40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

백혈병환자의 요추천자 후 침상안정시간에 따를 두통과 요통의 차이

정영남 ( Young Nam Jeong ),이향련 ( Hyang Yeon Lee ),박영미 ( Young Mi Park ) 경희대학교 동서의학연구소 2008 동서간호학연구지 Vol.14 No.1

요추천자 후 침상안정을 취한 군(침상안정군)과 취하 지 않은 군(활동군)간의 두통의 발생 빈도를 비교하는 여러 연구가 있었으나, 어느 연구에서도 두 군간의 유 의한 차이를 발견하지 못하였다 (Carbaat & Crevel, 1981;Dieterich& Brandt 1985). 하지만 아직 대부 분의 병원에서는 요추천자 후 침상안정을 권하고 있는 실정이다 만약 요추천자 후 침상안정이 반드시 필요하지 않다면 피검자는 검사 후 일상생활에 바로 임할 수 있으므로 간호측면이나 시간적, 경제적 측면에서 많은 효과를 기대할 수 있을 것이다(KWon et al., 1997) . 실 제 서울시내 몇몇 종합병원의 경우를 보면, 성인 백혈병 환자의 요추천자가 시행된 후 대부분이 최소 6시간 이상 침상안정을 시키고 있었으며. 요추천자 후 6시간 이상 침상안정을 하는 환자들은 요통, 식사문제, 각종 검사의 지연, 생리적 현상 등을 참아 하는 고통을 갖게 된다. 특히 외래에서 요추천자를 시행한 경우에는 침상부족이라는 현실적 여건들이 6시간 침상안정을 철저히 준수하기 어렵게 한다고 사료된다. 본 연구에서 시도한 백혈병 환자의 요추천자 후 l시 간 침상안정과 6시간 침상안정에 따른 두통과 요통의 차이는 없었다. 이는 침상안정 시간이 척추마취 후 두 통 및 요통 발생에 영향을 주지 않았음을 확인한 Lee 와 mm (1996) 의 연구결과와, 소아종양환아를 대상으로 요추천자 후 1시간 및 6시간 침상안정 시간에 따라 두 통, 동반증상 및 두통의 강도는 유의한 차이가 없었다 는 Park과 Lee (1997) 의 연구결과와 유사하였다. 또한 18, 60세의 성인 신경계 환자 300명을 대상으로 전혀 침상 안정을 시키지 않은 군과 6시간 침상 안정 (3시간 은 앙와위, 3시간은 복위) 을 시킨 군의 천자 후 두통은 차이가 없음을 입증하여 침상안정을 하지 않는 것이 더 나을 것이라고 주장한 Vil血媤 등 (1988) 의 연구와 유사 하며 이는 6시간 이상 침상안정이 필요하지 않음을 시 사하고 있다. 다만 관찰할 수 있는 시간을 갖는다는 의 미에서 수평자세로 잠시 뉘어 놓는다 (Hong, 1993) 의 ‘잠지를 1시간 정도로 생각하면 무리가 없을 것으로 판단하게 된다는 근거 하에 본 연구에서 요추천자 후 l시 간 침상안정군과 6시간 침상안정군으로 구분하여 두통 정도를 비교하였을 때 두 군간에 통증 차이는 없었으며 통계적으로도 유의한 차이가 없었다 (U= 234. 0, P=. 498). 요추천자 후 요통 정도는 1시간 침상안정군과 6시간 침상안정군간에 통계적으로 유의하지 않아서 (u= 238. q p=. 532), 1시간 침상안정과 6시간 침상안정에 따른 요 통의 차이는 없는 것으로 나타났다. 이는 척추마취 환 자를 대상으로 침상안정 시간에 따른 요통의 발생률에 서 가능한 한 빨리 움직일 수 있도록 한 군이 요통 발생빈도가 적었다는 Lee와 mm (1996) 의 연구결과와 유 사하였다. 그러나 요통 점수에서 l시간 침상안정군의 평균점수보다 6시간 침상안정군의 평균점수가 높게 나 온 것은 대상자를 일찍 움직이게 하여 침상안정 시 히 리에 가해질 스트레스를 줄여 주었기 때문이 아닌가라는 견해를 피력한 Brattebo 등 (1993) 의 연구와도 관련성이 있었다. 통계적으로 유의하지 않았지만 6시간 동 안 침상안정을 시킨 군에시 요통 점수가 높은 것은 요 추천자라는 시술로 인한 스트레스 혹은 한국인에게 익숙하지 않은 침대 생활과 침대 매트리스로 얻어진 gj리 의 불펀감이 포함되었으리라 생각 되어진다. 이상으로 종합해 보면 연구대상이 백혈병으로 입원한 환자로 국한함으로써 전채 백혈병 대상자에게 연구결과를 일반화 하기는 어려우나 대상자 대부분이 움직일 수 있고 정상적인 일상생활을 할 수 있다는 점을 감안할 때 본 연구결과에서 나타난 것처럼 침상안정시간에 다른 두통과 요통정도에 차이가 없다면, l시간 이상 침상 안정을 지속하는 것이 꼭 필요한 것은 아니라고 생각된 다. 추후 연구로는 침상안정 기간 중 지속적으로 두통을 호소하는 환자에게 침상안정을 시키되 침상안정기간 동안 두통의 완화 정도 상대도 계속적으로 연구할 필요 가 있다고 사료된다. Purpose: This study was conducted for an evidence-based nursing intervention on bed rest period after puncture, by confirming whether there was a difference in scores of headache and back pain between the 1-hour bed rest group and the 6-hour bed rest group following lumbar puncture in patients with leukemia. Method: The subjects were 45 inpatients of the department of hematology at a general hospital in Seoul, from January 1 to March 31, 2005. There were 21 patients in the 1-hour bed rest group and 24 patients in the 6-hour bed rest group. A graphic rating scale was used to measure headaches and back pains. Collected data were analyzed With SPSS 12.0. Non-parametric statistics were used to analyze the data. Results: There was no significant difference between the 1-hour bed rest group and the 6-hour bed rest group in the headache level and back pain level. Conclusion: Therefore, it is considered that a long period of bed rest over 6 hours after lumbar puncture is not a necessary nursing intervention, and repeated studies are required to confirm the result.

한국 ‘근대 전통의약품’인 <이명래고약>의 역사

이영남(Young Nam LEE) 대한약학회 2016 약학회지 Vol.60 No.5

Over a hundred-year long history of Yi Myongrae s semi-solid ointment (Yi Myongrae Goyak??) was reviewed. Yi Myongrae Goyak??, which one would consider the first Korean traditional drug of modern times, was rooted on Seong Il-ron ( 성일론 ) ointment developed by Emil Devise (1871~1933, Korean name is Seong Il-ron), a Catholic priest of Paris Foreign Missions Society, who served over thirty-five years from 1895 at Gonseri Church, Asan, Chungcheong Nam-do. Devise s ointment made with his own special formular described in both Latin and Chinese was very helpful to many Korean suffered from pyogenic skin diseases. A teenage errand, Yi Myongrae (1890~1952) at Gonseri Church was apprenticed several years to Devise s special formular of herbal medicine and eventually open a cure-house named Yi Myongrae Goyak house at Gonseri in 1906. Since then, Yi Myongrae Goyak?? became very popular for treating pyogenic skin disease such as furuncle, carbuncle, impetigo, ecthyma, etc and gained reputation as the cure-all (panacea) of various purulent skin disease among Korean people even in 1980 s. In 1920, Yi Myongrae Goyak house?? was relocated at Joongrim-dong, near Yakhyun Catholic Church in Seoul. Yi Myongrae Goyak house?? became a family business succeeding to son-in law, Lee Kwangjin (1911~1996). A short time after National Liberation from Japanese Colony, Yi Myongrae Goyak house?? commenced Chungjeongro period, by running the Goyak house??, Myongrae Oriental Clinic at Chungjeongro 3-ga 331 upto 1950 s, at Chungjeongro 375-5 during 1960 s-1978 and relocated at Chungjeong-ro 61-1 since 1978. These sites at a junction of three busy streets were just a few steps apart from each other. Yi Myongrae Goyak?? has been succeeded into two lines: one was Original Yi Myongrae Goyak?? house, Myongrae Oriental Clinic run by doctors of oriental medicine, Lee Kwangjin along with Im Jae-hyung (1944~) who is Lee s son-in law. This Myongrae Oriental Clinic closed currently is looking for a successor. The other line, Myongrae Pharmaceutical Co. at Lipjong-dong and Kwanchul-dong in Seoul operated from 1956 to 2002, by Yi Yongjae (1921~2009), a daughter of Yi Myongrae. Myongrae Pharmaceutical Co. had manufactured massively Yi Myongrae Goyak??, and distributed its product through local pharmacy. However, the full-right on Yi Myongrae Goyak??, owned by Myongrae Pharmaceutical Co. was transferred in a year of 2005 to Mr. Hwnag Kyu-Jang who has been a technical staff of Myongrae Pharmaceutical Co. for many years. Hwang had been in charge of production of Yi Myongrae Goyak?? in cooperative with GP Pharmaceutical Co. Currently Mr Hwang is collaborating with JungWoo Pharmaceutical co.

골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

Korean Dictionaries and Some Model Dictionaries of the World : Critical Essays toward the Plan for a New Korean Dictionary

Lee, Sang Sup,Nam, Ki Shim,Ahn, Sam Huan,Choi, Young Ai,Hong, Chai Song 연세대학교 언어정보개발원 1988 사전편찬학 연구 Vol.1 No.1

After briefly reviewing the history of lexcoigraphy in modem Korea, Nam Kishim tackles many problems created by the general deficiency of current Korean monolingual dictionaries in phonological morphological and semantic points. For example, most Korean dictionaries do not treat such phonological changes as the shortening of the stem vowel ㅓ in 더운, the prenominal form of the adjective 덥다, whose stem vowel ㅓ is pronounced long. He also takes issue with the practice of Korean dictionaries of including all kinds of proper names on little reliable principles : a typical dictionary enters a 600m-high hill while excluding better-known mountains higher than that. Hong Chai-song concentrates on the often misguiding information on transitive / intransitive verbs in current dictionaries. For example, a representative dictionary designates the verb 뛰다 simply as intransitive. But it is quite often used as an transitive also. In the sentence, 철수는 운동장을 뛰었다, 운동장 is the object of the transitive verb 뛰다. How could the compilers miss such an obvious fact? Hong suggests that they may have not been interested in being grammatically informative. A historical survey of the Oxford English Dictionary(OED) is given by Lee Sang-sup, with special emphasis on the vast amount of quotations from real sources contributed by thousands of volunteer readers through several decades and on its unwavering historical principle. A comparison between the OED's definition of Kimchi and a Korean dictionary's 김치 is given, showing the difference of principle in treating the same lexical item. Ahn Sam-huan presents a detailed account of Grimm's Deutsches Wo¨rterbuch which took generations of German lexicographers 133 years from its inception to its completion in 1971. On the basis of his study, Ahn suggests that future dictionary makers should cooperate as a group on a long-range comprehensive project. A moltivolume dictionary is an all-important cultural event for the whole nation, not to be influenced by private commercial interests. Choi Young-ai's survey of Chinese lexicography highlights the now on-going publication of 漢語字典 and 漢語詞典, admirable results of the cooperative effort of hundreds of Chinese scholars, a modus operandi for the Yonsei University graze to adopt in planning a new dictionary of the Korean language.

유아의 성별, 연령에 따른 체력 특성

전영남,양점홍,김수진,이성민 釜山大學校 附設 體育科學硏究所 2005 體育科學硏究所 論文集 Vol.21 No.2

The purpose of this study is to examine the characteristics of young children's fitness development in accordance with gheir gender and age, providing information necessary for an effective physical education instruction for young children's growth and development. For the purpose, this researcher selected total 257 young children from K Kindergarten located at K-gu in B Metropolitan City who consisted of 73 boys and 45 girls, both of were fully aged 4, and 83 boys and 56 girls, fully aged 5.......

그레이브스병에서 치료에 따른 폐동맥압의 변화

남택만,조한수,이진서,송영림,김두만,두영철,박철영,정인경,홍은경,이성진,오기원,김현규,유재명,최문기,유형준,박성우 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경: 갑상선기능항진증에 의한 갑상선중독증 환자들은 호흡곤란을 호소하며, 그 원인으로 호흡근의 근력 약화, 좌심실부전으로 인한 폐모세혈관의 울혈, 기도저항의 증가, 갑상선종으로 인한 기관의 압박, 호흡기능 이상 등이 거론되고 있다. 폐동맥고혈압이 동반된 그레이브스병 환자가 여러 증례가 보고되었으며, 폐동맥고혈압 환자에게서 갑상선 자가항체와 갑상선기능저하증의 빈도가 높음이 알려지면서 갑상선중독증이 동반된 그레이브스병 환자에게서 관찰되는 호흡곤란의 한 원인으로 폐동맥압 증가가 작용할 가능성이 제시되고 있다. 이에 저자 등은 그레이브스병 환자를 대상으로 폐동맥압을 측정하고 치료 전후의 폐동맥압의 변화를 전향적으로 연구하였다. 방법: 갑상선중독증이 동반된 그레이브스병 환자와 정상 갑상선기능을 나타낸 대조군을 대상으로 갑상선기능검사 및 갑상선 자가항체를 측정하고, 심초음파를 이용하여 치료 전후로 폐동맥압을 측정하여 폐동맥압과 갑상선기능 및 갑상선 자가항체와의 관계, 폐동맥압의 변화 등을 관찰하였다. 결과: 1. 연구대상은 대조군 10명 (남녀비 1:9, 관해 상태의 그레이브스병 3명, 갑상선종 3명, 정상인 4명), 그레이브스병 환자 26명 (남녀비 7:19)이었다. 2. 대조군과 치료 전 그레이브스병 환자의 폐동맥압은 각각 23.5±2.32 mmHg, 29.6±10.3 mmHg이었고, 치료 전의 폐동맥압과 혈청 갑상선자극호르몬 결합억제 면역글로불린 (TBII) 농도는 유의한 양의 상관관계를 보였다. 3. 26명의 그레이브스병 환자 중에서 10명 (38.5%)이 폐동맥고혈압 (기준: 폐동맥압 > 30 mmHg)으로 진단되었다. 4. 치료 전후로 폐동맥압을 측정한 13명은 폐동맥압이 치료 전 29.6±10.3 mmHg에서 치료 후 폐동맥압 22.2±6.48 mmHg로 의미있게 감소하였다. 결론: 갑상선중독증을 보이는 그레이브스병 환자의 약 40% 정도에서 폐동맥고혈압이 발견되어 폐동맥고 혈압은 그레이브스병에 흔하게 동반하는 질환으로 생각된다. 향후 그레이브스병 환자에서 관찰되는 폐동맥압의 증가와 관련한 병인, 발생기전 및 임상적 의의 등에 대한 연구가 필요할 것으로 생각된다. Background: Exertional symptoms, dyspnea and impaired effort tolerance are common in patients with Graves' disease. Proposed explanations include: high-output left heart failure, ineffective oxygen utilization and respiratory muscle weakness. In addition, pulmonary hypertension has also been reported in patients with Graves' disease. A high prevalence of hypothyroidism and positive thyroid autoantibody were also observed in patients with pulmonary arterial hypertension. Therefore, the pulmonary artery pressure in patients with Graves' disease was evaluated. Methods: Two-dimensional and Doppler echocardiographic examinations (Hewlett Packard Sonos 2500) were performed to determine the pulmonary artery (PA) pressure in 26 Graves' disease patients, both before and after treatment (23 patients with propylthiouracil and 3 with RAI), and in 10 euthyroid controls. The changes in the PA pressure after treatment were evaluated in 13 patients with Graves' disease, who became euthyroid after treatment. Results: The pulmonary artery pressure was increased in the untreated Graves' disease patients compared to the normal controls (23.5±2.32 vs. 29.6±10.3 mmHg). 38.5% of the Graves' disease patients (10/26) showed pulmonary arterial hypertension (PA>30 mmHg) and the serum TBII level was higher in the Graves' disease patients with pulmonary arterial hypertension than in those with normal PA pressure (P<0.05). In the Graves' patients who became euthyroid after treatment, the PA pressure was significantly decreased. Conclusion: 38.5% of the untreated Graves' disease patients showed pulmonary arterial hypertension, and the pulmonary artery pressure was significantly decreased in those who became euthyroid after treatment. The pathogenesis and clinical importance of pulmonary arterial hypertension in Graves' disease requires further studies (J Kor Soc Endocrinol 18:465∼472, 2003).

만성두통 환자의 성격유형 A 행태, 스트레스, 우울 및 두통영향정도의 관계 연구

차남현,임사비나,정인태,김수영,안경애,김건식,이재동,이상훈,최도영,이윤호,이두익 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

To examine an estimate factor and grasp the relation of difference for Ype A Behavior Pattern(TABP), Perceived Stress Questionnaire. Depression and HIT-6 in the Chronic headache client. Method: Data collected by self-reported questionnaires from 38 client in S city who were selected by criteria of IHS, from the 19^(th) of October to 10^(th) of December, 2004. Result: 1) Differences between biographical data by TABP was significant by SaSang constitutions, by Stress was significantly influenced by age, and by Depression were significantly influenced health status and SaSang constitutions. 2) Correlations Coefficients among Study Variables were Stress and Depression(r=.494, p=.002) and Depression and HIT-6(r=.432, p=.010). 3) In regression analysis, HIT-6 were significantly influenced by Depression and Type A Behavior Pattern(TABP). These variables explained 38% and 34% respectively. Conclusion: The result suggest that chronic headache management with psychological aspect, as well as physical aspect should be a focus to enhance the quality of life.

안양시 유치원 교육환경의 실태와 발전 방향 : The Actual Conditions and the Directions for Improvement

최양미,이은상,김영숙,구광현,이수남 안양대학교 인문과학연구소 1998 人文科學硏究 Vol.6 No.1

Abstract Although environmental factors are important in all stages of education, those factors play more significant roles in the field of early childhood education than in any other school settings in that young children grow and develop rapidly and they are very sensitive to environmental elements. Consequently, it is essential to prepare appropriate educational environments for young children in order to maximize the effect of educational efforts. The environment of a kindergarten can be divided into personal environments and physical environments. Personal environments include parents, teachers, peer groups, and other people in the community. On the other hand, physical environments include the site of a school, school buildings, playgrounds, books, and several kinds of educational facilities and materials.The purpose of this study was to analyze the actual conditions of educational environment of kindergartens in Anyang city and to propose the directions for improving the environment. For this purpose, this study reviewed the significance of educational environment of kindergarten and the history of early childhood education in Anyang. In addition, the information on actual conditions of educational environment of kindergartens was collected using a series of questionnaire and the collected data were examined on the basis of the following categories: 1) Curriculum planning and program implementation 2) Educational facilities and teaching materials 3) Heads and teachersThe results of data analysis revealed that, in general, actual conditions of educational environment of kindergartens in Anyang city were appropriate. However, several problems to be solved were also found. Based on the results of the study, following suggestions can be made for improving educational environment of kindergartens in Anyang city: 1) First of all, heads/managers and teachers in the kindergarten should have strong attitudes and make efforts to solve the environmental problems pointed out in this study. 2) In addition, it is necessary to establish an effective corporation system among educational administrative authorities, schools, and other organizations of social education. 3) In parallel with the above, the government should provide not only strict administrative controls but also proper supports to the field of early childhood education for maintaining and improving the quality of educational environment. It seems that these suggestions are consistent with Anyang city's policy to make this city as “a city of hope in the 21th century, the period of localization” and minimum requirements for preparing the implement of kindergarten education as a stage of public education.

유치 및 초기 영구치아의 치수 신경분포

김영진,남순현,김현정,이재문,이인정 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.2

유치 및 초기 영구치의 치수신경분포 및 변화를 평가하기 위하여 교정치료를 위해 발치한 치근흡수가 비교적 적은 유치,정상 탈락기의 유치,맹출중인 교합하지 않은 제 1소구치,맹출이 완료되어 교합하고 있는 1소구치를 대상으로 neurofilament protein(NEP)을 이용한 면역조직화학적 방법으로 관찰하여 다음과 같은 결과를 얻었다. 치근흡수가 비교적 적은 유치에서도 영구치와 유사한 신경총의 존재와 신경분포 형태가 관찰되었으나,영구치에 비해 그 신경분포 밀도가 낮았으며 분지형성 또한 미약하게 나타났고,전상아질로 진입하는 섬유의 수가 적었다. 정상탈락기의 유치에서는 신경의 변성으로 소포(vesicle),단절(fragmentation)등이 관찰되었으며,그 신경분포가 현저히 감소되어 나타났고,총상의 형태도 소실되었다. 교합하지 않은 제 1소구치에서 치수내의 신경은 말단가지의 숫자가 적고,치수 조상아 세포 경계에 도달하였으며,비교적 가는 신경 섬유가 많았다. 교합하고 있는 제 1소구치에서 치수내의 신경은 말단이 조상아층으로 진출하고,어떤 신경섬유는 전상아질층까지 진입하였으며,비교적 굵은신경 섬유의 분포가 많아졌다. The purpose of this study was to investigate the distribution of nerves in the dental pulp of early extracted primary teeth,normal exfoliated teeth,partially-erupted,nonfunctional,premolars,and erupted,functional,premolars.Numbers of sample were 10 teeth in each group. The distribution of nerves in the dental pulp were investigated by means of immunohistochemistry for detection of neurofilament protein(NFP). The results were as follows: The early extracted primary teeth exhibited patterns of innervation similar to those observed for young permanent teeth.The plexiform arrangement of fibers was not evident in the primary teeth.Most nerves appear to terminate about the odontoblasts. As primary teeth began to undergo root resorption,degenerative changes such as vesicles and fragmentation appear in nerves.The quantity of neural tissue also decreased.In teeth in which the roots were almost completely resorbed only a small number of nerves remain. There was a decrease in the number of terminal branches in the pulp of the partiallyerupted,nonfunctional,premolars and those present reached the pulpo-odontoblastic border. The nerve terminals in the pulp of the erupted,functional,premolars were traced to the dentinal tubule and a few nerve fibers formed loops in the predentin.