갱년기 여성의 호르몬 대치 요법에 대한 수용율

이임순,장진영,이정재,이순곤,이권해,이해혁,김승형 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Purpose: We have evaluated the compliance of hormone replacement therapy. Method: There are 185 climacteric women who are divided into three groups (Group I, Group II, Group III). Group I is given conjugated equine estrogen(CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate(MPA, 5mg, day 1-12). Group II is given conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 2.5mg, day 1-30), Group III is given only conjugated equine estrogen(CEE, 0.625mg, day 1-30). Results: 1) The compliance rate of hormone replacement therapy during three months is 77.9% including each Group I : 77.7%, Group Ⅱ : 76.1%, Group Ⅲ :80.4%. 2) The compliance rate of hormone replacement therapy during six months is 60.7% including each Group Ⅰ:52.9%, Group Ⅱ: 56.4%, Group Ⅲ: 79.5%. 3) The compliance rate of hormone replacement therapy during nine months is 49.7% including each Group Ⅰ: 45.5%, Group Ⅱ:41.7%, Group Ⅲ: 64.3%. 4) The compliance rate of hormone replacement therapy during a year is 44.4% including each Group Ⅰ: 40.2%, Group Ⅱ:35.3%, Group Ⅲ: 59.5%. Conclusion : It is vital that we maximize compliance if patients are to receive the full benefits from hormone replacement therapy. We think that physicians who prescribe hormone replacement therapy for climacteric women should enough explain the purpose, risks, and side effect of treatment for maximizing compliance of hormone replacement therapy.

폐경기 여성에서 호르몬 대치 요법시 병행 투여된 프로제스토젠 투여 방법에 따른 혈청 지질 및 지단백에 미치는 영향

이임순,전섭,이순곤,이해혁,이권해,정집광,이석민 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Objective : The purpose of our study is to evaluate the effect of different administration method of progestogen on lipid profiles including total cholesterol, LDL(low density lipoprotein)-cholesterol, HDL(high density lipoprotein)-cholesterol, triglycerides during hormone replacement therapy in postmenopausal women. Methods and Materials : Seventy-one postmenopausal women who were assigned to following groups (Group I : conjugated equine estrogen(CEE), 0.625 mg/day plus continuous medroxyprogesterone acetate (MPA), 2.5mg/day, Group II : CEE, 0.625 mg/day plus cyclic MPA, 5mg/day for 12days/month. And we measured serum total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, and triglycerides before hormone replacement therapy(HRT) and 12 months later after hormone replacement therapy. Results: 1. Total cholesterol decreased in group I,III. 2. HDL-cholesterol increased in group I,II,III. 3. LDL-cholesterol decrease in group I,II. 4. Triglycerides increased in group I,II,III. There was significance in serum total cholesterol and LDL-cholestrerol among three groups. Conclusions : Estrogen alone or in combination with progestogen both in cyclic and continuous use improves lipid profiles, so medroxyprogesterone acetate(MPA) does not seem to blunt estrogenic effect on lipid profiles.

자궁내 태아사망의 임상적 고찰

이권해,이정재,조현철,이석민,이임순,이해혁,김권대,이순곤,남계현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Objective: This study was designed to evaluate diagnosis and complication, prognosis during clinical study of cases of intrauterine fetal death. Methods and materials: This is a clinical study of 56 cases of the intrauterine fetal death among 8064 deliveries at Seoul Sunchunhyang university hospital during 5 years from January, 1994 to December, 1998. Results: The incidence was 0.7%. The age distribution of mothers was 18 - 44 years and was highest in the 25 - 29 years range(46.4%). The parity was the most highest in the nulliparous group(51.8%). The most common gestational weeks was 20 - 28 weeks gestational period(46.4%), and most common presentation was cephalic(73.5%). The most common weights of the intrauterine fetal death was from 5,00gm to 1,000g(48.2%). The mode of the most common delivery was the induction of delivery(57.2%). The etiologic factors were: unknown(42.9%), preeclampsia(17.9%), chorioamnionitis(14.3%), congenital anomaly(12.5%), abruptio placenta(7.1%), cord complication(3.6%), placenta previa, death of one for twin. There were 2 cases of maternal complication(DIC, Uterine atony). Conclusion : Intrauterine fetal death should be diagnosised early and treated properly to reduce risk of the maternal complication.

조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

자궁선근증의 고찰

조환성,이해혁,정성윤,김성욱,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: This study was designed to estimate the frequency and risk factor for edenomyosis Methods: The clinical records of 623 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital, during 5 years, from Jan. 1995 to Dec. 1999. Results: The following result were obtained. 1. Adenomyosis was found in 247 of 623 patients(39.6%) 2. The highest incidence was 40-49 years of age group, an incidence of 46.6% and mean age was 44.7 years. 3. Adenomyosis was more frequently observed in parous women than non-parous women, such as 93.1% and 6.9%, respectively. 4. Dysmenorrhea, metrorrhagia, pelvic pain and vaginal bleeding were common symptom of adenomyosis, an incidence of 28.7%, 19.0%, 18.2% and 16.2%, respectively. 5. Myoma was the most combined disease in adenomyosis, showing the incidence of 54.7%. 6. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 61.9%. 7. Preoperative diagnostic accuracy of adenomyosis was 6.9%. Conclusion: The results show that deeply understanding of the common symptoms and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.

2차원 및 3차원 초음파를 이용한 태아표면의 해부학적 선별 검사에 관한 연구

윤석범,이해혁,이정재,최경훈,이순곤,이임순,이권해 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Objective : Our purpose of this study was to determine the clarity and consuming time of fetal surface screening in thirty-eight fetuses from 24 to 32 weeks of gestation by use of two and three-dimensional ultrasonography. Methods : From May 1998 to July 1998, we performed the fetal surface screening of the fetal face, extremities, and spine. Thirty-eight fetuses of 24-32 weeks of gestation (thirty-seven normal fetuses and one abnormal fetus) were studied by use two-dimensional (AI 5200S, 3.5-5.0MHz; Acoustic Imaging Technologic Cooperation, U.S.A.) and three-dimensional ultrasonography (Volusion 530D, 3.5-5.0 MHz ; Kretz-Medicine, Korea). On the fetal face, we evaluated both orbits, nose, lips and brow. Both hands and feet, five digits and toes should be seen in this study. We evaluated cervical spine and lumbosacral junction of the spine. Results : The maternal average age of 38 patients was 29.9 years and the average gestational age was 29.7 weeks. The results of fetal surface screening were as follows : face (both orbits 89.5%, lips 92.1%, nose 92.1%, and brow 89.5%), extremities (both hands 68.4% and feet 73.7%), and spine (cervical spine 94.7% and lumbosacral junction 97.4%) by use of two-dimensional ultrasonography. By use of three-dimensional ultrasonography, results were as follows : face (both orbits 76.3%, lips 81.6%, nose 81.6%, and brow 78.9%), extremities (both hands 76.3% and feet 78.9%), and spine (cervical spine 71.1% and lumbosacral junction 73.7%). Consuming time for two-dimensional ultrasonography were 4.7 minutes for face, 11.6 minutes for extremities, and 5.7 minutes for spine. Using three-dimensional ultrasonography results were 12.8 minutes for face, 17.9 minutes for extremities, and 11.7 minutes for spine. Average consuming time of all fetal anatomic screening was 22.0 and 42.4 minutes by use of two and three dimensional ultrasonography. In one abnormal fetus had cleft lip and polydactyly of right foot which were detected all by three-dimensional ultrasonography, but we couldn't detect the polydactyly by two-dimensional ultrasonography. Conclusion : Three-dimensional ultrasonography was more time-consuming method, but we suggested that three-dimensional ultrasonography was superior than two-dimensional ultrasonography in fetal surface screening.

아동의 손톱중 질소 함량과 영양상태에 관한 연구

권선옥,박선미,장순영,전혜숙,정원혜,최혜옥 효성여자대학교 가정대학 학도호국단 1984 家政大論集 Vol.3 No.-

We estimated fingernail nitrogen content from children in a city, a farm village, a mountain village and a fishing village. Therefore, the result is as follow. In summer, nail nitrogen content was estimated 130.79±15.39mg/g in a city, 123.86±24.93mg/g in a farm village, 96.16±17.04mg/g in fishing village, 91.96±6.76mg/g in a mountain village. In winter was estimated 137.43ㄷ69.06mg/g in a city, 131.70±8.49mg/g in a farm village, 124.75±16.34mg/g in a fishing village, 115.81±6.36mg/g in a mountain village. According to this analysis, the nail nitrogen content lowered by turns a city, a farm village, a fishing village, a mountain village. The nitrogen contents of nails obtained in winter were found to be higher than those obtained in summer.

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.

문제발견 및 가설설정 능력 신장 과학영재교육프로그램 개발 : 멘델의 과학적 사고과정 적용

김순옥,김봉선,서혜애,김영민,박종석 韓國英才學會 2011 영재교육연구 Vol.21 No.4

본 연구는 역사적 발견을 이루어낸 과학자 가운데 멘델(Mendel, Gregor Johann, 1822-1884)의 과학적 사고과정을 활용하여 과학영재교육프로그램을 개발하고, 이 프로그램을 학습한 학생들의 문제발견 및 가설설정 능력의 변화를 측정하여, 프로그램의 효과성을 검증하는데 목적을 두었다. 이를 위해 먼저, 멘델이 유전법칙을 확립하는 과정에서 나타낸 과학적 사고과정을 분석하여 특징적 탐구요소를 추출하였다. 추출된 탐구요소 가운데 문제발견과 가설설정을 적용한 프로그램으로서 완두를 활용한 모의실험탐구중심의 과학영재교육프로그램을 개발하였다. 개발한 과학영재교육프로그램은 대학교 부설 과학영재교육원 소속 중학교 1, 2학년 학생 19명(남학생 11명, 여학생 8명)을 대상으로 적용되었다. 적용한 결과, 학생들은 문제발견 능력의 하위요소 융통성, 정교성, 독창성이 신장되었고, 가설설정 능력의 논리성도 신장되었다. 이에 개발된 과학영재교육프로그램은 중학교 과학영재로 선발된 학생들의 문제발견 및 가설 설정 능력을 향상시키는데 효과가 있는 것으로 고찰되었다. In the process of establishing the principle of genetics, Mendel discovered problems based on various observations. Mendel’s scientific thinking ability can be effective if this ability is embedded in gifted science education programs. The study aims to develop a science gifted education program utilizing Mendel’s scientific thinking ability shown in the principles of genetics and examine students’ changes in scientific thinking ability before and after the program implementation. For the program development, first, the characteristics of Mendel’s scientific thinking ability in the process of establishing the principle of genetics were investigated and extracted the major elements of inquiry. Second, the science gifted education programs was developed by applying the inquiry elements from the Mendel's Law. The program was implemented with 19 students of 7th, 8th graders who attend the science gifted education center affiliated with university during July 2011. The Mendel's scientific thinking ability was classified into induction, deduction, and integration. The elements of inquiry extracted from the Mendel’s scientific thinking include making observation, puzzling observation, proposing causal questions, generating hypothesis, drawing inference, designing experiment, gathering and analyzing data, drawing conclusions, and making generalization. With applying these elements, the program was developed with four phases: 1st - problem finding; 2nd - hypothesis generating; 3rd - hypothesis testing and 4th - problem solving. After implementation, students’ changes in scientific thinking ability were measured. The findings from the study are as follows: First, students’ abilities of problem finding is significantly (p<.05) increased. Second, students’ abilities of hypothesis generating is significantly (p<.05) increased.

효율적인 통합 업무를 위한 정보관리 시스템 구축

박두순,안종근,공용해,정재헌 호서대학교 반도체제조장비국산화연구센터 2001 반도체장비학술심포지움 Vol.2001 No.-

기업의 효율적인 정보시스템 구축은 정보화 사회에서는 반드시 필요하다.또한 기업의 성장 규모, 기업의 요구 사항, 기업의 보다 향상된 업무를 위해 시스템을 능동적으로 구현, 확장, 재구성되어야 한다.이에 정보의 연계, 최신 정보의 효율적 관리를 이용한 구체화와 정보화를 유지할 수 있다.이를 위하여 중소 업체에서는 한 번에 많은 투자를 해야되는 종합 정보화 시스템보다는 생산 관리, 인사 관리, 회계 관리 등 각각에 대한 정보화를 위해 가장 기본적인 프로그램들을 업체의 특성과 차별성을 고려하여 실용 업무에 보다 적합한 자동화 시스템구성의 필요성이 강조된다.따라서 이들 시스템간에 서로 정보를 교환하고, 의사결정을 하는 종합 관리 시스템을 구축하여야 하는데, 이를 위하여 기존에 개발된 영업관리, 생산 관리, 인사 관리, 회계관리 프로그램들을 통합하는 것이 새로운 시스템을 개발하는 것보다 경제적, 기능적 측면에서 매우 유리하다 할 것이다. 본 연구에서는 (주)두양금속의 기존에 사용중인 영업관리, 생산 관리, 인사 관리, 회계 관리 시스템을 통합하고자 이미 구축된 시스템을 분석하고 각각의 독립된 업무를 연계하여 효율적인 정보 관리 시스템을 구축하는 것에 목적을 두고있다.