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    ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„์˜ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™

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    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์‹ฌ๋ฆฌํ•™๊ณผ, 2014. 2. ๋ฏผ๊ฒฝํ™˜.์ฐฝ์กฐ์„ฑ์˜ ์‹ฌ๋ฆฌํ•™์€ ๊ฐœ์ธ์˜ ์ฐฝ์กฐ์  ๋Šฅ๋ ฅ์— ๋Œ€ํ•œ ์—ฐ๊ตฌ๋กœ ์ถœ๋ฐœํ–ˆ๋‹ค. ๊ฐœ์ธ ๋Šฅ๋ ฅ์˜ ์—ฐ๊ตฌ๋Š” ํ™•์‚ฐ์  ์‚ฌ๊ณ ์˜ ์ค‘์š”์„ฑ์„ ๋ฐœ๊ฒฌํ•˜๋Š” ์„ฑ๊ณผ๋ฅผ ์ด๋ฃจ์—ˆ์œผ๋‚˜ ๊ฐœ์ธ์˜ ํ™•์‚ฐ์  ์‚ฌ๊ณ  ๋Šฅ๋ ฅ์ด ๋ฐ˜๋“œ์‹œ ์ฐฝ์กฐ์  ์„ฑ๊ณผ๋กœ ๋ฐœํ˜„๋˜์ง€๋Š” ์•Š๋Š”๋‹ค๋Š” ์‚ฌ์‹ค๋„ ๊ณง ๋ฐํ˜€์กŒ๋‹ค. ์ด์— ๋”ฐ๋ผ ์‚ฌํšŒ์ ์œผ๋กœ ์ธ์ •๋ฐ›๋Š” ์‚ฐ๋ฌผ์˜ ์ฐฝ์กฐ๋กœ ๊ท€๊ฒฐ๋˜๋Š” ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„์˜ ์žฅ๊ธฐ์ ์ด๊ณ  ์‚ฌํšŒ์ ์ธ ๊ณผ์ •์— ๋Œ€ํ•œ ๊ด€์‹ฌ์ด ํ˜•์„ฑ๋˜์—ˆ์œผ๋ฉฐ ์ด๋Š” ์ฐฝ์กฐ์„ฑ์˜ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™์œผ๋กœ ์—ฐ๊ฒฐ๋˜์—ˆ๋‹ค. ์ฐฝ์กฐ์„ฑ์˜ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™์€ ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„ ๊ณผ์ •์— ๊ด€์—ฌํ•˜๋Š” ์‚ฌํšŒ์  ์ด‰์ง„ ์š”์ธ์„ ํƒ๊ตฌํ•˜๊ณ , ์‚ฌํšŒ์  ํ™˜๊ฒฝ๊ณผ ์ฐฝ์กฐ์ž ๊ฐœ์ธ์˜ ๋™๊ธฐ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ํšจ๊ณผ๋ฅผ ๋ฐํ˜€๋‚ด๋ ค ํ•œ๋‹ค. ํŠนํžˆ Simonton(1999, 2012)์˜ ๋‹ค์œˆ์ฃผ์˜์  ์ฐฝ์กฐ์„ฑ ๋ชจํ˜•์€ ์ฐฝ์กฐ ์˜์—ญ์— ๋”ฐ๋ผ ๋‹ฌ๋ผ์ง€๋Š” ์ž์œ ๋กญ๊ณ  ์œ ์—ฐํ•œ ํ™•์‚ฐ์  ๊ณผ์ •๊ณผ ์—„๋ฐ€ํ•œ ๋ถ„์„์ , ์ˆ˜๋ ด์  ๊ณผ์ •์˜ ์ƒ๋Œ€์  ๋น„์ค‘์— ๋งž์ถ”์–ด ์ฐฝ์กฐ์ž์— ์ž‘์šฉํ•˜๋Š” ์‚ฌํšŒ์  ํ™˜๊ฒฝ๊ณผ ๋™๊ธฐ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ํšจ๊ณผ ์–‘์ƒ์„ ๊ตฌ์กฐํ™”ํ•˜๋Š” ํ‹€์„ ๋งˆ๋ จํ•œ๋‹ค. ์ด ๋…ผ๋ฌธ์€ ์ฐฝ์กฐ์„ฑ์˜ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™์„ ๋ฐ”ํƒ•์œผ๋กœ ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ํ˜„๋Œ€ ์†Œ์„ค ์˜์—ญ๊ณผ ๋ฏธ์ˆ  ์˜์—ญ์˜ ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„์„ ํ•ด๋ช…ํ•˜๊ณ ์ž ํ•œ ์—ฐ๊ตฌ ์ž‘์—…์ด๋‹ค. ์ด๋ฅผ ํ†ตํ•ด ์•„์ง๊นŒ์ง€ ์‹ฌ๋ฆฌํ•™์  ์—ฐ๊ตฌ ๋Œ€์ƒ์œผ๋กœ ์ฃผ๋ชฉ๋ฐ›์ง€ ๋ชปํ•œ ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ๋‘ ์˜ˆ์ˆ  ์˜์—ญ์„ ๊นŠ์ด ์žˆ๊ฒŒ ๊ธฐ์ˆ ํ•ด๋‚ด๊ณ , ์ด ๊ณผ์ •์—์„œ ๋‹ค์œˆ์ฃผ์˜์  ์ฐฝ์กฐ์„ฑ ๋ชจํ˜•์„ ์ค‘์‹ฌ์œผ๋กœ ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„์˜ ํ™˜๊ฒฝ๋ก ๊ณผ ๋™๊ธฐ๋ก ์„ ์—ฐ๊ฒฐํ•˜๋ ค๋Š” ๋…ธ๋ ฅ์„ ๊ธฐ์šธ์˜€๋‹ค. ์—ฐ๊ตฌ 1์€ ์šฐ๋ฆฌ๋‚˜๋ผ ํ˜„๋Œ€ ์†Œ์„ค๊ณผ ๋ฏธ์ˆ  ์˜์—ญ์—์„œ ์ด๋ฆ„ ์žˆ๋Š” ์ธ๋ฌผ๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ๋ฌธํ—Œ ์—ฐ๊ตฌ๋ฅผ ์ง„ํ–‰ํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ 1-1์—์„œ๋Š” ์†Œ์„ค๊ณผ ๋ฏธ์ˆ  ๋‘ ์˜์—ญ ์ฐฝ์กฐ์ž์˜ ๋‚˜์ด์— ๋”ฐ๋ฅธ ๋ช…์„ฑ ๋ณ€ํ™”๋ฅผ ๊ด€์ฐฐํ•˜์—ฌ ์ด๋“ค์ด ์„œ๊ตฌ์˜ ์—ฌ๋Ÿฌ ์˜์—ญ๊ณผ ๋น„๊ตํ–ˆ์„ ๋•Œ ๋น„๊ต์  ๋น ๋ฅธ ์‹œ์ ์— ๋†’์€ ๋ช…์„ฑ์„ ํš๋“ํ•˜๋Š” ๊ฒƒ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๋‹ค์œˆ์ฃผ์˜์  ์ฐฝ์กฐ์„ฑ ๋ชจํ˜•์— ์˜๊ฑฐํ•˜์—ฌ ์ด ๊ฒฐ๊ณผ๋Š” ๋‘ ์˜์—ญ์˜ ์ฐฝ์กฐ์ž๊ฐ€ ํ™•์‚ฐ์  ๊ณผ์ •์— ๋น„์ค‘์„ ๋‘๊ณ  ๋‹ค์–‘ํ•œ ์‚ฐ๋ฌผ์˜ ๋น ๋ฅธ ์‚ฐ์ถœ์„ ๊พ€ํ•จ์„ ๋ณด์—ฌ์ฃผ๋Š” ๋‹จ์„œ๋กœ ํ•ด์„๋˜์—ˆ๋‹ค. ๋˜ํ•œ ์†Œ์„ค ์˜์—ญ์€ ๋ฏธ์ˆ  ์˜์—ญ์— ๋น„ํ•ด ๋ช…์„ฑ ํš๋“ ์‹œ์ ์ด ๋” ๋น ๋ฅธ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚˜ ์†Œ์„ค๊ฐ€์—๊ฒŒ์„œ ํ™•์‚ฐ์  ๊ณผ์ • ๋ฐ ๊ทธ์™€ ๊ด€๋ จ๋˜๋Š” ํ™˜๊ฒฝ์˜ ์˜ํ–ฅ๊ณผ ๋™๊ธฐ ์—ญ๋™์ด ๋” ๋‘๋“œ๋Ÿฌ์งˆ ๊ฒƒ์œผ๋กœ ์˜ˆ์ƒ๋˜์—ˆ๋‹ค. ์ด์–ด์ง€๋Š” ์—ฐ๊ตฌ 1-2์—์„œ๋Š” ๋‹ค์ฑ„๋กœ์šด ์ง€์‹๊ณผ ์ƒ๊ฐ์„ ๊ณต๊ธ‰ํ•จ์œผ๋กœ์จ ํ™•์‚ฐ์  ๊ณผ์ •์„ ๋•๋Š” ์—ฌ๋Ÿฌ ์‚ฌํšŒ ํ™˜๊ฒฝ ์š”์ธ์ด ๋‘ ์˜์—ญ ๋ชจ๋‘์—์„œ ๊ธ์ •์  ํšจ๊ณผ๋ฅผ ๋‚˜ํƒ€๋ƒ„์„ ํ™•์ธํ•˜์˜€์œผ๋‚˜ ํŠนํžˆ ์†Œ์„ค๊ฐ€๊ฐ€ ์ด ๊ฐ™์€ ํ™˜๊ฒฝ์˜ ์˜ํ–ฅ์„ ๋” ํฌ๊ฒŒ ๋ฐ›๋Š”๋‹ค๋Š” ์ฆ๊ฑฐ๋Š” ๋ฐœ๊ฒฌํ•˜์ง€ ๋ชปํ–ˆ๋‹ค. ์—ฐ๊ตฌ 2์—์„œ๋Š” ํ˜„์žฌ ์†Œ์„ค๊ณผ ๋ฏธ์ˆ  ์˜์—ญ์—์„œ ํ™œ๋™ ์ค‘์ธ ์ฐฝ์กฐ์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๋ฉด๋‹ด ์—ฐ๊ตฌ๋ฅผ ์ง„ํ–‰ํ•˜์—ฌ ํŠนํžˆ ์ด๋“ค์˜ ์ฐฝ์กฐ ๊ณผ์ •์˜ ์ €๋ณ€์—์„œ ์ž‘๋™ํ•˜๋Š” ๋™๊ธฐ์ , ์ •์„œ์  ์—ญ๋™์„ ํ•ด๋ช…ํ•˜๊ณ ์ž ํ–ˆ๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ์†Œ์„ค๊ฐ€ ์ฐธ์—ฌ์ž๋“ค์€ ํ™•์‚ฐ์  ๊ณผ์ •๊ณผ ๊ธ์ •์  ๊ด€๊ณ„๋ฅผ ๋งบ๋Š” ๋ชฐ์ž…(flow)์„ ์ค‘์‹œํ•˜๊ณ  ๋ชฐ์ž…์— ๋“œ๋Š” ๋ฐฉ๋ฒ•์„ ๊ฐ•๊ตฌํ•˜๋Š” ๊ฒƒ์„ ๋ฐœ๊ฒฌํ•˜์˜€์œผ๋ฉฐ ์ด๋Š” ์—ฐ๊ตฌ 1์˜ ๊ฒฐ๊ณผ์™€ ๋ถ€ํ•ฉํ•˜์˜€๋‹ค. ๋ฐ˜๋ฉด ๋ฏธ์ˆ ๊ฐ€ ์ฐธ์—ฌ์ž๋“ค์€ ํŠนํžˆ ์˜์—ญ์˜ ๊ตฌ์„ฑ ๋‚ด์šฉ์„ ๋ฉด๋ฐ€ํžˆ ๋ถ„์„ํ•˜๊ณ  ์˜์—ญ์— ๋Œ€ํ•œ ๊ธฐ์—ฌ๋ฅผ ๊ฐ•์กฐํ•˜๋Š” ๋“ฑ ์ˆ˜๋ ด์ ์ธ ๊ณผ์ •์„ ๋ณด๋‹ค ์ค‘์‹œํ•˜๋Š” ๋ชจ์Šต์„ ๋ณด์˜€์œผ๋ฉฐ ์ด๋Š” ์—ฐ๊ตฌ 1-1์— ๋‚˜ํƒ€๋‚œ ๋‘ ์˜์—ญ์˜ ๊ฒฝ๋ ฅ ํ‘œ์ง€์  ์ฐจ์ด๋ฅผ ์ž˜ ์„ค๋ช…ํ•ด์ฃผ์—ˆ๋‹ค. ๋งˆ์ง€๋ง‰์œผ๋กœ ์—ฐ๊ตฌ์˜ ์ข…ํ•ฉ ๋…ผ์˜์—์„œ ์ด ๋…ผ๋ฌธ์ด ํ•œ๊ตญ ์†Œ์„ค๊ณผ ๋ฏธ์ˆ  ์˜์—ญ์„ ๊ธฐ์ˆ ํ•ด๋‚ธ ๋ฐ”์™€ ์ฐฝ์กฐ์„ฑ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™์— ๊ธฐ์—ฌํ•œ ๋ฐ”๋ฅผ ์ •๋ฆฌํ•˜๊ณ  ๊ทธ ํ•จ์˜๋ฅผ ๋…ผํ•˜์˜€์œผ๋ฉฐ ๋ฏธ๋ž˜ ์—ฐ๊ตฌ์˜ ๋ฐœ์ „ ๋ฐฉํ–ฅ์„ ์ œ์•ˆํ•˜์˜€๋‹ค.์„œ ๋ก  1 ์—ฐ๊ตฌ ๋ชฉ์  1 ์ฐฝ์กฐ์„ฑ ์—ฐ๊ตฌ์˜ ๋ณ€์ฒœ: ๊ฐœ์ธ ๋Šฅ๋ ฅ์—์„œ ์‚ฌํšŒ์  ์—ญ๋™์œผ๋กœ 3 ๊ณผํ•™์  ์ฐฝ์กฐ์„ฑ ์—ฐ๊ตฌ์˜ 1์„ธ๋Œ€์™€ ํ™•์‚ฐ์  ์‚ฌ๊ณ  3 ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„ ๊ณผ์ •๊ณผ ์‚ฌํšŒ์  ์ฒด๊ณ„: ์ฐฝ์กฐ์„ฑ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™์˜ ํ˜•์„ฑ 8 ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„์˜ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™ 10 ์ฐฝ์กฐ์„ฑ์˜ ๊ณผํ•™์  ์ •์˜ 10 ์ฐฝ์กฐ์„ฑ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™์˜ ๋ฐฉ๋ฒ•๋ก  13 ๊ฐœ์ธ์˜ ์ƒˆ๋กœ์›€ ์‚ฐ์ถœ์— ์ž‘์šฉํ•˜๋Š” ์‚ฌํšŒ์  ํ™˜๊ฒฝ 16 ๊ฐœ์ธ์˜ ์ƒˆ๋กœ์›€ ์‚ฐ์ถœ์— ์ž‘์šฉํ•˜๋Š” ๋™๊ธฐ ์š”์ธ๊ณผ ๊ทธ ์‚ฌํšŒ์  ํ™˜๊ฒฝ 18 ์˜์—ญ ํšจ๊ณผ์˜ ์ด๋ก : ์ฐฝ์กฐ์„ฑ ์‚ฌํšŒ์‹ฌ๋ฆฌํ•™์˜ ์ข…ํ•ฉ 24 ์˜์—ญ์˜ ์‹ค์ฒด์™€ ํšจ๊ณผ 24 ๋‹ค์œˆ์ฃผ์˜์  ์ฐฝ์กฐ์„ฑ ๋ชจํ˜• 28 ์˜์—ญ๊ณผ ์‚ฌํšŒ์  ํ™˜๊ฒฝ 33 ์˜์—ญ๊ณผ ๋™๊ธฐ์  ์ƒํ˜ธ์ž‘์šฉ 36 ํ•œ๊ตญ ํ˜„๋Œ€ ์†Œ์„ค๊ณผ ๋ฏธ์ˆ ์˜ ์—ญ์‚ฌ์  ๋ฐฐ๊ฒฝ๊ณผ ์—ฐ๊ตฌ ์˜ˆ์ธก 39 ์—ฐ๊ตฌ ๊ตฌ์„ฑ 42 ์—ฐ ๊ตฌ 1 45 ์—ฐ๊ตฌ 1-1: ํ•œ๊ตญ ํ˜„๋Œ€ ์†Œ์„ค๊ณผ ๋ฏธ์ˆ ์˜ ๊ฒฝ๋ ฅ ํ‘œ์ง€์  45 1. ๋ฐฉ๋ฒ• 45 2. ๊ฒฐ๊ณผ ๋ฐ ๋…ผ์˜ 48 ์—ฐ๊ตฌ 1-2: ์‚ฌํšŒ์  ํ™˜๊ฒฝ์˜ ํšจ๊ณผ 53 1. ์ ˆ์ฐจ 53 2. ๊ฒฐ๊ณผ 56 ์—ฐ๊ตฌ 1 ๋…ผ์˜ 66 ์—ฐ ๊ตฌ 2 69 ๋ฐฉ๋ฒ• 69 ์—ฐ๊ตฌ 2-1: ์†Œ์„ค๊ฐ€์˜ ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„ ๊ณผ์ • 74 1. ์†Œ์„ค๊ฐ€๊ฐ€ ๋˜๊ธฐ 74 2. ์†Œ์„ค๊ฐ€๋กœ ์‚ด๊ธฐ 80 3. ์ž‘์—…ํ•˜๊ธฐ 86 ์—ฐ๊ตฌ 2-2: ๋ฏธ์ˆ ๊ฐ€์˜ ์ฐฝ์กฐ์„ฑ ๋ฐœํ˜„ ๊ณผ์ • 94 1. ๋ฏธ์ˆ ๊ฐ€๊ฐ€ ๋˜๊ธฐ 94 2. ๋ฏธ์ˆ ๊ฐ€๋กœ ์‚ด๊ธฐ 97 3. ์ž‘์—…ํ•˜๊ธฐ 107 ์—ฐ๊ตฌ 2 ๋…ผ์˜ 112 ์ข…ํ•ฉ ๋…ผ์˜ 121 ์ฐธ๊ณ ๋ฌธํ—Œ 127 Abstract 142Docto

    Determinants of emotion regulation motive : focusing on the effect of daily mood

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์‹ฌ๋ฆฌํ•™๊ณผ ์„ฑ๊ฒฉ์‹ฌ๋ฆฌ์ „๊ณต,2005.Maste

    Development of CDR model for lifetime health management based on EHR

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    ๋ณด๊ฑด์ •๋ณด๊ด€๋ฆฌํ•™๊ณผ/์„์‚ฌ[ํ•œ๊ธ€] ์ด ์—ฐ๊ตฌ๋Š” HL7์—์„œ ์ œ์•ˆํ•˜๋Š” ํ‘œ์ค€ ์˜๋ฃŒ์ •๋ณด ๊ธฐ์ˆ ์„ ์ ์šฉํ•˜์—ฌ, ๊ตญ๋ฏผ๊ฐœ์ธ ์ƒ์• ๊ฑด๊ฐ•๊ด€๋ฆฌ ํšจ์œจ์„ ๋†’์ด๊ณ , ํ™˜์ž๊ฐ€ ๋‹ค๋ฅธ ๋ณ‘์›์œผ๋กœ ์ด๋™ํ•  ๋•Œ ์ง„๋ฃŒ์˜ ์—ฐ์†์„ฑ์„ ๋ณด์žฅํ•˜๊ณ ์ž ๊ตญ๋ฏผ๊ฑด๊ฐ•๋ณดํ—˜๊ณต๋‹จ์˜ ๊ฑด๊ฐ•๊ฒ€์ง„๊ธฐ๋ฐ˜ CDR ๊ธฐ๋ณธ ๋ชจํ˜•์„ ์ œ์‹œํ•˜์˜€๋‹ค. ์ด๋ฅผ ์œ„ํ•˜์—ฌ ๋ฌธํ—Œ๊ณ ์ฐฐ์„ ํ†ตํ•˜์—ฌ ASP.Net ํ”„๋กœ๊ทธ๋žจ๊ณผ C++, XML ์–ธ์–ด์˜ ์ตœ์‹ ๊ธฐ์ˆ ์„ ์ ์šฉํ•˜์—ฌ CDR์„ ๊ฐœ๋ฐœํ•˜์˜€๋‹ค.CDR์˜ ๊ฐœ๋ฐœ๊ณผ ํ‰๊ฐ€ ๊ฒฐ๊ณผ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค.์ฒซ์งธ, ์ •์ฑ…์ˆ˜๋ฆฝ์ž, ๊ตญ๋ฏผ๊ฐœ์ธ, ์ž„์ƒ์—ฐ๊ตฌ์ž์—๊ฒŒ ๊ฑด๊ฐ•๊ฒ€์ง„ ๋‚ด์—ญ, ์ง„๋ฃŒ๋‚ด์—ญ, ์š”์–‘๊ธฐ๊ด€์˜ ํ‡ด์›์š”์•ฝ์ •๋ณด, ์ธ๊ตฌ์˜ ์‚ฌํšŒ๊ฒฝ์ œ์  ํ†ต๊ณ„์™€ ๊ด€๋ จ๋œ 11๊ฐœ ์—ฐ๊ณ„๊ธฐ๊ด€ ์ •๋ณด๋ฅผ ์‹ค์‹œ๊ฐ„์œผ๋กœ ์ œ๊ณตํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ๊ตญ๋ฏผ๊ฑด๊ฐ•๋ณดํ—˜๊ณต๋‹จ์˜ ๊ฑด๊ฐ•๊ฒ€์ง„ ๊ธฐ๋ฐ˜ EHR ๋ชจํ˜•์„ ์„ค๊ณ„ํ•˜์˜€๋‹ค.๋‘˜์งธ, CDR๋ชจํ˜• ๊ฐœ๋ฐœ์— ํ•„์š”ํ•œ ๊ธฐ์ดˆ๋ฐ์ดํ„ฐ๋Š” ๊ฐ€์ž…์ž(์ž๊ฒฉ)ยท๋ณดํ—˜๋ฃŒ ์ •๋ณด 18๊ฐœ ํ•ญ๋ชฉ, ์˜๋ฃŒ์ด์šฉ ์ •๋ณด 11๊ฐœ ํ•ญ๋ชฉ, ๊ฑด๊ฐ•๊ฒ€์ง„์ •๋ณด 108๊ฐœ ํ•ญ๋ชฉ, ์š”์–‘๊ธฐ๊ด€์ •๋ณด 16๊ฐœ ํ•ญ๋ชฉ, ํ‡ด์›์š”์•ฝ์ •๋ณด 16๊ฐœ ํ•ญ๋ชฉ์„ ๋„์ถœํ•˜์˜€๋‹ค.์…‹์งธ, ๊ฑด๊ฐ•๊ฒ€์ง„๊ธฐ๋ฐ˜์˜ EHR ๊ตฌํ˜„์„ ์œ„ํ•ด ๊ตญ๋ฏผ๊ฑด๊ฐ•๋ณดํ—˜๊ณต๋‹จ์˜ ํ‘œ์ค€ํ™”๋œ ์„œ์‹์„ CDA๋กœ ๊ตฌ์„ฑํ•˜๊ณ  ๊ธฐ์กด DW์˜ DBํ…Œ์ด๋ธ”๊ณผ ์—ฐ๊ณ„ํ•˜์—ฌ 3๊ณ„์ธต์˜ CDR์„ ๊ตฌ์ถ•ํ•˜์˜€๋‹ค.๋„ท์งธ, CDR์„ ๊ตฌ์ถ•ํ•œ ํ›„ ์ง€๋‚œ 2๋…„ ๋™์•ˆ ์š”๊ตฌ์ •๋ณด๋ฅผ ๋ถ„์„ํ•˜์—ฌ ๋‹ค ๋นˆ๋„ ์งˆ๋ฌธ์„ ์„ ์ •ํ•˜์—ฌ CDR์˜ ํšจ์œจ์„ฑ์„ ํ‰๊ฐ€ํ•œ ๊ฒฐ๊ณผ ๊ธฐ์กด DW์‹œ์Šคํ…œ ๋ณด๋‹ค ์ฟผ๋ฆฌ์˜ ์ž‘์—…๊ณผ์ •์ด 37๋‹จ๊ณ„์„œ 5๋‹จ๊ณ„๋กœ ๊ฐ„์†Œํ™”๋˜์—ˆ๊ณ , ์†Œ์š”์‹œ๊ฐ„์€ 15๋ถ„ 48์ดˆ์—์„œ 51์ดˆ๋กœ ๊ฐœ์„ ๋œ ๊ฒฐ๊ณผ๋ฅผ ๋ณด์˜€๋‹ค.์ตœ์ข…์ ์œผ๋กœ ์ด ์—ฐ๊ตฌ๊ฒฐ๊ณผ๋Š” ๊ตญ๋ฏผ๊ฑด๊ฐ•๋ณดํ—˜๊ณต๋‹จ์˜ ๊ฑด๊ฐ•๊ฒ€์ง„๊ธฐ๋ฐ˜์˜ EHR ๊ตฌํ˜„์„ ์œ„ํ•œ CDR์€ ์‹œ๊ฐ„๊ณผ ๋น„์šฉ์—์„œ ํšจ์œจ์„ฑ ์žˆ๋Š” ์„ค๊ณ„๋ชจํ˜•์ž„์„ ์ฆ๋ช…ํ•˜์˜€๋‹ค.์ด ์—ฐ๊ตฌ๋Š” ์˜ํ•™์ง€์‹์— ์ ํ•ฉํ•œ ๋ถ„๋ฅ˜์ฒด๊ณ„์— ๋Œ€ํ•œ ๊ณ ๋ ค๊ฐ€ ์—†์ด ๊ตญ๋ฏผ๊ฑด๊ฐ•๋ณดํ—˜๊ณต๋‹จ์—์„œ ์‚ฌ์šฉ์ค‘์ธ ์ •๋ณด ๋ถ„๋ฅ˜์ฒด๊ณ„๋ฅผ ์ ์šฉํ•˜์˜€๊ณ , EMR ์ž๋ฃŒ ํ†ตํ•ฉ๊ณผ์ •์—์„œ ์ผ๊ฐœ ๋ณ‘์›์˜ ํ‡ด์›์š”์•ฝ ํ˜•์‹๋งŒ์„ ์‚ฌ์šฉํ•˜์—ฌ ๊ฐœ๋ฐœํ•˜์˜€๋‹ค๋Š” ์ œํ•œ์ ์„ ๊ฐ€์ง€๋‚˜ ์‹ค์ œ ๊ตญ๋ฏผ๊ฑด๊ฐ•๋ณดํ—˜๊ณต๋‹จ์˜ ์—…๋ฌด์— ์ ์šฉํ•˜์—ฌ ํšจ๊ณผ๋ฅผ ๊ฒ€์ฆํ•˜์—ฌ ์‹œ๊ฐ„๊ณผ ๋น„์šฉ์—์„œ ํšจ์œจ์„ฑ ์žˆ๋Š” ๋ชจํ˜•์„ ๋„์ถœํ•˜์˜€๋‹ค๋Š” ์ ์—์„œ ์˜์˜๋ฅผ ๊ฐ€์ง„๋‹ค๊ณ  ํŒ๋‹จ๋œ๋‹ค.ํ–ฅํ›„ ๊ฐœ์ธ๊ฑด๊ฐ•์˜ˆ๋ฐฉ์„œ๋น„์Šค์™€ ์—ฐ๊ตฌ์ž์˜ ๊ฑด๊ฐ•๊ฒ€์ง„ ์ •๋ณด์ ‘๊ทผ์„ฑ๊ณผ ํŽธ์ด์„ฑ์„ ๋†’์ด๋Š” ๋ฒ•, ์ œ๋„์  ๋ฌธ์ œ๋ฅผ ํ•ด๊ฒฐํ•ด์•ผ ํ•  ๊ฒƒ์ด๋‹ค. [์˜๋ฌธ]This study presents the CDR(clinical document repository) model for lifetime health management of health insurance beneficiaries and their families by using physical examination database and utilization database at NHIC(National Health Insurance Cooperatives). The CDR may help improve continuity of medical treatment by applying HL7 standards when patients are transferred to other hospitals. Based on the literature review, the CDR was developed by using the latest technologies such as ASP .Net program, C++, and XML language.The CDR was developed and evaluated as follows:First, EHR model was developed by using physical examination database and utilization database at NHIC in order to provide information on physical examination data, health records, discharge summary, and socio-economic data for 11 related agencies to policy makers, health researchers, and beneficiaries.Second, data items for CDR model were determined from physical examination database and utilization database. They were: 18 items on eligibility and insurance fee, 11 items on health care utilization, 108 items on physical examination data, 16 items on healthcare institution data, and 16 items on discharge summary data.Third, a standardized document for EHR was developed by using CDA(clinical document architecture), and 3 layer-CDR was developed by integrating with database table from the existing data warehouse.Finally, a performance of CDR was evaluated by comparing its processing time with that of data warehouse using the most frequent query for the past two years. As a result, the work process for this query has reduced from 37 steps to 5 steps, and its processing time has reduced from 15 minutes 48 seconds to only 51 seconds.In conclusion, the results of this study showed that CDR for the physical examination-based EHR performed better than the existing data warehouse and that it is a cost-efficient alternative for developing EHR.In the future, more studies on improving accessibility of CDR and EHR for beneficiaries and researchers are needed in order to help them better utilize these data for their health promotion and the related research. This may require not only technical efforts as well as legal studies.ope

    Synoptic characteristics for Korean regional heavy snowfall when Siberian High extends to the peninsula

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์‚ฌํšŒ๊ต์œก๊ณผ(์ง€๋ฆฌ์ „๊ณต), 2011.2. ๋ฐ•๋ณ‘์ต.Maste

    Effects of renal decapsulation on renin-angiotensin-aldosterone system in renal hypertensive dogs

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    In 8 mongrel dogs , renal hypertension was produced by partial constriction of their renal artery and 3 weeks after the constriction of renal artery, reoperation, decapsulation of both kidneys were done in every hypertensive dogs. The changes in blood pressure and body weight were measured every week during the course of experiment for 5 weeks, and also simultaneous blood samples were drawn for analysis of activities of plasma reninl steroid, aldosterone, sodium and potassium concentrations. The results obtained were as follows: 1. The control mean systolic pressure before operation was 136ยฑ22 mmHg. After constriction of renal artery, it was greatly increased within 3 days and rised up to 3 weeks continuously when maximum mean value of 264ยฑ12 mmHg was measured. However , blood pressure in every hypertensive dogs were gradWllly decreased and return to normal 2 weeks after renal decapsulation. 2. The control plasma renin activities were aver aged 132ยฑ57 ng%/hr. After renal constriction, the plasma renin activities rised proportionately with the rise of blood pressure up to 3 weeks. The maximal value at 3 weeks after operation was 2. 5 times of control value. Renin activities were also decreased to almost normal value within 2 weeks by renal decapsulation. . .f 3. There are no signifi๋”ฐ['t ๏ผŒ ~ variations in total blood steroid either after renal constriction or renal decapsulation. Aldosterone levels were however proportionately increased or decreased according to the blood renin activities. While , blood Na level was increased and K levels were decreased during renal arterial constriction period but their relations hips were reversed after renal decapsulation. 4. The changes in body weight after constriction of renal artery were increased from 11.8ยฑ0. 8kg in control to 12. 9ยฑ0. 8 kg. Thereafter these mean values were tend to normal value within 2 weeks after renal decapsulation. The increase in body weight is supposed to mean the degree of edema due to Na retension by aldosterone. From the above data it can be reconfirmed that remarkable disordered function in R-A-A system in the renal hyPertension were same with those in the typical secondary aldosteronism and functions of R-A-A system in the renal hypertensive dogs also tend to return to normal by renal decapsulation

    Changes in Plasma Renin Activity at Various Postures in Rabbits

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    In order to investigate the changes in plasma renin activity at various postures in rabbits, the experi mental animals were maintained at prone, side. upright, and headside down postures for 10 hours. Plasma renin activity was measured by the method of radioimmunoassay. The data obtained were as follows: 1) At prone posture, the plasma renin activity was 14.72ยฑ3. 49 nanogram per 100ml plasma per hour. which was regarded as resting plasma renin activity. 2) At side posture, the plasma renin activity was 46.60ยฑ5. 41 ng/100ml plasma/hr, which was signi ficantly higher than that of resting plasma renin activity. 3) At upright posture, the plasma renin activity was 45.82ยฑ11. 51 ng/100ml plasma/hr, which was also significantly higher than that of resting level 4) At headside down posture, the plasma renin activity was 44. 16ยฑ10. 33 ng/1ooml plasma/hr, which Was also significantly higher than that of resting plasma leve l. From the adove results. it was concluded that the postures other than normal prone position in rabbits stimulated the release of renin in the kidne

    Renal Autoregulation in the Perfused Kidney of Rabbit

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    The phenomenon of renal autoregulation was investigated in the rabbits weighed from 1.8 to 2.3 kg. An isolated kidney from a experimental rabbit was perfused with the blood coIIected from the other one rabbit and the renal blood flow was measured in various arterial perfusion pressures. From the perfusion studies in connection of the isolated rabbit kidney with the perfusion system, foIIowing results were obtained: 1) The autoregulation was continued for 30 minutes from the time of perfusi~n ๏ผŒ and deteriora tion was noted rapidly. 2) The change in kidney weight was noted after the experiment. The increase in weight was revealed by the 3.2%. (from 6.54 gm to 6.75 gm) 3) The range of autoregulation was from the 110โ€ข 120 mmHg of renal perfusion pressure to the 180โ€ข 190 mmHg. 4) Within the range of autoregulation, the mean renal blood flow was 1.25 mljgm/min. 5) Total renal resistance calculated was increased proportionately within the range of autoregulation. However, that was inversely related to changes in renal perfusion pressure

    Renal Responses to the Changes in Volume and Osmolar Concentration of Extracellular Fluid

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    Sixty-six healthy medical students were divided into 5 groups and induced the changes in volume and/or osmolar concentration of extracellular fluid: The first group (water group) ingested 1.000ml water; The second group (saline group) ingested 1.000 ml isotonic saline solution; The third group (ADH group) ingested 600 ml water as a priming dose and thereafter 200 ml water every 30 minutes. and ADH(lOmU) was injected intramuscularly 2 hours after the start of the experiment; The fourth group (urea group) ingested 50 grams of urea; The fifth group (beer group) ingested 1. 000 ml beer(4% ethyl alcohol). Urine was collected every 30 minutes. Urinary volume. osmolarity and the excretion of sodium ions were measured. The results obtained are summerized as follows: 1. The water group showed that the urinary flow begins to increase within 30 minutes and reached its peak at 90 minutes after the start of the ex periment. The total volume excreted for 2 hours was approximately 1, 000ml. Urinary osmolaritฮณ and sodium ion concentration decreased almost in proportion to the increase of urinary flow. 2. The saline group revealed that the diuresis was moderate and greatly prolonged. The volume of urine eliminated for 3 hours was less than 500 mI. Urinary osmolarity and especially sodium ion concentration increased in parallel with the increase of urinary flow. 3. The ADH group showed that the urinary flow increased as the water group, but the decrement of urinary flow rapidly developed within 30 minutes after ADH injection and the urinary flow reached subnormal level 60 minutes after the injection. 4. The urea group revealed that the changes in urinary flow were in parallel with the changes in solute, especially urea excretion. Maximal urinary flow developed 45 minutes after the start of the experiment and then decreased gradually. 5. The beer group revealed that the pattern of the urinary flow was similar to that of the water group, but the volume of urine eliminated for 2 hours was more than that of the water group (1. 100mI)
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