모양체 해리로 인한 저안압의 치료효과

김창식,안승일,박근성 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

We assessed 12 eyes of 12 patients with persisting hypotony after traumatic cyclodialysis and one eye of another patient with cyclodialysis cleft after secondary intraocular lens implantation. All eyes showed persistent hypotony and no increment of intraocular pressure (IOP) nor the visual acuity during the follow up period of average 4.8 months before treatment. We treated these eyes with argon laser photocoagulation and/ or direct cyclopexy with scleral incision under the partial thickness scleral flap as the method presented by Naumann et al. The IOP changed from 3.7±1.6mmHg to 13.2±5. 6mmHg and visual acuity improved by 4.6±3.2 lines during the average 10.1 months of follow-up period. Of the 13 eyes, 9 eyes (69.2%) showed improvement of visual acuity more than 4 lines and increment of IOP more than 8mmHg and they were classified as a success, and 2 eyes (15.4%) showed no or little improvement of visual acuity despite the increment of IOP to 8 mmHg and 12mmHg respectively and they were classified as a partial success. Another 2 eyes (15.4%) were classified as a failure because they showed no improvement of visual acuity nor the IOP. The last 2 eyes had severe associated injuries on the other parts of eye such as choriod and retina. A-scan axial length measurement was performed on 6 eyes and the axial lengths were increased by 1.14±0.96mm after cyclopexy in 5 eyes those were classified as a success or partial success, but in one eye classified as a failure the IOP and the axial length were decreased after surgery. The refractive errors were examined in 7 eyes and it was changed from +1.95Dsph to +0.55Dsph on average spherical equivalent after treatment in 5 eyes that were classified as a success or partial success.

2D-PC MRA를 이용한 넥타이의 순간적인 壓迫이 내경정맥의 혈류에 미치는 영향에 대한 硏究

김긍식(Keung-Sik Kim),정태섭(Tae-Sub Chung),박인국(In-Kook Park),이범수(Bum-Soo Lee),김현수(Hyun-Soo Kim),유병규(Beong-Gyu Yoo) 대한방사선과학회(구 대한방사선기술학회) 2008 방사선기술과학 Vol.31 No.3

  본 연구는 20세에서 50세까지 건강한 남성 지원자를 대상으로 내경동맥과 내경정맥의 혈류속도를 측정하기 위하여 2D-PC MRA를 촬영했다.<BR>  2D-PC MRA는 제4-5경추디스크를 지나는 FOV 24㎝ 넓이로 횡단 촬영하여 내경동맥과 내경정맥의 혈류속도를 넥타이를 매지 않은 상태와 세게 맨 상태에서 각각 측정하였다.<BR>  넥타이를 매지 않았을 때 내경동맥의 평균 혈류속도 최고치는 우측 72.13 ㎝/sec, 좌측 74.96 ㎝/sec (양측평균 73.54 ㎝/sec)이였고 내경정맥의 평균 혈류속도 최고치는 우측 -34.45 ㎝/sec, 좌측 -24.99 ㎝/sec(양측평균 -29.72 ㎝/sec)였다. 그러나 넥타이를 세게 매었을 때 내경동맥의 평균 혈류속도 최고치는 우측 61.35 ㎝/sec, 좌측 65.19 ㎝/sec(양측 평균 63.27 ㎝/sec)이며 내경정맥의 혈류속도 최고치는 우측 -22.14 ㎝/sec, 좌측 -17.93 ㎝/sec (양측 평균 20.03 ㎝/sec)였다.<BR>  목에 세게 넥타이를 맨 경우가 넥타이를 매지 않은 상태 보다 양쪽 내경동맥의 평균 혈류속도가 86%(63.27/73.54 ㎝/sec)로 약간 감소하는 반면 양쪽 내경정맥의 평균 혈류속도는 67%(-20.03/-29.72 ㎝/sec)로 유의성 있게 감소하였다(P < 0.05). 따라서 넥타이를 세게 매었을 때 내경정맥의 순환에 미치는 영향(33%의 혈류속도감소)이 내경동맥(14%의 혈류속도감소) 보다 유의성 있게 큰 것을 알 수 있었다(P < 0.05).<BR>  결론적으로 본 연구결과는 2D-PC MRA를 이용하여 넥타이를 목에 세게 매었을 때 순간적으로 양쪽 내경정맥이 내경동맥보다 상대적으로 압박되어 혈류속도가 의미 있게 감소되며 일시적 폐쇄가 되는 소견을 보였다. 이 경우 넥타이를 목에 세게 매고 생활을 하는 경우에 대변을 보거나 또는 세면을 하는 등 일상적인 생활에서도 예기치 않게 일시적으로 내경정맥혈관이 압박되어 폐쇄되며 이차적으로 두개강 내의 정맥성고혈압을 일으켜 뇌졸중의 요인이 될 수 있는 것으로 유추된다.   The 25 healthy male volunteers aged from 20 to 50 years old have been employed in this study. 2D-PC MRA was performed to measure the velocity of the blood flow in the internal carotid artery and internal jugular veins using 3.0T MRI Whole body (signa VH/i GE). ECTRICKS-CEMRA was performed to evaluate the pattern of blood circulation from internal carotid artery to internal jugular vein. Using 2D-PC MRA, the cross-section of the 4th and 5th cervical discs was scanned with 24 ㎝  FOV. Then the speed of blood flow was measured for internal carotid artery and internal jugular vein when the subject wears a necktie tightly and no tie.<BR>  The average of maximum velocity of internal carotid arteries without a necktie was 72.13 ㎝/sec in the right side and 74.96 ㎝/sec in the left side(average 73.54 ㎝/sec in both sides) while the average of maximum velocity of internal jugular veins without a necktie was -34.45 ㎝/sec in the right side and -24.99 ㎝/sec in the left side (-29.72 ㎝/sec in both sides).<BR>  However, when wearing a necktie tightly, the average of maximum velocity of internal carotid arteries was 61.35 ㎝/sec in the right side and 65.19 ㎝/sec in the left side(average 63.27 ㎝/sec in both sides) while the average of maximum velocity of internal jugular veins was -22.14 ㎝/sec in the right side and -17.93 ㎝/sec in the left side(-20.03 ㎝/sec in both sides). With the necktie tightly knotted, the average blood flow speed of both internal carotid arteries slightly decreased to 86% (63.27/73.54 ㎝/sec) compared to no tie case in which both internal jugularveins significantly went down to 67% (-20.03/-29.72 ㎝/sec).<BR>  Thus it is suggested that wearing a necktie affects the circulation of internal jugular veins(33% decrease in blood flow speed) more significantly than that of internal carotid artery(14% decrease in blood flow speed). Without a necktie, ECTRICKS-CEMRA showed natural blood circulation patterns of internal carotid arteries and internal jugular veins without any disturbances or compressions. However, when wearing a necktie tightly, ECTRICKS-CEMRA showed severe compression onto both internal jugular veins in all 25 volunteers.<BR>  In conclusion, the result of the study showed that the tightly worn necktie instantly presses more internal jugular veins than internal carotid arteries, thereby significantly reducing the blood flow speed and leading to the temporary occlusion. Thus, the defecation or washing the face under the tightly tied necktie situations can cause the unexpected and temporary compression or occlusion of the internal jugular veins, subsequently leading to the occurrences of the stroke due to the secondary intracranial venous hypertension.

Multidetector-Row Computed Tomography(MDCT) Corronary Agniography에서 Arrhythmia Correction이 영상의 질에 미치는 영향에 관한 연구

김현수(Hyun Soo Kim),김긍식(Keung Sik Kim),김태훈(Tae Hoon Kim),유병규(Beong Gyu Yoo) 대한방사선과학회(구 대한방사선기술학회) 2004 방사선기술과학 Vol.27 No.2

MDCT는 비침습적인 방볍으로 관상동맥 질환을 검사하는데 유용하다고 알려져 있다. 하지만 영상의 질에 있어서 환자의 심장박동이 결정적인 영향을 주게 된다. 특히 심장박통이 불규칙하거나 조기 심설수축 환자일 경우 영상을 재구성하는데 있어 왜곡 현상이 증가하여 진단에 어려움을 초래한다. 최근 본원에서 심장박동이 불규칙한 환자에서 영상 재구성시 불규칙한 R-R 간격을 조정한 후 얻은 영상이 artifact가 감소하는 현상을 경험한 바 있다. 따라서 본 연구에서는 다양한 교정 방법(disable, inesrt, R-R interval 교정)이 영상의 질에 어떤 영향이 있는지를 알아보고자 한다. 심박동이 불규칙한 24명의 환자에서 교정방법에 따라 영상을 재구성한 결과 R-R Interval 조정에서 통계학적으로 유의한 결과를 얻을 수 있었다(p<0.05). 본 연구에서는 R-R Interval 조정에서 가장 우수한 영상을 얻을 수 있었으며, 향후 심장 질환의 진단에 도움을 줄 수 있는 기초연구로서 그 가치가 충분하리라 사료된다. MDCT is a useful, non-invasive, diagnostic tool in the evaluation of coronary artery disease. However, the image quality is affected by an irregular heart rhythm of the patients. Especially, premature ventricular contraction induced stair-step artifacts in the reconstruction of 2-D or 3-D images of the heart including coronary arteries. In recent, we experienced some improving of the image quality after correcting the PVC. Accordingly, the purpose of our study was to evaluate the effectiveness of the arrhythmia correction method, which was commer챠ally available software, in improving the quality of the reconstruction images of the heart. Image analysis Was performed, in consensus, by two radiologists. The scores for image quality were ranked as follows; excellent is 4 (image quality is markedly improved and is helpful in the Image evaluation), good is 3 (image quality is mildly improved, but is somewhat helpful in the image evaluation), fair is 2 (image quality is improved and is not helpful in the image evaluation), and poor is 1 (image quality is not improved). We used ANOVA method to evaluate the statistical significant differences in the image qualities among the correction methods of the arrhythmia with below 0.05 of p-value. The method of moving the R-R interval showed statistically significant differences in improving of the image quality in patients with arrhythmia. We concluded that the regulation of R-R interval in patients with arrhythmia was an effective method to improve the image quality in the reconstructions of the MDCT coronary angiograms.

비소세포 폐암의 국소화 및 방사선치료 판정에 있어 Tc-99m MIBI SPECT 의 유용성

김지열(Ji Yeul Kim),범희승(Hee Seung Bom),송호천(Ho Chun Song),남택근(Taek Keung Nam),안정자(Sung Ja Ahn),정웅기(Woong Ki Chung),나병식(Byung Sik Nah) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.2

N/A Tc-99m MIBI, a lipophilic cation, was reported as a useful agent for localization of lung cancer. The effect of radiation therapy on the uptake of Tc-99m MIBI in lung cancer, however, was not well evaluated. The aim of the present study was to elucidate the usefulness of Tc-99m MIBI SPECT in the localization and the assessment. of radiotherapy in non-small cell lung cancer, Tvrenty patients(19 males and 1 female, mean age 59, 16 squamous cell ca and 4 adenocal were studied with Tc-99m MIRI SPECT before radiation therapy. Eleven patients(10 males and 1 female, mean age 59, 8 squamous cell ca and 3 adenoca) were repeated the study 1 month after the completion of radiation therapy(mean dose 6453cGy). All patients showed positive uptakes of Tc-99m MIBI in their tumors. One patient showed a hot uptake in atelectatic area. There was no difference of Tc-99m MIBI uptakes between squamous cell ca and adenoca either on planar or tomographic images. Tc-99m MIBI uptake ratios of squarnous cell ca and adenoca were 1.50 +- 0.16 and 1.45 +- 0.15 on planar images, and 2.73 +- 0.46 and 2.54 +-0.37 on tomographic irnages, respectively. The concordance between radivlogical change(chest x-ray and CT) and change of Tc-99m MIBI uptakes was 9/11 (81.8%). In conclusion, Tc-99m MIRI SPECT was useful in the localization of tumor and the assessment of radiation therapy in non-small cell lung cancer.

원발성 담즙성 간경변증 2예

이광재,김경희,이관식,문영명,최흥재,정현주,박찬일 대한내과학회 1990 대한내과학회지 Vol.38 No.4

Two cases of primary biliary cirrhosis were diagnosed in a 40-year-old woman and a 61-year-old woman. One case complained of generalized pruritus, easy fatigability and indigestion, and the other case complained of easy fatigability and generalized weakness. They showed an increase in serum alkaline phosphatase and serum IgM, positive antimitochondrial antibody tests, histologic findings of portal expansion with fibrosis, a decreased number of interlobular bile ducts, focal periportal destruction and inflammatory cell infiltration. From the above two cases of primary biliary cirrhosis, we can conclude that we should suspect this disease in patients with pruritus and generalized weakness along with those who show obstructive types of liver function tests but do not display the obstructive lesions of extrahepatic bile ducts and larger intrahepatic bile ducts in U/S, CT or ERCP. It can help us to detect primary biliary cirrhosis that we reconsider the findings of liver biopsy in patients diagnosed as chronic B viral hepatitis or nonAnonB chronic hepatitis who complain of pruritus and show an increase in serum alkaline phosphatase, serum IgM, cholesterol and GGTP, along with positive antimitochondrial antibody test.

심한 상부요로확장과 배뇨근 기능부전을 초래한 신성 요붕증 1례

양승대,박경원,임희관,김종성,임정식 大韓泌尿器科學會 2000 Korean Journal of Urology Vol.41 No.5

BSC를 활용한 청소년대상 인문학 대중화사업에 관한 실행연구

안영식(Ahn Young sik),윤명희(Yun Myung hee),김영석(Kim Young sek),서희정(Seo Hee jung),김경희(Kim Keung hee) 고려대학교 교육문제연구소 2015 敎育問題硏究 Vol.28 No.3

인간의 진정한 가치와 삶의 궁극적인 의미를 탐구하는 인문학의 중요성이 강조되고 있는 시점에 본 연구는 인문학 대중화사업의 BSC 성과평가모형을 실행연구를 통해 청소년대상 인문학 대중화사업에 적용해 보았다. 본 연구의 목적은 인문학 대중화사업의 BSC 성과평가모형의 유용성을 밝히고 청소년대상 인문학 대중화사업의 실행과정과 성과를 제시하는 것이다. 이를 위해 본 연구에서는 초기 청소년대상으로 인문학 대중화사업의 실행과정을 실행준비, 실행, 종결 단계로 나누어 제시하였고, 학습자, 사업운영, 조직의 학습 및 성장, 자원, 지역사회공동체의 5가지 관점에 따른 성과를 분석하였다. 본 연구를 통해 인문학 대중화사업의 운영에 BSC 성과평가모형의 핵심성과지표가 효과적으로 활용될 수 있음이 밝혀졌고, 청소년 대상 인문학 대중화사업의 사업운영을 위한 방안을 제시하였다. 본 연구는 청소년대상 인문학 대중화사업 운영의 효율화 추구 및 사업성과 논의를 위한 기초자료를 제공하였다는데 의의가 있다. This study applied BSC performance evaluation model to humanities popularization project focus on youth through action research. The purpose of this study was to show the utility of BSC performance evaluation model of humanities popularization project and to address the implementation process and performance of humanities popularization project. The process of humanities popularization project with youth was classified into planning, implementation, evaluation. This study analyzed performance of implementation process with five perspectives such as 'learner', 'managing process', 'organization's learning and development', 'resources', and 'community.' This study provided that key performance indicators of BSC performance model utilized effectively for the operation of humanities popularization project, and suggested several strategies for the operation of humanities popularization project focusing on youth. This study also provided important information for the effectiveness and performance of the operation of humanities popularization project focusing on youth.

유방 X-선 촬영술에서 한국 여성의 적정 압박력에 대한 고찰과 촬영 조건 비교

김영화,김긍식,권영갑,Kim Young Wha,Kim Keung Sik,Kwon Young Kap 대한방사선사협회 2002 대한방사선사협회지 Vol.28 No.1

Purpose : For the woman, compression of breast during mammogram introduce pain that woman used to have fear for mammogram. Therefore, the purpose of this study was to determine the adequate and minimized compression power for mammogram with maintaining th

석회화된 관상동맥 질환에서 16 Slice MDCT의 Kernel 값이 관상동맥 내경협착에 미치는 영향평가에 대한 연구

김현수(Hyun Soo Kim),김긍식(Keung Sik Kim),이춘배(Choon Bae Lee) 대한전산화단층기술학회 2006 대한CT영상기술학회지 Vol.8 No.1

Purpose The purposes of this study were to evaluate the effect to change of kernel factors using 16 slice multi-dectector computed tomography. Materials and Methods Twenty patients were evaluated for subsistence calcification of coronary artery. Twenty asymptomatic subject(8 womwn, 12 men; age range, 54~83; mean age 65 years) underwent 16 slice multi-detector computed tomography. MDCT was performed on a 16 slice multi-dectector computed tomography with a standard coronary protocol(detector collimation 12×0.75mm, table feed 6.8mm/rotation, rotation time 420 ms, tube current time 150mAs, tube voltage 120kVp). Agaston scores and maximun intensity projection were performed with a workstation. MIP image evaluation was performed by two radiologists in a consensus decision on a eight-point scale: 1=severe blooming artifact, 8=small blooming artifact. For evaluation of images window width 900 and windoq center 400 were used. Results The point of reading that the B40f kernel were very higher than other kernel the score 7.5. And blooming artifact is the lowest at the kernel of B50f. Conclusion We recommended high resolution kernel(B40f) for evaluation of coronary artery lumen with cacification.

증기발생기를 이용한 정지냉각계통의 냉각능력 해석

장정봉(Cheong Bong Chang),김영인(Young In Kim),한훈식(Hun Sik Han),김우식(Woo Shik Kim),이민규(Minkyu Lee),김긍구(Keung Koo Kim) 한국유체기계학회 2015 한국유체기계학회 학술대회 논문집 Vol.2015 No.6