환자안전과 QA활동

이상흔 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

Child-Pugh Score Is an Independent Risk Factor for Immediate Bleeding after Colonoscopic Polypectomy in Liver Cirrhosis

이상흔,홍성필,박수정,천재희,김태일,김원호,강대룡 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.5

Purpose: Post-polypectomy bleeding is the most common colonoscopic polypectomycomplication. However, the risk of post-polypectomy bleeding in liver cirrhosisis unknown. We aimed to evaluate the risk of post-polypectomy bleeding in patients with liver cirrhosis. Materials and Methods: We included 89 patients with liver cirrhosis who received colonoscopic polypectomy between January 2006 and October 2012. Three hundred forty-eight subjects without liver disease who underwent colonoscopic polypectomy comprised the control group. Risks of post-polypectomy bleeding were analyzed according to patient- and polyp-related factors. Results: Among 89 patients, 75 (84.3%) were Child-Pugh class A, 10 (11.2%) were class B, and 4 (4.5%) were class C. Incidence of immediate post-polypectomy bleeding was significantly increased in cirrhosis with Child-Pugh class B or C compared to liver cirrhosis with Child-Pugh class A or control group [hazard ratio (HR) 3.5; p<0.001]. Polyp size (HR 3.6; p=0.032) and pedunculated polyps (HR 2.4; p=0.022) were also significant risk factors for immediate post-polypectomy bleeding in multivariate analysis. Conclusion: Cirrhotic patients with Child-Pugh class B or C have a high risk of immediate post-polypectomy bleeding. Thus, endoscopists should be cautious about performing colonoscopic polypectomy in patients with Child-Pugh class B or C.

신생검에서 급성 사구체신염 양상을 보인 Henoch-$Sch{\ddot{o}}nlein$ 자반증 2례

이상흔,남궁미경,차병호,김종수,Lee Sang Heun,Namgoong Mee Kyung,Cha Byung Ho,Kim Jong Soo 대한소아신장학회 1998 Childhood kidney diseases Vol.2 No.2

[ $\beta$ ]-streptococci have been reported as an etiology of Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP), but the role of $\beta$-streptococci in HSP is not yet confirmed. Our report of two HSP patients is as follows : Although the two patients' clinical symptoms resembled those symptoms of HSP, whereas serum $C_3$ decreased in one case, ASO titer increased in both cases and a histological examination of renal biopsy specimens revealed the fetures commonly described in poststreptococcal glomerulonephritis.

선천성 고도 난청에서 Connexin 26의 유전자 변이의 형태분석

이상흔,이정래,이지은,김태정,강봉석 대한청각학회 2001 Journal of Audiology & Otology Vol.5 No.2

에파타

이상흔,Lee, Sang-Heun 한국건강관리협회 2007 건강소식 Vol.31 No.6

지방족 폴리에스터 / 글루텐 블랜드의 몰폴로지와 물성연구

이상흔,정인권,이광희 한국고분자학회 1996 한국고분자학회 학술대회 연구논문 초록집 Vol.1996 No.10

원발성 비루관 폐쇄환자에서 누낭의 병리학적 소견

이상흔,유혜린,심정연 대한안과학회 2004 대한안과학회지 Vol.45 No.2

목적 : 원발성 비루관 폐쇄 환자에서 다양한 임상적 특징과 누낭점막의 병리학적 소견과의 관계를 알아보고자 하였다. 대상과 방법 : 경피적 누낭비강문합술을 시행한 21명 23안의 의무기록을 후향적으로 분석하였고 비루관 폐쇄의 양상과 위치를 누낭조영술 결과에 따라 분류하고, 누낭의 특징적 병리소견 4가지 항목(염증, 섬유화, 술잔세포, 상피화생)의 정도를 점수화하였으며 다양한 임상적 특성과 병리학적 소견과의 상관관계를 조사하였다. 결과 : 누낭의 염증, 술잔세포, 상피화생의 정도는 인구학적 특성이나 임상적 특성과 통계학적으로 유의한 차이가 없었다(P>0.05). 누낭조영술상 완전폐쇄일 때 섬유화 점수가(1.95±0.62) 부분폐쇄일 때(1.00±0.82) 보다 유의하게 증가되어 있었다(p=0.015). 폐쇄위치가 누낭인 경우 섬유화 점수가(2.20±0.63) 총누소관의 경우와(1.57±0.53) 비루관의 경우(1.33±0.82)보다 유의 하게 증가되어 있었다(p=0.041). 섬유화와 환자의 성별, 나이, 유병기간, 누석유무와 병리소견 사이에 통계학적으로 유의한 차이는 없었다(P>0.05). 결론 : 누낭의 섬유화는 비루관 폐쇄의 주요한 병리 소견이며 특히 누낭 폐쇄 환자에서 특징적 이었다. 향후 비루관 폐쇄의 병태생리를 알기 위해 비루관에 대한 연구와 초기 비루관 폐쇄 환자에 대한 연구가 필요 할 것이다. Purpose: The purpose of this study is to find out the relationship between clinical characteristics and pathologic findings of lacrimal sac in patients of primary acquired nasolacrimal duct obstruction. Methods: This study reviewed medical records of 23 eyes of 21 patients who were received external dacryocystorhinostomy, and analyzed patients according to the obstruction patterns and locations on dacryocystography. The relationship between the pathologic degrees of lacrimal sac (inflammation, fibrosis, presence of goblet cells and squamous metaplasia) and clinical characteristics of the patients, was also evaluated. Results: There were no significant relation between the pathologic degrees of lacrimal sac and clinical characteristics. From dacryocystography, the degree of fibrosis was 1.95±0.62 in complete obstruction, which was significantly higher than 1.00±0.82 in partial obstruction (p=0.015). In addition, the degree of fibrosis (2.20±0.63) was different depending on the location of the obstruction. In common canaliculus-obstruction group, it was 1.57±0.53 and in the nasolacrimal duct-obstruction group, it was 1.33±0.82 (p=0.041). However, there was no significant statistical difference between the patient's demographics and pathologic findings of lacrimal sac. Conclusions: The fibrosis of lacrimal sac mucosa is a major pathological finding of nasolacrimal duct obstruction and in particular, it is the characteristic of patients with lacrimal sac obstruction.

청성안정유발반응

이상흔 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.8

초고출력 안테나 시스템 급전용 다중 모드 혼 안테나 설계에 관한 연구

이상흔,윤영중,이병무,소준호,Lee Sang-Heun,Yoon Young-Joong,Lee Byoung-Moo,So Joon-Ho 한국전자파학회 2006 한국전자파학회논문지 Vol.17 No.5

In this paper, a multimode feed horn antenna is suggested for a high power microwave(HPM) antenna system. The proposed HPM feed horn antenna which is connected with a mode converter is located between source and reflector antenna. A multimode feed horn antenna which has reduced -25 dB beamwidth is designed and fabricated for miniaturization of reflector antenna because -25 dB beamwidth which is determined by considering spillover of feed horn antenna decides a size of reflector in case of HPM. As a result, feed system which uses the multimode feed horn antenna has high gain about 27 dBi and return loss is less than -22 dB at 10 GHz. The measured -25 dB beamwidths of the radiation pattern at vertical, horizontal-plane equal to $20.24^{\circ},\;28.92^{\circ}$ which is less than about $10^{\circ}$ beamwidth of conventional feed system. Thus the suggested feed hem antenna is suitable to feed horn for miniaturization of HPM antenna system. 본 논문에서는 초고출력 안테나 시스템의 급전용 다중 모드 혼 안테나를 제안한다. 제안된 초고출력용 급전 혼 안테나는 모드 변환기와 연결되며, 전원부와 반사판 안테나의 사이에 위치한다. 초고출력 시스템의 경우 급전 안테나의 spillover를 고려한 -25 dB 빔 폭이 반사판 안테나의 크기를 결정하므로 반사판 안테나의 소형화를 위해 -25 dB 빔 폭을 줄인 급전용 다중 모드 혼 안테나를 설계 및 제작하였다. 그 결과 제안된 다중 모드 혼 안테나를 이용한 급전 시스템의 이득은 27 dBi이며 반사 손실은 10 GHz에서 -22 dB 이하의 값이 측정되었다. 또한 -25 dB 범 폭은 수직 평면과 수평 평면에서 각각 $20.24^{\circ}$와 $28.92^{\circ}$로 측정되었고 이는 기존의 혼 안테나를 이용한 급전 시스템의 빔 폭보다 약 $10^{\circ}$가량 작은 값으로, 제안된 혼 안테나는 초고출력 안테나 시스템 소형화에 적합한 형태임을 확인하였다.

갑상샘눈병증 환자에서 보툴리눔독소를 이용한 위눈꺼풀뒤당김 치료의 결과

이상흔,유혜린,윤영수,Sang Hun Lee,Helen Lew,Young Soo Yun 대한안과학회 2006 대한안과학회지 Vol.47 No.8

Purpose: This study is to determine the effects of botulinum toxin injection on patients who suffer from upper eyelid retraction caused by thyroid ophthalmopathy. Methods: We injected 10-15 units botulinum toxin (Botox?, Allergan, USA) on the upper tarsus of 12 eyes of 12 thyroid ophthalmopathy patients and compared duration of disease, clinical activity scores (CAS), intraocular pressures (mmHg), exophthalmometry (mm), upper eyelid retraction (mm), marginal reflex distance1 (MRD1, mm), levator function test (mm), lid lag (mm), limitation of ocular movement (mm), lid tension test results, phenylephrine test results, and orbital computed tomography results before and after the injection. Results: The patient group with smaller-sized cross section of superior rectus/levator complex before the injection showed a greater decrease of upper eyelid retraction after the injection (p=0.04). Other clinical parameters showed no significant relations on the effect of the toxin injection. Conclusions: Botulinum toxin injection can have variable effects on the upper eyelid retraction of thyroid ophthalmopathy patients. The patients who had smaller volume of superior rectus/levator complex measured in orbital cross sections on CT, could expect good results after botulinum toxin injection.