대장내시경 전처치제로서 Sodium Phosphate 와 Polyethylene Glycol 용액의 전향적 비교 분석

이헌경,김승용,홍원선,민영일,정훈용,김해련,정성애,김석균,심기남,양석균,박의련,조문경 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3

Background/Aims: Although some authors have suggested that sodium phosphate (NaP) is more effective than polyethylene glycol (PEG) in bowel cleansing, there has been no crossover study proving the superiority of NaP over PEG in bowel cleansing and patients' compliance. The aim of this study was to compare the two solutions for colonoscopy, PEG and NaP, through crossover design with regard to patients' compliance, cleansing ability and side effects. Methods: Thirty patients underwent two separate colonoscopies for colonic polyp(s) with PEG and NaP, respectively. Before and after bowel preparation, blood pressure, body weight, and serum biochemical parameters were measured in all patients. In addition, a detailed questionnaire was used to assess side effects and the patients' preference. The presence of bubbles, types of residual stool, and overall quality of colon cleansing were assessed by one endoscopist blinded to the type of preparation used. In each colonoscopy, two biopsy specimens were taken at rectum. Results: In the NaP group, but not in the PEG group, there were significant changes in several biochemical parameters including sodium (+3.0±3.0 mEq/L), potassium (-0.3±0.3mEq/L), calcium (-0.5±0.5 mg/dL), phosphorus (+3.9±2.2 mg/dL) and osmolarity ( +10.1±9.3 mOsm/kg) after bowel preparation. In addition, the degree of body weight change was greater with NaP (-2.2±2.3 kg) than with PEG (-1.2±2.0 kg) (p=0.06) and the formation of bubbles that disturb luminal observation was more frequently found in the NaP group (p$lt;0.01). There was no difference, however, in the type of residual stool and the overall quality of bowel preparation between the two groups and no significant mucosal change was noted after bowel preparation in both groups. Moreover, PEG was found to be more difficult to take than NaP (p$lt;0.05) and among the 30 patients, 26 (87%) preferred NaP, while only two favored PEG (p$lt;0.01). Conclusions: We conclude that NaP can replace PEG at least in patients with good general condition. Further studies to decrease the incidence of bubbles and to establish subgroups suitable for NaP are needed.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

사상체질별 비만요인에 대한 환자-대조군 연구

이갑수,석재화,김상혁,김윤희,이의주,김달래,고병희,이수경,Seok, Jae-Hwa,Kim, Sang-Hyuk,Kim, Yun-Hee,Lee, Eui-Ju,Kim, Dal-Lae,Koh, Byung-Hee,Lee, Soo-Kyung 사상체질의학회 2007 사상체질의학회지 Vol.19 No.2

1. Backgrounds and Aims Human being is divided into 4 constitution types(Taeyangin, Soyangin, Taeumin, and Soumin). According to Sasang Constitutional Medicine[SCM] Each constitution has its own incidence, treatment and prevention of disease. The purpose of this study is to find the relation of dietary habits, life styles and Psychosocial stress with obesity in each Sasang Constitution. 2. Methods 975 subjects who have received health examinations and diagnosis of Sasang Constitution at Kyung-hee Medical Center were divided into each constitutional group. Each constitutional group was then divided into obese group and normal group. We evaluated risk factors of obesity such as dietary habits, life styles, and Psychosocial stress. These data were statistically analysed to investigate the relations between risk factors and obesity. And then significant factors were analysed by multinomial logistic regression analysis to get each odds ratio. 3. Results In a multinomial logistic regression analysis adjusted for age and sex, promotion of appetite and overeating or excessive diet elevated risks of obesity in Taeumin, promotion of appetite and high speed of diet elevated risks of obesity in Soyangin, and Psychosocial stress elevated risks of obesity in Soeumin. 4. Conclusions The results suggest that promotion of appetite and overeating or excessive diet may be major risk factors for obesity in Taeumin, promotion of appetite and high speed of diet in Soyangin and Psychosocial stress and dyschezia in Soeumin.

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

골반 경사로 인한 요추부 측만증에서 신발 높이기의 효과

김용민,김동수,최의성,손현철,박경진,김융성 대한척추외과학회 2004 대한척추외과학회지 Vol.11 No.2

골격계의 원발성, 전이성 혈관외피세포종 : 증례 보고

김동수,김용민,최의성,손현철,박경진,조병기,이형준 충북대학교 의과대학 충북대학교 의학연구소 2009 忠北醫大學術誌 Vol.19 No.2

혈관악성종양은 혈관내피종(hemangioendothelioma), 혈관육종(angiosarcoma), 혈관외피세포종(hemangio pericytoma) 및 카포지 육종(Kposi's sarcoma) 등이 있으며, 이 중 혈관외피세포종은 비전형적인 외피 세포가 증식된 경우를 말한다. 골의 혈관외피세포종은 드문 악성종양으로 문헌상 보고되어 있는 예들은 주로 성인의 대퇴골, 골반골에 발생된 경우이다. 이 경우 원발성은 드물며 주로 비골격계에서 기원하여 골로 전이되어 발생하는 것으로 알려져 있다. 남녀 발생 빈도는 거의 동일하며, 12세부터 90세까지 어느 연령층에서도 발생할 수 있으나, 호발 연령은 40대에서 50대 사이 이다. 대개 연부조직 종양으로 신체 어디에서도 일어날 수 있고, 하지 특히 서혜부 및 대퇴부에서 가장 많이 발생하며, 후복막, 두경부 및 흉복부의 순으로 나타난다. 전이도 빈번하게 발생하는데, 그 경로는 주로 혈행성으로, 발생부위는 폐와 골이 제일 많다. 저자들은 8년 전, 우측 아래턱의 원발성 혈관외피세포종으로 절제술을 시행한 환자에서 술후 3년 뒤, 우 경골 근위부에 원격 전이가 발생하여 절제술, 예방적 골수강내 금속정 삽입술 및 골시멘트 충전술을 시행하였다. 현재 2차 수술 후 5년여가 경과한 상태로 경골에 재발의 증거가 없어 만족할 결과를 가져다주었다고 판단하여 문헌 고찰과 함께 보고하는 바이다. Hemangiopericytoma is a rare tumor of blood vessels, first described and named by Stout and Murray in 1942, arising from the contractile, elongated cells the pericytes of Zimmermann which surround capillaries. It can develop whereever there are capillaries and mostly in the connective tissue of the human body. It can also develop in any age from 12 to 90 years, and the rate of metastasis and prognosis depend on its histologic grade. We report a case of hemangiopericytoma metastasized to the right proximal tibia from the right mandible, resected three years ago. The hemangiopericytoma is a extremely rare primary malignant tumor in the bone and bone to bone metastasis is never been found in the literature before. So, we report this case and also report the good result.

고립골낭에 관한 X선학적 연구

김경락,황의환,이상래 慶熙大學校 齒科大學 1994 慶熙齒大論文集 Vol.16 No.1

The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary ?.cone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University The obtained results were as follows 1. The incidence of solitary bone cyst was almost equal in males(52.2%) and in females(47.8%) and the prevalent age of the solitary bone cyst were the second decade(47.8%) and the third decade (21.7%). 2 In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17`.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 435% were asymptom and the tooth vitality involved in the solitary bone cyst, 76.5% were positive and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partialy, and 30.4% were not aeon. 5. In the change of tooth, 59.1% were intact, 18.2% were loss of the alveolar lamina dura, 13.6% were root resorption 4:55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11;1% were thickened myxofibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

분비촉진물질 투여 후 흰쥐 턱밑샘에서 상피성장인자 수용체와 신경성장인자 수용체의변화양상

김은경,김정기,조의식 대한해부학회 1999 Anatomy & Cell Biology Vol.32 No.5

장기적 흡인 배액법을 이용한 척추 후방 기기 고정술 후 감염의 치료

김용민,김동수,최의성,손현철,박경진,김융성 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

연구 목적 : 척추경 나사못을 이용한 척추 후방 기기 고정술 후 심부 감염이 발생한 증례 들을 대상으로 관련 인자를 분석하고 Hemo-vac을 이용한 장기간의 폐쇄성 흡인 배액법을 통한 치료와 그 결과에 대해 알아보고자 하였다. 대상 및 방법 : 1996년 5월부터 2001년 8월까지 척추후방기기고정술 후 심부 감염이 발생 한 5례를 연구 대상으로 하여 전신 질환 동반, 감염의 발현 양상을 조사하였고, 창상 세척 등 감염 수술 후 장기적 배액법을 이용한 치료 과정 및 최종 결과를 후향적으로 분석하였다. 결 과 : 당뇨와 비만이 술후 심부 감염의 위험요인으로 분석되었다. 수술 환부로부터의 배농, 발열 등 감염 증상은 술후 평균 18.8(8-36)일에 발현되기 시작하였다. 일인당 단 1회의 세척술이 실시되었고 고정기기는 제거하지 않았다. 이후 평균 19.2일간의 지속적 흡인 배농 및 평균 43.6일간의 항생제 정맥투여에 이은 평균 33.8일간의 경구투여로 심부감염은 특별한 합병증 없이 모두 치료되었으며 양호한 임상적 결과와 후외방 골융합을 얻을 수 있었다. 결 론: 척추 후방 기기 고정술 후 발생한 심부 감염에 대해 창상의 세척 및 육아조직 제 거 후 항생제 투여와 Hemo-vac을 이용한 장기간의 장기적 흡인 배액법은 감염의 조절과 척추의 안정성을 동시에 얻을 수 있는 유용한 방법중 하나인 것으로 생각되었다 Purpose: Various treatment modalities have been applied to control deep infection after spinal instrumentation. Validity of removing implants to control the infection is still contro- versial because it may cause loss of spinal stability. Analysis of the inherent risk factors associated with deep infection and the efficacy of management with long-term suction drainage without removal of implants. Materials and Methods : Fiye cases of postoperative deep infection after posterior spinal fixation from May 1996 to August 2001 were investigated on combined general ill- ness, features of infection, various profiles on the management of infection with surgical irrigation and debridement followed by long-term suction drainage, and final outcomes. Results :Remarkable risk factors were diabetes and obesity. Evidences of infection such as discharge from the wound, dehiscence, or fever were observed on the average of 18.8th day postoperatively By only one additional surgical procedure for each patient followed by long-term suction drainage for mean 19.2 days and administration of intravenous antibiotics for average of 43.6 days, deep infections were controlled successfully without removal of implants and without any grave complications. All achieved favorable clinical results and posterolateral fusion. Conclusion : Irrigation and debridement accompanied by long-term suction drainage using Hemo-vac and administration of susceptible antibiotics seemed to be one of the effective methods to control deep infection after posterior spinal instrumentation and main than the postoperative stability of spine.

주부들의 에어로빅 운동이 슈산소성 능력 및 피하지방에 미치는 영향

김의영,이필영,이현경 龍仁大學校 體育科學硏究所 1998 體育科學硏究論叢 Vol.4 No.1

The aim of this study is to examine the effect of aerobic dance on aerobic capacity and subcutaneous fat for this purpose 5 women(35-37 yrs) was choses as subjects. They performed aerobic dance for 5 days per 1 week by 1 hour a day for a period of 8 week. The conclusions are as follows: 1. The exercise intensity of aerobic dance executed in the study showed the high intensity to give burden to housewifes, it is necessity that it has aeribic program development. 2. It was not significant difference after aerobic dance in comparison with pre training. This is due to the training methods such as exercise intensity, the beginning of physical fitness level, duration. 3. It was not significant diffence in subcutaneous fat except for chest after aerobic dance in comparison with pre training. This is associaion with aerobic dance a peculiarity.