병원정보시스템이 의료기관 성과에 미치는 영향

김상아,박웅섭,이상엽,이승근,송재석,이상욱,곽연희,박성준 關東大學校 醫科大學 醫科學硏究所 2003 關東醫大學術誌 Vol.7 No.1

This study is conducted to established integrated principal framework for the effects of the Hospital Information System(HIS) specially Physician Order Entry system(POE), Laboratory Information System(LIS), and Picture Archiving and Communication System(PACS) on the performance of medical institute. We had reviewed and analyzed the literature of POE, LIS, and PACS, and then formulated principal framework. In conclusion, the implementation of HIS could improve the satisfaction of medical staff and reengineer the work process, and those leaded improving the quality of service, and that also leaded increasing the number of patients and case mix of disease, and then those leaded increasing the performance of medical institute.

Evaluation of Hot Deformation and Dynamic Recrystallization Behaviors of Advanced Reduced-Activated Alloy (ARAA)

Sang‑Wook Kim,Hyeon‑Woo Son,Taek‑Kyun Jung,Young‑Bum Chun,Yi‑Hyun Park,Ji‑Woon Lee,Soong‑Keun Hyun 대한금속·재료학회 2019 METALS AND MATERIALS International Vol.25 No.4

The hot deformation behavior of advanced reduced-activation alloy (ARAA) was investigated using hot torsion tests. Thefl ow stress decreased as deformation temperature increased and as strain rate decreased. The fl ow behavior demonstratedthe typical dynamic recrystallization (DRX). Based on the constitutive analysis of peak stress, the activation energy for hotdeformation was found to be 330.3 kJ mol −1 . Peak stress was analyzed as a function of the Zener–Hollomon parameter, andcalculated and experimental values were in good agreement. A DRX kinetic model for ARAA was derived with deformationconditions based on the Avrami-type model. It was confi rmed that the volume fraction of dynamically recrystallized grainsincreased as deformation temperature increased and as strain rate decreased. The necklace structure and grain boundarybulging were observed in the deformed microstructure of ARAA. The suggested DRX mechanism for ARAA during hotworking is discontinuous DRX.

전국 관청의 금연프로그램 실시 현황과 문제점

이상욱,오희철,이지전,김태욱,허남욱 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.1

The purpose of this study is to investigate the conditions and problems of anti-smoking education programs in government offices for civil servants. A mail-in survey was carried out for the chief of the general affairs of 248 government offices. 1. There were 154 responses to the surveys. Only 34 govermental offices have carried out anti-smoking education programs for civil servants. 2. Only one office has a department to supervise an anti-smoking program. 17 offices have 1 worker and thirteen offices have no manpower to supervise anti-smoking program. 3. Only eight offices have budgeted for anti-smoking programs. The average budget was 3,750,000Won. Expected budget for smoking cessation program was 7,500,000 Won. 4. 25 offices have an anti-smoking lecture program for civil servants. Only five offices have an anti-smoking counseling services for smokers. 5. Only seven surveys responded that civil servants had a positive response to anti-smoking programs. 6. The most important problem of anti-smoking programs in governmental offices was the lack of concern of civil servants. Governmental offices have to provide the greatest administrative services and services concerning the quality of life for citizens. Anti-smoking education programs in governmental offices for civil servants was the beginning of an activity of the services concerning the quality of life for citizens. Governmental offices have to actively implement anti-smoking programs for civil servants.

강릉시 의료기관 수요공급 분석

김상아,곽연희,박웅섭,송재석,이상욱,강명근 關東大學校 醫科大學 醫科學硏究所 2002 關東醫大學術誌 Vol.6 No.1

This study was conducted to use for the Community Health Care Plan through the demand-supply analysis of medical institution in Gangneung. The study data were obtained from the Korean National Health Insurance Corporation and the government of Gangneung. The major findings is follows; First, the hospital beds in Gangneung was 793 beds, but supply was 2,187 beds. Second, the demand of clinic in rural area was 43, and supply was 21. But demand of clinic in urban area was 115, and supply was 144. Third, the pubic medical institution in rural covered 4.7% of outpatient demand, and that in urban covered 0.9% of outpatient demand.

강릉시 사망원인 분석

김상아,곽연희,박웅섭,송재석,이상욱,박덕영,강명근 關東大學校 醫科大學 醫科學硏究所 2002 關東醫大學術誌 Vol.6 No.1

This study was conducted to use for the Community Health Care Plan through analyzing the specific cause of death in Gangneung. The study subject were death in Gangneung that happened from January 1, to December 31 in 2000, and that were enrolled as the citizen of Gangneung. The causes of death were classified according to the 56 selected list for ranking of causes of death in Korean National Statistical Office in order to compare the data of nation. We also estimated Years of Potential Life Lost in order to evaluate the burden of disease in Gangneung.

제 3형 급성 견봉-쇄골 관절 분리 환자의 수술적 치료 결과

한성호,양보규,이승림,정선욱,이동호,김민석 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목적 : 본 연구를 통하여 Rockwood 제 3형 급성 견봉-쇄골 관절 분리 환자에서 Phemister 술식과 modified Phemister 술식의 치료 결과를 비교하고자 한다. 대상 및 방법 : 1992년 2월부터 2001년 8월까지 제 3형 급성 견봉-쇄골 관절 분리로 수술적 치료를 받고 1년 이상 추시 가능하였던 45명, 45예의 환자를 대상으로 하였다. 평균 연령은 28.1세였으며, 남자가 42명, 여자가 3명이었다. 진단은 이학적 검사와 단순 방사선 부하 촬영법을 이용하였으며, 수상일로부터 수술적 치료까지의 평균 기간은 7.8일이었다. 술장 소견상 오구-쇄골인대 봉합술이 어려운 15예에서는 Phemister 술식을 시행하였고 (Ⅰ군), 인대 봉합이 가능한 30예에서는 modified Phemister 술식을 시행하였다(Ⅱ군). 수술 후 추시 기간은 평균 16.2개월이었고, 결과 판정은 최종 추시 때의 임상 소견과 이학적 검사 및 방사선 촬영을 통해 UCLA shoulder scoring system과 acromio-clavicular separation scoring system을 이용하였다. 결과 : 술후 합병증은 Ⅱ군에만 표재성 감염이 2예, K-강선 이주가 1예에서 발생하였다. 최종 추시상 전예에서 동통, 관절 운동 범위의 제한은 없었고 , Ⅱ군에서만 방사선 촬영상 2예에서 아탈구가 관찰되었다. UCLA shoulder scoring system은 Ⅱ군에서 우수 93.3%, 양호 6.7%였고, acromio-clavicular shoulder scoring system은 Ⅱ군에서 우수 90%, 양호 10%였다. 결론 : 활동적인 연령에서 발생한 제 3형 급성 견봉-쇄골 관절 손상의 환자에서 Phemister 술식만으로도 좋은 결과를 보일 수 있을 것으로 사료된다. Purpose : The purpose of this study is to compare the Phemister technique with the modified Phemister technique for the patients with Rockwood type 3, acromio-clavicular separation. Materials and Methods : The 45 cases of 45 patients received surgical treatment for Rockwood type 3, acute acromio-clavicular separation in our hospital from Feb. 1992 to Aug. 2001 later with the follow-up study were selected as subjects. The average ages were 28.1 years old, male and female were 42, 3 persons, respectively. Physical examination and plain radiography were used for their diagnosis and the intervals between injury and surgical treatment were 7.8 days. In intraoperative finding, we performed Phemister technique in 15 cases according not to be able to repair coraco-clavicular ligament (groupⅠ), modified Phemister technique in 30 cases according to be able to repair that (groupⅡ). The average follow up period was 16.2 months, and the UCLA shoulder scoring system and the acromio-clavicular separation scoring system were used to obtain clinical results. Results : Only in Group Ⅱ, the complication after surgery were associated with superficial infection in two cases and K-wire migration in one case. At last follow up, there were no pain and limitation of range of motion in all cases, and two cases in Group Ⅱ were found to be subluxation in radiography. Clinical results revealed excellent was 93.3%, good was 6.7% in UCLA shoulder scoring system in both groups, and excellent was 90%, good was 10% for group Ⅱ in acromio-clavicular separation scoring system. Conclusion : The results are considered to be food with only Phemister technique in type 3, acute injury occurred in working ages.

제주도 고등학교 학생들의 비만 유병률과 심혈과 위험인자

황승욱,김현주,홍성철,이상이 제주대학교 생명과학연구소 2002 제주생명과학연구 Vol.5 No.6

연구배경 : 최근 청소년 연령층의 비만이 급격히 증가하고 있으며, 비만 청소년들에 있어서 고혈압, 당뇨, 고지혈증이 조기에 발현될 뿐 아니라 성인비만과 성인병 발생의 주 원인이 되고 있다. 본 연구는 제주도내 고등학생들의 비만 유병률과 청소년 비만과 심혈간 위험인자인 혈압, 총콜레스테롤, 공복시혈당의 관련성을 알아보고 소아비만과 청소년 비만의 관련성을 조사하였다. 방법 : 연구대상은 제주도내 22개 고등학생 1학년 6,064명을 대상으로 하였고. 체격조사는1999년도 학교 신체검사 자료와 병원 건강검진 자료를 이용하였다. 비만에 대한 평가는 대한소아과학회에서 발행한 1998년도 한국소아표준치와 체질량 지수 두가지를 이용하였다 심혈관 위험인자로는 총콜레스테롤 수축기 혈압, 이완기혈압 공복시 혈당으로 하였으며, 배상자중 646명에 대해 과거 건강기록부를 열람하여 초등학생 때의 비만실태를 조사하였다. 결과 : 제주도 고등학생의 비만 유병률은 표준체중에 의한 비만 산출법으로는 남, 여학생 각각 12.6%, 13.3%이었고 체질량 지수에 의한 비만 위험군 및 비만 학생이 남, 녀 각각 12.7%, 13.4%로 나타났다. 지역에 따른 비만 유병률은 남학생의 경우 시 지역 12.9%, 군 지역 10.3%로 시 시역에서 비만 유병률이 유의하게 높았으며, 여학생의 경우 시·군지역 각각 12.9%, 14.2%이었으나 통계적 유의성은 없었다. 고등하교 계열에 따른 비만 유병률은 남학생의 경우 인문계 13.9%, 실업계 10.1%로 인문계가 유의하게 높았으나, 여학생의 경우는 통계적 유의성은 없었다. 비만 정도에 따른 심혈관 위험인자와의 관련성에서 남학생의 경우 수축기와 이완기혈압, 공복시혈당, 총콜레스테롤 수치가 비만 정도에 따라 유의한 차이를 보였으며(P<0.05), 여학생의 경우 공복시혈당을 제외한 나머지 변수에서 유의한 차이를 보였다. 체질량지수와 심혈간 위험인자간의 상관관계에서 남학생은 혈압, 공복시혈당 총콜레스테롤이 유의한 양의 상관관계를 보였으며, 여학생의 경우 공복시혈당 외에 다른 수치에서 유의한 양의 상관관계를 보였다. 연구대상자 중 646명에 대해 초등학교 1학넌 때의 비만실태를 추적한 결과 초등학생 비만이 고등학생 비만에 미치는 비교위험도가 남녀 각각 3.77, 2.16으로 유의하게 나타났다(P<0.05). 결론 : 제주도지역 고등학생들의 비만 유병률이 상당히 높게 나타났고, 청소년 비만과 심혈관 위험인자간의 관련성을 알 수 있었다. 또한 소아비만이 청소년 비만으로 상당수 이행되었으므로 소아 및 청소년기에 적절한 비만관리 프로그램이 요구된다. Background: Recently, adolescent obesity was increased and tended to become obese adults, facing increased risk for diabetes, cardiovascular disease. Even vefore reaching adulthood, adolescent, obesity already was experiencing hypertension, dyslipidemia, and diabetes mellitus. The purpose of this study was to find prevalence of obesity of high school students in Jeju island and association between obesity and cardiovascular risk factors and association between childhood obesity and adolescent obesity. Method: The study subjects were 6,064 students of twenty-two high school in Jeju island and health survey data was gathered from high school health examination data and hospital health examination data from Aug. 1999 to Dec. 1999. Adolescent obesity was evaluated by ideal body weight method in 1998 and body mass index. Cardiovascular risk factors were checked total cholesterol, systolic and diastolic blood pressure, fasting blood sugar. In 646 students, obesity at primary school is checked by primary school health record. Results: Prevalence of obesity in Jeju island high school students was 12.6% in male students, 13.3% in female students by ideal body weight method and Prevalence of obesity risk and obesity was 12.7% in male students, 13.4% in female student by body mass index. Prevalence of obesity of male students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 14.2% and not significantly different. Prevalence of obesity of male students in general and commercial school group were each 13.9%, 10.1% and that of general school group was significantly higher. In female students, Prevalence of obesity general and commercial school group was not significantly different. Total cholesterol, systolic and diastolic blood pressure were significantly associated with degree of obesity in male and female students(P<0.05) and fasting blood sugar was only significantly associated with degree of obesity in male students (P<0.05). In 646students, Relative risk of obesity at primary school and that at high school in male and female students were 3.77, 2.66 and was significantly associated. Conclusion: Prevalence of obesity of high school students in Jeju island is very high and adolescent obesity was significantly associated with cardiovascular risk factors. Mostly childhood obesity tended to become adolescent obesity and program of control of obesity at childhood and adolescence is required.

TERUDERMIS를 이용한 골 혹은 건이 노출된 창상의 치료

최민호,이상복,황정욱,양완석,이강길 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well- vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2∼3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.

구조적 동인이 제조간접비에 미치는 영향에 관한 연구

원정연,이성욱 한양대학교 산업경영연구소 1999 産業經營硏究 Vol.11 No.-

폐경기 여성에서의 Cyclofenil의 효능에 관한 연구 : 갱년기 장애 및 Ca 장흡수에 관하여

노흥규,윤상임,성기양,이경숙,이강욱 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

In postmenopausal syndrome, most common symptoms are those of vasomotor irritability such as hot flush and palpitation, irritable bladder symptoms and dyspareunia according to atrophy of urogenital epithelium, anxiety, nervousness, depression and insomnia. Approximately 40 percent of women in postmenopausal period develop symptoms serious enough to seek medical assistance. Among non-steroid agents, cyclofenil(4, 4' cyclohexidene methlyene diphenoacetate) is known to be a quite interesting substance according to the action at the level of the hypophyseal and hypothalamic centers by reducing the incretion of FSH and restoring normal endorphin, dopamine and norepinephrine activities, thus favorably affecting the whole postmenpausal neurovegutative symptomatology. In order to evaluate effect of cyclofenil on postmenopausal symptomatology and calcium metabolism, we examined 32 patients with postmenopausal syndrome before and after 200mg/day of oral cyclofenil treatment for 30-60 days. The results were as follows: 1. With 30 days of cyclofenil administration, subjective symptoms such as facial flush, palpitation, anxiety, nervousness and dyspareunia were improved significantly (p<0.001, p<0.001, p<0.01, p<0.005, respectively). But insomnia and depression were improved significantly after 60 days of cyclofenil administration (p<0.05, p<0.001, respectively). 2. Intestinal calcium absorption rate disclosed tendency of improvement without statistical significance 30 days after cyclofenil treatment. 3. Serum calcium and phosphorus level were not changed significantly before and after cyclofenil. 4. There was no definite evidence of side effects such as uterine bleeding due to cyclofenil. In conclusion, we thought that cycofenil is effective in management of postmenopausal syndrome but for the effect on calcium metabolism, further evaluation should be needed.