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.

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.

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.

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.

한국 여성의 초경에 관한 연구

김성무,박정덕,정규철 중앙대학교 의과대학 의과학연구소 1986 中央醫大誌 Vol.11 No.4

To find out mean age of menarche, possible factors affecting the onset of menarche, and attitude and knowledge toward menarche among college women, a questionnaire survey was done on 1,353 female college students in a freshman class in 1985 born from 1957 to 1969. 1. Mean age of menarche was 13.9±1.23years as a whole: 13.8±1.25years for students grown up in urban areas (Seoul, Busan, Daegu, Incheon, 4 major cities in Korea) and 14.0±1.19 years for those in rural areas(z = 2.63, p<0.01). 2. Mean age of menarche showed distinct difference between those who were born before 1965 and those after 1966, showing the value of 14.3±1.44 years old for the former and 13.8±1.14 years old for the latter (z =5.47, p<0.01). 3. Majority (90.3%) of the females experienced menarche between age of 12 and 15 years : 31.0% at 14, 26.9% at 13, 21.5% at 15 and 8.O% at age of 16 and 17 years. A few(1.3%) experienced it at 11 years of age. 4. Menarche occurred most common]y in winter(33.4%), and in summer(29.7%), in autumn(19.4%) and in spring (17.5%) in order. 5. Number of brothers, feeding methods during infancy and parents' educational level had no influence on the onset of menarche. 6. As for the emotional feelings that they experienced at menarche, "surprised" was most common (46.6%), "shyness" (24.O%) came next, and "discomfort" (11.0%), "indifference" (9.8%), "mistaken feeling of illness" (2.4%), "pleasure" (2.1%), "guilty feeling" (0.4%), and "others" (3.7%) in order. 7. Majority of the female students(84.8%) had some knowledge about menarche prior to its occurrence, but the rest of them(13.8%) had not. 8. Sources of information from which they obtained some knowledge about menarche were teachers(49.2%), parents(33.1%), friends(9.3%), mass media(6.6%), relatives(0.1%), and others(1.7%) in order.

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.

대동물 임상에서의 침술마취의 적용

김명철,김덕환,전무형,홍성혁,박창식,이재일,이수진,김영석 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

Acupuncture is used to treat pathological conditions and to prevent pain from arising. The pathological conditions that can be treated can be painless or painful conditions. Acupuncture analgesia (AA) is a specific form of acupuncture; the stimulation of the acupuncture points must be strong and long (about 15 to 30 minutes) before a local or general analgesia or hypalgesia will develop. Development of modern AA began in the late fifties. Effectiveness of acupuncture in alleviation of pain was quickly noticed and brought to the medical researchers and surgeons. Through their diligent pursuit, AA has been established as a viable alternative for relief of pain and substitution of conventional anesthesia. In veterinary medicine. early successful applications of AA to surgery of domestic animals were reported in the late sixties. Local or regional anesthesia is often preferred to general anesthesia in cattle. Acupuncture was effective in inducing analgesia. Regional electroacupuncture analgesia is potentially useful for standing surgeries in cattle. Some standing surgeries may be easily accomplished using electroacupuncture anesthesia.

정밀주조 다이캐스팅을 이용한 자동차 레귤레이터 하우징 성형해석에 관한 연구

성백섭,김미애,차용훈,김정대,김덕중,이연신 한국공작기계학회 2006 한국공작기계학회 추계학술대회논문집 Vol.2006 No.-

The casting defects that are caused by molten metal were cold shut formation, entrapment of air, gas, and inclusion. But the control of casting defects has been based on the experience of the foundry engineers. In this thesis, the computer simulation analyzed the flow of molten metal. The quantitative analyses which proposed the effective mold design was executed Flow patterns of 0.1-0.16m/s molten metal in 15mm thin plate casting were investigated in order to optimize die-casting process. As increasing ingate velocity in thin plate casting, cold shot was decreased. The parameters of runner shape that affected on the optimized conditions that was calculated with simple equation were investigated. These die casting process control techniques of automobile regulator housing parts have achieved good agreement with the experimental data of tensile strength, hardness test, and material structure photographies satisfactory results.

위암환자의 생존율에 관한 역학적 조사연구

김덕성,이태용,이영수,류기하 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

To find out the survival rates of stomach cancer patients, the author studied 288 stomach cancer patients who took operation at the Department of Surgery in Chungnam National University Hospital from January 1, 1985 to December 31, 1991. The results were as follows: 1. Of the total patients, 67.4% were male: but 32.6% were female. 2. 64.6% of patients lived in rural area and 35.4% urban;98.3% of those were married; 30.6% were farmers and 17.4% were commercial workers; 54.5% were smokers; 48.3% were alcohol drinkers. 3. By types of gastric cancer, 84.4% were progressive gastric cancer patients. Among these, type 2 patients were more than other type patients. 61.5% of those had metastasis to lymph node. 55.2% of those took operation by RSG with gastrojejunostomy; 97.6% of those knew that they had cancer; 19.1% of those had a family history that at least one of family members had cancer. 4. The gross 5 year survival rate of total patients was 47.2%. 5. The 5 year survival rate of male patients was 41.6% but that of female was 46.3%. The 5 year survival rates by residential area, chemotherapy, marital status, blood type, family history, smoking, and drinking were not significantly different. 6. The 5 year survival rate of type 2 progressive gastric cancer patients was the highest with the rate of 72.0%. Metastasis to lymph node and type of operation showed statistically significant difference in 5 year survival rates.