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.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

조경설계의 대안적 방법에 관한 연구 : 꼴라쥬 기법의 가능성에 대해

김신원,박수영 경희대학교 디자인연구원 2006 예술· 디자인학연구 Vol.9 No.1

Today landscape design looks tendency that is complex and is pluralistic condition. This shows aspect that machine by expression means is more complex being undergone the change by considerations means. We use expression 'Collage' when we speak about complex, hybrid, heterogeneous, pluralism trend, Actually, collage techniques in conversation changed variously flowing cubism, futurism, dadaism, surrealism. Therefore, speech called Collage' that is used in complex expression vocabulary of trend can know that is including phenomenon side as well as techniques side. Approach from collage techniques as art and analyze through literature investigation about background and meaning of techniques, and utilization studied possible techniques in landscape design. With change age through this research, can know whether classical methodology can not express variety of expression method and 'Collage expression' as access methodology of modern landscape design presents possibility of how various expression. Wish to put meaning of research that present methodology freshing complex expression method.

정신분열병 환자에서 얼굴 영상의 작동기억 장애 : 기능자기공명영상연구

이창욱,김태석,주라형,박주미,박여진,김종진,전신수,배치운,김정진,이수정,이철,백인호 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : Impaired processing of facial information is one of the broad ranges of cognitive deficits seen in patients with Schi-zophrenia. We aimed to elucidate the differences in brain activities involved in the process of facial working memory between schizophrenic patients and healthy comparison subjects. Methods : Twelve patients with schizophrenia were recruited along with twelve demographically matched healthy volunteers as a comparison group. Functional magnetic resonance imaging (fMRI) was used to assess cortical activities during the Perfor-mance of a 2-back working memory paradigm using images of neutral faces as mnemonic content. Rcsults : The patient group performed the tasks with reduced accuracy. Group analysis revealed that the left fusiform gyrus, the right superior frontal gyrus, the bilateral middle frontal gyri/insula, the left middle temporal gyrus, the precuneus, the quadrangular lobules and the vermis of cerebellum showed decreased cortical activities in the patient group. On the other hand, an increased level of activation in the lateral prefrontal cortex and the pahetal lobule was observed from the patient group, all in the right hemisphere. Conulusion : A decreased level of activity in the left fusiform gyrus among the patient group implicates inefficient processing of facial information. An increased level of activation in prefrontal and parietal neural networks from the patient group confirms earlier findings on the impaired working memory of patients with schizophrenia.

β-naphthol 유도체 합성 및 항종양활성 검토

이주영,류수진,박예진,황순호,이마세,김인종,김동현,김신규 慶熙大學校 1996 論文集 Vol.25 No.-

Sythesis of β-naphthol derivatives and their anti-tumor activity were investigated. Binaphthol 1 obtained from β-naphthol by oxidative C-C bond formation(phenoloxydation) was converted into its derivatives. Treatment of 1 with POCl_3 followed by aziridine introduction gave phosphoryl aziridine 3. Also, diaziridine 5 was obtained from 1 by chlorination and successive aziridine introdution. Typical chemical transformation of 1 to obtain ester-type afforded compound 7 and 8. Compound 5 was the most effective derivative of the tested compounds on their anti-tumor activity.

주요 국가의 의료기관 신임제도 비교연구 : 미국, 영국, 캐나다, 호주, 한국을 중심으로 United States of America, United Kingdom, Canada, Australia, Republic of Korea

신영수,이신호,김수경,이영성 한국의료QA학회 1994 한국의료질향상학회지 Vol.1 No.1

Hospital Accreditation Programme(HAP) has been introduced in many countries in the world for these recent years. This article reviews the HAP in the aspects of the organization, survey and evaluation process, evaluation criteria, and its impact to the hospital quality improvement. The nations included in this study are USA, UK, Canada, Australia, and Korea. To carry out this comparative study, the authors have reviewed articles and accreditation manuals having been issued in many countries. An expert panel of medical doctor, nurse, pharmacist, administrator, and specialist in health facilities formulated a study framework. The results of this study enhance understanding about hospital accreditation activities according to each nation's health care system. In recent years, the Korean government has launched the plan to improve the quality of health services by strengthening the hospital accreditation programme. This study results can provide useful information in development and implementation of the national hospital accreditation programme in Korea.

습식텍스쳐를 이용한 삼결정 실리콘 광학적.전기적 특성 연구

한규민(Han, Kyu-Min),유진수(Yoo, Jin-Su),유권종(Yoo, Kwon-Jong),이희덕(Lee, Hi-Deok),최성진(Choi, Sung-Jin),권준영(Kwon, Jun-Young),김기호(Kim, Ki-Ho),이준신(Yi, Jun-Sin) 한국신재생에너지학회 2009 한국신재생에너지학회 학술대회논문집 Vol.2009 No.06

Two different wet etching solutions, NaOH 40% and Acid, were used for etching in tri-crystalline Silicon(Tri-Si) solar cell fabrication. The wafers etched in NaOH40% solution showed higher reflectance compared to the wafers etched in Acid solution after SiN_x deposition. In light current-voltage results, the cells etched in Acid solution exhibited higher short circuit current and open circuit voltage than those of the cells etched in NaOH 40% solution. We have obtained 16.70% conversion efficiency in large area(156cm²) Tri-Si solar cells etched in Acid solution.

Comparison of Histopathological Changes on the Three Drugs of Carbon Tetrachloride, Dimethylnitrosamine, Thioacetamide, and Bile Duct Ligation used for Induction of Liver Fibrosis in Rat

Kim, Jung-Hun,Park, Mi-Jung,Kim, Yo-El,Kim, Jin-Yeong,Sin, Jin-Hee,Park, Su-Young,Jekal, Seung-Joo 대한임상검사과학회 2011 대한임상검사과학회지(KJCLS) Vol.43 No.4

This study was carried out to compare the histopathological differences of liver lesions in carbon tetrachloride ($CCI_4$), dimethylnitrosamine (DMN), thioacetamide (TAA) and bile duct ligation (BDL)-induced rats. $CCl_4$, DMN and TAA were administered intraperitoneally and conducted bile duct ligation for 4 weeks to induce hepatic fibrosis. Indices of liver cell injury (steatosis, hydropic degeneration, bile duct hyperplasia, hemorrhage & hemosiderin deposition), the extent of liver fibrosis (fibrotic area) and the rate of regeneration (number of PCNA-positive cells) were investigated in each group. Liver tissues were stained with hematoxylin-eosin (HE), sirius red, prussian blue and immunostained with ${\alpha}$-smooth muscle actin (${\alpha}$-SMA), transforming growth factor-${\beta}1$ (TGF-${\beta}1$), proliferative cell nuclear antigen (PCNA), and quantified using a computerized image analysis system. Liver cell steatosis was significantly increased in $CCl_4$ and TAA groups, and hydropic degeneration and bile duct hyperplasia were significantly increased in TAA and BDL groups when compared with that in normal control, respectively. Fibrosis area was significantly increased in all four groups, especially in $CCl_4$ group. Correlation between ${\alpha}$-SMA and TGF-${\beta}1$ expressions in four groups was good. Hemorrhage area in liver parenchyma was significantly increased in DMN group only when compared with that in normal control, while hemosiderin deposition area was significantly increased in TAA and BDL groups as well as DMN group. The Number of PCNA-positive cells was significantly increased in all four groups, especially in TAA group. These results indicate that the duration and methods of hepatotoxic drug treatment are very important factors to make plans for animal experimentation on the induction of hepatic fibrogenesis in rats.

Existence of glioma stroma mesenchymal stemlike cells in Korean glioma specimens.

Kim, Young Goo,Jeon, Soyoun,Sin, Ga-Yeong,Shim, Jin-Kyoung,Kim, Bo-Kyung,Shin, Hye-Jin,Lee, Ji-Hyun,Huh, Yong-Min,Lee, Su-Jae,Kim, Eui-Hyun,Park, Eun Kyung,Kim, Se-Hoon,Chang, Jong Hee,Kim, Dong Seok Springer Verlag 2013 Child’s nervous system Vol.29 No.4

<P>It was presented that mesenchymal stem cells (MSCs) can be isolated from western glioma specimens. However, whether MSCs exist in glioma specimens of different ethnicities is unknown. To verify the existence of MSCs in an independent cohort, we undertook studies to isolate MSCs from a group of Korean patients. We hypothesized that cells resembling MSCs that were deemed mesenchymal stemlike cells (MSLCs) exist in an independent cohort of Korean gliomas. We cultured fresh glioma specimens using the protocols used for culturing MSCs. The cultured cells were analyzed with fluorescence-activated cell sorting (FACS) for surface markers associated with MSCs. Cultured cells were exposed to mesenchymal differentiation conditions. To presume possible locations of MSLCs in the glioma, sections of glioma were analyzed by immunofluorescent labeling for CD105, CD31, and NG2. From nine of 31 glioma specimens, we isolated cells resembling MSCs, which were deemed Korean glioma stroma MSLCs (KGS-MSLCs). KGS-MSLCs were spindle shaped and adherent to plastic. KGS-MSLCs had similar surface markers to MSCs (CD105(+), CD90(+), CD73(+), and CD45(-)). KGS-MSLCs were capable of mesenchymal differentiation and might be located around endothelial cells, pericytes, and in a disorganized perivascular area inside glioma stroma. We found that cells resembling MSCs indeed exist in an independent cohort of glioma patients, as presented in western populations. We could presume that the possible location of KGS-MSLCs was in perivascular area or in glioma stroma that was a disorganized vascular niche. It might be possible that KGS-MSLCs could be one of constituent of stroma of glioma microenvironment.</P>

Asymmetric Total Synthesis of (-)-Lentiginosine

Jung Young Hoon,Kim Sin Jung,Kim In Su 대한약학회 2004 大韓藥學會 總會 및 學術大會 Vol.2004 No.2