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        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.

      • 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.

      • 노인의 영적 간호요구

        최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

        This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

      • Gd₂O₃doped CeO₂의 미분말 합성 및 소결특성

        이주신,김원중,박성용 경성대학교 공학기술연구소 1999 공학기술연구지 Vol.6 No.-

        10mol% Gd₂O₃doped CeO₂ doped fine powders were synthesized by the oxalate coprecipitation method and then their powder characteristics and sintering behavior were studied. The characterization of powders has been investigated using thermogravimetry and differential thermal analysis for thermal analysis, X-ray diffraction for phase identification. Brunauer-Emmett-Teller, X-ray diffraction-line broadening and transmission electron microscopy for particle size and morphology determination. The sintering behavior were investigated by means of the sintering density measurements and scanning electron microscopy techniques. The characteristics of powders prepared by the oxalate coprecipitation method and their sintering behavior are discussed.

      • 평면형 Bi-Sb 다중접합 열전변환기의 특성

        이현철,유호종,김진섭,함성호,신장규,이종현,이정희,권성원,박세일 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

        A planar Bi-Sb multijunction thermal converter for the precise measurements of ac voltage and current has been fabricated and its characteristics was discussed. In order to convert ac power into heat, a bifilar thin film Pt-heater, which could cancel its Thomson and Peltier effects, was prepared on the Si_(3)N_(4)/SiO_(2)/Si_(3)N_(4) diaphragm for the thermal isolation between heater and silicon substrate. To convert the temperature or the heat generated by the heater into dc voltage and current, hot and cold junctions of the Bi-Sb thermopile, which has a large difference in Seebeck coefficients, were formed on the dielectric diaphragm and the silicon substrate, respectively. The respective thermal sensitivity of the thermal converter with a bifilar heater was about 10.1 mV/mW and 14.8 mV/mW in the air and vacuum, which is about eight times higher than that of commercial 3-dimensional thermal converter. In the case of ac 2 V-input voltage, the ac-dc voltage transfer difference was about ±2.0 ppm, and in the case of ac 10 mA-input current, the ac-dc current transfer difference was about ± 0.6 ppm, in the frequency range from 10 Hz to 10 kHz.

      • 공업고등학교 전기학과의 전기수학교육에 관한 연구

        이상석,신용철,김민회,박찬규,이재용 영남이공대학 2004 論文集 Vol.33 No.-

        This research is that concern in electrical mathematics education of Technical high school Department of Electricity in the 7th educational curriculum. In the 7th educational curriculum, indicated problem about mathematics education of Technical high school Department of Electricity and examine major subject, contents of mathematics that use in major subject and analyzed contents of mathematics that must supplement. With this analysis, established necessary electrical mathematics contents for major subject studying of Technical high school Department of Electricity.

      • KCI등재

        신수혈의 침자극과 황기약침이 실험용 생쥐의 면역활성물질인 IL-1 α의 遺傳子發現에 미치는 影響

        申相習,朴元煥,洪文燁,李泰均,崔達永 대한동의병리학회 1999 동의생리병리학회지 Vol.13 No.2

        체내의 환경을 항상적으로 유지하는 생체방어체계에는 면역활성물질이 있으며, 이러한 면역활성물질의 적절한 발현이 생체의 항상성을 유지하는데 작용하게 된다. 이에 한의학에서는 생체의 항상성 유지와 체내의 면역력 증가를 위해 많은 요법들이 시행되어 왔는데, 그 중 자침요법과 약침요법이 많이 응용되고 있다. 그러나 침자극과 약침의 효과에 대한 기전은 기대하는 만큼 제시되지 못하고 있다. 이에 본 논문은 침자극과 약침의 효과에 대한 기전을 밝히는 방법의 일환으로서 면역활성물질인 IL-1α가 補腎臟, 振氣化, 祛水濕, 强腰脊, 益水壯火 등의 穴性이 있는 신수혈(BL23)의 침자극과 황기약침처치를 통해 어떻게 발현하는가를 관찰하였다. 그 결과, 면역 증강 작용을 나타내는 cytokine IL-1α 에 대한 침자극의 반응은 관찰되었고, 황기약침에 의한 IL-1α 의 발현은 명확하지 않았다. 그러므로 신수혈을 이용한 cytokine IL-1α의 추적은 황기약침의 효과보다 침자극의 효과에 대한 근거를 추측할 수 있을 것이며, 뿐만 아니라 침자극에 의한 면역반응정도를 통해 질병의 진행상태를 나타내는 진단지표로서 활용가능성이 있을 것이다. Acupuncture and Radix Astragali aqua-acupuncture stimuli have long been used to cure human diseases. However, it still remains to be unknown on its action mechanism, physiological and biochemical aspects. Thus, many attempts were made to show the scientific background covering the above mentioned mechanisms. Most recent studies show that these tests improve blood circulatory system and increase leucocyte counts. In this study, we have applied the acupuncture stimuli to mouse Sinsu(BL23), which is a stimulative point of oriental medicine, to see if cytokine such as IL-1α can be detected. Mice were treated with lipopolysaccharide(LPS) for inflammation induction, and then reverse transcriptase-polymerase chain reaction (RT-PCR) using each primer set was performed to trace the amounts of mRNA. The results are as follows ; 1. The RT-PCR product using IL-1α primers was detected as 450 bp on agarose gels and the IL-1α gene was not expressed in normal mice at 15 min after the removal of acupuncture. However, it was gradually increased indicating a faint expression after 30 min. 2. IL-1α was expressed in LPS-treated mice 30 min after the acupuncture was pulled out, and expressed most highly at 3 h after the removal of acupuncture. The gene expression of LPS-treated mice were more effective than those of normal mice. 3. IL-1α was not expressed in normal mice and LPS-treated mice from 30 min to 3hs. after Radix Astragali aqua-acupuncture stimulation. Therefore, a tracing the gene expression of cytokine IL-1α can be used more not only for a basis of the effect of acupuncture stimulation but a diagnosis guide through the immunological action than the effect of Radix Astragali aqua-acupuncture. Moreover, we need to further study the cytokine's expression in Radix Astragali aqua-acupuncture stimulation.

      • 光質이 채소作物의 種子發芽와 初期生育 및 除草劑의 活性에 미치는 效果

        李政明,金侊來,權臣漢,曺哉銑,朴啓仁,金尙根,李承雨 慶熙大學校 1987 論文集 Vol.16 No.-

        Studies were conducted to investigate the response of some horticultural plants to various light qualities provided by different kind of materials such as cellophane sheets, EVA, PVC(polyvinyl chloride, and polyethylene (PE) films of different color. Major findings are summarized as follows. White fluorescence light and red light promoted seed germination of lettuce and inhibited that of radish seeds. Blue light inhibited the seed germination of both types of light-sensitive seeds. The light sensitivity varied considerably depending upon the kind of crops, cultivars, and the seed batches of the same cultivar. The blue light was equally or more strongly effective in inhibiting the seed germination as compared to the farred light. The growth of young seedlings developed from seeds was considerably promoted when grown under orange colored plastic film coverings. The growth of larger seedlings was, however, not influenced by the color of plastic films. Mulching pepper field with colored PVC film did not show further advantages over the commonly-used black PE film. Herbicidal activity of oxyfluorfen was very strong under natural light or red light conditions' and weak under blue or green light conditions. The degree of oxyfluorfen-induced phytotoxicity varied considerably depending upon the light quality and the kind of vegetable crops.

      • 아음속풍동의 제작과 난류경계층 구조의 변화에 관한 연구

        李南榮,朴桂香,柳相信 한국항공대학교 1991 論文集 Vol.29 No.-

        본 연구에서는 풍동의 활용성과 경제성, 장비설치 및 취급의 용이성등을 고려하여 요구풍속을 결정한 후 확산부, 정체실, 수축부, 시험부등을 설계하고, 제작된 풍동에 대한 성능검사를 실시하였다. 정체부와 시험부 수축비는 9이고 시험부의 단면은 406mm×406mm 이며 길이는 1,200mm 이다. 시험부에서 얻을 수 있는 최대속도는 송풍기 회전수 1,500rpm 일때 36m/sec이다. 송풍기 동력은 19kW 이며 송풍기 형태는 원심형 임펠러를 선택하였다. 시험부의 성능을 검사하기 위해 열선유속계를 사용하여 시험부 출구 단면에서의 속도분포와 난류강도를 조사하였다. 시험부의 속도는 5m/sec 에서 30m/sec 까지의 범위에서 난류강도는 0.5%이고 벽면경계층 두께를 고려하면 유효 단면적은 약 85%이다. 제작된 풍동에 에머리 페이퍼(emery paper) 또는 트리핑 와이어(tripping wire)를 부착한 매끈한 평판과 축대칭 3차원 물체를 장치하여 경계층 속의 흐름이 난류가 되도록 하였고 발생된 난류 경계층의 특성을 분석 하였다. In the present experimental study, the range of wind speed at the test section was determined by considering the availability, economy, installation and handling of the wind tunnel, and diffuser section, settling chamber, contraction section and test section of the wind tunnel were designed and manufactured to satisfy the prescribed wind speed range. Performance of the manufactured wind tunnel was tested according to the normal testing procedure. Contraction ratio of the test section to the settling chamber is 9 and the cross section of the test section is 406mm×406mm and the test section is 1200mm long. The maximum air speed at the test section is 36m/sec for the motor speed of 1500 rpm. A centrifugal type fan is used and the maximum power required is 19kw. The hot-wire anemometer system was employed to test the performance of the wind tunnel by measuring the velocity distribution and turbulent intensity at the exit of the test section. Measured values of turbulent intensity were less than 0.5% for the range of wind speed from 5m/sec to 30m/sec. The available cross sectional area of the test section was about 85%. Flat plate and axisymmetric three dimensional body were used as models to identify the boundary layer characteristics. The boundary layers were triggered by emery paper and/or tripping wire. The characteristics of the generated turbulent boundary layers were analyzed.

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