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.

신축학교 실내공기질이 초등학생들의 인지기능에 미치는 영향

김태섭,김선주,박시영,전만중,김규태,김창윤,정종학,백성옥,사공준 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 신축초등학교와 대조학교를 선정하여 교실 내 포름알데히드와 TVOCs를 측정하고 컴퓨터 신경행동검사를 이용하여 실내공기 오염물질이 학생들의 인지기능에 미치는 영향을 평가하였다. 방법: 신축초등학교 5학년 71명을 실내공기 오염물질 노출군으로 하고, 개교한지 12년째인 대구시의 일개 초등학교 5학년 2학급 63명을 대조군으로 하여 실내공기 오염물질농도 측정 및 컴퓨터 신경행동검사를 실시하였다. 결과: 신축학교에서 의도적으로 창문을 개방한 학급에서 1교시 포름알데히드 농도는 34.6 ㎍/㎥, 4교시에는 27.3 ㎍/㎥, 창문을 개방하지 않은 학급에서 1교시 80.2 ㎍/㎥, 4교시 127.1 ㎍/㎥, 대조학교에서는 2학급 각각 1교시에 12.6 ㎍/㎥, 7.5 ㎍/㎥, 4교시에 19.8 ㎍/㎥, 25.2 ㎍/㎥였다. TVOCs의 경우 신축학교의 의도적으로 창문을 개방한 학급에서 1교시에 농도는 487.2 ㎍/㎥, 4교시에 428.2 ㎍/㎥, 창문을 개방하지 않은 학급에서 1 교시에 농도는 1,283.5 ㎍/㎥, 4교시에 1,715.4 ㎍/㎥, 대조학교의 경우 2학급에서 각각 1교시에 농도는 240.9 ㎍/㎥, 150.8 ㎍/㎥, 4교시에 농도는 371.9 ㎍/㎥, 448.0 ㎍/㎥였다. 부호숫자 짝짓기의 평균반응시간은 대조학급이 1교시에 2,585 msec에서 4교시에 2,459 msec으로 감소한 반면 신축학교의 창문을 의도적으로 개방한 학급은 2,343 msec에서 2,510 msec으로, 평소대로 수업한 학급은 2,340 msec에서 2,563 msec으로 반응시간이 각각 167 msec, 223 msec 증가하였다. 1교시의 부호숫자 짝짓기 의 반응시간을 100%로 했을 때 창문을 의도적으로 개방 한 학급은 4교시에 5.9% 증가하였고(p<0.01), 평소대로 수업한 학급은8.3% 증가하였다(p<0.01). 반면에 대조학급은 4교시에 5.0% 감소하였다(p<0.01). 결론: 향후 학교의 실내공기질의 안전성 평가는 샘플링 된 공기의 오염수준의 측정뿐만 아니라 학생들의 건강영향도 함께 고려되는 것이 바람직할 것이다. Objectives: Most studies on the indoor air quality of newly built schools have focused only on the number of schools exceeding a standard or on subjective symptoms, such as sneezing, irritated eyes and an irritated nose. However, there has been no report on how poor indoor air quality affects children's academic performance. This study evaluated the effects of indoor air quality on the neurobehavioral performance of elementary school children. Methods: This study measured the indoor air pollutants and compared children's performance, using a computerized neurobehavioral test, between a newly built and a 12-year-old school. In addition, a questionnaire was administered regarding the indoor air quality related symptoms of children in a newly built and a 12-year-old school. Results: In the newly built school, the formaldehyde levels in the 1^(st) and 4^(th) classes with an open window were 34.6 and 27.3 μg/㎥, respectively. The levels in the 1^(st) and 4^(th) classes with the window closed were 80.2 and 127.1 μg/㎥, respectively. In the 12-year-old school, the formaldehyde levels in 1^(st) and 4^(th) class with open and closed window were 12.6 and 7.5 μg/㎥, and 19.8 and 25.2 μg/㎥, respectively. With respect to total volatile organic compounds, the levels in the 1^(st) and 4^(th) classes with the window open in the newly built school were 87.2 and 428.2 μg/㎥, respectively. In the 1^(st) and 4^(th) classes with the window closed, the total volatile organic compounds were 1,283.5 and 1,715.4 μg/㎥, respectively. In the 12-year-old school, the total volatile organic compounds were 240.9 and 150.8 μg/㎥, and 371.9 and 448.0 μg/㎥ in the 1^(st) and 4^(th) classes, respectively. In the case of a newly built school, the performance of the students in the neurobehavioral test in the 4^(th) class with the window closed was 8.3% lower than for those in the 1^(st) class with the window closed, but was only 5.9% lower when the windows were open. There was a statistical significant difference in the total numbers of symptoms between the two schools. Conclusions: These results suggest a proper evaluation of the indoor air quality within schools is required into both the level of contamination and the health effects of these contaminants toward children.

바이오필터에 의한 VOCs의 제거에 대한 연구

김장호,김옥택,안종수,김종수 동아대학교 환경문제연구소 2001 硏究報告 Vol.24 No.1

Biofiltration was successfully applied to treat amixture of volatile organic compounds(Benzene, Xylene) from contaminated air stream. Immobilized Ps.oleovorans biofilter was evaluated for its value in simultaneous removal of B.X from waste air stream. The variety of operating conditions were tested to evaluated important factors such as space velocity, PH, water content, ect. In the loading rate(1,000ppmv) and space velocity(l,200hr), the average removal efficiencies of B.X. were 39.3% and 30.5% and CO₂ production rate were 6.72 mg/hr, 4.65mg/hr, respectively. Removal efficiency of B.X. mixture was lower than it's each individual at same loading rate. When the concentrations of B.X. mixture were controlled 300ppmv and 900ppmv at two stages reactor, the average outlet concentration were 7.lppmv, 184.5ppmv and CO₂ production rate were 6.04mg/hr, 12.6mg/hr, respectively.

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.

제주도 연안 정치망 조업시스템 개발에 관한 연구 : 낙망에 의한 조업시스템 생력화 Studies for the Man Power Saving of Fishing System by Pound net

김병엽,김석종,이창헌,김종범,서두옥 濟州大學校 海洋硏究所 2002 해양과환경연구소 연구논문집 Vol.26 No.-

제주도 연안 정치망의 조업시스템 생력화와 실용화를 목적으로 어군의 도피를 최대한 방지하고 양망작업이 용이하도록 개량 설계된 낙망어구를 제주도 북제주군 한경면 금등정치망 어장에 부설하고 실용화 및 조업시스템 생력화에 대하여 현장실험을 실시하였는데 그 결과를 요약하면 다음과 같다. 1. 낙망어구규모에 적합한 조업선을 기계화하여 1척의 어선으로 조업이 가능하였다. 2. 조업어선 선수미부 양망현에 양망기인 캡스턴을 설치하므로 조업인원 2∼3명으로도 양망작업이 가능하였다. 3. 망갈이 작업시 양망한 그물을 선상에서 적재하고 육상에서 양륙할 때 파워블록을 사용함으로써 작업효율을 높일 수 있었다. In order to obtain the fundamental data for the man power saving and the practical use of fishing system for a set net in the coast of Jeju island, a pound net designed for making hauling operation easier and preventing a school of fish from escaping was set up at a fishing ground in Geumdeung and a field experiment was carried out. The fishing operation was feasible with one boat mechanized for the pound net and the hauling operation was not made possible with 2-3 persons till a net haular, that is, a capstan was set up on the hauling side of the boat. In addition, a power block enhanced the efficiency of operation for hauling up the net on board or hauling down on land.

정전위 SSRT법에 의한 해양구조물용 Cu함유 고장력저합금강의 수소취성한계전위 규명에 관한 연구

김성종,박태원,심인옥,김종호,김영식,문경만 한국해양대학교 해양과학기술연구소 2001 硏究論文集 Vol.10 No.1

A marine structural material was well known to have high tensile strength, good weldability and proper corrosion resistance . Cu-containing high strength low alloy (HSLA) steel was recently developed for their purposes mentioned above, And the steel is free about preheating for welding, therefore it is reported that shipbuilding cost by using it can be saved more or less. However the marine structural materials like Cu-containing HSLA steel are being generally adopted with cathodic protection method in severe corrosive environment like natural sea water but the high strength steel may give rise to Hydrogen Embrittlement due to over protection at high cathodic current density for cathodic protection. In this study, Cu-containing HSLA steel using well for marine atructure was investigated about the susceptibility of Hydrogen Embrittlement as functions of tensile strength, strain ratio, fracture time, and fracture mode, etc. and an optimum cathodic protection potential by slow strain rate test(SSRT) method as well as corrosion properties in natural sea water. And its corrosion resistance was superior to SS400 steel , but Hydrogen Embrittlement susceptibility of Cu-containing HSLA steel was hider than that of SS400 steel. However Hydrogen Embrittlement of its steel by SSRT method was showed with pheonomena such as decreasing of fracture time. strain ratio and fracture mode of QC (quasi-cleavage) Eventually it is suggested that an optimum cathodic protection potential not presenting Hydrogen Embrittlement of Cu-containing of HSLA steel by SSRT method was from-770mV(SCE) to - 900mV(SCE) under natural sea water. (Received September 21, 2000)

초·중·고 학생들의 과학 탐구 능력 추이 분석을 위한 종단적 연구

우종옥,김범기,허명,김찬종,양일호,최관순,김태선 한국교원대학교 과학교육연구소 1999 청람과학교육연구논총 Vol.9 No.1

본 연구에서는 우리 나라 초·중·고등학교 학생들의 과학 탐구 능력에 대한 종단적 추이를 분석하였다. 1997년에는 우종옥 등(1998)이 개발한 검사지를 사용하였으며, 1999년에는 이를 일부만 수정하여 사용하였다. 조사 대상은 성별, 지역별 등을 고려하여 표집하였다. 조사된 자료는 각각 횡단적으로 분석하고, 이를 바탕으로 학생들의 과학 탐구능력이 어떻게 변해 가는지 종단적 추이를 분석하였다. 조사 결과 초등학생들의 과학 탐구 능력은 유의미한차이가 없었으나, 중·고등학생들의 과학 탐구 능력은 유의미하게 향상된 것으로 나타났다. 학교 과학 교육의 질을 과학적으로 관리하기 위해서는 교육과정이 추구하는 교육 목표의 달성이 성공적으로 이루어지고 있는지를 국가수준에서 주기적으로 측정하여 부진의 원인을 진단하고, 개선 방안을 계속 연구하여야 할 것이다. The longitudinal trend of elementary and secondary students' science process skills were investigated to monitor the progress of science learning. Science process skill test, developedin an earlier study on developing a national science process skills assessment system, was revised and administered for the study on March, 1999. Subjects were sampled nation wide according to sex and region. The results of this assessments were compared to those administered on February, 1997. The results showed little difference on science process skills among elementary school students. However, secondary students showed marked increase in science process skills. More systematic and long-term research for assessing science process skills should be planned and performed periodically to provide empirical and foundational data for educational policy making.

영어 Much of an N 구문에 대한 말뭉치 기반적 접근

김옥기(Ok gi Kim),김종복(Jong Bok Kim) 현대문법학회 2015 현대문법연구 Vol.86 No.-

Okgi Kim and Jong-Bok Kim. 2015. English much of an N Construction: A Corpus-based Approach. Studies in Modern Grammar 86, 47-70. English much of an N (henceforth, MOA) construction (e.g., It’s not much of a problem.) consists of quantifiers like much, more/less, enough, little and of-an-NP to intensify the indefinite singular degree NP. In this paper, we first review basic properties of the construction, focusing on the relation between the gradability of the NP and its predicativeness. In particular, after investigating authentic corpus data of the MOA, we provide a qualitative and quantitative analysis which allows a constraint-based approach in accounting for various syntactic as well as semantic properties of the construction.

경기도 거북놀이의 전승과 새로운 계승양상

김종대(Kim, Jong-dae),윤서옥(Yoon, Seo-ok) 중앙어문학회 2014 語文論集 Vol.60 No.-

경기도와 충청도의 내륙지방에서는 추석의 민속놀이로서 거북놀이가 전승되어 왔다. 흥미롭게도 이들 놀이는 주로 청소년이 전승시켜 왔다는 점과 모의 동물로 거북이를 수수 잎으로 만들어서 활용하였다는 점이다. 거북놀이의 기록은 현재까지 역사시대의 문헌에는 찾기가 어려운데, 문헌상으로는 일제침략기의 朝鮮の鄕土娛樂에서부터 찾아볼 수 있다. 일제침략기의 기록에 등장하는 것으로 보아 아마도 조선시대에는 널리 행해졌던 민속놀이로 추정되기는 하나, 현재까지 명확한 기록이 보이지 않아서 언제 어떻게 만들어졌는지를 고증하기란 쉽지 않은 실정이다. 거북놀이의 주체에 대한 논의도 이런 사정 때문인지 여러 가지의 설이 있으나 이들도 확실성이 떨어진다. 하지만 朝鮮の鄕土娛樂을 보면 주로 어린이나 청소년이 주동이 되었다고 하며, 어른이나 성년으로 기록된 사례는 많지 않다. 예컨대 경기도의 경우 용인은 농민, 안성은 남자로 표현되었으며, 충청도의 홍성은 청년, 예산은 어린이와 부인 등으로 되어 있다. 이들 외의 다른 지역은 모두 어린이가 행한 것으로 기록되어 있다는 점이 특징이다. 결국 이들 놀이는 용인이나 안성, 수원 등 대개 다른 지역의 거북놀이와 유사하게 행해졌다고 하는 것으로 보아 어린이들이 주동이 되었음은 쉽사리 짐작된다. 이러한 거북놀이는 일제침략기를 거치면서 한동안 전승이 단절되다가 해방이후 1970년대에 와서 다시 복원하는 운동이 일어난다. 예컨대 음성의 윤병준 선생과 이천의 김종민 선생이 대표적인 예이다. 문제는 이들 복원과정에서 판굿과 농악의 개입이 이루어졌다는 사실이다. 즉 거북놀이의 주도적인 계층이 풍물패로 이전되는 과정에 의해서 과거의 주도층이었던 어린이들이 입지를 잃어버리게 되었다는 점이다. 이런 변화과정은 거북놀이를 민속경연대회나 민속예술축제 등에 출품하려는 시도와 밀접한 관계에 있다. 어린이가 주동이 된 거북놀이의 경우에는 놀이판의 형식화가 없었지만, 이들과 결합하면서 제의과정과 판굿의 연행방식을 갖추게 된다는 점이다. 현재의 연행방식은 대개 이런 틀로 고정화되는 과정을 겪고 있다. 특히 연행의 변화양상은 이들 놀이를 농촌체험 프로그램으로 참여하여 지역 민속문화의 특징을 보여주려는 방식으로 탈바꿈하고 있음은 주목할 만하다. 동시에 단순히 연희되는 것 뿐만 아니라, 거북이 만들기 등 다양한 프로그램을 개발하여 과거의 정형성을 효과적으로 활용하려는 시도를 보여준다는 점에서 전통 민속놀이의 계승 발전에 유의미한 면을 보여주고 있다. Geobuk-nori, the Turtle Play, is performed during Chuseok (a Korean harvest holiday) in Gyeonggi and Chungcheong provinces. During The Turtle Play, young people wear turtle costumes made out of sorghum leaves and go about the village giving their wishes for a good harvest and good luck in the coming year. While there is no historical record of the origin of the play, interestingly, it appeared in Indigenous Entertainment of Joseon, written during the Japanese occupation. Because of the book, it is assumed the play was performed during the Joseon dynasty; however, its origin has not been confirmed. Several theories regarding Turtle Play and Joseon need further research. According to Indigenous Entertainment of Joseon, the play was mainly performed by children. It was rare to see adults performing it, and there are only a few cases of adult involvement: farmers in Yongin, Gyeonggi Province; men in Anseong; young people in Hongseong, Chungcheong Province, and children and married women in Yeosan. Apart from these cases, the play was performed solely by children. Performances of The Turtle Play stopped during the Japanese occupation; however, there was a movement to revitalize it in the 1970s. Mr. Byeongjun Yoon from Eumseong and Mr. Jong-min Kim from Icheon are representatives of this revitalization movement. In the process of revitalization, some changes were made, such as the inclusion of shamanic rituals and children lost their roles as the main performers of the play. This change is closely related to participation of the play in competitions such as the National Folk Arts Contest and the National Folk Art Festival. When the play was performed by children, it did not have a specific formality. However, it changed into a combination of ritual and shamanic ceremony, and there are new ways of performing the play. Additionally, The Turtle Play is often used to introduce regional folk culture to tourists. In relation to this, various educational programs, such as a class for making turtles, were developed. In terms of production, these kinds of programs might have a positive effect in that they may help people understand more about the play and have more interest in it.

Depth Jump 시 하지 관절 상해에 관한 운동역학적 분석

소재무,김윤지,이종희,서진희,정연옥,김광기 한국운동역학회 2005 한국운동역학회지 Vol.15 No.1

J. M. SO, Y. J. KIM, J. H. LEE, H. J. SEO, Y. O. CHUNG ? K. K. KIM. The analysis of lower extremities injury on depth jump. Korean Journal of Sport Biomechanics, Vol. 15, No. 1, pp. 127-142, 2005. The purpose of this study was to analysis biomechanics of the lower extremities injury the heights(40cm, 60cm, 80cm) of jump box as performed depth jump motion by 6 females aerobic athletes and 6 non-experience females students. The event of depth jump were set to be drop, landing and jump. The depth jump motions on the force plate were filmed using a digital video cameras, and data were collected through the cinematography and force plate. On the basis of the results analyzed, the conclusions were drawn as follows: 1. The landing time of skill group was shorter than unskill group at 40cm, 60cm drop height during drop-landing-jump phase especially. The landing time of 60cm drop height was significant between two group(p<.05). 2. The peak GRF of sagittal and frontal direction following drop height improve was variety pattern and the peak vertical force of 40cm drop height was significantly(p<.05). 3. The magnitude of peak passive force was not increase to change the drop height. 4. The peak passive forces was significant at 40cm drop height between two groups(p<.05)