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.

담양신설 IC의 교통소음도 조사연구

최형일,강영주,채희정,김연풍,조도호,설동화,정숙경 조선대학교 환경공해연구소 2007 環境公害硏究 Vol.20 No.1

After the vehicle has become a large formation with high-speed, loud noise from an express highway is increasing, and the number of large-scale apartment complexes, which are recently being constructed in the metropolitan area nearby the express highway and IC, is increasing gradually. Compared with a main road, the traffic volume and the speed of a vehicle between IC and the ramp way [turn-off] are smaller. If the ramp way is rightly connected with the downtown area, however, the traffic-noise that comes about in surrounding areas will be in conjunction with the traffic-noise from the main road of express highway and that of the ramp way. This research has selected a place that hasn't had a road or a commercial quarter nearby the main-road of IC and ramp way. Then we have studied the traffic-noise status under minimizing influence of its outer-noise, which occurs in IC. 1. The traffic volume change of a small and full-sized car with time has been kept on regularity in 2004 and 2005. As the traffic volume of a full-sized car has diminished remarkably, it has been maintaining through 6:00a.m.-10:00 a.m. As it has decreased since lO:OO a.m.. we have also observed the traffic proportion going up. 2. Monthly traffic volume of small cars was higher in May, August and October than other months. We have observed that the high traffic volume during these months is due to the following: May-The Damyang festival, August-a high-demand season, October-viewing scarlet maple leaves. Monthly traffic volume of full-sized cars was generally higher in August, but it has decreased during 2006. This was due to the many construction trucks that were working on the extension of the 88 Olympic expressway. Therefore, there was more traffic volume in 2006 compared to 2004 and 2005. 3. In this study, the noise figures have been less than 55 dB(A) in 18 spots. There were 14 spots from 55dB(A) to 58dB(A). 58-61dB(A) : 20, 61-64dB(A) : 17, 64-67dB(A) : 18. There were 8 spots we observed at the highest level from 67dB(A) to 70dB(A). Those were the nearby spots separating the main road and Damyang IC. 4. Traffic-noise at the boundary between IC and the main road of an expressway was higher than that of the same distance in other places. 5. We have observed that traffic-noise is low in places with mountains that serve the role of soundproofing walls. Thus, the fundamental sound hadn't affected it.

Si₃N₄/SiO₂/Si₃N₄열차단막을 이용한 유속센서 제작

이형주,김도훈,김진섭,박세일,최용문,권대혁,이정희 경북대학교 센서기술연구소 2002 센서技術學術大會論文集 Vol.13 No.1

월출산국립공원 수질특성에 관한 연구

최형일,김난희,강영주,채희정,김연풍,조도호,설동화 조선대학교 환경공해연구소 2007 環境公害硏究 Vol.20 No.1

Because mountain streams have narrow widths and steep slopes compared to streams and lakes, hours of immobility are considerably short, and the quality of mountain streams has been greatly influenced by rainfall, land-use, components of the streambed and types of forests. During the summer when heavy rainfall occurs, eroded earth and sand flow into mountain streams and cause temporarily high turbidity. It is also the cause of eutrophication, which is frequently found in downstream. As evaluation standards for the quality of mountain streams were not established in Korea, this quality was evaluated by examining some items based on quality standards for drinkable water and research on the influences of pollution in mountain streams, which showed that these were seldom in downstream water systems. Mountain streams within Wolchulsan National Park flow into a reservoir and when characteristics of mountain streams from forests and rainfall that flow into mountain streams through forest ecosystems were studied, results of measuring its changes are as follows. Monthly changes of pH were low between April and August and higher starting October, and the EC was measured higher in the winter and the spring and tended to be low starting April. The EC on the 19th of May and the 23rd of October and the concentration of floating materials and COD_(Mn) were observed to be higher due to the influence of rainfall on the 19th of May and the 22nd of October, and it was judged that the washing out of dried deposits attached to the water pipe and the leaching of woods were influenced by rainfall. It is considered that real-time monitoring of water quality for a long time and water quality conditions during and after rainfall should be examined for ensuring basic data of water quality and evaluating characteristics and seasonableness of mountain streams, which may be greatly changed by artificial influence in the future.

Cadmium이 넙치(Paralichthys olivaceus)의 면역 반응에 미치는 영향

변주영,유민호,전려진,이형호,정현도 한국어병학회 2001 한국어병학회지 Vol.14 No.2

어류의 면역반응에 대한 cadmium (Cd)의 영향을 분석하기 위하여 넙치 (Paralichthys olivaceus)를 각기 다른 방향으로 Cd에 노출시킨 후 특이적 면역반응의 변화와 Edrwrdsiella tarda KFE (E. tarda KFE)의 인위감염에 대한 저항성을 분석하였다. E. tarda KFE의 formalin killed cell (FKC)로 면역시키기 2주전부터 계속하여 실험 기간동안 침지법으로 Cd(20ppb)에 노출된 시험구는 노출되지 않은 시험구와 양성 대조구보다 혈청 내 특이 항체가가 빠르게 최고치에 이르렀으나, 감소속도는 노출시키지 않은 양성 대조구에 비하여 빠른 것으로 나타났다. 이러한 경향은 splenocytes를 ELISPOT-assay (enzyme-linked immunospot assay)를 이용하여 특이 항체 생성 세포 (specific antibody secreting cell, SASC) 수를 분석해 보았을 때에도 동일하게 나타났다. 그러나 면역 전 2주 동안만 Cd에 노출시킨 시험구에서는 혈청내 항체생성 결과와는 달리 증가된 SASC의 수를 보여 주었다. 그리고 면역 2주 전부터 실험 전기간동안 계속해서 Cd에 노출시킨 넙치를 대상으로 하여 E. tarda FKC 생균으로 인위 감염시켰을 때 100% 폐사율을 보여 주었다. 이것은 Cd에 지속적으로 노출된 어류에서의 방어 체계는 면역반응뿐만 아니라 독성효과도 함께 고려되어야 하는 복합적인 것임을 확인 할 수 있었다. Olive flounder, Paralichthys olivaceus known as an one of the major aquacultured species in Korea were exposed to cadmium(Cd) with different protocols and analyzed the effects of exposure on the immune response. Antibody levels in sera of the group exposed to Cd(20ppb) by immersion method from 2 weeks before immuniztion with formalinised Edwardsiella tarda(E. tarda) KFE entigen to the end of experiment reached to peak level faster than that of the non-exposed group. After this peaking time the levels decreased much at a faster rate compared to the non-exposed group. This tendency was also appeared in the numbers of specific antibody secreting cells(SASC) analyzed with the enzyme-linked immunospot (ELISPOT)-assay technique in the splenocytes of the experimental groups exposed to Cd with different ways. Interestingly, the group exposed to Cd for 2 weeks before immunization also showed increased numbers of SASC unlikely the antibody production and suggested a more critical influence of cadmium exposure in early stage of immune reaction. Artificial infection with live E. tarda KFE induces 100% mortality in the flounder exposed to cadmium throughout the experimental period from two weeks before the immunization. It may imply that some other factors related to specific immunity are involving in the defence system of flounder exposed to Cd. Taked together. Cd exposure may induce temporaily stimulatory or indhibitory effects on the immune reaction, but suppress the physiological systems for the resistant against the infective agents with other toxic effects.

복숭아나무 硬枝揷木時 揷木 用土와 基間이 發根과 圃場活着에 미치는 영향

林敬鎬,林炯基,金道翊,金月洙,鄭淳柱 全南大學校 農業科學技術硏究所 1998 農業科學技術硏究 Vol.33 No.-

복숭아나무 경지삽목 번식에 있어서 삽목 용토와 기간 및 삽수내 저장 양분 함량 변화 등이 발근과 포장 활착에 미치는 영향을 구명하였다. 삽목 용토는 vermiculite가 peat pellets 岩線보다 발근율, 발근수와 발근장 및 포장 활착율 등에 있어서 가장 좋은 효과를 나타냈다. 삽목 기간은 35일에서 55일로 기간이 길어질수록 발근율이 높고 뿌리 발달이 좋아졌으나, 포장 활착율은 삽수내전탄수화물과 전당 등 전당 등 저장양분 소비가 많아 삽목 기간이 짧은 35일에서 높았다. 특히 이들 양분 중에서 sucrose의 소비가 가장 많았다. 포장에서 활착후 수고, 간경 등 생육은 모든 처리에서 수고 136㎝, 간경 22.9㎜ 이상으로 삽목 당년에 우량묘가 생산되었다. This experiment was studied to examine the effect of cutting media and duration on rooting and transplanting using hardwood cutting of 'Sunaga Wase' peach to establish mass production system of rooted cutting. In cutting media, vermiculite showed higher root growth than peat pellets and rock-wool on rooting, root number, root length, and survival in field. The longer cutting duration was from 35 to 55 days, the better rooting and root growth obtained. But the transplanting was the best at 35 days, because it held enough storage nutrient including carbohydrate and sugar which were consumed in cutting stem tissue of 'Sunaga Wase' peach during hardwood cutting. Especially, among these nutrients, sucrose showed the highest consumption. After transplanting of rooted cutting to field, tree height and diameter of ' Sunaga Wase' peach was 136㎝ and 22.9㎜, respectively. therefore it could product the best quality of rooted cutting.

양식 은어의 미포자충 감염예에 대한 병리조직학적 관찰

조병열,강형길,강효주,류갑민,이재영,박남규,허민도 한국어병학회 2003 한국어병학회지 Vol.16 No.1

1998년 9월 말경, 경남 지역의 양식 은어(Plecoglossus altivelis)에서 미포자충증이 발생하였다. 채집 당시, 하루 약 200마리씩의 폐사가 10일째 진행되고 있었으며 약 10%의 누적폐사율을 나타내었다. 병어는 입올림을 하거나 기면 상태에 있었으며, 대부분 체색흑화 및 복부팽만 소견을 보이고 있었다. 아가미, 아가미 뚜껑, 각종 내장, 복강벽 및 생식소에 직경 1~3㎜의 흰색 결절이 다수 형성되어 있었다. 감염 어종, 기생충의 형태 및 xenoma 분포 장기의 다양성에 근거하여 Glugea plecoglossi에 의한 감염증으로 추정되었다. 병리조직학적 검사를 실시한 결과, 광범위한 장기에 걸쳐 xenoma를 형성하고 있었으나 xenoma 인접조직에 변성 변화는 없었다. 아가미 새변, 비장, 두신 및 체신의 조혈영역에 심한 울혈 소견이 인정되었고, 간장, 심근 및 신세뇨관 국소에는 응고 내지 액화괴사 소견이 확인되었다. 따라서, xenoma의 인접조직에 대한 물리화학적인 영향보다는 xenoma형성 장기 및 조직에 야기된 국소 순환장애가 은어의 폐사와 직접적인 관련을 갖는 것으로 사료되었다. On September in 1998, a microsporidian infection was recognized in ayu, Plecoglossus altivelis, farmed on Kyongnam province of South Korea. Cumulative mortality was around 10% in 10 days. Infected fish which were piping for air near the surface of the water or in the asphyxic, lethargic condition revealed darkening of body and abdominal distention. Numerous whitish nodules up to 3㎜ in size were observed throughout most of body organs and tissues including gill, operculum, peritoneal wall and organs. Xenomas were also histologically confirmed in multiple internal organs with the evidences suggesting circulatory disturbance. Based on the morphology of spore and xenoma, and the distribution of xenomas in organs and tissues, this disease was diagnosed to be a microsporidiosis caused by Glugea plecoglossi. The mortality might be deeply related to the local circulatory disturbance by xemonas rather than the mechano-chemical effect of xenomas on adjacent tissues.

수온 변동 자극이 양식 넙치, Paralichthys olivaceus의 비특이적 생체 방어에 미치는 영향

이덕찬,김도형,김수미,강명석,홍미주,김현정,박수일 한국어병학회 2002 한국어병학회지 Vol.15 No.2

본 연구는 넙치에 대한 수온 변동 자극의 영향을 생체 방어적인 측면에서 검토하고자 하였다. 수온 변동 자극은 매일 18℃에서 25℃까지 상승과 하강을 반복하는 방법을 사용하였으며 그 기간은 30일간 지속하였다. 실험어는 온도변화를 주기 시작한 후 28일째까지 무작위로 채포하여 말초혈액 중의 백혈구 수, 전혈의 식작용능, 활성산소, 환원능, chemiluminescence(CL) response 및 lysozyme용균능과 같은 각종 비특이적 생체방어와 관련한 실험을 수행하였다. 수온 변동 자극을 주기 시작한 후 1일째부터 시작하여 1주일 이내에 약 18%의 넙치가 폐사하였으며 이후에는 대조구와 유사하였다. 또한, 수온 변동 자극을 준 실험구의 호중구 수는 2주째에 유의적인 증가를 보였으며, 림프구 수는 2일과 3일째에 감소하였으나 1주째부터 대조구와 유사한 수준으로 회복되었다. 실험구에서는 식작용 결과 식균율과 식균지수에서 이물질 투여 후의 반응이 늦게 나타났다. 식세포의 활성을 조사한 NBT reduction 실험에서는 실험 기간 동안 대조구와 유사한 경향ㅇ르 나타내었다. 또한, CL response의 경우, 실험구는 온도 변동 자극초기에 대조구에 비하여 유의적으로 낮았다. 그리고, 식세포가 분비하는 용균성 효소인 점액 내 lysozyme의 활성은 실험 기간 동안 실험구에서 낮게 나타나는 경향을 보였다. 이러한 여러 가지 비특이적 생체 방어 반응의 저하 현상은 수온 변동 자극 초기에 나타났으며, 1주일 정도 지속하면 그 환경에 적응하는 것을 알 수 있었다. 그리고 이러한 현상은 이들이 초기 폐사 발생과 어떤 상관 관계에 있는 것으로 생각되었다. This study was performed to know the effects of stress nduced by the daily fluctuation of water temperature fro 18? to 25? up and down for 30 days on the defence mechanism of olive flounde,r Paralichthys olivaceus. To make clear the temperature stress on the defense mechanism of the tested fish, several factors of immune response such as counting of leucocyte appearance in periopheral blood, phagocytic activity in whole blood cells, nitroblue tetrazolium(NBT) reduction, chemiluminescence(CL) response, and lysozyme activity were investigated at 28 days after giving the change of water temperature. The fish was controlled under the none feeding condition during experimental period. Mortality of the tested fish was rapidly increased up to 22% within the first one week of the experimental period without any additional stress factors. The number of neutrophil of peripheral blood in the tested group was significantly higher than the control group at the 2nd week, but the number of lymphocyte was significantly lower than the control group at the 1st and 3rd day of the experimental period, respectively. In the NBT reduction test, the activity of macrophage in the control group fish was the highest on the 7th day while that in the tested group was on the 3rd day. Also, the phagocytosis of tested group against formalin killed cells was retarded compared with the control CL response of the tested group was significantly lower from 2nd to 5th day of the experimental period than the contro. The lysozyme activity of tested group was remained higher during the experimental period than the contro. Even through the tested fish showed different results in some non-specific factors of immune responses between tested and control group fish, olive flounder seems highly adaptable in repeated water temperature change in condition after one week under the given temperature fluctuation range

虹彩 體質 分析에서 心腎結合組織의 虛弱 體質과 高血壓 家族歷과 관련성 硏究

金鐘牛,黃祐準,琴坰樹,李始炯,李宗淳,都金錄,趙在運,趙州掌,金鐘煜 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

Iridology, developed more than 100 years ago, is the diagnosis of medical conditions through noting irregularities of the pigmentation in the iris The purpose of this study is to compare interrelation between CVA, hypertension family history and cardio-renal connective tissue in Iris Constitution through iris constitution examination. The subjects consist of 114 patients who were examined in Iris Constitution at Chonju Oriental Medicine Hospital attached to Wonkwang Univ. from September. 1St. 2000 to August. 31th. 2002. 1. In the distribution of Iris Constitution, among of 79cases, There are neurogenic type 13cases, abdominal connective tissue weakness constitution 31 cases, cardio-renal connective tissue weakness constitution 6 cases, cholesterol 7 cases and others 22 case in control group. 2. There are familial history of CVA and hypertention 32 cases, no familial history of CVA and hypertention1 3 cases, in 35cases of experimental group. These results imply that there is meaningfulness of interrelation between cardio-renal connective tissue weakness constitution and. CVA, hypertention.

정신과 외래환자의 약물치료 반응과 심박동 변이의 변화 양상

이상규,이홍석,김인주,김형태,김도훈,손봉기 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : The purpose of this study was to investigate the change of heart rate variability after antidepressant treatment in depressed or anxious patients. We tried to find the usefulness of heart rate variability as a predictive marker of response to pharmacological treatments in the psychiatric field. Methods : Forty-seven patients with major depression, anxiety disorder, and somatoform disorder were treated over 4 weeks with antidepressants and were then classified as responders or nonresponders according to Hamilton depression scales or CGI scores. The HRV variables were measured and compared among the responders/nonresponders and the matched normal control. Results : The responders group exhibited low heart rate, low PSI, high SDNN, RMSSD, HRV index, NN50, pNN50, LNTP, LNLF, and LNHF compared with the nonresponders after 4 weeks antidepressant treatment. However, no significant differencein HRV vanables was observed between the responders group after treatment and the nonnal control group and the responsegroup after treatment. Conclusion : These results indicate that HRV variables would are normalized after successful antidepressant treatment and it that HRV has some possible uses as a predicting marker of antidepressant response.