제품회복 전략, 기업이미지, 고객유보 관련 구조방정식모델

김계수 ( Kim Gye-soo ),민병서 ( Min Byeong-seo ),유병대 ( Yoo Byung-dae ),배규락 ( Bae Gyu-rak ) 한국품질경영학회 2016 한국품질경영학회 학술대회 Vol.2016 No.2

고용량 졸피뎀 복용 중단 이후 발생한 경련발작 1례

문형준 ( Hyung Jun Moon ),이정원 ( Jung Won Lee ),유병대 ( Byeong Dae Yoo ) 대한임상독성학회 2013 대한임상독성학회지 Vol.11 No.2

The imidazopyridine, zolpidem, a non-benzodiazepine hypnotic drug, is widely-prescribed for insomnia. It is regarded as a good alternative to benzodiazepine because of the reduced possibility for abuse and development of dependence. However, more recently, due to the reduced possibility for abuse and development of dependence, it is regarded as a good alternative to benzodiazepine. adverse effects of zolpidem have been recognized. The objective of this report is to provide information on the potential for occurrence of benzodiazepine-like withdrawal seizure in patients who chronically take zolpidem continually. We present and discuss a case of seizure after sudden interruption of the protracted use of an abusively high dose of zolpidem. Zolpidem may not be the ideal drug for longterm pharmacotherapeutic management of insomnia. Clinicians should administer zolpidem at a low-dose for a short period of time for prevention of drug abuse and dependence and the potential for occurrence of benzodiazepine- like withdrawal seizure.

응급실에 내원한 두부외상환자의 2차 평가로써 초음파를 이용한 시각신경집 지름 측정은 유용한가?

이동욱 ( Dong Wook Lee ),이정원 ( Jung Won Lee ),박세훈 ( Sae Hoon Park ),박일성 ( Ihl Sung Park ),이현정 ( Hyun Jung Lee ),유병대 ( Byeong Dae Yoo ),문형준 ( Hyung Jun Moon ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.3

Purpose: Bedside ultrasonography is available in most emergency departments, and detecting the intracranial pressure is elevated is critical. Our objective is to evaluate the availability of bedside optic nerve ultrasound (ONUS) as a secondary survey for patients with head injuries in the emergency department (ED). Methods: From September, 2012, to March, 2013, we performed a prospective study of patients presenting to the ED after an accident. Patients with head injuries but without obvious ocular trauma or ocular disease were included. The ONUS was performed using a 3 to 12 MHz linear probe on closed eyelids after a primary survey. We analyzed the correlation between the brain computed tomography (CT) findings that suggested elevated intracranial pressure (ICP) and the Optic nerve sheath diameter (ONSD) measured by using ONUS. Results: A total of 81 patients were enrolled. Forty-seven had CT results consistent with elevated ICP, and their mean ONSD was 5.98±0.59 mm; the mean ONSD of patients who showed no signs of elevated ICP on CT was 4.63±0.21 mm. The sensitivity and the specificity for the ONSD, compared with elevated ICP, were 98.87% and 100%, respectively, when the cut-off value was set to 4.96 mm. The area under curve (AUC) was 0.997 in the receiver operating characteristic curve (ROC curve). Conclusion: An evaluation using ONUS is a simple noninvasive procedure and is a potentially useful tool as a secondary survey to identify an elevated ICP.

인슐린비의존성 당뇨쥐에서 심방이뇨호르몬 농도와 mRNA 변동

유병대,박원균,홍영수,송대규,배재훈 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:신생 흰쥐에서 streptozotocin(STZ)으로 유도한 인슐린 비의존성 당뇨병( NIDDM )모델의 흰쥐를 대상으로 ANP의 혈중 농도의 변동과 심장, 시상하부 및 신장의 ANP 합성의 변동을 관찰하여, 당뇨병에서 발생될 수 있는 체액 및 전해질 불균형에 대한 ANP의 조절기능을 규명하고자 하였다. 방법: NIDDM 쥐(당뇨군)는 생후 1∼2일된 Sprague­Dawley종 수컷 흰쥐에 citrate buffer에 녹인 STZ(80㎎/㎏)을 등쪽에 피하 주사하여 유도하였다. 같은 날 STZ이 없는 동량의 cirtrate buffer만을 투여한 쥐를 대조균으로 하였다. 혈장 ANP 농도는 STZ을 투여한 8주 후에 대동맥을 통해 채혈한 뒤 방사면역법으로 측정하였다. ANP 합성단계의 병동을 파악하고자 우심방, 좌심실, 시상하부 및 신장의 피질부위를 채취하여[³²P]­dCTP를 이용한 역전사­중합효소연쇄반응을 시행하여 ANP mRNA의 변동을 관찰하였다. 결과:생후 7주에 시행한 당부하시험에서 공복시 혈당치는 당뇨군과 대조군사이에 차이가 없었고, 당뇨군에서는 glucose주입 후 30분후에 혈당치가 크게 증가 하였으며 2시간 뒤에도 계속 증가하여 유지되었다. 생후 8주에 당뇨군이 대조군에 비해 체중은 약간 감소, 수분 섭취량은 증가하는 경향이 있었다. 혈자 ANP 농도는 당뇨군에서 대조군에 비해 유의하게 증가하였다. ANP mRNA 발현의 정도는 조직에 따라 차이가 있었다. 당뇨군의 ANP mRNA 발현은 대조군에 비해서, 우심방에서는 약간 증가하는 경향이 있었고, 좌심실에서는 양군사이에 거의 동일한 값을 보였다. 반면에 시상하부와 신자의 피질에서는 당뇨군이 대조군에 비해 ANP mRNA 발현이 유의하게 증가하였다. 결론:신생 흰쥐에 streptozotocin으로 유도한 NIDDM 모델에서 관찰한 ANP mRNA 변동의 결과로 보아, ANP가 이미 알려진 심방이외 신장 및 시상하부에서 ANP 합성의 증가를 통해 NIDDM에서 세포 외액량과 전해질 균형의 조절에 중요한 역할을 담당하는 것으로 생각된다. Background : Diabetes mellitus has led to change in fluid and electrolyte balance and consequently affected blood volume and blood pressure. These changes can trigger the secretion and synthesis of atrial natriuretic peptide (ANP) from both atrial and extra-atrial tissues. ANP plays an important role in the regulations of body-fluid balance and blood pressure. Therefore, this study was carried out to elucidate whether of not atrial and extra-atrial synthesis of ANP is influenced in experimental non-insulin dependent diabetes mellitus (NIDDM) rats. Methods : Neonatal rats were induced into NIDDM rats by single injection of streptozotocin (80 ㎎/㎏). Plasma ANP level was measured by the use of radio immunoassay method and the ANP m RNA expressions from the right atrium, left ventricle, hypothalamus and kidney were analyzed by reverse transcription-polymerase chain reaction with [32^P]-dCTP at 8 weeks after injection of streptozotocin or citrate buffer. Results: Blood glucose was more significantly increased at 2 hours after glucose loading in NIDDM rats than control rats. Plasma concentration of ANP tended to significantly increase in NIDDM rats compared with control rats. The expressions of ANP m RNA from each tissue were observed in different patterns. Right atrial ANP m RNA expression revealed non-significant increeasing trend in NIDDM rats, where as left ventricular ANP m RNA expressions in NIDDM rats were significantly increased. Conclusion : These results indicate that the enhanced expressions of hypothalamic and renal ANP m RNA actasan important regulator of electrolytes and body fluid volume in neonatally streptozotocin-induced NIDDM rats(J Kor Diabetes ASSO 421~430, 2000).

Siriraj Stroke Score 따른 뇌졸중 환자 감별의 적합성

유병대,이명갑,서영조,조준,박찬상,이동필 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The differentiation between hemorrhagic(HS) and norhemorrhagic(NHS) stroke is the most important first step in the management of acute stroke because clinical management of the two disorders differs substantially. Neuroimaging studies are useful in diagnosing and distinctioning between HS and NHS. The use of clinical variables, such as Siriraj stroke scores(SSS), has led to good sensitivity, specificity and predictive values. The aim of our study was to evaluate the use of the SSS in the Korean population and assess whether it could aid to expedite treatment decisions. Methods: We reviewed 111 cases of stroke patients admitted to our hospital via the emergency department over a 6 months period from July to December 1998. Levels of consciousness, vomiting, headache, and atheroma markers used in the SSS were applied to these patients who met the criteria for a stroke. Results: Of the 111 patients, the SSS classified 83 with sensitivities of 81.1%(NHS) and 73.3%(HS) and positive predictive values of 84.3% and 68.8%, respectively. The overall accuracy rate was 78.3%. Conclusion: Our results suggest that the SSS is not reliable in distinguishing stroke types in the Korean population. Definite neuroimaging studies are needed prior to thrombolytic therapy.

初·中·高校 確率·統計의 효율적인 指導에 關한 硏究

오후진,유병대 한국학교수학회 1998 韓國學校數學會論文集 Vol.1 No.1

Probability and statistics is an important section in mathematics which is deeply related to everyday living, natural science and social science. In spite of its importance, many students will throw away it because it becomes very harder as its step(stage) deepens and probability and statistics' relative importance is very small in Korea-SAT(the test of college entrance in Korea). Therefore, by analyzing the involvement carefully between the curriculum in the elementary. middle, high school and the text book, by studying the problem and improvement direction, it is necessary to investigate an effective teaching method. This study intends to give the students the confidence, interests, and accomplishment motive about probability and statistics field and to make a rational and creative decision-making through mathematical speculation by proposing an effective teaching method through analyzing an existing facts in school's probability and statistics field. The contents of this study are composed of four chapters. Chapter three looks into the mathematical curriculum in the elementary, middle, high school and its teaching meaning, the outline of contents, some tips on teaching and problems and presents an effective and concrete teaching method on the basis of the theoretical background in the chapter two. Chapter four is a conclusive part and gives the general improvement and intentional direction in educating the probability and statistics.

진전섬망 환자에 대한 임상적 고찰

이명갑,유병대,이동필 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4

Purpose: We performed this study to identify the clinical characteristics of delirium tremens in Korea. Methods: We reviewed the charts of patients suffering from delirium tremens who visited the Emergency Department of Keimyung University Hospital during the period of Jan, 2001 through Jun. 2002. Results: All patients were mail, and the number was 28. The age distribution was 40∼49, and the most common duration of drinking (15 cases) was between 11 and 20 years. The abstinence period before development of Delirium Tremens was, in most cases, less than 4 days, and the average period of symptoms of Delirium Tremens was less than 6 days. Various abnormal laboratory finding were noted: increased bilirubin level in 50%, prolonged prothrombin time in 14.3%, increased amylase level in 19.9% and electrolyte imbalance in 25%. Conclusion: During the study period, there was no mortalities. The author believes that sufficient vitamins and fluid supplement contributed to the results.

버섯 중독 환자에 대한 임상적 고찰

박찬상,조준,최우익,안영호,유병대,이동필 대한응급의학회 1998 대한응급의학회지 Vol.9 No.2

Background: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. Methods: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. Results: Mean age of the patients was 40.0years and the ratio of male to female was 1:0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea, except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1 %) Conclucion : The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are dischrged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.

비외상성 병원전 심정지 환자의 심폐소생술 결과

이명갑,김성진,최대해,전덕호,유병대,이동필 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4

Purpose: There has been an increase in the number of nontraumatic prehospital cardiac arrests due to increases in both cardiovascular diseases and the average age of the population. We performed this study to identify the proper resuscitation technique to be used to increase the survival rate in nontraumatic, prehospital cardiac arrest. Methods: We reviewed the charts of patients with nontraumatic, prehospital cardiac arrest who visited our Emergency Department of Keimyung University Hospital during the period of May 2001 through April 2002. Results: Out of 60 cases of nontraumatic, prehospital cardiac arrest, 27 (45%) experienced no ROCS, 15 (25%) experienced transient ROSC, 6 (10%) died after 24 hours, and 12 (20%) alived and were discharged. Among those discharged, 10 had visited our emergency department for cardiac causes and 2 for non-cardiac causes. EKG findings were VF in 8, PEA in 2, and bradycardia in 2. In the discharged survival cases, the cardiac arrest had been witnessed. Conclusion: We failed to find significant statistical survival differences based on the causes of cardiac arrest, the initial EKG monitoring, or the method of visit. Witnessed cases of cardiac arrest had a higher survival rate than non-witnessed cases (p<0.05).