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

관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

상악골에 발생한 Monostotic 섬유성 이형성증의 1례

이승학,김경일,김완수,나한조 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

원발성 유방암에서 p53 단백발현과 예후와의 상관성에 관한 연구

이학승,이광만,채권묵,문형배 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.1

p53 is a nuclear phosphoprotein which is normally expressed at very low level in all mammalian cells and plays a role in the regulation of cell proliferation. It has also been suggested that normal p53(wild type) serves as a tumor suppressor gene, and inhibits the oncogene-mediated cellular transformation and the rate of cellular proliferation. But, wild type p53 is hardly stained by immunohistochemistry because of its low intracellular concentration and very short half-life. Mutant form of p53 protein is detectable in various human malignancies e.g. colon, stomach, lung and breast cancer by immunohistochemical stain because of its prolonged half-life. In breast cancer, p53 protein expression has been regarded as an unfavorable prognostic factor, but the results of studies about the relationship between the p53 protein expression and prognosis are equivocal. So, author performed this study to evaluate the prognostic significance of p53 expression in 54 patients with primary breast cancer who underwent surgical treatment at Wonkwang University Hospital from October 1985 to September 1991. Follow-up period was 24-91 months (mean: 54.7months). p53 protein was stained by immunohistochemical methods in formalin-fixed, paraffin-embedded tissues using monoclonal antibody(DAKO-p53, DO-7). The prognostic significance of p53 protein was evaluated by positivity and 5-year survival rate, and comparing with well-known prognostic factors of breast cancer. p53 protein was expressed 48.1%(26/54) of primary breast cancers. 5-year survival rate of patients with p53 protein expression was 42.0%, and that of patients without p53 protein expression was 76.4%(p = 0.0277) There was no relationship between p53 protein expression and tumor size, lymph node metastasis, histologic grade or vascular invasion. These results suggest that p53 protein expression is another independent prognostic factor in primary breast cancer.

흉·요추 불안정성 척추 손상 환자에서 전방감압술과 KANEDA Ⅱ와 SURGICAL TITANIUM MESH를 이용한 내고정술에 대한 임상적 고찰

이학준,김용현,이승명 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.6

The following is a retrospective study on the results of anterior spinal surgery with Kaneda Ⅱ instrumentation and Surgical Titanium MESH after thoracolumbar unstable spinal injuries. From July 1994 to June 1995, we operated on 14 patients at the Chosun University Kwang Yang hospital. Fourteen patients were followed for at least three months. Anterior spinal surgery was performed on the patients who had thoracolumbar unstable spine injuries. The procedure consisted of anterior decompression through corpectomy and stabilization with Kaneda Ⅱ instrumentation and Surgical Titanium MESH which was impacked with resected bone chip. Most of patients had demonstrated showed neurological improvement, relief of pain, immediate stabilization and early return to normal activities. Radiologic evaluation showed the correction of the fracture deformity with satisfactory outcome postoperatively.

표면 SH파 모드의 분산특성 해석과 그 응용

이상용,박익근,윤종학,노승남,안형근 한국공작기계학회 2001 한국공작기계학회 춘계학술대회논문집 Vol.2001 No.-

A new flaw detection technique using by SH angle beam method has been discussed. The SH-wave is horizontally polarized shear wave and the surface SH wave has a characteristic of traveling along near surface layer. The surface SH wave technique is valuable for the detection of fatigue cracks at fillet weld heels which cannot be detected by other ultrasonic technique such as angle beam technique and The dispersion curves of it has simple characterization. In this work, using these beneficial chraterization, quality evaluation of spot weld with ultrasonic sound intensity of SH-wave passing through nugget area of spot weld are verified experimentally.

제4경추의 형태와 초경을 통한 성숙지표에 관한 연구

이규홍,황용인,김윤지,박양호,백승학,차경석 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.1

본 연구는 측모 두부 규격 방사선사진을 이용하여 성장 중인 아동의 제4경추 형태를 경추 몸체부 하연의 만곡 정도에 따라 분류하고 초경의 시기와 수완부 골 성숙 단계를 평가하여, 성장 중인 아동의 골격적 부정교합의 진단 및 악정형 치료를 위한 성장 시기 평가에 제4경추의 형태 변화가 진단의 참고자료로 활용될 수 있는지를 연구하였다. 11-14세 여자 환자 중, 같은 날짜에 촬영된 측모 두부 규격 방사선사진과 수완부 방사선사진이 모두 있는 81명을 대상으로 환자의 측모 두부 규격 방사선사진상 제4경추 몸체부 하연의 만곡 정도에 따라 세 그룹으로 분류하였다. (Group A - 제4경추 몸체부 하연의 만곡 정도가 1.05 mm 이하, Group B -제4경추 몸체부 하연의 만곡 정도가 1.05- 2.07 mm 사이, Group C -제4경추 몸체부 하연의 만곡 정도가 2.07 mm 이상)세 그룹에서 각각 제4경추 몸체부의 수직 길이, 수평 길이, 수직/수평 비율, 초경의 시기, 수완부 골 성숙 단계를 측정한 결과 다음과 같은 결론을 얻었다. 평균 수완부 골 성숙 단계는 Group A가 SMI 5.67 ± 2.57단계, Group B는 SMI 8,73 ± 2.41 단계, Group C는 SMI 10.00 ± 1.47단계로 나타났다. GroupA에서 Group B, Group C로 갈수록 제4경추의 수직 길이, 수평 길이, 수직/수평 비율, 수완부 골 성숙 단계에 있어서 각각 유의하게 더 큰 값을 보였다. 본 연구대상 아동의 평균 초경 시기는 11.64 ± 0.92세를 보였다. 제4경추 몸체부 하연의 만곡 정도, 수직 길이, 수평 길이, 수직/수평 비율은 수완부 골 성숙 단계와 각각 서로 유의한 양의 상관관계를 나타냈다. 초경을 경험한 그룹이 초경을 경험하지 않은 그룹에 비해 제4경추의 수직 길이, 수평 길이, 수직/수평 비율, 수완부 골 성숙 단계에 있어서 유의하게 큰 값을 보였다. 연구 결과 측모 두부 규격 방사선사진상 제4경추 하연의 만곡 깊이가 2.07 mm 이상인 경우 성장의 완료 단계에 가까운 시기로 나타나 이 시기의 악정형적 치료는 큰 효과를 얻을 수 없을 것으로 사료된다. Objective: This study analyzed the morphologic changes of the fourth cervical vertebra body to determine the skeletal age of orthodontic patients during growth. Methods: Eighty-one female patients aged from 11 to 14 who had cephalograms taken on the same day were examined. The subjects were divided into three groups depending on the depth of the concavity of the lower border of the fourth cervical vertebra (Group A: less than 1.05 mm, Group B: 1.05 - 2.07 mm, Group C: greater than 2.07 mm). Menarcheal timing, SMI stage, length, width and ratio of length and width of the fourth cervical vertebra body were analyzed and the following results were obtained. Results: The average SMI stage of group A,B and C were 5.67 ± 2.57, 8.73 ± 2.41, and 10.00 ± 1.47, respectively. Length, width, ratio of length and width, and SMI stage were greater in group B than group A and in group C than group B. Mean menarcheal timing was 11.64 ± 0.92 years. Concavity depth, length, width, ratio of length and width showed a significant positive correlation with SMI stage, especially with the concavity depth. Conclusion: The results of this study propose a simple method for determining the timing of orthopedic treatment by measuring the concavity depth of the fourth cervical vertebra on the cephalogram.

석회화 치성 낭종 1례

이상학,염범우,이승훈,한승훈,김응식,김광일 한국의학사 1998 診斷과治療 Vol.18 No.10

歷史地理硏究 : 新羅行政凶域

李聖學 경북대학교 문리과대학 지리학회 1981 洛東地理 Vol.- No.6

(1) Administrative districts of unification period of Shilla dynasty were transformed to chinese style, and their system was the stem of administrative districts in Korea and lee dynasty. (2) Concerning to the relationships of northern boundary in local administrative district in this period, the southern area of Korea peninsular from northern area of Dae-Dong River and duck-Won area of Ham-Nam province, in spite of unification of Sam-Guk (three nations: Kogure, Shilla and Bakje) by Shilla, was not more than two third aarea of Korea peninsular. (3) U-San-Kuk and Tam-La-Kuk were not belong to Gun-Hyn system of Shilla, but they were only the colony which submited to tax to the mother county, Shilla. (4) Military occupied area, different from administrative district, was established over-lap in order to protect from other invations. (5) Land lords of villages who livied in living units had to take charge of administrative offices and this system, so we can say that they took the autonomy of family community in ancient period.

의과대학생에서 임상 수기 수행능력에 대한 자가평가 결과와 임상수행능력 평가시험(CPX) 결과의 비교

이학승 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

본 연구는 의과대학생들이 한 학기 동안 임상실습을 마치고 난 후, 실습지침서에서 요구하고 있는 흔한 임상 증상을 얼마자 자주 경험하였는가를 조사해 보고, 흔한 임상 증상에 대한 학생들의 경험 빈도와 자가 평가한 염상수행능력과의 상관성을 조사해보는 것이었다. 둘째로, 시험문항으로 제시된 임상수기에 대한 의과대학생들의 주관적 자가평가 결과와 객관적 CPX 결과를 비교하여 주관적 평가 결과와 객관적 평가 결과의 상관성을 조사해 보는 것이었다. 그 결과는 다음과 같다. 1. 임상 증상에 대한 학생들의 경험 빈도와 자가평가한 임상수행능력과의 상관성은 경험 빈도가 많을수록 자가평가 점수도 높게 나오는 결과를 보였다. 2. 객관적 CPX 결과와 주관적 자가평가 결과는 상관성이 없는 것으로 나타났다. Purpose: The purpose of this study was to assess the clinical experience state of medical students 3-grade, and compare the self-assessment about their competency on clinical skills and the assessment of instructors through the Clinical Performance Examination(CPX). Methods: Fifty-two medical students who are in 3-grade were included. Their clinical experiences state and the self-assessment of their condidence on clinical skills were evaluated by questionnaires givend before the CPX. After completing the CPX, they evaluated their own performance state to 9 whole clinical skills of the CPX by self-assessment questionnaires, again. The correlation and comparison between self assessments' socre and instructor's score were analyzed. Results: For 19 of 28 clinical skills items listed in the questionnaires, self-assessment of competence by medical students correlated with the frequency of performance(p<0.05). For 9 clinical skills in the CPX, the self-assessment scores did not correlate significantly with the instructors' assessment scores(p>0.05). However, these 9 clinical skills scores from the instructors correlated significantly with the scores of clinical experienceand the final semester grade point averages(p<0.05). Conclusion: There was a significant association between frequency of performance and self-assessed competency. And there was no significant correlation between self-assessed score on competency with instructor's score in the CPX.