계획수술 취소율과 취소사유에 대한 분석

유시현,조성환,김천숙 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Background: Cancellation of a planned surgery is a waste of time and money. Also cancelled patients experience significant psychologic and economic burdens. Object: The aim of this study is to analyze the reasons for cancellation of an elective operation and enhance the efficacy of managing the OR. Material and Method: We performed prospective study in patients who planned elective surgery under general or regional anesthesia from January 1, 2003 to March 31(the first period) and from August 1, 2003 to September 31, 2003(the second period) in the operating room of Soonchunhyang cheonan Hospital. Daily total number of planned elective surgeries, number of cancellation, and the most important reasons for cancellation were recorded. Comparison of the cancellation rate between the two period was performed. Result: The total number of planned elective surgery in first and second period was 1,655 patients and 1,186 patients respectly. The the total number of cancelled patients in first and second period was 57 patients and 42 patients respectly. Thus the mean rate of cancellation was 3.44% in the first period and 3.54% in the second period. The reasons for cancellation were as follows: refusal of operation(39%) was most common in the first period, the next were no admission(21%) and combined systemic disease(21%). But in the second period, no admission(45.3%) was most common, the next were combined systemic disease(21.4%). Conclusion: There are several ways to decrease the cancellation rate in operating room. Good rapport and sincere communication with patients is the most important ways to decrease cancellation rate in Soonchunhyang cheonan hospital.

횡 요천골부 후피부판 (Transverse Lumbosacral Back Flap)을 이용한 천골부 욕창 치험례

전건수,김유승,하재성,박준용,서정오 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.3

Pressure sore is an area of ischemic tissue loss resulting from prolonged or often repeated pressure, usually over a bony prominence of body. Recently, the prevalence of pressure sore is major clinical problem, due to the increased number of patients with spinal cord injuries or longterm comatous patient after traffic, industrial accidents. The surgical principles in the treatment of pressure sores are total excision of the ulcer, scartissue, bursae, complete removal of all infected bone with recontouring of bony prominences to alleviate discrete pressure points and resurfacing and padding of the defects with healthy and well vascularized tissues. The sacral sore is the most common site for the development of pressure sore in Korea. We had experienced 14 cases who had received surgical treatments for sacral sores with transverse lumbosacral back flap. We obtained the following conclusions. Advantages 1)It is quick and easy procedure 2)The flap elevation itself is relatively bloodless 3)The donor defect is in a non-weight-bearing area 4)Muscle is not sacrified(possibly of importance in the ambulatory patient) 5)Surgical options are preserved in cases of recurrence(the flap itself may be reelevated and inset in some cases of recurrence) Disadvantages 1)It is lacking the bulky padding afforded by alternative musculocutaneous flaps 2)The vascularity of the flap tip is empirically less dependable than that of a musculocutaneous flap 3)The donor defect is large, cannot usually be closed primarily, and may prove of cosmetic concern

흰쥐 재생간에서의 Aryl Sulfotransferase의 활성도

곽춘식,김여희,신미정 啓明大學校 醫科大學 1995 계명의대학술지 Vol.14 No.4

This study was made to know the changes of aryl sulfotransferase activity in regenerating rat liver. Cytosolic, mitochondrial and microsomal aryl sulfotransferase isozymes I,II and III, IV activities were determined in regenerating liver tissue following 70% (median and left lateral lobes) partial hepatectomy in rats for a period of ten days. The activities of these enzymes in serum were measured, the values of the Km and Vmax in these hepatic enzymes were also measured. The activities of cytosolic, Mitochondrial, and microsomal aryl sulfotransferase I,II in regenerating rat liver tissue showed a significant increase between the second and the third day, the first and the third day, and the twelfth hour and the third day, respectively, following partial hepatectomy. The activities of aryl sulfotransferase isozymes I,II and III,IV in rat serum showed a significant increase between the twelfth hour and the first day following partial hepatectomy. The values of Vmax of cytosolic, mitochndrial and icrosomal aryl sulfotransferase isozyme I,II and III,IV in the regenerating liver showed significant increases at the second day following partial hepatectomy However, the values of Km of the these hepatic enzymes did not change. In View of the above results, aryl sulfotransferase isozymes in regenerating rat liver suggest that these are the enzymes increasing their bisoyntheses in the regenerating stage.

삶의 질과 관련된 국내 간호논문 분석

노유자,김춘길,이영숙 성인간호학회 1999 성인간호학회지 Vol.11 No.4

This study was done to analyze research trends and to suggest future directions for nursing research on the quality of life (QL) in Korea. The purposes of this study were to describe systematically 10 years of QL nursing, and to identify patterns of tools and significant variables on studies of QL. This article reviewed 71 nursing researches on QL between 1987 and 1996, by examining them according to the period of publication, research for a degree or not, research design, type of subjects, dat collection methods, measurement instruments and range of reliabilities, type of nursing intervention and association of QL and related variables. The findings of the analysis can be summarized as follows: 1. The number of studies related to QL increased from 1987 to 1994. But they have decreased since 1995. 48 of them(67.6%) identified surveys and correlational studies. 2. In all the titles of the studies, there were 7 types of concepts, including QL, quality satisfaction, life satisfaction, and well-being. Among them, QL was the most often used. 3. The subjects of 21 studies were healthy people. In 49 studies, patients had various illnesses. The majority of the patients were hemodialysis patients and cancer patients. Questionnaires were used for data collection in 58 studies. 56 studies were done for the thesis of a degree. while those in the remaining studies were not for degrees. 4. The research designs were various, except in the thesis for a doctorate. There were many more experimental studies(57.1%) done in the thesis for a doctorate. 5. The types of intervention were categorized as exercise(6), supportive care(3), reminiscence(2), relaxation(1), music(1), and hospice care(1). 6. As measurement tools, 14 types of tools relating to QL were used. 11 of them were composed of multiple dimensions. Among them, the QL Scale by You-Ja Ro(1988) was the most widely used in the studies. In the following, the Life Satisfaction Index by Jin Yun(1982), the Quality of life Scale of National Conference of Cancer nursing(1983), and the Life Satisfaction Index by Wood, Wylie & Sheafor(1969) were used. The reliabilities of the QL Scale were reported in 63 studies, and the Cronbach's alpha coefficients were over 0.7 in 60 cases. The quality of life scales included five dimensions ; such as physical, psychological, social, economical, and spiritual dimensions. 7. There were two categories of factors influencing the quality of life: First, factors that cannot be changed by nursing intervention were : age, educational level, gender, marital status, income, employment status, occupation, number of family members, religion, and illness history. Second, factors that can be changed by nursing intervention were : physical activity, health status, the presence of complications, support, self-esteem, stress, self-efficacy, activities of daily life, physical strength, satisfaction with life, and anxiety. Types of nursing intervention used to improve quality of life were : therapies in relaxation, exercise, reminiscence, and family support, social support, and hospice care. On the basis of the above findings, the following recommendations were made : 1. Further studies on the quality of life instruments of analysis are needed to provide an understanding of dimensions of life in detail. 2. A Meta-analysis needs to be conducted to identify intervention effects on the quality of life. 3. A tool development study is needed to measure the quality of life appropriately in different illnesses. 4. More replicated analysis studies of QL are needed to prove the effect of variables on the QL.

주정 중독 흰쥐에서 총담관 결찰이 혈청 및 간의 α-D-및 β-D-Glucosidase 활성에 미치는 영향

곽춘식,김여희,임종술 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.2

이 연구는 간담도 질환시 음주의 해로움에 대한 생화학적 배경의 일단을 밝히고자 시행한 실험으로서 급성 및 만성 주정 중독을 시킨 흰쥐에게 총담관결찰로 담즙울체를 야기시켜 혈청과 간의 α-D-glucosidase와 β-D-glucosidase의 활성도를 측정한 것이다. 쥐간의 lysosomal α-D-glucosidase 활성도는 총담관만 결찰한 군보다 만성 주정 중독 후 총담관을 결찰한 군이 총담관 결찰 후 7일부터 14일까지 덜 현저한 증가를 나타내었다. 총담관을 결찰한 군과 만성 주정 중독 후 총담관을 결찰한 군에서 간의 lysosomal acid β-D-glucosidase 및 cytosolic broad specificity β-D-glucosidase 활성도를 비교했을 때는 양군간에 별 차이가 없었다. 총담관을 결찰하고 14일 경과한 군과 총담관 결찰 14일 후 급성 주정 중독을 시킨 군에서 간의 lysosomal α-D-glucosidase, lysosomal acid β-D-glucosidase 및 cytosolic broad specificity β-D-glucosidase의 활성도를 비교했을 때는 양군간에 별 차이가 없었다. 쥐 혈청의 lysosomal α-D-glucosidase와 broad specificity β-D-glucosidase 활성도를 총담관을 결찰한 군과 만성 주정 중독 후 총담관을 결찰한 군을 비교했을 때는 만성 주정 중독 후 총담관을 결찰한 군이 총담관만 결찰한 군보다 더 현저한 증가를 나타내었다. 그러나 총담관을 결찰하고 14일 경과한 군과 총담관 결찰 후 급성 주정 중독을 시킨 군에서 혈청의 이들 효소의 활성도를 비교했을 때는 broad specificity β-D-glucosidase만 총담관 결찰 후 14일 경과한 군보다 총담관결찰 14일 후 급성 주정 중독을 시킨 군이 그 활성도가 더 높았다. 이들 성적 중에서 혈청의 lysosomal α-D-glucosidase와 broad specificity β -D-glucosidase의 활성도가 총담관만 결찰했을 때 보다 만성 주정 중독 후 총담관을 결찰했을 때 더 증가되고 아울러 혈청의 broad specificity β-D-glucosidase 활성도가 총담관 결찰 14일 후 급성 주정 중독을 시켰을 때는 총담관만 결찰한 후 14일 경과했을 때보다 그 활성도가 높은 것은 만성 주정 중독 및 급성 주정 중독시 담즙울체가 야기되면 담즙울체만 있을 때보다 간손상이 증폭된다는 것을 나타낸 결과라 생각되며 이성적은 간손상의 증폭으로 간에서 이들 효소의 누출일 증가된 것이라 할 수 있다. 따라서 이 성적은 담즙울체로 간손상이 있을 때는 음주를 해서는 안된다는 것을 뒷받침하는 자료라 하겠다. The activities of the liver and serum α-D and β-D-glucosidase were studied for cholestasis induced by common bile duct ligation and chronic ethanol intoxication developed, or cholestasis after acute ethanol intoxication for manifestation of the biochemical background of alcohol intoxication in hepatobiliary disease. The groups that received common bile duct(CBD) ligation after being chronically intoxicated with ethanol showed a marked increase at the 7th and 14th day after the ligation in the liver lysosomal α-D-glucosidase activities. However, the activities showd a lower degree than groups of the CBD lgation. The groups that received CBD ligation after being chronically intoxicated with ethanol showed a slight increase after the ligation in the liver lysosomal acid β-D-glucosidase and cytosolic broad specificity β-D-glucosidase activities, and the same was seen in the groups of the CBD ligation. At the 1.5th and 24th hours after the acute intoxication with ethanol which was done after 14 days of the CBD ligation, the rats showed a considerable increase in the liver lysosomal α-D-glucosidase, lysosomal acid β-D-glucosidase and cytosolic broad speciticity β-D-glucosidase activities, and the same was seen in the group sacrificed on the 14th day after the CBD ligation. The groups that received CBD ligation after being chronically intoxicated with ethanol showed a marked increase after the ligation in the serum lysosomal α-D-glucosidase and broad specificity β-D-glucosidase activities. However, the activities showed a far higher degree than groups of the CBD ligation. For the groups of acute intoxication with ethanol done after 14 days of the CBD ligation, the serum broad specificity β-D-glucosidase activities increased markadly, but the activities showed a higher degree than the group with the 14th day after the CBD ligation. In summary, especially, when the acute and chronic ethanol intoxication with cholestasis occurred, the serum lysosomal α-D-glucosidase and broad specificity β-D-glucosidase are higher than in cholestasis because of increased liver cell damage, which causes the enzyme to leak into the blood in great quantity. Accordingly, these results will be the data supporting the alcoholic drink is enzymologically harmful in hepatobiliary disease.

흰쥐 재생간의 Malate Dehydrogenase의 활성치

김여희,곽춘식,문교철 啓明大學校 醫科大學 1986 계명의대학술지 Vol.5 No.2

A study was made on the changes in the activities of the following during 6 post-perative days: Cytosolic and mitochondrial malate dehydrogenase of regenerating rat livers, and rat serum malate dehydrogenase after 70% (median and left lateral lobes) partial hepatectomy. The activities of lactate dehydrogenase and alanine aminotransferase in both serum and cytosol of regenerating rat liver were also measured. After parial hepatectomy in the rats, activity of serum malate dehydrogenase trmendously increased in in the span between the 12 hours and the second day. The activity of cytoslic malate dehydrogenase in the regenerating liver significantly increased from the first to the second day after partial hepatectomy. However, no significant changes in hepatic mitochondrial malate dehydrogenase was noted throughout the experiments. The activities of serum lactate dehydrogenase and alanine aminotransferase markedly elevated after partial hepatectomy. And activity of alanine aminotransferase significantly decreased in the hepatic cytosol after partial hepatectomy but hepatic cytosolic lactate dehydrogenase showed no change.

발달장애유아의 언어행동발달 연구

김춘희,변찬석,서경희,유은정,이효신,전헌선,최성규 大邱大學校 特殊敎育·再活科學硏究所 2000 特殊敎育硏究 Vol.23 No.1

본 논문은 발달장애유아 언어행동발달 컨텐츠 개발에 요구되는 기초연구로써 연구의 이론적 바탕을 확립하고자 하였다. 연구에 사용된 방법은 문헌조사 방법 및 현장 인터뷰기법을 병행하였다. 본 연구의 주된 목적은 크게 3가지로 구분된다. 첫째, 발달장애유아의 가정 내 교육 욕구를 분석하고자 하였다. 둘째, 발달장애유아의 언어발달 양상을 검토하고자 하였다. 세 번째 목적은 유아의 언어행동발달 컨텐츠 구성의 주요 지침을 설정하고자 하였다. 이상의 연구목적에 따른 연구결과를 요약하면 다음 몇 가지로 제시된다. 1.가정 내 부모-유아간 관계형성이 우선 고려 되어야하고, 이에 따른 상호작용은 발달적 애착형성이 가능한 방향으로 정립되어야한다. 2.발달장애유아의 언어행동발달양상을 검토한 결과에 따르면, Piaget는 언어행동발달에 있어 감각운동기적 환경탐색 기능을 강조하고 있고, 이는 현재까지 중요한 유아 발달의 기저로 정착되었다. 따라서, 발달장애유아의 언어행동발달을 위한 컨텐츠 개발 내용에 있어서도 이러한 기저에 충실함이 합리적이다. 3.발달장애유아들에게는 언어행동 양상의 갈래가 크게 운동장애 및 감각결함으로 나누어질 수 있으므로, 이 두 가지 갈래의 각기 다른 특성이 컨텐츠 구성에서 충분히 고려되어야한다. 4.자폐성과 같은 중증 전반적 발달장애 유아를 위한 언어행동발달 컨텐츠 구성에서 특히 고려해야 할 두 가지 요소는 모방행동기능과 반복단순훈련기능 향상으로 결론지을 수 있다. This article planed to establish the theoretical foundations of the research as a basic study needed for developing the contents of verbal(language) behavior development for the infants with developmental disabilities. The methods used in the study was previous literature researches and interviews with subjects. The purposes of the study were divided into three parts. First, it was to analyze the educational needs of the infants with developmental disabilities in home settings. Second, it was to review and discover the language patterns of the infants with developmental disabilities. The third purpose was to devise the major guidelines of their language development's contents. The results of the study were described as the followings. 1.The relationships between the infants with developmental disabilities and their parents and their interactions should move to build the developmental attachments between them. 2.According to the literature findings of their language development patterns, Piaget concentrated on the functions of sensory motor environmental exploring in the language behavior development. The functions have been settled down into the important foundation for the infants' development. Thus, it was resonable that the content's development of the language behaviors for the infants with developmental disabilities should based on the function addressed by Piaget. 3.The language behaviors' patterns of the infants with developmental disabilities generally were classified into motor disabilities and sensory defect(deficiency). Therefore, the two factors should be considered for the constructions of the contents. 4.Constructing the contents of the language behavior developments for the infants with severely pervasive developmental disabilities such as autism, the improvements of two functions, imitative behavior and repetitive simple training should be considered.

저압 증발하의 열교환 특성에 관한 연구

신유식,이윤환,서종수,전영흥,정효민,정한식 경상대학교 해양산업연구소 2002 해양산업연구소보 Vol.15 No.-

The purpose of this research is to obtain the characteristics of heat transfer or heat exchange under the vacuum pressure. The general heat transfer or heat exchange can be changed with the experimental environment. In this report, the exothermic calorie and endothermic calorie were measured under the vacuum chamber. These two kinds of calories show the evaporative and condensing sides, respectively, and these calories were measured by using the parameter with flow rate.

Catechol-O-Methyltransferase Activity from Regenerating Liver after Partial Hepatectomy in Rats

곽춘식,--,-- 대한의생명과학회 2005 Biomedical Science Letters Vol.11 No.1

The change of catechol-O-methyltransferase (COMT) activity during regeneration of rat liver was studied. Cytosolic, mitochondrial and microsomal COMTs activities were estimated in regenerating rat livers over a period of ten days after 70% (median and left lateral lobes) partial hepatectomy. The values of Km and Vmax in the hepatic enzymes were also measured. The activities of cytosolic and microsomal COMTs in regenerating rat liver after partial hepatectomy were found to be significantly increased between the second and the third day. Whereas the mitochondrial COMT activity did not change. The Vmax values of the cytosolic and microsomal COMTs in the regenerating rat liver were significantly increased at the second day after partial hepatectomy, however, the Km values of the above hepatic enzymes did not vary in all the experimental groups. Therefore, the results suggest that the biosynthesis of COMT was increased during the regeneration of rat liver.

Effect of Acute Ethanol Intoxication on Hepatic Rhodanese Activity in Rats with Extrahepatic Cholestasis

곽춘식,--,--,-- THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 2004 Journal of biomedical laboratory sciences Vol.10 No.2

Liver and serum rhodanese activities were determined in acute ethanol intoxicated rats with extrahepatic cholestasis induced by common bile duct ligation (CBD) to manifest the biochemical background of alcohol drinking hazard under the hepatobiliary disease. Liver cytosolic and microsomal rhodanese activities and these Vmax values in CBD ligated rats with acute ethanol intoxication were found to be decreased much more than that in CBD ligation alone. However, the difference of Km value on above hepatic enzyme was not found between the experimental groups. On the other hand, serum rhodanese activity in CBD ligated rats with acute ethanol intoxication was greater increased more than that in CBD ligation alone. These results indicate that the biosynthesis of the hepatic rhodanese decreases and the serum rhodanese activity increases in cholestasis combined with acute ethanol intoxication. reflecting damage of aggravated hapatocytic membrane. Accordingly, the resulting data supported the fact that alcoholic drinks were enzymologically harmful to the hepatobiliary disease.