익산시 취학 전 어린이의 중증 유아기 우식증 유병률과 섭식습관

유래관,이광희,라지영,이동진 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.3

요로결석 환자에 대한 응급실에서의 진단방법

유지영,최옥경,유진현,정구영 大韓應急醫學會 1997 대한응급의학회지 Vol.8 No.1

Nephrolithiasis is one of the most common disease seen in the Emergency Department. Among the patients who visited in the Emergency Department with acute abdominal pain, many people were suspected urolithiasis. Because of limitation of diagnostic method on Emergency Department we planned this study in order to confirm the our accuracy of diagnosis and the possibility of misdiagnosis. During 5 months from April 1996 to August 1996, the 189 patients was suspected the urolithiasis. Among this patient, 51 cases was excluded due to incomplete study. After performing P/Ex, U/A, KUB in the Emergency Department, they were followed out patients department of Urology and perfomed Intravenous Pyelogram. The sensitivity and specificity for KUB were 84.5% and 94.0%, respectively. The positive predictive value was 93.8%, the nagative predictive value was 93.8%. Diagnostic accuracy of urolithiasis in our Emergency Department is 89.1%. There was no relationship between urinary occult blood and KUB or IVP. There was no relationship between degree of occult blood and diagnosis of urolithiasis. For differential diagnosis of urolithisis, emergency ultrasound and IVP will be available. So combination of this diagnostic methods will improve accuracy and safty of diagnosis and treatment of urolithiasis.

인터넷을 활용한 영어 교육에 관한 연구

이유진,하지훈 The English Linguistic Science Association of Kore 2000 English Linguistic Science Vol.5 No.-

The main purpose of this study is to show a more effective way to study English via the Internet, and to give mare information about how to use it in the class with many students. Using the Internet in English language classroom has lots of advantages and merits. Firstly, it is the best substitute for native spearkers in English education. Secondly, as it offers a virtually real environment to leasers, it is possible for us to communicate with others. Thirdly, it allows English learners to face the culture of English, motivating them to learn English by eliminating the cultural bounds. Fourthly, it helps us overcome the negative attitude which can be easily found in English language classrooms. In this study, I have researched the Internet use in English language learning: vocabularies, communication activity and supplementary materials. A large number of students showed interest and satisfaction in studding English on the Internet. In conclusion, in this study it has been proved that the Internet was a very helpful device in teaching and learning English in school, that a sufficient number of computers should be provided in classes and that further research in this field is urgently needed.

우리나라 유방아마에서 CYPIA1, EPHX 유전자 다형성의 역할

최지엽,유정희,이은옥,유근영,박수경,안세현,노동영,최국진,강대희 대한암예방학회 2002 Journal of cancer prevention Vol.7 No.3

심한 척추후측만증 환자의 대퇴골절 복원술을 위한 부위마취 : 증례보고 A case report

김지은,박대용,유시현,강규식,권진형,김천숙,안기량 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Kyphoscoliosis is a disease manifested as lateral curvature of spine and accompanying rotation of the vertebrae, resulting in distortion of rib cage. Restrictive lung disease and pulmonary hypertension progressing to cor pulmonale are the major cause of mortality in patients with kyphoscoliosis. We had experienced a successful spinal and caudal epidural anesthesia for the open reduction and internal fixation with plate of fractured femur shaft in two patients with severe kyphosoliosis. We had chosen regional anesthesia as an anesthetic method because of there poor pulmonary function and severe deformities of thoracolumbar spine. We could achieve the adequate anesthetic sensory dermatome level, T_(5) and T_(8), for operation without any significant deterioration of blood pressure and respiration. We recommended that regional anesthesia is a useful anesthetic method for a patients with severe kyphoscoliosis when the operation on hip or lower extremity is required.

석면관련 폐질환의 진단에 있어서 흉부고해상도전산화단층촬영검사(HRCT)의 유용성

이현재,손지언,,홍영습,,이영일,예병진,유창훈,정갑열,김상훈,임형준,장은철,김정만,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 석면에 노출된 근로자에서 석면관련 폐질환의 양상을 분석하고 진단에 있어 HRCT의 유용성을 연구하여 석면에 대한 의학적 감시프로그램의 개발에 기여하고자 하였다. 방법: 석면에 직접 노출되는 작업자 68명과 간접 노출되는 작업자 94명 등 총 162명에 대해 OSHA 석면 표준, 의학적 감시 프로그램에 따라 단순 흉부방사선검사, 폐활량검사 및 우리나라 실정에 맞게 일부 수정한 의학적 설문지를 통해 면접조사의 방식으로 환자에 관한 정보를 수집하였으며, 자료의 신뢰성을 확보하기 위하여 면접조사는 1달 이상의 기간을 두고 2차례에 걸쳐 실시된 후 확인, 수정하였다. 또한, 석면관련 폐질환을 확진하기 위하여 HRCT를 추가적으로 실시하였다. 결과: HRCT결과 석면관련 폐질환의 유병율은 162명의 근로자중 17명으로 10.5%였는데, 직접 노출군에서 10명 (14.7%), 간접 노출군에서 7명 (7.4%)이었다. HRCT와 비교할 때 단순 흉부방사선검사의 민감도와 특이도는 각각 70.6%와 98.6%이었고, 양성 예측도와 음성 예측도는 각각 85.7%와 96.6%으로, HRCT는 단순흉부방사선검사에 비해 민감도가 높아 초기 석면관련 폐질환을 진단하는데 효과적이었다. 석면관련 폐질환의 진단에 있어 HRCT와 폐활량검사 사이에 유의한 관련성이 관찰되었다. HRCT 결과 석면관련 폐질환의 유무와 의학적 설문조사 결과의 빈도분석을 실시한 결과, 유의한 변수는 작업기간, 흡연량, 호흡기질환의 과거력, 기침, 호흡곤란이었다. 결론: HRCT는 석면관련 폐질환의 진단에 있어 단순 흉부방사선검사와 비교하여 민감도가 높아 초기 진단에 유용하므로 단순 흉부방사선선검사 결과 석면관련 폐질환소견을 보일 때뿐만 아니라, 정상소견을 보이더라도 폐활량 검사결과와 근무력, 흡연력, 호흡기질환의 과거력, 기침, 호흡곤란 등의 호흡기 증상을 참고하여 HRCT검사를 고려해야 한다. 또한, 본 연구에서 관련성이 없었던 요인들에 대해서도 향후 연관성을 규명하는 광범위한 전향적 연구가 필요하다. Objectives: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. Methods: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveilance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveilance program consists of simple chest x-ray, spirometry and medical questionnarie. Results: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT, HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. Conclusions: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

우리나라 사람면역결핍바이러스(Human Immunodeficiency Virus) 감염환자에서 발병한 악성종양

최평균,송진수,조재현,김성한,박경화,방지환,박완범,김홍빈,김동완,김태유,허대석,오명돈,김남중,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : Since highly active antiretroviral therapy has lengthened the life span of individuals infected with human immunodeficiency virus (HIV), the importance of malignancy associated with HIV has been increased. The relative frequencies of malignancies in HIV infected patients may vary in different race and region. The aim of this study is to determine the prevalence and characteristics of malignancies in patients with HIV infection in South Korea. Materials and Methods : To identify HIV patients with malignancy, we reviewed the electronic database of pathological reports for all HIV-infected patients seen from January 1986 to December 2005 at the Seoul National University Hospital. We retrospectively reviewed the medical records of them. Results : Among 850 patients infected with HIV, 33 episodes of malignant diseases were diagnosed in 32 patients (3.76%). Thirty were males, and median age was 46 years (range 29-70). At the time of the diagnosis of malignancy, median CD4^(+) lymphocytes count was 100/uL (range 5-620) and in 27 (82%) patients, CD4^(+) lymphocytes count were less than 200/uL. For 13 patients (40%), malignancy was initial presentation of HIV infection. Excluding patients initially diagnosed as malignancy, median follow-up duration from the first visit to diagnosis of malignancy was 36 months (range 3-96). Non-Hodgkin's lymphoma was the most frequent malignancy (13 patients), followed by Kaposi's sarcoma (7), Hodgkin‘s disease (3), acute myeloid leukemia (1), and other solid cancer (9) including one case of anal cancer associated with human papillomavirus. Among 13 patients with non- Hodgkin's lymphoma, 4(31%) achieved the complete remission after chemotherapy and/or radiation therapy, and had been followed without evidence of recurrence. Conclusion : Malignancy was diagnosed in 3.76% of patients infected with HIV. Non-Hodgkin‘s lymphoma is the most prevalent malignancy in HIV patients in South Korea. 목적 : 효과적인 항레트로바이러스 다제요법이 도입됨에 따라, HIV 감염환자들의 수명이 증가되었고, 이에 따라 HIV 감염환자에서 악성종양의 중요성 또한 증가하고 있다. 본 연구의 목적은 우리나라 HIV 감염환자에서 악성종양의 유병률과 호발하는 악성종양의 특성을 밝히는 것이다. 재료 및 방법 : 1986년부터 2005년까지 서울대학교병원에서 치료를 받은 HIV 감염환자의 의무기록을 후향적으로 분석하였고, 병리학적 검사 결과를 검토하여 악성종양이 진단된 환자들을 대상으로 연구를 시행하였다. 결과 : 총 850명의 환자 중, 32명(3.76%)에서 33예의 악성종양이 진단되어, 악성종양의 발병률은 1,000인년 당13.0명(95% 신뢰구간: 8.6∼17.4명)이었다. 그 중 남자는 30명이었고, 악성종양 진단 당시 연령의 중간값은 46 (29-70)세이었다. 악성종양 진단받을 당시, CD4 림프구 수의 중간값은 lOO/uL (5-620 uL) 이었고, CD4 림프구수가 200/ uL 미만인 환자가 27명(82%)이었다. 악성종양에 대한 검사 도중에 HIV 감염사실이 밝혀진 환자가 13명(40%)이었다. HIV를 진단 받은 후 악성종양이 발병한 환자들에서, HIV 진단 후 악성종양의 발병까지는 평균 36개월(3-96개월)이 걸렸다. 13명의 HIV 감염 환자에서 진단된 비호지킨림프종이 가장 흔한 악성종양이었고, 이외에 카포시육종이 7명, 호지킨병이 3명, HPV와 연관된 항문암이 1명의 HIV 환자에서 진단되었다. 그 밖에 급성백혈병, 방광암, 췌장장, 폐암, 진행성위암, 갑상선암, 간세포암, 후두암이 각각 1예씩 진단되었다. 비호지킨림프종이 진단된13명 환자 중, 4명(31%)은 항암치료 및 방사선치료를 받아 완전관해가 되었고, 현재 재발의 증거 없이 외래에서 경과 관찰 중이다. 결론 : 우리나라 HIV 감염환자에서 악성종양의 유병률은 3.76%이었고, 비호지킨림프종이 가장 흔한 악성종양이었다.

복수과 진료 환자의 중복 처방에 대한 분석 및 평가

이지은,장혜경,오지영,유윤경,김현지,임숙인,연숙희,강진숙,최귀령 한국병원약사회 2003 병원약사회지 Vol.20 No.1

In an aging society, there is an increasing possibility of the duplication of the drugs given to patients because they take many kinds of drugs. Among the prescriptions given to the patients who was treated at multiple ambulatory clinics in St. Mary's hospital for one month of September, 2002, in which drugs that has identical or similar effects are prescribed, we analysed and evaluated them by patients' characteristics, kinds of medication, severity of side effects on a case by case basis. More, we assessed the potential additional costs. As a result of this study, the duplication rate turned out to be 6.69% and it was shown that the proportion of the elderly patients over 60 was high. The gastro-intestinal medications took up a large part and most of the cases showed that the danger caused by double taking of medicine was slight, but there were some examples in which the serious side effects were predicted. Expected additional costs were the average 11.349 won and it ranges from the minimum of 56 won to the maximum of 135,720 won. In conclusion, the management of drug histories of the patients who need the plural treatments is very important and the necessity of the individual and professional guidance of taking medicines for the elderly patients is emerged, too.

Nuss 방법에 의한 소아 오목가슴 수술 후 정맥 통증자가조절법을 사용한 Fentanyl 과 Fentanyl-Ketorolac의 진통효과 비교

안기량,서은정,김천숙,강규식,유시현,정진헌,정지원 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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누두흉 환자에서 Nuss 금속막대 제거 전 · 후 폐 역학 변화

강규식,백남순,김천숙,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Nuss operation is one of the surgical procedure for pectus excavatum and it's method is the insertion of convex steel bar under the sternum through small bilateral thoracic incision. As the patients is growing, the thorax can be compressed gradually by steel bar. So Nuss bar needs to be removed two years after Nuss operation. This study was undertaken to assess the effect on the repiratory mechanics before and after the removal of the Nuss bar. Twenty patients with previous Nuss operation were allocated for the removal of Nuss bar. Lung mechanics (dynamic lung compliance, static lung compliance, and airway resistance), hemodynamic change (heart rate, systolic pressure, and diastolic pressure), and pulmonary gas exchange (arterial oxygen tension, arterial carbon dioxide tension, pulse oximeter saturation, and end tidal carbon dioxide tension) were measured before and after removal of Nuss bar. Respiratory mechanics (dynamic and static lung compliance, inspiratory airway resistance), pulmonary gas exchange and hemodynamic parameter were unchanged before and after the removal of Nuss bar. We concluded that lung mechanics were not changed before and after the removal of Nuss bar in the patients with pectus excavatum and the 95% patients were satisfied with operation.