약물 유해반응 보고지침 -임상시험의 안전성에 관한 정보 관리지침 -

지동현,김훈교,배진우,손동렬,김인범,전용관,박혜연 大韓臨床藥理學會 1998 臨床藥理學會誌 Vol.6 No.2

회맹장 및 대장을 침범한 장 결핵에 있어서 바륨을 이용한 방사선 이중조영촬영 소견에 대한 연구

진용현,전혜정,이용근,강철호,조성범,김윤환,박철민,차상훈,김일영,이혜경 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

To determine the characteristic double contrast barium enema findings of ileo-cecal and colonic tuberculosis and to make differential diagnosis from other bowel inflammatory disease. Sixty-seven patients confirmed as ileo-cecal and/or colonic-tuberculosis in six hospitals were evaluated retrospectively. The diagnosis was proven by endoscopic biopsy, surgery, and clinical follow up. Nine of 67 patients were excluded because radiologic findings were normal though endocopic biopsy examinations resulted in tuberculosis. Histopathological diagnosis were madein 58 cases as follows: endoscopic biopsy(n=29), operation(n=12), follow up examination(n=14), tissue culture(n=1), laparoscopic biopsy(n=2). There were 30 men and 28 females. The mean age were 36 yrs(range:16-67), 34 patients were in the second and third decade. The distribution of lesions, morphological characteristics, mucosal changes, ulcer shape and depth, associated with other tuberculous lesion, multiplicity were retrospectively analyzed in the findngs of double contrast barim enema. The commonest clinical symptoms were abdominal pain(n=35, 60%) and diarrhea(n=18, 31%). The chest radiography revealed association of pulmonary tuberculosis in 39 cases. Tuberculous lesions of other organs except chest were present in five cases. Double contrast barium enema findings showed a thickening and irregularity of intestinal mucosal fold(n=29, 50%), bowel contraction and/or shortening(n=26, 45%). There were small, nodular, superficial ulcers in the case of ulcer depth less than 2 mm in the depth. As many as 39 cases(67%) in this series had two or more lesions in the intestinal tuberculosis. The involved segment revealed symmetrical feature(n=21, 36%). Inflammatory pseudopolypoid lesions were noted in 30 cases(52%). The ileo-cecal region was involved in 38 cases(66%). The ascending colon(n=25, 43%) was the second commonest site with or without contiguous cecal involvement. Lesions in terminal ileum, ileo-cecal valve, transverse colon, descending colon and appendix were seen in 19, 18, 18, 12 and seven cases, respectively. Among 18 cases of ileo-cecal valve lesions, there were incompetency in nine cases(16%) and wide gapping in four cases(7%). In 14 cases, tuberculous enterocolitis was diagnosed by clinical follow-up and double contrast barium enema study. 12 out of 14 cases, the findings of double contrast barium enema of tuberculous enterocolitis were normalized after anti-tuberculous medication. However, two cases showed more aggravated state than before due to inappropriate treatment. Double contrast barium enema plays an important role in the diagnosis of tuberculous enterocolitis, determines the type, site and extent of the involvement and helps in treatment guide by using sequential studies.

유방암의 위와 대장전이

유현아,김은영,서민지,정은,조민정,오현진,장지혜,박지찬,이정의,박석영 이화여자대학교 의과학연구소 2014 EMJ (Ewha medical journal) Vol.37 No.2

Gastric metastasis from breast cancer is rare and only six cases have been reported in Korea. Colon metastasis is more rare than gastric metastasis. We report a 63-year-old woman with gastric and colon metastases of invasive lobular carcinoma of breast. She was diagnosed as right breast cancer, received right modified radical mastectomy 10 years ago and has been treated with chemotherapy and hormone therapy. Investigating for melena and a small caliber of stool, we found gastric and colon metastases. The diagnosis of metastatic breast cancer was made through gross pathologic and immunohistochemistry staining. We report a case with gastric and colon metastases from breast cancer and a review of the associated six case reports in Korea.

반복적인 급성 신부전을 유발한 호산구성 장염 1 예

정혜진;김현태;김유선;정현걸;강윤경;문정섭 인제대학교 2011 仁濟醫學 Vol.32 No.-

Eosinophilic gastroenteritis is a rare disorder of unknown etiology characterized by presence of gastrointestinal symptoms, eosinophilic infiltratio n of one or more parts of gastrointestinal tract without involvement of other organs and absence of parasitic infestation. The clinical presentation depends on the extents and depths of eosinophilic infiltration. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea and weight loss. We report a case of eosinophilic enterocolitis in a 55-year-old female presented with abdominal pain and watery diarrhea resulting in recurrent acute renal failure.

외상으로 실활된 미성숙 영구치에서의 계속된 치근 형성

강유진,김혜영,김영진,김현정,남순현 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.4

치아에 외상을 받은 경우 치수 생활력의 상실은 흔한 일이다. 치수 생활력을 검사하는 방법으로는 임상적, 방사선학적으로 여러 가지가 있지만, 미성숙 외상치의 경우 일시적 현상과 가성 반응이 나타날 수 있으므로 치수 괴사에 대한 정확한 진단은 매우 어렵다. 생활력을 상실한 치아는 염증성 치근흡수, 치근단 낭종 등의 발생을 방지하기 위하여 치수 치료를 시행한다. 그러나 미성숙 영구치의 경우, 치수 치료를 시행 후 치근 성장이 정지될 수 있어 결과적으로 얇고 짧은 치근이 형성되어 장기적인 예후는 좋지 않다. 본 임상 증례에서는 외상으로 인하여 실활된 초기 영구치에서 치근단부의 최소한의 침습적 치근단 형성술로 계속된 치근 형성을 보여 이에 보고하는 바이다. In case of luxation injuries, loss of tooth vitality is common. And in case of trauma in the immature permanent teeth, precise diagnosis of pulp necrosis is very difficult. That is because limitation in distinguishing between normal dental papilla in immature permanent teeth, transient apical breakdown(TAB), which is part of normal healing process, and apical radiolucency in pulp necrosis. Especially in non-vital immature permanent tooth, the treatment is complex and requires long time. This clinical case report shows that severely infected immature teeth with periradicular periodontitis can undergo healing and apexogenesis or maturogenesis with no definative treatment or after conservative treatment. In the cases reported, we emphasize the considerable power of regeneration of the tooth, probably due to its large number of undifferentiated mesenchymal cells in the dental papilla, pulp tissue, periodontal ligament tissues. Thus, when endodontic treatment in immature permanent teeth, over instrumentation is not recommend for preserve the apical vital stem cells.

초등학교 교사들의 직무스트레스와 건강 수준

조현숙,이종태,손혜숙,박진국 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : The purpose of this study was to assess the effect of job strain on stress and health status among elementary school teachers. Methods and Material : The subjects in this study were 300 teachers who were selected from among 588 teachers in 13 out of 42 elementary schools in the city of Gimhae. Through the questionnaire, demographic characteristics, Karasek's Job Content Questionnaire(JCQ) and the Psychosocial Well-being Index (PWI) to assess their occupational characteristics and psychosocial stress level were surveyed. Medical checkup results of them were adopted to measure their Health status. Results : 24.9 percent of the general teachers were low strain group, and 16.3 percent of them were high strain group. In the senior teachers, 19.7 percent belonged to a low strain group and 21.3 percent belonged to a high strain group. In regard to health status, more senior teachers than junior teachers suffered from obesity(24.6%) and diabetes(11.5%) (p<0.O5), and they also were higher in DBP(p<0.057), total cholesterol(p=0.039) and blood sugar level(p=0.000), the low strain group perceived more social support(p=0.000), and the high strain group felt bigger physical overload(p=0.000). Concerning psychosocial stress, the low strain group was more aware of teacher social role and put more confidence in themselves(p=0.004). The high strain group was more depressed(p=0.001), but no difference was detected in health status. The health status difference between the high strain and low strain groups was significant in depression of psychosocial stress(OR=3.823, 95%CI=1.584-9.224). Conclusion : The senior teachers group was more morbid to obesity, diabetes and hyperlipidemia, which implies that some measure should be studied to help senior teachers manage those diseases properly. The high strain group suffered more from physical overload and was high 'Social support'. Therefore it's required for high strain group to be given more support from colleagues and supervisors, and a stress management program should be implemented to reduce their psychosocial stress.

전공의들의 직업적 유해인자 및 직업만족도

송혜란,김진하,변주현,이광영,이덕희,김호찬 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.3

목적: 전공의는 여러 유해인자에 노출되어지고 있으며 과중한 업무로 인한 수면 부족에 시달리고 있다. 본 연구는 전공의의 건강상태의 기초 자료를 제공하고 향후개선 방안을 도출하기 위하여 시행하였다. 방법: 연구대상은 2000년 3사관학교와 국군군의학교에 입소한 전체 1,316명 중 전공의 수련과정 없이 입대한 의사와 치과의사, 한의사를 제외한 881명을 대상으로 설문지를 배포하여 784부(회수율: 89.0%)를 회수하고 이중 분석이 가능한 704(79.9%)명의 자료를 최종 분석하였다. 결과: 월평균 당진횟수는 레지던트 1년차에서 19회 정도이었다. 당직 시 평균 수면시간은 레지던트 1년차에서 4시간미만 이었다. 수련기간 동안 전공의의 20%이상에서 방사선, 레이저, 살균소독제, 마취가스, 항암제에 노출되었으며 예방대책은 방사선과 레이저의 노출의 경우 35%정도를 제외하고는 10%내외로 조사되었다. 연구대상자중 91.1%에서 수련기간 동안 주사침이나 시술에 의해 손상을 입었으며 그 중 본인이 감염된 경우는 HBV 2.3%(4명), HCV 0.6%(1명)으로 조사되었다. 응답자의 28.4%에서 자신의 직업에 불만족 하였으며 96.5%가 과중한 업무부담을 느꼈고 69.5%가 동일한 임금수준에서 직업을 바꾸고자 한다고 응답하였다. 결론: 전공의는 수련기간 동안 물리적, 화학적, 생물학적 유해인자에 노출되고 있었으나 이에 대한 보호나 예방대책은 거의이루어지지 않고 있었으며 과중한 업무부담으로 수면부족을 초래하여 가장 중요한 환자 진료에 지장을 받고 있었다. 수련기간 동안 대다수가 의사로서 직업에 대한 흥미를 가지고 있었으나 업무부담과 진료이외의 업무 등으로 소득과 조건이 비슷하다면 다른 직업을 선택하고자 하였다. 이상의 결과를 토대로 전공의들을 위한 유해인자의 보호대책 및 예방대책을 마련하며 과중예방대책이 마련되어야 하고 업무환경개선 및 업무로 인한 건강장해에 대한 정당한 보상이 향후에 마련되어야 할 것이다. Objects: Residents are exposed to various hazards and harassed by sleep dificiency due to overwork. This study was performed to outline the health condition of residents and develop the ways of improving it. Mehtods: A questionnaire was distributed to 881 army doctors who enrolled at the Korea Third Military Academy and The Armed force Health Service School in 2000 with the exception of medical doctors who joined the armed service without going through intern and resident periods, dental and oriental medical doctors. 784(89.0%) of the 881 questionnaires were resident of which 704 cases (79.9%). This should actually be 89.0% were regarded for analyses as being reliable data. Results: More than 20% of residents were exposed to radiation, laser, disinfectants, anesthetic gas, and anticancer drugs during their training periods with preventive neasures for each of these hazards taken in about 10% of the cases of the lesser hazards but in about 35% for the hazards from radiation and laser. 91.1% of residents had experience of needlestick injuries during theirtraining periods with over 36.3% being exposed to patients with infection during that time. The cases contracting HBV and HCV diseases due to pricking are 2.3% and 0.6% respectively. The average number of night duties per month during a one-year resident's period was about 10. The average sleeping time on duty during a one-year residents was less than 4 hours. 28.4% of respondents were not satisfied with their occupation, 96.5% delt tired from overwork and 69.5% wanted to change their occupation to another that would pay the same salary. Conclusion: Residents are exposed to harmful physical, chemical and biological factors, but the preventive care seldom undertaken. In addition, their overwork brings about lack of sleep which causes them problems when giving medical treatment to patients during their training periods. Despite the resident's interest in an occupation as a doctor, many intend to select other occupations if they can receive the same salary. According to the above results, preventative systems and measures should be prepared with environmental improvements for residents, and proper rewards for their overwork should be accomplished

다운 증후군과 동반된 그레이브스병 1예

노혜정,신진호,김하영,김용성,백승훈,박병현,조정구 圓光大學校 醫科學硏究所 2005 圓光醫科學 Vol.20 No.1

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

남자대학생의 흡연태도와 행동에 관한 연구

강경진,김정미,민혜영,안소진,오경숙,은경희,이현,이희선,홍주미,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

There have been so many researches about problems of cigarettes and relation of smoking and heath since 1950's and generally known that smoking is one of the worst factor of increasing disease and mortality. No matter what such many proofs about various problems of smoking have been researched, smoking rate of current male collage students has not been decreased. Besides, most of the researches about cigarette use and its addiction have been focused on the adolescent or adult women smokers or adult male, not male collage student. Therefore, the subject of this study is about smoking attitude and smoking behavior of male collage students by general features. Smoking attitude was analyzed by modifying 'Guidelines for the content of tobacco smoking surveys of the general population'(WHO, 1982). Two hundred of male collage students participated to the distributed questionnaire for one week in May. The smoking attitude was categorized into duration of smoking and number of cigarette per day(CPD), and nicotine dependency, investigated by Fagerstrom Tolerance Questionnaire(FTQ) (Fagerstorm & Schneider, 1989). All statistics were performed by procedure of SAS according to number, percentage, mean, standard deviation, and ANOVA. The results are as follows: 1. Smoking attitude level was mean 25.73±5.15 marks, ranging from 13 to 39 marks of the total 40 marks. 2. Duration of cigarettes, number of cigarette per day, and nicotine dependency were mean 5.14±2.84 years, 12.88±6.85 pieces, and 4.78±1.69, respectively. 3. Smoking attitude showed significance according to general features such as marital state and allowance, but the significance according to marital state is not valuable because the numerical difference is so big between married one and single that they cannot be compared with each other. 4. Duration of smoking was significant according to general features such as age and allowance. 5. Smoking amount showed significance the factors of age only. 6. ll1ere was no significance in nicotine dependency according to general features. As a result, smoking attitude of male collage student in this study shows moderate level. Smoking attitude and duration is significant according to allowance, and smoking amount is significant according to age. Nicotine dependency according to general features is not significant but comparing with the preceding study about adult male, male collage students in this study are respectively more nicotine-dependent than adult male smokers. In conclusion, the right allowance usage strategies and effective heath education focused on the young are needed. In addition, helpful programs and information spreading strategies are necessary for establishing higher level of smoking attitude. At last, systemic regulations in daily living for ""anti-nico-dependent"" and perspective reforming of male university student are needed for reducing nicotine dependency.