Adamkiewicz 동맥의 폐색에 의한 척수경색 1례

이광훈,이종걸,이태연,신동익,이성현,이상수,한설희,차상훈 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

집단상담과정에서의 응집성 및 자기노출수준의 변화와 친밀감에 대한 일연구

설기문,이상훈 東亞大學校 學生生活硏究所 1991 學生硏究 Vol.19 No.-

This study dealt with group cohesiveness, self-disclosure, and intimacy during the group counseling sessions. The purpose of this study was that if group cohesiveness and self-disclosure would increase as group develops and that if there would be significant relationship between self-disclosure and closeness. The group cohesiveness and closenss were measured by the perceived closeness on the Psychological Distance Diagram which was designed by the current researchers. The self-disclosure was measured by the Johari Window Self-Rating Sheet. The subjects were thirty paid participants who volunteered. They were divided into three groups according to their prior group experience. The Group A and Group B were advanced group, and group C was a basic group, where personal growth group counseling program was applied. They had a total of thirty hours of group counseling sessions during which the two instruments, mentioned above, administered three times respectively in each group. The data were analyzed statistically using MANOVA and Pearson r coefficients by SPSS-PC. The data-analysis supported hypothesis 1 and hypothesis 3(partially), and rejected hypothesis 2. Thus, the following conclusions were derived from the results and discussions. 1. Group cohesiveness increase as group develops. 2. Self-disclosure does not always increase as group develops. 3. There are not always significant positive relationship between self-disclosure and closeness.

1980年度 痢疾樣 大便을 가진 患兒들에 對한 臨床的 細菌學的 觀察

趙龍勳,南聖枝,具滋薰,安斗洪,薛盛用 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.2

1980年 1月부터 1980年 8月까지 滿 8個月間 痢疾樣 大便을 主訴로 本 小兒科에서 入院및 來院한 患兒 75名을 對象으로 臨床的, 細菌學的 觀察을 하여 다음과 같은 咸績을 얻었다. 年齡別 分布는 1歲에서 5歲 사이가 35例(47%)로 가장 높았으며 이들中 Shigella는 23例(30%), Entameba histolytica는 13例(17%)였고 Vibrio parahaemolyticus는 한 例도 檢出되지 않았다. 檢出된 Shigella 23菌株는 모두 Shigella flexneri 였다. 月別分布는 6月 16例(20%), 7月 30例(40%)로서 最多數를 占하였으나 細菌性 痢疾의 경우 月別에 관계없이 均等하게 分布하고 있었다. 臨床症狀및 理學的 所見으로는 細菌性痢疾의 경우 38℃ 以上의 發熱 19例(83%), 嘔吐 6例(26%), 腹痛 8例(35%), 痙攣 5例(22%)였으며, 아메바性 痢疾에서는 發熱 4例(31%), 痙攣 1例(8%)로서 細菌性 痢疾에서 아메바性 痢疾보다 發熱과 痙攣이 빈번히 나타났다. 泄瀉의 性狀에서는 細菌性 痢疾 23例中 血粘液性이 19例(83%)였는데 비해 아메바性 痢疾 13例에서는 粘液性이 8例(62%)였다. 泄瀉의 回數에서도 細菌性 痢疾에서는 대부분이 11回以上이었는데 比해 아메바性 痢疾에서는 대부분이 10回未滿이었다. 末梢血液에서의 白血球數는 全例의 35%에서 白血球 增多症을 보였다. 分離된 Shigella 23菌株에 對한 抗生劑 感受性 檢査를 平板混合포稀釋法에 依해 調査해 본 結果 kanamycin, gentamicin, amikacin, cephaloridine, rifampin이 100%의 感受性을 나타내어 가장 높았고, nalidixic acid에서도 87%의 感愛性을 나타냈으며, sulfonamide, chloramphenicol, streptomycin, tetracycline, ampicillin, bactrim 에서는 한 菌株를 제외한 모든 菌株에서 耐性을 나타냈다. 그리고 이들 Shigella 23菌株中 1菌株를 제외한 나머지 모든 菌株에서 6種 以上의 抗生物質에 對해 多抗生物質耐性을 보여 주었다. A clinical and laboratory study was conducted on 75 children with dysentery-like stool, who were admitted or visited to our pediatric department during 8 months period from January to August 1980. The following results were obtained: One to five years of age group was affected most frequently (47%). Shigella flexneri was identified by stool culture in 23 cases (30%) and Entameba hitolytica in 13 cases (17%). In bacillary dysentery group, fever was the most common symptom occuring in 83%, followed by abdominal pain in 35%, vomiting in 26% and convulsion in 22%. In amoebic dysentery group, fever was noted in 31% and convulsion in 8%, showing some contrast to the frequency of fever and CNS manifestation. About the character of diarrheal stools, 83% of bacillary dysentery group showed bloody, mucoid stool and 62% of amoebic dysentery group mucoid ones. Frequency of diarrhea was 11 times per day or more in 73% of bacillary dysentery patients, and 10 times per day or less in 92% of amoebic dysentery patients. The result of sensitivity test of isolated Shigella to various antibiotics were as follow: 100% sensitive to kanamicin, gentamicin, amikacin, cephaloridine and rifampin. 87% to nalidixic acid, and 4.3% to sulfonamide, chloramphenicol, streptomycin, tetracyclin, ampicillin and bactrim. And 22 out of 23 isolated Shigella strains revealed multiplydrug-resistance patterns to 6 or more antibiotics.

가족지향 집단상담 프로그램의 개발

이상훈,설기문 동아대학교 교육대학원 1998 동아교육논총 Vol.24 No.-

본 연구는 가족으로부터 기인한 개인의 문제를 집단상담 장면 속에서 다룰 수 있도록 하기 위하여, 가족상담의 이론과 기법을 집단상담에 통합시킨 가족지향 집단상담 프로그램을 개발하기 위한 목적으로 이루어졌다. 본 연구에서는 집단상담 프로그램을 개발하는 이론적 근거로서 Schutz(1958)의 기본적 대인관계 지향 이론(FIRO)개념인 대인간 욕구 가설과 집단발달 가설을 채택하였으며 이에 따라 집단상담 프로그램을 개발하였다. 아울러 FIRO의 이론체계를 활용한 Doherty와 Colangelo(1984)의 가족 FIRO모형에 근거하여 가족치료 이론과 기법을 통합하고 하위변인별로 분류한 체계를 활용하였다. 즉 집단발달의 가설에 의해 소속, 통제, 개방의 순서로 집단의 단계를 나누어 구획지웠으며 가족 FIRO모형에서 각 하위변인에 적합한 것으로 분류된 상담모형을 각 세 구획속에 배치하였다. This study aims to develop a family-oriented group counseling program, as the program includes the theory and techniques of family counseling in group counseling. In this approach, therefore, a program was developed so that each person could lead a more growth-oriented lifestyle by rightly understanding oneself and one's family and probe for alternatives about family problems. As a theoretical foundation for the new program, two gypotheses of interpersonal desire and group development were adopted, coming from the FIRO(Fundamental Interpersonal Relational Orientation) theory of Schutz(1958). Also, based on the FIRO family models by Doherty and Colangelo(1984), the theory and techniques of family therapy were synthesized and the subcategorization system was utilized. That is, group stages were divided into inclusion, control and openness, while the subdivided counseling models were allocated in each of the three divisions.

초음파를 이용한 표재성 신경초종의 분석 : 초음파기기 주파수 및 종양의 변성이 후방음파증강에 미치는 영향 The Influence of Sonographic Frequency and the Degenerative Change of Tumor on the Posterior Acoustic Enhancement

차상훈,설혜영,정규병 고려대학교 의과대학 1994 고려대 의대 잡지 Vol.31 No.2

We retrospectively analyzed the sonographic findings of 18 pathologically proven superficial neurilemmomas in 17 patients during recent 5 years. We evaluated the contuor, size and internal echo pattern of the tumor, the presence of tumor capsule, and the degree of acoustic enhancement behind the tumor. We correlated the posterior acoustic enhancement with the pathologic features. Eighteen tumors showed oval or round in contuor and 9 tumors revealed hypoechoic pattern, 3 tumors revealed homogenously echogenic pattern and 6 tumors revealed heterogenously echogenic pattern. Sixteen tumors showed the capsule of tumor. Fourteen tumors showed posterior acoustic enhancement. Grade Ⅰ posterior acoustic enhancements were noted at 10 MHz transducer examination only and Grade Ⅱ posterior acoustic enhancements were noted at 5 MHz or 7.5 MHz tranducer examination. No definite correlation between hemorrhagic or cystic degenerations of superficial neurilemmomas and Grade Ⅱ posterior acoustic enhancements were noted. The mean size of hypoechoic superficial neurilemmoma was smallest and that of heterogenously echogenic superficial neurilemmoma was largest. We conclude that sonographic exammination was useful for evaluation of superficial neurilemmoma.

뇌혈관질환을 동반한 당뇨병 환자에서 지속적 혈당측정의 유용성 평가

정성훈,강인구,박철영,류미숙,우정택,김성운,김진우,김영설 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2

연구배경: 뇌혈관질환을 동반한 고령의 당뇨병환자는 이들의 신경학적 결손으로 경고 증상없이 심한 저혈당에 노출될 가능성이 크다. 실제로 하루 4번 정도의 자가 혈당 측정으로는 이를 감지하기 어려울 뿐 아니라 검사에 따른 고통으로 적극적인 혈당 조절에 제한이 따르게 된다. 이에 저자들은 Mini Med사의 지속적 혈당측정기(CGMS, continuous glucose monitoring system)를 이용하여 뇌혈관질환을 동반한 당뇨병 환자에서 24시간 혈당의 변동양상을 알아보고 각기 다른 인슐린 치료방침에 따른 혈당조절의 효율성을 비교하고자 하였다. 방법: 2001년 1월부터 6월까지 경희대학교 부속병원에 입원해 있는 10명의 뇌혈관질환을 동반한 제 2형 당뇨병환자를 대상으로 하였다. 이 들은 모두 튜브식이를 받고 있엇고 최소 1개월 이상 인슐린 치료를 시행 받았다. 지속적 혈당측정기를 착용하고 3일간의 연속적인 혈당을 측정하였고, 치료 첫 날은 NPH, 둘째 날은 속효성 인슐린과 NPH, 마지막 날은 혼합형 인슐린제제로 치료하여 그 효과를 비교하였다. 이들 각기 다른 인슐린 제재의 하루 총량에 차이는 없었다. 혈당치가 3.3mmol/L 미만이거나 7.8mmol/L를 초과하는 경우 그 차이값의 총합을 시간으로 나누어 이 값(△Glu)이 적을수록 치료효과가 우수한 것으로 판정하였다. 또한 당 수치가 3.3mmol/L 미만인 경우를 저혈당 event, 16.7mmol/L 초과한 경우를 고혈당 event로 임의로 정의하였고, 이를 통해 지속적 혈당측정의 유용성을 간접적으로 평가하고자 하였다. 결과: 평균 △Glu값은 첫째 날이 0.93 ± 0.43mmol/Lㆍmin?¹, 둘째날이 0.71 ± 0.29mmol/Lㆍmin?¹ 마지막 날이 0.58 ± 0.29mmol/Lㆍmin?¹로서 서로 다른 3가지 치료방침사이에 통계학적으로 유의한 차이는 없었다(p=0.115). 10명의 환자들 중 자가 혈당측정기로는 1명에서 저혈당 event, 2명에서 고혈당 event를 인지하였으나 지속적 혈당측정기로는 각각 9명에서 event를 확인하였다. 결론: 지속적 혈당측정기를 이용한 각각의 인슐린 치료방침에 따른 혈당조절 효율성의 차이는 없었으나, 자가혈당 측정기로는 알 수 없었던 일 중 혈당 변동사항을 정확하게 알 수 있어, 뇌혈관질환을 동반한 당뇨병 환자에서 보다 적극적인 인슐린 치료 및 관리를 할 수 있을 것으로 생각된다. Background: Diabetic stroke patients are susceptible to hypoglycemia. However, there are many limitations in detecting hypoglycemic events, even though glucoses levels are checked 3 to 4 times per day using the fingerstick method. Therefore, we investigated the glycemic excursions and pattern in diabetic stroke patients using the continuous glucose monitoring system (CGMS, MiniMed) and its clinical utility. The other objective was to compare the treatment dfficacy between insulin regimens. Methods: From jan 2001 to jun 2001, 10 adult type 2 diabetic stroke patients wore CGMS for consecutive 3 days, which continuously checked the glucose level. NPH insulin, multiple daily injection of regular insulin ± NPH and the mixed type(Novolet 30/70, Novo Nordisk) were used on the first, second and third days of the study, respectively. If the mean delta glucose(△Glu = A+B/time, A=∑(hlucose-7.8), glucose > 7.8 mmol/l, B=∑(3.3-glucose) if, glucose < 3.3 mmol/l) was calculated in order to recognize the degree of individual glycemic changes and to compare the efficacy of each treatment diverse insulin regimen. We arbitrarily defined a glucose level less than 3.3mmol/l, as a hypoglycemic event, and more than 16.7mmol/l as a hyperglycemic event. Results: Variable patterns of glycemic changes were observed among patients with the same dosage, but a different insulin regimen. The mean △Glu was 0.93±0.43 on the first day, 0.71±0.29 on the second day and 0.58±0.29 on the third. There was no significant difference in treatment efficacy between the 3 different insulin modalities(p=0.115). Of the 10 patients, a hypoglycemic event was detected in 1 with the fingerstick method, in contrast to 9 with CGMS, with hyperglycemic events being detedted in 2 and 9, respectively. Conclusion: Continuous glucose monitoring maybe useful in providing the information necessary for optimal glycemic control in the diabetic stroke patients.

갑상선 결절의 초음파 유도하 세침흡인 검사의 유용성

배일헌,한기석,차상훈,김성진,박길선,한설희,김동호 충북대학교 의학연구소 2002 忠北醫大學術誌 Vol.12 No.2

연구목적: 본 연구의 목적은 초음파 유도 하에 갑상선 결절을 경피적 흡인 생검 할 때 검체 획득률을 알아 보고, 검체 획득률에 영향을 주는 요소들을 알아보고자 하였다. 대상 및 방법: 갑상선 결절이 있어 초음파 유도하 경피적 흡인 생검을 하였던 132명 (12-71; 평균 42세) 환자의 결절 215예를 대상으로 전향적 연구를 시행하였다. 2000년 9월부터 2001년 2월까지 62명의 환자의 결절 111예에서 21-gauge 세침을 이용하였고, 2001년 3월부터 9월까지 70명의 환자의 결절 104예에서 20-gauge 절단침을 이용하였다. 초음파 유도하 경피적 흡인 생검의 검체 획득률을 구하였고, 결절 단경이 1 ㎝ 이하와 1 ㎝ 초과, 결절의 성상, 촉지여부에 따라 검체 확득률에 차이가 있는지 비교 분석하였다. 통계적 분석은 Chisquare test로 검증하였다 (p<0.05). 결과: 총 215예 중 188예에서 적절한 검체가 얻어져 전체 검체 획득률은 87.4%이었다. 낭성 결절 (78.8%)보다 고형 결절 (90.2%)에서 더 높은 검체 획득율을 보였으나, 결절의 크기(≤1 ㎝:85.7% vs. >1 ㎝:88.7%)와 촉지 여부 (촉지되는 결절: 87.5% vs. 촉지되지 않는 결절:87.4%)에 따라서는 유의한 차이를 보이지 않았다. 결론: 갑상선 결절의 초음파 유도하 경피적 흡인 생검은 높은 검체 획득율을 보이며, 결절의 크기, 촉지 여부에 따른 차이는 없으나, 고형 결절에서 낭성 결절보다 높은 검체 획득율을 보인다. Purpose: The purpose of this study is to evaluate the acquisition rate of adequate specimen in ultrasound-guided percutaneous needle aspiration biopsy (US-PCNB) of thyroid nodules and to find the factors influencing the acquisition rate. Materials and Methods: We conducted a prospective study in 132 patients (mean age 47 years: range 12-71) who had 215 nodules. Aspiration biopsy was performed with 21-gauge fine needles for 111 nodules (62 patients) and with 20-gauge cutting needles for 104 nodules (70 patients). We calculated overall acquisition rate of adequate specimen of US-PCNB and compared acquisition rates according to nodule size, nature and palpability. Results: Total acquisition rate of adequate specimen was 87.4%. The acquisition rate of adequate specimen of solid nodules (90.2%) was higher than that of cystic nodules (78.8%). The size of nodules did not affect the acquisition rate of specimen (≤1 ㎝:85.7% vs. >1 ㎝:88.7%). The palpability of nodules also cause no difference the acquisition rate (palpable: 87.5% vs. non-palpable:87.4%). Conclusion: US-guided PCNB of thyroid nodules was high acquisition rate of adequate specimen. There was no statistically significant difference according to size and palpability of nodules but was according to nature of nodules in the acquisition rate of adequate specimen.

High-Intensity Focused Ultrasound Induced Changes in Left Ventricular Two-Dimensional Speckle-Tracking Strain in a Mouse Model

Sang-Hoon Seol 한국심초음파학회 2021 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.29 No.2

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만성 B형 간질환 환자에서 라미부딘 1년 치료효과

설상훈,엄수정,이연재,최봉기,박은택,장윤식,이상혁,설상영,정정명 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1

■ Objectives The aim of this study was to evaluate the biochemical and virological responses to one year lamivudine therapy in HBV-associated chronic liver diseases including interferon(IKF) -naive. INF-failed chronic hepatitis and liver cirrhosis. ■ Methods This study was conducted as an one-year trial of lamivudine in 60 patients with HBV-associated liver disease(INF-naive chronic hepatitis 20. INF-failed chronic hepatitis 18. liver cirrhosis 22). We classifed the patients as INF-naive chronic hepatitis(Group A), as INF-failed chronic hepatitis(Group B) and as liver cirrhosis(Group C). ■ Results The mean normalization rate of serum ALT was 71.7%: 65.0% in Group A. 61.1% in Group B and 86.4% in Group C. The negative conversion rate of HBV-DNA was 73.3%: 60.0% in Group A, 83.3% in Group B and 77.3% in Group C. The seroconversion rate of HBeAg was 30.0%: 22.2% in Group A, 35.3% in Group B and 26.3% in Group C. The breakthrough was occurred in 26.7% of patients: 40% in Group A, 16.7% in Group B and 22.7% in Group C. However, they did not deteriorate clinically in spite of ALT elevation and HBV-DNA reappearance. In case of anti-HBe positive chronic liver disease, ALT was normalized and HBV-DNA became undetactable in all 6 patients after 1 year lamivudine treatment. ■ Conclusions One year lamivudine treatment resulted in biochemical and virological improvements in patients with HBV- associated liver disease irrespective of the severity of liver disease and the status of HBeAg/Anti-HBe. Further studies are required to determine the effects of long-term suppressive therapy and optimal duration of therapy in patients with chronic HBV infection.

임상화보 : 시멘트 폐색전증

설상훈 ( Sang Hoon Seol ),김웅 ( Woong Kim ),양태현 ( Tae Hyun Yang ),김대경 ( Dae Kyeong Kim ),김두일 ( Doo Il Kim ),김동수 ( Dong Soo Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5