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.

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.

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.

다산부에서 자간전증의 임상적 고찰

이주롱,이석민,한효상,이해혁,이임순,이권해 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

목적 : 전자간증 산모에서 초임신부와 다산부 각각의 임상적 특징을 조사하여 비교 분석하고자 하였다. 연구방법 : 1998년 1월부터 1999년 12월까지 2년간 순천향대학 서울병원에서 입원 분만한 임신성 고혈압성 질환 환자중 초임신부 106명과 다산부 50명, 총 150명을 대상으로 임상통계학적으로 조사 분석하였다. 결과 : 분만까지 임신기간의 비교시 초임신부에서는 33-36주에서 17.9%였고 다산부에서는 34.0%로, 다산부에서 조기분만의 예가 의의있게 많았다. 신생아 체중이 2500g 미만인 군이 초임신부군에서는 36.8%였고 다산부군에서는 62.0%로 다산부군에서 더 많았다. 임신성 고혈압성 질환의 중등도를 보면 중증자간전증의 초임신부에서 35.8%와 다산부에서는 44.0%로, 초임신부에 비해 다산부군의 중증 자간전증의 비율이 많았다. 결론 : 중증 임신성 고혈압성 질환이 다산부군에서 더 많았으며 적은 주수에서 제왕절개술을 시행해 출생아의 체중이 초임신부군에 비해 더 작았고 Apgar 점수도 더 낮았다. Objective : To study the clinical differences of primiparous and multiparous preeclamptic patients. Methods : We statistically analyzed 106 primiparous and 50 multiparous preeclamptic patients who were admitted to the Soonchunhyang University Hospital from January 1998 to December 1999. Results : It was statistically found that multiparae were more likely to give premature birth than primiparae: Thirty four percents of multiparae gave birth in the period between the 33rd and the 36th gestational weeks while 17.9% of primiparae did in the same period. Sixty two percents of the newborn babies of multiparae weighed less than 2500g. Among primiparae, the ratio was 36.8%. In addition, more multiparae(44.0% vs. 35.8%) suffered from severe preeclampsia. Conclusion : severe preeclampsia was found more frequently among multiparae. Since they gave birth earlier by cesarian section than primiparae, their babies weighed less and had lower apgar scores.

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.

면역 알고리즘을 이용한 AGV의 2자유도 PID 조향 제어기 설계에 관한 연구

이창훈,이진우,이영진,이권순 동아대학교 정보기술연구소 2002 情報技術硏究所論文誌 Vol.9 No.2

Immune system is an evolutionary biological system to protect innumerable foreign materials such as virus, germ cell, and et cetera. Immune algorithm is the modeling of this system's response that has adaptation and reliableness when disturbance occur. In this paper, Immune algorithm controller was proposed to control four wheels steering(4ws). Automated Guided vehicle(AGV) in container yard. And then the simulation result was analysed and compared with result of Neural Network PID controller.

密陽驪州李氏 亭子建築 造營活動 - 密陽驪州李氏 亭子建築의 建立背景을 中心으로 -

권순강(Kwon Soon-Kang),이호열(Lee Ho-Yeol) 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

This study is about the feature of arbor construction of Miryang Yeoju Lee's family, who resides in Miryang. Miryang Yeoju Lee moved to Miryang around 1500 and has larger number of arbors than any other families. This is probably resulted from family members' efforts. It is because that the arbors are mainly created by individuals or close descendants but later operated by the next generation who leads management and restoration. Therefore, the arbors have significant meaning within the family, too.

Special Issue of Professor Kiehwa Lee`s Retirement: Geophysical Environments of the Korean Peninsula : Articles ; Geoelectrical Structure of the Kyongsang Basin from Magnetotelluric Sounding

( Choon Ki Lee ),( Heui Soon Lee ),( Byung Doo Kwon ),( In Ky Cho ),( Seok Hoon Oh ),( Yoon Ho Song ),( Tae Jong Lee ) 대한지구물리학회 2006 지구물리 Vol.9 No.3

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.