• Title/Summary/Keyword: Kim Won-wu

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Intravascular Hemolysis after Prosthetic Valve Replacement (인공판막 치환수술후의 용혈)

  • Jang, Won-Chae;Lee, Gye-Yeong;Kim, Sang-Hyeong
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1556-1562
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    • 1992
  • Forty two consecutive patients who had had valve replacement with St. Jude Medical prosthesis were studied on a view point of intravascular hemolysis. Patients were consisted of 14 mitral valve replacement, and 7 aortic valve replacement, and 21 double, mitral and aortic, valve replacement. Serum LDH, indirect bilirubin, GOT, hemoglobin levels and ret-iculocyte count were pursued in postopeative 1st day, 3rd day, 7th day, 14th day and 21th day. Postoperatively, all patients were not detected paravalvular leakage on the ech-ocardiographical study. The patients with double valve replacement revealed higher levels of LDH on postopeative 14th day[P<0 05] than those with single valve replacement. Among the patients with single valve replacement, the patients with aortic valve replacement revealed slightly higher levels of entire postopeative data, but considered insignificant. There was correlation between the severity of hemolysis and the size of replaced aortic valve. In the postoperative LDH levels, the patients with small sized-aortic valve[less than 21mm in diameter] replacement revealed higher levels of postoperative 3rd day, 7th day and 14th day than those with large size[more than 23mm in diameter]. The patients with high level LDH of greater than 800 WU /L on postoperative 7th day were 61.9%[26 of 42]. The high LDH frequency of DVR was 71.4%[15 of 21], MVR 50.0%[7 of 14] and AVR, 57.1%[4 of 7]. The level of LDH declined gradualiy thereafter through postoperative 3 weeks. In conclusion, intravascular hemolysis after prosthetic valve replacement was dependent on position of valve replacement and size of valve. And this study supports the conventional valve selection and usage in our hospital. The patients with subclinical hemolysis after valve replacement should be placed on a close observation.

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An Application Study of Six Sigma in Clinical Chemistry (6 시그마의 적용에 대한 연구)

  • Chang, Sang Wu;Kim, Nam Yong;Choi, Ho Sung;Park, Yong Won;Chu, Kyung Bok;Yun, Kyeun Young
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.2
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    • pp.121-126
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    • 2004
  • The primary goal of six sigma is to improve patient satisfaction, and thereby profitability, by reducing and eliminating defects. Defects may be related to any aspect of customer satisfaction: high product quality, schedule adherence, cost minimization, process capability indices, defects per unit, and yield. Many six sigma metrics can be mathematically related to the others. Literally, six means six standard deviations from the mean or median value. As applied to quality metrics, the term indicates that failures are at least six standard deviations from the mean or norm. This would mean about 3.4 failures per million opportunities for failure. The objective of six sigma quality is to reduce process output variation so that on a long term basis, which is the customer's aggregate experience with our process over time, this will result in no more than 3.4 defect Parts Per Million(PPM) opportunities (or 3.4 Defects Per Million Opportunities. For a process with only one specification limit (upper or lower), this results in six process standard deviations between the mean of the process and the customer's specification limit (hence, 6 Sigma). The results of applicative six sigma experiment studied on 18 items TP, ALB, T.B, ALP, AST, ALT, CL, CK, LD, K, Na, CRE, BUN, T.C, GLU, AML, CA tests in clinical chemistry were follows. Assessment of process performance fits within six sigma tolerance limits were TP, ALB, T.B, ALP, AST, ALT, CL, CK, LD, K, Na, CRE, BUN, T.C, GLU, AML, CA with 72.2%, items that fit within five sigma limits were total bilirubin, chloride and sodium were 3 sigma. We were sure that the goal of six sigma would reduce test variation in the process.

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A Review of Clinical Studies for Journal of Oriental Neuropsychiatry - since 2001 to 2010 - (동의신경정신과학회지에 게재된 임상연구논문 동향분석 - 2001년부터 2010년까지 -)

  • Heo, Eun-Jung;Jeon, Won-Kyung;Kim, Wu-Young;Han, Chang-Hyun
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.3
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    • pp.115-125
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    • 2011
  • Objectives : This study was aimed to review the trend of clinical studies in Journal of Oriental Neuropsychiatry since 2001 to 2010. Methods : We collected 260 clinical studies and analyzed them for publish year, sorts of disease or symptoms, pattern identification diagnosis, and classification of clinical studies. Among them, we selected 46 clinical experimental studies and these studies were further analyzed for publish year, research institution, sort of disease or symptoms, sorts of treatments, number of subject, and pattern identification diagnosis. Results : The number of clinical studies in Journal of Oriental Neuropsychiatry have increased since the year of 2001. There were 62 kinds of diseases and symptoms and Hwa-Byung had the highest number of studies followed by depression, headache, insomnia and so on. The clinical experimental studies, which took up 17% of the clinical studies, have increased since 2001 and was varied with year. There were 13 reserch institutions for clinical experimental studies and they studied about stress, dementia, Hwa-Byung, and so on. Most of studies researched treatment about acupuncture, herb medicine, and meditation treatment for persons under 144. There are only 22% of studies using pattern identification diagnosis. Conclusions : For the development of oriental medicine for psychiatric disease, we need more qualifying clinical studies like RCT. We hope more researchers for psychiatry disease of oriental medicine will be interested in the publication of clinical studies and this will serve to produce advance of oriental medicine as evidence based medecine.

On the Characteristics of Form Factors -Series 60, $C_B=0.60$- (Series 60, $C_B=0.60$ 선형의 형상계수의 특성고찰)

  • Kim, Hun-Chol;Yang, Seung-Il;Kim, Eun-Chan;Kang, Kuk-Jin;Van, Suak-Ho;Lee, Young-Gill;Kim, Yoon-Ho;Lee, Kwi-Joo;Kwak, Young-Ki;Joa, Soon-Won;Kim, Hyo-Chul;Kim, Wu-Joan;Song, Mu-Seok;Cho, Kyu-Jong;Hong, Sung-Wan;Lee, Seung-Hee;Sin, Yeong-Kiun
    • Bulletin of the Society of Naval Architects of Korea
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    • v.25 no.4
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    • pp.7-12
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    • 1988
  • The Resistance Committee of Korea Towing Tank Conference extended the Cooperative Experimental Study Program(1985)[1] to perform the geosim tests by exchanging the five different scaled Series 60, $C_B=0.60$ models between the participating organizations and 13 sets of resistance data have been obtained. The test results are compared among the participating towing tanks and also with the results given in the report of the Resistance and Flow Com-identify the mittee of 18th ITTC. The form factor of each model is derived by Prohaska's method to investigate its dependency on $R_n$. On the other hand, at each $F_n$, form factors are also derived by Telfer's method to relation between $F_n$ and form factor. For this hull form, form factors show relatively weak dependency on $R_n$ and strong dependency on $F_n$. And it is also found that dependencies on both have a cross relation. It seems that further study should be continued to understand more clearly the physical phenomena involved in this problem.

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5 Cases of Patients with Multiple Fractures of Ribs after a Traffic Accident who Improved with the Combination of Korean Medical Admission Treatment: Case Series (교통 사고로 발생한 다발 늑골 골절 환자의 한방복합입원치료로 호전된 증례 보고 5례)

  • Lee, Ji-won;Roh, Ji-ae;Choi, Gyu-cheol;Kim, Dong-jin;Hong, Jeong-su;Kim, Gook-beom;Kim, Hyo-jun;Kim, Sun-a;Kim, Hye-gyeong;Jeong, Wu-jin
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.506-516
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    • 2019
  • Objectives: This study aimed to report five patients who had multiple rib fractures after a traffic accident who improved with the combination of Korean medical admission treatment. Methods: We collected the data of traffic accident patients with multiple rib fractures who were admitted to the Daejeon Jaseng Hospital of Korean Medicine from April 2018 to May 2018 to receive the combinational Korean medical treatment. We observed these cases of patients treated by Acupuncture, Pharmacopuncture, Herbal medicine, Oriental physical therapy, Chuna treatment. We measured the validity of the treatment with a numerical rating scale (NRS) and the European Quality of Life-5 Dimension (EQ5D) at admission, at two weeks, and at the discharge date of hospitalization. Results: At the end of the treatment, all patients showed a decrease in NRS scores and in increase in EQ5D. The median NRS score was 6 (5-7) at the date of admission and 4 (2-7) at two weeks and then decreased to 3 (2-6). The median EQ5D score was 0.513 (0.350-0.752) at the date of admission and 0.692 (0.418-0.913) at two weeks, and then increased to 0.783 (0.671-0.913). Conclusions: After the combination of Korean medicine admission treatment, five patients with multiple rib fractures after a traffic accident showed that the treatments were effective. However, the number of subjects was insufficient and individual efficacy was not measured in this study. Therefore, further studies are needed on this topic.

The influence of adjuvant radiotherapy on patterns of failure and survivals in uterine carcinosarcoma

  • Park, Hae-Jin;Kim, Hak-Jae;Wu, Hong-Gyun;Kim, Hans;Ha, Sung-Whan;Kang, Soon-Beom;Song, Yong-Sang;Park, Noh-Hyun;Kim, Jae-Won
    • Radiation Oncology Journal
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    • v.29 no.4
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    • pp.228-235
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    • 2011
  • Purpose: To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery. Materials and Methods: Between October 1998 and August 2010, 19 patients with stage I-III uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months). Results: At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in locoregional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS. Conclusion: Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.

Why Do Patients Drop Out During Radiation Therapy? - Analyses of Incompletely Treated Patients - (불완전 방사선치료 환자의 분석)

  • Huh Seung Jae;Wu Hong Gyun;Ahn Yong Chan;Kim Dae Yong;Shin Kyung Hwan;Lee Kyu Chan;Chong Won A;Kim Hyun Joo
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.347-350
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    • 1998
  • Purpose : This study is to see how much proportion of the patients receiving radiation therapy drop out during radiation therapy and to analyze the reason for the incomplete treatment. Materials and Methods : The base population of this study was 1,100 patients with registration numbers 901 through 2,000 at Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea. Authors investigated the incidence of incomplete radiation therapy, which was defined as less than 95$\%$ of initially planned radiation dose, and the reasons for incomplete radiation therapy. Results : One hundred and twenty eight patients (12$\%$) did not complete the planned radiation therapy. The performance status of the incompletely treated patients was generally Poorer than that of the base population, and the aim of radiation therapy was more commonly palliative. The most common reason for not completing the planned treatment was the patients' refusal of further radiation therapy because of the distrust of radiation therapy and/or the poor economic status. Conclusion : Careful case selection for radiation therapy with consideration of the socioeconomic status of the patients in addition to the clinical indication would be necessary for the reduction of incomplete treatment, especially in the palliative setting.

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A Study of Carry Over Contamination in Chematology (이월오염에 대한 연구)

  • Chang, Sang-Wu;Kim, Nam-Yong;Lyu, Jae-Gi;Jung, Dong-Jin;Kim, Gi-You;Park, Yong-Won;Chu, Kyung-Bok
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.3
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    • pp.178-184
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    • 2005
  • Carry over contamination has been reduced in some systems by flushing the internal and external surfaces of the sample probe with copious amount of diluent. It between specimens should be kept as small as possible. A built-in, continuous-flow wash reservoir, which allows the simultaneous washing of the interior and exterior of the syringe needles, addresses this issue. In addition, residual contamination can further be prevented through the use of efficient needle rinsing procedures. In discrete systems with disposable reaction vessels and measuring cuvets, any carry over is entirely caused by the pipetting system. In analyzers with reuseable cuvets or flow cells, carry over may arise at every point through which high samples pass sequentially. Therefore, disposable sample probe tips can eliminate both the contamination of one sample by another inside the probe and the carry over of in specimen into the specimen in the cup. The results of the applicative carry over experiment studied on 21 items for total protein (TP), albumin (ALB), total bilirubin (TB), alkaline phosphatase (ALP), aspratate aminotranferase (AST), alanine aminotranferase (ALT), gamma glutamyl transferase (GGT), creatinine kinase (CK), lactic dehydrogenase (LD), creatnine (CRE), blood urea nitrogen (BUN), uric acid (UA), total cholesterol (TC), triglyceride (TG), glucose (GLU), amylase (AMY), calcium (CA), inorganic phosphorus (IP), sodium (Na), potassium (K), chloride (CL) tests in chematology were as follows. Evaluation of process performance less than 1% in all tests was very good, but a percentage of ALB, TP, TB, ALP, CRE, UA, TC, GLU, AMY, IP, K, Na, and CL was 0%, implying no carry over. Other tests were ALT(-0.08%), GGT(-0.09%), CK(0.08%), LD(0.06%), BUN(0.12%), TG (-0.06%), and CA(0.89%).

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An Empirical Validation Study for Calibration Verification in TDM Test (검량보정 검증의 실험적 적합성에 대한 연구 -치료적 약물검사를 중심으로-)

  • Chang, Sang-Wu;Kim, Nam-Yong;Choi, Ho-Sung;Park, Yong-Won;Chu, Gyung-Bok;Yun, Keun-Young;Park, Byung-Ok
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.1
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    • pp.1-7
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    • 2005
  • The purpose of this study was to verify (i) a consistent calibration verification for the assessment of method linearity and (ii) calibration agreement with calibration settings. We validated calibration verification through method linearity with different lot number of individual calibrators that span the working range for 9 tests except salicylate with control sample in test. We evaluated that it covered broad analyte range to assay from near zero to the top of the measuring range with 5 or 6 points every three times for 10 analytes in TDM test. Target values were plotted on X-axis with assigned or observed values on the Y-axis. Working range were as follows. Calibration verification of the measuring range (maximum to minimum values) has been validated asetaminophen 0.1 to $304.6_{\mu}g/mL$, salicylate 0 to $1005_{\mu}g/mL$, valproic acid 3.2 to $154.19_{\mu}g/mL$, digoxin 0.17 to 5.65 ng/mL, vancomycine 1.3 to $80.51_{\mu}g/mL$, carbarmazepine 0.1 to $22.3_{\mu}g/mL$, phenytonin 0.6 to $40.21_{\mu}g/mL$, theophyline 0.2 to $40.21_{\mu}g/mL$, primidone 0 to $24.07_{\mu}g/mL$, phenobarbital 0.6 to $60.0_{\mu}g/mL$. Drawing a straight line through five or six points of these data showed good linearity. We are sure that it is important to assess the calibration verification of a test method to ascertain the lowest and highest test results that are reliable.

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Roles of B-dot Controller and Failure Analysis for Dawn-dusk LEO Satellite (6시 저궤도 위성에서 B-dot 제어기 역할과 고장분석)

  • Rhee, Seung-Wu;Kim, Hong-Joong;Son, Jun-Won
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.41 no.3
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    • pp.200-209
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    • 2013
  • In this paper, the types of B-dot controller and the review results of B-dot controller stability are summarized. Also, it is confirmed that B-dot controller is very useful and essential tool when a dawn-dusk low earth orbit(LEO) large satellite has especially to capture the Sun for a required power supply in a reliable way after anomaly and that its algorithm is very simple for on-board implementation. New physical interpretation of B-dot controller is presented as a result of extensive theoretical investigation introducing the concept of transient control torque and steady state control torque. Also, the failure effect analysis results of magnetic torquers as well as a simulation verification are included. And the design recommendation for optimal design is provided to cope with the failure of magnetic torquer. Nonlinear simulation results are included to justify its capability as well as its performance for an application to a dawn-dusk LEO large satellite.