심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

상악골에 발생한 Monostotic 섬유성 이형성증의 1례

이승학,김경일,김완수,나한조 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

의과대학생에서 임상 수기 수행능력에 대한 자가평가 결과와 임상수행능력 평가시험(CPX) 결과의 비교

이학승 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

본 연구는 의과대학생들이 한 학기 동안 임상실습을 마치고 난 후, 실습지침서에서 요구하고 있는 흔한 임상 증상을 얼마자 자주 경험하였는가를 조사해 보고, 흔한 임상 증상에 대한 학생들의 경험 빈도와 자가 평가한 염상수행능력과의 상관성을 조사해보는 것이었다. 둘째로, 시험문항으로 제시된 임상수기에 대한 의과대학생들의 주관적 자가평가 결과와 객관적 CPX 결과를 비교하여 주관적 평가 결과와 객관적 평가 결과의 상관성을 조사해 보는 것이었다. 그 결과는 다음과 같다. 1. 임상 증상에 대한 학생들의 경험 빈도와 자가평가한 임상수행능력과의 상관성은 경험 빈도가 많을수록 자가평가 점수도 높게 나오는 결과를 보였다. 2. 객관적 CPX 결과와 주관적 자가평가 결과는 상관성이 없는 것으로 나타났다. Purpose: The purpose of this study was to assess the clinical experience state of medical students 3-grade, and compare the self-assessment about their competency on clinical skills and the assessment of instructors through the Clinical Performance Examination(CPX). Methods: Fifty-two medical students who are in 3-grade were included. Their clinical experiences state and the self-assessment of their condidence on clinical skills were evaluated by questionnaires givend before the CPX. After completing the CPX, they evaluated their own performance state to 9 whole clinical skills of the CPX by self-assessment questionnaires, again. The correlation and comparison between self assessments' socre and instructor's score were analyzed. Results: For 19 of 28 clinical skills items listed in the questionnaires, self-assessment of competence by medical students correlated with the frequency of performance(p<0.05). For 9 clinical skills in the CPX, the self-assessment scores did not correlate significantly with the instructors' assessment scores(p>0.05). However, these 9 clinical skills scores from the instructors correlated significantly with the scores of clinical experienceand the final semester grade point averages(p<0.05). Conclusion: There was a significant association between frequency of performance and self-assessed competency. And there was no significant correlation between self-assessed score on competency with instructor's score in the CPX.

韓國 行政區域의 『縣』에 關한 硏究 : 歷史地理學的 考察 By method of Historical Geography

李聖學 慶北大學校 1980 論文集 Vol.29 No.-

1. "Hyun" have been a unit name of administrative district since establishment of "Hansagun" in Korea. "Boo" "Gun" and "Hyun", which were subordinated to "Do", had coordinative relationship each other. But "Hyun" was the lower hierarchy than "Boo""Gun" in the sense of the magistval-ship. 2. There were a lot of changes in the upgrading and downgrading. the establishment and abandenment, and the subordination and coalition of "Hyun". The reason is not due to the change of Geographical characteristics but to the change of Social relationship. 3. Even in the same "Hyun", there were two kinds of magistral-ship. And there was hierachical relation between dominative and subordinative "Hyun". 4. "Hyun" was abolished by the local administrative district reform in 1895 A.D. (King Kojong 32) in Korea. Then the previous "Hyun" area was reorganized to "Gun" or "Myun" area. But "Hyun" is continuing existence in the neighboring country such as Japan and China. By the was, As "Hyun" in Japan cooresponds to "Do" in Korea nowadays, the characteristic of "Hyun" is quite different from that of Korea. 5. "Hyun" as the unit name of administrative district has been abolished. But the name of "Hyun" is used as the name of "Gun" or "Myun".

위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.

원발성 유방암에서 p53 단백발현과 예후와의 상관성에 관한 연구

이학승,이광만,채권묵,문형배 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.1

p53 is a nuclear phosphoprotein which is normally expressed at very low level in all mammalian cells and plays a role in the regulation of cell proliferation. It has also been suggested that normal p53(wild type) serves as a tumor suppressor gene, and inhibits the oncogene-mediated cellular transformation and the rate of cellular proliferation. But, wild type p53 is hardly stained by immunohistochemistry because of its low intracellular concentration and very short half-life. Mutant form of p53 protein is detectable in various human malignancies e.g. colon, stomach, lung and breast cancer by immunohistochemical stain because of its prolonged half-life. In breast cancer, p53 protein expression has been regarded as an unfavorable prognostic factor, but the results of studies about the relationship between the p53 protein expression and prognosis are equivocal. So, author performed this study to evaluate the prognostic significance of p53 expression in 54 patients with primary breast cancer who underwent surgical treatment at Wonkwang University Hospital from October 1985 to September 1991. Follow-up period was 24-91 months (mean: 54.7months). p53 protein was stained by immunohistochemical methods in formalin-fixed, paraffin-embedded tissues using monoclonal antibody(DAKO-p53, DO-7). The prognostic significance of p53 protein was evaluated by positivity and 5-year survival rate, and comparing with well-known prognostic factors of breast cancer. p53 protein was expressed 48.1%(26/54) of primary breast cancers. 5-year survival rate of patients with p53 protein expression was 42.0%, and that of patients without p53 protein expression was 76.4%(p = 0.0277) There was no relationship between p53 protein expression and tumor size, lymph node metastasis, histologic grade or vascular invasion. These results suggest that p53 protein expression is another independent prognostic factor in primary breast cancer.

중국의 '서부대개발'과 자동차 산업 : 한국에의 시사

이승훈,김광억,이근,은종학 서울대학교 사회과학연구원 2001 한국사회과학 Vol.23 No.2

본고는 중국의 서부대개발 정책의 내용과 향후 전망 및 이 정책이 가지는 중국 자동차 산업에의 시사를 찾고자 하였다. 중국 서부지역의 주민들의 의식이나 인프라 등은 동부 대도시의 80년대 말 상황과 비슷할 정도로 뒤떨어져 있다. 서부대개발이 중국정부의 장기적인 프로젝트인 만큼, 우리도 중국 서부를 장기적으로 인식해 적절한 전략적 접근이 필요하다. 한국의 자동차 산업과 기업이 얻을 수 있는 시사점은, 장기적 비전과 전략적 접근의 필요성 외에 다음과 같은 것들이 있다. 첫째, 같은 서부지역이라도 소득수준과 교통 인프라 차원에서 우수한 몇몇 省·市(중경, 사천, 섬서 등)가 서부지역의 발전을 주도할 것이기 때문에 이들 지역을 통한 단계적 진입 전략이 필요하다. 둘째, 서부대개발에 따른 자동차 수요증가는 차종에 따라 달리 나타날 것이므로 이에 대한 고려가 필요하다. 즉, 화물차에 대한 수요증가는 직접적으로 나타날 것이나, 일반승용차에 대한 수요증가는 간접적이고 또한 그 정도도 제한적일 것이다. 셋째, 중국의 자동차 시장은 지역분할 구도의 약화, 시장경쟁의 격화, 유통구조의 개편, 개인구매의 증가 등의 변화를 겪고 있어, 이 같은 자동차 시장 자체의 역동성에 적절히 대응해야 한다 This paper first discusses the main contents and prospect of the Great West Development project of China and then tries to find implications of this project for automobile makers. First we note that this project spans a very long time horizon and thus the firms should approach this with a long term oriented view, rather than expecting any short term benefits. Also, because the projects, especially during the early stage, will be led by selective fore-running regions, like Chungqing, Sichuan and Shaanxi, the firms should take a differentiated and gradual approach. Expansion of demand for automobiles will be different depending upon the kinds of cars. Initial expansion will be more for trucks whereas demand for passenger cars will be indirect or limited. At the moment, the automobile industry in China is undergoing radical changes in terms of regional distribution of market power among the major makers, ever-increasing market competition, changes in the marketing networks, and increasing participation of individual customers. This kind of industrial dynamism should be fully considered in designing corporate strategy or public policy.

한국인 부정교합자의 하악 치열궁의 크기와 형태

이성준,백승학,김상철,국윤아 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.1

본 연구의 목적은 한국인 부정교합자에서 하악 치열궁간의 형태적 차이를 알아보고자 하였다. Ⅰ급 114명. Ⅱ급 119명, Ⅲ급 135명의 부정교합자를 대상으로 하악 모형의 교합면을 복사한 후 13개의 접촉점 중에서 가장 협측면으로 위치한 부분을 digitize 하였고 각 치아의 브라켓 위치에 해당하는 점을 하악치아의 두께에 의거하여 4개의 선계측과 2개의 비율을 측정하였다. 치열궁의 형태는 square ovoid, tapered형으로 분류하여 그 빈도를 조사한 결과 Angle 분류와 남녀 성별에 따른 특별한 치열궁 형태가 존재하지 않았으나, 특정 치열궁 형태의 빈도는 Angle 분류에 따라 다르게 나타났다. 치열궁 크기의 계측항목에서는 대구치간 폭경에서만 남녀 성별 차이를 보였으며, 치열궁 크기에 있어서 Ⅰ급과 Ⅲ급, Ⅱ급 부정교합군간에는 유의한 차이가 있었다. 치열궁 형태의 분포는 Ⅰ급과 Ⅲ급 부정교합군에서는 square, ovoid, tapered 형태 순이었고, Ⅱ급 부정교합군은 square, tapered ovoid 형태 순이었다. 치열궁 형태의 빈도분포에 있어서는 남녀간의 차이는 없었다. The purpose of this study was to clarify morphological differences among mandibular dental arch forms in Korean malocclusion patients. The sample in this study consisted of 114 Class Ⅰ, 119 Class Ⅱ, and 135 Class Ⅲ malocclusion cases. The most facial portions of 13 proximal contact areas were digitized from photocopied images of the mandibular dental arches. Clinical bracket points were calculated for each tooth based on the data of the mandibular tooth thickness. Four linear and two proportional measurements were undertaken. The dental arches were classified into square, ovoid, and tapered forms to compare the frequency distributions. Our results suggested that there was no single arch form specific to any particular Angle classification or sex. It appeared to be the frequency of a particular arch form that varies among the Angle classifications. In comparison of arch measure between male and female, there was no statistical difference except in the intermolar width. In comparison of arch size measurements among the different Angle classifications, there were statistically significant differences between Class Ⅰ and Class Ⅲ malocclusion groups and between Class Ⅱ and Class Ⅲ malocclusion groups. In comparison of frequency distribution of arch forms in Class Ⅰ and Ⅲ malocclusion groups, the square form demonstrated the highest distribution followed by the ovoid and tapered forms in that order. In the Class Ⅱ malocclusion group, the square form showed the highest distribution, followed by the tapered and ovoid forms in that order. There was no statistical difference in the frequency distribution of arch forms between male and female groups.

新羅의 歷史地理에 關한 硏究 : 行政區域에 對하여

李聖學 新羅大學校 1980 論文集 Vol.9 No.-

(1) Administrative districts of unification period of Shilla dynasty were transformed to chinese style, and their system was the stem of administrative districts in Korea and Lee dynasty. (2) Concerning to the relationships of northern boundary in local administrative district in this period, the southern area of Korea peninsular from northern area of Dae-Dong River and Duck-Won area of Ham-Nam province, in spite of unification of Sam-Guk (three nations: Kogure, Shilla and Bakje) by Shilla, was not more than two third area of Korea peninsular. (3) U-San-Kuk and Tam-La-Kuk were not belong to Gun-Hyn system of Shilla, but they were only the colony which submited to tax to the mother county, Shilla. (4) Military occupied area, different from administrative district, was established over-lap in order to protect from other invations. (5) Land lords of villages who lived in living units had to take charge of administrative offices and this system, so we can say that they took the autonomy of family community in ancient period.