Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

우리나라 외래치료명령제의 시행과 개선방향

이유진,용효중,김건우,나리지,이기경,황태연,이종국,홍진표 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:Since the order for medical treatment as outpatient has begun in Korea, there have been no requests due to the absence of specific details relating to its enforcement and lack of understanding of related specialists. We reviewed current guidelines and administrative conditions for order for medical treatment as outpatient in Korea, and examined examples of operation and related regulations of developed countries. Methods:Korean studies concerning development of the order for medical treatment as outpatient were inquired. We investigated the guidelines of other countries including U.S.A., Australia, United Kingdom and Canada. The survey of related specialists for the improvement of order for medical treatment as outpatient was performed. Results:Related specialists agreed that current order for medical treatment as outpatient needed more detailed guidelines for candidate patients, processes and management for noncompliance. Additionally, majority of the specialists suggested that candidates for order for medical treatment as outpatient should be extended for not only hospitalized patients but also patients in community. Conclusions:We reviewed detailed considerations regarding candidate recipients within current legislation, complemented post-enforcement report, management procedures, and stipulated actions for noncompliance, to be used as practical guidelines for application. More fundamental measures than complementation of guidelines, such as modification of related legislature will be needed to increase usage, and further details with reference to confidentiality of recipients and safety measures and financial support of treatment personnel will be needed.

일부 인쇄회로기판 납땜근로자들의 눈, 호흡기, 피부의 증상에 대한 조사연구

유재영,우극현,김진석,함정오,최태성,하봉구,정상재,박신구,김일룡 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 이 연구는 납점작업자를 대상으로 납점작업으로 유발될 가능성이 높은 눈, 호흡기, 피부 등의 증상호소율 및 노출강도에 따른 관련성을 파악하기위해 수행되었다. 방법 : 연구참가자 146명중 연구목적에 적합한 20명을 제외한 126명을 대상으로 '눈이 가렵고 충혈됨', '코가 가렵거나 파가움', '재채기', '콧물'. '코막힘' , '목이 따끔거림' , '목에 무언가가 걸려있는것 같음' , '갑자기 연속적인 기침을 함' , '운동 시에 다른 사람에 비해 숨이 가쁨', '숨을 쉴 때 쌕쌕하는 소리가 남', '가래가 끓음', '손이나 안면에 가려움을 느낌' , '안면에 여드름이 날' '손이나 안면에 붉은 반점이 남' 등 14가지 증상에 대한 경험유무와 혈중연농도, 납점작업의 건강위험요인에 대한 지식상태 등을 조사하였다. 결과 : 조사된 14가지의 증상 중, '갑자기 연속적인 기침을 함'이 하루 납점시간 4시간 이상인 군아서 4시간 미만인 군보다 유의하게 증상호소율이 높았으며, 다른 증상의 경우 하루 납땜시간에 따라 유의한 결과를 보이지 않았다. 납땜작업의 건강위험요인에 대한 질문에 12.8 %가 플럭스에 의한 건강위험을 지적하였다. 전체 대상자의 평균 혈중연농도는6.05 rg/dL였으며, 히고치는 15.50 rg/dL이었다.결론 : 납땜작업자에게 호흡기 증상의 위험이 높을 가능성이 있으며, 납땜작업의 건강위험에 대한추가적인 연구와 납점작업자들을 대상으로 납점작업에 의해 유발될 수 있는 건강장해에 대한 적극적인교육 및 홍보활동을 필요로 한다. Objectives : This study was conducted to evaluate the prevalence of ocular, respiratory and skin symptoms among solderers and to investigate the relationship between symptom prevalence and exposure intensity. Methods : We analyzed 126 eligible participants out of a population of 146 male solder-ers who completed the symptom questionnaires. Fourteen symptoms including 'itchy and red eyes', 'itchy or prickly nose', 'sneezing', 'rhinorrhea', 'blocked nose', 'prickly throat', 'foreign body sensation in throat', 'sudden bouts of coughing', 'exertional breathlessness', 'wheezing', 'sputum production', 'itchy face or hands', 'acneiform erup-tions on the face' and 'red spots on the face or hands' were contained. Blood lead levels of all the 126 participants were tested and the participants' own assessments of the health risk of soldering were collected. Results : Of the 14 investigated symptoms, 'sudden bouts of coughing' was significantly more prevalent in solderers who worked 4 hours or more a day than those who worked less than 4 hours a day, as for the other symptoms, there were no significant differences in the prevalences related to daily soldering hours. 2.8% of the solderers considered the risk of flux exposure to be serious. The mean blood lead bevel was 6.05 μg/dL (maximum 15.50 μg/dL). Conclusions : Soldering may increase the risk of respiratory symptoms. Further invert tigations on the hazards of soldering processes are warranted and solderers should be educarted on these hazards.

남성 건강검진 수진자에서 간기능 장애 및 비알코올성 지방간과 대사 증후군과의 관련성

최태성,유재영,김진석,장은철,박주언,김병익 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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석이로부터 분리한 페놀성 화합물의 phospholipase A_2 저해활성

김진우,송경식,유익동,장현욱,유승현,배강규,민태진 충남대학교 생물공학연구소 1997 생물공학연구지 Vol.5 No.-

호알카리성 진균 Cephalosporium sp. RYM-202가 생산하는 alkaline xylanase (CX-III)의 작용에 의해 xylan 기질로부터 생성되는 주요 가수분해 산물은 xylobiose와 중합도가 4 이상인 xylooligosaccharides이었다. 이 효소는 xylobiose에 대한 분해능을 가지고 있지 않지만 xylotriose로부터는 xylobiose를, xylotetraose로부터는 xylobiose와 xylotriose를 주산물로 형성하였다. 이러한 결과들은 CX-III가 transglycosidase 활성을 소유하는 전형적인 endo-type xylanase임을 보여준다. N-bromosuccinimide에 의한 CX-III의 화학적 변화 실험 결과 효소 1분자 당 2개의 tryptophan 잔기가 활성에 관여하는 것으로 나타났다. 그러나 iodoacetamide 및 diethylpyrocarbonate에 의한 효소활성의 저해효과는 나타나지 않음으로써 이 효소의 활성부위에 cysteine과 histidine 잔기가 필수적이지 않음이 확인되었다. The hydrolysis products formed from birchwood xylan by the action of an alkaline xylanase (CX-III) from alkalophilic Cephalosporium sp. RYM-202 were xylobiose and xylooligosaccharides polymerized with more than 4 sugar molecules. This enzyme was not active on xylobiose but readily attacked xylotriose accumulating xylobiose as a major product. The predominant end-products from xylotetraose by CX-III were xylobiose and xylotriose. These results indicate that the enzyme is typically endo-type xylanase possessing transglycosidase activity. Chemaical modification of CX-III with N-bromosuccinimide revealed that two tryptophan residues per molecule of CX-III were essential for its catalytic activity on xylan. On the other hand, iodoacetamide and diethylpyrocarbonate did not influence the activity of the enzyme, suggesting that cysteine and histidine residues are not involved in the active site of this alkaline xylanase.

직업적 디메틸아세트아미드(Dimethylacetamide) 노출에 의해 집단적으로 발생한 독성간염

최태성,우극현,김진석,박완섭,함정오,정상재,유재영 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : DMAC에 노출된 후 집단적으로 발생한 독성 간염 7례보고. 방법 : 2000년 2월 신설된 스판덱스 섬유제조 공장에 근무하는 생산직 근로자 178명중 2000년 2월 부터 8월까지 7명이 간장질환이 발생하였다. 환례들의 나이는 23∼47세였고, 남자 5명, 여자 2명이었다. 이들에 대해 혈액검사, 간 초음파 검사 등의 임상검사와 작업장 조사를 실시하였다. 결과 : 근무 부서는 중합 1명, 방사 1명, 권취 4명, 그리고 포장 1명이며 평균근무기간은 10주였다. 주 호소 증상은 심한 피로감, 어지럼증 및 황달이었고, 검사실 소견상 독성간염의 소견을 보였다. A, B 및 C형 간염 표지자 검사는 모두 음성이었고, 간초음파 소견상 특이 소견이 없었다. 문진 상 알코올 성 간염을 일으킬 정도의 음주력이나 최근 약물 복용력을 가지고 있는 환례는 없었다. 입원 후 보존적인 치료로 모두 급속히 호전되었다. 초기에 발생했던 환례에서 퇴원후 DMAC에 재 노출되어 독성 간염이 재발되었다. 이후 모든 환례들은 퇴원 후 DMAC 비노출 부서로 전환하였고, 퇴원후 지속적인 추적검사에서 간 효소 수치가 완전히 정상화되었고, 정상화되는 기간은 1∼2개월 정도 소요되었다. 결론 : 환례들의 임상증상, 검사결파, 노출력 및 과거력상 DMAC에 의한 독성간염으로 추정된다. Dimethylacetamide is widely used in the production of plasics, resins, synthetic fibers, and gums and in purification and crystallization processes. Inhalation of the vapor or skin absorption of the liquid of dimethylacetamide (DMAC) can cause liver damage. Toxic hepatitis possibly attributable to DMAC exposure occurred in seven works among 178 employees who had worked on a new spandex-fiber production line. A large amount of DMAC is used as a spinning solvent for synthetic fibers in the factory. The patients were aged 23-47 years old and composed of five males and two females. They were involved in the process of polymerization(1 patient), spinning(1), take-up(4) and packaging(1). The mean duration of exposure was 10 weeks. They experienced fatigue, dizziness and jaundice. The patients showed elavated total bilirubln, alanlne aminotransferase (ALT), and aspartate aminotransferase (AST) levels. The serologic test for viral hepatitis A, B and C were negative, as were the abdominal ultrasonographic scans. Based on the presumptive diagnosis of DMAC-induced toxic hepatitis, they were removed from the workplaces. One or two months after removal from the work, the transaminase levels returned to normal. The patients had no history of significant alcohol use, blood transfusion, recent medication, and drug abuse. As a result, authors could not find any attributable cause of toxic hepatitis but the toxicity by DMAC exposure.

체조선수의 심리적 기능과 역할에 관한 이론적 고찰

김충태,박영희,송유진 韓國體育大學校附屬 體育科學硏究所 1997 韓國體育大學校附屬 體育科學硏究所論文集 Vol.16 No.1

The purpose of this study was to identify psychological methods and a range of applications as well as to apply theoretical knowledges about how gymnastic performers approach psychologically to increase quality of performance in terms of training and games. The psychological factors were an important tool in performing gymnastics underlying comples tasks and balances. As a matter of facts, researchers have investigated the most specific description of personality and characteristics of mental activity in systematic training of gymnatics. however, there has been a problem that coaches do not use psychological methods in training processes. The coaches who were related to the most aggressive factors were not open-minded in using the psychological methods. The guidelines of the most important psychological training for the coaches were as follows, 1. Coaches should know how they select potentially competitive performers and methods of psychological test for coaching strategies. 2. Coaches should learn psychological training methods about motion perspective, overcoming protective response, focus on strengths, overcoming physical-emotional fatigue and adopting psychological-physical load. 3. Coaches should learn educational-psychological methods that lead to the successful outcome, which performers can release psychological tension and competitive stress, cultivate persistence and overcom the emotional reactions about success and failure for beneficaial psychological background. 4. Coaches should learn coaching methods which were continuing instructional training, positively motivating performers and stimulating performers more interest about training and practice. 5. Coaches should provide beneficial psychological environments during training session. 6. According to the factors of analytic psychology, coaches should get to know each performer's age, personality characteristics, game preparation. For the sake of the above guidelines, coaches must execute continually goal-directed training and require recent research background in the field of sport psychology.

포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.

상악중절치에서 전부도재관의 finish line 형태에 따른 파절강도와 응력 분포에 관한 연구

기태석,김계순,이진한,김유리,동진근 원광대학교 치의학연구소 2003 圓光齒醫學 Vol.12 No.1

The purpose of this study was to compare the fracture resistance of the IPS Empress ceramic crown with 1.0mm width rounded shoulder, which is usually recommended in all ceramic crown, and 0.5mm width chamfer finish lines on the maxillary central incisor. After 15 metal dies were made for each group, the IPS Empress all ceramic crowns were fabricated and cemented with resin cement(Bistite resin cement, Tokuyama Soda Co. LTD., Japan) on the metal die. The cemented crowns were mounted on the positioning jig and the universal testing machine(Zwick Z020, Zwick Co, Germany)was used to measure the fracture strength, with loading on the incisal edge. And also, three-dimensional finite element stress analysis was used to measure the stress distribution with the various types of the finish lines (1.0mm width rounded shoulder, 0.5mm width chamfer), the loading site (incisal edge, incisal ⅓), and the type of loading(concentration loading, distribution loading). The results of this study were as follows. 1. In the fracture resistance experiment according to the finish line, the mean fracture strength of rounded shoulder(876N) and the mean fracture strength of chamfer(882N) did not show any significant difference between each other(p>0.05). 2. The stress distribution of all ceramic crown in three dimensional finite element analysis showed concentration aspect at loading point and cervical area of labial surface. 3. In metal die, there were no differences in stress distribution between finish lines, but in natural teeth model, chamfer finish line showed higher stress than rounded shoulder finish line. 4. When force was loaded on the incisal edge, the stress was concentrated on the incisal edge and the cervical area of labial surface. When force was loaded on the incisal ⅓, the stress concentrated on the cervical area of labial surface and the cingulum area. 5. Generally, natural teeth model showed higher and various stress than the metal die.

다물체 동역학 모델을 이용한 밸런싱 방법에 관한 연구

지창진,유태규,홍성욱 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

Aysmmetric rotors are often employed in a variety of machines. A large amount of asymmetry in rotors makes the conventional balancing schemes very difficult in implementation. In this paper, a balancing scheme which systematically adjusts principal inertial axes by adding balancing weights is applied. A multi-body dynamic model using commercial codes, ADAMS and SIMULINK, is developed to prove the effect of balancing in a heavily unbalanced rotor.