Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

비가열 축합에 의한 포도당 정량법

윤규태,이미영 순천향대학교 기초과학연구소 2002 순천향자연과학연구 논문집 Vol.8 No.1

Glucose concentration was determined by using the modified method of o-toluidine /boric acid condensation method. Instead of heating in the presence of acetic acid in o-toluidine /boric acid condensation method, NaOCl, H₂O₂or ClC_(6)H₄CO₃H was used to stimulate the formation offufural derivative. The r values of calibration curve for glucose determinatiion by using H₂O₂, NaOCl, and ClC_(6)H₄CO₃H without heating were 0.97, 0.99 and 0.76, respectively. These results suggest that NaOCl might be the most effective condensation stimulator in glucose determination in terms of high r value when non-heating condensation method was used.

변연골 흡수가 내측연결 임플란트 매식체의 응력분포에 미치는 영향

윤미정,윤민철,엄태관,허중보,정창모 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.2

Purpose: The change of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. The purpose of this study was to investigate the load transfer of internal conical joint type implant according to marginal bone resorption by using the three-dimensional finite element analysis model. Materials and methods: The internal conical joint type system was selected as an experimental model. Finite element models of bone/implant/prosthesis complex were constructed. A load of 300 N was applied vertically beside 3 mm of implant axis. Results: The pattern of stress distribution according to marginal bone resorption was similar. The maximum equivalent stress of implant was increase according to marginal bone resorption and the largest maximum equivalent stress was shown at model of 1 mm marginal bone resorption. Although marginal bone loss more than 1mm was occurred increasing of stress, the width of the stress increase was decreasing. Conclusion: According to these results, the exposure of thin neck portion of internal conical joint type implant is most important factor in stress increasing. 연구 목적: 지금까지 성공적인 임플란트 치료를 위해 많은 연구가 진행되어 왔으며, 임플란트 주변 골 흡수 현상에 대한 연구는 매우 관심이 높은 분야 중 하나이다. 이에 본 연구에서는 삼차원 유한요소응력분석을 이용하여 변연골 흡수가 내측연결 임플란트 매식체의 기계적 안정성에 미치는 영향을 간접적으로 확인하고자 하였다. 연구 재료 및 방법: 악골에 식립된 내측연결 형태의 임플란트 매식체에 티타늄 소재의 임플란트 지대주를 지대주 나사로 연결하고 상부에 금합금관을 장착하는 삼차원 유한요소모형을 설계하였다. 0, 1, 2, 3 mm의 변연골 흡수 상태를 적용하고, 교합면 중심에서부터 3 mm 편측에 300 N의 수직 하중을 가하여 임플란트 매식체에 발생하는 최대 주응력을 계산하였다. 결과: 유한요소분석결과 변연골 흡수에 따른 임플란트 매식체의 최대 주응력 분포는 유사한 양상을 보였으며, 임플란트 매식체 상단에서 가장 높은 응력 집중이 나타났다. 최대 주응력은 처음 1 mm 변연골 흡수를 가정하였을 때 가장 크게 증가하였고, 이후 변연골 흡수가 증가할수록 응력은 증가하였지만 응력 증가의 폭은 감소하는 경향을 보였다. 결론: 이러한 결과로부터 내측연결 임플란트에서 매식체 두께가 얇은 경부의 노출은 변연골 흡수로 인한 응력 증가에 가장 큰 원인임을 알 수 있었으며, 매식체의 변형, 균열 및 파절 등의 기계적 실패를 감소시키기 위해서는 이에 대한 외과적, 보철적 고려가 필요할 것으로 생각된다.

일개 대학병원 간호사들의 근무형태에 따른 건강행태

권미경,강복수,황태윤,이경수 영남대학교 기초/임상의학연구소 2007 Yeungnam University Journal of Medicine Vol.24 No.1

Methicillin-Resistant Staphylococcus aureus 감염에 있어서의 국내에서 제조된 반코마이신의 임상적 효과와 안전성에 관한 연구

김태형,최상호,이미숙,김남중,김양수,류지소,우준희,염윤기 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.4

배경 : 1980년대에 methicillin-resistant Staphylococcus aureus (MRSA)가 출현한 이래 반코마이신은 MRSA 감염증에 있어 선택적 약물로 널리 쓰여 왔다. 반코마이신과 관련된 부작용으로 알려져 있는 것으로는 red-man syndrome, 신 독성, 이 독성 등이 있다. 저자들은 MRSA감염증의 치료에 있어 국내에서 제조된 반코마이신의 임상적 효능과 안전성을 검증하고자 본 연구를 시행하였다. 방법 : 1999년 4월부터 2001년 9월까지 MRSA 감염증이 증명되거나 의심되어 반코마이신을 사용한 79명의 환자를 전향적으로 추적하여 반코마이신의 효능과 부작용을 평가하였다. 결과 : 총 42명의 환자가 MRSA 감염증으로 확진되어 평가 가능하였다. 폐렴(14/42 ; 33.3%)이 가장 흔한 MRSA 감염증이었으며 그 외의 원인으로는 피부와 연조직 감염(9/42: 11.9%), 원발병소미상의 패혈증(5/42: 11.9%), 중심정맥도관감염증(5/42; 11.9%)의 순이었다. Favorable clinical response (cure or improved)는 31명(75.6%)의 환자에게서 나타났고, favorable bacteriological response (eradicated or presumed eradicated)는 28명(68.3%)에서 나타났다. MRSA 감염증과 관련된 사망률은 14.3%였다. 반코마이신과 관련된 부작용으로는 피부발진, red-man syndrome, 신독성, 백혈구감소증이 각각 2명이었고 혈소판 감소증이 1명에서 발생하였다. 결론 : 제한적인 수의 환자를 대상으로 한 결과이기는 하나 국내에서 제조된 반코마이신은 다양한 종류의 MRSA 감염증에 있어 비교적 효과적이고 안전한 치료제로 평가되며 보다 대규모의 비교연구가 필요할 것이다. Background : Since the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in 1980s, vancomycin has been widely used as the antibiotic of choice for MRSA infections. Adverse events known as related with vancomycin are red-man syndrome, ototoxicity, and nephrotoxicity. We studied the clinical and bacteriological efficacy and safety of generic vancomycin (Cheiljedang vancomycin®) in the treatment of infections caused by MRSA. Methods : During the period between April 1999 and September 2001, we prospectively enrolled 79 patients with established or suspected MRSA infection and evaluated the clinical and bacteriological efficacy and adverse events. Results : Total 42 patients were evaluable for MRSA infections. MRSA pneumonia (14/42; 33.3%) was the most common diagnosis, followed by skin &. soft tissue infection (9/42: 21.4%), primary bacteremia (5/42; 11.9%), and catheter-related infection (5/42; 11,9%). A favorable clinical response (cure or improved) occurred in 31 patients (75.6%) and a favorable bacteriological response (eradicated or presumed eradicated) occurred in 28 (68.3%) patients. MRSA infection related case fatality was 14.3%. The adverse events related to vancomycin were as follows; 2 patients (4.8%) with skin rash, 2 (4.8%) red-man syndrome, 2 nephrotoxicity, 2 leukopenia, and 1 thrombocytopenia. Conclusion : These results suggest that Cheiljedang vancomycin hydrochloride could be effective and safe as treatment for severe infections caused by MRSA.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

스트레칭운동에서 온열요법이 요부의 유연성에 미치는 영향

황윤태,유경태,이미영,박래준 대구대학교 특수교육재활과학연구소 2007 再活科學硏究 Vol.25 No.1

스트레칭(stretching)은 최근 신체 각 부위를 적절하게 움직이게 하여 긴장과 피로를 풀어주어 신체 발달을 꾀하고 유연성을 향상시키는데 좋은 운동방법으로 평가되고 있다. 온열요법(heating therapy)은 신체부분에 국소적으로 열을 가하여 혈액의 순환을 증가시켜서 손상의 빠른 회복을 기대하여 물리치료학에서 현재 많이 이용되는 방법으로 관절 경직의 완화, 동통 완화, 그리고 근 경련의 감소에 효과적이다. 본 연구에서는 20대에서 40대 사이의 신경학적 제한이 없는 정상인을 대상으로, 스트레칭 운동을 시행할 때 혼합되는 온열요법이 요부의 유연성 개선에 미치는 효과를 알아보고자 하였다. 20대에서 40대 20명(남10, 여10명)을 10명씩 두 집단으로 나누어 한 집단은 8 동작의 스트레칭 시행하는 스트레칭 집단으로 하고, 다른 한 집단은 온습포(hot pack)와 8 동작의 스트레칭을 혼합하는 열-스트레칭 혼합 집단으로 하였다. 각 집단은 주 4회 6주간 실시되었으며, 유연성 검사를 위해 체간 굴곡(trunk flexion), 체간 신전(trunk extension), 그리고 요부의 유연성을 나타내는 Schober-test를 측정하였다. 두 그룹간의 차이를 연구하여 요부의 유연성 개선에 미치는 효과를 검증하였으며, 나아가 본 연구는 요부 안정화 프로그램의 중요성과 산업체 근로자와 장시간 같은 자세로 작업을 하는 장애자들에게서 흔히 발생하는 요부의 통증에 접근하기 위해 고안되었다. The purpose of this study is to verify the difference of effect between group and period in order to find out effect on lumbar flexibility of treatment modality(stretching, heat - stretching) and period. The subject was chosen from the mild physically normal person who range from 20 to 40 years old without any neurological problem. Among these subjects, 20 persons(10 male, 10 female) were selected to two different groups. These were classified as stretching and heat- stretching groups. In stretching group, 8 different kind of stretching exercises were performed. In heat-stretching group, hot pack and stretching were performed together with 8 different stretching exercises. For the measurement of flexibility, trunk flexion test, trunk extension test and Schober-test were used. Pre-test was performed before treatment test, post-test was performed after 6 week of treatment test. As a result of this test, the following fact was shown 1) In trunk flexion and trunk extension test, effect between groups did not occur but effect of treatment period showed significance statistically. In addition, interactive effect between treatment period and each group showed the biggest difference in heat and stretching group. 2) In Schober-test, effect of treatment period showed significance statistically, effect between group and interactive effect did not occur.

영아 급성 출혈설 부종 1례

나보미,이진석,하태선,윤태영 충북대학교 의과대학 충북대학교 의학연구소 2004 忠北醫大學術誌 Vol.14 No.1

영아 급성 출혈성 부종 (acute hemorrhagic edema of infancy, AHEI)은 4개월에서 2세 사시의 소아에서 주로 얼굴과 사지에 국한된 염증성 부종과 특징적인 자반성 피부 병변을 보이는 백혈구 파쇄성 혈관염으로, 내부 장기의 침범 없이 급성의 피부 병변을 보이며 대게 1-3주 내에 자연 치유되는 양성질환이다. 이 질환은 비슷한 임상양상이나 조직소견을 보이는 다양한 질환들과의 감별이 필요한데, 특히 소아에서는 Henoch-Schonlein 자반증과의 감별이 특히 중요하다. 이에 저자들은 자반성 피부병변과 얼굴과 사지의 부종 등의 특징적 피부증상과 피부 병리소견을 통하여 AHEI로 진단한 17개월 남아 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Acute hemorrhagic edema of infancy (AHEI) is a variant of leukocytoclastic vasculitis which is characterized by edema and pupuric skin lesions involving mainly the face and extremities. However, there is usually no visceral involvement. The onset of the disease is acute but self-limited, bearing a benign clinical course within 1 to 3 weeks. The main differential diagnosis of AHEI is Henoch-Schonlein purpura. We report a 17-month old boy with AHEI presenting purpuric skin lesions, edema on face and extremities, and leukocytoclastic vasculitis on skin pathology.

기능성 Catechol-O-Methyltransferase 유전자 다형성과 한국인 정신분열병의 관련성

박태원,홍영준,박임순,김형섭,최인미,배수영,윤경식,강대희 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : Catechol-O-Methyltransferase(COMT)는 카테콜아민 신경전달물질의 불활성화를 담당하는 효소로서, 정신분열병과 관련된 후보 유전자로서 알려져 왔다. 최근, 기능성 COMT유전자 다형성과 정신분열병의 관련성이 제기되었는데, 한국인 정신분열병에서도 이러한 관련성이 있는지를 살피기 위해 본 연구를 시행하였다. 방 법 : 정신분열병으로 진단된 환자군 103명과 성별 및 연령별로 1:1 짝짓기 대조군 사이에 유전자형과 대립유전자의 분포를 비교하였다. 또한, 환자군은 공격적 행동, 가족력, 아동기 발병 여부에 따라 두 군으로 나누어 비교하였다. DNA의 다형성 부의를 중합효소연쇄반응에 의해 증폭한 후 ,NlaⅢ제한효소법과 전기영동을 실시하여 유전자형을 판별하였다. 결 과 : 환자군 전체와 대조군 사이에 유전자형과 대립유전자 빈도의 차이가 없었다. 가족력이 있는 환자군을 대조군과 비교하였을 때는, 대립유전자 L을 포함하는 유전자형과 그렇지 않은 유전자형의 분포에 있어 유의한 차이를 보였다(p=0.02, OR=3.9, 95% Cl=1.1∼14.3). 결 론 : 한국인 정신분열병과 기능성 COMT 유전자 다형성 사이에 유의한 관련성이 없었다. 따라서, 기능성 COMT 유전자 다형성이 한국인 정신분열병의 발병에 영향을 주지 못한다. 그러나, 정신분열병 가족력과 기능성 COMT유전자 다형성의 관련성이 시시돠어, 향후 본 연구에서 나타난 방법론적인 문제점을 보완하고 추가 대상자를 확보한 연구가 필요하다. Objectives : Catechol-O-methyltransferase(COMT) is involved in the degradation of catecholamine meurotransmitters and has been investigated as a candidate gene in schizophrenia. Recently, possible relationship between functional COMT gene polymorphism and schizophrenia has been suggested. To address the possible role of functional COMT gene polymorphism in the predisposition to schizophrenia, we carried out an association study in Korean schizophrenic patients and controls. Methods : One hundred and three Korean inpatients diagnosed as schizophrenia and 103 age and sex matched controls were selected as study subjects. Patients were subgrouped into two groups on the basis of history of aggressive behavior, family history of schizophrenia and related disorders, and age at onset. We determined COMT genotypes using PCR of the relevant region followed by digestion with NlaⅢ and electrophoresis. Results : No significant differences of allele and genotype frequencies were noted between patients and controls. However, when patients were categorized by the presence of family history of schizophrenia and related disorders, patients with family history showed almost 4 fold higher frequency of having COMT L allele containing genotype compared to controls(p=0.02, OR=3.9, 9.5% CI=1.10-14.33). Conclusion : Although our results do not support an association between functional polymorphism of COMT gene and schizophrenia overall, the findings suggest an association between functional COMT gene polymorphism and familial schizophrenia. Further studies with large samples are needed to confirm this association.

진공포장한 소 등심육의 저장성에 관한 연구

손태문,김미숙,문윤희 慶星大學校 1997 論文集 Vol.18 No.2

This study was investigated storage stability period as a result of physico-chemical properties, total plate count and sensory evaluation on storage stability. The vacuum packaged beef loin stored at 2, 10, 20 and 30℃. The result of evaluated quality change was used, and the shelf-life predicted according to change of storage temperature. A judgement of the early stage of decomposition was by criterion according to aroma, color and appearance of slime in sensory evaluation of vacuum packaged beef loin. The early stage of decomposition by storage period were 11 days at 10℃ and 2 days at 20℃, but the stage at 30℃ was decomposed in the first day. The pH, VBN, TBA and total plate counts of the early stage of decomposition were above 6.05, 26.29mg%, 0.987mg malonaldehyde/kg and 10? CFU/cm², respectively. And the storage during 43 days at 2℃ was not decomposed. The appearance of gas during stored by vacuum package not showed in the early stage of decomposition, but showed during the advance of decomposition. The Q? value 5.5 gained as a result of this studies, the storage stability period in different temperature predicted. The 72 days at -1℃ , 61 days at 0℃, 26 days at 5℃, 9 days at 11℃ and 5 days at 15℃ predicted by storage stability period.