위암수술 환자에서의 cp 개발과 cp적용에 따른 질 향상 활동에 관한 연구

임은주,황순휘,박도중,하광일,배현주,김형호 한국의료QA학회 2006 한국의료질향상학회지 Vol.13 No.2

Background : In an era of increasing medical costs, safe reduction in postoperative stay has become a major focus to optimize utilization of healthcare resources. The authors aimed to evaluate the clinical significance of the critical pathway(CP) for gastrectomy patients by implementing standardized postoperative management and electronic medical records. Method : From August 2006 to April 2007, critical pathways were introduced to inpatients and outpatients with gastric cancer. 60 consecutive patients undergoing distal gastrectomy were randomly divided into two groups; 30 CP group(A) and 30 non-CP group(B). Simultaneously, we also retrospectively reviewed the records of 438 patients(C:control group) who were able to be enrolled in CP program. We compared group(A) with (B), (C) in terms of hospital stay, complication rate, use of antibiotics and hospital costs. Patient satisfaction was surveyed by questionnaires. Result : There was no significant demographic difference between group(A) and (B). Of 30 patients in group(A), 5 drop-outs and 14 variances occurred. The mean postoperative hospital stays(Laparoscopy-assisted distal gastrectomy: LADG/Open distal gastrectomy: ODG) were 7.6/10.5 days for the group(A), 8.9/12.7 days for the group(B) and 12.6/14.5 days for the group(C) (p=0.02 in LADG). The total hospital cost of group(A) had a tendency to be less than that of group(B) and the amount of hospital cost per day in group(A) was significantly higher than that in group(B). The usage rates of the first generation antibiotics were 73.33%, 63.33%, and 59.2% in group(A), (B), and (C), respectively. Patients’ satisfaction had a tendency to be higher in the CP group than non-CP group. Conclusion : The mean hospital stay in LADG patients was shortened meaningfully and hospital cost per day was enlarged after introduction of clinical pathway. It is necessary to apply a number of patients to the critical pathway and to make an effort to reduce the variation and drop-out rates.

랫드에서 인체 재조합 적혈구 조혈인자, rHuEPO의 13주 정맥투여 아만성독성에 관한 연구

김형식,곽승준,천선아,박현선,한하수,임소영,안미영,김원배,김병문,안병옥,홍성렬,이병무 성균관대학교 약학연구소 1998 成均藥硏論文集 Vol.10 No.1

A recombinant human erythropoietin (rHuEPO) was administered intravenously at dosage levels of 0, 100, 500, and 2500 IU/㎏/day for a period of 13 weeks. There were no observed clinical signs and deaths related to treatment in all groups tested. Decreases in body weight gain and food consumption were observed only in males of 2,500 IU/㎏ group after 2 weeks. In hematological parameters, erythrocyte content, hematocrit values and hemoglobin concentration were dose-dependently increased in rHuEPO treated groups. The ratio between kidney weight and whole body weight was significantly increased in females of 500 and 2,500 IU/㎏ groups. The spleen weight was also increased in both sexes of 500 and 2,500 IU/㎏ groups. However, the absolute weight change of other organs was not observed. In histopathological examinations, the renal tubular basophilia was observed only in males and females of 2,500 IU/㎏ groups. From these results, it is concluded that the no-observed adverse effect level(NOAEL) of rHuEPO is 100 IU/㎏ in rats in the present study.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

개에서 발생한 신우신염 증례

유건우,이선희,임수정,박형진,김태신,송은식,송근호 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2009 動物醫科學硏究誌 Vol.16 No.1

A 6 years old Schunauzer dog (7.2kg, intact female) with history of hematuria for two days was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. Complete blood cell count showed no significant abnormalities and serum chemistry profile showed increased phosphate profile. On urinanalysis, there was evidence of bacterial infection. On ultrasonographic evaluation, irregular renal contour and increased echogenecity, pelvic and uretral dilation, and thickening of urinary bladder wall were observed. Based on these finding, the dog was diagnosed as pyelonephritis. The dog was treated with antibiotics based on antimicrobial susceptibility test results, then successfully resolved after 8 weeks of treatment.

갑상선기능저하증 이환견에 대한 치료 증례

김혜원,이선희,임수정,박형진,김태신,송은식,송근호 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2009 動物醫科學硏究誌 Vol.16 No.1

A 10-year-old, male, poodle dog was referred to the Veterinary Medical Teaching Hospital of Chungnam National University because of continuous cough and cardiomegaly. Weight gain, lethargy, unwillingness to exercise and decreased activity was revealed on history. Obesty and alopecia was also observed on physical examination. Hypercholesterolemia and increased ALP was revealed on blood exam. So, evaluation of thyroid gland function was performed and cTSH concentration was increased. tT4 and fT4 concentrations was decreased. Results of a history, physical examination, blood exam, and thyroid gland fuction test support a diagnosis of hypothyroidism. Initial therapy with sodium levothyroxine was indicated. On 32 days after treatment of hypothyroidism, clinical signs was relieved and cTSH concentration was decreased, tT4 and fT4 concenctrations was increased.

개 원발성 면역매개성 혈소판 감소증 증례

유찬,임수정,이선희,박형진,김태신,송은식,김덕환,송근호 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2009 動物醫科學硏究誌 Vol.16 No.1

A 13-year-old, castrated male, Maltese-dog was admitted to the Veterinary Medical Teaching Hospital of Chungnam National University with the history fo petechiae. On physical examination, she had petechiae and ecchymoses at her back, bilateral inguinal region, and inner part of ear pinna. CBC indicated neutrophilia and severe thrombocytopenia. A few platelets, no autoagglutination of RBC, and no spherocyte were observed. Coagulation profile demonstrated normal PT, and aPTT. No significant findings was not found on serum biochemical profile and electolytes test. FNA of a splenic mass which was found on the abdominal radiograph and sonograph demonstrated extramedullary hematopoiesis, Proteinuria was observed on urinarysis. Primary immune-mediated thrombocytopenia was diagnosed by ruling out of other underlying disease, severe thrombocytopenia, and response to immunosuppressive therapy. Prednisone and antibiotics were administered orally and parenterally, respectively. After altering prednisone to azathioprine, the number of platelets was recovered to normal range and petechiae and ecchymoses were improved.

足三里의 電鍼刺戟이 흰쥐의 中樞神經系에서 Interleukin-6의 活性에 미치는 影響 - 求心性 體感覺 情報傳達을 中心으로- : 求心性 體感覺 情保傳達을 중심으로

이혜정,신형철,진수희,손양선,윤동학,임사비나 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2000 No.-

Objectives : Acupuncture is expected to have somewhat like the efficacy parallel increasing activity of immune system in Western modern medicine. There, already, are many animal researches on activating effect of acupuncture for the immune system in peripheral organs. So, we carried out this experiment to see whether acupuncture has controlling effect on interleukin-6(IL-6) activity in rat's brain. Methods and Results : We had topical application of IL-6(1U-1pg, 10㎕) on brain of rat. It reduced afferent sensory transmission to the primary somatosensory(SI) cortex from periphery. Whereas, electrical stimulation(ES, 2Hz, 1.5V, 15min) of ST36(足三里) with application of IL-6 prominently activated afferent sensory transmission. ES of non-acupoint(proximal tail) with IL-6 showed suppression of afferent transmission. ES of ST36 without IL-6 application also exerted facilitation of afferent transmission to the SI cortex. Conclusions : Electoacupuncture(EA) on ST36 has noticeable influences on modulating activation of IL-6 in central nervous system, which do major role in immune system.

알록산 투여로 유발된 실험적 당뇨병에 대한 사인추출물의 치료 효과

노혜원,이지나,구본선,조정임,박진우,김형로 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:사인추출물이 알록산에 의한 당뇨 유발을 억제하는 효과가 있음을 이미 확인하였던 바 사인 추출물이 췌장 베타세포가 손상되어 유발된 당뇨병의 치료에 사용할 수 있는지의 가능성을 알아보았다. 방법:실험적 당뇨는 알록산(60㎎/㎏)을 생쥐 꼬리 정맥을 통해 주사하여 유발시켰다. 당뇨에 미치는 사인추출물의 영향을 관찰하기 위하여 사인추출물의 영향을 관찰하기 위하여 사인추출물(2.5㎎/생쥐)을 하루에 두 번 생쥐 복강 내로 투여하였다. 당뇨에 미치는 사인추출물의 영향을 관찰하기 위하여 생쥐에 사인추출물을 처리한 다음 혈당 및 혈청 인슐린 농도 변화 및 조직학적인 소견으로 확인하였다. 결과:생쥐에 알록산을 투여하면 췌장 베타세포가 파괴되어 고혈당 및 hypoinsulinemia가 유발되었다. 사인추출물을 알록산 투여 전 2일 동안 전처리하면 알록산에 의한 고혈당이 완전히 억제되었다. 뿐만 아니라 알록산에 의해 유발된 췌장 베타세포의 손상은 사인추출물의 투여로 현저히 개선되어 혈당 및 혈청 인슐린 농도가 거의 정상 수준으로 회복되었다. 알록산을 투여한 생쥐의 췌장 소도는 정상군에 비해 수가 현저히 감소되었을 뿐 아니라 남아있는 소도의 크기도 현저히 줄어들어 있었으나, 사인추출물을 처리하면 모두 회복되어 정상군과 유사한 양상을 보였다. 결론:사인추출물은 알록산에 의해 유발되는 당뇨병을 억제하는 방어 작용 뿐만 아니라, 알록산 투여로 이미 손상된 췌장 베타세포를 개선시킬 수 있는 치료 효과작용도 가지고 있음을 확인하였다. 이를 토대로 사인의 당뇨 개선 기전을 규명하면 당뇨병 치료제로서 이용할 수 있으리라 사료된다. Background : During the screening of natural products for potential antidiabetogenic components, a strong protective effect of Amomum xanthoides extract on alloxan-induced β-cell damage and in a mice diabetic model. In this study, the therapeutic effect of Amomum xanthoides extract was investigated after induction of diabetes by alloxan. Methods : Experimental diabetes was induced by the injection of alloxan(60mg/kg) to the mouse via the tail vein. To examine the effect the of Amomum xanthoides extract on diabetes, Amomum xanthoides extract (2.5mg/mouse) was admini-strated intraperitoneally. The effect of the Amomum xanthoides extract on alloxan-induced diabetes was observed by measuring the blood glucose and serum insulin level, and a histological examination. Results : Alloxan caused hyperglycemia and hypoinsulinemia by a selectively destroying pancreatic β-cell. Pretreating the with an Amoumum xanthoides extract completely protected them from the hyperglycemia induced by alloxan. In addition, the Amomum xanthoides extract administe 3 days after the of alloxan injection significantly abolished the hyperglycemia and hypoinsulinemia induced by alloxan. The alloxan-treated mice showed a marked change of in the pancreatic islets: the number of islets was reduced and the size of the remaining islets also decreased. However these effects of alloxan were significantly recovered by a later administration of the Amomum xanthoides extract. Conclusion : The amomum xanthoides extract contains potentially effective components, which both protect and treat alloxan-induced diabetes. The identification and action mechanism of the effective components of the Amomum xanthoides extract requires further investigation and it is suggested that the Amomum xanthoides extract be used as a therapeutic drug for diabetes(J Kor Diabetes 26:126~133, 2002).

철근콘크리트 연속보에서 부분프리스트레스 도입에 의한 휨보강 효과에 관한 연구

한병찬,윤현도,박완신,황선경,임재형,문정호 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

A strengthening technique for reinforced concrete beams using external unbonded reinforcement offers advantages in speed and simplicity of installation over other, established, strengthening techniques. The purpose of this paper is to investigate the capabilities of a new retrofitting technique, namely external prestressing(Bow), for flexural strengthening of beams. The paper provides a general description of structural behavior of beams strengthened using the technique. Results of 2 physical tests on strengthened reinforced concrete continuous beams are reported and compared. It is shown that the technique can provide greater strength enhancement to lightly reinforced sections and that provision of deflectors enhances efficiency.

흰쥐 경동맥 손상 모형에서 체외 방사선조사에 의한 신내막 과증식억제 : Intercellular Adhesion Molecule-1과 Vascular cell Adhesion Molecule-1의 역할 The Possible Role of Intercellular Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1

강동헌,승기배,장기육,임상현,정해억,임효영,김연실,채장성,김재형,홍순조,최규보 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.9