항암화학요법 관련 오심과 구토 완화를 위한 비약물요법에 관한 연구동향

소향숙,최자윤,조인숙,김영재,김지영,김애숙,김옥미,김춘심,김현오,설영애,안정옥,이애리,이영자 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. Method: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. Result: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group: 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. Conclusion: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.

외과중환자에서 APACHE-Ⅱ score의 임상적 의의

설지영,장진성,장일성,배진선 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

The objectives of this study were to refine the Acute Physiology and Chronic Health Evaluation (APACHE-Ⅱ) scoring system in order to more accurately predict hospital mortality risk and to identify the patients who need the ICU admission and the predictability of length of ICU stay for critically ill hospitalized patients. We retrospectively collected data on 36 surgical intensive care unit (ICU) admissions at Dept. of Surgery, Chungnam National University Hospital between March 1993 and June 1996. An increasing APACHE-Ⅱ score was associated with increased mortality rate (p<0.005). And daily APACHE-Ⅱ scores may be used for monitoring of the patient progression and the course of illness (p<0.005). But APACHE-Ⅱ can not predict ICU length of stay (p>0.005). We conclude that APACHE-Ⅱ may be utilized to clinical assessment in the evaluation of the severity of illness and mortality risk in critically ill patients and also APACHE-Ⅱ may prove a useful means of monitoring the course of the illness and response to therapy in any selected patients.

선천성 거대결장증 진단에 필요한 조직화학염색 : Rapid Acetylcholinesterase Staining

설지영,김제룡,김진만,장일성 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Hirschsprung's disease is a congenital absence of ganglion cells in the Meissner's and Auerbach's plexuses of the colon. The definitive diagnosis of the disease can only be based on histologic examination of bowel wall biopsies demonstrating aganglionosis. To distinguish Hirschsprung's disease from other causes of contipation and megacolon, it is helpful to use histologic examination with routine hematoxylin and eosin (H&E) staining and acetylcholinesterase (AChE) special histochemical staining techniques. With H&E staining, the difficulties may arise in the hypoganglionic area of the transition zone, or in hypoganglionosis or neuronal intestinal dyspiasia. The AChE technique provides reliable identification of ganglion cells by staining nerve filaments in close proximity to the ganglion cells. However, the conventional AChE technique takes about 2 hours for the examination of specimens, so it is not suitable for intraoperative examination. Using a rapid AChE histochemical staining technique, it is possible to produce staining of cholinergic fibers in 20 minutes. It should enable the surgeon to use it selectively during operation and to support or refute the H&E findings.

전기로 작업시 폭로된 크롬에 의한 천식 일례

김지용,이영현,임현술 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.2

Occupational asthma is an important occupation-related disease. We experienced a case of asthma induced by chromium. After discovery, chromium has been widely used in industry, Health effects of chromium and its compounds are contact dermatitis(allergic and irritant), mucosal irritation, nasal septal performance, asthma, and lung cancer. Their toxicity depends on valency, solubility, concentration, pH, exposure duration and route. The patient was a 47-year-old male and an ex-smoker. He complained of cough, sputum and dyspnea while working. Total eosinophil count was elevated but serum IgE value was normal. Bronchoprovocation test with 0.5%(w/v) chromium solution revealed early and late asthmatic responses. Although his initial methacholine bronchial challenge test showed a negative result, bronchial hyperresponsiveness deveolped after bronchoprovocation test with chromium solution. After discharge, he has complained of an intermittent dyspnea. It was suggested that chromium could induce occupational asthma in exposed workers. Further investigated are clarify their pathogenetic mechanisms.

선천성담관낭포의 외과적 처치

손기섭,설지영 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

Congenital choledochal cyst is relatively rare disease, however, it is common in East Aisan countries especially in Japan, where more than two thirds of cases are reported. Since in 1723, Vater first reported, many authors have been reported over 1500 cases. It has been reported on operative procedures and prognosis in many ways because of complications and associated diseases including pancreatitis, cholangitis, biliary obstruction, calculus formation and carcinogenesis. Congenital choledochal cyst had chiefly been treated by drainage procedures such as cystoduodenostomy, cystojejunostomy and choledochocystoduodenostomy at thebeginning of surgical therapy. Recently, however, cyst excision is preferred because of complications and associated diseases previously mentioned, authors also has been preformed excision and Roux-en-Y hepatico- or choledochojejunostomy for almost all patients of congenital choledochal cysts.

소아의 장중첩증에 대한 임상적 고찰

배진선,설진영 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

lntussusception is a common cause of intestinal obstruction in the infants and most often observed in babies between 8 and 12 months of age. A clinical analysis was made in 69 children with intussusception who has been treated during 5 years and 11 months from January 1985 through November 1990 in the Department of Surgery, Chungnam National University Hospital. The results were as follows: 1. The sex ratio of male to female was 2:1. 2. As to the age distribution, 82.6% of all patients was occured during 1st year of life, and 60.8% of all was between the third and ninth month. 3. As to the clinical manifestations, vomiting was most frequent(79.7%), followed by abdominal pain(71.0%), bloody-mucus stool(66.7%) and palpable abdominal mass (50.7%) in order of frequency. 4. Overall success rate of reduction by barium enema was 71.0%, and it was decreased with the passage of time, i.e. 90% within 12 hours. 89% within 24 hours, 80% within 48 hours, and 25% later than 72 hours. 5. Body temperature or WBC count was not determinants about the management or outcome of intussusception. 6. Laparotomy was undertaken in 29% of all cases, in whom 70% was managed by manual reduction and resection was performed in 30% of cases. 7. As to the anatomical types in operation group, ileoileal type was most frequent, followed by ileocecal, ileocolic and ileoileocolic type. 8. The complications were present in four cases(5.8%) and there was no death.

갑상선암의 임상적 고찰

배진선,설지영 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

Thyriod carrinoma is rare, representing approximately 1% of all malignancies but account for 90% of all endocrine malignancies. Thyroid carcinoma has a wide spectrum of biologic activity varying from nearly innocuous to very lethal malignancies. The primary treatment for thyroid carcinoma is surgical excision. But the extent of resection, indications for regional lymph node dissection, and the postoperative follow up of patients are the most controversial aspects of management. To formulate a valid rationale for the diagnosis and treatment of the thyroid cancer, a retrospective study of the thyroid cancer treated at the Department of Surgery, Chungnam National University Hospital from January, 1986 to October, 1991 was conducted. The results were as follows ; 1)By the pathological classification, the papillary carcinoma was the most common type and its incidence was 81.1% 2)Female was predminated over male by the ratio of 6.5:1 and most common age incidence was noted from fourth decade to sixth decade, that was 68.9%. 3)The most common duration of illness between the appearance of the symptoms and the treatment was 3 months, which was 31.1%. 4)The most common symptom was the palpable mass at the anterior portion of the neck. 5)Most cases of the thyroid cancer were appeared as cold nodule in the ^99m Tc-Thyroid scan, which was 98.9% in incidence. 6)The right lobe(50%)was the more common site of the thyroid cancer in comparison to the left lobe(28.9%). 7)The incidence of thyroid cancer located in the gland without extrathyroidal extension was 48.9%, and that of the metastasis to the cervical lymph nodes was 34.4% 8)The common surgical procedures of the thyriod cancer were lobectomy which incidence was 51.1%, total thyroidectomy 15.6%, near-total thyroidectomy 10.0% and lobectomy with isthmusectomy 5.6% in order respecitively. And the neck dissection was performed in 16 cases(17.7%) 9) The most common postoperative complications were transient hypoparathyroidism(11.1%), and followed by transient unilateral recurrent laryngeal nerve paralysis(10.0%), hematoma(5.6%). bilateral recurrent laryngeal nerve paralysis and permanent hypoparathyroidism.

소아에서의 선천성 상완동맥 동맥류 : Case report and review of the literatures

배진선,설지영,김경헌,이영 大韓脈管外科學會 1995 大韓脈管外科學會誌 Vol.11 No.2

림프절외 림프종의 WHO 분류 : 임상적 및 면역학적인 표현형의 분석 Clinical and Immunophenotypic Analysis

김진만,설지영,강대영 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

The authors retrospectively reviewed extranodal malignant lymphomas which include various distinctive clinicopathologic entities according to the new WHO lymphoma classification system. The aim of this study was to analyze the clinical characteristics of extranodal lymphomas and the relative frequency of the subtypes with immunophenotype in the Daejeon city and Chungcheong province. The authors reviewed 134 cases of extranodal lymphoma out of 220 cases of total non-Hodgkin's lymphoma which was diagnosed during the last 10 years. Among the cases, gastric lymphomas (26.1%) were the most common anatomic site. Nasal and paranasal (14.4%), skin (13.4%), and Waldeyer's tonsillar ring (11.2%) lymphomas were relatively common in order of frequency. The most frequent subtypes of extranodal lymphoma were marginal zone B-cell lymphoma of MALT (31%), diffuse large B-cell lymphoma (20%), peripheral T-cell lymphoma, unspecified (15.7%), and nasal NK/T cell lymphoma (13.4%), in decreasing order. Compared with a previous studies, the relative frequency of nasal NK/T cell lymphoma was much higher in our study than western countries and similiar to East Asia. The immunophenotype of our extranodal lymphomas was mainly B-cell type (68%) and the remaining cases were T- or NK-cell origin. In conclusion, the occurrence rates for various subtypes of extranodal lymphoma in Daejeon and Chungcheong province were distinct from those in western countries and similiar to those in East Asian countries. The most distincitive entities in our study were marginal zone B-cell lymphoma of MALT and nasal NK/T cell lymphoma. It also appears that the frequency of lymphoma subtypes is changing according to the classification system.

담낭염 및 담석의 임상적 연구

배진선,길기선,설지영,김제룡 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

A retrospective clinical analysis was performed on 152 patients with cholelithiasis who were admitted and treated surgically at the Department of Surgery of Chungnam National University Hospital from January 1995 through December 1996. The results were as follows. 1. The peak incidence of cholelithiasis was 6th decade (27.6%), followed by 7th decade, and the ratio of male to female was 1:1.3. 2. The duration of symptoms was within 1 month in 44.7% of patients. 3. The most common symptom and sign were RUQ abdominal pain (89.5%) and RUQ abdominal tenderness (58.6%). 4. The positive laboratory findings were eleveated ALT (42.8%), elevated AST (38.2%) and leukocytosis (38.8%). 5. The major associated conditions in cholelithiasis were cholecystitis (59.7%), cholangitis (15. 1%) and pancreatitis (9.2%). 6. The location of stones was most prevalent in the gallbladder (86.1%), followed by in the common bile duct (26.9%), and in the intrahepatic duct (12.5%). 7. The most common operative procedure was cholecystectomy (63.2%), followed by cholecystectomy and T-tube drainage (15.8%). 8. Bile was cultured in 44 cases, and the most frequent microorganism was E. coli (40.9%). 9. The postoperative complication rate was 34 of 152 (22.4%), among which residual stone and wound infection were most frequent. 10. The operative mortality was 0.7% and the cause of death was sepsis.