임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

여호와의 증인 환자에서 산과적 출혈 후 무수혈 치료 2예

김재령,여소진,이해혁,김정식,김태희,남계현,이권해,이임순,박진화,황경호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Jehovah's Witness comprise a unique obstetric population. Their refusal of blood stems from an interpretation of a literal translation of the Bible, and it is this belief that puts them at an increased risk of morbidity and mortality if hemorrhage occurs. We report two cases of a Jehovah's Witness who bled massively due to obstetric hemorrhage, refused blood transfusion and had profound anemia. The patients were treated with recombinant human erythropoietin, parenteral iron and oxygen. And they were treated on an intensive care unit with intermittent positive pressure ventilation. We reviewed with literature considering the therapy for acutely anemic patients who refuse transfusion to decrease the duration of the most severe anemia.

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.

Assessment of In Vitro Assay System for Thyroid HormoneDisruptors Using Rat Pituitary GH3 Cells

Hee Jin Kim1,Hae Young Park1,Jeonga Kim1,Il Hyun Kang2,Tae Sung Kim2,Soon Young Han2,Tae Seok Kang2,Kui Lea Park2,Hyung Sik Kim1 한국독성학회 2006 Toxicological Research Vol.22 No.4

The development of in vitro assays has been recommended to screening and test-ing the potential endocrine disruptors (EDs). These assay systems focus only on identifying thethe thyroid hormone (TH) disruptors. The aim of this study was to evaluate a test system to detectTH disruptors using rat pituitary tumor GH3 cells. The test system is based on the TH-dependentincrease in growth rate. As expected, L-3,5,3-triiodothyronine (T3) markedly induced a morphologicalchange in GH 3 cells from flattened fibroblastic types to rounded or spindle-shaped types. T3 stimu-lated GH3 cell growth in a dose-dependent manner with the maximum growth-stimulating effect9 M. In addition, T3 increased the release of growth hor-mone and prolactin into the medium of the GH3 cells culture. Using this assay system, the TH-dis-rupting activities of bisphenol A (BPA) and its related compounds were examined. BPA,dimethylbisphenol A (DMBPA), and TCI-EP significantly enhanced the growth of GH3 cells in therange of 1 × 10-5M to 1 × 10-6M concentrations. In conclusion, this in vitro assay system might bestandardization before it can be used as a broad-based screening tool.

석고법을 이용한 상지 견갑골부위의 체표변화에 따른 여유량 설정에 관한 연구

김혜경,서추연,박순지 연세대학교 생활과학연구소 1999 生活科學論集 Vol.13 No.-

This study was performed to determine the ease amount of upper arm and scapula whose motion range and capacity were highest in the upper body. Subjects were 10 women aged 23 to 25 and suing gypsum method, the body surface change according to the motion of upper arm were obtained. The results obtained from this study were as follows ; 1. In the upper arm area, increasing the motion, sleeve width increased but height of sleeve cap and armhole girth dcreased. In the scapula area, shoulder length showed the highest contraction ratio of 36.2%. 2. It was the sleeve width area including anterior and posterior armpit points that indicated the highest change ratio, demanding ease amount. 3. Overapping of body suface draft and sleeve pattern, the appropriate height of sleeve cap were A.H./4+3∼3.5㎝ in M1∼M3 and A.H./5 in M4. 4. Analyzing the shape of scapula according to the motion of upper arm by means of Moire´ Photography increasing to the motion, moire´contour line moved to the shoulder point.

골반 초음파 감시 하에 16 Gauge Angioneedle™을 사용하여 치료적 더글라스와 천자를 시행하여 치유된 복강 내 출혈 1예

김미영,이해혁,유애리,박정희,이임순,정수호,레앙소팔,배동한,김태희,이권해 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

Culdocentesis is a procedure that checks for abnormal Quid in the space just behind the vagina (cul-de-sac). First, a pelvic examination is done. Then, after exposing the postehor vaginal fonix with a bivalve vaginal speculum the posterior lip of the cervix is grasped with a tenaculum. The cul-de-sac is then entered through the postehor vaginal wall with an 18-20 gauge needle with a syringe inserted. As the cul-de-sac is entered, suction is applied, and the intraperitoneal contents are aspirated. In the recent past, culdocentesis was commonly used in the evaluation of a vahety of common intraperitoneal conditions, principally, the hemorrhage associated with ectopic gestations and ruptured ovarian cysts the presence and/or drainage of purulent associated with pelvic inGammatory disease, and as a screening procedure to facilitate early diagnosis of ovarian neoplasms. Usually 16-18 gauge needle with a syhnge attached was used for culdocentesis. But we have experienced a case of therapeutic culdocentesis with 16 gauge angioneedle in patient of hemoperitoneum. So, report it with a bhef review of literature.

종격동 종괴를 의심케한 우대동맥궁 1례

김만우,백학연,정춘해,장경식,홍순표,조건국,김종진 朝鮮大學校 附設 醫學硏究所 1987 The Medical Journal of Chosun University Vol.12 No.1

Developmental anomalies of the aortic arch, commonly known as vascular rings, are relatively rare congenital vascular anomalies which can compress the trachea and esophagus. One routine chest film of a patient who was checked and hepatoma-diagnosed in Internal Medicine, Chosun University Hospital left the room for doubt of mediastinal mass. But no subjective symptoms for the mass was told by the patient. This is to report our experience of a patient having right side aortic arch with aberrant left subclavian artery, as proved by diagnosis, but none of congenital heart disease. This right side aortic arch with aberrant left subclavian artery is the most frequent type among right aortic arch, the anomaly of which is usually detected from the incidental suspicion for mediastinal mass at routine chest film; because no symptoms are accompanied therewith.

임상간호사의 자아실현과 정신건강에 관한 연구

김혜순,강익화 京畿專門大學 1994 京畿專門大學 論文集 Vol.- No.22

식도암의 임상적 고찰

김만중,김만우,채종구,정춘해,홍순표,조건국 朝鮮大學校 附設 醫學硏究所 1987 The Medical Journal of Chosun University Vol.12 No.1

A Clinical observation was made in 52 cases of patients with esophageal cancer at Chosun University Hospital during about 5years from january 1981 until may 1986. The following results were obtained: 1. The peak age of patients was fifth decade. The average age of patients is 55.7 years old. The sex ratio is 7.6 : 1 with a greater prevalence male. 2. Duration of the disease before admission was relatively long, about 4~6 months is 48% of all case. 3. The most common initial symptoms were swallowing difficulty, weight loss, substernal pain. 4. On the majority of patients, Heavy s.noking was manifested. 5. In blood type, A type was predominent. 6. In location of tumor, 69.2% of total cases were located in mid esophagus. 7. In histopathologic finding, 73% of total cases was squamous cell ca.

난소 임신 10예의 분석

김용진,이충일,이해혁,남계현,이임순,이권해 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Ovarian pregnancy is an uncommon form of the ectopic pregnancies. The ovarian vascularity results in maternal hemorrhage early in the first trimester, which disrupts the pregnancy and usually ruptures the ovary with sufficient hemoperitoneum to require emergency operation. This report presents 10 cases of ovarian pregnancy by retrospective review between January 1986 and December 1995 at the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital. There was 19,849 deliveries and 637 ectopic pregnancies during same period. It showed that the incidence of ovarian pregnancy was 3.21 % of all ectopic pregnancies. The clinical features of ovarian pregnancy revealed that abdominal pain was the major symptom, and history of amenorrhea was obscure. Because of life-threatening course, the early diagnosis and treatment of ovarian pregnancy is important. The clinical diagnosis of ovarian pregnancy was more difficult than that of tubal pregnancy.