농촌병원과 도시 종합병원 외래환자의 수진행동에 관한 비교연구

민현옥,이종숙 中央醫學社 1993 中央醫學 Vol.58 No.11

In order to know the sick role behavior of outpatients who visiting the Hospitals in City and Rural, this questionnaire survey was conducted from Dec, 1990 to Feb, 1991 in the five selected hospitals; 3 general hospitals in Taejeon City al d 2 general hospitals in Chungnam provincial for 876 outpatients. The major findings of this survey were as follows: 1. A total of 49.3 % of the study population were male and female were 50.7 % and average age were 40.14 years old. 2. The average time spent on diagnosis and treatment in hospitals was 138.6 minutes, the spent times were longer in hospitals in city than one in Rural area. 3. The average time spent on diagnosis and treatments by departments was 168.7 min. in internal medicine, 136.1 min. in orthopedic surgery, 104.4 min. in obstetrics and gynecology, 86.8 min. in general surgery, 81.4 min. in pediatrics. 4. The previous medical facility from which patients were transport were 37.2 % in clinic, 16.4 % in hospital, 4.2 % in health center and subcenter and 38.8 % in no transfarted medical facility. 5. The Routes of hospital choice were 30.9 % in patients' own first choice, 35.8 in transferred from other facility on patients' own decision, 26.5 % in recommended by other medical facility. 6. The reasons of hospital choice were 32.1 % in previous experience and familiarity, 26.6 % in bad treatments in previous hospitals, 28.0 % in good facility and equipment. 7. The dissatisfaction against currently treating hospital were 58.9 % in long waiting time, 16.4 % in insufficient explanation of disease, 16.5 % in unkindness, 13.4 % in diagnosis time is too short, 26.6 % in no dissatisfaction. 8. The attitude on medical care delivery system were 34.8 % in acceptable, 23.4 % in not acceptable, 36.5 % in don't know.

혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

경막외 마취시 Clonidine 과 Epinephrine 첨가에 따른 마취연장효과의 비교

최영석,이미경,이일옥,윤석민,임상호,김난숙 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.2

Epidural clonidine is reported to produce analgesia in humans. To investigate the analgesic effect and prolongation of epidural and spinal anesthesia, we mixed 0.2mg epinephrine, 150 mcg clonidine, or 1 cc normal saline with 0.5% bupivacaine and compared the hemodynamie and analgesic effects of each drug. Heart rate and blood pressure were checked before, during and after anesthesia. Sensory level was checked by pin-prick method. The results were as follows; 1) The analgesia onset time and the time to highest level of sensory loss was most rapid in the epinephrine group. 2) The two segment regression time was significantly prolonged in the epinephrine group. 3) The analgesia duration was significantly prolonged in the clonidine and epinephrine group. 4) Although the heart rate gradually decreased over 60 min. After injection of each drug, there was no significant change between the groups. 5) Blood pressure decreased over 20-30 min. After injection of each drug, but there was no significant change between the groups.

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.

Radicicol Inhibits iNOS Expression in Cytokine-Stimulated Pancreatic Beta Cells

Cha Kyung Youn,Seon Joo Park,Mei Hong Li,Min Young Lee,Kun Yeong Lee,Man Jin Cha,Ok Hyeun Kim,Ho Jin You,In Youp Chang,Sang Pil Yoon,Young Jin Jeon 대한생리학회-대한약리학회 2013 The Korean Journal of Physiology & Pharmacology Vol.17 No.4

Here, we show that radicicol, a fungal antibiotic, resulted in marked inhibition of inducible nitric oxide synthase (iNOS) transcription by the pancreatic beta cell line MIN6N8a in response to cytokine mixture (CM: TNF-Ձ, IFN-Ճ, and IL-1Ղ). Treatment of MIN6N8a cells with radicicol inhibited CM-stimulated activation of NF-ՊB/Rel, which plays a critical role in iNOS transcription, in a dose-related manner. Nitrite production in the presence of PD98059, a specific inhibitor of the extracellular signal-regulated protein kinase-1 and 2 (ERK1/2) pathway, was dramatically diminished, suggesting that the ERK1/2 pathway is involved in CM-induced iNOS expression. In contrast, SB203580, a specific inhibitor of p38, had no effect on nitrite generation. Collectively, this series of experiments indicates that radicicol inhibits iNOS gene expression by blocking ERK1/2 signaling. Due to the critical role that NO release plays in mediating destruction of pancreatic beta cells, the inhibitory effects of radicicol on iNOS expression suggest that radicicol may represent a useful anti-diabetic activity.

Radicicol Inhibits iNOS Expression in Cytokine-Stimulated Pancreatic Beta Cells

Youn, Cha Kyung,Park, Seon Joo,Li, Mei Hong,Lee, Min Young,Lee, Kun Yeong,Cha, Man Jin,Kim, Ok Hyeun,You, Ho Jin,Chang, In Youp,Yoon, Sang Pil,Jeon, Young Jin The Korean Society of Pharmacology 2013 The Korean Journal of Physiology & Pharmacology Vol.17 No.4

Here, we show that radicicol, a fungal antibiotic, resulted in marked inhibition of inducible nitric oxide synthase (iNOS) transcription by the pancreatic beta cell line MIN6N8a in response to cytokine mixture (CM: TNF-${\alpha}$, IFN-${\gamma}$, and IL-$1{\beta}$). Treatment of MIN6N8a cells with radicicol inhibited CM-stimulated activation of NF-${\kappa}B$/Rel, which plays a critical role in iNOS transcription, in a dose-related manner. Nitrite production in the presence of PD98059, a specific inhibitor of the extracellular signal-regulated protein kinase-1 and 2 (ERK1/2) pathway, was dramatically diminished, suggesting that the ERK1/2 pathway is involved in CM-induced iNOS expression. In contrast, SB203580, a specific inhibitor of p38, had no effect on nitrite generation. Collectively, this series of experiments indicates that radicicol inhibits iNOS gene expression by blocking ERK1/2 signaling. Due to the critical role that NO release plays in mediating destruction of pancreatic beta cells, the inhibitory effects of radicicol on iNOS expression suggest that radicicol may represent a useful anti-diabetic activity.

인체혈장 중 에탐부톨의 HPLC 분석법의 검증 및 단일용량 투여에 의한 약물동태 연구

곽혜선,박경호,최준식,송진아,성민경,장정옥,이화정 한국약제학회 2005 Journal of Pharmaceutical Investigation Vol.35 No.2

An HPLC method was employed for the determination of ethambutol in human plasma. After addition of internal standard (IS, octylamine, 2 μg/mL) and alkalinization of the plasma with 5 M sodium hydroxide, the drug and IS were extracted into the mixture of chloroform and diethyl ether (40:60, v/v). Following a 15-min vortex-mixing and a 10-min centrifugation, the organic phase was spiked with 100 pL of phenylethylisocyanate (2000 μg/mL) for chemical derivatization, mixed for 5 min and evaporated to dryness under a stream of nitrogen. The residue was reconstituted with 100 μL of mobile phase and 20 pL was injected into Cl8 column with a mobile phase consisting of methanol:water (70:30, v/v). The samples were detected utilizing an ultraviolet detector at 200 nm. The method was specific and validated with a limit of 0.15 μg/mL. Infra- and inter-day precision and accuracy were acceptable for all quality control samples including the lower limit of quantification. The applicability of this method was demonstrated by analysis of human plasma after oral administration of a single 1200-mg dose to 20 healthy subjects. From the plasma ethambutol concentration vs. time curves, the mean AUC was 9.61 ± 1.64 μg hr/mL. and Cmax of 2.68 μg/mL reached 2.73 hr after administration. The mean biological half-life of ethambutol was 3.46 ± 1.21 hr. Based on the results, this simple and validated assay could readily be used in any pharmacokinetic studies using humans.

디자인 프로세스를 적용한 환자복 개발 사례 연구

이연희;박재옥;서미아;안민영 한양대학교 2004 韓國 生活 科學 硏究 Vol.- No.24

The purpose of this project was to design a patient's uniform which gives functional and psychological satisfaction to the patients. The project was developed to follow the design process. That is, the project was based on the survey which is on dissatisfaction of exiting patient's uniform, evaluation criteria and design preference for patient's uniform. The result of the survey was reflected to the design of new patient's uniform for Hanyang University Hospital. The uniform consists of a shirt and a pair of pants. The style of the garment is comfortable box-silhouette for ease and action. The shirt has a compromised neckline of U-neckline and round-neckline. It has buttons on front for closure, a patch pocketon left side of the garment. It also has three-quarter sleeves to complement dissatisfactions on the length and the distinction of seasons. The button extension was deeply given to avoid becoming open. To give decorative accents, piping was added. The ankle-length pants aredesigned to satisfy the need for shortening the length of existing uniform pants. The waistband of the pants has both closures, a drawstring and an elastic band, to make up for the dissatisfactions on durability and slip-off problems. The colors, white, light blue, pink, and yellow, are used to give a psychological sense of security to the patients. The flower symbol of Hanyang University was used for the textile surface design. Therefore, this project is worthwhile to present more systematic and scientific approach for patient's uniform design which gives functional and psychological satisfaction to the patients.

스포츠 브랜드의 캐릭터에 대한 소비자 인식과 구매행동

이지연,안민영,박재옥 服飾文化學會 2002 服飾文化硏究 Vol.10 No.2

The purpose of this study is to investigate the consumers' cognition and buying behavior on sports brand character. Since the character industries are booming, this study focused on the source and the expression method of sports brand characters that are already known to consumers. Subjects of this study were university students who were interested in sports brand characters, living in Seoul and Kyenggi-do. The questionnaire were developed based on the previous studies. Data were analyzed by Frequency analysis, ANOVA, Duncan Test, and Spearman's Rho. The results were as follows: 1. The most preferred source of sports brands character was "illustrated human figure"(i.e. a famous athlete like Michael Jordan). And the most favorite expression method of character was the combination of letter and symbol as the character of ASICS and NIKE, 2. The important design factors of sports brand character were the symbolism and aesthetics. The consumer recognized NIKE as the most well-designed character design. 3. Consumers' preference of sports brand was found to be NIKE, REEBOK, ADIDAS, and FILA, in order. The reasons for preference were the design, the brand image, and the quality. On the other hand, the most frequently purchased brand was NIKE, FILA, and ADIDAS in order. Most of the purchase took place in the brand outlet store, and the consumers usually came with their friends for purchase of sports brand. The display of store was the consumers' major source of information. 4. The preference group of sports brand character recognized more importantly color, design, brand, and especially fashionability than the non-preference group. And the most important criteria for brand selection were design, price, and comfort orderly. 5. Female consumers recognized more importantly color, design, brand, and others' recommendations that male consumers. The aged consumers recognized importantly durability, comfort, and quality.

수두백신의 역가시험법 표준화를 위한 연구

민경일,백선영,신진호,김재옥,류승렬,민복순,김병국,김도근,김훈,이석호,박순희 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

수두(chicltenpo즈) 및 대상포진(shingles)의 예방을 위해 사용되는 수두 생 바이러스 백근은 현재 국내 -외 제조사들이 정상사람 2배체 폐 태아 세포 주들을 이용하여 바이러스를 배양 · 증식시켜 생산하고 있으나, 품질관리를 쒸한 역가 시험에는 t·fRC튼 띤 LB딘EL 세포 주외에 제조사가 설정한 세포 주를 이용하고 있으며, 역파신험 방법인 fH Ui'rFO Plaque 3SSaIT에도 조사별로 다소 차이가 있는 시헌법을 사용하고 있다. 그러므로 일반적으로 세포 주간우 감수성 차이, 계대력(passa딩e level)간의 차이,varicelta-zoster virus(4'2V) diluent medium 등에 의한 차이에 의해 역가시힘 결과에 많은 차이를 나타낼 수 있다. 이에 본 연구에서는 역가 시험 결과꼭 편차를 촉소화 할 수 있는 시헌방법을 극힙하고자 Ok퍼 백신 주와 세로 주간 및 기타 요인에 따른 차이를 비교 분석하고 이를 표준확하여 일관겅있는 국가 및 제조사의 품질관리예 활용하고 나아가 수두 생 바이러스 백신 역가시헌 국가 표준품 거달에 활용하고자 하는데 목적이 운.다. 수두 생 바이러스 빅신의 역가 시험에 영향을 띠칠 수 꿀.는 모민으로 우선 바이러스 흡착에 사용되는 1#Z)·'diluent medium이 가장 큰 오인으로 확인되.고. 현개까기 최종적으로 if4 sucrose, 10% FBS, 0.1% sodiun) rrlonog)utamate in PBS(-), fIH 7.2가 가당 두수글 L'z).「 린luent medium 조성으로 확인되었단. 또한 '·:~l포 주별로 다소의 차이는 잇.으나 최대 바이러스 흡착시간은 90분으론:÷잰착인 되었다. 다른 negati)Fe effect를 보일 수 있는 요인으로 항생물질 및 항츤 제인 fuugiBone이 곡이러스의 역가에 영향을 미치는 것으로 확인되었다 따라서 이러한 항생물 띤 항균제를 standard solid agarose overla?·(5.tO) 시헌방법에는 사용하지 않는 것이 역가 시험의 편차를 줄일 수 있는 요인이라 판단된다. 최적의 조건하데서 Oka 수두 백신 주의 j 종의 세포 쭈에 대한 역가시험 수행 결과 각 세포 주의 감수성의 차이는 크지 않았으나, 반복시헌에 대한 표준편차는 다소 차이를 나타났다. Until now in Korea, the international and domestic vaccine maufacturers produce and sale live attenuated daricella vaccines, used to prevent chickenpox and shinglees, which are propagated in and done the potency test with various originated human diploid embryonic lung cells. Also manufacturers perform in vitro plaque assay with a little different methods to their quality control tests. Therefore, in general, there is slight or big difference among in vitro plaque assay results because of the difference in susceptibility of various originated human diploid embryonic lung cells and in assay methods. The purpose of this study is to confirm what factors occurring deviation to establish the standardized method which minimize deviation intracellularly and intercellularly. Eventually the standadized method will be used in consistent national and manufacturer's quality control and moreover intra and inter laboratory's validation assay of national standard for live varicella vaccine candidate. We confirmed VZV diluent medium was the biggest factor influencing in vitor plaque assay and the excellent composition of VZV diluent medium was final 5% sucrose, 10% FBS, 0.1% sodium monoglutamate in PBS(-), pH 7.2. We confirmed 90 minutes was maximum and optimum VZV adsorption time, but a little different among cells Also we recommended not use antibiotics and antimycotic, fungizone in standard solid agarose overlay assay in varicella potency test. Eventually 5 different originated human diploid embryonic lung cells showed little difference in susceptibility to Oka vaccine strain, but showed a lot of difference in reproducibility.