하라다병 환자에서 섬모체맥락막 삼출로 인해 발생한 양안의 급성 근시와 전방각 폐쇄 1예

김지훈,임재석,이지웅,이지은,엄부섭,Ji Hun Kim,MD,Jae Seok Lim,MD,Ji Woong Lee,MD,Ji Eun Lee,MD,PhD,Boo Sup Oum,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.8

Purpose: To report a case of bilateral acute myopia and angle-closure with ciliochoroidal detachment in Vogt-Koyanagi-Harada (VKH) syndrome. Case summary: A 43-year-old Korean woman diagnosed with VKH syndrome underwent intravenous methylprednisolone steroid pulse treatment. After oral medication was given for 2 days, the anterior chambers became shallow in both eyes. Intraocular pressure (IOP) increased to 25 mm Hg in the right eye and 23 mm Hg in the left eye. Subretinal fluid increased and visual acuity decreased with myopic shift in both eyes. IOP did not decrease despite maximum tolerated medical therapy. Ultrasound biomicroscopy (UBM) revealed that ciliochoroidal effusion caused forward displacement of the lens-iris diaphragm, which resulted in anterior chamber shallowing and angle closure in both eyes. The patient was treated with cycloplegic eyedrops and intravenous steroid pulse therapy. After intravenous steroid pulse treatment was given for 2 days, the anterior chambers became deep in both eyes. IOP reduced to 13 mm Hg and 14 mm Hg in the right and left eye respectively. Visual acuity increased with normalization of myopic shift. UBM revealed that the ciliochoroidal effusion had resolved in both eyes. J Korean Ophthalmol Soc 2012;53(8):1194-1199

근위부 위절제술 후 재건 술식에 따른 경과 관찰

김지훈,육정환,김병식,오성태,Kim, Ji-Hoon,Yook, Jeong-Hwan,Kim, Byung-Sik,Oh, Sung-Tae 대한위암학회 2006 대한위암학회지 Vol.6 No.1

목적: 근위부 위절제술 후 식도-위 문합술을 시행받은 환자에서 문합부 협착, 역류성 식도염 등이 드물지 않게 발생한다. 저자들 역시 이러한 합병증을 경험하였고 이를 극복하기 위한 방법으로 공장간치술을 시행하였으며 식도-위 문합술과 공장간치술 간의 경과 관찰을 통해 보다 나은 재건 술식을 찾고자 하였다. 대상 및 방법: 1998년 6월부터 2002년 12월까지 울산의대 서울아산병원 외과에서 상부위암 혹은 위상부의 위장관기질종양으로 진단받고 근위부 위절제술을 시행한 환자를 대상으로 재건 술식에 따른 수술시간, 수술 후 증상, 체중변화, 추적관찰 시 시행한 내시경 소견 등을 비교하였다. 결과: 대상 환자 총 33명의 평균연령은 59세였고, 남녀 비는 3 : 1이었다. 식도-위 문합술을 시행한 환자는 25명, 공장간치술을 시행한 환자는 8명이었다. 통과장애, 속쓰림, 신트림, 구토 등의 증상을 관찰하였으며 식도-위 문합술 환자에서 통과장애 12예, 구토 3예, 속쓰림 4예, 신트림 4예가 관찰되었으며, 공장간치술 환자에서는 통과장애 12예, 구토 3예가 있었고, 속쓰림과 신트림은 관찰되지 않았다. 수술 후 체중변화는 1개월 후 수술 전 체중의 90%까지 감소한 경우가 식도-위 문합술 환자에서 7예, 공장간치술 환자에서 없었다. 수술 후 추적 내시경 검사 결과 역류성 식도염이 관찰된 경우는 식도-위 문합술 환자에서 9예, 공장간치술 환자에서 0예였다. 문합부위 협착으로 인해 풍선 확장술이 필요하였던 경우가 식도-위 문합술 환자에서 4예, 공장간치술 환자에서 1예가 있었다. 결론: 상부 위절제 시 재건방법으로 역류성 식도염 및 여러 소화기 증상을 예방하기 위해 공장간치술이 식도-위문합술의 대안이 될 수 있다고 생각한다. 하지만 통계적 유의성을 가지기 위해 더 많은 대상군이 포함되어야 할 것이다. Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients. (J Korean Gastric Cancer Assoc 2006;6:1-5)

우수교육 프로그램 - 가치창출을 위한 상생 산학협력의 시작, 한국산업기술대학교

김지훈,Kim, Ji-Hun 한국대학교육협의회 2013 大學敎育 Vol.179 No.-

$La_2CuO_4$ 구조를 갖는 $(C_4H_9NH_3)_2PbI_4$의 합성 및 분석

김지훈,박성훈,최동식,Kim, Ji Hoon,Park, Sung Hoon,Chair, Tong Seek 대한화학회 1998 대한화학회지 Vol.42 No.5

대형등명기 모니터링 시스템 설계 및 구현

김지훈,예성현,한순희,Kim, Ji-Hoon,Ye, Seong-Hyeon,Han, Soonhee 한국정보통신학회 2014 한국정보통신학회논문지 Vol.18 No.10

우리나라는 해안선이 복잡하여 연안을 항해하는 선박이나 어선의 안전한 항해 및 조업을 위해 효과적인 항로표지 운영이 필요하다. 특히 대형등명기는 야간에 항상 점등되어 선박의 안전을 보장해야 한다. 등대에 설치된 대형등명기가 점등되지 않을 경우 자신의 선위를 확인할 수 없어 사고가 발생하기 쉬우며 이는 커다란 경제적 피해를 야기할 수 있다. 본 연구에서는 대형등명기의 상태정보를 감시 제어하는 대형등명기 모니터링 시스템을 설계하고 구현하였다. 이 시스템은 다양한 장애상황에 신속히 대처하여 해양 안전사고를 미연에 방지할 수 있도록 하는데 그 목적이 있다. Our country has a convoluted coastline and the marine weather fluctuates locally, so it needs effective AtoN operation for the safe navigation of vessels and fishing boats sailing the coast. Especially, large beacon must ensure the safety of the vessels and always lit at night. If large beacons installed in the lighthouse are not lit, vessels can not assure their location. Thus the accidents is likely to occur, which can cause great economic damage. In this paper, we developed a monitoring system of large beacon to monitor and control the status of information. This system was designed for a special purpose of taking precautions against possible accidents on the sea.

소족지 변형에서 시행한 관절 절제 성형술

김지훈,박형준,서진수,Kim, Ji Hoon,Park, Hyung Jun,Suh, Jin Soo 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.4

Purpose: The objective of this study was to examine the clinical results and effectiveness of resection arthroplasty for correction of lesser toe deformity. Materials and Methods: From January 2000 to November 2012, 92 cases of resection arthroplasty for lesser toe deformity were reviewed. Hammer toe was the most common type of deformity, accounting for 44 toes (33 patients). Hallux valgus was the most common comorbid illness. Second toe was the most commonly affected toe and proximal interphalangeal joint was the most common location of resection arthroplasty (69 toes, 75.0%). We also analyzed the alignment of phalanges using the last follow-up weight bearing radiographic image. The analysis included clinical evaluation with American Orthopaedic Foot and Ankle Society (AOFAS) score as well as subjective satisfaction. Results: Flexor tenotomy (19 cases) was the most common combined surgery. Floating toe (4 cases) was the most common complication. The last follow-up alignment of phalanges was better than good in 71 toes (77.2%) in anteroposterior view and in 69 toes (75.0%) in lateral view. Sixty one cases (85.9%) resulted in better satisfaction than 'good' and the final average AOFAS score was 87.4. Conclusion: Resection arthroplasty is a valuable surgical option for treatment of lesser toe deformity, with high patient satisfaction, easy surgical technique and remarkable correction of deformity.

말초성 안면신경마비의 한양방 협진치료에 관한 임상적 연구

김지훈,송재준,홍승욱,Kim, Ji-Hoon,Song, Jae-Jun,Hong, Seung-Ug 대한한방안이비인후피부과학회 2009 한방안이비인후피부과학회지 Vol.22 No.1

Objectives : Facial palsy is not uncommon disease and most patients with facial palsy are peripheral type, as in Bell' s palsy. In western medicine, oral steroid is the mainstay of the treatment. Recently, oriental-western treatment became one of the alternative modality for the treatment of the facial palsy. However, the treatment result and the degree of patient' s satisfaction were not evaluated. In this study, we tried to characterize the clinical characteristics, short-term recovery rate and degree of patient' s satisfaction after oriental-western medicine treatment on facial palsy of peripheral type. Methods : Between May 2008 and December 2008, we examined 16 patients who presented with facial palsy of peripheral type in Dongguk University Medical Center. Clinical characteristics and recovery rate was analyzed by retrospective chart review. The degree of patient' s satisfaction was measured by 5 point scale. Results : The causes of facial palsy were Bell' s palsy (87.5%) and the Ramsay-Hunt syndrome (12.5%). The highest age groups of facial palsy were 6th and 7th decades. Most frequent accompanying symptom was postauricular pain. After oriental-western medicine treatment, 10 patients (62.5%) showed recovery of facial palsy better than House-Brackmann grade 2. 11 patients (68.8%) were satisfied with the oriental-western medicine treatment. Conclusions : Considering the degree of patient' s satisfaction and treatment result, we believe that oriental-western treatment could be safe and reliable protocol for the treatment of facial nerve palsy of peripheral type.

자돈에 있어 산미제의 질병예방 및 면역증강 기능

김지훈,Kim, Ji-Hun 한국단미사료협회 2004 사료산업 Vol.2 No.11

작업치료사의 직업윤리와 교육에 대한 인식이 직무스트레스와 직무몰입에 미치는 영향

김지훈,정재훈,Kim, Ji Hoon,Jung, Jae Hun 한국디지털정책학회 2021 디지털융복합연구 Vol.19 No.10

본 연구는 작업치료사의 직업윤리와 교육에 대한 인식이 직무스트레스와 직무몰입에 미치는 영향을 파악하기 위한 조사연구이다. 이를 위하여 작업치료사 173명을 대상으로 직업윤리와 교육에 대한 인식, 직무스트레스와 직무몰입을 평가하였으며, 본 연구의 결과는 다음과 같다. 첫째, 직업윤리와 교육에 대한 인식, 직무스트레스와 직무몰입(p<.01) 간에는 유의한 상관관계가 있었다. 둘째, 직업윤리와 교육에 대한 인식의 하위요인 중 교육경험(p<.01)과 윤리문제의 심각성(p<.05)은 직무스트레스에 영향을 미치는 것으로 나타났다. 셋째, 직업윤리와 교육에 대한 인식의 하위요인 중 교육경험(p<.05)은 직무몰입에 영향을 미치는 것으로 나타났다. 본 연구의 결과들을 통하여 직업윤리의 중요성을 인식하고, 이를 향상하기 위한 체계적인 교육이 필요할 것이다. The aimed of this research was to identify the influence of perception of the vocational ethics and education on job stress and job commitment in occupational therapists. 173 occupational therapists measure for perception of vocational ethics and education, job stress and job commitment, the findings of the study were as follows. First, perception of vocational ethics and education was correlated with job stress, job commitment(p<.01). Second, perception of vocational ethics and education sub-factor of education experience(p<.01), seriousness of ethical issues(p<.05) was found to have affected the job stress. Third, perception of vocational ethics and education sub-factor of education experience(p<.05) was found to have affected the job commitment. Through the results of this study, systematic education will be needed to recognize the importance of vocational ethics and improve it.

개복 위절제술에 경험이 풍부한 술자에 의한 복강경 보조하 원위부 위절제술의 Learning Curve

김지훈,정영수,정오,임정택,육정환,오성태,박건춘,김병식,Kim, Ji-Hoon,Jung, Young-Soo,Jung, Oh,Lim, Jeong-Taek,Yook, Jeong-Hwan,Oh, Sung-Tae,Park, Kun-Choon,Kim, Byung-Sik 대한위암학회 2006 대한위암학회지 Vol.6 No.3

목적: 조기위암 치료에 있어서 복강경 위암 수술이 새로운 패러다임으로 정착하고 있다. 기존에 시행하고 있던 개복에 의한 위절제술에 익숙한 경험 많은 외과의사들은 복강경 위암 수술은 시간이 많이 소요되며 기술적으로 습득하는데 많은 제약이 있음을 느끼며 복강경 수술에 소극적 자세를 취하는 경향이 있다. 이에 저자 등은 개복 위절제술에 경험이 풍부한 외과의사에 의한 복강경 위절제술의 learning curve를 결정하고, 이에 영향을 미치는 요인들을 분석하였다. 대상 및 방법: 2005년 4월부터 2006년 3월까지 한 명의 술자에 의하여 수술전 조기 위암(cT1N0)으로 진단 받고 복강경 보조하 원위부 위절제술(LADG) 및 $D1+{\beta}$ 림프절 곽청을 시행 받은 62명을 대상으로 하였으며 복강경 위절제술 시행을 위하여 전문팀을 구성하였다. 대상 환자를 6명씩 한 그룹으로 총 10그룹(마지막 그룹은 8명으로 구성함)으로 나누어 각 그룹의 평균 수술시간을 비교하여 learning curve 극복 전후의 나이, 성별, 수술 후 합병증, 절개창의 길이, 수혈유무, 적출된 림프절 개수, 수술 전 후 혈색소 변화 등을 분석하였다. 결과: 평균 수술 시간을 분석한 결과 여섯 번째 그룹 (31st case)부터 수술 시간의 Plateau를 보였다. 이에 저자들은 learning curve 극복시점을 30th case (7개월)로 간주하였으며 극복 전후 집단 간의 평균 수술시간을 분석하였을 때 각각 $239.0{\pm}69.7$분과 $170.0{\pm}32.6$분으로 유의하게 나타났다(P<0.05), 양 군 간 평균나이, 성별, BMI, 수술 전후의 혈색소 수치변화, 적출된 림프절 개수 등은 유의한 차이를 보이지 않았다. 또한 절개창의 길이, 수혈유무, 수술 후 합병증 유무도 양 군 간에 통계적으로 유의하지 않았다. 결론: 저자들의 LADG learning curve 극복은 30예(7개월)로 다른 보고보다 일찍 도달할 수 있었다. 이는 개복 수술의 풍부한 경험, 전문 수술팀 구성, 그리고 단기간 집중적인 시술에 의한 것으로 생각된다. Purpose: The laparoscopy assisted gastrectomy has been increasingly reported as the treatment of choice for early gastric cancer. However, expert surgeons, who have performed a conventional open gastrectomy for a long time, tend to have a negative attitude toward laparoscopic procedures. The aim of this study was to determine the learning curve of a laparoscopy assisted distal gastrectomy (LADG) for a surgeon expert in performing an open gastrectomy and to analyze the factors that have an effect on a LADG. Materials and Methods: Between April 2005 and March 2006, 62 patients underwent a LADG with D1+beta lymph-node dissection. The 62 patients were divided into 10 sequential groups with 6 cases in each group (the last group was 8 cases), and the time required to reach the plateau of the learning curve was determined by examining the average operative times of these 10 groups. Other factors, such as sex, BMI, complications, transfusion requirements, the number of retrieved lymph nodes, and change of postoperative hemoglobin level, were also analyzed. Results: With the $5^{th}$ group (after 30 cases), the operative time reached a plateau (average: 170 min/operation). The differences between before the $30^{th}$ case and after the $31^{st}$ case with respect to changes in the postoperative hemoglobin level, the number of retrieved lymph nodes, the transfusion requirements, and the complications rate were not significant. Conclusion: According to an analysis of the operative time, experience with 30 LADGs in patients with early gastric cancer is the point at which the plateau of the learning curve (7 months) is reached. Abundant experience with a conventional open gastrectomy and a well-organized laparoscopic surgery team are important factors in overcoming the learning curie earlier.