소에서 盲腸擴張을 동반한 第4胃食滯 手術 1例

김명철,김덕환,신상태,임준호,김남중,김종만 충남대학교 수의과대학 동물의과학연구소 1998 動物醫科學硏究誌 Vol.6 No.-

Abomasal impaction with cecal dilatation was diagnosed in a 3 years old holstein cow. The clinical signs were loss of appetite, scant feces and moderate distension of the abdomen. Ping sound was revealed in the right 11th intercostal space by auscultation. Cecal dilatation and abomasal impaction were ascertained by right flank laparotomy and abdominal exploration, and intestinal content and gas were removed from the cecal apex incised. One day later, 2.5㎏ of sand was removed by ventral paramedian abomasotomy.

신장이식 환자에서 HCMV 항원혈증 검사의 임상적 유용성

김탁,성흥섭,박관태,김송철,김성한,최상호,김양수,우준희,박수길,한덕종,이상오 대한감염학회 2009 감염과 화학요법 Vol.41 No.2

Background : This study was performed to determine the cut-off value and the predictability of symptomatic human cytomegalovirus (HCMV) infection according to the peak value of HCMV antigenemia assay in kidney transplant recipients. Materials and Methods : We reviewed the results of HCMV antigenemia assay (Chemicon, CA, USA) in patients who received kidney transplantation at our institution from May 2003 through May 2008, and investigated the existence and the type of HCMV infection by the medical record review. Patients who underwent the test only once during the episode or those who received ganciclovir for more than 48hrs before the test were excluded. The receiver-operator characteristic curve was drawn and the point showing maximum likelihood ratio (LR) was chosen as the cut-off value of symptomatic HCMV infection. Results : A total of 689 episodes were screened and 134 episodes were enrolled. Thirty-three (24.6%) episodes were symptomatic HCMV infection, 23 (17.2%) episodes were associated with HCMV syndrome, and 10 (7.5%) episodes were tissue-invasive diseases. The maximum LR was 7.5 (95% confidence interval, 4.014.2) and the cut-off value was 29.5 cells/200,000 WBC. The sensitivity, specificity, Positive predictive value, and negative predictive value were 66.7%, 91.1%, 71.0%, and 89.3%, respectively. Conclusions : The cut-off value of symptomatic HCMV infection by the peak value of HCMV antigenemia assay in our study was similar with previous results, although the sensitivity was relatively low.

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.

정재의 시대적 변천과 전승보급에 관한 연구

김상덕(Kim Sang Duck) 한국체육철학회 1997 움직임의철학 : 한국체육철학회지 Vol.5 No.1

Chong-Jae as a court dance is dedicated to the king. That means contributing talent. It originated grom the shape of court dance music under the control of professional department, and was named 「bang Ark and Hayng Ark」 and 「A-Ark Chong Jae」 has the genre as a dance. In the times of 「Korea」, the respect of Buddism made a present to the king customary, directed to inflew 「Sin Ark of the sung」 and 「Tae Song A-Ark」, and the sting contribute organized The department of court music of the tang, which modified to be in harmony with our people`s emoting, dance and music admired the great achievement of the founding country, prayed the national peace in the early of 「Cho-Sun」 era. So to speak, It developed to make a display of the kings authority. And the completing of 「Hoonmin Jong um」 dirceted Chang Sa, which use 「Korea and Chinese characters in combingation. Since, the early of the 「Cho-Sun」 dynasty, the golden age of the civilization, the dance and music declined, and not reached the level of the first stage. It caused by the much invasion of the Japanese and with the help of the political and economical peace of the king Sook Jong, the court music revived under the rale of the King 「Young Jong」. To the modes ages from the king 「Soon Jae」, there was np dance and music system, introduced 「Chong Jae」, as it is, and became extinct Since the annexation of the Korean and Japan. And, 「Lee Wang Jik」 court dance department renamed court dance department, opened the national classical music institute in 1951. With the designation as a 「Intagible cultural assets」, the modern full-dresses reappearance of 「Chong Jae」 accomplish by 「Kim Chon Heng」 as a 「Chong Jae」 reappearance choregrapher theagh the performance of the national classical music Institute. This work of the reapperarcne done by the national classical music institute must be estimatel affirmatively. As a researcher, I examined the inflow and conservation theroughout the times with the process of historcal changes of 「Chong Jae」, according to the creative Korean dance and the flood of the inflow of foreign culture, I made some conclusion on the pressevation and transmission of 「Chong Jae」. First, the recognition both school education and the institytional system in the national -public organization must direct the chance of various learning in view of the preservation and trancsmission of 「Chong Jae」. Second, the estrangement of court dance on the ceremony of dnace in the dance stage and students dance contest, a group of positive participation must be groped. Third, there is dnace which designation 「intangible cultural assents」 in 「Chong Jae」. Especially, Ovserng the dance of a group 「Chong Jae」, composition dance equipment, I feel sure that It will help the exploitation of various composition, dance, properties and device in the scope of the stage effection in the 「ceremony of the korean creative dance」. In the view of inheriting and tradition the reappearance, reviral, transmiting and spread of 「Chong Jae」 have the meaning as it is. The reappearance and revival must be developed top the arctic value which is in harmony with the present age, consider the internationalization and globalization and Institutional devices are essential to hand it down to poeterity as a research naterials and a concera to cultural art is indispensible.

단일공법 복강경하 질식자궁절제술 110예의 고찰 및 다공법과의 비교

박병준 ( Byung Joon Park ),김용욱 ( Yong Wook Kim ),노덕영 ( Duck Yeong Ro ),김태응 ( Tae Eung Kim ),류기성 ( Ki Sung Ryu ),김장흡 ( Jang Heup Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.7

목적: 통상적인 복강경기구만을 사용한 단일공법 복강경하 질식자궁절제술을 다공법 복강경하 질식자궁절제술과 비교하여 안전성 및 유용성을 평가하고자 하였다. 연구 방법: 2007년 4월부터 2009년 11월까지 인천성모병원에서 자궁근종 또는 자궁샘근증의 질환으로 단일공법 복강경하 질식 자궁절제술을 시행받은 환자 110명과 다공법 복강경하 질식자궁절제술을 시행받은 환자 110명, 총 220명의 환자를 대상으로 하였다. 우리는 모든 수술에서 통상적으로 사용되는 구부러지지 않는 일직선의 복강경기구를 사용하였다. 또한 단일공법 및 다공법 복강경하 질식자궁절제술 둘 다에서 수술자 (Kim, YW)의 이름을 따서 명명한 새로운 질단부 봉합 방법인 김씨 질구개 현수법 (Kim`s Vaginal Vault Suspension Method)을 사용하였다. 결과: 환자 나이, 수술 시간, 자궁의 무게, 혈색소 수치의 변화, 수혈 빈도, 수술 후 발열에서 두 군 간에 유의한 차이를 보이지 않았다. 환자들의 평균 나이는 46.7±7.0세(단일공법)와 45.5±6.3세(다공법)이었다. 평균 수술 시간은 87.2±21.0분(단일공법)과 83.3±20.3분(다공법), 평균 자궁의 무게는 261.4±139.7 g(단일공법)과 257.8±132.9 g(다공법), 평균 혈색소 수치의 변화는 1.1±0.7 g/dL(단일공법)와 1.2±0.6 g/dL(다공법)이었다. 두 군 모두에서 수술 중 장 또는 요로의 손상은 없었다. 두 군 모두에서 각각 한 건의 개복수술로의 전환이 있었다. 단일공법을 시행한 군에서 입원 기간이 유의하게 짧았다(2.6±0.6일 [단일공법], 3.3±0.7일 [다공법], P<0.05). 결론: 통상적으로 사용하는 구부러지지 않는 일직선의 복강경기구를 이용한 단일공법 복강경하 질식자궁절제술은 다공법 복강경하 질식자궁절제술에 대한 안전하고 유용한 대체 수술이 될 수 있다. Objective: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). Methods: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary`s Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim`s Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. Results: There was no significant difference in patients` age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients` mean age was 46.1±7.0 years (SPA-LAVH) and 45.5±6.3 years (MPA-LAVH). The mean operating time was 87.2±21.0 minutes (SPA-LAVH) and 83.3±20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4±139.7 g (SPA-LAVH) and 257.8±132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1±0.7 g/dL (SPA-LAVH) and 1.2±0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6±0.6 days [SPA-LAVH] and 3.3±0.7 days [MPA-LAVH], P<0.05). Conclusion: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.

시스템 다이내믹스를 이용한 간호단위별 간호인력 산정에 관한 연구

김문실,성영희,권경자,김도형,김정아,신덕신,유인자,유재국,이현숙 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: The purpose of the study was to forecast manpower by building the nursing manpower-staffing model(surgical-medical nursing unite). Method: The system dynamics approach was adapted to build a simulation model for calculating medical-surgical nursing manpower-staffing. The model was built up on Venism 5.0b DSS. Result: The results in the basic circumstance are in following. The level of nursing service quality, patientsatisfaction, and nurse job satisfaction maintains higher at medical-surgical nursing unit of the tertiary hospitals with the ratio of bed to nurse 2.5:1-3.0:1 than at any other situations. The level of nursing service quality, patient satisfaction, and nurse job satisfaction maintains higher at madical nursing unit of the secontary hospotals with the ratio of bed to nurse 3.0:1 and at surgical nursing unit of the secondary hospitals with the ratio of bed to nurse 3.0:1-3.5:1 than at any other situations in the fundamental from. The results in the simulation circumstance are in following, As author raises the operating rate of bed into 95-100%, and cut skilled nursing staff down, the level of nursing-service quality, patient satisfaction, and nurse job satisfaction drops slightly. Conclusion: In terms of economic efficiency on tertiary hospotals, the ratio of bed to nurse for the best reasonable medical-surgical nursing manpower-staffing is 3.0:1. In terms of economic efficiency on secondary hospitals, the ratio of bed to nurse for the best reasonable medical nursing manpower-staffing is 3.0:1 and surgical nursing manpower-staffing is 3.5:1

2-[(4-Cyanophenyl)amino]-3-chloro-1,4-naphthalenedione(NQ-Y15)의 돌연변이원성

김봉희,정기화,유충규,창동신,이기선,전선덕,소동수,채상호,문창규 한국환경독성학회 2000 환경독성보건학회지 Vol.15 No.4

2-[(4-Cyanophenyl)amino]-3-chloro-1, 4-naphthalenedione (NQ-Y15) was asssayed for its genotoxic potential by using Salmonella typhimurium reversion assay and in vitro chromosome aberration test on Chinese hamster lung cells. In the Ames test, NQ-Y 15 induced his+ revertants of Salmonella typhimurium TA 98 and TA1537, reaching levels twice the negative control values. But, NQ-Y15 induced only his^(+) revertants of Salmonella typhimurium TA1537 more than twice the control values under the condition with metabolic activation system. In the cytogenetic test on chinese hamster lung cells, NQ-Y15 showed significant chromosomal aberrations, but the incidence was significantly reduced in the presence of metabolic activation.

원통 연삭에서 가공 능률 향상을 위한 연삭 저항의 측정에 관한 연구

김원일,이진,이윤경,왕덕현,이상복,이관철,문원길 경남대학교 공업기술연구소 2000 硏究論文集 Vol.18 No.-

본 연구에서는 원통 연삭 가공에서 가공 능률 향상을 위한 연삭 저항을 측정하고자 연삭 가공 중에 발생하는 연삭 저항의 추이를 확인하였고 다음과 같은 결과를 얻었다. 숫돌과 공작물간의 연삭 강성은 공작 속도의 증가에 따라 지지계의 강성이 높은 경우 증가하였고 절삭 깊이와 연삭 숫돌의 속도에는 연삭 강성이 감소하는 경향을 보였다. 또한 총합 강성은 공작 속도, 절삭 깊이 및 연삭 숫돌의 속도 증가에 따라 지지계의 강성이 높을 수록 증가하였다. 연삭기의 강성 변형과 가공 능률에 영향을 주는 값으로 연삭 강성비는 지지계의 강성이 높을 수록 감소하였다. In this study, the measurement of grinding resistance to improve grinding efficiency in cylindrical grinding was studied and the following conclusions could be obtained. Relation grinding wheel and workpiece, grinding stiffness increases according to increase of work speed for high machine stiffness and decreases depth of cut and grinding wheel speed. Also, resultant stiffness increases high machine stiffness according to increase work speed, depth of cut and grinding wheel speed. The values of the effect stiffness deflection in grinding machine, grinding stiffness ratio decrease according to high machine stiffness.

페디그리 사료 섭취에 의한 급성신부전증의 치료 1례

김영실,신영지,박정희,김명철,신상태,조종기,김덕환 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

A 4 years old male poodle dog with gastro-intestinal distress was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. The patient was presented with history of vomiting, hemorrhagic diarrhea and inappetence. Laboratory evaluation revealed that WBC (23.8 x 10^(3)/㎕). BUN (87.9 ㎎/㎗), creatinine (7.3 ㎎/㎗) and phosphate (9.6 ㎎/㎗) was elevated, and proteinuria, hematuria and bilirubinuria were detected on urinalysis. Increased renal cortical echogenicity and parenchymal calcification of kidney were observed by ultrasonography. Based on the findings of history, clinical signs, laboratory assessment and ultrasonography, it was diagnosed as acute renal failure. The present patient showed favorable therapeutic response by fluid therapy. diuretics, peritoneal dialysis and blood transfusion.

학기제 현장실습제도의 교육적 가치 분석

김상길,조덕호,이상호,구본급 한밭대학교 생산융합기술연구소 2004 생산기반기술연구소 논문집 Vol.4 No.1

The main purpose of this study forcuses on the analysis of the educational value of the semester-based practicum system by comparing from the 1999 to the 2001 school years. This study is based on questionnaires from the student, faculty members and the industrial personnel who were participated to the practicum. The question is related with the educational value of the program, such as "I think that classroom learning is enriched through the program", "I think that the program is helpful to decide my future job", and so on. The results of the 2001 year program have shown much improvement compared to those of the 1999 and 2000 school years. Especially, many of the negative views students showed in 1999 have turned positive in 2001.