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.

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)

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.

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,

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.

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.

타가메트정 400㎎에 대한 신일시메티딘정 400㎎의 생물학적동등성시험

윤미경,이병무,이성재,김선규,이재휘,최영욱 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.6

Cimetidine is a histamine H₂-receptor antagonist, used for the treatment of endoscopically or radiographically comfirmed duodenal ulcer. pathologic GI hypersecretory conditions. and active, benign and gastric ulcer. Simple method for determining cimetidine in human plasma has been developed and validated. The analytical procedure for cimetidine showed a linear relationship in the concentration ranges from 0.05 to 5 pg/ml. Coefficient of variance (CV, ° o) for intraday and interdav validation and relative error (RE. ° o) were less than ±150 o. Based on this analytical method. the bioequivalence of two cimetidine 400 mg tablets, reference (Tagamet 400 mg) and test drug (Sinil CIMETIDINE 400 mg) was evaluated according to the guidelines set by the Korea Food and Drug Administration (KFDA). Release of cimetidine from the tablets in vitro was tested using KP VIII Apparatus II with various dissolution media (pH 1.2. 4.0. 6.8 butter solutions and water). Twenty-four healthy volunteers. 21.38±1.86 years in age and 68.71±8.68 kg in bode weight, were divided into two groups and a randomized 2x2 cross-over study was performed. After oral administration of a tablet containing 400 mg of cimetidine. blood samples were taken at predetermined time intervals and concentrations of cimetidine in plasma were determined using HPLC equipped with UV detector. The dissolution profiles of the two tablet formulations were very similar at all dissolution media. In addition. pharmacokinetic parameters such as AUC, and C_(max) were calculated and ANOVA was employed for the statistical analysis of parameters. The results were revealed that the diterences in AUCf and Cma, between the two tablets were 4.17% and 0.97% respectively. At 90% confidence intervals. the differences in these parameters were also within ± 20° o. All of the above mentioned parameters have met the criteria of KFDA guidelines for bioequivalence, indicating that the test drug tablet (Sinil CIMETIDINE tablet) is bioequivalent to Tagamet 400 mg tablet.

대학 강의실 환경개선 후 평가(POE) 연구 : 강의실 리모델링을 중심으로

하미경,제해성,이경희,소윤경 대한건축학회 2004 대한건축학회논문집 Vol.20 No.10

According to the results from the evaluation, that was enforced by the Academic Affairs of Y University in the year 2002, the satisfaction level of interiors of classrooms appeared to be very low Only 11.6% of the respondents said that they felt comfortable in classroom environment The other 54.8% said that they were unsatisfied with the physical quality of classrooms at school In addition, students demanded a change in such items as lighting, air circulation, room temperature, worn out chairs and desks, and the size of the classrooms It is surprising to see that classrooms that have been built during the evolution of technology have created such a discomfort to students Therefore, creating a comfortable environment for all classrooms throughout the campus by applying a systematic approach that would meet students' needs is the purpose of research The results show that the project of remodeling has improved the quality of classrooms and increased the level of satisfaction on the overall classroom environment