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      • Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

        ( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

      • KCI등재후보

        일본 '백화파'에 대한 한일 비교문학적 연구 : 이광수와 김동인을 중심으로 Mainly Lee Kwang-Soo and Kim Dong-In

        김종태,강현구 한국현대문예비평학회 2003 한국문예비평연구 Vol.- No.13

        After this treatise grasped the point that a character of the Baekhwa school was idealism, egoism, illuminism, and art for art’s sake, it investigated what appearances that these thoughts had reflected on the Korean modern literature to make Lee Kwang-Soo and Kim Dong-In two pivot objects of study. They, Lee Kwang-Soo and Kim Dong-In met with works and thoughts of the Baekhwa school writers to go to Japan about the time when they played an important role in the Japanese literary world. But they who had quite different characters and thoughts accepted the Baekhwa school through a different logical connection with each other. When He, Lee Kwang-Soo had met with works, he formed an enlightenment consciousness of idealism, and Kim Dong-In egoism and art for art’s sake. The Baekhwa school is the representative writers in the Japanese idealism. They are an important writers from the viewpoint of on the comparative literature of Korea & Japan novel because the Baekhwa school had an effect on two writers who formed the basis of the Korean modern novel. We find out that the Baekhwa school had an enormous effect on the Korean literature if we will consider a relative importance Lee Kwang-Soo and Kim Dong-In have come into possession of the history of Korean novel.

      • KCI등재

        정신분열병에 대한 리스페리돈의 효과 및 안정성

        이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

        연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

      • 청심연자탕(淸心蓮子湯)으로 호전된 뇌내출혈에 고혈압이 동반된 태음인 환자 치험 1례

        오정민,엄태민,최고은,허종원,유호룡,설인찬,김윤식,Oh, Jeong-Min,Eom, Tae-Min,Choi, Ko-Eun,Heo, Jong-Won,Yoo, Ho-Ryong,Seol, In-Chan,Kim, Yoon-Sik 대한중풍순환신경학회 2014 대한중풍.순환신경학회지 Vol.15 No.1

        ■ Objectives The purpose of this case study is to report that a hypertension with intracerebral hemorrhage of tae-eumin was treated with 'Cheongsim Yeunja-tang' and then the symptoms were improved and blood pressure was decreased. ■ Methods Although the patient who had hypertension with intracerebral hemorrhage took antihypertension drugs, intermittent increase of blood pressure was shown. We diagnosed him as Tae-eumin and treated with Cheongsim Yeunja-tang. We daily checked blood pressure and evaluated the symptoms. ■ Results After the treatment with Cheongsim Yeunja-tang, blood pressure was decreased and symptoms were improved. ■ Conclusion The result shows Cheongsim Yeunja-tang has antihypertensive effect and improve hypertension symptoms of Tae-eumin patient with intracerebral hemorrhage.

      • KCI등재후보

        자동차 조립작업자의 사회ㆍ심리적 스트레스와 근골격계 증상과의 연관성

        김일룡,김재영,박종태,최재욱,김해준,염용태 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

        목적 : 이 연구는 자동차 조립라인 근로자들의 사회·심리적 스트레스와 작업관련 근골격계 자각증상간의 연관성을 확인하는 데에 있다. 방법 : 경인지역 소재 자동차 회사 두곳의 조립라인에 근무하는 근로자 636명을 대상으로 하여, 근골격계 자각증상에 대해서는 목과 어깨, 팔과 팔꿈치,. 손목과 손, 허리부위에서의 통증, 쑤심, 뻣뻣함, 화끈거림, 무감각 또는 저림 등을 묻는 표준화된 설문지로 질문하였고, 스트레스 정도는 4개 분야, 45개 항목으로 이루어진 Psychosocial Well-being Index 설문지를 배포후 3점 척도를 적용하였다. 이들간에는 카이자승법, ANOVA rm리고 로짓회귀분석을 사용하여 통계적으로 유의한 연관성을 알고자 하였다. 결과 : 1. 수면시간을 제외하고 연령, 근속기간, 결혼여부, 학력수준, 흡연력, 음주력에 따른 상지근골격계 증상의 빈도 차이는 없었다. 2. 30세 미만의 작업자군에서 사회 심리적 스트레스 점수(p-value: 0.0461)와 스트레스 Factor 3 (p-value: 0.0368), Factor 4 (p-value: 0.0053)의 점수가 높았다. 3. 11∼15년의 근속기간을 가진 작업자의 경우 Factor 1을 제외한 PWI(p-value: 0.0001), Factor 2(p-value:0.0001), Factor 3(p-value: 0.0004), Factor 4(p-value: 0.0001)에서 기타의 근속기간을 갖는 동료에 비해 높은 스트레스 점수를 보였다. 4. 미혼자는 Factor 4에서 기혼자보다 높은 스트레스 점수를 보였다(p-value: 0.0068). 5. 수면시간이 6시간 이하인 작업자군은 6시간을 초과하는 작업자보다 PWI(p-value: 0.0087), Factor 2(p-value: 0.0194), Factor 3(p-value: 0.0048), Factor 4(p-value: 0.0314) 등에서 높은 스트레스 점수를 보였다. 6. 스트레스 점수는 정규분포를 이루었으며 정상군과 스트레스위험군간에 증상의 빈도 차이는 없었다. 7. 근골격계 증상이 있는 작업자군은 무증상군과 비교하여 기타 스트레스 점수는 두 군간에 유의한 차이가 없었으나, Factor 2에서 통계적으로 유의하게 높은 스트레스 점수를 보였고(p-value: 0.028), 단변량(OR: 1.02) 및 다변량(OR: 1.04) 로짓 회귀분석에서도 Factor 2가 양의 회귀계수(0.0226; 0.0352)를 보여 증상에 영향을 주는 것으로 나타났다. 결론 : 근골격계 자각 증상이 있는 조립작업자군은 증상이 없는 군에 비해 우울증 항목에서 높은 스트레스 점수를 보였으나 기타 사회적 역할 수행 및 자기신뢰도, 수면장애 및 불안, 일반건강 및 생명력등의 사회심리적 스트레스 항목에서는 두 군간에 유의한 차이를 보이지 않았다. 로짓회귀분석예서도 우울증이 근골격계 증상에 영향을 주는 것으로 나타나서 비록 제한적이지만 우울증에 해당하는 항목인 Factor 2와 증상간의 연관성을 일부 확인할 수 있었다. 그러나 근골격계 증상발현에는 스트레스 이외에도 인간공학적 혹은 알려지지 않은 요인들 중요하게 작용하므로 이들을 통제한 후의 추가적인 조사를 해야 할 것으로 생각된다. Objectives : To determine the relationship between stress Factors and work-related muscul-loskeletal symptoms of assembly line workers in the automobile industry. Methods : A cross-sectional study was conducted in two Factories of automobile manufacturing companies where inappropriate posture and repetitive motions were required. The total number of subjects was 636, and consisted entirely of men. The Age, length of work duration, marital status, education level, smoking status, drinking status, sleeping time and stress scores were investigated according to subgroups of general characteristics. We divided the subjects into a Reference group and a Stress risk group to compare the frequency of the variables between them. The stress scores of the Positive symptom group were compared with the Symptom free group by the t-test. To measure the stress level, the PWI(Psychosocial Well being Index) which consists of 4 Factors, totaling 45 items, was used. A standardized self-reported questionnaire was used to assess the symptoms in workers. The criteria for positive symptoms were based on Operational Definition of Work-related Musculoskeletal Disorders of the NIOSH. Results : 1) The subgroups of Age, Work duration, Marital status, Education level, Smoking status, Drinking status and Sleeping time revealed no differences in frequencies in musculoskeletal symptoms. 2) Higher PWI(p<0.05), Factor 3(p>0.05) and Factor 4(p<0.01) scores were observed in younger workers compared with older workers. 3) The workers who had work durations betwen 11-15 years showed higher PWI(p<0.01), Factor 2(p<0.01), Factor 3(p<0.01), and Factor 4(p<0.01), compared with other work duration subgroups. 4) Singles had higher Factor 4 scores(p<0.01). 5) The sleeping time of less than 6 hours a day expressed a higher PWI(p<0.01), Factor 2(p<0.05), and Factor 3(p<0.01), Factor 4(p<0.05). 6) There was no difference in the prevalence of musculoskeletal symptoms between the Reference group and Stress risk group. 7) The subjects who had Positive musculoskeletal symptoms showed a significant difference in Factor 2 scores compared with the Symptom free groups. 8) According to a univariate logistic regression analysis, Factor 2(OR: 1.02, 95% CI:1.00-1.04, p-value: 0.0291) expressed significant but mild effects on the musculoskeletal symptoms and a multivariate logistic regression showed a statistically significant effect on musculoskeletal symptoms(OR:1.04, 95% CI: 1.01-1.07, p-value: 0.0170). Conclusion : Psychosocial stress scores were not higher in symptomatic subjects compared with those who had no symptoms. Sleeping longer showed a protective effect on symptoms but this was not statistically significant. There was no relationship between the stress scores and musculoskeletal symptoms in social performance and self-confidence, general well-being and vitality. Factor 2(Depression) was statistically significant though its effect was mild. Limited to this study, We could find partial relationship between psychosocial stress(Depression) and musculoskeletal symptoms. So it could therefore be suspected that ergonomic or other unknown factors may be more significant causes of musculoskeletal symptoms but we did not investigate these.

      • 정전위 SSRT법에 의한 해양구조물용 Cu함유 고장력저합금강의 수소취성한계전위 규명에 관한 연구

        김성종,박태원,심인옥,김종호,김영식,문경만 한국해양대학교 해양과학기술연구소 2001 硏究論文集 Vol.10 No.1

        A marine structural material was well known to have high tensile strength, good weldability and proper corrosion resistance . Cu-containing high strength low alloy (HSLA) steel was recently developed for their purposes mentioned above, And the steel is free about preheating for welding, therefore it is reported that shipbuilding cost by using it can be saved more or less. However the marine structural materials like Cu-containing HSLA steel are being generally adopted with cathodic protection method in severe corrosive environment like natural sea water but the high strength steel may give rise to Hydrogen Embrittlement due to over protection at high cathodic current density for cathodic protection. In this study, Cu-containing HSLA steel using well for marine atructure was investigated about the susceptibility of Hydrogen Embrittlement as functions of tensile strength, strain ratio, fracture time, and fracture mode, etc. and an optimum cathodic protection potential by slow strain rate test(SSRT) method as well as corrosion properties in natural sea water. And its corrosion resistance was superior to SS400 steel , but Hydrogen Embrittlement susceptibility of Cu-containing HSLA steel was hider than that of SS400 steel. However Hydrogen Embrittlement of its steel by SSRT method was showed with pheonomena such as decreasing of fracture time. strain ratio and fracture mode of QC (quasi-cleavage) Eventually it is suggested that an optimum cathodic protection potential not presenting Hydrogen Embrittlement of Cu-containing of HSLA steel by SSRT method was from-770mV(SCE) to - 900mV(SCE) under natural sea water. (Received September 21, 2000)

      • 목형의 엔드 밀링시 절삭조건에 따른 가공 특성에 관한 연구

        김성일,김종택,김민호,신형곤,김태영 한국공작기계학회 2006 한국공작기계학회 추계학술대회논문집 Vol.2006 No.-

        The cutting tests of wood patterns are carried out using CNC milling machine. The cutting forces and surface characteristics of machined surface are investigated at various cutting conditions such as spindle speed, feed speed, cutting direction of wood pattern and wood material. In the CNC end-milling, the surface roughness increases as feed speed increases and decreases as spindle speed increases. However, the cutting force and surface roughness are different along the cutting direction and material of wood pattern.

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