, 36.2%), 정상인 집단의 경우는 가정생활 스트레스(44명, 38.9%)였다. 2) 소극적 대처(t=0.93, p=.35)만을 제외하고 환자 집단과 정상인 집단에서 BDI 우울 점수(t=15.94, p<.0001), 생활사건 스트레스 점수(t=4.73, p<.0001), 적극적 대처점수(t=6.29, p<.0001), 사회적 지지점수(t=7.20, p<.0001), 가족 관계 점수(t=5.75, p<.0001)에서 유의한 차이를 보였다. 3) 우울증 환자 집단에서 BDI 우울 점수는 생활사건 스트레스(r=.24, p<.01) 변인과 유의한 정적 상관을 보였고, 적극적 대처(r= -.22, p<.01) 변인, 사회적 지지(r= -.35, p<.001) 변인, 가족관계(r= -.30, p<.001) 변인과는 유의한 역 상관을 보였다. 4) 우울증 환자 집단에서 BDI 우울에 대한 각 변인들의 중다회귀분석은 사회적 지지(12.3%, β= -.281, T= -3.162, P=.002, 생활사건 스트레스(5.1%, β=.279, T=3.195, P=.002), 적극적 대처(3.5%, β= -.204, T= -2.225, P=.028) 변인이 합하여 20.9%의 설명력을 나타냈다. 5) 중년기 여성에서 생활사건 스트레스는 가족 관계에서 겪는 스트레스가 가장 큰 스트레스였고, 대처방식은 우울과의 관계에서 일관성이 부족하였으며, 사회적 지지는 우울에 영향을 주는 가장 중요한 요인이었고, 가족관계는 양 집단에서 유의한 차이는 있었으나 우울에 대하여 의미있게 설명하지 못하고 있다. ABSTRACTLife Events, Coping Styles, Social Support, and Family Relationships of Middle-Aged Depressed Women Jin-Wook Lee, M.D., Yim Kim, M.D., Sun-Mi Yi, M.S., Dong-In Kim, M.D., Heon-Jeong Eun, M.D. Department of Neuropsychiatry, Presbyterian Medical Center, Chonju The objective of this study was to explore the psychosocial factors such as life events, coping styles and family relationships in middle-aged depressed women. This study was designed to compare how different variables relate to depression in two different test groups : a depressed patient group and a normal group. The Beck Depression Inventory(BDI), The Ways of Coping Checklist, Interpersonal Support Evaluation List(ISEL), Family Environment Scale were administered to 116 depressed patients and 113 normal persons between the ages of 35 and 64. The results were as follows : 1) The highest stress was marital stress(n=42, 36.2%) in patient group and family stress(n=44, 38.9%) in normal group, respectively. 2) There were significant differences between patient group and normal group in BDI scores(t=15.94, p<.0001), life events(t=4.73, p<.0001), active copinig(t=6.29, p<.0001), social support(t=7.20, p<.0001), and family relationships(t=5.75, p<.0001) except for passive coping(t=0.93, p=.35). 3) In depressed patient group, BDI scores had a significantly positive correlation with the scores of the life events(r=.24, p<.01) and negative correlation with active coping(r= -.22, p<.01), social support(r= -.35, p<.001) and family relationships(r= -.30, p<.001). 4) In depressed patient group, multiple regression analysis showed that social support(12.3%, β= -.281, T= -3.162, P=.002), life events(5.1%, β=.279. T=3.195, P=.002), and active coping(3.5%, β= -.204, T= -2.225, P=.028) had predictability on the BDI scores and the total predictability was 20.9%. 5) Stress experienced in family relationships were highest in life events and there was a lack of consistency(in the BDI scores of the coping styles). Social support was the most important factor and there were no significant differences between the two groups in family relationships.

Two Types of Egress Based on Initiation: On The Pearl, “Flight,” and The Forgotten Village

( Kim¸ Eun-jin ),( Lee¸ Geon-geun ) 동국대학교 영어권문화연구소 2015 영어권문화연구 Vol.8 No.2

John Steinbeck, a Nobel-Literature laureate, is said to have had the strong impulse to get away to nature when young. His novels are distinctive of the description of egress from the society. For example, the characters of The Pearl, “Flight,” and The Forgotten Village leave their home to mountains and another city. Also, the egress is based on their initiation into a process of maturity and divided into two types―autobiographical and dramatic transition story. This paper aims to distinguish their characteristics by analyzing the texts of the three works in detail. Especially, it is possible that the egress of The Pearl is explained with both the styles depending on who is the hero of the story between Kino and the personified pearl. Besides, the takeoff of “Flight” is interpreted as the dramatic transition type, while that of The Forgotten Village as autographical one. Meanwhile, during more than half a century, the initiation story has been classified by Mordecai Marcus's idea according to its power as tentative, uncompleted, and decisive. However, the older typology is contingent on forms, not on contents. The newer one can reveal the speed of initiation, the tone and mood, the narrator's position, the clarity of a turning point, the role of supporting characters, the necessity of supplementary devices, the extent of the individual's conflict with the society, family relationship, the range of affecting factors, symbolic effect, the difference between what the hero knows and what s/he does not yet know, and the relationship between the internal and external part the protagonist has. All in all, two types of egress based on initiation are intended to contribute to developing the research on initiation stories.

두경부 마사지가 중환자실 환자의 수면과 불안에 미치는 효과

김미용,전선영,송윤희,최은진,김재희,김미성,주명순,김남선 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: This study was to apply head and neck massage to patients in intensive care unit and to inventigate the effect of that massage on sleep and state anxiety. Method: The subjects in this study were 27 patients who were admitted in medical intensive care unit. The study was performed from June thru September of 2005 on the One-group pretest-posttest design and the sleep, state anxiety of the subjects were measured before and after head and neck massage. For data analysis, paired t-test and Pearson correlation coefficient were utilized. Result: The first hypothesis that the subjects might have a better sleep after being exposed to head and neck massage was accepted. The second hypothesis that the subjects might feel less state anxiety afrer being exposed to head and neck massage was accepted. The third hypothesis that the sleep of the ICU patients maight be correlated to their anxiety was accepted, as there appeared correlation between their sleep and anxiety. Conclusion: Head and neck massage is identified as one of independent nursing interwentions to improve the sleep of ICU patients and ease their anxiety, and it is necessary to apply it to clinical practices.

심실 조기 수축의 발생 부위 및 연결 간격의 차이에 따른 혈역학적 변화

진승원,김재형,노태호,조은주,김희열,이만영,김종진,박준철,채장성,홍순조,최규보 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.7

비만여중생에서 에어로빅스 운동에 따른 Leptin 농도와 혈청지질간의 상관관계

김주혁,김종인,김은희,김수진,김도형,장성동 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

The subjects of this study included 7 obese middle school girls aged 14 to 15 whose percent at was 35% or over and who were found having no diseases as a result of medical examinations, There's no significant change in Total Cholesterol between 170.7±34.81 before training and 169.0±32.31mg/㎗ after training Triglyceride was significantly decreased from 125.8±75.41 before training to 111.7±54.72.mg/㎗ after training(p<.01). HDL-C showed no significant change from 49.9±10.37 before training to 42.5±7.64mg/㎗ after training, Free Fat Acid was significantly increased from 623,3±176.07 before training to 695.7± 238.73μUq/l after training, Growth Hormone also showed a significant increase from 6.59± 5.29 before training to 9.17±4.24ng/㎖ after training(p<.05). Insluin showed a significant change from 22.3±6.08 to 16.8±4.84μ[U/㎖ between before and after training Lipoprotein Lipase was changed from 53.3±13.25 before training to 39.1±14.19ng/㎖ after training Finally, Leptin showed a change from 24.1±7.17 before training to 23.3±12.22ng/㎖ after training but with no significant difference. Concerning correlations between leptin and serum lipid, there were high correlations between total cholesterol and HDL-C and low between growth hormone and free fat acid, Lein was highly correlated with free fat acid and low with insulin.

Effects of Phenytoin and Diazepam on the Seizure Activity in the Cortical Dysplasia Animal Models

Kim, Si-Hyung,Choi, In-Sun,Cho, Jin-Hwa,Park, Eun-Ju,Jang, Il-Sung,Choi, Byung-Ju,Kim, Hyun-Jung,Kim, Young-Jin,Nam, Soon-Hyeun The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Dysplasia-associated seizure disorders are markedly resistant to pharmacological intervention. Relatively little research has been conducted studying the effects of antiepileptic drugs(AEDs) on seizure activity in a rat model of dysplasia. We have used rats exposed to methylazoxymethanol acetate(MAM) in utero, an animal model featuring nodular heterotopia, to investigate the effects of AEDs in the dysplastic brain. Pilocarpine was used to induce acute seizure in MAM-exposed and age-matched vehicle-injucted control animals. Field potential recordings were used to monitor amplitude and numbers population spikes, and paired pulse inhibition in response to stimulation of commissural pathway. Two commonly used AEDs were tested: diazepam 5, 2.5mg/kg;phenytoin 40, 60mg/kg. Diazepam(DZP) and phenytoin(PHT) reduced the amplitude of population spike in control and MAM-exposed rats. However, the amplitude of population spike was nearly eliminated in control rats as compared to the MAM-exposed rats. Pharmaco-resistance was tested by measuring seizure latencies in awake rats after pilocarpine administration(320mg/kg, i.p.) with and without pretreatment with AEDs. Pre-treatment with PHT 60 mg prolonged seizure latency in control rats, but not in MAM-exposed animals. The main findings of this study are that acute seizures initiated in MAM-exposed rats are relatively resistant to standard AEDs assessed in vivo. These data suggest that animal model with cortical dysplasia can be used to screen the effects of potential AEDs.