대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

고삼투압성 비케톤성 상태의 예후인자

안성훈,김양원,김미란,진헌철,안지영,이상래,류석용,김홍용,김성준,이병권,김경환 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: A hyperosmolar nonketotic state has been known to have a high mortality, and even now, despite this high mortality, only a few studies of this disease have been performed. We studied the prognostic factors for the hyperosmolar nonketotic state. Methods: We retrospectively studied the cases of 40 patients who were in a hypersomolar nonketotic state when admitted to Sanggye Paik Hospital during the 6-year Period from 1995 through 2000. We divided the hyperosmolar nonketotic patients into two groups, the complete recovery group and the incomplete recovery group, and compared the clinical features, the laboratory findings, and the precipitating factors between two groups. Results: 1) A total of 40 patients were studied: 24 in the complete recovery group and 16 patients in the incomplete recovery group. The mortality rate was 32.5%. 2) No significant statistical difference existed among the clinical features of the two groups, except for the sex(p<0.01). 3) Among the laboratory findings of both groups, analysis revealed that the effective osmolarity was significantly higher among those in the incomplete recovery group(p<0.01). Serum sodium concentration was also significantly higher among those in the incomplete recovery group(p<0.01). Serum creatinine was also significantly higher among those in the incomplete recovery group(p<0.05). Serum bicarbonate concentration, on the other hand, was significantly lower among those in that group(p<0.05).4) Infection was identified as the most common precipitating factor(62.5%). Among the precipitating factors of the two groups, there were significant statistical difference in pneumonia, UTI, and inappropriate glucose control. 5) A significant statistical difference existed among the initial level of consciousness of both groups(p<0.05). 6) The only significant independent factor responsible for prognosis of nonketotic hyperosmolar state patients was the sex. Conclusion: The sex was only significant independent prognostic factor of nonketotic hyperosmolar state patients.

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

브로콜리 추출물의 향장활성 효과

김대용ㆍ조석철ㆍ권혁선ㆍ김미경(Dae Young KimㆍSeok chul ChoㆍHyuk sun KwonㆍMee Kyung Kim) 한국인체미용예술학회 2016 한국인체미용예술학회지 Vol.17 No.1

In this study, we investigated the anti-oxidative effects, antimicrobial, and anti-inflammatory activities of the extracts from broccoli to evaluate its use as a functional ingredient in cosmetics. The extracts are WE (water extract at RT), MWE (mineral water extract at RT), EE (70% ethanol extract at RT), and USEE (heat process for 12 hours at 60℃ after ultrasonification for six hours with 70% ethanol). The measurements of the total polyphenol content from broccoli extracts were highest in EE at 425.24±13.9 mg/g dry. The result of electron donating ability of EE was the highest at 10,000 ㎍/㎖ as 97.81% and increased in a concentration-dependent manner. The ferric reducing antioxidant powder (FRAP) of EE was the highest at 10,000 ㎍/㎖ as 1235.6 μM. In an antimicrobial activity test, the EE showed significant antimicrobial activity against S. epidermidis, S. aureus, E. coli, P. acnes, and P. ovale. Furthermore, broccoli extract exhibited no cytotoxicity in RAW 264.7 cells. Also anti- inflammatory activity by NO assay showed LPS-induced NO was significantly inhibited following treatment with EE of 1,000 ㎍/㎖. Therefore, the broccoli ethanol extract can be used as a resource of natural cosmetic material for functional cosmetics.

초등학생들의 물질 개념에 관한 연구

김석중,남철우,김정길,송판섭,한광래,최도성,김숙희 光州敎育大學校 初等敎育硏究所 2002 初等敎育硏究 Vol.17 No.-

Over the past 20 years, research on students' conceptual development of science concepts has begun to inform educators about the roles that prior knowledge and experiences play in the development of conceptual understandings. Whereas many initial studies focused on identifying and cataloging naive of misconceptions, more recent research has focused on how student concept development research can inform teaching practice and curriculum design. In this study, we investigated children's (ages 11∼12) spontaneously constructed or naive understanding of the particulate nature of matter prior to any formal instruction in the domain. Thirty students were interviewed concerning their understanding of the macroscopic and microscopic properties of the states of matter(solid, liquid, and gas), as well as their macro/microscopic understanding of phase changes and dissolving. Children expressed ideas about states of matter which were categorized as macrocontinuous, macroparticulate, or microparticulate. Furthermore, a substantial number of the children provided explanations of properties and processes which were consistent with those beliefs. These children's beliefs about matter were not fully and consistently developed across the spectrum of substances from continuous solids to particulate solids to liquids to gases. We speculate that children first develop local frameworks particular to different classes of substances and then slowly expand these frameworks to include a wide range of substances and their properties as well as such processes as melting and freezing.

Lactic Acid의 심근 수축성에 미치는 영향

김성철,장석종 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

In order to evaluate the effects of lactice acid on the cardiac muscle contractility, turtle Ringer solution contained various concentration of lactic acid or HCl were perfused into isolated turtle ventricle by Langendrof preparation and contractility parameters, such as tension, maximal contraction dT/dt, and maximal relaxation dT/dt were measured by Physiograph. Lactic acid depressed remarkably the contractility parameters of the heart and the magnitude of depression was about 23-28 percent with decrease in one unit of pH at the pH range between 6.80 and 8.20. Furthermore the degree of inhibition of contractility parameters between lactic acid and HCl were not significant differance statistically. Therefore it was suggested that inhibitory effect of cardiac muscle contractility by lactic acid may depend on hydrogen ion concentration, ie. pH.

기중기에 사용된 모터의 회전수 측정장치 개발

김강철,한석붕 호서대학교 반도체제조장비국산화연구센터 2001 반도체장비학술심포지움 Vol.2001 No.-

본 논문에서는 기중기에 사용된 모터의 회전수를 측정하는 장치를 설계하였다.이 장치는 로타리엔코더, 회전수를 계산하는 속도 측정부, LCD표시부 및 모터의 방향판별회로로 구성된다.모터의 회전수측정 장치는 모터의 회전수를 측정하여 RPM으로 표시하고, 모터가 6˚ 회전 후에 모터의 방향을 판별할 수 있다.그리고 모터가 제한속도를 벗어나면 위험신호를 발생하는 신호와 회전방향을 나타내는 신호를 발생한다.

顎關節機能장애 珍斷을 爲한 頭部軸方向放射線寫眞에서의 下顎顆頭의 位置分析

金碩鎬,卞種秀,崔珣哲 慶北大學校 齒科大學 1986 慶北齒大論文集 Vol.3 No.1

著者는 顎關節機能障碍의 소견을 가진 환자 75명과 악관절기능장애의 炳歷 및 現症이 없는 정상인 75명을 표준화된 조건하에서 頭部軸方向放射線撮影을 하여 顆頭水平角과 initial 및 final depth of cut를 측정하고 통계학적으로 분석한 결과를 다음과 같이 요약할 수 있었다. 환자군과 정상군, 患側과 非患側에 있어 顆頭水平角과 initial 및 final depth of cut는 통계학적으로 유의한 차가 없었으므로 頭部軸方向放射線寫眞은 임상에서 악관절기능장애의 유무 및 患側과 非患側의 감별에 이용하기에는 부적합한 방법이라 사료된다. 본 연구의 계측치는 편차가 심하므로 환자마다 顆頭水平角을 측정하여 이각에 맞추어 顎關節斷層撮影을 해야 한다고 사료된다. The purpose of this study was to analyze the position of mandibular condyle on the submentovertex radiograph, thereafter to evaluate the usefulness of submentovertex radiograph in diagnosis of temporomandibular joint dysfunction, and to check the best method of tomographic techniques. Submentovertex radiographs which were taken in 75 tempormandibular joint dysfuction patients and 75 normal persons were used as the sample for this study. The obstients results were as follows : The submentovertex radiograph was a improper method in diagnosis of temporomandibular joint dysfuction and discrimination of affected side. The selective tomography was a better method than any other temographic techniques in diagnosis of temporomandibular joint dysfunction.

牛耳島의 植物相과 植生에 關한 硏究

金喆洙,張允錫,吳長根 木浦大學校沿岸生物硏究所 1987 沿岸生物硏究 Vol.4 No.1

The flora and vegetation of Ui-do were investigated two times from July 23th to July 29th in 1985, and from July 8th to July 15th in 1985. The vascular plants identified in these investigations were 102 families, 302 genera, 376 species, 58 varieties and 4 formae, summing up to 438 species total. Of these species, 126 species were found commonly in the lists reported previously by Lee, etc. (1980) and Lee (1981). The total number of species in this island was thus summerized as 104 families, 323 genera and 481 species. Also Fisher's index was calculated as 426.4. This value was higher than that of Hong-do. By the ZM school method, the vegetaion of Ui-do was classified into 15 community types, i.e. the evergreen broad-leaved forests(Camellia japonica-Machilus thunbergii, Camellia japonica-Castanopsis cuspidata var. sieboldii, Camellia japonica community), the evergreen needle-leaved forests (Pinus thunbergii community), the deciduous forests (Mallotus japonicus, Carpinus coreana community), Pseudosasa japonica community, the grassland vegetation (Miscanthus sinensis var. purpurascens, Arundinella hirta-Zoysia japonica, pennisetum alopecuroides-Artemisia princeps var. orientalis, Agrostis clavata-Artemisia princeps var. orientalis community), the sand dune vegetation (Carex pumila, Imperata cylindrica var. koengii-Vitex rotundifolia, Ligustrvm quihoui var. latifolium community) and the grazing land. Each community was described in term of floristic, structual and environmental features. The synthesis table and the actual vegetaion map were prepared.