심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

척추 마취에서 소용량 Bupivacaine-Fentanyl 과 상용용량 Bupivacaine 의 비교

조영훈,이상곤,민병우,이지향,반종석 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Comparison of Small Dose Bupivacaine-Fentanyl with Conventional Dose Bupivacaine during Spinal Anesthesia Young-Hoon Cho, M.D., Ji-Hyang Lee, M.D., Sang-Gon Lee, M.D. Jong-Suk Ban, M.D., and Byung-Woo Min, M.D. Department of Anesthesiology, Daegu Fatima Hospital, Daegu, Korea Background: Although spinal anesthesia has a lot of advantages, it has some disadvantages or undesirable effects. Hypotension and unnecessarily long neural blockade are included among them. Although using small dose local anesthetics fairly solves these problems, it is insufficient to provide reliable surgical anesthesia by itself. Therefore the authors investigated whether such an opioid as fentanyl and small dose local anesthetic used together during spinal anesthesia can prevent hypotension and unnecessarily long neural blockade and provide reliable surgical anesthesia simultaneously. Methods: Thirty patients undergoing knee or below knee surgery were randomized into two groups. Group 1 received bupivacaine 5 mg combined with fentanyl 20 ㎍, and group 2 receive 10 mg bupivacaine. Hypotension was recorded and was treated with intravenous ephedrine. Sensory blockade, intraoperative analgesia, motor blockade and side effects were assessed. Results: NO significant differences were observed in values for assessing hypotension, sensory block-ade or intraoperative analgesia between the two groups. Also no significant differences were observed in intensity of the motor blockade and side effects between the two groups. However the duration of the motor blockade of group 1 was longer significantly than that of group 2. Conclusions: Small dose bupivacaine and fentanyl administered together intrathecally reduced duration of motor blockade and didn't augment of side effects and provided reliable anesthesia for surgery of knee or below knee simultaneously. (Korean J Anesthesiol 2001; 41: 423~427)

Ropivacaine 을 이용한 경막의 마취시 Clonidine 병용의 효과

김종일,조영훈,이상곤,민병우,이지향,반종석 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Effects of Clonidine Added to Ropivacaine in Epidural Anesthesia Young-Hoon Cho, M.D., Ji-Hyang Lee, M.D., Sang-Gon Lee, M.D., Jong-Il Kim, M.D.^*, Jong-Suk Ban, M.D., and Byung-Woo Min, M.D. Department of Anesthesiology, Daegu Fatima Hospital, Daegu, Korea ^*Kim Jong Il Pain clinic, Daegu, Korea Background: Clonidine has been regarded as an adequate supplementary anesthetic during epidural anesthesia and has been used with local anesthetics such as bupivacaine or lidocaine to support the effects of these anesthetics. The authors would examine whether clonidine is an adequate supplementary anesthetic when it is used with ropivacaine during epidural ane-sthesia. Methods: Thirty-two healthy patients undergoing a hip or lower limb surgery were diveded into two groups. In group 1, 0.5% ropivacaine 15 ml was administered. In group 2, 0.5% ropivacaine 15 ml combined with clonidine 150 ㎍ was administered. Onset, duration and maximal height of sensory block were assessed. Sedation score, blood pressure and heart rate were measured. Results: Duration of sensory block of group 2 was significantly longer than that of group 1. Sedation score of group 2 was significantly higher than that of group 1. Blood pressure of group 2 was sig-nificantly lower thatn that of group 1 at 50 min, 70 min and 90 min after epidural injection. No significant differences were observed in onset of sensory block and heart rate between the two groups. Conclusions: The addition of clonidine to ropivacaine during epidural anesthesia prolonged duration of sensory block and produced useful sedation. It caused relatively stable hemodynamic changes. These results suggest that clonidine is an adequate supplementary anesthetic when it is used with ropivacaine during epidural anesthesia. (Korean J Anesthesiol 2001; 41: 428~433)

수술전 가온과 수술중 가온이 수술환자의 체온과 전율에 미치는 영향

이지연,이향련 성인간호학회 2002 성인간호학회지 Vol.14 No.3

Purpose: The purpose of this study is to examine the changes of surgical patients' body temperature in applying warming to patients. The study of an effective nursing intervention, which aims to prevent hypothermia during surgical operations, use of anesthesia, and to remove dermal discomforts. The nonequivalent control group pre-test/post-test design was used for this quasi-experimental study. Method: The study subjects were adult patients who would take a surgical operation under general anesthesia in C Hospital: the surgical operations done were, total abdominal hysterectomy or Myomectomy; 20 patients were included in experimental group I, 20 patients were included in experimental group II, and 20 patients were in the comparative group. The total number of study subjects was 60. The data was collected from September the 1st, 2001 to October the 20th, 2001. The data was analyzed by SPSS program, F-test and Repeated measures of ANOVA. Multi-comparison method of DUNCAN was used for the sections that show the significant differences at the level of p<.05, which was a posterior examination. Result: 1) "The body temperatures of the three groups of patients will be respectively different at the end of the operations: experimental group I to which warming was applied before the operations, experimental group II to which warming was applied during the operations, and the comparative group with no warming being given," showed (F=12.609, p=.000). 2) "Degrees of shivering symptoms for the three groups will be respectively different at the end of the operations; experimental group I which applied warming before operations, experimental group II which applied warming during operations and the comparative group with no warming." Showed assumed (F=6.626, p=.000). Conclusion: Summing up the above study, the warming assumed during operations was a more effective nursing intervention for preventing patients' hypothermia than the warming assumed before operations.

폐 내 병변으로 인한 소아 급성 호흡부전의 원인 질환과 예후

이혜영,박지숙,최희라,서지현,김점수,임재영,최명범,박찬후,우향옥,윤희상 대한소아과학회 2004 小兒科 Vol.47 No.5

콩 및 당의 종류의 달리한 매실 콩아이스크림의 품질특성

이숙영,김아영,유지영,이중기,이향섭 중앙대학교 생활과학연구소 2003 생활과학논집 Vol.17 No.-

The purpose of this experiment was to compare the quality characteristics of soy ice creams prepared with soy protein isolate(SPI) or Jinpum-soybean, and different kinds of sweeteners of maltitol and sucrose, xylitol+sucrose, or malitiol. The viscosity of the ice cream mix containing xylitol+sucrose appeared the highest, and that from Jinpum-soybean was higher than that from SPI. The overrun of soy ice creams containing xylitol+sucrose was the highest, and the next was the samples containing maltitol+sucrose. The overrun values of Jinpum-soybean samples appeared higher than those of SPI samples. As for the case of the SPI samples, the melt-down percent was the highest in the sample of maltitol addition, and the next were maltitol+sucrose addition, xylitol+sucrose addition in order. The melt-down percent of Jinpum-soybean was the highest in the sample of maltitol+sucrose addition, and the next were maltitol addition, xylitol+sucrose addition in order. The higher the viscosity of samples, the lower the melt-down percent. In sensory characteristics, the beany flavor, flavor, mouthfeel, overall quality of Jinpum-soybean samples were evaluated better than those of SPI in general. The samples containing xylitol+sucrose evaluated better in beany flavor, mouthfeel, icy feel, and overall quality. The quality characteristics of the samples prepared with Jinpum-soybeans and xylitol+sucrose were evaluated the best.

영․유아 그림 표상 특성에 관한 연구

이승옥,최은영,임지향 대구대학교 특수교육재활과학연구소 2005 再活科學硏究 Vol.23 No.2

The purpose of this study was to refer a symbolic characteristic of painting during scribbling period by applying a task condition, to present basic data about effective symbolic painting by analyzing a process of a construct activity, and to examine verification of effectiveness in the Korean infant. The one way anova is carried out to find out a symbolic characteristic of painting of Age(4)X group and the two way anova to Group(2)×Age(4), is conducted to figure out the difference of NC performance owing to task presented type upon age bracket. The followings were ostensive purposes of this study. First, there would be differences in symbolic characteristic by tasks and ages(the total score, the score of symbol inside the outline, the score of constituent, the score of pair symbolic). Second, the NC performance would differ in symbolic characteristic by age and painting type(the total score, the score of symbol inside the outline, the score of constituent, the score of pair symbolic). The study participants were randomly selected one - three years old infants (total of 80) who attend in an infant home in northern Daegu. They were divided in four groups. Each age group was presented two type of painting and multivariate analysis was taken in order to compare and analyze paintings. The result of this study was followed. First, the characteristic of painting symbol was different by task and age. The expressive ability in total score, constituent of object, pair symbolic in P task and DC task was increased as aging. Among the group of infants aged 1.5 - 2.5, P task was performed better than DC task, and the score of P task and DC task was equally heightened as they become age of 3. Second, NC performance owing to task presented type upon age bracket would be different (the total score, the score of symbol inside the outline, the score of constituent, the score of pair symbolic). The older has shown more expressive ability in two type of painting. NC task was taken after pre- P task and -DC task, but the symbolic score of NC task differed from. NC task followed by P task represented the more constituents and pair symbols than by DC task. Therefore, this study found out that the development of symbolic level in infant had close relationship with an age, the symbolic abilities in different painting tasks differed order of P task, DC task, and NC task, and symbolic painting was shown from infant age 1.5-2. 본 연구는 초기 그림 표상 출현과정을 살피기 위한 것으로 구체적인 가설은 다음과 같다. 첫째, 과제별 연령에 따른 그림 표상의 특성(총점수, 윤곽선 안의 표상의 점수, 대상의 구성요소 표상의 점수, 쌍표상의 점수)은 차이가 있을 것이다. 둘째, 연령별 과제 제시유형에 따른 NC과제 수행(총점수, 윤곽선 안의 표상의 점수, 대상의 구성요소 표상의 점수, 쌍표상의 점수)은 차이가 있을 것이다. 연구대상은 00시에 위치한 어린이집에 재원중인 1-3세 유아 총80명을 무선선정하여 연령별로 4집단을 나누고 각 연령집단별로 두 그룹으로 나누어 서로 다른 유형의 과제를 실시하였다. 즉 한 그룹은 P과제 이후 NC과제를 실시하였고, 다른 한 그룹은 DC과제 이후 NC과제를 실시하였다. 과제실시 이후 각 과제에서 얻어진 표상그림을 채점하였다. 자료처리는 과제별 연령에 따른 그림표상의 특성을 살펴보기 위해 연령(4)x집단간의 일원 다변량분석을 실시하였고, 연령별 과제 제시유형에 따른 NC과제 수행의 차이를 보기 위하여 집단(2)×연령(4)에 대하여 2원 다변량분석을 실시하였다. 본 연구의 결과를 요약하면 다음과 같다. 첫째, 과제별 연령별에 따른 그림 표상의 특성은 차이가 있다. 연령에 따라 P과제 또는 DC과제 모두가 총점수, 대상의 구성요소, 쌍표상의 표현능력은 연령이 높음에 따라 표상능력이 증가함을 알 수 있었다. 1.5세-2.5세에서는 P과제가 DC과제보다 훨씬 잘 수행했으며 3세가 되면서 P과제와 DC과제 점수가 같이 높아졌다. 둘째, 연령별 과제 제시유형에 따른 NC과제 수행은 차이가 있다. 연령이 증가 할수록 과제 제시유형에서 과제의 표상 능력도 증가하였다. 연령에 따라 P과제 선행 후 NC과제와 DC과제 선행 후 NC과제의 표상의 점수는 다르다. P과제 선행 후 NC과제가 DC과제 선행 후 NC과제에서 보다 더 많은 대상의 구성요소, 쌍표상을 표현한 것으로 나타났다. 따라서, 본 연구를 통해 유아의 표상 수준의 발달은 연령과 밀접한 관계가 있고 과제에 따른 그리기 표상능력도 P과제, DC과제, NC과제 순으로 일어나며, 표상적 그리기가 1.5세와 2세경에 시작된다는 것을 보여준다.

미술치료가 경도정신지체 학생의 부적응 행동에 미치는 효과

이근매,김향지,조진식 한국정신지체아교육학회 2003 지적장애연구 Vol.5 No.-

연구는 경도정신지체 중학생의 부적응 행동을 개선하여 일상생활의 적응력을 높일 수 있도록 하기위해 미술치료를 실시하여 그 효과를 살펴보고자 한다. 연구의 구체적 목적은 다음과 같다. 첫째, 미술치료가 경도정신지체학생의 부적응 행동에 미치는 효과를 알아본다. 둘째, 회기별 진행과정에서 경도정신지체 학생의 부적응행동 변화 에 미치는 효과를 살펴본다. 연구의 결론은 다음과 같다. 첫째, 다양한 미술치료 프로그램을 실시했을 때 경도정신지체 학생의 부적응 행동이 감소되었다. 둘째, 미술치료 초기에는 연구자의 지시에 잘 따르지 못했고 동료와 잘 어울리지 못했지만, 회기가 진행 될수록 연구자와의 상호작용도 증가되었고 동료관계도 개선되었다. 따라서 미술치료 프로그램은 일선 교육현장에서 정신지체아동의 부적응행동을 긍정적으로 개선하는데 유용하게 활용 될 수 있을 것으로 본다. This research sought to conduct art therapy to mild mentally retarded students in middle school to correct their maladjustment behavior and enhance their adaptability to the routine life. The specific objectives of the research are as follows. First, the research determines the effect of art therapy on the maladjustment behavior of mild mentally retarded students. Second, the research determines the effect on the change in maladjustment behavior of the mentally retarded students in the process of treatment by session. The conclusion of the research is as follows. First, when various art therapy programs were offered, the maladjustment behavior of less serious mentally retarded students lessened. Second, the students could not follow appropriately the researcher's instruction and befriend each other during the initial phase of the art therapy, but with sessions continuing, students increased their interaction with the researcher, and improved relations with their peers. Hence, art therapy programs are considered to be useful in improving the maladjustment behavior of mentally retarded children on the education field.

특발성 과호산구 증후군 환자의 치료 도중 발생한 간혈종 1례

이영태,김동기,박지훈,김윤정,김기향,박보민,권민정,김애란,이원식,주영돈,손창학 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Idiopathic hypereosinophilic syndrome is characterized by marked elevation of eosinophil count ( >1,500/㎣) in peripheral blood without explaining etiology. It shows tissue involvement in many organs such as liver, G-I tract, myocar dium, lung, skin, kidney and nerve. Some case of hypereosinophilic syndrome with hepatic involvement have been reported, but not much. We have recently experienced a case with idiopathic hypereosinophilic syndrome of a 40 year old man who presented with RUQ pain. By abdominal CT, ill- defined subcapsular hematoma was detected. Liver biopsy showed eosinophilic infiltration within the portal tract and sinusoid. Drain procedure and corticosteroid adminiiatbrought marked improvement of clinical manifestation, hematologic abnormality and radiologic abnormality.

베체트병 환자에서 Azathioprine으로 유발된 급성 췌장염 1례

김기향,권민정,김동기,김애란,김윤정,박지훈,이영태,박보민,김동욱 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Although many drug are thought capable of initiating acute pancreatitis, following azathioprine administration represents the 5% incidence by far the highest recorded incidence to date. We report a 35-year-old male who developed acute pancreatitis in the course of treatment with azathioprine for Behcet's disease. He was admitted due to abdominal pain, diarrhea, and fever for 10 days. Serum amylase and lipase levels were 510U/L and 3702U/L respectively. The abdominal CT scan revealed diffuse enlargement of the pancreas. There was no history of alcohol use or gall bladder disease. We considered drugs, especially azathioprine, as the cause of acute pancreatitis. We diagnosed it as acute pancreatitis. The patient was treated conservatively with hydration and analgesics. The symptom subsided within four days. Five days later, azathioprine was resumed. And the patient complained of abdominal pain. The elevated levels of serum amylase and lipase confirmed the recurrence of pancreatitis. His symptom subsided when azathioprine intake the stopped, and the serum amylase and lipase levels returned to normal level within five days.