폐광산 주변의 목본 식생 현황 및 오염 토양에 대한 목본 종자의 발아 특성

서경원,손요환,김래현,구진우,노남진,경지현,김정규 한국환경농학회 2006 한국환경농학회지 Vol.25 No.1

3개 대학병원의 주 진단 코딩사례 평가

서순원,김광환,부유경,서진숙,서정돈,윤석준,이영성,이무식,정희웅 한국의료QA학회 2002 한국의료질향상학회지 Vol.9 No.1

Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators(MRAs) of 3 university hospitals participated in coding principal Dx. From August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three(A,B,C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses ; how they decide and code the principal diagnosis when day see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician’s opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in coding among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

EEA 자동 봉합기를 이용한 저위전방절제술에서 콘돔(Condors)을 이용한 문합부 보호술의 효과

윤서구,황덕원,최경우,우제홍 대한대장항문학회 1996 Annals of Coloproctolgy Vol.12 No.4

간헐적 복통과 혈변이 동반된 성인의 맹장-결장 회전결여증 1예

정서진,박성흠,윤서구,박치구,최경우 대한대장항문학회 1998 Annals of Coloproctolgy Vol.14 No.3

구강 편평세포암종에서 E-cadherin 및 β-catenin 발현의 변화 : Correlation with Histologic Features and p53 Expression

서진건,권창석,박진배,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : Altered expression of cell adheion molecules is associated with biologic behavior of tumor. The aim of this study is to evaluate the expression pattern of E-cadherin, β-catenin and p53 protein according to histologic grade and invasion pattern of squamous cell carcinoma of the oral cavity and the relationship between E-cadherin, β-catenin and p53 protein expression. Methods and Material : The materials were fifty seven cses of squamous cell carcinoma, and clinicl parameers such as age, sex, tumor location, stage and recurrence were recorded. Histologic review was done based on histologic grade and invasion pattern(nodular vs infiltrative). Immunohistochemical stains for E-cadherin and β-ca tenin were interpreted based on staining pattern as los of membranous expression and cytoplasmic expression and p53 protein expression was defined as positive if more than 10% of nuclei were reactive. Statistical analysis between E-cadherin, β-catenin and p53 protein expressions and histologic grade and invasion pattern and the relationship between E-cdherin, β-catenin and p53 protein expressions were perfomed. Results : There wa positive correlation between higher histologic grade and infiltrative pattern. Loss of membranous expression and cytoplasmic expression of E-cadherin were noted in 33.3% and 57.9%, respectively, and loss of membranous expression of E-cadherin showed increaing tendency in poorly differentiated carcinomas, however, there was no significant difference of cytoplasmic expression rate of E-cadherin according to histoogic grade. Altered expression of E-cadherin was more frequent in poorly differentiated carcinomas. Loss of membranous expression and cytoplasmic expression of E-cadherin were more frequent in carinomas with infiltrative pattern than in carcinomas with nodular pattern, but their diferences were not significant, Loss of membranous expression and cytoplasmic expression of β-catenin were observed in 19.3% and 80.7%, respectively. Loss of membranous expression of β-catenin howed no positive correlation according to histologic grade and invasion pattern, but cytoplasmic expression rate of β-catenin was higher in poorly differentiated carcinomas and in carcinomas with infiltrative pettern. p53 protein expression rate was 45.6%, and showed invreasing tendency in poorly differentiated carcinomas, but no significant relationship with invasion pattern. There was an inverse relationship of loss of membranous expression and cytoplasmic expression of E-cadherin and β-catenin. Altered expression of E-cadherin was related to cytoplasmic expression of β-catenin, however, there were no significant relationship between altered expressions of E-cadherin and β-catenin and p53 protein expression. Conclusion : In squamous cell carcinomas of the oral cavity, altered expression of E-cadherin and β-catenin was more frequent in poorly differentiated carcinomas and in carcinomas with infiltrative pattern and there was positive correlation betwween altered expression of E-cadherin and β-catenin. These findings suggest that altered expressions of E-cadherin and β-catenin may have a role in the development of squamous cell carcinomas with aggressive biologic behavior. but altered explosions of E-cadherin and β-catenin. These findings suggest that altered expressions of E-cdherin and β-catenin my have a role in the development of squmaous cell carcinomas with aggressive biologic behavior. But altered expression of E-cadherin and β-catenin might not be related to p53 protein expression. Further study on genetic mutation related to altered expression of E-cadherin and β-catenin will be needed

개에서 발생한 이혈종의 임상적 관리

이우철,윤기영,서경원,최호정,정성목,송근호,조종기,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2012 動物醫科學硏究誌 Vol.19 No.1

A 14-year-old male pomeranian was present with swollen left ear. The swelling occurred from base to apex of pinna. Otitis externa persisted for two years. Hematological and serum biochemistry values were not remarkable. The surgery treatment was the most appropriate method among indwelling drain, surgical, and steroid treatment in the aural hematoma because the dog was very sensitive to touching pinna and the size of aural hematoma. Longitudinal incision was applied after general anesthesia. Cefovecin was injected to prevent secondary infection. The outcome of surgery was good. There was no evidence of recurrence for one year.

산업재해에 의한 수부손상의 임상적 고찰 (Ⅱ)

서형교,이병일,박승하,김우경,정전은 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

Industrial hand injury causes not only loss of hand function but also many socio-economic problem, because they are low socio-economic class, age of productivity and unemployed status due to functional disability of hand. Mainly, inexpert workers suffer from industrial hand injury (62%) probably due to absence of safe guard, safe-education and occupational training. Therefore, industrial hand injury may be diminished by preventive measure such as adequate safeguard, safe-education and occupational training. Statistical analysis was carried out retrospectively on 495 patients with industrial hand injury at Dept. of plastic and Reconstructive Surgery, Korea University College of Medicine, KURO hospital, from September 1986 to December 1988, and following items are studied. 1. Constitutions of industrial compartments and labors in Kuro and Youngdeungpo region. 2. Educational status of the patients. 3. Area distribution. 4. Monthly distribution. 5. Day of week distribution. 6. Onset time distribution. 7. Duration of occupation in the patients. 8. Causative factor. 9. Underlying factor. 10. Physical treatment and its duration. 11. postoperative grasping power. 12. Aesthetic result. We want this paper attribute to reduction of industrial hand injury.

응급실 내원 환자의 만족도 평가 및 관련 요인에 대한 연구

서강석,감신,박정배,이정헌,김종근,윤영국,곽경숙,이원기,우석정 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: To examine the influencing factors on patients' satisfaction in the emergency department(ED) for quality assurance. Methods: Patients who visited to the ED were prospectively investigated from November 1 to December 31, 1997. Authors developed questionnaire to investigate influencing factors on patients' satisfaction. A Chi-square test and LISREL 7.0 were applied for statistical analysis. Results: Patients' satisfaction was significantly related to physical environment variables, accessibility variables, kindness of hospital personnel variables, and patient's trust for doctors variables. In path analysis, willingness for revisit was influenced by patients' satisfation, accessibility, physical environment, patients' trust for doctors in order, and willingness for recommendation was influenced by accessibility, patients' satisfaction, and kindness of hospital personnel in order. Conclusions: The influencing factors on patients' satisfaction are physical environment, accessibility, kindness of hospital personnel, and patient's trust for doctors. Willingness for revisit and willingness for recommendation are influenced by patients' satisfation. In spite of some limitations, the results of this study can be used as a baseline information for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the study of patients' satisfactoin in the ED.

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

상악궁 확장술을 통한 치료전,후 및 보정후 상악 구치부 변화에 관한 연구

박태서,이진우,차경석 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.1

치열궁의 크기와 폭경 변화에 대한 연구가 사용된 장치형태, 사용시기에 따라, 그리고 사용 목적에 따라 다양한 연구가 활발히 이루어져 왔다. 또한 Quad-helix도 선학들에게 관심의 대상이었으며 Quad-helix의 안정성과 장치 사용 전, 후에 대한 효과도 연구가 이루어졌다. 그러나 장치 사용에 대한 장기적인 효과에 대한 연구가 미흡하여 본 논문은 이 장치를 사용하여 치료한 환자의 치료 전, 후 및 보정후의 치열궁 변화에 대한 연구를 시행하여 Quad-helix사용 전, 후 구치부의 적응 양상을 연구함으로써 임상에서 Quad-helix를 통한 치료를 시행할 때 이 장치사용에 따른 효과 및 예후에 대하여 효과를 이해함으로써 교정치료에 도움을 주고자 연구를 시행하여 다음과 같은 결과를 얻었다. 1. Quadhelix를 사용한 교정치료시 상악 제 1 소구치와 제 1 대구치는 치료전과 치료 후 및 보정후에서 교두간 폭경의 증가를 보였고 제 2 소구치에서는 치료후와 보정후간에 유의성있는 증가를 보였다. 2. 상악 제 1 소구치와 제 1 대구치의 치축은 치료전과 치료후 그리고 보정후에서 협측 경사도가 유의하게 증가를 보였으며, 상악 제 2 소구치는 치료전과 치료후 및 치료전과 보정후 비교에서 설측 경사도가 유의하게 증가를 보였다. 3. 최대 풍융부 항목에서 상악 제 1, 2소구치는 치료전과 치료후의 비교에서 유의한 증가를, 제 1 대구치에서는 치료 전, 후, 및 보정후에 유의한 증가를 보였다. 4. 상악 제 1 대구치의 설면구 폭경은 치료전, 후 및 보정기간을 통하여 유의한 증가 를 보였고, 구개 높이는 치료전과 치료후 비교시 유의한 증가를 보였다. 5. 확장시킨 상악 치열궁은 회귀현상을 보이지 않고 안정적으로 유지되었다. The purpose of this study was to measure the changes of arch and dentition of maxillary posterior teeth before and after treatment and postretentios in patients treated with Quad-helix. Measurements and analysis were performed on study model with carlipers. Seventeen cases, eight boys and nine girls, were selected with average ages of 12.7 years. Mean retention period was 4 months, and mean wearing time was 127 days. The result were as follows 1. The interpremolar widths and intermolar width were significantly increased in maxillary first premolar and molar when compared between before and after treatment and postretention. The maxillary second premolar resulted in significant increase in interpremolar between after treatment and post retention. 2.The long axis of maxillary first premolar and first molar accompaning buccaltipping was significant increased before and after Tx and post retention. Significant increase of the lingual inclination of maxillary second premolar was obsered both in before and after Tx, and before Tx and post retention. 3.The distance between the height of tooth contour was significantly increased in the first and second premolar before and after Tx, and was significant increased in the first molar before and after Tx and post retention. 4.Intermolar width at the palatal groove was increased in before and after and after Tx. and post retention. The palatal depth was significant increased in before and after Tx. In conclusion, expansion of maxillary dental arch showed no relapse and results were stable retention.