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치매전문요양병원 병동부의 공간구성 특성에 관한 연구 : 공용생활공간을 중심으로
주현돈,박재승 한국의료복지시설학회 2007 의료·복지 건축 Vol.13 No.1
As the population of the elderly increases drastically year by year in Korea, this phenomenon is being a serious problem because of the increasing speed not having been showed ever all over the world. This thesis would propose the space organizing features for well-organized dementia hospital focused on the public living space. The way arranging each function is very important because values of the physical and functional accessibility have a wide range of value as each type of facility. Moreover, if the arranged function unit is the same as the territory of the space, it could be a good guideline on architectural planning.
반복작업으로 유발된 수근관내의 굴곡근 건초염과 수근관 증후군 : 증례 보고 Case Report
김돈규,서경묵,신주연,강시현,송인섭 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1
A 46 year-old woman who had worked repetitive manual job for 3 years visited our hospital because of aggravated right hand sensory symptom and newly developed limitation of 3, 4, 5th finger extension. In physical examination, moderate swelling of volar aspect of wrist and limitation of finger extension was noticed as well as positive tinnel sign. We confirmed carpal tunnel syndrome after electrodiagnostic studies and associated flexor tenosynovitis of 4th flexor tendon in the carpal tunnel through MRI (magnetic resonance imaging) study. She was successfully treated with conservative program including wrist splint and steroid injection. We also tracked the result of treatment using MRI and electrodiagnositic studies. Analyzing her work procedure, we concluded that repetitive and forceful exertional nature of job impose a high burden on hand and wrist region and it caused her carpal tunnel syndrome.
최강원,오명돈,배현주,백경란,박선양,김병국,신완식,강문원,진종률,박종원,김춘추,김동집,한지숙,민유홍,이선주,고윤웅 대한화학요법학회 1993 대한화학요법학회지 Vol.11 No.2
Fluconazole의 진균 감염증 예방 효과와 안전성에 관하여 3개 대학병원에서 관해유도화학요법을 받는 급성 백혈병환자를 대상으로 무작위 배정법과 너도나도 누가림법에 의하여 연구하였다. 모두 62명의 환자에게 fluconazole(100㎎ bid) 또는 nystatin(1,000,000IU/day)을 무작위로 투여하였다. 투약은 관해유도화학요법과 같은 날짜에 시작하여 호중구수가 1,000㎣이상으로 회복되거나 진균 감염증이 확인되거나 의심되어 Amphotericin-B를 시작하거나, 약과 관련된 부작용이 나타날 때까지 계속하였다. 진균 colonization은 fluconazole군에서 감소하였으나 nystqatin군에서는 증가하였다, 표재성 진균감염증으로 nystatin군에서 C. albicans 진균혈증 1례와 C.parasilosis 진균혈중 1례가 발생하였다. 경험적 항진균요법으로 Amphotericin-B를 투여한 경우는 fluconazolerns 34명중 7례(21%), nystatinrns 28명중 10례(36%)였다(p<0.05). Fluconazole군과 nystatin군 사이에 부작용이나 사망률에 차이는 없었다. 결론적으로, fluconazole은 관해유도화학요법을 받는 급성 백혈병환자에서 진균의 colonization을 줄이는데 효과적이고 안전한 항진균제이다. We made a randomized, double-blind, multicenter trial to compare the efficacy and safety of fluconazole with nystatin for prevention of fungal infections in patients with acute leukemia. Sixty-two adult undergoing remission induction chemotherapy for cute leukemia were enrolled. Patients were randomly assigned to receive either fluconazole (100㎎ bid) or nystatin(1,000,000IU×6/day) with corresponding placebo. The study drug was started in initiation of chemotherapy and continued until recovery of neutrophil counts(>1,000/㎣), development of proven or suspected invasive fungal infection, or the occurrence of drug-related toxicity. Fungal colonization decreased in fluconazole(F) group, however increased in nystain(n) group. Superficial fungal infection occurred in 1 of 34 F group, whereas invasive fungal infection developed in 3 of 28 N group. Empirical amphotericin-B therapy was given in 7 of 34(21%) F group and 10 of 28(36%) N group(p>0.05). The incidence of drug-related side effects and overall moratlity were similar in both study groups.
삼출성 중이염 환자에서의 혈중 및 아데노이드 면역글로불린 E의 면역혈청학적 연구
장혁순,강성호,유창수,김성현,이병돈,박영진,윤세동,안희영,강주원 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1
Otitis media with effusion (OME) is one of the most common disease in children but its pathogenesis is not clear. In particular the role of allergy has revealed conflicting support with widely varing opinions as to its importance. Within recent years, striking biochemical and immunochemical analytic techniques have opened a new approach the study of otitis media with effusion. So we focused on distributions of IgE in adenoid tissue and serum IgE levels. Authors compared the serum IgE and the distribution of IgE in adenoid tissue between the 20 patients underwent tonsillectomy, adenoidectomy and ventilating tube insertion and control group of 11 patients underwent tonsillectomy and adenoidectomy. The results were as follows; 1. In the distribution of IgE in adenoid tissue, there was a significant increase in the group of patients with OME compared to the control group (P<0.01). 2. In the analysis of serum IgE levels, the levels of IgE in the OME patients an control group were higher than normal level, although the level of IgE in the OME patients were less than that of control group, there was no significance P>0.05).
( Hyun Don Joo ),( Kyoung Hwang Shin ),( Sung Hwahn Hahn ),( Jae Hwan Kong ),( Suk Bae Kim ),( Il Han Song ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Cardiac cirrhosis, an uncommon disease entity of chronic liver injury, usually results from long-standing right-sided heart failure in which an elevated venous pressure was transmitted via inferior vena cava (IVC) and hepatic vein to sinusoids of the liver. Long-term hepatic congestion with relative ischemia can induce centrilobular necrosis, leading to pericentral fi brosis. Case: A 67 year-old male with liver cirrhosis of unknown origin was admitted with pretibial pitting edema, ascites and progressive dyspnea on exertion for 1 month. Four years ago, He received transcatheter arterial chemoembolization for hepatocellular carcinoma. At that time on admission, electrocardiography showed typical atrial fi utter with 2:1 or 3:1 conduction and serum cardiac enzymes were within normal limit. A chest radiograph showed a remarkable cardiomegaly with bilateral pleural effusion, being ascertained as transudate. Chest computed tomography (CT) scan showed the anterior pericardial calcifi cation with wall thickening. Dynamic liver CT scan showed a nodular hepatic contour with a small amount of ascites, especially, accompanying with the regurgitation of contrast materials to intrahepatic veins via IVC from right-sided heart chamber. Transthoracic echocardiography demonstrated moderate tricuspid regurgitation and left ventricular ejection fraction of 40%. Liver histology by ultrasound-guided needle biopsy revealed macrovesicular steatosis and bridging fi brosis with a minimal hepatic necroinfi ammation. Cardiac cirrhosis was confi rmed by histological and radiological fi ndings. After symptomatic improvement following conservative managements including diuretics, the patient is being followed up regularly. Conclusions: Based on the histological and radiological features, we report an uncommon case of cardiac cirrhosis caused by constrictive pericarditis accompanying with pericardial calcifi cation.
( Hyun Joo Jang ),( Jae Young Lee ),( Don Haeng Lee ),( Won Hong Kim ),( Joo Ha Hwang ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.s1
High-intensity focused ultrasound (HIFU) is a novel therapeutic modality that permits noninvasive treatment of various benign and malignant solid tumors, including prostatic cancer, uterine fibroids, hepatic tumors, renal tumors, breast cancers, and pancreatic cancers. Several preclinical and clinical studies have investigated the safety and efficacy of HIFU for treating solid tumors, including pancreatic cancer. The results of nonrandomized studies of HIFU therapy in patients with pancreatic cancer have suggested that HIFU treatment can effectively alleviate cancer-related pain without any significant complications. This noninvasive method of delivering ultrasound energy into the body has recently been evolving from a method for purely thermal ablation to harnessing the mechanical effects of HIFU to induce a systemic immune response and to enhance targeted drug delivery. This review provides a brief overview of HIFU, describes current clinical applications of HIFU for pancreatic cancer, and discusses future applications and challenges. (Gut Liver 2010;4(Suppl. 1):S57-61)
Lee, Ji Hyun,Kwon, Kyung A,Lee, Suee,Oh, Sung Yong,Kim, Sung-Hyun,Kwon, Hyuk-Chan,Han, Jin-Yeong,Song, Moo-Kon,Chung, Joo-Seop,Lee, Ho Sup,Kim, Yang Soo,Lee, Sang-Min,Joo, Young-Don,Kim, Hyo-Jin Korean Society of Hematology; Korean Society of Bl 2010 Blood Research Vol.45 No.4
<P><B>Background</B></P><P>Cytogenetic abnormalities (CAs) have been reported frequently in patients with otherwise typical aplastic anemia (AA), but their implications in the prognosis and in the evolution to hematologic malignancies are controversial.</P><P><B>Methods</B></P><P>We retrospectively analyzed 127 adult AA patients who had successful cytogenetic analysis at initial diagnosis.</P><P><B>Results</B></P><P>The patients were classified into 3 groups according to the initial and follow-up results of cytogenetic profiles. Group 1 included patients who had persistent AA with normal cytogenetic profiles (N=117); Group 2, those who had a normal cytogenetic profile at initial diagnosis but later acquired CA (N=4, 3.1%); and Group 3, those who had CA at the initial diagnosis, regardless of follow-up cytogenetic status (N=6,4.7%). In Group 2, 2 patients later developed CA without progression to acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS); the other 2 patients later progressed to AML. None of the patients in Group 3 progressed to AML or MDS. There was no significant difference in overall survival between Groups 1 and 3.</P><P><B>Conclusion</B></P><P>AA patients with CA at initial diagnosis or follow-up may not be at greater risk for evolution to AML or MDS, or show shorter survival periods. Prospective studies and a larger patient samples are needed to establish the clinical relevance of CA.</P>
( Hyun Jung Lee ),( Young Joo Jin ),( Jin Woo Lee ),( Hyun Jung Chung ),( Byung Wook Bang ),( Seok Jeong ),( Kye Sook Kwon ),( Don Haeng Lee ),( Hyung Gil Kim ),( Yong Woon Shin ),( Young Soo Kim ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: Patients with liver cirrhosis frequently undergo secondary prophylactic endoscopic band ligation (EVL), and these patients can suffer from EVL with non-sleep endoscopy. Given the impaired metabolism of drugs administered for sedation in cirrhotic patients, we investigated the safety of sleep endoscopy for secondary prophylactic EVL in those patients who had a previous history of variceal bleeding Methods: A total of 59 cases with secondary prophylactic EVL that were performed at our institution between August, 2010 and April, 2013 were consecutively recruited. We compared the frequency of hepatic encephalopathy (HEP) between patients with sleep endoscopy and non-sleep endoscopy. Midazolam was intravenously injected for conscious sedation, and flumazenil was always used as antidote after sleep endoscopy. Results: The median patient`s age was 55 years (range, 29-89 years). The most common causes of liver cirrhosis were hepatitis B virus infection (44.1%) and alcohol (42.4%). Of the 59 cases, 39 (66.1%), 13 (22.0%), and 7 (11.9%) had Child-Tur- Turcotte- Pugh class A, B, and C, respectively. Sleep endoscopy was performed in 52 (88.1%) of the 59 cases [CTP class A (n=35, 67.3%), B (n=13, 25.0%), and C (n=4, 7.7%), respectively], and the remaining 7 (11.9%) underwent non-sleep endoscopy. Median dosage of midazolam was 5 mg (range, 2-10 mg). None of the patients had experienced HEP after sleep endoscopy for secondary prophylactic EVL, and this result was same to those with non-sleep endoscopy. Conclusions: Our data showed that intravenous midazolam may be used safely in cirrhotic patients, even in those with CTP class C undergoing secondary prophylactic EVL for conscious sedation, but large scaled prospective randomized studies should be performed to confirm our results.