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대학병원 외래환자의 일반적 특성과 만족도 - 서울시내 5개 대학병원을 대상으로 -
장성구,하헌영,신영전,이종길,Chang, Sung-Goo,Ha, Hun-Young,Shin, Young-Jun,Lee, Jong-Gil 한국의료질향상학회 1996 한국의료질향상학회지 Vol.2 No.2
Purpose : the management of University Hospital is being challenged in maintenance of reasonable level of income and high ranked reputation by domestic competition with each other and emergence of enterprised owned hospitals. It is imperative that University Hospitals have to make management for patient satisfaction. Furthermore, increased patient's requirement for qualified hospital services (quality assurance) and low-estimated service fee also repress the hospital management condition as well as medical markets open following with Urguay Connection. Due to these unforable conditions surrounding hospital management, -University Hospitals are being pressed to seek improved management strategies. To develope the strategies, we need to have basic understanding about the problems on hospital management and detail information for various patient's requirement. Methods: For this study, we have analysed out-patients from five different University Hospitals located in Seoul, Korea. To obtain the data, we have carried out personal interviews with patients who patients who visit the Out-Patient Clinics of five different University Hospitals using a previously prepared questionnaire. Result: Around 65.7 percent of the visits to University Hospitals were indwelt in the vicinity of 1 hour and motuvation of visiting University Hospital was expending high wuality medical csre in 49.3 percent. The 79.3 percent of the patients have experienced inconvenience during medical care in University Hospital. The most inconvenient condition was waiting for doctors. The 57.2 percent of total patient have experienced rudness. The most rudness condition was registration and receipt desk in 44.4 percent. Patient expect that doctors working in University Hospitals as professors have high and updated medical knowledge(50.4%) and University Hospitals have a high quality medical care system(79.4%). The patient satisfaction was relatively low in 61.1 percent of total patient and revealed high frequency of again visit University Hospital in satisfaction group. Comparison of interhospital analytical study showed quite difference on various problems. Conclusion: Almost patients who visit to Out-Patient Clinic of University Hospital havevisiting motivation to high quality medical care. University Hospitals have several different unsatisfactorial factors and revealed different degree of patient satisfaction. In a future day, University Hospitals have to make use of another University Hospital's merits for approach of Benchmarking and also should be studied decision factors of patient satisfaction and interhospital difference of them.
Antitumor Activity and Nephrotoxicity of the Novel Platinum(II) Coordination Complex
정지창,이문호,장성구,노영수,Jung Jee-Chang,Lee Moon-Ho,Chang Sung-Goo,Rho Young-Soo The Korean Society of Pharmacology 1995 대한약리학잡지 Vol.31 No.1
Platinum coordination complexes are currently one of the most compounds used in the treatment of solid tumors. However, its use is limited by severe side effects such as renal toxicity. Our platinum-based drug discovery program is aimed at developing drugs capable of diminishing toxicity and improving antitumor activity. We synthesized new Pt (Ⅱ) complex analogue containing 1,2-diaminocyclohexane (dach) as carrier ligand and 1,2-bis(diphenylphosphino) ethane (DPPE) as a leaving group. Furthermore, nitrate was added to improve the solubility. A new series of [Pt(trans-ddach)(DPPE).$2NO_3(PC)$ was synthesized and characterized by their elemental analysis and by various spectroscopic techniques [infrared (IR), $^{13}carbon$ nuclear magnetic resonance (NMR)]. PC demonstrated acceptable antitumor activity aganist P388, L-1210 lymphocytic leukemia cells and SK=OV3 human ovarian adenocarcinoma cells, and significant. activity as compared with that. cisplatin. The toxicity of PC was found quite less than thar of cisplatin using MTT, $[^3H]$ thymidine uptake and glucose consumption tests in rabbit proximal tubule cells, human kidney cortical cells and human renal cortical tissues. Based on these results, this novel platinum compound represent a valuable lead in the development of a new anticancer chemotherapeutic agent capable of improving antitumor activity and low toxicity. 일부 malignant tumor에 Pt-complex의 일상 응용 과정에서 신장독성등의 심한 부작용이 문제점으로 지적되고 있다. 이 연구에서는 기존의 cisplatin보다 항암효과는 우수하면서, 부작용을 감소시킨 새로운 Pt-complex의 개발에 역점을 두었다. 본 연구에서 합성한 Pt(Ⅱ) complex는 carrier ligand로서 1,2-diaminocyclohexane(dach)을 사용하였고, leaving group으로는 diophosphine류인 1,2-bisdiphenylphosphinoethane(DPPE)을 도입하였으며, 물에 대한 용해도를 높이기 위해 dinitrate로 만들었다. 새로이 합성한 [Pt(Ⅱ)(trans-d-dach)(DPPE)]$(NO_3)_2$는 원소 분석, IR 및 $^{13}C-NMR$ 분석 data에 의하여 위의 물질임이 확인되었다. MTT assay method에 의한 항암활성 연구를 통하여 P-388, L-1210 lymphocytic leukemia cell과 SK-OV3 난소암세포에서 항암효과가 인정되었으며, 이 항암효과는 대조 약물로 사용된 cisplatin과 유사하였다. 토끼의 신세뇨관 세포와 인체의 신피질 세포를 이용한 cytotoxity 및 thymidine 섭취율과 인체 신피질 조직 배양을 이용한 glucose consumption 실험을 통하여 모두 cisplatin보다 신장독성이 현저히 감소되었다. 이상의 결과로 보아 Pt(Ⅱ)complexes는 carrier ligand와 leaving group의 선택에 따라 항암활성의 증가와 신독성의 감소를 일으키는 요인으로 보여지며, 이 연구에서 만들어진 Pt(Ⅱ)complex는 앞으로 다각적인 검토를 거쳐 새로운 항암화학요법제로 개발될 가능성이 있을 것으로 생각된다.
정지창(Jee-Chang Jung),윤진희(Chin-Hee Yoon),장성구(Sung-Goo Chang),이경태(Kyung-Tae Lee),노영수(Young-Soo Rho) 대한약리학회 1993 대한약리학잡지 Vol.29 No.2
일부 malignant tumor에 Pt-complex의 임상 응용 과정에서 신장독성등의 심한 부작용이 문제점으로 지적되고 있다. 이 연구에서는 기존의 cisplatin보다 항암효과는 우수하면서, 부작용을 감소시킨 새로운 Pt-complex의 개발에 역점을 두었다. 본 연구에서는 합성한 Pt (II) complex는 carrier ligand로서 1, 2-diaminocyclohexane (dach)을 사용하였고, leaving group으로는 diphosphine류인 1, 3-bis (diphenylphosphine)의 propane (DPPP) 및 ethane (DPPE)을 도입하였으며, 물에 대한 용해도를 높이기 위해 dinitrate로 만들었다. 새로이 합성한 [Pt (II)-(trans-1-dach)(DPPP)] (NO<sub>3</sub>)<sub>2</sub> <KHPC-001>과 [Pt (II)(trans-1-dach)(DPPE)] (NO<sub>3</sub>)<sub>2</sub> <KHPC-002>는 원소 분석, IR 및 <sup>13</sup>C-NMR 분석 data에 의하여 위의 물질임이 확인되었다. KHPC-001과 KHPC-002는 MTT assay method에 의한 항암활성 연구를 통하여 P-388, L-1210 lymphocytic leukemia cell에서 항암효과가 인정되었으며, 이 항암효과는 대조 약물로 사용된 cisplatin에 비하여 우수하였다. KHPC-001과 KHPC-002는 토끼의 신세뇨관 세포와 인체의 신피질 세포를 이용한 cytotoxity 및 thymidine 섭취율과 인체 신피질 조직 배양을 이용한 glucose consumption 실험을 통하여 모두 cisplatin보다 신장독성이 현저히 감소되었다. 이상의 결과로 보아 Pt (II) complex는 carrier ligand와 leaving group의 선택에 따라 항암활성의 증가와 신독성의 감소를 일으키는 요인으로 보여지며, 이 연구에서 만들어진 두 Pt (II) complex는 앞으로 다각적인 검토를 거쳐 새로운 anticancer chemotherapeutic agent로 개발될 가능성이 있을 것으로 생각된다. Pt-complexes is currently one of the most compounds used in the treatment of solid tumors. However, its used is limited by severe side effects such as renal toxicity. Our platinum-based drug discovery program is aimed at developing drugs capable of diminishing toxicity and improving antitumor activity. We synthesized new Pt (II) complex analogues containing 1, 2-diaminocyclohexane (dach) as carrier ligand and 1, 3-bis (diphenylphosphino) propane (DPPP)/1,2-bis (diphenylphosphino) ethane (DPPE) as a leaving group. Furthermore, nitrate was added to improve the solubility. A new series of (KHPC-001) [Pt (trans-1-dach)(DPPP)] 2NO<sub>3</sub> and (KHPC-002) [Pt (trans-1-dach)(DPPE)] 2NO<sub>3</sub> were synthesized and characterized by their elemental analysis and by various spectroscopic techniques [infrared (IR), <sup>13</sup>carbon nuclear magnetic resonance (NMR)]. KHPC-001 and KHPC-002 demonstrated acceptable antitumor activity aganist P-388, L-1210 lymphocytic leukemia cells and significant activity as compared with that of cisplatin. The toxicity of KHPC-001 and KHPC-002 was found quite less than that of cisplatin using MTT, [<sup>3</sup>H] thymidine uptake and glucose consumption tests in rabbit proximal tubule cells and human kidney cortical cells.