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경동맥 내막절제술 후 조기 합병증(<30일) 발생에 대한 고찰 및 술 후 뇌경색 발생 위험인자 분석
이경복(Kyung-Bok Lee),이광호(Kwang-Ho Lee),정진상(Chin-Sang Chung),김경문(Gyeong-Moon Kim),변홍식(Hong-Sik Byun),전평(Pyoung Jeon),김건하(Keon-Ha Kim),김동익(Dong-Ik Kim),김영욱(Young-Wook Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.3
Purpose: We aimed to evaluate the early (<30 days) results and to analyze risk factors for the development of stroke and new brain infarction (NBI) after carotid endarterectomy (CEA). Methods: From September 2003 to August 2008, 233 CEAs were performed on 222 patients with critical internal carotid artery (ICA) stenosis in a single center. Patient characteristics, history of neurological symptoms, procedural details, and postoperative complications were examined based on the medical records. The incidence and risk factors for early postoperative stroke were evaluated. After excluding CEAs without performing diffusion-weighted brain MRI, 128 CEAs were investigated for frequency and the risk factors of NBI were analyzed. Chi-square test, Fisher’s exact test, Student T-test, and logistic regression model were used for statistical analysis. Results: Of a total of 233 CEAs, any and ipsilateral stroke rates were 1.3% and 0.4%, respectively. There was no early postoperative mortality. Early postoperative complications included 4.3% in transient cranial nerve injury, 1.7% in myocardial infarction, and 3.4% in hematoma. In univariate analysis, the significant risk factor for stroke was plaque ulceration (P=0.04). The frequency of NBI and ipsilateral NBI were 8.4% and 3.1%, respectively. The ulceration on ipsilateral ICA revealed statistically significant risk factors for the development of NBI (RR, 5.29; 95% CI, 1.024∼27.325; P=0.04). Conclusion: Our study showed a lower incidence of stroke and NBI after carotid endarterectomy and that it is safe procedure for the treatment of patients with severe (>70%) carotid stenosis. We also found that plaque with ulceration was a significant risk factor for the development of postoperative NBI.
김향희(Hyanghee Kim),권미선(Miseon Kwon),나덕렬(Duk L. Na),최상숙(Sang-sook Choi),이광호(Kwang ho Lee),정진상(Chin Sang Chung) 한국언어청각임상학회 1998 Communication Sciences and Disorders Vol.3 No.-
실어증환자들이 산출하는 자발화의 유창성 정도에 대한 평가는 상당히 주관적이며, 과연 어떤 요소들을 기준으로 유창성 판단이 이루어지는지 명확하지 않다. 본 연구에서는 청지각적인 판단에 의하여 31명의 실어증환자들을 비유창군, 정상유창군 및 과유창군 등 세 환자군으로 나눈 후, 그들의 그림설명 자발화들을 여덞가지 유창성 요소들(총 발화수, 총 발화수 내 총 문장수 비율, 총 문장수 내 복문수 비율, 발화당 음절수, 발화당 단어수, 초당 음절수, 한국어 9품사 출현비율, 발화오류비율)에 준하여 분석해 보았다. 그 결과, 적어도 두 환자군간에 유의미한 차이를 보였던 요소들은 발화당 음절수, 발화당 단어수, 총 발화수 내 총 문장수 비율 등이었다. 그 밖에, 단계식 판별분석 결과, 환자군간의 유창성 정도를 결정짓는 가장 중요한 첫째 요인은 ‘발화당 음절수’로 밝혀졌으며 두 번째 요인은 ‘총 발화수’로서 이 두 요인들을 이용할 때 전체환자의 79.37%가 청지각적인 판단으로 할당된 환자군에 정확하게 분류되었다. 본 연구의 결과는 임상에서 실어증환자들의 유창성 정도에 대한 판단력을 향상시킬 수 있는 계기를 마련해 준다고 할 수 있겠다. Fluency judgements of an aphasic patient's spontaneous speech can be extremely subjective. A number of variables that might be related to the fluency produced by aphasic patients were investigated. Tape-recorded language samples of the picture description task of K-WAB were used for the analysis. A consensus judgement on the degree of fluency (i.e., hypo- fluent, normal-fluent, and hyper-fluent) was made by three speech-language pathologists. The picture description measures of the three groups (hypo-fluent = 16 patients; normal- fluent = 11; hyper-fluent=4) were analyzed using eight variables (i.e., the number of syllables per second or SPS the mean number of syllables per utterance or SPU; the mean number of words per utterance or WPU; the total number of utterances or TU; the total number of complex sentences/TU ratio; the total number of sentences /TU radio or TS/TU; the analysis of nine content-function words; and the per-centages of errors). We used the aforementioned eight variables as dependent variables and the three fluency groups as independent variables. The variables that categorize at least two patient groups were SPU, WPU, TU, and TS/TU. Based on a discriminant function analysis, the percentage of group cases correctly classified was 79.37%. This study reveals important variables that might contribute to improving the fluency judgement of language of patients with aphasia.