허혈 유사 조건이 심방근의 활동전위 특성에 미치는 영향

김재하,주정민,조용범,신동호,안병희,주신배,김상형 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.11

허혈성 심질환에 있어서 아데노신 급속 정맥투여후 관동맥압의 변화에 관한 연구

봉종대,오종용,배성한,신원용,김철현,이광희,최태명,현민수,김성구,권영주 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Background: Adenosine interacts with A1 receptors present on the extracellular surface of cardiac cells, activating K+channels in a fashion. It produces coronary vasodilatation and AV nodal block. The half-time is one to six second and has ultra-short action. In ischemic heart disease, fractional flow reserve(FFR) can be achieved safely with intravenous adenosine infusions at a rate of 150㎍/kg/min which cause maximal coronary hyperemia. Purpose: We investigated the patients who have had ischemic heart disease(n=8). After adenosine intravenous administration(150㎍/kg/min), the effect cause maximal hyperemia of coronary artery. During peak maximal hyperemia, we reported clinical findings, coronary hemodynamics and electrocardiogram findings. Methods: After diagnostic coronary angiography and left ventriculography, catheter was advanced into the ostium of coronary artery. We investigated coronary hemodynamics such as systolic coronary artery pressure, diastolic coronary artery pressure, mean coronary artery pressure and heart rate. To assess the use of adenosine for determination of fractional flow reserve, hemodynamics and electrocardiogram were measured at basal state and during peak maximal hyperemia. Results: Symptoms developed 1.5-2 minute after adenosine intravenous administration and each symptom disappeared 2-2.5 minute after adenosine administration. Two patients represented asymptomatic appearance and six patients complained of flushing, chest pain, palpitation and headache. In eight patients with ischemic heart disease, 1.5 minute after venous administration of 150㎍/kg/min of adenosine, coronary artery pressure decreased and heart rate increased significantly. Conduction abnormalities after administration of 150㎍/kg/min of adenosine were transient 2nd degree AV block 2 cases(25%). Conclusions: Adenosine is a potent ultra short-acting vasodilator. Although coronary artery pressure decreased and heart rate increased and mild cardiovascular symptoms occurred after continuous infusion of 150㎍/kg/min of adenosine, it is useful as an agent for determination of fractional flow reserve.

지속성 외래 복막투석 환자의 복막염

신영태,황평주,김종학,강민규,구영선,양종오,장윤경,이강욱 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

CAPD has established itself as an effective method maintaining the patients with end stage renal disease. CAPD peritonitis is one of the most important complication of peritoneal dialysis. We analyzed the incidence, pathogens, and outcome of the peritonitis, of the 95 patients who underwent CAPD at CNUH from January 1993 to July 1998. The result were as follows : 1) A total of 72 episodes of peritonitis occurred during this periods. The incidence of peritonitis were 0.64/patient/year. 2) The first episode of peritonitis was occurred within a year in 75%, within two year in 95.8%. 3) The rate of positive and negative culture were 27.8% and 72.2% respectively. Gram positive organisms were cultured in 60%, Gram negative organisms in 40%. S. aureus were most prevalent organisms(30%). 4) The cure rate were 83.3% in Gram positive organisms and 62.5% in negative organisms. 5) Peritoneal catheter were removed in 18 cases. Among them, 7 cases are due to peritonitis. In conclusion, improved technology and increasing patients' effort to careful management of catheter will reduce the incidence of peritonitis.

Scintigraphy를 이용한 척수 손상 환자와 정상인의 담즙 배설양상 비교

신용일,양충용,주민철,위훈,정환정,김창근,길은영 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.1

급성 심근경색 초기에 도플러 심초음파를 이용한 좌심실 이완기 기능의 평가

신원용,김주성,김철현,이광희,최태명,현민수,김성구,권영주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background : Congestive heart failure after acute myocardial infarction relate to left ventricular systolic sysfunction. Also, left ventricular diastolic function contribute to heart failure. The aims of this study were, firstly to characterize left ventricular diastolic function by transmitral flow velocity, and secondly to study the significance of Doppler measurements in relation to the development of heart failure in the early phase of myocardial infarction. Method : Pulsed Doppler echocardiography of transmitral flow was assessed in 34 patients with acute myocardial infarction. According to the Doppler transmitral flwo velocity profile, the study patients were assigned to the three groups: normal filling pattern (DT > 140ms, IVRT < 100ms), relaxation abnormality (DT > 140ms, IVRT ≥ 100ms), pseudonormal or restrictive pattern (DT ≤ 140ms). Also, on the basis of the presence of heart failure during first week of hospitalization, the patients were divided into two groups: patients with no sign of heart failure (Killip class Ⅰ) and heart failure (Killip class Ⅱ-Ⅳ). Results : Of the 34 patients studied, 10(29%) were normal filling pattern, 17(50%) abnormal relaxation and 7(21%) were restrictive patterns. The left ventricular ejection fraction(EF, 40 ±6%) of restrictive pattern was significantly lower than that of normal filling pattern of abnormal relaxation(p < 0.01). And, the IVRT, DT, E/A and left ventricular EF were reduced in patients with heart failure(14 patients) compared to no sign of heart failure(20 patients)(p<0.05). Of the patients with heart failure, IVRT and left ventricular EF were reduced in patients with DT≤140 ms compared to DT> 140ms(p=0.001). Conclusion : Left ventricular diastolic dysfunction is present early after onset of symptoms of acute myocardial infarction. Assessment of left ventricular diastolic function complements measurements of systolic function in the evaluation of cardiac function. DT, IVRT, E/A and left ventricular EF are useful predictors for development of congestive heart failure following acute myocardial infarction.

철근콘크리트 프레임면내 조적벽체의 내진성능 개선 기술 개발

申鍾學,河基柱,崔民權 慶一大學校 2002 論文集 Vol.18 No.-

Experimental programs were accomplished to improve and evaluate the structural performance of test specimens, such as the hysteretic behavior, the maximum horizontal strength, crack propagation, and ductility etc. Test variables are restraining factors of frame, with or without masonry infilled wall, and masonry method. Six reinforced concrete rigid frame and masonry infilled wall were tesed and constructed in one-third scale size under vertical and cyclic loads simultaneously. For masonry infilled wall with restraining factors of frame, maximum horizontal capacities were increased by 1.26∼2.24 times in comparision with that of rigid frame. For masonry infilled wall with restraining factors of frame(IFWB-1), cumulated energy dissipation capacities wear increased by 1.60 times in comparision with that of masonry infilled wall(IFB-1) at final stage of testing.

뇌졸중후 연하곤란 환자의 식이 상태 비교

신용일,양충용,김헌수,강문규,주민철,길은영,권영미 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.2

멘토링의 도입 및 성공 사례에 관한 연구

신용주,김민선 생활과학연구소 2005 생활과학연구 Vol.10 No.-

The concept of mentoring has been known as an effective way of fostering individual growth of younger persons by helping, guiding, supporting and leading them. Mentoring was introduced and adopted recently to diverse organizational contexts in Korea mainly to secure the competent workforce and to encourage career development of new workers. Unlike previous research focused on theory building, this study attempts to provide more practical information on mentoring by illustrating cases of mentoring in the organizations. This paper delineates the major characteristics and functions of mentoring and describes the current status of mentoring systems in the firms and universities. It also presents the domestic and foreign cases of successful mentoring programs and compares the factors that made them successful.

정신분열병 환자의 주관적 증상과 객관적 정신병리와의 관련성

주연호,김용식,정성훈,신민섭,이창인 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 주관적 증상평가도구인 K-FBF(Kyung Hee-Frankfurter Beschwerde-Fragebogen)가 정신분열병 환자의 어떤 증상 영역을 반영하는지, 특히 정신분열병의 병태생리와 밀접한 관련을 가지며 객관적 평가도구로는 파악이 어려운 음성 증상 또는 인지 장애의 측면들을 반영하는지 조사하고자, 정신분열병 환자의 K-FBF 결과를 객관적 정신병리 평가도구인 PANSS(Positive and Negative Syndrome Scale for Schizophrenia), 대표적인 자기보고식 다차원 증상목록(multidimensional self-report symptom inventory)인 간이정신진단검사(SCL-90-R)의 평가 결과와 비교 분석하였다. 방 법 : 고졸이상의 학력으로 DSM-IV진단기준에 의한 정신분열병 환자 중 급성기가 경과한 66명을 대사으로 연구를 수행하였다. K-FBF, SCL-90-R을 시행한 날, 두 명의 정신과 의사가 PANSS를 수행하였다. K-FBF의 질문항목에 대한 반응양상을 조사하고, 10개 소척도에 대하여 요인분석을 시행하였다. K-FBF와 연령, 성별, 병식과의 상관관계를 조사하였다. 또한, K-FBF, PANSS, SCL-90-R제반 척도간에 상관관계 분석을 시행하였다. 결 과 : K-FBF는 높은 연령일수록 호소하는 항목의 수나 그 정도가 감소하였으며, 유병기간을 조절변수로 삼았을 때도 동일한 결과를 보였다. K-FBF의 소척도를 요인분석하여 두개의 합산척도를 추출, 각각 자각된 고통(RD, Recognized Distress)과 지각왜곡(PA, Perceptual Alteration)으로 명명하였다. 위의 합산척도와 PANSS의 상관관계에서, K-FBF 표준화 총점을 조절변수로 하여 편상관을 조사한 결과 PA척도와 PANSS 음성척도가 상관관계를 보였다. 이는 Huber의 기본증상이란 정신분열병의 음성증상을 주관적 측면에서 접근한 것이라는 평가와 관련된다. 한편, K-FBF표준화 총점과 SCL-90-R총점은 강한 상관관계를 나타낸 반면, SCL-90-R총점과 PANSS총점은 비록 통계적으로는 유의하지만 매우 미미한 상관관계만을 보였다. 따라서 평가척도의 상관성은 그 내용보다는 평가하는 주체에 더 큰 영향을 받는다고 판단되었다. 결 론 : 본 연구결과 K-FBF로 측정된 Huber의 기본증상은 정신분열병의 음성증상을 보다 더 반영하는 것으로 평가되었으며, 또 객관적 평가도구인 PANSS보다는 자기보고형 도구인 SCL-90-R과 더 높은 상관관계를 보인 것으로 나타났다. 그러나, 본 연구결과의 일반화를 위해서는 다른 질병단계, 다른 인구학적 변인을 가진 환자들을 대상으로 한 연구가 계속되어야 할 것이다. Objectives : Kyung Hee-Frankfurter Beschwerde-Fragebogen(K-FBF) is a representative subjective symptom measuring tool of schizophrenic patients. We performed psychopathology measurements using K-FBF, Positive and Negative Syndrome Scale(PANSS) and Symptom Checklist-90-Revised(SCL-90-R) in patients with schizophrenia and then compared the results of these three examinations one another, in order to examine which psychopathologic aspects K-FBF might reflect and to measure the possibility whether this instrument reflect the negative symptoms or cognitive impairments, which are difficult to measure by conventional objective instruments measuring psychopathology. Methods : All 66 patients satisfying DSM-IV criteria for schizophrenia, were approached. Their education level was more than high school and they were not in the acute stage of schizophrenia. They performed K-FBF and SCL-90-R, and at the same day, they were interviewed by one of both psychiatrists using PANSS. We examined the patterns of K-FBF response and performed facor analysis about 10 subscales. We examined the correlation between K-FBF and age, sex and insight. Also, we performed correlation analysis among the K-FBF, PANSS and SCL-90-R. Results : As for K-FBF, with increasing age, the number of positive response items and the symptom severity were decreased. Even when controlling prevalence period as control variable, the correlation remained unchanged. Performing factor analysis to the K-FBF subscales, we created 2 factors, ie summation subscales. We named those recognized distress(RD) and perceptual alteration(PA) each. Using K-FBF standardized total scores as controlling variable, we performed partial correlation between PA and PANSS negative symptom scale. The result was PA and PANSS have statistically significant correlation. This correspons with the view that Huber's basic symptoms are reflecting subjective approach of negative symptoms of schizophrenia. While K-FBF standardized total scores and PANSS total scores had statistically strong correlations, SCL-90-R total scores and PANSS total scores had statistically significant, but very mild correlations. So, we had the judgement that the correlations among the psychopathology measurement tools are more influenced by the rater than the contents of tools. Conclusion : We concluded that Huber's basic symptoms, measured by K-FBF, reflect more negative symptoms of schizophrenia than other symptoms. And K-FBF has more correlation with the PANSS, objective psychopathology. Measuring tool, than the SCL-90-R, self-report quetionnaire. But, more studies using patients with another disease stages and another demographic variables are needed in order to generalize the results of this study.

전신성 홍반성 낭창의 임상적 고찰

신영태,김종학,장윤경,양종오,구영선,강민규,황평주,나기량,이강욱,서광선 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The epidemiology, diagnostic criteria, clinical features, symptoms and signs laboratory findings, kidney pathology, and clinicopathologic correlation of systemic lupus erythematosus(SLE) were analyzed. The 63 patients studied were managed at the Department of Internal medicine, CNUH, from January 1983 to December 1997. Kidney biopsy was performed in 53 patients out of 63 patients with SLE. The results were as follows: 1. The ratio of male to female was 1:26. They were 12 to 71 years old and mean age was 32.1 years old. The peak age incidence was 4th decades(30%). 2. The most frequent chief complaint on admission was generalized edema. Most patients complain two or more symptoms. 3. Immunologic and renal disorders were the most frequently observed in the ARA criteria of SLE. And the positive ANA, hematologic disorder, malar rash, and arthritis, were observed in order of frequency. 4. Among the 53 patients with renal biopsy, 30 patients revealed class Ⅳ lupus nephritis(56%), class II in 12 patients(23%), class V in 8 patients(15%) and class III in 2 patients(6%). 5. The cases of lupus nephritis represented as nephrotic syndrome were high in the class IV with 68% and class V with 86%. 6. Of 30 patients who can be followed up, 5 patients resulted in death(17 % of mortality). They "were 14 to 57 years old and mean age was 28 years old. Follow up duration were from 1 month to 6 years and 3 months, and mean duration was 1 year and 1 month, but 3 cases 7. The causes of death were as follows: Two cases were due to seizure and coma resulted from CNS involvement. One was sepsis due to miliary the & pneumonia. One was dilated cardiomyopathy and heart failure due to cardiac ac involvement. And the other one was sepsis and acute renal failure resulted from cellulitis. 8. Prednisolone was used in all patients basically, and methyl-prednisolone pulse therapy, antimalarials and alkylating agents were used in some cases. In the cases of combined therapy, the activity of SLE was well controlled.