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비정형 향정신병약물을 투여 중인 정신분열병 환자의 주관적 삶의 질 : 정신병리, 약물 부작용 및 약물에 대한 주관적 반응과의 관련성
김종훈,윤정희,이자영,노경희,홍성극,윤세창,강웅구,김용식 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2
Objectives : The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and Subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics. Methods : One hundred and one schizophrenic patients, who were receiving maintenance treatment with atypical antipsychotics, were evaluated. Subjective quality of life was assessed using the standardized Korean modification of a self-rating scale to measure subjective well-being under neuroleptics (KmSWN). Patients' psychopathology was evaluated using the Positive and Negative Syndrome Scale. Adverse effects and subjective response to drug were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale and the Drug Attitude Inventory-10, respectively. Correlation analysis and stepwise multiple regression analysis were conducted. Results : In psychopathology, the severity of depression and anxiety showed the most significant correlation with the score ofKmSWN. In adverse drug effects, the severity of psychic side effect and extrapyramidal side effect showed the most significant correlation with the score ofKmSWN. Regarding subjective response to drug, significant correlation was observed between the severity of subjective negative response and the score of KmSWN. Stepwise multiple regression analysis revealed that psychic side effect, extrapyramidal side effect, and depression contributed significantly to the total score of KmSWN. These variables accounted for 59.7% of the total variance. Conclusion : The results of the present study suggest that psychic side effect, extrapyramidal side effect and depressive symptom are the clinical characteristics that are significantly associated with the subjective quality of life. An effective management strategy for these variables should be established in developing a treatment program to enhance the quality of life of patients with schizophrenia.
Se Hyun Kim,Hong Geun Park,Seong Hoon Jeong,Ung Gu Kang,Yong Min Ahn,Yong Sik Kim 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.7
Objective Electroconvulsive therapy (ECT) is the most effective treatment for mood disorders. Accumulating evidence has suggested the important role of circadian genes in mood disorders. However, the effects of ECT on circadian genes have not been systemically investigated. Methods We examined the expression and daily oscillation of major circadian genes in the rat frontal cortex after electroconvulsive seizure(ECS). Results Firstly, mRNA and protein level were investigated at 24 hr after single ECS (E1X) and repeated ECS treatements for 10 days(E10X), which showed more remarkable changes after E10X than E1X. mRNA expression of Rorα, Bmal1, Clock, Per1, and Cry1 was decreased, while Rev-erbα expression was increased at 24 hr after E10X compared to sham. The proteins showed similar pattern of changes. Next, the effects on oscillation and rhythm properties (mesor, amplitude, and acrophase) were examined, which also showed more prominent changes after E10X than E1X. After E10X, mesor of Rorα, Bmal1, and Cry1 was reduced, and that of Rev-erbα was increased. Five genes, Rev-erbα, Bmal1, Per1, Per2, and Cry2, showed earlier acrophase after E10X. Conclusion The findings suggest that repeated ECS induces reduced expression and phase advance of major circadian genes in the in vivo rat frontal cortex.
The outcome of endoscopic management of bile leakage after hepatobiliary surgery
( Seon Ung Yun ),( Young Koog Cheon ),( Chan Sup Shim ),( Tae Yoon Lee ),( Hyung Min Yu ),( Hyun Ah Chung ),( Se Woong Kwon ),( Taek Gun Jeong ),( Sang Hee An ),( Gyung Won Jeong ),( Ji Wan Kim ) 대한내과학회 2017 The Korean Journal of Internal Medicine Vol.32 No.1
Background/Aims: Despite improvements in surgical techniques and postoperative patient care, bile leakage can occur after hepatobiliary surgery and may lead to serious complications. The aim of this retrospective study was to evaluate the efficacy of endoscopic treatment of bile leakage after hepatobiliary surgery. Methods: The medical records of 20 patients who underwent endoscopic retrograde cholangiopancreatography because of bile leakage after hepatobiliary surgery from August 2009 to September 2014 were reviewed retrospectively. Endoscopic treatment included insertion of an endoscopic retrograde biliary drainage stent after endoscopic sphincterotomy. Results: Most cases of bile leakage presented as percutaneous bile drainage through a Jackson-Pratt bag (75%), followed by abdominal pain (20%). The sites of bile leaks were the cystic duct stump in 10 patients, intrahepatic ducts in five, liver beds in three, common hepatic duct in one, and common bile duct in one. Of the three cases of bile leakage combined with bile duct stricture, one patient had severe bile duct obstruction, and the others had mild strictures. Five cases of bile leakage also exhibited common bile duct stones. Concerning endoscopic modalities, endoscopic therapy for bile leakage was successful in 19 patients (95%). One patient experienced endoscopic failure because of an operation-induced bile duct deformity. One patient developed guidewire-induced microperforation during cannulation, which recovered with conservative treatment. One patient developed recurrent bile leakage, which required additional biliary stenting with sphincter-otomy. Conclusions: The endoscopic approach should be considered a first-line modality for the diagnosis and treatment of bile leakage after hepatobiliary surgery.
이세환(Se-Hwan Lee),이대은(Dae-Oen Lee),박근수(Keun-Soo Park),전호찬(Ho-Chan Jeon),김성태(Seong-Tae Kim),박정웅(Jeong-Ung Park) 대한용접·접합학회 2020 대한용접·접합학회지 Vol.38 No.6
Deformation that occurs during girth welding and seam welding of large-diameter STS304 thin plate structure changes the shape of the structure and affects the manufacturing of the next process. In order to control this deformation, the welding deformation generated during girth and seam laser welding was controlled by generating the relationship between the neutral axis and the welding position and initial tensile stress by the tensile force method. The deformation that occurs during girth welding is caused by angular distortion, and the amount of the deformation is affected by the neutral axis and the position of the weld. By changing the position of the welding part, welding deformation by up to 50% has been reduced. Deformation generated during seam welding caused by angular distortion and longitudinal bending deformation created an initial tensile residual stress in the weld, and the deformation was controlled by minimizing the constraint by welding heat stress generated during welding. At this time, when the magnitude of the initial tensile stress due to the external load increased to 50% of the yield stress of the base metal, the final deformation appeared close to zero.
Choi, Se Yeon,Choi, Byoung Geol,Rha, Seung-Woon,Byun, Jae Kyeong,Shim, Min suk,Li, Hu,Mashaly, Ahmed,Choi, Cheol Ung,Park, Chang Gyu,Seo, Hong Seog,Oh, Dong Joo,Jeong, Myung Ho Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.249 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Diabetes Mellitus (DM) is an important factor of adverse cardiovascular events in acute ST-segment elevation myocardial infarction (STEMI) patients. Renin-angiotensin-aldosterone system (RAAS) inhibitors is associated with improved clinical outcomes, however, there are limited data comparing the effectiveness of two different RAAS inhibitors in STEMI patients with DM undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES).</P> <P><B>Methods</B></P> <P>A total of 3811 eligible STEMI patients with DM were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR). They were stratified into two groups: Angiotensin converting enzyme inhibitors (ACEI) group (n=2691) and angiotensin receptor blockers (ARB) group (n=1120). To adjust baseline confounding factors, we performed propensity score matching (PSM) analysis and evaluated individual and composite major clinical outcomes between the two groups up to 2years.</P> <P><B>Results</B></P> <P>After PSM, a total of 1049 well-matched pairs were generated. Baseline clinical, angiographic and procedural characteristics were well-balanced between the two groups. The incidence of death, recurrent myocardial infarction (MI), revascularization and major adverse cardiac events (MACE) were not significantly different between the two groups up to 2years,</P> <P><B>Conclusion</B></P> <P>In the present study, ACEI and ARB showed comparable effectiveness and safety on individual and composite clinical outcomes in STEMI patients with DM who underwent successful PCI with DES at least up to 2years.</P>