야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

개에서 실리콘고무를 골막으로 싸서 안면골 위에 이식시 그 골막에 일어나는 조직학적 변화

박관규,강진성,함희정,한기환,최동원 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.3

Bony depression in the face may occur doe to congenital failure of development trauma or excessive surgical resection. Various materials, autogenous bone, autogenous cartilage and silicone rubber have been employed for bony contour restoration. Since autogenous bone grafts become consolidated with the underlying recipient bones, the incidence of extrusion or deviation of the graft is much fewer. But they may be easily fractured at the time of carving because of their rigidity. Autogenous cartilage grafts do not require contact with the nasal bony framework, but they tend to curl and bend. Using silicone rubber is a simple and fast procedure, but the prosthesis itself is a foreign body which causes occasional foreign body reaction or exposure of the prosthesis. Therefore, the materials, which have such nature as consolidation, complete contact and convenience without complication are considered to be ideal for augmentation of the bony depression. It may be an ideal material for prevention of the complication of the implants, if a new bone formation at the gratted periosteum wrapping the silicone rubber implants develops. To confirm the possibility, biological test with dogs was initiated. Six samples of periosteum and fascia wrapping the silicone rubber implants, respectively were collected from 9dogs at 8, 16 and 24 weeks. Grossly, difference between translucent periosteum and whitish fascia was noticeable at 8 weeks after implantation. However, it is difficult to distinguish between fascia and periosteum at 24 weeks. Histologically, fibrous capsule developed at 8 weeks and there was a marked thickening at 24 weeks on both periosteum and fascia. At one of 6 samples of 24 weeks periosteum, wrapping the silicone rubber implant, formed a new bone. In conclusion it is possible for the grafted periosteum wrapping the silicone rubber implants to make a new bone. Therefore the periosteum and fascia wrapping the silicone rubber are well taken at the recipient site. Also, they play a good role of barrier against exposure of implant. Especially the periosteum is better than the fascia, because of its bony formation and easier obtaining

방사선적 물리적 특성에 의한 담석의 성분 분석

함희원,성무경,전혜정,선관우 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

In this study, gall stones from 45 patients were analyzed in vitro. Gall stones from 23 patients were cholesterol stones and the others were non-cholesterol. Correlation with each radiologic physical properties(the number of stones, shape, calcification pattern, Hounsfield units measured by computed tomography) and chemical composition(cholesterol or non-cholesterol) were analyzed. The results revealed that the numbers and size were not related to the chemical composition, but there were significant correlation with faceted stones(p=0.002) or stones with no calcification (p=0.010) and cholesterol composition, and with irregular stones(p=0.000) or stones with dense calcification(p=0.015) and non-cholesterol composition. In study of Hounsfield units, it was difficult to fix the boundary, but the difference between cholesterol composition(138.43±281.81) and non-cholesterol composition(404.32±306.06)was significant(p=0.0109).

진행성 위암환자에서 Capecitabine/Cisplatin 치료군과 Fluorouracil/Cisplatin 치료군 간의 삶의 질 비교

유희원,신은정,이광자,한현주,손인자 韓國病院藥師會 2004 병원약사회지 Vol.21 No.1

The improvement of medical treatment and anticancer drug has led a complete recovery and prolonged survival time of cancer patients. And recent study of cancer has included evaluation of quality of life. This study was performed to evaluate quality of life between Capecitabine/Cisplatin arm and Fluorouracil/Cisplatin arm. This study was performed in the Seoul National University Hospital from August to October 2003. A total of 8 AGC patients on adjuvant chemotherapy successfully completed this study. Method of study is questionnairing by EORTC QLQ-C30, cancer specific questionnaire. The questionnaire consists of Functional, Symptom, Global health quality of life scale. Patients eligible for this study had histologically confirmed stage III or IV AGC. Patients were to be between 18 and 60 years old, and have performance status of 1. Patients were ineligible if they had a history of 6 months prior or concomitant chemotherapy, radiotherapy. Statistically significant differences favoring the Fluorouracil/Cisplatin arm was noted in the physical scale. In addition, patients in the Fluorouracil/Cisplatin arm reported an improvement in physical functioning after one cycle chemotherapy.

요골동맥과 복재정맥을 이용한 관상동맥우회술의 조기성적

김관창,원태희,한재진,최수승,안재호 이화여자대학교 의과학연구소 2008 EMJ (Ewha medical journal) Vol.31 No.2

Background:Increasing interest and use of arterial conduits is based on the better patency of left internal thoracic artery(LITA) than that of saphenous vein(SV) graft. We compared the early result of coronary artery bypass grafting(CABG) using LITA and radial artery(RA group) with CABG using LITA and SV only(SV group). Material and Method:We compared the early operative results of 6 cases in RA group with 18 cases in SV group selected from 24 cases that had CABG between January 2006 and December 2006. We analyzed each group on the preoperative risk factors and operative results. Results:We can’t find significant differences in clinical and hemodynamic characteristics before surgery. There were no statically significant difference between two groups in operative mortality and each morbidities(postoperative intraaortic balloon pump insertion, bleeding, stroke, perioperative myocardial infarction, wound dehiscence), respectively. However, the overall incidence of conventional CABG using cardiopulmonary bypass was higher in RA group compared to SV group(p=0.016). Accordingly, RA group had longer duration of ventilation time(p=0.004) and ICU stay(p=0.003) than SV group with statically significant difference between two groups in hospital stay. The graft patency on postoperative coronary angiography or computerized tomographic angiography at 7-14 days after operation in both group patients were 100%(includeing LITA, RA and SV). Conclusion:We had early good operative results in RA group and SV group. 관상동맥우회술에서 내흉동맥의 장기개통률이 복재정맥보다 우수하다는 것이 알려짐과 더불어 두 개의 내흉동맥을 이용한 군에서의 장기 임상 성적이 하나의 내흉동맥만을 이용한 군에서의 성적보다 우월하다 것이 알려지면서 최근에는 동맥이식편의 사용이 증가하고 있다1)2). 좌내흉동맥이 동맥이식편중 가장 많이 그리고 오래 전부터 사용되어왔고 그 장기 개통률이 매우 우수한 것으로 증명되면서, 이식편으로 사용 가능한 다른 동맥이식편에 대한 사용이 늘어나고 있는 추세이다. 좌내흉동맥 이외에 사용될 수 있는 동맥이식편으로는 요골동맥, 우내흉동맥, 우위망막동맥 등이 있다. 이 중 우내흉동맥은 좌내흉동맥과 같이 사용한 경우 장기 생존율이 높다는 보고도 있지만 가용길이가 짧아 이용에 한계가 있고 수술시간이 길어지며 상처 합병증과 기술적인 문제 등이 있다2). 요골동맥은 Carpentier 등3)에 의해 1970년대 초 처음 이식편으로 소개되었으나 추적 관상동맥조영술상 높은 이식편 부전으로 인해 사용이 중단되었다가 1989년 다시 소개되어 주목을 받게 되었고4), 요골동맥박리술의 기술적인 변형과 항연축제의 사용으로 요골동맥의 연축을 최소화하여 사용하면서 많은 저자들에 의해 좋은 임상 성적과 높은 개통률을 보이고 있다5-7). 본 이화여자대학교 목동병원 흉부외과에서도 요골동맥을 좌내흉동맥에 이은 두 번째 동맥이식편으로 사용하고 있는데 본 연구에서는 본원에서 경험한 요골동맥을 사용하여 시행한 관상동맥우회술의 임상 성적과 수술 후 관상동맥조영술 혹은 컴퓨터 단층 혈관조영술 결과를 분석해 보고 아울러 이를 요골동맥을 사용하지 않고 내흉동맥과 복재정맥만을 이용한 군의 성적과 비교 분석해 보았다.

장을 이용한 요로전환술 후 요석형성 위험인자의 변화

신관희,한광희,정원일,이형래,이상철,김원재 충북대학교 의학연구소 2002 忠北醫大學術誌 Vol.12 No.2

연구목적: 장을 이용한 요로전환술을 받은 환자들에게는 여러 가지 대사적 장애에 따른 합병증이 발생하게 되는데 그 중 하나인 요석형성의 위험인자에 대해 대사적 검사를 실시하였다. 대상 및 방법: 장을 이요한 요로전환술을 시행 받은 후 적어도 6개월간 추적관찰이 가능했던 30명(회장 도관술 24명, Mainz pouch 4명, 방광 확대술 2명)을 환자군으로 하였고 요석의 과거력이 없는 건강한 38명을 대조군으로 선정하였다. 요로감염이나 항생제를 투여하는 경우에는 대상에서 제외하였고 식이 제한을 하지 않은 상태에서 24시간 소변을 외래에서 모았다. 소변량, 나트륨, 인, 요산, 크레아티닌, 칼슘, 마그네슘, 수산, 구연산 등의 요검사 항목을 조사하여 환자군과 대조군의 측정치 및 크레아티닌으로 보정한 측정값을 각 성별에 따라 비교하였다. 결과: 혈중 칼슘, 인, 요산, 나트륨, 칼륨, 크레아티닌, 혈액요소질소 (BUN) 등 대부분의 혈중 검사 항목들은 환자군과 대조군 사이에 차이가 없었으나 혈중 단백질 수치만이 차이를 보였다. 23명의 남성 환자에게서 수산의 요 배설량이 대조군에 비해 현저히 높았으며 반대로 구연산과 요산은 대조군에 비해 낮았다 (p=0.006, p=0.001, and p=0.005, respectively). 또한, 남성 환자의 칼슘의 요 배설량은 대조군보다 오히려 적게 나타나 환자군의 칼슘/수산 비가 현저히 감소하였다 (p<0.001). 요중 칼슘, 나트륨, 인 및 요산은 크레아티닌의 농도와 관련성을 보였으며, 오직 수산만이 크레아티닌 보정 후에도 남성 환자군과 대조군 사이에 유의한 차이를 보였다. 한편, 7명의 여성 환자들에게서 대조군에 비해 마그네슘의 배설이 감소한 것 이외에 유의한 차이는 나타나지 않았다 (p=0.04). 결론: 본 연구의 결과로 볼 때 요로전환술을 받은 환자에게 요중 칼슘, 마그네슘, 구연산 등이 요석형성에 영향을 끼치는 인자로 작용하지만, 요중 수산 배설의 증가와 이에 따른 칼슘/수산 비율의 감소가 보다 더 주된 위험 요인이라 할 수 있다. Purpose: The present study was performed to assess the risk factors for urolithiasis in patients receiving urinary intestinal diversion due to certain underlying etiology. Materials and Methods: This study included 30 patients who had undergone various forms of urinary intestinal diversion (24 of ileal conduits, 4 of Mainz continent diversions, and 2 of augmentation cystoplasties) with post-operative duration of at least 6 months and 38 age-matched normal controls. Urine samples (24-hour) were randomly collected on an outpatient basis without any dietary restriction when the patients were free of urinary tract infection or antibiotics. Investigation of urinary analytes comprised urine volume, sodium, phosphorus, uric acid, creatinine, calcium, magnesium, oxalate, and citrate. Data were compared in original values and adjusted values by creatinine in each sex. Results: Almost serum analytes such as calcium, phosphorus, uric acid, sodium, potassium, creatinine, and BUN were not significantly different between patients and controls except protein. In 23 male patients, mean urinary excretion of oxalate was significantly greater than control group and conversely in that of citrate and uric acid (p=0.006, p=0.001 and p=0.005, respectively). Unexpectedly, urinary excretion of calcium in male patients was lower than in control (p=0.002) resulting in significant decrease in the ratio of calcium to oxalate (p<0.001). Among the urinary analytes, excretions of calcium, sodium, phosphorus, and uric acid were significantly correlated with that of creatinine. Oxalate was only different analyte when adjusted by creatinine between male patients and controls. In 7 female patients, decreased excretion of magnesium was observed when compared to control (p=0.04). Conclusions: Our study indicated that urinary intestinal diversion cause increased excretion of urinary oxalate leading to decreased calcium to oxalate ratio, as major metabolic alteration for urolithiasis, although urinary calcium, magnesium, or citrate may take a role.

『韓國 金融(銀行)産業의 構造 및 特性分析』

유관희,원석희,김인호 漢陽大學校 産業經營硏究所 1992 産業經營硏究 Vol.4 No.-

당뇨병 환자에서 총항산화능, 지질 과산화 및 산화 저밀도 지단백에 대한 자가항체의 측정

강윤희,전사일,장성수,홍성관,민원기 대한임상병리학회 2000 대한임상병리학회지 Vol.20 No.6

콘크리트 온도변화 특성에 관한 실험적 연구

김우중,이원홍,이관희 진주산업대학교 1999 산업과학기술연구소보 Vol.- No.6

Generally, concrete temperature is risen by hydration at mixture right after, after that falling gradually until the atmospheric temperature. For this temperature falling concrete is contracted. If contraction is restricted externally of internally tensile stress is occurred at concrete. If this tensile stress exceeds tensile strength of concrete tensile crack is occurred at concrete. The rahmen bridge among many bridge type is typical type that is occurred tensile crack at slab. In this paper, the authors investigate how temperature of a rahmen concrete bridge is changed by slab position and the number of days. The experimental results will be applied important crack control data by hydration at concrete.

제2형 당뇨병 환자에서 적극적 환자 교육이 혈당조절에 미치는 효과

이윤욱,황원선,최선정,이동훈,김도현,이은희,홍은경,노혜림,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 현재까지의 당뇨병 교육에 대한 노력은 제한되었으며, 연구 결과를 보면 식사 조절 교육과 체중 조절 프로그램을 수행한 환자들 중 적극적이고 기간이 긴 교육을 받은 경우, 성공적 결과가 나타남을 알 수 있었다. 자가관리나 체중감량 등의 당뇨병 치료의 중요한 목표는 적극적이고 긴 기간의 교육 없이는 시행되기 어렵다. 본 연구에서는 외래에서 당뇨병 환자를 대상으로 시행할 수 있는 행동 및 식사 교육 등의 적극적 교육 프로그램을 개발하여 제2형 당뇨병 환자들을 대상으로 이들에게 식사 조절 방법에 대한 목표설정과 문제에 직면하였을 때의 해결 방법 등을 교육해서 궁극적으로는 적극적 자아관리에 연결될 수 있도록 도와주는 것을 목적으로 기존의 통상적 교육과 보다 적극적인 교육이 당뇨병 환자의 혈당 조절에 어떠한 영향을 미치는지에 대해 알아보기 위해 다음과 같은 연구를 시행하였다. 방법: 본 연구는 아주대학교 병원 내분비 대사 내과를 처음으로 방문하여 치료받았던 58명의 제2형 당뇨병 환자를 대상으로 하였다. 내원 환자들을 무작위하게 추출하여 진찰권 번호 끝자리에 따라 홀수는 통상적 교육군(conventional education group, CE)과 짝수는 적극적 교육군(intensive education group, IE)으로 나누어 교육하고, 3개월후에 교육의 효과를 평가하였다. 결과: 1) 연구 대상자들의 교육 전과 후의 공복혈당, 식후2시간 혈당 및 HbA_lc 치는 IE군과 CE군 모두 각 그룹 내에서, 유의적으로 감소하였다(p<0.05). IE군에서는 공복혈당이 12.4nmol/L에서 7.7nmol/L로, 식후2시간 혈당이 20.3nmol/L에서 10.9nmol/L으로, HbA_lc치가 9.4%에서 7.0%로 모두 교육 전에 비하여, 교육 후에 감소(p<0.05)하였고, CE군도 공복혈당은 10.9nmol/L에서 9.4nmol/L로, 식후2시간 혈당은 17.1nmol/L에서 14.6nmol/L으로 HbA_lc가 8.5%에서 7.3%으로 모두 교육 후에 감소하였다(p<0.05). 또한, 교육 전에 비하여 교육 후에 공복 혈당 및 HbA_lc치가 감소하는 정도는 IE군에서의 감소가 CE군에 비해 더 현저하였다Op<0.05). 2) 식사에 대한 태도는 3부분으로 나누어 식사에 대한 규칙성, 식사 내용의 균형성, 식사에 대한 태도 등으로 나누어 각각의 점수 및 총점을 비교하였으며 교육 전에 비해 교육 후에 연구 대상자들의 식태도가 향상되었음을 알 수 있었다. 두 그룹간의 차이를 분석한 결과 식사의 균형성 항목에서와 총점에서 유의적으로 두 그룹의 차이를 보여서 IE군에 CE군에 비해 식사의 균형성 측면이 향상되었고, 전체적인 식태도가 좋아졌음을 알 수 있었다(p<0.05). 결론: 비교적 긴 기간은 아니지만 적극적 교육을 받은 당뇨병 환자들이 통상적 교육을 받은 군보다 혈당 및 HbA_lc, 식태도 점수등의 수치의 호전뿐만 아니라 당뇨병 환자의 삶에서 중요한 부분을 차지하는 식사요법 관리 부분에 있어 향상됨을 알 수 있었다. Background: To this date, efforts to develop effective methods for the education of diabetic patients have been limited. The important goal of self-management and weight control for diabetic treatment can not be attained without long and intensive period of education. This study was undertaken to assess the effectiveness of an intensive educational program, of behavior and diet control, which was carried out on subjects with type 2 diabetes, on and out-patient basis. we compared the effectiveness of an intensive education programme with that of a conventional education programme for the self-management of type 2 diabetic patients. Methods: Subjects with type 2 diabetes were randomly selected, and allocated to one of two groups. One group received a conventional education programme of self-management(the CE group), and the second group received an intensive education progammes for three months, after which the effectiveness of the programmes were evaluate. Results: 1) The levels of fasting blood sugar(FBS), postprandial 2 hour blood sugar(PP2h) and HbA1c were significantly lowered in both groups following the intervention(p<0.05). In the IE group, the FBS declined from 12.4nmol/L to 7.7nmol/L, PP2h declined from 20.3nmol/L to 10.9nmol/L, and the HbA_lc showed a similar decline from 9.4 to 7.0% after intervention(p<0.05). In the Ce group, the FBS declined from 10.9 to 9.4nmol/l, the PP2h decreased from 17.1 to 14.6nmol/l, and the HbA_lc also decreased from 8.5 to 7.3% after intervention(p<0.05). The decrease in the FBS and HbA_lc following the educational intervention was more pronounced in the IE group than the CE group(p<0.05). 2) The effectiveness of the education programmes in promoting appropriate dietary behavior in the diabetic subjects was assessed by a scoring system in three parts: a regularity score, a balance score and an attitude score. From a comparative study of the three scores, the patients attitudes were observed to be much improved in both the groups following the intervention compared to before the programmes, but the balance and total scores were significantly higher in the IE group than the CE group(p<0.05). Conclusion: We can conclude that the intensive diabetic education programme is more effective than a conventional programme, not only in improving the patients' levels of glucose, HbA_lc, and dietary score, but also the diabetic patients self-control abilities, promoting behavioral change, and prompting problem solving capabilities in respect to the everyday problems that they have to face throughout their lives(J Kor Soc Endocrinol 18:63∼72, 2003).