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.

빌트인 모터를 이용한 2축 제어 미세 가공기 개발

김건희,김효식,양순철,이상용,국명호,이선규,김윤중,홍권희 한국공작기계학회 2007 한국공작기계학회 추계학술대회논문집 Vol.2007 No.-

This paper describes development of low cost precision machine that has combined the Build-in Motor with a vacuum chuck. This study mainly aims to find out a cutting condition for maintaining optimum surface condition and to examine cutting characteristics of the precision machine that is equipped by diamond bites. The cutting materials is Al alloy. Several experiments were carried out to find out the main factors that affect the surface roughness such as principal axis RPM(rotation per minute), feeding speed, and cutting depth. As a result, we obtain The optimum cutting condition of the developed precision machine.

그레이브스병에 병발된 상장간막동맥증후군 1예

박상율,김현주,김모세,박진한,이영진,이순희 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

Superior mesenteric artery (SMA) syndrome is a rare entity characterized by external compression of the third portion of the duodenum by the SMA, resulting in proximal duodenal obstruction. SMA syndrome is manifesting with nausea, anorexia, epigastric pain, bilious vomiting, and postprandial discomfort severe weight loss in catabolic states, external and intra-abdominal compression, mesenteric tension or postoperative states can lead to SMA syndrome. A 36-year-old man developed sudden-onset epigastric pain, bilious vomiting. He was diagnosed with hyperthyroidism 8 months ago and he was treated with antithyroid drugs for 6 months, but he stopped taking the medicine 2 months ago. Abdominal computed tomography revealed typical findings of SMA syndrome. His symptoms subsided shortly after treatment of hyperthyroidism including antithyroid drugs, beta blocker therapy. Then he took radio-iodine treatment. He has taken synthyroid as hypothyroidism after radio-iodine therapy and maintained euthyroid state.

農家所得을 위한 감의 효율적 이용을 위한 젖산발효

김순동,서정식,상채규,구경희 효성여자대학교 새마을연구소 1984 새마을硏究論文集 Vol.4 No.-

This study was carried out to improve the utility of persimmon fruit by lactic acid fermentation and drying. A strain of Streptococcus lactis was used in the fermentation. The changes in acidity, pH, number of microorganism, and the content of sugar, lycopene and tannin were determined during fermentation. Color of the fermented persimmon was checked by using a colorimeter, while quality of persimmon was evaluated by sensory test. The optimum temperature for lactate fermentation was at 25℃ showing on acidity of 50mg lactate per 100g fresh weight, when 10^7 cells per ml(1% inoclum)of Streptococcus lactis was added as the starter. By sterilization at 1kg/cm^2 for 15 minutes, the fruit was coagulated and colored reddish. The loss of brix degree was 2.3%. The content of fructose was increased while sucrose and glucose 23%, respectively. The rate of tannin and lycopene loss were 32% and 23%, respectively. Tannin slightly inhibited growth of the microorganism. Optimum temperature for drying of fermented fruit was at 60℃ with little variation in color. The fermented and dried persimmon was better in texture and taste than the raisin. From above results, it was clear that quality of persimmon fruit such as texture, and storage characteristics can be improved by lactate fermentation and drying.

녹차 및 결명자 추출물의 교정용 브라켓과 치면 사이의 경계부에서 분리된 mutans streptococci에 대한 항균작용

임성훈,서정순,윤영주,김광원,유소영,김화숙,국중기,이병래,차종희,박재윤 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.5

본 연구는 치아우식증에 관련된 Mutans streptococci 표준균주 및 임상분리 균주의 성장억제를 유도할 수 있는 천연 생약추출물을 검색하기 위하여 실시되었다. 녹차추출물은 CHMC-2032를 사용하였으며, 결명자 추출물은 50% 에탄올을 이용하여 얻었다. 이들 추출물의 Mutans streptococci 표준균주 및 교정환자들에서 브라켓과 치면 사이의 경계부에서 분리된 각각 10 균주씩의 S. mutans 및 S. sobrinus에 대한 최소성장억제농도를 액체배지 희석법으로 구하였다. 그 결과 CHMC-2032의 S. mutans 및 S. sobrinus의 표준 균주, S. sobrinus의 대부분 임상분리 균주에 대한 최소성장억제농도는 5 mg/ml이었다. 그러나 결명자 추출물에 의한 S. mutans 및 S. sobrinus에 대한 세균 성장억제 효과는 미미하였다. 본 연구 결과 치아우식증의 예방적 측면에서 결명자차보다는 녹차를 마시는 것이 유리하며, CHMC-2032를 이용하여 구강양치용액을 제조하여 사용할 경우 교정환자를 포함하여 대부분의 사람에게서 치아우식증 예방 효과가 있으리고 추정된다. Mutans streptococci is the major causative factor in dental caries. Especially, orthodontic patients with fixed appliance are a risk group for dental caries. Because fixed appliances attached on teeth may change the environment of dental plaque, the enamel decalcification or dental caries around the bracket and band is a major side effect of orthodontic treatment. The aim of this study was to search plant extracts that have antimicrobial effect on mutans streptococci. Seed-extract of Casio tora were prepared with ethanol and CHMC-2032, the leaf-extracts from Camellia sinensis extract, was obtained extract, 2 type strains and 20 clinical isolates of mutans streptococci isolated from the interface between orthodontic brackets and tooth surfaces in the orthodontic patients were used in this study. The minimal inhibitory concentration of CHMC-2032 was 5 mg/ml on the S. mutans KCTC 3065, S. sobrinus KCTC 3088, and 8 clinical isolates of S. sobrinus. However, there was no antibacterial effect of seed-extract of C. tora on mutans streptococci. These data suggest that green tea may be more effective than the tea prepared from C. tora in the prevention of enamel decalcification or dental caries around brackets.

Clozapine 투여후 발생한 급성 간염

장순주,이호택,백주희,이상연 대한신경정신의학회 1999 신경정신의학 Vol.38 No.1

Clozapine 투여 후에 급성 간염이 발생했던 두 명의 환자에 대한 증례로, 두 명 모두 이전에 약물에 이한 간염이 발생한 과거력이 있었던 환자로서 무증사의 급성 간염이 발생한 후에 보존적 치료 후에 호전 되었다. 간염이 발생한 후에 간효소수치에 대해 정기적으로 검사를 하면서, 사용하고 있던 clozapine의 용량을 낮춘 후 간장제를 투여함으로써 간효소수치는 정상화되었다. Clozapine과 비교하면 clozapine은 간세포의 cytochrome P450에 영향을 미치는 것으로 생각되고 있고 chlorpromazine은 간내 담즙저류에 영향을 미치는 것으로 생각된다. 과거 약물에 의한 간염을 경험한 환자는 clozapine에 의해 유도된 감염에 보다 취약성을 보일 가능성이 있으며, 이런 관점에서 이전의 간 기능 이상을 경험했거나 물질 사용 장애 등의 병발이 있을 경우 정기적인 간기능 평가가 임상적으로 중요할 것으로 판단된다. The authors report two cases of clzapine-induced acute hepatitis. Two patients developed asymptomatic hepatitis and got better with conservative care. We decreased the dosage of clozapine and added hepatic protections, resulting in normalized laboratory findings. The authors also reviewed side effects of clozapine in this report. We reviewed the suggested mechanism of either clozapine or chlorpromazine-induced hepatitis. clozapine influences the liver cell via cytochrome P 450 and chlorpromazine does so via mild cholestasis. There may be a possibility that a patient who has experienced drug-induced hepatitis is vulnerable to clozapine-induced acute hepatitis. In this respect, those who have experienced drug-induced hepatitis must be observed more closely.

고추 국내외 수집 유전자원의 특성

황희숙,황재문,이우승,김점순,김병수 慶北大學校農業科學技術硏究所 1998 慶北大農學誌 Vol.16 No.-

국내외로부터 수집한 고추 유전자원을 포장에 재배하여 종자를 증식하는 동시에 주요 특성을 조사하였다. 헝가리에서 도입하여 1992년도에 평가한 계통들은 Hungarian Wax 혹은 Bell형으로서 바이러스에 심하게 걸려 우리포장환경에 잘 적응하지 못하였다. 1994년도에 평가한 계통들 중 브라질에서 풋마름병 저항성으로 도입한 KC350과 KC351은 직립성이며 바이러스에 강한 편이어서 매우 유망한 유전자원으로 사료되었다. 중국에서 도입한 KC376는 바이러스에 강한 편이며 대과를 착생하여 유망하게 보였다. 태국에서 도입된 계통들은 안동대에서 특성을 평가기록하였다. Accessions of pepper germplasm were planted in the field and their characteristics were recorded. Lines introduced from Hungary were very susceptible to virus diseases and as a result poor in adaptability in domestic field condition. KC350 and KC351 which were introduced from Brazil were growing errectly and tolerant to both bacterial spot and virus diseases. KC376, an introduction from China, was bearing large fruits with tolerance to virus. Introductions from Thailand were grown and evaluated in Andong Universiy, and major characters of them were recorded.

Natto의 텍스쳐 및 관능적평가

오성천,서연희,조정순 명지대학교 자연과학연구소 1997 자연과학논문집 Vol.16 No.-

To make Natto, traditional Japanese food fermented by Bacillus natto, acceptable to Koreans, garlic(2%) and ginseng(2%) were added. General soybean Natto(S₁), 2% garlic Natto(S₂), 2% ginseng Natto(S₃) and black soybean Natto(S₄) were prepared. The proximate composition revealed the most moisture content in S₂ among the all samples. The most cmde protein, crude fat and ash were found in S₄. The non-fibrous and fiber contents were the most in S₁ and S₃. In the texture characteristics, hardness and gumminess were the highest in S₄. The highest springness and cohesiveness were found in S₁. Adhesiveness and chewing were the best in S₂ and S₃. In the sensory evaluation, S₃ showed the best preference, appearance and color. In the aspects of taste and texture, S₄ was mostly prefered. Flavor and viscosity of S₂ were the best among the all samples. The general soybean Natto(S₁) without any addition showed low values in most examinations and tests. In the sensory evaluation, S₃ has the best overall acceptability among the all experimental Nattos.

농흉과 종격동염이 합병된 viridans streptococcus에 의한 인후농양 1예

임상현,유진홍,권순석,김연식,신완식,강문원,정명희 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.2

최근 저자들은 viridans streptococcus에 의한 인후농약으로 인하여 발생한 종격동염 및 농흉을 보인 47세 여자 환자를 적절한 배농과 항생제로 치료한 국내 최초의 1예를 치험하였기에 문헌 고찰과 함께 보고하는 바이다. Since the antibiotic era, retropharyngeal abscess became a rare disease entity nowadays. But it may often progress to lethal complications involving vital structure if diagnosis or treatment is delayed. We experienced a case of empyema and mediastinitis complicating retropharyngeal abscess caused by viridans streptococcus in a 47-year-old female patient with diabetes mellitus. She was successfully treated with appropriate antibiotic therapy combined with percutaneous abscess drainage. To our knowledge, such a complication of retropharyngeal abscess has not been reported in Korea yet and we present this unusual case herein followed by a review of the related literature.

트레드밀 運動負荷後 恢復時 靜的 및 動的인 休息方法에 의한 恢復率 比較

李喆熙,金相洪,李淳川,李源才 啓明大學校 生活科學硏究所 1991 科學論集 Vol.17 No.-

This study was performed to compare recovery rate with the passive and the active recovery methods during the first and the second recovery periods after the first and the second treadmill running. Forteen female subjects aged between 13 and 14 years were divided into passive recovery and active recovery groups. Running exercise was performed on the treadmill at 3.5mph speed with incremental increase of 2% grade per 1 minute until attaining their target heart rate. Heart tare, blood pressure(systolic and diastolic pressure), respiratory rate, and blood lactic acid concentrations were measured at resting state and 1min, 3min, 5min, 7min, and 10min during the first and the second recovery periods. Especially, heart rate and respiratory rate were measured at the starting and termination time of the first and the second exercise. The results are summarized as follows. Heart rate at the starting of the first exercise was significantly higher than that of the resting value. Two groups were higher than the resting state until 10minutes of the first recovery periods, but there were no difference between the two. The starting and termination of exercise in the second exercise also was significantly higher than resting state ; especially the active recovery group in the first starting exercise was significantly higher than passive recovery group. The active recovery group was shown the higher heart rate than that of passive recovery group at recovery period of 5minutes and 10 minutes. Systolic blood pressure was higher than resting values until recovery periods of 5minutes after the first treadmill exercise. The level of systolic blood pressure was restored to the resting state after recovery period of 7minutes until the recovery period of 3minutes. It was restored to the resting state after the second exercise. The active recovery group in the first and the second exercise recovery was restored to the resting level after recovery period of 10minutes. The active recovery group at the recovery period of the first and the second exercise was significantly higher than the passive recovery group. Diastolic blood pressure was showed no significant difference between the two groups during the first and the second recovery period. Respiratory rate in two groups were increased to the above resting level. The passive recovery group was significantly higher than the active recovery group. It was returned to the resting level by 3minutes during the first and the second recovery period. Hematocrit in the passive recovery group was lower by 10minutes than that of active recovery group during the first and the second recovery period during the first and the second recovery period. The active recovery group was no significant difference throughout the recovery period. The blood lactic acid concentrations in the two groups were significantly higher than those of resting values during the first recovery periods. The two groups were restored to the resting level by recovery period of 10minutes, but were higher than resting values by recovery periods of 1minute. As a results, the active recovery group was somewhat higher than the passive recovery group. This indicate that recovery rate in the active recovery group was higher than that of the passive recovery group.