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.

불안정 지지면을 이용한 운동 프로그램이 뇌졸중 환자의 균형에 미치는 효과

이지연,김용수,김진섭,박진현,최윤희,전덕훈,김경 대구대학교 특수교육재활과학연구소 2010 再活科學硏究 Vol.28 No.1

본 연구의 목적은 뇌졸중 환자의 재활을 위하여 불안정 지지면을 이용한 운동 프로그램이 균형 능력과 운동 기능 능력에 미치는 효과를 알아보고자 실시하였다. 불안정 지지면의 이용한 치료는 임상적으로 뇌졸중으로 인한 편마비 환자뿐만 아니라 스포츠 손상 및 노인들의 질환 등 다양한 병인을 가진 환자들의 치료에 이용되고 있다. 대부분의 뇌졸중 환자들은 재활 훈련을 할 수 있는 병원이나 기관에서 치료를 받을 때에 지지면의 차이를 제공함으로써 보다 더 안정한 지지면에서 적응할 수 있는 방법이 요구되고 있다. 하지만, 아직도 불안정 지지면을 이용한 구체화된 치료적 운동 방법과 객관적 평가에 대한 연구가 미비한 실정이다. 이러한 문제점을 해결하기 위하여 최근 뇌졸중 환자의 불안정 지지면과 이론적 근거를 바탕으로 한 운동 프로그램에 대한 연구가 더욱 필요하다. 본 연구에서는 실험군과 대조군이 같은 운동 프로그램을 적용하였을 때, 두 그룹 간에서 나타나는 균형 향상과 운동 기능 향상에 어떠한 효과를 주는지 살펴보고자 하였다. The purpose of this article was to study the effect of the exercise programme that uses the unstable supporting surface to rehabilitate cerebrovascular patients on balance ability and exercise function ability. The therapy is being clinically used for the patients with diverse pathological factors such as hemiplegia caused by CVA, sports injury, and diseases in the elderly. when most patients with CVA are treated in the hospital or institute that can provide rehabilitation training, they need to be given the way to adjust more stable surpporting surface by being provide with various stages of surface. However, the actual therapeutic exercises is still needed and the study for objective assessments wants conducting. To solve these problems, the study of unstable surface exercise programmes based on the evidences recently need to be made for the patients with CVA. in this study, we intend to look into what effects on the balance improvement and the exercise function are different from the experimental group to the control group with the same programme applied to the two groups.

신장수여자의 수술경과시간에 따른 자기존경감, 희망감, 염려 및 스트레스원의 차이

이 철,김창윤,한오수,박인호,유희정,한덕종 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.2

This study attempted to examine the differences of self - esteem, hopes, concerns and total stress scores of 110 kidney recipients in before(N=32) and fellowing kidney transplantation [1 to 6 months(N=29), 6 to 12 months(N=23), 12 to 36 months(N=26)] and utilizing severity rating scale of 44 potential stressors on a 5-point scale of 110 kidney recipients in before(N=32) and following kidney transplantation operation [1 to 6 months(N=29), 6 to 12 months(N=23), 12 to 24 months(N=15) and 24 to 36 months(N=11)]. On scores of hopes and total stress, pretransplant group exhibited significantly higher scores than three posttransplant recipient groups. But, it was found that there was no significant differences among four transplant kidney recipient groups on the scores of self - esteem and concerns. In the pretransplant group, craving for foods was identified as the most stressful event, on the contrary, changes in friends was identified as the lowest stressful events. In the 1 to 6 months posttransplant group, side effect of medications was identified as the most stressful event, however, loss of contact with dialysis patients was identified as the lowest stressful event. In the 6 to 12 months posttransplant group, cost of medication, changes in body appearance were identified as the most stressful event, on the other hand, managing of medications at home was identified as the lowest stressful event. In the 12 to 24 months posttransplant group, cost of medication and insurance coverage were identified as the most stressful event, but possibility of dying and competence of nursing staff were identified as the lowest stressful event. In the 24 to 36 months posttransplant group, changes of body appearance was identified as the most stressful event, on the contrary, possibility of infection was identified as the lowest stressful event. Insurance coverage was a continuing concern throughout posttransplant period.

간호대학생들의 대인가치관과 가치관변화에 대한 연구

이강오,장수현,나덕미 朝鮮大學校 附設 醫學硏究所 1989 The Medical Journal of Chosun University Vol.14 No.1

The purpose of this study is to determine interpersonal values and value change of the four year course nursing students. The survey was conducted against 217 students of a department of nursing, from all classes (freshman, sophomore, junior and senior). This study was conducted during the period of 7th through 15th of march 1987 in accordance with the Lee Kyung-Hye and Hawang Eung-Yun's "Survey of Interpersonal Values (STV)." The results of the study were as follows: 1. Those nursing students surveyed show that conformity (18.32) took the highest place and leadership (8.64) lowest in the general value orieUtaiton. In accordance with the Lee and Hwang's SIV, those of other woman college students indicate 32~63% tile, respectively. 2. Changes in values by class were significant difference. (P<.05) Accordingly, the hypothesis 1 of this study has been supported. 3. Significant variation has been shown by each class in each factor such as conformity and leadership but no variation has been indicated in benevolence, independence, support and recognition. 4. There was significant difference in values between higher class (junior and senior) students with clinical experience and starting class (freshman and sophomore) students without clinical experience. (P<.05) The study indicates the values of higher class students is lower than that of starting class students. Therefore, the hypothesis 2 of this study has been supported. 5. There was no significant difference in values between entering students and graduating students. (P>.05) Thus, the hypothesis 3 of this study has been rejected. The results of the study show that there is no positive influence curricuium and clinical practice in forming the value for the students. Thcrefore, it is concluded that new strategy of clinical practice and special education program should be established for fromation of the right values for the nursing students.

사염화탄소의 간독성에 대한 파두 다당류분획의 예방효과

이은경,길이룡,소동수,창동신,전선덕,정명규,문창규 한국환경독성학회 1996 환경독성보건학회지 Vol.11 No.2

In present study, we fractionated polysaccharides from Croton tiglium and investigated their hepatoprotective effects on CCI₄ intoxication. Polysaccharide fraction of which molecular weight is over 300,000(HP) showed the most potent hepatoprotective effects on CC1₄ intoxication. Lipid peroxidation, BAST and sALT were used as parameters to evaluate the liver damage. Glucose, xylose and arabinose were found to be monosaccharides composing sugar moiety of HP.

분포정수 회로해석과 고장 조건을 이용한 지중 케이블 시스템 고장점 표정 알고리즘

李德洙,楊霞,崔勉松 明知大學校 産業技術硏究所 2005 産業技術硏究所論文集 Vol.24 No.-

본 논문은 분포정수회로 해석 방법에 기초한 새로운 지중 케이블 고장점 표정 알고리즘을 제안한다. 제안한 방법은 장거리 가공선로 해석에 적용되는 분포정수회로 해석 방법인 쌍곡선 함수 해석 방법을 케이블 시스템에 응용하여 코어와 시스에 관한 전압, 전류 방정식을 세우고, 각 고장에 대한 전체 회로를 분석하여 각 고장조건을 만들고 그것을 이용하여 고장거리에 관한 방정식을 수립한다. 마지막으로 저력계통 과도현상 해석 프로그램으로부터 측정한 케이블의 전압, 전류 데이터를 입력하고, 뉴튼-랩슨 반복법을 이용하여 고장거리를 추정한다. PSCAD/EMTDC를 이용하여 케이블의 다양한 고장을 모의하였으며, 제안한 알고리즘을 검증하였다.

강자성체용 와전류센서의 주파수 및 lift-off 효과

최덕수,이향범 崇實大學校 生産技術硏究所 2002 論文集 Vol.32 No.-

In this paper, the frequency and lift-off effect of eddy current sensor for ferromagnetic material is presented. To analyze the effect of frequency and lift-off of sensor on the sensor output signal, three eddy sensors are made. Because the test sample is ferromagnetic material, frequencies for the sensor are selected on the low frequency range. When the sensor is in the air and far from the sample, the sensor output voltage is adjusted to lower limit value. So as the sensor moves from the surface of the sample to the air, the output voltage falls from the high value to the low value. At some frequency, as the lift-off is increased, the sensor output is saturated to the low value abruptly. And at other frequency, the sensor output voltage is smoothly decreased as the sensor moves to the air from the surface. From the result of experiment in this paper, we can conclude that selection of proper frequency is important in the design of eddy current sensor for the variation of lift-off.

全南地方의 輸出業體運營實態에 관한 硏究 : 特히 中小企業을 中心으로

柳文壽,宋正鉉,李德懋,尹柱漢 朝鮮大學校 1981 經營經濟硏究 = Management and economics research Vol.4 No.-

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.

大邱地域 綜合流通團地造成을 위한 實證的 硏究 : 立地妥當性 模型開發을 中心으로 For Developmental Location Validity Model

金圭昌,具滋慶,李洪閏,魏秀一,林德相 효성여자대학교 산업경영연구소 1993 경영경제 Vol.10 No.-