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만성 실질환 환자에서 허혈성 심질환에 대한 좌심실 이완기능 장애의 영향
최보경 ( Bo Kyung Choi ),이경남 ( Kyung Nam Lee ),황인혜 ( In Hye Hwang ),김일영 ( Ii Young Kim ),이하린 ( Ha Rin Rhee ),성은영 ( Eun Young Seoung ),송상헌 ( Sang Heon Song ),이동원 ( Dong Won Lee ),이수봉 ( Soo Bong Lee ),곽임수 대한내과학회 2012 대한내과학회지 Vol.83 No.3
목적: 만성 실질환 환자에서 허혈성 심질환은 주된 사망 원인으로, 이와 연관된 위험인자를 파악하고 관리하는 것은 중요하다. 허혈성 심질환과 관련된 심장의 구조적인 변화 중특히 좌심실 이완기능 장애는 최근 발생률이 증가하고 있으며, 예후 또한 불량한 것으로 보고되고 있다. 따라서 본 연구는 만성 실질환 환자를 대상으로 심초음파를 이용하여 좌심실 이완기능 장애를 진단하고, 좌심실 이완기능 장애가 사망률 및 허혈성 심질환의 발생률에 미치는 영향에 대하여 알아보고자 하였다. 방법: 2005년 1월부터 2010년 5월까지 본원에서 심초음파를 시행한 만성 실질환 환자 중, 좌심실 구혈률이 55% 미만, 중등도 이상의 판막질환이 있는 환자와 관찰기간이 6개월 미만인 환자를 제외한 71명의 환자를 대상으로 하였다. 임상적 지표들은 의무기록 조사를 통해 수집하였고, 심초음파 검사, 혈액검사를 후향적으로 분석하였다. 결과: ROC curve를 이용한 허혈성 심질환과 연관된 좌심실 이완기능 장애의 진단 기준값은 E/E` = 15.55 (sensitivity: 100%, specificity: 64.7%, p = 0.005), E/A = 0.79 (sensitivity: 84.6%, specificity: 55.9%, p = 0.006)였다. 이 값을 기준으로 E/E` > 15.55, E/A > 0.79인 19명을 좌심실 이완기능 장애가 있는 환자군, Group I으로 지정하였고, 그 외 나머지 환자 52명을 Group II로 나누었다. 심초음파에서 Group I의 E/A, DT, E/E`값은 각각 1.27, 184.21, 19.08이었고 Group II에서는 0.73, 225.19, 13.58이었다(E/A, p < 0.001; DT, p = 0.017; E/E`, p <0.001). 좌심실 이완기능 장애에 영향을 미치는 인자를 분석하였고 연령, 허혈성 심질환의 병력, 낮은 혈색소 수치, 높은 저밀도 지단백 수치가 관련이 되었다. 또한 허혈성 심질환을 야기시키는 위험인자를 분석하였을 때는 좌심실 이완기능 장애, 흡연, 높은 저밀도 지단백 수치, 높은 부갑상선 호르몬수치가 상관관계가 있었다. 좌심실 이완기능 장애와 사망률 사이의 연관성을 살펴보면, 전체 사망률은 Group I, II에서 유의한 차이를 보이지 않았지만(p = 0.177), 허혈성 심질환을 나타내는 disease free survival로 비교하면 Group I이 Group II보다 의미있게 생존율이 감소하였다(p = 0.001). 결론: 만성 신질환 환자에서 좌심실 수축기능이 정상이라도 E/E` > 15.55, E/A > 0.79인 중등도 좌심실 이완기능 장애를 가진 환자는 허혈성 심질환의 발생률이 높았다. Background/Aims: Cardiovascular complications are commonly seen in patients with chronic kidney disease (CKD). Recently, the prevalence of left ventricular diastolic dysfunction (LVDD) has increased, and the importance of LVDD has emerged in patients with CKD. The objectives of this study were to identify diagnostic criteria for LVDD related to ischemic heart disease (IHD) and evaluate the prognostic impact of diastolic dysfunction in patients with CKD. Methods: A total of 71 patients with CKD who were evaluated between January 2005 and May 2010 were included in this study. These patients were evaluated by conventional echocardiography and tissue Doppler imaging (TDI) for diastolic dysfunction. Results: Diagnostic cutoff values for LVDD related to IHD were E/E` = 15.55 (sensitivity: 100%, specificity: 64.7%, p = 0.005) and E/A = 0.79 (sensitivity: 84.6%, specificity: 55.9%, p = 0.006), Group I consisted of 19 patients with an E/E` > 15.55 and E/A > 0.79. Group II consisted of the remaining patients. Factors contributing to LVDD were age, history of ischemic heart disease, anemia, and high low-density lipoprotein (LDL) level. Factors contributing to IHD were LVDD, smoking, high LDL level, and high parathyroid hormone (PTH) level. The disease-free survival for IHD was significantly lower in group I compared to group II (p= 0.001). However, there was no significant difference in overall survival between groups I and II (p = 0.177). Conclusions: Our study showed that moderate LVDD (E/E` > 15.55 and E/A > 0.79) in patients with CKD is positively associated with IHD.
肋膜疾患의 臨床的 考察 : 非特異性肋膜?出에 關한 診斷的 考察 1.Diagnostic Studies on Idiopathi Pleural Effusions
金洋一,李英玉,金東秀,李學重 中央醫學社 1976 中央醫學 Vol.30 No.2
Twenty-three patients with pleural effusion of unknown etiology were selected because by means of radiological and cytologic examination, smear of the sputum and pleural fluids for tubercle bacilli and eggs of the lung fluke had failed to provide a diagnosis, from September, 1974 to October, 1975 at the Department of internal Medicine, National Medical Center in Korea. Needle biopsy of the pleura using Vim-Silverman needle, culture of the sputum and pleural fluids for tubercle bacilli, red blood cell, lymphocyte, monocyte and mesothelial cell counts in the pleural fluids, and measurement of the pleural fluid glucose and pH levels were done to provide definite or suspected diagnosis. The results were as follows: 1) neeedle biopsies were done on 23 patients and 11 of these showed tuberculous findings, 2 of these showed lymphoma and the remaining 10 showed nonspecific chronic inflammation (43.5%). In one patient of the nonspecific group, an open pleural biopsy which showed paragonimiasis. 2) culture of the pleural fluid was positive for tubercle bacilli in only 2 of the tuberculous group and 1 of the nonspecific group. 3) Used in conjunction with pleural fluid red blood cell, lymphocyte, monocyte, rresothelial cell counts and glucose, pH levels, most provable tuberculous etiology could be established in 6 of 8 nonspecific group, and remaining 2 were as idiopathic pleural effusion. There was no significant statistical difference in the laboratory
Jae Yeon Yoo,Ok Ran Jeong,Dong II Seo 대구대학교 2003 Journal of Asia-Pacific Special Education Vol.3 No.1
The present study attempted to investigate the effects of the Seo Dongil's voice technique on voice quality in patients with sulcus vocalis. Three patients participated in the study. Fo, jitter, shimmer, and NNE were measured before and after implementing the technique to determine the efficacy. Dr. Speech was used to compare the acoustic parameters. The Seo Dongil's voice technique consisted of relaxation, breathing, and phonation exercises. The result showed that the Seo Dongli's voice technique tended to improve voice quality acoustically in patients with sulcus vocalis.
정철영,고재관,황원채,윤희철,박가열,김재호,이성식,김동승,표성일,이건남,양안나,최수정,김은석 한국직업능력개발원 2008 직업능력개발연구 Vol.11 No.1
이 연구의 목적은 제대군인에 대한 효율적인 전직지원을 위해서 현행 전직지원 프로세스에 대한 개선 안과 이에 따른 국방부, 국가보훈처 등 제대군인 전직지원관련 기관 간의 역할분담 및 연계방안에 대해서 제안하는 것이다. 연구는 크게 세 가지 과정을 거쳤다. 첫째, 국내 군 전직지원 실태를 분석하여 문제점과 시사점을 도출하였다. 둘째, 이러한 문제점과 시사점, 군 전직지원 선행연구를 종합하여 효율적인 군 전직지원 프로세스 안을 제시하였다. 셋째, 구축한 군 전직지원 프로세스 안에 따라 주요 군 전직지원 관련 기관인 국방부, 국가보훈처의 역할 분담 안을 제안하였다. This study aims to suggest an improvement plan for the support process of effective occupation change for discharged soldiers and then role assignments among related institutions for supporting discharged soldiers such as Ministry of Defense, Ministry of Patriots and Veterans Affairs, Ministry of Labor and the cooperation plan among the institutions. The study was made in three steps. First, after analyzing currents support facts and status for discharged soldiers, it induced its problems and implications. Second, integrating the findings of previous studies related to support plan on occupation changes for the discharged soldiers, Problems and implications mentioned above, it constructed effective occupation change process for discharged soldiers. Then, according to the established process, it suggested role assignments such as Ministry of Defense, Ministry of Patriots and Veterans Affairs, Ministry of Labor.
Velocity Profile Generation Methods for Industrial Robots and CNC Machine tools
Dong-II Kim,Jin-Il Song,Sungkwun Kim 대한전자공학회 1992 대한전자공학회 학술대회 Vol.1992 No.10
We propose software algorithms which provide the characteristics of acceleration/deceleration essential to high dynamic performance at the transient state where industrial robots or CNC machine tools start and stop. The path error, which is one of the most significant factors in performance evaluation of industrial robots and CNC machine tools, is analyzed for linear, exponential, and parabolic acceleration/deceleration algorithms in case of circular interpolation. The analysis shows that the path error depends on the acceleration/deceleration routine and the servo control system. In experiments, the entire control algorithm including the proposed acceleration/deceleration algorithms is executed on the motion control system with a floating point digital signal processor(DSP) TMS320C30 as a CPU. The experimental results demonstrate that the proposed algorithms are very effective in controlling axes of motion of industrial robots or CNC machine tools with the desired characteristics.