간섭형 광섬유 센서용 신호처리기 설계

홍영준,김도익,예윤해 慶熙大學校 레이저 工學硏究所 2002 레이저공학 Vol.13 No.-

We propose a singnal processor that demodulates the output from an interferometeric sensor at high seed. It is a modified version of the ADPT(Advanced Digital Phase Tracking) that was developed to measure the phase difference in the interferometer with high resolution. The implemented signal processor was turned out to have a speed of 44 mrad/㎲, which is good enough to measure the vibration or voice signal with the maximum phase shift of π/4 rad.

도시 거주 노인 수면 습관 및 불면증상의 요인 : 인구학적,질병 및 정신증상의 관련성

홍진표,안준호,윤영국,박종익,이소영,함봉진,김장규,한오수,조맹제 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 본 연구는 국내 노인의 습관을 조사하고 불면 증상과 연관 있는 인구학적, 질병학적 요인을 알고자 했다. 방 법 : 1997년 12월부터 1998년 1월까지 약 1개월에 걸쳐 2단계 층화집락표본추출의 역학조사법을 통해 선정된 3개 4개동 거주의 만 65세 이상 노인을 대상으로 수행되었다. 대상자 중 723명에서 등답을 받았으며 응답률은 73.8였다. 대학생인 설문조사요원들을 훈련시킨 뒤, 이들로 하여금 대상지역의 노인거주가정을 방문하여 개개 노인을 대상으로 반구조화된 면담으로 수면습관 및 불면증상 설문을 실시하였으며 그 외 한국어판 노인정신장애평가척도, 삶의 질 척도를 이용한 설문조사와 과거 질병력을 청취조사하게 하였다. 결 과 : 국내 노인들은 평균 오후 10시 16분에 자리에 누워 오전 5시22분에 일어나서 총 7시간 6분의 수면시간을 보였다. 노인의 11.7%가 거의 매일 밤 불면증을 14.8%가 간헐적 불면증을 호소하였다. 남자에서는 연령이 증가할수록 침상에 누워있는 시간이 증가하고, 또, 입면시까지 소요되는 시간과 수면 중의 각성회수가 증가되었으나 여성에서는 명확하지 않았다. 단변수 분석에서 요통, 중풍 병력의 환자에서 불면증상이 심했다. 다변량분석 결과 불면 증상과 관련 깊은 요인으로 남자에게서는 고령과 우울증상이 여자에게서는 남자의 위험요인에다 신체통증과 피부병력이 추가로 관련이 있었다. 결 론 : 지역 거주 노인에서 불면 증상은 매우 흔한 증상이며 우울증상과 명확한 상관관계를 보이고 있었다. 불면증을 극복하기 위해 불면증 위험요인의 인과관계에 대한 추후 연구가 필요하다. Objectives : The purpose of this study is to analyze sleep habit and investigate the association between insomnia and demographic, health and psycho-behavioral symptomatology in Korean urban elderly Method : A total of 723 community residents aged 65 years or older were surveyed by two stage, random cluster sampling method. The response rate was 76.2%. Interviewers performed door to door visits and administered a questionnaire about sleep, past medical history, and several scales as the Psychogeriatric Assessment Scale(PAS), the short form Quality of Life Scale (SF-36) and etc. Results : The mean scores are as follows : retiring time was ten-sixteen p.m., wake-up time was five twenty two a.m., duration of sleep was seven hours and six minutes. Among the elderly, 11.6% and 14.8% of the subjects reported chronic and intermittent difficulty in sleeping, respectively. The patients with back pain and history of stroke complained of more insomnia symptoms in univariate analysis. In ANCOVA analysis, insomnia symptoms were associated with an old age, depressive symptoms in male. Bodily pain and history of dermatologic disease were additional risk factors in female. Conclusions : The data suggest insomnia is one of most common health problems among elderly Koreans living in the community. Strong positive relationship between depressive symptoms and insomnia were found. Further research is needed to explore the causal relationship between insomnia and risk factors.

혈액투석요법 환자의 우울, 불안 및 수면장애에 대한 연구

윤석준,양창국,한홍무 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 혈액투석요법을 받는 말기 신부전증 환자들은 불안이나 우울 등의 심인증상 외에도 여러 가지 수면장애를 호소할 수 있다. 말기 신부전증 환자에서 심인증상과 수면장애가 많을수록 삶의 질에 장애를 초래하며 혈액투석요법 도중 탈락이 높다. 저자는 본 연구에서 혈액투석요법 중인 환자의 우울, 불안 및 수면장애 등을 조사하여 향후 환자가료에 활용하고자 하였다. 방 법 : 부산시내 4곳의 혈액투석요법기관에서 혈액투석요법을 받는 말기 신부전증 환자 153명(남 87, 여 66)과 정신적, 신체적으로 건강한 동아대학교병원 행정직원 및 의과대학 학부모 113명(남 58, 여 55)을 대상으로 구조화된 면담과 자기평가척도를 실시하였다. 연구도구는 저자 등이 본 연구에 알맞게 개발한 인구통계학적 자료를 포함한 수면관련 설문지, 우울증 자가평가 척도인 Beck Depression Inventory(BDI), 불안 자가평가 척도인 State-Trait Anxiety Inventory(STAI)를 이용하였다. 결 과 : 환자군이 대조군에 비하여 신체증상 및 심인증상을 더 많이 호소하였고(p<0.05), 수면관련 불편을 더 많이 나타내었다(p<0.001). 환자군의 BDI 평균은 22.9로 대조군의 11.2보다 유의하게 높았다(p<0.001). BDI 점수를 기준으로 볼 때 남자환자 64명(74.7%), 여자환자 47명(71.2%)은 우울증군에 속하였다. STAI 평균 점수는 두 군간에 유의한 차이가 없었다. 환자군은 대조군에 비하여 입면잠복기와 수면 중 깨어 있는 시간이 더 길었고, 낮 동안의 졸리움 등 수면관련 불편을 더 많이 호소하고 있었다. 또한 환자군은 불면증(65.4%), 하지불편증후군(46.4%), 악몽(27.3%), 주기성사지운동장애(23.5%), 수면 식사장애(18.3%), 야경증(14.4%) 등을 유의하게 더 많이 호소하고 있었다(p<0.05). 결 론 : 혈액투석요법을 받고 있는 말기 신부전증 환자들은 대조군에 비해서 신체적, 심인적 증상을 유의하게 더 호소하고 불면증을 포함한 다양한 수면장애를 동반하고 있다. 또한 이들 사이에 높은 상호관계가 있는 바, 이는 혈액투석요법 증인 환자들에서 신체적 증상 및 심인적 증상뿐만 아니라 수면장애에 대한 치료적 접근이 필요함을 시사한다. Objectives : Psychological distresses and complaints in sleep, in addition to physical distresses such as pruritus and bone pain, are common in patients with hemodialysis. The purposes of this study were to investigate 1) the severity of physical distresses, 2) the severity of depression and anxiety, 3) the sleep disturbances, and 4) the correlation of the above variables in patients with hemodialysis. Methods : The patients with hemodialysis(male 87, female 66) and controls(male 58, female 55) completed a self-administered questionnaire package, which included Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and questions characterizing the reported sleep problems and quantitating the severity of the self-perceived physical and psychological conditions with linear visual analogue scales. Results : The results indicated that patients with hemodialysis complained of more physical distresses, more depressed mood, and more sleep disturbances suggesting insomnia, restless legs syndrome, periodic limb movement disorder, nightmare and obstructive sleep apnea syndrome, etc. There were significant positive correlations of physical distresses, depressed mood and sleep disturbances. However, there were no significant differences in state and trait anxiety between both groups. Conclusions : The authors suggest that the quality of life in patients with hemodialysis

간세포암종에 대한 간동맥 화학색전술 후 발생한 급성호흡곤란증후군

조윤원,이정미,최자윤,유동훈,차라리,오혜원,김홍준,민현주,김현진,정운태,이옥재,하창윤,이선영 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.1

Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.

유입 전염병 열대열(Plasmodium falciparum) 1예

우준희,이지윤,최창현,홍성태 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

Recently the prevalence of malaria has been increasing around the world and there is an increasing concern about exogenous malaria in non-endemic areas, We experienced a case of imported malaria(Plasmodium falciparum) in a 37 year-old Koran male. The management with chloroquine was successful and wish to report this unusual case, along with a review of literatures.

국내 건설 프로젝트의 하도급체계에서 대금불공정 거래에 대한 연구

황윤재,이창훈,윤준선,백준홍 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The purpose of this study is to investigate Unfair Practice and Unfair-Bidding Practice of Sub-Contract System in domestic Construction Project. Even though the Sub-Contractors are very important positioned in Construction Project, Sub-Contractors have not been given fair services in Construction project. Firstly, This study investigates the Sub-contract system. Unfair Practice and bidding Practice. And then the investigated documents are rearranged for searching why Unfair-Practices spreaded in Korea and why unfair-bidding Practices were followed. The results include Unfair institutions. Law and Contractors' oppressions which should be corrected. Rearranged documents are suggested to Contractors. Sub-contractors and government for improving Fair Sub-contracts system in domestic Construction industry.

중증 외상환자에서 염기 결핍수치의 유용성

문준동,김수진,문철규,최성혁,전정민,이성우,홍윤식 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: This study's objective was to determine the prognostic value of the base deficit measured in the emergency department(ED) and to determine whether base deficit can provide information not provided by advanced injury scoring system. Methods: This study was a retrospective analysis of data collected for two years. Thirty-two severe trauma patients who were admitted to the Emergency Department of Korea University Hospital were included in this study. The patients were divided into two groups: the normal base deficit group(-3 mmol/L to 3 mmol/L) and the elevated base deficit group(>3 mmol/L). The base-deficit value, age, sex, head injury, organ failure rate, and survival were considered, and the also Revised Trauma Score(RTS), Acute Physiology And Chronic Health Evaluation(APACHE II), and Injury Severity Score(ISS) were measured. Result: The elevated base-deficit group showed a lower survival rate and a higher organ failure rate compared to the normal base deficit group. Logistic Regression showed a strong association between base deficit and mortality rate. Among the previous injury scoring Systems(RTS, APACHE II, ISS), base deficit had the strongest correlation with RTS. By using base deficit value and the RTS together, we obtained a higher positive predictive value than that obtained by using base deficit or RTS alone. Conclusion: The admission value of the base deficit in the ED is a useful tool in predicting the outcome in severe trauma patients, and it can be an adjunct to previous injury scoring systems. As an advanced injury scoring System is developed in the future, the base deficit may have some significant role.

Delphi방법을 이용한 일차의료 고혈압 진료지침 개발 및 적용

양윤준,홍명호 한국의료QA학회 1995 한국의료질향상학회지 Vol.2 No.1

background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists. responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, Jaboratory examination and decision making about time fo pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

우측 대장에 발생한 연소성 용종 1예

이준식,박성한,홍현진,안광순,김지연,배용목,이은영,박선자 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Juvenile polyp, also known as a retention polyp because they contain mucin cysts, is a relatively common hamartomatous lesion in chlidhood. It occurs in 1-2% of children and young adults; however it is uncommon in adulthood. Juvenile polyp is rare in the first year of life and is thus presumed to be acquired and not congenital. It is pedunculated, 2-3 cm in size, red-tan in colour, smooth and always shows fluid filled cystic spaces on cut surface. Histologically, Juvenile polyps are hamartomatous with distended, mucus-filled glands, often with cystic dilatation and edematous lamina propria containing abundant vasculature. The most common manifestation is rectal bleeding produced by auto-amputation of the polyp. Juvenile polyp has been considered not to be at increased risk of developing carcinoma. However, atypical epithelium is observed in some lesions, especially in larger polyps, which may give rise to adenoma and subsequent malignant transformation. Therefore the diagnosis of solitary juvenile polyp should not be made only with colonoscopy and biopsy, but should be totally resected endoscopically for pathologic evaluation. About 90% of the lesions are solitary and localized within 20cm from anal verge. In Korea, there are some reports of juvenile polyps located in the rectosigmoid colon. We report one case of juvenile polyp in adolescent that presented as a hematochezia & abdominal pain, which is located at right colon.

공중보건의의 고혈압 진단 및 치료과정 평가

송윤미,김윤,조홍준,정희숙,김용익 한국의료QA학회 1996 한국의료질향상학회지 Vol.3 No.1

Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.8%). Level of training, duration of practice as a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the preestablished clinical guidelines, which leaves much to be desired in diagnosion and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.