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확산텐서자기공명영상(Diffusion Tensor MRI)을 이용한 시상부 및 피각부출혈에서 운동신경로 손상의 진단 및 운동마비 회복정도와 상관관계
신철식,김성호,장성호,변우목,장철훈,김오룡 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.35 No.6
Objective : The purpose of this study is to prove and quantify motor tract disruption and to correlate with motor weakness and its recovery in thalamic and putaminal hemorrhage using diffusion tensor magnetic resonance(MR) image. Methods : We studied 24 patients with thalamic and putaminal hemorrhage with motor weakness who did not underwent surgery(hematoma volume < 25ml). We performed diffusion tensor MR image within a week, and then calculated FA(fractional anisotropy) index and FA ratio of posterior limb of internal capsule. We checked motor power of the patients at initial, 2 weeks, 1 month, 3 months and 6 months after hemorrhage. We divided patients into three groups according to FA ratio(group A : FA ratio < 50.0%, group B : FA ratio 50.0~75.0%, group C : FA ratio > 75.0%)and compared means of motor power at each time. Results : The means of FA ratio were 42.5% in group A, 63.0% in group B and 88.2% in group C. The means of motor power were 1.1, 2.3 and 3.7 at initial. After 6 months the means of motor power were 3.0, 4.0 and 4.5. The group of lower FA ratio had more severe motor weakness and showed worse motor recovery clinically than the group of higher FA ratio(P < 0.01). Though patients had severe motor weakness initially, the patients with high FA ratio showed good recovery. Conclusion : In thalamic and putaminal hemorrhage, diffusion tensor MR image can prove the degree of motor tract damage and predict the degree of motor recovery.
신철식,임영재,김영준,고석신,김문식,Shin, Cheol-Shick,Im, Young-Jae,Kim, Young-Jun,Koh, Seok-Shin,Kim, Moon-Shik 대한결핵및호흡기학회 1992 Tuberculosis and Respiratory Diseases Vol.39 No.2
PTA, CS, PAS, SM (KM 또는 TUM) 4제 요법의 임상효과를 알고자 지난 5년동안 국립 공주 병원에 입원하였던 도말양성 환자중 추적 가능한 112명을 대상으로 한 조사에서 다음과 같은 결과를 얻었다. 균 도말검사상 64%가 음전을 나타내었고 그 시기는 85%가 3개월 이내에 이루어졌다. 방사선 소견은 반응이 없는 경우가 약 반 정도이었으며, 세균학적 검사를 함께 고려하여 판단할 때 62% 정도만이 양호한 결과를 나타내었다. 양호한 결과는 병력이 짧고 내성정도가 적을수록 좋았다. 그리고 병력이 오래된 환자의 재치료 처방은 적어도 3제 이상의 감수성을 가진 약제를 선택해야 되며, 두가지 이하의 감수성이 있는 경우는 INH 단독 요법등의 고려가 필요할 것으로 사료된다. Background:In the management of patients whose primary chemotherapy has failed, very careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow-up of 112 smear positive cases, who were treated by four-drug regimen between July 1985 and June 1990. Four drugs were, namely prothionamide, cycloserine, para-aminosalicylic acid, and streptomycin (kanamycin or tuber-actinomycin). The duration of follow-up was over one year. Results: 1) Out of 112 cases with positive sputum AFB smear, 72 (64%) achieved the negative conversion. 2) Among the 72 patients, 85% achieved negative conversion within 3 months after treatment. 3) When the duration of patient's illness was less than 2 years, 2 to 4 years and more than 5 years, the favourable response to retreatment was 86%, 62% and 54%, respectively. 4) When the number of sensitive drugs was 4,3,2 and 1, the favourable response rate was 74%, 68%, 39% and 0%, respectively. Conclusion: The shorter the duration of patient's illness was, the larger the number of sensitive drugs was. And the larger the number of sensitive drugs was, the better the result of treatment was. Thus it is very crucial to successfully treat newly discovered patients with adequate regimens and proper case-holding.
尹能基,廓護淳,李性寬,申哲植 啓明大學校 醫科大學 1984 계명의대학술지 Vol.3 No.2
都市周邊住民들의 日常生活은 環境衛生施設에 未備狀態에 따라 經濟的으로 貧困한 사람들은 保健行態에 있어서 一般住民에 比하여 非衛生的이고 日常習性에 있어서도 吸煙 및 飮酒率이 一般人보다 高率인 同時에 過多吸煙 過多飮傾向이었다. 이는 健康에 지장을 줄 뿐만 아니라 이는 家計에다 영향을 끼쳐 貧困과 疾病의 惡循環을 되풀이 하고 있다. 子女生産率에서도 姙娠數에 있어서 貧困層은 一般人에 比하여 많았고 現想子女數 亦是 많음을 알 수 있었다. 慢性病有病率은 全體로서 22.5%였고 이중 神經痛이 가장 많았고 다음이 胃腸病, 高血壓, 心臟病 및 肝臟病의 順이었다. 20歲以上者의 慢性病有病率은 貧困者는 81%로 一般人에 比하여 約 2倍나 높았다. 疾病時에 醫療機關利用狀況은 醫療保護對象者는 受診機關이 保健所로 指定되어 있으나 保健所利用은 41%에 지나지 않고 藥局利用이 26%, 其他醫療機關利用이 28%였다. 醫療保險對象者는 처음부터 綜合病院 및 專門醫 利用이 63%의 高率이고 自費患者는 漢醫利用이 30%의 高率로서 醫療機關利用에 있어서 不合理性을 確認하였다. Most of residents in suburban area consist of the people who came from rural area to get a job recklessly. They have high prevalence of disease because of unhygienic environmental condition and poor economic situation. The data were analysed by the type of medical care services i.e. medical aid, their own expenses and medical insurance. Medical aid group showed unhygienic behavior in daily life and habit; the rates of smoking and drinking were higher than those of them own expenses group and medical insurance group. Fertility rate and ideal number of children were higher in medical aid group compared to those of other two groups. Prevalence rate of chronic disease in persons over 20 years of age was as high as twice that of other two groups. Classifying the first contact of medical facilities by the type of medical care services, medical aid group used primarily health center by 41%, drug store by 20% and other medical facilities by 28%, medical insurance group used primarily general hospital and sol practice of specialist by 63%. general practitioner by 21%, Their own expense group used primarily general hospital und sol practice of specialist by 42%, herb medicine by 30%.