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성기혜 ( Ki Hye Sung ),김민희 ( Min Hee Kim ),김은령 ( Eun Ryoung Kim ),심재원 ( Jae Won Shim ),이정주 ( Jung Ju Lee ),임재우 ( Jae Woo Im ),진현승 ( Hyun Seung Jin ) 대한주산의학회 2009 Perinatology Vol.20 No.3
목적: 최근 극소 저출생 체중아의 생존율의 개선으로 기관지폐 이형성증(bronchopulmonary dysplasia, BPD)이 늘고 있다. 다기관 연구에 의해 전국적인 BPD의 역학, 임상 양상과 각 병원 간의 차이를 조사하여 향후 우리나라의 BPD 감소와 중증도를 줄이는 것을 목적으로 본 연구를 시행하였다. 방법: 2005년 6월부터 2007년 5월까지 건국대학교병원, 영등포 성애병원, 강북삼성병원, 중앙대학교병원, 건양대학교병원, 강릉아산병원의 신생아 집중 치료실에 입원하였던 신생아 4,476명을 대상으로 하였다. BPD의 진단 기준은 비전형적인 BPD를 포함하여 병인적인 분류를 하고 있는 Ogawa 등의 분류법을 이용하여 신생아 호흡 곤란 증후군(respiratory distress syndrome, RDS)과 전형적 또는 미만성 혼탁의 방사선 소견, 산전 감염의 유무에 따라 6가지 type으로 분류하였다. 또한 전체 신생아의 출생체중 분포와 생존율, 각 출생체중 군별 BPD의 발생률, 병태 비율, 사망률 등을 조사하고, 이 후 재택 산소요법 시행 여부와 미숙아 망막증, 괴사성 장염 등의 합병증 여부를 조사하였다. 결과: 생후 28일째 산소 치료가 필요한 신생아는 89명이었고, 이 중 Ogawa 분류법에 의한 BPD 환아는 70명(1.6%)이었으며, 특히 1,500 g 미만의 환아 237명 중 60명(25.3%)이었다. 생후 28일 이상 생존율은 98.7%이고, 사망 예는 없었으며 평균 재원 기간은 97.8±51.2일(43~405일)이었다. BPD는 900~999 g, 1,000~1,249 g의 체중 군에서 발생률이 각각 15명(21.4%)으로 가장 높았으며, 교정 36주 이후에도 산소투여가 필요한 중증 BPD의 경우 900~999 g의 체중 군에서 7명(23.3%)로 가장 높았다. Ogawa 분류법으로 BPD의 각 병태 비율로는 RDS 이후에 나타나는 I, II형이 각각 전체의 17예(24.3%), 44예(62.9%)로 대다수를 차지하였다. 이외에도 III`형은 2예(2.9%), IV형은 2예(2.9%), V형은 5예(7.1%)이었고, III형, VI형은 없었다. 재택 산소요법은 8예에서 시행되어 전체의 11.4%였으며, 이 중 BPD I형이 7예로 87.5%를 차지하였다. 미숙아 망막증은 35명(50.0%)에서 발생하였으며, 700 g 이하 신생아에서 9예(26.5%)로 가장 많았다. 또한 괴사성 장염은 3명(4.3%)이었다. 결론: 본 연구는 국내에서 처음으로 진행된 BPD의 전국적인 다기관 역학 조사로, 대상 신생아의 Ogawa 분류에 의한 BPD 유병률은 1.6% 이었고 1,500 g 미만 신생아의 25.3%이었으며, 전체 신생아의 BPD 70명 중 Ogawa 분류의 I, II형이 각각 24.3%, 62.9%로 대다수를 차지하였다. Purpose: As the neonatal intensive care advanced, the incidence of neonatal bronchopulmonary dysplasia (BPD) has increased. We conducted a multi-center investigation of the prevalence of BPD in six hospitals to investigate the epidemiology of BPD in Korea. Methods: Retrospective reviews ware performed for survival rate, prevalence of BPD of total 4,476 newborn infants who were admitted to neonatal intensive care unit in Konkuk university hospital, Sung-Ae General hospital, Kangbuk Samsung hospital, Chung-Ang university hospital, Konyang university hospital, and Gangneung Asan hospital between June, 2005 and May, 2007. By Ogawa, BPD was defined as oxygen dependency at 28 days after birth, with respiratory distress symptoms and the change of chest x-ray finding, and classified as 6 subtypes. Classic BPD was defined as oxygen dependency at 36 weeks of postmenstrual age. Results: Survival rate at 28 day after birth was 98.7%. BPD infants by Ogawa classification were 70 (1.6% of overall newborn infants), classic BPD infants were 30 (0.7%). Especially, among 237 preterm infants with birth weight less than 1,500 gram who survived to 28 days of life, 60 (25.3%) had BPD by Ogawa classification and 23 (9.7%) had classic BPD. In Ogawa classification, infants with RDS as type I and II, were 17 infants (24.3%) and 44 infants (62.9%). Home oxygen therapy was performed 8 infants (11.4%). Prevalence of retinopathy of prematurity was 35 infants (50.0%), necrotizing enterocolitis was 3 infants (4.3%), and intraventricular hemorrhage was 6 infants (8.6%). Conclusion: Prevalence of BPD infants was 1.6% of overall newborn, 25.3% of preterm infants with birth weight less than 1,500 gram. Among 70 BPD infants, BPD by Ogawa classification with history of RDS as type I and II were 24.3%, 62.9% as the majority of BPD. This study would be the first report of epidemiology of Korean BPD infants by multi-center study.
김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1
The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.
회맹장 및 대장을 침범한 장 결핵에 있어서 바륨을 이용한 방사선 이중조영촬영 소견에 대한 연구
진용현,전혜정,이용근,강철호,조성범,김윤환,박철민,차상훈,김일영,이혜경 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-
To determine the characteristic double contrast barium enema findings of ileo-cecal and colonic tuberculosis and to make differential diagnosis from other bowel inflammatory disease. Sixty-seven patients confirmed as ileo-cecal and/or colonic-tuberculosis in six hospitals were evaluated retrospectively. The diagnosis was proven by endoscopic biopsy, surgery, and clinical follow up. Nine of 67 patients were excluded because radiologic findings were normal though endocopic biopsy examinations resulted in tuberculosis. Histopathological diagnosis were madein 58 cases as follows: endoscopic biopsy(n=29), operation(n=12), follow up examination(n=14), tissue culture(n=1), laparoscopic biopsy(n=2). There were 30 men and 28 females. The mean age were 36 yrs(range:16-67), 34 patients were in the second and third decade. The distribution of lesions, morphological characteristics, mucosal changes, ulcer shape and depth, associated with other tuberculous lesion, multiplicity were retrospectively analyzed in the findngs of double contrast barim enema. The commonest clinical symptoms were abdominal pain(n=35, 60%) and diarrhea(n=18, 31%). The chest radiography revealed association of pulmonary tuberculosis in 39 cases. Tuberculous lesions of other organs except chest were present in five cases. Double contrast barium enema findings showed a thickening and irregularity of intestinal mucosal fold(n=29, 50%), bowel contraction and/or shortening(n=26, 45%). There were small, nodular, superficial ulcers in the case of ulcer depth less than 2 mm in the depth. As many as 39 cases(67%) in this series had two or more lesions in the intestinal tuberculosis. The involved segment revealed symmetrical feature(n=21, 36%). Inflammatory pseudopolypoid lesions were noted in 30 cases(52%). The ileo-cecal region was involved in 38 cases(66%). The ascending colon(n=25, 43%) was the second commonest site with or without contiguous cecal involvement. Lesions in terminal ileum, ileo-cecal valve, transverse colon, descending colon and appendix were seen in 19, 18, 18, 12 and seven cases, respectively. Among 18 cases of ileo-cecal valve lesions, there were incompetency in nine cases(16%) and wide gapping in four cases(7%). In 14 cases, tuberculous enterocolitis was diagnosed by clinical follow-up and double contrast barium enema study. 12 out of 14 cases, the findings of double contrast barium enema of tuberculous enterocolitis were normalized after anti-tuberculous medication. However, two cases showed more aggravated state than before due to inappropriate treatment. Double contrast barium enema plays an important role in the diagnosis of tuberculous enterocolitis, determines the type, site and extent of the involvement and helps in treatment guide by using sequential studies.
교육용 소프트웨어 개발에 적합한 하이퍼미디어 시스템에 관한 연구
박성한,정혜윤,한민규,심진석 한양대학교 공학기술연구소 1993 공학기술논문집 Vol.2 No.1
This paper presents a back-end system of hypermedia authoring system for courseware development. For the design, repersentative hypertext reference models, the Dexter model and the HAM(Hypertext Abstract Machine) which belongs to Campbell & Goodman model were analyzed. Based on those models, data objects, attributes, and operations of back-end system were designed and implemented. Because the application area of this system is on computer based education, the path mechanism is enforced for the various educational strategies. In order to reduce the user disorientation and cognitive overheads in navigating hypernetwork, filtering, backtracking and history mechanism were implemented.
관상정맥동과의 연결이 없는 좌상대정맥의 CT 소견 : 1예 보고 case report
백상현,박재성,이혜경,홍현숙,김대호,조준희,박성진,차장규 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It is a persistent remnant of a vessel that is present as a counterpart of normal right-sided superior vena cava(SVC) in early embryological development but normally disappears later. Its diagnosis can be confirmed by many noninvasive and invasive tests, or it is incidentally diagnosed at insertion into the left subclavian or jugular vein or thoracic surgery. If it is not associated with other congenital cardiac anomalies, it is usually asymptomatic and hemodynamically insignificant. We describe the chest radiograph and CT findings of bilateral SVC with drainage to left superior intercostal vein, hemiazygos, azygos vein and right SVC, and no connection of coronary sinus.