과민성 장 증후군의 증상 경감을 위한 비약물적 접근 고찰

최명애,김금순,안경주,채영란,최정안,홍해숙,박미정,이경숙,신기수,정재심 대한기초간호자연과학회 2005 Journal of korean biological nursing science Vol.7 No.2

There have been many trials of clinical efficacy of multicomponent and single component treatments for irritable bowel syndrome(IBS). We reviewed effects of non phamacological treatments in the IBS. Though the efficacy of multi-component approaches was unclear, several results suggest that cognitive behavioral therapy was effective in improving gastrointestinal symptoms of IBS. As a single component, cognitive therapy and relaxation with or without biofeedback could improve the symptoms and psychological health of IBS patients. Yoga, meditation, self-help information and hypnotherapy could be applicable to IBS.

고콜레스테롤혈증 토끼에서의 지질강하효과와 독립적인 Naringin의 항동맥경화 효과

최성준,김효수,정태숙,복성해,박영배 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.11

폐좌상시 폐단락률과 PEEP치료의 효과

김영식,황성오,최경훈,안무업,오중환,임경수,윤정환,강성준 大韓應急醫學會 1992 대한응급의학회지 Vol.3 No.1

To evaluate the physiologic extent of pulmonary contusion and effect of PEEP therapy for pulmonary contusion, we studied 16 patients received PEEP therapy with pulmonary contusion from nonpenetrating chest trauma. Hemodynamic parameters including pulmonary vascular resistance index and intrapulmonary shunt fraction were calculated from standard measurement, and arterial oxygen tension was measured. Pulmonary vascular resistance index and intrapulmonary shunt fraction were increased in patient group. Arterial oxygen tension was decreased with increase of the intrapulmonary shunt fraction(R=0.75). Arter minimal PEEP therap(5-10 ㎝H₂O), pulmonary vascular resistance index was remained unchanged and intrapulmonary shunt fraction was decreased without significant changes of pulmonary hemodynamics. Increment of arterial tension was increased with decrease of intrapulmonary shunt fraction(R=0.43). Decreased stroke volume index suggested of cardiac injury such as cardiac contusion in patient group. These results of our study suggested that increased intrapulmonary shunt fraction caused arterial hypoxia in pulmonary contusion and arterial oxygen tension was increased as a result of reduced intrapulmonary shunt by PEEP therapy.

원주지역에서 발생한 비외상성 심정지의 일주변화

박금수,김영식,이진응,임종천,이강현,임경수,황성오,최경훈 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

To estimate the quality of the emergency medical services system of Wonju City, we studied the diurnal variations of 179 non-traumatic cardiac arrest victims who received cardiopulmonary reuscitation at the emergency center of Wonju Christian Hospital. Diurnal variations of non-traumatic cardiac arrest patients were as follows ; The occurence of cardiac arrest at day-time was higher than night-time; 18 cases (11%) from midnight to AM 4, 25 cases (14%) from AM 4 to AM 8, 42 cases (24%) from AM 8 to AM 12, 46 cases (25%) from AM 12 to PM 4, 35 cases (19%) from PM 4 to PM 8, 13 cases (7%) from PM 8 to midnight. Witness cardiac arrest was increased more during the day than night ; 40% from midnight to AM 4, 48% from AM 4 to AM 8, 57% from AM 8 to AM 12.52% from AM 12 to PM 4, 60% from PM 4 to PM 8, 38% from PM 8 to midnight. The transportation time at night-time cardiac arrest was more longer than day-time cardiac arrest ; 30±12mins from midnight to AM 4, 26±9mins from AM 4 to AM 8, 27±12mins AM 8 to Am 12, 25±11mins from AM 12 to PM 4, 25±9mins from PM 4 to PM 8, 35±15mins from PM 8 to midnight. The rate of restoration of spontaneous circulation(ROSC) in day-time cardiac arrest was higher than the night-time cardiac arrest ; 30% from midnight to AM 4, 36% from AM 4 to AM 8, 32% AM 8 to AM 12, 44% from AM 12 to PM 4, 41% from PM 4 to PM 8, 15% from PM 8 to midnight. The survival rate of cardiac arrest has been correlated with collapse time, early bystander CPR, early advanced care. To improve outcome for prehospital cardiac arrest, we concluded that early bystander CPR, and early advanced life support should be performed at the scene and during the transportation especially at night.

심폐소생술중 심실기능 및 판막운동의 평가

이부수,김영식,이강현,황성오,임경수,박금수,윤정한,안무업,최경훈 대한응급의학회 1994 대한응급의학회지 Vol.5 No.2

Background : Mechanism of blood flow during cardiopulmonary resuscitation(CPR) in humans remains controversial and poorly understood, although cardiac or thoracic pump theory was proposed. We investigated cardiac movement, ventricular function and atrioventricular valve motion with aid of transesophageal echocardiography during precordial compression during CPR in humans. Methods and results : During CPR transesophageal echocardiography was performed in 14 patients with non-traumatic cardiac arrest. Manual precordial compression during CPR was performed according to American Heart Association guidelines. Mitral valve closed in 9 and did not close in 5 patients during "compression systole". Tricuspid valve closed during compression systole. Compression vector directed to right ventricle, basal portion of interventricular septum and left atrium. The heart rotated clockwise and the apex was more displaced than the base("swing motion"). Fractional shortening(FS) and ejection fraction(EF) of right ventricle exceeded those of left ventricle(FS : 55±9% vs 18±8%, p<0.05), EF : 79±9% vs 37±16%, p<0.05). FS and EF of left ventricle was higher in patients with systolic mitral valve closure than patients with persistent systolic opening of mitral valve(FS : 21±7 vs 13±7%, EF : 45±12 vs 22±12%, p<0.05), but FS and EF of right ventricle was not different. Conclusion : During precordial compression, the heart rotated clockwise and displaced. Systolic function of right ventricle exceeded left ventricle. Marked compression of right ventricle and systolic closure of tricuspid valve suggested that right ventricle functioned as a pump generating blood flow during precordial compression. Closure of mitral valve was dependant on systolic function of the left ventricle.

지역 사회 감염성 폐렴에서 Cefodizime의 효능 및 안전성을 Ceftriaxone과 비교한 연구

심영수,오명돈,한성구,최강원,정희순,김영환,유철규,최형석 대한감염학회 1994 감염 Vol.26 No.3

목적: Cefodizime은 새로운 주사용 제 3세대 항생제이다. 저자들은 감염성 폐렴 환자들에서 이 약물을 하루 1번 정맥주사하였을 때 관찰되는 임상적및 세균학적 효과와 안전성을 ceftriazone과 비교하기 위하여 본 연구를 시행하였다. 방법: 1992년 6월부터 1993년 11월까지 서울대학교 병원에 지역사회 감염성 폐렴으로 입원하였던 환자 32명을 무작위로 3군으로 나누고 제 1군 : Cefodizime 1g(n=11), 제2군 : Cefodizime 2g(n=10), 제3군 : Ceftrizxone 1g(n=11)을 각각 하루 1회 정맥주사로 투여하여 그 치료율및 안전성을 비교하였다. 결과: 1)Cefodizime은 제1군 100%, 제2군 80.0%의 임상적 반응율을 보였다. Ceftriaxone을 투여하였던 제 3군에서는 81.8%의 임상적 반응율을 보였다. 이러한 임상적 반응율의 결과는 세 군간에 통계적으로 유의한 차이를 보이지 않았다(p>0.05). 2)세균학적 반응율도 세 군간에 유의한 차이를 보이지 않았다. 3)Cefodizime의 안전성의 평가에서 제1군 및 제2군에서 구토 및 오심이 2예(9.5%)에서 관찰되었고 일시적인 간효소치의 상승이 1예(4.8%)에서 관찰되었다. 경미한 공복시 위통이 1예(4.8%)에서 관찰되었다. Ceftriaxone으로 치료한 군에서는 특별한 부작용은 관찰되지 않았다. 결론: 이상의 결과로 지역사회 감염성 폐렴의 치료에 있어서 cefodizime 1내지 2g을 정맥 주사로 하루 1회 치료할 경우 적어도 ceftriaxone과 유사하게 효과적이며 안전한 것으로 사료된다. Background:Cefodizime(Modivid) is a new parenteral form of cephalosporin showing the antibacterial specturm of the third generation. The clinical efficacy and safety of cefodizime have been well proven by some previous clinical studies performed in European countries and Japan. The objective of this study was to evaluate the clinical, radiological and antimicrobial efficacy of this drug in patients with community-acquired pneumonia compared to that of ceftriaxone. Methods: We performed an open, controlled, randomized study in 32 patients with community-acquired pneumonia at Seoul national University hospital from June 1992 to November 1993. In the first group(n=11) 1g of cefodizime, and in the second group(n=10) 2g of cefodizime were respectively administered intravenously once a day. and in the third group(n=11), 1g of ceftriaxone was administered intravenously. Results: The results were as follows. 1) Cefodizime showed the clinical response rate of 100% in group I, and 80.0% in group Ⅱ. The clinical response rate of ceftriaxone in group Ⅲ was 81.8%. There was no significant statistical difference(p>0.05). 2) The rates of bacteriological efficacy wee not statistically different among three groups. 3) In the cefodizime treatment group(group Ⅰ, group Ⅱ) nausea and vomiting were observed in 2 cases(9.5%) and transient elevations of hepatic transaminases in 1 case(4.8%). Mild abdominal pain occurred in 1 case(4.8%). No significant adverse reactions were observed in the ceftriaxone treatment group. Conclusion: We could conclude that once a day intravenous cefodizime therapy was as effective and well tolerated as ceftriaxone in the treatment of community-acquired pneumonia.

한국인 심부전증 환자 심근에서의 인형 거대 세포 바이러스 감염

이명용,이무용,김영권,한성식,최성준,김효수,이영우,서정돈 단국대학교 1998 論文集 Vol.33 No.-

Objectives: In order to evaluated the prevalence and the site of infection of cytomegalovirus in terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. Methods: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts(N=5) and polymerase cain reactions(PCRs) were done for detection of late gene sequence coding pp150 glycoprotein. The products were confirmed by electrophoresis on the 1% agarose gel. n order to improve the detectability of cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. In situ PCRs also were done with the samples which were confirmed as positive for CMV viral genome by nested PCRs. Results: All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing heart(3 cases/22. 13.5%) and normal hearts( 1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/2, RV 4/22, RA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 2/5, RA 2/5). These was no significant change in positivity of cytomegaloviral DNA genome between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to the nested PCR results. The positivity of cytomegaloviral DNA by n situ PCR was 33.3%(4/12), and the site of positive reaction was the nuclei of the myocardial cells. Conclusion: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. The result of the in situ PCR showed the site of the cytomegaloviral infection was nuclei of the myocardial cells. Cytomegalovirus, however, might have no direct causal relationship in the development of terminal heart failure.

영구형 항서맥 심박조율기 환자의 장기추적관찰

최현석,이무용,최영진,최성준,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우,이명용 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

Session E : Enzymes : Mechanism of Action and Regulation : STRUCTURAL AND CATALYTIC PROPERTIES OF BRAIN GLUTAMATE DECARBOXYLASE

Soo Young Choi,Su Jin Lee,Sang Ho Jang,Kil Soo Lee,Joon Ho Choe,Se Chan Woo 생화학분자생물학회(구 한국생화학분자생물학회) 1993 추계학술대회집 Vol.- No.-

Metabolic Changes in Patients with Parkinson's Disease after Stereotactic Neurosurgery by Follow-up 1H MR Spectroscopy

Choe, Bo-Young,Baik, Hyun-Man,Chun, Shin-Soo,Son, Byung-Chul,Kim, Moon-Chan,Kim, Bum-Soo,Lee, Hyoung-Koo,Suh, Tae-Suk Korean Magnetic Resonance Society 2001 Journal of the Korean Magnetic Resonance Society Vol.5 No.2

Authors investigated neuronal changes of local cellular metabolism in the cerebral lesions of Parkinsonian symptomatic side between before and after stereotactic neurosurgery by follow-up 1H magnetic resonance spectroscopy (MRS). Patients with Parkinson's disease (PD) (n = 15) and age-matched normal controls (n = 15) underwen MRS examinations using a stimulated echo acquisition mode (STEAM) pulse sequence that provided 2${\times}$2${\times}$2 ㎤ (8ml) volume of interest in the regions of substantia nigra, thalamus, and lentiform nucleus. Spectral parameters were 20 ms TE, 2000 ms TR, 128 averages,2500 Hz spectral width, and 2048 data points. Raw data were processed by the SAGE data analysis package (GE Medical Systems). Peak areas of N-acetylaspartate (NAA), creatine (Cr), choline-containing compounds (Cho), inositols (Ins), and the sum (Glx) of glutamate and GABA were calculated by means of fitting the spectrum to a summation of Lorentzian curves using Marquardt algorithm. After blindly processed, we evaluated neuronal alterations of observable metabolite ratios between before and after stereotactic neurosurgery using Pearson product-moment analysis (SPSS, Ver. 6.0). A significant reduction of NAA/Cho ratio was observed in the cerebral lesion in substantia nigra of PD patient related to the symptomatic side after neurosurgery (P : 0.03). In thalamus, NAA/Cho ratio was also significantly decreased in the cerebral lesion including the electrode-surgical region (P : 0.03). A significant reduction of NAA/Cho ratio in lentiform nucleus was not oberved, but tended toward significant reduction after neurosurgery (P = 0.08). In particular, remarkable lactate signal was noted from the surgical thalamic lesions of 6 among 8 patients and internal segments of globus pallidus of 6 among 7 patients, respectively. Significant metabolic alterations of NAA/Cho ratio might reflect functional changes of neuropathological processes in the lesion of substantia nigra, thalamus, and lentiform nucleus, and could be a valuable finding fur evaluation of Parkinson's disease after neurosurgery. Increase of lactate signals, being remarkable in surgical lesions, could be consistent with a common consequence of neurosurgical necrosis. Thus, IH MRS could be a useful modality to evaluate the diagnostic and prognostic implications fur Parkinsons disease after functional neurosurgery.