한국인 성인 남성 폐쇄성수면무호흡 환자의 측모 두부 방사선계측학적 비교

황상희,박인숙,남기영,김종배,조용원,서영성,안병훈,박신구,박효상 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.3

본 연구는 비만도에 따른 한국인 남성 폐쇄성수면무호흡 환자의 측모 두부 방사선계측학적 특성을 파악하기 위하여 시행되었다. 이를 위하여 계명대학교 의과대학 동산의료원 수면클리닉에 수면장애를 주소로 내원하여 수면다원검사 후 치과에서 측모 두부방사선계측사진 촬영을 한 87명의 성인 환자들을 체질량지수(BMI)와 수면무호흡지수(AHI)에 따라 비비만 단순코골이군(Non-obese, simple snorers), 비만 단순코골이군(Obese, simple snorers), 비비만 수면 무호흡군(Non-obese, OSA patients), 비만 수면무호흡군(Obese, OSA patients)의 4군으로 나누어 비교하였다. 그결과, 4군 중 비만 수면무호흡군의 수면무호흡지수가 가장 컸으며, 비만 수면무호흡군보다 비비만 수면무호흡군의 하악각이 더 크고 혀 길이는 더 작았다. 또한, 비비만 수면무호흡군보다 비만수면무호흡군의 설골이 더 전하방에 위치하였고, 수면무호흡지수에 영향을 미치는 기여 인자는 비만 수면무호흡군에서는 혀 길이, 비비만 수면무호흡군에서는 설골의 후방위치였다. 이처럼 비만 수면무호흡 환자와 비비만 수면무호흡 환자의 측모 두부방사선계측학적 특성과 기여 인자가 다르게 나타나므로, 치료방법도 따라서 다르게 선택해야 할 것이다. 비만 수면무호흡 환자들에게는 먼저 체중감량이 권고되어야 할 것이고, 비비만 수면무호흡 환자들은 폐쇄부위에 따라 구강 내 장치나 Nasal CPAP (continuous positive airway pressure), UPPP (uvulopalatopharyngoplasty) 등이 추천될 수 있을 것이다. Objective: The purpose of this study was to compare the cephalometric measurements of obese and non-obese Korean male patients with obstructive sleep apnea syndrome (OSA). Methods: Eighty-seven adults who had visited the Sleep Disorder Clinic Center in Keimyung University, Daegu, Korea were examined and evaluated with polysomnography (PSG) and lateral cephalogram. They were divided into 4 groups (non-obese simple snorers, obese simple snorers, non-obese OSA patients, obese OSA patients) according to AHI (Apnea-Hypopnea Index) and BMI (Body Mass Index). Results: The obese OSA group had the highest AHI among the 4 groups. The non-obese OSA group had a significantly steeper mandibular angle and shorter tongue length than the obese OSA group. The hyoid bone of the obese OSA group was positioned anterior and inferior as compared with the non-obese OSA group. Multiple regression analysis showed that tongue length in the obese OSA group and retroposition of hyoid bone in the non-obese OSA group were significant determinants for the severity of AHI. Conclusions: From a cephalometric point of view, the obese and non-obese pateints with OSA may be characterized by different pathogeneses. Therefore, they have to be managed by individualized treatment. For the obese OSA patients, weight control must be advised as a first choice and for the non-obese OSA patients, oral appliance, nasal CPAP, UPPP and others could be chosen according to the obstructive sites.

대전시 도시숲의 식생 및 토양특성에 관한 연구

김동일 ( Dong Il Kim ),박관수 ( Gwan Soo Park ),김길남 ( Gil Nam Kim ),김현숙 ( Hyoun Sook Kim ),이항구 ( Hang Goo Lee ),박범환 ( Beom Hwan Park ),이상진 ( Sang Jin Lee ),강길남 ( Kil Nam Kang ) 한국환경복원기술학회(구 한국환경복원녹화기술학회) 2011 한국환경복원기술학회지 Vol.14 No.2

This study was conducted to suggest appropriate methods for management of urban forest after investigating the present condition and problems of urban forests by analyzing vegetation and soil properties in urban forests in the Daejeon. On the basis of our research, Pinus rigida dominate Gyejoksan and Bomunsan. Pinus densiflora dominate Wolpyeong park and Quercus acutissima dominate Namsun park. On the basis of our result of analysis of soil chemical properties, all investigated areas have low pHs, available phosphates and exchangeable cations. They indicate that the soil of those areas have been acidifying progressively. Soil hardness measurements were conducted to know the conditions of trampled soils and the results of them show that soil hardness in Namsun park was higher than the others. This indicates that human interference affect the health of the urban forest.

太谿穴의 臨床 活用에 대한 文獻考察

구성태,송문영,강정묵,김용명,박보라,이은석,홍정아,김경식,손인철 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

Literally, the mean of Tae-gye is highest brook. And on the basis of the acupuncture theory, Tae-gye point is the Soo earth point and source point of the Kidney Channel as well. In addition, Tae-gye point is one of the Yang-Returning Nine points. We were trying to study bibliographically on the Tae-gye point because Tae-gye point can be used very broadly across the symptoms in the theoretical aspect described above. As a results, we found out that according to the classical books of acupuncture, Tae-gye point is entering point of the Meridian Water as a source point and can be used at both Kidney-Sufficient Syndrom and Kidney-Deficient Syndrom. And Tae-gye can be applied to the disease of kidney or bladder that is urogenital symtoms, Also, Tae-gye is an useful option of tooth-ache, asthma, indigestion, constipation, edema etc whose cause is related with decrease of Kidney ki.

응급진료시 여성환자의 소변검체 채취방법

박원녕,정상원,이종호,구홍두,심호식,김승호 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Urinalysis is a useful laboratory test in the diagnosis of various diseases. In sampling for the urinalysis, there is much concern about contamination that can lead to misdiagnosis in the mid-stream urine sampling method. We conducted this study to determine, in terms of concordance of results and contamination in culture, whether there was any superiority in nod-stream sampling methods with or without disinfection measures compared to the catheterization method. Materials and Methods: We used three kinds of urine sampling methods sequentially, mid-stream non-clean catch, mid-stream clean catch, and catheterization, for ambulatory, non-pregnant, non-men-struating female patients who visited NHIC Ilsan Hospital emergency department during a one-week period in September 2001. Each sample was electrophotometrically analyzed for leukocyte esterase, nitrite, and blood by using a reagent strip and was cultured immediately or after overnight refrigeration. Results: Of the 41 patients, 9 had culture-proven urinary tract infections. The concordance rates(kappa) for nitrite, blood, and leukocyte esterase were 0.875, 0.403, and 0.406 between non-clean catch and catheterized samples and 0.875, 0.481, and 0.560 between clean catch and catheterized samples, respectively. The contamination rate of the non-clean catch, the clean catch, and the catheterized samples were statistically different: 51.2%, 29.3% and 0%, respectively. Conclusion: We found that cleaning with disinfectant was effective for reducing the contamination rate, even though the best urine sampling method for zero contamination was catheterization. We recommend considering cost, patients' comfort, an acceptable threshold for contamination, and the necessity for a culture before choosing a urine sampling method for women who visit the emergency department.

갑상선결절의 임상 및 초음차소견의 진단적 가치

박거운,박철진,박일구,신지혜,정중화,배학연,김상용 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Backgrounds: Thyroid nodule have been relatively common disease and it's prevalence estimated about 4-7%. Recently, high resolution ultrasonography has made the detection of small thyroid nodule possible, Increases in the detection of thyroid nodule have created a clinical dilemma on how to properly manage such thyroid nodules. We investigated the prevalence, clinical and ultrasonographic characterristics, and optimal diagnostic approach toward detected benign and malignant thyroid nodules. Methods: A retrosepctive review was undertaken on the 372 patients who was done Ultrasonograpy guided fine needle aspiration biopsy in Chosun University Hospital, Gwang-Ju, Korea between July 2003 and Spring 2005. Devided into four group such as benign and malignant thyroid nodule on the basis of size 1.5Cm. The review consisted of thyroid function test, antithyroid antibodies, thyroid autoantibodies, thyroid ultrasonography, fine needle aspiration biopsy in each group. Results: The prevalence of thyroid nodule malignancy rate was 18.0%. The prevalence of thyroid incidentaloma malignanct rate was 17.5%. There were no significant differences in age, sex, thyroid function test and size between the benign, malignant incidentalomas and nodule. Ultrasonographic characteristics, include ultrasonography index point showed meaningful diagnostic value for the detection of malignancy in thyroid nodule, Conclusion: Thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodule; however, ultrasonographic findings can be used to decision of optimal management strategies 배경: 최근갑상선 초음파의 빈번한 시행으로 갑상선 결절의 발견이 증가하고 있다. 이러한 갑상선 결절중 특히 갑상션우연종을 임상적으로 어떻게 접근하고 치료를해야하는지는 적지 않는 문제가 되고 있다. 본 연구에서는 갑상선 우연종 및 직경 1.5 cm 이상의 갑상션결절의 유병률, 임상적 특징, 초음파특정 및 초음파의 진단적 유용성에 대해 알아 보았다. 방법: 2003년 7윌부터 2005년 3월까지 조선 대학교병원 내과 및 일반외과및 건강검진 센터를 통해 갑상선 초음파, 경동맥 초음파 및 경부 CT등을 통해 우연히 발견된 갑상션결절을 가진 372명을 대상으로 후향적 연구를 시행하였다. 크기 1.5 cm 미만의 양성및 악성 갑상선 결절군과 크기 1.5 cm 이상의 양성 및 악성결절로 그룹을 나누고 각 군에서 나이, 성별, 갑상선 기능검사, 항갑상선 항체, 갑상선 초음파 및 미세침흡인세포검사등을 검토하였고, 모든 갑상선 결절에 Koike (6)가 제한한 초음파지표 점수(Ultrasonographie index point)를 부여하여 각 군을 비교하였다. 결과: 분석한 갑상선 결절 372예 중 악성결절의 유병율은 18.0% (67예)였다. 갑상선 우연 종의 유병율은 81.5% (303예)였다. 갑상선 우연 종에서의 악성률은 17.5% (53예)로 나왔다. 크기 1.5 cm 이상의 양성 및 악성 갑상선 결절과 양성 및 악성 갑상선 우연종에서 나이, 성별, 갑상선 기능검사, 항갑상선항체에는 의미있는 차이가 없었다. 또한 양성 및 악성우연종에서 의 갑상선 결절크기에도 의미있는 차이는 보이지 않았다. 갑상선 결절의 초음파 지표점수만이 양성 및 악성우연종과 양성 및 악성갑상선 결절의 감별에 의미있는 차이를 보였다. 갑상 선우연종과 크기 1.5 cm 이상의 갑상선 결절에 서 양성을 나타내는 초음파지표점수는 각각 3 점과 4점으로 다르게 나타났다. 양성 및 악성 갑상선우연종의 감별에서 초음파 지표점수의 민감도는 93.6%, 특이도는 52.8%, 양성예측율은 92.4%로 나왔고, 진단적 효율은 86.4% 였으며 크기 1.5 cm 이상의 양성 및 악성 갑상선 결정의 감별에서 초음파지수 민감도는 92.7%, 특이도가 42.9%, 양성 예측도 86%, 효율 82.6%를 보였다. 결론: 갑상선결절에서의 양성 및 악성의 유무는 임상적으로 판단하기 힘들지만 갑상선 결절에서의 초음파 소견 및 초음파 지표 점수를 도입하면 이에 대한 감별에 도움을 줄 수 있다. 따라서 갑상선 초음파검사시 초음파지표점수의 사용은 향후 갑상선 결절의 진단 방향을 제시하는 중요한 길잡이가 될 수 있으리라 사료된다.

중환자실 병원감염에 대한 다기관 공동 조사연구

박은숙,박미라,진혜영,김정은,최정실,송영구,최영화,이위교,홍성관,허애정,양동규,김준명 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1

전문계 고등학교 교사들의 이러닝 활용과 영향요인 간의 구조방정식 모형

박성열,남민우,박운구 한국농업교육학회 2008 농업교육과 인적자원개발 Vol.40 No.2

이 연구는 전문계 고등학교 교사들을 대상으로 이러닝을 활용하는데 영향을 미치는 요인들을 파악하고, 이들 요인들간의 인과관계성을 구조 모형적인 측면에서 분석 · 설명하는 데 중점을 두고 있다. 연구모형에 포함된 요인은 교직경력, 컴퓨터 사용경험, 이러닝 지원부문, 이러닝의 사회/조직 관련성 등의 외생변인과 이러닝 활용을 위한 컴퓨터 리터러시, 이러닝 활용 의향도 등의 내생변인 등이며, 요인들간의 상관계수를 산출하여 그 행렬을 이용, LISREL 프로그램에 의해 공변량 구조 이론 모델 분석을 수행하였다. 이 연구에서 제시된 모델 분석을 통한 연구결과는 다음과 같다. 첫째, 교사들의 이러닝 활용을 위한 컴퓨터 리터러시에는 설정된 외생변인 중 컴퓨터 사용경험의 영향을 가장 크게 받고 있으며, 다음으로 이러닝 지원정도, 사회/조직 관련성 등의 순으로 영향을 받고 있다. 둘째, 최종 내생변인인 교사들의 이러닝 활용 의향도에는 외생변인 중 이러닝의 사회/조직 관련성만이 영향을 미치는 것으로 분석되었다. 셋째, 내생변인간의 관계성을 분석한 결과 교사들의 이러닝의 활용 의향도는 이러닝 활용을 위한 컴퓨터 리터러시에 매우 큰 영향을 받고 있음을 보여 주었다. This study was designed and implemented to identify factors affecting e-learning use of vocational high school teachers based on structural equation model. The model career, computer experience, e-learning support, social and organizational norm related to e-learning as exogenous variables and computer literacy and intention to use as endogenous variables. The researcher produces a correlation matrix among the variables and run a structural model using LISREL program. The major findings after are as follows. First, teachers' computer experience was the most significant factors affecting their computer literacy to utilize e-learning, followed by e-learning support and soial and organizational norm. Second, intention to use e-learning, terminal exogenous variable was influenced by e-learning social and orginizational norm among exogenous variables. Third, in terms of the relationships between endogenous variables, intention to use e-learning was largely influenced by computer literacy from the model analysis.

천연두 백신 접종 후 발생된 급성 심근염 1예

박옥성,김종환,이광욱,윤성훈,강동구,이승욱,조상기 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Acute myocarditis complicating coronary vasospasm after smallpox vaccination is very rare complication that can be generally developed within less than 30 days after vaccination. Clinically and biochemically, this disorder is often mimic and highly suggestive of acute myocardial infarction. We report 21 years old man that had a history of a smallpox vaccination 3 weeks ago and prodromal symptoms(fever, malaise etc) a few days ago. hIe visited to our hospital because of abrupt onset of severe substernal chest pain, dyspnea and diaphoresis. At admission, electrocardiography was ST elevation in lead Ⅰ, aVL, V4, V5, and V6. The CK-MB level was 68 U/L, LDH level was 760 U/L, Troponin-Ⅰ was 24.64 ng/㎖, and Troponin-T was positive. 2D-echocardiograpy was normal left ventricular function, Clinically we presumed this disorder as acute myocardial infarction and we promptly performed the coronary angiography and revealed focal spasm in distal left coronary artery territory without critical stenosis in both coronary arteries. We diagnosed this disorder as coronary vasospam complicating acute myocarditis that is different with acute myocardial infarction, and we prescribed nitroglycerin and nifedipine. After discharge, he is now well without any symptoms and has been following up monthly at our outward department for 6 months.

서울·경기지역 병원직원의 혈액매개 감염노출에 대한 다기관 조사연구

박미라,김정은,박은숙,최정실,정선영,송영구,홍성관,김준명,허애정,양동규,조영주 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1

스포츠 성취목표 지향성과 동기지각 분위기가 내적동기, 자긍심, 운동수행에 미치는 효과

박성준,이홍구 경기대학교 1999 論文集 Vol.43 No.2

Drawing from contemporary goal perspective theories of achievement motivation, this investigation had purpose to the relationship of goal orientation and perceived motivational climate to intrinsic motivation, self-esteem, and sport performance in physical education settings. To test the dynamic Matching Model(goal-climate), this study also examined the interactional effects between goal orientation and motivational climate on cognitive and behavioral components of motivation. 218 male college student attending to physical education classes requested to complete the four instruments. The results of canonical correlations indicated that both task orientation and mastery climate positively related to reported intrinsic motivation. Task orientation and mastery climate positively related to self-esteem and sport performance, respectively. The results of Goal X Climate MANOVA procedures showed the interactional effect on intrinsic motivation. Subjects in task orientation and mastery climate increased in their intrinsic motivation(interest and effort) to sport activities in physical education classes. Matching between ego orientation and competitive climate had not effect on increased intrinsic motivation. This results partially supported the goats-climate matching model.