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.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

人事管理(HRM)上 沒入모델의 現實的 適用에 關한 硏究

魯淳圭 동국대학교 경영관리연구소 1992 經營經濟論叢 Vol.16 No.-

Personnel management is one of most complex and challenging fields of business administration. Not only must the firm's requirements for an effective work force be met, but also the employee should be treated simultaneously as an instrument of the firm and human being. The process of personnel manageent is the planning, organization, diresting and separation of human resources. Individual, organizational, and societal objectives must be accomplished. The three authority models be Lodge et al. describe different patterns of management and can be helpful in understanding HRM. These models are proprietary individualism, collective adversarialism, and consensualism. The management of human resources, responding to powerful external and internal forces, is in a state of significant change. The new HRM model which is composed of politics that promote mutuality will elicit employee commitment, and yield both better economic performance and greater human development. This commitment model is replacing the control model. The differences of the control model and the commitment model are job design, performance expectation, management organization, competition politics, employment assurance, employee voice politics, labor-management relations and management philosophy. The commitment model has been increasingly adopted in American industries, especially newly founded enterprises and new plants. The trend toward the commitment strategy is extensive, affecting a large number of plants and a growing number of offices in a very diverse set of industries. High performance organizations require high commitment work system, and more highly committed work forces require a radically different management model. And Korean firms begin to adopt the commitment model, and the effect of this new attempt will be quite important with regard to performance and the prevention of quit of valuable human resources.

加熱油 投與가 흰쥐의 血淸 및 肝藏內의 Alkaline Phosphatase 와 Acid Phosphatase 活性에 미치는 影響

李淳宰,朴奎映,李仁慈 효성여자대학교 새마을연구소 1986 새마을硏究論文集 Vol.6 No.-

In order to investigate effect of heated oil on the alkaline and acidphosphatase activity in the rat serum and liver, rats were fed 3and 6 weeks by intubating oils heated for 11 hours(acid value 2.10:HA group) and 24 hours (acid value 4.02: HB group) at 180"C. Thechanges of alkaline phosphotase and acid phosphatase activities inthe serum and liver were observed. Average liver weight of HA andHB group were heavier than control group which were fed the freshcorn oil. In both HA and HB groups, alkaline phosphatase in serumand liver were increased. The activities of alkaline phosphatase inthe HB group was higher than the those of HA group. Changes ofactivity of acid phosphatase in serum of rat fed the heated oil weresimilar to that of alkaline phosphatase. The activities of both enzymeswere decreased in the 6 weeks than 3 weeks.

거대 구부요도결석 1례

손형규,하달봉,박동일,오연희,권순훤 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

요도결석은 대개 방광결석에 의해 생기며 드물게 원발성으로 요도에서 발견된다. 원발성 요도결석은 남성에 있어서는 요도협착, 요도게실, 이전의 요도 및 전립선수술과, 여성의 경우 거의 대부분 요도게실과 관계가 있다. 요도결석은 신체검사, 내시경검사 및 방사선학적 검사를 통해 진단하여 치료시 결석의 치료뿐 아니라 기존 질환의 진단 및 치료를 병행하여야 한다. 저자들은 급성 요폐로 내원한 55세 남자환자에서 신체검사 및 요도 내시경검사를 통해 거대 구부요도결석으로 진단한 후 관혈적 요도결석제거술로 치유하였기에 문헌고찰과 함께 보고하는 바이다. Urethral stone may from primarily in the urethra or may migrate from the bladder or upper urinary tract. Primary urethral calculi usually are associated with chronic stasis and infection. Virtually all urethral stone in women have been found in a urethral diveniculum. The diagnosis may be confirmed by palpation, endoscopic visualizatlon, or radiographic study. Treatment should be directed by the underlying cause. Herein, we reported a case of giant bulbous urethral stone in 55-year-old men, with a brief review of literature. Key Words: Stone, Bulbous urethra.

확산 광 단층촬영 시스템 구현

최순규,전영식,백운식 경희대학교 레이저공학연구소 2005 레이저공학 Vol.16 No.-

In this paper, diffuse optical techniques utilize light in the near infrared spectral range (600∼1000nm) to measure tissue physiology non-invasively. A light transport model based on the diffusion approximation is widely used to describe photon propagation in the NIR. We made diffuse optical tomography (DOT) system and measured about changed amplitude and phase in phantom. And then we compared simulation data with measured data. This research has pioneered the development of diffuse optical measurements.

건설현장 근로자들의 안저예방실태와 사고예방과의 개선요인 조사연구

심규범,남철현,최상복,이송권,이정희,이순자,문기내,김문환 慶山大學校 保健福祉硏究所 2003 保健福祉硏究 Vol.8 No.-

This study was conducted to examine aspects of health and safety education and demand level of safety education in construction job sites in order to provide direction of safety education development. The subjects of this study were 566 workers who were working in construction job sites located in Daegu City and Kyungbuk Province. Data were collected from June 1, 2002 to August 30, 2002. The results of this study can be summarized as follows. 1. According to safety education by experience methods, the proportion of education by lecture was highest (90.6%). The proportion of education by field practice was 13.1%. 2. Among the education methods which they thought as the most desirable method, the proportion of audio-visual education was 39.4% and the proportion of education by experience was 37.5%. Those who had more monthly income and higher education level preferred audio-visual education, while those who were younger and less educated preferred education by experience. 3. In the case of the contents of the safety education which they thought as the most important one, the proportion of enhancement of safety awareness and education of risk factors was highest (24.7%). The groups of older workers, having longer working period, and belonging to higher education level preferred these contents. 4. According to the factors which were most important to increase effectiveness of the safety education were workers' voluntary participation (27.7%), 40 to 49 years old (27.7%), and monthly income of one million, five hundred thousand won to one million, nine hundred ninety thousand won (32.0%). The proportions of lower educated workers and working as daily workers were also high. 5. The variable which most influenced the safety education was age. The safety awareness of construction job sites was the second highest influential variable. From above results, it is clear that the workers' participation in the safety education was low since most of the safety educations were formal education by lecture. Although they participated in the education, the education was also not effective because they compulsorily participated in it. Therefore, it can be concluded that effective alternative policies must be formulated.

합성골조 외부접합부의 전단변형에 관한 해석

조순호,선성규 광주대학교 산업기술연구소 2002 産業技術硏究 Vol.16 No.-

전편의 실험연구에 이어, 본 논문은 스프링모델을 사용한 합성접합부의 변형해석 모델을 설명하고 있다. 최근 들어 접합부상세에 따른 콘크리트의 구속특성을 고려한 접근방법이 Wight에 의해 제시되어, 이를 조사하였으며, 또한 실험결과와 비교하여 내진성능을 평가하였다. Wight는 변형예측을 위하여 평면응력에 근거한 간단한 해석을 제시하고 있으나, 본 연구의 접합부와는 상이한 구속 및 기하학적 조건을 포함하고 있으므로 구속계수 k_c값의 수정이 요구되었다. 이렇게 하여 예측된 결과는 실험결과와 어느 정도 일치하였다. Further to the companion paper that treats a experimental research carried out as part of this research, various analytical approaches to model the joint deformation based on a series of springs was also examined. Recently, To consider the enhanced characteristics of confined concrete depending on joint details, the procedure and an empirical constant for the enhanced strength suggested by Wight was adopted. The analytical model presented including the joint deformation can be used for the future overall building analyses. Further, modifications for defining the enhanced properties of confined concrete and inclination angles for struts and uniform, stress fields tests are necessary for present tests in predicting the shear versus shear strain response of a joint panel with the Wight's procedure.

자동차 보수도장의 도막에 관한 연구

김순경,장성규 동의공업대학 1999 論文集 Vol.25 No.1

An extensive investigation was conducted to assess the influence of steel sheet surface finish on pained surface appearance. Several kinds of textured steel sheet were painted simultaneously using advanced solvent-based luxury vehicle paint systems. Especially, the current emphasis on control of surface roughness of cold rolled steel sheet has been prompted by the automotive industry's concern with the as-painted appearance of sheet products, because the influence of such characteristics on paintability, formability and painted surface appearance is important in defining steel surface requirements for automotive industries. The results are discussed in detail with respect to 1) the influence of different steel surface textures on paint appearance, 2) the evolution of surface topography during painting, and 3) the implication of this work. 4) Painted sheet appearance is strongly affected by surface roughness and peak count of base-metal and influenced by the topographical properties of substrate, paint thickness and zinc coating variables. 5) The painted appearance of shot blast textured(SBT) and electro-discharge textured(EDT) automotive cold rolled steel sheets was determined and related to surface roughness parameters, zinc coating method, and paint thickness.

절삭공정의 성능예측에 관한 연구

황규완,김순경,전언찬 동아대학교 공과대학부설 생산기술연구소 1996 生産技術硏究所硏究論文集 Vol.1 No.2

This paper focuses on the aurtomatic selection of optimal cutting condition and cycle time on multispindle metal cutting machine. The several mathematical relationships were formulated for simultaneous selection of machining parameters and tool changing scheme. In this research we two step generative approach ; step 1 is mathematical modeling for the selection of optimal cutting conditions and the other is GMDH-TYPE modeling to find prediction equation of system performance. Thus in this paper, mathematical machining models combined with a heuristic GMDH-TYPE modeling to estimate the system performance. These models are developed computer programs for practical applocation and it was shown that the proposed approach has a good potential and offeers a valuable tools to analyze the metal cutting system.