대학생의 노인복지에 대한 인식도

차병준,김무룡,김기열,차경미,김귀희,김현실,서인선,임상규,이순자,위광복,남철현 慶山大學校 保健福祉硏究所 1999 保健福祉硏究 Vol.2 No.-

The purpose of this study is to grasp the change of consciousness of young people in order to seek new approach of policy for aged era. 1,200 students attending collages and universities in three small or medium sized cities were inquired for 2 months, from October 1 to November 30, 1996. The result is as follows. 1. The characteristic of the respondents of this survey is that they include 72.1% of women, 40.4% of people aged between 20 to 21, and 49.1% of people who do not have any religion. Those who are from big cities and those who are form farming villages or fishing village occupy equally 40.2%, those who reside in that cities for a long period 49.0%, and those who live with their family 60.9%. 2. The family feature of the subject is that 31.5% of them are those whose father is the age of 55 and more than 55, 10% of them are those whose mothers age is so, 33.1% of them have 5 family members, 29.5% of them have the family income of 1,000,000 to 1,490,000 won, 83.9% of them are from middle class, 47.7% of them are the people whose grand parents have passed away, 70.4% of them live apart from their grand parents, and 60.9% of them are second child. 3. 64.0% of males, 70% of respondents who are aged over 24, 58.1% of respondents who are from rural communities, 62.4% of respondents who live in rural area, and 58.3% of respondents who live alone, prefer to live with grand parents, marked higher rate than other groups. The groups whose father and mother are the age of more than 55 marked higher rate of 55.9% and 58% each than any other groups(p<0.05). The groups whose family member is less than three, whose grand parents both have passed away in middle class, who live with their grand parents, and who are second children, give more positive answers than any other groups. 4. Those who are older, who are buddhists, who are from rural area or live in rural area, whose family is small, whose family income is small, who are from lower class and whose grand parents are still alive, shows preference to support their parents after marriage. 5. Females(89.4%), those who are from small or medium sized cities(89%), who live with their family(85.6%), whose father is the age of 55 and more than 55, whose mother is the age of 54 and less than 54, whose family member is 6, who are from middle class, whose grandparents are still alive and who are the eldest child in their family, give more response that they prefer to live apart from their children in their old age than any other groups. 6. What elderly people need most right now is past time(42.3%), and the respondents whose age is 20 to 21, who are buddhists, who are from middle sized cities and live alone, whose parents are the age of more than 55, who have small family income, who live with their grand parents and who are second children show higher level than any other groups. 7. 76.8% of respondents answer that they do not need their parent's fortune, marked still higher rate than the opposite answer. Those who are older, who are buddhists, who are from big cities, who reside in rural area, who live alone and have smaller family, who are in bad family economic conditions and who live with grand parents present higher rate of positive response. 8. 59.3% of respondents reply that they think about death from time to time, and those who are female, who are in the age of 20 to 21, who are christian, who live with their family, whose siblings or other family members offer their education expenses show higher rate than any other groups. 9. 92.3% of respondents answer that the budget for welfare facility for elderly people is very small. The younger the respondents are and the worse economic condition they have among those who live in big cities, the more answered that. 10. 50% of respondents think social security should provide for their old age, and 42.8% of them believe they themselves provide against it. The respondence that social security ought provide for it appeared more among those whose age are over 24, who are female, who reside in rural area, who are christian, who are in bad economic condition, and who ever used medical institutions in recent one month, marked higher level than other groups. 11. The adequate time of retirement is 59.97±5.60 for public officers, the highest and 59.28±6.35 for teachers, the next. 12. 35.2% of respondents reply that the adequate budget for the old age after their retirement at the age of 60 is 220 million won, showed the highest level of respondence. 13. The factors which affect on the old people in the charged welfare facilities are sex(p<0.01), the type of housing(p<0.05) and whole family income(p<0.05). 14. The factors which affect on remarriage are sex(p<0.05) and religion(p<0.05). For varying old population and expanded welfare service for them, government and relevant authority should give more attention to secure the budget, establish effective plans to expand various program and the facilities for elderly people in order that elderly people spend the rest of life time more happily and more fruitfully. To do that, each college and university should open Health courses, and educate and inform about health and welfare.

응급실내에서 발생한 폭력의 실태

최웅지,조남수,조수형,김성중,박광철,박진실 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background and Objectives: The objective of this study was to obtain circumstances about violence providers and cause of the violence in emergency room. Materials and Methods: Reports were provided to emergency department doctors, nurses and emergency medical technicians working in Chosun University Hospital Emergency Center during the sixty days from 26 May 2003 to 24 July 2003. Report form consisted of the degree of violence, the reason for the violence, dermographic information about violence providers, outbreak time of violence and response of emergency personnels. Results: SixtyUeight case of violence in the emergency department were reported. Almost all of the violence was due to the male gender and high incidence in third and fourth decade. The violence occured mostly in the night shift. 55.9% of violence was done by patient and 41.2% was done by patient's guardians. The leading cause of violence were alcohol drunken and delay of laboratory test and treatment. Verbal abuse and threats were the most concern form of violence, Conclusion: It is necessary to solve the problems faced in the emergency department not only administrative and financial aid but also regular preventive education and further study.

Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents

Kim, Gwang-Sil,Kim, Byeong-Keuk,Shin, Dong-Ho,Kim, Jung-Sun,Hong, Myeong-Ki,Gwon, Hyeon-Cheol,Kim, Hyo-Soo,Yu, Cheol Woong,Park, Hun Sik,Chae, In-Ho,Rha, Seung-Woon,Jang, Yangsoo Wolters Kluwer Health, Inc. All rights reserved. 2017 Coronary artery disease Vol.28 No.5

<P>Conclusion Clinical parameters such as age, diabetes, and heart failure were independent predictors of the composite of cardiac death, myocardial infarction, and stent thrombosis, whereas angiographic or procedural parameters such as lesion length and number of implanted stents were predictors of target-vessel revascularization. Clinical outcomes after CTO intervention were worse in patients with multiple risk factors. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.</P>

Impact of Angiotensin II Receptor Blockers on Clinical Outcomes after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction Based on Data from the Korean National Health Insurance Database (2005–2014)

Gwang Sil Kim,Young-Guk Ko,Yongsung Suh,Hoyoun Won,Sung-Jin Hong,Chul-Min Ahn,Jung-Sun Kim,Byeong-Keuk Kim,Donghoon Choi,Myeong-Ki Hong,Yangsoo Jang 대한심장학회 2020 Korean Circulation Journal Vol.50 No.11

Background and Objectives: The effectiveness of angiotensin II receptor blockers (ARBs) compared with angiotensin converting enzyme inhibitors (ACEIs) in patients with acute myocardial infarction (AMI) has not been established. We investigated the effects of ARBs on clinical outcomes after percutaneous coronary intervention (PCI) in AMI patients. Methods: Patients receiving ACEIs or ARBs after AMI treated with PCI between January 2005 and December 2014 were selected from the Korean National Health Insurance Service database. The primary endpoint was major cardiovascular adverse event (MACE; all-cause death, myocardial infarct [MI], or stroke). Results: We included patients regularly taking ACEIs (n=22,331) or ARBs (n=28,533) (medication possession ratio ≥80%). Compared with the ACEI group, the ARB group contained more females (31% vs. 18%), were older (mean, 63 vs. 60 years), and had more comorbidities, including hypertension (62.8% vs. 44.8%), diabetes (33.9% vs. 26.4%), congestive heart failure (7.9% vs. 4.3%), chronic obstructive pulmonary disease (25.5% vs. 18.9%), and end-stage renal disease (1.3% vs. 0.4%) (p<0.001 for all). After propensity score–matching, ARBs were associated with a 23% lower risk of MACE (hazard ratio [HR], 0.774; 95% confidence interval [CI], 0.715–0.838; p<0.001) than ACEIs. ARB use was also associated with a significantly reduced risk of death (HR, 0.741; 95% CI, 0.659–0.834; p<0.001), MI (HR, 0.731; 95% CI, 0.638–0.837; p<0.001), and revascularization (HR, 0.816; 95% CI, 0.773–0.861; p<0.001). Conclusions: ARB use was associated with a lower risk of MACE, MI, and revascularization than ACEIs in our retrospective analysis of AMI patients who underwent PCI.

산전진단된 뇌들보무형성증

김광준 ( Gwang Jun Kim ),이은실 ( Eun Sil Lee ),이은주 ( Eun Ju Lee ),한승수 ( Seung Su Han ),이상훈 ( Sang Hoon Lee ),김동호 ( Dong Ho Kim ),이정주 ( Jung Ju Lee ),윤신원 ( Sin Weon Yun ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.12

목적: 산전 초음파검사상 진단된 뇌량무형성증 태아의 임상적 특징을 알아보고자한다. 연구 방법: 1998년 1월부터 2007년 12월까지 22예의 뇌량무형성증 태아를 경험하였으며, 초음파검사결과와 의무기록을 후향적으로 조사하였다. 경복식 초음파 탐촉자와 경질식 탐촉자를 이용하였으며, 삼차원 다면식 (3D multi-slice technique) 방법과 색도플러를 부가적으로 이용하였다. 산전진단은 초음파로 뇌량을 직접 확인함으로 이루어졌다. 결과: 본원에서 뇌량무형성 진단시 평균 재태연령은 26주 (19주-34주)였다. 가장 흔한 초음파 소견은 뇌실확장 (19예) 이었고, 투명사이막공간이 없는 소견이 그 다음으로 18예에서 관찰되었다. 제삼뇌실이 확장되면서 상향 변위된 소견이 15예에서 있었다. 반수의 뇌량무형성증 태아는 산전 초음파검사에서 단독병변으로 여겨졌으나 출생 후 한 명은 심기형이 발견되었고, 또 다른 하나는 Aicardi 증후군이었다. 염색체분석은 14예에서 행해졌으며, 1예의 에드워드 증후군이 발견되었다. 출산 후 최종 확인 과정은 9예에서 가능하였으며, 4명의 생존 출생아는 MRI에 의해서, 5명의 사산아는 부검에 의해서 확인되었다. 임신종결은 9예에서 있었고, 산전 진단 후 경과관찰을 할 수 없었던 경우가 9예였다. 결론: 뇌량무형성의 산전진단은 초음파에 의해 가능하다. 하지만 예후와 직접적인 연관성이 있는 복합기형과 단독발생을 구분하는 것은 쉽지않으며, 따라서 산전 초음파상 단독발생 뇌량무형성으로 진단되어도 상담은 조심스럽게 이루어져야한다. Objective: To report the clinical characteristics of the fetuses with agenesis of corpus callosum (ACC) diagnosed by prenatal ultrasonography. Methods: Between 1998 and 2007, total twenty-two cases of ACC were identified. All cases were diagnosed by the direct evaluation of the corpus callosum using the ultrasonograpy with or without 3D multi-slice technique and color Doppler. Postnatal work-up was done by MRI or autopsy. Results: The median gestational week was 26 weeks (19 to 34 weeks). The most common abnormal ultrasonographic finding was ventriculomegaly, shown in 19 (86.3%) of 22 cases. Absent cavum septum pellucidum and dilated upward displacement of third ventricle were also shown in 18 (81.8%) and 15 (68.2%) of 22 cases, respectively. Postnatal work-up performed in 9 cases (4 live-born babies and 5 still births) additionally confirmed the associated anomalies in three cases including a heart defect, an Aicardi syndrome, and trisomy 18. Conclusion: The analysis of 22 cases presented in this report provides the precise materials to understand ACC. Targeted ultrasonographic evaluation may be helpful for prenatal diagnosis of ACC but has the limitation in differentiation of an isolated ACC from complex defect. To solve this limitation, therefore, the meticulous prenatal work-up and counseling would be needed.

완전 뇌량무형성

김정준 ( Kim Jeong Jun ),신철수 ( Shin Chul Su ),윤창수 ( Yun Chang Su ),김성미 ( Kim Seong Mi ),김창수 ( Kim Chang Su ),배국환 ( Bae Gug Hwan ),한광수 ( Han Gwang Su ),박정실 ( Park Jeong Sil ),주재영 ( Ju Jae Yeong ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.7

The corpus callosum is the main interhemispheric connection in human brain. Agenesis of corpus callosum may partial or complete, and it may have not functional abnormalities. Its prenatal sonographic diagnosis is difficult because of fetal head position, especially in a cephalic presentation. We experienced a case of complete agenesis of corpus callosum. The prenatal sonographic findings was disproportionate dilatation of lateral ventricle, which were suggestive finding of agenesis of corpus callosum or hydrocephalus. We could confirm the diagnosis of complete agenesis of corpus callosum by postnatal MRI.

개방형 신경관결손증 태아에서 두개내징후 발현에 영향을 미치는 인자에 관한 연구

김광준 ( Gwang Jun Kim ),이은실 ( Eun Sil Lee ),김동호 ( Dong Ho Kim ),이상훈 ( Sang Hoon Lee ),박정덕 ( Jung Duck Park ),박미혜 ( Mi Hye Park ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.11

만삭 단태임신의 분만일 예측과 관련된 초음파 인자

김광준 ( Gwang Jun Kim ),이은실 ( Eun Sil Lee ),이우석 ( Woo Seok Lee ),이상훈 ( Sang Hoon Lee ),장영진 ( Young Jin Jang ),김동호 ( Dong Ho Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.7

목적: 본격적인 분만 진통 시작 전에 자궁근육과 자궁경부는 생화학적, 형태적 변화를 겪게 된다. 초음파 검사를 통해 이러한 형태적 변화 양상을 관찰함으로 실제 분만일과 연관된 인자를 찾고, 나아가 분만일의 예측이 가능한 지 알아보고자 하였다. 연구 방법: 재태기간 36주가 지난 단태임신 산모 61명을 대상으로 자연 진통에 따른 질식 분만을 하기까지 매주 초음파 검사를 시행하여 자궁하절부의 두께, 자궁경부의 길이, 자궁경관선의 두께와 양수지수를 측정하여 분만까지 남은 날과의 상관관계를 분석하였다. 대상 산모중 태아 기형이나 양수의 이상, 자궁하절부에 자궁근종이나 하위 태반이 존재하는 경우는 제외하고 52명을 최종 분석대상으로 하였다. 결과: 재태기간에 따라 자궁하절부의 두께, 양수지수, 자궁경부의 길이는 점차 감소하는 경향을 보였지만 통계적 유의성은 없었다. 초음파로 측정한 4가지 분만 연관 요인 중에서 자궁경부 길이가 측정일로부터 분만까지 남은 날을 예측하는데 통계적인 유의성을 보였으며 다음과 같은 수식으로 나타낼 수 있었다. 측정일에서 분만까지 남은 일수=6.12+0.24×자궁경부길이 (㎜) (r=0.29, p<0.01) 결론: 재태기간 36주 이후의 단태임신 산모에서 자궁경부길이의 초음파 측정은 측정일로부터 분만일까지의 남은 일 수와 관련이 있었다. Objective: The aim of this study was to find out the relating factors with the actual delivery day in term singleton pregnancy. Methods: The 52 patients with singleton gestation were visited weekly and measured for their lower uterine segment (LUS) thickness, cervical length and cervical gland thickness by transvaginal ultrasonography and for amnionic fluid index (AFI) by transabdominal ultrasonography from 36 weeks of gestation until birth. Regression analysis was used to find out the relevance between these factors and remaining days to birth. Resullts: There was a significant relationship between cervical length and remaining days to birth in term pregnancy, which could be described as a mathematical equation (remaining days for delivery=6.12+0.24×cervical length (㎜) r=0.29, p<0.01). However, no relationship was found between factors such as LUS, AFI, and cervical gland thickness and remaining days to birth. Conclusion: Our results suggest that the actual delivery day in term singleton pregnancy might be predicted with cervical length.

다발성 정맥 혈전증으로 발견된 루푸스 신염 1예

서지영 ( Ji Young Seo ),김광실 ( Gwang Sil Kim ),김대명 ( Dae Myung Kim ),김선영 ( Sun Young Kim ),유경돈 ( Kyung Don Yoo ),홍진희 ( Jin Hee Hong ),주혜원 ( Hye Won Joo ),조영미 ( Yong Mee Cho ),김상현 ( Sang Hyun Kim ),박원도 ( W 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5

Kidney involvement in systemic lupus erythematosus (SLE) is common. The incidence of venous thrombosis in SLE ranges from 5-15%, and venous thrombosis in lupus nephritis associated with nephritic syndrome or antiphospholipid antibody syndrome is reported in 30-35%. Lupus nephritis with nephrotic syndrome is not infrequently encountered at the point of diagnosis of SLE, but venous thrombosis as the first manifestation of SLE is rare. Herein we present our clinical experience with a case of multiple venous thrombosis with nephrotic-range proteinuria as the first manifestation of lupus nephritis.

일측신 절제 쥐에서 급성 Cyclosporine A 신독성에 관한 비타민 C와 E의 예방적 효과

김용진,박용훈,박종민,이은실,최광해 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.5

Purpose: It has been reported that there is close association between cyclsoporine nephrotoxicity and lipid peroxidation. This study was performed to evaluate the protective effects of vitamin C and E as oxygen free radical scavenger. Method: Sprague Dawley male rates were divided into 3 groups: Group I(the control group), group II(injection of only CsA 50mg/kg of day intraperitoneally), and group III(CsA 50mg/kg of day intraperitoneally with vitamin E 10mg/kg of day and vitamin C 250mg/kg of day intramuscularly). The all of Sprague Dawley male rats were heminephrectomized at seven days prior to injection of CsA for nephrotoxicity more effectively. On the 6th day of the experiment, all rats were placed in a metabolic cage to collect urine samples to measure 24-hours urine creatinine, α-glutathione transferase. On the 7th day upon sacrifice of the experimental animals, blood sampling for measurement of blood CsA level and serum creatinine and nephrectomy for morphological study and malondialdehyde obtained frm fractionation of the mitochondria were performed. Results: Final creatinine clearance of group I and III was not significantly decreased compared to initial creatinine clearance, but creatinine clearance of group II was significantly decreased(initial vs final: 2.15±1.24 vs 0.55±0.42mL/min/100g p$lt;0.05). Urine α-glutathione transferase and renal cortical malondialdehyde of group II were significantly increased compared to group I but in group III, there were no significant increasement in comparison with group I. Histological change, CsA induced nephrotoxicity, characterized by the presence of a large number of lysosomes and derangement of mitochondria in the tubular epithelium but this change was diminished by administration of vitamin C and E. Conclusions: The result of this study provide the evidence that CsA induced nephrotoxicity is associated with lipid peroxidation. Based on this finding, we proposed that vitamin C and E, oxygen radical scavenger, may be effective in attenuating CsA induced nephrotcity in this setting.