근위부 위절제술 후 재건 술식에 따른 경과 관찰

김지훈,육정환,김병식,오성태,Kim, Ji-Hoon,Yook, Jeong-Hwan,Kim, Byung-Sik,Oh, Sung-Tae 대한위암학회 2006 대한위암학회지 Vol.6 No.1

목적: 근위부 위절제술 후 식도-위 문합술을 시행받은 환자에서 문합부 협착, 역류성 식도염 등이 드물지 않게 발생한다. 저자들 역시 이러한 합병증을 경험하였고 이를 극복하기 위한 방법으로 공장간치술을 시행하였으며 식도-위 문합술과 공장간치술 간의 경과 관찰을 통해 보다 나은 재건 술식을 찾고자 하였다. 대상 및 방법: 1998년 6월부터 2002년 12월까지 울산의대 서울아산병원 외과에서 상부위암 혹은 위상부의 위장관기질종양으로 진단받고 근위부 위절제술을 시행한 환자를 대상으로 재건 술식에 따른 수술시간, 수술 후 증상, 체중변화, 추적관찰 시 시행한 내시경 소견 등을 비교하였다. 결과: 대상 환자 총 33명의 평균연령은 59세였고, 남녀 비는 3 : 1이었다. 식도-위 문합술을 시행한 환자는 25명, 공장간치술을 시행한 환자는 8명이었다. 통과장애, 속쓰림, 신트림, 구토 등의 증상을 관찰하였으며 식도-위 문합술 환자에서 통과장애 12예, 구토 3예, 속쓰림 4예, 신트림 4예가 관찰되었으며, 공장간치술 환자에서는 통과장애 12예, 구토 3예가 있었고, 속쓰림과 신트림은 관찰되지 않았다. 수술 후 체중변화는 1개월 후 수술 전 체중의 90%까지 감소한 경우가 식도-위 문합술 환자에서 7예, 공장간치술 환자에서 없었다. 수술 후 추적 내시경 검사 결과 역류성 식도염이 관찰된 경우는 식도-위 문합술 환자에서 9예, 공장간치술 환자에서 0예였다. 문합부위 협착으로 인해 풍선 확장술이 필요하였던 경우가 식도-위 문합술 환자에서 4예, 공장간치술 환자에서 1예가 있었다. 결론: 상부 위절제 시 재건방법으로 역류성 식도염 및 여러 소화기 증상을 예방하기 위해 공장간치술이 식도-위문합술의 대안이 될 수 있다고 생각한다. 하지만 통계적 유의성을 가지기 위해 더 많은 대상군이 포함되어야 할 것이다. Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients. (J Korean Gastric Cancer Assoc 2006;6:1-5)

하라다병 환자에서 섬모체맥락막 삼출로 인해 발생한 양안의 급성 근시와 전방각 폐쇄 1예

김지훈,임재석,이지웅,이지은,엄부섭,Ji Hun Kim,MD,Jae Seok Lim,MD,Ji Woong Lee,MD,Ji Eun Lee,MD,PhD,Boo Sup Oum,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.8

Purpose: To report a case of bilateral acute myopia and angle-closure with ciliochoroidal detachment in Vogt-Koyanagi-Harada (VKH) syndrome. Case summary: A 43-year-old Korean woman diagnosed with VKH syndrome underwent intravenous methylprednisolone steroid pulse treatment. After oral medication was given for 2 days, the anterior chambers became shallow in both eyes. Intraocular pressure (IOP) increased to 25 mm Hg in the right eye and 23 mm Hg in the left eye. Subretinal fluid increased and visual acuity decreased with myopic shift in both eyes. IOP did not decrease despite maximum tolerated medical therapy. Ultrasound biomicroscopy (UBM) revealed that ciliochoroidal effusion caused forward displacement of the lens-iris diaphragm, which resulted in anterior chamber shallowing and angle closure in both eyes. The patient was treated with cycloplegic eyedrops and intravenous steroid pulse therapy. After intravenous steroid pulse treatment was given for 2 days, the anterior chambers became deep in both eyes. IOP reduced to 13 mm Hg and 14 mm Hg in the right and left eye respectively. Visual acuity increased with normalization of myopic shift. UBM revealed that the ciliochoroidal effusion had resolved in both eyes. J Korean Ophthalmol Soc 2012;53(8):1194-1199

기존한약서 수재 처방 Database 구축 연구

김지훈,이대중,윤성중,안상우,김윤경,Kim, Ji-Hoon,Lee, Dae-Jung,Yun, Sung-Joong,Ahn, Sang-Woo,Kim, Yun-Kyung 대한한의학방제학회 2015 大韓韓醫學方劑學會誌 Vol.23 No.2

Objective : The main purpose of this study is to find a reasonable solutions for utilization of herbal formulas based on the medical classics. Methods : We used official Ten 'Selected Korean Medical Classics(SKMC)'. For input of formulas from SKMC, we had to select proper editions of them. After consultations with experts of 'The Korean Medicine Society for the Herbal Formula Study' and 'Korean Society of Medical History', we chose the proper editions of SKMC, and according to those books, we built formulas database using microsoft office excel sheets, respectively. Results : After whole input procedures, we requested several experts to inspect the results and also, to correct errors in them. Input categories were name of formula, name of classic, classification, original source, composition herb, weight, unit of weight, weight conversion index, converted weight, basic formula, indications, reason for modification, preparing method, taking method and contraindications. Final number of whole formulas in DB was 32,882. Conclusions : We used SKMC and built database using excel program. Through this procedure, we can provide a developmental ways to make a foundation for herbal formulas from the medical classics, so that we can make herbal formulas be standardized or industrialized more efficiently.

올 한해도 이슈였던 사료와 질병, 그 복잡한 상관관계

김지훈,Kim, Ji-Hun 한국단미사료협회 2005 피드저널 Vol.3 No.12

돼지의 사료섭취량에 영향을 주는 요인들(3)

김지훈,Kim, Ji-Hun 대한양돈협회 1999 養豚 Vol.21 No.12

중질유 분해 및 탈황 폐촉매로부터 유가금속의 회수

김지훈,김희택,조욱상 ( Ji Hoon Kim,Hee Taik Kim,Wook Sang Cho ) 한국화학공학회 1995 화학공학의이론과응용 Vol.1 No.2

작업치료사의 직업윤리와 교육에 대한 인식이 직무스트레스와 직무몰입에 미치는 영향

김지훈,정재훈,Kim, Ji Hoon,Jung, Jae Hun 한국디지털정책학회 2021 디지털융복합연구 Vol.19 No.10

본 연구는 작업치료사의 직업윤리와 교육에 대한 인식이 직무스트레스와 직무몰입에 미치는 영향을 파악하기 위한 조사연구이다. 이를 위하여 작업치료사 173명을 대상으로 직업윤리와 교육에 대한 인식, 직무스트레스와 직무몰입을 평가하였으며, 본 연구의 결과는 다음과 같다. 첫째, 직업윤리와 교육에 대한 인식, 직무스트레스와 직무몰입(p<.01) 간에는 유의한 상관관계가 있었다. 둘째, 직업윤리와 교육에 대한 인식의 하위요인 중 교육경험(p<.01)과 윤리문제의 심각성(p<.05)은 직무스트레스에 영향을 미치는 것으로 나타났다. 셋째, 직업윤리와 교육에 대한 인식의 하위요인 중 교육경험(p<.05)은 직무몰입에 영향을 미치는 것으로 나타났다. 본 연구의 결과들을 통하여 직업윤리의 중요성을 인식하고, 이를 향상하기 위한 체계적인 교육이 필요할 것이다. The aimed of this research was to identify the influence of perception of the vocational ethics and education on job stress and job commitment in occupational therapists. 173 occupational therapists measure for perception of vocational ethics and education, job stress and job commitment, the findings of the study were as follows. First, perception of vocational ethics and education was correlated with job stress, job commitment(p<.01). Second, perception of vocational ethics and education sub-factor of education experience(p<.01), seriousness of ethical issues(p<.05) was found to have affected the job stress. Third, perception of vocational ethics and education sub-factor of education experience(p<.05) was found to have affected the job commitment. Through the results of this study, systematic education will be needed to recognize the importance of vocational ethics and improve it.

후두 결핵의 임상 양상 분석: 최근 10년간 단일 기관의 경험

김지훈,공태훈,최홍식,변형권,Kim, Ji-Hoon,Kong, Tae Hoon,Choi, Hong-Shik,Byeon, Hyung Kwon 대한후두음성언어의학회 2020 대한후두음성언어의학회지 Vol.31 No.2

Background and Objectives The overall incidence of laryngeal tuberculosis (LT) has generally decreased over the recent years, yet there is still a discrete population of patients newly diagnosed with the disease. This study is aimed to examine the patients with LT over the recent 10 years and to investigate the changes in clinical pattern with respect to the past period. Materials and Method A retrospective review has been performed on 20 patients who have been initially diagnosed with LT between 2005 and 2015. Results The age of the patients ranged from 25 years to 95 years with an average age of 45.6 years. Seventeen patients (85%) showed hoarseness, which was the most common clinical symptom. Most affected lesion was the true vocal cord. Laryngoscopic examination showed various clinical manifestations: polypoid 30%, granulomatous 25%, nonspecific 25%, ulcerative 20%. A variety of methods were used for diagnostic confirmation of LT [acid-fast bacilli (AFB) smear 45%, AFB culture 40%, polymerase chain reaction 30%, surgical pathology 45%]. Coexisting pulmonary tuberculosis (PT) was detected in 10 patients (50%). Relative to the patients with inactive PT or normal lung status, those with active PT showed higher incidence of laryngeal lesions located in areas other than true vocal cord (p=0.050). Conclusion Based on the analytic results from this study, laryngologists should recognize the changes in the recent clinical patterns of LT and always be ready for clinical suspicion of this disease on such atypical laryngeal findings which can often mimic laryngeal malignancies to provide the pertinent treatment.

족관절의 골절-탈구에 대한 임상적 고찰

김지훈,송재광,서진수,Kim, Ji Hoon,Song, Jae Gwang,Suh, Jin Soo 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.3

Purpose: We evaluate clinical manifestations and radiologic features of ankle fracture & dislocation, as well as the usefulness of computed tomography on posterior ankle fracture & dislocation to study factors contributing to ankle fracture & dislocation. Material and Methods: Ankle dislocation was defined as the center of talar body being translated over the cortex of tibia on AP or lateral view on simple X-ray. Surgical treatments of 30 patients from January 2007 to March 2012 were categorized according to the injury mechanism, the direction of dislocation and fracture site. Joint involvement of posterior malleoalr fracture was evaluated through simple x-ray and computed tomography. We treated surgically if posterior malleolus fracture involves more than 25% of dital tibial articular surface. Thereafter, clinical outcomes were identified through radiographs and by using the AOFAS score. Results: The mean age was 42(13-78) years old, and slip down was the most common injury mechanism (13 cases). Car accident (6 cases) and fall accident (4 cases) were the next frequently found injury mechanisms. As for the types of ankle fracture, posterior fracture and dislocation (21 cases, 43.3%) was most commonly found. Out of these 21 cases, 15 cases involved trimalleolar fracture, and 19 cases were associated with posterior malleolar fracture. Danis-weber type B and C patients were 11 cases and 10 cases respectively. Articular involvement of posterior malleolar fracture turned out to be average 27.9%(5.1%~49.1%) on simple x-ray. The rate was evaluated as average 31.7%(12.6%~55.3%) on computed tomography which was conducted 15 times, and led us to more meaningful data. Conclusion: Anterolateral fracture and dislocation often accompanied open dislocation. Posterior fracture dislocation was most commonly found. Posterior malleolus was an important factor that ensures posterior stability of the ankle joint. Computed tomograph is useful to evaluate the articular involvement of posterior malleolar fracture.

만성두통환자의 침치료효과에 대한 임상적 고찰

김지훈,이재동,최도영,안병철,박동석,이윤호,Kim, Ji-Hoon,Lee, Jae-Dong,Choi, Do-Young,Ahn, Byung-Choul,Park, Dong-Suk,Lee, Yun-Ho 대한침구의학회 2000 대한침구의학회지 Vol.17 No.3

Chronic headache is one of the most common symptoms of outpatients. There are many approaches to treat chronic headache, but it is difficult to be resolved completely. So analgesics-addicted patients are increased in numbers. Acupuncture and ear-acupuncture have been used for relief headache. But it is not sufficient to compare the effect of acupuncture on several chronic headache groups. Thus we investigate the effect of acupuncture and ear-acupuncture on several chronic headache groups and analgesics-abused groups. We researched 36 patients who were treated at Department of Acupuncture & Moxibustion, Kyung Hee Medical Center from August 1998 to July 1999. The chronic headache patients were classified into tension-type headache group, migraine group and unclassified headache group by Guide of IHS. Each group was treated with acupuncture and ear-acupuncture. The effect was assessed through questionnaires and self-rating headache index.