우심방을 침범한 거대 비호지킨씨 림프종 1예

강상범,진승원,이은경,박용현,최용호,김용주,박준철,김재형,홍순조,최규보,권종범,원용순,박건,이은희 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

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.

위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.

경추손상의 형태와 원인

이용재,이경석 순천향대학교 1994 논문집 Vol.17 No.4

We present a series of 205 patients with cervical spinal injury. Those patients were treated at Soonchunhyang University Chonan Hospital during eight-year-period (January 1986-December 1993). We collected data on types and causes of cervical spinal injuries, and frequency of cord injury retrospectively. Most(74.1%) of the cervical spinal injuries occurred in those patients with 20-60 years of age, and the peak age was the third decade. Male to female ratio was 3.2 : 1. Upper cervical(C1, C2) spine was injured in 22.9%, and lower cervical (C3-7) spinal injuries constituted 69.3%. In 7.8%, there were spinal cord injuries without radiological abnormality(SCIWORA). C6 was the most common level of cervical spinal injury, followed by C2, C5, C7 in that order, and the injury was least common in C1, C2 shared 87.2% of the upper cervical spinal injury. In lower cervical spine, C5-7 shared 79.6%. The common causes of injury were passenger traffic accidents (48.8%), falls (28.3%), and pedestrian traffic accidents (11.7%). In upper cervical spinal injuries, falls were more common than pedestrian traffic accidents, vice versa in lower cervical spinal injuries. Anatomical sites of spine injuries were intervertebral joint in 43.4%, body in 43.4%, pedicle and lamina in 11.1%, and processes in 8.5%. In two cases (1.1%), penetrating injury was responsible to the cord injury. Intervertebral joint and body injuries were common in fall, and less common in pedestrian traffic injury. Lamina injuries were common in traffic injuries and less common in falls. Process injuries were common in pedestrian traffic accidents, and less common in falls. SCIWORA was least common in pedestrian traffic accidents. Common types of injury were odontoid process fracture type Ⅲ and hangman fracture in the upper cervical spine. In lower cervical spine, dislocation(32.4%), subluxation(10.6%), and fracture-dislocation(10.6%) were common types. Cord injury occurred in 103 patients (50.2%). The rate of cord injury was dependent to the level and types of spinal injury. Age, cause, and site of injury did not significantly affect the rate of cord injury. The rate of cord injury in the upper cervical spine was 29.8%, and it was 51.4% in thw lower cervical spine. Dislocation was the most common type of injury resulting cord injury (76.0%), followed by fracture-dislocation (68.8%), body fracture (34.8%), lamina fracture (33.3%) in that order. Victims who were aged, injured by passenger's traffic accident or fall, and injured at the joint revealed the higher rate of cord injury, but those differences were statistically not significant. We again confirmed that cord injury occurred in more than a half of the cervical spine injuries, and were most common in those 20-50 years of age, that is the most active and productive period of life. Cervical spine is the most common site of spine injury, and most cervical spine injuries were brought on by potentially preventable causes. To reduce the number of secondarily disabled persons, an effort to prevent traffic accidents, the most common causes, is required.

백서의 우울모형에서의 칼슘통로 길항제 에타베린(Ethaverine)의 항우울효과

이상경,김선희,김록우,윤성환,김용관,김경태,김영훈 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 본 전임상연구에서는 우울증의 두가지 동물모형을 통해 에타베린이 단독 혹은 이미프라민과 병용처치 되었을 때의 효과를 알아보고자 하였다. 방법: 표준화된 검사법인 강제수영검사를 사용하여 옹성백서에게 에타베린(20mg/kg) 및 이미프라민 (20mg/kg)을 단독 혹은 병용 처치하였을 때의 부동시간의 변화를 관찰하였고, 경도의 만성 스트레스를 3주간 가한 후 4주간 에타베린과 이미프라민을 단독 혹은 병용 처치하였을때의 자당섭취량의 변화를 관찰하였다. 결과: 약물을 1회 단기처치 및 7일간 장기처치한 강제수영검사에서 이미프라민 및 에타베린 단독처치는 대조군에 비하여 부동시간의 단축을 보였고 에타베린은 이미프라민의 부동시간 감소에 대한 증강작용을보였다. 경도의 만성스트레스 실험에서도 3주간의 스트레스로 인하여 감소된 백서의 자당섭취량을 이미 프라민 및 에타베린이 회복시켰으며, 치료초기에 두 약물의 병용처치효과가 두드러졌다. 결론: 본 연구의 결과는 에타베린이 향우울 효과를 가지고 있음을 시사하며, 삼환계 항우울제인 이미프라민의 항우울효과를 증강시키므로 에타베린의 임상적 활용 가능성을 보여준다. Objectives: This pre-clinical study was performed to assess the effects of ethaverine in the two kinds of behavioral models of depression in rats. Methods: We observed the changes of the immobility time in the froced swimming test and the quantity of sucrose consumed in the chronic mild stress model, using ethaverine(20mg/kg) alone, imipramine(20mg/kg) alone, or ethaverine and imipramine concomitantly. Results: In the forced swimming test, both single treatment and chronic treatment(for 7days) with imipramine or ethaverine significantly reduced the immobility time, and concomitant chronic treatment with ethaverine potentiated the effect of imipramine. In the chronic mild stress model, both imipramine and ethaverine reversed the decreased sucrose consumption induced by 3-week stress and concomitantly treated ethaverine potentiated the effect of imi-pramine in the early phase of treatment. Conclusions: The data suggest that ethaverine can be used alone or concomitantly with other antidepressants in the clinical situation.

만경강 상류 수질 및 식생분포와 토양환경에 따른 하천식생의 종 다양성

이경보,김창환,이덕배,김종구,박찬원,나승용 한국환경농학회 2003 한국환경농학회지 Vol.22 No.2

만경강 상류유역 수질 및 하천식생 군락 변화를 조사 분석하여 수질에 따른 하천식생의 종 다양성 및 토양요인에 따른 종 다양성의 변화를 평가하기 위하여 2001년 6월부터 2002년 9월까지 만경강 상류유역 5개 조사지점을 선정한 후 조사를 실시하였다. 수질중 T-N의 농도는 전주천과 삼천에서 높았으며, 겨울철에 전주천에서 7.45 mg/L로 가장 높았다. 무기태 질소 성분벽 함량은 NH₄-N 경우 고산천과 소양천 유역은 0.01~0.06 mg/L 범위로 계절별 커다란 차이가 없는 낮은 농도를 나타냈으나, 생활하수가 유입되는 전주천과 삼천에서는 0.77~3.01 mg/L로 계절별로 큰 차이를 보였다. T-P의 농도는 계절별로 비슷하였으나 전주천에서 겨울천에 0.89 mg/L로 가장 높았다. 계절별 BOD의 농도는 고산천과 소양천 유역에서 0.92~2.14 mg/L를 나타내었으나 생활하수가 유입되는 유역에서는 2.01~7.65 mg/L범위를 보였다. SO₄²^(-)의 농도는 농업용수 수질기준인 50 mg/L를 초과하는 지역은 없었으며 소양천에서 다소 높았다. 만경강 지류인 고산천에서 조사된 식물은 59과 과 129속 165종 20변종으로 총 185종류가 조사되었으며, 소양천에서 조사된 식물은 53과 111속 141종 19변종으로 총 160종이었고, 전주천 하류에서 조사된 식물은 37과 68속 86종 15변종으로 총 103종이었다. 그리고 삼천에서 조사된 식물은 32과 92속 110종 18변종으로 총 128종류 조사되었으며, 만경강 본류인 하리유역에서 조사된 식물은 73과 134속 218종 33변종으로 총 251종류가 조사되었는데 식물의 생활형에 따라 분류하면 침수식물이 13종, 부엽식물이 5종, 부유식물이 2종, 추수식물이 26종, 수생식물이 46종, 습생식물이 47종으로 조사지점중 이 지역의 식생이 가장 다양하였다. 식물사회학적 방법에 따라 분류된 하천식생의 식물군락은 10개의 수생식물 군락과 2개의 습생 및 수변식물 군락으로 대별되어졌다. 이들 군락들에 대한 4종류(종수, 종의 풍부도지수, 종의 이질성지수, 종의 균등도지수)의 종 다양성과 토양요인(pH, EC, 유기물 함량, 전질소, 인삭)과의 관계를 분석한 결과 pH가 높을수록 4종류의 종 다양성 지수는 높아 졌으며, EC는 값이 높을수록 종수(SN), 종의 풍부도지수(SR), 종의 이질성지수(H'), 종의 균등도지수(J')가 낮아 졌다. 또한 유기물 함량(OM)과 전질소(T-N)의 경우도 4종류의 다양성지수와는 부의 상관관계를 나타내었다. 인산(P₂O_(5))은 4종류의 다양성 지수의 변화에 영향을 미치지 않았다. This study was conducted to evaluate influence of chemical properties in the riparian on the species diversity and to get plant information for enhancement of natural purification in Mankyeong River. The concentration of total nitrogen was high in Jeonju and Sam stream, while that of total nitrogen showed the highest peak in Winter. Concentrations of NH₄-N was 0.01-0.06 ㎎/L in Gosan and Soyang stream. The water quality of upstream along with Mankyeong River was suitable for the imgation source. The riparian vegetation was investigated by Zurich-Montpellier school's method from June, 2001 to September, 2002. The number of riparian plants were 59 families, 129 genera, 165 species, 20 varieties in Gosancheon, on the while 53 families, 111 genera, 141 species, 19 varieties in Soyangcheon The number of riparian plants in Hari basin was higher than that of other sites namely, 73 families, 134 genera, 218 species, 33 varieties. Riparian vegetation was consisted of 12 plant communities. The contents of organic matter, total nitrogen and electrical conductivity had negative relationship with species diversity (Species richness index, Heterogeneity index, Species evenness index, Species number). On the while, species diversity had positive relationship with soil pH. Species diversity of the plant communities were affected by topography and disturbance.

건축공학전공 졸업예정자들의 기술자격증 취득 및 취업증진에 관한 연구

이경락,조중근,정성진,전진용 永同大學校 1997 硏究論叢 Vol.3 No.1

본 연구는 건축공학 전공학생들의 졸업 후 진로 결정을 증진시키는 종합적인 방안을 모색하기 위한 것으로서, 우선적으로 건축전공 졸업자예정자들의 국가기술자격검정에의 합격률을 제고시키고, 그 결과에 따른 졸업 후 진로의 대책을 마련하는 것을 목적하며 세부사항은 다음과 같다. 1. 국가기술자격 취득률 제고를 위한 교육방법 2. 수학기간 중 건축관련 실무지식 함양 3. 관련업계와의 연계 구축 4. 산업체의 수요에 대한 교육에의 피드백 The purpose of this study is to search for the comprehensive and concrete methods of increasing the graduates' employment based on both fundamental and advanced knowledge concerned urban engineering major. For thi, existing condition, problems and improvement of students employment are searched in 3 view points such as strengthening of technical education to follow the social demands, enhancement of acquisition of the national qualifying examination and making the best of the field training system.

專門大學海洋土木科模型敎育課程 修正開發硏究

李東周,林秉龍,張仁奎,申文燮,金榮燮,朴昌圭,金康洙 군산대학교 1988 群山水産專門大學 硏究報告 Vol.22 No.1

This is a study to modify the curriculum of the ocean civil engineering department in junior college. We collected and analyzed data which are concerned on the curriculum development or improvement, the marine techniques and the ocean policy. And then we also gathered the opinions of the professors serving at the ocean civil engineering department by holding several conferences and investigated the opinions of the ocean civil engineers serving at the industrial organization by way of the inquring papers. In addition we collected the advices of educational specialists and ocean civil specialists by visiting personally. On the basis of above opinions we developed the jobs of graduates and made a model curriculum shown in Table 6. We tried to intensify the subjects of special basic field related to the ocean & civil engineering and the subjects of basic experiment & practise. The ocean observation practise was newly formed and the E. D. P.S was reinforced.

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.

Stroke에서 감압적 개두술, 정위적 조직 생검과 병리적 소견 고찰 : 중증 제뇌탈출을 동반한 초급성 뇌경색과 신경교종 내 출혈 감별 To differentiate the Herniated hyperacute Cerebral Infarction from the Glioma bleeding

이주용,조준,박호권,장상근,문창택,한혜승,이경룡 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

The authors in this manuscript aimed to provide a practical importance of the differential diagnosis of intracranial brain tumor with emphasis on non-neoplastic abnormalities such as cytotoxic edema of the penumbra zone in strokes. The well known SOLs are cerebral ischemic, inflammatory and dysplastic lesions, which intraaxially imitate glioma and other neurogenic tumors. Brain tumor is the one of common intracranial space-occupying lesions (SOLs) on the diagnostic images. However, many non-neoplastic lesions may be indistinguishable from tumors. Especially, early mortality used to be caused by space-occupying hyperacute ischemic stroke, brain edema and herniations. For the retrospective analysis, the authors reviewed the patient charts, the emergency brain Computerized Tomography (CT), magnetic resonance imaging (MRI), clinical stroke history. From Jan. 2003 to Dec. 2003, we managed total 61 acute strokes in ICU. Even though we operated six decompressive craniotomies, nine stereotactic craniotomies including two procedures of brain biopsy and three extraventricular drainage procedures, three patients (4.91%) were finally expired out from the induced herniation and medullary failure by those aggressive strokes. 43 patients (70.5%) were recovered good from stroke attack. 15 patients (24.6%) were improved with residual neurologic deficits. In conclusion, aside from growing efforts of the radiologist to make the early diagnostic impression, the authors suggest that urgent neurosurgical explorations with the pathologic diagnostic decision should be requested to decrease the fatality.