최씨 훅을 이용한 복강경 버찌씨 수술

김영혜 ( Young Hye Kim ),박준선 ( Jun Seon Park ),최상준 ( Sang Joon Choi ),송창훈 ( Chang Hoon Song ),한세준 ( Sei Jun Han ),정혁 ( Hyuk Jung ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.6

목적: 버찌씨 수술은 복압성 요실금 수술에 효과적인 수술로 여겨져 왔다. 요실금의 원인이 내인성 요도 괄약근의 결손소견 없이 요도의 과운동성으로 인한 경우 버찌씨 수술이 일반적으로 추천되어진다. 본 연구에서는 복강경 버찌씨 수술에서 최씨 훅의 유용성에 대해 알아보고자 하였다. 연구방법: 2000년 10월부터 2005년 3월까지 본원에서 복강경 버찌씨 수술을 시행받은 47명의 환자를 대상으로 하였다. 27명은 고전적 복강경 버찌씨 수술을 시행하였고 20명은 내골반 근막을 Cooper 인대를 부착하는데 유용한 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행하였다. 결과: 고전적 복강경 버찌씨 수술을 시행한 군과 최씨 훅을 이용한 복강경 버찌씨 수술을 시행한 군의 평균 나이, 분만력, 폐경률, BMI는 두 군간에 통계학적으로 유의한 차이를 보이지 않았다 (p>0.05). 수술 시간은 고전적 복강경 버찌씨 수술은 90.52±15.32분, 최씨 훅을 이용한 복강경 버찌씨 수술은 38.50±10.14분으로 최씨 훅을 이용한 경우 수술시간이 통계적으로 유의하게 짧았다 (p<0.05). 두 군간에 재발률 및 합병증 발생은 통계적 유의성을 보이지 않았다 (p>0.05). 결론: 본 연구에서 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행한 결과 수술 시간을 단축시킬 수 있었으며 수술 효과는 기존 방법과 동일하게 관찰되었다. 이에 최씨 훅은 복강경 버찌씨 수술에서 사용할 때 집도자의 봉합 과정을 단순화시켜 수술 시간을 단축시키므로 복강경 버찌씨 수술에 용이한 기구이다. Objective: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi`s hook in laparoscopic Burch operation. Methods: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament (Group 2). Results: The mean age of patients of Group 1 was 55.6±9.37 years of age and that of Group 2 was 56.0±5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5±15.32 minutes for Group 1 and 38.5±10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P<0.05). There was no difference in recurrence rate and complication rate between Group 1 and Group 2 (P>0.05). Conclusion: We performed laparoscopic Burch operation with the Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi`s Hook, we could shorten the operation time using the Choi`s Hook.

2007년 대한감염학회 권장 성인 예방접종 권장안

강진한,김홍빈,손장욱,이상오,정문현,정희진,최영화,최정현,최준용,최희정 대한감염학회 2008 감염과 화학요법 Vol.40 No.1

In 2007, the Korean Society of Infectious Diseases recommended an immunization schedule for adults residing in Korea. This recommendation includes four categories: standard immunization for healthy persons, supplementary immunization for persons with underlying illnesses, recommendations for health-care personnel and for international travelers. The Standard Immunization Schedule consists of universal vaccination (tetanus-diphtheria/tetanus-diphtheria-pertussis (Td/Tdap); hepatitis A vaccine for persons aged 20s; human papilloma virus vaccine for women under 26 years old; meningococcal vaccine for military recruits and college students in dormitories; influenza vaccination for persons aged 50 years or more and pregnant women; and pneumococcal vaccination for persons aged 65 years or more) and catch-up vaccination (hepatitis A vaccine for persons aged 30s; hepatitis B vaccine, varicella and MMR vaccines for persons who have uncertain specific immunities). The Supplementary Immunization Schedule recommends 4 vaccines, i.e., pneumococcal, influenza, meningococcal, and Haemophilus influenzae type b, appropriate to the underlying illnesses, and confirmation of the presence of antibodies to hepatitis A and hepatitis B. The Recommendation for Health-Care Personnel includes universal vaccination (influenza and pertussis) and catch-up vaccination (hepatitis B, measles-mumps-rubella and varicella for seronegative health-care personnel). The Recommended Immunization for International Travelers focuses reinforcement of vaccinations for healthy persons and includes certain immunizations necessary for international travel (yellow fever, meningococcal, plaque, tick-borne encephalitis, and cholera). These guidelines can be seen at www.ksid.or.kr.

텔레비젼(TV)생산업체 근로자들의 영상단말기(VDT)작업이 시력과 안증상에 미치는 영향

우극현,최광서,정영연,한구웅,박정한,이종협,Woo, Kuck-Hyeun,Choi, Gwang-Seo,Jung, Young-Yeon,Han, Gu-Wung,Park, Jung-Han,Lee, Jong-Hyeob 대한예방의학회 1992 예방의학회지 Vol.25 No.3

영상단말기 (VDT)작업이 시력과 안증상에 미치는 영향을 알아보기 위해 1991년 7월에서 10월 사이에 구미시의 1개 TV생산업체에 종사하는 근로자들 가운데 채용 당시 안과적으로 문제가 없었고, 나안시력이 1.0 이상인 40세 미만 남자 338명을 대상으로 일일 평균 화면작업시간이 4시간 미만인 근로자(I군, 60명)와 4시간 이상인 근로자(II군, 204명)를 폭로군으로 하고 유사한 작업환경에서 근무하는 비화면작업자(74명)를 비폭로군으로 나누어 연령, 작업경력, 교대근무형태, 확대경 사용유무, 1일 평균 TV시청 시간 및 수면시간과 그리고 안자각증상에 대한 설문조사를 실시한 후, 안과적검사를 시행하였다. 조사시 원거리시력 (양안의 평균시력)이 채용시에 비해 0.15 이상 저하된 비율은 II군이 20.6%로 비화면작업군의 14.9 %, I군의 15.0 % 보다 다소 높았으나 통계적으로 유의한 차는 아니었다. 연령, 작업경력, 확대경 사용유무, 교대근무형태 등에 따라 층화하여 원거리시력 저하율을 비교해 본 결과 세 군간에 통계적으로 유의한 차가 없었다. 근거리시력 저하율도 비화면작업군이 28.4 %, I군이 18.3 %, II군이 27.5 %로 통계적으로 유의한 차이가 없었으며, 연령 등 4가지 독립변수를 층화하여 비교해 보아도 유의한 차이가 없었다. 안자각증상 호소율은 안피로를 포함한 7가지 항목에서 눈물이 나는 것을 제외한 모든 항목에서 비화면작업군에 비해 I군이, I군 보다는 II군이 통계적으로 유의하게 높았다(P<0.01). 화면작업자 264명 가운데 조명이 나쁜 장소에서 일하는 근로자들의 원거리시력 저하율과 안자각증상 호소율이 조명이 좋은 작업장에서 일하는 근로자보다 더 높았다(P<0.05). 7가지 안자각증상을 각 증상 마다 늘 느끼는 경우는 2, 가끔 느끼면 1, 느끼지 않으면 0으로 점수화하여 개인별 총 안증상 점수를 구해 세 군간에 원거리시력 차이 유무별로 비교해 본 결과, 시력차 유무에 따른 평균 안자각증상 점수의 차는 없었으나 시력차 유무에 관계없이 II군의 평균 안자각증상 점수가 6.13 으로 I군(3.53) 또는 비화면작업군(3.30) 보다 훨씬 더 높았다(P<0.01). 안자각증상 점수와 유의한 상관관계를 보인 독립변수들은 화면작업시간, 확대경 사용유무, 교대근무형태 등이었고, 채용시와 조사시 원거리시력 차이, 원거리시력과 근거리시력 차이, 누액분비기능, 안압, 굴절력 등과 유의한 상관관계를 보인 독립 변수는 하나도 없었다. 안자각증상 점수를 종속변수로 하는 중선형 회귀분석 결과에서는 화면작업시간이 길수록, 단부제나 2교대 근무자보다 3교대 근무자에서 유의한 선형관계를 나타내었다(P<0.01). 본 조사에서는 1일 장시간 VDT작업으로 시력이 저하되는 것은 관찰할 수 없었고 안자각증상은 유발되는 것으로 나타났다. 안자각증상의 예방을 위해 VDT 작업장의 조명을 적절하게 유지하고 장시간 연속해서 작업하지 않도록 작업관리를 해야 할 것이다. This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day : Group I, 60 workers, lesser than 4 hours a day and group II, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0.15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group II. 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05) . The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of seven subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker(2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P<0.01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the work place and control of excessive VDT work are recommended to prevent such eye symptoms.

五加皮의 效能에 대한 硏究

최민호,이계복,조규원,박진영,김경수,송정석,한종현 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

The purpose of this study is to measure the changes of regional cerebral blood flow (rCBF) and blood pressure (BP) of Cortex Acanthopanacis in rats, and to determine the effect of Cortex Acanthopanacis on phenylephrine (PE) induced contraction of isolated rat thoracic aorts. The measurement was continually monitored by laser-doppler flowmeter (Transonic Instrument, USA) and pressure transducer (Grass, USA) in anesthetized adult Sprague-Dawley rats through the data acquisition system composed of MacLab and Macintosh computer. Contractile force was measured with force displacement transducer under 1.5 g loading tension. The result of this experiment was as following; 1. Cortex Acanthopanacis did not effect the changes of rCBF and blood pressure significantly. 2. Contractions evoked by phenylephrine were decreased significantly by Cortex Acanthopanacis 3. L-NNA, ODQ, atropine and indomethacin significantly altered the relaxation of Cortex Acanthopanacis. 4. Propranolol did not change the relaxation of Cortex Acanthopanacis. These results indicate that Cortex Acanthopanacis did not change the rCBF and BP, but Cortex Acanthopanacis can relax PE induced contraction of isolated rat thoracic aorta and that this increasing contraction related to endothelium and various mechanism.

도시주부의 정보탐색에 따른 소비자문제에 관한 연구

한정화,최덕경 안성산업대학교 1996 論文集 Vol.28 No.-

This study is mainly concerned with the consumer problems according to the quantity and the interests of the information search of the urban housewives. The samples are composed of 347 adolescent consumers filtered by the purposive sampling. In order to achieve study objects, the statistics used for data analysis are frequency distribution, percentile, t-test, analysis of variance and multiple regression analysis. The information search of the housewives showed the significant differences between the family life cycle, the age, the living style and the income. And the perceptions of the consumer problems showed the significant differences between the family life cycle, the living style, the income, the quantity of the information search and the interests of the information search. Findings of this study suggest the housewives have difficulties in finding the information search. In order to improve the economic and the social wellbeing of the urban housewives, this study suggests that the younger, the aged and the other type of consumers should have an opportunity to improve their knowledge and the information. So the consumers should have the ability to cope with their problems faced in the market place. The current government and the business policy should be reevaluated and revised for the improvement of the consumer welfare.

기존 세굴심 산정공식 적용을 위한 모형실험과의 비교 연구

최한규,백효선,정창동 江原大學校 産業技術硏究所 2004 産業技術硏究 Vol.24 No.B

The existing of developed scour Equation have a very different value by boundary condition, hydraulic condition and bed condition. Therefore it may give rise to a serious trouble if it make a wrong application of the scour Equation. So this research of purpose is the predicting of scour depths, the method is that analysis river of feature and hydrauric feature for river in kangwondo young-seo region. And hydrauric model experiment of Scour phenomenon execute after the existing of calculate scour depths equation analysis sensitivity, assort a practical.

탄소섬유보강판의 홈삽입에 따른 철근콘크리트 보의 보강효과

한상훈,최만용,조홍동,박중열,황선일 충북대학교 건설기술연구소 2002 建設技術論文集 Vol.21 No.1

This paper presents a feasibility study of an alternative strengthening method by slot-bonded CFRP plates for reinforced concrete beam. A total 14 reinforced concrete beam were constructed, tested and the response of the beams in terms of deflection, strains, failure load and failure mode were examined. Each specimen was initially loaded for 75% of ultimate load, cracked specimen were strengthened with CFRP plate and then tested until complete failure. Test variables included the strengthening method, steel ratio and strengthening length, and the effects according to each test variables are analysed. The experimental results show that proposed methods can increase the flexural strength and stiffness of the beam significantly. Also, the failure of the specimens strengthened by the proposed method are more ductile than externally bonded specimen.

고분자 특성분석에 의한 케이블 사고분석

정창수,이우선,최한수 조선대학교 에너지.자원신기술연구소 1999 에너지·자원신기술연구소 논문지 Vol.21 No.2

The characterization and AC breakdown test for identifying a cause of premature failure of 7 URD power cables which failed during service are presented in this paper. The failed cables used for more than 10 years showed that the main cause of failure was water tree growth due to the water penetration. Almost trees grown from interface between insulation shield and insulation layer. Especially, there was a close relation between water tree length and content of ionic impurities. On the other hand, the failed cable used for less than 1 year has protrusion and void at the same position. From this, it can be concluded that the main cause of premature failure was the defects from manufacturing processes. In order to prevent the premature failure of URD cable, it is needed to improve the service environment, raw materials and manufacturing process.

看護師의 精神科 諮問에 대한 見解

崔重哲,韓辰熙 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.3

The attitudes of 140 non-psychiatric nurses in a general university hospital towards psychiatric consultation were studied using a questionnaire. The results were as follows : 1)Nurses felt that 15.5% of the medical inpatients had significant psychiatric problems. but they considered that psychiatric was indicated for only 9.2%. 2) Opinions on the occasion of requestion a psychiatric consultation form the nurses view-point appeared as ‘immediately when psychiatric problem is found’(37.8%). ‘on serious problem. but try to handle minor one by myself’(38.7%). and ‘only if I can't deal with the problem’(21.8%). 3) Most common reasons or situation that would need psychiatric consultation were reported as follows : overt psychiatric symptoms(76.4%). risk of suicide or suicidal behaviors (51.4%). previous psychiatric history(31.4%). symptoms suggesting psychoses(26.4%). and diagnostic uncertainty(20.0%). 4) Only 43.7% of nurses were satisfied with currents psychiatric consultation. however their satisfaction with individual aspects of psychiatric consultation (quality of answers to questions. help in understanding the symptoms. and contribution to the patient care) appeared high (ranging from 71.1% to 79.3%). 5) 65.2% of nurses acknowledged the need of post-graduate training on the psychiatric aspects of patient care and. in addition. they want more follow-up work and open communications for practical guide from the psychiatric consultation service.

흰쥐 적출 대동맥에서의 알파-1 아드레날린성 수용체 탈감작 현상

최도희,한형수,박정숙,김중영 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.4

목적 : 흰쥐의 적출 대동맥 절편에서 알파-1 아드레날린성 수용체의 탈감작에 따른 수축력 변화를 확인하고 수축력 변화와 관련된 요인들과의 관계를 검정하기 위해 실시되었다. 대상 및 방법 : Sprague-Dawley rat의 대동맥을 적출하여 알파-1 아드레날린성 수용체 선택적 효현제인 phenylephrine으로 탈감작시킨 뒤 수축력과 이완력의 변화를 확인하였다. 결과 : Phenylephrine에 의한 수축력은 phenylephrine 탈감작에 의해 감소되었다. EDRF와 관련이 있는 이완제인 acetylcholine과 histamine에 의한 이완반응은 phenylephrine 처치로서 변화를 볼 수 없었으나 sodium nitroprusside에 의한 이완은 항진되었다. 탈감작현상은 LNMMA와 methylene blue처치로 인해 영향을 받지 아니하였다. KCl에 의한 수축은 phenylephrine 탈감작으로 억제되었으나 phorbol ester에 의한 수축은 phenylephrine 탈감작으로 인해 영향을 받지 아니하였다. 결론 : phenylephrine에 의해 나타나는 알파-1 수용체 탈감작에 따른 수축력 감소 현상은 이완 작용의 변화와는 관련이 없으며 수축기전의 변화, 특히 calcium에 대한 반응성의 변화에 기인함을 시사하였다. We evaluated alpha 1 adrenergic receptor desensitization and decreased contractility in isolated rat aorta. 4 hour exposure to 10^-5M of phenylephrine (phenylephrine exposure) decreased phenylephrine(10^-10 to 10^-5M)-induced contractility. Phenylephrine exposure had no effect on the relaxation by NO releasing agents, such as acetylcholine(10^-9 to 10^-5M) and histamine(10^-8 to 10^-4M), but enhanced nitroprusside(10^-10 to 10^-6M)-induced relaxation. Phenylephrine-induced desensitization was not altered by the presence of methylene blue and N-monomethyl-L-arginine. After phenylephrine exposure KCl-induced contractility was decreased but phorbol ester-induced contractility was not changed. From these results we can assume that prolonged phenylephrine exposure alter calcium-dependent contraction mechanism and involve in alpha 1 adrenergic receptor desensitization-mediated decrease in contractility.