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.

하루 콩단백질 25g 섭취를 위한 메뉴작성 및 영양성분 분석

한재숙,김정애,서봉순,이연정,서향순,조연숙,한경필,이신정,오옥희,우경자,조은자,구성자,김수진,李承彦,南出隆久 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.2

The purpose of this study was to develop menus for daily intake of 25g soybean protein and to analyse nutrients of these foods. Analytical values were compared to the theoretical one using the food composition table and recommended dietary allowances for Koreans (7th revision). The results are as follows. 1. Soybean curd residue stew, Soybean curd, Kimchi saute, and hard boiled soybean and lotus root were selected for the menu for January, of which the content of soy bean protein(SBP) was 33.1g, soybean stew, soybean curd and soybean sprout saute, and Italian deep fried soybean curd were for February, of which the content of SBP was 35.0g. The content of SBP in soybean paste soup with soybean curd, fried soybean curd and fried soybean curd roll, the menu for March, was 24.9g. That of April were soybean curd gratin with soymilk, soybean curd and ham with garlic dressing and the content of SBP was 26.3g. That of May were soybean porridge, soybean flour cake with honey (Dasik), soybean sprout soup and the content of SBP was 26.7g. That of June were soymilk, pan-fried soybean curd, steamed soybean curd with chicken and the content of SBP was 28.4g. That of July were noodle with soymilk, mapatofu, soybean curd salad and the content of SBP was 24.7g. That of August were soybean sprout with mustard dressing, Tossed green pepper with raw soybean flour, Tofu and Kimchi stew, soybean curd steak and the content of SBP was 26.2g. That of September were Chinese cabbage soup with raw soybean flour, sweet and sour tofu and the content of SBP was 23.2g. That of Oct. were Fermented soybean stew, soybean pan cake and the content of SBP was 24.3g. That of November were not-pressed soybean curd casserole, pan-fried mashed soybean curd with egg, stir frying deep-fried soybean curd with vegetables and the content of SBP was 22.4g. That of December were soybean curd and mushroom casserole, fried soybean curd and vegetables, hard boiled soybean curd and the content of SBP was 28.9g. 2. The ratio of the analytical value over theoretical value (A/B%) of one serving in kcal, carbohydrate, protein, fat, ash and dietary fiber were 57.7~107.7%, 42.9~131.9%, 79.2~118.3%, 54.5~100%, 40.7~80.8% and 42.1~113.2%, respectively. 3. The ratio of A/B% of one serving in Ca, K, Na, P and Fe were 44.1~93.6%, 59.0~153.1%, 53.1~117.7% 64.6%~138.8 and 33.8~77.3%, respectively. That in Fe was the lowest among minerals. 4. The ratio of analytical value over Korean R.D.A(A/C%) in Ca was relatively higher (22.0~85.9%) than that in kcal(18~63%). 5. The ratio of A/C% in Fe was 25.1~64.3% and lower than that in Ca and protein in general.

한국 재래식 된장 중 indole의 분포 및 indole 생성균

이은주,박선미,신진돈,김종규 嶺南大學校 環境問題硏究所 1991 環境硏究 Vol.11 No.1

Indole contents and microorganisms producing indole were investigated from traditional Korean soybean paste. Distributions of indole contents were 0∼140㎍/g in the soybean paste and the mean was 8.1㎍/g. Through quantitative analysis of indole and sensory evaluation indole was found to be the main cause of feacal odor in soybean paste. Microorganisms producing indole isolated in soybean paste were rods, Gram positive and spore formation, so they were Bacillus species. But the microorganisms were different from characters of known Bacillus species, so they were types of Bacillus species.

보육시설 유아들의 식행동과 식품기호도 조사를 통한 식단개발 및 평가

신은경,이연경 한국식생활문화학회 2005 韓國食生活文化學會誌 Vol.20 No.1

This study was conducted to develop and evaluate food menus after investigating eating behaviors and food preferences of preschool children. Parents of the preschool children in 2 Gumi City day-care centers completed questionnaires in July 2003, which were used to assess eating behaviors and food preferences of their preschool children. Analysis of the questionnaires led to the development of the menus. Menus (n=10) were developed for five different categories (two menus were developed for each category) including general menu, unbalanced menu, anemia menu, obese menu. and traditional menu. The preschool children(n=656) evaluated the menus as they were provided with each them throughout October 2003. The five score scale method was used to evaluate taste, smell, looks, texture and general preference of each menu. Results in eating behaviors showed that 70.7% of preschool children had unbalanced eating behaviors. No gender based differences in eating behaviors were found, but in regard to food preferences boys tended to prefer carbonated drinks more than girls. Results indicated that among all menus, fruit ranked highest (3.97±0.65) for food preference, and vegetables ranked lowest for food preference (2.46±0.68). Food preference in regard to cooking process indicated the highest preference was for fried foods (3.80±0.68) and the lowest preference was for raw vegetables (2.61±1.27) and namul (2.85±1.13). Preference for taste ranked the highest (4.30±0.91) but preference for looks recorded the lowest (3.95± 0.89). Of all the foods in the menus. steamed tofu rated the highest for individual food item preference, while tuna sesame leaf rice rated the lowest preference. Statistical analysis of interrelationships among food taste, smell, looks, texture and general preference were significant (p〈0.01). Results from this study suggest that various factors including food taste, smell, looks, and texture influence the food preferences of preschool children. Therefore, it is concluded that by developing a variety of appetizing menus for use at home and in day-care centers, containing varied food items and cooking methods. preschool children will be encouraged to increase their food preferences and to establish appropriate eating behaviors.

대구·경북지역 단체급식소 유형별 영양사의 개인특성과 직무특성이 조직몰입과 직무만족에 미치는 영향

신은경,이연경 한국식생활문화학회 2003 韓國食生活文化學會誌 Vol.18 No.2

The objective of this study was to investigate the effects of personal and job characteristics on the organizational commitment and job satisfaction of dietitians employed in different foodservice settings. The subjects were dietitians(n=830) employed by schools, hospitals, and industries in Daegu · Gyeongbuk area. A questionnaire as used to determine personal and job characteristics, commitment and satisfaction. Organizational commitment scores were the highest for hospital dietitians, and the lowest for industry dietitians (p<0.05). Industry dietitians felt significantly less loyal to their organizations than did the other dietitians(p<0.05). School and hospital dietitians were significantly more likely to say they cared about the fate of their organizations and thought their organizations were the best to work for. Age, education, length of employment, and wages were positively associated with hospital dietitians' commitment(p<0.05). For all dietitians, the fewer the work hours, the higher the commitment(p<0.05). When asked to rate their satisfaction with various aspects of their jobs, dietitians expressed the most satisfaction with co-workers, and the least satisfaction with promotion opportunities. School dietitians were significantly less satisfied with pay and promotion than were the other dietitians. Organizational commitment was associated with wages(p<0.05), autonomy(0.08), feedback(0.16), dealings with others(0.07), and task identity(0.09). Job satisfaction was affected by educational level(-0.13), wages(-0.10), autonomy(0.18), friendship opportunities(0.14), feedback(0.16), task identity(-0.11) and organizational commitment(0.40) (Lisrel program).

복합트레이닝이 수영경기력 및 근력에 미치는 영향

이정숙,안민호,이은희,신옥연,김영준,이윤관 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.6

This study was aimed to find what impacts the combined training of circuit weight training and swimming training can give to the competing power of swimming athletes and their respiratory functions and to provide the basic data for preparing the desirable training program to shorten swimming records through 14 girl swimming athletes, a group of 7 athletes in circuit weight training and another 7 in swimming training and the following conclusions were obtained: 1. Swimming and Circuit training groups showed, before and after 12 week training, the changes of muscular strength: grasping power (p<.001), back muscle (p<.01), arm extensor (p<.05), leg extensor (p<.05), leg curl extensor (p<.01), broad jump (p<.05) increased espectively than those of swimming training group and which were more effective. 2. In the comparison between groups, the meaningful difference appeared in swimming training groups, showing grasping power (p<.01), back muscular strength (p<.01), arm extensor (p<.05), leg extensor (p<.01), leg extensor (p <.01) 3. In the changes of competition record, in swimming and circuit training group, before and after 12 week training, meaningful increases appeared by 50m record(p<.05), 200m record (p<.05) 4. In the changes of competition record, as for the comparison between groups, meaning ful increases, 50m record (p<.05), 200m record (p<.05) appeared.

흰쥐 선조체에서 6-OHDA-유도 도파민 고갈 및 SH-SY5Y 세포주에서 6-OHDA-유도 산화적 스트레스에 대한 I-Deprenyl의 신경 보호효과

김은미,최신규,이경림,김화정 이화여자대학교 약학연구소 2005 藥學硏究論文集 Vol.- No.15

A neurotoxin, 6-hydroxydopamine (6-OHDA) has long been used to form a Parkinson's disease (PD) model by inducing the lesion in catecholaminergic pathways, particularly the nigrostriatal dopamine (DA) pathway. Whereas I-deprenyl, a selective inhibitor of monoamine exidase (MAO) type B, is now widely used in the treatment of PD, the precise action mechanism of the drug remains elusive. In this studym, we investigated whether I-deprenyl shows protective effect against the DA depletion induced by 6-OHDA in rat brain, and against 6-OHDA-induced neurotoxicity and oxidative stress in catecholaminergic neuroblastoma SH-SY5Y cells that are known to lack MAO-B activity. Pretreatment fo I-deprenyl significantly enhanced the striatal DA, 3,4-dihydroxyphenylacetic acid, homovanilic acid, and 3-methoxytyramine levels compared to the untreated 6-OHDA-lesioned rat, indicating that I-deprenyl pretreatment prevents 6-OHDA-induced depletion of not only striatal dopamine but also its metabolites. Treatment of 6-OHDA for 24 hrs decreased the cell viability and increase the generation of ROS in dose-dependent manners.We further investigated whether caspase activity is involved in the action of I-deprenyl. Treatment of I-deprenyl (0.1~100μM) did not produce any changes in 6-OHDA-induced cleavage of poly (ACP-ridose) polymerase in SH-SY5Y cells. Our result suggest that the neuroprotective effect of I-deprenyl against 6-OHDA is due to its incresed scavenger activity, but independent of inhibition of MAO-B or caspase-3activation.

축대칭 다단계 딥드로잉 공정의 성형인자에 대한 연구

여은구,조선형,이용신 한국공작기계학회 2002 한국생산제조학회지 Vol.11 No.4

Formability in deep drawing process depends not only on a drawability of workpiece material but also on process conditions such as die punch corner radius, lubricant conditions, punch-die clearance etc. For instance, bending resistance should be reduced by increasing die round appropriately, drawing load should be minimized by improving the lubricant condition between die and material, and blanking load should be increased by selecting a pertinent punch round and by augmenting the friction resistance in punch. In this study, a multi-stage deep drawing process is analyzed using ABAQUS. The effects of formability factors, such as die shoulder radius, punch-die clearance and coefficient, are investigated, and the results are also discussed in detail.

진행성 위암환자에서 Capecitabine/Cisplatin 치료군과 Fluorouracil/Cisplatin 치료군 간의 삶의 질 비교

유희원,신은정,이광자,한현주,손인자 韓國病院藥師會 2004 병원약사회지 Vol.21 No.1

The improvement of medical treatment and anticancer drug has led a complete recovery and prolonged survival time of cancer patients. And recent study of cancer has included evaluation of quality of life. This study was performed to evaluate quality of life between Capecitabine/Cisplatin arm and Fluorouracil/Cisplatin arm. This study was performed in the Seoul National University Hospital from August to October 2003. A total of 8 AGC patients on adjuvant chemotherapy successfully completed this study. Method of study is questionnairing by EORTC QLQ-C30, cancer specific questionnaire. The questionnaire consists of Functional, Symptom, Global health quality of life scale. Patients eligible for this study had histologically confirmed stage III or IV AGC. Patients were to be between 18 and 60 years old, and have performance status of 1. Patients were ineligible if they had a history of 6 months prior or concomitant chemotherapy, radiotherapy. Statistically significant differences favoring the Fluorouracil/Cisplatin arm was noted in the physical scale. In addition, patients in the Fluorouracil/Cisplatin arm reported an improvement in physical functioning after one cycle chemotherapy.

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.