위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

탄소 나노튜브의 전계방출 특성

이경원,김은미,권민철,김용,이재열,박홍준 동아대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.17 No.1

본 연구에서는 emitter와 collector 사이의 간격과 current density 대 electric field (J-K)특성을 초점으로 카본나노튜브의 전계방출 특성을 조사하였다. 카본 소스로 CH4, 촉매 및 희석가스로서 NH3를 사용하고 HFCVD를 이용하여 실리콘 위에 카본나노튜브를 성장하였다. 나노튜브의 지름이 20-40nm이고 길이는 15㎛이다. I-V곡선에서 onset voltage는 Vons=3.36V/㎛이고, 2.5V/㎛ 의 전기장에서 8mA/cm2이상의 높은 전류밀도 특성을 보였다. Fowler-Nordheim 그래프를 그려서 팁의 특성을 나타내는 β값을 계산하였다. We report the field emission properties of carbon nanotube, focusing on current density versus electric field (J-F) characteristics and the spacing between the emitter and collector. We grow carbon nanotubes on sillicon using hot-fillament chemical vapor deposition, using CH4 gas as the carbon source and NH3 gas as the catalyst and dilution gas. Nanotubes are distributed from 20 to 40nm in diameter and 15㎛ long. Onset field of the field emission is 3.36V/㎛ and the current density is 8mA/cm2 at an electric field of 2.5V/㎛. A Fowler-Nordheim plot was made. Field enhancement factor β is calculated.

충남지역 대학생의 섭취실태를 통한 전통발효식품의 영양적 평가

이나영,최미경 대한영양사협회 2003 대한영양사협회 학술지 Vol.9 No.2

The purpose of this study was to evaluate nutritional value of traditional fermented foods by dietary intake of university students living in Chungnam. 210 students were asked for their daily food intake using 24-hour recall method for 3 days. And daily nutrient intakes from total foods and fermented foods were analyzed and compared. The mean weight, height, and BMI of the subjects were 67.36㎏, 174.39㎝, 22.15㎏/㎡ in men and 53.45㎏, 161.86㎝, 20.40㎏/㎡ in women, respectively. The daily intakes of protein, phosphorus, and vitamin B_1 were 106.82%, 137.88%, and 108.99% of the Korean RDA. However, the energy, calcium, iron, vitamin A, vitamin B_2, niacin, vitamin C intakes did not reached the RDA for Koreans. The fermented food intake was 9.09% of total food intake. And the percentages of fermented food intakes were 81.53% for Kimchi and 14.75% for Chang. The vegetable protein, vegetable oil, dietary fiber, calcium, phosphorus, iron, sodium, potassium, vitamin A, vitamin B_1, vitamin B_2, niacin and vitamin C intakes per 1000㎉ consumption from fermented foods were significantly higher than those from total foods. The fermented food intake showed positive correlation with iron, and plant iron intakes. In conclusion, the percentage of fermented food intake was about 9% and the major items were Kimchi and Changs in university students. Fermented food intake may be important to improve the intakes of calcium, iron and vitamins.

천식을 악화시킨 흉선 유암종 1예

임정묵,김미경 대한천식 및 알레르기학회 2004 천식 및 알레르기 Vol.24 No.1

Thymic carcinoid tumors are very rare and grow slowly with low grade of malignancy. It can manifest flushing, diarrhea, and bronchial constriction with secretion of serotonins, histamines or neuropeptides. We experienced a case of thymic carcinoid tumor, which aggravated asthma. A 59-year-old male had been in a well-controlled state, until he was admitted for status asthmaticus 2 years ago. Since then, he had suffered from frequent dyspnea and had severe asthma attack leading to ICU care twice in spite of full optimal anti-asthma therapy Nine months ago, anterior mediastinal tumor was found incidentally, which was diagnosed as carcinoid tumor. After resection, his asthmatic symptoms and signs were improved and controlled in a persistent mild state. Taken together, this case indicates that asthma might be aggravated by carcinoid syndrome caused by thymic carcinoid tumors. (J Asthma Allergy Clin Immunol 24 : 156-60, 2004)

TIMSS-R 과학 성취도에서의 성 차이

이미경,홍미영,정은영 한국과학교육학회 2004 한국과학교육학회지 Vol.24 No.6

학업성취도 국제 비교 연구 결과에서 우리나라 남렛?학생의 과학 성취도 차이가 큰 것으로 보고되고 있다. 이 연구에서는 TIMSS-R과학 성취도에서의 성 차이를 문항 수준에서 살펴보기 위하여 각 문항의 GDI(Gender Difference Index) 값을 산출하였다. 그리고 문항 유형, 성취수준, 내용 영역에 따른 GDI 값을 비교하였다. 문항 유형에 상관없이 우리나라와 국제 결과 모두 남학생이 여학생보다 성취도가 높은 것으로 나타났으며, 우리나라의 성차가 국제 평균보다 크게 나타났다. 특히 우리나라 여학생들은 선다형 문항에서 상대적으로 낮은 성취도를 나타내었다 성취수준에 따른 우리나라와 국제의 GDI 값을 비교해 보면, 상위 10%에 해당되는 문항들에 대해서는 우리나라의 GDI 값이 국제의 경우보다 낮게 나타났으나 그 이외의 성취수준에 해당되는 문항들에 대해서는 우리나라의 GDI 값이 더 높게 나타났고 특히 상위 50%에 해당되는 문항들의 경우 우리나라와 국제의 차이가 크게 나타났다. 내용 영역별로 남ㆍ여학생의 성취도를 비교했을 때는 과학 탐구와 과학의 본성 영역을 제외하고는 모든 내용 영역에서 우리나라 남학생들의 성취도가 여학생들보다 높았다. GDI가 10 이상인 문항 중 남학생들의 성취도가 높은 문항들은 생물과 지구과학 영역에 속하는 경우가 상대적으로 많았으며, 학교 교육과정에서 전혀 배우지 않은 문항들의 비율 또한 비교적 높았다. 그리고 남학생들이 높은 성취도를 보이는 문항은 전 수행 영역에 걸쳐서 비교적 골고루 분포되어 있었다. 이상에서와 같이 문항 유형, 성취수준, 내용 영역에 따라 과학에서의 남렛㈖剋萱?성취도 차이가 다르게 나타났다. 이러한 결과는 여학생들의 과학 성취도를 향상시키기 위한 방안을 모색하는 과정에서 보다 구체적인 방향을 제시할 것으로 기대된다. The purpose of the study was to produce resources to help develop instructional methods and programs for school science to reduce gender differences in science achievement by analyzing TIMSS-R results according to item type, benchmark, and content category. Korean male students performed higher than Korean female students and gender differences of Korean students were higher than international means in all item types including multiple-choice, short answer, and extended response type. GDI(Gender Difference Index) of Korean students was lower than international mean in top 10% benchmark but higher than international means in other benchmarks. Korean male students also exhibited higher performance than Korean female students in all content categories except scientific inquiry and the nature of science category. Regarding items that GDIs were higher than 10, the number of items belonged to life science and earth science category was relatively larger and a high percentage of them was not included in school science curriculum. In addition, the items were equally distributed in each performance category. In sum, the study showed various gender differences according to item type, benchmark, and content category. The results could be used to find appropriate instructional methods to reduce gender differences in science achievement.

한국전통생활문화에 관한 고찰

이숙,홍윤호,신윤숙,신효식,한경미,최정미,김은정 全南大學校家政科學硏究所 2002 生活科學硏究 Vol.12 No.-

This study is objected on preliminary research for more scientific and wider studies on the Traditional Living Culture of Korea. For this purpose, studies about clothing, food, home management, Traditional Living Culture were reviewed and analysed. The results were as follows : First, Clothing culture studies concentrated on ritual clothings, Second, Food Culture studies included history of traditional food development and recipes. Third, in the field of home management value system, attitudes and parent-child relations were studied,

분진의 중량농도분석을 위한 유리섬유 필터와 PVC 필터의 항량 비교

이병수,김경미 경인여자대학 2002 경인논집 Vol.- No.9

This study was performed to collection basic data to identify the measurement of dust exposure in industrial environments. The major objectives were to establish the quality control and standardization of dust sampling and analytical methods. First, comparative tests on the constant between glass fiber filter and PVC filter were performed. Weight of glass fiber filters and PVC filters were measured in variable conditions. -the change of filter type(glass fiber & PVC filter), dry time(24hr, 48hr, 72hr, 96hr), constant method(using dry oven)-. Weight variation of each filter was analyzed by a balance in each condition and the relationship between each constant measurement data were analyzed statistically by SAS package program. The results were as follows: 1. The weight variation of glass fiber filters reduced in proportion to constant time changes and relative standard deviation were less than 2%. It was significantly difference between decrease of glass fiber filter and increase of dry time(P<0.05). 2. The weight variation of PVC filter not reduced in proportion to constant time changes and relative standard deviation was less than 4%. It was not significantly difference between decrease of glass fiber filter and increase of dry time(P>0.05). 3. The weight variation of glass fiber filters reduced in proportion to constant method changes by using dry oven and relative standard deviation was less than 2%. It was significantly difference between decrease of glass fiber filter and increase of dry time(P<0.05). 4. The weight variation of PVC filters not reduced in proportion to constant method changes by using dry oven(50℃, 70℃)and relative standard deviation was less than each 2%. It was significantly difference between decrease of glass fiber filter and increase of dry time(P>0.05). Finally, it is necessary to study the applicability of sampling material information for dust exposure measurement in industrial environment.

대식세포에서 산화질소 생성에 대한 當歸 에탄올 추출물의 억제효과

정미영,박히준,정지행,김진용,강전모,이나경,임사비나 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

Objective : The Angelica gigas Nakai ethanol extract (AGE) was investigated to compare nitric oxide (NO) production and NF-kB activity from RAW 264.7 cells, since NO and nuclear factor-kB(NF-kB) have been shown to be factors implicated In inflammatory disease. Method : AGE was prepared by extracting medicinal herb with 70% (v/v) ethanol solution. We investigated production nitric oxide (NO) and inducible nitric oxide synthase (iNOS) gene expression by ARE in LPS-stimulated RAW 264.7 macrophage cells. We also investigated inhibition of LPS-induced activation of NF-kB on western blot. Result : LPS-induced RAW 264.7 cells increascd NO production and ,iNOS expression. Upon treatment with AGE, nitrite production was significantly inhibited in a concentration-dependent manner compared to the untreated control. AGE inhibited this LPS-induced ,iNOS mRNA and protein in a dose-dependent manner. AGE markedly inhibited the expression of iNOS mRNA and protein at a concentration of 100 μg/ml. LPS-induced RAW 264.7 cells with AGE blocked inhibitory factor-kBα degradation. Conclusion : This study shows that AGE seems to attenuate inflammation through inhibition of NO production and iNOS expression by blockade of NF-kB activation in LPS-stimulated RAW 264.7 cells.

인적자원의 적정지각과 행위별 가정관리수행

서리나,한경미 全南大學校家政科學硏究所 1994 生活科學硏究 Vol.4 No.-

The purposes of this study are to find out factors influencing the perceived adequacy of human resources and home management performance of housewives and to investigate the effects of the perceived adequacy of human resources on home management performance of housewives in behavior specific. The results are as follows : (1) The level of the perceived adequacy of human resources is showed that interpersonal resource is the highest and time resource is the lowest. (2) The total perceived adequacy of human resources according to education, income, occupation, and housework time shows differences. So housewives with higher education, more income, less housework time, and full-time wives are more adequately perceiving total family-resources. (3) The level of home management performance in behavior specific is showed that controling is the highest, guiding, adjusting, estimating and planning are in order. (4) The variable which has influence on total level of home management performance in behavior specific is husband's housework-helping. Therefore housewife perceiving that husband helps housework very much is high on home management performance wholely. (5) The perception of human-resources adequacy perception positively correlates with the home management performance in behavior specific. Housewife perceives more adequate, her level of management performance is more high.

항원 흡입에 의한 비특이적 기관지과민성: II. 화분

김미경,엄재호,이동호,조명찬,이상도,윤세진,궁성수,김승택,이복희 충북대학교 의과대학 충북대학교 의학연구소 1992 忠北醫大學術誌 Vol.2 No.1

피부단자검사, RAST 및 항원 기관지유발검사(allergen bronchial provocation test, ABPT)결과 쑥, 잔듸, 나무화분에 감작된 기관지 천식 환자 13명을 대상으로 이들 화분이 비특이적 기관지과민도(non-specific bronchial hyperresponsiveness, NSBR)에 미치는 영향을 알아보고, ABPT시의 조기 및 후기 천식반응(early, late asthmatic response, EAR, LAR)이 NSBR 생성에 관여하는지와 각각 화분의 항원성을 비교하고자, 감작된 화분으로 ABPT를 시행하고, 이를 전후하여 메타콜린 기관지유발검사(methacholine bronchial provocation test, MBPT)를 시행하여 아래와 같은 결과를 얻었다. 기저 폐기능상 기도 폐색을 보인 환자는 없었으며, 알레르기성 비염만을 호소하였던 환자 11명 중 4명(31%)은 MBPT에 양성반응을 나타내었으나, ABPT에는 11명 모두 양성반응을 보인 천식 환자였다. ABPT상 3명은 EAR, 2명은 ILAR, 8명은 LAR이였다. EAR만을 나타낸 경우는 ABPT 24시간 후 PC20이 감소하지 않고, 오히려 다소 증가하였으나, ILAR을 나타낸 환자들은 24시간 후 PC20가 감소하여 3일 후 기저치로 환원된 반면, LAR에서는 24시간 후 PC20가 현저히 감소하여, 2주 내지 6주 후에야 기저치로 환원되었다. LAR을 보인 환자들 중 쑥에 감작된 환자들이 목초 화분에 감작된 환자에 비해 Pc20의 감소기간이 유의하게 길었다. 이상의 결과를 종합해 보면 화분 흡입에 의한 LAR에 의해 NSBR이 악화되며 지속기간이 상당히 긴 것을 알 수 있다. 또한 화분 중 쑥의 항원성이 목초보다 상당히 강한 것도 알 수 있다. 더불어 화분에 감작된 알레르기성 비염 환자들의 대부분에서 천식이 잠재해 있음도 알 수 있다. 그러므로 향후 천식의 증상이 없는 화분에 감작된 비염환자라 할지라도 MBPT 및 ABPT를 시행하여 정확한 진단을 해야겠다. 본 연구에서 종래의 다른 연구 결과들과는 달리 쑥의 경우 ILAR의 경우도 NSBR을 악화시킴을 관찰하였는데, ILAR과 LAR의 차이가 단순한 기도폐색의 정도 차이인지, 기도 내에서 염증반응에 차이가 있는지는 향후 기관지 페포세척이나 조직 검사등을 통해 밝힘으로써, ABPT에 의한 NSBR의 발생 및 악화의 기전을 보다 확실히 규명할 수 있을 것으로 사료된다. Bronchial hyperresponsiveness is a fundamental characteristics in bronchial asthma. The pathogenesis of bronchial hyperreactivity has not been clearly understood, yet. We studied non-specific bronchial hyperresponsiveness with methacholine inhalation sequentially afterallergen provocation in pollen such as, alder, grass and mugwort-sensitzed allergic asthma and/or allergic rhinitis to investigate if there is any relation between allergen exposure and bronchial hyperreactivity, and compare the allergenicity of each pollen. 3 of 13 study subjects showed early asthmatic reaction, but 8 of them showed late(dual) asthmatic reaction, and the other 2 showed intermediate late asthmatic reaction. Non-specific bronchial hyperreactivity was not increased in early asthmatic responder, however, it was increased upto 45 days after allergen inhalation in all late asthmatic responder and in intermediate late reactor, upto 3 days. In mugwort-sensitized late asthmatic responder NSBR decreased much longer than any others. Taken together, pollen-induced late asthmatic reaction is one factor which contributes NSBR in pollinosis patients.