18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

물질남용 치료프로그램 후 재범여부에 대한 예비적 추적조사 연구

김현수,조선미,오은영,임기영,정영기,윤웅장,이영미 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구는 물질사범에게 시행되는 수강명령 프로그램의 효과를 재범률을 중심으로 살펴보고자 한 것이다. 방 법: 이 연구의 대상집단은 보호관찰소에서 의뢰받은 물질남용자집단이다. 이들은 법원으로부터 보호관찰, 수강명령, 치료명령, 사회봉사 등을 부과받았다. 총 104명의 대상자집단을 치료프로그램을 이수한 수강군과 비수강군으로 나누었으며 이들에 대한 재범률을 조사하였다. 결 과: 프로그램을 이수한 수강군이 비수강군에 비해 재범률이 낮았다(p<.05). 또한 단기 수강군과 장기수강군의 재범률의 차이를 조사하였는데 대상자 집단의 수가 적기 때문에 장기 수강군의 효과가 통계적으로 입증되지는 않았다. 결 론: 우리는 물질남용자에 대한 정책이 보다 교육적으로 변화할 것을 본 논문을 통하여 제시하려 하였으며 정부 및 법무부는 물질남용자에게 교육과 치료를 제공해주어야만 한다. Objectives: Using recidivism rate, we investigated the outcome after our substance abuse treatment program had been implemented. Methods: Our target population was substance abuse criminals referred by probational office. They either received the parole and probation order, treatment order or social service order from the court. We divided 104 substance abuse criminals into treatment group and non-treatment group. We examined their recidivism rate. Results: We reached a conclusion that treatment group had lower recidivism rate than non-treatment group(p<.0.5). We examined the effectiveness of short-term and long-term programs. However, no effectivess of long-term program was found because the sabject number was too small. Conclusion: We suggest that the strategies for substance abuse should be changed to more educative ones. The Government and Ministry of Justice must provide education and treatment to the substance abuse criminals.

서양복식에 나타난 복색규제에 관한 고찰

은영자,이해연 啓明大學校 生活科學硏究所 2005 科學論集 Vol.31 No.-

The costumes have been changed and developed with the development of the mankind. Also the color of the costume reflect the culture of the times and change. Furthermore the color of the costume has been used as symbol of social status. This study analysed the restrictions of color in the sumptuary of the western costume. The relations between the symbolic meaning of color and the sumptuary of the costume color were analysed through a literature survey. On the western costume sumptuary law, the major restriction colors were red, purple and violet. These were used only for governing class who have the Power and authority. Especially purple was used only for royal family. The symbolic meanings of color are given to costumes of specific social status. The color of the costume was related to the symbolic meanings of a specific color in the times and societies.

일부 운수사업장 근로자의 건강진단 유소견자의 사후관리 실행과 관련요인

윤혜은,박종,이영선,강성득,김철호 조선대학교 2003 The Medical Journal of Chosun University Vol.28 No.1

Objective : The purpose of this study was to find the relationship between the follow-up management status for medical problem to be treated and various characteristics of some workers at transportation business. Methods : A questionnaire survey was made toward 183 workers with medical problem(C and D2) among 945 examine in 1997. Results: Sixty four point five percent of surveyee received the examination result report and 40.5% were explained about the result 80.3% of surveyee answered that they knew the result of health examination. Most workers felt the necessity of the health examination, but 54.1% were dissatisfied with present health examination system and 66.7% pointed it out as nominal The rate of follow-up management for the medical problem was 62.8% By the multiple logistic regression the follow-up management rate for those who knew the health examination result were 2.98 times higher than those who didn't know the result (OR=2.98, 95% CI 1.41~6.29) The rate for those who perceived the medical problem already were 2.64 times higher than those who perceived the problem for the first time (OR=2.64, 95% CI 1.13~6.15). The rate for those who had subjective symptoms were 2.83 times higher than those who didn't have subjective symptoms. Conclusion : sixty two point eight percent of workers with medical problem performed the follow-up management and perception of health examination result, perception of the problem in the past and experience of subjective symptoms were related with the follow-up management.

개의 대퇴골간에서 발생한 유합부전의 1례

강은경,조성환,류시윤,손화영 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

Fracture healing is a complex physiological process that involves the coordinated participation of several cell types. Unlike other tissues that heal by the formation of poorly organized scar, in fracture healing the original tissue, bone, is regenerated and the properties of the preexisting tissue largely are restored. Fracture healing generally proceeds in an orderly fashion when appropriate biological and mechanical component are present. Many complications may occur with repair and subsequent healing of fracture, including osteomyelitis, implant loosening, and fracture instability. All of these complications may result in delayed union, nonunion or malunion of the fracture. A 1-year-old male, Collie sustained a closed, transverse femoral fracture in a mortor vehicle accident. His initial treatment with open reduction and bone plating was failed. A second surgery was done to remove the plate and perform corrective osteotomy, and bone grafting. Histopathological observation of the bone fragment from fracture end was carried.

일 간호대학의 지역사회 방문간호사업 사례

강윤숙,최양자,고영애,전시자,조갑출,이옥철,주혜경,신기수,안은숙 적십자간호전문대학 2000 적십자간호전문대학논문집 Vol.22 No.-

강박장애 환자에서 Sertraline 치료반응의 예측인자에 관한 연구

유은정,우행원,김영철,연규월,김종원,임원정 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 1980년 중반부터 강박장애의 치료로 SSRIs가 널리 쓰이고 있으나 치료반응의 예측인자에 대한 연구는 미비한 실정이다. 본 연구에서는 sertraline 투여후 호전군과 비호전군의 인구학적 특성, 발병연령, 이환기간, 과거의 강방장애에 대한 투약경력, 정신과 질환의 가족력, 증상의 심각도, 임상양상 등의 변수들을 관찰하여 sertraline 치료반응과의 상관관계를 살펴보았으며 치료방응을 예측 할 수 있는 인자를 알아보았다. 방법: 연구 대상은 이대부속 동대문병원 정신과에 입원 또는 외래치료를 받은 환자들 중 정신과 진단 편람제 4판 진단 기준에 의거하여 강박장애로 진단 받은 31명(남자 10명, 여자 21명)이었다. 연구 방법은 sertraline을 하루 50mg씩 투약하면서 Y-BOCS, NIMHOCS, CGI로 강박증상의 변화를 평가하였고, HAM-A로 불안정도의 변화를 측정하여 투약 전 점수와 비교하였다. 결과: 1) Y-BOCS 점수 40%이상 감소와 함께 CGI 점수 2점 이상 감소를 보인 호전군은 대상환자 31명중 17명(54.8%)이었고, 비호전군은 14명이었다. 호전군이 비호전군에 비해 늦은 나이에 발병하는 경향을보였고(p<0.1), 이환기간이 짧았으며(p<0.05), 과거의 강박장애에 대한 투약경력은 적었다(p<0.05), 정신과 질환의 가족력은 두 집단간에 차이가 없었다. 2) 호전군에서 투약 전 Y-BOCS의 강박행동 점수가 유의하게 낮았으며(p<0.05), 기타 다른 평가척도에서는 두 집단간에 유의한 차이가 없었다. 3) 평균 Y-BOCS 점수는 투약 전에 비해 sertraline 투약 12주째 43.5%가 감소하였다. 투약 전과 비교하여 투약 2주째부터 불안을 평가하는 HAM-A 점수가 유의하게 감소하였고, 투약 4주째부터 Y-BOCS, NIMHOCS, CGI 점수가 유의하게 감소되기 시작하여 12주까지 지속되었다.(p<0.01). 4) 호전군에서 오염에 대한 강박사고와 씻음의 강박행동의 유의하게 많았으며(p<0.05), 셈의 강박행동은 없었다(p<0.05), 병적 의심은 비호전군에서 많은 경향을 보였다(p<0.1). 결론: 이상의 결과를 종합하면, 질병의 이환기간이 짧으며 과거의 강박장애에 대한 투약경력이 적고 투약 전강박행동이 심하지 않으며, 주된 임상양상이 오염에 대한 강박사고와 씻음의 강박행동인 경우 sertra-line에 좋은 치료반응을 보이지만, 셈의 강박행동이 있는 경우에는 치료반응이 좋지 않다고 예측할 수 있다. Objectives: The pharmacologic treatment of obsessive-compulsive disorder(OCD) with serotonergic antidepressant agents is well established in clinical psychiatry on the basis of serotonin hypothesis. Studies on predictive factors of treatment reponse to OCD are relatively scarce. The author compared the demographic factors, age of onset, length of illness, family history of mental illness, previous drug history for OCD, severity and type of symptoms between the drug reponders and non-responders to find out the predicitive factors that may be related to treatment response. Methods: The subjects were 31, both inpatients and outpatients who met the diagnostic criteria for OCD by DSM-IV and scored 20 or higher on the Yale-Brown Obsessive-Com-pulsive Scale(Y-BOCS) completed 12-week trial of sertraline. Y-BOCS, National Institute of Mental Health Obsessive-Compulsive Scale(NIMHOCS), Clinical Global Impression Scale(CGI) were scored to measure the changes of obsessive-compulsive symptoms, and Hamilto Anxiety Scale(HAM-A) was measured at each visit. Results: 1) The responders, defined as achieving at least a 40% decrease in the Y-BOCS total score and more than a 2 point decrease in CGI score, were 17(54.8%), and non-responders were 14(45.2%). Responders tended to show later onset(p<0.1), and shorter duration of illness(p<0.05), and less previous drug therapy for OCD(p<0.05) than non-responders. There were no significant differences in family history of mental illness between the two groups. 2) The basline Y-BOCS compulsive score was significantly lower in responders(p<0.05), although there was no significant difference in the basline severity of other measures. 3) The obsession of contamination and washing behaviors were more frequent, but compulsive counting was not shown, in responders(p<0.05). The pathological doubt tended to be more common in nonresponders(p<0.1). Conclusions: In summary, the patients with shorter duration of illness, less prior drug ther-apy for OCD, and less severe compulsive behaviors, and the obsession of contamination and washing behaviors are expected to be better outcome with sertraline, whereas compulsive counting are the predictor of poor response.

동종골수이식 후 혈당 및 혈중 지질농도의 변화양상 및 관련인자

이원영,강무일,오은숙,오기원,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘주 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.6

연구배경:골수이식은 비교적 젊은 연령의 환자들을 대상으로 하며 면역억제제의 사용기간이 비교적 짧으므로, 주로 고령의 만성 질환 환자에서 시행되는 고형장기이식에서와는 달리 당대사 및 지단백 대사에 있어서 많은 차이점이 있을 것으로 추측된다. 저자들은 전향적 연구를 통하여 골수이식 후 시기별로 혈당 및 혈중지단백 변화 양상을 알아보고 이와 관련된 임상인자들을 규명하고자 하였다. 방법:1998년 10월부터 1999년 8월까지 가톨릭대학교 성모병원에서 동종골수이식을 시행한 환자들 중 43명을 대상으로 이식 전 및 이식 후 1, 2, 3, 4주와 3개월, 6개월에 공복 혈당, 혈중 총 콜레스테롤, 중성지방, 고밀도지단백을 측정하여 골수이식 후 시기별 변화를 관찰하고 여러 임상인자들에 따른 차이를 알아보았다. 결과:1. 공복혈당은 골수이식 수 첫4주 동안 상승하였고 이후 감소하였으나 이식 6개월 시점의 평균 공복혈당은 이식 전보다 유의하게 높게 관찰되었다. 혈중 총 콜레스테롤은 이식 후 1주에 최고치를 형성하였고 이후 기저수준으로 회복되었다가 이식 수 3,6개월에 다시 증가하여 기저치에 비해 유의하게 높았다. 혈중 중성지방은 이식 후 1개월까지 유의하게 증가하였고 이후 감소하여, 3,6개월에는 기저치와 유의한 차이가 관찰되지 않았다. 혈중 고밀도지단백은 이식 후 2,3주에 이식 전보다 유의하게 감소하였고 이후 이식 전 수준으로 회복되었다. 혈중 저밀도지단백은 총 콜레스테롤의 변화와 매우 유사하였다. 2. 골수이식 후 6개월 시점에서 공복 혈당이 126㎎/dL이상인 환자는 7명(16%)이었다. 이들 환자들과 공복혈당 126㎎/dL 미만의 환자 36명을 비교한 결과, 공복혈당이 126㎎/dL 이상인 환자군에서 스테로이드 평균 투여량이 많았고 고밀도지단백이 유의하게 낮았다. 3. 이식편대숙주질환이 발생한 환자는 그렇지 않은 환자보다 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤이 더 낮았고, 3개월의 공복혈당이 더 높았다. 혈연골수이식 환자군은 비혈연골수이식 환자에 비해 투여된 스테로이드 용량이 더 적음에도 불구하고 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤 수치가 더 높았다. 스테로이드 고용량 투여군(하루 평균 7.5㎎기준)은 저용량군보다 이식 후 3개월 시점의 공복혈당이 더 높았으나 나머지 시점의 혈당, 혈중 지질농도에 있어서는 유의한 차이가 관찰되지 않았다. 결론:골수이식 후 초기시기에 주로 당 대사 및 지질대사이상이 관찰되며 이는 면역억제제 투여와 관련이 있음을 알 수 있었다. 면역억제제가 고용량 투여되는 합병증 발생 시 이들 대사이상에 관심을 기울여 대처해야 할 것이다. Background: In bone marrow transplantation(BMT), recipients are usually younger and immunosuppressants are open used in shorter period than in solid organ transplantation. Therefore, there might be a difference in glucose and lipid metabolism between BMT and solid organ transplantation. However, the serial changes of metabolic parameters following BMT have not been studied. Therefore, the aim of this study is to investigate the serial changes of blood glucose, lipids and the putative factors that are related with these changes after BMT. Methods: We have prospectively investigated 43 patients who underwent allogeneic BMT. Fasting plasma glucose(FPG), total cholesterol, triglyceride and high-density lipoprotein(HDL) were measured before BMT, and at 1, 2, 3, 4, 12 weeks and 6 months after BMT. The serial changes of these metabolic parameters according to clinical factors including type of BMT, mean daily steroid dosage, and occurrence of graft versus host disease (GVHD) were examined. Results: 1. Mean FPG level increased during 4 weeks after BMT and remained above basal value at post-transplant 6 months. Total Cholesterol level was increased during initial 4 weeks after BMT and was above basal value at post-BMT of 3 and 6 months. Triglyceride level was progressively increased during initial 4 weeks after BMT, but returned to basal value there after. HDL-cholesterol level was significantly decreased during initial 4 weeks after BMT, but returned to basal value there after. 2. Patients with FPG above 126 mg/dL and the other patients, the former received larger amounts of daily steroid and had lower HDL-cholesterol level. 3. The changes of metabolic parameters were different according to type of BMT, steroid dose, and occurrence of GVHD. Conclusion: Although there was increase of FPG, TC, TG and decrease of HDL-C during initial 4 weeks after BMT, these metabolic changes recovered slowly thereafter. Immunosuppressants are thought to be associated with these changes. Further observation will be needed for the long-term effect of BMT on metabolic changes(J Kor Diabetes Asso 24:689~698, 2000).

부산시 고령자의 통행행태에 관한 연구

오윤표,안영종,김은정 東亞大學校 建設技術硏究所 2005 硏究論文集 Vol.29 No.1

The purpose of this study os to analyze the elderly's travel behavior and to measure the factors affecting their travel mode choice. Questionnaire survey was conducted for this study. It is assumed that the elderly is over 65 years old for this study. The major results of this study are as follows:(1) Because driving alone is very expensive travel mode, bus is considered as main travel mode for the elderly over 65 years old. (2) The friendship, recreation, an medical treatment are significant travel purpose. It was showed that the elderly's travel pattern is irregular. (3) Going up and down of stairs are the most important restriction for the elderly's travel.

미국 대중 주택의 공간디자인 특성에 관한 연구

이윤희;김영은;황연숙 한양대학교 2007 韓國 生活 科學 硏究 Vol.27 No.2

The purpose of the study is to analyze systematically the characteristics of the American Housing according to the trend of American Housing Market recently. The study analyzes the transition of the Housing design since 1950's and the trend of American Housing Market through the characteristics of the social change hereafter. Above all, the study finds out the space design characteristics of the American houses due to the trend of American housing design. Through the study, we found out the design characteristics of the housing such as open housing style in the public space, eco-friendly concept, high functioning of the elements in the space, and personality in the private space.