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.

한인진 추출물의 간장보호 작용에 관한 연구

이순복,조태순,윤기욱,이종찬,이선미,심성보 성균관대학교 약학연구소 1998 成均藥硏論文集 Vol.10 No.1

The dose-response effect of polysaccharide extracts(PS-1) from Artemisia iwayomogi was investigated under various hepatic disease models. Silymarin, DDB and UDCA were used as reference compounds. We found that the maximal effective dose of PS-1 was 100 ㎎/㎏ b.wt. in CCl_4-induced hepatotoxicity, D-galactosamine-induced hepatitis, in ANIT-induced cholestasis and 300 ㎎/㎏ b.wt. in CCl_4-induced chronic liver disease, 30 ㎎/㎏ b.wt. in chronic bile duct ligation and chronic ethanol fatty liver. These findings suggest that PS-1 fraction protects the hepatocyte against various hepatic injuries, and this fracton might be of therapeutic value.

産業災害로 인한 手脂切斷 患者의 療養期間과 診療費의 變異

이종호,이종영,손지연,하영애,박순우,감신,이영숙,김건엽,강윤식 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.3

This study was conducted to analyze variation in patient days and medical care benefits among finger-amputated patients due to industrial injury. The 242 personal data on medical care for finger-amputated patients due to industrial injury(131 in 1994, 111 in 1995) of Regional Labor Office were analyzed. The major results of this study were as follows: Patient days per case were 69. And the ratio of the maximum and the minimum among patient days for case was 26.6. Patient days per case in university hospital were 134.8 and the longest than other medical facilites. The ratio of the maximum and the minimum among the patient days per case was higher in hospital(24.7) than in other medical facilities. Benefits per case were 1,258,000 Won. And the ratio of the maximum and the minimum among benefits of case was 232.0. Case benefits was higher in university hospital (2,685,000 Won) than in other medicl facilities. The ratio of the maximum and the minimum among the benefits per case was higher in hospital(232.0) than in other medical facilities. Variation in patient days and medical care benefits per finger-amputated patient in industrial injury was large. This study results indicated need for a new industrial injury compensation insurance policy initiative for efficient utilization of medical resources and quality assurance. And the author thought that the results of this study would influence the policy for the industrial injury compensation insurance policy.

Family Origin Names and Haplotypes of Y - DNA in Korean Population

Kim, Jong Soon,Kim, Yung Jin,Ahn, Gwang Sook,Lee, Ju Won,You, Sun Ah 한국유전학회 1996 Genes & Genomics Vol.18 No.4

The use of restriction fragment length polymorphisms (RFLPs) has been proposed for the construction of a human genetic linkage map and also become a powerful tool in human population genetics. Human Y-chromosome which is haploid and paternally inherited is valuable for investigating male-mediated gene flow and for complement maternally based studies of mtDNA. We have studied 166 samples from 4 kinds of family origin names such as Kyungju Kim, Kimhae Kim, Chunju Lee and Milyang Park based on the 49aTaq 1 polymorphisms, and a total of 25 haplotypes were observed. The B, F, and I bands is observed in all haplotypes and haplotype showing A3, B, D2, D3, F, and I bands is common haplotype except for Chunju Lee. The result obtained are summarized as follows.

임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

경기도 지역 정신보건 사업의 추진배경과 정책결정과정

이충순,윤배중,이주훈,이종국,고영,이영문,최향순,김혜숙 용인정신의학연구소 1997 용인정신의학보 Vol.4 No.2

虹彩 體質 分析에서 心腎結合組織의 虛弱 體質과 高血壓 家族歷과 관련성 硏究

金鐘牛,黃祐準,琴坰樹,李始炯,李宗淳,都金錄,趙在運,趙州掌,金鐘煜 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

Iridology, developed more than 100 years ago, is the diagnosis of medical conditions through noting irregularities of the pigmentation in the iris The purpose of this study is to compare interrelation between CVA, hypertension family history and cardio-renal connective tissue in Iris Constitution through iris constitution examination. The subjects consist of 114 patients who were examined in Iris Constitution at Chonju Oriental Medicine Hospital attached to Wonkwang Univ. from September. 1St. 2000 to August. 31th. 2002. 1. In the distribution of Iris Constitution, among of 79cases, There are neurogenic type 13cases, abdominal connective tissue weakness constitution 31 cases, cardio-renal connective tissue weakness constitution 6 cases, cholesterol 7 cases and others 22 case in control group. 2. There are familial history of CVA and hypertention 32 cases, no familial history of CVA and hypertention1 3 cases, in 35cases of experimental group. These results imply that there is meaningfulness of interrelation between cardio-renal connective tissue weakness constitution and. CVA, hypertention.

크롬(Ⅵ)의 체내 흡수와 소실속도에 관한 연구

김현영,이성배,임철홍,이권섭,정용현,이종성,한정희,전윤석,황호순,이용묵 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.1

The CrO3 mostly used in plating. metal surface disposal, leather, cosmetic manufacturing, as an experiment material by repeatedly inhaling and exposure the male S.D. rats at a 0.00, 0.2., 0.50, 1.25 mg/㎡ concentration(particle size: 0.5-0.5 aerosol)6hours a day, 5day a week in 13weeks comparing with 2weeks, 8weeks of recovery group about the noxiousness of the experiment animal and the reduce scale of the CrO3 in the internal organ especially in blook and respiratory organ with the period of convalescent and clearance. The experiment results which we received are as follows. 1. In blood the RBC, HGB and HCT experiment, rats with 0.20, 0.50 mg/㎡ concentration showed that there were some decreases but not dependent. The kidneys absolute weight compared with control group was reduced intentionally(p〈0.05) and the lungs absolute weight compared with control group showed intentional increase(p〉0.05). 2. After the exposure of the experiment material, the whole blook, l\blood plasma and red blood cell in blood by (x): the period of convalescent, per (y); the decreasing of Cr concentration, was y=66.51 e -0.057x, y=67.2 e-0.101x, y=70.01 e-0.030 in 0.50 mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life (day)was estimated 12.0, 6086, 23.0 each. 3, After the exposure of the experiment material, the experiment animals lung, liver and kidneys by(x); the period of convalescent, per (y); the decreasing of Cr conentration, was y=1808 e-0.00493x, y=12.02e-0.0297x, y=67.61 e-0.0292x in 0.50mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life(day)was estimated 140.6, 23.3, 23.7, each, and including lung, liver with all of the experiment internal organs, the Cr clearance decreased as the exposure concentration increased.

Special Issue of Professor Kiehwa Lee`s Retirement: Geophysical Environments of the Korean Peninsula : Articles ; Geoelectrical Structure of the Kyongsang Basin from Magnetotelluric Sounding

( Choon Ki Lee ),( Heui Soon Lee ),( Byung Doo Kwon ),( In Ky Cho ),( Seok Hoon Oh ),( Yoon Ho Song ),( Tae Jong Lee ) 대한지구물리학회 2006 지구물리 Vol.9 No.3

디지털 영상인식 방법을 통한 자세평가 및 운동가동범위 측정시스템 개발

문영진,이순호,백진호,이종각,이건범 한국운동역학회 2004 한국운동역학회지 Vol.14 No.3

Y. J. MOON, S. H. LEE, J. H. BACK, J. K, LEE, K. B. LEE. The development of posture evaluation and Range of Motion(ROM) system by using digital vision analysis method. Korean Journal of Sport Biomechanics, Vol. 14, No. 3, pp. 49-65, 2004. The purpose of this study is development of posture evaluation and Range of Motion(ROM) system by using digital vision analysis method. The results of this study are as follows. First, Scoliosis evaluation through this research measurement system represent 3mm error in 7 cervical point and deepest lumbar point, 0.7mm error in other point. This mean this research measurement system have a reliability for scoliosis evaluation. Second, for spine line evaluation on high fat subject, we need reconstrection spine line after mesurement for fat thickness in 7 cervical point and deepest lumbar point. Third, In pedioscope error test, it present 0.01848cm in X axis and 0.01757cm in Y axis. This results mean pedioscope have a reliability foot evaluation. Forth, Posture evaluation and Range of Motion measurement system by using digital vision analysis method can fast measure in range of motion and foot evaluation and posture. therefore we can expect this system application in young people posture clinic center and hospital and so on.