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.

密陽驪州李氏 亭子建築 造營活動 - 密陽驪州李氏 亭子建築의 建立背景을 中心으로 -

권순강(Kwon Soon-Kang),이호열(Lee Ho-Yeol) 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

This study is about the feature of arbor construction of Miryang Yeoju Lee's family, who resides in Miryang. Miryang Yeoju Lee moved to Miryang around 1500 and has larger number of arbors than any other families. This is probably resulted from family members' efforts. It is because that the arbors are mainly created by individuals or close descendants but later operated by the next generation who leads management and restoration. Therefore, the arbors have significant meaning within the family, too.

위암과 식도암이 병발된 다발성 원발성 악성종양 1예

박사영,이나영,이효진,이선영,최진혁,이순남,심강섭,성순희,한운섭 梨花女子大學校 醫科大學 醫科學硏究所 1996 EMJ (Ewha medical journal) Vol.19 No.3

Multiple primary cancer means that more that two cancers occur independently in an individual. Recently, the incidence of multiple primary cancer has increased with lengthened survival, of cancer patients, development of new diagnostic technique and increased clinical evaluation. We report a patient who had adenocarcinoma of stomach combined with squamous cell carcinoma of esophagus simultaneously.

Predicting postoperative total calcium requirements after parathyroidectomy in secondary hyperparathyroidism

( Byung Heon Kang ),( Soon Young Hwang ),( Jeong Yeop Kim ),( Yu Ah Hong ),( Mi Yeon Jung ),( Eun Ah Lee ),( Ji Eun Lee3 ),( Jae Bok Lee ),( Gang Jee Ko ),( Heui Jung Pyo ),( Young Joo Kwon ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.6

Background/Aims: To prevent hypocalcemia after parathyroidectomy (PTX), parenteral calcium is required in addition to oral calcitriol and calcium. After switching to oral calcium, patients can be discharged from the hospital. The aim of this study was to analyze the clinical characteristics and outcomes of PTX performed at a single Korean center and to investigate the associated laboratory factors used to analyze the total amount of postoperative calcium required. Methods: We enrolled 91 hemodialysis patients undergoing PTX from November 2003 to December 2011. We collected clinical and laboratory data preoperatively, 12 and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively. Results: In total, 59 patients underwent PTX with autotransplantation (AT), 6 underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent limited PTX. Total PTX without AT showed the lowest recurrence rate. At all postoperative time points, the mean levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) decreased significantly, compared with preoperative levels; however, alkaline phosphatase (ALP) increased significantly from 48 hours postoperatively to discharge (p < 0.001). On multiple linear regression analysis, the total amount of injected calcium during hospitalization showed a significant correlation with preoperative ALP (p < 0.001), preoperative iPTH (p = 0.037), and Δphosphorus at 48 hours (p < 0.001). We developed an equation for estimating the total calcium requirement after PTX. Conclusions: Preoperative ALP, preoperative iPTH, and Δphosphorus at 48 hours may be significant factors in estimating the postoperative calcium requirement. The formula for postoperative calcium requirement after PTX may help to predict the duration of postoperative hospitalization.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

수술전 교육프로그램이 환자의 정서상태에 미치는 영향

김분한,정연,강화정,이순우,김진순,이묘섭 성인간호학회 2000 성인간호학회지 Vol.12 No.3

The purpose of this study was to examine the effect of preoperative teaching as a nursing intervention on the emotional status of the patients prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronize Design. The data were selected from H universuty hospital in Seoul and they consisted of an experimental group-30patients, and a control group-30 patients. The questionnaire consisted of 28 Preoperative Stress Inventory(Kang. 1998), and 16 State-Trait Anxiety Inventory(Spielberger. 1972). The collected data were analized by means of frequency, percentage, x²test, t-test and paired t-test with SPSS WIN. The results of this study were as follows : 1. The level of stress prior to surgery was significantly lower for the preoperative teaching group than for the control group(t=2.61. p$lt;.01). 2. The level of anxiety prior to surgery was not significantly lower for the preoperative teaching group than for the control group. 3. The difference level of the anxiety level the prior to surgery was significantly higher for the preoperative teaching group than for the control group(t=2.82, p$lt;.01). In conclusion, preoperative teaching is a beneficial nursing intervention that has a positive effect on the stress and anxiety of patients prior to surgery. Therefore it is recommended to use the preoperative teaching program as a nursing intervention for patients prior to surgery.

환자의 권리에 대한 인식정도와 요구정도에 관한 연구

이강오,정순아 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

The purpose of this study was to find out the degree of recognition and demand on the patients' rights in hospital. 187 subjects were selected among adult patients admitted in medical and surgical area of two University hospitals and one general hospital. The data were collected through questionnaires and interviews from March 17th to April 7th in 1989. The data were analyzed by T-test, ANOVA and Pearson's Correlation Coefficient. The findings were as follows : In the relations of subjects' geveral characteristics and the degree of recognition, demand and favor of patients' rights, there were significant differences in the degree of recognition and the family's monthly income(F=3.293, P<.05), in the degree of demand and the experience on the patients' rights(T=3.43, P<.05), and in the degree of favor and ages (F=2.701, P<.05). Hypothesis 1 : " there would be correlation between the degree of recognition and demand on the patients' rights of the subjects", was not supported. Hypothesis 2 : " There would be correlation between the degree of recognition and favor on the patients' rights of the subjects", was supported. (r=.1689, P<.05) Hypothesis 3 : " There would bd correlation between the degree of demand and favor on the patients' rights of the subjects", was supported.(r=.2254, P<.05)

우심방을 침범한 거대 비호지킨씨 림프종 1예

강상범,진승원,이은경,박용현,최용호,김용주,박준철,김재형,홍순조,최규보,권종범,원용순,박건,이은희 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

親和性 크로마토그라피에 의한 大豆β-amylase의 精製 및 特性

金贊植,李東恩,姜順善 제주대학교 1992 논문집 Vol.34 No.-

Soybean β-amyase 〔β-1.4-glucan maltohydrolase EC 3.2.1.2 〕has been purified from defatted soybean meal by fractional precipitation with ammonium sulfate, ion ezchange chromatography on CM-Toyopearl 650M,affinity chromatography on γ-CD-sepharose column,and some physicochemical properties of the enzyme were investigated. The purified enzyme showed 50.5 folds of purification , 1,136unit/mg protein of specific activity and 36% of yield,respectively,compared to the curde extract. The enzyme showed a single band on Sodium Dodecyl Sulfate polyacrylamide gel electrophoresis, and its molecular was estimated to be 58,000 daltons by SDS-PAGE. The prified enzyme was identified as homegenous by HPLC analysis and maltose activity assay. The optimum pH and temperature was 5.6and 55℃ ,respentively. The enzyme was stable below 60℃,but was very labile over 65℃ The enzyme was most stable at pH 5.0~6.0, and was more stable in the acidic region than in neutral region. From the Hanes-Woolf plot,the Km value for soluble starch was calculates as 0.05% and Vmax value was 1.3×10²μmol maltose. min??.mg??

Application of in vitro ovary culture for cottonwood (Populus deltoides) breeding

Kang,Ho-Duck,Lee,Min-Soon 한국자원식물학회 2004 Plant Resources Vol.7 No.2

Five different poplar hybrids were tested for rescuing embryo to elongate in vitro plantiets after hybridization. Ovaries and ovules were cultured on Woody Plant Medium (WPM) supplemented with cytokinins, 6-benzylamine (BA) and zeatin. Multiple shoots were initiated from half section of capsule with immature embryos after 21 days from pollination and tiny shoots were formed after the expansion of cotyledons in ovule cultures. Germinating response was better in intraspecific hybrids (6.53±1.66) than interspecific crosses (0.93±0.54) 수식 이미지 from half section of capsules on WPM medium. In general, zeatin was better than BA in inducing multiple shoots from isolated ovules. The highest average number (19.40±4.53) of shoots was produced from immature ovules of 21 days post-pollination of WPM medium supplemented with 5.0 mg/L zeatin. The highest percentage of germination was 93% from the half section of in vitro ovary cultures. Soil acclimation was successfully conducted in cell tray containing artificially mixed soil with 96% survival rate.