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.

Li₂O-B₂0₃-SiO₂계 유리의 유전특성

정순영,정석종,남상탁 慶尙大學校 1986 論文集 Vol.25 No.2

The one K-family of 5 glasses was fabricated to study the dielectric properties. Room temperature measurements of the real (εreal) and imaginary (εimag.) parts of the dielectric constant for the Li₂O-B₂0₃-SiO₂₃ glass system were obtained over a frequency range from 102 to 2×104Hz. The dielectric constants were increased with decreasing frequency and increasing molar fraction of Li₂O, which could be interpreted by a bistable model of Debye's theory.

甲狀腺炎과 Lithium 治療에 의한 甲狀腺機能低下症

鄭道彦,禹鍾仁,李定均,趙普衍,高昌舜,金勇一 大韓神經精神醫學會 1982 신경정신의학 Vol.21 No.2

A case of a female Manic Depressive Illness patient with goitrous hypothyroidism is presented. After ten and half months of lithium maintenance therapy starting during her first psychiatric admission, she was admitted again due to acute recurrent manic episode. On admission, she complained of easy fatigability and cold intolerance, and thyroid gland was palpable and enlarged in moderate degree. Thyroid function test revealed markedly increased TSH and moderately decreased thyroxine levels. TRH stimulation test showed an exaggerated response. Needle biopsy specimen revealed chronic lymphocytic and immune complex thyroiditis. However, antithyroglobulin and antimicrosomal antibodies were negative. In pretreatment thyroid evaluation on her first admission, neither goiter nor thyroid function abnormality was detectable and no signs of underlying thyroid disease or hereditary predisposition to hypothyroidism were present. Within three weeks of discontinuation of lithium, goiter was no more palpable and within five weeks, thyroid function test returned to normal range. The possibility that patients with underlying thyroiditis may be particularly susceptible to a rapid onset of lithium-induced hypothyroidism is discussed.

뇌동맥류 수술환자의 정신신경학적 분석

정현태,박순필,김상진,도종웅 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.4

The mortality rate of aneurysmal surgery had recently been reduced remarkably due to mordern microsurgical technique and refinement of the timing of operation. Despite recovery without neurological deficits, many patients remain with emotional and psychological sequelae postoperatively. We evaluated 33 patients, operated on intracranial aneurysm for recent 2 years, about quality of life and degree of cognitive function. For proper evaluation of outcome of aneurysmal surgery, in addition to the neurological outcome, psychological aspects must be considered.

전하 제어법을 이용한 압전 액추에이터의 이력저감

정순종,이대수,송재성,홍원표,강은구,최원종 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

This paper presents a method to reduce hysteresis in multilayer ceramic actuator by connecting the actuator with a capacitor in a series circuit. The change in hysteresis with respect to the capacitor was examined. 0.2Pb(Mg_(1/3)Nb_(2/3))O₃-0.8Pb(Zr_(0.475)Ti_(0.525)) O₃ ceramic material was used as a piezoelectric material for the actuator. Displacement of the actuator was measured in a capacitive gap sensor measuring system. In case of inserting a capacitor in a total circuit, hysteresis became dramatically decreased, and then finally the hysteresis value can be reduced below 0.2%. It was found in this present study that reducing the hysteresis in the actuator is dependent upon the characteristics of the capacitor in total circuit and also operating frequency

난소절제로 유도된 골다공증 백서의 발치창 치유과정에 관한 조직학적 연구

정지순,임창준,김경욱,김종여 단국대학교 치의학연구소 1994 논문집 Vol.6 No.1

As the old aged population is on a rise, osteoporosis become considered as a major systemic disease causing severe impediment. For the purpose of knowing about the healing process of the extraction socket in the osteoporotic rat and for applying the results to modify treatment plan in the dental management of osteoporosis patient following aging and menopausing, the author induced osteoporosis by orariectomy in rats, and histologically observed the healing process of the extraction socket. The results were as follows. 1. In the control group, 2 weeks after surgery active bone formation was found and after six weeks extraction socket was filled with mature lamellated bone to the middle half. 2. In the experimental group active new bone formation was found one week after surgery and the poor trabeculae was observed composed of immature woven bone in the wall of extraction socket to six weeks. 3. In the fluroscent microscopic study the amount of bone formation of the experimental group was increased in 2 weeks than in 4 weeks, and its quantity of the newly formed bone was less than that of the control group.

난소절제로 유도된 골다공증 백서의 발치창 치유과정에 관한 조직학적 연구

정지순,임창준,김경욱,김종여 단국대학교 치의학연구소 1994 단국대치의학연구소논문집 Vol.6 No.1

水盜作에서 親環境農業 定着을 위한 오리 및 왕우렁이 農法의 可能性 分析

이종성,김기영,황필성,오주성,정원복,정순재 동아대학교 농업생명과학연구소 2001 農業生命資援硏究 Vol.10 No.1

Concerns on use of excess amount of chemical fertilizer and pesticide in current farming system turns both of the producer and consumer of agricultural products to an organic farming which use a less chemicals and more natural manure. Possibility Analysis of Pond-snail and Duck Faming for Environment-friendly Agriculture in paddy field. Depression effect of weed occurrence by pasture of 5kg of the Pond-snail(Ampullarius insularus) per 10a and the 7th day after transplanting. Optimum duck rasing density in rice paddy field was was 25~30 heads per 10a and ducks could be harvested three times in a year starting from 40 days after mature-seedling machine transplanting. The weed control rate of the duck raised paddy field was superior to the conventional agriculture. Yield per 10a of the duck raised and pond-snail(Ampullarius insularus) farming was inferior to conventional agriculture. The earnings of The Duck and Pond-snail farming realize a profit. From these results, it seems that the Organic farming are usefel and pasture of the Duck, Pond-snail(Ampullarius insularus) for depression of the weed occurrence is effective as the environmental perservation farming.

비복신경이식을 이용한 긴 거리의 말초신경 결손부 수복

이종호,이세영,김명진,이은진,안강민,김성민,최원재,명훈,황순정,서병무,최진영,정필훈 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.2

The surgery of oral and maxillofacial area poses the risk of cranial nerve damage such as trigeminal nerve or facial nerve. Inferior alveolar nerve is prone to damage in the third molar extraction, implant installation, orthognathic surgery, open reduction and rigid fixation, and tumor ablation surgery. On the other hands,facial nerve is likely to be damaged or sacrificed with trauma or parotidectomy. In case of inferior alveolar nerve injury, the incidence is reported to be about 1.3%. The nerve function will almost recover in minimal damage, but it won't recover at last in total damage of a part of nerve unit. In latter cases, nerve regeneration in intended by allograft as nerve substitute or various route of merve condit. But the recovery with autograft is believed to be most relialbe mrthod in the rapair of long-span(longer than 15㎜)nerve defect. We have performed autologous sural nerve graft in the repair of nerve defect, which is caused by resection of benign or malignant tumor. Hereby we report the method of nerve harvesting, recovery of defected peripheral nerve and the complications of donor site with the discussion of sural nerve anatomy.

熱펌프의 性能 特性에 관한 實驗

金鐘喆,鄭淳宰,白耳 東亞大學校 大學院 1994 大學院論文集 Vol.19 No.-

Nowadays, resource crisis has come to the front of the world. So it is necessary for all countries to conserve and develope energy. Heat Pump Systems were designed for the purpose of upgrading the utility of energy. Especially the heat pump systems which originated from the basic conception of Carnot and Faraday in 1824 are recently highlighted for the use of heat from waste hot water or steam. Thses experimantal studies, of Heat Pump is possible to predict that input temperature of hat water and cooling water significantly affects temperature boost and COP. The COP of heat pump decreases with the decrease in the source water temperature and with the increase in the hat water temperature and increases with the increase in the source water flow rate and hot water flow rate. And the local temperature and concentration profiles can be obtained from the results. Results of the simulation were compared with experimental results.