다산부에서 자간전증의 임상적 고찰

이주롱,이석민,한효상,이해혁,이임순,이권해 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

목적 : 전자간증 산모에서 초임신부와 다산부 각각의 임상적 특징을 조사하여 비교 분석하고자 하였다. 연구방법 : 1998년 1월부터 1999년 12월까지 2년간 순천향대학 서울병원에서 입원 분만한 임신성 고혈압성 질환 환자중 초임신부 106명과 다산부 50명, 총 150명을 대상으로 임상통계학적으로 조사 분석하였다. 결과 : 분만까지 임신기간의 비교시 초임신부에서는 33-36주에서 17.9%였고 다산부에서는 34.0%로, 다산부에서 조기분만의 예가 의의있게 많았다. 신생아 체중이 2500g 미만인 군이 초임신부군에서는 36.8%였고 다산부군에서는 62.0%로 다산부군에서 더 많았다. 임신성 고혈압성 질환의 중등도를 보면 중증자간전증의 초임신부에서 35.8%와 다산부에서는 44.0%로, 초임신부에 비해 다산부군의 중증 자간전증의 비율이 많았다. 결론 : 중증 임신성 고혈압성 질환이 다산부군에서 더 많았으며 적은 주수에서 제왕절개술을 시행해 출생아의 체중이 초임신부군에 비해 더 작았고 Apgar 점수도 더 낮았다. Objective : To study the clinical differences of primiparous and multiparous preeclamptic patients. Methods : We statistically analyzed 106 primiparous and 50 multiparous preeclamptic patients who were admitted to the Soonchunhyang University Hospital from January 1998 to December 1999. Results : It was statistically found that multiparae were more likely to give premature birth than primiparae: Thirty four percents of multiparae gave birth in the period between the 33rd and the 36th gestational weeks while 17.9% of primiparae did in the same period. Sixty two percents of the newborn babies of multiparae weighed less than 2500g. Among primiparae, the ratio was 36.8%. In addition, more multiparae(44.0% vs. 35.8%) suffered from severe preeclampsia. Conclusion : severe preeclampsia was found more frequently among multiparae. Since they gave birth earlier by cesarian section than primiparae, their babies weighed less and had lower apgar scores.

Genetic Variation and Discrimination of Korean Arkshell Scapharca Species (Bivalvia, Arcoida) Based on Mitochondrial COI Gene Sequences and PCR-RFLP

Lee, Sang Youp,Kim, Sang Hae 한국유전학회 2003 Genes & Genomics Vol.25 No.4

The genetic variation and the molecular discrimination of Scapharca species in Korea were investigated through the mitochondrial DNA sequence analyses. A partial portion (646 bp) of the mitochondrial cytochrome c oxidase subunit I gene (COI) for these species was analyzed by DNA sequencing and restriction fragment length polymorphism (RFLP). A sequence comparison and phylogenetic analysis showed both S. broughtonii and S. satowi formed a sister group, with then S. subcrenata clustered with the clade. It was assumed that all Scapharca species could form a monophyletic clade, with high bootstrap support (99%). In order to effectively discriminate the morphologically hard to classified spats, a PCR-RFLP diagnostic marker was developed with two restriction enzyme (HaeⅢ and HinfI) digestions. Digestion of the 646-bp fragments of the COI gene amplified from each species with HaeⅢ produced no fragment in the S. broughtonii, and two fragments, but of different sizes in S. satowi and S. subcrenata. In the HinfI digestion, two distinct fragments were produced in S. broughtonii and S. subcrenata, but no fragment in S. satowi. Twenty individuals from each population were digested by these two restriction enzymes, but no individual variations occurred.

In Vitro Fertilization and Embryo Cleavage in Canine Oocytes

Hae }ung Kim,Sang Ryeul Lee,Sin Hae Park,Sung Hyun Kim,Bong Soo Kim,Dong Hun Yoo,Sin Hae Park,Mi Jung Shin,Jae Wook Kim,Zae Young Ryoo 한국동물생명공학회(구 한국동물번식학회) 2006 Reproductive & developmental biology Vol.30 No.2

자궁선근증의 고찰

조환성,이해혁,정성윤,김성욱,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: This study was designed to estimate the frequency and risk factor for edenomyosis Methods: The clinical records of 623 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital, during 5 years, from Jan. 1995 to Dec. 1999. Results: The following result were obtained. 1. Adenomyosis was found in 247 of 623 patients(39.6%) 2. The highest incidence was 40-49 years of age group, an incidence of 46.6% and mean age was 44.7 years. 3. Adenomyosis was more frequently observed in parous women than non-parous women, such as 93.1% and 6.9%, respectively. 4. Dysmenorrhea, metrorrhagia, pelvic pain and vaginal bleeding were common symptom of adenomyosis, an incidence of 28.7%, 19.0%, 18.2% and 16.2%, respectively. 5. Myoma was the most combined disease in adenomyosis, showing the incidence of 54.7%. 6. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 61.9%. 7. Preoperative diagnostic accuracy of adenomyosis was 6.9%. Conclusion: The results show that deeply understanding of the common symptoms and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.

난소 및 난소 종양 염전의 초음파 소견

오연희,이현경,이원재,이성우,박수성,윤혜원,임문환,심재철,김용탁,김성숙,김정란 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Acute torsion of the ovary and ovarian mass is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. The sonographic findings in 14 cases of surgically proven torsion of the ovary and ovarian mass are described. Mostly cystic ovarian mass, engorged vessel, dilated uterine tube, beak-like echo(torsion site), smooth mass wall thickening an free-fluid collection in cul-de-sac are described. More significant in terms of specificity were the demonstration in 6 cases(42.9%) of the smooth mass wall thickening and in 8 cases(57.1%) of a free fluid in the cul-de-sac. We report the sonographic findings of ovary and ovarian mass torsion that may suggest the preoperative diagnosis of this condition.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

비외상성 두개내 출혈 환자에서 심근손상의 발생과 예후에 미치는 영향

강구현,황성호,이강현,조준휘,김성환,문중범,박해상,이서영,이성수,김헌주 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Objective: The aim of this study was to investigate the clinical significance of myocardial injuries in patients with nontraumatic intracranial hemorrhage by identifying the occurrence of myocardial injury and defining its correlation with subsequent cardiovascular events. Subjects and methods: One hundred twenty-four patients with nontraumatic intracraninal hemorrhage presented to the emergency department within six hours from onset of symptoms were enrolled. Brain CT, serial electrocardiography, and echocardiography were done at the emergency center. Blood samples for troponin I and creatine kinase(CK)-MB were drawn immediately and eight hours after admission, Troponin I and CK-MB were measured using a chemiluminescent immunoassay, respectively. Results: Electrocardiographic and echocardiography abnormalities were found in 65 cases(52.4%) and 21 cases(17%), respectively. Serum troponin I and creative kinase-MB were increased in 35 cases (28.2%) and in 58 cases(46.8%), respectively. Abnormal findings of echocardiography and ECG, as well as elevated levels of serum troponin I and creative kinase-MB, were associated with an increased risk of cardiovascular event and survival. Logistic regression analysis revealed that an abnormal echcocardiographic finding and elevation of serum troponin I were factors associated with the occurrence an adverse cardiovascular event and that electrocardiographic abnormalities and initial mental status were factors associated with poor prognosis. Conclusion: This study reveals that actual myocardial injury develops in a significant proportion of patients with nontraumatic intracranial hemorrhage and that the development of the myocardial injury is associated with an adverse cardiovascular event that occurs during admission.

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

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

중기발암성시험기법을 이용한 Carbendazim의 간발암성 검색

성하정,이제봉,정미혜,이해근 한국환경독성학회 1998 환경독성보건학회지 Vol.13 No.2

Carbendazim, which is widely used fungicide, was investigated for rat hepatocarcinogenesis using a medium-term carcinogenicity bioassay. All rats were initially given a single dose (200 mg/kg) of diethylnitrosamine (DEN) i. p. and then, starting 2 weeks later, carbendazim treatment group and positive control group received carbendazim (7 mg/kg/ day) and 2-acetylaminofluorene (2-AAF, V/0, respectively, in the diet for 6 weeks. All rats were subjected to two-thirds partial hepatectomy (PH) at week 3 and sacrificed at week 8. Carcinogenic potential was scored by comparing the number and area per cm" of induced glutathione-S-transferase placental form (GST-P) positive foci in the liver. Carbendazim had no effect in the increase of body weight, hematological and biochemical values, and the number and area of GST-P positive foci. These results suggest that this bioassay using DEN-PH method can be useful for detection of hepatocarcinogenic potentials of pesticide.