한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

압축성 코드에서 예조건화 코드로의 이진

한상훈(Sang-Hoon Han),김명호(Myeong-Ho Kim),최정열(Jeong-Yeol Choi) 한국항공우주학회 2007 韓國航空宇宙學會誌 Vol.35 No.3

이차원 범프 유동에 대한 다양한 예조건화 행렬의 수렴 특성을 살펴 Choi와 Merkle의 예조건화 행렬을 선택하여, 압축성 및 예조건화 Roe의 Riemann 해법의 수치 소산항을 수학적으로 비교하였다. 이 결과 코드의 구조는 동일하게 유지한 채, 고유치의 작은 수정만으로 압축성 해법을 예조건화 해법으로 이전할 수 있는 방법을 알 수 있었다. 아울러 점성 유동 영역에서의 안정성 및 정확성을 향상시키기 위하여 von Neumann 안정 조건 및 점성 자코비안을 고려하였으며, 개발된 코드는 표준 검증 문제에 적용하여 검증을 수행하였다. Comprehensive mathematical comparison of numerical dissipation vector was made for a compressible and the preconditioned version Roe's Riemann solvers. Choi and Merkle type preconditioning method was selected from the investigation of the convergence characteristics of the various preconditioning methods for the flows over a two-dimensional bump. The investigation suggests a way of migration from a compressible code to a preconditioning code with a minor changes in Eigenvalues while maintaining the same code structure. Von Neumann stability condition and viscous Jacobian were considered additionally to improve the stability and accuracy for the viscous flow analysis. The developed code was validated through the applications to the standard validation problems.

최씨 훅을 이용한 복강경 버찌씨 수술

김영혜 ( Young Hye Kim ),박준선 ( Jun Seon Park ),최상준 ( Sang Joon Choi ),송창훈 ( Chang Hoon Song ),한세준 ( Sei Jun Han ),정혁 ( Hyuk Jung ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.6

목적: 버찌씨 수술은 복압성 요실금 수술에 효과적인 수술로 여겨져 왔다. 요실금의 원인이 내인성 요도 괄약근의 결손소견 없이 요도의 과운동성으로 인한 경우 버찌씨 수술이 일반적으로 추천되어진다. 본 연구에서는 복강경 버찌씨 수술에서 최씨 훅의 유용성에 대해 알아보고자 하였다. 연구방법: 2000년 10월부터 2005년 3월까지 본원에서 복강경 버찌씨 수술을 시행받은 47명의 환자를 대상으로 하였다. 27명은 고전적 복강경 버찌씨 수술을 시행하였고 20명은 내골반 근막을 Cooper 인대를 부착하는데 유용한 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행하였다. 결과: 고전적 복강경 버찌씨 수술을 시행한 군과 최씨 훅을 이용한 복강경 버찌씨 수술을 시행한 군의 평균 나이, 분만력, 폐경률, BMI는 두 군간에 통계학적으로 유의한 차이를 보이지 않았다 (p>0.05). 수술 시간은 고전적 복강경 버찌씨 수술은 90.52±15.32분, 최씨 훅을 이용한 복강경 버찌씨 수술은 38.50±10.14분으로 최씨 훅을 이용한 경우 수술시간이 통계적으로 유의하게 짧았다 (p<0.05). 두 군간에 재발률 및 합병증 발생은 통계적 유의성을 보이지 않았다 (p>0.05). 결론: 본 연구에서 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행한 결과 수술 시간을 단축시킬 수 있었으며 수술 효과는 기존 방법과 동일하게 관찰되었다. 이에 최씨 훅은 복강경 버찌씨 수술에서 사용할 때 집도자의 봉합 과정을 단순화시켜 수술 시간을 단축시키므로 복강경 버찌씨 수술에 용이한 기구이다. Objective: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi`s hook in laparoscopic Burch operation. Methods: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament (Group 2). Results: The mean age of patients of Group 1 was 55.6±9.37 years of age and that of Group 2 was 56.0±5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5±15.32 minutes for Group 1 and 38.5±10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P<0.05). There was no difference in recurrence rate and complication rate between Group 1 and Group 2 (P>0.05). Conclusion: We performed laparoscopic Burch operation with the Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi`s Hook, we could shorten the operation time using the Choi`s Hook.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

장애인 주간보호센터의 현황과 공간구성에 관한 연구

최상훈 서강정보대학 2000 論文集 Vol.19 No.-

Day care center service for the handicapped has been made at the welfare center for the handicapped or social welfare center with their programs rather than at the special day care facilith and the existing facilities are used without the exclusive day care system. When the survey facilities are divided centering around those providing day care service, these are divided into annex type, monolithic type and exclusive use type. From the viewpoint of the current spatial components at survey functions day club providing the child care facilities of the handicapped children instead of providing the specialized service because it has poor equipments, facilities and personnel organization of managers. Also, for day care service, the related service facilities are arranged an the first floor for easy access of the handicapped and it will enhance the availability of service. Especially, the approval of day care service only for the facilities which can provide the appropriate service for its qualitative improvement is required.

치아의 순(협)설 경사도 변화에 따라 파노라마 방사선 사진에 나타난 치아 길이 및 각도 변화

최갑림,임성훈,김광원,김재덕 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.2

파노라마 방사선 사진은 치아 및 주위 조직에 대한 많은 정보를 제공해 주며 교정치료 동안에도 치근의 근원심 경사도나 길이 평가를 위해 흔히 이용되고 있지만 파노라마 방사선 사진에서 보이는 치아의 근원심 각도와 길이는 순(협)설 경사도에 의해 영향을 받는 것으로 알려져 있다. 따라서 본 연구에서는 치아의 근원심 경사도를 정상교합자의 평균 근원심 각도로 유지하면서 순(협)설 경사도만 변화시킬 때 파노라마 방사선 사진에서 각 치아의 근원심 경사도와 길이가 어떻게 변화되는지 알아보고자 하였다. 성인 정상 교합자 30명의 평균 악궁을 기초로 하여 아크릴 모델을 제작한 후 치아를 대신하는 와이어를 정상 근원심 및 순(협)설 경사도(I°)로 식립하고 여기에 순(협)설 경사도만 I-15°에서 I+15°까지 5°씩 변화시켜 파노라마 방사선 사진을 촬영한 후 방사선 사진에 나타난 와이어의 길이와 각도를 각각 계측하였다. 와이어를 정상 근원심 및 순(협)설 각도로 식립했을 때 방사선 사진에서 계측된 길이는 중절치, 측절치, 견치의 경우 실제 길이의 111% ~ 117%의 확대율을 보였고, 소구치와 대구치에서는 121% ~ 125%의 확대율을 보였다. 이 때 근원심 경사도는 그대로 유지하면서 순(협)설 경사도만 I-15°(순측경사)에서 I+15°(설측경사)로 변화시킨 경우 중절치 (p < 0.01)와 측절치 (p < 0.05)에서만 유의한 확대율 증가를 보였다. 파노라마 방사선 사진에서 치아의 경사도는 대부분 실제 근원심 경사도보다 더 크게 즉 원심경사된 것으로 계측되었고, 이러한 원심경사 경향은 측절치와 견치에서 가장 크게 나타났으며, 제1, 2소구치의 I+10°, I+15° 그룹과 제1, 2대구치의 I+15° 그룹에서만 실제 근원심 각도보다 더 작게, 즉 근심 경사된 것으로 계측되었다. 또한 순(협)설 경사도의 변화에 따라 파노라마 방사선 사진에서 모든 치아의 근원심 각도가 유의한 변화를 보였는데, 순(협)설 경사도가 작아질수록, 즉 순(협)측 경사될수록 파노라마 방사선 사진에서 더 원심경사되어 나타났다. 따라서 파노라마 방사선 사진에서 중절치와 측절치의 치아 길이와 모든 치아의 근원심 경사도를 평가할 때 치아의 순(협)설 경사도에 따라 영향을 받기 때문에 이를 고려해야 할 것이다. Objective: The purpose of this study was to examine how the mesio-distal angulation and the length of each tooth changes on panoramic radiograph at different bucco-lingual inclinations. Methods: After constructing an acrylic model based on the mean arch of 30 adults with normal occlusion, the wire was placed in the center of the teeth on the acrylic model. First, the wire was implanted in normal angulation and inclination and a panoramic radiograph taken. After changing the inclination from I-15° to I+15° by 5°, a panoramic radiograph was taken again and the mesio-distal angle and wire length on the panoramic radiograph were assessed. Results: When the wire was implanted at the normal angulation and inclination, the length measured in the panoramic radiograph was magnified 111 ~ 117% from the original length in the anterior region and 121 ~ 125% in the posterior region. Only the central and lateral incisors showed significant length differences when the inclination was changed from I-15° to I+15° at fixed angulation. When the inclination was changed from I-15° to I+15°, the angulation of most teeth on panoramic radiograph appeared to be more disto-angulated than in reality, and the lateral incisor and canine showed the largest difference. Only I-15°, I+15° groups of premolars and I+15° group of molars showed more mesio-angulation than in reality. As the labio(bucco)lingual inclination of all teeth were decreased, tooth angulation in the panoramic radiograph appeared to be more disto-angulated. Conclusion: The labio-liugual inclination of teeth should be considered because it affects panoramic image of teeth, such as length of incisors and angulation of other teeth.

추적조사를 중심으로 한 腰椎間板脫出症에 대한 蜈蚣藥鍼의 臨床的 硏究

최회강,소기숙,고강훈,박소영,김성남,이종덕,원경숙,문형철,김성철 大韓鍼灸學會 2003 대한침구의학회지 Vol.20 No.3

Objective : This study is performed for the purpose of examining the efficacy of the scolopendrid(Scolopendra morsitans L) which has been to low back pain as a folk remedy. Methods & Results : Seventy patints with H.I.V.D. treated with the scolopendrid aquacupuncture and examined 4 tests; D.I.T.I., physical test, Oswestry disability index, and self-conscious pain rate were studied. And we follow up after discharge, we evaluated the present state and recovery period. Or we evaluated by herniated type and duration of onset. There was 58~97% of efficacy rate in each tests. Moreover, statistically valuable change in all 7D.I.T.I. points and in disability index and in self-conscious pain rate was showed. Conclusion : The scolopendrid aquacupuncture is possible to be effective terating the H.I.V.D patients. so we suggest the possibility using this new remedy to the H.I.V.D. patients.

양측성 관상동정맥루 1예

최용원,오석규,이재훈,이상재,권경희,최은경,김남호,정진원 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.1

저자들은 호흡곤란, 흉부불쾌감, 심계항진 등을 주소로 내원한 환자에서 경흉부 및 경식도 심초음파 검사상 주폐동맥에서 이완기에 전행하는 지속적인 혈류의 흐름을 관찰하고, 관상동맥 조영술을 통해 좌전하행지 중간부위와 우관상동맥 근위부에서 각각 기시하여 공통경로를 이루면서 주폐동맥으로 유입되는 양측성 관상동정맥루를 보이는 드문 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. A coronary arteriovenous fistula is infrequently encountered vascular communication between a coronary artery and a cardiac chamber, a great artery or the vena cava. It is the most common congenital anomaly that can affect coronary perfusion. Bilateral involvement of coronary fistula constitutes an uncommon subgroup of coronary arteriovenous fistulas. A 69 year-old female patient presented with chest discomfort, palpitation, and dyspnea. In the echocardiography, doppler color flow imaging visualized abnormal flow signals with mosaic appearance in the main pulmonary artery during diastolic phase. Coronary angiography revealed arteriovenous fistula arising from the left anterior descending artery and the right coronary artery. Both coronary arteriovenous fistulas drained into the main pulmonary artery. We report a case of bilateral coronary arteriovenous fistula that was confirmed by echocariography and coronary angiography.

추간공 경유 경막외 차단술 환자의 합병증에 대한 조사 연구

최선주,배성열,서성화,김상대,김세훈,박정율 대한척추신경외과학회 2004 Neurospine Vol.1 No.1

Objective: To study on the incidence of complications from C-arm guided lumbar transforarninal epidural injections in patients with radiculopathy caused by either lumbar spinal stenosis or herniated intervertebral disc. Materials & Methods: A total of 1200 patients with back/leg pain for more 3 months and received therapeutic injections in recent 1-year period was evaluated. All procedures were performed by one neurosurgeon with careful monitoring by nursing staffs during and after the procedures. Two party observers reviewed medical charts including immediate postprocedure complications using standardized questionnaire. Results: Average 1.9 injections per patient were done. Complications per injection seen included 12 transient headaches (0.9%), 5 increased back pain(0.4%), 4 increased leg pain(0.3%), 4 facial flushing(0.3%), 2 increased blood sugar in an insulin-dependent diabetic(0.2%), I vasovagal reaction(0.08%), and I hypertension(0.08%). All of these complications resolved within several hours to 2 weeks and there were no need for further specific management. There were no major or permanent complications. The incidence of minor complications was 2.3% per injection. All reactions resolved without morbidity. Conclusion: Although effectiveness varies with different pathologies, the C-arm guided lumbar transforaminal epidural injection seems to be a safe and effective procedure for these patients when carefully performed and closely observed with appropriate nursing care.