관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

韓國과 中國의 林産物 國際競爭力

張哲洙,張宇煥,鄭靖吉 한국산림경제학회 2002 산림경제연구 Vol.10 No.2

WTO 출범으로 세계 경제가 무역자유화를 통한 하나의 시장으로 빠르게 통합되고 있다. 특히 중국의 WTO가입은 세계무역뿐만 아니라 우리나라 임산업에도 크게 영향을 미칠 것으로 예상된다. 이러한 세계적 조류속에서 우리나라 임산업이 발전하기 위해선 경쟁력을 높여 나가는 것 외에는 대안이 없다. 여기에서는 우리나라 주요 수출임산물을 대상으로 한ㆍ중 임산물이 세계시장에서 갖는 국제 경쟁력, 상대국 또는 제3국에 대한 수출의존도, 상대국 또는 제3국 시장에서 보여주고 있는 상대적인 경쟁력, 그리고 각 국의 수입의존도 등을 비교 검토해 봄으로서 향후 우리나라 임산물의 대중국뿐만 아니라 제3국 시장으로의 수출확대를 위한 대응방안 마련에 기초자료를 제시하고자 하였다. With the launch of WTO, we can no longer think of our domestic interests and policies without reference to the wider global context. In particular, since China occuies important position in the world agriculture, forest industry, and trade, it is expected that China's joining to the WTO will substantially influence the world trade and forest industry in Korea. One alternative is to strengthen the international competition of our forest products for the development of our forest industry. In this context, the purposes of this paper are laid at the analysis on the international comparatives of some forest products in Korea and China, on the basis of Revealed Comparative Advantage Index(RCA), Exporting Dependent on a particular Country, Comparative Advantage by Countries (CAC), Market Share(MS), etc. This paper also suggests ways to strengthen the international competition of our forest producs in the market of China and Japan.

韓國의 山村振興 現況과 展望에 관한 硏究

張宇煥,孫喆鎬 한국산림경제학회 2002 산림경제연구 Vol.10 No.2

이 연구는 첫째, 산촌의 개념과 범위, 산촌의 실태와 문제상황 등을 이론적으로 검토하고, 둘째, 1995년 이후 현재 추진되고 있는 산촌개발사업의 효과와 문제점을 규명한 다음, 셋째, 이를 토대로 향후 산촌진흥의 기본방향과 정책개선 방향을 모색코자 하였다. 1995년 시작된 산촌개발사업은 2002년 현재 47개 마을이 완료되었으며, 61개 마을이 사업추진 중이거나 사전설계중이다. 이 사업은 지자체와 지역주민으로부터 호응도가 높지만, 사업의 성격, 계획수립단계, 사업집행단계, 사업사후관리단계 등의 측면에서 상당한 문제점도 내포하고 있다. 따라서 산촌진흥을 포괄적으로 규정할 수 있는 독립적인 산촌진흥법(안)을 제정함으로서 산촌개발사업의 원활한 추진과 효과를 제고할 필요가 있다. 그리고 산촌지역의 지속적인 발전을 도모하기 위해서는 산촌 관련 이해 당사자간의 횡적ㆍ종적 연대를 강화하고, 조건불리지역 산촌에 대한 직접지불제, 우수 산촌개발마을에 대한 인센티브제, 도농교류 활성화 프로그램 및 산촌유학제도 등의 신규제도를 도입할 필요가 있다. This study was tried to discuss the concept, area, status, and problems of mountain village, to identify the effects and the difficulties of package development project of mountain village, and to find out principles and political improvement directions. Package development project of mountain villages has been carried out since 1995; 15 villages on initial design, 46 villages on the business propulsion, and 47 villages in project completion. The project is judged to be effective to keep or increase mountain village's population and households, to increase income, and to improve liveing environments. But the project has also many problems in the identity, planning, processing, and post management. So, it inferior liveing condition. And also, to take sustainable development of mountain village, it is needed to intensify across and downward joint of respondence related to mountain development, and to introduce the schemes such as incentive, studying in mountain village, intercourse between mountain and urban area.

SPORTS 外傷에 關한 調査硏究 : Centering around 88 Olympic with representative player '88서울올림픽男子代表選手를 中心으로

盧日煥,姜忠植,金達永,金興植,朴贊弘,元忠熙,姜信一,金正洙,朴晶來,李哲遠,林鎬根 公州大學校스포츠科學硏究所 1988 스포츠科學硏究所論文集 Vol.- No.2

According to the investigation made by analyzing cause of the detail about sports injury. We make this things an object of all the male representative players 254 out of 286 (88.81%) that took part in the whole event from April 15, 1988 to September 16, 1988 in Seoul Olympic Games. The results are as follows. 1. The representative players in Korea started in the athlete life at age 13.1 on the average. Gymnast early started at age 8.4 and yachtist was later at age 18 in the athlete life. 2. There are about 5.7 cases on the outbreak of the sports trauma per person of player a year. This came into existence near the ankle at the high rate of damage formed 11.90%. 3. A sort of sports injury in analysis muscular bruise broke out at the highest rate of occurrence formed 15.70%. 4. The greater part of representative players themselves the injury of trauma by massage (12.53%). Some of them undergo medical treatment to the specialist hospital once a year on the average. Most of hockey players have had experience in this kind of injury treatment three times one year to per person of players. A few of them showed 0.15 times per person a year. 5. Most of representative players have been periodically to the orthopedist formed 27.59 (732) out of all 2653 cases at the high rate of fact. Especially a sort of injury in analysis, the injury of ankle region showed the percentage 11.86 (704) out of all 5,937 cases at the highest rate. 6. The period of medical treatment of the representative players in Korea came out about 14.7 days. Besides period of the other player's treatment came out mostly from one to five days formed 44.82%(935 cases) 7. Manyof them have been roughly treated with muscular bruise in analysis of sports injury. They were taking pains with muscular bruise formed 15.65% (1003) out of all 6408 case. 8. In major cause of sports injury came into existence during the training with waste of physical stamina formed 35.89% and were beyond their power with practicing the game formed 48.09%. Also, a sort of those were brought about the cause of sports injury with desire of outcome too much during in the game formed 44.20%

國産 羊毛의 物性에 관한 硏究

楊澈坤,金洪均,安泰煥 成均館大學校 1981 論文集 Vol.30 No.-

Physical properties of wool are closely related to species of sheep, locality of production and feeding conditions. This paper describes an basic investigation of physical properties of Korean wool. Specific properties affected by crimp were also investigated. The experiment for physical properties of Korean wool was carried out by the conventional method and its for specific properties was done by load extension test. The results of those were as follows; 1. As for fineness values of wool, the quality numbers of Corriedale wool was 56's and its of Romney marsh wool was 46's-48's. 2. As for fineness, mean length, distribution of fibre length, strength and elongation of Corriedale wool were superior to those of standard wool. 3. It was found that strength per denier and elastic limit strength of both species were sligtly higher than its of standard wool 4. Uncrimping force was 1/15-1/21 of yield stress, Recovering of uncimping force and enegy in Korean wool was also significant. 5. Corriedale wool has good quality of which uncrimping force and energy would be changed by crimp. Characteristics of Corriedale wool; elasticity, softness and bulking capacity of wool itself were slightly higher than its of Romney marsh wool

광범위 베타 락탐계 항생제 분해 효소를 생성하는 폐렴간균에 의한 균혈증이 발생한 환자에서 감영의 위험 인자 및 치료 결과

강철인,김성한,방지환,김홍빈,박상원,최영주,오명돈,김의종,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2

목적 : 본 연구는 ESBL을 생성하는 K. pneumoniae에 의한 균혈증 환자에서 감염의 위험 인자 및 치료 결과를 알아보고자 시행하였다. 방법 : 1998년 1월부터 2002년 4월까지 혈액 배양 검사에서 동정된 K. pneumoniae를 대상으로 NCCLS guidelines과 이중 디스크 확산법(double-disk diffusion test)을 이용하여 ESBL 생성 여부를 확인하였다. ESBL 생성 균주에 의한 균혈증 환자 60명(환자군)에 대해 ESBL을 생성하지 않는 균주에 의한 균혈증 환자들(대조군)을 연령, 성별, 균혈증 발생 시점을 고려하여 1:2 또는 1:3으로 배정하였다. 총 159명의 대조군을 선정하였고 후향적인 환자-대조군 연구를 시행하였다. 결과 : 환자군과 대조군 사이에 연령, 성별, APACHE Ⅱ score, 주된 감염 부위의 유의한 차이는 없었다. ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 발생할 독립적인 위험 인자에는 요관 삽입, 균혈증 발생 이전 72시간 동안 침습적인 시술을 받은 경우, 균혈증 발생 이전 30일 동안 투여받은 항생제 개수가 있었다. 초기 항생제 치료 72시간 후의 반응을 평가하였을 때, 완전 반응(complete response)은 대조군에서 더 많았고(13.3% vs. 40.3%, P<0.001), 치료 실패(treatment failure)는 환자군에서 더 많았다(33.3% vs. 11.9%, P<0.001). 7일 사망률은 환자군에서 20% (12/60), 대조군에서 15.6% (25/159)이었고(P=0.451), 30일 사망률은 환자군에서 30% (18/60), 대조군에서 24.5% (39/159)이었다(P=0.410). ESBL 생성 균주에 의한 균혈증이 있는 환자들에서 최종 항생제 치료가 부적절했던 환자들을 제외하고 30일 사망률을 분석하였을 때 효과적인 항생제 치료의 지연은 사망률을 높이지 않았다(11.1% vs. 9.1%, P=1.000). 결론 : ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 있는 환자에서 초기 항균제 치료 72시간 후의 치료 반응률은 낮지만 사망률은 유의하게 증가하지 않았다. 원인균이 동정된 후 최종 치료 항생제의 선정이 적절하다면 초기에 효과적인 항생제 투여의 지연은 사망률을 유의하게 증가시키지는 않았다. Background : This study was conducted to evaluate risk factors for infection and treatment outcome of bloodstream infection due to extended spectrum β-lactamases(ESBL)-producing K. pneumoniae. Methods: ESBL production was evaluated by NCCLS guidelines and/or double-disk synergy test in K. pneumoniae blood isolates stored from January, 1998 to April, 2002. Sixty patients with bloodstream infection due to ESBL-producing K. pneumoniae (case patients) were compared with 159 matched control patients with bloodstream infection of non-ESBL-producing K. pneumoniae. Retrospective case-control study was performed. Results : There were no significant differences in age, sex, APACHE Ⅱ score, and the primary site of infection between the case and control groups. In multivariate analysis, significant independent risk factors associated with bloodstream infection due to ESBL-producing K. pneumoniae were urinary catheterization, invasive procedure within previous 72 hours, and the number of antibiotics administered within previous 30 days. In clinical response at 72 hours after initial antibiotic treatment, complete response rate was higher in the controls (13.3% vs. 40.3%, respectively, P<0.001), however, treatment failure rate was higher in the cases (33.3% vs. 11.9%, respectively, P<0.001). Overall 7-day mortality rates in the cases and the controls were was 20% (12/60) and 15.7% (25/159) (P=0.451), respectively, and overall 30-day mortality rates were 30% (18/60) and 24.5% (39/159), respectively (P=0.410). When the patients with bloodstream infection of ESBL-producing organism were evaluated and the patients who received inadequate definitive antibiotic treatment were excluded, delayed effective antibiotic treatment was found to be not associated with higher mortality. Conclusion : In patients infected with ESBL-producing K. pneumoniae bacteremia, clinical response rate at 72 hours after antimicrobial therapy was lower, but the increase of mortality rate was not significant. Delayed effective antibiotic treatment was not associated with higher mortality, when definitive appropriate antibiotic treatment was prescribed.

과도한 운동으로 발생한 횡문근융해증에 의한 급성신부전증 1예

문철호,류보열,모성환,김태종,기장도,박용관,김용환,정종훈 조선대학교 1995 The Medical Journal of Chosun University Vol.20 No.1

Rhabdomyolysis may be defined as a clinical and laboratory syndrome which releases muscle cell contents into the plasma, such as creatine phosphokinase, due to skeletal muscle injuries. It can be the result of many diverse causes including muscle disease, ischemia, genetic disorder, metabolic disorder, infectious disease, drugs, comatose state, trauma or vigorous exercise that can lead to acute renal failure as a complication. Since first reported in 1941, rhabdomyolysis-induced acute renal failure has been documented many times, and the major causes of this disease are carbon monoxide poisoning, snake bites, and etc in Korea Reports of acute renal failure after exercise-related rhabdomyolysis with myoglobinemia are rare. We report a case of acute renal failure caused by exercise-related rhabdomyolysis in a 20 year old man.

韓國의 山村마을 開發實態와 改善方向

孫喆鎬,張宇煥 한국산림경제학회 2002 산림경제연구 Vol.10 No.2

이 연구는 1995년 이후 현재 추진되고 있는 산촌마을 개발의 평가를 위해 2000년까지 사업이 완료된 산촌마을을 대상으로 하여 투자실적, 계획수립단계, 사업집행단계, 사업사후관리단계의 측면에서 개발실태와 문제점을 규명한 다음, 이를 토대로 향후 산촌마을 사업의 개선 방향을 모색코자 하였다. 산촌마을 개발실태의 평가 결과, 첫째, 계획수립단계에서 주민의 의사 반영 미진과, 마을간 개발계획의 차별성 부족이 제기되었고, 둘째, 사업추진단계에서 지역주민의 참여부족, 사업비에 토지매입비의 미반영, 지역주민들의 융자사업기피로 사업의 집행에 어려움을 겪고 있으며, 셋째, 사후관리단계에서 도입시설의 사후관리체계의 미비 및 사후관리비용의 부족으로 사후관리가 미약한 것으로 나타났다. 이를 개선하기 위해서는 첫째, 산촌마을 개발의 계획 수립단계에서 지역주민을 중심으로 산촌개발협의체 구성과 수립된 계획의 타당성 검토를 강화, 둘째로, 산촌개발사업의 집행 단계에서는 지역주민 중심의 사업추진체제로의 점진적 전환과 사업비의 효율적 집행을 위해 보조사업 분야 조정 및 확대, 융자금의 이용조건 완화, 셋째로, 산촌개발사업의 사후관리 단계에서는 사후관리체계 및 도입 시설에 대한 사후관리비 지원 관련 제도적 장치를 강구하도록 한다. This research was carried out to closely examine the status and problems of mountain village development completed until 2000 by processing steps of the project such as the plan establishment step, the project execution step, and the post management step, and then to grope improvement direction of the project. According to the results, at the plan establishment step, mountain village development plan did not sufficiently reflect inhabitants' suggestions and the distiction among mountain village. Secondly, at the project execution step, the execution of the project was suffered from non-reflection of land purchase cost, finace business evasion of residents, and weak organic cooperation system among residents, company, and local government. Thirdly, at the post management step, local residents' dissatis - faction was grown up because of unprepared post management system and the non - appropriateness of management cost for introduced facilities. The direction to improve these controversial points is as follows : Firstly, at the plan establishment step of the project, it is needed to compose the organization of mountain village development negotiation with local residents so that local residents' intention can be sufficiently reflected. And it is needed to solidify the propriety examination of the plan. Secondly, at the execution step of the project, it is needed to change gradually the propulsion burden of the project from local govemment officer to local residents, to mitigate the condition of loan, and to adjust the subsid items of the project. Thirdly, at the post management step, it is needed to clarify the post management system of the project, and to reflect the fund for the facilitied that post management is required.

von Willebrand's diseasee 1예

박치영,모성환,문철호,곽재정,김태종,전용준,박유환,정춘해 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

다발성 골수종으로 이행한 단일형질세포종 1예

정재용,모성환,기장도,문철호,김창욱,전용준,박유환,정춘해,오윤경 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2