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.

탄소 나노튜브의 전계방출 특성

이경원,김은미,권민철,김용,이재열,박홍준 동아대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.17 No.1

본 연구에서는 emitter와 collector 사이의 간격과 current density 대 electric field (J-K)특성을 초점으로 카본나노튜브의 전계방출 특성을 조사하였다. 카본 소스로 CH4, 촉매 및 희석가스로서 NH3를 사용하고 HFCVD를 이용하여 실리콘 위에 카본나노튜브를 성장하였다. 나노튜브의 지름이 20-40nm이고 길이는 15㎛이다. I-V곡선에서 onset voltage는 Vons=3.36V/㎛이고, 2.5V/㎛ 의 전기장에서 8mA/cm2이상의 높은 전류밀도 특성을 보였다. Fowler-Nordheim 그래프를 그려서 팁의 특성을 나타내는 β값을 계산하였다. We report the field emission properties of carbon nanotube, focusing on current density versus electric field (J-F) characteristics and the spacing between the emitter and collector. We grow carbon nanotubes on sillicon using hot-fillament chemical vapor deposition, using CH4 gas as the carbon source and NH3 gas as the catalyst and dilution gas. Nanotubes are distributed from 20 to 40nm in diameter and 15㎛ long. Onset field of the field emission is 3.36V/㎛ and the current density is 8mA/cm2 at an electric field of 2.5V/㎛. A Fowler-Nordheim plot was made. Field enhancement factor β is calculated.

한국 궁궐의 지붕을 응용한 의상 디자인개발 - 경복궁의 팔작지붕을 중심으로

이선영, 이은경, 연승문, 김지영 충북대학교 생활과학연구소 2013 생활과학연구논총 Vol.17 No.2

The ideology and philosophy of ancestors were inherent in our traditional architecture. The purpose of this study is to review the beauty of traditional culture and to express it in the new and modern way through the development of fashion design applying Korean palace roof. After literature review and field survey of taking pictures and observation on palace roof, design planning was decided. The Paljak roof is the source of design, its both ends descend vertically and spread again in all directions in splendid and dignified. Four works were made with motives using characteristics and forms of roof. Work 1 was inspired by roof tiles form and applied to jacket peplum. Work 2 was inspired by rafters under the roof and applied to outer and the form of eaves was applied to one-piece dress. Work 3 was inspired by overall silhouette of Paljak roof and expressed as pointed shoulder line of jacket. Work 4 was expressed with structural and repeated shape using the form of eaves bottom of roof. The traditional motives and Korean beauty can be expressed with modern sense through this study. To show the excellence and values of Korean culture, the design planning using traditional culture should be carried out steadily.

흰쥐 혈액-태반 관문의 합포체성 영양세포막에서 특이성 유전자의 발현

이경은,강영숙 숙명여자대학교 약학연구소 2004 약학논문집-숙명여자대학교 Vol.21 No.-

태아에 대한약물및 영양물질의 수송은합포체성영양세포막이 혈액-태반관문의 역할을함으로써 조절되고 있다.사람의 경우는 이 세포막이 한층의 상피세포충으로 이루어져 있고횐쥐에서는 두충으로구성되어 있다. 이두 충사이는connexin 26이 통로역할울하는gap junction을 이루고 있는데 아직 이두상피세포충의 생리적 역할에 대해서는 정확히 밝혀지지 않았다. 최근에 횐쥐의 조건적 불사화합포체성 영양세포막의 세포주가수립되어 이를 이용하여 이 세포막의 생리적 역할에 대해서 분자유전학적인 측면에서 규명하였다. cDNA microarray를 사용하여 세포막의 두 충을 나타내는 세포주 TR-TBT 18d-l과 18d-2에서 서로 다르게 발현하는 10개의 유전자를 확인하였고,이 중에서 7개의 유전자는 18.1에 더 많이 발현하였다. 특히 막 특이성 유전자를 확인하기 위하여 정량적 real-time PCR로 조사한 결과, ezrin과 NHERF-1 등의 mRNA 발현량은 184-1에서 2-9배 더 높게 나타났으며 hsc70과 NHERF-2발현은18d-2에서 더 높게 나타났다. 그러므로 횐쥐의 태반세포의 각 충은 극성을 나타내는 특이 유전자의 발현량의 차이를 나타냄으로써 물질의 수송 또는 막의 결합등에 서로 다른 생리적 기능을 나타낼 것으로 보인다.

한국전통생활문화에 관한 고찰

이숙,홍윤호,신윤숙,신효식,한경미,최정미,김은정 全南大學校家政科學硏究所 2002 生活科學硏究 Vol.12 No.-

This study is objected on preliminary research for more scientific and wider studies on the Traditional Living Culture of Korea. For this purpose, studies about clothing, food, home management, Traditional Living Culture were reviewed and analysed. The results were as follows : First, Clothing culture studies concentrated on ritual clothings, Second, Food Culture studies included history of traditional food development and recipes. Third, in the field of home management value system, attitudes and parent-child relations were studied,

보건소중심형 정신보건센터에서 실시한 만성정신병환자들을 위한 주간보호모델

이후경,이선영,김은미 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구는 보건소중심형 정신보건센터에서 정신과전문의가 자문의로서 주 1회 참여하여 관리하는 주간보호모델(이하 모델이라 함)의 구조와 운영방법을 소개하고, 이 모델을 시행한 후 나타나는 결과를 분석하여 적절성과 타당성을 검증하며, 중소도시의 정신보건사업에 효과적으로 적용될 수 있는 모델로서 일반화할 수 있는 방법을 모색하여 만성정신병환자의 생활유지와 재활 및 사회복귀를 효과적으로 돕기 위한 목적으로 실시되었다. 방 법: 본 모델은 1997년 5월부터 1998년 12월까지 근 20개월 동안 하남시 정신보건센터에서 총 33명의 만성정신병환자를 대상으로 실시되었다. PANSS. Quality of Life, 삶의 만족 척도를 주간보호 시작 전과 주간보호 참여한 후 6개월 이상 경과된 후 각각 실시하였다. 결 과: 1) 본 모델은 만성정신병환자의 증상을 감소시키고 삶의 질을 향상시켜, 환자의 생활유지 및 재활에 도움을 주었다. 2) 본 모델은 정신과전문의의 최소한의 개입으로도 여러 분야의 전문가들과 다양한 치료방법들을 전체적으로 통합하는데 유용하였다. 3) 본 모델은 정신과전문의가 자문의로서 주 1회 참여하면서 주간보호를 중심축으로 전체 정신보건사업을 관리하고 조정해가는데 수월하였다. 4) 본 모델은 중소 도시형 지역정신보건사업을 실시함에 있어 그 적용 가능성이 있다. 결 론: 본 모델은 만성정신병환자의 생활유지와 재활 및 사회복귀를 위해 중소도시형 지역정신보건사업에서 효과적이면서 효율적으로 적용될 수 있을 것으로 생각된다. Objectives: The purposes of this study were as follows; introducing general structure and management of a day care model practiced in Community Mental Helth Center where a psychiatrist participates weekly as a consultant analyzing; the results after performing this model and then verifying appropriateness and validity; brooding the possibility of generalization as an effective day care model in Community Mental Health Service of small city and promoting maintenance, rehabilitation and returning to community of chronic psychotic patients. Methods: We performed this model from May 1977 to December 1998 for about 20 months. The subjects were composed of 33 psychotic patients. PANSS(Positive and Negative Sydrom Scale), QLS(Quality of Life Scale), LSSS(Life Satisfaction Self-Rating Scale) were administered twice before starting and after 6 months of participation in this program. Results: 1) This model helped the maintenance and rehabilitation of chronic psychotic patients, reducing symptoms and increasing quality of life; 2) This model was useful in integrating multi-disciplinary personnel and therapeutic methods as a whole with a psychiatrist intervening the least; 3) This model enabled a psychiatrist as a consultant to manage and control all Community Mental Health Service with him participating weekly; 4) It is possible for this model to be easily applied to Community Mental Health Service in a small city. Conclusion: This model will be likely to be applied effectively and efficiently to the Community Mental Health Service in a small city for maintenance, rehabilitation and returning to community of chronic psychotic patients.

韓國農村地域社會의 構造와 刷新(Ⅱ) : 集團 및 組織動態를 中心으로

李觀雨,李庚殷 淸州大學校 1976 論文集 Vol.9 No.1

TIMSS-R 과학 성취도에서의 성 차이

이미경,홍미영,정은영 한국과학교육학회 2004 한국과학교육학회지 Vol.24 No.6

학업성취도 국제 비교 연구 결과에서 우리나라 남렛?학생의 과학 성취도 차이가 큰 것으로 보고되고 있다. 이 연구에서는 TIMSS-R과학 성취도에서의 성 차이를 문항 수준에서 살펴보기 위하여 각 문항의 GDI(Gender Difference Index) 값을 산출하였다. 그리고 문항 유형, 성취수준, 내용 영역에 따른 GDI 값을 비교하였다. 문항 유형에 상관없이 우리나라와 국제 결과 모두 남학생이 여학생보다 성취도가 높은 것으로 나타났으며, 우리나라의 성차가 국제 평균보다 크게 나타났다. 특히 우리나라 여학생들은 선다형 문항에서 상대적으로 낮은 성취도를 나타내었다 성취수준에 따른 우리나라와 국제의 GDI 값을 비교해 보면, 상위 10%에 해당되는 문항들에 대해서는 우리나라의 GDI 값이 국제의 경우보다 낮게 나타났으나 그 이외의 성취수준에 해당되는 문항들에 대해서는 우리나라의 GDI 값이 더 높게 나타났고 특히 상위 50%에 해당되는 문항들의 경우 우리나라와 국제의 차이가 크게 나타났다. 내용 영역별로 남ㆍ여학생의 성취도를 비교했을 때는 과학 탐구와 과학의 본성 영역을 제외하고는 모든 내용 영역에서 우리나라 남학생들의 성취도가 여학생들보다 높았다. GDI가 10 이상인 문항 중 남학생들의 성취도가 높은 문항들은 생물과 지구과학 영역에 속하는 경우가 상대적으로 많았으며, 학교 교육과정에서 전혀 배우지 않은 문항들의 비율 또한 비교적 높았다. 그리고 남학생들이 높은 성취도를 보이는 문항은 전 수행 영역에 걸쳐서 비교적 골고루 분포되어 있었다. 이상에서와 같이 문항 유형, 성취수준, 내용 영역에 따라 과학에서의 남렛㈖剋萱?성취도 차이가 다르게 나타났다. 이러한 결과는 여학생들의 과학 성취도를 향상시키기 위한 방안을 모색하는 과정에서 보다 구체적인 방향을 제시할 것으로 기대된다. The purpose of the study was to produce resources to help develop instructional methods and programs for school science to reduce gender differences in science achievement by analyzing TIMSS-R results according to item type, benchmark, and content category. Korean male students performed higher than Korean female students and gender differences of Korean students were higher than international means in all item types including multiple-choice, short answer, and extended response type. GDI(Gender Difference Index) of Korean students was lower than international mean in top 10% benchmark but higher than international means in other benchmarks. Korean male students also exhibited higher performance than Korean female students in all content categories except scientific inquiry and the nature of science category. Regarding items that GDIs were higher than 10, the number of items belonged to life science and earth science category was relatively larger and a high percentage of them was not included in school science curriculum. In addition, the items were equally distributed in each performance category. In sum, the study showed various gender differences according to item type, benchmark, and content category. The results could be used to find appropriate instructional methods to reduce gender differences in science achievement.

알쯔하이머병 환자의 혈소판 아밀로이드 전구단백질 이상

이애영,조은경,김건익,김선국,손은희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Background:Although Alzheimer's disease (AD) is a progressive neurodegenerative disorder without any truly effective pharmacological treatment at present, early accurate diagnosis is important for the delaying of disease progression and proper management It would be desirable to have a peripheral biological marker to identify patients affected by AD Amyloid β-peptide originates from a larger precursor, the amyloid precursor protein (APP). which can be seen in the platelet of its equivalent to those found in brain. To investigate if there is a correlation between level of platelet APP isoform and AD, we evaluate a cohort of subjects including patients affected by sporadic AD, vascular dementia, and controls Subjects & Methods :Thirty-five patients with sporadic AD diagnosed according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Relatec Disorders criteria (NINCDS-ADRDA) and 26 vascular dementia patients diagnosed by the Diagnosis and Statistical Manual of Mental Disorders, Fouth Edition (DSM-Ⅳ) criteria and 12 controls were included Blood sample were drawn from fasting state and collected into 3 mL of 3.8% sodium citrate. Platelets were collected by centrifugation at 500 g for 20 minutes and washed. and the platelet pellet was stored at -80℃ until used APP was assessed by western blot analysis and quantified by densitometry using Image Analyzer Results:In platelets densitometer as well as the result of Western blot was higher compared with those of patients with non-Alzheimer dementia and controls We observed statistically significant reductions in the ratio of 120 kDa to 130 kDa APP to 110 kDa APP (APPr) for patients with probable AD compared with control subjects and patients with vascular dementia APPr levels in AD correlated with the severity of dementia measured by CDR. Accuracy levels measured by Receiver Operating Curve analysis showed that a cut-off level of 0.45 resulted in a sensitivity of 71% and a specificity of 74%, with an area under the curve of 0 793 Conclusion:Platelet APPr allowed to differentiate AD from normal aging and vascular dementia with high sensitivity and specificity These findings suggest that platelet APPr may be a helpful peripheral marker for diagnosis and clinical progression of Alzheimer disease.

半月工業團地의 特性과 安山市의 地域構造 分析

李恩卿 건국대학교 1989 장안지리 Vol.4 No.2

This study is aimed to explain the characteristics of Panwoˇl Industrial Complex and to analyze regional structure of Ansan city. Especially this study is focused on the growth of Ansan city related to the construction of Panwoˇl industrial Complex. There by this study can show the effect of new employment opportunity on the growth of population and service industries and the development of transportation system. The characteristics of Panwoˇl Industrial Complex can summarized as followes: First, as planned 1,030 enterprises are located in Panwoˇl Industrial Complex and the operating ratio is almost 85% of total industries. And the major industries in Panwoˇl Complex are metal, chemical, textile industry, which is composed of 82% if total industries. Secondly, in order to minimize the industrial pollution, harmful industries such as dyeing, leather and chemical industries ries are allocated in coastal area and Waste-wafer Treatment was constructed. Thirdly, among those which are located in Panwoˇl Complex, 63% of enterprises have their headquater in Panwoˇl and the rest (37%) are branch plants whose headquaters are located in Buˇchon, Inchoˇn, Anyang. Location of new incustries in Panwoˇl has induced the growth of Ansan city in terms of population, econmy, and social overhead infrastructure. The Changes in regional structure of Ansan city between the period of 1978-1988 are summarized as followes : First, population increased from 20,000 in 1979 to 160,000 in 1987. However distribution of population is highly concentrated on Wongok-dong (元谷洞) , Jungang-dong (中央洞) , Kunja-dong(君子洞), which are the nearest districts of Industrial Complex. Wongok-dong is viewed as the Central Bussiness Distict of Ansan city. Age structure and sex ratio of Ansan city may reflect the characteristics of newly formed industrial city. High ratio of young population and high sex ratio is due to the high demand of male employment in metal and chemical industries. Secondly, transportation system and communication network have developed and extended. Ansan city is connected with national road of 42 and 39, and subway system as opened up, which may increase the accessibility to Seoul. Thirdly, land use pattern has been changed dramatically over the 10 years. In 1978, most of this region were cultivated land and forest land. But in 1983, industrial Complex was built in coast of this region, and along national road of 39 an urban district was arranged in Wongok-dong. In 1988, Industrial Complex is extending toward the east and west and the urban district is extending toward the north, thus chancing cultivated land and forest Land into municipal usage fastly. Forthly, compared with other cities , service industries have not been developed well. Therefore people who live in Ansan city would stop by Seoul, Inchoˇn, Anyang and so on, in order to buy the high goods. Recently, the city of Ansan has been growing very fast. Big Apartment Complex has been builted and transportation facilities has been improved. Still the service function and other public facilities are not good situation. Therefore in order to grow Ansan city as a new industrial city, better public facilities and higher service function should be provided. Further the function of Ansan city should be diversified.