환자들의 건강 행위와 건강 통제위가 보건 의료 가치 및 이용에 미치는 영향

정연강,박경숙,윤은자,장영미 중앙대학교 의과대학 의과학연구소 1994 中央醫大誌 Vol.19 No.1

This study was conducted to find out the Health Behavior and health Locus of Control of the patients, and to identify the factors influencing the value and utilization of Health Service. The data for this study obtained from 728 patients selected from Out Patient Department of Chung-Ang University Hospital in Seoul. Data was collected from Mar. 25 to June 20, 1992. Analysis of data was done by use Mean, S.D., t-test, ANOVA, Pearsons's correlation coefficient and SNK test on 5% significant level with SPSS/PC. The major findings were as follows : 1. The first hypothesis : The higher degree of Health Behavior, the higher degree of Health Values, Utilization & Health Service was rejected (P>.05). 2. The second hypothesis : The higher degree of Internal Health Locus of Control, the higher degree of Health Values, Utilization & Health Service was supported (P<.01). 3. The third hypothesis : The lower degree of External Health Locus of Control, the higher degree of Health Values, Utilization & Health Service was supported (P<.00). 4. Health behavior was Influenced by educational level, and External Health Locus of Control was Influenced by occupation, educational level, religion, age and income, Health Values and general characteristics in the relationship between occupation, educational level, religion, age, income and economic status are showed significant(P<.05).

Lidocaine, Tetracaine 및 Bupivacaine이 백서 배양 심근세포에 미치는 세포독성에 관한 연구

장정수,최민규,오재민,김종영,정연태 圓光大學校 醫科學硏究所 1994 圓光醫科學 Vol.10 No.1-2

In an attempt to evaluate the cytotoxicity for lidocaine, tetracaine and bupivacaine, beating rates, tetrazolium MTT and lactate dehydrogenase activity were investigated in the medium containing the local anesthetic drugs for 24 hours after the neonatal rat myocardial cells were cultured for 72 hours. Light and electron microscopic studies were also carried out. The results were as follows: 1. Beating rates decreased dose-dependently. and beating myocardial cells were not observed at 10^-3M concentration of tetracaine and bupivacaine, and also beating activities were not recovered after 24hrs. 2. MTT_50 values were 995 μM in tetracaine and 983 μM in bupivacaine. 3. The amount of lactate dehydrogenase released into the medium at 10^-3M concentration were 123% in lidocaine, 156% in tetracaine and 182% in bupivacaine compared with control cells. 4. In the light microscopy, myocardial cells were decreased in number dosede-pendently, and showed a few cytoplasmic processes at 10^-3 M concentration of tetracaine and bupivacaine. 5. In electron microscopy, myocardial cells treated with tetracaine and bupivacaine showed destructed mitochondria and many dense bodies. These results suggest that high concentration of tetracaine and bupivacaine (10^-3M) induce remarkable toxicity compared with lidocaine on the cultured rat myocardial cells.

인삼 alcohol 동시투여백서의 혈액성분에 관한 연구

정연탁,김창세 순천향대학교 1986 논문집 Vol.9 No.1

White rats of 3 groups, control(water), A(ginseng extract), and B(combined ginseng extract alcohol), were pretreated with alcohol(2.4g/㎏ bd wt) for 15 days. And then those were given with ginseng extract(group A, 10㎖/㎏ bd wt) and combined ginseng-alcohol(group B), by catheter through mouth, periods from 1st to 30th day. And the following results were obtained; 1. In red blood cell, there were increased significantly from 5th day in group A and 25th in B. 2. In serum triglyceride concentration, there were decreased significantly from 3rd day in group A and 25th in B. 3. In serum phospholipid concentration, there was decreased significantly from 5th day in group A. 4. In serum cholesterol concentration, there was decreased significantly from 7th day in group A. 5. In serum GOT activity, there were markedly decreased in both groups A and B. 6. In serum total protein concentration, there were increased significantly from 7th day in group A and 15th in B. 7. In serum albumin fractions, there were increased from 3rd day in group A and 7th day in B. Other protein fractions especially α₂-globulin was decreased and γ-globulin was increased in group A. From above results it was suggested that ginseng was shown protective action against alcohol degradative effects of white rats blood components which includes red blood cell, triglyceride, phospholinpid, cholesterol, GOT, total protein, albumin, α₂-and γ-globulins.

방광 자극증상을 호소하는 복압성 요실금 환자에서 마이크로칩을 이용한 전기자극치료의 효과

정희창,정연호,신현진 영남대학교 의과대학 2004 Yeungnam University Journal of Medicine Vol.21 No.2

복압성 요실금에 동반되는 다양한 방광 자극증상은 빈뇨, 잔뇨감, 야간뇨, 절박뇨, 절박성 요실금, 배뇨통의 순이었으며, 이 증상들의 복합 정도가 많으면 삶의 질에 영향을 주고 있음을 알 수 있었다. 그리고 마이크로칩을 이용한 전기자극기는 특별한 부작용 없이 환자의 만족도가 높은 치료기로 생각되었으며, 복압성 요실금과 동반되는 야간뇨, 배뇨통 등의 방광 자극증상을 경감시킴으로 인해 현재의 배뇨 상태가 일상생활에 미치는 영향을 감소시키는 것을 관찰할 수 있었다. Purpose: This study was carried out to evaluate the efficacy of intravaginal pelvic floor electrical stimulation (FES) therapy on bladder irritability symptoms in stress urinary incontinent women. Materials and Methods: The evaluation before and after treatment included the Blaivas's female Bladder Questionnaire, the quality of life questionnaires and the overall satisfaction with present voiding state using visual analogue test (VAT). All patient were treated for 20 minutes, twice a week for 6 weeks, using a new intravaginal electrical stimulator with microchip (PIC16C74). Results: After the FES therapy, the overall success rate of the SUI was 50.4.% at 9 months. The bladder irritability symptoms such as frequency, nocturia, urgency, residual urine sensation and lower abdominal discomfort were improved. In particular, the symptoms of frequency, urge incontinence, dysuria were significantly improved after the FES therapy at 9 months. The VAT score of the overall satisfaction with the present voiding state was significantly lower after the FES therapy. 73.7% of patients were satisfied with the FES therapy and complications such as hemorrhage, vaginitis' urinary tract infection and pain were not encountered. Conclusion: These results suggest that FES therapy with microchip improves some bladder irritability in SUI women. Therefore, electrical stimulation therapy should be considered as a first line therapy in SUI women with bladder irritability symptoms.

B형 만성 간 질환이 있는 소아와 성인에서 HBV core promoter, precore/core 유전자 부위의 돌연변이에 대한 고찰

정정명,박영홍,설상영,이상혁,장윤식,이연재,채창식 인제대학교 1998 仁濟醫學 Vol.19 No.2

B형 간염은 전세계적으로 수억의 인구가 감염되었을 뿐아니라 간경변증 및 간암의 중요한 원인으로 알려져 있다. 특히 우리나라는 B형 간염바이러스에 전 인구의 약 60%가 과거 HBV에 감염되었던 소견이 있다. 또한 만성 간질환 및 간암 환자의 약 60∼70%가 HBsAg 양성으로 우리나라에서는 HBV가 간질환의 가장 중요한 원인임을 알 수 있다. 그러나 현재까지 간염의 중증도에 어떤 요인이 작용하는지 밝혀져 있지 않다. 이런 점에서 저자들은 B형 간염 바이러스의 변이종과 간질환의 관계를 조사하였다. 변이는 성인에서 많은 경향을 나타내었는데 변이가 주로 발생하는 부위는 core promoter, precore/core 영역에 공히 존재하나 변이와 질환의 중증도와의 직접적인 관계는 관찰되지 않았다. Objectives: To clarify the frequency of mutations in core promoter, precore and core region of HBV(hepatitis B virus) and their possible effects on the clinical course of HBV associated chronic liver diseases. Methods and Materials: we performed PCR (polimerase chain reaction) and direct sequencing for the sera of 48 patients who had been HBsAg positive for more than 6 months (adult 31, children 17). And in this study, adult patients were divided into 3 groups according to the histopathological severity of liver disease i.e. Group 1 as minimal change and chronic persistent hepatitis. Group 2 as chronic active and lobular hepatitis, Group 3 as liver cirrhosis and hepatocellular carcinoma, respectively. Results: 1.The number of mutations at core promoter region did not show statistically significant difference between children and adults. In comparisons among Group 1 vs Group 2 and Group 1 vs Group 3, statistically significant differences were not seen either. About 53.3% of mutations occurred at nucleotide 1753, 1762 and 1764. 2.The number of mutations at precore region which were associated with amino acid changes did not show statistically significant differences between children and adults. And 63.3% of mutations were developed at codon 28(nucleotide 1896). In comparisons among Group 1 vs. Group 2 and Group 1 vs. Group 3, there were no differences in the numbers of mutations. The mutations at this region were more prevalent in Anti-HBe positive group rather than in HBeAg positive group (p= 0.013). 3.At the core region, total number of mutations which were associated with amino acid changes were more frequent in adults than in children. At CTL epitome (codon 18∼27), there were no significant differences of mutations between adults and children, In comparisons among Group 1 vs Group 2 and Group 1 vs Group 3, statistically significant differences were not seen either. CD4 epitope showed statistically significant differences between children and adults (p=0.025), but the histopathological severity was not related with the frequency of mutations. At the B cell epitome, there were significantly different rates of mutations between children and adults(p=0.038). Group 1 and 2 did not show differences, but Group 1 and 3 showed significance. Assuming that the hot spot as mutations over 10% of total cases, 5 spots were identified in children and 11 spots were identified in adults. The area of more frequent mutations in adults were codon 13∼27, 33∼49, 59∼63, 92∼97, 113∼117, which comprise 67.5% of all mutations. Conclusion: We could not find the definite relationships between the mutation in the core promoter, precore/core gene region of HBV and the histopathological severity of HBY associated liver diseases. Further investigations are needed with larger number of patients.

Optimal dose and volume for postoperative radiotherapy in brain oligometastases from lung cancer: a retrospective study

Chung, Seung Yeun,Chang, Jong Hee,Kim, Hye Ryun,Cho, Byoung Chul,Lee, Chang Geol,Suh, Chang-Ok The Korean Society for Radiation Oncology 2017 Radiation Oncology Journal Vol.35 No.2

Purpose: To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume. Materials and Methods: Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ${\pm}$ boost (WBRT ${\pm}$ boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13). The most commonly used dose schedule was WBRT (25 Gy in 10 fractions, equivalent dose in 2 Gy fractions [EQD2] 26.04 Gy) with tumor bed boost (15 Gy in 5 fractions, EQD2 16.25 Gy). Results: The WBRT ${\pm}$ boost group showed the lowest 1-year intracranial recurrence rate of 30.4%, followed by the local RT and observation groups, at 66.7%, and 76.9%, respectively (p = 0.006). In the WBRT ${\pm}$ boost group, there was no significant increase in the 1-year new site recurrence rate of patients receiving a lower dose of WBRT (EQD2) <27 Gy compared to that in patients receiving a higher WBRT dose (p = 0.553). The 1-year initial tumor site recurrence rate was lower in patients receiving tumor bed dose (EQD2) of ${\geq}42.3Gy$ compared to those receiving <42.3 Gy, although the difference was not significant (p = 0.347). Conclusions: Adding WBRT after resection of brain oligometastases from NSCLC seems to enhance intracranial control. Furthermore, combining lower-dose WBRT with a tumor bed boost may be an attractive option.

Optimal dose and volume for postoperative radiotherapy in brain oligometastases from lung cancer:a retrospective study

Seung Yeun Chung,Jong Hee Chang,Hye Ryun Kim,Byoung Chul Cho,Chang Geol Lee,Chang-Ok Suh 대한방사선종양학회 2017 Radiation Oncology Journal Vol.35 No.2

Purpose: To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume. Materials and Methods: Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ± boost (WBRT ± boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13). The most commonly used dose schedule was WBRT (25 Gy in 10 fractions, equivalent dose in 2 Gy fractions [EQD2] 26.04 Gy) with tumor bed boost (15 Gy in 5 fractions, EQD2 16.25 Gy). Results: The WBRT ± boost group showed the lowest 1-year intracranial recurrence rate of 30.4%, followed by the local RT and observation groups, at 66.7%, and 76.9%, respectively (p = 0.006). In the WBRT ± boost group, there was no significant increase in the 1-year new site recurrence rate of patients receiving a lower dose of WBRT (EQD2) 〈27 Gy compared to that in patients receiving a higher WBRT dose (p = 0.553). The 1-year initial tumor site recurrence rate was lower in patients receiving tumor bed dose (EQD2) of ≥42.3 Gy compared to those receiving 〈42.3 Gy, although the difference was not significant (p = 0.347). Conclusions: Adding WBRT after resection of brain oligometastases from NSCLC seems to enhance intracranial control. Furthermore, combining lower-dose WBRT with a tumor bed boost may be an attractive option.

The successful clinical outcomes of pregnant women with advanced chronic kidney disease

( Ji Yeun Chang ),( Hanbeol Jang ),( Byung Ha Chung ),( Young Ah Youn ),( In Kyung Sung ),( Yong Soo Kim ),( Chul Woo Yang ) 대한신장학회 2016 Kidney Research and Clinical Practice Vol.35 No.2

Background: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. Methods: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary``s Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications. Results: There were no maternal or neonatal deaths in this cohort. The mean age at the time of conception and delivery was 35.8 ± 3.7 and 36.2 ± 3.5 years, respectively. Dialysis patients received more frequent and intensified HD during pregnancy, 20.0 ± 5.7 h/wk of HD over 5 visits with the ultrafiltration dose maintained between 1 and 2 kg per session. All patients received erythropoietin-stimulating agents and iron replacement therapy during pregnancy. The mean hematocrit was 33.1 ± 1.9% before pregnancy and was well maintained during gestation (33.9 ± 3.8% at the first trimester, 29.2 ± 4.2% at the second trimester, and 33.6 ± 8.7% at delivery). The mean gestation period was 32.7 ± 4.7 weeks, with 60% of patients experiencing premature delivery. The primary maternal complication was pre-eclampsia; 3 women developed pre-eclampsia and underwent emergency cesarean sections. Most neonatal complications were related to preterm birth. Conclusion: Dialysis-related care and general clinical management improved the clinical outcome of pregnancy for patients with advanced CKD.

Multislice CT Scans in Patients on Extracorporeal Membrane Oxygenation: Emphasis on Hemodynamic Changes and Imaging Pitfalls

Kao-Lang Liu,Yu-Feng Wang,Yeun-Chung Chang,Shu-Chien Huang,Shyh-Jye Chen,Yuk-Ming Tsang,Chin-Chen Chang 대한영상의학회 2014 Korean Journal of Radiology Vol.15 No.3

This pictorial review provides the principles of extracorporeal membrane oxygenation (ECMO) support and associated CT imaging features with emphasis on the hemodynamic changes and possible imaging pitfalls encountered. It is important that radiologists in ECMO centers apply well-designed imaging protocols and familiarize themselves with post-contrast CT imaging findings in patients on ECMO.

Reversed Effects of Phosphate Fertilizer on Reducing Phytoavailability of Cadmium in Mine Tailing Affected Soil

( Chang Oh Hong ),( Doug Young Chung ),( Byeoung Yeun Ha ),( Pil Joo Kim ) 한국환경농학회 2005 한국환경농학회지 Vol.24 No.3