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      • 선천성 대사 이상 환아에서 발생한 대사 위기의 복막 투석 치료 효과

        강정혜,이동환,문철,김은미 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

        Purpose : We have evaluated the outcomes of peritoneal dialysis in patients with metabolic crises caused by in born error of metabolism. Methods : There are 6 patients(8 episodes, 4 males and 2 females) who had inherited inborn errors of metabolism and were admitted to the department of pediatrics, Shoonchunhyang university hospital in Seoul from December 1991 to December 1994. The technique of dialysis is discribed, in short: A Tenckhoff catheter was inserted surgically in all patients through the lateral abdominal wall. Commerically available dialysate solutions(Peritosol, Korea Green Cross Co.) was applied to 5 patients(7 cases) with hyperammonemia. In a patient with propionic acidemia, we used a special custiom made dialysate that replaces lactate by bicarbonate. Results : 1) The mean age was 5.3 months old. There were 6 patients with 8 episodes. Six cases had Ornithin transcarbamylase deficiency. The remaining cases are Multiple carboxylase deficiency and Propionic acidemia (Table 1) 2) In 7 cases with hyperammonemia, mean levels of pre and post 24hrs peritoneal dialysis serum ammonia were 1000.2±310.9 ㎍/dl and 388.8 ±156.7 ㎍/dl at 24 hours respectively. Time on serum ammonia levels reached below 300 ㎍/dl was 88.7 ±39.6 ㎍/dl hours. 3) Four out of seven cases were a recorvert of mental status. Each episode of serum ammonia mean levels was 388.8 ±156.7 ㎍/dl after 19.7 ±5.8 hours of peritoneal dialysis (Table 3). 4) Peak serum ammonia levels of the survived group reached 1356.5 ㎍/dl, higher than the expired group of 847.5 ㎍/dl and time period of starting peritoneal dialysis after onset of the survived group was 15.5 hours earlier than the expired group of 23 hours(P>0.05)(Table 4). 5) 3 out of 7 cases of hyperammonemia died. The cause if death were 3 brain edema, 1 hyperkalemla and 1 intracranlal hemorrhage. 6) In onecase with Multiple carboxylase deficiency, serum ammonia level was normalized after 12 hours of peritoneal dialysis. The reduction of serum levels of the branched amino acid was also observed. 7) In a case of Propionic acidemia with severe metabolic acidosis, the prior serum bicarbonate level was 8 mmol/L and was increased up to 18 mmol/L by peritoneal dialysis lasting 19 hours. 8) Among 8 cases, complications of peritoneal dialysis were 5 hypoalbuminemia, 4 hyoercalcemia, 4 hyperglycemia and leakage of peritoneal dialysate. Conclusions : In cases of hyperammonemia, survival rate is 57.1%. They are showed excellant efficacy of treatment of peritoneal dialysis for metabolic crises. In a case of propinic acidemia is fastly corrected by peritoneal dialysis. But unfortunally clinical manifestations is not improved. Therefore, further studies is required with treatment of severe metabolic acidic conditions.

      • 지속성 외래 복막투석환자에서 발생한 장간막경색증 1예

        강동구,이준상,윤재호,장원철,조영일,송종호,전혜정 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

        The mesenteric infarction, as a abdominal disease which show acute abdominal pain and almost need to emergency operation, has very high mortality. This mesenteric infarction has been reported very rarely. Also specific clinical manifestations are not clear, therefore initial diagnosis can be missed easily so that patients usually miss their opportunities for adequate treatment. Especially CAPD patients have high mortality because of their rareness and having similar symptoms like CAPD peritonitis. The authors report that the mesenteric infarction was miss-diagnosed to the CAF'D peritonitis with unspecific symptoms.

      • 남자대학생의 흡연태도와 행동에 관한 연구

        강경진,김정미,민혜영,안소진,오경숙,은경희,이현,이희선,홍주미,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

        There have been so many researches about problems of cigarettes and relation of smoking and heath since 1950's and generally known that smoking is one of the worst factor of increasing disease and mortality. No matter what such many proofs about various problems of smoking have been researched, smoking rate of current male collage students has not been decreased. Besides, most of the researches about cigarette use and its addiction have been focused on the adolescent or adult women smokers or adult male, not male collage student. Therefore, the subject of this study is about smoking attitude and smoking behavior of male collage students by general features. Smoking attitude was analyzed by modifying 'Guidelines for the content of tobacco smoking surveys of the general population'(WHO, 1982). Two hundred of male collage students participated to the distributed questionnaire for one week in May. The smoking attitude was categorized into duration of smoking and number of cigarette per day(CPD), and nicotine dependency, investigated by Fagerstrom Tolerance Questionnaire(FTQ) (Fagerstorm & Schneider, 1989). All statistics were performed by procedure of SAS according to number, percentage, mean, standard deviation, and ANOVA. The results are as follows: 1. Smoking attitude level was mean 25.73±5.15 marks, ranging from 13 to 39 marks of the total 40 marks. 2. Duration of cigarettes, number of cigarette per day, and nicotine dependency were mean 5.14±2.84 years, 12.88±6.85 pieces, and 4.78±1.69, respectively. 3. Smoking attitude showed significance according to general features such as marital state and allowance, but the significance according to marital state is not valuable because the numerical difference is so big between married one and single that they cannot be compared with each other. 4. Duration of smoking was significant according to general features such as age and allowance. 5. Smoking amount showed significance the factors of age only. 6. ll1ere was no significance in nicotine dependency according to general features. As a result, smoking attitude of male collage student in this study shows moderate level. Smoking attitude and duration is significant according to allowance, and smoking amount is significant according to age. Nicotine dependency according to general features is not significant but comparing with the preceding study about adult male, male collage students in this study are respectively more nicotine-dependent than adult male smokers. In conclusion, the right allowance usage strategies and effective heath education focused on the young are needed. In addition, helpful programs and information spreading strategies are necessary for establishing higher level of smoking attitude. At last, systemic regulations in daily living for ""anti-nico-dependent"" and perspective reforming of male university student are needed for reducing nicotine dependency.

      • 알루미늄 압출부재의 굽힘붕괴 특성식 산출에 관한 연구

        강신유,장혜정 강원대학교 산업기술연구소 2000 産業技術硏究 Vol.20 No.B

        In this paper, we would like to develop the bending collapse specific equation of aluminum members which are usually used in light-weight vehicle or electromobiles. The result of the developed equation are compared with that of test and finite element methods as the moment-rotational angle curves. Three types of aluminum members are tested with the pure bending collapse test rig. PAM-CRASH and ABAQUS program are used for finite element analysis. As the result the developed bending collapse governing equation is accurate in estimating the yield moment and the maximum moment. Especially, in the case of the local buckling and the delayed buckling, the developed equation is better effective than F.E.M.

      • KCI등재
      • 시각적 피드백을 병행한 어깨복합운동프로그램이 어깨비대칭 청년들의 어깨 근력과 정렬에 미치는 영향

        강순희, 강은지, 목미경, 박지연, 손혜림, 연우정 한국교통대학교 2016 한국교통대학교 논문집 Vol.51 No.-

        The purpose of this study was to identify whether shoulder complex exercise program with visual feedback could improve the shoulder muscular strength and postural alignment in adolescents with shoulder asymmetry. Twenty eight subjects were recruited from the K university and divided into three groups: experimental 1, 2group(Each n=10) and control group(n=8). For 4 weeks, the experimental group 1 performed shoulder muscle complex exercise program and the experimental group 2 performed shoulder complex exercise program with visual feedback. The control group did not perform exercises. The shoulder muscle strength and difference between the height of left and right shoulders were assessed before, after training using the hand-held dynamometer and Global Posture System. Subordination variables, general characteristics analysis, χ² test and Kruskal Wallis H test were conducted to evaluate differences between groups and training before, after changes were checked Wilcoxon signed rank test with using the PASW 18.0 statistical program. The results of the study were as follows. 1) Both the experimental 1, 2group showed improvements in muscle strength of several muscles following training (p<.01). The control group showed significant reduction in the left posterior deltoid (p<.05), and did not show significant changes in examining other muscles (p>.05). And there were differences among three groups in shoulder muscle strength (p<.001). Muscle strength changes in several muscles were greater in the experimental 1, 2group compared with the control group (p<.001). Muscle strength changes in the several muscles were greater in the experimental group 2 compared with the experimental group 1 (p<.001) 2) Both the experimental 1, 2group showed significant decreases in the difference between the left and right shoulder heights following training (p<.01). The control group did not show change (p>.05). Changes in the difference between the left and right shoulder heights were greater in the experimental 1, 2group compared with the control group (p<.001).

      • KCI등재후보

        망간흄에 노출된 용접근로자의 뇌자기공명영상과 신경학적 소견의 관련성

        장혜숙,박정일,구정완,임현우,김지홍,이정욱,한시령,이강숙,피영규 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.2

        This study was carried out to investigate the relationship between brain magnetic resonance imaging(MRI) and neurological findings in welders exposed to manganese fume. Thirty five welders from a bus manufacturing factory who were occupationally exposed to low dose manganese fume were examined. We collected the information on the demographic factors and welding careers. Laboratory investigations included blood and urine manganese concentration and blood chemistry. Brain MRI was checked, and high signal intensity of the globus pallidus was graded from 0 to 3 compared to the white matter of the frontal lobe. Neurologic examination was carried out. The results were as follows; 1. The mean age of workers 48.3±5.7 years, mean duration of welding was 21.4±5.6 years. 2. On brain MRI, high signal intensity in the globus pallidus was observed in 27 workers(77.1%). Among them, 18 cases(66.7%) showed remarkedly high signal intensity(grade 2). Mean concentration of blood manganese was higher in those with high signal intensity and correlated to the grade of high signal intensity(p=0.02). 3. On neurologic examination, no workers showed the finding of typical parkinsonism. But 11 workers(31.4%) showed subtle neurological abnormalities such as gait without associated arm movement, postural instability, intention tremor, and so on. Blood manganese concentration of neurologically abnormal group was 2.4±0.7 μg/dL, which was significantly higher, compared to 1.8±0.7μg/dL of neurologically normal group(p=0.03). 4. Among 27 workers who showed high signal intensity on brain MRI, 10 workers(37%) were neurologically abnormal. Higher grade of signal intensity on globus pallidus showed higher rate of neorologic abnormality(p<0.05). Especially postural instability and gait without associated arm movement were prominent findings. These findings suggest that high signal intensity on brain MRI might be associated with a prodromal sign of manganese intoxication. Careful neurologic examination should be followed up on welders showing high signal intensity in the golbus pallidus of brain MRI.

      • KCI등재

        일개 제빵회사 근로자의 제빵공 천식 유병률

        김정민,권영준,주영수,임형준,이태경,강혜련,백도명 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.3

        목적: 일개 제빵회사에서 제빵공 천식 유병률을 조사하여 제빵공 천식으로 인한 국내 질병부담을 파악하는데 기초자료를 제공하고자 하였다. 방법: 일개 제빵회사의 생산관련 근로자 596명에서 수습기간(3개월) 중이거나 참여를 거부한 216명을 제외하고,380명을 연구대상으로 하였다. 밀가루분진 노출형태에 따라 직접노출군과 간접노출군으로 직무 카테고리를 분류하고,설문조사는 ISAAC 설문항목에 직업력 등을 추가한 설문지를 사용하였다. 설문조사에서 천식이나 알레르기병과 관련된 증상이나 병력이 전혀 없는 간접노출군은 임상검사대상에서 제외하였다. 임상검사대상 233명에게 피부단자검사,혈청 특이 IgE 항체검사,산업의학 전문의와의 면담을 시행하였고,면담에서 천식이나 알레르기비염과 관련된 증상이나 병력이 확인된 31명을 연속적 PEFR 측정대상으로 하였다. PEFR 변동률로써 메타콜린 기관지유발검사대상을 선정하였고,메타콜린 기관 지유발검사에서 기관지과민성이 확인된 경우에 특이 기관지유발검사를 시행하였다. 제빵공 천식은 특이 기관지유 발검사에서 천식반응이 확인된 경우로 정의하였다. 결과: 연구대상의 밀가루 민감화율은 21.0%(직접노출군 25.9%,간접노출군 13.3%), 제빵공 천식 유병률은 3.2%(직접노출군 5.1%,간접노출군 1.8%)였다. 직접 노출군이 간접노출군에 비해 밀가루에 민감화될 위험이 높았으며(OR 2.15,95% CI=1.03∼4.51), 제빵공 천식에 이환될 위험은 통계적으로 유의하지 않았다(PR 2.52,95% CI=O.78∼8.18). 밀가루에 민감화된 군이 그렇지 않은 군에 비해 제빵공 천식에 이환될 위험이 매우 높았다(PR 38.63, 95% CI=6.14∼243.22). 결론: 이번 연구결과는 직업적으로 밀가루에 노출되는 국내 근로자에서 제빵공 천식이 적지 않을 것임을 시사하고 있다. 향후 제빵공 천식으로 인한 질병부담을 보다 정확히 파악하기 위해서는 국내에서 연구된 바 없는 밀가루 취급 사업장(제분회사 등)에 대한 연구가 필요하며,근로자의 건강과 사회경제적 위치를 보호하기 위한 체계적인 연구도 요구된다. Objectives: To determine the prevalence of baker's asthma due to flour dust in an industrial bakery in Korea. Methods: Of the 596 active workers, 380 were allocated to a category of either direct exposure (DE) or indirect exposure (IE) to flour dust and completed a modified ISAAC questionnaire. Of the 380 participants, 233 were screened by an occupational physician interview, a skin prick test, and an ELISA for serum-specific IgE antibodies to wheat flour extracts. Selected workers received serial monitoring of peak expiratory flow rate (PEFR), and positive PEFR respondents received a methacholine challenge test. The diagnosis of baker's asthma was confirmed by a specific inhalation challenge with wheat flour extracts. Results: The prevalence of sensitization to wheat flour and baker's asthma was 21.0% (25.9% DE, 13.3% IE) and 3.2% (5.1 % DE, 1.8% IE), respectively. DE had an increased risk of sensitization to wheat flour (OR 2.15, 95% CI = 1.03∼4.51). Sensitization to wheat flour and the prevalence of baker's asthma correlated significantly (PR 38.63, 95% CI = 6.14∼243.22). Conclusions: These findings indicate a considerable prevalence of baker's asthma among flour-exposed workers in Korea. Future studies will be required to survey the situation in flour mill companies and seek ways to protect the health and socioeconomic position of flour industry workers.

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