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.

Micro SIM Card Socket에 사용된 Push-Push Type 기구의 다물체동역학 해석

최찬규,김주철,윤주영,심정길,유홍희,Choi, Chan Kyu,Kim, Ju Chul,Yun, Ju Young,Sim, Jung Kil,Yoo, Hong Hee 대한기계학회 2013 대한기계학회 논문집. Transactions of the KSME. C, 산업기술과 혁신 Vol.1 No.1

SIM card socket은 USIM 카드를 휴대폰에 고정시키기 위하여 많이 사용되며 사용자의 편의를 위하여 push-push 기구를 많이 사용하고 있다. Push-push 기구는 하트-캠 구조에 의해 작동되며 사용자가 USIM 카드를 한번 눌러주면 삽입이 되면서 locking, USIM 카드를 다시한번 눌러주면 토출이 되면서 unlocking이 되는 기구이다. Push-push 기구는 주 스프링에 의해 구동되는데 주 스프링에 의해 캠 슬라이더와 캠 스틱에 응력이 발생하여 기구가 파손되기도 한다. 따라서 push-push 기구 동작 시 발생하는 응력을 반드시 고려한 기구 설계가 필요하다. 기존의 기구 설계 방식은 정적인 응력해석 결과만 사용한 방식을 사용하였다. 하지만 기구 특성상 동작 시 충격력이 반드시 발생하기 때문에 충격력에 의해 발생하는 동응력을 해석하고 기구 설계에 반영하여야 한다. 본 논문에서는 push-push 기구 동작 시 발생하는 동응력 해석을 위하여 push-push 기구의 유연 다물체 동역학 모델을 개발하고 기구 동작 시 발생하는 동응력을 해석하였다. A SIM card socket is used for a cell phone to fix an USIM card and a push-push mechanism is typically employed in the SIM card socket for a user convenience. A SIM card is inserted with locking when a user pushes the card once and a SIM card is removed with unlocking when a user pushes the card again. A push-push mechanism is operated by a heart-cam structure and a main spring. A cam slider and a cam stick consisting a push-push mechanism may be broken because of the main spring. So, dynamic stress at a cam slider and a cam stick which is generated by a main spring during operating should be analyzed and considered in the push-push mechanism design. In this paper, a flexible multibody model of a push-push mechanism was developed to analyze dynamic stress at a cam slider and a cam stick.

양파 농축액이 고지혈증 성인 남자의 체성분, 혈장 전해질 및 지질 성분에 미치는 영향

황금희 ( Kum Hee Hwang ),정난희 ( Lan Hee Jung ),조남철 ( Nam Chul Cho ),유영균 ( Young Kyun Yoo ),박평심 ( Pyoung Sim Park ),노영희 ( Young Hee Noh ),서희숙 ( Hee Suk Seo ),노인옥 ( In Ok Noh ) 한국식품영양학회 2003 韓國食品營養學會誌 Vol.16 No.1

It is known as that onion is antioxidation effect, antibiotic effect, blood pressure decreasing effect and reducing serum cholesterol levels. This research about effect that onion concentrate gets blood cholesterol levels and body composition. Subject was 17 adult men of hyperlipidemia. Age distribution of investigation subjects were average 49.4 years old by 40 ~ 56 years old, and average height and weight were 167.6 cm and 75.5 kg each, BMI was 26.9 kg/㎡, and BMR was 1,460.6±87.5kcal, and AMC was 25.0±1.05cm, and BCM was 41.0±2.79cm. In the meantime, the body muscle was 53.7±3.7kg, and fat mass was 18.7±3.8kg, and intracellular fluid was 26.6±1.8kg, and extracellular fluid was 12.8±0.9kg. The % body fat was 24.6±3.8% , and fat distribution was 0.9±0.0%, and the obesity degree was 125.4±8.2%. Vegetables, seaweeds, fruits and juices increased by change of dietary life and greasy foods, instants, breads, rices etc. decreased or there was no change, fast foods and eggs were no change. Also, subject previewed that guidance about stress, smoking, drinking and beverage intake need. If compared the nutrient intake amount with before onion concentrate allowance, it was similar level almost without significant. Energy, calcium and riboflavin are lower than the RDA for koreans. After 3 months, the levels of plasma total cholesterol, triglycerides had decreased significantly : 15.0%, 31.2% respectively. And the HDL-cholesterol and LDL-cholesterol levels also showed a marked reduction of 6.8%, 8.7% respectively. Plasma lipid level change by onion concentrate supplement would can know that case of triglyceride more greatly than plasma cholesterol. The pH and Na^+ level of plasma were low significant since 8 weeks after, and K^+ level increase significant. While Ca^++ level was low significant after 1 month , there was no change since 2 months after, but nCa^++ level was low significantly. Plasma Mg^++ level was no change and nMg^++ level was low significant after intake.

당뇨병 환자의 우울증상과 스트레스 대처방식 : 류마티스 관절염 환자 및 건강 대조군과 비교

심민영,연규월,김하경,김영철,홍영선,이지수,이정희,류정화,하창윤,김지민,성유미,김수인,임원정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5

Objectives : This study investigated how diabetes mellitus (DM) and depressive symptoms are related, and differed in terms of coping strategies. In addition, we compared those findings with rheumatoid arthritis (RA) patients. Methods : 80 DM patients, 45 RA patients and 77 healthy subjects completed the Beck depression inventory (BDI) and the Korean version of the ways of coping checklist. Results : BDI scores of depressed DM patients were significantly higher than healthy subjects (p<0.01) but not Significantly with depressed RA patients. Both scores of active (p<0.01) and passive coping (p<0.05) in DM patients were significantly lower than healthy subjects (p<0.01), and the scores of wishful thinking of DM patients were significantly lower than RA patients (p<0.01). BDI scores of DM patients were significantly correlated with the number of complications and the scores of problem-focused coping (p<0.05). In the hierarchical regression analysis, even after controlling for clinical Characteristics, coping strategies altogether could account for 31.0% of the variance of the depressive symptoms in DM patients significantly (p<0.01). Conclusion : DM patients showed significantly higher depression rate than healthy subjects but not than RA patients. In DM patients, insufficient coping strategies could explain substantial portions of depressive symptoms. Therefore, enhancing healthier coping strategies in addition to prevent medical complications might lessen depressive symptoms experienced by DM patients.

Isolation of Antimicrobial Substances from Natural Products and Their Preservative Effect

Hee-Yun Kim,Young-Ja Lee,Ki-Hyoung Hong,Yong-Kwan Kwon,Kyu-Chang Sim,Ju-Yeun Lee,Hong-Yon Cho,In-Sook Kim,Sang-Bae Han,Chul-Won Lee,Il-Shik Shin,Jae Sun Cho 한국식품과학회 2001 Food Science and Biotechnology Vol.10 No.1

Removal and Decomposition of Impurities in Wastewater From the HyBRID Decontamination Process of the Primary System in a Nuclear Power Plant

Hee-Chul Eun,Jun-Young Jung,Sang-Yoon Park,Jeong-Sun Park,Na-On Chang,Hui-Jun Won,Ji-Hyoung Sim,Seon-Byeong Kim,Bum-Kyoung Seo 한국방사성폐기물학회 2019 방사성폐기물학회지 Vol.17 No.4

원전 일차계통 HyBRID 제염공정에서 발생되는 제염폐액에는 황산이온과 방사성 핵종을 포함한 금속이온 및 발암성 물질의 하이드라진을 포함하고 있어 이를 안전한 수준으로 처리할 수 있는 기술개발이 필요하다. 본 연구에서는 모의 제염폐액 내 황산 및 금속이온의 제거와 하이드라진의 분해시험을 실시하여 황산이온, 금속이온 및 하이드라진을 효과적으로 제거할 수 있는 HyBRID 제염폐액 처리공정을 도출하였으며, 1 L 규모에서의 반복실험과 Pilot 규모(300 L/batch)에서의 평가시험을 통해 도출한 HyBRID 제염폐액 처리공정의 성능 재현성과 적용성을 검증하였다. Decontamination wastewater generated from the HyBRID decontamination process of the primary system in a nuclear power plant contains impurities such as sulfate ions, metal ions containing radioactive nuclides, and hydrazine (carcinogenic agent). For this reason, it is necessary to develop a technology to remove these impurities from the wastewater to a safe level. In this study, it has been conducted to remove the impurities using a decontamination wastewater surrogate, and a treatment process of the HyBRID decontamination wastewater has been established. The performance and applicability of the treatment process have been verified through 1 L scale of replicates and a pilot scale (300 L/batch) test.

A Study on the Operating Characteristics of SMES for the Dispersed Power Generation System

Hee-Yeol Jung,A-Rong Kim,Jae-Ho Kim,Minwon Park,In-Keun Yu,Seok-Ho Kim,Kideok Sim,Hae-Jong Kim,Ki-Chul Seong,Asao, T.,Tamura, J. IEEE 2009 IEEE transactions on applied superconductivity Vol.19 No.3

<P>WPGS (Wind Power Generation System) output fluctuates due to wind speed variations and PV power generation output is changed by sudden cloudy weather conditions. Hence, if a large number of wind and PV power generators are connected to power system, their output can cause a serious influence on the power system operation, that is, frequency and voltage fluctuations. In order to solve these problems, the control of generator output fluctuations is very important. With these points as background, Superconducting Magnetic Energy Storage (SMES) is probably a key technology to overcome these fluctuations. For stabilization of power, the SMES is connected to the terminal of the WPGS. The authors compared the load side frequencies under the 1 MJ and 2.5 MJ of SMES connection, respectively. From the simulation results, it can be concluded that the SMES is a very effective device for stabilization of power system and minimization of frequency fluctuations.</P>

Self-organized wrinkling of liquid crystalline polymer with plasma treatment

Sim, Jaehyun,Oh, Sihwa,Kim, Se-Um,Heo, Kyuyoung,Park, Seung-Chul,Na, Jun-Hee Cambridge University Press (Materials Research Soc 2018 Journal of materials research Vol.33 No.23

<▼1><B>Abstract</B><P/></▼1><▼2><P>Highly ordered wrinkling morphologies of liquid crystalline polymer films are demonstrated based on simple multi-rubbing. The spontaneous pattern formation of periodic wrinkling morphology is achieved through utilizing plasma treatment on a predefined alignment layer. The multi-directional ordering on the alignment layer obtained through selectively covering the alignment layer with a protective layer, which is chemically inert and keeps alignment properties during another rubbing process. The ordering of the wrinkle pattern can be tailored through a molecular orientation of liquid crystal (LC) and a process condition, including film thickness, plasma treatment, and rubbing. The proposed methods enable the spontaneous pattern formation of well-aligned one- or two-dimensionally periodic microstructures over a large area, without an additional template or patterning steps. Since the LC polymer incorporated the optical anisotropic mesogenic groups into polymer chains, it has an optical birefringence in the film and it can be utilized for optical devices requiring a microstructure on a surface.</P></▼2>

Backbone NMR assignments of a putative secretory protein from Helicobacter pylori, using a high-field (900 MHz) NMR

Sim, Dae-Won,Ahn, Hee-Chul,Won, Hyung-Sik Korean Magnetic Resonance Society 2009 Journal of the Korean Magnetic Resonance Society Vol.13 No.2

The HP0902, a homodimeric 22.1 kDa protein, has been suggested as a putative secretory protein from Helicobacter pylori, although the protein possesses no signal peptide for secretion. Since it may be associated with the virulence of the bacterium, NMR study has been initiated in terms of structural genomics. In our previous effort to assign the backbone NMR resonances, using 800MHz NMR machine at pH 7.8, the resonances from eight of the 99 residues could not be assined due to missing of the signals. In this work, to enhance the extent of assignments, a 900 MHz machine was employed and the sample pH was reduced down to 6.5. Finally, almost all signals, except for those from G9 and S24, could be clearly assigned. The determined secondary structure using the assined chemical shifts indicated that the HP0902 consists of 11 ${\beta}$-strands with no helices. In our database search result, HP0902 was predicted to interact with VacA (Vacuolating cytotoxin A), which is a representative virulence factor secreted from Helicobacter pylori. Thus, molecular interaction between HP0902 and VacA would be worthy of investigation, on the basis of the present results of NMR assignments.

75 . Occupational asthma and IgE sensitization to cellulase in a textile industry worker

( Hee Yeon Kim,Dong Ho Nahm,Hae Sim Park,Dong Chul Choi ) 대한천식알레르기학회 1998 춘계학술대회 초록집 Vol.1998 No.-