Predicting Malignancy by Peroral Pancreatoscopy of an Intraductal Papillary Mucinous Neoplasm with a Dilated Main Pancreatic Duct: Is Seeing Enough?

이윤나,Jong Ho Moon 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.2

COMMENTARY

Recent update of therapeutic application of peroral cholangioscopy

이윤나 소화기인터벤션의학회 2021 Gastrointestinal Intervention Vol.10 No.3

Despite advancements in endoscopic retrograde cholangiopancreatography (ERCP), direct endoscopic visualization of the biliary tree by cholangioscopy is required to improve the diagnosis and treatment of the underlying disease. Although several types of peroral cholangioscopy (POC) systems are available, single-operator cholangioscopy (SOC) has been widely used for interventions in the biliary system. The first SOC was SpyGlass direct visualization system (Boston Scientific, Natick, MA, USA) expanded to a digital version of the SOC (SpyGlass DS; Boston Scientific). More recently, single-operator direct POC using an ultra-slim upper endoscope has been proposed. The remarkable developments in POC and available specialized accessories continue to improve therapeutic procedure of the biliary diseases. POC allows the visualization of bile duct stone and guide wire placement across difficult strictures and selective cannulation of the intrahepatic and cystic ducts. It is also demonstrating its utility in investigational applications such as intraductal ablation therapy for bile duct tumors, removal of foreign body in the bile duct and evaluation of hemobilia.

서울시 여의도 아파트단지내 국민학교 아동의 식생태조사

李允娜,牟壽美,柳德仁 대한보건협회 1993 대한보건연구 Vol.19 No.1

An ecological study of food and nutrition was undertaken among 276 children, 6 to 12 years old, in the Yunjung elementary school, which offers school lunch program, and is situated in Youido-dong, Youngdeungpo-gu, School, known the location of one of the socioeconomically high groups, to investigate food habits, dietary behavior, and family dietary environment, in July of 1990. The survey showed that 8.5% of subjects skipped a breakfast with complains of a lack of appetite in the morning. Among the obese children 13.5% skipped breakfast, whereas only 7% of normal children skipped breakfast. The percentage of children having meals with family on weekdays was 36.1% for breakfast; 58.9% for evening meal. The mean frequency of eating out the home was 2.6 times per month. Boiled rice was predominant dietary staple, and the principal sources of protein taken by subjects were eggs for breakfast, and meats for evening meal. However, the survey discovered a local dietary characteristic: only 49% of children ate boiled rice, and 21.3% ate bread, and 21.3% had others for breakfast. The average number of side dishes per meal was 1.7 excluding kimchi and soup, and the number was increased in the case of having a boiled rice-centered meal compared with that of having a bread-centered meal. For snacks, milk and milk products, and fruits were most popular among the children, and the majority of the children had 3 to 4 kinds of foods for snack. The children liked fastfoods, ice cream, and biscuits; in contrast, lowest preference was for vegetables, mushrooms and beans. The results suggest an urgent need of active and practical nutritional education throughout school, home, and community for better nutritional care of these school children.

간에서 발생한 악성 혼합 종양 보고

이윤나,김영석,김상균,문종호,이문성,김부성,김희경,이혜경,박성진 대한내과학회 2009 대한내과학회 추계학술발표논문집 Vol.2009 No.-

우리 나라 비만인구의 식생활 특성

이윤나,이행신,김복희,장영애,김초일 대한비만학회 2004 대한비만학회 학술대회 Vol.- No.-

대학생의 거주형태에 따른 영양섭취실태 및 식습관에 관한 연구

이윤나 대한지역사회영양학회 1996 대한지역사회영양학회지 Vol.1 No.2

This study was carried out with 1030 students of Seoul National University to investigate the relationship between residences and food habits of college students. The results obtained were as follows. 1) Food habit scores of the students living in dormitories and in boarding homes with cooking facilities were significantly lower than those of other students, especially with regards to the balance of five basic food groups and skipping breakfast. 2) Energy intake of students living in the boarding homes with meals were low. Students in the boarding home also showed low intake of calcium and iron, whether meals were provided or they had cooking facilities. 3) Cafeteria meals on campus showed better nutritional values than meals at home, or restaurants around the campus. But students were not satisfied with campus cafeterias, because the food items were monotonous, they had long waiting service lines, preferred foods were limited, dishes were not clean, and stated of hygiene did not seem satisfactory. Nutrition education for college students is needed, and menus of campus cafeterias should be developed to meet the various needs of students. (Korean J Community Nutrition 1(2) : 189~200, 1996)

정신과적 관점에서의 섬유근통

이윤나,이상신,김현석,김호찬,Lee, Yunna,Lee, Sang-Shin,Kim, Hyunseuk,Kim, Hochan 한국정신신체의학회 2020 정신신체의학 Vol.28 No.2

섬유근통은 피로, 수면장애, 기분변화, 인지장애 및 만성 전신통증을 핵심 증상으로 하는 질환이다. 섬유근통은 유전적 취약성, 통증 처리과정 및 스트레스 반응 체계의 변화 등을 포함하는 생물학적 요인과 불안, 우울, 분노, 스트레스 등의 심리적 요인, 그리고 감염, 발열 질환, 외상 등의 환경적 요인이 함께 작용하여 발생하는 것으로 알려져 있으며, 핵심 병인으로 감각 자극이 인식되는 과정에서 증폭되어 통증이 증진되는 중추성 감작의 역할이 강조되고 있다. 가이드라인들은 개별 환자의 필요에 따라 선택된 다원적 접근을 권고하며, 임상의는 충분한 교육을 통해 지적 이해의 틀을 제공하고 자기 관리의 중요성을 강조해야 한다. 섬유근통에서 정신건강 문제의 유병률은 일반인구집단의 7~9배로 유의하게 높으며, 특정 정신병리 및 수면장애와의 관련성도 제기되고 있다. 정신과적 상태는 섬유근통과 양방향성 상호작용을 하며 경과에 영향을 주고, 취약성을 공유하며 서로의 위험 요인으로 작용할 수 있으므로, 동반질환을 면밀히 평가하여 보다 통합적인 관리가 필요할 것이다. Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

일본에 있어서의 적극적 평등실현조치의 가능성 -쿼터제의 채택을 중심으로-

이윤나 한남대학교 과학기술법연구원 2013 한남법학연구 Vol.1 No.1

이 글에서는 일본에 있어서의 적극적 평등실현조치의 가능성, 그 중에서도 쿼터제를 채택하기 위한 쿼터제의 유익성과 합헌성에 관해서 검토하고 있다. 일본에서는 남녀공동 참획 사회기본법의 제정?시행에도 불구하고 유효한 적극적 평등실현조치인 쿼터제가 받아들여지지 않고 있는데, 제외국과 비교하여 특히 여성의 정치 분야의 진출이 늦어지고 있다는 점을 감안해 본다면, 쿼터제 도입을 위한 보다 적극적인 논의는 상당히 유의미한 것으로 이해될 수 있을 것이다. 쿼터제의 유익성에 관하여는 이미 제외국의 사례를 통하여 그 유익성이 보고되고 있는바, 이 글에서는 그러한 쿼터제의 합헌성에 관한 다수의 논의를 소개하고 있으며, 특히 프랑스와 이탈리아에서의 위헌판결로 헌법이 개정된 것에 주목하여 결론에 있어서의 법리적 전제로 삼고 있다. 쿼터제의 합헌성에 관하여 현재 일본 헌법 제13조 및 제14조에 대한 해석론을 분석하여 4가지 주요한 논점에 관하여 나름 면밀한 검토를 시행하고 있으며, 그 결과 현행 일본 헌법상으로 쿼터제 채택이 결과적으로 위헌으로 판단될 여지는 발견되지 아니하는 것으로 판단되었다. 오히려 필자의 관점에서는, 일본의 경우 여성차별철폐조약 제4조 제1항의 잠정적 특별조치에 관한 규정, 또는 남녀공동참획기본계획에 있어서의 격차시정을 위한 「적극적 개선조치」의 실시가 인정되고 있기 때문에, 일본에 있어서도 적극적으로 쿼터제를 채택하는 것은 지극히 합헌적인 조치가 될 것으로 판단된다.

19세기 역관 이상적과 김석준의 서적 간행활동

이윤나 한국서지학회 2016 서지학연구 Vol.66 No.-

Lee Sang Juk(1804-1865) and Kim Seok Joon(1831-1915) who were interpreters of Joseon Dynasty in 19thCentury took a part in publication of books between Joseon and Qing Dynasty. Lee Sang Juk was participated in the publication of Eungsongdang-jip, which is a collection of his own works, Cheounroisigo collection of works of Lee Jung jik(1781-1816) who is a his father, and Mongwansigo by Lee Jung ju. Kim Seok Joon published Songmokgwan-jip, a collection of works of Lee Un Jin and Woosunjunghwa-rok, collection of Lee Sang Juk who was a teacher of him. Kim Seok Joon was participated in the publication of Hongyakruhuein-rok, which is a collection of his own works. Among these collections, Eungsongdang-Jip, Cheounroisigo, and Songmokgwan-Jip were published in Qing Dynasty. The reason for they were able to publish collections of works in Qing Dynasty was because of that basically, there was an social interaction with literacy men in Qing Dynasty. When they stayed in Qing Dynasty, they were actually involved in publication of collections of works, however, they were able to publish books in Joseon as they exchanged letters with literacy men in Qing Dynasty. The reason of publishing the collections of works in Qing Dynasty was because of the social interaction with literacy men in Qing Dynasty. When they were interacting, they exchanged gifts each other and they generally used to exchange their collections of works as well. In Joseon, a collection of works can be published after the writer die, therefore, writers in Joseon generally did not exchange their collections of works with others. Writers in Joseon who wanted to interact with literacy men in Qing Dynasty used to organize their collections of works into manuscripts and also published the collections to exchange with them. Therefore, the publication work of books by Lee Sang Juk and Kim Seok Jun can be understood in this context. 19세기의 조선의 역관이었던 이상적(1804-1865)과 김석준(1831-1915)은 조선과 청나라를 오가며 서적 간행 활동에 참여하였던 인물이다. 이상적은 자신의 문집인 『은송당집』과 자신의 아버지인 이정직(1781-1816)의 문집인 『천뢰시고』, 이정주(1778-1853)의 『몽관시고』의 간행에 참여하였다. 김석준은 이언진의 문집인 『송목관집』과 스승 이상적의 문집인 『우선정화록』의 간행에 참여하였다. 또한 김석준은 자신의 시집인 『홍약루회인시록』을 간행하기도 하였다. 이 중에서 『은송당집』, 『천뢰시고』, 『송목관집』은 청나라에서 간행된 책이다. 이들이 청나라에서 문집을 간행할 수 있었던 이유는 청나라 문인들과의 교유가 그 바탕이 되었기 때문이다. 이들은 직접 청나라에 있을 때 문집 간행에 관여하기도 하였으나, 조선에 머물면서도 청나라 문인들과 서신으로 왕래하며 책을 간행할 수 있었다. 이들이 청나라에서 문집을 간행하고자 한 이유도 청나라 문인들과의 교유 때문이었다. 조선이나 청나라 모두 교유할 때 서로에게 선물을 주고받았는데, 청나라는 일반적인 선물 외에 서로의 문집을 주고받기도 하였다. 조선에서는 저작자가 죽은 후에 문집을 간행하였기 때문에 교유할 때 서로의 문집을 주고받지는 않았다. 청나라 문인들과 교유하기를 원했던 문인들은 문집을 원고로 정리하기도 하였고, 직접 간행하여 교유할 때 주고받기도 하였다. 이상적과 김석준의 서적 간행 활동은 이러한 맥락에서 이해할 수 있을 것이다.

췌장담도내시경 의사의 다양성과 수를 증대하기 위한 방안

이윤나 대한췌장담도학회 2023 대한췌담도학회지 Vol.28 No.4