靑少年의 異性交際왕 性에 대한 態度에 관한 硏究

고정자,박은령 동아대학교 생활과학연구소 2001 생활과학연구 논문집 Vol.9 No.-

The aims of this study are that teenagers learn the salutary intersexual friendship and sexual behavior for their mature personality growing up smooth by analysing the teenagers' intersexual relationship and sexual behavior. To achieve the purpose the themes of study are : First, general tendencies of the teenagers' intersexual friendship and the differencies of the teenagers' intersexual friendship according to the independent variables. Second, general tendencies of the teenagers' sexual behavior and the differencies of the teenagers' sexual behavior according to the independent variables. Third, the concern with teenagers' Intersexual friendship experience and sexual behavior. For this purpose, this study was surveyed 800 teenagers of senior high school located in Pusan. They were first and third year in their school of all questionnaires, 769 copies were used for the analysis of final data. Frequency, percentage, mean, standard deviation, chi-square test, t-test, ANOVA, correlate by SPSS compute program were performed for data treatment. The results of this study are as follows. 1.The general tendencies of the teenagers' intersexual friendship and the differencies of the teenagers' intersexual friendship according to the independent variables. Most teenagers think the teenagers' intersexual friendship is necessary but their intersexual friendship experiences are lower than their cognition of intersexual friendship necessity. Parents tend to aid their children's intersexual friendship and teenagers think intersexual friendship experiences are affirmative. Most questionnaires reply the reason that they do net associate with other sex is that they don't have chances. In gender, school, brothers and sisters, drinking, smoking factors, significant differencies were shown. 2.The general tendencies of the teenagers' sexual behavior and the differencies of the teenagers' intersexual friendship according to the independent variables. Teenagers regard that virginity is important. The interest of sex is very high and they feel sex is human's natural instinct. In gender, school, brothers and sisters, drinking, smoking factors, significant differencies were shown. 3.The concern with teenagers' Intersexual friendship experience and sexual behavior. As teenagers have experienced in Intersexual friendship, their sense of virginity is rare but their interests of sex is strong and view of sex is natural.

Lidocaine 이 흰쥐 해마박편에서 CA 1 추체세포의 활성에 미치는 영향

김형룡,민승기,김대업,오상천,유형근,김은철,고건일,원진숙 원광대학교 생명공학연구소 1995 생명공학연구소보 Vol.3 No.1

Endobronchial Neurilemmoma Mimicking a Bronchial Polyp

Ryoung Eun Ko,Ryoung Eun Ko,Ryoung Eun Ko,So Ri Kim,Heung Bum Lee,Yong Chul Lee,Seoung Ju Park 순천향대학교 순천향의학연구소 2015 Journal of Soonchunhyang Medical Science Vol.21 No.2

Neurilemmomas are relatively uncommon, slowly growing tumors which originate from Schwann cells. Intrathoracic neurilemmomas often occur in the chest wall and posterior mediastinum, but endobronchial neurilemmomas are exceedingly rare. These tumors in trachea or bronchus are usually detected by radiologic examinations, mostly computed tomography scan of chest. An 88-year-old man was admitted for management of pneumonia in left lower lobe and parapneumonic effusion. On bronchoscopic examination, there was a small polypoid nodule less than 1 cm in diameter mimicking an endobronchial inflammatory polyp at the bifurcation of the right anterior segmental bronchus and lateral segmental bronchus and under auto-fluorescence imaging, the nodule showed reddish brown area with defined margin. The bronchoscopic biopsy revealed that the bronchial nodule was endobronchial neurilemmoma. This is an interesting case of endobronchial neurilemmoma mimicking a bronchial polyp that is detected incidentally via bronchoscopy.

Association of time-to-treatment with outcomes of Pneumocystis pneumonia with respiratory failure in HIV-negative patients

( Ryoung-eun Ko ),( Kyeongman Jeon ),( Soo Jin Na ),( Kyungmin Huh ),( Gee Young Suh ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Pneumocystis pneumonia (PCP) with hypoxic respiratory failure is increasing in human immunodeficiency virus (HIV)-negative patients. However, there is no study evaluating the effect of early anti-PCP treatment on clinical outcomes in HIV-negative patient with severe PCP. Therefore, this study investigated the association between the time to anti-PCP treatment and clinical outcomes in HIV-negative patients with PCP presented with hypoxemic respiratory failure. A retrospective observational study was performed of 51 HIV-negative patients with PCP presented with respiratory failure and admitted to the intensive care unit between October 2005 and July 2018. A logistic regression model was used to adjust for potential confounding factors in the association between time to anti-PCP treatment and in hospital mortality. All patients were treated with appropriate anti-PCP treatment, primarily with trimethoprim/sulfamethoxazole. The median time to anti-PCP treatment was 58.0 (28.0 - 97.8) hours. Thirty-one (60.8%) patients were treated empirically prior to microbiological diagnosis confirmed. However, hospital mortality rates were not associated with increasing quartiles of time to anti-PCP treatment (P = 0.818, test for trend). All patients who applied high-flow nasal cannula for respiratory support on ICU admission day survived. In a multiple logistic regression model, the time to anti-PCP treatment was not associated with increased mortality. However, age (adjusted OR 1.07, 95% CI 1.01 - 1.14) and failure to initial treatment (adjusted OR 13.03, 95% CI 2.34 - 72.65) were independently associated with increased mortality. In conclusion, there was no association between the time to anti-PCP treatment and treatment outcomes in HIV-negative patients with PCP presented with hypoxemic respiratory failure. Higher mortality rate was independently associated with respiratory failure requiring mechanical ventilation support, age, and failure of the initial anti-PCP treatment.

Quick Sequential Organ Failure Assessment Score and the Modified Early Warning Score for Predicting Clinical Deterioration in General Ward Patients Regardless of Suspected Infection

Ko Ryoung-Eun,Kwon Oyeon,Cho Kyung-Jae,Lee Yeon Joo,Kwon Joon-myoung,Park Jinsik,Kim Jung Soo,Kim Ah Jin,Jo You Hwan,Lee Yeha,Jeon Kyeongman 대한의학회 2022 Journal of Korean medical science Vol.37 No.16

Background: The quick sequential organ failure assessment (qSOFA) score is suggested to use for screening patients with a high risk of clinical deterioration in the general wards, which could simply be regarded as a general early warning score. However, comparison of unselected admissions to highlight the benefits of introducing qSOFA in hospitals already using Modified Early Warning Score (MEWS) remains unclear. We sought to compare qSOFA with MEWS for predicting clinical deterioration in general ward patients regardless of suspected infection. Methods: The predictive performance of qSOFA and MEWS for in-hospital cardiac arrest (IHCA) or unexpected intensive care unit (ICU) transfer was compared with the areas under the receiver operating characteristic curve (AUC) analysis using the databases of vital signs collected from consecutive hospitalized adult patients over 12 months in five participating hospitals in Korea. Results: Of 173,057 hospitalized patients included for analysis, 668 (0.39%) experienced the composite outcome. The discrimination for the composite outcome for MEWS (AUC, 0.777; 95% confidence interval [CI], 0.770–0.781) was higher than that for qSOFA (AUC, 0.684; 95% CI, 0.676–0.686; P < 0.001). In addition, MEWS was better for prediction of IHCA (AUC, 0.792; 95% CI, 0.781–0.795 vs. AUC, 0.640; 95% CI, 0.625–0.645; P < 0.001) and unexpected ICU transfer (AUC, 0.767; 95% CI, 0.760–0.773 vs. AUC, 0.716; 95% CI, 0.707–0.718; P < 0.001) than qSOFA. Using the MEWS at a cutoff of ≥ 5 would correctly reclassify 3.7% of patients from qSOFA score ≥ 2. Most patients met MEWS ≥ 5 criteria 13 hours before the composite outcome compared with 11 hours for qSOFA score ≥ 2. Conclusion: MEWS is more accurate that qSOFA score for predicting IHCA or unexpected ICU transfer in patients outside the ICU. Our study suggests that qSOFA should not replace MEWS for identifying patients in the general wards at risk of poor outcome.

Association between the Presence of Delirium during Intensive Care Unit Admission and Cognitive Impairment or Psychiatric Problems: The Korean ICU National Data Study

( Ryoung-eun Ko ),( Chi Ryang Chung ),( Taewan Kim ),( Ire Heo ),( Areum Han ),( Chaiyoung Lee ),( Yunjoo Im ),( Gee Young Suh ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0

Background Previous studies have shown that intensive care unit (ICU) survivors are affected by a wide range of physical, cognitive, and psychiatric issues. Among post intensive care syndrome, cognitive impairment and psychiatric problems worsen the quality of life of ICU survivors, and they have become important public health issues. Delirium is a frequent disorder in ICU and is associated with substantially increased morbidity and mortality after ICU care. This study conducted to evaluate the association between the presence of delirium during hospitalization involving ICU care and post-discharge cognitive impairment or psychiatric problems. Methods We conducted a retrospective cohort study using a database of nationwide insurance claims data. All patients aged 18 years or older who were admitted to an ICU between January 1, 2008, and May 31, 2015, and had no history of previous cognitive impairment or psychiatric problems were included. Results Of 306,011 patients, the proportion of those who experienced delirium during hospitalization was 55.0% (n = 168,190). The patients with delirium during hospitalization had significantly increased odds for cognitive impairment (adjusted HR 1.17; 95% CI, 1.05-1.29) and psychiatric problems (adjusted HR 1.78; 95% CI, 1.67-1.90) after discharge compared with patients without delirium. In patients who had delirium, the incidence of cognitive impairment was 210.8 per 1,000 person-years. In 19,496 patients who were diagnosed with cognitive impairment, depression (n = 3,233, 16.5%), sleep disorder (n = 1,791, 9.2%), and anxiety (n = 1,683, 8.6%) were commonly co-diagnosed. The most common psychiatric problem was sleep disorder (148.7 per 1,000 person-years), followed by depression (133.3 per 1,000 person-years). Conclusions Among patients received ICU care, those who experienced delirium during hospitalization had an increased risk of developing cognitive impairment or psychiatric problems post-discharge. Many patients showed multiple cognitive impairment and psychiatric problems during the follow-up period.

Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea

( Ryoung-eun Ko ),( Kyung Hoon Min ),( Sang-bum Hong ),( Ae-rin Baek ),( Hyun-kyung Lee ),( Woo Hyun Cho ),( Changhwan Kim ),( Youjin Chang ),( Sung-soon Lee ),( Jee Youn Oh ),( Heung Bum Lee ),( Sooh 대한결핵 및 호흡기학회 2021 Tuberculosis and Respiratory Diseases Vol.84 No.4

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii . During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

Poster Session : PS 1266 ; Pulmonology : A Case of Double Covered-Self-Expandable Metallic Stents in Patient with Acquired Subglottic Tracheal Stenosis

( Ryoung Eun Ko ),( Heung Bum Lee ),( Seung Young Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Introduction: The incidence of tracheal post-intubation stenosis has increased because of the increasing number of patients who require mechanical ventilator support. Resection of the stenotic segment and reconstruction or Montgomery T-tube insertion are considered the ideal management. But these procedures require introduction with a rigid bronchoscope, surgical procedures, and an operating room under general anesthesia. Recently, airway stents have been extensively introduced with various results of success, and low intra-operative and early postoperative complications rates. However stenting for subglottic stenosis (SGS) remains a dif. cult therapeutic problem in respect of its location relating stent migration and granulation formation as well as shear stress inducing 2ndary tracheo-laryngeal injury. Case report: A 73-years-old man was referred to hospital due to severe dyspnea. He was intubated for about 2 weeks for an episode of acute pulmonary edema and aspiration pneumonia, 2 month ago. Medical history had chronic kidney disease(stage IV), diabetes, and hypertension. Physical examination revealed severe stidors on both lung fields. Chest computed tomography (CT) scan showed upper trachea narrowing from lower margin of cricoid cartilage to mid-trachea level, extending a distance of 3cm distally. fiexible bronchoscopy revealed a fibrotic stenosis more than 50% of circumference of the trachea, from 4cm distal to vocal cord. He underwent segmental resection and end-to-end anastomosis. Repeated bronchoscopy a month post operation showed that the subglottic area had narrowed further with granulation tissue. So, we performed with double covered SEMS, guided by fiexible bronchoscope and fiuoroscope. After that, his sympoms and brochoscopic findings was improved and without specific complications he was followed up to out-patient department. Conclusion: we reported a case of 74-years-old man who treated with double covered- SEMS, guided by fiexible bronchoscope and fiuoroscope, for post-intubation subglottic stenosis that disrupted end-to-end anastomosis.

Setting and Monitoring of Mechanical Ventilation During ECMO

( Ryoung-eun Ko ) 대한결핵 및 호흡기학회 2023 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.136 No.0

Safe and Feasibility of Continuous Ketamine Infusion for Analgosedation in Medical ICU Patients

( Ryoung-eun Ko ),( Chi Ryang Chung ),( Jihoon Jang ),( Sungmin Hong ),( Bo-guen Kim ),( Ju Yeun Song ),( Daegeun Lee ),( Gee Young Suh ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Some mechanical ventilated patients require deep sedation during acute respiratory distress syndrome management, and these patients frequently received opioids, benzodiazepine, and propofol. Recent meta-analysis has reported an increasing trend of ketamine use in mechanically ventilated patients and showed that ketamine may be play a role as a sedative-sparing agent. However, most previous continuous ketamine studies were conducted in patients with traumatic, post-operative, or cerebral ischemia with small sample sizes. This study conducted to assess the effect of continuous ketamine in patients who admitted medical or cardiac ICUs and received mechanical ventilator. Methods We conducted a retrospective cohort study between March 2012 and June 2020 at Samsung Medical Center. Adult patients who received mechanical ventilation support over 24 hours and received continuous ketamine infusion at least 8 hours were included. Results Of all 12,534 medical or cardiac ICU patients, 564 were eligible for analysis. Ketamine was used 33.3 (19.0-67.5) hours and median continuous infusion dose was 0.11 (0.06-0.23) mcg/kg/hr. Of all patients, 469 (83.2%) received continuous ketamine infusion concomitant with analgosedation. Blood pressure, and vasopressor inotropic score were not changed before and after continuous ketamine infusion. Heart rate was decreased significantly from 106.9 (91.4-120.9) in 8 hours prior- and to 99.8 (83.9-114.4) in 24 hours post-ketamine initiation. In addition, respiratory rate was decreased significantly from 21.7 (18.6-25.4) in 8 hours prior- and to 20.1 (17.0-23.0) in 24 hours post-ketamine initiation. Overall opioid usage was significantly reduced; 3.0 (0.0-6.0) mcg/kg/hr as fentanyl equivalent dose in 8 hours prior- and to 1.0 (0.0-4.1) mcg/kg/hr as fentanyl equivalent dose in 24 hours post-ketamine initiation. However, the use of sedatives and antipsychotic medication were not decreased. Conclusions Ketamine may be a safe and feasible analgesic for medical or cardiac ICU patients as an opioid sparing agent without adverse hemodynamic effects.