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.

Clinical Experience of Single-Session Percutaneous Aspiration and OK-432 Sclerotherapy for Treatment of Simple Renal Cysts: 1-Year Follow-Up

Choi, Young Deuk,Ham, Won Sik,Kim, Won Tae,Cho, Kang Su,Lee, Joo Hyoung,Cho, Soung Yong,Seo, Ju Wan,Jin, Ok Hyun Mary Ann Liebert 2009 Journal of endourology Vol.23 No.6

<P>PURPOSE: To evaluate the efficacy and safety of single-session OK-432 sclerotherapy for the treatment of renal cysts. MATERIALS AND METHODS: From October 2005 to November 2006, 48 patients (61 simple renal cysts) were included in the study. Indications were determined as flank discomfort (n = 37) or patient reassurance due to increasing size (n = 11). The simple renal cysts were aspirated under ultrasonography (US), at which point OK-432 was injected into the cyst. Follow-up was performed with US or computed tomography scan every 3 months until 1 year. Complete regression of the renal cyst or more than 70% reduction in size with no symptoms indicated a successful treatment. RESULTS: Among 61 renal cysts of 48 patients, the overall success rate was 98.4%. Complete regression occurred in 46 cysts (75.4%), and more than 90% reduction in size occurred in 6 cysts (9.8%). A size reduction of 80% to 90% and 70% to 80% occurred in five (8.2%) and three cysts (4.9%), respectively. A size reduction less than 70% occurred in only one cyst (1.6%). The success of cyst regression was correlated with cyst volume. Clinical symptoms resolved in 100% of patients with symptomatic cysts, and there was no enlargement of the aspirated cysts at the 1-year follow-up. After the procedure, there were only some minor complications, such as mild fever, flank pain, and leukocytosis, which subsided with the conservative treatment. CONCLUSIONS: Percutaneous OK-432 sclerotherapy is simple, safe, and effective, and it can be an alternative first-line therapy for simple renal cysts.</P>

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.

분산 버퍼를 갖는 Self-Routing ATM 스위치에 관한 연구

이옥재,정동수 群山大學校 1996 論文集 Vol.23 No.-

In this paper, we propose a new self-routing ATM (Asynchronous Transfer Mode) switch with distributed buffers. This switch is composed of 1x2 binary switching elements and concentrators. Switch element has selfrouting characteristic being routed by destination address in the cell header. Concentrator is composed of running adder, reverse Banyan network and shifter. FIFO(First In First OUT) buffers, to improve their efficiency, are connected to the output of the shifter, and their address is gradually increased by running adder to avoid internal blocking. Though ATM cells with the same destination address are routed through switching elements blocking does not break out at the last stage because of buffers. So, we evaluate the performance of proposed switch and analysis the throughput and cell delay.

캐릭터 연동 온라인 3D 게임을 위한 실시간 모션캡쳐 시스템 개발

이준호,유영기,노병욱,이수진 선문대학교 ·중소기업기술지원연구소 2002 선문공대 연구/기술 논문집 Vol.7 No.1

최근들어 3차원 가상현실의 발전과 더불어 동작을 트랙킹하는 모션캡쳐는 엔터테인먼트, 의학, 스포츠, 교육, 산업등에 다양하게 널리 사용되어지고 있다. 특히 엔터테인먼트분야의 애니메이션과 게임등에서는 캐릭터의 생성에 모션캡쳐 기술을 사용하는데 기존에는 마우스, 조이스틱, 미디 슬라이더(Midi Sliders) 및 기타 장치들을 사용하여 캐릭터를 직접 연기시키는 방법을 사용하였으나 모션캡쳐에 의한 방법은 이전에 볼 수 있었던 그 어떤 방법보다도 자연스러운 움직임을 만들어낼 수 있다. 본 연구에서는 캐릭터를 연동한 온라인 3D 게임을 실현하기 위하여 광센서를 이용한 저가이면서도 빠른 샘플링 빈도를 갖는 모션캡쳐 시스템을 개발하고자 한다. Motion trackings are being used in part of the entertainment, medical, sports, education and industry with the development of 3D virtual-reality. In particular, the technology is used for animation and games as a part of entertainment. We can make very smooth motion that was never realized before, if we use the technology instead of using mouse, joystick, midi-sliders and so on for making some characters. In this research, we have developed a very low priced and fast sampling system using optic sensors for capturing the motion.

학교체육 활성화 방안에 대한 연구(Ⅰ) : 강원대학교 교양체육 운영방법의 개선을 중심으로

이광재,문병용,노성규,박기동,홍관이,한상준,유옥재,엄기진,정청자,오수일,김윤래,박장평,부기원 江原大學校附設 體育科學硏究所 1986 江原大學校附設體育科學硏究所論文集 Vol.- No.11

Try to find a scheme for activation to College Physical Education, this Report informs the various kinds of Survey and process those were projected for improvement of management methods on Cultural Physical Education in Kang Weon National University. From experimentally carried out "Sports events Choosing System" not as usual be inforced "Total practical Skill System", Following Positive effects and sujestions were Presented; 1. "Sports events choosing system" gave birth to more students' interesting and more voluntary participation to the sports events they chose, and sports skill and instruction level was elevated due to charge of expert according to each sports events. This system would be managed continuously hereafter for it related to life sports. 2. This System needs to closed cooperations between College and Community, for the facilities of community are utilized by college. 3. To complete the plan for activation of college Physical Education, additionally, the successional study ; namely "autonomous extracurricular sports activity" should be excuted hereafter.

ATM 멀티캐스트 스위치에서 분배기를 갖는 이원적 복사네트워크

이옥재,정동수 群山大學校 情報通信技術硏究所 1998 情報通信技術硏究論文集 Vol.2 No.-

In this paper, a new algorithm is proposed which distributes multicast cells in a copy network. The dual copy network is composed of running adder network, distributor, dummy address encoder, and broadcasting network. It is operated lower input address and higher one simultaneously by the distribution algorithm. As a result, for each input has a better equal opportunity of processing, cell delay and hardware complexity are reduced in copy network. Also, for it adopts the broadcasting network from an expansion Banyan network with binary three and Banyan network, overflow probability is reduced to a half in that network. As a result of computer simulation, the copy network processed by the distribution algorithm is remarkably improved in cell delay o input buffer according to all input loads.

빈발재발성 미세변화 신증후군환아에서 발생한 다발성 뇌경색증

조성옥,한헌석,차상훈,이경희,박범수,하태선,채수안 충북대학교 의과대학 충북대학교 의학연구소 1995 忠北醫大學術誌 Vol.5 No.2

신증후군에서는 동맥 및 정맥의 혈전에 의한 혈전색전증의 위험이 높다. 이는 혈 중 응고인자 Ⅰ, Ⅱ, Ⅶ, Ⅷ, Ⅹ등의 증가와 뇨소실로 인한 antithrombin Ⅲ의 감소, 섬유소 용해계의 변화, 혈소판 응집력의 증가에 기인하며 그 외 스테로이드 투여, 이뇨제 투여, 저체액 상태도 관여한다고 생각하나 이런 과응고현상에 대한 정확한 병태생리는 규명되고 있지 않다. 저자들은 내원 21개원 전 처음 신증후군 증상을 보였고 신장 조직 검사상 미세변화 신증후군으로 진단을 받고 스테로이드와 면역 억제제를 사용하였으나 6개월에 3-4회의 재발을 보이던 중 내원 1달 전 보호자 자의로 모든 약물 복용을 중단한 채로 지내다가 고열과 반혼수 상태를 보여 내원한 7세 남아에서 다발성 뇌경객증을 발견하였기에 문헌 고찰과 함께 보고하는 바이다. The risk of thromboembolism by arterial or venous thrombosis is high in the nephrotic syndrome. This may be due to the increased serum concentrations of the factor Ⅰ, Ⅱ, Ⅶ, Ⅷ, Ⅹ etc, decrease of antithrombin Ⅲ due to urinary loss, the change of thrombolytic system, increase in the platelet aggregation capacity, the use of steroid, diuretics, and hypovolemic state. But, the pathophysiology of this hypercoagulable state has not been clear. A 7-year- old boy had been diagnosed as having frequently relapsing minimal change nephrotic syndrome, 21 months ago. In spite of the administration of prednisolone and cytoxan, he had presented recurrent proteinuria in the frequency of 3-4 times per 6 months. From 1 month prior to visiting emergency room, his parents discontinued his medications, therefore, he showed fever and semicomatous mental status. In brain MRI study, multiple cerebral infarcts were noted. So, the authors report a case of multiple cerebral infarcts in a patient with frequently relapsing minimal change nephrotic syndrome with a brief review of related literature.

광중합방식이 콤포머의 변연폐쇄에 미치는 영향

조옥환,한진순,임미경,이수종 대한치과보존학회 2001 Restorative Dentistry & Endodontics Vol.26 No.1

The aim of this study was to evaluate the effect of various polymerization techniques on the microleakage of compomer restorations. Fifty extracted human premolar and molar were used and randomly divided into 5 groups. After cavity preparation, compomer (F2000) was filled according to the manufacturer's directions. All groups, except group 5, were filled using an incremental technique. Group 1was polymerized for 40 seconds at a continuous 485mW/㎠ with a VIP (Bisco, USA) light cure unit. Group 2 was polymerized for 20 seconds at a continuous 345mW/㎠ and then for 20 seconds at 645mW/㎠ with the VIP light cure unit. Group 3 was polymerized at 400mW/㎠, gradually increased to 50mW/㎠ per 10 seconds until 550mW/㎠ was reached; total 40 seconds with a Spectrum 800 (Dentsply Caulk, USA) light cure unit. Group 4 was polymerized for for 3 seconds using an incremental technique with a Flipo (LOKKi, France) light cure unit. Group 5 was polymerized for 3 seconds using a bulk fill technique with the Flipo light cure unit. The specimens were embedded with acrylic resin, and were sectioned with diamond saws in a mesiodistal direction along the longitudinal axis of the tooth so as to pass through the center of the restoration, and three surfaces (occlusal, pulpal, and gingival) were examined with SEM. The results were as follows; 1. Group 5 showed a significantly larger gaps compared to other groups on the gingival, occlusal, and pulpal walls. 2. All groups except group 5 had no statistically significant gap on the gingival, occlusal, and pulpal walls. 3. There was no significant correlation between the amount of enamel on the gingival and occlusal walls and polymerization shrinkage.

패류중 중금속함량에 관한 연구

신현수,허옥순,이진하,김세은,주인선,신동우,강석종,박만종,김지연,김근희,강숙경,정래석,허숙진,소유섭,최장덕,문병우,김진수 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

본 연구는 패류중 중금속함량 측정을 위한 분석효율이 높고 간편한 분해법을 찾아내어 그 방법에 의끓 유종중인 패류중 중금속함량을 파악하고자 수행하였다. 시료를 분해시키는 Microwave와 습식, 건식회법을 비교한 결과 변형습식회화르가 가장 적합하였다. 변형습식회차딘는 려린0,3+C104+H2SOf의 혼찰산을 쪼 · j 1 (v/v)의 비율로 혼합하여 사용하였 을 때 회수을 Pb린틴. Cd 97.8, Cu 94.2, Zn 92.8%를 나타내었근 분해시간은 2~2.5시간 소요되었다. 유통중인 패류중 중금속함량 」최소~최대(평균), mgAgl 은 Pb 0.028~o.528(0.153), Cd 0.OO7~1,832(0.587), Cu 0.360~37.375(4.6691, Zn 6.317~233.2iO(38.881), Hg 0.001 ~O.151(0.012)mg/ltg으로 나타났다. 또한 유통중인 5종의 패류중 중금속평균항량이 생산지 하재지역에서 구입한 패류에 비해 모든 중금속언써 약간 높은 함량을 보였으나 오염된 수준이 아닌 자연함유량수준이었다. This study was conducted to improve the digestion method for the determination of heavy metals in shellfishes and to estimate the contents of heavy metal in commercial shellfishes by their digestion method. This digestion method was compared microwave with wet and dry ash digestion for shellfish samples, obtained results showed that the modified wet ash Ⅱ digestion was convenient and easy to use. For the modified wet ash Ⅱ digestion, The mixed acid of HNO₃+HClO₄+H₂SO₄(25:5:1, v/v) was used. Under this condition, Recoveries were Pb 94.3, Cd 97.8, Cu 94.2 and Zn 92.8% and digestion time was ∼2.5 hours. The contents of heavy metal [minimum∼maximum (mean), mg/kg in commercial shellfishes were as follows ; Pb:0.028∼0.528(0.153), Cd:0.007∼1.832(0.587), Cu:0.360∼37.375(4.669), Zn:6.317∼233.250(38.881), Hg:0.001∼0.151(0.013). The contents of heavy metal in commercial shellfishes of five species were slightly greater than those of shellfishes purchased at Hajae. There was no great difference between the contents of heavy metal of Hajae and those of shellfishes purchased at Whole market.