Successful removement of fractured guiding catheter in femoral sheath using 0.014″ wire and PTCA balloon

강버들,조윤형,조덕규 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-

Gefitinib에 의해 유발된 방사선 회귀 피부염

강버들,임아영,김영재,황의동,김선욱,김효송 Ewha Womans University School of Medicine 2013 EMJ (Ewha medical journal) Vol.36 No.S

Radiation recall dermatitis refers to an acute inflammatory reaction in a previously irradiated field triggered by the administration of certain drugs days to years after the exposure to radiation. Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor and is an effective treatment for patients with advanced stage of non small cell lung cancer (NSCLC). Here, we report a rare case of gefitinib induced radiation recall dermatitis. A 52-year-old woman with a metastatic NSCLC had received a palliative radiation therapy of 20 cGy on spine metastasis area (C6-T6). After 24 days of receiving radiation therapy, she had started to take gefitinib. Eight months after taking drug, pain, swelling and erythema of skin were occurred on previously irradiated field. These symptoms were resolved after the cessation of gefitinib for 6 days and the topical use of steroid.

수산지원정책 변화에 따른 수산자원의 반응 평가 방법

강버들 한국수산해양교육학회 2019 水産海洋敎育硏究 Vol.31 No.4

OECD Secretariate has been developing an approach to assess the response of fish stocks to changes in fishery supporting policies, and it requested external comments on the on-going version of the approach, so called FishPEM model. This paper attempted to evaluate the basic structure of the model by: analyzing the basic theories of associated equations explaining dynamics of stock size and harvest, analyzing and evaluating the performance of the biological component of FishPEM model, and suggesting an improved alternative approach. In order to apply this FishPEM model to generic circumstance, three factors need to be considered. First, it is necessary to test the model performance and applicability using data from fisheries and species which have long-term fishing history and their available population biological parameters. Second, Using these fishing and biological data, variability(variance or standard deviation) of model parameters (K, r and q) should be estimated. Third, robust simulations on the biological component of FishPEM should be conducted to evaluate the performance using the proper approach such as estimation of parameters based on the non-equilibrium stock production model. In the long run, an ecosystem-based stock assessment and management approach, which is recently stressed by a number of international society, should be developed to assess response of fish stocks to changes in fishery supporting policies, considering not only the sustainability of the stock, but also habitat quality, biodiversity of the fish community such as species interactions, and socio-economic benefits of the fishery.

Isolated Pulmonary Arterial Hypertension-Janus’ Faces of Hyperthyroidism

강버들,조덕규,변기현,은영민,조윤형 대한심장학회 2009 Korean Circulation Journal Vol.39 No.4

We describe a 54-year-old woman with isolated pulmonary arterial hypertension accompanied by hyperthyroidism due to Graves’ disease. Her pulmonary artery hypertension resolved spontaneously after restoration of euthyroidism. This case suggests that hyperthyroidism should be considered a reversible cause of pulmonary arterial hypertension. We describe a 54-year-old woman with isolated pulmonary arterial hypertension accompanied by hyperthyroidism due to Graves’ disease. Her pulmonary artery hypertension resolved spontaneously after restoration of euthyroidism. This case suggests that hyperthyroidism should be considered a reversible cause of pulmonary arterial hypertension.

해양수산자원 교육체계 구축을 위한 지식습득 기작 연구

강버들 한국수산해양교육학회 2020 水産海洋敎育硏究 Vol.32 No.5

This study is to establish an education system for assessing and managing marine fisheries resources for achieving sustainable fisheries, which are known to be at a significantly degraded state. Typical contemporary methodologies for fish stock assessment and management were reviewed. The mechanism and process of knowledge acquisition were analyzed and restructured, based on Zhang (2019)'s knowledge acquisition approach, and a Knowledge Acquisition Model (KAM) was developed in this study. The model is composed of four levels of knowledge, that is, character estimation, state assessment, trend forecast, and confirmation, corresponding to each level of information. This model was applied to the assessment and management of marine fisheries resources using the Knowledge-Information matrix, which was developed to identify proper knowledge contents for the education system. It was found that this approach could be used to establish a customized education system objectively in other relevant areas by adjusting the structure and process of the target education area.

베르사유 궁전 부속 왕실 경당에 대한 단상 (2)

강버들 수원교회사연구소 2011 상교우서 Vol.- No.30

모가 경험하는 사춘기 자녀 양육에 대한 현상학적 연구

강버들 한국성인계속교육학회 2020 성인계속교육연구 Vol.11 No.4

우리나라의 사회·문화적 특성상 사춘기 자녀의 주양육자이자 지원자인 어머니의 역할은 매우 중요하다. 이에 본 연구의 목적은 사춘기 자녀를 둔 중년 여성을 대상으로 어머니의 사춘기 자녀 양육경험에 대한 의미와 본질적 구조를 알아보는 것이다. 이를 위해 현상학적 연구 방법 중 Giorgi의 방법을 활용하였다. 연구를 위해 B시와 G도에 거주하는 어머니 6명을 대상자로 선정하였다. 현상학적 연구를 위한 인터뷰를 실시하였으며, Giorgi의 방법을 사용하여 분석하였다. 전사한 인터뷰 내용 전체를 읽으면서 진술 내용을 의미 단위로 분석하였으며, 이를 통해 385개의 의미 단위를 도출하였다. 그리고 이를 16개의 하위 구성요소로 묶었으며, 최종 4개의 단계로 나누었다. 연구 결과, 사춘기 자녀를 둔 어머니의 양육 경험은 ‘일상’, ‘갈등’, ‘극복’, ‘도약’이라는 단계로 구성된 본질적 구조로 이루어졌다. 특히 어머니의 사춘기 자녀 양육 경험에 대한 가장 핵심적인 주제는 소통이었으며, 소통을 위한 마음 비움의 과정을 통해 어머니가 성장함으로써 사춘기 자녀와의 관계가 긍정적으로 변화됨을 발견하였다. 이상의 연구 결과를 바탕으로 볼 때, 본 연구는 사춘기 자녀를 양육하는 어머니를 위한 부모교육에 대한 방향을 제시한다. 그리고 사춘기 자녀를 둔 중년기 어머니 교육에서 중년 여성의 심리발달단계에 대한 특성과 삶의 전환에 대한 의지 과정 관련 교육이 부가되어야 함을 시사한다.

기관게실을 동반한 호산구성기관지염 1예

강버들,유승훈,민주원,박상준,정재호 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-

우리나라 남해안 죽방렴 어업의 생태계 기반 준정량적 평가

강버들,장창익 한국수산해양교육학회 2023 水産海洋敎育硏究 Vol.35 No.1

This study aimed to assess the status of the Jukbangryum fishery in the south coast of Korea. The target species of the Jukbangryum fishery was anchovy. The assessment was carried out based on the semi-quantitative approach of the ecosystem-based fisheries assessment (EBFA), which used questionnaires data. The procedure of the approach applied was the screening of questionnaires, selection of reliable indicators including IUU fishing, estimation of risk scores, and estimation of two risk indices. In the analysis ten(55.5%) of indicators fell in the desirable green zone, five(27.8%) in the yellow zone, and three(16.7%) in the undesirable red zone out of a total of 18 indicators for assessing four management objectives. The risk score for the indication of IUU fishing was estimated at 0.11. Three indicators which were in the undesirable red zone were ‘length at first capture,’ ‘employment rate’ and ‘cultural consideration’. The ORI values were estimated at 1.4, 0.2, 0.1 and 1.7 for sustainability, biodiversity, habitat quality and socio-economic status, respectively. The species risk index(SRI) was estimated to be 0.94, which was adjusted by the penalty of the IUU fishing. Management measures were suggested to change the uncertain situation of the indicators in the yellow zone to improve the status of the Jukbangryum fishery and the ecosystem, on the basis of the precautionary approach. First, the Jukbangryum fishery should be closed from April to May to protect not only fry and juvenile anchovy for avoiding growth overfishing, but also adult spawning anchovy for avoiding recruitment overfishing. Second, the regular assessment system of the Jukbangryum fishery should be established for monitoring the status of the fishery and their ecosystem.

Successful removement of fractured guiding catheter in femoral sheath using 0.014″ wire and PTCA balloon

강버들,조윤형,조덕규 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1

47세 여자 환자로 가슴통증과 운동시 호흡곤란 증세로 내원하였다. 과거력상 ESRD로 혈액투석을 하고 있으며 고혈압과 말초혈관협착증의기왕력이 있었다. 신체검진상 혈압 170/96 mmHg, 맥박수는 분당 105회였다. 심전도에서 흉부유도에서 T파의 역전이 보였으며, 심장초음파에서 좌심실구혈율은 25%로 낮아져 있었다. 대퇴동맥을 천자 후 관동맥 조영술을 시행했으며, 우관상동맥의 70%의 협착이 관찰되어 관동맥성형술의 계획하였다. 6F JR 가이딩카테터 (Heartrail, Terumo)를 조작하던 중 가이딩카테터가 유도초(sheath) 안에서 완전 절단된 것을 확인하였다. 혈관손상을 최대한 막기 위해 절단된 가이딩카테터가 유도초 안에 계속 유지된 상태에서 제거하는 것이 중요하다고 판단하였다. 0.014″ 가이드와이어 (Whisper, Abbott)를 유도초와 절단된 가이딩카테터 사이로 지나가게 한 후, 2.0×15 mm 관동맥 풍선카테터 (Ikazuchi, AMG)의 중심 부위를 유도초의 끝부위에 위치시키고 1~2기압의 낮은 압력으로 유도초 끝부위만 잘록하게 만든 후 조심스럽게 당겨보아 절단된 가이딩카테더가 같이 움직이는지 확인하고 유도초와 풍선카테터 전체를 대퇴동맥 밖으로 성공적으로 제거하는 데 성공하였다. 절단되었던 가이딩카테터의 일부를 가위로 자른 후 와이어를 이용하여 유도초를 재삽입하고 사용되었던 풍선카테터 및 0.014″ 가이드와이어를 이용하여 관동맥성형술 및 스텐트 삽입술을 성공적으로 시행하였다. 시술 후 대퇴동맥의 혈관합병증은 없었다.