종합병원 전자건강카드 도입에 영향을 미치는 요인

안이수,윤석준,안형식,홍석원 한국의료QA학회 2005 한국의료질향상학회지 Vol.12 No.2

Objective : This research is focused on understanding the current status of the Health Smart Card already in use in other advanced countries. This research will analyze the current status of the medical institutions Health Smart Card system adoption process and its effects, and provide a basis for future policy decisions for the effective adoption and diffusion of a Health Smart Card system, in the medical field, through the completed research and analysis. Method : This research surveys the domestic, and foreign, status of Health Smart Card usage. The research also presents up-to-date methodology for the evaluation of the effects of medical and health care technology. The research also conducts a survey of the domestic medical institutions that have implemented a Health Smart Card system, and then analyzes the results of the survey. Additionally, the research carried out a survey and analysis of medical institutions with no Health Smart Card system implemented, and considered the factors affecting the diffusion of Health Smart Card systems in considering an effective policy for the introduction and diffusion of such a system. Research Results : Through the study of the methodology of medical and health care information technology in advanced countries, the methodology for assessing Health Smart Card technology has been established, and focuses on 6 aspects. The study on the status of foreign implementation has shown a model for the Health Smart Card system. A survey was conducted on the current status of medical institutions with an implemented Health Smart Card system, and the survey results have been analyzed. Also, factors influencing the adoption of Health Smart Card systems have been analyzed through the survey on those medical institutions that have not implemented a Health Smart Card system. Conclusion : The government must provide institutional measures for sharing medical records by constructing an IT infrastructure at the national level to enable the adoption and diffusion of a Health Smart Card system. Such a network will make connections between medical institutions possible, thus making the diffusion of the Health Smart Card system nationwide. For the successful adoption and diffusion of a Health Smart Card system, a model system development, under a medical record sharing system, should be conducted. Additionally, a regional unit based model should be developed for the model project, as is done in advanced countries, along with the application of such results.

둔부 통증을 주소로 내원한 괴사성 근막염 1례

안승찬,류석용,이상래,조석진,오성찬,김홍용 인제대학교 2008 仁濟醫學 Vol.29 No.-

Necrotizing fasciitis (NF) is a rare, life-threatening infection resulting in necrosis of the skin, subcutaneous tissue, and fascia. A very severe and usually fatal fasciitis is caused by a virulent species of streptococcus that is often referred to as the "flesh-eating bacteria". Mortality rates have been noted high. Certain conditions can predispose patients to NF, such as diabetes mellitus, immunosuppressive medications, and AIDS. Patients usually complain of excessive pain as well as constitutional symptoms. Because of this rapid progression, it is important to diagnose and treat NF quickly to decrease mortality. Treatment includes broad-spectrum antibiotic coverage, nutritional supplements, hemodynamic support, wound care, and prompt surgical debridement. We report a case of a 51-year-old man who had presented with right hip pain. Previously, he had been diagnosed with diabetes mellitus and alcoholic liver cirrhosis.

국내에서 분리된 Extended-Spectrum β-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의 빈도 및 유형

홍성근,김선주,정성훈,장철훈,조성란,안지영,신종희,이혜수,송원근,어영,염종화,용동은,이경원,정윤섭 대한임상미샐물학회 2003 Annals of clinical microbiology Vol.6 No.2

자발성 심막기종 1례

안지영,이상래,안성훈,류석용,김홍용 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Pneumopericardium, as a form of barotrauma, refers to the presence of air within the pericardial sac. The causes of pneumopericardium are various, Clinically, pneumopericardium is typically present with dyspnea and precordial chest pain. On physical examination, heart sounds are usually distant, and precordial tympany may be elicited. The diagnosis can be made by clinical and radiographic findings. Management of pneumopericardium depends on many factors, such as the age of the patient, the suspected causes, and the extent of clinically observed respiratory compromise. The case shown here, a patient who developed pneumopericardium, involved an associated underlying pulmonary parenchymal process as the cause of pneumopericardium.

항정신병약물 사용 중인 정신분열병 환자에서 올란자판으로의 교체 방법에 관한 연구(II) : Comparison of Safety 안전성 비교

안용민,권용실,권준수,민성호,박두병,양문정,소형석,송종호,신윤식,우행원,유범희,이홍석,정한용,한창환,김용식 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 이 다기관 공동임상연구는 사용 중인 항정신병약물을 ’직접 교체 방법’또는 ’시작-감량 교체 방법’중 한 가지 방법으로 올란자핀으로 교체한 후, 안정성 측면에서 두 교체 방법 간의 비교와 교체후의 변화를 관찰하기 위한 것이다. 방법: 국내 13개 병원의 입원 및 외래에 내원한 환자들 중 ICD-10 지단기준으로 정신분열병에 해당되며, 임상적으로 항정신병약물 교체가 필요한 환자를 대상으로 하였다. 두 가지 교체 방법 중 한 가지를 무작위로 피험자에 적용하였으며, ’직접 교체 방법’에 배정된 경우에는 사용중인 항정신병약물을 일시에 중단하고 10㎎의 올란자핀을 바로 투여하였고, ’시작-감량 교체 방법’에 배정된 경우는 10㎎의 올란자핀 투여하고 2주에 걸쳐서 기존 약물을 감량하여 중단하였다. 올란자핀 사용기간은 총 6주이며, 용량은 5∼20㎎ 범위로 제한하였다. 한정성 평가를 위해서 체중, 생명징후, 자발적인 이상반응 복, 실험실 검사 그리고 Simpson-Angus Scale(SAS), Barnes akathisia rating scale(BARS), Abnormal involuntary movement scale(AIMS). Liverpool University neuroleptic side effect rating scale(LUNSERS)등을 이용하였다. 결과: 총 103명의 정신분열병 환자를 대상으로 하였다. 사용한 올란자핀의 용량, 벤조디아제핀의 병용률, 탈락률과 탈락 사유, 자발적인 이상반응 보고, 생명징후, 실험실 검사 그리고 대부분의 부작용 척도 상에서 임상적으로 의미 있는 차이를 두 교체 방법간에 발견하지 못하였다. 다만 AIMS의 감소는 ’직접 교체 방법’군에서 보다 적었고, 항콜린제의 병용률은 ’시작-감량 교체 방법’군에서 보다 많았다. 기저 상태에서 전체 피험자의 SAS와 BARS 점수는 각각 3.5점과 1.8점이었으며 70% 이상의 피험자가 고프로락틴 혈증을 보였다. 올란자핀으로 교체한 후, SAS, BARS, AIMS 점수의 유의한 감소가 있었으며 고프로락틴 혈증을 보인 피험자 분율도 약 30%이하로 감소하였다. 그러나 교체 방법과 상관없이 올란자핀 교체 후 유의한 체중 증가가 있었다. 결론: 이 연구를 통해 교체 방법에 관계없이 비교적 안전하고 용이하게 올란자핀으로 교체 할 수 있음을 알 수 있었다. 그리고 기존 항정신병약물을 올란자핀으로 교체함으로써 일부 부작용들을 줄일 수 있음을 간접적으로 관찰할 수 있었다. 하지만 이 연구는 여러 제한점과 문제점을 지니고 있기 때문에 보다 체계적인 연구를 통해 검정이 필요하리라 생각된다. Objectives: This multicenter clinical trial involving 13 hospital sites compared the safely of switching to olanzapine between ’direct switching method’ and ’start-tapering switching method’. Method: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For ’direct switching method’group, previous antipsychotics were abruptly discontinued and 10㎎ of olanzapine was administered, and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20㎎. The safety of switching to olanzapine was measured with vital sings including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS). Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). Results: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in ’direct switching method’ group, and the concomitant use of anticholinergics was comparatively greater in ’start-tapering switching method’ group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. Conclusion: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.

조기분만 및 만기분만 산모 모유의 젖당, 단백질, 총지질 함량에 관한 비교 연구

안홍석,배현숙 대한지역사회영양학회 2003 대한지역사회영양학회지 Vol.8 No.4

The lactose, total nitrogen and total lipid contents of human breast milk were determined longitudinally after preterm and term deliveries. Milk samples were obtained from day 2 to 5, on weeks 1, 2, 4, and 6 after preterm (PM : n = 24) and term (TM : n = 22) deliveries. The lactose contents of PM and TM increased from 5.28 g/dl and 5.93 g/dl at days 2 to 5, to 7.95 g/dl, 7.87 g/dl at 6 weeks, respectively. The total nitrogen contents of PM and TM decreased significantly during the first 6 weeks after birth (from 374 to 220 mg/dl versus 382 to 220 mg/d, respectively). However the total lipid contents of the PM and TM increased during the same periods. Significant differences in the total lipid contents between the PM and TM were 2.15 versus 3.27 g/dl at 2 weeks, and 3.26 versus 2.52 g/dl at 6 weeks, respectively. The energy intakes of preterm infants was 134.8 kcal/kg/d during the 6 weeks of lactation, which satisfied with energy requirements (85-130 kcal/kg/d) of the preterm infants.

중년 여성의 영양상태와 골밀도와의 상관성

안홍석 성신여자대학교 생활문화연구소 1998 生活文化硏究 Vol.12 No.-

임신중의 영양성 빈혈

안홍석 연세대학교 생활과학대학 1975 婦學 Vol.8 No.-

자유곡면으로부터 단면정보를 이용한 황삭계획에 관한 연구

안대건,최홍태,이석희 한국경영과학회 1994 한국경영과학회 학술대회논문집 Vol.- No.1

This study deals with roughing planning by cross sectional information generated from sculptured surfaces. Bicubic Bezier surface is adopted as sculptured surfaces in this paper. The system consists of 3 parts : (1) modeling sculptured surface, (2) reconstruction of cross-section in 2D coordinates, (3) determination of roughing tool path with structural data. The system is developed by using IBM-PC in the environment of Auto CAD R11, AutoLISP and MetaWare High C. The proposed system shows an efficient algorithm for roughing planning with cross sectional informaiton.

한국 임신부의 혈청 아연함량에 관한 연구

안홍석 誠信女子大學校 1988 硏究論文集 Vol.27 No.-

The purpose of this study was to determine the serum zinc concentrations of Korean pregnant women and compared them with pregnancy outcomes. Serum zinc levels were measured in 119 pregnant and 20 nonpregnant women by ICP Optical Emission Spectroscopy. The results showed that the mean serum zinc concentrations of pregnant women were lower than those of nonpregnant wpmen. The mean serum zinc levels were significantly decreased in women experienced severe morning sickness in the early period of pregnancy. These findings suggest that the morning sickness such as nausea and vomitting is probably related to the low maternal zinc status. Any association between maternal serum zinc level and overall eventual birth weight of normal infants was not observed. The placental transfer of zinc from meternal blood to fetal tissues mav be a factor affecting meternal zinc status.