인터넷 인라인스케이트 동호회 회원의 분당 대사량 평가

김종혁,김도진 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.6

This study inquires into comparison and changes in Metabolic when people do inline-skating through comparing members of internet inline-skating association with normal people, and grasps the effect of doing inline-skating on Metabolic per minute. Also, this study provides information for activation of internet inline-skates association and health as scientific methods of inline-skating and domestic athletics. The conclusion is as follows. First, there are significant differences in 2minutes doing between members in association of internet inline-skates and normal people, and after verification, there are significant differences between male and female in association, between male in association and normal male, between male in association and normal female.(p<.01). Second, there is no significant difference in Metabolic of 4 minutes doing between members in association of internet inline-skates and normal people. Third, there are significant differences in 6 minutes doing between members in association of internet inline-skates and normal people, and after verification, there are significant differences between male and female in association, between male in association and normal male, between male in association and normal female.(p<.05). rmal people. Firth, there is no significant difference in Metabolic of 8 minutes doing between members in association of intemet inline-skates and normal people. Fifth, there is no significant difference in Metabolic of 10 minutes doing between members in association of intemet inline-skates and normal people. sixth, there are significant differences in sum total doing between members in association of internet inline-skates and normal people, and after verification, there are significant differences between male and female in association, between male in association and normal male, between male in association and normal female.(p<.05).

Do-Not-Resuscitate Orders for Terminal Patients with Cancer in Teaching Hospitals of Korea

Kim, Do Yeun,Lee, Kyoung Eun,Nam, Eun Mi,Lee, Hye Ran,Lee, Keun-Wook,Kim, Jee Hyun,Lee, Jong Seok,Lee, Soon Nam Mary Ann Liebert 2007 Journal of palliative medicine Vol.10 No.5

<P>OBJECTIVES: To examine the current practices relating to do-not-resuscitate (DNR) orders for terminal patients with cancer at teaching hospitals in Korea. METHODS: The records of 387 deaths from January 1 to December 31, 2005 at four cancer centers were identified and reviewed to assess the DNR delineation. Basic demographics, circumstances surrounding the establishment of the DNR directive, the percentage of orders for identified populations, and the time interval between DNR consent and death were evaluated. RESULTS: An order of DNR consent was obtained from 296 patients (76%) of a total of 387 patients. All DNR consents were made between the physician and family, without involving the patient. Written preprinted DNR consent forms were used in 169 (57%) cases and 127 patients (43%) had verbal DNR permission. DNR consent was interpreted in two ways: one forbade resuscitation in two hospitals and the other implied limited care in two other hospitals. A unilateral physician decision to withhold cardiopulmonary resuscitation (CPR) was decided for 62 (16%) patients. Terminal CPR was performed on 29 (7%) patients. DNR discussion was made within 7 days of the day of death on 228 (77%) patient among the 296 DNR consenting patients. CONCLUSION: From our teaching-hospital-based analysis of terminal cancer patients in Korea, consent for a DNR order was common. However, DNR order forms were not standardized and lacked room to document patient involvement in the decision. Usually the DNR decision was made within last days of the patient's life. Our results reflect the need for the improvement of end-of-life care decisions in Korea.</P>

뇌실외 배액술 시행과 관련된 뇌실염 : 원인균주와 경험적 치료약제의 적절성

도병훈,김신우,오종택,손종원,하상우,이응갑,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 본 연구는 뇌실외 배액술을 시행한 신경외과 환자들에서 뇌실염 발생 빈도, 원인균주와 감수성 추이 및 경험적 치료로 사용되는 항생제인 ceftazidime과 vancomycin의 적절성 여부에 대하여 조사하였다. 재료 및 방법 : 2000년 12월부터 2003년 10월까지 EVD를 시행한 경북대학교병원 신경외과 입원환자 340명 중 뇌실염이 발생한 39명을 대상으로 후향적으로 조사하였다. 결과 : 340명 중 39예 (11.5%)에서 뇌실염이 발생하였고 이들 가운데 4명이 뇌실염과 연관하여 사망하였다(10.3%). EVD 시행일로부터 뇌실염 발생까지는 평균 8.4일이었다. 원인균은 33예(87.1%)에서 확인되었으며 Aci-netobacter (19예, 45%), methicillin-resistant coagulase negative Staphylococcus (9예, 22%), methicillin-resistant Staphylococcus aureus (9예, 22%) 등의 순이었다. 가장 많이 동정된 Acinetobacter 19예 중에서 8예(42.1%)가 ceftriaxone에 내성을 보였으며 현재 경험적으로 널리 사용되는 ceftazidime에 대해서는 11예중 3예(27%)가 내성을 보였다. 결론 : 최근 EVD 시행과 관련된 뇌실염 뇌실염 최근 그람음성 non-fermenter 특히 Acinetobacter에 의한 경우가 증가하고 있으며, 이들 그람음성 non-fermenter는 현재까지 경험적으로 사용되는 ceftazidime에 점차 내성을 보이고 있다. 경험적 치료제에 대한 성공률을 높이기 위해서는 각 병원별 내실염의 원인균주의 감수성에 대한 검사가 필요하겠다. Purpose : To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. Materials and Methods : Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. Results : Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows : Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. Conclusion : These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.

An Evaluation of Nutrition Support for Terminal Cancer Patients at Teaching Hospitals in Korea

Do Yeun Kim,Sang Min Lee,Kyoung Eun Lee,Hye Ran Lee,김지현,Keun-Wook Lee,Jong Seok Lee,Soon Nam Lee 대한암학회 2006 Cancer Research and Treatment Vol.38 No.4

Purpose: We wanted to analyze the use of nutrition support for terminal cancer patients, the effect of discussing withdrawal of nutrition support and do-not- resuscitate (DNR) consent on the use of intravenous nutrition during the patient’s last week of life and at the time of death.Materials and Methods: The study involved 362 patients with terminal cancer from four teaching hospitals, and they all died between January 1 2003 and December 31 2005. The basic demographic data, the use of intravenous nutrition during the patient’s last week of life and at death, discussion of terminal nutrition withdrawal and DNR consent were evaluated.Results:In the week before death, the patients received artificial nutrition such as total parenteral nutrition (31%), intravenous albumin infusion (25%), and feeding tube placements (9%). A discussion concerning withdrawal of nutrition support was limited to 25 (7%) patients. DNR consent was obtained from 294 (81%) patients. None of the patients were directly involved in any of these decisions. The discussion about withdrawal of terminal nutrition and DNR consent with the patient’s surrogates did not have any effect on reducing the use of parenteral nutrition.Conclusion: The majority of patients dying of terminal cancer were still given potentially futile nutritional support. Modern clinical guidelines and ethical education about nutritional support at the end of life care is urgently needed in Korean medical practice to provide proper administration of terminal nutrition for end of life care. (Cancer Res Treat. 2006;38:214-217)

虹彩 體質 分析에서 心腎結合組織의 虛弱 體質과 高血壓 家族歷과 관련성 硏究

金鐘牛,黃祐準,琴坰樹,李始炯,李宗淳,都金錄,趙在運,趙州掌,金鐘煜 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

Iridology, developed more than 100 years ago, is the diagnosis of medical conditions through noting irregularities of the pigmentation in the iris The purpose of this study is to compare interrelation between CVA, hypertension family history and cardio-renal connective tissue in Iris Constitution through iris constitution examination. The subjects consist of 114 patients who were examined in Iris Constitution at Chonju Oriental Medicine Hospital attached to Wonkwang Univ. from September. 1St. 2000 to August. 31th. 2002. 1. In the distribution of Iris Constitution, among of 79cases, There are neurogenic type 13cases, abdominal connective tissue weakness constitution 31 cases, cardio-renal connective tissue weakness constitution 6 cases, cholesterol 7 cases and others 22 case in control group. 2. There are familial history of CVA and hypertention 32 cases, no familial history of CVA and hypertention1 3 cases, in 35cases of experimental group. These results imply that there is meaningfulness of interrelation between cardio-renal connective tissue weakness constitution and. CVA, hypertention.

아미노글리코사이드 사용제한에 따른 병원성 균혈증 유발 그람음성간균의 내성변화 및 임상적 의의

오종택,김신우,손종원,도병훈,한승우,신병철,박지현,이종명,김능수 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

목적 : 항균제 오남용으로 인한 내성균의 출현, 약물부작용의 발생 및 약제 비용의 증가는 환자 개인뿐만 아니라 사회적으로 문제가 되고 있다. 본 연구는 항생제의 오남용을 막기 위한 제도의 일환으로 시행한 아미노글리코사이드 사용 제한정책의 비용 효과적인 측면을 조사하고 그람음성간균에 의해 병원성 균혈증이 발생한 환자들을 대상으로 이 정책이 항생제 내성률과 환자 사망률에 미치는 영향을 연구하였다. 방법 : 930병상 규모의 3차 병원인 일개 대학병원에서 아미노글리코사이드 사용제한정책이 시행된 직후인 2002년 3월에서 9월 사이에 그람음성간균(Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Stenotrophomonas maltophilia, Burkholderia cepacia)에 의해 발생한 병원성 균혈증 환자 60명(실험군)과, 이 정책이 시행되기 전에 입원한 환자들 중 균주별로 같은 수만큼 선별한 병원성 균혈증 환자 60명(대조군)의 의무기록을 후향적으로 조사하였다. 결과 : 아미노글리코사이드 사용제한정책이 시행된 시기인 2002년 3월에서 9월 사이에 처방된 아미노글리코사이드 사용량 및 비용을 이 정책이 시행되기 전인 2001년 3월에서 9월 사이와 비교한 결과, 아미노글리코사이드의 사용량(antimicrobial utilization density)은 사용제한 후 225.2에서 130.3으로 42% 감소하였고 약제 비용은 44% 감소하였다. 아미노글리코사이드 사용제한 후 병원성 균혈증을 유발한 그람 음성간균의 이 항생제에 대한 내성률은 유의한 변화를 보이지 않았으며 균혈증과 직접 연관된 사망률도 환자의 나이, 성별, 기저질환 및 원발병소 등을 보정할 경우 유의한 차이를 보이지 않았다(40.4% vs. 24.1%, P=0.11). 결론 : 아미노글리코사이드를 5일을 초과한 사용 시 감염전문가의 사전 승인을 필요로 하는 사용제한정책은 아미노글리코사이드의 사용량과 비용을 유의하게 감소시켰다. 또한 이 정책 시행 후 그람음성간균에 의한 균혈증 환자에서 균혈증으로 인한 사망률과 아미노글리코사이드에 대한 내성률은 유의한 차이가 없었다. Objective : To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB). Methods : Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gramnegative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia. Results : During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225,2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy. Conclusion : Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.

경남 일부 지역 간흡충 감염 주민에 대한 혈청 생화학검사 소견 분석

손운목,조영표,김기진,김미영,이종욱,박도흠 한국건강관리협회 1999 건협 Report Vol.2 No.-

3년내 크기 증가를 보인 위 신경초종 1예

김도현,박무인,유찬희,김규종,문원,박선자,장희경 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

저자들은 65세 남자 환자의 위 중부체부 대만부 전벽에 발생한 점막하 종양에 대하여 3년간 추적관찰 중 크기증가소견으로 쐐기 절재술을 시행하였으며, 조직검사 및 면역 조직 화학 검사에서 위 신경초종으로 진단한 1예를 경험하였기에 보고하는 바이다. Gastric schwannoma is a very rare gastrointestinal benign tumor, which represents only 0.2% of all gastric tumors and 4% of all benign gastric tumors. We report a case of gastric schwannoma with enlargement of size through serial endoscopic examination. Endoscopic examination showed a hard mass of 4 x 3 cm in size with normal overlying gastric mucosa on the great curvature of the mid-body of stomach. The pathological finding revealed a picture of spindle cell tumor. Immunohistochemical stain was strongly positive for S-100 protein and non-reactive for CD34, C-kit and smooth muscle actin, thus leading to the diagnosis of gastric schwannoma.

급성 부비동염과 동반된 안와 합병증

도남용,임태승,김종희,김성렬 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.3

Acute paranasal sinusitis is frequently encountered in medical practice and is managed without complication in the majority of cases. But, paranasal sinus inflammation may invade the orbit because paranasal sinuses are close to the orbital wall. Orbital inflammation is the most common complication of acute paranasal sinusitis and lead to blindness, intracranial complications, and death. Orbital complications of acute paranasal sinusitis are thought to arise when the infection spreads to the orbit by direct extension, local thrombophlebitis, or less commonly infected thromboemboli along valveless venous connections. Diagnosis of orbital complication requires a thorough history and physical examination, including an ophthalmologic evaluation. Computed tomography is frequently required as an adjunct in assessing the clinical manifestations of advanced disease, and it can assist the physician in surgical planning if required. Most orbital infections respond to medical therapy. Some cases require surgical intervention. We report three cases that have required surgical intervention, with a review of related literatures.

증편제조시 첨가재료에 따른 물성적, 관능적 비교연구

도종희,김경자 東亞大學校附設 生活科學硏究所 2004 생활과학연구 논문집 Vol.12 No.-

The purpose of this study Is to improve the quality of Jeung-pyun which is made of rice flour. For the purpose, this researcher replaced a certain proportion of the flour with soybean and wheat flours and then surveyed tastes and changed physical properties of Jeung-pyun. In addition, the researcher compared and observed sensory properties of Jeung-pyun throughout its storage period, or 0 to 72 hours. 1. Protein and fat contents of soybean or wheat flour was even higher than those of rice flour. 2. Each of the three flours was pasted and fermented firstly and secondly, it showed significant decreases in PH. But the value was increased again after Jeung-pyun was steamed. 3. After Jeung-pyun was steamed, the two additives, wheat and soybean flours showed significant in creases in specific volume and expansion ratio in comparison to the control sample, rice flour. The comparis on of the two additives, bean and wheat flours which were same in quantity, showed that the latter additive was higher in specific volume and expansion ration than the former. 4. When its cross section was observed, Jeung-pyun was not uniform in particle size and pore distribution in case tha the it was only made of the control sample, or rice flour. In contrast, Jeung-pyun was uniformly small erin the size and more even in the distribution when it was added with soybean or wheat flour more. 5. The volume of Jeung-pyun was increased when soybean or wheat flour was added even more than when the control sample was only used. 6. The sensory evaluation showed that Jeung-pyun, 10% of which was the addition of bean flour, became better in softness, moistness and stickiness as the time of its storage was in creased, giving highest satisfaction. 7. The measurement of textural quality with Rheometer showed that Jeung-pyun, made only of the control sample, was increased in hardness as time passed. The hardness was only some what changed when bean flour was added. Jeung-pyun with soybean flour added showed no big changes in elasticity, cohesiveness, adhesiveness and attachment, suggesting that thoughstored, the added Jeung-pyun showed little changes in physical properties.