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위암수술 환자에서의 cp 개발과 cp적용에 따른 질 향상 활동에 관한 연구
임은주,황순휘,박도중,하광일,배현주,김형호 한국의료QA학회 2006 한국의료질향상학회지 Vol.13 No.2
Background : In an era of increasing medical costs, safe reduction in postoperative stay has become a major focus to optimize utilization of healthcare resources. The authors aimed to evaluate the clinical significance of the critical pathway(CP) for gastrectomy patients by implementing standardized postoperative management and electronic medical records. Method : From August 2006 to April 2007, critical pathways were introduced to inpatients and outpatients with gastric cancer. 60 consecutive patients undergoing distal gastrectomy were randomly divided into two groups; 30 CP group(A) and 30 non-CP group(B). Simultaneously, we also retrospectively reviewed the records of 438 patients(C:control group) who were able to be enrolled in CP program. We compared group(A) with (B), (C) in terms of hospital stay, complication rate, use of antibiotics and hospital costs. Patient satisfaction was surveyed by questionnaires. Result : There was no significant demographic difference between group(A) and (B). Of 30 patients in group(A), 5 drop-outs and 14 variances occurred. The mean postoperative hospital stays(Laparoscopy-assisted distal gastrectomy: LADG/Open distal gastrectomy: ODG) were 7.6/10.5 days for the group(A), 8.9/12.7 days for the group(B) and 12.6/14.5 days for the group(C) (p=0.02 in LADG). The total hospital cost of group(A) had a tendency to be less than that of group(B) and the amount of hospital cost per day in group(A) was significantly higher than that in group(B). The usage rates of the first generation antibiotics were 73.33%, 63.33%, and 59.2% in group(A), (B), and (C), respectively. Patients’ satisfaction had a tendency to be higher in the CP group than non-CP group. Conclusion : The mean hospital stay in LADG patients was shortened meaningfully and hospital cost per day was enlarged after introduction of clinical pathway. It is necessary to apply a number of patients to the critical pathway and to make an effort to reduce the variation and drop-out rates.
강선 이음형 PC 보-기둥 내부 접합부의 구조적 거동에 관한 실험적 연구
하상수,김승훈,문정호,이리형,임주혁 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)
In this study, new moment-resisting precast concrete beam-column joint is proposed for moderate seismic regions. it is attempt to devise connection detail which makes workability improve and confirm effective stress transfer in the region of connection. It has the connection details which help working process simplified and construction cost reduced. as replace 9.3㎜, 7strand for reinforcement. Fore specimens for partial tension test and three specimens for beam-column interior joint test were producted. An experimental study was carried out to investigate the joint behavior subjected to reverse cyclic loading and constant axial compressive load. The test variables was transverse reinforcement in joint. Structural performance of joint is evaluated on the basis of connection strength, stiffness, energy dissipation, and drift capacity. Based on the test results, the precast connection is capable of matching or exceeding the performance of the monolithic connection and thereby provides the sufficient moment-resisting behavior to be applicable for moderate seismic regions.
충주 지역에서 10년간 급성심근경색의 임상관찰에 대한 연구
박봉안,류하근,이종혁,김인숙,류주성,유재등,이용구,문언수,김형수 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-
Background: The current treatments of acute myocardial infarct(AMI) Include noninvasive method using thrombolytics and invasive methods such as primary percutaneous transluminal coronary angioplasty(PTCA) and coronary artery bypass graft(CABG)surgery. Although there are many studies comparing the effectiveness of noninvasive and invasive methods, when large clinical centers, 20% of totar hospitals, were excluded, most middle-sized hospitals lacked personnels and facilities for the invasive methods. Thus they opted for the noninvasive methods. Therefore, in this study, the clinical characteristics of AMI patients and the results of thrombolytic & conservative treatment were observed. Method: 137 patients with acute myocardial infarct, who visited KonKuk University Medical Center, ChoongJu Hospital during Sept. 1990 to Sept. 1999 were analysed retrospectively using medical records. Result: The sexual compositions of patients were 63.5% male, and 36.5% female. The mean age for male patients were 56±12.9, and for female patients 68.7±9.6 (p<0.05). The mean age for female patients was significantly older than male patients. The patients in the thrombolytic treatment group had mortality rate of 6.25% which is lower than that of the conservative treatment group at 12% (p>0.05). Conclusion: Although in our study, small number of acute myocardial infarct patients caused the statistical insignificance, rapid revascularization by thrombolytic therapy within 6 hours of onset of symptoms improved mortality rate and early ambulation. And we had good results on AMI with thrombolytic agent in ChungJu including near rural area as primary emergency hospital. Therefore a prospective research with greater number of subjects is needed to develop better treatments for AMI.
Implementation of US MACT Regulation to Korean Municipal Waste Incinerators
( Ha Na Jang ),( Yong Chil Seo ),( Ju Hyung Lee ),( Jeong Hun Kim ),( Deepak Pudasainee ),( Ju Myun Park ),( Kum Ju Song ),( Young Hun Mun ),( Kyu Shik Park ) 한국폐기물자원순환학회(구 한국폐기물학회) 2007 WASTE RECYCLING AND MANAGEMENT RESEARCH Vol.12 No.1