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.

Metagenomic Analysis of Fungal Communities Inhabiting the Fairy Ring Zone of Tricholoma matsutake

( Miae Kim1 ),( Hyeok Jun Yoon ),( Young Hyun You ),( Ye Eun Kim ),( Ju Ri Woo ),( Yeong Gyo Seo ),( Gyeong Min Lee ),( Young Ja Kim ),( Won Sik Kong ),( Jong Guk Kim ) 한국미생물 · 생명공학회 2013 Journal of microbiology and biotechnology Vol.23 No.10

Tricholoma matsutake, an ectomycorrhiza that has mutual relationships with the rootlet of Pinus denisflora, forms a fruiting body that serves as a valuable food in Asia. However, the artificial culture of this fungus has not been successful. Soil fungi, including T. matsutake, coexist with many other microorganisms and plants; therefore, complex microbial communities have an influence on the fruiting body formation of T. matsutake. Here, we report on the structures of fungal communities associated with the fairy ring of T. matsutake through the pyrosequencing method. Soil samples were collected inside the fairy ring zone, in the fairy ring zone, and outside the fairy ring zone. A total of 37,125 sequencing reads were obtained and 728 to 1,962 operational taxonomic units (OTUs) were observed in the sampling zones. The fairy ring zone had the lowest OTUs and the lowest fungal diversity of all sampling zones. The number of OTUs and fungal taxa inside and outside the fairy ring zone was, respectively, about 2 times and 1.5 times higher than the fairy ring. Taxonomic analysis showed that each sampling zone has different fungal communities. In particular, out of 209 genera total, 6 genera in the fairy ring zone, such as Hemimycena, were uniquely present and 31 genera, such as Mycena, Boletopsis, and Repetophragma, were specifically absent. The results of metagenomic analysis based on the pyrosequencing indicate a decrease of fungal communities in the fairy ring zone and changes of fungal communities depending on the fairy ring growth of T. matsutake.

고등어(Scomber japonicus ) 치어의 마취제로서 Clove oil, MS-222 및 2-Phenoxyethanol의 평가

한석중 ( Seock Jung Han ),김경민 ( Kyong Min Kim ),최낙중 ( Nack Jung Choi ),구준호 ( Jun Ho Koo ),박충국 ( Chung Kug Park ),이원교 ( Won Gyo Lee ),지승철 ( Seung Chul Ji ) 한국수산과학회(구 한국수산학회) 2011 한국수산과학회지 Vol.44 No.6

The efficiency of clove oil, MS-222, and 2-phenoxyethanol was evaluated as anesthetics in juvenile Scomber japonicus . Stage A5 of anesthesia was assumed to be sufficient for conducting routine aquaculture procedures in less than 3 min, with recovery (stage R5) in less than 5 min. The lowest effective doses of the three anesthetics were 50 mg L-1 clove oil (anesthetic time of 71.3 s and recovery time of 167.0 s), 100 mg L-1 MS-222 (anesthetic time of 70.7 s and recovery time of 115.7 s), and 400 mg L-1 2-phenoxyethanol (anesthetic time of 86.7 s and recovery time of 95.0 s). Anesthetic times decreased with increasing doses for all three anesthetic agents, and fish anesthetized with clove oil exhibited the longest recovery times. After 30 min, the highest plasma cortisol and lactate levels were detected with the use of clove oil, whereas the lowest values were observed with 2-phenoxyethanol. In addition, high glucose levels were maintained during recovery with clove oil, but the treatments did not significantly differ. The most effective of the three anesthetic agents was 2-phenoxyethanol, although all were considered acceptable for use in cultures of juvenile Scomber japonicus

競爭優位에 影響을 미치는 核心力量 要因에 관한 硏究

추교완,김수진,박민수 昌原大學校 産業經濟硏究所 2002 産經硏究 Vol.19 No.-

정상 관동맥을 가진 심장 점액종 환자에서 발생한 급성 심근 경색증 1예

이정민,이현승,전은정,윤호중,정욱성,오용석,김철민,김재형,최규보,홍순조,이교영,심상인 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9

개인식별을 위한 컴퓨터 영상 중첩시스템 연구

송현교,김하진,강민구 호남대학교 정보통신연구소 1996 정보통신연구 Vol.5 No.-

임포즈란 신원 미상의 두개골을 발견했을 때, 두개골의 사진과 동일인으로 판정되는 사람의 생전 사진을 서로 같은 비율로 축소한 후 두 사진을 겹침으로써 두 인물간의 동일인 여부를 비교, 검토하는 과정을 말한다. 이에 본 논문에서는 국립과학수사연구소에서 제 검사 및 DNA 유전자 검사를 통해 이미 동일인임이 확인된 7명의 두개골 사진, 생전사진을 이용하여 컴퓨터 프로그램을 이용한 응용프로그램을 개발하였다. 신원 미상의 두개골을 비디오 카메라, 컴퓨터를 이용, 영상처리후 임포즈하고 해부학적 특징으 기준으로 동일인여부를 비교, 검토하는 과정에서 다음과 같은 결과를 얻었다. 1. 두개골 및 생전사진을 처리하는 방법으로 다양한 영상처리 기법(Smooth, Sharpen, Emboss, Mosaic, Engrave, Invert, Neon, Color to Mono)을 개발하였고, 이들 중 Neon, Invert, Engrave기법에서 최적의 영상을 얻을수 있었다. 2. 다양한 방식(SrcOr. SrcAnd. SrcInvert. SrcErase,DstInvert. MergePaint) 으로 두 영상을 합성하여 임포즈 감정시 필요한 최적의 비교상태를 얻을수 있었다. 3. 비디오 카메라를 이용하여 두개골상을 직접 컴퓨터에 입력할 수 있었으며, 이를 생전사진과 임포즈함으로써 보다 정확하고 신속한 감정을 가능 하게 했다. 이상에서 볼 때 기존의 수작업으로 이루어졌던 임포즈가 이제는 컴퓨터 프로그램에 의해 이루어지므로서 보다 신속하고 정확한 임포즈 작업을 가능하게 할 것이라 사료된다. A Study on the Computer Impose System for Individual Recognization *Dept. of inform. and Comm Eng.. Honam University ** The Dental School of Yonsei University In this thesis. a new superimposition scheme using a computer vision system was proposed with 7 pairs of skull and ante-mortem photographs. which were already identified through other tests and DNA fingerprints at the Korea National Institute of scientific Investigation, At this computer vision system. an unidentified skull was caughty by video-camcoder with the MPEG and a ante-mortem photograhp was scanned by scanner. These two images were processed and superimposed using pixel processing. Recognition of the individual identification by anatomical references was performed on the two superimposed images. This image processing techniques for the superimposition of skull and ante-mortem photographs simplify used the previous approach taking skull photographs and developing it to the same size as the ante-mortem photographs. This system using various image processing techniques on computer screen. a more precise and time-saving superimposition technique could be able to be applied in the area of computer individual indentification.

케이슨 튜브 가물막이의 시공안정성 검토

정성교,김성렬,N. T. Dung,김민석 東亞大學校 建設技術硏究所 2005 硏究論文集 Vol.29 No.1

디지탈 통신 학습 시뮬레이터

송현교,김연구,이택희,강민구 호남대학교 정보통신연구소 1995 정보통신연구 Vol.4 No.-

본 논문에서는 실제 통신망에서 발생할 수 있는 데이타 전송과정을 컴퓨터상에 시뮬레이션하는 프로그램으로서, PC의 WINSOW 환경하에서 Visual-Basic을 활용하여 통신신호의 흐름과정을 하나의 화면에서 구현하도록 부호화와 변조파형을 표현하고 이 신호의 복조와 복호과정을 시뮬에이션한다. 아울러 통신채널에서 발생하는 랜덤오류를 제어하는 오류정정을 포함함으로서 통신이론을 이해하고 학습하는데 많은 도움이 될 수 있도록 통신신호에 대한 그래픽 처리에 목적을 둔다. In this thesis, the graphic signal for communication is presented in the WINDOW using `Visual-Basic'. All signals of PCM encoding/decoding and modulation/demodulation are processed in the same picture. Especially, error control schemes which are parity check, longiudinal redundancy check, cyclic redundancy check, are described for more reliable communication.

금속 적층제조 방식을 이용한 SUS316L 시편의 공정 파라미터 및 금속 분말 재사용에 따른 변형량 변화 분석

김민수(Min Soo Kim),김지윤(Ji-Yoon Kim),박은교(Eun Gyo Park),김태민(Tae Min Kim),조진연(Jin Yoen Cho),김정호(Jeong Ho Kim) 한국항공우주학회 2022 韓國航空宇宙學會誌 Vol.50 No.4

금속 적층제조 공정 중 발생할 수 있는 잔류응력은 3D 프린팅을 통한 정밀한 금속 부품 제작을 위해 적절히 통제되어야 하는 중요한 요소이다. 따라서 본 연구에서는 이러한 잔류응력에 영향을 끼치는 요인에 대하여 실험적인 방법을 이용하여 고찰하였다. 실험을 위해 적층제조 공정을 통해 시편을 제작하고 이를 절단하여 변형량 측정을 수행하였으며, 측정된 데이터를 curve fitting 등의 방법을 이용하여 적절히 보정함으로써 공정 파라미터 및 금속 분말 재사용 여부가 금속 적층제조공정에서 발생한 잔류응력으로 인한 변형에 끼치는 영향을 정량적으로 분석할 수 있는 자료를 확보하였다. 이 결과로부터 금속 적층제조 공정에서 잔류응력으로 인한 변형의 크기에 가장 큰 영향을 끼치는 요소는 금속 분말 재사용 여부임을 확인하였다. 또한 레이저의 패턴, 적층 회전 각도와 같은 공정 파라미터도 변형 크기에 영향을 줄 수 있는 것을 확인하였다. Residual stress that can occur during the metal additive manufacturing process is an important factor that must be properly controlled for the precise production of metal parts through 3D printing. Therefore, in this study, the factors affecting these residual stresses were investigated using an experimental method. For the experiment, a specimen was manufactured through an additive manufacturing process, and the amount of deformation was measured by cutting it. By appropriately calibrating the measured data using methods such as curve fitting, it was possible to quantitatively analyze the effect of process parameters and metal powder reuse on deformation due to residual stress. From this result, it was confirmed that the factor that has the greatest influence on the magnitude of deformation due to residual stress in the metal additive manufacturing process is whether the metal powder is reused. In addition, it was confirmed that process parameters such as laser pattern and laser scan angle can also affect the deformation.

Neisseria baciliformis Bacteremia Associated with Lung Abscess: First report in Korea

( Min Gyo Kim ),( Young Sun Suh ),( Yun Hong Cheon ),( In Gyu Bae ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1

Neisseria species는 그람음성 구균으로, Neiseeria gonorrhoeae 및 N. meningitides 이외의 다른 Niesseria sp.는 정상 상재균으로병원성이 극히 낮다고 인식되어 왔다. 그러나 최근 N. baciliformis, N. elongate, N. sicca등에 의한 인체 감염이 발생하면서 기회 감염균으로 관이 증가되고 있다. 이에 저자들은 비소세포암으로 치료 받던 환자에게서 폐농양에 동반된 N. baciliformis 균혈증 증례를 보고한다. 비소세포암로 방사선치료를 받고 있던 72세 남자가 하루 전부터 시작된 발열을 주소로 내원하였다. 내원 당시 신체학적 검사에서 우측 폐하부로 폐음이 하되었고, 흉부 CT에서 우측 폐 하부에 폐농양이 관찰되었다. 환자는 경험적 항생제로 cefepime을 사용하면서 경과관찰을 하였으나, 입원 일째에도 발열이 지속되어 piperacillin/tazobactam 및 vancomycin으로 항생제를 변경하여 치료를 하였다. 입원 4일째 혈액배양검사에서Neisseria anmaloris/zoodegmatis 및 Enterococcus faecium이 동정이되었다. Neisseria anmaloris/zoodegmatis 에 대해 16S ribosomal DNA 염분석을 한결과 N. bacilliformis 이 동정이 되었으며, cefotaxime, ciprofloxacin, cefoxitin, Penicillin-G, tetracycline 모두에 감수성이 었다. 이에 환자는 vancomycin 및 ampicillin/sulbactam으로 항생제를 변경하여 치료 후 호전되어 외부병원으로 전원하여 치료를 종결하였다.