부항으로 인해 발생한 철분결핍성빈혈 2례

최지호,이상현,Choi, Ji-Ho,Lee, Sang-Hyun 한국정신신체의학회 1999 정신신체의학 Vol.7 No.2

연구배경 : 철분결핍성빈혈은 매우 흔하며 그 원인이 다양하므로 근본 원인을 찾으려는 노력을 하여야만 한다. 저자는 소화기관 출혈, 임신, 과다월경 등의 원인 외에 우리 나라의 의료 특성상 빈번하게 이뤄지고 있는 부항에 의해 발생한 증례를 경험하였으므로 부항으로 인해 발생한 철분결핍성빈혈 2예를 보고하고자 한다. 이들의 행위는 설명모델로 이해될 수 있다. 증례 1 : 27세 여자 환자가 호흡곤란을 주소로 내원하였다. 환자는 10년 전부터 있었던 건선을 치료하기 위해 부항요법을 빈번하게 실시하였고 이로 인한 실혈로 철분결핍성빈혈이 발생하였다. 증례 2 : 70세 남자 환자가 식욕부진과 어지러움을 주소로 내원하였다. 환자는 내원 9개월 전에도 같은 증상이 있어 철분결핍성빈혈로 진단을 받고 치료 받았으나 5년 전부터 족부 무좀에 대해 실시한 부항요법을 지난 번 빈혈치료 후에도 반복해 실시한 결과 철분결핍성빈혈이 발생하였다. 결론 : 철분결핍성빈혈의 원인으로 우리나라 의료의 특성상 부항요법도 고려하여야 한다. Background : Iron deficiency anemia(IDA) is a very common condition, and its underlying causes are diverse. Gastrointestinal blood loss, pregnancy, menorrhagia are known as common causes of IDA. However, especially in the IDA case of unknown origin, we must consider the culture specific cause of IDA as a possible cause of IDA. As I found an unusual cause of IDA related to a cultural behavior, I would like to report two cases of IDA occurred by negative therapy in Korea. It is possible to explain these cases by explanatory model. Case 1 : With a chief complaint of dyspnea, a 27-year-old woman visited our clinic. She had multiple treatment histories of negative therapy for her psoriasis. The blood loss during this procedure is the cause of present IDA. Case 2 : A 70-year-old man visited our clinic complaining of anorexia and dizziness. The history of treatment showed that he had an IDA 9 month ago. The IDA developed again because of repeated negative therapy after previous treatment of IDA. He has used the negative therapy intermittently to treat tinea pedis for 5 years. Conclusion : We must consider the negative therapy as a possible cause of IDA in Korea.

폐쇄성 수면 무호흡증의 병인 및 기전

최지호,이승훈,신철,Choi, Ji-Ho,Lee, Seung-Hoon,Shin, Chol 대한수면의학회 2005 수면·정신생리 Vol.12 No.2

The pathogenesis and mechanism of obstructive sleep apnea (OSA) has been under investigation for over 25 years, but its etiology and mechanism remains elusive. Skeletal (maxillary and/or mandibular hypoplasia or retrodisplacement, inferior displacement of hyoid) and soft tissue (increased volume of soft tissue, adenotonsillar hypertrophy, macroglossia, thickened lateral pharyngeal walls) factors, pharyngeal compliance (increased), pharyngeal muscle factors (impaired strength and endurance of pharyngeal dilators and fixators), sensory factors (impaired mechanoreceptor sensitivity, impaired pharyngeal dilator reflexes), respiratory control system factors (unstable respiratory control) and so on facilitate collapse upper airway. Therefore, OSA may be a heterogeneous disorder, rather than a single disease entity and various pathogenic factors contribute to the OSA varies person to person. As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.

비강수술로 호전된 폐쇄성 수면무호흡증후군 1 례

최지호,이흥만,권순영,이상학,신철,이승훈,Choi, Ji-Ho,Lee, Heung-Man,Kwon, Soon-Young,Lee, Sang-Hag,Shin, Chol,Lee, Seung-Hoon 대한수면의학회 2005 수면·정신생리 Vol.12 No.1

폐쇄성 수면무호흡증은 이비인후과영역에서 흔하게 관찰되는 질환 중 하나로 수면 중에 상기도의 폐쇄로 인한 호흡정지가 주요한 병인이며 상기도를 구성하는 비강, 구강, 인두, 후두 중 어느 한 부분에서 폐쇄가 일어나도 질환의 원인이 될 수 있다. 비폐색의 가능한 원인들로는 주로 비중격 만곡, 비용, 기포성 갑개, 후비공 폐쇄, 종양, 이물, 술 후 또는 외상 후 발생한 유착, 여러 가지 비염, 기타 질환 등이 있다. 폐쇄성 수면무호흡증의 수술적 치료에는 비강수술, 구개인 두수술, 편도 및 아데노이드 절제술, 설부 축소수술, 기관절개술 등 여러 가지가 있는데 문헌들을 고찰한 결과 지금까지 성인에서 수면무호흡증 치료로 시행한 비강수술의 효과에 대해서는 아직 논란의 여지가 있는 상태이다. 최근 저자들은 비폐색과 동반된 코골이 및 수면무호흡증 환자에서 비폐색과 수면무호흡증의 원인으로 생각되는 비중격 만곡증 및 비후성비염을 교정하기 위해 비중격 교정술 및 하비갑개 절제술을 시행한 결과 수술 전, 후의 증상 및 수면 다원검사 비교에서 뚜렷한 호전을 경험하였기에 보고하는 바이다. Obstructive sleep apnea syndrome(OSAS) is a common disease in the field of otorhinolaryngology and is characterized by repeated upper airway occlusions occurring during sleep. OSAS can occur due to various etiologies of the nasal, oral, pharyngeal and laryngeal airway in adults. Nasal obstruction can be caused by septal deviation, nasal polyps, concha bullosa, choanal atresia, neoplasms, foreign body, postoperative/post-traumatic synechiae, various rhinitis and so on. There are various kinds of surgical treatment of OSAS including nasal surgery, LAUP, UPPP, surgery of tongue base, tracheostomy and so on, but the effect of nasal surgery on snoring and OSAS is controversial. The authors report the case of a patient who had experienced nasal obstruction, moderate snoring and OSAS and who improved after septoplasty and turbinoplasty.

BtoB 관계에서 신뢰의 내용 및 대상 차원이 관계몰입 및 시민행동에 미치는 영향

최지호(Jiho Choi),김재욱(JaeWook Kim),이성근(SeongKeun Yi),한계숙(Kyesook Han) 한국유통학회 2004 流通硏究 Vol.9 No.3

본 연구에서는 기업간 관계에서 핵심 개념 중의 하나인 신뢰를 호의 및 역량과 같은 내용별 차원과 더불어 기업 신뢰 및 영업사원 신뢰와 같은 대상별 차원을 동시에 고려하여 이들 차원이 관계몰입 및 시민행동에 영향을 미치는 차별적 효과를 검증하였다. 수도권에 소재하고 있는 유통업체의 구매담당자를 대상으로 수집된 자료를 가지고 분석한 결과, 공급업체의 경우 역량 차원은 구매업체의 관계몰입에 유의한 영향을 미치고 있으며, 호의 차원은 유의하지 않은 것으로 나타났다. 반대로 영업사원의 경우 호의 차원은 구매업체의 관계몰입에 유의한 영향을 미치고 있지만 역량 차원은 유의하지 않은 것으로 밝혀졌다. 또한 관계몰입은 협력적 행동, 비불평성, 공익성과 같은 관계적 시민행동에 모두 유의한 영향을 미치고 있는 것으로 나타났다. 끝으로 이러한 결과의 이론적 및 실무적 시사점이 논의되고 연구의 한계점과 미래의 연구방향이 제시되었다. The primary purpose of this research is to develop and test a model that explains the process of how multidimensional trust in a supplier firm and salesperson through relational commitment influence buyer's relational citizenship behavior. The proposed framework uses a multidimensional conceptualization for the trustworthiness construct such as benevolence and credibility and incorporates two distinct facets of consumer trust, namely, organization trust, and salesperson trust. The authors test the proposed model using data from MD in buying firms.. The tests show the differential effect of trust dimensions on relational commitment and citizenship behavior. The authors discuss the implications of the findings for trust-commitment theory and practice.

개선 클러스터링 화음탐색법 개발 및 다양한 최적화문제에 적용

최지호(Choi, Jiho),정동휘(Jung, Donghwi),김중훈(Kim, Joong Hoon) 한국산학기술학회 2018 한국산학기술학회논문지 Vol.19 No.3

본 연구에서는 최적화 기법의 하나인 화음탐색법 (HS: Harmony Search)에 클러스터링 기법을 적용하여 개선된 형태의 HS를 제안하였다. HS는 음악의 즉흥연주를 모방하여 개발되었으며 무작위선택, 기억회상, 음조조정의 세 가지 연산을 이용하여 최적해를 반복적으로 탐색해 나간다. 기존의 HS의 경우, 세 가지 연산 중 기억회상을 진행할 때 해집단의 저장공간인 해저장소 (HM: Harmony Memory)에 있는 해를 선택하는데, 이 과정에서 적합도를 정량화한 목적함수 값에 상관없이 모두 동일한 확률로 해의 선택이 이루어지고, 이에 따라 최적의 해를 탐색하는 속도가 상대적으로 낮다. 본 연구에서 제안한 개선 클러스터링 화음탐색법 (ICHS: Improved Clustering Harmony Search)는 HM에서 목적함수의 값을 기준으로 클러스터링 기법을 적용하여 목적함수 값이 유사한 솔루션들이 하나의 해집단을 형성하도록 클러스터링을 수행한다. 이를 통해 만들어진 클러스터 중 상대적으로 목적함수 값이 우수한 클러스터에는 더 높은 선택 확률을 부여하여, 적합도가 높은 클러스터에 포함된 해의 결정변수가 선택될 확률을 높게 하는 역할을 한다. 본 연구에서는 ICHS의 효율성을 검증하기 위하여 개발 기법을 기존 논문에서 제시된 수학적 최적화 문제에 적용하였고 우수한 해탐색 성능을 확인할 수 있었다. 또한 실제 공학 문제에 대한 적용성 평가를 위해 개발 기법을 대규모 상수도관망 관경최적화 문제에 적용하였다. 상수도관망 최적설계에 대한 ICHS의 적용 결과, 기존 최적화 기법에 비해 우수한 해를 안정적으로 도출할 수 있는 것으로 나타났다. Harmony search (HS) is a recently developed metaheuristic optimization algorithm. HS is inspired by the process of musical improvisation and repeatedly searches for the optimal solution using three operations: random selection, memory recall (or harmony memory consideration), and pitch adjustment. HS has been applied by many researchers in various fields. The increasing complexity of real-world optimization problems has created enormous challenges for the current technique, and improved techniques of optimization algorithms and HS are required. We propose an improved clustering harmony search (ICHS) that uses a clustering technique to group solutions in harmony memory based on their objective function values. The proposed ICHS performs modified harmony memory consideration in which decision variables of solutions in a high-ranked cluster have higher probability of being selected than those in a low-ranked cluster. The ICHS is demonstrated in various optimization problems, including mathematical benchmark functions and water distribution system pipe design problems. The results show that the proposed ICHS outperforms other improved versions of HS.

기업형 슈퍼마켓(SSM)의 시장진입이 소매업태간 시장점유율 변화에 미친 영향

최지호(Jiho Choi),윤민석(Min-Suk Yonn),문연희(Younhee Moon),최성호(Sungho Choi) 한국유통학회 2012 流通硏究 Vol.17 No.3

본 연구의 목적은 최근 급격하게 확산되고 있는 기업형 슈퍼마켓(SSM)의 시장 진입이 국내 소매업 경쟁구조에 미친 영향을 실증하는데 있다. 자료의 분석기간은 2000년 1월부터 2010년 12월까지이며, 기업형 슈퍼마켓이 월별로 진입한 점포수, 누적 점포수, 신규 SSM 사업체 중 165㎡ 미만 점포비율이 분석모형에 고려되어 소매업태별 상대적 시장점유율에 미치는 효과가 분석되었다. 한국표준산업분류 코드에서 종합소매업에 속해 있는 백화점, 대형마트, 슈퍼마켓, 체인화 편의점, 기타 음식료품 위주 종합 소매업으로 구분된 소매업태간 시장점유율은 매월 각 소매업태별 판매액을 합산하여 월별 총 소매판매액을 계산한 후, 각 소매업태의 판매액이 총 소매판매액에서 차지하는 비율로 측정하였다. 통제변수로 소매업태별 종사자 수, 통화량(M2)이 모형에 추가되어 분석되었다. 분석결과, 신규 SSM 시장진입으로 인한 소매업태별 시장점유율 변화는 대형마트에서만 통계적으로 유의한 결과가 도출되었다. SSM의 누적 점포수는 모든 소매업태의 시장점유율 변화에 유의한 영향을 미쳤으나 그 영향력에 대한 방향성이 소매업태별로 다르게 나타났다. 먼저 SSM의 확산은 대형마트와 편의점의 시장점유율을 감소시킨 반면에 백화점, 슈퍼마켓, 기타 음식료품 위주 종합 소매점의 시장점유율에는 긍정적인 공헌을 한 것으로 나타났다. 이러한 결과에 대한 논의, 시사점, 그리고 향후 연구 방향이 제시되었다.

Sweet 증후군 24예에 대한 임상적 고찰

최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),안세진(Se Jin Ahn),장경애(Kyoung Ae Jang),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh) 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.2

N/A Background:Sweet's syndrome is a neutrophilic dermatosis that has various clinical characteristics and is often associated with inflammatory, malignant or autoimmune diseases, so the viral or bacterial antigens and tumor antigens are suspected to play a role in the pathogenesis of Sweet's syndrome. Objective:This study was conducted to obtain a better understanding of the clinical features of Sweet's syndrome and estimate the prevalence of malignant associated Sweet's syndrome in Korea. Methods:Clinical manifestations and histopathologic features of 24 Sweet's syndrome patients were evaluated. Results:The age was varied from 24 to 85 years, averaging 49.3 years. The male to female ratio was 1:2.4 . The site of predilection was the extremities, and the most common involved site was the upper extremities. The associated clinical symptoms were fever, arthralgia, myalgia, and oral ulcer in varying frequencies. In laboratory examinations, there were increased ESR, leukocytosis, and neutrophilia in part of the patients. The associated systemic diseases were found in 58.3% of the patients and hematologic malignancies were the most common with prominent AML-association. The majority of the patients were treated with oral or topical steroids and the recurrences were reported in 50%. Conclusion:The associated systemic diseases were presented in 58.3% of 24 Sweet's syndrome patients. And there was high association of Sweet's syndrome and hematologic malignancies, especially AML, as previously reported, which implies the importance of thorough investigation for underlying diseases in the Sweet's syndrome patients. (Korean J Dermatol 2000;38(2):163~169)

Cross-sectional study to assess the clinical profile of psoriatic patients in Korea

최지호 ( Jee Ho Choi ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Psoriasis is associated with serious physical, psychological and sociofunctional disorders, as well as increased medical cost and reduced productivity, having a major impact on health-related quality of life (HRQoL). The United States and several countries in Europe recently conducted HRQoL survey among psoriatic patients, but national large-scale study on clinical profiles of psoriatic patients, including their HRQoL, has not been studied in Korea. Objectives: This nationwide cross-sectional study was aimed at determining epidemiologic characteristics of psoriasis, disease severity and HRQoL among psoriatic patients in Korea. In addition, we also investigated demographic, disease-specific, socio-economic, therapeutic and clinical factors that may affect disease severity and HRQoL of psoriatic patients in Korea. Methods: This study was conducted from February 2013 to June 2013 in psoriatic patients, aged 20 or older, recruited from 25 centers across the country. Data were collected on demographic factors, such as age, sex, height, body weight, and waist circumference; disease-specific factors, such as PASI score, BSA, onset age, clinical types, area of lesion, family history, and past and present medical history; drinking and smoking histories; presence of comorbidity (blood pressure, CRP, LFT, BUN, creatinine, fasting glucose, TG, total cholesterol, HDL-C, LDL-C); and the rate of patients suggesting psoriatic arthritis (PASE questionnaire). SF-36, DLQI, WPAI:PSO, and MSQ were used to determine HRQoL of psoriatic patients. Statistical significance was analyzed by ANOVA, Kruskal-Wallis test, student`s t-test, chi-square test, and Fisher`s exact test. Results: 1,278 psoriatic patients were enrolled and 1,260 of them completed the study. 749 (59.4%) were male and 511 (40.6%) were female patients (sex ratio, 1.47:1). Mean age was 47.1±14.5 years (range, 20-89 years); 24.9% were in their 50s, 22.3% were 40s, 20.1% were 30s, 12.6% were 20s, 12.1% were 60s, and 7.9% were 70s. Onset age was below 30 in 33.8%, 30 and older in 66.2%; the percentage was greatest among 20s (22.4%), followed by 30s (19.8%), 40s (18.7%), 50s (14.7%), teens (11.4%), 60s (7.1%), 70s (3.3%), and below teens (2.6%). Mean duration of psoriasis was 109.2±122.0 months (range, 1.0-825). Mean BMI was 23.9±3.5 kg/m2. 602 (47.8%) were current drinkers; 389 (30.9%) were current smokers and their mean duration of smoking was 19.9±10.7 years. Mean PASI score was 7.5±7.1; 75.6% were less than 10 points, 18.4% were between 10 and 20 points, and 6.0% were 20 points or beyond. Mean BSA was 13.1±14.6%; 21.2% were below 3%, 41.4% were 3-10%, and 37.4% were 10% or beyond. Mean DLQI score was 12.0±7.2; 21.2% were 5 points or below, 24.7% were between 6 and 10 points, and 54.1% were 11 points or higher, indicating that more than half of the psoriasis patients had their quality of life severely affected by psoriasis. Mean SF-36 score was 48.8±8.0 for PCS and 42.6±11.2 for MCS. WPAI:PSO results were 6.4±15.1% for absenteeism, 28.9±27.5% for presenteeism, 31.6±28.3% for TWPI and 37.2±30.0% for TAI. Mean PASE score was 33.7±13.1; symptom subscale was 16.1±6.1 points and function subscale was 17.6±7.7 points. 301 (24.0%) out of 1,255 patients had PASE score 44 points or higher, suggesting active psoriatic arthritis. Patients were not satisfied with treatments in 16.1%, neutral in 25.3%, and satisfied in 58.6%. Clinical type of psoriasis was plaque type in 1,081 patients (85.8%), guttate in 106 (8.4%), pustular in 66 (5.2%), erythrodermic in 44 (3.5%), and others in 28 patients (2.2%). Systolic BP was 140mmHg or higher in 12.9% and diastolic BP was 90mmHg or higher in 15.2% of patients. Waist circumference was 90cm or beyond in 38.5% of male patients and 85cm or beyond in 29.1% of female patients. The rate of patients with greater-than-normal fasting glucose, TG, total cholesterol, LDL-C, creatinine, and CRP level was 27.6%, 23.4%, 27.5%, 27.0%, 10.5%, and 18.6%, respectively. When patients were categorized to mild (<10), moderate (10-20), or severe (>20) groups according to their PASI score, the more severe, the higher their mean DLQI was, with significant difference among each group (p<0.001). PCS and MSC of SF-36 were both significantly lower in the severe group compared to the other groups (p<0.001). The duration of psoriasis was also significantly different among the three groups (p=0.0175); the mild group had significantly shorter duration than the other two groups. Onset age was significantly different between mild group and moderate- severe group, and psoriasis was more severe among the patients with onset age of below 30 than those with onset age of 30 or older (p=0.0196). Medical cost was significantly higher in the severe group than in the mild group (p=0.0398). According to WPAI:PSO test, the severe group had significantly higher absenteeism than the other two groups (p=0.0066). Presenteeism and TWPI were significantly different among the three groups, with increasing tendency toward the severe group (p<0.0001 for all comparison). TAI was significantly lower in the mild group compared to the other two groups (p<0.0001). As for PASE, total score, symptom score, function score and the number of patients with 44 points or higher were all significantly higher in the severe group than in the other two groups (p=0.0001, p=0.0005, p=0.0001, and p<0.0001, respectively). The severe group had significantly higher systolic and diastolic BPs than the mild group (p=0.0007 and p=0.0006, respectively), significantly greater waist circumference than the mild group among female patients (p=0.0172), and significantly higher glucose and TG than the mild and moderate groups (p=0.0008 and p=0.0411, respectively). Conclusion: This is the first nationwide survey of psoriatic patients in Korea and shows epidemiologic characteristics and clinical profiles of Korean psoriatic patients. Psoriasis also has a profound impact on quality of life including physical and psychological well-being in Korean patients. *Support: This study was conducted with support from Janssen Korea Ltd.

위치 센서에 따른 인휠 모터의 제어 특성 연구

최지호(Jiho Choi),시효석(Hyoseok Shi),고경진(Gyongjin Ko) 한국자동차공학회 2022 한국자동차공학회 학술대회 및 전시회 Vol.2022 No.11

고령자의 휴대전화기 사용성 평가에 관한 연구

최지호(Jiho Choi),이성일(Seongil Lee),조주은(Joo Eun Cho) 대한인간공학회 2011 大韓人間工學會誌 Vol.30 No.1

Objective: The aim of this study is to investigate the attributing factors influencing usability of the mobile phones specifically designed for the elderly users. Efforts to identify factors that cause usability problems for the elderly users in using mobile phones can provide the groundwork for changes aimed at usability enhancement and design of interfaces of mobile phones. Background: It became important to understand the behaviors and tendencies of the elderly in communication as the society became older. The problems in digital divide is contributed to mainly lack of understanding in terms of the use pattern of the elderly and lack of consideration of their characteristics in designing user interfaces of most ICT devices. Method: A total of 30 elderly users who were over 65 years in age participated in usability evaluation test experiment and performed seven different tasks using a widely accepted model of universally designed mobile phone. Their performance was compared with that of contrast group that consisted of 10 younger participants who were on their 20s. Results: It was found that the elderly users had hard times in using mobile phones, especially in keypad manipulation among search, understanding, and manipulation subtasks. Conclusion: Older users seemed to have difficulty in all the subtasks of search, recognition, and manipulation. It was suggested that designers of mobile phones need to give careful consideration into designing visual interfaces for search tasks and keypads for easier control and input for the elderly users. Application: The study is expected to provide guidelines for the universal design of mobile phones and their interfaces for enhancing usability of the mobile phone for elderly users.