췌장을 침습한 위의 암육종 1 예

김병호,김효종,조진만,김윤화,이정일,동석호,장영운,황일섭,장 린 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.1

Carcinosarcoma of the stomach is regarded as a rare malignant neoplasm composed of both carcinomatous and sarcomatous components in a given tumor. Few cases have been reported since 1904. This is a case of carcinosarcoma of the stomach in a 61-year-old man. He suffered from indigestion, vomiting, and epigastric pain. Endoscopic finding showed a huge protruding mass with intact mucosa on the posterior wall of the antrum up to the pylorus. Surgery was performed and carcinosarcoma with pancreatic invasion was confirmed by pathology.

단기교육으로 시행가능한 심실기능평가법

김원,임경수,오병연,홍은석,김영식,김선만,이부수,현석천,김영득 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The initial history, physical examination, and ECG assessment should focus on identification of potentially serious noncardiac or cardiac disorders, including coronary artery disease, congestive heart failure, and electrical instability at the emergency room. additionally, it is essential to define disease severity, stability and need for emergency therapy. echocardiography is a useful tool for this purpose. especially Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic symptoms. So we evaluate the feasibility of the echocardiographic measurement by emergency physicain after short-term course. Method and Results: Twenty volunteers(10 male, 38.8±9.3 years) were included in the study for measurement of myocardial performance index and established parameters of ventricular function using conventional echo-Doppler methods. Myocardial performance index: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The most of mean values of echocardiogrphic parameters were not significantly different between those of cardiologist and those of emergency physicians(p<0.01). The duration for measuring myocardial performance index was shortest among echocardiographic parameters. the validity of echocardiographic parameters measured by emergency physicians was proved relatively good. Conclusion: It is proved to be feasible for emergency physician to perform echocardiographic evaluation of ventricular function after short-term course

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

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.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

부산의 한 대학병원에서 분리된 Acinetobacter baumannii의 PER-1 Extended-Spectrum β-Lactamase 생성 현황

김정만,강현경,정석훈,배일권,권수봉,조병규,김둘만,김현주,김아성 대한임상미샐물학회 2004 Annals of clinical microbiology Vol.7 No.1

「3-5세 연령별 누리과정」을 중심으로 한 유아교육정책 평가척도의 타당화 및 적용

김병만(Kim Byung man) 학습자중심교과교육학회 2016 학습자중심교과교육연구 Vol.16 No.12

본 연구는 유치원 교사가 「3-5세 연령별 누리과정」정책에 기초하여 선행연구에서 개발된 유아교육정책 평가척도를 타당화하고 적용하는 데 목적이 있다. 이와같은 연구의 목적을 달성하기 위해 유치원 교사 366명을 연구대상으로 선정하였고, 김병만(2014)이 개발한 유아교육정책 평가척도를 「3-5세 연령별 누리과정」정책을 중심으로 수정·보완하여 연구도구로 사용하였다. SPSS 23.0을 사용하여 기술통계, 구인타당도, 상관분석, 신뢰도분석, 문항변별도 분석을 실시하였고, 이에 따른 연구결과는 다음과 같다. 첫째, 「3-5세 연령별 누리과정」정책의 평가 정도는 2.70∼3.70의 분포로 나타났다. 둘째, 구인타당도의 범위는 .31∼.80으로 모두 통계적으로 유의미하였다. 셋째, 전체 신뢰도는 .97, .93의 신뢰도로 양호한 결과가 나타났다. 넷째, 평가척도의 문항변별도는 상위 집단의 모든 평가지표 평균이 하위 집단의 평균보다 높게 나타났으며, 모두 통계적으로 유의미하였다. 끝으로, 평가척도에 상대적가중치를 적용한 최종 평가 결과를 제시한 결과, 평가 범주에서는 공공성, 적합성, 민주성, 경제성의 순으로 높은 점수가 나타났다. 이상과 같은 「3-5세 연령별 누리과정」정책에 기초한 유아교육정책 평가척도의 타당화 및 적용을 통해 유아교육정책 및 평가 분야의 학술적 발달에 의미 있는 시사점을 제공하였다. The purpose of this study was to examine the validation and application of an early childhood policy evaluation scale, which was developed in an earlier study, to the Nuri curriculum for ages 3 to 5 among kindergarten teachers. The subjects in this study were 366 selected kindergarten teachers. The instrument used in this study was Kim Byung-mann (2014) s Early Childhood Education Evaluation Scale, which was used with some modifications and supplementations to assess the Nuri curriculum for ages 3 to 5. The findings of the study were as follows: First, the evaluation scores for the Nurri curriculum for ages 3 to 5 ranged from 2.70 to 3.70. Second, as for construct validity, the correlations between the evaluation criteria and total scores and Pearson product-moment correlation coefficients between the evaluation indicators and total scores were calculated, and both of the two were between .31 and .80, which implied that the construct validity of the scale was statistically significantly good. Third, concerning reliability, the internal consistency and split-half reliability of the evaluation indicators were investigated, and the two were respectively .97 and .93. The reliability of the scale was good. Fourth, the item discrimination of the evaluation scale was analyzed after they were divided into two groups. The upper-tiered group gave higher scores to every evaluation indicator than the group in the lower tier, and the differences were all statistically significant. Finally, as to the results of final evaluation based on relative weights, the highest-scored evaluation category was publicness, followed by appropriateness, democracy and economic efficiency, and the evaluation criteria and the evaluation indicators were scored based on their relative weights. The findings of the study on the application of the early childhood education policy evaluation scale to the Nuri curriculum for ages 3 to 5 are expected to give meaningful suggestions on early childhood education policy and evaluation.

학부모용 유아교육정책 평가척도 적용 및 타당화 : 「3-5세 연령별 누리과정」 정책을 중심으로

김병만 ( Kim Byung-man ),김미진 ( Kim Mi-jin ),김정주 ( Kim Jung-ju ) 한국아동교육학회 2019 아동교육 Vol.28 No.1

본 연구는 학부모용 유아교육정책 평가척도에 「3-5세 연령별 누리과정」 정책을 적용하여 선행적으로 개발된 평가척도의 타당도를 검토하고자 한다. 연구의 목적을 달성하기 위해 학부모 232명을 연구대상으로 선정하였고, 김병만(2018)이 개발한 유아교육정책 평가척도를 「3-5세 연령별 누리과정」 정책 중심으로 수정·보완하여 연구도구로 사용하였다. SPSS 23.0과 AMOS 8.0 program을 사용하여 평가 정도, 내용단일성, 문항변별도, 척도양호도를 확인하였고, 연구결과는 다음과 같다. 첫째, 「3-5세 연령별 누리과정」 정책의 평가 정도는 2.84∼3.66의 분포로 나타났다. 둘째, 내용단일성의 범위는 .71∼.90으로 모두 통계적으로 유의미하였다. 셋째, 문항변별도는 모든 평가지표 상위 집단의 평균이 하위 집단의 평균보다 높게 나타났으며, 통계적으로 유의미한 차이가 있는 것으로 나타났다. 넷째, 척도양호도는 확인적 요인분석 결과 모든 측정변인이 잠재변인을 설명하는 경로가 통계적으로 유의미한 것으로 나타났다. 이상의 결과를 통해 「3-5세 연령별 누리과정」 정책에 기초한 학부모용 유아교육정책 평가척도는 타당하고 신뢰로운 평가척도임이 검증되었고, 유아교육정책 및 평가 분야에 가치 있는 학술적 의미와 시사점을 제공하였다. The purpose of this study is to validate and apply the parental early childhood education policy evaluation scale by applying the Nu-ri Curriculum for 3-to-5-year-olds. In order to achieve the purpose of this study, 232 parents were selected as the research subjects. The research tool was modified and supplemented with the policy of ‘Nu-ri Curriculum for 3-to-5-year-olds’ policy developed by Kim Byung-man (2018) Respectively. The data collected in this study were descriptive statistics, construct validity, correlation analysis, reliability analysis, item discrimination, confirmatory factor analysis, and AMOS 8.0 program. The results of this study are as follows. First, the degree of evaluation of the parental early childhood education policy evaluation scale applying the ‘Nu-ri Curriculum for 3-to-5-year-olds’ policy was 2.84 ~ 3.66. The average of the public interest evaluation index of the colony was the highest, and the demographic average of the true women index was the lowest. Second, as a result of the reliability and validity test, it was proved through statistical significance that the parents' evaluation scale applying the policy of ‘Nu-ri Curriculum for 3-to-5-year-olds’ was valid and reliable evaluation scale for the early childhood education policy. This study suggests that the validity and application of the early childhood education policy evaluation scale suggests the possibility of active involvement of parents in the evaluation area of early childhood education policy.

표층확대형 조기위암 1예

고성만,김기훈,서호종,서광섭,유광렬,채선애,임병욱,김홍자,김호정,김진승,허병원,김해경 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3

The superficial spreading type of early gastric cancer has usually been defined as an early gastric cancer in which the product of the longest diameter and the diameter perpendicular to it was greater than 25㎠. Although the superficial spreading type of early gastric cancer is histologically aggressive compared with those without such histological aggressiveness, the 5 year survival rate is as good as a non-superficial spreading types of early gastric cancers if the wide surgical resection with extensive lymph node dissection is performed as a treatment. We experienced a case of superficial spreading early gastric cancer in a 59-year-old man. This case is reported with a brief review of related literature.

췌장의 가성낭종 파열에 의한 하부 위장관 출혈 1예

장성종,김병수,부귀범,김동규,박찬국,김만우,김정용,박상헌 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Pancreatic pseudocysts usually develop as a complication of acute pancreatitis or repeated attacks of chronic pancreatitis. Pseudocysts may also develop as a result of traumatic injuries or neoplasms. An uncommon complication is massive hemorrhage inside the pancreatic pseudocyst. The exact mechanism of hemorrhage is unknown. Enzymatic digestion, pressure erosion from the cyst mass or a combination of these processes may play an important role. Gastrointestinal hemorrhage associated with a pancreatic pseudocyst can occur in 10 percent of cases. When hemorrhage occurs because of erosion into a blood vessel involved in the pseudocyst, surgery is indicated since the episodes of hemorrhage are often severe and may even be fatal. When there is colonic involvement, various complications may occur. The most dangerous one is spontaneous rupture into the colon, which requires immediate surgical treatment because of high incidence of fulminating sepsis or massive hemorrhage. We examined a sixty eight-year-old man complaining of hematochezia and dizziness, and reported that it was a case of massive lower gastrointestinal hemorrhage caused by pseudocyst of the pancreas ruptured into the colon associated with chronic pancreatitis. On operative findings, the peripancreatic fatty tissue had severe adhesions to transverse colon and tail portion of pancreas, where the pseudocyst had formed. A distal pancreatectomy, splenectomy and resection of transverse colon were performed. By microscopic examination, hemorrhagic necrosis and inflammatory change were observed in the pancreas specimen. The tail portion of pancreas had a 6×6 cm sized cystic mass and was proven to be a pseudocyst with no epithelial lining.