공동체 텃밭의 효과 측정을 위한 항목 유형화 연구

김재연(Kim, Jae Yeon),김윤수(Kim, Yun Soo),이연숙(Lee, Yuen Sook) 한국생태환경건축학회 2013 한국생태환경건축학회 논문집 Vol.13 No.5

산전 초음파검사로 진단된 척추이분증 3예

김성(Sung Kim),이동민(Dong Min Lee),김호영(Ho Young Kim),김재연(Jae Yun Kim),최영렬(Young Ryoul Choi),유재경(Jae Kyoung Yoo),윤길중(Gil Jung Yoon),황인수(In Su Hwang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.11

The prenatal diagnosis of spine bifida include the combined use of maternal serum α-fetoprotein (MSAFP) screening and fetal sonography. Sonographically, spina bifida is characterized by direct signs of the visualization of the spinal defect, and indirect signs of the cranial markers : the lemon sign, the banana sign, and ventriculomegaly. These ultrasonographic signs are more accurate in defining the cranial malformations associated with spina bifida than evaluation of the spine. Recently, three cases of spina bifida which was diagnosed as splaying of the posterior ossification centers, meningomyelocele sac at the lumbosacral area, lemon sign, banana sign and ventriculomegaly by ultrasonography at 21+2 gestational weeks in a 32 years old nullipara, at 21+2 gestational weeks in a 26 years old nullipara, at 23+6 gestational weeks in a 26 years old multipara were experienced at our department. We present this cases with a brief review of literatures

유문부-보존 췌장십이지장 절제 환자의 TPN 사용 현황 및 평가

박윤희 ( Yun Hee Park ),김성은 ( Sung Eun Kim ),김재연 ( Jae Youn Kim ),송영천 ( Young Cheon Song ),홍석경 ( Suk Kyung Hong ) 한국정맥경장영양학회 2009 한국정맥경장영양학회지 Vol.2 No.1

Purpose: Pylorus-preserving pancreatoduodenectomy PPPD is considered the treatment of choice for various periampullary diseases. Although patients who undergo PPPD require postoperative parental nutrition, no guideline has currently been established for this specific group. The aim of this study is to evaluate the TPN given to patients after PPPD and to identify a standard protocol for these patients. Methods: We conducted a retrospective study that reviewed the patients in Asan Medical Center who had undergone PPPD and who had received TPN from January to December in 2007. TPN utilization was evaluated with assessing the supplemented calories and the duration of the TPN. The observed outcomes were the changes in the nutritional status of each patient, the morbidity, the mortality and the length of the hospital stay. Results: A total of 160 patients were enrolled in this study and of these, 118 patients were malnourished. The worse the preoperative nutritional status was for each patient, the longer the TPN was required and this was also true for the length of the hospital stay. The mean calories and protein values given through TPN were 35.15 kcal/kg and 1.39 g/kg, respectively. This was more excessive than the recommended levels (33.02 kcal/kg and 1.34g/kg, respectively) when considering each patient`s nutritional status. We classified the patients by the ratio of supplied calories to the recommended calories; the 60) group. The duration of TPN (9.5d, 10.3d and 12.6d) and the length of the postoperative hospital stay (22.0d, 23.3d and 26.4d) were not statistically different between the groups. The rate of metabolic abnormalities and infectious complications were higher in the over-calories group (71.7% and 25%, respectively) when compared to that of the other two groups (67% and 14%, respectively).Major complications such as delayed gastric emptying, fistulae and anastomotic leakage were not significantly different between the groups. Conclusion: In this study, excessive calorie supplementation had no significant benefit on the outcome of patients after PPPD. Therefore, we suggest that an adequate amount of nutrition, with giving consideration for the pre-existing nutritional status, will be advantageous for the cost-benefit aspect. (KJPEN 2009;2(1):1-5)Key Words: Total parenteral nutrition, Pylorus-preserving pancreatoduodenectomy low-calories group (<90%; n=26), the adequate calories group (90~110%; n=74) and high-calories (>110%; n= 60) group. The duration of TPN (9.5d, 10.3d and 12.6d) and the length of the postoperative hospital stay (22.0d,23.3d and 26.4d) were not statistically different between the groups. The rate of metabolic abnormalities and infectious complications were higher in0 the over-calories group (71.7% and 25%, respectively) when compared to that of the other two groups (67% and 14%, respectively).Major complications such as delayed gastric emptying, fistulae and anastomotic leakage were not significantly different between the groups. Conclusion: In this study, excessive calorie supplementation had no significant benefit on the outcome of patients after PPPD. Therefore, we suggest that an adequate amount of nutrition, with giving consideration for the pre-existing nutritional status, will be advantageous for the cost-benefit aspect. (KJPEN 2009;2(1):1-5)

두통(頭痛)을 주소(主訴) 입원한 환자 25명에 관한 임상적(臨床的) 고찰(考察)

김지윤,홍현우,김재연,이성도,박동일,감철우,Kim, Ji-Yun,Hong, Hyun-Woo,Kim, Jae-Yeon,Lee, Sung-Do,Park, Dong-Il,Gam, Chul-Woo 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.4

Objective : The purpose of this study is to investigate clinical characteristics with 25 patients who have suffered from headache and were treated. Methods : We classified 25 patients into several groups by IHS classification and evaluated the effects of oriental medical therapy on headache. Results : 1. According to the statistics, instances of migraine were more prevalent than tension headache, especially among women. 2. 28% of patient had entered for treatment within one month of onset. 3. Common associated symptoms included dizziness, nausea, dyspepsia, palpitation and insomnia. 4. In classification by the oriental medical differentiation of symptoms and signs, the rate of stagnation of the humid dam and deficiency of qi, these two types were highest. 5. 56% of patients said they were satisfied with the treatment, reporting half the frequency of headache or better from before treatment. Conclusions : The present results suggest that oriental medical therapy has effects on headache. Further clinical comparative studies on herb-medication versus acupuncture therapy for headache are urged.

동의보감(東醫寶鑑)에 따른 편(偏), 담궐(痰厥) 몇 기궐두통(氣厥頭痛) 환자의 임상적 고찰

김지윤,홍현우,김재연,김기탁,허태율,박동일,감철우,Kim, Ji-Yun,Hong, Hyun-Woo,Kim, Jae-Yeon,Kim, Ki-Tak,Heo, Tae-Yool,Park, Dong-Il,Gam, Chul-Woo 대한한방내과학회 2005 大韓韓方內科學會誌 Vol.26 No.4

Objective : The purpose of this study is to investigate clinical characteristics and remedial value oriental medical therapy for sufferers of severe headache. Methods : On the authority of DongEuiBoCam, patients were classified into three groups: migraine, qi-syncope headache and phlegm-headache. All patients wert treated with acupuncture therapy and herb medicines. After that inquiry was made into the extent of improvement of headache. Results : 1. In accordance with the statistics, 56 cases(50.5%) had phlegm-syncope headache, 28 cases(25.2%) had qi-syncope headache and 27 cases(24.3%) had migraine. 2. The ratio between males and females was about 1:4. Most patients were in their forties. 3. 12 cases(31.6%) with migraine had pain only on the right side of the head, 20 cases(26.3%) with phlegm-syncope and 17 cases(45.6%) with qi-syncope headache suffered from the frontal lobe headache. 4. 8 cases(29.6%) with migraine had been suffering for a week or less, 12 cases(21.4%) with phlegm-syncope headache had been suffering for over six months and under one year and 6 cases(21.4%) with qi-syncupe headache had suffered over one year and under five. 5. Overwork and stress was deemed the main cause of migraine. Phlegm-syncope headache was also attributed to stress and tense situations. Qi-syncope headache was believed to be variously caused by traffic accident, noise, blood pressure and other reasons. 6. 46 cases(30%) felt dull headache and 32 cases(20.9%) felt dizzy. The common associated symptoms of migraine and qi-syncope headache included back, neck and shoulder pain and other pains. Dizziness was an especially prevalent symptom of phlegm-syncope headache. 7. After the oriental medical therapy, 12 cases(10.8%) almost entirely recovered, 50 cases(45%) were in about half as much pain, 45 cases(40.5%) improved little and 4 cases(3.6%) felt no improvement. Conclusions : The results support a role for oriental medical therapy in treatment of headache.

중풍(中風) 환자(患者) 중(中) 언어장애(言語障碍)에 대한 임상적(臨床的) 고찰(考察)

신우진,서수현,홍현우,이성도,김재연,감철우,박동일,Shin, Woo-Jin,Seo, Soo-Hyun,Hong, Hyun-Woo,Lee, Sung-Do,Kim, Jae-Yun,Kam, Chul-Woo,Park, Dong-Il 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.3

This clinical study on 93 cases of Dyslogia after stroke confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Dong-Eui University from january to September 2003. The following results were found: I. The ratio between males and females was 1.6:1. Of Dyslogia p who had suffered stroke, most were in their sixties. 2. Categorized by attack site, right hemiplegia patients comprised 15 cases(l6.1%), and left hemiplegia patients, 71 cases(54.8%), so the ratio between Rt. and Lt. was 1:4.7. 3. Categorized by preceeding disease, hypertension was seen 51 cases(54.8%), and diabetes mellitus was seen 21 cases(22.6%). 4. Categorized by repeat attack, it was the first attack for 71 cases(76.3%), and the second attack for 13 cases(l4.0%), and for 9 cases(9.7%) it was the third or nth attack. 5. According to the classification of Zhang Zhongjing, apoplexy involving Bu-organs comprised 42 cases(45.2%), apoplexy involving meridians 39 cases(41.9%), apoplexy involving Jang-organs 11 cases(11.8%), and for apoplexy involving collaaterals there was one case(1.1%). 6. According to the classification of Cheng Zhongling, 43 cases(46.7%) were classed heart meridian, 25 cases(27.2%) were classed Spleen meridian, and 24 cases(26. 1%) were classed Kidney meridian. 7. According to the classification of Sun Simiao, 49 cases(52.7%) were classed Pyungo, two cases(2.2%) were classed Pungeui, ,seven cases(7.5%) were classed Pungbi( I ), and two cases(2.2%) were classed Pungbi( II ).

신장 ; 암로디핀 중독 환자의 임상양상

전영우 ( Young Woo Jeon ),김재연 ( Jae Yun Kim ),박재석 ( Jae Seok Park ),박재만 ( Jae Man Park ),길효욱 ( Hyo Wook Gil ),양종오 ( Jong Oh Yang ),이은영 ( Eun Young Lee ),홍세용 ( Sae Yong Hong ) 대한내과학회 2011 대한내과학회지 Vol.81 No.2

목적: 칼슘 통로 차단제는 흔히 사용되는 항고혈압 약제이다. 전세계적으로 사용량 증가에 따른 과량 복용에 대한 보고가 증가 하고 있지만 국내 보고는 미흡하다. 칼슘 통로 차단제 중 암로디핀은 매우 흔히 사용되는 약제이나 과량복용에 대해서는 임상의에게는 익숙하지 않다. 따라서 본 연구는 암로디핀을 과다 복용한 환자들의 임상양상, 치료 경과, 합병증 및 예후에 대해 조사하였다. 방법: 2002년 1월부터 2010년 12월까지 순천향대학교 천안병원에 약물중독으로 내원한 환자 중 암로디핀을 과량복용한 환자를 대상으로 후향적 조사를 하였다. 약물 복용량은 환자나 보호자 진술에 근거하여 체표면적당 약물 복용량(Billy`s BSA formula)으로 계산하였고, 응급실 내원 당시의 초기 생징후, 혈액 검사, 심전도 검사 등을 조사하였으며, 심전도 이상은 서맥, 방실 전도장애, QT, QRS 간격의 증가 중1개 이상의 변화가 있을 경우로 정의하였다. 결과: 총 9명의 환자(남자 2명, 여자 7명)가 포함되었고, 체표면적당 암로디핀 복용량은 197.78±128.37 mg이었으며, 모든 환자에서 다른 종류의 약물을 같이 과량 복용했다. 9명의 환자 중 2명이 사망했고, 사망한 환자의 체표면적당 약물복용량은 343.5 mg/m2와 225.6 mg/m2이었고, 생존 환자 모두에서는 200 mg/m2 이하였다. 3명의 환자에서 glimepride를 같이 과량 복용했지만, 200 mg/dL 이상의 혈당 수치를 보였고, 이중에서 1명은 고혈당이 조절되지 않아 대사성 케톤산증이 진행되어 다장기 부전으로 사망하였다. 심전도 이상을 보인 환자의 평균 체표면적당 약물 복용량은 197.1±92.3 mg/m2이었고, 심전도 이상이 없는 환자에서는 58.5±27.1 mg/m2이었다. 결론: 비교적 안전하다고 알려진 non-dihydropyridine계인 암로디핀도 과량 복용 시 고혈당과 대사성 케톤산증 및 심장 전도이상이 유발되어 치명적인 결과를 보일 수 있다. 고혈당 발생은 나쁜 예후를 시사하므로 이에 대한 주의가 필요하다. Background/Aims: Calcium channel blockers (CCBs) are anti-hypertensive medications that are used worldwide. CCB overdose has increased in proportion to the use of these drugs. Although amlodipine is the most widely used CCB, many physicians are not familiar with amlodipine overdose. We report the clinical outcome in patients with an intentional amlodipine overdose. Methods: We retrospectively reviewed the medical records of the patients who visited Soonchunhyang University Cheonan Hospital with an amlodipine overdose from January 2002 through December 2010. We recorded the initial vital signs, blood chemistry, electrocardiography, and estimated amount of amlodipine ingested. Results: Nine patients were enrolled, of whom two patients died. Both patients who died had ingested more than 200 mg/m2 of amlodipine, while all of the patients who ingested less than 200 mg/m2 of amlodipine survived. Three patients had blood sugar levels exceeding 200 mg/dL and two of these died despite high-dose insulin therapy in combination with glucose infusion (hyperinsulinemia/euglycemia therapy). Although three patients also took a glimepiride overdose, none had hypoglycemia. The amount of amlodipine ingested relative to the body surfaced area (BSA) was 197.1±92.3 mg/m2 in patients with an abnormal ECG and 58.5±27.1 mg/m2 in patients with a normal ECG. Conclusions: Amlodipine overdose can induce hyperglycemia, resulting in lethal cardiogenic shock owing to the decreased calcium influx, inappropriate energy production, and weakened inotropic effect. Therefore, amlodipine-induced hyperglycemia indicates a poor prognosis. (Korean J Med 2011;81:208-214)

분역회전이 강유전체 세라믹 액추에이터 내의 균열발생에 미치는 영향

정경문(Kyoung Moon Jeong),김재연(Jae Yun Kim),범현규(Hyeon Gyu Beom) Korean Society for Precision Engineering 2005 한국정밀공학회지 Vol.22 No.2

군용 차량의 동역학 모델링 및 4-post 시험의 시뮬레이션 검증

황연걸(Yeon-Geol Hwang),김태윤(Tae-Yun Kim),정사무엘(Samuel Jung),김재연(Jae-Yeon Kim),김상영(Sang-Young Kim),유완석(Wan-Suk Yoo) 대한기계학회 2018 대한기계학회 춘추학술대회 Vol.2018 No.12

HELLP 증후군 16례의 임상적 경험

이동민(Dong Min Lee),김성(Sung Kim),김호영(Ho Young Kim),김재연(Jae Yun Kim),최영렬(Young Ryoul Choi),유재경(Jae Kyoung Yoo),황인수(In Su Hwang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9

목적: HELLP 증후군에 합병된 고혈압성 임신에서 모성, 태아에 미치는 심각한 산과적 합병증의 영향에 대하여 알아봄에 있다. 대상: 1994년 6월부터 1998년 6월까지 본원에 입원, 치료한 임신성 고혈압 환자 302명중 HELLP 증후군에 이환된 16명의 환자를 대상으로 임상 경험(발병 시기, 전구 증상, 임상 병리 소견, 분만 방법, 태아 모성 합병증, 모성 사망의 경우)을 기술하였다. 결과: 발병 시기를 볼 때 분만전에 15례, 분만후에 1례가 발생하였는데 이중 13례가 27주에서 36주 사이에 3례가 37주 이후에 발생하였다. 모성 사망의 경우는 1례가 있었다. 전구증상에 대하여 살펴볼 때 상복부 동통은 12례, 오심, 구토는 10례, 두통 12례, 시력 감소는 5례가 있었다. 임상 병리 소견은 혈소판 평균 수치는 68700/mm3 (범위 48000-91000), 혈중 asparate aminotransterase 평균 수치 335 IU/L(범위 62-836), lactic dehydrogenase 평균 수치 910 IU/L(범위 558-5794), total bilirubin 평균 수치가 2.6 mg/dl(범위 0.7-10.4) 이었으며 모성 합병증에 대해서는 태반 조기 박리 1례, 범발성 응고 부전 2례, 폐부종 3례, 흉막 삼출 4례, 신부전 4례가 있었으며 태아 합병증에 대해서는 자궁내 발육 부전 9례, 태변 착색 3례, 사산아 2례, 신생아 사망 2례가 있었다. 분만 방법으로는 6례에서 질식 분만을 하였고 10례에서 제왕 절개 수술을 시행하였는데 이 중 3례는 계획으로 7례에서 응급제왕 절개 수술을 시행하였다. 결론: HELLP 증후군의 중요성에 대한 인식과 초기 진단을 위한 임상 병리 검사, 임상증상에 대한 주의 깊은 관찰로 모성, 태아의 이환 대한 적절한 처치가 필요하리라 사료된다. Objective: Our purpose was to describe the clinical progress and the maternal and fetal outcome in 16 pregnancies complicated by the HELLP(hemolysis, elevated liver enzymes, low platelet). Material: We reviewed the maternal and neonatal charts from 16 consecutive pregnancies complicated by the HELLP syndrome among 302 pregnancies complicated by preeclamsia and eclamsia managed at our hospital during the period of 4 years from June 1994 through June 1998. The HELLP syndrome was defined by previously published laboratory criteria. We assessed the time of onset, presenting symptom, laboratory finding, mode of delivery, fetal and maternal complication in each case. We also reviewed the clinical finding in detail in the case resulted in maternal death. Results: In regards to the time of onset, 15 cases (93.7%) occurred at antepartum period and only 1 case (6.2%) occurred at postpartum period. Among the 15 cases occurred at antepartum period, 13 cases (81.25%) developed at 27 to 36 weeks gestation and 2 cases (12.5%) developed at near term. In regards to the presenting symptom, twelve patients (75%) complained of right upper quardrant or epigastric pain. Of 16 patients, 12 patients (75%) experienced headache and 10 patients (62.5%) complained of nausea, or vomiting and 5 patients (31.2%) had visual disturbance. The laboratory finding of all 16 cases were as follow; the mean level of platelet: 68700/mm3 (range: 48000 to 91700), the mean level of serum asparate aminotransferase: 335 IU/L (range: 62 to 135), the mean level of lactic dehydrogenase: 910 IU/L (range: 558 to 5794), and the mean level of total bilirubin: 2.6 mg/dl (range: 0.7 to 10.4). To review the mode of delivery, cesarean sections were done on 10 patients (62.5%) including 7(43.7%) emergency and 3(18.7%) elective operations. However, 6 patients (37.5%) delivered vaginally. Maternal complications were as follow; abruptio placenta in 1 case (6.2%), DIC in 2 cases (12.5%), pulmonary edema in 3 cases (18.7%), pleural effusion in 4 cases (25%), renal failure in 4 cases (25%), and 1 case of death. Fetal and neonatal outcome was assessed; 9 cases of intrauterine growth retardation (56.2%), meconium stained in 3 cases (18.7%), 2 stillbirth (12.5%), and 2 neonatal death (12.5%). Conclusion: HELLP syndrome is associated with serious maternal and fetal morbidity and mortality.