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이제경 ( Je Kyung Lee ),정성수 ( Sung Soo Jung ),유태석 ( Tae Seok Yoo ),장대국 ( Dae Kook Chang ),심승철 ( Seung Chul Shim ),고희관 ( Hee Kwan Koh ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),이인홍,배상철 ( Sang Cheol Bae ) 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.2
The presence of antiphospholipid antibodies in systemic lupus erythematosus (SLE) and the primary antiphospholipid antibody syndrome(APS) are well-known risk factors for thrombosis. However, aCL associated with rheumatic diseases other than SLE or primary APS tend to be in low prevalence and low titer, and unassociated with clinical complications. We experienced a 31-year-old female patient with painful swelling, purpura, and intermittent claudication of both lower extremities, moderate thrombocytopenia, and persistent positive antiphospholipid antibodies(43 GPL of aCL, positive LAC). Four years prior to admission, she had been diagnosed at our hospital as a mixed connective tissue disease because of positive anti-nRNP, Raynaud`s phenomenon, swollen hands, polyarthritis, sclerodactyly. After anticoagulant therapy, she experienced remarkable symptomatic improvement. We report an unusual case of antiphospholipid antibody syndrome in mixed connective tissue disease with a review of the literature.
Care Status of the ALS Patients With Long-Term Use of Tracheostomy Tube
박여진,이제상,김상훈,고성화,신명준,장재혁,신용범 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.6
Objective To evaluate the care status of the amyotrophic lateral sclerosis (ALS) patients with long-term use of tracheostomy tube by caregivers of ALS patients. Methods A survey was conducted in the form of questionnaires to ALS patients and their caregivers. All measurements were performed by two visiting nurses. For statistical analysis, SPSS ver. 22.0 and Mann-Whitney U test on non-normal distribution were used. Results In total, 19 patients (15 males and 4 females) and their caregivers participated in the survey. In the case of patients, the average duration of care was 5.9±3.7 years, and the mean periods of illness and tracheostomy were 5.3±3.2 years and 3.0±2.6 years, respectively. Replacement intervals were 14 days in 11 patients, 7 days in 4 patients, 28 days in 2 patients, and 21 days in 1 patient. One patient was unable to provide an accurate replacement interval. Eighteen (99%) caregivers had experience of adding volume to a cuff without pressure measure in the following instances: due to patients’ needs in 7 cases, air leakage in 7 cases, and no reason in 4 cases. Mean pressure of tracheostomy cuff was 40±9.4 cmH2O, and air volume of tracheostomy cuff was 6.7±3.2 mL, but real mean volume was 7.0±2.9 mL. The number of suctioning for airway clearance was a mean 27.5 ±18.2 times a day. Conclusion According to this survey, we notice that almost all the patients and caregivers had an erroneous idea about cuff volume and pressure. Moreover, education and long-term professional care of tracheostomy cannot be overemphasized in this manner.
공백역 지진에 의한 동해에 연한 해안에서의 지진해일 위험도 산정
최병호,에핌페리놉스키,이제신,우승범 한국지진공학회 2002 한국지진공학회논문집 Vol.6 No.5
전회의 논문(Choi et al)에 이어 본 논문에서는 동해에서의 가상해저지진에 의한 지진해일의 예단적 특성을 동해에 연한 전해안에 걸쳐 논하였는데 재해를 유발시킬 수 있는 지진해일의 근원역은 공백역이론으로부터 선택되었다. 선형장파이론에 근거한 수치모형을 채택하여 28개의 선정된 자세한 단층 파라미터를 갖는 가상지진(4경우 실제지진 포함)과 단순화시킨 형태의 초기 수면형에 의한 76개 사상의 지진해일 시뮬레이션을 수행하여 전파 및 해안에서의 지진해일의 파고를 산정하는 데 적용 되었다. 결과로서 동해에 연한 전해안 전역에 전파되는 지진해일의 특성과 해안역에서의 지진해일의 파고 분포가 산정되어 지진해일 재해위험도가 상대적으로 낮은 지리적 위치를 구획화하여 제시함으로써 해안재해경감대책의 도구로서 활용될 수 있게 하였다. Prognostic characteristics of hypothetical tsunamis in the East Sea are further discussed based on numerical simulations using linear long wave theory than the last paper(Choi et al). As for choice of source zones, we used 28 cases based on fault parameters of hypothetical earthquakes and 76 cases based on simple initial surface shapes of tsunamigenic earthquakes selected by the seismic gap theory. As a result, the wave heights along the whole coastline adjacent to the East See of tsunamis due to these hypothetical earthquake are presented. Analyses also lead us to conclude that the selection of geographical zones with low risk of tsunamis can be used as a tool for coastal disaster mitigation planning.
류마티스 관절염 환자에서 미립체로 구성된 거대 견봉하 점액낭염
심승철 ( Seung Cheol Shim ),전재범 ( Jae Bum Jun ),장대국 ( Dae Kook Chang ),이제경 ( Je Kyung Lee ),유태석 ( Tae Seok Yoo ),고희관 ( Hee Kwan Koh ),김태환 ( Tae Hwan Kim ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1
Rice bodies are numerous small fibrinous, cartilaginous-like materials which were first described in tuberculous joints. Rice bodies are common findings in joints afflicted with rheumatoid arthritis or other seronegative arthropathy. But less commonly, those can be seen in periarticular bursae or at the sites of tendon or ligament insertion. Rice bodies, thought to be a nonspecific response to synovial inflammation, probably evolve from ischemia in a proliferative synovium. Some of these bodies contain a core of collagen with a mantle of fibrin, others contain only fibrin. Subacromial bursa are sometimes involved in the patients with rheumatoid arthritis and can reach impressive dimensions before becoming clinically detectable because significant constrain is lacking. Subacromial arthrography or magnetic resonance imaging accurately delineated the existence of cartilaginous loose bodies before surgical exision. We experienced a man with rheumatoid arthritis who had massive subacromial bursitis with rice bodies. His shoulder had been swollen since 5 years ago. He felt no pain and had only mild limitation of motion. Subacromial arthrography or magnetic resonance imaging of right shoulder showed multiple rice bodies in enlarged subacromial bursa. Operation finding showed a large encapsulated mass in the subacromial bursa, and hundreds of fibrinous rice bodies were revealed, which were resected. We report this patient with a review of literatures.
김용욱,홍종원,유선국,김영수,이제범,박병윤 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.2
The measurement and visualization of the roundness of the cranial circumference has not been attempted by the simple measurement device. That's why there has been a tendency that the morphologic cranial deformity can be diagnosed with accuracy only by the experienced physician. The accurate understanding of the roundness of the cranial circumference, however, is essential for the diagnosis and the decision of the treatment principle in cranofacial morphological deformity. Current methods, such as simple physical examination and/or the photography, are not enough to accurately express the roundness of the cranial circumference. In order to develop the new method of measurement, authors selected 16 points from the axial cutting plane of the cranium. These points can be selected under the same principle even though the axial plane changes. After measuring the distance of 16 points, the values are put into computer program.In conclusion, authors can retrieve the x, y coordinates of the 16 points and can show the intuitive roundness of the circumference of the selected axial plane of the cranium. This measurement tool will be helpful not only for the identification of the severity of the morphologic cranial deformity, but for the classification and the assessment of the result of the surgery.
3차원 전산화단층촬영 영상을 이용한 안면 연조직 두께 계측의 임상적 유용성
정호걸,김기덕,한승호,허경석,이제범,박혁,최성호,김종관,박창서 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.2
Purpose : To evaluate clinical usefulness of facial soft tissue thickness measurement using 3D computed tomographic images. Materials and Methods : One cadaver that had sound facial soft tissues was chosen for the study. The cadaver was scanned with a Helical CT under following scanning protocols about slice thickness and table speed; 3 mm and 3 mm/sec, 5 mm and 5 mm/sec, 7 mm and 7 mm/sec. The acquired data were reconstructed 1.5, 2.5, 3.5 mm reconstruction interval respectively and the images were transferred to a personal computer. Using a program developed to measure facial soft tissue thickness in 3D image, the facial soft tissue thickness was measured. After the ten-time repeation of the measurement for ten times, repeated measure analysis of variance (ANOVA) was adopted to compare and analyze the measurements using the three scanning protocols. Comparison according to the areas was analyzed by Mann-Whitney test. Results : There were no statistically significant intraobserver differences in the measurements of the facial soft tissue thickness using the three scanning protocols (p>0.05). There were no statistically significant differences between measurements in the 3 mm slice thickness and those in the 5 mm, 7 mm slice thickness (p>0.05). There were statistical differences in the 14 of the total 30 measured points in the 5 mm slice thickness and 22 in the 7mm slice thickness. Conclusion : The facial soft tissue thickness measurement using 3D images of 7 mm slice thickness is acceptable clinically, but those of 5 mm slice thickness is recommended for the more accurate measurement.