Case Report : Improved severe hepatopulmonary syndrome after Liver transplantation in an adolescent with end-stage Liver disease secondary to biliary atresia

( Tae Jun Park ),( Keun Soo Ahn ),( Yong Hoon Kim ),( Hyungseop Kim ),( Ui Jun Park ),( Hyoung Tae Kim ),( Won Hyun Cho1 ),( Woo Hyun Park ),( Koo Jeong Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

Hepatopulmonary syndrome (HPS) is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT) is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient with typical findings of an extracardiac pulmonary arteriovenous shunt on contrast-enhanced transesophageal echocardiography (TEE), and clubbing fingers, who had complete correction of HPS by deceased donor LT. The patient was a 16-year-old female who was born with biliary atresia and underwent porto-enterostomy on the 55th day after birth. She had been suffered from progressive liver failure with dyspnea, clubbing fingers, and cyanosis. Preoperative arterial blood gas analysis revealed severe hypoxia (arterial O2 tension of 54.5 mmHg and O2 saturation of 84.2%). Contrast-enhanced TEE revealed an extracardiac right-to-left shunt, which suggested an intrapulmonary arteriovenous shunt. The patient recovered successfully after LT, not only with respect to physical parameters but also for pychosocial activity, including school performance, during the 30-month follow-up period. (Clin Mol Hepatol 2014;20:76-80)

정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

인터넷마케팅과 관광축제정보분석

조현준,이훈 한국문화관광학회 2001 문화관광연구 Vol.3 No.1

The purpose of this study was to analyze official web sites of major festivals using internet marketing approach. Contents analysis of each web site was examined by the 4ps marketing techniques, festival product, festival price, festival place, and festival promotion. While most web sites prepared the festival product information, other information was not enough. In special, price information and festival promotion of the web sites should be needed and added in order to invite potential festival visitors. Some implications were suggested to develop the Internet web sites.

장기간 댄스스포츠가 호흡순환 기능 및 심폐지구력에 미치는 효과

조현철,김준희,한주희 龍仁大學校 體育科學硏究所 1998 體育科學硏究論叢 Vol.8 No.1

The purpose of this study was to evaluate the effects in respire-circulatory function and cadio-pulmonary endurance capacity. Twelve females(trained 6, untrained 6) participated in dancesport program that is 90min/day, 2day/week for 20weeks. The results were obtained as follow : 1. No significant difference was found in heart rate, ventilation and respiration rate among pretest, after 10 weeks and 20 weeks of dance program and between trained and untrained group. 2. Significant differenced was found in VCO₂between pretest and 20Weeks later in untrained group. 3. There was significantly increased VO₂max in 20 weeks dance program later compared with pretest and significant difference between groups. 4. There was no significant difference in ventilatory threshold and exercise time was not significant difference among trials and between groups. Conclusively, respiro-circulatory function and cardio-pulmonary endurance capacity were not changed at submaximal stage of excise test but those were significantly increased at maximal of exercise test during 20 weeks. Therefore, it is suggested that long term dancesport exercise program is expected more effective on the repiro-circulation function and cardio-pulmonary endurance capacity.

Al-Cu-Mg合金의 時效析出에 미치는 豫備時效의 影響

趙顯麒,洪俊杓,全在英 경북대학교 공과대학 1983 工大硏究誌 Vol.12 No.-

The influences of preageing on age-precipitation in Al-2.02t% Cu-1.1wt% Mg alloy have been investigated by means of measurements of hardness, tensile strength and electrical resistivity and transmission electron microscopy. The results obtained are summarized as follows. The two-step aged alloy is more age-hardenable than the onestep aged alloy in early stage of ageing. It is because of the formation and growth of solute atom cluster and GPB zones. The maximum hardness and strength of the alloy aged 200℃ is obtained by preaged at 100℃. It is because of fine and dense distribution of S'metastable phase. The hardness and strength are remarkably decreased with sufficient ageing time after preageing at room temperature and 170℃. It is because of the formation and coarsening of S'metastable phase by the preageing.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

우울증 관련 평가도구의 개관

조현주,채정호,전태연 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.2

Objective : Since a lot of assessment tools for depression have been developed and used, it is difficult to choose the proper and optimal instruments for the purpose of their usage, In order to maximize the effectiveness of assessment for depression, this paper reviewed the characteristics and specific features of currently using tools. Method : The domestically and internationally using assessment tools for depression were reviewed and classified by litera-hire search and clinical experience. Results : Methods of assessment, selecting guides and characteristics of assessment tools for depression were presented. Conclusion : This paper would provide helpful guidelines for selecting the assessment tools. We suggest that it is needed to develop the assessment tools for depression that reflects Korean specific culture and custom.

구강암 환자에 대한 임상통계학적 분석

조준현,김진수 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

안면경련의 침구치료에 대한 문헌적 고찰

조현석,장준혁,김경호,윤종화,김갑성 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.7 No.2

편측 안면경련은 편측 안면근의 불수의적, 간헐적 수축으로서 심할 경우 안면 근력 약화 및 강직현상등이 나타나기도 하는 질환이다. 서양의학에서 편측 안면경련의 병태생리에 대한 가설은 크게 두가지로 대별되는데, 첫째는 중추성 가설(핵가설)이고, 둘째는 말초성가설이다. 치료방법은 대별하여 내과적 치료와 외과적 치료의 나눌 수 있는데, 외과적 치료가 다양하게 시행되어 왔으며, 근래에는 두개강내 미세혈관 감압술이 시행되고 있다. 韓醫學에서는 眼瞼痙攣울 眼胞振跳, 胞輪振跳라고 하고, 眼眉跳라고도 하며, 그 외 目瞬, 目跳, 眼皮跳 등의 이름으로도 불리운다. 外因으로는 風邪가 經絡에 侵入하는 것이며, 內因으로는 肝血虛한 中의 風邪가 兼하기 때문이다 따라서, 국부경혈 자침과 함께 장부변증에 따라 肝, 膽經 경혈의 사용과 합께 耳鍼T의 시술이 유용할 것으로 사료된다. Hemifacial spasm including blepharospasm is characterized by spontaneous clonic and tonic muscle spasm on one side of the face with synkinesis. Though the etiology of hemifacial spasm is not entirely understood, generally there are two. One is nuclear hypothesis and the other is peripheral hypothesis. There are two ways of treatment of hemifacial spasm. One is internal medicine and the other is operative method. In oriental medicine, hemifacial spasm is very similar to diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), or Anmido(眼眉跳) in symptoms. The diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), Anmido(眼眉跳) is related to the function of liver(肝) and risk factors are regarded as Pung(風). The acupuncture therapy of hemifacial spasm is based on Liver meridian(LV), Gallbladder meridian(GB), And ear-acupuncture is recommended as a good method for hemifacial spasm.

선천성 관동정맥루의 경피적 경도관 Coil 색전 1례

조준식,김동수,서정기,장양수,김현승,이도연 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9