급성 췌장염을 동반한 임신성 급성 지방간 1 예

강미선;박상훈;박지영 서희영;허란;김상현 인제대학교 백병원 2011 仁濟醫學 Vol.32 No.-

Acute fatty liver of pregnancy (AFLP) was first described as a specific clinical entity in 1940 and thought to be universally fatal. Maternal mortality in the past approached 75 percent. However early diagnosis and prompt delivery have dramatically improved the prognosis, and maternal mortality rate is now less than 18 percent. A early diagnosis, a prompt delivery, and a intensive supportive care have improved maternal and perinatal outcome. We report a 30—year—old woman at 37 weeks gestation who have multiple complications including acute pancreatitis in AFLP. She was complicated with acute renal failure, disseminated intravascular coagulation, duodenal ulcer bleeding, spontaneous bacterial peritonitis, pulmonary edema and acute pancreatitis.

나사형 임플란트 고정체의 길이, 직경, 플랫폼 형태에 따른 임플란트와 주위조직의 응력분포

강지은,정현주,양홍서 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.1

Seven finite element models were constructed in mandible having single screw-type implant fixture connected to the second premolar-shaped superstructure, in order to evaluate how the length, diameter and platform shape of a screw-type fixture influence the stress in the supporting tissue around fixtures. The superstructure were made using UCLA abutment, and connected to the fixture with abutment screw. Each finite element model was varied in terms of length, diameter, and platform shape of the fixture according to the commercial fixture(3i Implant Innovations Inc, Palm Beach Gardens, FL33410, USA) while the superstructure and the mandible with a single fixture placed in it shared no difference in terms of appearance. In each model, 250N of vertical load was placed on the central pit of an occlusal plane and 250N of oblique load placed on the buccal cusp. The stress distribution in the supporting tissue and the other components was analysed using 2-dimensional Finite element analysis and the maximum stress in each reference area was compared. 1. Under lateral loading, the stress was larger in the larger in the abutment/fixture interface, and in the crestal bone, compared to the stress pattern under vertical loading. 2. The amount of stress at the superstructure was similar regardless of the length, diameter and platform shape of a fixture. 3. Around the longer fixture, the stress was decreased at the bone crest and subjacent cancellous bone and increased in the cancellous bone area apical to the fixture. 4. Around the wider fixture, the stress was decreased at the abutment/fixture interface, and the bone crest and increased in the cancellous bone area apical to the fixture. 5. Around the fixture having wider platform, less stress was resulted at the abutnent/fixture interface and the upper part of the cortical bone, compared to the fixture having standard platform. In short, the stress distribution of the supporting tissue was affected by length, diameter, and platform shape of a fixture, and the fixture which was larger in diameter and length could reduce the stress in the supporting tissues at the bone-fixture interface and bone crest area.

급성 약물중독 환자의 응급의학적 고찰

강지훈,이현노,진영호,이재백 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.3

Background : Nowadays, acute drug intoxication is a important section of emergency medicine. The purpose of this study was to determine what is the best-way to manage acutely intoxicated patients with drug in emergency department setting. Methods : Clinical assessment were made on 135 cases of drug intoxication visited to emergency center of Hospital during one year from June 1997 to May 1998. Results : 1. The total number of cases of acute drug intoxication was 135 which is 0.5% of total patients presented to emergency center. 2. There was no sexual difference in incidence, but the highest incidence of age group was in 3rd decade(23.7%) and the next was 7th decade(20.0%). 3. High frequency of acute intoxication was observed in autumn. October had the largest portion in monthly distribution. The largest portion of presumed time of poisoning was noon - 4 p. m. and of the time on arrival to emergency center was 8 p. m. - midnight. 4. Suicidal attempt was the most common motive of intoxication (72.6%). 5. The most common drug of intoxication was insecticides (35.7%) and the others were centrally active agents, herbicides in orders. 6. Mental change was observed in 20.7% of patients and the abnormal vital signs were hypertension, tachycardia, and hypotension in order on arrival to emergency center. 7. Mean duration of treatment was 36.1 hours. Mortality rate of the cases was 7.4%. Conclusion : The mortality rate was high in patients who ingested relatively fatal drugs (i.e. herbicides, antimicrovials, insecticides), showed mental change on arrival or received mechanical ventilatory care(p < 0.05).

일 도시 고등학생의 음주동기와 음주문제

강혜영,신경은,장현지,나영화,조은희 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Purpose : The purpose of this study was to investigate drinking motives and the drinking-related problems of Korean high school students at a city in Jeonbuk province. Methods : There were 657 students from two academic and two vocational high schools at J city in Jeonbuk province. The sample was collected using a stratified sampling method and the data was collected from June 30th to July 16th 2003. The study instrument used to examine drinking motive was a 20.item summated scale (Cronbach's α = .95) and for drinking-related problems was an 18 item summated scale (Cronbach's α = .91). The data was analyzed using SPSS/PC+ by percentage, χ2.test, t-test and correlations. Results : 1. Drinking experience: Among the high school students, 74.3% of them had drinking episodes. Female students started drinking later (χ2 = 12.857, p = .002) and had more drinking friends (χ2 = 7.785, p = .020) than males. Vocational school students drank more frequently (χ2 = 32.138, p = .001), had more heavy drinking episodes (χ2 = 40.370, p = .001). 2. Drinking motives & Drinking-related problems: The mean score of drinking motives was 31.2 ± 11.12 out of 80 and that of drinking-related problems was 21.8 ± 5.85 out of 72 points. Neither score were stronger was significantly different according to gender and grade. On the other hand, both drinking motives (t = .4.077, p = .001) and drinking-related problems (t = .3.423, p = .001) were stronger in vocational school students than in academic school students. The correlation between drinking-related characteristics and problems were weak (from r = .286 to r = .520) but the correlation within the subcategories of drinking motives was high such as between enhancement and coping (r = .822) and enhancement and social motives (r = .822). Conclusion : The majority of Korean high school students start to drink during their junior high school days. Drinking motives and drinking-related problems were not serious but the drinking motives and the drinking-related problems are stronger among vocational school students. As a result, school-based health education and counseling programs should focus on solving drinking motives than on drinking-related problems.

한국판 주의력결핍 장애 평가 척도-가정판: 신뢰도 및 타당도 연구

강지현,박성찬,박형배 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

저자들은 주의력결핍 과잉운동장애에 대한 부모 평가척도인 주의력결핍 장애 평가척도-가정판(ADDES-HV)의 한국판 개발을 위해 본 연구를 시행하였다. 대구시 지역에 소재한 3개 국민학교 2학년 아동 538명과 주의력결핍 과잉운동장애 환자 36명의 환자군을 대상으로 ADDES-HV의 신뢰도와 타당도에 관한 검증을 실시하여 다음과 같은 결론을 얻었다. 1) 세 학교사이의 ADDES-HV 점수는 차이가 없었다. 2) 세 학교 학생들의 남녀간 비교에서 남자가 ADDES-HV 소척도 및 전체 점수 모두에서 여자보다 유의하게 높았다(p<0.05). 3) 주의력결핍 과잉운동장애 환자군 및 정상 대조군에서 남녀간의 ADDES-HV의 점수에는 유의한 차이가 없었다. 4) 검사-재검사 신뢰도 검증에서 신뢰도 계수는 주의 산만이 0.80, 충동성이 0.69, 과잉 운동이 0.63, 전체 점수 0.82로 모두 만족할 만큼 높았다 (p<0.05). 5) 내적일관성에 의한 신뢰도 검증에서 Cronbach α값은 주의산만,충동성,과잉운동 소척도에서 각각 0.91, 0.88, 0.89(p<0.05)이었고, 반복신뢰도 계수는 주의산만, 충동성, 과잉운동 소척도에서 각각 0.86, 0.86, 0.80(p<0.05)이었다. 6) ADDES-HV와 DSM-Ⅲ-R 척도와의 공존 타당도는 주의력결핍 과잉운동장애 환자군에서 0.57(p<0.05), 정상 대조군에서 0.84(p<0.05)였다. 7) 주의력결핍 과잉운동장애 환자군과 정상 대조군간의 감별 타당도 검증에서 모두 유의하게 환자군이 높은 점수를 보였다(p<0.05). 8) ADDES-HV의 환자군에 대한 판별력을 평가하기 위한 판별 분석에서 전체 판별력은 94.44%였다. 9) 정상적인 점수의 상한선인 절단점은 표준편차 1.5로 볼 때, 국민학교 2학년 남학생은 80점, 여학생은 69점이었다. 따라서 ADDES-HV 척도를 한국인에 적용한 결과 신뢰롭고 타당함이 입증되었고 환자를 판별하는 능력이 우수하여 향후 주의력결핍 과잉운동장애에 대한 선별 검사 및 조사 연구에 유용한 도구임이 입증되었다. The purpose of this study was to examine the reliability and validity of a Korean version of Attention Deficit Disorder Evaluation Scale-Home Version(ADDES-HV). ADDES-HV was administered to 538 second grade students from 3 elementary schools and 36 Attention Deficit Hyperactivity Disorder patients. There were no differences in the mean scores of ADDES-HV among schools. Male students showed significantly higher scores than female students in both subscale and total scores(p<0.05). There were no significantly differences in ADDES-HV scale scores between male students and female students both in attention deficit hyperactivity disorder patients group and in normal control group. In the reliability test, the test-retest reliability coefficient 0.82, significantly high ; 0.80 for inattention, 0.69 for impulsivity, 0.63 for hyperactivity and total score was 0.82. In the reliability test by internal consistancy, the Cronbach αcoefficient was also high ; 0.91 for inattention, 0.88 for impulsivity, 0.88 for hyperactivity(p<0.05). The split-half reliability coefficients by first-second half method showed high correlation, and coefficient of inattention was 0.86, that of impulsivity 0.86, that of hyperactivity 0.80(p<0.05). The concurrent validity between ADDES-HV and DSM-Ⅲ-R scale was 0.57 in attention deficit hyperactivity disorder patient group and 0.84 in normal control group(p<0.05). The ADHD group was were more discriminated than control group by ADDES-HV(p<0.05). The total discriminant capacity of the patient group in ADDES-HV was 94.44%. Regarding the cutoff point as 1.5 standard deviations, the cutoff scores were 80 for male students and 69 for female students. In this point of view, ADDES-HV scale showed high reliability and validity in applying to Korean subjects and was proved to be the useful screening test tool for attention deficit hyperactivity disorder research.

사회적 지지의 개념모델

강지연,김현숙 김천과학대학 2001 김천과학대학 논문집 Vol.27 No.-

Social support has been wildly used concept in the field of health science as well as in the social science. A positive relationship between social support and health is generally accepted in the literature. However, the set of dimensions used to define social support is inconsistent. This study was designed to analyse the concept of social support and to propose a conceptual model of social support. Social support has two different dimensions, functional and structural, and the social integration or embededness connects these two dimensions. In the contest of structural dismension support is an interpersonal process embedded in an array of social exchanges. Researchers who cling to this idea have focused on the social network and support system of clients. Functional aspect of social support suggests four of most frequently used defining attributes of the concept: emotional, instrumental, informational and appraisal. This type of researchers recognizing the importance of support for continued functioning and wellbeing, especially in time of stress and crisis. As an intervention strategy, the provision of social support is highly valued in nursing.

鹿脛骨이 卵巢摘出로 誘發된 흰쥐의 骨多孔症에 미치는 影響

姜智天,金頀哲,林康鉉,安德均 대한본초학회 1999 大韓本草學會誌 Vol.14 No.2

The purpose of this study is to examine what are the effects of the Deer Tibia on the postmenopausal osteoporosis. In order to observe the effects of the Deer Tibia on the osteoporosis induced from ovariectomy, administered the Deer Tibia in p.o to the ovariectomized Rats, and measured the variance of weight related to osteoporosis, the variance of osteocalcin, calcium, ALP, phosphorus, GOT and GPT in serum, the variance of creatinine, calcium to creatinine rate in urine and urinary volume, the variance of the organs in weight and the variance of the bones. The results of the experiment are as follows: 1. The level of serum ALP, S-GOT and S-GPT in Deer Tibia group was showed a significant decrease in comparison with control group. The level of serum osteocalcine, calcium, phosphorus in Deer Tibia group was showed no efficiency in comparison with control group. 2. The level of urinary volume in Deer Tibia group was showed a significant increase in comparison with control group, and calcium to creatnine ratio in Deer Tibia group showed a significant increase. 3. The weight of tibia ash and the length of femur in Deer Tibia group showed no significant change. The bone density in Deer Tibia group showed a significant increased in comparison with control group. 4. Body weight in Deer Tibia group was increased in comparison with control group, but showed no efficiency. The weight of heart, liver, spleen, kidney and uterus in Deer Tibia group showed no significant change in comparison with control group. According to the above results, effects of the Deer Tibia on the aged ovariectomized rat model showed a efficiency in elevation of bone density by increasing bone mass and in prevention of renal function failure by ovariectomy. So Deer Tibia can be used for prevention and curing of the postmenopausal osteoporosis, as for it's effects, continuous clinical study is needed.

말기신부전 환자에서 혈액투석 전후의 QT간격분산 비교

강대웅,정지용,윤나라,안치용,김종오,신병철,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Background: Some cases of QT interval, corrected QT interval (QTc), QT dispersion (QTd) and corrected QT dispersion (QTcd) have been reported in ESRD, but these results are variable and the influence of a hemodialysis is still controversial, In this study, we investigated the effect of hemodialysis on QT and QTc interval and QT and QTc dispersion in patients with ESRD 15 min before and 15 minute after each hemodialysis. Methods: Sixty-seven patients with ESRD (men 33 & women 34) on three-times stable hemodialysis (>3 months) were randomly enrolled. Fifty control subjects with a similar age and normal renal function were enrolled from this hospital. Routine biochemical studies were measured pre- and post dialysis, at the time of the ECG. Plasma Na+, K+, BUN, creatinine, ionized calcium and phosphate were checked. Twelve-lead electrocardiographs were performed at 10㎜/mv and 50㎜/s using a HewIett-Packard Pagewriter 100, before and after a single hemodialysis session.The QT interval was measured from the onset of the QRS complex to the end of the T wave. If the end of the T wave was not clear in a particular lead then it was excluded from analysis. When U waves were present, the end of the T wave was taken as the nadir between the T and U waves. Each QT interval was corrected for heart rate using Bazett's formula (QTc==QT/√(RR)) (ms). The difference between maximal and minimal QT interval duration was defined as QT dispersion (QTd) in each of the 12 leads. Result: This study demonstrates that QT, QTd, QTcd is higher in hemodialysis patients compared with control subjects, and QT and QTd rise postdialysis to levels comparable to those seen acutely following myocardial infarction, when patients are at greatly increased risk of potentially fatal ventricular arrhythmias, Conclusions: QT interval and QT dispersion, markers of risk for arrhythmias and sudden death, are elevated in hemodialysis patients, and rise postdialysis. QT interval and QT dispersion is an easily obtainable, noninvasive, simple, inexpensive, and widely available method of risk stratification in uremic patients receiving chronic dialysis. Additional studies are needed to clarity whether increased postdialysis QT dispersion results in an increased occurrence of arrhythmias.

파랑과 흐름이 공존하는 해역에서의 굴절특성

康仁植,柳志泫,咸契運 慶尙大學校生産技術硏究所 1999 生産技術硏究所論文集 Vol.15 No.-

Refraction phenomenon of waves characteristics of shoaling deformation phenomenon supply date of important to wave height distribution of breaker zone and near-shore currents characteristics examination. In this study, when there is current small amplitude wave development was numerical analysis from refraction equation of J.W. Johnson (1947), gripped refraction characteristics to extend computational program. For example application to waves and currents area Sang-ju beach estuary illustrated current phenomenon of jetty and groin vicinity. Discussed and calculated results are as follows ; 1. In case of incident wave period different(significant wave period)effect estuary sea zone refraction diagram. 2. River current of Sang-ju beach estuary effect refraction deformation of incident waves. 3. Currently, rip current occurring on the right jetty, rip current known more getter by currents.

잠김 금속판을 이용한 대퇴골 전자하 골절의 치료 : 압박 고 나사와 비교

손현철, 김용민, 김동수, 최의성, 박경진, 조병기, 박지강, 배승환 충북대학교 의과대학 충북대학교 의학연구소 2011 忠北醫大學術誌 Vol.21 No.2

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