혈액 투석 중인 만성 신부전 환자에서 조영 증강 전산화 단층 촬영 후 발생한 정맥 내 공기 색전증의 1례

양민아 ( Min A Yang ),김문철 ( Mun Chul Kim ),박재우 ( Jae Woo Park ),윤현주 ( Hyun Ju Yoon ),이천범 ( Cheon Beom Lee ),김정관 ( Jeong Gwan Kim ),선인오 ( In O Sun ),이광영 ( Kwang Young Lee ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2

Venous air embolism (VAE) was reported in up to 23% of patients after contrastenhanced computed tomography (CT) examination; most of the emboli are small and not associated with the symptoms. In cases of small and moderate-sized emboli, most patients recovered with supportive care, including intravascular fluid infusion to increase venous pressure and venous return, oxygen therapy, and patient positioning. However, with larger emboli, VAE can be a serious and even fatal event. There have been few cases of VAE in Korea, in which patients improved with supportive treatment. We report a successfully treated case of VAE in a patient with end-stage renal disease (ESRD) on regular hemodialysis, in whom large air emboli developed after contrast-enhanced CT scan, and who experienced improvement with supportive care including cardiopulmonary resuscitation.

새로운 MEN1 유전자 돌연변이가 증명된 위, 십이지장, 췌장의 신경내분비종양

양민아 ( Min A Yang ),이웅기 ( Woong Ki Lee ),신홍식 ( Hong Shik Shin ),박성현 ( Sung Hyun Park ),김병선 ( Byung Sun Kim ),김지웅 ( Ji Woong Kim ),조진웅 ( Jin Woong Cho ),윤소희 ( So Hee Yun ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.3

Multiple endocrine neoplasia type 1 (MEN1) syndrome is a relatively rare disease, characterized by the occurrence of multiple endocrine tumors in the parathyroid and pituitary glands as well as the pancreas. Here, we report a case of MEN1 with neuroendocrine tumors (NETs) in the stomach, duodenum, and pancreas. A 53-year-old man visited our hospital to manage gastric NET. Five years prior to his visit, he had undergone surgery for incidental meningioma. His brother had pancreatic nodules and a history of surgery for adrenal adenoma. His brother`s daughter also had pancreatic nodules, but had not undergone surgery. The lesion was treated by endoscopic submucosal dissection and diagnosed as a grade 1 NET. Another small NET was detected in the second duodenal portion, resected by endoscopic submucosal dissection, which was also diagnosed as a grade 1 NET. During evaluation, three nodules were detected in the pancreas, and no evidence of pituitary, parathyroid tumors, or metastasis was observed. After surgery, the pancreatic lesions were diagnosed as NETs, with the same immunohistochemical patterns as those of the stomach and duodenum. Genetic testing was performed, and a heterozygous mutation was detected in the MEN1 gene, which is located on 11q13. (Korean J Gastroenterol 2017;69:181-186)

Effect of tDCS on Cognitive Function of Patients With Stroke

양민아(Yang, Min Ah),원경아(Won, Kyung-A),박혜연(Park, Hae Yean),박지혁(Park, Ji-Hyuk) 대한신경계작업치료학회 2021 재활치료과학 Vol.10 No.2

목적 : 본 연구의 목적은 뇌졸중 환자의 인지기능 회복에 대한 경두개 직류자극(tDCS)의 효과를 살펴본 연구를 분석하기 위함이다. 연구방법 : 2009년부터 2019년까지 국내외 학술지에 게재된 논문들을 NDSL, RISS, PubMed, CINAHL을 통해 검색하였다. 선정기준과 배제기준을 통해 총 11개의 실험연구 논문이 선정되었다. 이를 질적 평가를 시행하고, 이 중 7편의 논문에서 9개의 결과값에 대해 메타분석을 실시하였다. 결과 : 메타 분석을 실시한 결과 효과크기는 attention 0.725, memory 0.796으로 모두 ‘보통 효과크기’를 보였다. 두 영역 모두 통계적으로 유의한 변화가 있던 것으로 분석되었다(p<0.05) 결론 : 본 연구 결과를 통하여 인지기능이 제한된 뇌졸중 환자에게 tDCS는 효과가 있음을 알 수 있었다. 또한, tDCS 적용법이 연구 간 서로 상이함을 알게 되었으며 이에 따라 정형화된 tDCS 프로토콜과 전문가 양성이 필요할 것으로 보인다. Objective : This study aimed to analyze the effect of transcranial direct current stimulation (tDCS) on cognitive function recovery in patients with stroke. Methods : Data published in Korean and foreign academic journals from 2009 to 2019 were searched using the NDSL, RISS, PubMed, and CINAHL databases. A total of 11 experimental research articles were selected based on the inclusion and exclusion criteria. A qualitative assessment was conducted, and a meta-analysis of nine results from seven of the stuides was performed using the Comprehensive Meta-Analysis 3.0 program. Results : Based on the results of the meta-analysis, the attention and memory effect sizes were 0.725 and 0.796, respectively, which were both considered a “medium effect size”. Statistically significant changes were observed in both the areas (p<0.05). Conclusion : The results of this study confirmed that tDCS can be useful in the rehabilitation of patients with stroke with limited cognitive function. In addition, the application methods differed, indicating that a formalized tDCS protocol is required.

총담관결석증 환자에서 침형절개도 누공형성술 후 유도선을 이용한 담도 삽관 과정 중 발생한 간문맥 내 삽관 1예

이원동 ( Won Dong Lee ),송재선 ( Jae Sun Song ),김병선 ( Byung Sun Kim ),양민아 ( Min A Yang ),이영재 ( Young Jae Lee ),정금모 ( Gum Mo Jung ),조용근 ( Yong Keun Cho ),조진웅 ( Jin Woong Cho ),김지웅 ( Ji Woong Kim ) 대한소화기학회 2021 대한소화기학회지 Vol.77 No.5

Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient. (Korean J Gastroenterol 2021;77:253-257)

치주건강에 대한 주관적 인식과 현존영구치수와의 관련성에 관한 연구

양민철 ( Min Cheol Yang ),조아영 ( A Young Jo ),이병진 ( Byoung Jin Lee ),김병옥 ( Byung Ock Kim ) 조선대학교 구강생물학연구소 2012 Oral Biology Research (Oral Biol Res) Vol.36 No.2

Purpose: periodontal health index is a dentist-centered index in which dentists perform examination and evaluation. Therefore, it is not appropriate for evaluation subjective symptoms and satisfaction levels of patients. To compensate for this shortcoming, we made use of a subjective index of periodontal health status with which patients can evaluate their oral health status. This research evaluated the usefulness of Periodontal age index in examining subjective consciousness of periodontal health status, estimated the number of existing permanent teeth, which is the objective index for oral health, and compared the relationships between them. Materials and Methods: The number of subjects was 2,198, consisting of 1,115 (50.7%) men and 1.083 (49.7%) women. The periodontal age increased in the 18-24 and 40-44 age groups. There were no significant differences between the 40-44 and 55-59 age groups. Further, periodontal age decreased in those aged over 60-64. Results: In this study, periodontal age index increased to age 40 when teeth are lost to periodontal disease and decreased with a decline in the number of permanent teeth. Conclusion: Therefore, the periodontal age index reflects the periodontal state rather than hypofunction by tooth loss.

복막 투석 환자에서 Pantoea agglomerans에 의해 발생한 복막염 1예

이천범 ( Cheon Beom Lee ),김문철 ( Mun Chul Kim ),박재우 ( Jae Woo Park ),양민아 ( Min A Yang ),윤현주 ( Hyun Ju Yoon ),선인오 ( In O Sun ),이광영 ( Kwang Young Lee ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2

Pantoea agglomerans (P. agglomerans) is a ubiquitous gram-negative aerobic bacillus member of the Enterobacteriaceae family that is found in plants, fruits and vegetables, and that can also be found in the human and animal fecal matter. It has been reported to play a limited role as an infectious agent, as well as an unusual pathogen for peritoneal dialysis (PD)-associated peritonitis. Beta-lactam antibiotics have been used against this pathogen with good results. Most of the reported cases of P.agglomerans peritonitis were also resolved with antibiotic therapy. Two cases of PD peritonitis caused by P.agglomerans were reported in Korea; clinical improvement was achieved by antibiotic treatment. However, no patient required catheter removal. Here we report a case of PD-associated peritonitis due to P.agglomerans that was successfully treated after catheter removal.

인천광역시 고령자의 보건의료이용에 영향을 미치는 요인 : 한국의료패널자료를 이용하여

원경아(Kyung-A Won),양민아(Min Ah Yang),박지혁(Ji-Hyuk Park) 한국노년학회 2020 한국노년학 Vol.40 No.4

본 연구는 한국의료패널을 통해 인천광역시 고령자의 보건의료이용 행태 예측요인을 확인하여 고령자의 보건의료접근성을높이거나 보건의료이용의 효율성을 높일 수 있는 서비스 또는 제도를 개발하는데 필요한 기초자료를 마련하는 것을 목적으로 한다. 한국의료패널 중 인천광역시에 거주하는 60세 이상 대상자 총 305개의 자료를 SPSS와 AMOS를 이용하여 분석하였다. 분석 결과, 개인속성과 건강수준, 건강수준과 보건의료이용행태에서 유의미한 상관이 나타났다. 또한, 구축된 연구모형의 적합도 및 효과 분석을통해 개인속성 요인, 생활습관, 건강수준이 모두 보건의료서비스 이용에 직 간접적으로 유의미한 영향을 미치고 있음을 확인하였다. · 이를 통해 인천시가 다른 지역들에 비해 보건의료서비스 수요 및 공급에서 불균형이 심한 편이므로 고령화 사회에 맞춰 인천시의보건의료체계 정립이 필요함을 알 수 있었으며, 인천시 거주 고령자에게 제공할 보건의료서비스의 방안과 관련 정책 제도 수립 시본 연구 결과를 기초자료로 활용할 수 있을 것이다. The purpose of this study is to prepare basic data necessary for the development of services or systems that can enhance the accessibility of health and medical services or enhance the efficiency of health and medical use of senior citizens by identifying factors for predicting health and medical use behavior of senior citizens in Incheon Metropolitan City through the Korea health panel data(version 1.5). Through the structural equation model established through the SPSS and AMOS, it was confirmed that the predisposing factors, health behaviors and needs factors had significant direct and indirect effects on the use of health care services. Since the imbalance in demand and supply of health and medical services is more severe than in other regions, the results of this study can be used as basic data when checking whether the current health and medical system in Incheon Metropolitan City can operate effectively in an aged society and discussing how to provide health and medical services to the elderly in Incheon.

채용공고 분석을 통한 작업치료사 구직 시장에 대한 연구

임승주(Lim Seung-Ju),양민아(Yang Min-A),한대성(Han Dae-Sung),박지혁(Park Ji-Hyuk) 대한신경계작업치료학회 2020 재활치료과학 Vol.9 No.2

목적 : 본 연구는 2011년부터 2018년까지의 작업치료사 채용공고를 분석하여 작업치료사 구직 시장을파악하고자 한다. 연구방법 : 국내 작업치료사 국가시험 응시 및 합격 현황과 작업치료 포털사이트(오티브레인)에 게시된총 15,869건의 작업치료사 채용 공고를 수집하여 지역, 고용형태, 급여수준, 채용시기, 채용분야를 기준으로 작업치료사 구직 시장을 분석하였다. 결과 : 연도별 작업치료사 전체 채용공고 건수는 국가시험 합격인원보다 평균 544건 높게 나타났으며, 서울과 경기지역에 채용공고가 집중된 것으로 확인되었다. 고용형태의 경우 연도별 정규직 채용비율이감소추세를 보였으나, 비정규직 채용비율은 증가추세로 나타났다. 급여수준은 연봉 2,000만원 이상 2,500 만원 이하의 수준이 가장 높았고, 채용분야는 성인 및 노인분야 공고가 아동분야 공고보다 약 4.6배이상 많은 것으로 확인되었다. 결론 : 본 연구는 작업치료사 구직시장을 파악하기 위한 기초자료로써 활용될 수 있을 것이다. Objective : This study aims to identify the job market for occupational therapists by analyzing recruitment advertisements for occupational therapists from 2011 to 2018. Methods : A total of 15,869 job placement notices posted on the portal site(http://otbrain.com/) were collected to analyze the job market for occupational therapists based on their regions, employment types, salary levels, employment times, and recruitment fields. Results : The total number of annual recruitment advertisements for occupational therapists was 544 which was higher than the number of people who passed the national exam. According to the region, recruitments were concentrated in the Seoul and Gyeonggi Province. According to employment type, the employment rate of permanent workers was on the decline but that of temporary workers showed an increasing trend. The salary level was the highest with the annual salary ranging from 20 million won to 25 million won or less, and the recruitment fields were found to have about 4.6 times more offerings in the adult and senior fields than in the pediatric fields. Conclusion : These study results can be used as a basic data for identifying the job market for occupational therapists.

뇌졸중 환자의 상지기능에 대한 경두개 직류자극술 효과 : 체계적 고찰 및 메타분석

원경아(Won, Kyung-A),양민아(Yang, Min Ah),박혜연(Park, Hae Yean),박지혁(Park, Ji-Hyuk) 대한신경계작업치료학회 2020 재활치료과학 Vol.9 No.1

Objective : The purpose of this article was to analyze the effects of tDCS on the recovery of upper limb function in stroke patients. Methods : We searched for papers published in journals between 2009 to 2018, using NDSL and RISS. A total 14 experimental research papers were selected for analysis. The quality of the 14 articles was evaluated using the PEDro scale and 12 articles were analyzed through the Comprehensive Meta Analysis 3.0 program. Results : All of the 14 articles that were systematically reviewed in this study were published in foreign journals. The effect sizes for upper extremity(U/Ex) strength and U/Ex motion were 0.19(small size effect) and 0.49(medium size effect) respectively. Furthermore, the effect sizes of anode mode and cathode mode were 0.71(large size effect) and 0.41(medium size effect), respectively .The effect size of U/Ex motion and the anode mode were statistically significant(p<0.05). Conclusion : We identified that tDCS can be a useful rehabilitation technique for stroke patients with limited upper body function. These findings are expected to help with suggestions for basic data on new rehabilitation techniques for stroke patients and the planning of effective interventions. 목적 : 본 연구는 뇌졸중 환자의 상지기능 회복에 대한 경두개 직류자극(transcranial Direct Current Stimulation; tDCS)의 효과를 살펴본 연구를 분석하는 데 목적이 있다. 연구 방법 : 2009년부터 2018년 현재까지 국내외 학술지에 게재된 논문들을 NDSL과 RISS를 통해 검색하였 다. 선정기준과 배제기준을 통해 총 14개의 실험연구 논문이 선정되었다. 이를 PEDro 척도를 사용하여 질적 평가를 시행하고, 이 중 12개 논문에 대해서 Comprehensive Meta Analysis 3.0 프로그램을 사용하여 메타분석을 실시하였다. 결과 : 본 연구에서 고찰한 문헌 14편은 모두 국외 학술지에 게재된 문헌들이었다. 메타분석을 실시한 결과 효과 크기는 상지 근력 0.19로 ‘작은 효과크기’, 상지 움직임 0.49로 ‘보통 효과크기’를 보였다. 상지 움직임의 효과크기는 통계적으로 유의한 변화가 있던 것으로 분석되었다(p<0.05). 또한 양극 (anode) 모드는 ‘큰 효과크기’를. 음극(cathode) 모드는 ‘보통 효과크기’를 보였으며, 양극 모드의 효과크기만 통계적으로 유의하였다(p<0.05). 결론 : 본 연구 결과를 통하여 상지기능이 제한된 뇌졸중 환자에게 tDCS는 유용한 재활 기법이 될 수있다는 것을 확인하였다. 이는 국내 임상가들에게 뇌졸중 환자를 위한 새로운 재활 기법의 기초자료를 제시하고, 효과적인 중재를 계획하는 데 도움이 될 것이다.

수술 위험도가 높은 다장기 부전을 동반한 급성담낭염 환자에서 병상에서의 초음파유도하 경위 담낭 흡인 및 세척

윤소희 ( So Hee Yun ),박문식 ( Moon Shik Park ),이재운 ( Jae Un Lee ),양민아 ( Min A Yang ),한상훈 ( Sang Hoon Han ),이영재 ( Young Jae Lee ),정금모 ( Geum Mo Jeong ),조용근 ( Yong Keun Cho ),김지웅 ( Ji Woong Kim ),조진웅 ( Jin W 대한소화기학회 2015 대한소화기학회지 Vol.65 No.6

Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Broad-spectrum antibiotics with bedside endoscopic nasobiliary drainage were administered, but clinical symptoms did not improve. Therefore, bedside EUS-guided transgastric gallbladder aspiration and lavage was performed, resulting in successful treatment of the patient. We report the above described case along with a discussion of relevant literature. (Korean J Gastroenterol 2015;65:370-374)