대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

Evaluation of Renal Toxicity by Combination Exposure to Melamine and Cyanuric Acid in Male Sprague-Dawley Rats

Ji Yeon Son,Yoon Jong Kang,Kyeong Seok Kim,Tae Hyung Kim,Sung Kwang Lim,Hyun Jung Lim,Tae Cheon Jeong,Dal Woong Choi,Kyu Hyuck Chung,Byung Mu Lee,Hyung Sik Kim 한국독성학회 2014 Toxicological Research Vol.30 No.2

Melamine-induced nephrotoxicity is closely associated with crystal formation in the kidney caused by combined exposure to melamine (Mel) and cyanuric acid (CA). However, there are few dosage-finding studies for toxicological evaluation of chronic co-exposure to Mel and CA. The objective of this study was to investigate the possible mechanism by which a Mel and CA mixture lead to renal toxicity in rats. Mel and CA were co-administered to rats via oral gavage for 50 days. Nephrotoxicity was determined by measuring blood urea nitrogen (BUN) and serum creatinine (sCr) levels. Relative kidney weights were significantly increased in rats after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg) mixtures. BUN and sCr levels were significantly increased after Mel and CA co-exposure. Taken together, significant increase in KIM-1, NGAL, and calbindin levels were observed in the urine of rats exposed to Mel+CA (63/6.3 or 630/6.3 mg/kg) compared with the corresponding control group. Histological analysis revealed epithelial degeneration and necrotic cell death in the proximal tubules of the kidney after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg). Our data suggest that Mel-mediated renal toxicity may be influenced by CA concentrations in Mel-contaminated milk or foods.

Evaluation of Renal Toxicity by Combination Exposure to Melamine and Cyanuric Acid in Male Sprague-Dawley Rats

Son, Ji Yeon,Kang, Yoon Jong,Kim, Kyeong Seok,Kim, Tae Hyung,Lim, Sung Kwang,Lim, Hyun Jung,Jeong, Tae Cheon,Choi, Dal Woong,Chung, Kyu Hyuck,Lee, Byung Mu,Kim, Hyung Sik Korean Society of ToxicologyKorea Environmental Mu 2014 Toxicological Research Vol.30 No.2

Melamine-induced nephrotoxicity is closely associated with crystal formation in the kidney caused by combined exposure to melamine (Mel) and cyanuric acid (CA). However, there are few dosage-finding studies for toxicological evaluation of chronic co-exposure to Mel and CA. The objective of this study was to investigate the possible mechanism by which a Mel and CA mixture lead to renal toxicity in rats. Mel and CA were co-administered to rats via oral gavage for 50 days. Nephrotoxicity was determined by measuring blood urea nitrogen (BUN) and serum creatinine (sCr) levels. Relative kidney weights were significantly increased in rats after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg) mixtures. BUN and sCr levels were significantly increased after Mel and CA co-exposure. Taken together, significant increase in KIM-1, NGAL, and calbindin levels were observed in the urine of rats exposed to Mel+CA (63/6.3 or 630/6.3 mg/kg) compared with the corresponding control group. Histological analysis revealed epithelial degeneration and necrotic cell death in the proximal tubules of the kidney after co-exposure to Mel+CA (63/6.3 or 630/6.3 mg/kg). Our data suggest that Mel-mediated renal toxicity may be influenced by CA concentrations in Mel-contaminated milk or foods.

병원정보시스템이 의료기관 성과에 미치는 영향

김상아,박웅섭,이상엽,이승근,송재석,이상욱,곽연희,박성준 關東大學校 醫科大學 醫科學硏究所 2003 關東醫大學術誌 Vol.7 No.1

This study is conducted to established integrated principal framework for the effects of the Hospital Information System(HIS) specially Physician Order Entry system(POE), Laboratory Information System(LIS), and Picture Archiving and Communication System(PACS) on the performance of medical institute. We had reviewed and analyzed the literature of POE, LIS, and PACS, and then formulated principal framework. In conclusion, the implementation of HIS could improve the satisfaction of medical staff and reengineer the work process, and those leaded improving the quality of service, and that also leaded increasing the number of patients and case mix of disease, and then those leaded increasing the performance of medical institute.

가족기업의 연구현황과 과제

김석웅 한국중소기업학회 2002 中小企業硏究 Vol.24 No.1

가족기업은 오래전부터 존재하였으며 전세계적으로 보편적인 기업형태이다. 가족이 안정적인 사회의 초석인 것처럼 가족기업도 안정적인 경제를 구축하는데 중요하다고 볼 수 있다. 가족기업은 국가경제에 큰 비중을 차지하는데, 미국의 경우에도 모든 기업의 90%가 가족기업이며 국내총생산의 50%을 가족기업이 차지하고 있다 가족기업은 가족이 기업의 주된 구성원으로 된 기업이기 때문에 기업의 속성과 가정의 속성이라는 양면속성을 가지고 있다. 가족기업에 관한 연구는 미국의 경우에는 1988년 이후부터 본격적으로 실시되고 있으며, 우리나라의 경우에도 주로 1997년 이후에 않은 논문들이 발표되고 있다. 가족기업에 관한 연구주제로는 가족기업의 개념정의, 경영전략, 가족영향, 기타로 나누어 볼 수 있다. 본고에서는 우리 나라에서 주로 발표되는 연구들의 전반적 특성, 주제별 내용분석 등으로 구분하여 연구현황을 살펴보았다. 앞으로 가족기업에 관한 실태조사의 실시로 기초자료의 확보, 포괄적인 개념적·이론적 연구의 확립, 가족기업의 정의확립 사례연구, 가족기업에 관한 학제적 연구의 실시 등이 필요하다. Family business has a long history and it is a common type of business in the world. As family is a brick and mortar in society, so family business is important to establish a stable economy. It is estimated that 90% of all businesses in the U.S.A. are family businesses and they produce over 50% of GDP. Family business has ambivalent attributes of family and business. In U.S.A. a lot of research papers on family business have been published since 1988 and in Korea a lot of those research papers have been published since 1997 by some home economists and other academics. In this paper, a state of the art such as general characteristics and topics content analysis of family business research are reviewed. Research agenda such as basic database through survey on family business, comprehensive establishment of conceptual and theoretical studies, definition of family business, case study and interdisciplinary approach to family business are suggested.

인터넷상에서의 최적 얼굴인식 시스템에 관한 연구

김종민,양환석,이웅기 朝鮮大學校 統計硏究所 2006 統計硏究所論文誌 Vol.8 No.1

본 논문은 다중 프레임(연속적 입력영상)을 이용한 실시간 얼굴인식 시스템에 관한 연구로써, 네트워크를 통한 얼굴인식 방법을 제안한다. 제안된 알고리즘은 우선 영상의 압축 및 축소 기법을 이용하여 전송 지연의 감소와 처리시간을 줄이고, 이에 따라 전체적인 인식 시간을 줄이는 것을 목표로 하고 있으며, 또한 여러 장의 입력영상을 이용하여 인식률을 높이는 방법을 제안하고자 한다. 그러나 단순히 기존의 방법인 point to point 방식인 단순 거리 계산은 오차가 많기 때문에 본 논문에서는 개선된 Class to Class방식인 Majority-Making-Decision rule을 이용하여 몇 개의 연속적인 입력영상을 모델영상의 인식의 단위로 이용하여 인식률을 높였다. 논문은 영상의 압축률과 크기에 따른 인식률의 상관관계를 바탕으로 전체적인 시스템 구현과 함께 알고리즘을 소개하는 것으로 구성되어 있으며, 실제 실험을 통한 성능을 비교 평가 하였다.

치과기공사 국가시험 과목 타당성 연구

김웅철,이원철,손영석,오세윤,김부섭,유진호,김지환 한국보건의료인국가시험원 2005 보건의료교육평가 Vol.2 No.1

This study prepared a basic framework for the development and improvement of Korean Dental Technicians' Licensing Examination, based on actual test questions. A peer review was conducted to ensure relevance to current practices in dental technology. For the statistical analysis, 1000 dental laboratory technicians were selected; specialists in dental laboratory technology (laboratory owners, educators, etc.) were involved in creating valid and reliable questions. Results indicated that examination subjects should be divided into three categories: basic dental laboratory theory, dental laboratory specialties, and a practical examination. To ensure relevance to current practice, there should be less emphasis on basic dental laboratory theory, including health-related laws, and more emphasis on dental laboratory specialties. Introduction to dental anatomy should be separated from oral anatomy and tooth morphology; and fixed prosthodontics should be separated from crown and bridge technology and dental ceramics technology. Removable orthodontic appliance technology should be renamed 'orthodontic laboratory technology'. There should be less questions related to health related law, oral anatomy, dental hygiene, dental materials science and inlay, while the distribution ratio of questions related to tooth morphology should be maintained. There should be a decrease in the distribution ratio of questions related to crown and bridge technology, dental ceramics technology, complete dentures and removable partial dentures technology, and orthodontic laboratory technology. In the practical examination, the current multiple choice test should be replaced with tooth carving using wax or plaster. In dental laboratory specialties, subjects related to contemporary dental laboratory technology should be included in the test items.

요양병원과 병원에 입원한 노인의 기능상태수준의 차이에 관한 연구

김정인,이지전,이상욱,박웅섭,송재석 關東大學校 醫科大學 醫科學硏究所 2003 關東醫大學術誌 Vol.7 No.2

In Korea, the proportion of 65-year-old elderly population were gradually increased and over 7 percentage in 2000. To care elderly properly, various type of healthcare institutions is needed. There is general hospital and long-term care hospital among medical institution. In this study, difference of functional status and severity between elderly inpatients in general hospital and those in long-term care hospital was investigated. Comprehensive functional status of 577 patients that were hospitalized in 3 long-term care hospitals and 2 general hospitals was examined. On the contrary to our expectation, patients in long-term care hospital had lower activities of daily livings and more severe medical conditions than those in hospital. These results suggested that healthcare system and healthcare resource distribution for elderly patients are not worked efficiently.

손가락 끝 점을 이용한 손 형상 인식

김종민,이웅기,장근실,양환석,허진경,박승규 朝鮮大學校 統計硏究所 2007 統計硏究所論文誌 Vol.9 No.1

최근 사용자 친화형 유저 인터페이스 구현을 위해 인간의 손 형상을 실시간으로 인식하는 연구의 중요성이 부각되고 있다. 그러나 인간의 손은 자유도가 크기 때문에 손 형상을 정확히 인식하기란 매우 어렵고 또한 피부색과 유사한 색을 가지는 복잡한 배경에서는 더욱 곤란하다. 본 논문에서는 별도의 센서를 부착하지 않고 카메라를 사용하여 피부색 정보에 의한 손 형상을 분할한 후 손가락 끝 점을 찾는다. 찾은 손가락 끝 점을 이용하여 방향을 탐지하는 알고리즘에 대해 기술한다. 이 방법은 템플리트 매칭을 이용하여 손가락 끝 점을 탐색한 후 찾은 손가락 끝 점과 손목의 중심을 이용하여 전, 후, 좌, 우 방향을 탐지한다. 제안하는 방법을 이용하여 3D 가상현실 공간에서의 네비게이션(Navigation)에 응용하였으며, 실험결과 전진, 후진 및 좌측, 우측의 방향전환도 매우 좋은 결과를 보였다. 또한 본 논문에서 제안하는 방법은 마우스, 키보드, 조이스틱 등의 조작 없이 전, 후, 좌, 우 방향전환을 사용자가 직관적으로 지시함으로써 보다 자연스러운 인간과 컴퓨터의 상호작용을 제공할 수 있을 것이다.

강릉시 사망원인 분석

김상아,곽연희,박웅섭,송재석,이상욱,박덕영,강명근 關東大學校 醫科大學 醫科學硏究所 2002 關東醫大學術誌 Vol.6 No.1

This study was conducted to use for the Community Health Care Plan through analyzing the specific cause of death in Gangneung. The study subject were death in Gangneung that happened from January 1, to December 31 in 2000, and that were enrolled as the citizen of Gangneung. The causes of death were classified according to the 56 selected list for ranking of causes of death in Korean National Statistical Office in order to compare the data of nation. We also estimated Years of Potential Life Lost in order to evaluate the burden of disease in Gangneung.