혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

슬라이스기반 정보흐름그래프에 기반한 프로그램 복잡도 측정

최완규,정문재 광주대학교 2000 産業技術硏究 Vol.14 No.-

In this paper, we developed a SIFG(Slice-based Information Flow Graph) for modeling the information flow on a program on the basis of the information flow of data tokens on the slices. Then we defined a measure, called SCM(Slice-based Complexity measure), for measuring the program complexity by measuring the complexity of the information flow on SIFG. We showed that SCM satisfied the necessary properties for the complexity measures proposed by Briand et al.

시비량이 생강의 생육 및 수량에 미치는 영향

최재을,김정선,이은정,이완재 충남대학교 농업과학연구소 1998 농업과학연구 Vol.25 No.2

This experiment was carried out to define the effects of application amounts of the chemical fertilizers on plant growth and yield of the ginger. The results obtained are summarized as follows. Plant height of the ginger was 45.3 cm at lower level of fertilizer, 52.6 cm at recommended level, and 49.4 cm at higher level. Leaf area, stem number, and stem diameter were more significantly increased at higher level of fertilization compared to recommended rate. Dry weight of shoots and rhizomes were significantly increased with the increase of fertilization level. Stem number, stem diameter, leaf area, dry weight of shoots, and fresh weight of rhizomes were positively correlated with the amounts of fertilizer applied. Yield of rhizomes were 1, 653 kg at lower level of fertilizer, 2,248 kg at recommended level and 2,428 kg at higher level, respectively. Ginger yield showed 7.4% higher at higher level of fertilization compared to recommended rate.

하악 무치악 인공치아매식술시 하치조신경 전위술

최의환,하정완,김수관,정태영,김수흥 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.3

Modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Five transpositions of the inferior alveolar nerve together with the installation of 10 implants were performed in four patients. The mean postoperative follow-up time was 17 months, with a range of 8 to 20 months. All implants with functioning pontics remained stable, with no mobility or symptoms of pain and infection during the follow-up period. Neurosensory evaluation was performed using the two-point discrimination test. Two patients had objective neurosensory dysfunction at postoperative, but all the nerve function were reported as normal by the patients 4 months postoperatively.

산업부산물인 Fly Ash의 라이닝콘크리트에의 적용에 관한 실험적 연구

최세진,임정열,정우성,김완영,김무한 공주대학교 자원재활용신소재지역협력센터 2000 2차년도 센터 사업 성과집 Vol.2000 No.1

This is an experimental study to analyze the usability of fly ash in the tunnel lining concrete. For this purpose, the mix proportion of plain concrete and concrete using fly ash(the replacement of 15 and 30% by weight of cement) to satisfy slump 15cm, air content 5% and compressive strength 270kgf/cm2, was selected. And then tests for slump, setting time, compressive strength, tensile strength, drying shrinkage and adiabatic temperature rise were performed. According to test results, it was found that the concrete using fly ash 15% (FA 15 concrete) was better than the plain concrete and FA 30 concrete. FA 15 concrete was more useful than the others in reducing the drying shrinkage : the drying shrinkage strains of FA 15 concrete after 20 weeks of air drying was lower about 10% than the plain concrete, and lower 6% than FA 30 concrete. And the highest compressive strength after curing for 28 days of 365kgf/cm2 was obtained from FA 15 concrete. This was almost 10-20% improvement in compressive sterngth, compare to the plain concrete and FA 30 concrete. And the effect of 5~7.5℃ of concrete using fly ash for hydration heat reducing was calculated. Therefore, concrete using fly ash 15% (FA 15) was expected to improve the performance of lining concrete.

AHP 접근법에 의한 마케팅 의사결정

崔洛煥,杜政玩 全北大學校 1997 論文集 Vol.43 No.-

It makes the rational decision making more critical that the complexity, importance of marketing decision and the radical change of marketing environment followed by technical innovation. Therefore, this study aim to review the Analytic Hierarchy Process which could help a marketing manager to come to a rational decision making, to study the analyzing procedure by the software of AHP for personal computer applied to the case of marketing decision which developed for this study. For the purpose, we premised the decision making as a consecutive three process; intelligence, design and choice. Analytic Hierarchy Process should be an useful tool for the third one. From the application of the case of marketing decision to AHP, it revealed that the analytical and systematic approach were essential. Expert Choice, which is a software of AHP for personal computer, compelled the decision maker to analyze the case in terms of at least three hierarchies; goal, objectives and alternatives. In short, AHP enable the decision maker to incorporate all the facts, and to compare of which through addition and subtraction so that he/she could lead to a reasonable decision or re-evaluate it for an advanced decision.

選手들의 不安과 運動行動의 關聯性에 關한 硏究

김정완,최경호 慶尙大學校 1999 論文集 Vol.38 No.-

The purpose of this study was to explore the adaptability of the Spielberger's 'state-trait anxiety test' for measuring athlete's state and trait anxiety. Questionnaire in-cluding 40 items for anxiety, 5 items for motivation, 13 items for self-efficacy, 6 items for performance was administrated to subjects. The subjects of this survey were 277 male and 124 female athletes of middle school(n=24), high school(n=364), and college(n=13) in Kyeong Sang Nam Do. The results of this study were as follows: 1) Accord-ing the result of factor analysis for items to measure, 3 factors(psychological safety, trait anxiety, and state anxiety)were extracted. 2) The validity(Cronbach's alpha) of each factors was .829 for psychological safety, .773 for trait anxiety, and 776 for state anxiety. 3) By the results of Multiple regression, Forward step-wised multiple regression, and t-test be-tween high and low group of sports anxiety score, The common and differential mechan-isms between Trait Anxiety and State Anxiety were founded. Both Trait Anxiety and State Anxiety statistically significant predict Psychological Safety. While Trait anxiety influenced to self-efficacy, motivation, and performance, State Anxiety didn't. The major limit of this study was a restricted sample. Thus, a future cross-validation study using another nationalized sample should be followed.

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

두개강내 출혈을 동반한 불응성 특발성 혈소판감소성 자반증의 CYCLOPHOSPHAMIDE 치험 1예

서정철,양태영,최연수,박유환,김완중,허경,정원영,정춘해 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Idiopathic thrombocytopenic purpura(ITP) is an autoimmune bleeding disorder characterized by the development of antibodies to one's own platelets, which are then destroyed by phagocytosis in the spleen and liver. Its clinical manifestations are characterized by bleeding and the most serious complication is hemorrhage into the central nervous system, but which is rarely seen below 1%. In treating IPT, the therapy of first chice is administration of adrenocorticosteroid and r-globuline. If satisfactory results are not obtained, then splenectomy is recommended. If this also proves inadequate, then administration of immunosuppressants is carried out. 16-year-old male was admitted with complaints of left hemiplegia and nasal bleeding. This case may be developed spontaneous intracerebral hemorrhage causing thrombocytopenia and was treated by steroid, r-globuline and splenectomy, but satisfactory results are not obtained. After all, the paient was successfully treated with cyclophosphamide.

과학수업모형의 비교 분석 및 내용과 활동 유형에 따른 적정 과학수업모형의 고안

정완호,권재술,최병순,정진우,김효남,허명 한국교원대학교 과학교육연구소 1996 청람과학교육연구논총 Vol.6 No.1

The purpose of this study is to develop appropriate science teaching models which can be applied effectively to relevant situations. Five science teaching models; cognitive conflict teaching model, generative teaching model, learning cycle teaching model, hypothesis verification teaching model and discovery teaching model, were identified from the existing models. The teaching models were modified and in primary and secondary students using a nonequivalent pretest-posttest control group design. Major findings of this study were as follows: 1. For teaching science concepts, three teaching models were found more effective; cognitive conflict teaching model, generative teaching model and discovery teaching model. 2. For teaching inquiry skills, two teaching models were found more effective; learning cycle teaching model and hypothesis verification teaching model. 3. For teaching scientific attitudes, two teaching models were found more effective; learning cycle teaching model and discovery teaching model. Each teaching model requires specific learning environment. It is strongly suggested that teachers should select a suitable teaching model carefully after evaluating the learning environment including teacher and student variables, learning objectives and curricular materials.