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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.
젊은 성인에서 흡연에 의한 상완동맥 내피기능의 부전에 관한 연구
이상철,권영주,방덕원,이선해,이보영,김지욱,김영훈,온영근,현민수,김성구 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1
Background and Objectives : Cigarette smoking is a major factor and the most modifiable risk factor for atherosclerosis. Endothelial dysfunction is an early event in atherosclerosis, before the structural change of the systemic arteries. We hypothesized that endothelial dysfunction might be present in the systemic arteries of young adult smokers and that this might be dose-dependent phenomenon. Therefore, we try to certify that smoking is associated with endothelial dysfunction in healthy young adults without other risk factor of atherosclerosis. Subjects and Methods : we studied noninvasively 29 subjects aged 3 to 4 decades without other risk factor of atherosclerosis, they were composed of the two groups, current smokers(n=15) and nonsmokers(n=14). Smoking history varied from 3 to 20 pack years. Using high-resolution ultrasound, vessel diameter and mean flow rate were measured at rest, during reactive hyperemia(with flow-mediated endothelium-dependent dilation), and after sublingual nitroglycerin(NG-induced endothelium-independent vasodilation). Result : Flow mediated endothelium dependent dilation was observed in the control subjects (9.4±3.44%) but was impaired in the smokers(5.8±2.51%)(p=0.004). NG-induced endothelium independent dilation is no difference in all subjects. Conclusion : Cigarette smoking is associated with endothelial dysfunction in healthy young adults.
( Min Young Rim ),( Soo Yong Park ),( In Ku Yo ),( Min Su Ha ),( Ju Seung Kim ),( Ju Won Lee ),( Young Kul Jung ),( Dong Hae Chung ),( Oh Sang Kwon ),( Yun Soo Kim ),( Duck Joo Choi ),( Ju Hyun Kim1 ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
Background: Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease of unknown etiology that is reported to be a consequence of aberrant autoreactivity. Several studies which reported the acute presentation of AIH have different clinical course and histologic features. In this study, we compared acute presentation of AIH and chronic presentation of AIH. Methods: We retrospectively reviewed the medical records of patients with autoimmune hepatitis from January 2003 to June 2011 at Gachon University, Gil Hospital. A total of 29 patients were enrolled, 7 patients were diagnosed with acute presentation of AIH. Results: There was no difference between two group in age, gender, and score system of AIH. Patients with acute presentation had higher serum levels of total bilirubin, lower serum levels of albumin in clinical feature (p<0.05), and higher frequency of zone 3 necrosis in histologic feature. The cumulative incidental rate of the normalization of serum AST and ALT levels with prednisolone treatment was similar between patients with acute presentation and chronic presentation in clinical course. Conclusions: Higher AST, ALT and, bilirubin were clinical specific feature, and zone 3 necrosis is a histological characteristic of autoimmune hepatitis with acute presentation.
Effect of alumina nanofiller on properties of heat-treated glass composite sealants.
Lee, Dong Bok,Jang, Dong-Hoon,Kim, Bong-Su,Kim, Kwang-Joong,Park, Sung,Lee, Jong-Ho,Lee, Hae-Weon,Lee, Jae Chun American Scientific Publishers 2014 Journal of nanoscience and nanotechnology Vol.14 No.11
<P>Alkali/alkaline-earth borosilicate glass-alumina composites containing 10 vol% Al2O3 were prepared for use as solid oxide fuel cell sealants. The effect of heat treatment and Al2O3, addition on the viscosities and electrical conductivities was investigated to improve cyclic sealing performance. Upon a 48-h heat treatment, the viscosity of the glass-alumina composites at 750 degrees C was approximately four orders of magnitude higher than that of the base glass owing to the crystallization of the glass in the presence of Al2O3. Heat treatment increased the electrical conductivities of both the base glass and the glass-alumina composites. The electrical conductivities of glass-alumina composites in the range from 400 degrees C to 550 degrees C were three times higher than those of the base glass regardless of heat treatment. This increase in the conductivities and viscosities by heat treatment was attributed to the devitrification and structural densification of the sealing glass and the partial dissolution of the Al2O3 filler in alkali/alkaline-earth borosilicate sealing glass.</P>
Lee, Sang Kwang,Kim, Jae Ho,Kim, Sung-Soo,Kang, Taewook,Park, Nam Hyun,Kwon, Kyung-Hoon,Lee, Sang Sook,Lee, Zee Won,Suh-Kim, Hae young,Cho, Kun,Yun, Su Yeoung,Han, Ji Young,Yoo, Jong Shin,An, Hyun Joo Springer-Verlag 2013 Analytical and bioanalytical chemistry Vol.405 No.16
<P>Mulitpotent mesenchymal stem cells (MSCs) derived from human bone marrow are promising candidates for the development of cell therapeutic strategies. MSC surface protein profiles provide novel biological knowledge concerning the proliferation and differentiation of these cells, including the potential for identifying therapeutic targets. Basic fibroblast growth factor (bFGF) affects cell surface proteins, which are associated with increased growth rate, differentiation potential, as well as morphological changes of MSCs in vitro. Cell surface proteins were isolated using a biotinylation-mediated method and identified using a combination of one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis and mass spectrometry. The resulting gel lines were cut into 20 bands and digested with trypsin. Each tryptic fragment was analyzed by liquid chromatography-electrospray ionization tandem mass spectrometry. Proteins were identified using the Mascot search program and the International Protein Index human database. Noble MSC surface proteins (n = 1,001) were identified from cells cultured either with (n = 857) or without (n = 667) bFGF-containing medium in three independent experiments. The proteins were classified using FatiGO to elucidate their function. We also confirmed the proteomics results using Western blotting and immunofluorescence microscopic analysis. The nature of the proteins identified makes it clear that MSCs express a wide variety of signaling molecules, including those related to cell differentiation. Among the latter proteins, four Ras-related Rab proteins, laminin-R, and three 14-3-3 proteins that were fractionated from MSCs cultured on bFGF-containing medium are implicated in bFGF-induced signal transduction of MSCs. Consequently, these finding provide insight into the understanding of the surface proteome of human MSCs.</P>