통일을 향한 의료계의 준비

金漢中 대한의사협회 1996 대한의사협회지 Vol.39 No.8

미세혈관술을 이용한 복벽동맥 단단문합이 피판원위부의 생존에 미치는 영향 : An Experimental Investigation

김한중 梨花女子大學校 醫科大學 醫科學硏究所 1982 EMJ (Ewha medical journal) Vol.5 No.4

Recent advances in microsurgery and myocutaneous flaps have induced many surgerns to consider skin flaps from a new point, and this has produced an in-terest in the fundamentals governing flaps. If the flap is longer and larger, it should be delayed for complete survival,but delay requeires considerable time . Therefore, as a substitute for delay, vascular anastomosis in the distal part of a flap will theoretically give the same effect. In this study, we investigated the importance of arterial inflow in the distal side of a flap in a rat. The experiment was done in 3 groups according to design of flaps and in each group, 3 subgroups was made. In A flap, the superficial epigastric artery was preserved or anastomosis. In B flap, both superficial epigastric artery and vein was preserved or anastomosis. In C flap, both artery and vein was severed. In result, C flap in all 3 groups were completely survived. In conclusion, we suggest the possibility that a large flap may be transposed in oen stage with vascular anastomosis in the distal part - preferably artery and vein, or artery only.

血管腫

金漢仲 중앙대부설한국의과학연구소 1977 한국의과학 Vol.9 No.1

전국민 의료보험 실시에 따른 사회전체 순편익 분석

김한중,이해종,Kim, Han-Joong,Lee, Hae-Jong 대한예방의학회 1989 Journal of Preventive Medicine and Public Health Vol.22 No.3

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

한 농촌(農村) 지역(地域)의 의료보호사업(醫療保護事業) 평가(評價) -의료이용(醫療利用)을 중심(中心)으로-

김한중,Kim, Han-Joong 대한예방의학회 1978 Journal of Preventive Medicine and Public Health Vol.11 No.1

To examine the result of the government Medical Aid Program which began in January, 1977 as a part of social security policy implementation, all the medical records of the clients and official statistics in the year were analysed. The specific objectives this study pursues include the magnitudes and patterns of morbidity and utilization, and the characteristics of clients. One Korean rural area, Koje county was selected as the study area and subsequently all the clinics and hospitals assigned to work out the Aid Program are the subjects for the survey. A brief summary of the sutdy results as follows: a. The clients of Koje county are 6.4% of the total population in the area, more than the average percentage of the clients in Korea. It reflects on low level of economic status of the residents of the area. b. The population structure of the clients indicates that the large proportions of young and old age group are overwhelming, while the middle age group share very small portions. c. The utilization rates for primary care are 2.0 persons, 11.6 visits and 22.6 treatment days per 100 persons per months. Annual hospitalization is rated as 13.7 cases and 164 days per 1,000 persons, The utilization rates are slightly lower than those expected rates during planning period but eventually become higher than those of general population in rural Korea. d. The factors which influence the utilization rates are identified with client group (low income vs indigent), age and sex. e. The utilization pattern for primary care demonstrates seasonal variation similar to the pattern of general rural population in the low income group, but none in the indigent group. f. The most common diseases revealed at the primary care clinics are the acute respiratory infection (26.9%), acute gastritis (10.8%), skin and subcutaneous infection (6.8%). The cases of acute conditions are outnumbered than the cases of chronic condition. 8. The clinics, hospitals and other related health institutions are well cooperated in dealing health care services in their own capacities. Considering the above results Medical Aid Program generated satisfactory results at least in the utilization aspect.

시간활동 접근법에 의한 면 보건요원의 업무량 분석

김한중,김문식,Kim, Han-Joong,Kim, Moon-Shik 대한예방의학회 1977 Journal of Preventive Medicine and Public Health Vol.10 No.1

This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.

백서의 정맥이식후 내막변화에 대한 주사현미경적 연구

임동헌,윤진호,김한중 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5

Microvenous grafts to arteries are being used increasingly in replantations and elective tissue transfer. Vein grafts are used to bridge defects in arteries and veins in order that the anastomosis may be performed without tension. Through an extensive scanning electron microscopic study, we observed histolorgic changes on the end-to-end anastomoses of the interpositional vein graft in rats. In this study, the anastomosed vein grafted were examined at 9 different intervals ; 1 hour, 4 hour, 1 day, 3 days, 1 week, 2 weeks, 1 month, 2 months and 4 months postoperatively. The results were as follows; 1. day ; The endothelium of anastomosed venous graft was almost desquamated and covered with platelets and leukocytes. 2. week ; The endothelium was often laid down in an irregular pattern, something in folds. 3. weeks ; Re-endothelialization was completed and wandering cells were occasionally seen on the endothelial surface. 4. months ; The graft has been fully endothelialized and arterialization was ocurring.

3도 화상을 입힌 백서 피부의 조직학적 변화

조철현,최규남,최희윤,김한중 大韓成形外科學會 1983 Archives of Plastic Surgery Vol.10 No.1

One of the persistent problems plaguing surgeons who treat burn victims is the difficulty in quickly assessing the depth of burn injury. Often areas of second-and third-degree burns are intermingled and difficult to accurately evaluate soon after injury. The lag phase between time of injury and development of morphologic evidence of damage is reported to be at lease 8 hours. with full development of damage becoming evident by 24 hours to 2 days after burning. A method to detect and document early manifestations of burn injury is needed. In this study, fifteen male Wister Albino rats weighing 200 to 300gm were used as experimental subjects, and the goal of this study is to define clearly the early morphologic events following a severe burn. In conclusion, histologic alteration was used in this study as a tool for diagnosis of the depth of a burn injury. It was proved useful method in making early diagnosis of burn injury, and it was also revealed the fact which burn injury is a progressive phenomenon.

제 24 차 학술대회 : 11. 담낭절제술 및 총수담관 십이지장 문합술에 관한 실험적 연구

김한중,목돈상 대한외과학회 1972 대한외과학회 학술대회자료집 Vol.- No.-

최근의 연구관리 추세와 한국의 특이성

김한중 대한전기학회 1996 전기의 세계 Vol.45 No.5