18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

Clinical Characteristics and Antimicrobial Susceptibility of Elderly Women with Acute Pyelonephritis

Ji Kang Yun,김웅빈,이상욱,Kwang Woo Lee,Jun Mo Kim,Young Ho Kim 대한요로생식기감염학회 2020 Urogenital Tract Infection Vol.15 No.3

Purpose: Acute pyelonephritis in older patients can lead to a poorer treatment response and prognosis. The objective of this study was to classify older female patients with acute pyelonephritis according to age and compare their clinical characteristics and antibiotic susceptibility. Materials and Methods: In this retrospective study, 360 patients aged 65 years or older and hospitalized for acute pyelonephritis in a single tertiary medical facility from 2012 to 2016 were selected as research subjects. The patients were divided into three groups according to their age. Their clinical symptoms, blood tests and urinalysis, underlying diseases, causative organisms for urinary tract infections (UTIs), and antibiotic susceptibility were compared. Results: One hundred and seventy-six patients aged 69.9±2.7 years, 142 patients aged 79.4±3.1 years, and 42 patients aged 87.3±3.1 years were assigned into the young-old, old-old, and oldest-old groups, respectively. The duration of hospitalization and fever due to acute pyelonephritis increased with age. On the other hand, the maximum body temperature was similar among the three groups. In blood tests, erythrocyte sedimentation rate and C-reactive protein increased with age. Among the underlying diseases, the incidence of diabetes and chronic renal disease was similar among the three groups, while cerebrovascular diseases, heart failure, and urinary stones were associated with aging. Older patients were more likely to have UTIs over the past year. Older groups showed a more significant decrease in sensitivity to carbapenems, amikacin, and ciprofloxacin. Conclusions: Choosing appropriate antibiotics, considering the patientʼs age, is important when treating acute pyelonephritis.

태양인(太陰人) 청혈강기탕(淸血降氣湯) 투여 후 호전된 시멘트 접촉 만성 피부염 환자 치험 1례

강기완,김민지,강세영,Kang, Ki-wan,Kim, Min-ji,Kang, Sei-young 대한한방내과학회 2015 大韓韓方內科學會誌 Vol.36 No.1

Objectives : The purpose of this report is to investigate the effect of Taeeumin Cheonghyeolgangki-tang on chronic contact dermatitis caused by cement. Methods : A 52-year-old male patient was diagnosed with contact dermatitis with the Questionnaire for Sasang Constitutional Classification-II (QSCC-II) as well as the four methods of diagnosis (四診), and treated with Taeeumin Cheonghyeolgangki-tang (qīngxuèjiàngqí-tāng). We observed redness and scaling on both palms, and recorded photographs of any changes during the inpatient and outpatient treatment period. Results : The symptoms of contact dermatitis on both palms were significantly improved. Scaling and cracked skin disappeared and the redness almost resolved. Conclusions : Therefore, Taeeumin Cheonghyeolgangki-tang ( qīngxuèjiàngqí-tāng ) is effective on chronic contact dermatitis caused by cement.

Biomass 유래 퓨란계 단량체를 이용한 폴리에스터의 중합 및 특성 연구

정용석(Yong Seong Chung),이영철(Young Chul Lee),서강진(Kang Jin Seo),김명준(Myeong Jun Kim),정지혜(Ji Hea Jeong),노시태(Si Tae Noh) 한국고분자학회 2011 폴리머 Vol.35 No.6

바이오매스에서 유래된 2,5-dihydroxymethylfuran(DHMF)을 KMnO4 산화반응으로 furan-2,5- dicarboxylic acid(FDCA)를 합성하였다. 합성한 FDCA와 다이올류를 에스테르화 반응과 축중합 반응을 진행시 켜 폴리에스터를 중합하였다. 폴리에스터는 NMR을 통해 조성을 분석하였고 DSC와 TGA를 통해 열적특성을 분 석하였다. 합성된 폴리에스터의 고유점도는 0.78∼1.2 dL/g으로 상용화된 poly(ethylene terephthalate)(PET) 와 비슷하였다. 다이올의 길이가 증가할수록 Young`s modulus와 strength는 낮아지고 elongation-to-break는 높아지는 경향을 확인하였다. 합성한 poly(ethylene furandicarboxylate)(PEF)의 Young`s modulus는 3551 MPa, strength는 103 MPa로 상용화된 PET와 비슷하였다. Furan-2,5-dicarboxylic acid (FDCA) was synthesized by KMnO4 oxidation of 2,5-dihydroxymethylfuran( DHMF) derived from biomass. Polyesters were synthesized by esterification and polycondensation of FDCA with various diols(ethane-1,2-diol, propane-1,3-diol, butane-1,4-diol, hexane- 1,6-diol, decane-1,10-diol). The composition of polyesters was characterized by using 1H NMR. Thermal properties of the polyesters were characterized by DSC and TGA. Intrinsic viscosities(IV) of the polyesters were measured to be 0.78∼1.2 dL/g comparable with IV of commercial poly(ethylene terephthalate)(PET). As the chain lengths of diols increased, Young`s modulus and strength decreased and elongation-to-break generally increased. Young`s modulus and strength of the polyesters were measured to be 3551 MPa and 103 MPa, respectively, comparable with commercial PET.

봉산탈춤 학습이 신체적 자기개념에 미치는 영향

송지영,이강순 한국문화교육학회 2008 문화예술교육연구 Vol.3 No.1

본 연구는 봉산탈춤 학습이 신체적 자기개념에 미치는 영향을 알아보는 데 목적을 두고 초등학교 4학년 학생들로 구성된 실험집단에 봉산탈춤 프로그램을 차시별로 적용하였고, 통제집단은 정규체육수업을 실시하였다. 본 연구 결과는 다음과 같다. 첫째, 신체적 자기개념의 심리적인 요인(봉산탈춤 유능감, 자기 존중감)에서 봉산탈춤 유능감과 자기 존중감 요인 모두 실험집단과 통제집단 간 차이가 나타났다. 둘째, 신체적 자기개념의 외적인 요인(체지방, 외모, 건강)에서 체지방, 외모, 건강 요인 모두 실험집단과 통제집단 간 차이가 나타났다. 셋째, 신체적 자기개념의 체력적인 요인(유연성, 지구력, 근력)에서는 유연성 요인에서 실험집단과 통제집단 간 차이가 나타났다. 넷째, 신체적 자기개념의 활동적인 요인(신체활동, 신체전반)에서는 신체활동과 신체전반 요인 모두 실험집단과 통제집단 간 차이가 나타났다. This study aims to examine the effects of Bongsan Mask Dance on elementary students' physical self-concept, focused on explaining the relation between Bongsan Mask Dance learning and physical self-concept. For this purpose, the data was collected from 74 male and female 4th-graders at G Elementary School in Incheon Metropolitan City and conducted a pretest and a posttest using a questionnaire with proved reliability and validity. The Bongsan Mask Dance learning program was applied to the experimental group for 6 weeks from September to October, 2007, 2 sessions per week and a total of 12 sessions, and 40 minutes per session. The control group had regular physical education classes with their class teacher while the experimental group was participating in the program. After the experiment, a posttest was performed. According to the results, the mean scores of the pretest was not significantly different between the experimental group and the control group(p<.05), which shows that the two groups were homogeneous. In the mean scores of the posttest, the experimental group and the control group were significantly different in 8 sub-factors of physical self-concept such as Bongsan Mask Dance competency, body fat/ slenderness, appearance, health, physical activity, self-esteem, flexibility and overall physical condition(p<.05). but were not significantly different in muscular strength and endurance.

수행 평가 도구를 이용한 심화·보충형 수준별 교수 전략 개발 : 과학 3의 물질의 구성 Composition of Matter Section in Science 3

강순희,김지영,박은미,이윤하 이화여자대학교 사범대학 교과교육연구소 2005 교과교육학연구 Vol.9 No.2

제7차 교육 과정의 과학 교과에 대한 심화·보충형 수준별 수업 전략을 개발하여 현장 과학 교사들에게 구체적인 도움을 주고자 하는 것이 본 연구의 목적이다. 수업 운영 형태는 동일 학급 내 교과 수준별 분단 편성이며, 연구된 구체적인 단원은 중학교 과학 3의 ‘물질의 구성’ 단원으로 총 17차시가 소요된다. 먼저 현실적으로 중등 과학 교육 현장에서 실현 가능한 과학과 수준별 교육 과정에 관련된 이론적 배경을 고찰하였다. 둘째, ‘물질의 구성’ 단원에 대하여 차시 수업의 목표로 사용 가능한 구체적인 성취 기준을 지식, 탐구, 태도 영역으로 개발하였다. 셋째, 앞에서 개발한 성취 수준의 도달 정도를 판별하는 평가 기준을 개발하고, 이 성취 수준과 평가 기준을 토대로 하여 동일 학급 내 과학 교과 수준별 분단 편성을 위한 진단 평가 도구들을 개발하였다. 넷째, 이 진단 평가 도구에 의하여 학생들을 수준별 소집단 분단으로 분류하는 구체적인 방법을 제시하였다. 마지막으로, 각 동일 학급 내 수준별 분단에 사용할 수 있는 보충 활동지를 개발하였으며 사용하는 방법을 제시하였다. The purpose of this study is to development of instructional strategy for differentiated curricular by enrichment and supplementary instructions about junior high school science under the 7th National Curricular Revision. The ability grouping for differentiated curricular in this study was within class ability grouping in same year. The composition of matter in junior high school science 3 was selected for this study and analyzed to develope the detailed achievement standards and assessment standards of school class level for science teacher. Based on those detailed achievement standards and assessment standards of school class level, the concept clusters of the composition of matter section was classified. The diagnostic evaluation which was the performance assessment tools according to the concept clusters was developed to classify for enrichment and supplementary groups. Also the method of classification about enrichment and supplementary groups in science class was suggested in details. Finally, teaching and learning materials for supplementary groups according to the concept clusters were developed about the composition of matter section in science 3 at junior high school.

Cone-beam CT로부터 제작된 측모 두부계측방사선사진의 정확도 평가

강지영,임성훈,김광원 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.6

최근 computed tomography (CT) 데이터로부터 실제 두부계측방사선사진 촬영기에서 촬영한 사진과 동일한 확대율을 갖는 두부계측방사선사진을 형성할 수 있는 기능을 갖춘 소프트웨어 (Accurex, CyberMed, Seoul, Korea)가 소개되었다. 이에 본 연구에서는 cone-beam CT (이하 CBCT) 데이터로부터 이 소프트웨어를 이용하여 제작된 측모두부계측방사선사진과 기존의 두부계측방사선사진촬영기로 촬영된 측모 두부계측방사선사진에서 각각 두부계측방사선사진 분석을 시행하여 그 차이를 비교함으로써 소프트웨어를 통해 CBCT로부터 제작된 측모 두부계측방사선사진의 활용 가능성을 평가하고자 하였다. 20명의 교정 환자를 대상으로 CBCT와 측모 두부계측방사선사진을 동시에 촬영하였다. CBCT로부터 제작된 측모 두부계측방사선사진과 기존 방식의 측모 두부계측방사선사진에서 두부계측방사선사진 분석을 시행한 후 두 사진의 계측치의 차이를 paired t-test로 검정하였다. 23개의 계측치들 중, 20개 항목에서는 통계학적으로 유의한 차이가 관찰되지 않았으나, U1-FH, Mx6 to PTV, Maxillomandibular difference의 항목에서는 유의한 차이가 나타났다. 이러한 차이는 CBCT로부터 형성된 측모 두부계측방사선사진의 해상도가 낮아 일부 해부학적 지표를 확인하기 어렵기 때문이며, 임상에서 CBCT로부터 제작된 측모 두부계측방사선사진을 porion, PTV, condylion과 같은 일부 해부학적 지표를 이용하지 않는 SNA, SNB, U1 to SN, IMPA, interincisal angle 등 흔히 사용되는 간단한 측모 두부계측방사선사진 계측에 활용 가능할 것이다. Objective: Three-dimensional approaches for the diagnosis and analysis of the dentofacial area are becoming more popular in accordance with the development of cone-beam CT (CBCT). The purposes of this study were to evaluate the reliability of cephalometric measurements of lateral cephalograms generated from a CBCT image by making comparisons with the traditional digital lateral cephalogram, and to evaluate the possibility of the clinical application of CBCT generated cephalogram images. Methods: Twenty patients whose external auditory meatus could be identified in the CBCT image were selected, and both CBCT and digital cephalograms were taken. Differences between the measurements of both cephalograms were tested by paired t-test. Results: Among the 22 measurements used, only U1-FH, Mx6 to PTV, and maxillomandibular difference showed statistically significant differences between the CBCT generated cephalogram and the digital cephalogram. Conclusions: The results suggest that the CBCT generated cephalogram can be used for some cephalometric measurements not requiring porion, PTV, condylion as a landmark (SNA, SNB, U1 to SN, IMPA, interincisal angle, etc.).

광범위 베타 락탐계 항생제 분해 효소를 생성하는 폐렴간균에 의한 균혈증이 발생한 환자에서 감영의 위험 인자 및 치료 결과

강철인,김성한,방지환,김홍빈,박상원,최영주,오명돈,김의종,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2

목적 : 본 연구는 ESBL을 생성하는 K. pneumoniae에 의한 균혈증 환자에서 감염의 위험 인자 및 치료 결과를 알아보고자 시행하였다. 방법 : 1998년 1월부터 2002년 4월까지 혈액 배양 검사에서 동정된 K. pneumoniae를 대상으로 NCCLS guidelines과 이중 디스크 확산법(double-disk diffusion test)을 이용하여 ESBL 생성 여부를 확인하였다. ESBL 생성 균주에 의한 균혈증 환자 60명(환자군)에 대해 ESBL을 생성하지 않는 균주에 의한 균혈증 환자들(대조군)을 연령, 성별, 균혈증 발생 시점을 고려하여 1:2 또는 1:3으로 배정하였다. 총 159명의 대조군을 선정하였고 후향적인 환자-대조군 연구를 시행하였다. 결과 : 환자군과 대조군 사이에 연령, 성별, APACHE Ⅱ score, 주된 감염 부위의 유의한 차이는 없었다. ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 발생할 독립적인 위험 인자에는 요관 삽입, 균혈증 발생 이전 72시간 동안 침습적인 시술을 받은 경우, 균혈증 발생 이전 30일 동안 투여받은 항생제 개수가 있었다. 초기 항생제 치료 72시간 후의 반응을 평가하였을 때, 완전 반응(complete response)은 대조군에서 더 많았고(13.3% vs. 40.3%, P<0.001), 치료 실패(treatment failure)는 환자군에서 더 많았다(33.3% vs. 11.9%, P<0.001). 7일 사망률은 환자군에서 20% (12/60), 대조군에서 15.6% (25/159)이었고(P=0.451), 30일 사망률은 환자군에서 30% (18/60), 대조군에서 24.5% (39/159)이었다(P=0.410). ESBL 생성 균주에 의한 균혈증이 있는 환자들에서 최종 항생제 치료가 부적절했던 환자들을 제외하고 30일 사망률을 분석하였을 때 효과적인 항생제 치료의 지연은 사망률을 높이지 않았다(11.1% vs. 9.1%, P=1.000). 결론 : ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 있는 환자에서 초기 항균제 치료 72시간 후의 치료 반응률은 낮지만 사망률은 유의하게 증가하지 않았다. 원인균이 동정된 후 최종 치료 항생제의 선정이 적절하다면 초기에 효과적인 항생제 투여의 지연은 사망률을 유의하게 증가시키지는 않았다. Background : This study was conducted to evaluate risk factors for infection and treatment outcome of bloodstream infection due to extended spectrum β-lactamases(ESBL)-producing K. pneumoniae. Methods: ESBL production was evaluated by NCCLS guidelines and/or double-disk synergy test in K. pneumoniae blood isolates stored from January, 1998 to April, 2002. Sixty patients with bloodstream infection due to ESBL-producing K. pneumoniae (case patients) were compared with 159 matched control patients with bloodstream infection of non-ESBL-producing K. pneumoniae. Retrospective case-control study was performed. Results : There were no significant differences in age, sex, APACHE Ⅱ score, and the primary site of infection between the case and control groups. In multivariate analysis, significant independent risk factors associated with bloodstream infection due to ESBL-producing K. pneumoniae were urinary catheterization, invasive procedure within previous 72 hours, and the number of antibiotics administered within previous 30 days. In clinical response at 72 hours after initial antibiotic treatment, complete response rate was higher in the controls (13.3% vs. 40.3%, respectively, P<0.001), however, treatment failure rate was higher in the cases (33.3% vs. 11.9%, respectively, P<0.001). Overall 7-day mortality rates in the cases and the controls were was 20% (12/60) and 15.7% (25/159) (P=0.451), respectively, and overall 30-day mortality rates were 30% (18/60) and 24.5% (39/159), respectively (P=0.410). When the patients with bloodstream infection of ESBL-producing organism were evaluated and the patients who received inadequate definitive antibiotic treatment were excluded, delayed effective antibiotic treatment was found to be not associated with higher mortality. Conclusion : In patients infected with ESBL-producing K. pneumoniae bacteremia, clinical response rate at 72 hours after antimicrobial therapy was lower, but the increase of mortality rate was not significant. Delayed effective antibiotic treatment was not associated with higher mortality, when definitive appropriate antibiotic treatment was prescribed.

개성ㆍ동조 추구자의 디자인 선호도와 자아실현과의 상관성 연구

姜京子,林志英 복식문화학회 2000 服飾文化硏究 Vol.8 No.3

In this study female college students having high interest in fashion were selected by homogeneous purposive sampling. The students were classified into two groups. 301 Students living in Chinju were asked on self-actualization and design preference. The date of respondents were analyzed by Pearson's correlation coefficients and t-test. The results of this study can be summarized as follows. 1. The line preference, chroma, thickness and weight of clothing textile were different in these two groups. 2. The students of individuality had self-actualization, feeling reactivity, self-regard, existentiality and capacity of intimate contact. 3. There were significant relation between self-actualization and the preference for clothing from, color and texture in two groups.