지역사회 정신의학 전공의 교육과정 실태조사

홍진표,황순찬,이영문,이선형,신나리,이종일,박종익,장동원,정인원 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : There is a increasing need to recruit and retain more psychiatrists who can plan and implement organized programs to work with chronic mentally ill patients in community settings. The aim of study is to discover what training is currently in place to prepare psychiatrist for work in "community" or "public" settings. Methods : Survey questionnaires were mailed to 85 residency training directors and 10 leaders of community mental health in 2005. Response rate was 75%. Results : Academic seminar about community mental health were not administered to residents in 63% of training hospitals. Forty one out of 64 training hospitals had community mental health rotation programs, Community mental health center (50%) and day hospital (36%) were the most common type of programs. Few general hospital had affiliation with community mental health programs. The amount of time for clinical rotation varied from less than three months part time to 6 months fulltime, with most frequent form of one day per week for three month in second or third year of psychiatry residents. Conclusion : Further steps are needed to improve residency training curricula and to encourage well qualified psychiatrist to choose careers in community psychiatry.

Predicting postoperative total calcium requirements after parathyroidectomy in secondary hyperparathyroidism

( Byung Heon Kang ),( Soon Young Hwang ),( Jeong Yeop Kim ),( Yu Ah Hong ),( Mi Yeon Jung ),( Eun Ah Lee ),( Ji Eun Lee3 ),( Jae Bok Lee ),( Gang Jee Ko ),( Heui Jung Pyo ),( Young Joo Kwon ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.6

Background/Aims: To prevent hypocalcemia after parathyroidectomy (PTX), parenteral calcium is required in addition to oral calcitriol and calcium. After switching to oral calcium, patients can be discharged from the hospital. The aim of this study was to analyze the clinical characteristics and outcomes of PTX performed at a single Korean center and to investigate the associated laboratory factors used to analyze the total amount of postoperative calcium required. Methods: We enrolled 91 hemodialysis patients undergoing PTX from November 2003 to December 2011. We collected clinical and laboratory data preoperatively, 12 and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively. Results: In total, 59 patients underwent PTX with autotransplantation (AT), 6 underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent limited PTX. Total PTX without AT showed the lowest recurrence rate. At all postoperative time points, the mean levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) decreased significantly, compared with preoperative levels; however, alkaline phosphatase (ALP) increased significantly from 48 hours postoperatively to discharge (p < 0.001). On multiple linear regression analysis, the total amount of injected calcium during hospitalization showed a significant correlation with preoperative ALP (p < 0.001), preoperative iPTH (p = 0.037), and Δphosphorus at 48 hours (p < 0.001). We developed an equation for estimating the total calcium requirement after PTX. Conclusions: Preoperative ALP, preoperative iPTH, and Δphosphorus at 48 hours may be significant factors in estimating the postoperative calcium requirement. The formula for postoperative calcium requirement after PTX may help to predict the duration of postoperative hospitalization.

인슐린 비의존성 당뇨병에 동반된 심상성 천포창 1 례

이상준,박진용,임태형,윤영호,권순대,남창욱,허규찬,박근용,구본식,김상표,장종억 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

저자들은 인슐린 비의존형 당뇨병 환자에서 통증성 구강내 미란 및 전신성 수포성 미란을 동반한 심상성 천포창 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Various skin conditions such as diabetic dermopathy, necrobiosis lipoidica diabeticorum, bullosis diabeticorum, granuloma annulare occur frequently in diabetes, although common lesions may be associated by chance. Pemphigus vulgaris(PV) is a blistering skin disease seen predominantly in elderly patients. This disorder is characterized by the loss of cohesion between epidermal cells with the resultant formation of intraepidermal blisters. These blisters rupture easily, leaving denuded areases that may crust and enlarge peripherally. In half or more of patients, lesions begin in the mouth: approximately 90% of patients have oromucosal involvement at some time during the course of their disease. But the relationship of this disorder with diabetes is not clear. We experienced a case of pemphigus vulgaris associated with NIDDM in 67 years old woman who was admitted due to painful oral ulcer and control of blood glucose, so we present this case with a review of literatures.

수지의 원위부 피판에서의 감각기능 회복에 대한 임상적 고찰

이세일,이시영,홍인표,심영기 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.1

A consecutive series of 271 patients(285 digits) underwent the distant flap reconstruction for digital injury between January 1985 and June 1991. The cases were reviewed and the sensory recovery of the finger tip was assessed by the two point discrimination test. It usually depends on the degree and the extent of the injury and involved digit. The results were as follows : 1. Younger patients showed better recovery of 2-point discrimination. 2. Better recovery of 2-point discrimination was related to the lapse of time. 3. The recovered 2-point discrimination resembled that of the recipient site more than that of the donor site. 4. The smaller size of the distant flap showed better recovery of 2-point discrimination 5. The cross arm flap showed better recovery of 2-point discrimination than abdomen, groin&buttock flaps. 6. The pedicled flap showed better recovery of 2-point discrimination than tubed flap. 7. Sensory recovery increased with the thinning of the flap with debulking 8. Reconstruction with the neurovascular island flap is recommended in the thumb and index where heat, cold, touch-pressure& vibration sense are required.

鹽水中에서의 疲勞强度에 關한 硏究

李榮培,表東根,吳在一 弘益大學校 1985 弘大論叢 Vol.17 No.2

Since the fatigue strength of steel under the corrosive environment, corrode and fatigue at the same time, thus fatigue strength is lowered eminently by these effects. Also, the fatigue limit does not appear in artificial sea water, but appear in air. As the N? increases, the fatigue strength decreases accordingly. Therefore the fatigue designs of machinery or steel structures, which are used under the corrosive environment, must be limited life-design. The estimation of life is a very important factor. The purpose of this investigation is to obtain the saturated values of fatigue strength. We investigated the rotary bending test (cyclic rate: 0.5cpm) with smooth bar specimen of SM50B steel (JIS) in two different environments which are air and artificial sea water and compared with results concerning of the 7.5cpm under the same condition. The following results are obtained. 1) The fatigue life decreases by about 46% in artificial sea water in comparison with that in air. 2) S-N curves of 7.5cpm and 0.5cpm are same, so that we conclude, at the 0.5cpm is the saturated value of fatigue strength. 3) The ratio of fatigue strength decreases minutely by the number of cycle to failure increases. 4) In artificial sea water, the corroded oxidation occured in the location where the stress was concentrated.

제조합 대장균에서 과발현된 Citrobacter freundii KCTC2006 유래의 β-Tyrosinase를 이용한 3,4-Dihydroxyphenyl-L-alanine의 생산

이승구,노현수,홍승표,이규종,왕지원,태동년,엄기남,방상구,김영준,성문희 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.1

재조합 대장균에서 대량발현 시킨 Citrobacter freundii KCTC 2006 유래이 효소 β-tyrosinase를 이용하여 pyrocatechol, sodium pyruvate, ammonium acetate로부터 3,4-dihydroxy phenyl-L-alanine을 생산하기 위한 연구를 수행하였다. 이 효소반응에 적합한 온도 및 pH 조건은 각각 18℃와 8.5로 결정되었고, 반응액 중의 ammonium acetate와 sodium pyruvate의 농도는 각각 300 mM, 50 mM 이상으로 조절하는 것이 적합하였다. Pyrocatechol의 경우는 20 mM에서 가장 높은 반응성을 나타냈으나, 기질을 반복적으로 첨가하며 장시간 동안 효소반응을 수행하는 경우에는 pyrocatechol의 고갈을 피하기 위하여, 20 mM에서 50 mM 사이로 조절하였다. 한편, 반응액 중에 ethanol을 10% 첨가한 경우에는 반응속도가약 20% 증가하였다. 이상과 같은 효소반응특성에 기초하여 조제한 기질용액에 β-tyrosinase를 1 unit/㎖ 농도로 가하고, pyrocatechol과 pyruvate가 고갈되지 않도록 간헐적으로 첨가하면서 효소반응을 수행한 결과, 24시간 만에 85.2%의 수율로 31.6g/ℓ의 3,4-dihydroxyphenyl-L-alanine를 생산할 수 있었다. By using the β-tyrosinase of Citrobacter freundii KCTC2006, which was cloned and overexpressed in Escherichia coli, 3,4-dihydroxy phenyl-L-alanine (L-DOPA) was synthesized efficiently from pyrocatechol, sodium pyruvate, and ammonium acetate. Optimal temperature and pH for the reaction were determined to be about 18℃ and 8.5, respectively. The effects of substrate concentrations were also examined at different concentrations of ammonium acetate, sodium pyruvate, and pyrocatechol. Ammonium acetate and sodium pyruvate increased the reaction rate until the concentrations reached to 300 mM and 50 mM, respectively. Although pyrocatechol showed the optimal concentration at 20 mM, it was controlled between 20 mM and 50 mM to avoid the depletion of substrate during the enzymatic synthesis. Based on above results, a reaction medium for the production of L-DOPA was prepared and incubated with 1 unit/㎖ of β-tyrosinase. Pyrocatechol and sodium pyruvate was added to the reaction solution intermittently to avoid the substrate depletion during the enzymatic reaction. After 24 hour of reaction, 31.6 g/ℓ L-DOPA was accumulated in the reaction solution as soluble and precipitated ones and the conversion yield was about 85.2%.

카드뮴폭로후 고환, 신장 및 간장내 카드뮴축적량과 조직손상의 변화

이영구,박정덕,최병선,홍연표,장임원 大韓産業醫學會 1994 대한직업환경의학회지 Vol.6 No.1

To assess the changes of cadmium deposit and histopathologic finding of testis, liver and kidney, different dose of cadmium (Cd) was administerd into male Sprague-Dawley rat(purchased from KIST, Korea Institute of Science and technology) by single intravenous injection. At 12, 24, 48, 168 and 672 hours after Cd injection, tissue cadmium concentration and histopathological change were examined. Cd exposed group showed lesser weight gain than the control. Renal Cd content tended to increase in time-dependent pattern, while hepatic and testicular Cd content tended to decrease. Mean of renal Cd content to hepatic Cd content (Cd K/Cd L) also progressively increased. These results suggest that Cd might be gradually transported to kidney from other organs. In testis and liver, degenerative changes appeared relatively in acute phase. These changes became more pronounced in testis, while less prominent in liver. In kidney, swelling of proximal tubluar cells and thickening of glomerular basement membrane appeared relatively later and these changes were progressively aggravated.

S-상 심실중격의 임상적 고찰

이동민,장경식,양종태,장대용,김종오,서영욱,고영엽,홍순표 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background: The sigmoid septum described an anatomical variation in the contour of the left ventricular outlet. It is related to degenerative change with aging. We observed clinical significance of sigmoid septum in Korean. Methods: Echocardiographic examination was performed in 434 patients. Sigmoid septum is defined as discrete bulging of the proximal interventricular septum with that thickness is greater than 1.3cm or the thickness is grater 1.5 times than adjacent mid interventricular septum in apical 3 chamber view. Result: The incidence of patient with sigmoid septum(septum patient) is 24.8% (male 8.4%, female 16.3%) . The incidence increases with age and is more common in women. The patients with sigmoid septum were compared with targeted groups, there was no significant difference in blood pressure between them, but in height and weight, the former were lower. (p<001, p<03). In the patients with sigmoid septum, weight and the surface area of a body have an opposite correlation with increase of age (p<03, r=-0.34) (p<04, r=-0.31) , but no decrease of height was found according to age increase (p=0.47, r=-0.11) The main reason patients with sigmoid septum ask echocardiolography and its clinical symptoms were abnormal results of previous electrocardiography and/or usual chest pain. Compared with control group, interventricular septal thickness is larger in septum patients (p<001). The thickness of interventricular septum located in subaortic left ventricular outflow tract is 1.6±0.3cm. There is another web like structure that continued from interventricualr septum to anterior free wall of left ventricle and the width is 1.6±0.4cm. A sign of insignificant obstruction due to left ventricular outflow was observed from three sigmoid septum patients. Conculusion: Septum patient is largely found in older age group and the body weight and body surface area are lower than control group. The body weight and body surface area are opposite correlation with age. So sigmoid septum is considered as structural change by weight reduction with aging. It is assumed that septum patients are related with asymptomatic ischemia because they have more abnormal ECG finding such as T wave inversion on precordial leads or standard leads, nonspecific ST-T change, LBBB etc. Sigmoid septum is not only proximal interventricular septal bludging but also another web like structure continuing to anterior wall of left ventricle.

傳統社會 女性의 家事作業觀에 關한 一考察 : 朝鮮朝 規範類를 中心으로 Centering on the Norm of Chosun-Dynasty

李吉杓,朱英愛 誠信女子大學校 生活文化硏究所 1992 生活文化硏究 Vol.6 No.-

The purpose of this study is to set up the new vision for a view of housework of women. To fulfil the purpose, 1 looked into the contents of the women's view of housework through "Nae-Hoon", "Gye-Joong. Yo-Ram", "Gye-Nyeo-Syeo", "Sasojeul" "Kyu-Hap-Chong-Syeo", "So-hak", "Yeo-Sa-Syeo", etc. And I investigated the contents of women's housework-food. clothing housing. The characteristics of the view of housework centering on the norm of CHosen-Dynastyare as follows. 1. Women should learn how to cook and make clothes. 2. Housework is related to filial duty to parents-in-law 3. The basic attitude toward to housework was devotion and cleanliness 4. Women have to do housework for the season. It is acclimate herself to environment 5. Housework-performing an ancestral rites is emphasized ancestor worship. 6. Women's housework in the early times of Chosun-Dynasty put its emphasis on benevolence ideal norm. however in late it was changed into housework as practical norm.

Spin-Peierls 전이를 하는 CuGeO₃계의 이온 치환 효과

이영배,채광표,권우현,백서욱,이성호 건국대학교 자연과학연구소 1998 建國自然科學硏究誌 Vol.9 No.1

Spin-Peierls 전이를 하는 CuGeO₃계에 원소를 치환했을 때의 자기적 및 결정학적 특성을 비교 검토하고, 직접 Cu₁-xGe₁-xFe₂O₃(x=0.05, 0.1) 시료를 제조하여 SQUID, Mssbauer 분광기, X-선 회절 방법으로 연구하였다. 이 시료의 결정구조는 orthorhombic 이고 격자 상수는 x= 0.05 때 a = 4.795Å, b=8.472Å, c=2.904Å 이고 x=0.1때는 a=4.784Å, b=8.472Å, c=2.904Å였다. 상온에서 Mssbauer 스펙트럼은 Fe³+ 이온의 사면체 자리에 의한 이중선과 팔면체 자리에 의한 Zeeman 선으로 중첩되어 나타났고 자기감수율의 극대점과 Mssbauer 변수의 불연속으로부터 본 시료의 spin-Peierls 전이 온도는 13K 임을 알아냈다. The magnetic and crystallograpic properties of the substituted spin-Peierls transition CuGeO₃ system have been reviewed, and we synthesized the Cu₁-xGe₁-xFe₂xO₃ (x=0.05 and x=0.1) system and studied by superconducting quantum interference device, Mossbauer spectrometer and x-ray diffractometer. The crystal structure is orthorhombic and the lattice constants are decreased as increasing iron contents. That is, in Cu₁-xGe₁-xFe₂xO₃ system a=4.795Å, b=8.472Å and c=2.932Å for x=0.05, and a=4.784Å, b=8.472Å and c=2.904Å for x=0.1 respectively. The Mossbauer spectra are superposition of the doublet due to the Fe³+ ions at tetrahedral sites and the sextet due to the Fe³+ ions at octahedral sites at room temperature. From the cusp of the magnetic susceptibility and the discontinuity of Mossbauer parameters we found the spin-Peierls transition temperature of our samples is 13K.