구연 : 소화기 ; 여성의 과민성대장증후군에서 생리주기에 따른 대장증상의 변화

조유경,정성애,심기남,김성은,박수현,정혜경,김도영,유권,문일환 대한내과학회 2002 대한내과학회 추계학술대회 Vol.63 No.-

Fault-Tree 기법을 이용한 해기사의 음주습관과 해양사고 사이의 연관성 분석에 관한 연구

조유경,임정빈,양원재 한국항해항만학회 2012 한국항해항만학회 학술대회논문집 Vol.2012 No.추계

해양사고의 70-80%가 인적 오류(Human Factor)에 기인한 것으로 알려져 있다. 특히 인적 오류 중 선원의 피로도는 실제 해양사고로 이어질 개연성이 대단히 큰데, 이러한 피로도는 선원의 음주로부터 비롯된 경우가 존재하며 해양사고와 연관이 있을 것으로 추정된다. 그러나 이러한 선원의 음주습관과 해양사고의 연관성에 관한 연구는 아직 정립된 바가 없는 실정이다. 이에 본 연구에서는 음주습관이 신체 및 행동에 미치는 영향을 알아보고 과거 해양사고 통계를 분석하여 해기사의 음주습관과 해양사고의 연관성에 대해 Fault-Tree 기법을 적용하여 연구하였다. 연구결과, 해기사의 음주습관은 피로도와 직접 연관성을 밝혀 낼 수 있지만 해양사고와 직접적인 연관성은 미약한 것으로 파악되었다. 그러나 선원의 피로도와 직접 연관된 음주습관은 해양사고 유발 원인이기 때문에 본 연구결과에 대한 타당성은 추후 다양한 실험을 통한 연구한 것으로 조사된다.

Functionally generated path technique을 이용한 편악 피개의치 수복 증례

조유경,이영후,홍성진,노관태,배아란,김형섭,권긍록,백장현 大韓齒科補綴學會 2022 대한치과보철학회지 Vol.60 No.1

The functionally generated path (FGP) technique, first described by Meyer in 1933, is a method in the oral cavity to use the movement pathway formed by the opposing cusps within the border movement of the mandible. Using this method, an appropriate occlusal shape can be given to the patient. In this case, the FGP technique was selected to provide a bilateral balanced occlusion when restoring the edentulous maxilla that opposes the natural mandibular teeth with irregular arrangement with overdentures. In addition, in order to precisely form the occlusal surface of the posterior region with the FGP technique and to reduce the attrition of denture teeth, zirconia denture teeth, not conventional resin artificial teeth, were individually manufactured. After treatment with these materials and methods, satisfactory results were obtained for both the operator and the patient. 1933년 Meyer에 의해 처음 기술된 Functionally generated path (FGP) technique은 하악의 한계운동 내에서 대합치 교두에 의해 형성된 운동 경로를 구강 내에서 인기하는 방법이다. 이 방법을 이용하여 환자에게 적절한 교합 형태를 부여할 수 있는데 이 증례에서는 자연치열과 대합되는 상악 피개의치를 제작하여 균형 교합을 부여하였다. 또한 FGP technique으로 구치부 교합면을 정밀하게 형성하고 의치 치아의 마모를 감소시키기 위해 통상적으로 사용하는 기성 레진 인공치가 아닌 지르코니아 의치 치아를 개별 제작하였다. 이러한 재료와 방법으로 치료 후 술자와 환자 모두 만족스러운 결과를 얻었기에 본 증례를 보고하는 바이다.

섬유육종성 융기성 피부섬유육종 1예

조유경,김미연,강지민,전영준,박철종 대한피부과학회 2003 大韓皮膚科學會誌 Vol.41 No.11

Dermatofibrosarcoma protuberans(DFSP) is an unusual, locally aggressive, cutaneous neoplasm of low grade malignancy. Several histologic variants have been described. Among them, fibrosar-comatous dermatofibrosarcorna protuberans is associated with a higher rate of local recurrence and distal metastases as well as a shorter latency period of time until recurrence than does ordinary DFSP. As a result, it needs more intense treatments and more vigorous follow up. A 37-year-old man presented with an asymptomatic erythematous hard nodule and several reddish papules on the chest for 2 years. Histopathologic examination revealed fibrosarcomatous dermatofibrosarcoma protuberans. We, herein, report an unusual case of fibrosarcomatous dermatofibrosarcoma protuberans. (Korean J Derrnatol 2003;41(11) : 1560-1563)

당뇨 환자에서 발생한 Candida albicans에 의한 완전 이영양성 조갑진균증 1예

조유경,정유진,박현정,오신택,이준영,조백기 대한의진균학회 2004 대한의진균학회지 Vol.9 No.2

Onychomycosis is the invasion of the healthy nail plate by species of dermatophytes, as well as a variety of non-dermatophytes (yeasts and moulds) which may cause nail infection, particularly after tissue damage by trauma or disease. Candida albicans and C. parapilosis are the most commonly isolated yeasts from abnormal toenails. The patient was a 20-year-old woman who presented with a thickened and crumbly nail plate of the right second finger for 4 months. Initially, a tiny yellowish macule appeared under the nail plate, which gradually involved the entire nail plate, resulting in complete deformity of the nail. She was diagnosed with diabetes mellitus 4 months ago and her blood sugar level was controlled with subcutaneous insulin injections. Direct microscopic examination of the scrapings prepared with potassium hydroxide revealed fungal elements. Repeated cultures on Sabouraud dextrose agar showed cream to white colored, semi-glossy, flat colonies, which were findings consistent with C. albicans. Complete extraction of the involved nail with meticulous curettage of the nail bed was made. She has been taking 150 mg of oral fluconazole weekly since August 2003 and showed substantial improvement.

Ethanol Production from Seaweed, Enteromorpha intestinalis, by Separate Hydrolysis and Fermentation (SHF) and Simultaneous Saccharification and Fermentation (SSF) with Saccharomyces cerevisiae

조유경,김민지,김성구 한국생물공학회 2013 KSBB Journal Vol.28 No.6

Ethanol productions were performed by separatehydrolysis and fermentation (SHF) and simultaneous saccharificationand fermentation (SSF) processes using seaweed,Enteromorpha intestinalis (sea lettuce). Pretreatment conditionswere optimized by the performing thermal acid hydrolysisand enzymatic hydrolysis for the increase of ethanol yield. The pretreatment by thermal acid hydrolysis was carried outwith different sulfuric acid concentrations in the range of 25mM to 75 mM H2SO4, pretreatment time from 30 to 90 minutesand solid contents of seaweed powder in the range of 10~16% (w/v). Optimal pretreatment conditions were determinedas 75 mM H2SO4 and 13% (w/v) slurry at 121oC for 60 min. For the further saccharification, enzymatic hydrolysis was performedby the addition of commercial enzymes, Celluclast1.5 L and Viscozyme L, after the neutralization. A maximumreducing sugar concentration of 40.4 g/L was obtained with73% of theoretical yield from total carbohydrate. The ethanolconcentration of 8.6 g/L of SHF process and 7.6 g/L of SSFprocess were obtained by the yeast, Saccharomyces cerevisiaeKCTC 1126, with the inoculation cell density of 0.2 g dcw/L.

Predictors of spontaneous viral clearance and outcomes of acute hepatitis C

조유경,김영남,송병철 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: This study evaluated the predictors of spontaneous viral clearance (SVC), as defined by twoconsecutive undetectable hepatitis C virus (HCV) RNA tests performed ≥12 weeks apart, and the outcomes of acutehepatitis C (AHC) demonstrating SVC or treatment-induced viral clearance. Methods: Thirty-two patients with AHC were followed for 12-16 weeks without administering antiviral therapy. Results: HCV RNA was undetectable at least once in 14 of the 32 patients. SVC occurred in 12 patients (37.5%), amongwhom relapse occurred in 4. SVC was exhibited in 8 of the 11 patients exhibiting undetectable HCV RNA within 12 weeks. HCV RNA reappeared in three patients (including two patients with SVC) exhibiting undetectable HCV RNA after 12weeks. SVC was more frequent in patients with low viremia than in those with high viremia (55.6% vs. 14.3%; P =0.02),and in patients with HCV genotype non-1b than in those with HCV genotype 1b (57.1% vs. 22.2%; P=0.04). SVC was morecommon in patients with a ≥2 log reduction of HCV RNA at 4 weeks than in those with a smaller reduction (90% vs. 9.1%,P<0.001). A sustained viral response was achieved in all patients (n=18 ) receiving antiviral therapy. Conclusions: Baseline levels of HCV RNA and genotype non-1b were independent predictors for SVC. A ≥2 log reductionof HCV RNA at 4 weeks was a follow-up predictor for SVC. Undetectable HCV RNA occurring after 12 weeks was notsustained. All patients receiving antiviral therapy achieved a sustained viral response. Antiviral therapy should beinitiated in patients with detectable HCV RNA at 12 weeks after the diagnosis.

전자내시경의무기록을 위한 내시경 보고서

조유경 대한소화기내시경학회 2010 Clinical Endoscopy Vol.41 No.4

내시경 분야에서 전자내시경의무기록 시스템은 간단한 내시경 결과보고서의 작성을 넘어 포괄적인 내시경실 관리시스템으로 발전하고 있다. 전자내시경의무기록 시스템은 내시경의사의 효율뿐 아니라 내시경실 관리의 효율을 높일 수 있다. 전산화된 내시경기록은 임상연구와 질 관리가 가능하도록 내시경결과의 데이터베이스 생성을 가능하게 한다. 그러기 위해서는 내시경 보고서의 구조를 계획할 때부터 표준 보고서의 형식을 표준화된 용어를 선택하여 결과를 입력하는 것이 중요하다. 이미 최소표준용어가 내시경의 전산기록을 위해 개발되어 사용되고 있다. 권장 내시경보고서의 사용과 양질의 영상기록은 내시경 질 관리 면에서도 중요하다. Electronic medical record systems for endoscopic data have evolved from simple endoscopy report generators to endoscopy unit managers. These systems may improve patient care and enhance endoscopy unit efficiency and productivity. Regarding endoscopists, the introduction of automated endoscopic reporting using endoscopic electronic medical records should permit database establishment. The systematic development of the structure and content of endoscopic reports is mandatory before it is possible to create large, clinically useful databases of endoscopic reports. An accurate endoscopic report is based on the use of standard terminology, a standard classification method, and image and video recordings. The minimal standard terminology was developed as a minimum list of terms that could be included in a computer system for endoscopic reporting. A standard framework of endoscopic reports using standard terminology and a minimal checklist of endoscopic images are also needed for quality assurance.

Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea

조유경,Jeong Seop Moon,Dong Su Han,Yong Chan Lee,Yeol Kim,Boyoung Park,Il-Kwun Chung,Jin-Oh Kim,Jong Pil Im,Jae Myung Cha,Hyun Gun Kim,Sang Kil Lee,Hang Lak Lee,장재영,Eun Sun Kim,Yunho Jung,문창모 대한소화기내시경학회 2016 Clinical Endoscopy Vol.49 No.6

Background/Aims: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA)program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QAprogram from the viewpoint of medical institutions. Methods: We surveyed the staff of institutional endoscopic units via e-mail. Results: Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QAprogram raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders whoreported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment,endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, manystaff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washedendoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created theirown quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%),especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) wereconsidered important to the success of the QA program. Conclusions: Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program

조유경 대한소화기내시경학회 2016 Clinical Endoscopy Vol.49 No.4

In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary.