신경섬유종증-제 2형의 진단과 치료 : 16례의 임상경험 Experience of 16 Cases

김정은,백선하,김종수,이상형,오창완,김동규,정희원,김현집,조병규,한대희,최길수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

Neurofibromatosis type 2(NF-2) is a dominantly inherited disorder characterized by the occurrence of bilateral acoustic neurinomas and the frequent association of other central nervous system tumors. We present a retrospective review of 16 patients with NF-2 who were treated at our hospital from 1984 to 1995 in 13 cases, the diagnoses of Nf-2 were based on the criteria developed at the Consensus Development Conference of National Institute of Health in the United States, and in another 3 cases. the criterias of NF-2 were not fully satisfied, but the diagnoses of NF-2 were highly suspected. The average age of the patients was 27.6 years, ranging from 13 years to 56 years. The most common symptom was hearing difficulty : intervals between symptom onset and deafness ranged from 8 months to 6 years(mean : 2.9 years) One family of NF-2 was documented consisting of a sister a brother and their mother. Nine patients underwent operations on unilateral acoustic neurinomas : these were subtotally removed in eight patients and totally in one patient Among these patients five were deaf on the ipsilateral side at surgery. Among the other four patients with useful hearing before surgery, hearing was preserved to preoperative status in two patients. Four patients with diagnoses of meningioma, received operations to relieve mass effect with subtotal removal in two patients and total removal in the other two. Early diagnosis and treatment are the most important in the management planning of patients with NF-2 for reasons of early manifestation and rapid progression of the disease.

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.

결핵성 중이염의 임상적 고찰

박병원,조우령,석상렬,김서규,김명구,권오준,김병헌 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.8

Application of heterogeneous RNA probes labeled immuno-fluorescent agent DIG for the screening a noble gene in cucumber

Kim,Dai-Hee,Kim,Byung-Oh,Park,Gyu-Hwan,Takahashi,Hideyuki,Kim,Kyung-Min 한국자원식물학회 2004 Plant Resources Vol.7 No.2

We tried to isolating a noble gene from cucumber library with heterogeneouse RNA probe labeled DIG of Arabidopsis PIN3 gene. Two kinds of RNA probes which had no significant homology each others, were designed from the 5 - and 3 - prime nucleotides of the AtPIN3 gene. In the first and second screenings of the cDNA library of cucumber with the probes, two positive clones were identified with specific duplicate signals. However, we isolated cDNA fragments homologous with putative nucleases from Nicotiana, Arabidopsis, Cordialis, and Oryza sativa, there was no significant homology with any other PIN family genes.

췌장의 가성낭종 파열에 의한 하부 위장관 출혈 1예

장성종,김병수,부귀범,김동규,박찬국,김만우,김정용,박상헌 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Pancreatic pseudocysts usually develop as a complication of acute pancreatitis or repeated attacks of chronic pancreatitis. Pseudocysts may also develop as a result of traumatic injuries or neoplasms. An uncommon complication is massive hemorrhage inside the pancreatic pseudocyst. The exact mechanism of hemorrhage is unknown. Enzymatic digestion, pressure erosion from the cyst mass or a combination of these processes may play an important role. Gastrointestinal hemorrhage associated with a pancreatic pseudocyst can occur in 10 percent of cases. When hemorrhage occurs because of erosion into a blood vessel involved in the pseudocyst, surgery is indicated since the episodes of hemorrhage are often severe and may even be fatal. When there is colonic involvement, various complications may occur. The most dangerous one is spontaneous rupture into the colon, which requires immediate surgical treatment because of high incidence of fulminating sepsis or massive hemorrhage. We examined a sixty eight-year-old man complaining of hematochezia and dizziness, and reported that it was a case of massive lower gastrointestinal hemorrhage caused by pseudocyst of the pancreas ruptured into the colon associated with chronic pancreatitis. On operative findings, the peripancreatic fatty tissue had severe adhesions to transverse colon and tail portion of pancreas, where the pseudocyst had formed. A distal pancreatectomy, splenectomy and resection of transverse colon were performed. By microscopic examination, hemorrhagic necrosis and inflammatory change were observed in the pancreas specimen. The tail portion of pancreas had a 6×6 cm sized cystic mass and was proven to be a pseudocyst with no epithelial lining.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

MRAC를 이용한 로보트 매니퓰레이터의 制御性能 向上에 관한 硏究 : Model Reference Adaptive Controller

김병수,김규로,선양래 慶熙大學校 大學院 1995 高凰論集 Vol.16 No.-

This paper is study on trajectory property of 6 DOF robot manipulator. This paper used to adaptive control and p-d(proportional-derivated) control for control methods, Simulation robot is stanford 6-dof robot manipulatr of stanford university. Main results obtained through this paper are summarized as followings. At each links, adaptive control has more excellant control than p-d control. At 1-st link, adaptive control and p-d control has a little error at 3.0 second. At 2 nd link, adaptive control and p-d control has a little error than other links without 3-rd link, At 3-rd link, two control methods has a superiority control results than other links with two control methods. At 5-st link, p-d control error is a most great than other links. Therefore, the adaptive control applications for 6-dof robot manipulator has a very excellant capability than applying classical p-d control.

생물학적 폐수처리시 휴지기간이 처리특성에 미치는 영향에 관한 연구

김상수,문병현,서규태,이택수 7개 국립대학교 환경연구 논문집 공동발행 위원회 2004 공업기술연구 Vol.4 No.-

Under recent situation of more stringent effluent regulations, small scale biological process for industrial wastewater treatment has on operational problems, such as highly variable loadings into the system. Especially, the seafood processing industry has difficulties to treat is because of its highly variable organic loading and high saline concentration (>30g/d㎥). High salt concentrations disrupt metabolic functions and cause plasmolysis and/or loss of activity of microbial flora, hence the biological treatment of the saline wastewaters could produce low COD removal efficiency. On the basis of background mentioned above, an appropriate operation of the existing treatment plant is required for stable effluent discharge at even highly influent loading. In this study, effects of long term ( days) idle periods on floc characteristics were investigated in treatment of saline wastewater by SBR. Temporal stop of feeding affects biological activity in the reactors and then floc structures such as size and fractal dimension. After a certain period of reoperation for orgnic activity, the size and fractal dimension of floc start to increase.

두개강내 상의세포종 : 임상적 병리적 특성 및 예후결정인자 Clinicopathologic Features and Prognostic Factors

김동규,조병규,양희진,지제근,정희원,김현집,최길수,한대희 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.10-11

The clinical and pathologic features, including prognostic factors and survival data, were analyzed for 23 patients with intracranial ependymoma treated surgically at the Seoul National University Hospital during the years 1979 to 1990. The age at diagnosis ranged from 2 months to 55 years(mean : 14.9 years). The male to female ratio was 10:13. Fifteen patients(65%) were under the age of 15. The tumors of twenty one patients(91%) were located infratentorially. The adjusted overall 5-year-survival rate of infratentorial ependymomas was 77% excluding 4 cases of surgical mortality(Kaplan-Meier method). The period of follow-up ranged from 2 to 70 months. No correlation was possible between 5-year-survival rate and extent of tumor, age group(below and above 6 years), extent of removal, or pathologic grading. Clinical or pathological evidence of spinal metastasis was not found.

效率的인 環境敎育을 위한 敎授·學習方法의 改善에 關限 硏究 : 中學校를 中心으로 in Middle School

김현철,이택순,문병현,서규태 7개 국립대학교 환경연구 논문집 공동발행 위원회 2002 환경연구논문집 Vol.2 No.1

This paper focuses on the development of desirable curriculum for environmental education in middel school. From the questionnaire investigation for teachers and students of 10 middle schools in Gyeongnam-do, it is desirable that the eduaction program should be practical and experiential rather than the current cramming lecture. In addition, environmental education program should be introduced as a compulsory subject through continuous and systematic curriculum. A training program is necessary for specialist group teaching environmental issues too. Institution of regional environmental education center is an appropriate meausre to develop such program. It will be helpful for open communication between school and social community. National support is necessarily required to promote research activity and to develop innovative teaching materials in such center. Consequently the national environmental network will be constructed and effective environmental education will be implemented.