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인슐린 비의존성 당뇨환자에서 도플러 심초음파를 이용한 좌우 심실 이완기 기능평가
김성배(Sung Bae Kim),변정란(Jeong Ran Byun),강성인(Sung In Kang),강덕희(Duck Hee Kang),성연아(Yeon Ah Sung),신길자(Gil Ja Shin),이우형(Woo Hyung Lee),경난호(Nan Ho Kyung) 대한내과학회 1991 대한내과학회지 Vol.40 No.3
N/A Doppler echocardiagrams of the mitral and tricuspid valve were recorded along with electrocardiograms from 32 non-insulin dependent diabetes and 17 normal subjects (1) to determine whether a relation existed between the microangiopahtic complications and the patterns of diastolic filling. (2) to evaluate the diastolic LV&RV filling characteristics in non-insulin dependent diabetic patients, and correlation between LFKRV filling parameters. The diabetics were divided into 3 groups according to the number of microangiopathic complications i.e., peripheral neuropathy, nephropathy, retinopathy. (Group I:10 cases without complications Group II:12 cases with 1, 2 complications Group III:10 cases with 3 complications) The results were as follows. 1) No significant difference was found among groups for PFVE 8r, AT in Lt&Rt ventricular filling pattern. 2) PFVA in control (Lt:53.64±16.88, Rt:30.23±7.54) and Group L(Lt:57.4±15.02, Rt:38.44±8.58) were significantly decreased (Lt:p<0.005, p<0.025, Rt:p<0. 005, p<0.05) compared to Group III (Lt:71.8±15.24, Rt: 44.6±89) 3) E/A ratio in contro (Lt:1.30±0.33+Rt:1.59±0.28) and Group I(Lt:1.09±0.28, Rt:1.27±0.35) were significantly increased (Lt:p<0.005,p<0.05, Rt:p<0,05, p<0.05) compared to Group III(Lt:1.11±0.28), 4) DT was prolonged in groups with more microgagniopathic complication, but it showed no significant differences among groups(p>0.05). 5) There was a significant correlation in PFVE, E/A ratio, deceleration time between the left and right ventricular inflow pattern, (r=0.56, 0.60, 0.47 respectively) Data indicated that indexes of RV diastolic dysfunction were closely related to corresponding LV diastolic filling parameters (PFVE, E/A ratio, DT), and a correlation existed between diabetic microangiopathic complications and diastolic filling pattern.
천막상부 종괴의 방사선 치료후 단기간에 발생한 시상하부성 뇌하수체 기능저하증 1예
강덕희,이선영,김지선,강성인,성연아,최경규,경난호 대한내과학회 1992 대한내과학회지 Vol.42 No.4
방사선 유발성 뇌하수체 기능 저하증은 내분비학적 이상의 정도 및 형태에서 심한 개인차가 있으나, 대부분의 경우 요붕증은 동반되지 않으며 방사선 조사후 1년이상 지난 뒤 발생하는 예가 많다. 이에 저자들은 방사선 치료 후 비교적 단기간인 2개월 만에 발생한 요붕증을 동반한 시상하부성 뇌하수체 기능 저하증을 경험하고 이에 본 증례를 보고하는 바이다. Postirradiation hypopituitarism is relatively common condition, and can be occurred via several mechanisms, including hypothalamic dysfunction, pituitary or hypophyseal portal system damage. Most of postirradiation hypopituitarism develop 7~48 months after radiation therapy, and usually is not associated with diabetes insipidus. We experienced a case of hypothalamic hypopituitarism combined with neurogenic diabetedes insipidus developed shortly-2 month-after cranial radiation in 26-year-old woman who has been diagnosed as supratentorial mass and receiced radiotherapy. We analyse hormone status at each condition, and managed with cortisone, levothyroxine and bromocriptine. We report a case of hypothalamic hypopituitarism with a brief review of literature.
심한 낙타혹(Hump)의 형성을 동반한 제 2 형 막증식성 사구체신염(Dense Deposit Disease) 1예
오희정,유민아,이영숙,김미연,김승정,강덕희,윤견일,최규복,성순희 이화여자대학교 의과대학 2004 EMJ (Ewha medical journal) Vol.27 No.1
Dense deposit disease (DDD), known as type Ⅱ MPGN, is an uncommon form of glomerulonephritis. It is an acquired primary glomerular disease, characterised by electron microscopic evidence of a continous, dense membrane deposition replacing the lamina densa. There is associated alternative pathway complement activation and a C3 nephritic factor maybe present. Patients with dense deposit disease tend to be young at clincal onset and more commonly have persistent nephrotic syndrome, gross hematuria, and acute nephritis episode and persistent depression of the serum complement level. The prognosis of dense deposit disease is worse than that of typeⅠMPGN. We experienced a patient with dense deposit disease that presenting persistent nephrotic syndrome, gross hematuria and having subepithelial hump. It is a first report of dense deposit disease having subepithelial hump in Korea, therefore we report this case with the review of relevant literatures.
심리사회적 중재가 간호대학생의 스트레스 지각, 대처방법, 스트레스 반응에 미치는 효과
김조자,허혜경,강덕희,김보환 성인간호학회 2004 성인간호학회지 Vol.16 No.1
Purpose: The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. Method: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. Result: Results showed for the two groups, 1) a significant difference in stress scores (U=19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm). 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. Conclusion: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.