혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

유기산을 이용한 납 요염토양의 복원에 관한 연구

정의덕,강신원,박덕수,신학기,백우현 한국환경과학회 2000 한국환경과학회지 Vol.9 No.5

A study on the removal of Pb ion from Pb-contaminated soil was carried out, using ex-situ extraction process. Tartaric acid (TA) and iminodiacetic acid sodium salt (IDA) as a washing agent were evaluated as a function of concentration, reaction time, mixing ratio of washing agent and recycling of washing agent. TA showed a better extraction performance than IDA. The optimum washing condition of TA and IDA were in the ratio of 1 : 15 and 1 : 20 between soil and acid solution during 1 hr reaction. The total concentrations of Pb ion by TA and IDA at three repeated extraction, were 368.8 ppm and 267.5 ppm, respectively. The recovery of Pb ion from washing solution was achieved by adding calcium hydroxide and sodium sulfide, form the precipitation of lead hydroxide and lead sulfide, and optimum amounts of sodium sulfide and calcium hydroxide were 7 g/ℓ for the TA washing solution and 4 g/ℓ , 5 g/ℓ for the IDA washing solution, respectively. The efficiency of recycle for TA and IDA washing solution were 78.8%, 95.1% and 89.2%, 96.6%, at third extractions under Na_2S and Ca(OH)_2, respectively.

지하수위에 따른 적양배추, 브로콜리, 양상추의 수분이용효율 특성

신수정, 홍순달 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

급성 백혈병 환자에서 수두양 피부병변을 보인 파종성 Fusarium 감염 1예와 국내 파종성 Fusarium 감염증에 대한 고찰

오수진,정희선,김준성,김태석,조병식,최수미,김명신,이연수,이석,신완식 대한감염학회 2007 감염과 화학요법 Vol.39 No.5

최근 면역저하환자의 증가와 함에 국내에서도 점차 침습성, 파종성 Fusarium 감염증 보고가 증가하고 있다. Fusarium 감염은 아스페르길루스 감염과 유사한 임상양상을 보이지만 특징적인 피부병변을 동반하고 혈액배양에서 균이 분리되는 경우가 더 많다. 저자들은 급성 림프구성 백혈병으로 진단받고 치료중인 30세 남자 환자에서 중증의 호중구 감소 상태에서 비특이적인 피부병변을 동반한 파종성 Fusarium 혈류감염을 경험하였기에 국내 증례 고찰과 함께 보고하는 바이다. 환자의 초기 피부병변은 구진에서 시작하여 주로 소포성 병변과 일부 통증을 동반한 결절 등 여러 형태로 나타났고, Tzank 도말검사 양성으로 비정형 수두로 오인되었다. 이후 피부병변은 농포로 변하였고, 혈액배양 및 피부 조직검사에서 파종성 Fusarium 감염으로 진단받았다. 환자는 liposomal amphotericin B, voriconazole 병합요법과 G-CSF 투여, 과립구 수혈을 받았으나, 호중구 감소증에서 회복하지 못하고 급성 호흡곤란증후군과 다장기 기능부전으로 사망하였다. 본 증례는 파종성 Fusarium 감염의 경우에도 수두양 병변으로 비특이적인 양상으로 나타날 수 있으므로, 감별진단을 위해 적극적으로 혈액배양과 피부조직검사를 시행해야 함을 보여준다. Recently, we experienced a case of disseminated fusarial blood stream infection with varicelloid skin eruptions, who had suffered from persistent neutropenic fever after salvage chemotherapy for relapsed acute lymphocytic leukemia (ALL). Neutropenia continued in spite of G-CSF and granulocyte transfusion, and he failed to respond to conventional amphotericin B initially, and then liposomal amphotericin B and voriconazole combination therapy. Disseminated fusariosis can be diagnosed by blood cultures in 50% of patients and present skin lesions in more than 80% of patients. So, typical skin lesions are important clue to diagnose of the disseminated fusariosis. However, many skin lesions in immunocompromised hosts are due to various infectious and non-infectious causes. So, this case shows that it is important to obtain biopsy specimens of skin lesions for histopathologic examination, culture and staining. Here, we present our case with the review of the literatures reported in our country, so far.

변형된 치관부 파절편 재부착술식을 이용한 치관치근파절의 치료

송창원,송민주,신수정,박정원 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.5

치관부 파절편 재부착술식은 접착치의학의 발달과 더불어 치관파절 치료 방법 중 하나로 자리매김하였다. 하지만 치관치근파절된 치아에 있어서 기존의 치관부 파절편 재부착술식으로는 치은연하 영역의 수복 및 생물학적 폭경의 유지가 어려워 부가적인 치관연장술 또는 치아 정출술 등이 요구되게 된다. 하지만 이번 증례보고는 치수노출을 동반한 치관-치근파절을 치료함에 있어서 이러한 부가적인 술식 없이 변형된 치관부 파절편 재부착술식만을 이용하여 처치한 사례이다. 환자는 근관치료 후 post 삽입 및 재부착 술식을 시행 받았으며 이때 치관 파절편의 변형을 통해 생물학적 폭경을 위한 공간 유지 및 적절한 접착을 위한 영역을 확보할 수 있었고 이후 한차례의 재파절이 발생하였지만 재차 재부착 후 2년간의 follow up을 통해 치주부착상실 없이 치관 파절편이 잘 유지되는 것이 관찰되었다. The development of adhesive dentistry has allowed that the crown fragment reattachment can be another option in the treatment of crown fracture. However, additional crown lengthening procedure or extrusion of the tooth may be necessary in the treatment of crown root fracture because subgingival fracture line in close proximity to the alveolar bone leads to challenges for restorative procedure and the violation of the biologic width. This case report presents a modified crown fragment reattachment technique of crown root fracture with pulp exposure, which was done without additional crown lengthening procedures. After the endodontic treatment, the patient was treated using a post insertion and the fragment reattachment technique, which made it possible to preserve the space for the biologic width and maintain a dry surgical field for adequate adhesion through the modification of the fractured coronal fragment. Since a coronal fracture was occurred and reattached afterward, it was observed that the coronal fragment was well maintained without the additional loss of periodontal attachment through 2-year follow up.

혼합치열기의 miniscrew를 이용한 교정치료

임수민,양연미,김재곤,백병주,이용훈,신정근 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

Anchorage plays an important role in orthodontic treatment, Skeletal anchorage like the miniscrew is considered a more effective method in anchorage control than conventional anchorage which needs much patient s cooperation. The miniscrew offers many advantages. 1) It is easy to insert and to remove. 2) It can endure the force needed for moving teeth. 3) It can be immediately loaded and 4) Patient cooperation is not needed. 5) It is economic compared to other skeletal anchorage systems, In comparison to adult's bones, children s bones have comparatively poor bone quality and quantity. Therefore, it is hard to obtain primary stability in younger patients. However, if the miniscrew can be retained successfully, it will be effective in many orthodontic treatments. In these cases we used the miniscrew in correcting of diastema, in aligning dental midline, and in rendering a forced eruption of impacted tooth in mixed dentition patient. We obtained satisfactory results. 교정치료 시 고정원은 항상 염두에 두면서 치료를 진행해야 하는 중요한 요소이다. 전통적인 고정원을 이용한 치료는 환자의 적극적인 협조를 필요로 하고 원하는 치아이동에 대한 반작용이 나타날 수 있는 등의 부작용을 가지고 있다. 그러므로 보다 견고한 구강 내 고정원이 요구되어져 왔으며 이를 위해 miniscrew가 임상에서 흔히 이용되고 있다. Miniscrew를 통한 고정원의 확보는 구외력 의존도 감소,치료기간의 단축,식립 후 즉시 교정력 적용,환자의 협조도 불필요,식립의 간편성,저렴한 비용 등의 장점을 가지고 있다. 그러나 성장기 환자는 성인에 비해 골질이 좋지 않아 miniscrew의 성공률이 성인에 비해 낮다. 그러나 일단 고정에 성공하면 많은 교정치료 시 매우 유용하게 이용할 수 있다. 본 증례는 흔합치열기 환자를 miniscrew를 이용하여 정중이개 및 정중선 불일치,매복치에 대한 양호한 교정치료를 하였기에 보고하는 바이다.

뇌졸중 노인을 돌보는 주간호제공자의 부담감과 예측요인 : 한방병원 입원 노인을 중심으로

유수정,김신미,이윤정,박연환 노인간호학회 2004 노인간호학회지 Vol.6 No.1

Purpose : The purpose of this study was to investigate factors influencing burden in primary caregivers caring for an elderly person who has had a stroke. Method : A convenience sample of 124 primary caregivers of elderly people with a stroke admitted to an oriental medicine hospital participated in this study. Interviews were done with a standardized questionnaire including Caregiver Burden Scale (Chang, 1995). Result: Average burden score was 93.19, indicating a moderate to severe level of burden. Time-dependent burden had the highest score of the sub-domains. For general characteristics, the factors significantly influencing caregiver burden were gender and age of the elderly person, age and educational level of the caregiver, whether living together or not, and the presence of another caregiver. Multiple regression analyses demonstrated that level of ADL of the elderly person, relationship between the elderly person and the caregiver prior to the stroke, caregivers' relation to the elderly person and primary income were significant factors in explaining variance in overall burden. Conclusion : Recognition of high levels of caregiver burden and factors influencing burden will allow us to develop different nursing strategies to decrease caregiver burden in those caring for an elderly person with a stroke.

Ripaired glass ionomer cement 의 결합강도에 관한 연구

서수정,김신 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.2

The purpose of this study was to compare the bond strengths of different kinds of glass ionomer cements (GIC),which is recently increasing the clinical application in the field of pediatric dentistry and measure the repaired the strengths in oder to examine the clinical applicability of partial repaired cases. By using one kind of the light cured type GIC and three kinds of the chemical cured type GIC,the bond strengths of followings were compared:unrepaired group as control,repaired conditioning group,which was treated the repaired surface using 25% polyacrylic acid and non-condition group without surface treatment.Three point bending test was performed under Universal Testing Machine in oder to measure the compressive bond strenghs. The results were as follows: 1.Light cured GIC had higher bond strength than chemical cured type GIC in both of repaired and unrepaired groups. 2.In repaired cases,all of the materials decreased the bond strength when compared to the control group.In the light cured type,the bond strength of repaired conditioning group decreased 31.6%,repaired non-conditioning group decreased 40.8%. In chemical cured types, the bond strength of repaired conditioning group decreased 11.8%, repaired non-conditioning group decreased 20.9%. 3.All the materials,in the case of the chemical treatment on the repaired surface using 25% polyacrylic acid had higher bond strength than untreated but,low than control group.

행복이란 무엇인가? 행복에 관한 연구 개관

이수정,안신호 심리과학연구소 2005 심리과학연구 Vol.4 No.-

Studies on happiness in psychology were reviewed. Studies on happiness have two philosophical traditions, the Hedonism and the Eudaimonism. The concepts of "Subjective Well-being"(Diener, 1984) and "Quality of Life" are based on the Hedonism; the concepts of "Psychological Well-being"(Ryff, 1989b) and the "Flow experience" are based on the Eudaimonism. The relationship between SW13 and extroversion was well established. Various Quality of Life measures were found to be useful for the various target populations (the elderly, for example). Researches based on the Eudaiomonism were not so much developed and seems to be needed for the future study. 심리학에서 ‘행복’이라는 주제 아래 수행되었던 연구들을 개관하였다. 행복에 관한 지금까지의 연구들은 크게 쾌락주의(Hedonism)와 행복주의(Eudaimonism)의 철학 전통을 따르는 것으로 구분할 수 있다. 쾌락주의 전통을 따른 것으로는 주관적 안녕감(Diener,1984)과 삶의 질에 관한 연구들을 들 수 있다. 정적, 부적 감정의 체험 및 만족감, 즉 행복의 현상적 요소를 측정하는 주관적 안녕감은 외향성과 밀접한 관련성이 있음이 밝혀졌다. 특정 집단(예:노인)을 대상으로 한 삶의 질에 관한 연구들의 그 나름의 유용성이 입증되었다. 진정한 자기의 구현과 덕을 강조하는 행복주의의 전통을 따르는 것으로는 Ryff(1989b)의 심리적 안녕감과 ‘몰입경험’에 관한 연구를 들 수 있는데 상대적으로 연구가 적으며 후속 연구가 필요한 영역으로 지적되었다.

Zn-Fe 합금 도금강판의 점용접성에 관한 연구

민준기,신재경,안효영,서수정,서창제 成均館大學校 科學技術硏究所 1992 論文集 Vol.43 No.1

Spot welding is widely used in automobile assembly lines. Electroplating of Zn-Fe on steel sheets is increasingly used in assembly lines, because of its good spot weldability, formability and corrosion resistance. In this study, to evaluate spot weldability, tensile shear strength and cross tensile strength of steel sheets electroplated with Zn and Fe up to 0.7mm thickness were investigated, and these mechanical properties were compared with those of steel sheets electroplated with Zn only. The thickness of electroplated steel sheets was measured with SEM. The following conclusions were obtained. (1) In spot welding, the weldability lobe was getting wider and directed toward low currency direction, in steel sheets electroplated with Zn-Fe compared with those electroplated with Zn only. (2) Electrode force and welding time obviously affected the ultimate welding strength, and the range representing constant ultimate welding strength was observed. (3) When Zn-Fe were electroplated on steel sheets, the ductility ratio was increased in optimal welding condition, indicating that good weldability was obtained. (4) Around 8.5KA where optimal strength existed, by spot welding, the amount of the electroplated layer was observed to be reduced by approximately 15% in thickness.