4주 이하 신생아에서 진단된 심방중격결손의 자연경과에 관한 연구

황영준,정경현,최석민,이규형,Hwang, Young Jun,Chung, Kyung Hyun,Choi, Suk Min,Lee, Kyu Hyung 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.5

목 적: 이차공 심방중격결손은 소아에서 두번째로 빈도가 높은 심기형이나 청진소견과 증상만으로는 조기에 진단하기 어렵기 때문에 이 질환의 자연경과가 잘 알려져 있지 않았으나 최근 2D 심초음파의 활용으로 조기진단의 빈도가 높아지면서 진단의 시기와 결손의 크기가 자연 경과와 밀접한 관계가 있다는 보고가 활발히 이루어지고 있다. 이에 저자들은 생후 4주 이내에 2D 심초음파로 이차공 심방중격결손이 진단된 환아들을 추적 검사하여 이 질환의 자연 경과를 알아 보고자 본 연구를 시행하였다. 방 법: 1995년 9월부터 1999년 9월까지 포천중문의대 분당차병원에서 2D 심초음파로 이차공 심방중격 결손이 진단된 환아들 중 첫 진단이 생후 4주 이하의 신생아기에 이루어졌고, 추적 검사가 가능했던 61명을 대상으로 하여 결손의 크기에 따라서 4개의 군으로 나누고, 마지막으로 시행한 2D 심초음파상의 결손의 크기를 기준으로 각 군에서 결손 크기의 변화를 비교하였다. A군은 결손의 크기가 4 mm 미만, B군은 4mm 이상 6 mm 미만, C군은 6 mm 이상 8 mm 미만, D군은 8 mm 이상인 환아들로 나누었다. 또한 동반된 선천성 심기형의 유무에 따라 2개의 군으로 나누어 동반된 심기형이 이 질환의 자연 경과에 영향을 미치는지 알아보았다. 동반된 심기형이 복합 심기형인 경우는 대상에서 제외하였다. 이차공 심방중격결손의 진단 및 결손 크기의 측정은 2D 심초음파(Hewlett-Packard Sonos $2500^{(R)}$)로 늑골하 단축면상(subcostal short axis view)과 늑골하 장축면상(subcostal long axis view)에서 시행하였다. 결 과 : 대상 환아 61명 중 A군은 24명(39%), B군은 27명(44.3%), C군은 6명(9.8%), D군은 4명(6.6%)이었다. 동반된 심기형이 없는 환아는 21명(34.4%)이었고, 동반된 심기형이 있는 환아는 40명(65.6%)이었다. 2D 심초음파 추적 검사 결과 A군은 24명 중 22명(91.7%), B군은 27명 중 23명(85.2%), C군은 6명 중 4명(66.7%)이 자연 폐쇄되었고, D군에서는 자연 폐쇄가 일어나지 않았고 4명 중 3명에서 수술적 치료를 하였다. 진단시 결손의 크기가 6 mm 미만인 환아들의 자연 폐쇄율이 유의하게 높은 것으로 나타났다 (P<0.05). 자연 폐쇄의 시기는 3개월에서 9개월 사이였으며, 대부분이 1세 이전에 자연 폐쇄되었다. 심실 중격결손, 동맥관 개존 등의 단순 심기형을 동반한 경우에도 자연 폐쇄율의 차이는 없었다(P=0.717). 결 론 : 생후 4주 이하의 신생아기에 진단된 이차공심방중격결손은 첫 진단시 결손의 크기가 작을수록 자연 폐쇄의 비율이 높았으며, 특히 결손의 크기가 6mm 미만인 경우에는 대부분 1세 이전에 자연 폐쇄가 일어난다는 것을 알 수 있었고, 8 mm 이상인 경우에는 자연 폐쇄가 일어나지 않았다. 또 심실중격결손, 동맥관 개존 등의 동반된 심기형의 존재 유무가 이차공 심방중격결손의 자연 폐쇄에는 영향을 주지 않았다. Purpose : The purpose of our investigation was to explore the natural course, and the factors that influence the natural course, in ostium secundum atrial septal defect(ASD) diagnosed within the first 4 weeks of life. Methods : We studied patients with ASD diagnosed within the first 4 weeks of life during the period from September 1995 to September 1999 in our hospital. The diagnosis and measuring of the size of ASD was carried out by two-dimensional echocardiogram(2DE, Hewlett-Packard Sonos $2500^{(R)}$) from subcostal long and short axis views. Results : There were 61 patients - 29 males and 32 females. According to the size of their defects, we divided them into four groups; group A(less than 4 mm : 24 cases), group B(four mm-six mm : 27 cases), group C(six mm-eight mm : six cases), group D(more than eight mm : four cases). In groups A and B, 22 of 24 patients(91.7%) and 23 of 27 patients(85.2%) had each closed spontaneously. In group C, four of six patients had closed spontaneously. In group D, no patient had closed spontaneously and three of four patients had been closed surgically. There were significant differences in the rate of spontaneous closure between less than six mm group and more than six mm group in the size of the defect(P<0.05). There were no significant differences in the rate of spontaneous closure between ASD combined with simple cardiac defect and isolated secundum ASD. Conclusion : We conclude that defects smaller than six mm in diameter are very likely to close spontaneously.

소아약증직결(小兒藥證直訣)의 의안(醫案)에 나타난 전을(錢乙)의 의학사상에 관한 연구

황영준,민상연,김장현,Hwang, Young Jun,Min, Sang Yeon,Kim, Jang Hyun 대한한방소아과학회 2010 대한한방소아과학회지 Vol.24 No.1

Objectives The Medical record consist of symptoms, the cause of a disease, diagnostic studies, medical treatment, prescription, and so on. Doctors can use medical records as data for diagnosis, treatment, and education. Therefore, medical records are beneficial. Methods Translating $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ into modern Korean, and studying the medical records of Qian Yi(錢乙)'s Medical concept in $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ were examined. Results Regarding the diagnosis of the pediatric diseases, Si Zhen He Can(四該合參), consider in the eye exam closely. In addition, he closely combined the concept of Wu Zang Bian Zheng(五藏辨證), and diagnosis the pediatric diseases. Wu Zang Bian Zheng(五藏辨證). what Qian-Yi(錢乙) established method was based on Zheng Ti Guan(整體觀) in Huang Di Nei Jing(黃帝內經). Qian-Yi(錢乙) took a close look on Chuang Zhen(瘡疹) which had been an inadequate field in those days. He criticized on the habitual misuse of medications. He treated Ji Jing(急驚) and Man Jing(慢驚) separately; Ji Jing(急驚) as Liang Xie(凉瀉) and Man Jing(慢驚) as Wen Bu(溫補). He proposed Zong Gan Zhu Feng and Xin Zhu Jing(縱肝主風, 心主驚) theory and formulated Jing Feng(驚風) theory as well. He emphasized the treatment to Gong Bu Shang Zheng, Bu Bu Zhi Xie, Xiao Bu Jian Shi(攻不傷正, 補不滯邪, 消補兼施) because he had a clear demonstration to Han Re Xu Shi(寒熱虛實) of the five viscera in the field of Fang yao(方藥). Conclusions Understanding $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ and its medical records of Qian Yi(錢乙)'s medical concept had quintessential meaning to both modern pediatrician and oriental medical doctors of all medical fields in treating children.

한방소아과 설문지 및 검사에 관한 임상현황연구

황영준,김기봉,민상연,김장현,Hwang, Young-Jun,Kim, Ki-Bong,Min, Sang-Yeon,Kim, Jang-Hyun 대한한방소아과학회 2008 대한한방소아과학회지 Vol.22 No.1

Objectives The purpose of this study is to investigate whether Korean oriental pediatrics hospitals are using their feedback surveys to improve their medical conditions. Methods We selected 24 oriental medicine university hospitals and sent surveys to investigate. 15 of those surveys were analyzed. Results The results were classified as follows; Only 9 of university hospital said that they are currently using their feedback surveys to improve their services. Question for asking the purpose of doing their feedback surveys, 58.3% of hospital responded to get some information for diagnosis, 25% of them said to see the progress of treatment of specific disease, and 16.7% answered for using their data to the further studies. The question about the reason why hospital were need to make these feedback surveys, 46.2% of them answered to apply better service, 38.4% of them said to post medical journal. The question for asking what do oriental medical hospitals check from feedback surveys, 40% of them said they check Ryodoraku, 33.3% was pulse diagnostic apparatus, EAV(Electro-puncture According to Voll) was 26.7%. The classification according to purpose of test resulted as follows; information for diagnosis was 48.1%, the progress of a disease was 37.3%. In addition oriental medical test there were blood test, radiological test, brain waves test, Hair Tissue Mineral Analysis(HTMA), ultrasonic test, body composition analysis. Conclusions Further clinical research is necessary for improvement of using the feedback survey effectively.

소아에서 진단된 다발성 저음영 결절 형태를 보인 간흡충증 1례

황영준,한만용,하두회,Hwang, Young Jun,Han, Man Yong,Ha, Doo Hoe 대한소아감염학회 2001 Pediatric Infection and Vaccine Vol.8 No.1

Clonorchiasis, known as the parasitic fluke in the intrahepatic bile ducts, occurs throughout Korea, Japan, Taiwan, and Vietnam with high frequency. Most of the infections follow the consumptions of raw or undercooked freshwater fish, which explains its rare occurrence to childhood even in those areas mentioned earlier above. The authors have experienced it with an 8 year old boy. Abdominal ultrasonogram revealed multiple low echogenic nodules in the right lobe of liver and lymph nodes proliferation around the porta hepatis area. And abdominal C.T. scan also found multiple low attenuated nodules with delayed enhancement in liver parenchyma with hepatomegaly and multiple conglomerated lymph nodes in porta hepatis. Both abdominal ultrasonogram and C.T. scan didn't show any dilatation of peripheral intrahepatic bile ducts. In repeated stool examination, Clonorchis sinensis eggs were found in feces and the result of the skin test for Clonorchis sinensis was positive. The patient had a history of having eaten raw pond smelt back in Cheongju a month before the symptom onset. On the basis of the patient's history and the fact that Clonorchis eggs were found in feces 3 weeks after eosinophilia and symptoms were noted, the authors estimated that the findings of the patient's abdominal sonogram and C.T. scan were the radiologic findings of the acute phase of clonorchiasis, of which no report had ever been made before. So the authors report a case of clonorchiasis with atypical radiologic findings in an 8 year old boy. 한국은 간흡충증의 집중유행지역이고 성인에서의 간흡충증과 합병증의 보고는 많이 있었으나 소아의 경우 보고가 없었다. 본 증례는 8세 소아의 대변검사에서 충란을 발견하여 간흡충증을 진단하였다. 방사선 검사 소견에서는 이전에 보고된 전형적인 간흡충증의 방사선 소견과는 달리 간내 말초담도계의 확장 없이 간실질에 다발성의 저음영 결절과 간문맥내에 임파선 증식을 보였다. 저자들은 환아의 과거력 및 임상증상과 말초혈액 검사소견 등을 미루어 볼 때, 이러한 소견을 간흡충 감염에서 급성기의 방사선학적 소견이 아닌가 추정하였다. 이에 8세 남아의 대변검사에서 충란을 발견하여 확진하고 praziquantel 경구복용으로 치유한 1례를 보고하는 바이다.

한방소아과 치료법에 관한 임상현황연구;대학 부속 한방병원 5개 클리닉을 중심으로

황영준,김기봉,민상연,김장현,Hwang, Young-Jun,Kim, Ki-Bong,Min, Sang-Yeon,Kim, Jang-Hyun 대한한방소아과학회 2008 대한한방소아과학회지 Vol.22 No.2

Objectives : The purpose of this study is to investigate the present medical treatment in Korean oriental pediatrics. Methods : We selected 24 hospitals attached to 11 colleges of oriental medicine those stand for oriental pediatrics. We sent questionnaires of medical treatment for investigation and analyzed 15 copies of those were answered. Results : The most popular treatment was medicinal therapy. Acupuncture with medicinal therapy was not used as much, but laser acupuncture was used five times more in rhinitis. The frequency of using moxibustion and cupping were less than acupuncture and moxibustion was used as indirectly. Aroma therapy was the third most frequent therapy after medicinal therapy and acupuncture therapy. Aroma therapy was mainly used as a vapor inhalation and massage. 16 of the answered that the most popular exercise therapy would be by providing exercise guidebook and 11 of them said writing exercise diary, and 5 of them said by using exercise machine in the hospital. Conclusions : The most popular oriental therapy in Korea was medicinal therapy and next following were aroma therapy and moxibustion, cupping which is one of the traditional therapies in Korean oriental medicine.

뉴로피드백을 이용한 주의력결핍 과잉행동장애의 치료 3례

황영준,김기봉,민상연,김장현,Hwang, Young-Jun,Kim, Ki-Bong,Min, Sang-Yeon,Kim, Jang-Hyun 대한한방소아과학회 2007 대한한방소아과학회지 Vol.21 No.3

Objectives Attention Deficit Hyperactivity Disorder(ADHD) is a type of psychiatric disorder characterized with the primary symptoms of inattention and/or impulsivity and hyperactivity. The purpose of this study is to examine ADHD children who were treated with neurofeedback therapy. Methods We analyzed clinical report of 3 ADHD children who treated with neurofeedback therapy from January 2006 to June 2006. Results 1. All 3 children were diagnosed with predominantly inattention type of ADHD. 2. After treatment, cognitive strength, response, concentration, workload, left / right brain activity score were all different from each children. 3. After treatment, left and right brain activities were balanced. 4. After treatment, learning ability level was increased. 5. After treatment, the childrenwere in a better state referred to conner's scale and H.S.Q. score. Conclusions Further studies will be needed to get more clinical cases about the benefits of neurofeedback therapy with herbal medicine and acupuncture treatment.

비침습 레이저 조사기를 이용한 통증 치료에 대한 증례 보고

황영준,김장현,Hwang, Young-Jun,Kim, Jang-Hyun 대한한방소아과학회 2006 대한한방소아과학회지 Vol.20 No.3

Objectives : The purpose of this study was to assess the ability of Extravascular Laser System on pain treatment. Methods : On this study, we carried out with the 9 cases of children who visited in the Department of Pediatrics, OO University Oriental Hospital as pain. 9 children suffering from pain were treated with Extravascular Laser System, and two of these were treated with combined acupuncture. In order to determine the degree of pain relief, a visual analogue scale was used. Results : Extravascular Laser System for pain resulted in a significant decline in the visual analogue scale. For Extravascular Laser System combined with acupuncture, VAS score has fallen by 30% each time compared to 17.5% of Extravascular Laser System only. In 2 cases of chronic pain, VAS score decreased to 0. In 7 cases of acute pain, All of 7 children improved 50% on VAS score, On average VAS score have seen 79.2% reduction. The average treatment times of chronic pain were 5 times, while that of acute pain were 4.1 times. Conclusions : We report the good result of the efficacy of extravascular laser system on children's pain. but, this study's cases were small in number. so more study is need.

초등학교 교사가 느끼는 부패인식 수준에 관한 연구

황영준 ( Young Jun Hwang ) 서울敎育大學校 初等敎育硏究所 2012 한국초등교육 Vol.23 No.2

이 연구는 초등학교 교사가 느끼는 부패인식 수준은 일반적 특성(근무지역, 성별, 연령, 근무기간)에 따라 차이가 있는지, 부패의미에 대한 인식에는 상황(공적 또는 사적 사용, 현금 또는 물품, 내부거래 또는 외부거래 등)에 따라 차이가 있는 지와 부패인식에 영향을 미치는 요인은 무엇인지에 대하여 살펴보았다. 3개 시·도 6개교 초등학교 교사 177명을 대상으로 자료를 분석한 결과는 다음과 같다. 첫째, 근무지역에 따라 부패인식 수준에 다소 차이를 보였으나, 성별, 근무년 수별로는 큰 차이가 없었다. 둘째, 수수된 금품을 사적으로 사용했을 때가 공적으로 사용했을 때보다. 이득의 형태가 물품보다는 현금일 때, 내부거래보다 외부거래가 더 부패하다고 인식하는 것으로 나타났다. 셋째, 부패인식에 영향을 미치는 요인으로 개인적 요인으로는 청렴도 인식수준과 개인의 윤리의식이, 조직특성적 요인으로는 부패통제시스템이, 환경문화적 요인으로는 부패인식환경이 내외부청탁, 인간관계 중시문화보다 더 부패인식에 영향을 미치는 것으로 나타났다. 이러한 결과를 바탕으로 논의하고 후속연구를 위한 제언을 하였다. This research has examined the differences in corruption perception level of elementary school teachers according to varying demographics (work location, gender, age, length of service) and circumstances (public or private use, cash or goods, internal or external), and reviewed the factors affecting the corruption perception of respondents. The data have been collected and analyzed from 177 teachers of 6 elementary school in 3 cities and provinces, and the results are as follows. First, there are some differences of corruption perception level depending on work location but there is no significant difference depending on gender and length of service. Second, it is recognized as more corrupt when bribe is used for a personal purpose, takes the form of cash, and involves external parties. Third, for the factors influencing corruption perception, integrity perception level and individual ethics awareness are the most important factors at the personal level. Anti-corruption system is the strongest factor at the organizational level, and corruption recognition environment is the deciding factor from the cultural context rather than the relationship centered culture or internal/external lobbying on corruption perception. Based on these results, the argument has been developed and suggestions have been provided for follow-up research.

얼굴인식 CNN 모델을 활용한 눈썹 모양 추천 서비스

황영준(Young-Jun Hwang),오용록(Yong-Rok Oh),최진영(Jin-Young Choi),박현재(Hyun-Jae Park),최영준(Young-Jun Choi) 한국정보과학회 2019 한국정보과학회 학술발표논문집 Vol.2019 No.12

소아에서 기도과민성 진단을 위한 최대호기유속 측정의 유용성

황영준(Young Jun Hwang),진영아(Young A Jin),한만용(Man Yong Han),장욱(Wook Chang),이규형(Kyu Hyung Lee) 대한천식알레르기학회 2002 천식 및 알레르기 Vol.22 No.3

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