전신성 홍반성 루푸스에 동반된 미세변화 신증후군 1예

주희린,안원석,이성원,정원태,나서희,김성은,김기현 대한내과학회 2003 대한내과학회지 Vol.65 No.2

저자들은 전신성홍반성 루푸스의 ClassⅠ병변에 미세변화 신증후군이 동반되어 고용량의 스테로이드 요법으로 관해를 이루고 이후 재발하여 재차 신생검 결과 막성신병증으로 확인된 환자에서 cyclophosphamide로 다시 관해를 이룬 매우 드문 증례를 경험하였기에 보고하는 바이다. Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by the overprocuction of autoantibodies and the deposition of immune complexes in various organs. Unusual case of systemic lupus erythematosus (SLE) associated with minimal change nephrotic syndrome (MCNS) is described. A 30-year-old woman who has been diagnosed as SLE and treated with prednisolone presented symptoms of nephrotic syndrome. Renal biopsy revealed minor glomerular abnormalities without deposition of immune complexes. The initial heavy proteinuria promptly decreased after the prednisolone dosage was increased and disappeared 10 weeks later. She developed proteinuria again 3 years after the initial episode. Repeated renal biopsy revealed membranous nephropathy. T-cell dysfunction, which is present both in SLE and MCNS, might have triggered MCNS during the course of SLE.

경연 대회를 통한 초ㆍ중고생의 창의력 신장 효과에 관한 연구

이희복,육근철,류해일,김현섭,김희수,박달원,유병환,김선효,김여상,서광수,변두원,서명석,배성효,박종석,심규철,이성희 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

미래 사회를 대비하기 위한 개인의 개성을 존중과 창의적인 능력을 지닌 인간을 양성을 목적으로 충청남도 지역의 초 ㆍ 중고등학생들을 대상으로 한 창의력 경연대회가 공주대학교 과학교육연구소에서 개최되었다. 충청남도 초 ㆍ중 ㆍ 고등학생들을 대상으로 실시한 창의력 경연대회는 창조적 아이디어를 내어 스스로 문제를 해결해 나갈 수 있는 교육 프로그램을 제공하는 좋은 기회였음이 확인되었으나, 일부의 팀에서만 참신하고 재미있는 아이디어들이 제안되었다. 여학생의 참가자 수가 상당히 증가하였으며, 대체적으로 입상권의 학생들의 상당 부분이 여학생이라는 것이 특이할만하다. 학년이 올라감에 따라서 창의적인 아이디어를 내는 양이나 질에 있어서 뒤떨어지는 것으로 분석되었으며, 토론 학습의 적응력이 미흡하고 발표력 및 청취력에 있어서도 떨어지는 것으로 나타났다. 따라서 중 ㆍ고등학교의 학교교육에서도 학생들에게 프로젝트형 탐구학습 프로그램의 적용은 물론 토론식 수습을 통한 학생들의 사고의 전환의 기회를 제공해야 할 것으로 사료된다. The creativity competition was held to foster the creativity of elementary and secondary school students in the Institute of Science Education, Kongju national University. It was found that the creativity competition effected on the improvement of inventing creative ideas and problem solving activities. But, only some competitors participated in semifinal and final contests, presented original and interesting ideas. More female students participated in competition than last year. More female participants were awarded a prize than males. Totally, participants were defective in discussion and communication, and presentation and listening ideas. Increasing grades correlated inversely with creativity and originality. There is need of inquiry project teaming programs and presenting opportunities of conversion of thinking by discussing instructions in school

가열로의 열적해석 및 설계인자에 관한 연구

서용석,강성규,박원희,민동호,김태국 중앙대학교 기술과학연구소 1998 기술과학연구소 논문집 Vol.28 No.-

본 연구에서는 3차원 정육면체 가열로 내의 전도-대류-복사 복합열전달 특서을 해석하였으며, 연소가스의 유입속도, 벽면의 반사율과 매체의 흡수계수 등과 같은 인자들의 변화에 따른 영향을 살펴보았다. 가열로의 벽면들은 단열되어 있고 가열로 내부로 일정한 온도의 연소가스가 유입될 때 시스템 내부의 온도는 유입 온도와 비슷하게 균일한 온도 분포를 갖는 것으로 예측할 수 있었다. 유입 속도가 증가하더라도 가열로 내부의 온도에는 거의 영향을 미치지 않았으며, 가열로는 유입되는 연소가스의 흡수계수가 증가할수록 가열로 내부의 온도는 보다 균일하게 된다. 또한, 가열로 내부 벽의 반사율이 커질수록 벽의 온도는 감소하고 또한 벽면에 작용하는 유효복사열유속은 증가함을 알 수 있었다. 이러한 해석 결과로부터 가열로 내부의 온도 분포는 매체의 흡수계수가 클수록 그리고, 벽면 반사율이 작을수록 일정하게 유지될 수 있다는 것을 알 수 있었다. 그리고 이러한 결과들을 종합하여 볼 때 가열로의 설계 시 일정한 열의 유입과 가열로를 단열시키는 것이 중요하며, 그리고 매체의 흡수 계수를 크게 하고, 그리고 벽면의 반사율을 작게 하는 것은 가열로 내부의 온도를 일정하게 유지할 수 있는 중요한 조건이 된다는 것을 알 수가 있었다.

3개 대학병원의 주 진단 코딩사례 평가

서순원,김광환,부유경,서진숙,서정돈,윤석준,이영성,이무식,정희웅 한국의료QA학회 2002 한국의료질향상학회지 Vol.9 No.1

Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators(MRAs) of 3 university hospitals participated in coding principal Dx. From August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three(A,B,C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses ; how they decide and code the principal diagnosis when day see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician’s opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in coding among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

보건소 건강증진사업 수행과정의 질 평가

서영준,정애숙,박태선,김주경,박남수,이희원 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.1

This study purports to assess the process quality of health promotion programs at public health centers. The sample used in this study consisted of 242 public health centers in South Korea. Data was collected with self-administered questionnaires between September. 3rd to September. 23rd in 2002. The 95 returned questionnaires were analyzed by SPSS 11.0 version. The major findings are as follows; There is a need to improve (1) a procedure for reviewing and analyzing strategic planning, (2) the quality of the staff in charge of program management, (3) the function of planning and training for monitoring and evaluation, (4) the ability of program managers in advising and consulting with clients, and (5) a procedure for organizing resources and information. In conclusion, in order to improve the process quality of health promotion programs at public health centers, integrated support from various institutions such as public health centers, community, regional and national health authorities and administrative departments is required.

무증상으로 발견된 담낭-담관 누공을 동반한 Mirizzi 증후군 1예

홍진희,전태주,서지영,서동대,오태훈,신원창,최원충,신은아,김기환 인제대학교 2009 仁濟醫學 Vol.30 No.-

Mirizzi's syndrome is a rare complication of the gallstone disease, characterized by narrowing of the common bile duct (CBD) due to chronic extrinsic compression of an impacted gallstone in the cystic duct or the neck of the gallbladder. The impacted gallstone may erode into the bile duct, causing cholecystocholedochal fistula. The patients generally have history of repeated attacks of jaundice and abdominal pain. But there is no report about asymptomatic Mirizzi syndrome with cholecystocholedochal fistula which were found incidentally. So herein we present our clinical experience with a case of asymptomatic Mirizzi syndrome with cholecystocholedochal fistula in a young female.

Self-drilling 방식의 마이크로임플란트 식립에 의해 발생하는 피질골 스트레인의 유한요소해석

박진서,유원재,경희문,권오원 대한치과교정학회 2009 대한치과교정학회지 Vol.39 No.4

골밀도가 높고 두꺼운 피질골에 마이크로임플란트를 self-drilling 방식으로 식립하는 경우 과도한 수준의 골부하(bone loading)가 발생할 위험이 있으며 이는 인접골의 정상적인 골개형(bone remodeling)에 장애를 초래할 수 있다. 이에, 본 연구에서는 유한요소해석으로 두께 1.0 mm의 피질골에 Absoanchor SH1312-7 마이크로임플란트((주)덴토스, 대구, 대한민국)가 self-drilling 방식으로 식립되는 과정(10회전, 식립깊이 5 mm)을 모사(simulation)하였으며 식립 단계별로 피질골에 발생되는 스트레인을 조사하였다. 식립중 마이크로임플란트 첨부의 절삭연(cutting flute)에 의한 골삭제로 생기는 나사길(threaded groove)의 치수를 얻기 위하여 가토 경골에 마이크로임플란트를 식립/제거한 후 Micro CT (Explore Locus RS, GE Healthcare, Ontario, Canada)를 이용하여 기하형상을 측정하였으며 이를 치밀골의 유한요소모델에 반영하였다. 해석결과, 치밀골에 발생되는 스트레인은 임플란트 식립깊이에 따라 증가하였고, 초기단계에서 나사산에 인접한 골에 국한되던 과부하 부위(스트레인이 4,000μ-strain을 상회하는 영역)가 식립깊이 증가에 따라 인접골 전체, 즉 나사산 인접부는 물론 골(valley) 부위에 접하는 모든 영역으로 확장되었다. 본 연구를 통해, self-drilling 방식으로 마이크로임플란트를 식립할 때 치밀골에 발생하는 스트레인 크기는 생리적인 골개형을 저해할 수 있는 수준임을 확인할 수 있었다. Objective: The aim of this study was to evaluate the strain induced in the cortical bone surrounding an orthodontic microimplant during insertion in a self-drilling manner. Methods: A 3D finite element method was used to simulate the insertion of a microimplant (AbsoAnchor SH1312-7, Dentos Co., Daegu, Korea) into 1 mm thick cortical bone. The shape and dimension of thread groove in the center of the cortical bone produced by the cutting flute at the apical of the microimplant was obtained from animal test using rabbit tibias. A total of 3,600 analysis steps was used to calculate the 10 turns and 5 mm advancement of the microimplant. A series of remesh in the cortical bone was allowed to accommodate the change in the geometry accompanied by the implant insertion. Results: Bone strains of well higher than 4,000 microstrain, the reported upper limit for normal bone remodeling, were observed in the peri-implant bone along the whole length of the microimplant. Level of strains in the vicinity of either the screw tip or the valley part were similar. Conclusions: Bone strains from a microimplant insertion in a self-drilling manner might have a negative impact on the physiological remodeling of cortical bone.

자궁내 태아 사망에 대한 임상적 고찰 (1990-1997)

김희범,서기원 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective : Our purpose of this study was to evaluated the incidence, cause of intrauterine fetal death, termination method and the maternal complications of fetal death clinically. Patients : From January 1990 to December 1997, a retrospective study was made of the hospital records of 188 cases of the intrauterine fetal death among 42,576 deliveries after 20 weeks gestation by gestational age in Soonchunhyang Kumi Hospital. Results : The incidence of the fetal death in utero was 0.44%. The most common gestational week when intrauterine fetal death was detected was 35-40 gestational weeks(35.6%). The parity of mother in the fetal demise in utero was not different between nulliparous and multiparous women. The sex ratio of fetus in intrauterine death was not different between male and female. The cases of the fetal death in utero weighting less than 2500gm were 134 cases(71.2%). The causes of the intrauterine fetal death showed unknown causes(51.6%), maternal diabetes(11.2%), abruptio placenta(8.5%), congenital anomaly(8.0%), pregnancy induced hypertension(5.9%), intrauterine infection(5.3%), cord complication(4.3%), multiple causes(2.7%), vasa previa rupture(1.6%) and oligohydramnios(1.1%). The mode of the pregnancy termination for intrauterine fetal death showed prostaglandin E2(42.0%), oxytocin(34.5%), hysterotomy(11.2%), spontaneous delivery (9.6%), and misoprostol(2.7%). The maternal complication were hemorrhage(4.3%), infection(1.6%), cervical laceration(1.1%), and uterine rupture(0.5%). Conclusion : The cause in about 50% of the intrauterine fetal death could not be determined, so further studies must be made on mother, stillborn infants, placenta and umbilical card in cases where the causes in unknown for the purpose of good outcome and prevention of intrauterine fetal death in next pregnancy. And the studies investigating the safe and effective method for pregnancy termination are needed in order to reduced maternal complication and shortened termination time.

길안천(경북 안동)의 저서성대형무척추동물 군집변동 및 생물학적 수질평가

조희욱,김경호,노상은,박진영,서을원,이종은 7개 국립대학교 환경연구 논문집 공동발행 위원회 2004 공업기술연구 Vol.4 No.-

A biological assessment of water quality was carried out in Giran stream from May 203 to January 2004. The benthic macroinvertebrates collected seasonally from 5 field sites were identified mostly up to species level. The benthic macroinvertebrates collected from the surveyed sites were composed of 88 species, 68 genera,42 families, 14 orders, 5 class and 4 phyla. The dominance index (DI) showed the high-est as 0.802 at site 5 and the lowest as 1.643 at site 3. Ecological score of benthic macroinvertebrate (ESB) showed the highest as 103 at site 2 and the lowest as 63 at site 3. All surveyed sites were Oligosaprobic that the water quality estimated by ecological score of benthic macroinvertebratc community.

한국어의 특성을 고려한 용례 검색 시스템

홍금원,임재수,서희철,임해창 고려대학교 컴퓨터과학기술연구소 2001 JOURNAL OF COMPUTER SCIENCE & ENGINEERING TECHNOLO Vol.3 No.-

본 논문에서는 한국어의 특성을 고려한 용례 검색 시스템을 제안한다. 제안된 시스템은 직접 용례 검색과 색인 기반 용례 검색을 제공한다. 직접 용례 검색에서는 원시 말뭉치에서 한글 음절 단위의 검색뿐만 아니라 한글 자소 단위의 검색이 가능하며, 색인 기반 용례 검색에서는 어절, 형태소, 그리고 체계화된 품사정보를 이용한 검색이 가능하다. 검색속도 및 색인된 파일의 크기는 실험을 통하여 최적화 한다. 사용자는 검색된 용례로부터 연산 및 정렬 과정을 거쳐서 보다 정확하게 선별된 용례를 얻을 수 있다. 본 시스템을 통해 얻어진 용례 정보는 사전 편찬 등의 한국어 연구의 기초 자료로 활용할 수 있으며, 말뭉치를 기반으로 한 다양한 분야에서 활용할 수 있을 것이다. In this paper, we propose the concordance system considering the characteristics of Korean. The proposed system provides two kinds of retrieval method: direct access retrieval and index based retrieval. In direct access retrieval method, it is possible to retrieve examples using grapheme-based query as well as syllable based query. In index-based retrieval method, it is possible to retrieve examples using eojeol, morpheme, or part-of-speech. The speed of the system and the size of the indexed file is optimized through several experiments. Users can acquire the exact and selective examples from previously retrieved items by filtering and/or sorting. The linguistic information acquired by the system can be utilized as basic data for Korean Linguistic research such as lexicography and it can be used in various application fields based on corpus.