2차원 및 3차원 초음파를 이용한 태아표면의 해부학적 선별 검사에 관한 연구

윤석범,이해혁,이정재,최경훈,이순곤,이임순,이권해 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Objective : Our purpose of this study was to determine the clarity and consuming time of fetal surface screening in thirty-eight fetuses from 24 to 32 weeks of gestation by use of two and three-dimensional ultrasonography. Methods : From May 1998 to July 1998, we performed the fetal surface screening of the fetal face, extremities, and spine. Thirty-eight fetuses of 24-32 weeks of gestation (thirty-seven normal fetuses and one abnormal fetus) were studied by use two-dimensional (AI 5200S, 3.5-5.0MHz; Acoustic Imaging Technologic Cooperation, U.S.A.) and three-dimensional ultrasonography (Volusion 530D, 3.5-5.0 MHz ; Kretz-Medicine, Korea). On the fetal face, we evaluated both orbits, nose, lips and brow. Both hands and feet, five digits and toes should be seen in this study. We evaluated cervical spine and lumbosacral junction of the spine. Results : The maternal average age of 38 patients was 29.9 years and the average gestational age was 29.7 weeks. The results of fetal surface screening were as follows : face (both orbits 89.5%, lips 92.1%, nose 92.1%, and brow 89.5%), extremities (both hands 68.4% and feet 73.7%), and spine (cervical spine 94.7% and lumbosacral junction 97.4%) by use of two-dimensional ultrasonography. By use of three-dimensional ultrasonography, results were as follows : face (both orbits 76.3%, lips 81.6%, nose 81.6%, and brow 78.9%), extremities (both hands 76.3% and feet 78.9%), and spine (cervical spine 71.1% and lumbosacral junction 73.7%). Consuming time for two-dimensional ultrasonography were 4.7 minutes for face, 11.6 minutes for extremities, and 5.7 minutes for spine. Using three-dimensional ultrasonography results were 12.8 minutes for face, 17.9 minutes for extremities, and 11.7 minutes for spine. Average consuming time of all fetal anatomic screening was 22.0 and 42.4 minutes by use of two and three dimensional ultrasonography. In one abnormal fetus had cleft lip and polydactyly of right foot which were detected all by three-dimensional ultrasonography, but we couldn't detect the polydactyly by two-dimensional ultrasonography. Conclusion : Three-dimensional ultrasonography was more time-consuming method, but we suggested that three-dimensional ultrasonography was superior than two-dimensional ultrasonography in fetal surface screening.

체간안정화 훈련이 만성 뇌졸중 환자의 호흡기능에 미치는 효과

이경진(Kyeong-Jin Lee),정주현(Ju-Hyeoun Jeong),조명래(Myeong-Rae Jo),김세윤(Se-Yoon Kim),김난수(Nan-Soo Kim) 대한심장호흡물리치료학회 2019 대한심장호흡물리치료학회지 Vol.7 No.1

Purpose : The purpose of this study is to examine the effects of trunk stability training on improving trunk control, respiratory function, and respiratory muscle activation in stroke patients. Methods : The subjects were assigned to two groups: the intervention group (n=15) and the control group (n=15). Both groups participated in a conventional stroke rehabilitation program, but the intervention group also received trunk stability training for 30 minutes a day, 3 times a week, for 6 weeks. The main trunk stability exercise consisted of the dead bug exercise. Trunk control was assessed using a trunk impairment scale, and respiratory function (pulmonary function and respiratory muscle function) was assessed using spirometry. The data were analyzed using the Pearson correlation, independent t-test, and paired t-test. Results : Trunk control was significantly positively correlated with pulmonary function and respiratory muscle strength. Both groups showed a significant increase in trunk control and respiratory function. Conclusion : This study demonstrated that a conventional stroke rehabilitation program and trunk stability training have positive effects on respiratory function and respiratory muscle activation in stroke patients.

조선후기 천문학자 이덕성의 생애와 천문활동

안영숙,민병희,서윤경,이기원,AHN, YOUNG SOOK,MIHN, BYEONG-HEE,SEO, YOON KYEONG,LEE, KI-WON 한국천문학회 2017 天文學論叢 Vol.32 No.2

The life and astronomical activity of Lee Deok-Seong (李德星, 1720-1794) was studied using various historical sources, including the astronomical almanac, Seungjeongwon-Ilgi (Daily records of Royal Secretariat of Joseon dynasty), and the Gwansang-Gam's logbooks during Joseon dynasty (A.D. 1392-1910). We present the results of the study including the following main findings. First, from the investigation of Lee's family tree, we find that a number of his relatives were also astronomers, notably Samryeok-Gwan (三曆官, the post of calendrical calculation). Second, we find that he took part in the compilation of an annual astronomical almanac over a period of at least 16 years. His major achievements in the astronomy of the Joseon dynasty were to establish a new method of calendar-making calculation and to bring astronomical materials to the Joseon court through a visit to China. The Joseon dynasty enforced the Shixianli (時憲曆, a Chinese calendar made by Adam Shall) in 1654 without fully understanding the calendar. So an astronomer and an envoy were dispatched to China in order to master the intricacies of the calendar and to learn as much of Western science as was available in that time and place. Lee Deok-Seong worked at the Gwansang-Gam (觀象監, Royal Astronomical Bureau) during the reigns of King Yeongjo (英祖) and Jeongjo (正祖). As best as we can ascertain in relation with the calculations in the Shixian calendar, Lee visited China four times. During his trips and interactions, he learned a new method for calendar-making calculations, and introduced many Western-Chinese astronomical books to Joseon academia. Lee greatly improved the accuracy of calendrical calculations, even while simplifying the calculation process. With these achievements, he finally was promoted to the title of Sungrok-Daebu (崇祿大夫), the third highest grade of royal official. In conclusion, history demonstrates that Lee Deok-Seong was one of the most outstanding astronomers in the late-Joseon dynasty.

60세 이상 환자의 척추수술

윤석만,이경석,도재원,배학근,윤일규 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Objective: Advances in surgical technique, anesthesia and perioperative patient management, coupled with the rapid increase in the population of patients reaching their 60s or older, have led to a signiticant rise in spinal precedures. The objective of this study was to evaluate frequency of the disease, surgical results and postoperative complications of the aged patients who underwent spinal surgeries. Methods : We reviewed all spinal procedures for spinal lesions including degenerative diseases, trauma, tumor and others in patients aged 60 years or older between January 1 1994 and October 1 1998(56 men and 26 women), retrospectively. Final outcome was assessed by telephone interview with the patient or the family in 67.1%(55/82). Results : There were 56 male patients and 26 female patients. There were 57 cases of degenerative diseases, 14 cases of trauma, 5 cases of metastaisis, 4 cases of infection and 2 cases of others. According to the level of surgical procedures, there were 20 cases fo cervical spine, 8 cases of thoracic spine, 54 cases of lumbar spine. Postoperaive complications included the following(17/82): 7 dural tears, 2 sepsis, 2 nerve root injury and 6 others. There were no operation-related deaths. During follow up period, ten patients(12.2%) had died, 45 patients(54.9%) were contacted and 27 patients(32.9%) could not be located. Mean follow up period for the 45 patients contacted was 26.1±15.7 months. Of the 45 persons contacted, 34(75.6%) reported improvement, 6(13.3%) no change and 5(11.1%) aggravation of their preoperative symptoms. Conclusion: Spine surgery in patients aged 60 years or older has higher complication rate compare to the younger but it is reasonable to consider the surgical procedures even in the elderly if it is needed. We should give attention not to tear the dura during the surgical procedures, especially in the elderly.

강진만 해역의 다모류 군집의 종조성 및 계절변동

윤성민,김춘철,서원일,황선영,이성훈,한경호,이우범 國立麗水大學校 環境問題硏究所 2004 環境硏究論文集 Vol.6 No.-

To detemine seasonal fluctuations in abundance and speices composition, polychaete samples were collected by Van Veen grab form March to November 2003 in Kangjin Bay. A total of 25,119.3 ind./㎡ polycaete were sampled and identified into 48 species. 25 families and 10 orders. Of the 10 orders. Phllodocida, Spionida, Eunicida and Sabellida accounted for approximately 79.9% of the polychaete fauna in this area. Phyllodocida, Nereidae, Nephtyidae ans Spionidae were dominant representing every moment 4 species. Of 48 species identified Neanthes japonica, Prionospio pinnate, Cirratulus cirratus and Palola siciliensis for 54.0% individuals collected. Season succession of dominant species was evident in study area: Neanthes japonica, Prionospio pinnata. Cirratulus cirratus. Nephtys oligobranchia in March, Neanthes japonica, Lumbrineris japonica. Cirratulus cirratus, Prionospio pinnata in May, Ncanthes japonica, Cirratulus cirratus, Lumbrineris nippnica. Lumbrineris japonica in August and Neanthes japonica, Prionospio pinnata, Laonice cirrata, Palola siciliensis in November, respectively. The diversity index was the highest value in March(H'=3.0059) and the lowest value in May(H'=2.7305). The eveness index was the highest in August(J=0.9184) and lowest in May(J=0.8524). The dominance index was the highest in May(D=0.3843) and the lowest in March(D=0.2275).

敎育課程構成의 知識社會學的 分析

李允卿 숙명여자대학교 대학원원우회 1984 원우논총 Vol.2 No.-

The present study analized the social control of curriculum content to clarify the social factors through sociological theory and sociology of knowledge. In a theoretical approach, a consideration was taken into the curriculum concept, construction model process and sociology of knowledge. Traditional study of curriculum that considers knowledge as neutral and universal understands educational contents of school curriculum as taken for granted or neutral. So traditionalists focus on selecting and constructing knowledge which is usually considered a set of idealistic structures of philosophy, psychology, sociology to teach efficiently. They intended to find an efficient way of constructing contents or learing experience (-knowledge) to achieve a higher academic level. And these were treated as the tools of social class movement. However, all of the curriculum studies were neglecting the inter-relations between knowledge and society. The view of sociology of knowledge prescribes that curriculum content is made in socio-cultural conditions, and regards it as valid knowledge. They investigate the politically, socially organized curriculum that reproduce the social classes, and try to reveal why the lower class student must fail, through analyzing the code, social class, hegemony, decisin-making process, etc. The intention of dominant groups in society and nation's policy become the major factors in determining curriculum contents. By doing that curriculum mean transmission that stratifies the society. In this view-point, curriculum construction is the social and political decision-making process in which dominant "groups preserve their interest. And consider that the society is ineqal and thai the curriculum reproduces the inequality. The purpose of the present study is directing to the construction of curriculum through searching its sociality, social control, and social effects. Through the analysis of Korean curriculum(l963's and 1973's), it is found that curriculum contents which were selected and organized speak for the socio-cultural particularity. The results of analysis are as follows: First, there are inter-relations between selecting and organizing curriculum contents and the socio-cultural basis. Second, curriculum constrution is a political decision which is made to achieve the special purpose of a nation. So curriclum was made under the control of national policy to solve the social problems of that time. Third, culture effects on the acceptance of knowledge as school curriculum content. Here tradition and ideology are importent factors. Conclusively, .as the curriculum is constructed for achieving the national purpose, curriculum study has not remained at considering the models and principles of selecting, organiging knowledge. To improve the speciality and function of curriculum, it is necessary the power of social control should be reduced and the curriculum construction must have interactions with society.

Scorpion intoxication 1례

이경룡,윤천재,이한식 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Scorpion intoxication is not often encountered. Scorpion venom is complex and species-specific, those of the family Buthidae being most harmful to humans. The toxin consists of phospholipase, acetylinesterase, hyaluronidase, serotonin, and neurotoxins. A neurotoxins envenomation can produce severe systemic toxicity, especially in children. Symptoms include throat spasms, muscular fasciculations, abdominal clamps, seizures, increased or decreased blood pressure, oliguria, dysrhythmias, pulmonary edema, and respiratory collapse. We experienced a 60-year-old female patient who suffered abdominal clamp and both leg pain with multifocal PVC through to be caused by scorpion intoxication. She hypertension for several years, but no medications. During last six months she had suffered from facial palsy. So she had received herb medication with scorpion venom. After treatment for 3days she recovered well and discharged. We report this case with literature reviews.

외상후 발작의 위험인자에 대한 조사

이재학,배학근,윤석만,도재원,이경석,윤일규,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Risk Factors for Posttraumatic Seizure The authors evaluate the risk factors for posttraumatic seizures. this prospective study was performed in a series of 470 head injured patient from January 1996 to Decomber 1998. The patients who were dead within 1 week of injury or children from 3 years old and under were excluded. There were 358 male and 112 female with a mean age of 35.2±22.8 years (range, 4-88 years). The results were as follows : 1). Of the 470 patients, pasttraumatic seizure occurred in 48 patients(10.2%): early seizure in 28(6%) and late seizure in 20 patients(4.2%). 2). The clinical risk factors for posttraumatic seizure were poor consciousness at admission, presence of brainstem herniation signs, poor GCS score, and posttraumatic amnesia more than 24 hours after trauma(p<0.001). 3). The radiological risk factors for posttraumatic seizure were subdural hematoma(p<0.001), intracerebral hematoma (p<0.02), mutiple intracranial CT lesions(p<0.001), or delayed lesions on follow-up CT scans(p<0.001). the incidence of seizure increased according to the severity of diffuse brain lesion(p<0.001), and the seizure rate in mass lesion was higher than that in diffuse lesion(p<0.001). 5). Hypoxia and coagulopathy had a statistically significant influence on posttraumatic seizure(p<0.05). Hypoxia had a infuence on occurrence of late seizure(p<0.05). 6). The incidence of posttraumatic seizure signiticantly increased in surgical group compared with coservative group(p<0.001) and significantly increased in patient who underwent decompressive craniectomy compared with those who underwent craniotomy(p<0.001) 7). Preventive administration of antiepileptic drugs decreased the incidence of early seizure, but did not affect on the reduction of late seizure. 8). Multivariate logistic regression analysis showed the subdural hematoma, GCS score, delayed lesion, and intracerebral hematoma in order of importance for seizure risk. in conclusion, the risk factors affecting on the occurrence of seizure were clinical status at admission, CT lesions, and severity of diffuse brain inJury. Considering that hypoxia affected on the late seizure, it is necessary to detect and treat it immediately after trauma. In addition, the patients who underwent decompressive craniectomy should be carefully followed to evaluate the risk of late seizure. Even though preventive administration of antiepileptic drugs had a tendency to decrease the incidence of early seizure, it is unclear whether administration of antiepileptic drugs can reduce the incidence of posttraumatic seizures. Prospective study will be needed in the selected patients.

장기입원환자 관리 방해요인

이경석,윤석만,권희,이호,김혜경,조미자,한규남,김명성 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background: Recently the health insurance review agency tried to cut off the cost of unnecessary hospital stay. It is important to reduce the prolonged occupation of the hospital beds. However, there are some obstacles of the management for the prolonged bed occupation. We report our experiences and the problems of bed-control. Methods: To increase the rate of effective bed-usage, a task force was made. This team was consisted of 4 dctors, 2 nurses and 2 personnel of the administrative department. From December 20th 2001 to May 17th 2002, the task force analysed the rate, number and causes of the prolonged (more than 60 days, regardless of the disease entities) bed occupation. We announced and explained the necessity of bed-control and actively pressed to reduce the prolonged bed occupation. Results: The number of the prolonged bed occupation was 71 at the beginning of the management. It was reduced to 46 at best, then turned back to 65 at the end. It seems to be impossible to reduce the prolonged bed occupation until there are sufficient numbers of long-term care facilities. Aggressive bed control makes the sick patients to move every two or three months, it is never desirable. Conclusion: We cannot expect any Quality Improvements without improvement of the wrong system. Prior to the management for the prolonged bed occupation, it is necessary to build a sufficient number of long-term care facilities.

방사선 조사 후 대뇌결질에 분포한 Neuropeptide-Y 양성신경세포에 관한 면역조직화학적 연구

이상욱,김종중,정윤영,정종달,오윤경 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background and Objectives : Severe irradiation on the cerebral cortex of the human and animals may result in functional alterations of central nervous system. The purpose of this study, the irradiation effects on the cerebral cortex of the rats after brain irradiation was to investigate the change of distribution and morphology of neuropeptide-Y(NPY) neurons. Materials and Methods : Radiation was produced by the linear accelerator 6MV X-ray, and the animals were categorized into control and experimental groups and we use 45 Sprague-Dawley rats weighing about 200~250gm. The head areas of the animals were positioned within the radiation field of 12㎝ × 20㎝ and with the radiation depth of 1.5㎝. Sodium chloral hydrate-anesthetized rats were exposed to the radiation with the dose rate of 240 cGy/min. The total dose was 1800 cGy. Animals were sacrificed on 2 hours, 5 hours, 1 day, 3 days, 7days after brain irradiation. Under anesthesia, animals were perfused with 4% paraformaldehyde-1% glutaraldehyde solution. On one or two hours after the perfusion, brain were taken out and refixed over night in the same fixative. Using ABC immunohistochemistry, morphology and distribution of neuropeptide-Y immunoractive(NPY-IR) neurons were studied on the cerebral cortex of the control and brain-irradiated rats. We used light, transmission electron and confocal laser scanning microscope. Results : The following results were obtained : 1. On control group, NPY-IR neurons were found in all layers of the primary sensory and motor cerebral cortex, and the NPY-IR neurons were concentrated within the layer II, III, IV, V and VI. The typical NPY-IR perikarya was bipolar and multipolar shape. 2. On 2 hours, 5 hours, 1 day after X-irradiation, decreased number of NPY-IR neurons were detected in the primary sensory and motor cerebral cortex of the rats. Also shrunken and transformed NPY-IR neurons were detected in the primary sensory and motor cerebral cortex of the rats. 3. On 3 days and 7 days after X-irradiation, morphology and distribution of NPY-IR neurons in the primary sensory and motor cerebral cortex was generally restored. 4. In optical serial section analysis of NPY-IR neurons, high fluorescence intensity were observed in a part of the 8~11 sections of the control and all irradiated groups. In optical single section analysis of NPY-IR neurons, red color(high fluorescence intensity) was observed in a part of 6, 7 sections of the control and all irradiated groups. 5. By electron microscopy, NPY-IR neurons on 2 hours, 5 hours, 1 day after X-irradiation rats exhibited severe alterations of their organelles concerning intracellular material transport ; such as disappearance of microvilli and basal infoldings, reduction of invaginating pits on the basal and apical plasma membranes, reduction of transformed vesicles and shrunken Golgi complexes, etc. Conclusion : From the above results, it was concluded that the release of neurotransmitters and transcapillary leakage of blood substance were occurred on 2 hours, 5 hours, 1 day after X-irradiation, but the condition was generally restored on 3 days and 7 days following X-irradiation.