혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

인천지역 대학생에 의한 대학급식소의 급식서비스에 대한 품질 평가

우경자,한복진,노정옥 동아시아식생활학회 2004 동아시아식생활학회지 Vol.14 No.3

This study was conducted to investigate the quality assessment of performance of the university foodservice. Self administered questionnaires were collected from 305 students living in Incheon. Statistical data analysis was completed using a SPSS v. 10.0 program. The results were summarized as follows: 61.4% of male students and 48.1% of female students responded to have lunch regularly. Only 23.4% of male students and 14.1% of female students used the university foodservice daily. Reasons for the irregularity of lunch were responded as "lecture", "eating when I want" and "appointment with friends", etc. The quantity, temperature, nutritional value, appearance, hygiene, taste and freshness of foods and price of menus were evaluated as appropriate but using seasonal foods, number of side-dishes, etc. as unsatisfactory. Service speed, cloth hygiene, neatness and kindness of employee were evaluated as appropriate. For the facilities of foodservice, counter location, menu board and lighting facilities were evaluated as appropriate but heating facilities, disponsition of tables and chairs of dining hall were as unsatisfactory. Sanitation of floors and walls of dining hall, restroom and utensils, etc. was evaluated as low.

식품유해세균에 대한 식초의 항균효과

우승미,장세영,김옥미,윤광섭,정용진 한국식품저장유통학회 ( 구 한국농산물저장유통학회 ) 2004 한국식품저장유통학회지 Vol.11 No.1

본 연구에서는 시판되고 있는 식초를 이용하여 6종의 식품 유해세균에 대한 항균력을 비교하였다. 그 결과, 감식초와 현미식초는 합성식초에 비해 S. aureus, M. luteus, S. enteritidis 및 E. coli에서 항균 활성이 높게 나타났으며, 현미식초가 감식초에 비해 식품유해세균에 대한 항균활성이 비교적 더 높게 나타났다. 현미식초의 농도에 따른 항균활성을 조사한 결과 5종의 그람양성 세균 및 음성 세균 모두 10μm/mL 이상의 농도에서 생육이 거의 억제되었으나, V. parahaemolyticus는 15 μm/mL 농도에서 생육이 거의 정지되어, 현미식초는 식품 부패균과 대장균 생육억제에 우수한 것으로 나타났다. 식초처리에 의한 미생물의 형태 변화를 전자 현미경으로 관찰한 결과 S. aureus, E. coli 모두 세포가 팽윤되고 일부 세포벽이 완전히 파괴된 형태를 관찰할 수 있어 식초처리로 인해 세균의 생육이 억제되는 것을 알 수 있었다. We investigated antimicrobial effects of commercial vinegar on the harmful food-born organisms. As a result, antimicrobial effects of brown rice vinegar showed stronger than persimmon and artificial vinegar. In 10μL/mL concentration of brown rice vinegar was completely inhibited about 5 strains except for V. parahaemolyticus, it was inhibited 15 μL/mL concentration. Therefore vinegars were effective for inhibition acitivity against foodborne organisms. S. aureus and E. coli treated with 25μL/mL concentration brown rice vinegar was observed by scanning electron micrographs(SEM). The cells were expanded and a part of cell wall was completely destructed by brown rice vinegar.

Cobb

이은우,임정수,손민균,김봉옥 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.4

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

중등학교 현장 물리교육의 현황과 개선방안

강정우,고영옥,강성진,김규용,박규은 濟州大學校 師範大學 科學敎育硏究所 1996 科學敎育 Vol.13 No.-

To investigete the obstacles of developing physics education in secondary schools and the countermeasure in present situtation, I distributed subject - description style answer sheets to middle & high school teachers in Cheju, which consist of 28 detail subjects under the big 8 themes. The recovery rate is 75%, and now I'm describing the result. According to the themes, total frequency is like this : Derection of Physics Leaming(412), Administration of Physics Facilities and Other Elements(298), Administration of Physics Education(268), Contents of Text( 183), Events of Science(163), Guiding of Students(l23), Grade and Evaluation of Students(101), 6th Education Cumculum(86). It suggests as the improvement that experiment training for teachers be reinforced, programs about new physicse teaching menthod be introduced, teachers try to motivate the students in class, teaching material for students?advanced learning be developed, usage of teaching material be presented, qualified experiment assistant be arranged and no less than two laboratories be provided by school unit and hours of teaching on physics teacher lessen. Besides, science events need to be held for every student by school unit, which should be eximined about when and how they would be he held.

한국판 섬망 평가 척도-98(K-DRS-98)의 표준화 연구

임경옥,김수영,이양현,이선우,김정란 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objective : This study was conducted to develop and to validate the Korean version of Delirium Rating Scale-Revised-98(K-DRS-98), which is a scale for diagnosing delirium and evaluating its severity. Method : After developing the K-DRS-98, 102 patients were rated by it among 4 diagnostic groups, such as delirium (N=25), dementia (N=27), schizophrenia (N=25) and others (N=25). To test for reliability, K-DRS-98 was independently administered by two psychiatrist. To test for validity, Korean version of Mini-Mental State Examination (MMSE-K) and Clinical Global Impression (CGI) were administered simultaneously. Statistical analysis was done with SPSS window version 12 package and statistical significance was p<0.05. Result : Intemal consistencies (Cronbach α) of two raters were 0.867 and 0.858, respectively. Inter-rater reliability (κ) was 0.893 for severity items of K-DRS-98 and κ value of diagnosis items was 0.969. In Delirium group, Pearson correlation Coefficients (r) of K-DRS-98 were -0.682 for MMSE-K and 0.667 for CGI. In comparison Delirium group with Others, ANOVA post hoc multiple comparison LSD was statistically significant (p<0.001). The cutoff score to diagnosis of delirium can be recommended 16 for seventy items and 21.5 for total score, respectively. Conclusion : The K-DRS-98 was showed good reliability and validity for the assessment of delirium. The K-DRS-98 is an easy and useful tool for diagnosing delirium and assessing its severity.

이성대상포진의 증상에 따른 안면신경마비의 정도와 예후

신시옥,송창근,이동욱,최영석,진흥률,신정우,윤희석 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

연구목적: 이성대상포진에 동반되는 안면신경마비는 Bell's palsy와는 달리 예후가 더 나쁘고 그 마비가 완전히 회복되지 않는 경우가 더 많다.본 연구에서는 이성대상포진에서 발현되는 증상들의 유무가 치료 전 안면신경마비의 정도 및 치료 후 예후와 상관관계가 있는지를 관찰하여 예후의 예측인자에 대해 분석하였다. 재료 및 방법: 지난 1992년 1월부터 1999년 6월까지 이성대상포진으로 진단받고 본원에 입원하여 고용량 부신피질호르몬제와 항바이러스제인 acyclovir의 병합투여로 동일한 치료를 받은 30명의 환자를 대상으로 후향적으로 의무기록을 분석 및 고찰하였으며, 치료 전 안면마비의 정도와 치료 후 마비의 회복 정도를 이통, 이명, 난청, 현훈 등의 증상의 유무와 치료 시작 시기, 그리고 안면신경의 electroneuronography(ENoG) 값에 따라 비교하였다. 결과: 이성대상포진수포가 안면신경마비 보다 먼저 발현된 경우에 안면신경마비의 치료 전 grade가 통계적으로 유의하게 좋았다(p<0.05).이통, 청력손실, 그리고 현훈의 유무에 따른 안면신경마비의 정도는 상관관계가 없었고 예후에도 차이가 없었다.이명의 유무에 따른 치료 전 안면신경마비의 정도는 상관관계가 없었으나 치료 후 완전회복율은 이명이 있었던 군에서 통계적으로 유의하게 높았다(p=0.003<0.05).완전회복군과 불완전회복군 사이의 치료 전 ENoG의 수치는 통계적으로 유의하게 예후와 상관이 있었다(p=0.037<0.05). 결론: 좀더 많은 수의 환자를 연구에 포함하여 증상에 따른 예후의 차이를 연구하는 것이 필 요하며 또한 ENoG 값이 10%에서 40% 사이인 환자들의 치료 방법에 대한 고려와 이성대상포진수포가 안면신경마비보다 먼저 생긴 환자에서 치료 전 마비정도가 경미했던 이유에 대한 연구가 필요할 것으로 생각된다. Purpose: Herpes zoster oticus generally has a poor prognosis, leaving many patients with permanent facial nerve dysfunction, compare to Bell's palsy.Acyclovir and prednisolone have been widely used for the treatment of herpes zoster oticus.This retrospective study was conducted to suggest the prognostic factors according to various symptoms. Materials and Methods : Clinical studies were retrospectively performed on 30 patients with herpes zoster oticus who were treated with acyclovir and prednisolone in the Chungbuk National University Hospital between 1991 and 1999.The authors analyze the pre-treatment grade and prognosis of facial nerve palsy according to symptoms(the existence of otalgia, tinnitus, hearing loss, and vertigo), the treatment onset, and electroneuronography ( ENoG ). Results : Of thirty patients who have been diagnosed as herpes zoster oticus, there is no significant difference in the pre-treatment grade of facial nerve palsy according to the existence of vesicle, otalgia, tinnitus, vertigo, and hearing loss.Of 25 patients who have facial nerve palsy, the recovery from the palsy is complete in 14 patients(56%).There is no significant difference in the pre-treatment grade of facial nerve palsy according to the existence of otalgia, tinnitus, vertigo, and hearing loss.The pre-treatment grade of facial palsy is better when the vesicles precede facial in the group with tinnitus than without tinnitus.A significant difference of the prognosis according to the onset of treatment and other symptoms are not found.ENoG is better in the group that facial nerve palsy is completely recovered than incomplete recovery group. Conclusion : Reliable prognostic factor according to symptoms is not found, ENoG is the only prognostic factor.

구조화된 문항을 이용한 지구과학 탐구능력 평가 도구 개발

정철,우종옥,김정률 한국교원대학교 과학교육연구소 1997 청람과학교육연구논총 Vol.7 No.1

The purpose of this study is to develop a test of earth science inquiry abilities using structured items. To develop a more valid and reliable instrument factual data was used, and most of the previous studies regarding inquiry teaching method and inquiry evaluation were consulted. The model developed in this study is composed of 5 stages; recognizing problems and generating hypotheses, designing inquiry, pursuiting inquiry, interpreting data, and drawing conclusion. Also, in this study 10 science inquiry abilities; recognizing problems, generating hypotheses, controlling variables, designing experiments, performing experiments, transforming data, inferencing, predicting, conclusing, and generalizing were clearly defined. The test developed in the study, Test of Earth Science Inquiry Abilities, includes 25 multiple-choice (five-choice) items and requires testing time of 50 minutes. The content validity of items, objectivity of scoring keys and clarity of items were checked by 7 experienced specialists in science education and earth science. The developed test were investigated and revised through three field tests. According to the results of the third field trial, test reliability (Cronbach α) was 0.62, difficulty index was 0.54, and index of discrimination was 0.35. Also, the developed Test of Earth Science Inquiry Abilities showed a correlation coefficient of 0.53 with TIPS. Therefore, the development of Test of Earth Science Inquiry Abilities using structured items satisfied the reliability and validity requirements for general assessment instruments for students' earth science inquiry abilities.

소목(Caesalpina sappan L.) 추출물의 항균성과 김치숙성에 미치는 효과

이신호,최우정,조옥기,손수정 대구효성가톨릭대학교 식품과학연구소 1997 식품과학지 Vol.9 No.-

김치의 숙성을 지연시킬수 있는 천연물질을 검색하기 위하여 소목 ethanol추출물의 항균력을 조사하고 김치제조에 응용할 수 있는 가능성을 검토하기 위하여 소목 추출물 1%를 김치 제조시 첨가하여 10℃에서 숙성시키면서 그 변화를 관찰하였다. 소목 ethanol추출물은 유산균 4종류 7균주에 대하여 성장억제 효과를 나타내었으며 생균수 측정시에도 시험균주 모두에 대해 공히 1~4 log cycle의 항균효과를 나타내었다. 김치 숙성 중 소목 첨가구의 경우 숙성 기간동안 대조구에 비해 pH와 산도가 다소 높은 경항을 나타내었다. 소목 추출물을 첨가한 김치의 관능검사는 대조구와 첨가구간의 유의적 차이를 보이지 않았으며 sour taste의 경우에는 대조구에 비해 첨가구의 수치가 더 낮은 경향을 나타내었다. Antimicrobial effect of ethanol extracts of Caesalpina sappan Linne and its effects on kimchi fermentation were investigated. Antimicrobial activities of the extract against 4 kinds of lactic acid bacteria isolated from kimchi, such as Lactobacillus plantarum, Lactobacillus sake. Leuconostoc mesenteroides and Pedicoccus pentosaceus showed 1~4 log_(10) reduction during incubation for 12 hours. The growth of tested lactic acid bacteria did not occur in Caesalpina sappan Linne containing modified MRS broth except L. plantarum HSU02 and L. mesenteroides HSU14. The pH of kimchi containing 1% of Caesalpina sappan Linne extracts was higher than that of control but titratable acidity, total bacteria and Lactobacilli were lower than that of control during fermentation for 25 days at 10℃. Sour taste of Caesalpina sappan Linne containing kimchi was more weak than that of control. Sensory score of flavor and overall acceptability did not show significant difference between Caesalpina sappan Linne containing kimchi and control during fermentation.