우심방을 침범한 거대 비호지킨씨 림프종 1예

강상범,진승원,이은경,박용현,최용호,김용주,박준철,김재형,홍순조,최규보,권종범,원용순,박건,이은희 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

일차의료에 내원한 성인에서 대사증후군의 유병률 및 관련 요인에 대한 연구

박혜순,신호철,김병성,이가영,최환석,신정아,남윤덕,배상필,천경수 대한비만학회 2003 The Korean journal of obesity Vol.12 No.2

연구배경: 심혈관 질환은 치근 국내에서 그 발생률과 유병률이 급증하여 점점 중요한 국민 건강 문제로 대두되고 있다. 2001년 NCEP ATP Ⅲ에서는 대사증후군에 대해 임상적으로 손쉽게 적용할 수 있는 기준을 제시하면서 심혈관 질환의 주 관리 차상으로 취급하였다. 본 연구에서는 일차의료에서 대사증후군의 유병률을 파악하고, 대사증후군과 관련된 요인을 규명하여 한국인에게 적절한 대사증후군 관리전략을 개발하고자 하였다. 방법: 전국 9개 병·의원 가정의학과에 내원한 20세 이상 80세 미만 성인에서 건강 문제와 무관하게 연속적 조사를 시행하여 총2,134명이 연구에 참여하였다. 대사증후군에 대해서 복부비만은 남자 ≥ 90cm, 여자 ≥ 80 cm으로 하였고 다른 위험인자들은 NCEP ATP Ⅲ의 기준에 따라 정의하였다. 신체 계측, 심혈관 위험인자를 측정하고 생활 습관을 조사하여 대사증후군의 유병률과 관련 요인을 파악하였다. 결과: 일차의료에 내원한 성인에서 대사증루군의 유병률은 남자에서 31.3%, 여자에서 29.5%로 나타났으며, 연령이 증가할수록, 비만도가 증가할수록 대사증후군의 유병률이 높아지는 경향을 나타냈다. 남자에서는 연령, 고소득, 비만, 과다 음주. 과다 흡연이 대사증후군의 관련 요인으로, 여자에서는 연령, 무직, 비만, 심혈관 질환의 가족력, 중등도의 스트레스가 관련 요인으로 나타났다. 결론: 대사증후군은 일차의료에 내원하는 성인 중 비교적 흔하게 나타나는 건강 문제로 약 30%의 유병률을 보였다. 일차의료에서 무증상 성인에게도 허리둘레 측정, 심혈관 위험인자 검사 등 대사증루군의선별검사에 의한 조기 발견과 예방적 차원의 관리가 필요하다고 하겠다 Backgroud: Cardiovascular disease is becoming an important national health issue since its recent increase in incidence and mortality. Despite the significant increase in mortality rate of cardio-vascular disease in Korea, there have been no specific studies concerning metabolic syndrome. The aim of this study was to assess the prevalence of metabolic syndrome and to evaluate the associated factors among adults who visited the primary care. Methods: A total of 2,134 subjects aged 20-79y were recruited from nine primary care clinic. The metabolic syndrome was defined by NCEP ATPⅢ criteria, however, abdominal obesity was assessed by ≥90cm in men and ≥80 cm in women. Anthro-pometric variables and cardiovascular risk factors were measured, and lifestyle factors were assessed through a questionnaire. Results: The prevalence of metabolic syndrome was 31.3% and 29.5% in men and women, respectively. The risk factors associated with metabolic syndrome, in common for both genders, were found to be age, and obesity. Excessive alcohol intake, and heavy smoking were also found to be risk factors of metabolic syndrome in men whereas moderate stress and family history of cardiovascular disease served as risk factors in women. For both genders, greater increase in body weight correlated with higher risk of metabolic syndrome. Conclusion: The prevalence of metabolic syndrome is presumed to be high considering the fact that it is commonly encountered in primary care, therefore a screening program for prevention and management of metabolic syndrome is required.

상부요추부수핵탈출증에 관하여

성경훈,김상진,박순필,도종웅 최신의학사 1988 最新醫學 Vol.31 No.2

페나진 유도체들의 抗菌性에 관한 분자궤도론적 연구

郭庚度,朴柄珏,金鎬順,徐萬哲,金鐘大 嶺南大學校附設 基礎科學硏究所 1988 基礎科學硏究 Vol.8 No.-

The electronic states of the antimicrobial phenzine and its derivatives were examined by Extended H?uckel Method. It was found that the sum of nucleophilic reactivity index for trans 1,2, and 4 positions, ?? in a molecule was found to be related antimicrobial activity. The index, ??, should be applied to biological activity as well as antimicrobial activity.

초등학생의 음주예방교육 요구

문정순,송경애,박선남,김한숙 대한간호학회 아동간호학회 2003 Child Health Nursing Research Vol.9 No.2

장기간 항갑상선제 투여 후 임의 중단 뒤 재복용시 발생한 무과립구증 1 예

김승만;김태영;박수영;배영환;서영경 정은주;김태균;권민정;박정현;이순희 인제대학교 2011 仁濟醫學 Vol.32 No.-

Agranulocytosis, one of the major side effects of antithyroid a gents, probably occurs in less than 0.25% of cases treated with antithyroid agents. It usually occurs within the first several weeks or months after the initiation of therapy, when drug dosage is higher. Most reported cases of agranulocytosis have occurred during the first 3 months of therapy. We describe here a rare case that did not experience the side effect for 6 years of antithyroid agent treatment but presented with agranulocytosis in one month after re-exposure. It suggests that the major side effect such as agranulocytosis can occur in patients who had undergone prior uneventful antithyroid drug therapy.

흉추간판 탈출증의 미세현미경적 후측방 접근법

김상진,성경훈,박순필,도종웅 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.6

The authors describe the case of a man who presented with T2-T3 disc herniation. The lesion was successfully identified by computed tomography with iopamidol myelogram and other radiological examinations. A posterolateral approach was tried and made successful result by the aids of microsurgcial divices.

베르누이 정리를 이용한 혈액 투석관내 혈류량 측정법 개발

이종훈,송순영,조현경,윤수영,양성자,허규하,김순일,김유선,박기일 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1

강릉지역 소아에서 비만도와 혈청 지질과의 관련성

심수정,천경수,박혜순 대한비만학회 2003 The Korean journal of obesity Vol.12 No.2

연구배경: 소가 비만이 급속히 증가함에 따라 가장 중요한 심혈관계 위험요인의 하나인 이상지질혈증이 치근 우리나라 소아에서도 중요한 문제로 대두되고 있다. 동맥경화는 아동기부터 시작된다고 알려져있으며 심혈관질환의 고위험인자인 고지혈증의 조기 발견과 치료가 동맥경화성 심질환의 발생을 현저히 감소시킬 수 있다. 본 연구에서는 강릉지역 소아에서 비만의 유병률을 조사하고 혈중지질치와 비만과의 관계를 알아보고자 하였다. 방법: 강릉지역 일개 초등학교에서 7∼12세 사이의 초등학생 1326명 (남자 720명, 여자 606명)을 대상으로 신장 및 체중을 측정하였고 그에 의한 체질량지수를 산출하였다. 혈액 검사는 자발적 참여를 원하는 725명 (남자 393명, 여자 332명)을 대상으로 공복 상태에서 총콜레스테롤, 중성지방 및 HDL-콜레스테롤을 측정하였다. 결과: 해당 성별과 연령에 대한 체질량지수가 85 백분위수 이상인 경우를 비만으로 정의하였을 때 비만의 평균 유병률은 남아 18.9%, 여아 20.6%였다. 남, 녀 모두 비만도가 증가함에 따라 중성지방 및 동맥경화지수는 증가하는 경향을. HDL-콜레스테롤은 감소하는 경향을 나타내었다. 체질량지수가 85 백분위수 이상인 비만군에서 고중성지방렬증과 동맥경화지수 ≥ 4.0의 교차비는 각각 2.3 (1.1∼5.0), 3.7 (1. 2∼11.1)로 유의하게 증가하였다. 결론: 비만한 어린이에서 고중성지방렬증과 동맥경화지수는 독립적인 관련성이 있는 것으로 나타나 동맥경화의 위험을 줄이기 위해 체중 조절이 강조되어야 한다. Background: Atherosclerosis might progress from early life stage if the person is at high risk. Dyslipidemia, one of the most important cardiovascular risk factors, has increased among children in recent years in South Korea. The aim of this study was to evaluate the prevalence of overweight, and to investigate the relation of serum lipid profiles to overweight among children in Gangneung area. Methods: The study subjects were recruited from an elementary school in Gangneung area. Anthro- pometric measurements were examined aged 6-12 years 1326 children (720 boys; 606 girls). Total cholesterol, triglyceride, and HDL-cholesterol were measured in fasting state in 725 children (393 boys; 332 girls) among them. Result: The prevalence of overweight defined as BMI≥285 percentile by gender and age was 18.9% in boys and 20.6% in girls. The prevalence of triglyceride 2130 mg/dL, and atherogenic index (TC/HDL-C) 24.0 among overweight children was significantly higher than that of normal weight children. The triglyceride and atherogenic index increased according to BMI, and HDL-cholsterol decreased according to BMI in both boys and girls. The odds ratio for hypertriglyceridemia, and high atherogenic index in overweight children was 2.3 (1.1-5.0) and 3.7 (1.2-11.1) with adjustment for age and parental BMI. Conclusion: The hypertriglycerdemia and high atherogenic index (TC/HDL-C) was independently associated with overweight among children. Manage- ment of overweight in children is reinforced to decrease the risk of dyslipidemia or atherosclerosis.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.