Case Report : Improved severe hepatopulmonary syndrome after Liver transplantation in an adolescent with end-stage Liver disease secondary to biliary atresia

( Tae Jun Park ),( Keun Soo Ahn ),( Yong Hoon Kim ),( Hyungseop Kim ),( Ui Jun Park ),( Hyoung Tae Kim ),( Won Hyun Cho1 ),( Woo Hyun Park ),( Koo Jeong Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

Hepatopulmonary syndrome (HPS) is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT) is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient with typical findings of an extracardiac pulmonary arteriovenous shunt on contrast-enhanced transesophageal echocardiography (TEE), and clubbing fingers, who had complete correction of HPS by deceased donor LT. The patient was a 16-year-old female who was born with biliary atresia and underwent porto-enterostomy on the 55th day after birth. She had been suffered from progressive liver failure with dyspnea, clubbing fingers, and cyanosis. Preoperative arterial blood gas analysis revealed severe hypoxia (arterial O2 tension of 54.5 mmHg and O2 saturation of 84.2%). Contrast-enhanced TEE revealed an extracardiac right-to-left shunt, which suggested an intrapulmonary arteriovenous shunt. The patient recovered successfully after LT, not only with respect to physical parameters but also for pychosocial activity, including school performance, during the 30-month follow-up period. (Clin Mol Hepatol 2014;20:76-80)

정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

안면경련의 침구치료에 대한 문헌적 고찰

조현석,장준혁,김경호,윤종화,김갑성 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.7 No.2

편측 안면경련은 편측 안면근의 불수의적, 간헐적 수축으로서 심할 경우 안면 근력 약화 및 강직현상등이 나타나기도 하는 질환이다. 서양의학에서 편측 안면경련의 병태생리에 대한 가설은 크게 두가지로 대별되는데, 첫째는 중추성 가설(핵가설)이고, 둘째는 말초성가설이다. 치료방법은 대별하여 내과적 치료와 외과적 치료의 나눌 수 있는데, 외과적 치료가 다양하게 시행되어 왔으며, 근래에는 두개강내 미세혈관 감압술이 시행되고 있다. 韓醫學에서는 眼瞼痙攣울 眼胞振跳, 胞輪振跳라고 하고, 眼眉跳라고도 하며, 그 외 目瞬, 目跳, 眼皮跳 등의 이름으로도 불리운다. 外因으로는 風邪가 經絡에 侵入하는 것이며, 內因으로는 肝血虛한 中의 風邪가 兼하기 때문이다 따라서, 국부경혈 자침과 함께 장부변증에 따라 肝, 膽經 경혈의 사용과 합께 耳鍼T의 시술이 유용할 것으로 사료된다. Hemifacial spasm including blepharospasm is characterized by spontaneous clonic and tonic muscle spasm on one side of the face with synkinesis. Though the etiology of hemifacial spasm is not entirely understood, generally there are two. One is nuclear hypothesis and the other is peripheral hypothesis. There are two ways of treatment of hemifacial spasm. One is internal medicine and the other is operative method. In oriental medicine, hemifacial spasm is very similar to diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), or Anmido(眼眉跳) in symptoms. The diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), Anmido(眼眉跳) is related to the function of liver(肝) and risk factors are regarded as Pung(風). The acupuncture therapy of hemifacial spasm is based on Liver meridian(LV), Gallbladder meridian(GB), And ear-acupuncture is recommended as a good method for hemifacial spasm.

구강암 환자에 대한 임상통계학적 분석

조준현,김진수 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

돼지생식기호흡기 증후군(PRRS) 바이러스 감염시킨 돼지 기관의 병리학적 관찰

조성환,김현수,윤원기,전무형,류시윤,박배근,손화영,김무강 충남대학교 수의과대학 동물의과학연구소 1996 動物醫科學硏究誌 Vol.4 No.-

The porcine reproductive and respiratory syndrome virus was inoculated into swine tracheal organ culture. The ballooning degeneration of the tracheal ciliated epithelium and a decrease of ciliary activity from the tracheal organs infected with PRRS virus were observed one day post-infection(PI). Tracheal epithelium showed degeneration and focal necrosis 2 days PI. Epithelial necrosis and loss of cilia and epithelial cells became more severe 3 and 4 days PI. An entire loss of cilia and epithelial cells were recognized 4 days PI, however, control tracheal organs were normal during the period of the experiment except a little decrease of ciliary activities with time..

상 요추 추간판 탈출증의 수술적 치료

조태현,송준혁,김명현,박향권,김성학,신규만,박동빈 梨花女子大學校 醫科大學 醫科學硏究所 2000 EMJ (Ewha medical journal) Vol.23 No.3

Objectives : Lumbar disc herniations at the L1-L2, L2-L3, and L3-L4 level are rare. The purpose of this study is to observe the variable clinical finding of upper lumbar disc herniations and to provide proper treatment modality. Patients and Methods : Between 1998 Jan. and 1999 Dec., seventeen patients with upper lumbar disc herniations who were undergone surgery in our institute were retrospectively evaluated. Patients were evaluated based on following factors : age, sex, aggravating factor, symptoms and signs type of disc herniation, type of surgery, and outcome of post-surgery. Results : The incidence of lumbar disc herniation at the level of L1-2, L2-3 and L3-4 is 6.1% with declining frequency as the level ascends. The peak age incidence is 6th decade in both sex. Preoperative symptomes and signs are variabe. In sixteen cases, posterior approach was done. In these cases, twelve cases were performed microscopic partial hemilaminectomy, and four cases with spinal stenosis were performed total laminectomy and posterior screw fixation with bone fusion. In one case, lateral extracavitary approach was done. In results of operation, fourteen cases showed more than good grade(82%). Conclusion : The age incidence of lumbar disc herniations at the level of L1-2, L2-3 and L3-4 older than lumbar disc herniations at the lower level of L4-5 and L5-S1. The signs and symptoms are variable. In our cases, most of the patients were performed posterior approach with microscopic partial hemilaminectomy except the patients combined spinal stenosis. One case was performed a lateral extracavitary approach because the risk of the cord and cauda equina injuries. The prognosis of upper lumbar disc herniations after treatment with only microscopic partial hemilaminectomy and diskectomy is comparable with the prognosis of lumbar disc herniations at the lower level.

프로축구 선수들의 포지션별 유산소성 파워능력과 슬관절 등속성 근 기능의 특성

조현철,김준호,강민철,김종규 龍仁大學校 體育科學硏究所 2004 體育科學硏究論叢 Vol.14 No.1

The purpose this study was to investigate the aerobic power and isokinetic muscular function of knee joint for korea the pro-soccer players in field position. Data were obtained from thirty one pro-soccer players. They didn't have any medical problem. They performed exercise stress test and isokinetic muscular function on treadmill and Isomed 2000. The assessment of cardiorespiratory and isokinetic muscular function were VO2max, Maximal heart, ATVO2, AT heart rate, Total Work, Average Work, Maximum Torque, Maximum Work and Flex/Ext. A two-way analysis of variance with repeated measures(two-way(2x4)RM ANOVA) was used to compare group and field position differences aerobic power and isokinetic muscular function. A Tukey post hoc test was used when significant mean differences were observed. Statistical significance was accepted as p<O.05. Aerobic power do not showed any significant difference among in field position. Hamstring muscle power was significantly higher in Forward and Middle field than Defense and Goal keeper. Muscular endurance was higher Defense and Goal keeper than Forward and Middle field. Based on the facts that we have discussed, aerobic and anaerobic power in field position do not showed any difference. However, isokinetic muscular function was significant difference in field position. Ratios of conventional and functional for isokinetic Hamsting: Quadriceps muscle strength in soccer player for prediction and decision injures, it is thought that more researches on it should be required.

Information Technology의 기존 관광산업에 대한 영향 및 향후 Trend에 대한 전망 : 사이버여행사 수익모델을 중심으로 Profit Model of Cyber Travel Agency

조현준,나윤중,임형순,엄서호 한국문화관광학회 2001 문화관광연구 Vol.3 No.1

IT has an influence on the travel agency as chance and threat. The purpose of this study is to find what profit model of cyber travel agency. Ernst&Young's five business profit models that are based on target audience and transaction focus is selected to evaluated existing model of cyber travel agency. Those are off-line facilitator, gateway, context provider, commerce destination, online exchange. The result of this study show that there is no specific profit model in domestic cyber and on-offline travel agencies. Just Portal cyber travel agencies abroad have a few profit model. They have online exchange model, which are various target audience and abound provide contents.

영상처리에 의한 블랭크 가공품의 치수측정을 위한 형상요소 추출법에 관한 연구

조연상,전성재,구현호,박흥식 朝鮮大學校 機械技術硏究所 2005 機械技術硏究 Vol.8 No.1

In the design process of a press product, the reverse engineering is a necessary process. Therefore, the method of measurement must be constructed for a blank shape. In order to measure a blank shape, the vision system with non-distortion ren was constructed, and the image processing, the shape recognition and the element extraction module was made with the Visual C++ language. For the shape recognition, the distance-angle function with a shape characteristics ware used and, for the shape of element extraction, the slop function with a element characteristics was used. In this study, the shape of the rectangular gage block and circular product with a simple shape was recognized and elements in the polygon were extracted by using this system.

[논문]사장교의 케이블 장력 결정

조현준,박용명 釜山大學校生産技術硏究所 2005 生産技術硏究所論文集 Vol.64 No.-

본 연구에서는 사장교의 적절한 초기평형상태 결정을 위하여 최소자승법을 이용한 케이블 장력 결정 방법을 제시하였다. 본 방법은 거더의 케이블 지지점을 지점으로 한 연속보로부터의 처짐 및 모멘트 둥을 목표치로 하고 케이블을 포함한 사장교 전체계 해석으로부터 구해진 응답과의 차이를 오차로 정의하여 거더 및 주탑의 오차를 최소화하는 방법이다. 특히,주탑 모멘트, 거더 모멘트,그리고 처짐의 보정 정도를 가중행렬을 도입하여 선택적으로 조절할 수 있으며, 여러 가지 사장교 형식에 대한 수치예제 및 기존 연구와의 비교를 통하여 본 방법의 효율성 및 타당성을 검증하였다.