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.

탈수 칼륨 및 칼슘-제올라이트 A 구조에서 큰바구니의 8-고리에 존재하는 양이온 1가 및 2가와 골격산화물 이온에 대한 화학 특성

손만식,박경원,백우현,김효기 국립경상대학교 공과대학 부설 첨단소재연구소 1992 尖端素材 Vol.2 No.-

Starting with the structural unit of 8-ring in supercage for dehydrated ?? and Ca-zeolite A, we studied chemical characterization and electronic structure and properties of monovalent ?? and divalent ?? cations with framework oxide ions of the above materials by semiempirical molecular orbital theory. On 8-ring in the supercage for dehydrated Tl and Ca-zeolite A, framework oxide ions are strongly bonded by chemical bonding. This results show structure stability of structural skeleton for z대lite A. When ?? or ?? cations are incorporated in 8-ring, framework oxide ions with ?? cation are bonded by chemical antibonding while framework oxide ions with ?? cation are weakly bonded by chemical antibonding. Charge transfer in ?? with framework oxide ions is moved ?? to 8-ring. Then, net charge of O atoms in 8-ring including ?? cation are increased. But, net charge of O atoms in 8-ring including ?? cation are decreased. With these results, we here indicate that ?? ion are located in the 8-ring and ?? ion are not located in the 8-ring. These results are supported by the recent X-ray experimental study by Kim et al..

페나진 유도체들의 抗菌性에 관한 분자궤도론적 연구

郭庚度,朴柄珏,金鎬順,徐萬哲,金鐘大 嶺南大學校附設 基礎科學硏究所 1988 基礎科學硏究 Vol.8 No.-

The electronic states of the antimicrobial phenzine and its derivatives were examined by Extended H?uckel Method. It was found that the sum of nucleophilic reactivity index for trans 1,2, and 4 positions, ?? in a molecule was found to be related antimicrobial activity. The index, ??, should be applied to biological activity as well as antimicrobial activity.

Phellinus linteus 균사 배양물로부터 분리한 단백다당체 Kp의 항암활성

정경수,김신숙,김희수,한만우,김병각 충남대학교 약학대학 의약품개발연구소 1994 藥學論文集 Vol.10 No.-

A protein-polysaccaride fraction Kp(53.9% polysaccharide, 14.2% protein) was separated from the shake-cultured mycelia of a basidiomycetous fungus, Phellinus linteus, and its antitumor activity against sarcoma 180 in ICR mice was investigated. When administered after the tumor implantation. Kp exerted antitumor activity by inhibiting the growth of the sarcoma 180 solid tumor by 71.5% and increasing the life span of the sarcoma 180 ascitic mice by 51.5% at 100 ㎎/㎏. In pretreatment tests, in which Kp was administered once daily for 9 days before the tumor implantation. Kp inhibited the growth of the solid and ascites form of sarcoma 180, respectively, by 35.4% and by 80.3% at 100 ㎎/㎏. However, Kp showed no in vitro cytotoxic activity against a murine leukemia L1210 and a human gastric tumor SNU.1 upto the concentration of 200 ㎍/㎖. From these results, it is clear that the antitumor activity of Kp is exerted through its immunomodulating activity on the host's immune system.

장기입원환자 관리 방해요인

이경석,윤석만,권희,이호,김혜경,조미자,한규남,김명성 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background: Recently the health insurance review agency tried to cut off the cost of unnecessary hospital stay. It is important to reduce the prolonged occupation of the hospital beds. However, there are some obstacles of the management for the prolonged bed occupation. We report our experiences and the problems of bed-control. Methods: To increase the rate of effective bed-usage, a task force was made. This team was consisted of 4 dctors, 2 nurses and 2 personnel of the administrative department. From December 20th 2001 to May 17th 2002, the task force analysed the rate, number and causes of the prolonged (more than 60 days, regardless of the disease entities) bed occupation. We announced and explained the necessity of bed-control and actively pressed to reduce the prolonged bed occupation. Results: The number of the prolonged bed occupation was 71 at the beginning of the management. It was reduced to 46 at best, then turned back to 65 at the end. It seems to be impossible to reduce the prolonged bed occupation until there are sufficient numbers of long-term care facilities. Aggressive bed control makes the sick patients to move every two or three months, it is never desirable. Conclusion: We cannot expect any Quality Improvements without improvement of the wrong system. Prior to the management for the prolonged bed occupation, it is necessary to build a sufficient number of long-term care facilities.

政府出捐 硏究機關의 財務報告目的에 관한 硏究

吳世道,金景萬 충남대학교 경상대학부설 경영경제연구소 1996 경영논집 Vol.12 No.2

호두 기름의 성분조성과 항알레르기 효과

서영호,김욱희,김경만,황태영,손현숙 동아시아식생활학회 2001 동아시아식생활학회지 Vol.11 No.3

This study was conducted to investigate physicochemical properties and anti-allergic properties of walnut oil, pH, acid value and iodine value of walnut oil were respectively 4.9, 0.8 and 117. Most of general composition of walnut oil was crude fat(99.9%). Vitamin A and E were 0.06 and 10.25㎎/100g and the major fatty acids of walnut oil was linoleic acid(62.8%). Total phenolics and antiallergic effects of walnut oil were estimated 27㎎% and 62.82% at the concentration of 0.5% ethanol walnut oil. These results suggest that the walnut oil can provide one of the valuable resource for the functional foods.

Incisional Hernia in Adult Liver Transplant Recipients

( Ji Soo Lee ),( Kyeong Sik Kim ),( Chan Woo Cho ),( Kyo Won Lee ),( Gyu-seoung Choi ),( Jong Man Kim ),( Choon Hyuck David Kwon ),( Jae-won Joh ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Incisional hernia is one of the complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing an incisional hernia because of immunosuppression. The purpose of this study is to review incisional hernia cases after liver transplantation and to identify the risk factors for hernia formation. Methods: We retrospectively reviewed and analyzed the medical records of the ninety-four incisional hernia patients after liver transplant recipients from January 2000 to December 2015 in single center institution. Results: 1463 underwent adult liver transplantation during the study period. 94 Incisional hernia patients were found among them. The overall incisional hernia rate was 6.4 %. Mean age was 54 years old and 76.6 % were men. No significant difference was observed for sex, diagnosis, smoking, alcohol, albumin, Child-Pugh score, MELD score, intensive care unit stay, hepatorenal syndrome, ventilator, spontaneous bacterial peritonitis, diabetes, bile leakage, wound problems between patients with incisional hernia and patients without incisional hernia. The characteristics of patients with incisional hernia showed old recipient, more body weight, higher body mass index, living donor recipient compared with patients without incisional hernia. Hypertension, tuberculosis, rejection, postoperative complication event before hernia were significant risk factor (p<0.05). Conclusions: Present study identifies the risk factors for incisional hernia. Surgeons should strive to reduce the risk of incisional hernia after adult liver transplantation.

PPAR-α Activation Mediates Innate Host Defense through Induction of TFEB and Lipid Catabolism

Kim, Yi Sak,Lee, Hye-Mi,Kim, Jin Kyung,Yang, Chul-Su,Kim, Tae Sung,Jung, Mingyu,Jin, Hyo Sun,Kim, Sup,Jang, Jichan,Oh, Goo Taeg,Kim, Jin-Man,Jo, Eun-Kyeong American Association of Immunologists 2017 Journal of Immunology Vol. No.

<P>The role of peroxisome proliferator-activated receptor a (PPAR-alpha) in innate host defense is largely unknown. In this study, we show that PPAR-alpha is essential for antimycobacterial responses via activation of transcription factor EB (TFEB) transcription and inhibition of lipid body formation. PPAR-alpha deficiency resulted in an increased bacterial load and exaggerated inflammatory responses during mycobacterial infection. PPAR-alpha agonists promoted autophagy, lysosomal biogenesis, phagosomal maturation, and antimicrobial defense against Mycobacterium tuberculosis or M. bovis bacillus Calmette-Guerin. PPAR-alpha agonists regulated multiple genes involved in autophagy and lysosomal biogenesis, including Lamp2, Rab7, and Tfeb in bone marrow-derived macrophages. Silencing of TFEB reduced phagosomal maturation and antimicrobial responses, but increased macrophage inflammatory responses during mycobacterial infection. Moreover, PPAR-alpha activation promoted lipid catabolism and fatty acid beta-oxidation in macrophages during mycobacterial infection. Taken together, our data indicate that PPAR-alpha mediates antimicrobial responses to mycobacterial infection by inducing TFEB and lipid catabolism.</P>

난소의 성숙 낭성기형종에서 발생한 신경아세포종 1예

김정자,최현주,김영신,김기범,심상인,김수평,강창석,이헌영,나종구,백은정,한구택,여경아,권순만,이교영 대한부인종양 콜포스코피학회 1998 Journal of Gynecologic Oncology Vol.9 No.3

The incidence of malignant change of ovarian mature teratoma is 1∼2%. The majority is squamous cell cancer, the others was adenocarcinoma. Neuroepithelial tissue was frequently detected in mature cystic teratoma, but their malignant change was extremely rare. Only, two cases of neuroblastoma of ovarian teratoma were reported in the world. We report one case of neuroblastoma arising in ovarian mature teratoma with a brief review. Our case is the third reported one in the world.