메트암페타민 정맥주사 남용후 발생한 뇌경색 2예

김종환,김동선,김상진,예종수,김성은,김응규,허경 대한신경과학회 1998 대한신경과학회지 Vol.16 No.5

環境製品에 대한 消費者 行動에 관한 硏究

이종호,정경택,김은환 公州大學校 經濟經營硏究所 2000 經濟經營硏究 Vol.1 No.-

We should not regard the notion of Green Marketing as a narrow field which just treats environmental protection and recycling at the level of the pursuit for commercial gains but regard it something wild notion which promotes all the functions, goals and human life. Green marketing is a means by which an enterprise try to accomplish the social responsibility through the way of life approach centered on the quality of human life. In relation to above statement, the purpose of this study is to help a company build the effective marketing strategies by the study which measures the recognition of consumer about the sense of environment, the sense of consumer about the Green Marketing practiced by the company, verifies the purchase behavior of consumer to the environmental production, treats the interrelation between the demographic variables such as gender, ages, income, occupation, educational background of consumer, and the recognition of comsumer about the sense of environment, the attitude of consumer about environmental productions. So, the enterprise's production and marketing activity which ignores the environmental problem is turned the colder shoulder from consumer, in terms of this, enterprise must divert its passive attitude to active attitude and make production which has good intention for environment. Also enterprise must develope the technical skill to produce production which for environment, with the sense of responsibility and ethics enterprise must do its business.

정상인에서 전기 및 자기 자극을 이용한 설 근육의 전기생리학적 평가

조은미,류종현,안성환,조경원,임건한,김진호,김후원 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.1

Background: Abnormality of lingual muscles is clinically common. But its exact clinical assessment is quite difficult. Evaluation of motor power of the lingual muscles and their neural pathway is limited because of anatomical inaccessibility and individual variation of subjective symptoms. Transcranial magnetic stimulation (TMS) of the human motor cortex is a non-invasive tool to assess the functional integrity of the fast conducting central motor pathways and electrical stimulation of lingual nerve is a conventional method of peripheral nerve conduction. Therefore both study will be helpful to understanding of pathophysiology of lingual abnormality. Until now there is no such report in Korea. This study was conducted to acquire the easier method and normal control values of Korean subjects. Method: We recorded the motor responses from the lingual muscles of 32 healthy subjects (22 men, 10 women) by focal cortical TMS with a circular coil. Motor potentials were recorded by means of surface electrodes applied on the both side of the tongue, following TMS several centimeters lateral from the vertex and parietooccipital cortex and peripheral electrical stimulation of the 12th cranial nerve at the lateral 1/3 point of the line between the midline and angle of mandible. Results: During moderate motor activation, majority of maximal motor response were obtained 4-6cm lateral to the vertex with similar latencies. And the responses from magnetic stimulation of the intracranial segment of hypoglossal nerve were discarded because of difficulty to obtain and unsatisfactory reproducibility. The latency of motor evoked potentials in right cortical stimulation was 10.08 ± 1.17 msec and in left stimulation 10.04 ± 1.32 msec. The amplitudes in right 2.15 ± 1.02, left 2.09 ± 1.11 mV. The latencies electric hypoglossal nerve stimulation were 2.42 ± 0.34 in right, 2.49 ± 0.35 msec in left side. The amplitudes were 2.90 ± 2.37 in right, 2.43 ± 1.86 mV in left side. Central conduction times as calculated by subtracting the response latencies obtained by magnetic and electric stimulation are right 7.65 ± 1.19, left 7.55 ± 1.35 msec. There was no significant difference between man and woman, Conclusion: The method may be efficient, noninvasive, painless, and easy reproduced. With more extensive application to various neurological disorders, it comes close to being an ideal clinical conduction study technique for this cranial nerve.

우리나라 지역 직업성질환 감시체계의 현황과 전망

임종한,장성실,김성아,문재동,채창호,홍윤철,김수영,김진석,김영욱,한상환,이혜숙,원종욱,송동빈,하은희,강성규 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

기존의 특수건강진단과 작업환경측정을 통한 직업병 관리가 진폐증, 소음성난청 등의 소수 특정질환에 국한되고 실제 직업병 발생 규모 파악이나 신종 직업병의 발견에 한계를 보인다는 사실은 산업의학전문가들 사이에서도 공감을 이루고 있다. 미국과 영국 등에서의 직업성질환 감시체계에 대한 경험은 우리 나라의 직업성질환 감시체계 구축에도 새로운 자극제가 되면서, 1998년이후 인천, 대전, 여천, 구미, 부울경 지역에서 지역 직업성질환감시체계를 산업보건관리의 중요한 시스템으로 구축하려는 노력이 확산되고 있다. 새로이 구축되어지는 이들 지역 직업성질환 감시체계는 감시하고자 하는 대상질환, 활용 가능한 인적자원 및 자료원, 지역 의료체계의 특수성 등에 따라서 목적과 방법을 달리하면서 독특한 형태로 발전을 하고 있다. 각 지역단위 감시체계들이 그 상황에 맞게 독특한 목적과 전략들을 발전 시키면서도, 향후 발전할 국가적인 차원의 직업성질환 감시체계 구축을 위하여 직업성질환 감시의 기본 전략 등을 공유하는 등의 노력이 필요하다. 환례 정의 및 기본적인 등록 서식의 공유, 직업성질환 감시 자료원의 발굴, 공동의 정보 네트워크 및 직업성질환 감시 데이터베이스 구축 등 직업성질환 감시활동을 지원하기 위한 여러 기초 인프라 구축에 힘을 모아야 할 것이다. 우리 나라에서 직업성질환 감시체계를 성공적으로 구축하기 위해서는 수집된 자료의 질 관리를 위한 직업성질환 감시의 원칙 제정과 감시 전략의 공유 등이 필요하며, 전국적인 직업성질환 감시체계의 하부구조라고 할 수 있는 지역감시체계의 기초 토대 마련과 강화작업이 절실하게 필요하다.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

충북 지역 초등학교 과학교육의 실태 조사

김찬종,이선경,김수환,고은성 淸州敎育大學校 科學敎育硏究所 科學과 數學敎育論文集 Vol.23 No.-

A survey was carried out comprehensively to investigate the present status of science education in primary schools 496 teachers in 199 primary schools in Chungbuk area participate in the survey. They questionnaire used in this study included items regarding goals or objectives for science education, approaches for instruction, teaching-learning strategies, assessment for instruction, teaching-learning strategies, assessment for instruction, computer use in science classes students' activity and the status of experimental equipment or tools for science education. Items on science textbooks and the understanding of the 7th national curriculum were also included in it. The results based on the teachers' responses were summarized and provided in this paper and it showed practices of science education in Chungbuk area.

변단면 고층건물의 변동풍압특성

조지은,김동환,김종수,김영문 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

Nowadays the assessment of structural safety and serviceability of a tall building during strong wind is one of the important design criteria. The purpose of this study is to predict the pressure fluctuation of the tall building have different taper ratio of 5%, 10%, 15%. According to taper ratio, to know that the effect of vibration control on a tapered tall building attacked across wind. And also to give basic concepts of the tapered building on unpredictable wind directions. Acquired pressure data allowed analysis of the mean and r.m.s pressure coefficient, power spectral density function in measured taps at different levels and columns with considering the effects of wind directions and boundary layer conditions.

정신분열병과 N-Methyl-D-Aspartate 수용체 유전자와 연관된 VNTR 표지자인 D9S158 다형성의 연합

김종원,채영규,정은기,김길숙,박강규,이영호,최인근,양병환,한진희 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

정신분열병과 NMDA 수용체와 연관된 D9S158 유전적 표지자와의 연관성을 알아보기 위해 75명의 정신분열병 환자군과 87명의 정상대조군을 대상으로 중합효소연쇄반응을 이용하여 연합연구를 시행하여 다음과 같은 결론을 얻었다. D9S158 유전좌위에는 모두 8개의 대립유전자가 있었고, 각 대립유전자는 cytosine-adenine염기가 반복되는 217염기쌍에서 233염기쌍의 형태였다. 먼저 정신분열병 환자와 정상대조군의 대립유전자의 빈도를 비교해 본 결과 통계적으로 유의한 차이를 보이지 않았다(p〉.05). 환자군을 좀 더 동질적으로 만들기 위해 정신분열병의 가족력 유무, 음성 및 양성증상, 연성신경학적 징후, DSM-IV 임상아형에 따라 환자군을 나누어 대립유전자의 빈도를 비교해 본 결과, 특정 임상양상과 관련이 있는 대립유전자를 발견하지 못하였다. 결론적으로 본 연구에서는 D9S158 유전좌위와 정신분열병의 연관성을 입증하지 못하였으나 NMDA 수용체 유전자주위의 다른 표지자나 좀 더 유전적으로 동질한 환자군을 대상으로 한 추후연구가 필요할 것으로 생각된다. An association study with Korean schizophrenic patients(N=75) and normal controls(N=87) was performed to find the relationship between D9S158 polymorphism and schizophrenia using polymerase chain reaction. Eight different alleles of a dinucleotide polymorphism on D9S158 locus were observed in both group. When we compared the frequencies of alleles between schizophrenics and normal controls, there was no significant difference between two groups. To increase homogeneity of schizophrenic group, we divided schizophrenic group by clinical phenotypes such as family history, negative and positive symptoms(PANSS), soft neurologic signs(NES-K) and DSM-IV diagnostic subtypes. Then we compared the frequencies of alleles among subgroups of clinical phenotypes, and there were no significant differences between subgroups(p〉.05). Although our findings fail to provide an evidence of association between schizophrenia and D9S158 locus, further investigation of other loci that are linked to NMDA receptor gene may be needed in genetically homogeneous subgroups of schizophrenia.

조기위암의 형태학적인 분류에 따른 임파절 전이 양상

최은서,강길,박정희,장정환,김권천,김경종,민영돈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Currently, in the limited cases of early gastric cancer (EGC), endoscopic mucosal resection (EMR) is used for curative treatment. However, its completeness is still controversial. The purpose of this study was to review the suggested indications of EMR. We retrospectively analyzed 234 patients with EGC who underwent curative (RO) gastrectomy. The enrolled cases were further classified into mucosal and submucosal types, and mucosal EGC were further classified according to the size, gross type and histologic pattern. 133 patients had mucosal cancers and 101 patients submucosal. The overall incidence of positive lymph node was 14.1% (33/234), the incidence of mucosal cancer was 8. 3% (11/133), which was significantly lower than that of submucosal, 22% (22/101). Of 133 patients with mucosal EGC, 90 were smaller than 2㎝ in size and the incidence of lymph node metastasis was 5.6% (5/90), compared to 43 of larger than 2㎝ with the incidence of 14% (6/43). According to the gross type classification of mucosal cancer, incidence of lymph node metastasis in protruded type (EGC type Ⅰ, Ⅱa, Ⅰ+Ⅱa) was 15.4% (4/26), nat type(EGC type Ⅱb) 2. 9% (1/35), depressed type (EGC type Ⅱc, Ⅲ) 8.3% (6/72). Lymph node metastasis in differentiated type of mucosal cancer was 6.9% (5/72) and undifferentiatcd type 9.8% (6/61). In this study, there was no single indication free from lymph node metastasis, It is thought that the selection of EMR for the curative treatment of EGC should be considered carefully and more clinical studies with long-term follow up are necessary for EMR to be generally acceptable.

실험적 치아이동시 glycosaminoglycan의 발현에 관한 연구

이경환,이종진,강경화,김은철,김상철 대한치과교정학회 2001 대한치과교정학회지 Vol.31 No.4

치아이동시 골대사에 있어 glycosaminoglycan의 역할에 대해 알아보고자 glycosaminoglycan의 주요 구성 성분인 chondroitin 4-sulfate(CH-4S)의 치주조직 내에서의 면역반응 정도 및 분포 양상을 백서 치아의 실험적 이동 과정에서 면역조직화학적으로 관찰하였다. 또한 사람 치주인대세포를 배양하여 여러 종류의 cytokine을 투여한 후 CH-4S의 발현 양상의 변화를 Western blot analysis를 통해 확인하여 다음과 같은 결과를 얻었다. 1.치아이동에 반응하는 치수, 치주인대, 골모세포, 파골세포, 골세포 부위에서의 CH-4S 발현이 대조군보다 많았으나 상아질, 백악질에서의 CH-4S의 발현은 견인력 적용 기간에 관계없이 대조군과 큰 차이가 없었다. 2.치수에서 CH-4S의 발현은 교정력을 가한 1일째에 크게 증가하였다가 7일째부터 감소되었으며 14일째에는 대조군과 차이가 없었다. 3.치주인대에서 CH-4S의 발현은 주로 치조골 면을 따라 견인측에서 나타났는데 교정력을 가한 1일째에 가장 많은 발현을 보인 후 4일째부터 감소하기 시작하였다. 4.골모세포와 파골세포 및 골세포에서 CH-4S의 발현은 4일째에 가장 많은 발현을 보였고 7일째 이후에는 크게 감소 하였다. 5.치주인대세포에 PDGF-BB를 투여한 경우 3일째에 가장 많은 CH-4S의 발현을 보였다. 6.치주인대세포에 TNF-α 처리 시 배양 1일째에 CH-4S의 발현 감소를 보였다. 7.치주인대세포에 PDGF-BB와 TGF-β를 혼합 투여한 경우가 PDGF-BB 및 TGF-β를 단독 투여한 경우 보다 배양 3일째에 CH-4S의 발현이 많았고 LPS나 TNF-α 투여군은 유사한 발현 감소를 보였다. 이상과 같이 교정적 치아이동시 시기 및 부위에 따라 glycosaminoglycan의 발현이 차이를 보이며, 치주인대세포에서도 cytokine의 자극에 따라 glycosaminoglycan의 발현이 변화하는 것으로 보아, glycosaminoglycan이 골대사에 있어 중요한 조절 인자로서의 역할을 하는 것으로 여겨진다. (주요 단어 : 치아이동, 치주인대세포, 골대사, glycosaminoglycan, chondroitin (CH) 4-sulfate) The purpose of this study was to evaluate 1) in vivo, the expression of chondroitin 4-sulfate (CH-4S), a structural element of glycosaminoglycans(GAGs), in periodontal tissue during the experimental movement of rat incisors, by labelled streptavidine biotin immunohistochemical staining for CH-4S, 2) In vitro, the expression of CH-4S in cultured human periodontal ligament(PDL) cells supplemented with 10ng/㎖ of TGF-β1, 20ng/㎕ of PDGF-BB, 1ng/ml TNF-α, or 1㎍/ml LPS by western blot analysis. The results of this study were as follows ; 1.The expression of CH-4S was stronger in pulp, PDL, osteoblasts, osteoclasts and osteocytes in experimental group than in control group, but was rare in dentin, and cementum of experimental groups, regardless of the duration of force application, which was not different from that of control group. 2.In experimental group, the expression of CH-4S in pulp began to increase at 1 day after force application and got to the highest degree at 7 days. After 14 days, the expression in CH-4S immunoreactivity was decreased, and became similar to that of control group at 28 days. 3.The expression of CH-4S in PDL was noted in adjacent to alveolar bone. PDL showed higher intensity of immunolabelling after 1 day of orthodontic tooth movement. And the expression was more stronger in the tension side than that of pressure side of PDL at 1 day, but more stronger in the pressure side than that of tension side of PDL at 4 days. After 7 days, a decrease in CH-4S expression was observed. 4.The expression of CH-4S in alveolar bone got to the highest degree at 4 days, and At 7 days, a decrease in CH-4S expression was observed. 5.PDGF-BB notably raised the expression of CH-4S in the PDL cells at 3 days of cultivation 6.The expression of CH-4S of PDL cells was decreased with the application of TNF-α at 1 day. 7.Admixture of TGF-β1 and PDGF-BB got more expression of CH-4S in PDL as compared to only TGF-β1 or PDGF-BB. A similar decrease of the expression of CH-4S was observed in the case of application of LPS or TNF-α. ※ Key words : Tooth movement, Periodontal ligament cell, Bone metabolism. Glycosaminoglycans,Chondroitin 4-sulfate