제2형 당뇨병 환자의 치료에서 복약순응도가 혈당 조절에 미치는 영향

김경선,김민정,박소현,박영주,허정순,이은경,김선영,이수형,김상수,강양호,손석만,김인주,김용기 한국병원약사회 2009 병원약사회지 Vol.26 No.2

Abstract: As known in clinical trial like DCCT, UKPDS, tight glycemic control is essential to prevent complications from diabetes mellitus(DM). In type 2 diabetes taking multiple medication, nonadherence to medications is common problem. The aim of our study is to investigate adher-ence rate of patients with type 2 DM and to evaluate association between many factors including adherence rate and HbA_(1C). 441 patients with type 2 DM who visited Busan National University Hospital endocrine internal department from Aug 13 to Sep 2, 2008(3weeks) were enrolled. We conducted a man-to-man questionnaire survey about general knowledge about diabetes mellitus, medicine and adherence, and measured HbA_(1C). Among them, 305 patients taking oral hypo-glycemic agent(OHA) were analyzed to investigate correlation between adherence rate and glycemic control. We studied 305 patients(male 126, female 179, average age 61.2±9.8 years, DM duration 8.6±6.4 years, average adherence 88.8±16.2%, average HbA_(1C) 7.03± 1.18%). HbA_(1C) showed significant relation with DM duration(r=0.137, p=0.017), number of aHA in regimen (r=0.135, p=0.018), dosage frequency(r=0.132, p=0.026), Medication Refill Adherence(MRA)(r=-0.124, p=0.030) and adherence(r=-0.168, p=0.003). Adherence had significant relation with MRA(r=0.148, p=0.010) but didn't have statical corelationship with DM duration, number of aHA and dosage frequency. Patients that their adherence rate exceed 90% took fewer OHA(p=0.011) and went on a better dietary treatment(p=0.007). In patients controlling diabetes mellitus with aHA, when adherence rate and MRA was higher, HbA_(1C) was lower. As a result, to improve adher-ence rate, it is necessary to enhance patient education, do careful consideration about prescrip-tion medicine number and dosage frequency

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

위암의 연령에 따른 차이

김영재(Young Jae Kim),이영철(Young Chul Rhee),이만길(man Kill Lee),차호(Ho Cha),정영채(Young Chae Jung) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A Comparative analytic review on clinical, endoscopic and histopathological findings was done in 13 cases of young age (under 29), 446 cases of mid age (30~69) and 39 cases of old age (above 70) stomach cancer who were visited Department of Internal Medicine of Masan Koryo General Hospital from March 1981 to July 1985. The following results were obtained: The peak of age incidence was the 5th decade amounting to 36.8%. The ratio between male and female was 2.6:1. The main chief complaint of each group was epigastric pain and it was followed by epigastric fullness. The most patient had the duration of symptom from 3 months to 6 months. For old-age group, mid-age group, major site of lesion in the antrum, meanwhile body for young-age group. The most frequent type of gastric cancer was type III in each group by Borrmanns classification. For each group, adenocarcinoma was major cases in the view of histopathological findings, and incidence of well differentiated type adenocarcinoma were lower in young-age group than others.

태권도 앞굽이 몸통반대지르기를 통한 고령자의 건각도의 유효성 분석

김기만(Ki Man Kim),배영상(Young Sang Bae) 한국발육발달학회 2009 한국발육발달학회지 Vol.17 No.4

The purpose of this study was to identify effectiveness of Taekwondo Apkubi Momtong Bandae Jireugi (AMBJ) as diagnostic method of health related to muscle level of older men. To accomplish the purpose, relationship between a 3 stride of AMBJ distance and a cross section area of psoas major muscle were analyze. By using random sampling, 10 older men were sampled as subject who participate Gate-ball club in S-Gu, D-metropolitan city. Analysis of relation between the 3 stride of AMBJ and psoas major muscle scale recorded by MRI of older men were executed. Results of the analysis could be summarized as the following. 1) In the case of older men, the male who has much muscle weight and large thigh girth has big cross section area of psoas major muscle. 2) Relation among 3 stride of AMBJ, muscle weight(r=.822, p<.01), and thigh girth(r=.720, p<.05) especially, cross section area of psoas major muscle presented very high correlation(r=.91, p<.001). 3) Based on the analysis, measurement result of the 3 stride of Taekwondo Apkubi Momtong Bandae Jireugi was very effective diagnostic method to assume for health related to muscle strength level and all the muscular strength level of older men.

장기간 항갑상선제 투여 후 임의 중단 뒤 재복용시 발생한 무과립구증 1 예

김승만;김태영;박수영;배영환;서영경 정은주;김태균;권민정;박정현;이순희 인제대학교 2011 仁濟醫學 Vol.32 No.-

Agranulocytosis, one of the major side effects of antithyroid a gents, probably occurs in less than 0.25% of cases treated with antithyroid agents. It usually occurs within the first several weeks or months after the initiation of therapy, when drug dosage is higher. Most reported cases of agranulocytosis have occurred during the first 3 months of therapy. We describe here a rare case that did not experience the side effect for 6 years of antithyroid agent treatment but presented with agranulocytosis in one month after re-exposure. It suggests that the major side effect such as agranulocytosis can occur in patients who had undergone prior uneventful antithyroid drug therapy.

췌장을 침습한 위의 암육종 1 예

김병호,김효종,조진만,김윤화,이정일,동석호,장영운,황일섭,장 린 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.1

Carcinosarcoma of the stomach is regarded as a rare malignant neoplasm composed of both carcinomatous and sarcomatous components in a given tumor. Few cases have been reported since 1904. This is a case of carcinosarcoma of the stomach in a 61-year-old man. He suffered from indigestion, vomiting, and epigastric pain. Endoscopic finding showed a huge protruding mass with intact mucosa on the posterior wall of the antrum up to the pylorus. Surgery was performed and carcinosarcoma with pancreatic invasion was confirmed by pathology.

진공열간가압성형 (VHP) 법 및 압출로 제조한 SiCp/Al 및 SiCp/2024Al 복합재료의 동적탄성계수와 감쇄능 (내부마찰) : 금속기 복합재료의 동적탄성계수 및 감쇄능 측정

김영만,조기현,이경민,홍성길 대한금속재료학회(대한금속학회) 1999 대한금속·재료학회지 Vol.37 No.9

To shorten the processes of MMC fabrication, a number of techniques are being studied. In this study, a new process for MMC's fabrication was developed utilizing vacuum hot pressing and subsequent extrusion. MMC's with pure Al and 2024Al matrices reinforced with various volume fractions of SiC particulates were produced at 400℃ by vacuum hot pressing(VHP), followed by direct extrusion with extrusion ratios of 10:1 at 480℃ at constant ram speed of 2㎜/sec. The effects of extrusion pressure and relative density according to the volume fractions of the reinforcement were compared with the resultant metallurgical microstructures. Young's moduli of the manufactured composites were measured by the sonic resonance method, damping capacity by free decay method. Measured Young's moduli of the composites at room temperature were compared with the predictions based on Rule of Mixtures, Halpin-Tsai and Mean-field models. Measured Young's moduli of the composites are in good agreement with the predictions based on Mean-field model. The composites reinforced with finer particles showed higher damping capacity under the same amount of SiC reinforcement.

자궁내막암 환자에서 복강경하 자궁적출술과 복식 자궁적출술의 비교 연구

김종혁,이상수,김천복,김대연,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

목적 : 자궁내막암 환자에서 시행된 복강경 수술의 임상적 결과를 평가하고 수술적 지표 및 재발률에 대하여 기존의 개복 수술과 비교하고자 하였다. 연구 방법 : 1997년 8월부터 2003년 11월까지 저자들은 임상적 병기 I기인 79명의 자궁내막암 환자에서 복강경하 자궁적출술과 골반 및 부대동맥 림프절 절제술을 시행하였다. 총 79명의 환자 중, 수술적 병기 I기와 II기로 판명된 74명의 환자를 연구 대상으로 하였다. 대조군으로는 같은 기간 동안에 개복수술을 시행한 환자중 복강경 수술군과 병기가 같은 168예를 선정하였다. 결과 : 평균 수술 기간, 수혈량은 양군에서 비슷하였으며, 평균 재원 기간은 복강경 수술군에서 유의하게 짧았다. 수술전후 및 만성 합병증의 발생은 개복 수술군에서 유의하게 증가되었으며, 획득한 림프절의 수는 복강경 수술군에서 유의하게 더 많았다. 복강경 수술군에서 1예, 개복 수술군에서는 2예에서 재발하였고, 2년 무병 생존률은 복강경 수술군과 개복 수술군에서 각각 97.5%와 98.6%으로 유의한 차이는 관찰되지 않았다. 결론 : 자궁내막암 치료로서 복강경 수술은 기존의 개복술을 대신할 수 있는 안전하고 효과적인 시술 방법이다. 개복 수술과 비교해 볼 때, 재발 및 생존율 면에서 차이가 없었지만, 향후 전향적이고 더 오랜 추적기간을 갖는 연구가 필요하다고 사료된다. Objective : To evaluate the outcomes of laparoscopic surgery and to compare surgical parameters and recurrence rate of these with those of conventional abdominal surgery in patients with endometrial cancer. Methods : From August 1997 to November 2003, we have performed 79 cases of LAVH (laparoscopically assisted vaginal hysterectomy) with or without lymph node dissection. Laparoscopic approach was adapted in patients with FIGO clinical stage I by imaging study. Of the 79 patients, 74 patients who were proved to be surgical stage I and II were enrolled in this comparative study. As a control group, We selected 168 cases for the laparotomy group of the same stages. Results : The mean duration of surgery, the amount of blood transfusion and hemoglobin chamges were similar in both the laparoscory and the convertional alparotomy group. The mean duration of hospital stay was significantly shorter in patients treated by laparoscopic surgery (10.2 vs. 15.5 days). The number of lymph node obtained was significantly higher in the laparoscopy group. Two year recurrence-free survival rates were 97.5% in laparoscopy group and 98.6% in laparotomy group (p=0.763). Conclusion : Laparoscopic surgery for the treatment of early stage endometrial cancer is safe and effective altematives in terms of perioperative complications. Overall and recurrence-free survival did not differ significantly in both groups however long term risk for recurrence and survival has yet to be defined.

단기교육으로 시행가능한 심실기능평가법

김원,임경수,오병연,홍은석,김영식,김선만,이부수,현석천,김영득 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The initial history, physical examination, and ECG assessment should focus on identification of potentially serious noncardiac or cardiac disorders, including coronary artery disease, congestive heart failure, and electrical instability at the emergency room. additionally, it is essential to define disease severity, stability and need for emergency therapy. echocardiography is a useful tool for this purpose. especially Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic symptoms. So we evaluate the feasibility of the echocardiographic measurement by emergency physicain after short-term course. Method and Results: Twenty volunteers(10 male, 38.8±9.3 years) were included in the study for measurement of myocardial performance index and established parameters of ventricular function using conventional echo-Doppler methods. Myocardial performance index: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The most of mean values of echocardiogrphic parameters were not significantly different between those of cardiologist and those of emergency physicians(p<0.01). The duration for measuring myocardial performance index was shortest among echocardiographic parameters. the validity of echocardiographic parameters measured by emergency physicians was proved relatively good. Conclusion: It is proved to be feasible for emergency physician to perform echocardiographic evaluation of ventricular function after short-term course