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.

교육기관에서의 해킹 기법과 학내망 보안 방안에 관한 연구

이철환,한선관 인천교육대학교 과학교육연구소 2001 과학교육논총 Vol.13 No.-

본 연구는 교육기관에서의 학교망인 네트워크를 해킹하는 사례 및 이에 대한 보안 방법에 관한 연구이다. 이를 위해 보안의 중요성에 대해 논하고 최근 많이 발생하는 해킹 사고를 유형별로 분석하였다. 또한 이러한 해킹 사고가 학내망에 어떠한 위협을 주고 있으며 기술적으로 어떻게 발전하고 있는지 최근 해킹 동향 을 조사 분석하며 이를 방지하기 위한 보안 방법에 대해 논하였다. 마지막으로 바이러스의 위험과 그 예방에 대해 살펴봄으로써 실제 교육기관에서 적용할 수 있는 방향을 제시하였다. Security of network system is very important factor in the school information system. Almost all existing security systems are developed and implemented in very weak manner. And almost all computer is connected by security system at recently. Therefore, a majority of school network systems could be attacked by various hacking methods. The study investigate the methods of hacking technique and suggested a sound solution of school network security system. The importance of security, types of hacking/tracking accident, and the trends of hacking/ tracking method are reviewed. Finally the study summarized danger of virus, preventing method of virus, and implementation method in school system.

石灰物質 施用이 Burley種 煙草의 收量과 化學成分에 미치는 影響

李哲煥,金容鈺,朴秀俊 충북대학교 엽연초연구소 1988 煙草硏究 Vol.13 No.-

Field experiment was conducted to find out the effect of liming materials application on yield, and chemical composition of Burley 21 in 1986. Liming materials and application rate were CaSO4 : Ca 35kg/10a, CaCO3 : Ca 35kg/10a and Liming : pH 6.5. Lime increased Ca, Mg and pH of fresh and cured leaves, but decreased Al, Fe and Mn concentrations. Yield were increased by liming materials application. Among liming materials treatment, yield of limed and CaCO3 plot were higher than that of CaSO4 plot. Value per kg of cured leaves was not affected by liming materials application. Cured leaves of CaSO4 plot contained higher NH3-nitrogen and alkalinity number of water insoluble ash than those of unlimed plot. Cured leaves of CaCO3 plot contained higher alkalinity number of water soluble ash, insoluble ash and volatile neutral constituent, but lower protein - nitrogen and petroleum ether extracts than those of unlimed plot. Cured leaves of limed plot contained higher alkalinity number of water soluble and insoluble ash, NO3-nitrogen and volatile neutral constituents, but lower protein-nitrogen, nicotine and petroleum ether extracts than those unlimed plot. Limed increased yield, however it did not affect leaf quality in respect to chemical and organoleptic characteristics, suggesting that controlling the soil pH about 6.5 by liming should be necessary for tobacco cultivation.

백서의 카드뮴 중독시 마늘, D-penicillamine 및 N-acetyl-DL-penicillamine의 방어효과에 관한 연구

李榮玉,車喆煥,林國煥 고려대학교 의과대학 1986 고려대 의대 잡지 Vol.23 No.3

In recent studies, they have insisted that the Korean garlic which contains a large amount of disulfide and sulfhydryl compounds and selenium, has a remarkable protective effect against heavy metal poisoning. The mechanism of the effect, however, has still not been proved in detail. Authors tried to compare the protective effect of the garlic on cadmium poisoning with those of N-acetyl-DL-penicillamine (APEK) and D-penicillamine (PEN). For the purpose, the experiment was performed in two steps of treatment. In first step, Experiment Ⅰ, CdCl₂ (1 mg/Kg of body weight) was injected into the peritoneal cavity of rats with experimental agents such as garlic, APEX or PEN for 7 days, and after that only the experimental agents were administered per os to each group of rats for 23 days respectively. In second step, Experiment Ⅱ, CdCl₂ alone was injected into the peritoneum for 7 days and 24 hours after that the experimental agents were administered for 23 days in the same way. The dosage of experimental agents was doubled in last 1 week of 23 days in the second step. For the treatment with the experimental agents, garlic was fed with 6.4% mixture pellets, and APEN (60 mg/Kg/day) and PEN (40 mg/Kg/day) were dosed with water. After the treatment, cadmium levels in liver, kidney, testis and bone were measured and the histopathological examination of testis was done. The results of the study were as follows; 1. When the experimental agents were administered from the beginning of cadmium injection (Experiment I), cadmimum levels in each organs of garlic or APEN-dosed group were markedly lower than those of cadmium-alone-dosed group and also of PEN-dosed group. In kidney, cadmium level of PEN-dosed group was higher than that of cadmium-alone-dosed control group. The extent of damage due to cadmium in the histopathological examination of testis, was mild in garlic or APEN-dosed group compared with the FEN-dosed group. The degree of damage in the latter group was similar with that of cadmium-alone-dosed group. 2. When the experimental agents were administered 7 days latter the cadmium alone was injected (Experiment Ⅱ), the cadmium levels in each organ were decreased little and the histopathological damage in testis was not recovered by the administration of experimental agents. We can conclude, therefore, that the protective or preventive effect of garlic in terms of its potency would be similar with that of APEX and superior to that of PEN. However, it was also revealed that the above mentioned experimental agents including garlic was not so effective as we expected for the treatment of cadmium poisoning if we administer them after the intoxication happened.

21世紀 體育, Sports의 方向摸索을 위한 小考

李喆熙,裵元煥,李達源 啓明大學校 生活科學硏究所 1993 科學論集 Vol.19 No.-

This study was investigated for the purpose of conereting the arm of the physical education and acquiring intrinsic area of the physical education and contributing human culture in highly developed industrial society of the future. The conclusions were summerized as follows; In highly developed industrial society, sports activity for health and leisure by changing of physical education environment will be increased. The mass sports and sports science which social group carrys out positively will be accelerated. With recognition change for physical education, Eco-sports will be important sports. By developing sports scientification, Techno-sports will be more developed. The attitude and a view of value of the people for the sports will be more promoted. The conception of Pro-sports will be changed and the acceleration of political tool of physical education will be done in international sports. The role of physical education scientists who have the specialization and self-confidence of academy and deep experience will be large.

하악골 과두에 발생한 골연골종의 치험례

이미향,김미숙,장창수,김철환 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.2

Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and the proximal metaphysis of the tibia, however, is occurred rarely in the facial skeleton. Development of the tumor is most frequently seen in the second or third decades of life. Typically, it arises directly from the cortex of the underlying bone, without any intervening zone of abnormal osseous tissue, and is covered by a cap composed of cartilage undergoing calcification. In case of osteochondroma of the mandibular condyle, its clinical features are occulusal change, facial asymmetry, headache, pain and click on temporomandibular joint, mouth opening limitation, and jaw deviation to involved site. This is a case report of a 13-year old woman who had mouth opening limitation and severe temporomandibular joint pain. We obtained successful results with surgical removal of the osteochondroma on the mandibular condyle.

섬유종류 및 잔골재용적비에 따른 HPFRCC의 공학적 특성에 관한 실험적 연구

이의배,이동혁,나철성,조봉석,김재환,김무한 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

In general, concrete showed brittle fracture but HPFRCC(High Performance fiber reinforced cementitious composite) showed ultra high ductile behavior in the hardened state, because of the fiber bridging properties. So a variety of experiments have being performed to access the performance of HPFRCC recently. In this study, to develope HPFRCC with high ductility and strain capacity, effects of fiber types and sand volume fraction were investigated. And results of this study were as follows; · HPFRCC reinforced with PVA or hybrid fiber were superior to PP or singleness. · Effect of sand volume fraction on HPFRCC reinforced with PP was insignificant.

물을 전기분해하여 제조한 수소/산소 혼합가스의 특성에 관한 연구

이환철,정목근 대진대학교 신과학연구소 1998 신과학연구 Vol.1 No.-

물을 전기분해하여 제조한 수소/산소 혼합가스의 응폭특성과 연소특성에 관해 연구하였다. 자동차용 점화코일을 이용한 고압방전장치를 제작하였으며, 이를 이용하여 응폭실험을 행한 결과에 따르면 강력한 외부로의 폭발이 있고난 후 진공이 형성되면서 응폭현상이 일어남을 확인할 수 있었다. 그러나 응폭특성이 수소/산소 혼합가스만의 유일한 특성인가에 대해서는 현재 결론을 내리기에는 어려운 실정이다. 또한 텅스텐금속의 연소실험결과에 따르면 수소/산소 혼합가스나 산소-LPG가스 모두 텅스텐금속을 연소시킬 수 있으므로,실제로는 대기중의 산소와 텅스텐금속이 산화반응을 일으켜 텅스텐산화물이 형성됨에 따라 녹는점이 1400-1600℃로 낮아진 결과로 판단되지만 보다 정확한 결론을 내리기 위해서는 좀 더 많은 연구가 필요하다고 판단된다.

유기물부하가 낮은 하수의 전단탈질공법에 의한 탈질방안

이철승,서종환,김진우 한국환경과학회 2004 한국환경과학회지 Vol.13 No.9

This study was conducted to analyze the operating conditions of predenitrification process to improve the treatment efficiency in low organic loading sewage plant in use today, and to investigate the treatment efficiency of pilot plant added night soil as well as the nitrogen removal characteristics of pilot plant added carbon sources. In the operation under the condition of BOD_(5) sludge load 0.03-0.28kg BOD_(5)/kg VSS/d and oxic ammoniac nitrogen sludge load 0.02-0.24 kgNH₄^(+)-N/kg MLVSS/d, nitrification efficiency is higher than 95%. In order to achieve 70% nitrogen removal at the T-N sludge loading 0.06kg T-N/kg VSS d and the SRT 6-11 days, optimum operating factors were revealed to CODc_(r)/T-N ratio 9, recycle ratio 2.6, and denitrification volume ratio 0.33. At this time, denitrification capacity was approximately 0.09 kg NO₃^(-)-N/kg CODc_(r); specific nitrification rate was 3.4mg NH₄^(+)-N/g MLVSS/hr; and specific denitrification rate was 4.8mg NO₃^(-)-N/g MLVSS/hr.

접촉각 측정에 의한 사이즈 분석

이찬용,김철환,최경민,박종열 경상대학교 농업생명과학연구원 2001 농업생명과학연구 Vol.35 No.-

접촉각(Contact Angle)이란 액체가 고체표면 위에서 열역학적으로 평형을 이룰 때 형성하는 각을 의미하며, 고체와 액체 사이에서 이루는 접촉각의 측정은 접착, 표면처리, 폴리머 표면 분석과 같은 많은 분야에서 잘 알려진 기술이다. 이러한 접촉각은 종이의 내수성에 대한 정밀한 예측을 가능하게 하는데 본 연구를 통하여 개발된 접촉각 자동 측정 시스템(AMS-2001)은 종이에 부여된 내수성을 종이 시료 상에 형성된 접촉각 측정을 통하여 정량화 할 수 있었다. 본 연구에서 개발한 AMS-2001을 이용하면 사이징 처리된 종이의 접촉각, 발수각, 액적의 폭, 지름, 표면장력 등을 측정할 수 있었고, 액적이 변화되는 모양을 디지털 화상을 통하여 추적할 수 있었으며 또한 기존의 Stockigt 실험 방법과 거의 유사한 재현성 및 신뢰성을 나타낼 수 있었다. The contact angle formed by a droplet of water used to estimate a repellency property of paper. The conventional systems measuring a contact angle are based on a manual measurement of the angle by a 3-point determination such as a far-left or far-right point, and a top point of a water droplet on a sample sheet. Thus the manual method to analyze a water repellency property can be greatly affected by an operator's bias. The new method to measure a sizing degree by a contact angle was developed using an automatic determination of 3-end point coordinates of the water droplet, which could diminish the operator's bias during measurement. The system could also quantify width and height of a water droplet, a surface tension of a solid specimen, and a time elapsed during complete absorption of water into a sheet. Finally, the values measured by the system were quite reproducible and reliable.