위식도 역류질환 환아에서 보행성 이중채널 식도내 산도 검사에 대한 연구

안영준,문경래,Ahn, Young-Joon,Moon, Kyung-Rye 대한소아소화기영양학회 2000 Pediatric gastroenterology, hepatology & nutrition Vol.3 No.1

목 적: 위식도 역류 질환 환아에서 이중 채널 24시간 식도 pH 측정 검사의 유용성을 평가하고 식도 원위부와 근위부에서 얻은 식도 pH 검사 계측치를 비교 평가하고자 본 연구를 하였다. 대상 및 방법: 1997년 7월부터 1998년 12월까지 조선의대 병원 소아과에서 식도역류가 의심되어 내원한 환아 46명을 대상으로 18~24시간 동안 식도의 상부와 하부 두 부위에서 동시에 식도 pH를 측정하였다. 병적 역류의 기준은 95백분위수 이상의 역류지표를 병적 역류로 정의하였다. 결 과: 1) 원위부 병적 위식도역류를 보인 환자군(group I)은 24명으로 평균연령이 $36.7{\pm}12$개월이었으며, 원위부 생리적 위식도 역류를 보인 대조군(group II)은 22명으로 평균연령이 $31.4{\pm}19$개월이었다. 가장 흔한 증상은 구토와 역류였으며 재발성 흡인성폐렴, 속 쓰림, 천식 등이었다. 2) 환자군에서 근위부와 원위부의 24시간 식도 pH 검사의 성적을 비교하면 최장 역류시간을 제외하고 pH 4.0 이하인 시간의 백분율, 총 역류횟수, 5분 이상 지속된 역류횟수, score 등의 항목에서 통계학적으로 의의 있는 차이를 보였다(p<0.01). 원위부와 근위부의 pH 검사 성적을 비교해 보았을 때 최장 역류시간과 총 역류횟수에서 상관계수가 각각 0.646과 0.451로 높은 상관관계가 있었다. 3) 대조군에서 근위부와 원위부의 24시간 pH 검사결과를 비교해 보았을 때, 모든 항목에서 유의한 차이가 없었다(P>0.05). 4) 원위부 병적 위식도 역류를 보인 환자군의 50%에서는 근위부 식도에도 병적 역류가 있었다. 근위부에서 비정상 역류점수를 보인 군과 정상 역류점수를 보인 군간에 원위부에서 역류점수는 유의한 차이가 없었다(p>0.05). 결 론: 근위부 위식도 역류는 원위부 역류외에도 중력, 식도 체부의 운동능력에 영향을 받은 것으로 생각되며 위식도 역류 환아 특히 재발성 호흡기증상을 보이는 경우에는 이중채널 식도 pH 측정검사가 필요할 것으로 생각된다. Purpose: The aim of this study was to determine how much acid exposure would occur in the proximal esophagus, both in normal and in patients with abnormal distal esophageal acid exposure. Methods: Fourty-six patients with suspected GER were classified into two groups, 24 patients with pathological distal reflux (group I); 22 patients with normal distal reflux (group II). The ambulatory dual-probe esophageal pH monitoring was performed for 18-24hr. The abnormal reflux was defined when the percent of time that pH was below 4.0 exceeded the 95th percentile of normal value. Results: The siginficant differences between distal and proximal esophageal pH recordings in group I persisted for all parameters except for the longest episode, but didn't persist in group II. At the distal esophageal site, the median percent time with pH<4.0 in group I was 19.3 and significantly higher than at proximal site. Half of patients with pathological distal reflux also had proximal acid reflux. Correlation coefficients between the distal and proximal esophageal sites in group I of the number of reflux episodes and time of the longest episode were 0.451 and 0.646 respectively. Conclusion: The 50 percent of patients with pathological distal acid reflux also had abnormal acid exposure in the proximal esophageal site. Therefore, we recommand simultaneous pH recordings from dual probe esophageal sites in children with gastroesophageal reflux.

거골의 골연골 병변에 대한 자가 골연골 이식술의 결과

안영준,한성호,양보규,이승림,유재호,정선욱,빈성우,주민홍,김성완,Ahn, Young-Joon,Hahn, Sung-Ho,Yang, Bo-Kyu,Yi, Seung-Rim,Yoo, Jae-Ho,Chung, Shun-Wook,Bin, Sung-Woo,Zoo, Min-Hong,Kim, Seong-Wan 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.1

Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. Materials and Methods: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. Results: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. Conclusion: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.

젊은 성인 무지 외반증 환자에서 원위부 갈매기형 절골술의 결과

안영준,한성호,양보규,이승림,유재호,정병준,길경민,Ahn, Young-Joon,Hahn, Sung-Ho,Yang, Bo-Kyu,Yi, Seung-Rim,Yoo, Jae-Ho,Chung, Byung-June,Kil, Kyung-Min 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.2

Purpose: To analyze the risk factors and the treatment results of the distal chevron osteotomy for the hallux valgus in young adult. Materials and Methods: Eleven cases of hallux valgus in 9 patients who underwent the distal chevron osteotomy between February 2000 and January 2004 were included for the study. For the clinical evaluation, we used hallux-metatarsophalangeal interphalangeal scale of American Orthopaedic Foot and Ankle Society (AOFAS). For radiological evaluation, we measured hallux valgus angle (HVA) and intermetatarsal angle (IMA). Results: Five patients had family history of hallux valgus. Symptoms were aggravated by military drill and sports activity. The average AOFAS scale was 62.5 preoperatively, and 88.4 at final follow-up. The HVA and IMA were $34.9^{\circ}$, and $15.8^{\circ}$ preoperatively, $16.3^{\circ}$ and $8.2^{\circ}$ at postoperative 6 weeks, and $19.9^{\circ}$ and $9.8^{\circ}$ at final follow-up. Conclusion: The symptoms of hallux valgus in young adults were aggravated by military drill and sports activity. Distal chevron osteotomy was useful for the treatment of the moderate to severe hallux valgus in young patients.

Clinical Study of Rhabdomyolysis After Exercise

안영준,이승림,유재호,주민홍,김성완,박지만,양보규,Ahn, Young-Joon,Yi, Seung-Rim,Yoo, Jae-Ho,Zoo, Min-Hong,Kim, Seong-Wan,Park, Ji-Man,Yang, Bo-Kyu Korean Orthopaedic Society for Sports Medicine 2007 대한정형외과스포츠의학회지 Vol.6 No.2

목적: 전투 경찰에게서 과도한 신체 활동 후 발생한 횡문근 융해증의 임상 양상 및 치료에 대해 알아 보고자 하였다. 대상 및 방법: 2004년 6월 1 일부터 2005년 5월 23일까지 운동이나 훈련 후 발생한 근육통 및 근육종창을 주소로 본원을 방문한 전투 경찰 중에서 횡문근 융해증이 의심되어 입원한 13명의 환자를 대상으로 혈액검사(CPK, CK-MB, AST BUN/Cr, Electrolyte) 및 임상 경과를 관찰하였다. 이 들은 모두 남자였고, 평균 연령은 20세 ($19\sim21$세) 였다. 발병 원인으로는 팔굽혀펴기 후 발생한 것이 7례, 축구 경기 후 발생한 것이 5례, 시위 진압 후 발생한 것이 1례였다. 이 학적 소견상 다양한 신체 부위에 종창 및 압통을 호소하였는데 전완부에 발생한 경우가 4례, 상완부가 3례, 견갑부가 1례, 하지가 5례였다. 횡문근 융해증의 진단기준은 내원 당시 임상증상과 함께 혈중 CPK가 1,000 IU/L이상인 경우로 하였고 약물 복용력이나 내과적 질환이 있는 경우는 대상에서 제외하였다. 모든 환자에서 99mTc-MDP 20mCi를 정맥주사 후 4시간에 bone scan을 시행하였다. 치료는 침상 안정가료 및 수액요법을 시행하였고 동통을 심하게 호소하는 환자에게는 부목고정을 실시 하였다. 결과: 전체 입원환자 13명의 평균 재원 기간은 20일 (14일$\sim$42일)이었고 내원 당시 급성신부전을 보인 1례를 제외하고는 수액 요법 및 휴식을 시행한지 평균 8일 (2일$\sim$11일) 후 혈액학적으로 CPK가 1000이 하로 감소되었으며 임상적으로도 뚜렷한 회복을 보였다. 급성신부전을 보인 1례에서는 혈액투석 및 수액요법을 시행 한 후 회복되었다. 결론: 심한 운동이나 훈련 후 부종 및 근육통을 호소하는 환자에서 운동 유발 횡문근 융해증을 의심하여 조기에 혈액검사 및 수액 치료를 시행하는 것이 중요하다. Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

CaCO₃ 첨가법에 따른 재생 ONP의 특성변화

안영준,남성영,엄남일,안지환,한춘,Ahn, Young-Jun,Nam, Seong-Young,Um, Nam-Il,Ahn, Ji-Whan,Han, Choon 한국세라믹학회 2014 한국세라믹학회지 Vol.51 No.2

In order to improve the refresh rate of old newspaper(ONP), PCC shape-controlling experiments were carried out. The effect of a PCC polymorph on improving the quality of old newspaper was studied for a transformation from waste paper to eco-friendly paper. The synthesis of PCC consists of an in-situ process and a loading process to enhance the refresh rate of old newspaper. The characteristics between the in-situ process and the loading process could be analysed by SEM analyses of coated fiber surfaces. The retention rate ranges from 65 to 67% after the application of the in-situ process, and that after the loading process ranges from 55 to 58%. The retention rates thus show a difference of about 7-10%. In addition, the whiteness and ERIC characteristics of the in-situ process gave more efficient results than those of the loading process.

Mycolasma pneumoniae 감염에 의한 뇌경색증 1례

안영준,최기철,양은석,박영봉,박상기,문경래,김영숙,Ahn, Young Joon,Choi, Ki Cheol,Yang, Eun Seok,Park, Yeong-Bong,Park, Sang-Gi,Moon, Kyung Rye,Kim, Young Sook 대한소아감염학회 1998 Pediatric Infection and Vaccine Vol.5 No.2

Mycoplasma pneumoniae infection is usually confined to the respiratory tract but it can cause a variety of extrapulmonary manifestations such as rashes, myalgia, hemolytic anemia, cerebral infarction, transverse myelitis, cerebellar ataxia, Guillain-Barre syndrome and meningoencephalitis. Neurologic complications of Mycoplasma pneumonia have been rarely reported until now. Cerebral infarction as a complication of mycoplasma infection in children has been very rarely reported. In our case, in a young girl with M. pneumoniae infection, a cerebral infarct resulted in persistent and significant neurological dysfunction. We report a 11-year-old girl with cerebral infarction associated with clinical and serologic evidence of Mycoplasma infection.

학동기 소아에서 반복성 복통과 우울 성향과의 관계

안영준,문경래,Ahn, Young-Joon,Moon, Kyung-Rye 대한소아소화기영양학회 2002 Pediatric gastroenterology, hepatology & nutrition Vol.5 No.2

정도에서 흔히 볼 수 있는 증상으로, 정확한 원인을 발견할 수 없는 경우가 많다. 또한 반복성 복통이 학동기 아동에 있어 사회적, 정신적 발달에 장애를 초래할 수 있다. 이에 저자들은 반복성 복통과 정서적인 문제중 하나인 우울성향과의 연관성을 알아보고자 본 연구를 시행하였다. 방 법: 광주시내 2개 초등학교 4, 5, 6학년 학생 1,181명, 남아 566명, 여아 615명을 대상으로 반복성 복통의 유형을 평가하였으며, 우울의 정도는 한국판 Kovacs & Beck의 Children's Depression Inventory (CDI) 설문지를 이용하여 비교 분석하였다. 결 과: 1) 반복성 복통의 빈도는 총 265명(22.4%)이며 남아 107명(18.9%), 여아 158명(25.7%)으로 여아에서 의미 있게 높았고,연령별로 9세 19.8%, 10세 21.2%, 11세 26.1%, 12세 19.1%였다. 2) 반복성 복통군에서 평균 우울점수가 대조군에서 높았다. 3) 반복성 복통군에서 복통이 자주 있을수록, 다른 증상을 동반한 경우 우울점수가 유의하게 높았다. 4) 복통은 배꼽주위가 가장 많았고, 복통 양상이 쥐어 짜는 듯한, 화끈거리는 통증이 있는 경우에 우울점수가 의의 있게 높았다. 5) 반복성 복통군에서 아이의 성격이 혼자 놀기를 좋아하거나, 학교가기를 싫어하거나, 친구가 적은 경우의 우울점수가 성격이 활발하거나, 친구가 많거나, 꼼꼼한 경우보다 의미 있게 높았다. 6) 반복성 복통군에서 복통의 지속시간, 하루 중 복통의 발현시기 및 요일 사이에는 유의한 차이는 없었다. 결 론: 초등학교 아동에서 반복성 복통은 높은 유병율을 보이며, 우울점수가 대조군보다 높아 우울증과 연관성이 있음을 시사하였다 그러므로 학동기의 반복성 복통의 적절한 진단과 신속한 치료가 필요하며 치료시 정서적, 심리적 지지요법을 고려하는 것이 좋을 것으로 생각된다. Purpose: Recurrent abdominal pain (RAP) is common, affecting between 7% and 25% of school-aged children and young adult. This study was designed to assess the relationship between RAP and depressive trends in school-aged children. Methods: In 1999, We surveyed 1,181 elementary school children (566 boys and 615 girls) whose ages ranged from 9 to 12 years. The degree of depression was compared between the group with RAP and normal control group without RAP according to Korean Children's Depression Inventory (CDI) of Kovacs and Beck. Results: The number of the group with RAP was significantly higher in female (25.7%) than in male (18.9%). The most common site of abdominal pain was periumbilical. The mean depression score in the group with RAP was higher than that of the control group. The depression score was significantly higher in the group with RAP who has frequently pain and additional symptoms. The depression score was significantly higher in the group with RAP who prefered to play alone, did not enjoy going to school and had few friends than in the group with RAP who had a lot of friends, had active and meticulous characters. The depression scores were not significantly different according to the duration of abdominal pain, the onset time of pain, and the day of pain in the group with RAP. Conclusion: The depression score of the group with RAP was higher than that of normal group. So, there is relatively a specific association between childhood RAP and depression in school aged children. It is good for physicians to consider psychological support in the treatment of childhood RAP.

Effect of Inferior Alveolar Nerve Block Anesthesia on Taste Threshold

안영준,김성환,김미은,김기석,Ahn, Young-Joon,Kim, Seung-Whan,Kim, Mee-Eun,Kim, Ki-Suk Korean Academy of Orofacial Pain and Oral Medicine 2007 Journal of Oral Medicine and Pain Vol.32 No.2

Iatrogenic injury following dental treatments and the use of local anesthetics may cause taste disorders. The aims of this study were to investigate quantitative and qualitative changes of taste due to unilateral inferior alveolar nerve block anesthesia and further to evaluate potential effects on taste function related to anesthesia or hypoesthesia of inferior alveolar nerve, possibly occurring after dental procedure. 30 healthy volunteers in their twenties participated in this study (male to female = 1:1, mean age of $24.0{\pm}1.8$ years). Each subject received inferior alveolar nerve block anesthesia on his or her right side with 2% lidocaine HCl containing 1:100,000 epinephrine. Before and after anesthesia, electrogustometric test and chemical localized test for salty, sweet, sour and bitter tastes were performed on the eight sites in the oral cavity; right and left anterior and lateral tongue and circumvallate papilla of the tongue and soft palate. Unilateral inferior alveolar nerve anesthesia produced elevation of electrical taste threshold and reduction of intensity ratings for all 4 tastes (salty, sweet, sour and bitter) over anterior and lateral tongue and circumvallate papilla on the ipsilateral side (p<0.05). Contralateral sides exhibited decreased intensity ratings for salty and sweet taste (p<0.05) on anterior and lateral tongue while there was no significant difference in electrogustometric testing. Based on the results of this study, it is assumed that unilateral local anesthesia on inferior alveolar nerve can affect chorda tympani and glossopharyngeal nerves on the same side, leading to taste deficits. Taste intensity on the contralateral side may, in part, be deteriorated as well.

과포화도에 의한 침강성 탄산칼슘 다형체의 생성거동

안영준,전종혁,이신행,유영환,전홍명,안지환,한춘,Ahn, Young jun,Jeon, ong Hyuk,Lee, Shin Haeng,Yu, Young Hwan,Jeon, Hong Myeong,Ahn, Ji Whan,Han, Choon 한국자원리싸이클링학회 2015 資源 리싸이클링 Vol.24 No.4

From results obtained by adjusting experimental variables based on the kinetic, the nucleation rate for formation of precipitated calcium carbonate (PCC) was investigated. Formation behavior of PCC was investigated for various concentrations of NaOH solution and $Na_2CO_3$ addition methods in the $Ca(OH)_2$ slurry. The range of nucleation rate was investigated for dissolution rates of major ion concentrations, $Ca^{2+}$ and $CO{_3}^{2-}$. In case of high concentration of major ions, vaterite and calcite were synthesized. The high nucleation rate was achieved for lower either $Ca^{2+}$ or $CO{_3}^{2-}$ ion concentration, calcite was mainly synthesized and when concentration of major ions was low, aragonite was synthesized. Furthermore, the formation of calcite was decreased with increasing concentration of NaOH. homogeneous aragonite could be obtained by addition 5 M NaOH. Therefore, in this study, specific shape of polymorphs could be prepared through controlling supersaturation. 속도론적인 관점에서 실험변수를 조절하여 얻어진 결과로부터 침강성 탄산칼슘(precipitated calcium carbonate, PCC)의 생성을 핵생성속도로 규명하였다. 반응온도 $80^{\circ}C$에서 $Ca(OH)_2$ slurry, $Na_2CO_3$ 수용액 및 다양한 농도의 NaOH를 첨가하여 침강성 탄산칼슘의 생성거동을 관찰하였다. 핵생성속도는 주 반응물인 $Ca^{2+}$ 이온과 $CO{_3}^{2-}$ 용해속도를 조건으로 나누어 진행하였다. 두 이온의 농도가 고농도일경우에는 vaterite와 calcite가 혼재되어 나타났다. $Ca^{2+}$ 이온과 $CO{_3}^{2-}$ 이온농도 중 어느 하나만을 낮게 하여 반응시킨 경우에는 주로 calcite가 생성되었으며 두 이온농도가 모두 낮을 경우에는 aragonite가 형성되었다. 또한 NaOH 농도를 증가시킴에 따라 calcite의 생성은 감소하였으며 5M NaOH 수용액 내에서 단일상의 aragonite를 얻을 수 있었다. 따라서 본 연구에서는 과포화도 조절을 통해 다형체(polymorphs) 중 특정 형태를 합성할 수 있었다.

중학생의 인터넷 사용행태와 인터넷 중독증과의 관계

안영준,김자옥,문경래,Ahn, Young-Joon,Kim, Ja-Ok,Moon, Kyung-Rye 한국전자통신학회 2013 한국전자통신학회 논문지 Vol.8 No.7

인터넷 의존도가 높아지면서 인터넷 중독증 문제가 사회적인 문제로 대두 되었으나 인터넷 중독증에 대한 임상 연구는 부족한 상태이다. 본 연구에서는 인터넷 사용 행태와 인터넷 중독증을 파악하여 임상연구와 교육중재 및 집단상담 프로그램의 기초 자료를 제공하고자 한다. 인터넷 사용 행태와 인터넷 중독의 관계를 확인하는 서술적 조사 연구로 광주광역시 2개의 중학교의 1,984명을 대상으로 자가 기입식의 구조화된 설문지를 이용하여 자료를 수집하였다. 대상자의 인터넷 중독증은 전체 대상자의 11.8% 이였으며. 일반적 특성에 따른 인터넷 중독증은 성별, 종교에서 통계적으로 유의 하였고, 인터넷 사용 행태와 인터넷 중독증과의 관계에서는 인터넷 사용량 시간, 사용 시간대, 사용 장소, 성인 사이트 이용 행태, 사용 목적에서 통계적으로 유의하였다. 인터넷 중독성의 경중에 따라 의료진에게 정신과적인 상담과 약물 치료를 받거나 인터넷 바로 알고 유용하게 이용하기, 즐거운 활동과 꿈 찾기, 과거와 미래의 인생 곡선과 자신의 현재 욕구를 찾아 긍정적인 부분을 강화하면서 변화된 자신의 모습을 찾아보는 프로그램을 통해서 본인 스스로 인터넷 사용을 줄이고 싶은 동기를 내재화 시켜 인터넷 게임 지향적인 활동을 억제 할 수 있도록 가정, 학교, 사회에서 지속적인 관심과 효과적인 교육 프로그램을 수행해야 할 것으로 판단된다. Internet addiction is a social problem occurring by overuse of internet. And internet addiction is associated with pathologic personality but clinic study about Internet addiction disorder is lack. This study was designed to evaluate the relationship between internet addiction and pattern of internet utilization. We conducted a questionnaire survey on 1,984 middle school students in Gwang -Ju. We questioned about internet addiction, general characteristics, pattern of internet utilization. 11.8% of total number were internet addiction. Sex, religion, duration, time, place, obscene sites, most frequent using service is associated with internet addiction. Family number, occupation of parents, using internet in home, use of parents isn't associated with internet addiction. We show interest in general characteristics and pattern of internet utilization about internet addiction. So we council youths about internet problem in accordance with this study results. Then internet addiction and other psychologic problem are decreased.