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.

A Study of Psychiatric Impotance on the OPENING OF Nae-ui-won(內醫院)

Lyu, Yong Su,Lyu, Hui Yong 대한한방신경정신과학회 1991 동의신경정신과학회지 Vol.2 No.1

內醫院은 병원과 약국을 겸비한 일종의 궁중의료기관으로 의사를 비롯하여 여러의원들이 임금과 왕비 및 왕자들의 약을 조제하여 달이던 곳으로, 일명 내국(內局) 또는 약원(藥院)이라고 내의원 앞에 예시되어 있다. 그러나 내의원은 현재 그 내용이 전해지지 않고, 단지 관광지의 유물로만 여겨지고 있다. 현재이 내의원은 창덕궁(昌德宮)에 위치하고 있다. 내의원은 창덕궁의 돈화문(敦化門)을 지나, 인정전(仁政殿)을 거쳐 희정당(熙政當) 좌측에 있으며, 왕비의 거처인 대조전에 가장 가까이 자리잡고 있다. 내의원은 조선왕조 세종25년(1443)에 개원하게 되었으니, 이때는 정치, 문화적으로 안정이 이루어져 가는 상황이었다. 또한 당시 왕이나 왕비 기타 왕족들의 여러 가지 정신적인 갈등으로 인한 질병이 많았으며, 이로인해 전문적이고 독립적인 왕실의료기관의 필요성에 의해 내의원이 독립적인 개원이 이루어졌으리라 사료된다. 이로인하여 저자가 내의원에 관한 자료조사와 실제답사를 통하여 다음과 같은 사실을 알수 있었다. 1) 내의원의 개원은 조선왕조 초기 중앙의료질서 성립을 통한 봉건왕조의 절대왕권확립을 의미함으로 사료된다. 2) 내의원의 위치가 창덕궁의 중심부에 위치하고, 특히 어전(御殿)과 내전(內殿) 가까이에 위치함은 왕실의 질병을 신속하고도 중요하게 다루기 위함으로 사료된다. 3) 특히 의인을 내전에서도 대조전(大造殿) 가까히 둔 것은 왕실의 질병중 왕 비의 정신신체질완의 치료를 위함으로 사료된다. 4) 내의원의 진료형태는 왕진(往診)이었으며, 이는 당시 의원신분이 중인층이었음으로 사료된다. 5) 내의원의 이용중에서 평민에게는 왕명에 의해서만 이루어졌음으로 사료된다.

A Study of Psychiatric Impotance on the Openning of Nae-ui-won(內醫院)

Lyu Yong-Su,Lyu Hui-Yong The Korean Society of Oriental Neuropsychiatry 1991 동의신경정신과학회지 Vol.2 No.1

내의원(內醫院)은 병원과 약국을 겸비한 일종의 궁중의료기관으로 의사를 비롯하여 여러의원들이 임금과 왕비 및 왕자들의 약을 조제하여 달이던 곳으로, 일명 내국(內局) 또는 약원(藥院)이라고 내의원 앞에 예시되어 있다. 그러나 내의원은 현재 그 내용이 전해지지 않고, 단지 관광지의 유물로만 여겨지고 있다. 현재의 내의원은 창덕궁(昌德宮)에 위치하고 있다. 내의원은 창덕궁의 돈화문(敦化門)을 지나, 인정전(仁政殿)을 거쳐 희정당(熙政當) 좌측에 있으며, 왕비의 거처인 대조전에 가장 가까이 자리잡고 있다. 내의원은 조선왕조 세종25년(1443)에 개원하게 되었으니, 이때는 정치, 문화적으로 안정이 이루어져 가는 상황이었다. 또한 당시 왕이나 왕비 기타 왕족들의 여러 가지 정신적인 갈등으로 인한 질병이 많았으며, 이로인해 전문적이고 독립적인 왕실의료기관의 필요성에 의해 내의원이 독립적인 개원이 이루어졌으리라 사료된다. 이로인하여 저자가 내의원에 관한 자료조사와 실제답사를 통하여 다음과 같은 사실을 알수 있었다. 1) 내의원의 개원은 조선왕조 초기 중앙의료질서 성립을 통한 봉건왕조의 절대왕권확립을 의미함으로 사료된다. 2) 내의원의 위치가 창덕궁의 중심부에 위치하고, 특히 어전(御殿)과 내전(內殿) 가까이에 위치함은 왕실의 질병을 신속하고도 중요하게 다루기 위함으로 사료된다. 3) 특히 의인을 내전에서도 대조전(大造殿) 가까히 둔것은 왕실의 질병중 왕비의 정신신체질환의 치료를 위함으로 사료된다. 4) 내의원의 진료형태는 왕진(往診)이었으며, 이는 당시 의원신분이 중인층이었음으로 사료된다. 5) 내의원의 이용중에서 평민에게는 왕명에 의해서만 이루어졌음으로 사료된다.

H2O2로 유도된 산화적 스트레스에 대한 장원환가감방(壯元丸加減方)의 PC 12 cell 에서의 항산화 효과

박용훈 ( Yong Hoon Park ),손일홍 ( Il Hong Son ),이상원 ( Sang Won Lee ),임정현 ( Jung Hyun Lim ),김태헌 ( Tae Heon Kim ),류영수 ( Yeoung Su Lyu ),강형원 ( Hyung Won Kang ) 대한한방신경정신과학회 2009 동의신경정신과학회지 Vol.20 No.2

Objectives: Antioxidant effects of Gagam-Jangwonhwan(LMK01 and 02) water extract against H2O2-induced oxidative damage and cell death were investigated in rat pheochromocytoma line PC 12. Methods: The cells were treated with LMK01 and 02 water extract and H2O2, oxidative damage-inducing materials for 24 h. The cellular viability was assessed by WST-1 assay, oxidative damages of the cells by 8-OHdG quantitation, apoptosis by Hoechst 33342 staining assay and activity of antioxidant enzymes by catalase and glutathione peroxidase assay. Results: 1. LMK01 and LMK02 water extracts improved significantly cell viability in H2O2-treated groups than H2O2-alone treated cells 2. LMK02 suppressed significantly oxidative damage in H2O2-treated groups than H2O2-alone treated cells but LMK01 didn`t. Meanwhile, difference of oxidative damages in conditions treated with LMK01 or LMK02 was not significant, 3. The H2O2 induced-apoptosis in PC 12 cell lines was inhibited effectively by LMK01 and LMK02, and especially the features of apoptosis were obviously reduced in LMK02-treated cells. 4. LMK01 and LMK02 increased significantly activities of both catalase and glutathione peroxidase than those of H2O2-alone treated group and moreover, LMK02 showed significantly higher activities than those of LMK01. Conclusions: As shown, LMK01 and LMK02 suppressed H2O2-induced oxidative damage and cell death in PC 12 cell effectively. And they increased activity of major antioxidant enzymes in PC 12 cell line. Therefore, this study suggests the possibility of clinical usage over oxidative stress-induced neurodegenerative disease such as Alzheimer`s disease.

Poria cocos water extract (PCW) protects PC12 neuronal cells from beta-amyloid-induced cell death through antioxidant and antiapoptotic functions.

Park, Yong-Hoon,Son, Il Hong,Kim, Bokyung,Lyu, Yeoung-Su,Moon, Hyung-In,Kang, Hyung-Won Govi-Verlag Pharmazeutischer Verlag [etc.] ; Verla 2009 Die Pharmazie Vol.64 No.11

<P>Beta-amyloid (Abeta)-induced neurotoxicity is considered to be mediated through the formation of reactive oxygen species (ROS). In this study, the protective effects of Poria cocos water extract (PCW) against Abeta1-42-induced cell death were investigated using rat pheochromocytoma (PC12) cells. Exposure of PC12 cells to the Abeta1-42 (20 microM) for 48h resulted in neuronal cell death, whereas pretreatment with PCW at the concentration range of 5-125 microg/ml reduced Abeta1-42-induced cell death. In addition, PC12 cells treated with Abeta1-42 exhibited increased accumulation of intracellular oxidative damages and underwent apoptotic death as determined by characteristic morphological alterations and positive in situ terminal end-labeling (TUNEL staining). However, PCW attenuated Abeta1-42-induced cytotoxicity, apoptotic features, and accumulation of intracellular oxidative damage. Moreover, PCW (5 to 125 microg/ml) decreased expression of apoptotic protein Bax and activity of caspase-3, but enhanced expression of anti-apoptotic protein Bcl-2. These results suggest that PCW may protect cells through suppressing the oxidative stress and the apoptosis induced by Abeta1-42, implying that PCW may be potential natural agents for Alzheimer's diseases.</P>

地黃飮子와 加味地黃飮子 抽出液이 XO/HX로 손상된 배양 海馬神經細胞에 미치는 효과

이용근(Yong Geun Lee),김상호(Sang Ho Kim),민상준(Sang Jun Min),양희숙(Hee Suk Yang),장현호(Hyun Ho Jang),김태헌(Tae Hean Kim),강형원(Hyung Won Kang),유영수(Yeoung Su Lyu) 한의병리학회 2002 동의생리병리학회지 Vol.16 No.5

토사자의 Acetylcholinesterase 저해 활성에 관한 연구

류승엽 ( Lyu Seung Yeob ),박용기 ( Park Yong Gi ),강병수 ( Kang Byeong Su ) 대한본초학회 2003 大韓本草學會誌 Vol.18 No.4

N/A Objectives : In the course of searching for acetylcholinesterase(AChE) inhibitors from Semen of Cuscuta Australis R. BR in Korea and Cuscuta Austmlis R. BR in ChiM This study was carried out to investigate the effects protecting or improving Alzheimer`s disease of the acetylcholimsterase(AChE) inhibitors. Methods : This oriental drugs was extracted with 8oo/o methanol in room temperature and the extract was fives fractionation by hexane, chlorofm, ethylacetate, butanol and water. A mouse model of passive avoidance was used for recovery effect of Cuscutu Austmlis R. BR in Korea and Cuscuta Austmlis R. BR in China. on learning and memory deficits induced by scopolamine.. Results : 1. Acetylcholinesterase(AChE) inhibitors of Cuscuta Austmlis R. BR in Korea and Cuscutu Austmlis R. BR in China were investigated. It was found that Cuscuta Austmlis R. BR in Korea(64%) showed significantly inhibitory effect on AChE than in the Cuscuta Austmlis R. BR in China (29%). 2. Recovery effect on scopolamine-induced memory impairment in a mouse model of passive avoidance of Cuscuta Austmlis R. BR in Korea and Cuscuta Australis R. BR in China were investigated. Cuscuta Austmlis R. BR in Korea showed significant recovery effect on than Cuscuta Australis R. BR in China. 3. Acetylcholinesterase(AChE) inhibitors for recovery effect on scopolamine - induced memory impairment in a mouse model of passive avoidance of Cuscuta Australis R. BR in Korea and Cuscuta Australis R. BR in China were investigated. Cuscuta Australis R. BR in Korea increased acetylcholinesterase (AChE) inhibitors than Cuscuta Austmlis R. BR in China 4. The activity of DPPH and SOD of Cuscuta Austmlis R. BR in Korea were increase than Cuscuta Australis R. BR in China, but catalase were decrease than Cuscuta Austmlis R. BR in China. Conclusion : According to the above results, we found that ethylacetate extract of Semen of Cuscuta Austmlis R. BR in Korea showed significant inhibitory effect on AChE.

마음챙김 명상과 이정변기요법을 이용한 공황장애 그룹치료 효과에 대한 임상적 고찰

이성용 ( Seong Yong Lee ),유소정 ( So Jung Lyu ),최성열 ( Sung Youl Choi ),유영수 ( Yeoung Su Lyu ),강형원 ( Hyung Won Kang ) 대한한방신경정신과학회 2014 동의신경정신과학회지 Vol.25 No.4

Objectives: This study was conducted to evaluate the clinical effects of group therapy for Panic disorder patients based on Mindfulness & Li-Gyeung-Byun-Qi therapy. Methods: The FFMQ, BDI, STAI, STAXI, Panic attack, Anticipatory anxiety and subjective improvement of three Panic disorder patients were compared pre- and post-treatment when given Mindfulness & Li-Gyeung-Byun-Qi therapy. Results: 1) After the patient in case 1 underwent 5 weeks of group therapy for Panic disorder, the Mindfulness meditation score was slightly improved, anxiety and depression were significantly decreased, and expression of anger was also improved. In addition, the Panic attack and Anticipatory anxiety became more stable in the objective evaluation, while ``Extreme improvement`` was shown in the subjective evaluation. 2) After the patients in case 2 and 3 underwent 5 weeks of group therapy for Panic disorder, Mindfulness meditation scores were slightly improved, anxiety and depression were significantly decreased, and expression of anger was also improved. In addition, the Panic attack and Anticipatory anxiety became more stable in the objective evaluation, while ``Moderate improvements`` were shown in the subjective evaluation. Conclusions: As per the results in these cases, it was shown that group therapy for Panic disorder utilizing Mindfulness & Li-Gyeung-Byun-Qi therapy was effective to maintain meditation and control the emotions of anxiety, depression, anger and so on. Therefore, it was considered that expansion of clinical utilization through the standardization of a group therapy program for Panic disorder is needed. Furthermore, it was also considered that a comparative study of the effects of previous cognitive programs for Panic disorder according to the objectified and standardized manual is needed in the future.

도파민 유도성 SH-SY5Y 세포독성에 대한 遠志의 방어기전 연구

이지용(Ji Yong Lee),박재현(Jae Hyeon Park),김경렬(Kyung Yeol Kim),김태헌(Tae Heon Kim),강형원(Hyung Won Kang),류영수(Young Su Lyu) 한의병리학회 2004 동의생리병리학회지 Vol.18 No.2

Detection and characterization of Clostridium difficile infections tracking the trends of Clostridium difficile culture

Ock, Min-Su,Oh, Jin-Sun,Kim, Hwa-Jung,Lyu, Yong-Man,Lee, Moo-Song Korean Society for Quality in Health Care 2016 한국의료질향상학회지 Vol.22 No.2

Objectives: In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results. Methods: We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed. Result: The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients. Conclusion: In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.