소프트웨어 개발요원에 대한 전문교육의 필요성

김문재,Kim, Mun-Jae 한국과학기술단체총연합회 1987 과학과 기술 Vol.20 No.8

특집 : 신장과 고혈압

김문재 ( Kim Mun Jae ) 대한신장학회 2002 신장과건강 Vol.2 No.-

연구논단 : 개정 일본상법상 주식회사 경영관리구조의 개혁과 우리나라 상법에의 시준점

김문재 ( Kim Mun Jae ) 한국상사판례학회 2003 상사판례연구 Vol.14 No.-

Today, one of the most important issues in the amendment of the law of corporation is corporate governance, specially, the effective system of monitoring the business of large-scale corporation. Recently, the revised Commercial Code of Japan(2002) adopted the system of new corporate governance, following U.S. legislation. It is the system of the corporation that is set up the audit committee, nominating committee and compensation committee in the board of directors, and as a set with the system of executive officers, only about the great company and the company that be regarded as the great company, The every committee has to get independent directors, and the number of independent directors in every committee should be more than one-second of the total number of director. The directors in the board of directors can not put through business execution but also monitor the business execution of the executive of officers. The end of this reform about the corporate governance is the separation of the executing function of corporate management and monitoring function about execution in the board of directors. This changes of new system following that of the U.S. give many implication about the reform of corporate governance in Korea.

대사성 산증

김문재 ( Kim Mun Jae ) 대한신장학회 2003 추계학술대회 초록집 Vol.22 No.2

재보험자의 대위권에 관한 최근 판례의 동향

김문재 ( Kim Mun Jae ) 한국상사판례학회 2003 상사판례연구 Vol.15 No.-

Reinsurance agreement is a contract whereby one party, known as the reinsurer, undertakes to indemnity the other party for liabilities he may incur under a contract of insurance. therefore, the special legal rules governing insurance contracts similarly apply to reinsurance. In general reinsurer, on payment of a loss, aquires the same rights by subrogation as are acquired in similar cases where the original insurer pay a loss, wether the obligation so complied with by reinsurer is for the whole or for part of the loss incurred by reinsured in favor of the original insured. But a reinsurer, in practice, having indemnified his reinsured, is entitled to benefit from any recovery which the original insured obtains by successful exercise of his rights to subrogation arising from the loss, and under some reinsurance agreements entitling reinsurer to share with reinsured in any salvage recoverd, reinsured has the sole control of a claim for salvage and only reinsured may, in the first instance, recover salvage. Recovery by reinsured in a proceeding to enforce its subrogated rights in general is for the benefit of reinsurer and reinsured, as their interests may appear, and reinsured must account to reinsurer accordingly the relationship between reinsurer and reinsured with respect to salvage fund held by reinsured, in which they are both entitled to share, is not one of debtor and creditor, but is one of trustee and cestui que trust.

증례 3 : Na(+) ; 급성신근경색증으로 입원한 49세 남자에서 Cardiac arrest resuscitation후 발생한 Hypernatremia

김문재 ( Kim Mun Jae ) 대한신장학회 1999 추계학술대회 초록집 Vol.18 No.4

포스터 발표 : 폐 색전증으로 발현된 재발성 막성 사구체 신염 1례

김덕영 ( Kim Deog Yeong ),김경아 ( Kim Gyeong A ),김은아 ( Kim Eun A ),서주현 ( Seo Ju Hyeon ),임희정 ( Im Hui Jeong ),송준호 ( Song Jun Ho ),이승우 ( Lee Seung U ),김문재 ( Kim Mun Jae ) 대한신장학회 2003 춘계학술대회 초록집 Vol.22 No.1

급성신부전 환자의 간헐적 응급 혈액투석에서의 투석량 전달과 이에 미치는 영향 인자

김덕영 ( Kim Deog Yeong ),송준호 ( Song Jun Ho ),임희정 ( Im Hui Jeong ),서주현 ( Seo Ju Hyeon ),박근호 ( Park Geun Ho ),김희구 ( Kim Hui Gu ),이승우 ( Lee Seung U ),김문재 ( Kim Mun Jae ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.1

목 적 : 중증 급성신부전 환자에서 투석량 전달이 예후에 미치는 영향에 대한 연구들이 최근 진행되고 있고 투석량이 많았던 환자들에서 생존율이 높았다는 연구결과가 보고된 바 있다. 저자들은 간헐적 응급 혈액투석 (intermittent hemodialysis)을 시행 받는 급성신부전 환자들에서 실제 전달된 투석량을 파악하고 투석량 전달에 미치는 임상 요인과 투석량과 예후와의 관계를 조사하였다. 방 법 : 1999년 1월부터 6개월간 본원에서 급성신부전으로 투석을 받은 중증 신부전 환자들에서 single pool urea kinetic modeling을 이용하여 Kt/V를 구하였으며 (평균연령 49.3±180세, 남녀비 4:5), 이를 여러 임상 인자들과 비교하였다. 결 과 : 전체 대상 환자는 1회 평균 투석시간 225.6±40.4분의 간헐적 응급 혈액투석을 평균 6.4±4.8회 받았으며, 전체 생존율은 55.5%였다. 전체 환자에서 처방된 투석량 (prescribed Kt/V)는 1.24±0.39이었으나, 실제 전달된 투석량 (delivered Kt/V)은 1.08±0.17로 평균 전달 투석량 대 처방 투석량 비 (delivered/prescribed Kt/V)는 87.1±43%였다. 각 임상인자 중 전달 투석량 대 예상 투석량 비와 유의한 상관 관계를 보인 것은 투석시간 (R=-0.547, p=0.019), Cleveland Clinic Foundation (CCF) severity score (R=-0.486, p=0.041), 투석 중 저혈압 빈도 (R=-0.419, p=0.043)로 나타났다. 전체 환자의 66.7%에서 전달된 투석량이 1.2 이하였으며, 이들의 생존율은 50.0%로 1.2 이상 환자의 66.6%에 비해 낮았으나 통계학적 유의성은 없었다 (p>0.05). 전달된 투석량 1.2 이하인 환자는 통계학적으로 유의하게 짧은 투석시간과 적은 처방 투석량을 보였다 (p<0.05). 전달된 투석량에 유의한 상관 관계를 보인 인자는 투석 시간, 투석 시작시의 BUN값, 처방된 투석량 등이었다 (p<0.05). 사망자는 생존자에 비해 의미있게 낮은 최초 혈청 creatinine치, 높은 CCF severity score, 투석 중 빈번한 저혈압, heparin의 저용량 사용 등을 보였으며 (p<0.05), 처방 투석량은 생존자와 사망자간에 차이가 없었으나 (1.22±0.30 대 1.31±0.45), 실제 전달된 투석량 (1.17±0.17 대 1.04±0.17; p<0.05)과 전달 투석량 대 처방 투석량 비 (95.9±22.6 대 79.3±15.6%; p<0.05)는 사망자에서 유의하게 낮았다. 결 론 : 급성신부전 환자의 혈액투석 증 투석량 전달율은 약 87%이며 반수 이상의 환자에서 투석량이 적은 것으로 나타났고, 사망자에서 투석량 전달율이 유의하게 낮았다. 생존자들에서 투석량이 많았던 양상을 보인 것은 기존 연구와 일치하나 이것이 독립변수로 작용한 것인지, 중증도와 혈압상태에 따른 투석시간 단축에 따른 종속변수로 작용한 것인지에 대해서는 결론을 내리기가 어려우며, 전향적 연구가 필요할 것으로 사료된다. Background : Recent studies have suggested that the outcomes of the patients with acute renal failure (ARF) may related to delivered dose of dialysis. In such context, a number of investigators have reported about delivered dose of dialysis and its contribution to outcomes of ARF, using Kt/V. The purpose of the study was to evaluate actual delivered dose of dialysis in intermittent hemodialysis (HD) in critically ill ARF patients, clinical factors contributing delivery of dialysis dose, and relationship of delivered dialysis dose and survival. Methods : Delivered and prescribed dose of dialysis, presented as Kt/V, were measured in ARF patients intermittent HD in intensive care unit of Inha University Hospital from January 1999, until December 1999, using single pool urea kinetic model. Results : All subjects received intermittent HD of 6.4±4.8 times with mean of 225.6±40.4 min per session. Overall survival was 55.5%. Prescribed Kt/V in all subjects was 1.24±0.39, but actual delivered Kt/V was 1.08±0.17. A mean delivered/prescribed Kt/V ratio was 87.1±43%. Duration of HD session (R=-0.547, p=0.019), Cleveland Clinic Foundation Severity Score (R=-0.486, p=0.041), and frequency of hypotensive episodes (R=-0.419, p=0.043) were significantly correlated with delivered/prescribed Kt/V ratio. Delivered dose was under 1.2 in 66.7% of the subjects. Survival rate of these patients was 50.0%, which was lower as compared to 66.6% of the patients with delivered dose over 1.2. Patients with low delivered dose (Kt/V<1.2) showed significantly low prescribed dose and short HD time (p<0.05). Delivered Kt/V was correlated with BUN at initiation of dialysis, HD duration, and prescribed Kt/V (p<0.05). Non-survivors showed significantly low initial serum creatinine, low CCF severity score, high frequency of hypotensive episodes, and less use of heparin (p<0.05). Prescribed Kt/V was not different between survivors and non-survivor (1.22±0.30 vs 1.31±0.45), but delivered Kt/V (1.17±0.17 vs 1.04±0.17; p<0.05) and delivered/prscribed Kt/V (95.9±22.6% vs 73.9±15.6%; p<0.05) were significantly higher in survivors than in non-survivors. Conclusion : In ARF patients, the delivery of dialysis was significantly lower than as was expected. Delivered/prescribed Kt/V was about 87% and more than half of the patients received intermittent HD of Kt/V less than 1.2. Better survival was associated with higher delivered dose of dialysis. We need further prospective studies about the causal relationship between delivered dose of dialysis and outcomes in ARF patients. (Korean J Nephrol 2004;23(1):92-100)

Sodium Phosphate에 의한 급성 신부전

김일권 ( Kim Il Gwon ),박진영 ( Park Jin Yeong ),송준호 ( Song Jun Ho ),이승우 ( Lee Seung U ),김문재 ( Kim Mun Jae ) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.6

Although oral sodium phosphate, a colonic cleasing agent for colonoscopy, had been usually known to be safe, several cases have been reported on the development of acute renal failure(ARF) after the administration of this agent. Many authors suggested that the pathogenesis of ARF developed after sodium phosphate administration is related with hyperphosphatemia, which caused ARF by the deposition of phosphate and/or calcium in renal tubule or interstitium, or by the direct toxicity to renal tubular cells. Elderly patients or the patients with dehydration, underlying cardiovascular, renal, or hepatic disease predispose the development of adverse effects of sodium phosphate, such as water and electrolyte imbalance, especially hyperphosphatemia which may ultimately lead to ARF. We described here a case of acute renal failure associated with hyperphosphatemia after the administration of sodium phosphate. A review of the literatures is presented.

포스터 발표 : 포스터 연제 ; Wegener`s granulomatosis에 의한 급속 진행성 사구체 신염 1예

김경아 ( Kim Gyeong A ),송준호 ( Song Jun Ho ),양해주 ( Yang Hae Ju ),이경주 ( Lee Gyeong Ju ),이승우 ( Lee Seung U ),김문재 ( Kim Mun Jae ) 대한신장학회 1999 춘계학술대회 초록집 Vol.18 No.2