췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

지속형 항응고성 살서제 중독에 기인한 뇌실질출형 1예

양충용,이진훈,이서울,정복희,노상균,신용일 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

저자들은 brodifacoum성분의 지속형 효과를 갖은 항응고제인 쿠마린계 살서제를 정확한 용량을 추정할 수는 없지만 다회의 약물 복용 17일 후 뇌실질출혈이 발생한 증례를 문헌 고찰과 함께 보고하는 바이다. 지금껏 쿠마린계의 지속형 항응고성 살서제의 약물 중독이 알려져 있다. 이러한 약물은 vitamin K₁ 2,3-epoxide 환원효소를 억제하여 vitamin K₁과 연속적으로 vitamin K₁ 의존성 응고인자 Ⅱ, Ⅶ, Ⅸ, Ⅹ의 합성을 억제하고 이로써 출혈 경향을 증가시킨다. 이 증례를 토대로 향후 출혈성 환자 특히 선행 질환이 없는 젊은 뇌실질출혈 환자에서 원인을 감별진단 함에 있어 환자의 약물 중독 가능성과 치료에 대한세심한 주의가 필요할 것으로 생각한다. Spontaneous intracerebral hemorrhage is one-tenth of all strokes and represents relatively high frequency and morbidity. Hypertension is the most common cause of spontaneous intracerebral hemorrhage and other causes are vascular malformation, intracerebral amyloid angiopathy, hemorrhagic infarction, blood diseases and drug abuse. Some peoples have the intoxication of drug such as long-acting anticoagulant of rodenticides, family of cumarin, that inhibit vitamin K₁ 2,3-epoxide reductase, the synthesis of vitamin K₁ and subsequently vitamin K₁ dependent clotting factors Ⅱ, Ⅶ, Ⅸ, and Ⅹ. Finally these make prolonged PT, INR and aPTT, which are prone to trigger bleeding tendency. We report a rare case of intracerebral hemorrhage maybe caused by after frequent intended ingestion of long-acting anticoagulant rodenticide(brodifacoum) for suicide.

여성 요실금에서 Kontinence™와 Compact Elite™의 치료효과 비교

양상국,정상원,오미희,노용수,김홍섭,우응제,박승훈,이수열 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

Biofeedback and pelvic floor electrical stimulation are new modalities that have been advocated for the treatment of female urinary incontinence. The aim of this study was to compare prospectively the therapeutic effect of Kontinence™(HMT Co., Korea) with Compact Elite™(ECL Co., France) in female urinary incontinence. All patients were evaluated with a complete history, physical examination, urinalysis, urine culture and urodynamic study. Eighteen patients were treated with Compact Elite™, and thirteen patients with Kontinence™. Enrolled patients had completed 8 office sessions consisting of biofeedback and intravaginal electrical stimulation according to the program of each machines. Overall treatment response was graded by patients on a scale of complete cure to aggravation. At two weeks after last session, overall improvement rate was 78% in Compact Elite™group and 92% in Kontinence™group(p>0.05). Overall patients' acceptability during treatment course was greater than 80% in both machines(p>0.05). There were no unexpected clinical findings during Kontinence™ treatment. After Kontinence™treatment, there were no laboratory changes including electrocardiography, complete blood count, liver function profile, and chest PA. These results showed that the biofeedback and electrical stimulation with Kontinence™was safe and moderately effective for female urinary incontinence comparable to Compact Elite™. However, long-term results of a larger patients are needed to ensure the therapeutic effect of Kontinence™.

경계선 검출 알고리듬의 검출 성능 평가를 위한 정량적인 측정 방법

양희성,김유호,이준호 成均館大學校 科學技術硏究所 2000 論文集 Vol.51 No.1

This research features a method that quantitatively evaluates the performance of edge detection algorithms. Contrary to conventional methods that evaluate the performance of edge detection as a function of the amount of noise added to the input image, the proposed method is capable of assessing the performance of edge detection algoritms based on chosen parameters that influence the performance of edge detection. We have proposed a quantative measure, called average performance index, that compares the average performance of different edge detection algorithms. We have applied the method to the commonly used edge detectors, Sobel, LOG(Laplacian of Gaussian), and Canny edge detectors for images that contain. straight line edges and curved line edges. Experimental results show that our method of quantitatively evaluating the performance of edge detection algorithms can facilitate the selection of the optimal edge detection algorithm for a given task.

불소가 유리되는 교정용 전색제가 법랑질 탈회에 미치는 영향에 관한 실험적 연구

양희상,김광원,윤영주 대한치과교정학회 1999 대한치과교정학회지 Vol.29 No.5

본 연구는 불소가 유리되는 교정용 전색제의 법랑질 탈회에 대한 효과를 미세경도법을 통해 실험적으로 규명하기 위해 112개의 치아를 7개의 군으로 나누어 실험편을 제작한 뒤, 4개의 군에 광중합형(L1군, L2군) 및 자가 중합형(S1군, S2군) 교정용 전색제인 FluoroBond를 실험편에 도포하고 인공우식용액하에서 실험적으로 처리 완료된 실험편에 Knoop indenter를 부착한 Tukon microhardness tester를 이용해 미세경도를 측정하였고, 이를 KHN(Knoop hardness number)으로 환산하고 조직의 변성 여부를 검색하여 다음과 같은 결과를 얻었다. 1. 법랑질 깊이에 따른 미세경도는 모든 군의 50㎛ 깊이에서 최소였고, 200㎛에서 최고인 L2군을 제외한 모든 군의 300㎛깊이에서 최고의 수치를 보였으며, L2, S2군을 제외한 모든군에서 법랑질 깊이가 증가됨에 따라 미세경도치도 증가되었다. 2. 광중합형 및 자가중합형 교정용 전색제 군 모두 어느정도 치아우식에 저항하는 예방효과를 가지고 있었으나 통계학적인 유의성은 없었다(p>0.05). 3. 광중합형 교정용 전색제는 법랑질 깊이 100㎛, 150㎛, 200㎛에서 치아우식 진행 억제효과가 있었다.(p<0.05). 4. 자가중합형 교정용 전색제는 법랑질 깊이 150㎛에서 치아우식 진행 억제효과가 있었다.(p<0.05). 5. 광중합형 교정용 전색제군과 자가중합형 교정용 전색제 군 사이의 법랑질 탈회 억제효과의 차이는 없었다(p>0.05). The purpose of this study was to evaluate the effects of fluoride releasing orthodontic sealants, light-cured(Group L1&L2) and self-cured (Group S1&S2) FluoroBond, on enamel microhardness under artificial carious solution in vitro.112 extracted human premolar teeth were collected for experiments and divided into seven groups. A Tukon microhardness tester equipped with a Knoop diamond indenter was employed to determine microhardness. Tukon 23 program converted the number of microhardness into KHN(Knoop hardness number). The results were as follows: 1. The microhardness of enamel depth of all groups were the least at the depth of 50㎛ and that of all groups except L2 group, the greatest at the depth of 200㎛, were the greatest at the depth of 300㎛. And as the enamel depth of all groups except L2 and S2 group increased, the microhardness value also increased. 2. There was a little preventive effect in enamel decalcification both light- and self-cured orthodontic sealant groups, but had no statistical significance between the groups(p>0.05). 3. Light-cured orthodontic sealant groups had a progressive inhibiting effect in enamel decalcification at the depth of 100㎛, 150㎛, and 200㎛ (p<0.05). 4. Self-cured orthodontic sealant groups had a progressive inhibiting effect in enamel decalcification at the depth of 150㎛ (p<0.05). 5. There was no difference of the anti-enamel demineralization effect between light- and self-cured orthodontic sealant groups (p>0.05).

광주시 특화거리의 자생력 강화 방안 : 예술의 거리를 중심으로

양상욱,장희천 호남대학교 2008 학술논문집 Vol.29 No.2

This thesis investigated details like followings to draw up plans centering around 'Street Of Art' which one of four specialized streets was indicated in existing plan. The aim of this thesis is securing of autogenous power in the future through present condition and problem. (1) Containing comprehensive approach (2) Incremental Approach (3) Community Driven (4) Under public-private effort (5) Build on Existing Assets (6) Can make positive change in the future (7) Implementation Oriented

직류철도급전계통에서의 고장판단 및 고장점표정

梁彦泌,姜相熙 明知大學校 産業技術硏究所 2003 産業技術硏究所論文集 Vol.22 No.-

Abstract - The load starting current increases step by step so the time constant of each step is so smaller than that of fault current. The first aim of the present paper is to detect a fault with a time constant using least squared method. If a fault occurs on the DC railway system it is important to find a fault location to repair the faulted system as soon as possible. The second aim of the present paper is to locate the position of the fault using Kirchhoff's voltage law.