혈액투석요법 환자의 우울, 불안 및 수면장애에 대한 연구

윤석준,양창국,한홍무 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 혈액투석요법을 받는 말기 신부전증 환자들은 불안이나 우울 등의 심인증상 외에도 여러 가지 수면장애를 호소할 수 있다. 말기 신부전증 환자에서 심인증상과 수면장애가 많을수록 삶의 질에 장애를 초래하며 혈액투석요법 도중 탈락이 높다. 저자는 본 연구에서 혈액투석요법 중인 환자의 우울, 불안 및 수면장애 등을 조사하여 향후 환자가료에 활용하고자 하였다. 방 법 : 부산시내 4곳의 혈액투석요법기관에서 혈액투석요법을 받는 말기 신부전증 환자 153명(남 87, 여 66)과 정신적, 신체적으로 건강한 동아대학교병원 행정직원 및 의과대학 학부모 113명(남 58, 여 55)을 대상으로 구조화된 면담과 자기평가척도를 실시하였다. 연구도구는 저자 등이 본 연구에 알맞게 개발한 인구통계학적 자료를 포함한 수면관련 설문지, 우울증 자가평가 척도인 Beck Depression Inventory(BDI), 불안 자가평가 척도인 State-Trait Anxiety Inventory(STAI)를 이용하였다. 결 과 : 환자군이 대조군에 비하여 신체증상 및 심인증상을 더 많이 호소하였고(p<0.05), 수면관련 불편을 더 많이 나타내었다(p<0.001). 환자군의 BDI 평균은 22.9로 대조군의 11.2보다 유의하게 높았다(p<0.001). BDI 점수를 기준으로 볼 때 남자환자 64명(74.7%), 여자환자 47명(71.2%)은 우울증군에 속하였다. STAI 평균 점수는 두 군간에 유의한 차이가 없었다. 환자군은 대조군에 비하여 입면잠복기와 수면 중 깨어 있는 시간이 더 길었고, 낮 동안의 졸리움 등 수면관련 불편을 더 많이 호소하고 있었다. 또한 환자군은 불면증(65.4%), 하지불편증후군(46.4%), 악몽(27.3%), 주기성사지운동장애(23.5%), 수면 식사장애(18.3%), 야경증(14.4%) 등을 유의하게 더 많이 호소하고 있었다(p<0.05). 결 론 : 혈액투석요법을 받고 있는 말기 신부전증 환자들은 대조군에 비해서 신체적, 심인적 증상을 유의하게 더 호소하고 불면증을 포함한 다양한 수면장애를 동반하고 있다. 또한 이들 사이에 높은 상호관계가 있는 바, 이는 혈액투석요법 증인 환자들에서 신체적 증상 및 심인적 증상뿐만 아니라 수면장애에 대한 치료적 접근이 필요함을 시사한다. Objectives : Psychological distresses and complaints in sleep, in addition to physical distresses such as pruritus and bone pain, are common in patients with hemodialysis. The purposes of this study were to investigate 1) the severity of physical distresses, 2) the severity of depression and anxiety, 3) the sleep disturbances, and 4) the correlation of the above variables in patients with hemodialysis. Methods : The patients with hemodialysis(male 87, female 66) and controls(male 58, female 55) completed a self-administered questionnaire package, which included Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and questions characterizing the reported sleep problems and quantitating the severity of the self-perceived physical and psychological conditions with linear visual analogue scales. Results : The results indicated that patients with hemodialysis complained of more physical distresses, more depressed mood, and more sleep disturbances suggesting insomnia, restless legs syndrome, periodic limb movement disorder, nightmare and obstructive sleep apnea syndrome, etc. There were significant positive correlations of physical distresses, depressed mood and sleep disturbances. However, there were no significant differences in state and trait anxiety between both groups. Conclusions : The authors suggest that the quality of life in patients with hemodialysis

소아에서 발생한 골수이형성 증후군 2례

홍성진,윤석중,김성우,조형구,오명호,김기혁,이인성 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

Myelodysplastic syndrome(MDS) is a group of acquired conditions characterized by progressive bone marrow failure associated with normocellular or hypercellular bone marrow that cannot be attributed to nutritional deficiency, chronic infection, or other chronic systemic illness, and cannot be reversed by the successful treatment of those conditions. Whereas the cases of secondary MDS occur at all ages, primary MDS is essentially a disease of elderly, though no age group is exempt and predomonant in men. The MDS is fundamentally clonal disorders at the level of the haemopoietic totipotent stem cell. Clinically, they are characterized by varing degrees of peripheral cytopenia(s) with morphological and functional abnormalities of blood elements. We have experienced two unrelated pediatric cases, who showed pancytopenia on admission and the characteristic marrow findings of MDS. The first case, a 12 months-old girl, showed increased reticulin with abnormal localization of immature precursor cells(ALIP) in her bone marrow, in addition to dysplastic features such as bi-and multi-nucleation of late normoblasts and internuclear bridging. She also showed 22% of blasts in her bone marrow cells thus classified in the category of RAEB-t after FAB classification. Also found were a chromosomal abnormality namely 46 XX t(14q21q), which was an unusual one. Her family brought her home and, 4 month later, she deceased. The second case, a 12 year-old boy, showed pancytopenia with Pseudo-Pelger-Huet anomaly in neutrophils but no blasts in the peripheral blood. Bone marrow of this case also showed the picture of dyserythropoiesis with binuclearity, internuclear bridging, nuclear fragments, multinuclearity of late normoblasts, in addition to megaloblastoid change in the normoblasts and increased mitosis in granulocytic series. No chromosomal abnormality was found. Classified as RA after FAB classification of MDS. Showed good response to conservative management for anemia for more than one year.

한국인 선천성 난청에서 Connexin 26의 분자유전학적 분석

박홍준,박기현,송정환,정영훈,최호석 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.4

기계적으로 밀링된 나노결정 Al-14wt%Ni-14wt%Mm 합금 분말의 열 안정성과 미세조직

홍순직,이윤석,천병선 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.10

Mechanical milling has been performed for Al-14 wt%Ni-14 wt%Mm(Mm=misch metal) alloy powders rapidly solidified by the gas atomization method. The microstructure, hardness, and thermal stability of the powders were investigated as a function of milling time using X-ray diffraction(XRD), transmission electron microscopy(TEM), Vickers micro-hardness tester and differential scanning calorimetry(DSC) methods. In the early stage of milling, a cold-welded layer with a fine microstructure was formed along the edge of the milled powder (Zone A). The interior of the powder remained unworked (Zone B), resulting in a formation of two-zone microstructure. With increasing milling time, the nanocrystallite size decreased gradually reaching a size of about 10-15 nm and the lattice strain increased reaching a maximum value of about 0.7% after milling for 200 hours. The microhardness of the mechanically milled powder was 132 kg/㎟ after milling for 72 hours, and it increased to 290 kg/㎟ after milling for 200 hours because of the presence of fine nano structured phases.

RDA 표준에서의 다중 매체 정보에 관한 연구

김홍일,김국보,장윤석 대진대학교 1994 大眞論叢 Vol.2 No.-

The RDA(Remote Database Access) standard defines a generalized service interface that can be used in a variety of Database Management System environments. This places considerable importance on the management of diverse data types including text, images, audio, and video; these requirements in turn generate the need for a new generation of distributed heterogeneous multimedia database systems In this paper, a set of functional requirements is identified for the RDA standard, Multimedia information and management. A method of the requirements to a RDA is presented, and some briefing of the RDA SQL specialization and multimedia data types are discussed.

디스크 시스템의 설계를 위한 모의 실험에 대한 연구

장윤석,김홍일,김국보 대진대학교 1994 大眞論叢 Vol.2 No.-

I/O subsystems, especially, disk systems are the most important aspect at computer system performance for recent high-performance computer systems. But development of new d s k system consumes very high costs, it performed by simulation, in general. This paper researches accurate disk modeling techniques for basis of accurate simulation, and implements the disk model, and proves the modelled disk can be executed with small deviation, compares with real disk system, by trace-driven simulation The simulation program can widely be used for basic tool to develope new disk systems.

Lifting을 이용한 고저항 고장 검출에 관한 연구

고윤석,홍대승 남서울대학교 2004 남서울대학교 논문집 Vol.10 No.2

The research presented in this paper focuses on a method for the detection of High Impedance Fault(HIF). The method will use the Lifting and neural network system. HIF on the multi-grounded three-phase four-wires primary distribution power system cannot be detected effectively by existing over current sensing devices. These paper describes the application of lifting scheme to the various HIF data. These data were measured in actual 22.9kV distribution system. Wavelet transform analysis gives the frequency and time-scale information. The neural network system as a fault detector was trained to discriminate HIF from the normal status by a gradient descent method. The proposed method performed very well by proving the right state when it was applied staged fault data and normal load mimics HIF, such as arc-welder.

ETACS와 CDMA 디지털 셀룰라 시스템이 공존하는 환경에서 Interference Canceller System의 설계 및 구현

장원호,홍주석,이윤현 한국항행학회 2002 韓國航行學會論文誌 Vol.6 No.4

본 논문에서는 인접한 대역에 ETACS와 CDMA 방식의 디지털 셀룰라 시스템이 공존하는 중국 상해 지역의 간섭환경에서 기존의 간섭제거장비보다 이를 효과적으로 개선할 수 있는 Interference Canceller Systern(ICS)을 설계하고, 개발된 부품들을 통해 구현하였다. 구현된 ICS는 무선 채널환경의 변화에 안정적이면서 인접한 대역의 ETACS와 CDMA방식의 디지털 셀룰라 시스템 간에 약 29dB이상의 간섭 제거 성능을 보유한 시스템임을 확인하였다. In this paper, we provide the Interference Canceller Systems(ICS) in the wireless environments in the presence of co-existing ETACS and CDMA digital cellular systems to effectively cancel the interference than the established canceller systems. We proved the enhanced cancelling performances more than 29 dB cancellation characteristics between co-existing ETACS and CDMA digital cellular systems and the stabilized system characteristics in the rapidly changing wireless circumstances.

객체 지향 데이타베이스 시스템의 질의 및 객체 관리기 인터페이스

이재봉,배석찬,이홍로,이연식 群山大學校 1993 論文集 Vol.20 No.-

객체 지향 데이타 모델을 지원하는 데이타베이스 시스템은 기존의 데이타베이스의 단점을 보완하며, 다양하고 복잡한 실세계의 정보를 처리할 수 있다. 객체 지향 데이타베이스 시스템은 사용자의 접근을 위해 질의 및 객체 관리 인터페이스를 필요로 한다. 본 논문에서는 사용자를 위한 질의 인터페이스와 질의 계획을 수행하기 위한 객체 관리 인터페이스를 설계함으로써 질의 목적을 달성토록 하였다. 설계된 객체 관리 인터페이스는 응용을 위해 "C"언어 함수로 구성하였고, 성능 항상을 위한 확장성을 제공할 수 있도록 설계 하였다. The database system that supports object oriented data model can complements conventional DBMS's drawbacks and processes complex and intensive applications. In object oriented database system, the access and management of all objects are manipulated by object manager. Therefore, a query interface as well as an Object Manager Interface(OMI) is required for interfacing between a user and an object store. In this paper, we propose the query interface which can support object oriented paradigm and design rules of OMI, and implement OMI based on the rules. The OMI have been implemented by using C language on UNIX OS machine.

몽타주 자동 작성을 위한 퍼지 의사 결정 시스템의 설계

김국보,김홍일,장윤석 대진대학교 1994 大眞論叢 Vol.2 No.-

It is well known that search method for multimedia information is very difficult problem. In this paper, the implementation of a automatic montage generator using fuzzy decision making system is described and proposed an effective fuzzy inference system based on description data. In addition, some techniques which can improve the retrieval efficiency of a image information are also suggested.