혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

무세포혈관과 자가 골수줄기세포를 이용한 조직공학적 인공혈관 제조

김동익,김병수,조승우,임정은,어현선,이민재,김종성,장인성 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1

유도 '되치기 본'의 개선 방안에 관한 연구

김의환,김도준,김규수,김관현,김종달,최종삼,조용철,박순진,윤익선,안병근,정 훈,김미정,한성철 龍仁大學校 武道硏究所 1999 武道硏究所誌 Vol.10 No.1

The purpose of this study was to reform practically a Korean Judo's Doechigi-Bon(Forms of Counterattack, judo's Gaeshi no Kata, Judo's Uradori no Kata, Judo's Gonosen no Kata) that was established in 1955 Korea, according to changing of techniques by Judo's modernization, in order to have Judo's carefulness and systematic diffusion. Reform procedure of Judo's Doechigi-Bon was 1st stage, Questionnaire survey 303 judokas, 2nd stage, Technical seminar by judo experts(12 judo professor) 4 times, 3rd stage, wording report for reform, 4rd stage, Discussion and judgement of Teaching and Judgement commission of Korean judo Association(KJA), 5th stage, Public hearing for reform in KJA, 6th stage, Report and decision of board of directors in KJA, 7th stage, public publication of Judo News(No.53) in KJA. Basic principle of reform of Judo's Doechigi-Bon were as table 1. Table 1. Basic principle of reform of Judo's Doechigi-Bon ------------------------------------------------------------------------------- Items Reformed Key Points of Judo's Doechigi-Bon ------------------------------------------------------------------------------- 1. Structure 1) Grand classification : Classified by 3 parts(1,2,3Gyo) 2)Medium classification : Te waza, Goshi waza, Ashi waza devided per each part(Gyo) 3)Sub-classification : Classified five techniques per each part(Gyo) 2. Contents 1) Selected established techniques as possible 2) Considered rationalty and overlapping of counterattack techniques 3. Decision of Conterattack techniques 1) Refered to results of Basic Questionnaire survey 2) Priority to decisions of Judo expert technical seminar -------------------------------------------------------------------------------- Reformed Korean Judo's Doechigi-Bon(Forms of Counterattack techniques-KJA, 1999) are as follows: 1. Gyo; ① Uki otoshi -> Uchi mata ② Harai goshi -> Harai goshi gaeshi ③ O soto gari -> O soto gake ④ Ko uchi gari -> Sasae tsurikomi ashi ⑤ O uchi gari -> Ko soto gari 2. Gyo; ① Ippon seoi nage -> Okuri eri jime ② Tsuri domi goshi -> Uki waza ③ Okuri ashi harai -> Okuri ashi harai ④ Ko soto gari -> Tai otoshi ⑤ Hiza guruma -> Hiza guruma 3. Gyo; ① Kata guruma -> Sumi gaeshi ② Tai otoshi -> Ko soto gari ③ Hane goshi -> Harai tsurikomi ashi ④ Uchi mata -> Tai otoshi ⑤ Tomoe nage -> O uchi gari

중증 만성정신질환자 수의 추산 : Through Two Community Surveys 두 지역사회 조사를 중심으로

홍진표,김윤,배재남,정유진,강영호,양병국,김용익,김병후,이철,조맹제 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

국내 중증 만성정신질환자 수를 추정하기 위하여 일 농촌 및 대도시 지역의 지역의료보험 및 의료보호 대상자 중 1993년 1년간 의료기관에서 정신증 상병(ICD-9 code 상 290-299) 및 알콜 남용/중독, 성격장애 및 정신박약 진단하에 치료를 받은 적이 있는 사람에 대해 설문조사를 실시하였다. 연구자들이 개발한 진단도구를 이용하여 진단을 평가하고, Strauss-Carpenter scale 등을 이용하여 기능 장애를 평가하고 유병기간 등을 조사하였다. 결과를 요약하면 다음과 같다. 1) 진단평가상 정신분열병군(61.1%)이 가장 많았으며, 정동장애군(23.7%), 알콜장애군(11.2%), 기질성 정신장애군(4.0%)의 순서이었다. 2) 직업활동정도는 진단군별로 차이가 많았다. 지난 1년간 직업활동이 6개월 미만이거나 전혀 없는 환자 비율이 정신분열병군은 67.2%, 알콜장애군 52.0%, 정동장애20.8%의 순으로 정신분열병군이 가장 불량하였다. 3) 사회활동도 진단군별로 차이가 많아서 지난 1년간 의도적, 사회활동이 없는 비율이 정신분열병군이 가장 높았고(72.3%), 알콜장애군(32.0%), 정동장애군(20.7%)의 순이었다. 4) 국내 의료보험 및 사회복지시설 이용 자료 등을 토대로 본 조사 결과를 적용한 결과 국내중증 만성 정신질환자의 수는 약 8만 7천명으로 추산되었다. Objectives: The purpose of this study was to estimate the number of serious and persistent mentally ill patients in Korea. Methods : Study populations were recruited from medical insurance data of two district areas ; one rural and the other urban areas. Subject were all mentally ill who had ever visited any hospital in 1993 and were diagnosed as having psychosis, personality disorder and drug abuse. We conducted a home visiting survey applying semi-structured diagnostic interview, assessing the level of social adjustment with Strauss-Carpenter Scale, and past psychiatric history by the trained researchers, in October and November,1994. Results : According to diagnostic assessment schizophrenic patients constituted the major portion(61.1%) of study subjects. The distribution of occupational functions and social contacts was variable according to diagnosis. Most schizophrenic patients were unemployed or worked less than 6 months in the previous year(67.2%), and showed poor social contact(72.3%). But affective disorder patients were relatively independent in job maintenance and social relationship. Alcoholic patients lay between those of schizophrenic and affective disorder groups. It was estimated that about 87,000 adult Koreans were suffering from chronic mental disorders which seriously interfere with their daily life. Conclusions : Serious and persistent mentally ill patients were common in Korea. Community support program should be provided for them.

자가 골수 중간엽줄기세포와 생분해성 고분자 스캐폴드를이용한 조직공학적 인공혈관 제조

조승우,김동익,박희정,임상현,전오주,김수현,김영하,최차용,이민재,김종성,장인성,김병수 대한혈관외과학회 2003 Vascular Specialist International Vol.19 No.2

척추전방전위증의 수술적치료

김익동,김풍택,박병철,유영구,이구희 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.1

Spondylolisthesis has become one of the major causes of the lower back pain in the orthopedic field. The treatment of spondylolisthesis has been a matter of debate among orthopedic surgeons since Neugebauer's report in 1888. Since then, many methods of treatment have been introduced. The posterolateral fusion, first described by Watkins, is the established method with a satisfactory result in the great majority of patients. We reviewed 26 patients who were surgically treated by posterolateral fusion at the department of orthopedic surgery, Kyungpook National University Hospital from January 1983 to December 1988. We obtained the following results; 1. The age distribution was from 34 to 65 years of age and prevalent decade was fifth. 2. 18 cases(69%) were female. 3. The isthmic type was 19 cases(73%), degenerative type in 7 cases(27%). 4. The level of the lesion was L4-5 in 13 cases(50%), L5-Sl in 10 cases(38%), L3-4 in 3 cases. 5. The most common clinical symptom was low back pain(26 cases, 100%) and next common symptom was sciatica(20 cases, 77%). 6. By Myerding's grading, grade 1 were 15 cases(58%), grade 2, 9 cases(35%), and grade 3,2 cases. 7. The posterolateral fusion with instrumentation was done in 20 case and combined laminectomy was done in 14 cases. 8. The postoperative result was evaluated by Gill's criteria. 1) Overall results were excellent in 14 cases(54%), good in 8 cases(31%), fair in 3 cases, unsatisfactory in 1 case. 2) The result of isthmic type was better than that of degenerative type. 3) The result of grade 1 was better than that of higher grade type. 4) No significant change in follow-up result was found between posterolateral fusion with and without instrumentation, but it was possible to do earlier social activity in fusion with instrumentation. 5) The improvement of functional result was not affected by the degree of initial reduction, but in early postoperative period, the more complication was developed in the more reduced group.

[논문]보육교사의 보육컨설팅에 대한 인식, 요구도 및 활성화 방안

황해익,조준오,김병만 부산대학교 교육연구소 2012 교육혁신연구 Vol.22 No.1

The purpose of this study was to examine the awareness of childcare teachers on childcare consulting, their needs for that and ways of revitalizing childcare consulting in a bid to lend professional assistance to childcare centers in terms of how to boost the quality of childcare. And it's also meant to provide some information on how to improve childcare consulting both in theory and practice. The subjects in this study were 200 childcare teachers in the city of Busan. The findings of the study were as follows: First, as a result of analyzing their awareness of childcare consulting, 147 respondents (87.5%) considered that to be necessary or very necessary. As for the reason for the necessity of childcare consulting, the biggest group that numbered 62 responded (42.2%) that it would be necessary to pinpoint and resolve problems. Concerning the reason why it's not necessary, the largest group that numbered four answered (19.1%) that there was no problem about which childcare consulting would be required. Second, as a result of checking their needs for childcare consulting, the biggest group that numbered 35 asked (20.8%) for education about accreditation indicators in terms of the content of childcare consulting. Regarding childcare consultants, the biggest group that numbered 55 preferred (32.7%) professional assistants, lecturers and professional personnels of childcare centers. Concerning the term of childcare consulting, the largest group that numbered 71 considered (42.3%) it advisable to receive this consulting for less than a week. As to the time for childcare consulting, the biggest group that numbered 58 answered (34.5%) that it should be provided at the request of accredited childcare centers. Third, as a result of analyzing their opinions on how to revitalize childcare consulting, the biggest group that numbered 128 felt (76.2%) the need for a separate consulting institution. The largest group that numbered 30 thought (23.4%) that the Ministry of Health and Welfare should be responsible for that, and the greatest group that numbered 76 thought (45.2%) that the top priority for childcare consulting would be to secure professional childcare consultants. 본 연구는 보육교사의 보육컨설팅에 대한 인식과 요구도 및 활성화 방안을 확인하여 어린이집의 개별적인 질적 수준 관리 및 지속적인 질 향상에 전문적이고 체계적인 도움을 제공하고, 향후 보육컨설팅의 개념적․실제적 측면을 보완하는 데 기초자료로 활용하는 것에 연구의 목적이 있다. 본 연구는 부산광역시에서 근무하는 보육교사 200명을 연구대상으로 선정하였고, 회수된 설문지 중 총 168부를 최종 분석대상으로 선정하였다. 연구결과를 살펴보면 첫째, 보육컨설팅에 대한 인식을 살펴본 결과 보육컨설팅이 ‘필요하다’와 ‘매우 필요하다’가 총 147명(87.5%)으로 높게 나타났고, 필요한 이유로는 ‘문제진단 및 현안해결’이 62명(42.2%), 불필요한 이유는 ‘보육컨설팅을 필요로 하는 문제가 없기 때문에’가 4명(19.1%)으로 가장 높게 나타났다. 둘째, 보육컨설팅에 대한 요구도를 살펴본 결과 보육컨설팅 내용에 서는 ‘평가인증 지표 교육’이 35명(20.8%), 대상은 ‘조력전문가, 강의, 센터전문요원’이 55명(32.7%), 보육 컨설팅 실시기간은 ‘1주일 미만’이 71명(42.3%), 보육컨설팅 실시 시기는 ‘평가인증을 통과한 어린이집의 요청 시’가 58명(34.5%), 보육컨설팅 지도방법은 ‘원장, 교사 상호작용 및 의견 교환’이 69명(41.1%)으로 가장 높게 나타났다. 셋째, 보육컨설팅에 대한 활성화 방안을 살펴본 결과 전담기관의 필요성은 ‘필요하다’가 128명(76.2%), 전담부서는 ‘보건복지부’가 30명(23.4%), 보육컨설팅 활성화를 위해 가장 필요한 과제는 ‘전문성을 갖춘 보육컨설턴트의 확보’가 76명(45.2%)으로 가장 높게 나타났다. 끝으로 본 연구에 서는 보육교사의 보육컨설팅에 대한 인식과 요구도 그리고 활성화 방안을 토대로 중요성과 필요성을 논의하였다.

비정상 모세관 점도계의 개발 및 혈액 대용 유체의 점도 측정

김동익,이병붕,서상호,조민태 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

The purpose of the present study is to measure the viscometer is consisted of a small cylindrical reservoir, capillary tubes, and the mass flow rate measuring system interfaced with computer. Two capillary tubes with 1.152 and 3.002 mm (inner diameter) are used to determine the diameter effects on the viscosity measurements. The instantaneous shear rate and gravitational driving force in the capillary tube are determined by measuring the mass flow rate through the capillary tube instantaneously. The measured viscosities of water and aqueous Separan solution as the blood analogue fluid are in good agreement with the reported experimental data

사지 임파부종에 대한 임상적 분석

김동익,허세호,이병붕,김은숙,문지영,황지혜 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

Purpose: Given the increased frequency of operative therapy and radiation therapy on breast cancers and uterine cancers, there is very little information on lymphedema associated with these treatments in Korea. Thus, the authors conducted this study to describe and analyze the data which they had obtained from the patients. Method: A retrospective study was undertaken on 840 patients who registered to the Lymphedema Clinic of Samsung Seoul Hospital throughout the period of February 1995 to August 2001. Result: Out of 840 patients, 205 patients (24%) were confirmed as having primary lymphedema, while 635 patients (76%) had secondary lymphedema. The ratio of male to female for primary lymphedema was 1 :1.8(Male : Female), while secondary lymphedema demonstrated to be 1:21 (Male : Female), demonstrating a female preponderance. Secondary lymphedema mostly developed after undergoing treatment for uterine cancer (341 patients, 53.7%) and breast cancer (226 patients, 35.5%) The lesions of occurrence for both primary and secondary lymphedema were mainly in the lower extremities than the upper extremities. In regards to the degree of clinical edema, a large number of the patients, that is 633 patients (76%) had progressed to Stage Ⅱ~Ⅲ. Among the patients who developed edema after undergoing treatment for cancers, only 43 patients (7%) were provided information on the possibility of developing lymphedema, while the majority of the patients had no knowledge about this possibility. When the patients' subjective experiences were investigated on the degree of the edema, there was no significant increase in pain despite an increase in the degree of the edema (P<0.05), nevertheless, a significant increase was found in cosmetic problems (P>0.05). Conclusion: As a general rule, complete recovery from chronic lymphedema is not expected. However, early detection of lymphedema and timely appropriate treatment as well as aggressive patient education on lymphedema and its related complications can prevent its progression.