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.

중증 허혈성 지체질환 환자에서 시행된 vascular endothelial growth factor의 혈관신생 유전자치료 1예

김현중,장신이,김종묵,김선영,김병문,김원배,김덕경 대한내과학회 2003 대한내과학회지 Vol.64 No.1

저자 등은 기존의 치료에 반응하지 않은 중증 허혈성 지체질환 환자를 대상으로 하여 vascular endothelial growth factor를 이용한 혈관신생 유전자 치료를 시행하였다. 치료 후 환자의 허혈에 의한 하지 통증이 현격하게 감소하고 상처의 진행이 측부혈관이 많이 증가됨이 관찰되어 이에 문헌고찰과 함께 보고하는 바이다. We report VEGF-induced angiogenic gene therapy in a patient with critical limb ischemia, who did not respond to conventional treatment. This patient was the first case in a dose-escalating series of phase I clinical trial. The patient had severe resting pain, gangrene and diffuse ulcer in his left foot. Total 1,000㎍ of naked DNA encoding human VEGF165 was administered intramuscularly to 8 sites of the loft lower extremity. Four weeks after the first 1,000㎛ was administered to the same sites (total dose: 2,000㎛). After gene therapy, resting pain gradually reduced and the amount of analgesics taken by the patient decreased. The ischemic wound of lower extremity slightly improved. However, there was no complete wound healing at 12 weeks of treatment. Digital subtraction angiography at 12 weeks after gene therapy showed an increase in collateral vessels at the mid-tibial, ankle and foot arch levels. Immediately and up to 12 weeks, there was no complication related to gene therapy. These findings may be cautiously interpreted to indicate that intramuscular injection of naked plasmid DNA of VEGF_165 may induce therapeutic angiogencsis in a patient with critical limb ischemia. Further clinical evaluation of VEGF-induced gene therapy is needed to evaluate the safety and efficiency of this treatment.(Korean J Med 64:85-90, 2003)

老齡者의 建康을 위한 生活習慣 實態調査

申東敏,長鳳愚,李揆文,金賢俊,金昌範,崔宗洙,崔鍾晥,李鍾珏,金圭碩,趙庚旭,金鍾聲,朴鍾振 平生體育硏究所 論文集 1987 平生體育硏究所 論文集 Vol.2 No.-

With a view to examining the habit and method in which old people maintain and improve their health, we consulted 551 men and 444 women who were over 65 years old, and concluded as follows: 1. Habit of eating It's been revealed that most of the old people keep a regular eating hour, control the quantity of meal or eat a little food, and prefer vegetables to meat. 2. Mental health Old people feel the necessity for mental health and most of them (about 80%) keep good mental health without becoming pessimistic. Their chief concenrs have turned out to be about their sons and daughters and their own health and finance. 3. Managing Good Health It has been revelaed that old people do not possess any special kind of secret to keep good health but taking plenty of rest, regular meal, and proper exercise, and many of them (about 60%) have been shown to eat invigorant food that they can easily get around their living area. 4. Physical Functions It has been revealed that many old people are conscious of some symptoms about their parts of body and about to percent of them suffers from neuralgia. Some measures like medical aid especially for old people need to be taken as soon as possible. As we have found that the health-keeping method of old people consists plenty of rest, proper exercise, and appropriate nutrition, we can conclude that the recreatonal and culture facilities and programs for keeping old people in good health should be developed. It is also necessary to study food that contribute to their health and develop ways to get rid of the stresses to which they are exposed in their daily life. Presides, it is natural that government found an administrative department to deal with these matters effectively.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

미생물 고정화를 위한 재료의 안정성에 관한 연구

김종신,조춘석,원찬희 全北大學校 附設 都市및環境硏究所 1997 都市 및 環境硏究 Vol.12 No.1

The purpose of this paper is to decide the ratio mixture between microbes and the most suitable material in order to immobilize white rot fungus. It shows that white rot fungus favorably lives, regarding to respiration speed and activity when pellet is immobilized by PVA. In addition, it survives better with sodium alginate, concerning about the rate of swelling. When PVA-frozen method is applied, methylene blue is decolorized 100% by immobilized Trametes versicolor and 90% by immobilized Irpex lacteus after 44hr. As a result, pellet immobilized by PVA, which indicates better mechanical stability and declororization rate, is superior to sodium alginate. The mixture rate between microorganisms and PVA is 1:1.

경기력 수준별 기계체조선수의 형태학적 비교

김대식,이상종,윤신중,이일재 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

This research aims at examining Physical Characteristics of apparatus gymnast by degrees, Physical Traits are important information to choose better apparatus gymnast and to predict the ability of improvement, To do this, 8 national team members, 8 such-like substitutes, and 8 general team members, 24 apparatus gymnast in total were subjected, Analyzing average value with two variants performed two times. The research made a conclusion as following. 1. Weight makes difference in apparatus gymnast according to the level of competence, National team members were the lightest, and substitutes, and general team members in turn. 2. Skinfolds makes difference in apparatus gymnast's iliac crest, front thigh, medial calf, subscapular, eiceps, supraspinale and abdominal according to the level of competence. 3. Girths makes difference in apparatus gymnast's forearm(maximum), gluteal(hips), arm(relaxed), arm(flexed & tensed), thigh(1cm gluteal), thigh(mid troch-tib-lat), calf(maximum) and ankle(minimum) according to the level of competence. 4. Lengths doesn't maim difference in apparatus gymnast according to the level of competence. 5. Breadths doesn't make difference in apparatus gymnast according to the level of competence.

物流管理現況과 改善方安 : 大邱地域企業을 中心으로 Present Situation and Suggestions for Improvement

金鍾信 경북대학교 경제경영연구소 1991 經商論集 Vol.19 No.1

Vector 合成法을 이용한 Booming Noise 低減에 關한 硏究

김재열,유신,오성민,장종훈,김갑중 조선대학교 생산기술연구소 1997 生産技術硏究 Vol.19 No.1

Booming Noise of a Automotive can be divided in Air Borne Noise and Structure Borne Noise. In this study, Booming Noise is reduced by the vector Synthesis method. The vibration that transferred by the engine is managed. The car that by the used model is composed of Mount system supported to three point with 2000 cc 14 engine FR vehicle. The vibration that is transmitted from propeller sharft and Differential Gear to Sub Frame and Suspention effect Booming Noise. but, The vibration that generated by the Mount has Booming Noise more than it. So, We research that sound generated by the Mount and reduce that Booming Noise used the Dynamic Damper. The Booming. Noise by the vector Synthesis. is reduced in 2000 ~ 4000 rpm front of vehicle. We know that Booming Noise is reduced into hoped for rpm by the vector Synthesis.

프레데릭 J.키슬러의 상호현실주의를 통한 디지털 공간에 관한 연구 : 키슬러의 Endless Space와 그렉 린의 Endless Surface를 중심으로

김성신,양철권,임종엽 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The purpose of this study is to find out the relationship between Kiesler's Correalism and Digital Architecture, and the essence of the Digital Architecture, by comparing the spatial concept of Frederick J. Kiesler, who was active between 1920's and 1960's, with that of Greg Lynn, who is a digital architect. How Kiesler, who was contemporary with Le Corbusier, had tried to approach architecturally in a way other than the functionalism of Modernism, and how it is interlinked with the way the digital architects of today designs is analyzed in this thesis. Kiesler's Concepts - Correalism, Endless House, Biotechnique, and Galaxy - is analyzed, and compared with the Concept of Greg Lynn's space.

江地開發이 地域社會發展에 미친 影響에 關한 比較硏究 : 테네시江 事例와 4大江 流域 開發計劃을 中心으로

金裕赫,琴東信,石琮顯 단국대학교 법정대학 지역개발학과 1982 地域開發論叢 Vol.3-4 No.-