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.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

공업고등학교 전기학과의 전기수학교육에 관한 연구

이상석,신용철,김민회,박찬규,이재용 영남이공대학 2004 論文集 Vol.33 No.-

This research is that concern in electrical mathematics education of Technical high school Department of Electricity in the 7th educational curriculum. In the 7th educational curriculum, indicated problem about mathematics education of Technical high school Department of Electricity and examine major subject, contents of mathematics that use in major subject and analyzed contents of mathematics that must supplement. With this analysis, established necessary electrical mathematics contents for major subject studying of Technical high school Department of Electricity.

골수강과 관절면을 침범한 족무지 건막 거대 세포종 : 증례보고

이호승,성노현,이신노,허윤무 충북대학교 의학연구소 2000 忠北醫大學術誌 Vol.10 No.2

16세 남자 환자가 우측 족무지 동통과 종창을 주소로 내원하였다. 방사선 사진상 제1 족지 근위지골 골간에 낭포성 병변이 관찰되어 낭포성 골종양 의심하에 소파술 및 골이식술 시행하였다. 수술 소견상 단 족무지 굴근에서 기원한 연한 쵸콜렛 색깔의 소엽성 연부종양이 제1 족지 근위지골 피질골을 침식하여 골수강을 통해 관절면을 천공해 있었고, 조직 소견상 건막 거대 세포종에 일치하는 소견이 관찰되었다. 저자들은 제1 족지 근위지골을 침식하여 원위 관절면을 천공한 공격적 양태를 보이는, 족무지 굴근에서 기원한 건막 거대 세포종을 치험하였기에 문헌 고찰과 함께 보고하고자 한다. A 16-year-old man admitted with painful swelling of right big toe. plain radiographic examination demonstrated a cystic bony lesion at the metaphysis of proximal phalangeal bone toe. On operative findings, The medullary cavity was filled with multilobulated soft tissue mass and distal articular surface of the proximal phalangeal bone perforated by mass invasion. The mass was orginated from the sheath of the flexor hallucis brevis tendon. After curettage the mass, cancellous bone graft was done. Histologically, it was compatible with giant cell tumor of tendon sheath. We report a case of giant cell tumor of tendon sheath that invaded medullary cavity and articular surface of phalangeal bone

日本의 敎員養成制度 改革

李相魯,姜信珠,安泰潤,奇宇恒 慶北大學校 師範大學 1985 敎育硏究誌 Vol.27 No.-

It is said that Korean teacher education is facing some critical Problems. We think that we can get some imformations from the reexaminations on the recent reforms in Japaness teacher education system. 1) As the basic orientation of teacher education, we need to distinguish open system and closed system; teacher education in all college level and teachers college level. Institutional improvements should be directed to democratization and specialization; abuses in massproductive teacher education are required to correct. 2) In principle, teacher education should be enforced solely in regular college level; through strengthening teaching method course, teaching subject courses, and student teaching practices, professionally of teacher education must be elivated. 3) As teacher education heavily depends upon teacher employment directly or indirectly, the plan of the teacher demand and supply is needed to be reasonable. And incentive systems for teachers are demanded. 4) In-service education should be qualified to enhance the autonomy of teaching profession. 5) The Co-research between colleges, educatibnal institutes, and schools is expected to strengthen and enlarge action research.

경부의 근력트레이닝과 탈 트레이닝이 경부근력에 미치는 영향

이신언,한권상 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.2

Effects of neck muscle training and their changes after discontinuation of training(detraining) were studied in 22 athletes (college American football playeres) and 19 non-athletes. The subjects underwent narrow grip shoulder shrug training using free weights(NGSS group). isometric training of the neck in pairs(PAIR group), or both types of training (COMB group) for 14 weeks, and were then detrained during the following 14 weeks. Extension and flexion muscle strength(maximum isometric muscle strength) of the neck were measured using a method in which subjects pulled a wire attached over the head in a sitting position at 2-week intervals after the start of training. The following results were obtained. 1. In the athletes. the flexion muscle strength increased by 16.9=5.6%(mean=standard deviation) in the COMB group and by 14.8=5.2% in the NGSS group. and the increases in these groups were significantly greater than the increase in the PAIR group(p<.01). The extension mus칟 strength also increased, most notably in the COMB group(12.2±4.7%). 2. In the non-athletes. the flexion muscle strength increased by 29.4±7.2% in the COMB group. and this increase was significantly greater than that in the PAIR group(p<.01). This increase was also significantly greater than that in the COMB group of the athletes(p<.01). The extension muscle strength increased by 1.1±5.2% in the COMB group. 3. In the athletes. the flexion muscle strength of the COMB group was increased by 8.3% after 14 weeks of training and 14 weeks of detraining as compared with that at the start of training. In the non-athletes. the flexion and extension muscle strength of the COMB group increased by 17.4% and 9.8%, respectively, after the start of training. These results suggest that narrow grip shoulder shrug training used for the development of muscle strength in the lower neck is effective for improving flexion as well as extension muscle strength. and that the decrease in muscle strength due to detraining can be reduced by combining this training with isometric training performed by the PAIR group.

정사각형 장애물 주위 유동에서 역압력구배의 영향에 관한 실험적 연구

이학성,박계향,유상신 한국 항공대학교 항공산업기술연구소 1996 航空宇宙産業技術硏究所 硏究誌 Vol.6 No.-

An experimental study on the reattachment length behind the square obstacle under the adverse pressure gradient is conducted. An obstacle is fixed on the flat plate and the plate is installed in the test section of the wind tunnel. The upper wall of the wind tunnel is designed to be adjusted to impose the adverse pressure gradient on the flat plate. Tufts, ink-dot-liquid-film technique and a single hot wire are used to visualize and to determine the reattachment length of the flow field. Experimental results for the reattachment length of a model installed in the wind tunnel are strongly affected by the circumstances of the plate, installation, that is, whether sides of a model to the wind tunnel wall is open or completely closed. In order to ensure the two-dimensional flow on the plate sides of a model to the wind tunnel should be completely closed. The reattachment length of the square obstacle increase as the adverse pressure gradient increases.

縱斷的 資料에서 본 다운症兒와 精神遲滯兒의 身體發育樣相에 관한 硏究

李相于,朴俊東,辛尙根,安起英,姜信範 東亞大學校 附設 스포츠科學硏究所 1994 스포츠科學硏究論文集 Vol.12 No.-

The purpose of this study was to clarify physical growth pattern from longitudinal data of the down's syndrome and the mentally retarded children, through comparing our results with those of the normal children. Measurements of body height, body weight, chest girth and sitting height on 16 down's syndrome boys(16girls), 21 mentally retarded boys(14girls) and 90 normal boys(97girls) from 1982 to 1992 were taken every year during 11 years. The results were as follows : 1. In body height growth pattern for down's syndrome and mentally retarded children, down's syndrome and mentally retarded children showed lower then normal children, and then, group difference was significantly started 12 and 13-years-old of age over(P<0.05∼P<0.01) 2. Down's syndrome boys were significantly higher then normal boys except 17 years-old of age in body weight(P<0.01). 3. Down's syndrome and mentally retarded girls were significantly higher then normal girls except 13~15 years-old of age in body weight(P<0.05∼P<0.01) 4. Down's syndrome boys were significantly higher then normal boys between all age intervals in chest girth (P<0.01) 5. Down's syndrome and mentally retarded girls were significantly higher then normal girls in chest girth(P<0.01) 6. Down's syndrome and mentally retarded children were significantly lower then normal children except 7 through 11 years-old of age in sitting height(P<0.05∼P<0.01)

光質이 채소作物의 種子發芽와 初期生育 및 除草劑의 活性에 미치는 效果

李政明,金侊來,權臣漢,曺哉銑,朴啓仁,金尙根,李承雨 慶熙大學校 1987 論文集 Vol.16 No.-

Studies were conducted to investigate the response of some horticultural plants to various light qualities provided by different kind of materials such as cellophane sheets, EVA, PVC(polyvinyl chloride, and polyethylene (PE) films of different color. Major findings are summarized as follows. White fluorescence light and red light promoted seed germination of lettuce and inhibited that of radish seeds. Blue light inhibited the seed germination of both types of light-sensitive seeds. The light sensitivity varied considerably depending upon the kind of crops, cultivars, and the seed batches of the same cultivar. The blue light was equally or more strongly effective in inhibiting the seed germination as compared to the farred light. The growth of young seedlings developed from seeds was considerably promoted when grown under orange colored plastic film coverings. The growth of larger seedlings was, however, not influenced by the color of plastic films. Mulching pepper field with colored PVC film did not show further advantages over the commonly-used black PE film. Herbicidal activity of oxyfluorfen was very strong under natural light or red light conditions' and weak under blue or green light conditions. The degree of oxyfluorfen-induced phytotoxicity varied considerably depending upon the light quality and the kind of vegetable crops.