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.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

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.

日本의 敎員養成制度 改革

李相魯,姜信珠,安泰潤,奇宇恒 慶北大學校 師範大學 1985 敎育硏究誌 Vol.27 No.-

It is said that Korean teacher education is facing some critical Problems. We think that we can get some imformations from the reexaminations on the recent reforms in Japaness teacher education system. 1) As the basic orientation of teacher education, we need to distinguish open system and closed system; teacher education in all college level and teachers college level. Institutional improvements should be directed to democratization and specialization; abuses in massproductive teacher education are required to correct. 2) In principle, teacher education should be enforced solely in regular college level; through strengthening teaching method course, teaching subject courses, and student teaching practices, professionally of teacher education must be elivated. 3) As teacher education heavily depends upon teacher employment directly or indirectly, the plan of the teacher demand and supply is needed to be reasonable. And incentive systems for teachers are demanded. 4) In-service education should be qualified to enhance the autonomy of teaching profession. 5) The Co-research between colleges, educatibnal institutes, and schools is expected to strengthen and enlarge action research.

골프 선수들의 체격·운동능력 및 신체구성에 관한 연구

이재호,김광중,김해중,신승남 한국스포츠리서치 2001 한국 스포츠 리서치 Vol.12 No.4

The purpose of this study was to observe the physique, motor ability and body composition of Golfers. The subjects were healthy 20 male Golfers and 20 male non athletes. Every subject performed continuous incremental work laod test by bicycle ergometers. They were warm up with 50 rpm at 25 watt for 2 minutes and gradually increased 50 watt every 3 minutes until exhausition(?). They were tested the motor ability and body composition. They results obtained by this study were as follows ; 1. Physique Golf playes body height showed to be 176.45±5.62cm, body weight was 77.14±13.86kg, chest girth was 96.32±8.37cm, BMI was 22.14±2.70kg/㎡. 2. motor ability Golf playes motor ability showed to be 69.41±9.17beats/min, in HRRest, 194.74±6.97beats/min in HRmax, 46.47±6.01ml/kg/min in VO_2max. The grip strength showed to be 48.70±5.64kg, back strength was 124.95±17.14kg, sargent jump test 58.24±6.98cm, jump step test 22.17±2.76ti, sit up 45.17±8.17ti, one leg balance with eyes close 45.89±18.87sec, trunk flexion 16.81±2.16cm. 3. body composition Golf playes % bodyfat showed to be 11.97±2.50%, body fatkg was 9.68±2.24kg, LBM, 67.45±3.94kg, TBW, 45.47±2.79ℓ.

대용량 이미지 스테가노그라피에 대한 연구

이신주,정성환,배재민 한국산업정보응용수학회 2001 한국산업정보응용수학회 Vol.5 No.2

Steganography, a form of data hiding, embeds secret data into digital media for the purpose of identification, annotation, and copyright. We propose a high capacity image steganography based on E. Kawaguch's method. It embeds secret data to some LSBs and selectively embed MSBs with the complexity measure. In the experiment, it presents that our scheme improves the maximum capacity by 11,008 byte, compared with E. Kawaguch's. It also shows that about 4dB improvement in PSNR when the same amount of data is inserted.

멀티미디어에 적용된 워터마크 기술들의 개관

이신주,정성환 한국산업정보응용수학회 2001 한국산업정보응용수학회 Vol.5 No.1

In the early days, encryption and control access techniques were used to protect the ownership of media. Recently, the watermark techniques are utilized to keep the copyright of media. Digital watermarking, a concept of embedding a special pattern. uses an algorithm of inserting a watermark to protect the copyright of media. It has recently become important in various application areas. The various watermark techniques have been proposed by many authors in the last several years. However, there are not enough analysis and comparison on the previous researches. In this paper, for the understanding of the previous works and for the future related research, we try to classify and analyze the conventional watermark techniques from the various points of view. Currently watermark techniques based on the transfer domain, are more popular than those of the spatial domain. DCT-based methods have been most widely used among the transform based methods. However, recently wavelet-based watermark techniques are becoming main research topic. With wide use of internet, effective audio and video watermarking researches are also required.

光質이 채소作物의 種子發芽와 初期生育 및 除草劑의 活性에 미치는 效果

李政明,金侊來,權臣漢,曺哉銑,朴啓仁,金尙根,李承雨 慶熙大學校 1987 論文集 Vol.16 No.-

Studies were conducted to investigate the response of some horticultural plants to various light qualities provided by different kind of materials such as cellophane sheets, EVA, PVC(polyvinyl chloride, and polyethylene (PE) films of different color. Major findings are summarized as follows. White fluorescence light and red light promoted seed germination of lettuce and inhibited that of radish seeds. Blue light inhibited the seed germination of both types of light-sensitive seeds. The light sensitivity varied considerably depending upon the kind of crops, cultivars, and the seed batches of the same cultivar. The blue light was equally or more strongly effective in inhibiting the seed germination as compared to the farred light. The growth of young seedlings developed from seeds was considerably promoted when grown under orange colored plastic film coverings. The growth of larger seedlings was, however, not influenced by the color of plastic films. Mulching pepper field with colored PVC film did not show further advantages over the commonly-used black PE film. Herbicidal activity of oxyfluorfen was very strong under natural light or red light conditions' and weak under blue or green light conditions. The degree of oxyfluorfen-induced phytotoxicity varied considerably depending upon the light quality and the kind of vegetable crops.

Gd₂O₃doped CeO₂의 미분말 합성 및 소결특성

이주신,김원중,박성용 경성대학교 공학기술연구소 1999 공학기술연구지 Vol.6 No.-

10mol% Gd₂O₃doped CeO₂ doped fine powders were synthesized by the oxalate coprecipitation method and then their powder characteristics and sintering behavior were studied. The characterization of powders has been investigated using thermogravimetry and differential thermal analysis for thermal analysis, X-ray diffraction for phase identification. Brunauer-Emmett-Teller, X-ray diffraction-line broadening and transmission electron microscopy for particle size and morphology determination. The sintering behavior were investigated by means of the sintering density measurements and scanning electron microscopy techniques. The characteristics of powders prepared by the oxalate coprecipitation method and their sintering behavior are discussed.

울산지역 췌담관질환 환자의 간흡충 감염 실태 : 담즙검사를 기준으로 based on bile examination

이기영,주광로,김현수,신수진,이효섭,윤태권,추연익,박종호,신정우,방성조,김도하,박능화 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 간흡충증의 진단은 분변 또는 담즙에서 간흡충의 성충 또는 충란을 발견하는 것이다. 담즙을 통한 간흡충 진단은 간흡충이 존재하는 담관에서 검체를 직접 채취한다는 장점과 이 검체가 분변이나 체액에 의해 희석되지 않으며, 특히 담관 폐색이 있을 경우 담즙배설 장애로 인한 분변검사의 위음성을 줄일 수 있는 가장 정확한 간흡충의 기생충학적 검사로 생각된다. 이에 저자들은 울산지역 췌담관 질환 환자에서 담즙검사를 기준으로 한 간흡충의 감염 실태를 알아보고자 하였다. 방법 : 내시경적 또는 경피경간 담관배액술을 통해 담즙을 채취하여 간흡충 충란 유무를 확인한 309명의 췌담과 질환 환자에서 간흡충 감염 실태를 조사하였다. 결과 : 대상 환자 전체의 충란 양성률은 27.5%였고, 남녀의 충란 양성률은 각각 35.%와 17.6%로 남자에서 더 높았다. 연령별 충란 양성률은 30대 20.0%, 40대 26.7%, 50대 24.2%, 60대 29.9%, 70대 36.2% 그리고 80대 이상이 16.7%로 연량에 따른 통계적 차이는 없었다. 질병별 충란 양성률은 담관암 32.65, 담낭암 38.5%, 파터팽대부암 11.1%, 췌장암 24.0%, 담석질환 26.4%,간흡충담관염 61.5% 그리고 이외 질환이 12.5%로 간흡충 담관염ㅇ르 제외한 질병간 의미있는 차이는 없었으며 결석의 위치, 간흡충 연관질환인지 아닌지가 충란 양성률에 영향을 미치지 못했다. 담관 조영술을 포함한 방사선 검사에서 정상 담관을 보인 환자에서 충란 양성률은 17.0%였다. 결론 : 본 연구 결과 울산지역 췌담관 질환 환자에서 간흡충 감염률은 연령, 성별, 질병의 종류에 관계없이 전반적으로 매우 높았다. 따라서 이러한 자료를 근거로 생각해 볼 때 우리 나라가 아직도 심각한 간흡충 감염의 유행지임을 추론할 수 있겠다. Background : Bile examination is believed to be the most precise method for detecting Clonorchis sinesis (CS) eggs. We carried out bile examination to evaluate infestation state of CS in patients with pancreatobiliary diseases in Ulsan, known as an endemic area of CS infestation. Methods : We examined CS eggs in bile in three hundreds and nine patients with pancreatobiliary diseases. The bile was obtained from endoscopic nasobiliary or percutaneous transhepatic biliary drainage tubes. Results : The overall egg positive rate was 27.5% (35.3% in male,17.6% in female). The egg positive rate was not significantly different according to the age group: 20.0% in thirties, 26.7% in forties, 24.2% in fifties, 29.9% in sixties, 36.2% in seventies and 16.7% in eighties or more. The egg positive rate according to the disease, except CS cholangitis, was not also statistically different: 32.6% in bile duct cancer, 38.5% in gallbladder cancer, 11.1% in ampulla of Vater cancer, 24.0% in pancreatic cancer, 26.4% in gallstone diseases and 12.5% in the reminder. The location of gallstone and whether CS related diseases or CS unrelated diseases did not affect the egg positive rates. The egg positive rate in patients with normal radiological findings including cholangiography was 17.0%. Conclusion : This result shows that regardless of age, sex and sorts of diseases, the infestation rate of CS was very high. On the basis of our results, it if therefore presumes that clonorchiasis is still endemic disease in Korea.