상부 조기 위암 환자의 복강경하 상부 위절제술 3례 경험

조규석,김형철,박경규,이문수,송옥평,임철완,신웅진,주종우,유기원 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Background : The reported incidence of early gastric cancer located in the upper portion of the stomach has been increasing with the recent advances in its diagnosis and screening. Recently, we have successfully performed laparoscopic assisted proximal gastrectomy and gastric tube reconstruction without pyloroplasty on three patients with early gastric carcinoma localized to the upper third of the stomach. We describe our modification of this procedure in this report. Method : After creating an surgical pneumoperitoneum, the stomach was mobilized using laparoscopic coagulating shears. Upper half of the greater curvature and three-quarters of the lesser curvature were then dissected along with regoinal D2 lymphadenectomy. This was followed by a 5 cm, longitudinal mini-laparotomy in the upper abdomen, and the construction of the exteriorized stomach with a gastric tube measuring 20 cm long and 4 cm wide. Reconstruction with an esophagogastrostomy was performed using a circular stapler. Result : No post-operative morbidity or mortality was observed in this small series of patients. The average operative time was 250 minutes (range 220-300 minutes), and the average blood loss was 150 ml (range 90-180 ml). The mean number of lymph nodes harvested during these laparoscopic proximal gastrectomies was 24 nodes (range 22-25 lymph nodes). The average postoperative hospital stays was 7.5 days (range 7-8 days). Conclusion : Our technique of laparoscopic assisted proximal gastrectomy and gastric tube reconstruction without phloroplasty offers a minimally invasive technique with the potential of impoving the post-operative quality of life patients with an early-stage proximal gastric cancer.

태권도 수련 참여자의 참여 동기와 만족도의 관계

조은형,김갑수 한국스포츠리서치 2005 한국 스포츠 리서치 Vol.16 No.2

The Purpose of this study was to be use for more rational, systematic instruction for students who are a taekwondo participant's as of 2002 in elementary school, middle school, high school and university, by examining the relationship of gender, edcational level and social class to the motivation of being a taekwondo participant's and to satisfaction. and of relationship of participation intensity and personal training to satisfaction. The subjects in this study were 335 participant's. and the reponses from 295 participant's were selected for analysis. The stastistical method used for the analysis of this study T-test. one-way ANOVA and LSD multiple comparison range test with SPSS/PC+ 11.0 Version for Windows. The results of this study are as Follows. First, as to the relationship of general characteristics to motivation. gender. educational level and social class made a significant difference to cognitive motivation. The stronger cognitive motivation was possessed by the male participant's than the female. by the university participant's than the high school players, and 1w those from the upper class than the participant's from the lower class. Second, as to the relationship of general characteristics to satisfaction. the male participant's expressed better psychological. rest, social. educational and physiological satisfaction than the female participant's. By educational level. the university participant's were more contented psychologically and environmentally than the high school participant's. By social class, there was to significant satisfaction gap between the upper, middle and lower classes. Third. regarding the impact of participation intensity on satisfaction, those who exercised five or six times a week were satisfied in every factor than the participant's who did everyday. By personal training, the players who took personal training showed more satisfaction at every factor except environment factor.

순화슬러지와 생슬러지로 본 질산염제거특성

조순자,정용주,이나은,이정은,손형식,이상준 부산대학교 환경문제연구소 2003 環境硏究報 Vol.21 No.-

Using acclimated sludge with inorganic nitrogen medium for three months and non-acclimated sludge, raw sludge, under aerobic condition we investigated characteristics biological nitrogen removal. As results, e acclimated sludge under aerobic condition accomplished nitrification efficiently. But the samples from the reactor operated raw sludge had higher ammonium concentration rather than the concentration which was loaded by the medium. This means when we are trying to reorganize existing facilities, we should take high initial ammonium concentration into account.

백내장 수술환자 진료결과들간의 관계 : 사전 연구를 중심으로 Pilot study

박은철,김한중,홍영재,조우현,손명세,임승정,강형곤,최윤정 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

Background : This study was done to assess the relationship among multiple patient outcomes of cataract surgery perioperatively, 3-4 months and 12 months after surgery. The patient outcomes include changes in visual acuity(operated eye, better eye), visual function(VF-14), patient satisfaction, subjective satisfaction with vision, and subjective overall health status. Methods : For the assessment of relationship, prospective study was performed with 92 patients who had undergone either one or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed, and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 4 stages : preoperatively, perioperatively, postoperative 3-4 months, and postoperative 12 months. Results : The correlations within patient outcomes at 4 stages - the visual acuity of operated eye and that of better eye, patient satisfaction and VF-14, subjective overall health status and relative health status as against others - were found to be positively correlated. The change in the visual acuity of operated eye and better eye was correlated with VF-14 as well as with patient satisfaction. The change was also correlated with overall health status. However, the correlations between variables were decreased as the postoperative period got longer. Conclusion : As for the postoperative clinical patient outcomes, VF-14 is acted to linker between visual acuity - clinical outcomes and overall health status - endpoint outcomes. Therefore, VF-14 is the index of patient-sided and disease-specific outcome for cataract surgery.

사지의 주요 동맥손상의 처치: 23증례에 대한 분석

원형섭,김상은,배성만,박철완,이 근,조상훈,김상일,우병완 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Extremity vascular trauma is common in most emergency centers, and controversy remains about the optimal management of arterial injuries. Retrospectively we reviewed the records of 23 patients who had upper or lower extremity arterial trauma from July 1994 to December 1995. The purpose of this study was to evaluate our department`s management policy to major arterial injuries. The leading cause of major arterial injuries was penetrating trauma. We found that there were clinical findings such as absence of or decreased strength of pulsation(82.6%), cool ischemic extremity(69.6%), large expanding hematoma(43.5%), major bleeding(17.4%) and bruit or thill(8.7%). We gave the priority to management of life-threatening injuries and applied the pressure dressing to wounds as early as possible. There were 18 men(78.3%) and 5 women(21.7%); the mean age was 35(range 20-56 years old) years. There were 12 arterial injuries(52.2%) in the upper extremity and 11 arterial injuries(47.8%) in the lower exteremity. The most commonly injured artery was the brachial artery in the upper(34.8%) and the femoral artery in the lower(30.4%) extremity. The etiology included knife stabbing in 10 patients(43.5%), motor vehicle accidents in 6(26.1%), industrial accidents in 4(17.4%), falls in 2(8.7%) and a farm equipment accident in 1 patient(4.3%). The associated injuries were muscle injuries(78.3%), fracture(56.5%), nerve injuries(52.2%), vein injuries(43.5%), shock(17.4%) and dislocation(13.0%). All patients with arterial injuries were given a preoperative prophylactic antibiotic and TIG(tetanus immunoglobulin). We used Doppler technique as a means of detecting the blood flow. Fourteen patients(60.9%) underwent preoperative arteriography in the radiology department. We performed surgical exploration as soon as major arterial injuries were suspected. The most common methods of treating major arterial injuries were interposition vein graft(69.6%) and end to end anastomosis(21.7%). Systemic or locally infused heparin was used for all vascular repairs. In many of our patients(56.5%), fasciotomy was performed before the vascular repair, as a part of the exploration of the distal arteries. There were 2 amputations(8.7%) but no death. The reason for secondary amputation were wound infection in one and failure to achieve sufficient arterial flow to the involved extremity with resulting gangrene in the other. As the time factor is vitally important in the management of arterial injuries, we advocate prompt and early surgical treatment within 6 hours of the trauma. In conclusion, we believe that the crucial factorsin successful management of major arterial injuries of the extremities are early diagnosis, prompt treatment, complete debridement, fasciotomy when indicated, and simultaneous treatment of concomitant injuries.

백내장 수술환자의 진료결과에 미치는 요인 : 사전 연구를 중심으로 Pilot study

박은철,홍영재,임승정,강형곤,최윤정,김한중,조우현,손명세 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

Backgroud : This study is to identify preoperative patient characteristics associated with a lack of improvement on one or more measures perioperatively, postoperative 3-4 months, and postoperative 12 months. Methods : For the assessment, prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. The criteria of improvement were (1) Snellen visual acuity, (2) a cataract-related symptom score(possible range: 0. 0 of 6 symptoms present or bothersome, to 18. all 6 symptoms very bothersome), and (3) VF-14 score - a measure of functional impairment in patient with cataract - (possible range: 0, inability to perform any of the applicable activities, to 100, no difficulty in performing any of the applicable activities). Results : Although 14 patients (15.2%) failed to improve on one or more of the outcome measures assessed, no one failed to improve on all three measures. Both eyes of surgery than one eye, preoperative cataract symptom score of 1-4, 5 or higher than 0 were associated independently with the increased likelihood of improvement (odds ratio 8.95, 7.16, 8.87 respectively). And the preoperative level of Snellen visual acuity was not associated with the likelihood of improvement Conclusion : We conclude that specific preoperative characteristics (both eyes, cataract symptom score) are independent predictors of patient outcome after cataract surgery,

신생아 고 17α-Hydroxyprogesterone치의 추이

박은영,조진형,이수진,양승,김광남,신재훈,오필수 대한소아내분비학회 2003 Annals of Pediatirc Endocrinology & Metabolism Vol.8 No.2

백내장 환자의 시기능지표 : 사전 연구를 중심으로 Pilot study

강형곤,박은철,최윤정,김한중,홍영재,조우현,손명세,임승정 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university-hospital. Patients were interviewed, and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery-process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity (VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ≥0.86). The better visual acuity(operated eye. better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest R². Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to beused for analysis.

체급별 태권도 선수의 유·무산소성 능력의 판별함수

김갑수,조은형 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

The purpose of this study is to analyze highschool Taekwondo player's physiological characteristics such as aerobic capacity, anaerobic capacity, and isokinetic muscle functions and to find out the discriminant suitable for the qualified weight classification on the basis of the results. To carry out this purpose, eighty players (ten in each weight) were observed in the experiment and the physiological characteristics of them were obtained and analyzed by discriminant analysis. The methods used in this experiment are as follows: The analysis of the data was performed by SPSS (Statistical Package for the Social Sciences), One-Way ANOVA (Analysis Of Variance between groups), and Discriminant Analysis. The P value is significant when it is less than 0.05. The results of this experiments are given as below. First, Maximal Oxygen Uptake(VO₂max) in GXT and Peak Torque in Isokinetic Muscle Functions Test make some differences in each group. But, (Maximal Heart Rate (HRmax) and AT (Anaerobic Threshold) in GXT didn't differ from each group as well as Mean Power in Isokinetic Muscle Functions test. Second, AT measured by Wingate test represented that Peak Power, Mean Power, Fatigue Index were different for each weigh. Also, Peak Torque in Isokinetic Muscular Strength Test was different for each weigh. Rut, there was no difference in total work in Wingate Test and Mean Power in Isokinetic Muscular Strength Test. Third, both results of Aerobic Capacity and Anaerobic Capacity analyzed by discriminant Analysis in each weigh were both significant on(in) Function 1. The results of Aerobic Capacity analyzed by discriminant Analysis had remarkable significance in order of Peak Torque(R), Peak Torque(L), and, VO₂max And, the result of Anaerobic Capacity analyzed by discriminant Analysis had remarkable significance in order of Fatigue Index, Mean Power, Peak Torque(R), and Peak Power. In conclusion, the result of this experiment represents that the weight classification of Taekwondo players based on the Body Composition, Aerobic Capacity, and Anaerobic Capacity except Basal Physical Fitness had significance in the qualified weight classification.

요추 Y-각 협착증 : 요추간 협착증의 새로운 개념 New Concept of Lumbar Stenosis

김영수,조용은,박형천,윤도흠,노성우 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.1

Authors measured the Y-shaped angle made by both yellow ligaments and both laminae named Y-angle at the spinal CT scan in normal and lumbar stenosis group. The normal range of Y-angle is between 60˚and 95˚. Lumbar stenosis is classified into narrow Y-angle stenosis(<60°) and wide Y-angle stenosis(>95°) by Y-angle. Narrow Y-angle stenosis is most common in degenerative spondylotic stenosis. Wide Y-angle is most common in congenital stenosis. The Y-angle is a simple and useful diagnostic indicator in the diagnosis of lumbar spinal stenosis on CT scan and MEU scan.