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(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

소아청소년기에 치수치료를 받은 제1대구치의 술전 상태 조사

이순영,이경호,노홍석,정태성,김신 大韓小兒齒科學會 2011 大韓小兒齒科學會誌 Vol.38 No.4

제1대구치는 막중한 역할을 함에도 불구하고, 청소년 이전에 건강을 상실하는 경우가 드물지 않다. 본 연구는 청소년기 이 전에 치수치료를 받게 된 제1대구치의 우식 및 수복 상태와 분포를 파악할 목적으로 시도되었다. 최근 5년간 부산대학교 치 과병원에서 치수치료를 받은 18세 이하 106명 환자의 135개 제1대구치를 대상으로 의무기록에 대한 조사를 시행하여 다음 과 같은 결과를 얻었다. 1. 평균 연령은 11.9세(남 11.5세, 여 12.5세)였고 유의한 성차를 보였으며(p<0.05), 악별로는 상악 47개, 하악 88개로 하악 치아가 더 많았다. 2. 치수 치료 전 치료 기왕력이 없는 치아는 74개, 치수 또는 수복 치료를 받은 치아는 61개였다. 그 중 재치수치료를 받게 된 경우는 22개로 치수절제술-치수절단술의 순이었으며, 단순 수복치료를 받았던 치아는 39개로 복합레진-아말감-GI- 인레이-수복물 탈락 후 미치료-열구전색 및 주조 전장관의 순이었다. 3. 병소 위치가 분류 가능한 73개의 병소 중에서는 근심면 병소가 22개, 교합면 혹은 협설면 병소 39개, 원심면 병소가 12 개를 차지하였다. In clinical dentistry, it is not difficult to meet the permanent first molars with severe coronal caries lesions in children or adolescents. The circumstances surrounding the first molars of children and adolescents are so immature and imperfect compared with those of adults. So we thought it significant to understand the status of these teeth at the moment of endodontic treatment and immediate cause of it. 106 patients with 135 permanent molars necessitating endodontic treatment in childhood and adolescence were included in this study, and the dental records and radiographs were examined. 1. The mean age was 11.9 year (male 11.5, female 12.5) and the result shows significant difference between gender(p<0.05). The mandibular teeth took more than half percentage than maxillary teeth. 2. Of 135 teeth, 45.2 percent of teeth had history of dental treatment previously and 16.3 percent of teeth showed necessity of re-endodontic treatment. 3. Of 73 teeth, 22 teeth had mesial-wall cavity causing endodontic treatment, 39 had occlusal cavity, and 12 had distal cavity.

흰쥐에서 출혈량에 따른 비장세포 증식력과 말초임파구 아형의 변화

이한식,정성필,김욱진,조영순,장석준 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Hemorrhage itself has been shown to produce abnormalities in immunity, particularly depression of the lymphocyte function. In order to better examine the amount of hemorrhage required to suppress the lymphocyte function, we determined the effect of graded fixed-volume hemorrhage on splenocyte proliferation and the lymphocyte subpopulation. Methods: Male Sprague-Dawley rats(weight,350∼400 g) were anesthetized, subjected to hemorrhages of 7.5 ㎖/㎏, 15 ㎖/㎏, and 22.5 ㎖/㎏ by percutaneous cardiac puncture with ㎖/㎏ needles, After 1, 2, 4, and 7 days, animals were killed to obtain the blood and spleen. The splenocyte proliferative capacity was measured by using the tritiated thymidine incorporation technique, and the peripheral lymphocyte subpopulation was determined using flow cytometry with the following monoclonal antibodies: T cell(CD3+), T helper cell(CD4+),7 cytotoxic cell(CD8+), and B cell(CD45RA+). Results: Hemorrhage of 7.5 ㎖/㎏ did not induce depression of splenocyte proliferation. However, for hemorrhage greater than 15 ㎖/㎏, the splenocyte proliferative capacity was significantly depressed at 2 days after hemorrhage and recovered at 4 days. Hemorrhage induced no changes in the relative percentage of lymphocyte subpopulations and in the number of each cell in peripheral blood. Conclusion: This study suggests that cellular immunity is depressed at 48 hrs after a hemorrhage greater than 15 ㎖/㎏ without any change in the peripheral lymphocyte subpopulation.

선물시장에서의 투자자 형태에 관한 이론적 연구

이상호,권순삼 경일대학교 산업정보연구소 2000 産經硏究 Vol.6 No.2

한국의 선물시장은 1996년 주가지수선물을 도입으로 지금은 CD선물, 금선물, 외환선물 등 선물의 종류도 점차 많아지고 있다. 미국의 경우 선물시장은 주식시장보다 더 활성화되어 있고, 그 밖의 선진국에서도 선물시장이 도입되어 활발히 운영되고 있는 현실을 보면 향후 한국의 선물시장도 점차 활성화되리라 본다. 이러한 시점에서 선물시장에 참여하는 투자자의 행태를 분석해 보는 것은 의미 있는 일이라 하겠다. 본 연구에서는 주식시장에서 투자자의 행태분석에 유용한 틀을 제공하고 있는 네 가지의 가설을 살펴보고, 한국의 주가지수선물시장에서는 어떤 유형의 투자자가 주가지수 선물가격에 영향을 미칠 수 있는지를 살펴보았다.

法人稅期間配分會計의 導入에 관한 硏究

李相周,洪淳福 新羅大學校 1992 論文集 Vol.34 No.1

The aim of the study is to examine the theoretical background and method of the interperiod tax alloction, and to apply the allocation method to Korea's coporations in business. The interperiod allocation is to distribute the differences between income tax and income expense for the accounting year related, so the objective of the allocation is to provide the useful information to the users of financial statements. As Korea has not the accounting method of interperiod tax allocation as the current accountion standart yet, the methods developed in the study for the application are suggested as follows. First, the allocation method should be applied after revision the tax law of Korea, and be applied first to the listed enterprises which are large in scale and require more information, and be extented to the outside enterprises. Second, the method of the allocation are deferred method, liability method and net of tax method, and among them, adopting the liability method is reasonable as it is considerable and applicable to practical use. Third, for the applicable range for accounting of the allocationg there are two different concepts, partical allocation and comprehensive allocation, and of the two methods comprehensive allocation will be suitable. Fourth, the items of balance sheet should be showed by the year and the effect and extinction of income taxes should be indicated as footnotes in the financial statement.

Trapezoidal Rule을 이용한 점탄성 구조물의 경계요소 해석

이상순 한국기술교육대학교 1999 論文集 Vol.6 No.1

This paper presents an accurate and efficient method for the treatment of time integrals in time-domain boundary integral equations for viscoelastic problems. A trapezoidal rule is proposed as an easy effective integration scheme. The proposed procedure requires a small computational effort and it is applicable even in time-domain boundary element analysis of many different problems. Numerical results of example problems show the accuracy and effectiveness of the proposed method.

지연 보장 다중전송에 관한 연구

이상순 京畿專門大學 1998 京畿專門大學 論文集 Vol.- No.26

A multicast routing algorithm which guarantees transmission delay is required for continuous media such as video, audio, animation. In this study, we propose the efficient multicast routing algorithm which guarantees transmission delay within maximum permissible delay in continuous media transmission. The proposed algorithm is composed of two phase. In the First phase, the algorithm finds a candidate path that guarantees delay with applying heuristic function to node in network. And, in the second phase, it connects source node to all destination nodes with near optimal cost, The performance of algorithm is measured with a view point of inefficiency, rate of guranteeing delay and time complexity. As a result of simulation, it is impossible for KMB algorithm to guarantee transmission delay to all destination in 19% range, but the proposed algorithm is possible. In the side of cost that is sacrificed for guaranteeing delay, the Kompella algorithm solution is increased 10% of KMB's, but the proposed algorithm solution is increased only 7%. Futhermore, the time complexity of pro-posed algorithm is O(n^(3)) which is lower than O(Δn^(3)) of Kompella's. In the conclusion, it is shown that the proposed routing algorithm is appropriate is continuous media multicasting service.

이익유연화에 따른 회계이익과 장부가치의 상대적인 주가설명력

이상봉,박한순,김영조 제주대학교 관광산업연구소 2001 産經論集 Vol.15 No.1

NTSC/PAL/SECAM 표준을 만족하는 Variable-clock Video Encoder의 내부 필터 설계

이성목,김주현,강봉순 東亞大學校附設 情報技術硏究所 2005 情報技術硏究所論文誌 Vol.13 No.1

In this paper, we present the design of the filters for variable-clock video encoder in CCTV system The SONY corporation preoccupies 80% of the CCD market in CCTV application. But, SONY corporation's CCD module used in CCTV requires particular clock frequency. Generally, a video encoder is operated 27MHz sampling frequency. That is clock frequency of video encoder different with CCD's clock frequency. If we used a filter of general video encoder, filter's characteristics are changed and don't be satisfied with standard. So, we design the filters that satisfied with TV broadcasting standards without regard to clock frequency. The proposed filters are simulated by using the MATLAB. This paper also proposes the variable-clock encoder that can be activated at the clock equal to the CCD clock without the scaler and the PLL.