만성간염환자의 삶의 질에 관한 연구

이명화,이지현,손수경 고신대학교(의대) 고신대학교 의과대학 학술지 1997 고신대학교 의과대학 학술지 Vol.12 No.1

-Abstract- This descriptive study was under taken to explore relationships between the quality of life and perceived state of health persons with chronic hepatitis to contribute theoretical understanding about these phenomenon of interest to the quality of nursing care. The subjects of this study were 100 persons with chronic hepatitis, both male and female, between 30 and 59 years of age. Data was obtained using a convenience sample technique from K Medical Center, B hospital and G hospital in Pusan from August, 1996, to November, 1996. The instruments used for this study were the quality of life scale developed by Ro, You-ja. Data was analyzed using a SPSS/PC program for ANOVA, t-test, Pearson Correlation Coefficients and Stepwise Multiple Regression. The results were as follows : 1. The mean score of the quality of life scale was 152.21. The mean scores on different dimensions were family relationships 3.44, relationships with neighbours 3.42, self-esteem 3.31, emotional life 3.14, physical state and function 3.06, economic life 3.06. 2. Higher scores on quality of life were correlated with educational level (F=2.945, p=0.05). 3. There was a significant positive correlation between the subjects perceptions of their current state of health and the quality of life score (r=0.3849, p<0.001). 4. Stepwise Multiple Regression analysis showed that 1) the perception of current health status was the main predictor and accounted for 14.99% of the total variance. 2) educational level accounted for an additional 23.6% of total variance. 5. The quality of life and the perception of their current health status of these patients with chronic hepatitis were generally lower than those of healthy adults and higher than those of cancer patients as noted in previous studies. In conclusion, the quality of life for these chronic hepatitis patients was lower than those of healthy adults and higher than those of cancer patients. The educational level was significant variable relating to quality of life of chronic hepatitis patients.

병기 2b 자궁경부암의 방사선 치료에서 온열치료 병용의 원격전이에 대한 영향 및 관련인자 분석

문창우 고신대학교(의대) 고신대학교 의과대학 학술지 2000 고신대학교 의과대학 학술지 Vol.15 No.1

Background/Objective : This retrospective study was conducted to analyze effect of addition of hyperthermia on distant metastasis and to determine factor affecting distant metastasis in radiotherapy of stage 2b uterine cervical cancer. Methods : From May 1992 to Dec. 1996, among patients treated with radio-thermotherapy in stage 2b uterine cervical cancer at department of Radiation Oncology in Kosin Medical College, 25 patients without evidence of distant metastasis in initial work-ups by physical examination, computed tomography, magnetic resonance imaging, ultrasonography and radioisotope scan were enrolled. The range of age was 33-71 years (median : 52). Radiotherapy used 6-10 MV linear accelerator was performed in whole pelvis with 4 portals technique. Total dose administered was 50-125.5 Gy (median: 77.24) with external irradiation alone or combined with intracavitary brachytherapy by conventional (200 rads/ fraction, 5 fr./week) or hyperfractionated (120-135 rads/ fr., 2fr./day, 10 fr. / wk) methods. Hyperthermia used 8 MHz radiofrequency capacitive heating device (CANCERMIA, Green-Cross Corp.) was applied in pelvic area with 2-3 sessions / week, 40-60 minute / session within 15-20 minute after radiotherapy. The range of power was 800-1300 Watt and 2.7-3.5 kv in kvp. Measurement of intratumoral temperature used Teflon-coated cooper constantans microthermocouple was done with once per 2 weeks. Eleven patients (44%) were received heating less than 7 sessions and 14 (56%) were more than 8 sessions. Statistics was calculated with logistic regression model in SPSS for window and significance was Chi-square test. Duration of follow-up was 9-75 months (median : 36). Results : Distant metastasis were found in 8 patients (32%). Among 8 patients, 4 revealed distant metastasis only and 4 showed distant metastasis with locoregional failure. The sites of distant metastasis were retroperitoneal lymph node (3 patients), bone (3), peritoneal cavity (2), supraclavicular lymph node (2), liver (1), brain (1) and lung (1). In univariate and multivariate analyses, there was no significant factor affecting distant metastasis. Conclusions : There were no evidence of increase of distant metastasis by radio-thermotherapy compared to radiotherapy alone in stage 2b uterine cervical cancer.

Safety issues regarding melatonin use in child and adolescent patients with sleep problems

문은수,이정현 고신대학교(의대) 고신대학교 의과대학 학술지 2022 고신대학교 의과대학 학술지 Vol.37 No.4

Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warranted. Therefore, we aimed to summarize the literature on the safety of melatonin use in children and adolescents with insomnia and sleep disturbances. According to existing evidence, there are no serious adverse effects of long-term melatonin use in children and adolescents. The common adverse effects reported in long-term studies are fatigue, somnolence, and mood swings. In addition, there is no evidence that long-term use of melatonin inhibits the natural secretion of melatonin. It is necessary to monitor potential drug interactions with medications such as inhibitors and enhancers of cytochrome P450 1A2 (CYP1A2). Furthermore, low CYP1A2 expression in young children requires proper dose adjustment. Although sufficient experience of melatonin use in children and adolescents has yet to be attained, accumulating evidence suggests that the use of melatonin in children and adolescents with sleep problems might be effective and tolerable. Considering the abuse or overdose risk of hypnotics or benzodiazepines, melatonin supplements may be a good therapeutic alternative. Future studies on the long-term safety of melatonin for physiological and mental function in children and adolescents are required to establish certainty about melatonin use in children and adolescents.

Idiopathic Intracranial Hypertension following Ventriculoperitoneal Shunt Malfunction in Infant Hydrocephalus

안상준,이재민,김영미,전혜신,최창화 고신대학교(의대) 고신대학교 의과대학 학술지 2021 고신대학교 의과대학 학술지 Vol.36 No.1

Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial pressure without any abnormal findings. In the present study, we report a rare case of IIH in a patient after ventriculoperitoneal shunt (VPS) due to infant hydrocephalus. A 13-year-old girl with a history of VPS due to infant hydrocephalus was admitted to emergency room with the complaint of severe headache and visual disturbance. Brain computed tomography showed normal findings. However, based on the measurement by lumbar puncture, her cerebrospinal fluid (CSF) pressure was observed to be very high. The shunt function test revealed a VPS malfunction. Thus, we conducted VPS revision in this patient. All symptoms improved immediately after the revision. Thus, it is proposed that IIH should be considered for patients with visual disturbance and severe headache after VPS due to infant hydrocephalus without ventriculomegaly.

지주막하출혈 환자에서 아세타졸아미드 부하 뇌혈류 SPECT의 유용성

이석모,배상균,염하용,문재곤 고신대학교(의대) 고신대학교 의과대학 학술지 2000 고신대학교 의과대학 학술지 Vol.15 No.1

Background : We obtained basal and acetazolamide-enhanced cerebral perfusion SPECT to evaluate the vascular reserve capacity in patients with subarachnoid hemorrhage. Methods : Basal cerebral perfusion SPECT was obtained following the injection of 555 MBq (15 mCi) of Tc-99m HMPAO. For acetazolamide-enhanced SPECT, acetazolamide was injected 20 minutes prior to the injection of Tc-99m HMPAO on separate day. The result of acetazolamide response was compared with the clinical outcomes. Results : Fourteen patients (male : 5, female : 9, mean 50 years old) with subarachnoid hemorrhage were included. We obtained SPECT study in 4 patients preoperatively and delayed operation in 2 patients because of diagnosing vasospasm. The 7 patients among 8 patients with normal response to acetazolamide revealed good outcome. But 3 patients among 5 patients with poor response to acetazolamide didn't recover. The response to acetazolamide correlates with the clinical outcome (p<0.05), but Hunt& Hess grade and Fisher grade do not correlated with outcome. Conclusion : Acetazolamide-enhanced cerebral perfusion SPECT is considered as a useful tool to diagnose the vascular reserve state and to aid the treatment plan.

수두증 치료에 있어 내시경을 이용한 제3뇌실 천자술의 역할

전병찬,김도헌 고신대학교(의대) 고신대학교 의과대학 학술지 2002 고신대학교 의과대학 학술지 Vol.17 No.1

Background : Owing to the development of endoscopic equipment, endoscopic 3rd ventriculostomy (ETV) is commonly used in the treatment of hydrocephalus substituting shunt operation. ETV is the preferred treatment of aqueductal stenosis or 4th ventricle outlet obstruction. Recently, the role of ETV is expanded to selected cases of communicating hydrocephalus. We elucidated the effectiveness of ETV in hydrocephalus with our experience. Methods : Twelve endoscopic 3rd ventriculosomies were done between February 1999 and February 2001. These included 8 non-communicating hydrocephalus and 4 communicating hydrocephalus. Non-communicating hydrocephalus were caused by four pineal gland tumors, one invasive pituitary adenoma, one spontaneous cerebellar hemorrhage, and two cerebellar tumors. Communicating hydrocephalus were caused by two subarachnoid hemorrhages, one meningitis, and one acute subdural hematoma. Mean follow-up period was 11.5 months. Results : Nine of 12 patients achieved clinical success. Seven patients showed clinical improvement among eight non-communicating hydrocephalus. Two of four communicating hydrocephalus patients improved. A case of meningitis and two cases of transient fever due to hypothalamic injury were observed as complications. Conclusion : ETV can be suggested in the treatment of selected cases of communicating hydrocephalus as well as non-communicating hydrocephalus replacing the shunt operation with high morbidities and reoperation rates. Reliable clinical tests that can predict whether ETV will be successful are necessary.

Case of hyperosmolar hyperglycemic state by a sodium-glucose cotransporter 2 inhibitor

노인영,박석오,김해성,강남규,이명원,김수경 고신대학교(의대) 고신대학교 의과대학 학술지 2018 고신대학교 의과대학 학술지 Vol.33 No.3

Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) are proposed as a novel approach for the management of type 2 diabetes mellitus. SGLT2 cotransporters are responsible for reabsorption of 90 % of the glucose filtered by the kidney. The glucuretic effect resulting from SGLT2 inhibition contributes to reduce hyperglycaemia and also assists weight loss and blood pressure reduction. In this study, we presented the case of a 59-year-old male who developed hyperosmolar hyperglycemic state (HHS), possibly caused by a sodium-glucose cotransporter 2 (SGLT2) inhibitor, a novel class of antihyperglycemic agents. This case highlights that HHS can develop in patients with diabetes treated with SGLT2 inhibitors.

증상점수표를 이용한 상부위장관질환 상태예측

김원경,김윤진 고신대학교(의대) 고신대학교 의과대학 학술지 1992 고신대학교 의과대학 학술지 Vol.8 No.2

-Abstract- The prevalence of upper gastrointestinal disease is high. To predict the state of gastrointestinal tract without endoscopy, the sooring system was developed. In order to study, 153 patients attending for endoscopy were selected and asked to the questionaires with 30 items. State of gastrointestinal tract was divided to two groups,-severe group(erosive gastritis, hemorrhagic gastritis, atrophic gastritis, polyp, dysplasia, ulcer, cancer) and mild group (normal state, chronic superficial gastritis). Data were analysed by stepwise discriminant analysis in SPSS package. The factors discriminated between groups with severe states and groups with mild states were nine characteristics which were age over 60, amount of coffee intake, medication of ulcer inducing drugs, symptom of vomiting, symptom duration over 6 month, disability of daily living, symptom of indigestion, symptom of bloting, symptom of nausea. The scoring system was devised with nine characteristics. The distribution of score of normal state were below 2900. There were no cancer under 1499. The possibility of cancer was 41.7% over score of 2500. The similar results were obtained in simplified scoring system. The scoring system can be useful diagnostic tool to prediction of state of gastrointestinal disease. In primary care setting, scoring system may be useful before gastroendocsopic examination.

영아기에 범혈구 감소증이 발생된 Fanconi Anemia 1례

박성희,이경아,박재선 고신대학교(의대) 고신대학교 의과대학 학술지 1992 고신대학교 의과대학 학술지 Vol.8 No.2

-Abstract- We experienced a case of Fanconi anemia in a 4 months old boy, characterized by early manifestation of hematological findings. The patient showed small thumbs attached to each side of hand only by soft tissue, microcephaly and growth retardation. Bone marrow finding of the patient revealed marked hypocellularity with increased number of histiocytes. Chromosomal study of conventional method showed normal karyotype, however. The patient is kept on androgen and prednisone without noticeable improvement in peripheral blood findings. We report this case with brief review of related literatures.

A Case of Attention Deficit Hyperactivity Disorder in Association with Postinflammatory Hydrocephalus

전진숙 고신대학교(의대) 고신대학교 의과대학 학술지 1992 고신대학교 의과대학 학술지 Vol.8 No.2

-Abstract- An arrested hydrocephalus viewed as enlarged lateral and the third ventricles with thinning of corpus callosum was found on MR imaging in a ten year-old boy whose behavior was disruptive with hyperactivity, impulsivity and inattention, a typical clinical features of attention deficit hyperactivity disorder according to the DSM-Ⅲ-R, and was responsive to the stimulant. The hydrocephalus seemed to be secondary to tuberculous meningoenphalitis which had occurred at 12 months of his age, I reported the case to speculate organic causes of attention deficit hyperactivity disorder and reviewed articles related to the etiology of the attention deficit hyperactivity disorder.