시대에 따른 한국인 머리뼈의 형태 변화

민유선,신동훈,오창석,황영일 대한체질인류학회 2012 대한체질인류학회 학술대회 연제 초록 Vol.55 No.-

일반연제 발표 : DNA로 진단이 가능한 유전질환의 분석

민유선,이숙환,전혜선,이미화,곽인평,신명철,윤태기,이위현,이정로,차광열 대한산부인과학회 1999 대한산부인과학회 학술대회 Vol.83 No.-

손목과 손의 정상 초음파 소견

민유선 대한임상통증학회 2022 Clinical Pain Vol.21 No.1

Tendon disorders commonly cause wrist and hand disability and curtail the performance of work-related tasks. Sonography allows for cost-effective, noninvasive, and dynamic evaluation of soft tissue structures, thus representing a valuable tool for ruling out musculoskeletal disorders of the wrist and hand. Because of the complexity of the wrist joint, sonographic training and familiarity with normal and variant anatomy are needed to avoid misdiagnosis and improper treatment. The purpose of this article is to demonstrate the structures representing normal findings during sonographic evaluations of the wrist and hand. The main reviews the gross anatomy and procedures that are recommended to assess the soft tissue structures of the wrist and hand, with particular emphasis given to tendons, nerves, and ligaments. In conclusion, sonography is effective in assessing the tendons of the hand and wrist and related disorders and represents a valuable tool for diagnosis.

포스터 10 : Phlebotomy를 위한 정맥천자 시행 시 lidocaine 연고 도포군과 placebo 연고 도포군간 통증완화 비교 분석

민유선,임재명,권석운 대한임상병리사협회 2013 임상수혈검사학회 발표자료집 Vol.2013 No.-

배경(Background): 치료적 사혈요법(phlebotomy)은 환자의 전혈 또는 적혈구성분을 일정량채혈하여 제거하는 시술이며 주로 진성적혈구증가증(polycythemia vera) 및 혈색소침착증(hemochromatosis) 등의 질환을 치료하기 위해서 이용된다. 전혈 또는 적혈구를 16-18게이지(gauge)의 굵은 주사침으로 팔오금 부위의 정맥에 천자하여 환자의 체외로 제거하여야 하므로 환자들에게는 고통스러운 침습적인 처치 중 하나이다. 따라서 환자들의 고통스러운 치료과정의 신체적, 정신적인 영향을 최소화하고 통증을 관리하여 통증으로 인해 발생할 수 있는 채혈부작용과 심리적인 부담을 최소화하기 위해서 정맥천자 시 통증을 완화시키는 방법의모색이 필요하다. 방법(Methods): 2013년 5월 2일부터 9월 30일까지 치료적 사혈요법 시술을 받은 환자들중에서 본 연구의 목적을 이해하고 참여에 동의했던 40명의 환자를 대상으로 하였다. 치료적사혈요법 시행 시 40명의 대상자 중 무작위로 선정하여 20명의 연구 대상자에게는 2%lidocaine 연고를, 다른 20명의 연구 대상자에게는 placebo 연고를 천자할 부위에 도포하고, 30분 경과 후 알코올과 베타딘으로 소독한 다음 16게이지 철바늘(steel needle)로 천자하였으며, 천자 후 통증 정도를 VAS(visual analog scales)를 이용하여 측정하였다. 통계분석은 SPSSversion 21을 이용하여 paired-t test로 검정하였고 P-value가 0.05미만인 경우 유의한 차이가 있는 것으로 판정하였다. 결과(Results): 치료적 사혈요법 정맥천자를 시행 할 때 2% lidocaine 연고 피부도포군과 placebo 연고 도포군 모두에서 중재 전보다 중재 후가 유의하게 통증이 감소하였다(2%lidocaine 연고 도포군 p<0.002, placebo 연고 도포군 p<0.016). Placebo 연고 중재 후에도 유의하게 통증이 감소된 것으로 나타났다 (p<0.016). 2% lidocaine 연고 피부도포군이placebo 연고 피부도포군보다 치료적 사혈요법 정맥천자 시행 시 유의하게 통증이 감소되지않았다(p<0.186). 고찰(Discussion): 정맥천자시에 2% lidocaine 연고 피부도포와 placebo 연고 피부도포 모두에서 통증에 유의한 감소가 있는 것으로 나타남으로써 간호사의 통증이 감소한다는 설명만으로도 통증감소에 효과가 있는 것으로 생각되며, 본 연구와 선행연구를 근거로 하여 placebo연고를 도포했을 때 정맥천자 시에 확실히 통증과 불안이 감소하는 지에 대해 검정할 필요가 있다. 또한 정맥천자 시에 간호사들의 적절한 통증 중재가 환자들의 불안감소에 중요하다.

하지불안증후군의 진단과 치료

민유선 대한뇌신경재활학회 2016 뇌신경재활 Vol.9 No.1

Restless legs syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations. It most commonly affects the legs. Moving the affected body part, such as walking or stretching provide relief the urge to move the legs and any accompanying unpleasant sensation partially or totally. RLS is relatively common, affecting 5 to 15 % of the general population, with prevalence rates increasing alongside age. Restless legs syndrome can lead to sleep-onset or sleep-maintenance insomnia, and occasionally excessive daytime sleepiness, all leading to significant morbidity. Dopaminergic systems are known to be strongly related with RLS that are closely linked to CNS iron homeostasis. Besides defective dopaminergic system that is closely related with iron metabolism, genetic factors play a role in early-onset individual with a positive family history. The diagnosis can be made based on the symptom characteristics, differential diagnosis is important because many conditions could mimic RLS symptoms. Dopamine agonists (DAs) have been considered the first-line therapy, but with the growing appreciation of problems associated with long-term treatment, particularly augmentation and impulse control disorder, alpha-2-delta drugs, such as gabapentin, are now considered the first line of treatment in patients with troublesome RLS. In more severe cases, a combination therapy may be required.

난소의 이행성 상피세포암

민유선,김종오,이재관,장기훈,김혜중,이규완 대한산부인과학회 1996 대한산부인과학회 학술대회 Vol.77 No.-

자궁경부 편평상피암의 피부전이 4예 증례보고

민유선,이상희,이용호,이규완 대한산부인과학회 1995 대한산부인과학회 학술대회 Vol.76 No.-

Change of Brain Functional Connectivity in Patients With Spinal Cord Injury: Graph Theory Based Approach

민유선,장용민,박장우,이종민,차정호,양진주,김철현,황종문,유지나,정태두 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.3

Objective To investigate the global functional reorganization of the brain following spinal cord injury with graph theory based approach by creating whole brain functional connectivity networks from resting state-functional magnetic resonance imaging (rs-fMRI), characterizing the reorganization of these networks using graph theoretical metrics and to compare these metrics between patients with spinal cord injury (SCI) and age-matched controls.Methods Twenty patients with incomplete cervical SCI (14 males, 6 females; age, 55±14.1 years) and 20 healthy subjects (10 males, 10 females; age, 52.9±13.6 years) participated in this study. To analyze the characteristics of the whole brain network constructed with functional connectivity using rs-fMRI, graph theoretical measures were calculated including clustering coefficient, characteristic path length, global efficiency and small-worldness. Results Clustering coefficient, global efficiency and small-worldness did not show any difference between controls and SCIs in all density ranges. The normalized characteristic path length to random network was higher in SCI patients than in controls and reached statistical significance at 12%–13% of density (p<0.05, uncorrected).Conclusion The graph theoretical approach in brain functional connectivity might be helpful to reveal the information processing after SCI. These findings imply that patients with SCI can build on preserved competent brain control. Further analyses, such as topological rearrangement and hub region identification, will be needed for better understanding of neuroplasticity in patients with SCI.

호흡보조기를 사용하는 근위축성측삭경화증 환자 간병인의 삶의 질 및 간병 부담

민유선,김정윤,김명수,김정순,김현리,신형익 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.4

Objective: To describe the quality of life (QOL) and care burden of caregivers of ventilator-dependent amyotrophic lateral sclerosis (ALS) patients and to compare the QOL of ALS caregivers with that of dementia caregivers. Method: Ninety-one pairs of ALS patients and their caregivers were interviewed. Patients were asked to provide their age, sex, time since diagnosis, and length of ventilator use, as well as complete the ALS functional rating scale- revised (ALSFRS-R). Caregivers were asked to provide baseline demographic data including age, sex, education level, marital status, link with the patient, occupation, care time, substitute caregiver, and personal caregiver. The short form- 36 (SF-36) and burden interview (BI) were also administered to evaluate caregivers’ QOL and care burden. T-tests, ANOVA, and Pearson correlation coefficients were used for data analysis. Results: Ninety-one pairs of patients (men 69.2%, women 30.8%) and caregivers (men 24.2%, women 73.6%) completed the study. The mean SF-36 physical component summary (PCS), mental component summary (MCS), and total scores of caregivers were 131.5±13.2, 114.3±17.6, 245.8±28.2, respectively, which showed that the QOL of ventilator-dependent ALS patients was decreased. The BI score was 52.8±17.8, which meant that caregivers were heavily burdened. The SF-36 total and MCS were correlated with the BI. Care time was an important factor that influenced QOL and care burden. QOL was significantly lower for ventilator-dependent ALS caregivers than for dementia caregivers. Conclusion: This survey revealed the poor QOL and heavy burden of ventilator-dependent ALS caregivers, which necessitates social interventions including strategies about care time. (J Korean Acad Rehab Med 2010; 34: 442-450) Objective: To describe the quality of life (QOL) and care burden of caregivers of ventilator-dependent amyotrophic lateral sclerosis (ALS) patients and to compare the QOL of ALS caregivers with that of dementia caregivers. Method: Ninety-one pairs of ALS patients and their caregivers were interviewed. Patients were asked to provide their age, sex, time since diagnosis, and length of ventilator use, as well as complete the ALS functional rating scale- revised (ALSFRS-R). Caregivers were asked to provide baseline demographic data including age, sex, education level, marital status, link with the patient, occupation, care time, substitute caregiver, and personal caregiver. The short form- 36 (SF-36) and burden interview (BI) were also administered to evaluate caregivers’ QOL and care burden. T-tests, ANOVA, and Pearson correlation coefficients were used for data analysis. Results: Ninety-one pairs of patients (men 69.2%, women 30.8%) and caregivers (men 24.2%, women 73.6%) completed the study. The mean SF-36 physical component summary (PCS), mental component summary (MCS), and total scores of caregivers were 131.5±13.2, 114.3±17.6, 245.8±28.2, respectively, which showed that the QOL of ventilator-dependent ALS patients was decreased. The BI score was 52.8±17.8, which meant that caregivers were heavily burdened. The SF-36 total and MCS were correlated with the BI. Care time was an important factor that influenced QOL and care burden. QOL was significantly lower for ventilator-dependent ALS caregivers than for dementia caregivers. Conclusion: This survey revealed the poor QOL and heavy burden of ventilator-dependent ALS caregivers, which necessitates social interventions including strategies about care time. (J Korean Acad Rehab Med 2010; 34: 442-450)

치료적 혈장성분채집술과 관련된 부작용 분석

민유선,권석운,최원호,김복자,조광자,김성수 대한수혈학회 2011 大韓輸血學會誌 Vol.22 No.2

Background: Although therapeutic plasmapheresis (TP) is a useful procedure in removing pathogenic antibodies and toxic substances from the patient, adverse reactions could arise from the use of replacement fluids and anticoagulants. Comprehensive analysis on those adverse effects had been rarely reported in Korea. Methods: We retrospectively investigated the clinical records and the TP records from 3,962 TP sessions for 581 patients between January 1995 and October 2008 at Asan Medical Center, and we analyzed the adverse reactions related to TP. Results: Adverse reactions were seen in 142 patients (24.4%) in 348 TP procedures (8.8%). Citrate toxicity was most frequently seen in 83 procedures (23.9%) followed by chills in 72 procedures (20.7%), allergic reactions in 69 procedures (19.8%) and hypotension in 60 procedures (17.2%). Citrate toxicity, chills and allergic reactions were seen more frequently in the TP procedures using FFP than in the TP procedures using albumin (P=0.001). The prevalence of citrate toxicity was significantly lower in the cases where calcium gluconate was administered (P<0.001), while it was significantly higher in the patients whose hematocrit was below 28.5%(P<0.001). In terms of severity, the mild, moderate and severe adverse reactions were 36.8%, 56.3% and 6.9%,respectively. Conclusion: TP is a relatively safe method of treatment, but it is important to predict and prevent adverse reactions and to respond appropriately to these adverse reactions.