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.

미소압입시험법과 SEM/EPMA를 이용한 치과용 금속-세라믹 시스템의 계면특성 연구

이해형,송윤희,이수종,Yokoyama, Gen,Akimoto, Naotake,Hirano, Susumu 大韓齒科器材學會 2003 대한치과재료학회지 Vol.30 No.2

The purposes of this study were to investigate the interface area of dental metal-ceramic systems by using nanoindentation technique and SEM/EPMA. Gold (PFG) and Ni-Cr-Be alloy (PFM) coupons (10×10×1 ㎜) were cast and veneered with Ceramco Ⅱ opaque and body porcelain. Specimens tired once (one-tiring) and nine times (nine-firing) of body porcelain were prepared and compared in this study. The metal-ceramic interfaces embedded in epoxy resin were exposed and received 0.25-㎛ finish. Nanoindentation test (ENT-1100a, Elionix, Japan) was conducted at the interlaces with a load of 100 ㎎f (0.98 mN). Sixty indentations were made at two specimens of each metal-ceramic group. Nanoindentation marks were confirmed to allot their positions under a reflected microscope. Mean indentation hardness and elastic modulus values were determined at the area of metal area >5㎛ (M) and <5㎛ (MI) from interface, and porcelain area (P). Indentation hardness value was also compared with Knoop hardness values. Distribution of trace elements in alloys was examined at the metal-ceramic interfaces through X-ray mapping obtained from SEM/EPMA. From this study, following results were discussed. Mean indentation hardness values of gold alloy and porcelain were agreed with their Knoop hardness data, except for the base metal. There were no abrupt changes of mechanical property at the interlace areas of PFG and PFM specimens, although transition area of mechanical properties was not observed clearly at the interlace However, elastic modulus values obtained by nanoindentation were higher than their respect literature values. These results were probably caused by residual stress arisen at the metal-ceramic area, even though further study should be considered. High resolution SEM/EPMA study successively revealed fine mapping of trace elements at the metal-ceramic interfaces. A high concentration of Indium was observed at the gold-ceramic interface. Beryllium was not concentrated at the interface of PFM, although they appeared in NiBe phase. Generally, mechanical properties and distribution of trace elements of metal-ceramic interface were not significantly changed with increased firing times. Nanoindentation technique was useful to analyze interface properties of metal-ceramic systems.

자동운전을 위한 지능 제어 기법

이해영,박종수 嶺南大學校 工業技術硏究所 1998 工業技術硏究所論文集 Vol.26 No.2

This paper presents an intelligent control method which can automatically drive a model car. The model car adopted in this paper only two sensors. Automatic driving fuzzy control rules designed by investigating road types are divided into five groups whose functions are independent. Each group is composed of seven fuzzy rules of imitating human experience. In order to show validity of fuzzy control rules suggested, computer simulation are done for a Z type, S type, Hat type, U type and mixed type roads containing basic types. Simulation results show that the model car can pass through every type road well.

유한요소법을 이용한 밸브 스프링 리테이너의 형상설계

신혁수, 김동범, 박진근, 이인환, 조해용 충북대학교 산업과학기술연구소 2013 산업과학기술연구 논문집 Vol.27 No.2

A valve spring retainer is a small disc and located at intake and exhaust valve stem of engine. The retainer supports a valve spring and transmits spring force to a valve. Force is applied to the retainer repeatedly by a rocker arm. Durability of the retainer is an important factor of performance. Weight of retainer affect dynamic performance of engine. Therefore, optimal strength and weight of the retainer design are needed. In this study, stress distribution and fracture load of retainer were analyzed by using FEM to design optimal strength and weight. Static load test was simulated by using commercial FEM code DEFORM-3D. Shapes of the retainer to reduce weight were designed and analyzed to verify validity of it. Simulated results and experimental ones were compared

냉동생지의 제조 및 최적 해동조건 연구

이수태,기해진,정순택,박양균 木浦大學校 工業技術硏究所 2000 工業技術硏究誌 Vol.10 No.-

Frozen dough of two flour, Tazo and Tazo-S, and two thawing, room and cold temperature, were determined to qualified bread quality. For best bread quality from frozen doughs, very strong flour should be used. Frozen doughs are increasingly being produced in the baking industry even though they generally provide bread with lower loaf volume than dose unfrozen fresh dough. Several investigators have reported that the major changes in doughs that have been frozen are related to yeast. During the dough fermentation, yeast produces carbon dioxide and flavor compounds. Loaf volume decreased markedly with freezing and thawing, and gradually during frozen storage.

관광정보 웹사이트 평가에 관한 연구

이미혜,이수진 문화관광연구학회 2002 문화관광연구 Vol.4 No.2

The progress of information technology makes people to exchange the information easier, faster and more efficient than ever. The internet is the network that connects all the computers in the world so it makes the virtual tourism information intermediary, open 24 hours, 365 days, that does not have time and space limit. The suppliers aspect it helps advertising, promoting and updating the products less cost and more effective and demanders aspect it helps planning, deciding the various tour products less time and more valuable. So this relationship meet those party on online as a business. Currently Korean tourism information providers do not have enough income streams because not only the web-sites do not have useful and well organized the information, they do not have lack of know-how to manage the tourism information on online as well. To build the profitable and efficient web-site for furnishing tourism information, they should re-organize the information, synchronize video and audio(multimedia), provide other languages for foreigners, and distribute various contents by items for the demanders to access what they want easily, we should analyze them(travel information network) accurately and minutely by web-site evaluation.

차세대 인터넷 도입을 위한 경계 라우터의 성능분석에 관한 연구

이수욱,황성호,임해진 三陟大學校 2004 論文集 Vol.37 No.-

The IPv6(Internet Protocol version 6), a next generation internet protocol. was standardized to solve the problems of the IPv4(Intemet Protocol version 4). However. the IPv4 could not be actually converted to the IPv6 at one time. Therefore. the transition mechanism is thought to be very much important to be compatible with the IPv4 naturally and convert to the IPv6 network gradually. Despite of the development of various kinds of the transition mechanism, the IPv6 network was not expanded. The research was mainly made not for current system environment but for technical purposes. This paper investigated the performances through the transition mechanism and examined proper ways being applicable to current environment.

싸주아리쑥(Artemisia herba)으로부터 phytol의 분리

유종수,방면호,정해곤,정태숙,최명숙,이경태,백남인 경희대학교식량자원개발연구소 2006 硏究論文集 Vol.25 No.-

싸주아리쑥 지상부의 80% MeOH 추출물로부터 얻어진 EtOAc 분획물에 대하여 silica gel 및 ODS column chromatography를 반복하여 diterpene을 분리하였다. 화합물의 화학구조는, NMR, MS 및 IR 등의 스펙트럼을 해석하여 phytol로 동정하였다. The aerial part of Artemisia herba was extracted with 80% aqueous MeOH and the concentrated extract was partitioned with EtOAc, n-BuOH and H_(2)O, successively. From the EtOAc fraction, a terpenoid was isolated through the repeated silica gel and ODS column chromatographies. From the result of physico-chemical data including NMR, MS and IR, the chemical structure of the compound was determined as phytol.

고 Mn-Cr 강의 조사손상에 미치는 전자선 조사 온도의 영향

배동수,정호신,강창용,남승훈,이해무 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.3

The effect of electron-beam irradiation temperature on irradiation damage of 12%Cr-15%Mn austenitic steel for structural material of nuclear and/or fusion reactors from the point of view of the reduced activation was investigated by using the 1,250 keV HVEM and an energy dispersed X-ray analyzer(EDX) in a 200 keV FE-TEM with beam diameter of about 0.5 nm. Void formation was not observed in irradiated specimen. The dislocation loop growth was observed and the density and size of dislocation loop were increased with irradiation dose. Irradiation-induced segregations of Cr and Mn at grain boundary were also observed by electron-beam irradiation condition. The amount of Mn segregation was increased with irradiation temperature, however, segregation phenomenon was disappeared in the case of Cr.

고체발효기를 이용한 농산폐기물의 퇴비화에 따른 물리화학적 및 미생물상 변화

강태수,안문섭,한동준,이해승 도립 강원전문대학 1999 道立 江原專門大學 論文集 Vol.2 No.-

This study was performed to evaluate the composting process of agricultural wastes using the solid state fermentor at the general optimum composting conditions. The changes of physico-chemical and microbiological flora in the reactant during the composting time were investigated. The results were summarized as follows : From the results of proximate composition analysis of fermentation enzyme, the content of moisture, crude ash and total carbohydrate were 2.29, 67.57 and 22.69%, respectively. The number of thermophilic bacteria and actinomycetes in the enzyme were 2.6×10^(4) and 4.1×10^(5) respectively. During the composting time, the content of moisture in all wastes was decreased but acorn waste was not changed. The generation of maximum CO_(2) was in the range of 1,500∼10,000ppm after 12∼36hrs of composting time and then was gradually fallen. The C/N ratios of the Injin murgwort, arrow root and mushroom media waste were increased, but acorn waste was decreased. The contents of inorganic components(P_(2)O_(5), K_(2)O, CaO, and MgO) in the Injin murgwort, arrow root and mushroom media waste were a little decreased, but acorn and hole wastes were increased. The changes of thermophilic bacteria, in the Iniin-murgwort and arrow root waste showed big diversity while acorn and hof waste were slowly decreased. However the population number of thermophilic actinomycetes in the acorn waste was increased until for 24 hrs and then gradually decreased. The population number of thermophilic bacteria and actinomycetes showed not much difference.