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만성 간장 질환자에서 뇌 MRI 상의 pallidal index와 생물학적 망간지표들 간의 관련성
최영희,박능화,신정우,김효경,김성률,정태흠,박지강,이헌,유철인,이충렬,이지호,김양호 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2
목적 : 만성 간장 질환자를 대상으로 T1강조 자기공명영상(MRI)에서 나타나는 담창구 부위의 고신호강도 소견(pallidal index, PI)과 생물학적 망간 지표들 간의 관련성을 알아본다. 방법 : B형간염 바이러스에 의한 간경변증으로 진단 받은 40세 이상의 환자 31명과 정상 대조군 10명을 대상으로 설문조사와 혈액 및 소변검사, 뇌 MRI를 시행하였다. 전체 41명 가운데 검사 전 수혈을 받았던 환자군 9명을 제외하고 전체 32명의 자료를 분석하였다. 망간 축적에 관련된 객관적 지표로서 T1 강조 MRI에서 나타나는 담창구 부위의 고신호강도를 전두부 백색질 신호강도로 나눈 수에 100을 곱하여 구한 PI를 택하였다. 환자군과 대조군 사이의 PI와 망간농도들의 평균을 비교하였다. 여러 변수들과 PI와의 상관성을 보기 위해서는 상관분석을 시행하였다. 결과 : 간장 질환자 22명 가운데 18명(81.8%)에서 뇌 MRI 상 고신호강도가 나타났다. 대조군 10명에서는 아무도 MRI 소견상 고신호강도가 나타나지 않았다. 간장 질환자에서의 평균 PI는 122.62로 대조군의 106.23보다 유의하게 높게 나타났다(p<0.01). 간장 질환자의 전혈에서 망간농도는 2.34㎍/㎗으로 대조군의 1.44㎍/㎗와 비교하여 유의하게 높게 나타났다(p<0.05). 혈장과 소변 내 망간농도는 대조군에서 다소 높게 나타났으나, 통계적으로 유의하지는 않았다. 또한 혈색소, 빌리루빈, AST가 대조군과 환자군 사이에서 유의한 차이가 있었다(p<0.05). 전혈(p=0.489, P<0.01, n=29)과 적혈구(p=0.573, P<0.01, n=22) 내 망간농도와 PI 사이에는 각각 유의한 상관관계가 있었다. 그러나 혈장과 소변 내 망간 농도와 PI와의 상관관계는 통계적으로 유의하지 않았다. 총빌리루빈 또한 PI와 유의한 상관관계를 나타내었다(p=0.509, P<0.01, n=32). 결론 : 전혈 또는 적혈구 내의 망간 농도가 뇌 내 망간 침착으로 인한 T1 강조 MRI상 담창구 부위의 고신호 강도를 잘 반영하는 유용한 지표이다. Objectives: The objectives of this study were to clarify which biological manganese exposure indices reflect the pallidal signal intensities in magnetic resonance imaging (MRI) in liver cirrhotics. Methods: We examined whole blood, plasma, RBC and urinary manganese concentrations, as well as, brain MRI in 22 cirrhotic patients and 10 healthy controls. From MRI scans we calculated the signal intensity of the globus pallidus using the pallidal index (PI), the ratio of the globus pallidus to subcortical frontal white-matter signal intensity in axial T1 -weighted MRl planes multiplied by 100. In addition, we studied the relationships between PI and other measurements. Results: The high signal intensity in the globus pallidus on T1-weighted MRI was observed in 18 (81.8%) patients. There was a significant correlation between whole blood and RBC manganese concentration, and PI on MRI. According to multiple linear regression, whole blood and RBC manganese concentration reflected PI on MRI better the other indices did. Conclusions: Whole blood and RBC manganese concentrations could be useful as biological manganese exposure indices that reflect PI on MRI.
중학교 체육교사의 코칭리더십과 교사신뢰, 수업몰입의 구조적 관계
박지흠(Ji-Heum Park),박종률(Jong-Lyoul Park) 학습자중심교과교육학회 2024 학습자중심교과교육연구 Vol.24 No.1
목적 본 연구의 목적은 코칭리더십의 개념을 학교체육에 도입하여 체육교사의 코칭리더십이 교사신뢰와 수업태도에 어떠한 영향을 미치는지 살펴보고, 코칭리더십과 수업몰입 간의 관계에서 교사신뢰가 매개하는지를 검증하는 것이다. 방법 이를 위해 S시 8개 중학교에 재학 중인 중학생 400명을 대상으로 372부의 자료를 수집하였고, 불성실하게 응답한 설문지 등 21부를 제외한 351부를 분석에 활용하였다. SPSS 28.0 프로그램을 활용하여 기술 분석을 실시하였으며, AMOS 29.0 프로그램을 활용하여 확인적 요인분석, 구조방정식 모델을 적용하였다. 결과 첫째, 체육교사의 코칭리더십은 교사신뢰에 긍정적인 영향을 미치는 것으로 나타났다. 둘째, 교사신뢰는 수업몰입에 긍정적인 영향을 미치는 것으로 나타났다. 셋째, 코칭리더십은 수업몰입에 긍정적인 영향을 미치는 것으로 나타났다. 넷째, 교사신뢰는 체육교사의 코칭리더십과 수업몰입의 관계에서 매개효과를 지니는 것으로 나타났다. 결론 연구 결과를 통해 체육교사의 코칭리더십과 학생들의 교사신뢰, 수업몰입이 서로 긍정적인 영향을 미치는 관계가 있다는 것이 확인되었으며, 이러한 결과는 코칭리더십이 학교체육에서도 적용이 가능하며, 학생들의 교사신뢰와 수업몰입 향상에 도움이 될 수 있다는 것을 의미한다. 또한 학생들을 지도하는 체육교사에게 올바른 리더십과 지도방법에 대해 참고자료로 제시될 수 있을 것이다. Objectives The purpose of this study is to introduce the concept of coaching leadership into school sports to ex-amine how physical education teachers' coaching leadership affects teacher trust and class attitude, and to verify whether teacher trust mediates the relationship between coaching leadership and class flow. Methods To this end, 372 copies of data were collected from 400 middle school students attending 8 middle schools in S City, and 351 copies, excluding 21 copies, including questionnaires that responded faithfully, were used for analysis. Technical analysis was conducted using the SPSS 28.0 program, and confirmatory factor analy-sis and structural equation model were applied using the AMOS 29.0 program. Results First, it was found that the coaching leadership of physical education teachers had a positive effect on teacher trust. Second, teacher trust was found to have a positive effect on class flow. Third, coaching leadership was found to have a positive effect on class flow. Fourth, teacher trust was found to have a mediating effect in the relationship between physical education teachers' coaching leadership and class flow. Conclusions The results of the study confirmed that physical education teachers' coaching leadership, students' trust in teachers, and class flow have a positive effect on each other, which means that coaching leadership can also be applied in school sports and can help students improve teacher trust and class flow. In addition, it can be presented as a reference for the right leadership and guidance methods to physical education teachers who guide students.
Se-Heum Park,Woo-Jin Kim,Yun-Jung Lim,Cheol-Won On,Ji-Ho Park,Eun-Ho Min 대한재활의학회 2020 Annals of Rehabilitation Medicine Vol.44 No.3
Internal auditory canal (IAC) stenosis with hypoplasia of the facial and vestibulocochlear nerves is a rare cause of congenital facial palsy. In this case report, a 3-month-old female infant was referred for a neurological developmental assessment for developmental delay and congenital facial palsy. Upon evaluation of developmental delay, hearing loss was detected. Following a magnetic resonance imaging scan of the brain and a computed tomography scan of the temporal bone, IAC stenosis with hypoplasia of facial and vestibular nerves was diagnosed. This is a rare case of IAC stenosis in an infant with initial presentations of left facial palsy and developmental delay associated with hearing loss in the left ear. We strongly suggest that IAC stenosis be considered a cause of congenital facial palsy in infants, especially in patients with developmental delay. In infants with congenital facial palsy, a thorough physical examination and neurological developmental assessment should be performed.
박지연 ( Ji Yeon Park ),정민 ( Min Chung ),이영돈 ( Yeong Don Lee ),이정남 ( Jung Nam Lee ),이운기 ( Woon Ki Lee ),박연호 ( Yeon Ho Park ),백정흠 ( Jung Heum Baek ),박흥규 ( Heung Gyu Park ),김건국 ( Keon Kuk Kim ),강진모 ( Jin M 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2
Purpose: A classic approach to abdominal stab wounds has been a routine laparotomy for the purpose of diagnosis or treatment. However, management protocols for abdominal stab wounds are still contentious in most trauma centers. We examined the relationship between the character of the stab wound and the injured intraabdominal organs by retrospectively analyzing the medical records of patients with abdominal stab wounds admitted to Gil hospital, and the findings for our patients are then confronted with a review of the literature. We aimed to propose proper management protocols to approach abdominal stab wounds. Methods: The medical records of all 80 patients sustaining abdominal stab wounds, admitted at the Department of Surgery, Gil Hospital, Gachon Medical School, from January 2004 to December 2008 were retrospectively reviewed. All the abdominal stab wounds were collated based on the site and the character of the injury, investigations performed on admission, results of investigations, operations performed and findings at the time of the operation. Results: The most prevalent age group was patients in their forties and the average age of the patients was 41 years for both genders. The stab wounds were most commonly located at the periumbilical area (16.9%), followed by the epigastric area (15.6%), and 18.2% of the patients had multiple wounds. The most commonly eviscerated organ was the omentum (9 out of 16 cases); 61.7% of non-eviscerated patients underwent a therapeutic laparotomy while 81.3% of eviscerated patients underwent a therapeutic laparotomy. The small bowel was the most commonly injured organ (22.7%, 17 out of 75 injuries). The review revealed a relatively common diaphragmatic injury in abdominal stab wound patients (8 cases, 10.5%). The average hospital stay was 11 days. Conclusion: This review revealed commonly eviscerated and injured intraabdominal organs in abdominal stab wound patients and their relationship with a therapeutic laparotomy. Although the management is still controversial, the authors suggest indications for an immediate laparotomy and a protocol for managing abdominal stab wounds. Hemodynamic instability and peritoneal irritation signs are definite indicators for an immediate laparotomy, but the review revealed intraabdominal organ evisceration alone not to be a statistically significant factor. In addition, the authors suggest that abnormal CT findings can be valuable for making a decision on management of hemodynamically stable stab wound patients. Further study may clarify a role for a more selective approach to operative intervention and for a more extensive use of selective observation. (J Korean Soc Traumatol 2010;23:134-141)
( Young Mi Choi ),( Hyun Jong Park ),( Ji Yun Lee ),( Ga Won Yim ),( Maria Lee ),( San Hee Lee ),( Ji Heum Park ),( Eun Ji Nam ),( Sang Wun Kim ),( Young Tae Kim ) 대한산부인과학회 2010 Journal of Womens Medicine Vol.3 No.2
Chylous ascites is an infrequent postoperative complication of retroperitoneal surgery caused by unrecognized disruption of major retroperitoneal lymphatics and is associated with serious mechanical, nutritional, and immunologic consequences due to the constant loss of protein and lymphocytes. Recently, the robotic-assisted approach to surgical staging for gynecologic malignancy is increased, which allows for enabling the performance of complex procedures. As our experience, in patients with robotic-assisted lymphadenectomy for endometrial cancer, chylous ascites can be also developed despite the meticulous dissection. In our opinion, it is recommended to remove large amount of ascites through paracentesis as much as possible at a time and we should be observed at least 8 weeks before surgical intervention while maintaining nutritional supports.
Mesalamine 투여 중인 궤양성 대장염 환자에서 발생한 약제 유발성 간질성 폐질환 1예
이태훈 ( Tae Hoon Lee ),이석호 ( Suck Ho Lee ),조영신 ( Young Sin Cho ),박지영 ( Ji Young Park ),박정훈 ( Jeong Hoon Park ),박도현 ( Do Hyun Park ),정일권 ( Il Kwun Chung ),김홍수 ( Hong Soo Kim ),박상흠 ( Sang Heum Park ),김선주 대한장연구학회 2007 Intestinal Research Vol.5 No.2
Pulmonary involvement in ulcerative colitis is very rare and may present as a variety of disorders. Pulmonary disease in patients with inflammatory bowel disease may be due to lung involvement in the disease itself or to drugs used for treatment, such as sulfasalazine or mesalamine. The use of mesalamine was initially thought to be free of adverse effects. Recently, however, pulmonary diseases related to the use of mesalamine have been reported. In this report, we describe a patient with ulcerative colitis and mesalamine induced interstitial lung disease. (Intest Res 2007;5:192-195)