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 Plant Breeder’s View on H5N1

Soon‐Kwon Kim 한국육종학회 2008 한국육종학회지 Vol.40 No.2

International conferences to block the spread of Avian bird flu occurred in Beijing, 2006 and others warned of the seriousness of the H5N1 strain. The meetings succeeded in generating billions of dollars from USA, EU and World Bank. Migratory birds seem to play a major role in the spread of the aggressive strain globally from Asia to Europe and Africa. Experiences of tolerance breeding of maize (Zea mays L.) for four decades against 20 biotic stresses suggest that the prime cause of the occurrence of H5N1 strain was due to the human beings’counter‐efforts against nature. Excessive use of chemicals (spray and injection) in the commercial poultry farms had created high selection pressure on virus. The new strain had mutated for survival. Attempting to eliminate the virus by chemicals for 100% control is a dangerous way to control biotic stresses. This can create more aggressive strains. A solution would be to build up tolerability of the commercial animals against the virus. Improvement of poultry cage environments and respect for nature must be integrated. Potential foes must be watched.

Increased Urinary KIM-1 and Tubular KIM-1 Expression in IgA Nephroapathy (초)

( Mi Seon Seo ),( Soon Hyo Kwon ),( Moo Young Park ),( Soo Jung Choi ),( Jin Seok Jeon ),( Hyun Jin Noh ),( Jin Gook Kim ),( Dong Cheol Han ),( Seung Duk Hwang ) 대한내과학회 2010 대한내과학회 추계학술대회 Vol.2010 No.-

저해음의 비음화 : 음운론 및 음성학적 접근 Its Phonology and Phonetics

안현기,권순석,김기열 대한언어학회 2000 언어학 Vol.8 No.1

Ahn, Hyunkee, Soon-Suk Kwon, and Ki-Yeol Kim. 2000. Obstruent Nasalization: Its Phonology and Phonetics. Linguistics 8-1, 27-38. This paper discusses a Korean phonological rule, Obstruent Nasalization--i.e., an obstruent is phonologically nasalized when followed by a nasal. As is well known, this rule is productively prevalent in Korean, but not in English. Within the Optimality Theoretic framework, the difference in this phonological pattern between the two languages is well captured by means of adjusting the dominance relationship between two constraints (markedness and faithfulness constraints). This constraint-based explanation, however, doesn't suffice our question of why the phenomenon is phonetically natural in Korean, but cross-linguistically rare. To this question, we will provide one possible answer by suggesting that the markedness constraint is phonetically oriented due to a phonetic constraint on laryngeal feature juxtapositions. (Kyung Hee University)

Multiple Markers of Contrast Induced Nephropathy after the Percutaneous Coronary Intervention

Byoung-won Park,Seong Soon Kwon,Min Ho Lee,Do Hoi Kim,Min Su Hyon,Duk Won Bang 순천향대학교 순천향의학연구소 2018 Journal of Soonchunhyang Medical Science Vol.24 No.1

Objective: Contrast-induced nephropathy (CIN) frequently occurs after percutaneous intervention. Objective of this study was to investigate the usefulness of serum cystatin C, neutrophil gelatinase-associated lipocalcin (NGAL), urinary kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) as early predictors for CIN after percutaneous coronary intervention (PCI). Methods: In 53 patients who underwent PCI were enrolled. Serum creatinine and cystatin C level were measured immediately before, and 24 hours and 48 hours after catheterization. Serum NGAL, urinary KIM-1, and IL-18 were measured immediately before, and 4 hours, 24 hours, and 48 hours after catheterization. CIN was defined as a rise in creatinine 0.5 mg/dL or 25% above baseline. Results: CIN occurred in four patients (7.5%). Serum cystatin C levels were higher at 24 hours and 48 hours in CIN patients than in those without CIN (P<0.05). Serum NGAL levels were higher at 48 hours in CIN patients than in those without CIN. Urinary KIM-1 levels were higher at 48 hours in CIN patients than in those without CIN. There were no significant markers of CIN on multi-variate analysis. Conclusion: In this study, the occurrence of CIN after PCI was 7.5%. Although there were some time-course changes in serum cystatin C and urinary KIM-1 after PCI, there was no significant predictor for CIN after PCI.

인삼 선발계통의 지역적응성 검정

Bong Jae Seong,Sun Ick Kim,Ka Soon Lee,Moo Geun Jee,Su Dong Kim,A Reum Kwon,Hyun Ho Kim1,Young Chang Kim 한국약용작물학회 2017 한국약용작물학술대회 발표집 Vol.2017 No.05

Background : For cultivation of varieties of ginseng, the pure line selection method, which is to select the best among those cultivated in farms for pedigree breeding, replicated yield trials and regional adaptation trials before registering as a new variety, is widely used. Although there are 25 registered varieties of ginseng in Korea, the quality of ginseng is declining together with the amount of harvest being decreased by 15 - 20% due to the heat injuries and diseases from the warming & abnormal climate. Thus, the needs for development of disaster-resistant varieties with better chances of surviving through high temperature, salts and disease are increasing. Therefore, this study is to cultivate disaster-resistant varieties among those selected for their disaster tolerance and salt tolerance through regional adaptation trials. Methods and Results : As a result of examining the growth characteristics of the selected 2 - 5 year old varieties used in the study, among the 5-year old crops, Goryeo 4 and Eumseong 5 showed superior growth in both above and below aerial parts, and among the 4-year old crops, Eumseong 11 and Cheonryang showed superior growth while the growth in the below aerial parts were satisfactory in the order of Cheonryang > Eumseong 10 > Eumseong 11 > Eumseong 9. Among the 3-year old crops, the most superior growth in both above and below aerial parts was observed in Eumseong 14 with the weight of the below aerial part, root diameter and taproot length at 13.8 g, 11.8 ㎝ and 6.2 ㎝ respectively. Among the 2-year old crops, Eumseong 10 showed the most superior growth in both above and below aerial parts. Conclusion : Based on the above results, Goryeo 4 and Eumseong 5 among the 5-year old crops, Eumseong 11 among the 4-year old crops, Eumseong 14 among the 3-year old crops and Eumseon 10 among the 2-year old crops showed the most superior growth among the selected varieties. The growth characteristics of both above and below aerial parts in each year will continuously be monitored.

AZ91 합금융체내의 Fe 용해도

권순일,변지영,김선진,심재동 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.1

Fe solubility in AZ91 alloy melts was measured by a new method designed for removal of Al_(8)(Mn,Fe)_(5) inclusions. In the AZ91 alloy melts, Al_(8)(Mn,Fe)_(5) precipitates were formed due to supersaturated Mn and Fe, but all precipitates were not settled down from the melts and hence part of them was included in the samples for measuring Fe solubility. This means that the solubility measured from these samples is higher than the true solubility. In the present study, it was shown that these Al_(8)(Mn,Fe)_(5) inclusions could be separated from the samples by the new method. As a result, the Fe solubility measured by the present method was lower than the previous solubility data. Amount of the unsettled Al_(8)(Mn,Fe)_(5) inclusions was estimated to be 59-148 ppm. It was also observed that Fe contents in Al_(8)(Mn,Fe)_(5) were varied with the Fe and Mn content in AZ91 alloy melts.

1,2-Benzothiazine 계열 새로운 항염진통제에 대한 약리작용 및 대사효소발현 유형의 연구

김상건,조주연,권순경,이은방 德成女子大學校 藥學硏究所 2000 藥學論文誌 Vol.11 No.1

Expression of xenobiotic-metabolizing enzymes can be altered by xenobiotics, which represents changes in the production of reactive metabolic intermediates as well as toxicities in tissues. Metabolic intermediates derived from xenobiotics are considered to produce the reactive oxygen species including drug free radicals and hydroxyl free radicals, which would be ultimately responsible for drug-induced toxicities. The effects of 1,2-benzothiazine anti-inflammatory agents on the expression of xenobiotic-metabolizing enzymes including major cytochrome P450s, microsomal epoxide hydrolase (mEH) and glutathione S-transferase (GST) were studied in the liver with the aim of providing the part of information on potential production of reactive metabolites and hepatotoxicity by the agents. The synthetic compounds 24, 36 and 39 exhibited anti-inflammatory effects in rats as assessed by the Randall-Selitto method. The anti-inflammatory effect was detected as early as at 30 min after gavaging the agents with the ED50 being noted at 80 ㎎/㎏, which was comparable to that of ibuprofen. Treatment of rats with each compound (100 ㎎/㎏,3d) resulted in no significant induction in the immunochemically-detectable cytochromes P450 1A1/2, P450 2B1/2, P450 2C11 and P450 2E1. Changes in the mEH expression were also minimal, as evidenced by both Western blot and Northern blot analyses. Hepatic GST expression was slightly increased by the agents: GST Ya protein and mRNA expression was 1.5-fold increased after treatment with compounds 24 and 39, whereas GST Yb1/2 and Yc1/2 mRNA levels were elevated 2-to 3-fold. In summary, the effects of the synthetic 1,2-benzothiazines on the expression of major P450, mEH and GST were not significant, providing evidence that methbolic activation of the agents, potential drug interaction and hepatotoxicity would be minimal.

자기스위치의 설계와 특성해석에 관한 연구

권순걸,김복권 慶南大學校 附設 工業技術硏究所 1999 硏究論文集 Vol.17 No.-

마그네틱 스위치의 스위칭은 포화 인덕터의 투자율에 따른 인덕턴스 값에 의하여 가변되며 고전압 펄스전력의 펄스에너지 압축을 위해 마그네틱 펄스 발전기가 사용된다. 그러나 마그네틱 스위치는 포화 인덕터의 비선형특성 때문에 높은 효율의 최적 설계에는 많은 어려움이 있다 본 연구에서는 고효율의 마그네틱 펄스 발전기의 최적설계를 실행하기 위하여 중급의 마그네틱 펄스 제너레이터의 동작특성을 해석하였으며. 다양한 입력전압과 입력에너지에 대하여 마그네틱 스위치 코어의 단면적이 계산되었으며, 입력특성이 해석되었다. 또한 일정한 부하조건에서의 에너지 전달 비와 전류이득의 관계가 연구되었다. Switching of magnetic switch is varied by the inductance in accordance with permeability of saturable inductor, and is used at magnetic pulse generator in use of pulse energy compression action in high voltage pulse power. But magnetic switch is difficult for optimum design with high efficiency because of nonlinear characteristics of saturable inductor. In this paper, operation characteristics of middle stage magnetic pulse generator is analyzed in order to execute optimum design of high efficiency magnetic pulse generator. And also, each cross section area of magnetic switch core is evaluated for various input voltage and input energy, and input characteristic is examined. And energy transfer ratio and current gain are investigated for each input conditions at constant load condition.

인터넷 광고에서 방문 횟수를 측정하는 암호학적 방법들에 관한 고찰

김순석,신제용,김성권 중앙대학교 정보통신연구소 2000 정보통신연구소논문집 Vol.2 No.2

본 논문에서는 웹 광고에서 웹사이트를 방문하려는 고객과 서버(예를 들어, 웹사이트 발행자들)간에 상호작용을 측정하기 위한 안전하고도 효율적인 측정 방법들에 관해 살펴보고자 한다. 대개의 웹 광고는 많은 고객들과 서버들 그리고 서버들에 의해 제공된 고객들의 수 에 관한 정보를 수집하는 감사 기관의 상호작용으로 이루어진다. 이때, 대부분의 서버들은 실제 제공되는 것보다는 훨씬 많은 수의 방문 정보를 감사기관에게 제시함으로서 보다 많은 광고 수익을 얻고자 한다. 이에 본 논문에서는 과장된 서버로부터의 방문기록을 막는 암호학적으로 안전한 몇 가지 측정 방법들을 소개하고자 한다. 아울러 이들 측정 방법들은 전반적인 통신 트래픽 이라든가 다른 부수적인 오버헤드가 부가되지 않을 만큼 효율적이어야 할 것이다. In this paper we study on secure and efficient metering schemes to measure the interaction between clients and servers(e.g. the web site publishers) on the web advertisements. In a representative scenario there are many clients and servers, and an audit agency should collect information about the number of clients that were served by each server. A typical server is motivated to claim that it served many more clients than it has actually served. We introduce some metering schemes which are cryptographically secure and prevent servers from inflating the count of their visits. At the same time the metering schemes should be efficient and do not add a considerable overhead to the different parties and to the overall communication traffic.