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강민창,조혜진,최상준,한세준,정혁 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2
Objective: Pelviscopic surgery has been used in the treatment of some gynecologic disease. And now, it is applied in almost all cases of gynecologic disease. This study is performed to evaluate the clinical advantages of pelviscopic surgery and current circumstance of ORGY of chosun university hospital. Methods: From March, 2000 to February 2003, total 437 cases were received laparoscopic surgery on department of ORGY of Chosun University hospital. We reviewed the chart and analyzed these cases according to age, parity, clinical indication, operation type, duration of hospitalization, operation time and complication. Results: The results are summarized as follows, The mean age of patients was 42.5 years old with ranges between 15 and 61 years old and mean parity of the patients was 1.95. The common indications were uterine myoma (45.1%) , ovarian tumor (15.3%) and ectopic pregnancy (7.3%) and frequent types of surgery were laparoscopic assisted vaginal hysterectomy (LAVH) (46.9%) , salpingectomy (8.5%), oophorectomy (8.5%). The operation time was variable according to types of operation and difficulty and the mean duration of hospitalization was 4.27 days. The most frequent complication was hemorrhage at the trocar site. Conclusion: Pelviscopic surgery is useful and recommended for the treatment of gynecologic disease, because this is safe and has many advantages. So, we expect the number and indication of pelviscopic surgery will be increased in future. 목적 : 진단목적으로 시행되어오던 골반경 수술이 부인과 질환의 거의 모든 영역에서 적용되어있다. 이에 골반경 수술의 임상적 이점에 대해 알아보고자 본 연구를 시행하였다. 연구방법 : 2000년 3월부터 2003년 2월가지 조선대학교 병원 산부인과에서 골반경 수술을 시행 받은 437명의 외래 및 입원기록을 검토하여 환자의 연령, 출산력, 골반경수술의 적응증, 수술종류 및 시간, 입원기간, 합병증을 분석하였다. 결과 : 2000년 3월부터 2003년 2월까지 시행한 437예의 골반경수술을 분석하여 다음과 같은 결과를 얻었다. 환자들의 평균연령분포는 15세에서 61세 사이였고 평균 연령은 42.5세이었다. 평균 출산력은 1.95회이었다. 골반경 수술은 LAVH가 205예 (46.9%) 로 가장 많았고, 난관 절제술이 37예 (8.5%), 난소 적출술이 35예 (8.%), 난소부분절제술이 28예(6.4%) 이었다. 골반경 수술의 적응증은 자궁외 임신이 43예(86%), 자궁근종이 197예(61.2%), 난소종양이 82예(52.6%) 이었다. 수술시간은 수술의 종류 및 난이도에 따라 다양하였다. LAVH의 경우 평균 38.2분, 난소난관 절제술의 경우 평균 31.9분, 난관 절제술의 경우 평균 30.7분이 소요 되었다. 평균 실혈량은 LAVH가 1.16g/dl, 난관절제술은 0.94g/dl, 난소난관 절제술의 경우는 0.97g/dl이었다. 입원기간은 대부분 1일에서 5일 사이였으며, 평균 4.27일 이었다. 가장 많은 합병증은 트로카 천공부위 출혈이었다. 결론 : 본 연구의 결과로 골반경 수술은 현재 부인과 질환의 진단과 치료에 있어서 매우 유용하며 개복 수술을 대치하는 상황으로 나아가고 있다.
Prevalence of Malnutrition in Hospitalized Patients: a Multicenter Cross-sectional Study
강민창,김지훈,류승완,문재영,박제훈,박종경,박종훈,백현욱,서정민,손명원,송근암,신동우,신연명,안홍엽,양한광,유희철,윤익진,이재길,이재명,이정화,이태희,임해준,전현정,정규완,정미란,정치영,임희숙,홍석경 대한의학회 2018 Journal of Korean medical science Vol.33 No.2
Background: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. Methods: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. Results: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). Conclusion: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
췌장중앙절제에 있어서 복강경 수술과 개복 수술의 비교: 단일기관 95예의 경험
강민창,김송철,송기병,박광민,이재훈,황지웅,김영환,남정수,윤종희,이영주 대한내시경복강경외과학회 2012 Journal of Minimally Invasive Surgery Vol.15 No.4
Purpose: Despite recent advances in laparoscopic pancreatic surgery, few studies have compared laparoscopic central pancreatectomy (LCP) with open central pancreatectomy (OCP). The aim of this study was to compare clinical outcomes between LCP and OCP as a single institutional study. Methods: During the study period (From January, 1998 to December, 2010), we performed central pancreatectomy in 95 cases. Among them, 26 cases of totally LCP and 55 cases of OCP were compared retrospectively. Results: Benign pancreatic neoplasm was the main indication. The mean operation time for the LCP group (350.2 min) was longer than that for the OCP group (283.4 min). And there was no significant difference in mean actual blood loss (477ml versus 714 ml, p=0.083) between the LCP and OCP groups. Return to a normal bowel movement and resumption of aliquid diet were achieved 5.5±2.6 days after the operation in the LCP group and 6.6±2.0 days after the operation in the OCP group (p=0.039). The mean duration of postoperative hospital stay was 13.8 days for the LCP group, which was significantly shorter than the 22.5 days for the OCP group (p=0.015). The overall complication rate was 42.3% (11 cases) in the LCP group and 45.5% (25 cases) in the OCP group (p=0.790). Conclusion: Use of LCP for benign or low grade malignant lesions of the pancreatic neck portion is feasible and safe. Compared to the open method, the laparoscopic approach to central pancreatectomy appears to provide advantages of early resumption of a normal diet and reduction of postoperative hospital stay without further complications.
강민창 ( Kang Min Chang ),조혜진 ( Jo Hye Jin ),최상준 ( Choe Sang Jun ),한세준 ( Han Se Jun ),송창훈 ( Song Chang Hun ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.5
목적 : 조산아의 주산기 예후를 결정하는 위험요인을 분석하고, 각 요인별 예후를 비교분석함으로써 조산아 관리의 산과적 지표를 산출하고자 하였다. 연구 방법 : 2000년 1월 1일부터 2002년 12월 31일까지 조선대학교병원에서 분만후 신생아 집중치료실(NICU)에 입원한 37주 미만의 조산아와 신생아 집중치료실 (NICU)에 전원되어 입원치료한 조산아 236예를 대상으로 하였다. 조산아의 생존률, 이환율, 합병증, 장ㆍ단기 예후 등을 후향적으로 조사하였다. 결과 : 출생시 체중 및 재태연령은 주산기 예후를 결정하는 주요한 산과적 요인이다. 조산의 주산기 합병증을 보면 빌리루빈혈증이 27.5%로 가장 많았고, 호흡 곤란 증후군이 24.2%, 패혈증이 11.4% 등의 순이었다. 조산의 원인에 따른 생존률은 임신성고혈압 (88.2%)이 가장 높은 반면 자궁경부무력증 (50.0%)이 가장 낮은 생존률을 보임으로서 원인질환에 따른 생존률의 차이가 있으며, 자궁경무부력증의 경우 진단이 도면 대게 조산으로 귀결되므로 조산예방을 위한 조기진단과 치료가 필요하다. 결론 : 조산아의 생존률을 증가시키기 위해서 조기진통은 최소 제대연령 27주, 출생체중 1000 gm까지는 조절되어야 한다. Objective : To investigate the change of prognosis of the preterm infants delivered in Chosun University Hospital. Methods : A study was conducted for 236 newborns who were born at Chosun University hospital from January 1. 2000 to December 31, 2002. The data were collected by review of the hospital record. Results : 1) The survival rate of the preterm infants who weigh below 999 gm was 2% and 68.4% in 1,000-1,499 gm of infants 90.9% in 1,500-1,999 gm of infants and 92.7% in 2,000-2,499 gm of infants respectively. 2) The survival rate of the preterm infants who born 25% at 25-26 weeks, 50% at 27-28 weeks, 80% at 29-30 weeks, 88.2% at 31-32 weeks, 94.4% at 33-34 weeks and 95% after 35 wks respectively. 3) The cause of preterm delivery were premature rupture of membranes (41.7%), preterm labor (23.7%), pregnancy induced hypertension (10.9%), multiple pregnancy (8.3%) etc. 4) The perinatal complications of the preterm infants were hyperbilirubinemia (27.5%), respiratory distress syndrome (24.2%), sepsis (11.4%) etc. Conclusion : To increase the survival rates of preterm infants, the preterm labor should be controlled by 27 week`s gestation and the birth weight of 1,000 gm minimally.
SILS를 이용한 엔진 제어기 Driving Cycle 자동 주행 제어 기능 개발
강민균(Mingyun Kang),노영창(Youngchang Noh),임무창(Muchang Lim),임성빈(Sungbin Yim),이현규(Hyeonkyu Lee) 한국자동차공학회 2018 한국자동차공학회 학술대회 및 전시회 Vol.2018 No.11
This paper is the investigation on the effect of vehicle speed control to match driving trace automatically using application SW of ECU through simulation. For emission driving test, it needs numerous tests to get reliable result because of driver’s deviation even if driver is same person. In case of automatic control by application SW of ECU, it is easy and simple. Also it reduces time to get more effective result on complicated driving trace. To apply automatic control system, it designs PID system to control acceleration and deceleration by application SW and CAN communication. These methods are operated and confirmed by simulation of SILS. As a result of SILS, the virtual vehicle speed is matched entered WLTC driving cycle in ECU. And the vehicle speed deviation is satisfied with standard of permission.