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.

티타늄 레이저 용접부의 기계적 성질 평가

이중재,김길수,안승근,배태성,박찬운 大韓齒科器材學會 2003 대한치과재료학회지 Vol.30 No.2

This study was performed to examine the effects of laser output energy on the mechanical properties of laser-welded titanium joints. Titanium rods of 3 ㎜ in diameter were perpendicularly cut to 30 ㎜ in length for the laser welding. Two rods were fixed to each other with a jig and welded vertically using a Nd:YAG laser at output current of 210-270 A. The penetration depth of the laser beam against the titanium was measured with the changes of output current, pulse duration, and spot diameter. Mechanical tests included tensile testing and Vickers microhardness of the joints. Tensile testing was performed at the crosshead 00speed of 1.0 ㎜/min and a gauge length of 30 ㎜ with a universal testing machine. Vickers microhardness was mesured under 9.8 N load for 15 seconds. The results obtained were summarized as follows; With increasing the output current, the penetration depth of the laser to titanium was increased. Tensile strength values of laser-welded groups were the relatively higher than that of non-welded parent material group. There were significant differences in tensile strength between the specimens of laser-welded at output currents 250 A, 270 A and non-welded parent material group(p<0.05). Microhardness values were increased in the heat-affected zone. Brittle fracture regions were observed in the specimens of laser-welded at output currents 270 A.

Furfural 어류급독성 및 조직병리에 관한 연구

이철우,최성수,최필선,이상협,이길철,박광식 한국환경독성학회 1997 환경독성보건학회지 Vol.12 No.2

Furfural, an organic solvent, is widely used as synthetic component material in producing chemical products. However, furfural has been reported that it shows strong toxicities to human being showing intense stimulus to skin, eyes, mucous membrane and nerve system. It is also known to cause anemia, liver cirrhosis, kidney failure and genetic toxicity in the human being working in the exposed area. LD50 of furfural for peritoneal injected mouse has been known around 20mg/kg, but the acute toxicity on aquatic organisms such as fish, daphnid or algae are not well known, compared to those on rodents. In this experiment, we studied on the fish toxicity of furfural using Japanese Meclaka (Oryzias latipes) and Common Carp (Cyprinus carpio). We also observed histological changes in the fish organs. The LC50s were 12.8 mg/L in Japanese Medaka and 21.8 mg/L in Common Carp, respectively. When Common Carps were exposed to 120 mg/L of furfural concentration for 30 minutes, blood congestion in gills and lysis of secondary lamella were shown. Though the muscle of caudal fin was not completely eroded, its epidermic cells were shown to be necrotic in various parts. Tissue atrophy and cell necrosis were also shown in the liver of Common Carps exposed to furfural. From these results, furfural seems to cause histological damages on liver, an internal organ as well as on external organs such as gills and fins eventhough the fish were exposed for a short-term.

강원도 가칠봉의 식물자원

이재훈,장수길,유기억 강원대학교 환경연구소 2004 Journal of the Environment Vol.1 No.-

Plant resources of the Gachilbong were investigated from May, 2004 to October, 2004. Vascular plants of Gachilbong were composed of 86 families, 294 genera, 457 species 1 subspecies, 70 varieties and 10 formae, totaling 538 taxa. Twenty six species among the 538 species were Korean endemic, and the specific plants based on the distribution pattern appointed by Ministry of Environment were 96 taxa, and estimated 422 points. The naturalized plants were composed of 8 taxa. Life form spectra was H-D₄-R_(5)-e type, and the use of plant resources were composed edible 41.9%, pasture 35.7%, medicinal 32.9%, ornamental 10%, respectively.

단상유도전동기의 부하적응형 위상제어시스템 설계

이성길,김승국,박수강 광주보건대학 2003 論文集 Vol.28 No.-

The three-phase induction motor is rugged, reliable, long-lived, self-starting, smooth-running. But it is relatively inexpensive and three-phase power in not available everywhere, so if possible we need single-phase motor with the same characteristics. In fact, single-phase induction motors have excellent characteristics and outnumber the three-phase variety. Most of the small electric motors used in home, farm, or office are single-phase induction motors of one type or another. This electric motors application field need most energy saving type drive according to enlargement of electronic goods and to tend high class. The paper is proposed a various phase control methods for energy saving of single- phase induction motor. The controllers that are embodied by each method can use by various usage according to each performance and it is considered that application may help in the electrical energy saving because is possible to other electrical appliances.

LC 공진형 PWM 인버터를 이용한 X선 발생장치의 특성에 관한 연구

이성길,박수강,임홍우,조금배,백형래,임양수 조선대학교 에너지.자원신기술연구소 2002 에너지·자원신기술연구소 논문지 Vol.24 No.1

The conventional types of X-ray generators were bulky in physical size and heavy in weight, and the control accuracies of the output voltages were not always satisfactory. The high frequency switching inverter and converter technology on power conversion and control systems have been greatly closed up introducing power semiconductor devices. In this paper, the newly developed converter to take the balance of the output voltage versus the ground are also presented in detail to decreasing the volume and the weight of high voltage transformer and to stabilize ripple. This converter consists of the two independent L-C series resonant circuits using the two capacitances and the two primary windings of high voltage transformer.

상피종양의 keratin 생성능에 대한 전자현미경적 연구

이길선,이명주,장정수,이민전,노광을,서재홍 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Keratins are characteristically present in all keratinizing and nonkeratinizing epithelial cells and their neoplasms. They consist of at least 19 different polypeptides ranging from 40 to 69 kilodaltons, which are developmentally related to specific epithelial cell types. Keratins of high and intermediate molecular weights are readily demonstrated in squamous cell carcinomas, which are characteristically rich in tonofilaments and tonofilament-desmosome complexes. Keratins of low molecular weights are expressed in adenocarcinoma including renal cell carinoma, hepatocellular carcinoma, small cell carcinoma, and carcinoid tumor. These tumors do not reveal any tonofilaments and sacrcely show discrete filaments on electron microscopy. An immunoperoxidase technique employing antibody to keratin was used to study distribution and staining pattern of keratin filaments in benign and malignant epithelial tumors (20 squamous cell carcinomas, 20 gastric adenocarcinomas, 20 transitional cell carcinomas and 15 non-neoplastic epithelia). These immunohistochemical results were compared with ultrastructural features of neoplastic diagnosis of squamous cell carcinoma, adenocarcinoma and transitional cell carcinoma, and estimation of degree of differentiation. The results are as follows : 1. The squamous epithelium, glandular epithelium and transitional epithelium disclosed the positive reaction for keratin. 2. Squamous cell carcinoma and transitional cell carcinoma exhibited positive reaction for keratin. 3. Gastric adenocarcinoma showed uniformly negative or weakly positive reaction for keratin. 4. On electron microscopy, heavy bundles of tonofilaments and desmosomes were more frequently encountered in well differentiated squamous cell carcinoma, In poorly differentiated squamous cell carcinoma, a few tonofibrils and desmosome were noted. 5. In the adenocarcinomas, the intermediate filaments were arranged randomly as nonaggregated, short filaments spread throughout the cytoplasm, although occasionally they formed a perinuclear whorl. These filaments did not become aggregated to form tonofilaments. 6. On the immunogold labeling for keratin of low molecular weight areas in gastric adenocinoma, in tense labeling of intermediate filaments for keratin was noted. From the above result, ultrastructural and immunohistochemical study on malignant epithelial cell were useful in differential diagnosis of squamous cell carcinoma, adenocarcinoma and transitional cell carcinoma, and estimation of degree of differentiation. It was also proved that immunogold labeling technique was especially valuable for diagnosis of vague case which showed negative or weakly positive reaction in immunohistochemical stain.

히피 헤어스타일과 패션의 의미 및 영향에 관한 연구

李水仁,朴吉順 服飾文化學會 1999 服飾文化硏究 Vol.7 No.4

The study has the aim to now the significance of hippe dress and hairstyle and to understand the influence upon them in 1990'. The results of this study are as follow. First, the results of the significance of hippie dress and hairstyle in 1960' which had analized by the basis of pierce's semiotic theory showed social resistence, piece and anti-war, psychodelic, ethnic and nostalgia, and individualism. Second, studying the character of the end of 1990' when hippie dress and hairstyle reappeared through realted the papers, magazine, and articles, we could get the phenomenon of pastiche, postmodernism which had excepted the spiritual significance of hippie in 1960'.

고주파 공진형 인버터식 X선발생장치의 관전압 불균형 개선

이성길,김영근,박수강 광주보건대학 2000 論文集 Vol.25 No.-

In order to radiate X-ray, the low ripple stabilized high voltage DC over the range of 40kV to 150kV is directly inflicted to X-ray tube. The energy characteristics of the radiated X-ray depend on the pulsating waveforms of the DC voltage supplied X -ray tube. In general, the low ripple voltage waveforms with fast rising times are required to increase with the dosage per unit time lest the exposure time should be longer in order that the motion artifacts of an object may be eliminated in actual. The rotating anode and the cathode of the metal-envelope X-ray tube are incorporated into an envelope made of metal, for instance stainless steel and copper, instead of hard glass. This metal envelope is able to collect the secondary electrons which causes harmful influence to thequality of the diagnostic images. Furthermore, the metal-envelope X-ray tube has mechanically higher strength than glass-envelope type, and so it suits for high power X-ray system. For those benefits, this type of X-ray tube is mainly used to obtain the high quality diagnostic images in X-ray angiography and X-ray computed tomography. The electrons collected at th envelope generate the eletric current flow form the ground to the cathode and occasionally the unmatched impedance of the anode side and the cathode side of the X-ray tube. The unmatched impedance causes the remarkable imblacne of the output voltage of the series resonant inverter-fed converter. In this paper, the newly-developed converter to take the balance of the output voltage versus the ground are also presented in detail. This converter consists of the two independent series resonant circuit using the two capacitance and the two parimary winding high-voltage transformer.

스크립트 MIB을 이용한 분산 망 관리

이길홍,김민수 서울産業大學校 2001 논문집 Vol.52 No.1

현재 급성장하고 있는 인터넷망을 관리하는데 있어, 확장성과 효율성, 유연성을 갖는 네트워크 및 시스템 관리 방안이 필요하게 되었다. 이를 위해서 동적으로 변하는 네트워크 환경에 맞도록 관리 기능을 분산시키고, 관리 기능을 전달하고 실행할 수 있는 새로운 분산관리 구조가 필요하다. 본고에서는 IETF 스크립트 MIB을 이용한 분산 망 관리 구조를 이용하는 관리 방안을 구현해 본다. 실험한 망 관리 구조는 스크립트 MIB을 제어하는 관리시스템을 구현하고, 관리 기능의 하나인 구성 관리 기능과 성능 관리를 수행하는 에이젼트의 기능을 제안하고 구현하였다. 제안한 구조를 이용하여 실제 인터넷망에서 응용하여 실험하였다. To ensure the scalability, efficiency and flexibility of network and systems management platforms of today's growing Internet networks, distributed management systems are strongly required. To solve this problem, it is required that a distributed management architecture that delegates and performs management functions for managing dynamically changed network environments We present the new architecture for managing distributedly using the IETF script MIB. We implemented and applied proposed scripts to the applications of monitoring and configuring management of the Internet.