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이영수 고신대학교 자연과학연구소 2008 고신대학교 자연과학연구소 논문집 Vol.16 No.-
자유 경쟁 체제에 ‘대학’도 예외일 수 없다. ‘대학’도 광고를 해야 하는 때가 온 것이다. 고신대학 교도 신문, 잡지, 라디오, TV( 협찬) 뿐만 아니라 옥외광고까지 집행하는 현실에 이르렀다. 부산역에 집행한 고신대학교 옥외광고물을 중심으로, 광고 제작의 기본이 되는 필수 요소들을 분 석하고 그 대안을 마련해 보고자 한다. 통일 된 이미지를 제시하고 있는지, 명확한 메시지를 전달하 고 있는지, 전략적 접근은 제대로 되었는지에 대해 알아보았다. 분석 후 문제점을 지적하고, 매체적 특성을 고려하여 부산역 옥외광고의 효과를 높이기 위한 비주얼 엄팩트 위주의 광고시안 몇 가지를 마련하였다. 결론적으로, 광고 제작은 마구잡이식이 아닌 정상적인 과정을 거쳐야 한다는 점과 전문성이 배재 되어서는 안 된다는 점, 그리고 보다 효율적인 광고 집행을 위한 시스템이 학내에 구축되어야 한다 는 점 등을 제시하였다.
조성국 고신대학교 고신신학연구회 2005 고신신학 Vol.- No.7
Comtemplation on the ideal and real Christian university model comes from both the Christian philosophical(theological) reflection on the aim and function of the university and the historical contextual reflection of the Christian community. These reflections get into shape a theory in keeping accord with a specific Christian worldview. The typical Christian worldviews are (1) gratia contra neturam, (2) gratia supra naturam, (3) gratia juxta naturam, (4) gratia instar naturae, (5) gratia in anturam. A specific worldview gives birth to a type of Christian universities. Christian university models in the humanistic Western context, except the last, have progressed in the same order of the models in history, and the order has been true in Korean society, which has followed the process of the Westernization, that is, modernization and democracy. Noweadays Korean Christian universities suffer from crucial identity crisis because of student application decline, financial problem as well as worldview conflict. The model of the Christian university in consonance with the Reformed worldview is "gratia in naturam". However, the successful administration of the Christian university depends on the extent of the church support in student supply, financial fund as well as prayer. Therefore Christian universities should take the university size and the church support limitation into consideration. 기독교대학교의 유형탐색은 기독교교육철학(신학)적 반성 못지않게 특정 역사적 상황에 대한 기독교공동체의 반성에서 나왔다. 기독교철학(신학)적 반성과 상황적 반성은 역사 안에서 다양한 유형의 기독교세계관을 반영하였다. 기독교세계관의 주된 유형은 (1) "자연에 대립하는 은총", (2) "자연 위에 있는 은총", (3) "자연과 병행하는 은총", (4) "자연과 유사한 은총", (5) "자연을 관통하는 은총" 유형이다. 한 공동체의 내면에 작동하는 기독교세계관은 현실적 상황에서 그 유형을 따른 기독교대학교를 낳았다. 마지막 유형을 제외하고 이 모든 유형들은 상황이었던 서양역사의 발전과정에서 거의 순서대로 진행되었고, 그 유형의 진행순서는 서양의 영향으로 근대화와 민주화를 이루어온 우리나라에도 그대로 적용되고 있다. 인본주의와 경제중심주의가 더 강력하게 작동하는 21세기 상황에서 기독교 공동체가 취해야 할 기독교대학교 유형은 성경적 세계관에 일치하는 "자연을 관통하는 은총" 유형이어야 한다. 기독교공동체가 그 유형에 따라 기독교대학교를 구현하고 발전시켜가야 할 적극적인 소명과 과제를 갖지만 성공할 수 있는 기독교대학경영은 기독교공동체의 지원정도를 고려하면서, 또 그 지원정도를 확대하면서, 그 정도에 맞게 대학교의 규모를 조정하는 일이다. 그리고 그 기독교공동체는 교회여야 한다.
최근 10년간 고신대학교 복음병원 일반외과에서 치험한 대장 및 직장암의 추세 변화
이승현,안병권,백승언 고신대학교(의대) 고신대학교 의과대학 학술지 2002 고신대학교 의과대학 학술지 Vol.17 No.1
Background : In western countries, colorectal cancers are one of the most common malignant tumors. In Korea, colorectal cancers are the fourth common malignancy following gastric cancer, hapatoma, and lung cancer. It's incidence and importance has been rising over the past 10 years. We reviewed colorectal cancer patients to study the changing pattern in the last decade. Methods : We reviewed 1453 patients with primary colorectal cancers who were operated at Gospel Hospital, School of Medicine, Kosin University between 1991 and 2000, retrospectively. The colorectal patients were divided into two groups. First group was the patients who were operated in the first half of the decade, between 1991 to 1995. The second group was the patients who were operated in the second half of the decade, between 1996 to 2000. We compared the two groups according to sex, age, location, tumor size, preoperative serum carcinoembryonic antigen (CEA), and stages of the patients. Results : We operated the 1453 colorectal cancer patients in the last decade. Males were accounted for 734 of the cases, and females were accounted for 719 of the cases (sex ratio was 1:1). The Peak age incidence was 7th decade (30.4%). Of the tumor location, colon cancer cases totalled 598 (48.7%), rectal cancer cases totalled 630 (51.3%). Of the rectal cancer operation, the number of the low anterior resection were 337 (67.0%), the abdominoperineal resection were 166 (33.0%). The incidence of stage 1,2,3 and 4 were 10.9%, 35.4%, 36.2% and 16.3%, respectively. In comparison of the 2 group, the number of the patients who were operated in the first half of the decade were 519, in the second half of the decade were 934 (1:1.8). The sex ratio was 1:1 and peak age incidence was 6th decade in the first half of the decade. In the second half of the decade, sex ration was 1:1 and peak age incidence was 7th decade. The number of colon cancers were 194 (49.7%), rectal cancers were 196 (50.3%) in the first half of the decade. In the second half of the decade, the number of the colon cancer were 404 (48.2%), rectal cancers were 434 (51.8%). Of the rectal cancer operation comparing low anterior resection and abdominoperineal resection, the incidence of the lower anterior resection was 56.8% (83/146) in the first half of the decade, 71.1% (254/357) in the second half of the decade. In the preoperative serum CEA level, 177 cases (37.2%) were more than 5ng/ml in the first half of the decade, 254 cases (43.5%) in the second half of the decade. The incidence of stage 1,2,3 and 4 were 8.8%, 34.2%, 36.2% and 19.8% in the first half of the decade, 12.3%, 36.1%, 36.1% and 14.2% in the second half of the decade. Conclusion : During the second half of the decade, there was a significant increase of the incidence of the total number, the older patients, the higher CEA level in colorectal cancers. And the incidence of low anterior resection was increased in rectal cancer operations. The incidence of stage 1,2 was slightly increased in the second half of the decade, but not significant. There was no difference of the distributions according to age, sex, tumor location, size.
이해영,김송명 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1
Background : Echocardiography is a non-invasive exam,which allows one to gather various informations regarding cardiac function, prior to and after the surgery. It use prior to and after surgery is gaining more popularity. However, echocardiographic indices which are related with improved postoperative cardiac functions are not well known. We compared and analyzed various echocardiographic data collected prior to and after surgery to investigate various indices which may be related with postoperative restoration of ventricular function. Material and Method : The transthoracic echocardiographic examination was performed 1-2 months before and 3 weeks after operation in 95 patients who received prosthetic valve replacement surgery due to acquired valvular heart disease. The left ventricular ejection fraction(LVEF), mitral valvular area(MVA),mitral inflow, LV dimension, the thickness of the IVS and LVPW, internal dimension of the RV, aorta and LA were measured. Results : Of 95 patients, there were 26 cases of MS (27.4%), 52 cases of MR (54,7%),and 7 cases of MSR (17.9%),There were 28 males (29.5%),and 67 females (70.5%),thus male to female ratio of 1:3. Preoperatively AF was detected in total 51 cases (537%): 14 cases (46.2%) were MS,24 cases (53.8%) were MR, and 13 (23.5%) cases were MSR. The preoperatively measured mitral valvular area was 0.66 土 0,15 cm2 for MS,0.78土0,38 cm2 for MR, and 1.22土0,33 cm2 for MSR. LVEF of the MS was 54,35土7.15% preoperatively, and improved to 66,43±6.42% pos切peratively (p-0.050). In MS and MSR, the LVEF decreased postoperatively. This finding was consistent regardless of the presence of AF. Mitral inflow decreased with respect to increment of postoperative mitral valvular area,however increased in MR and MSR. This finding was consistent regardless of the presence of AF. Deceleration time decreased in MS (p-0.005) and MSR (p=0+000), however in MR, it increased in the early postoperative period and showed decreasing tendency in long term follow up. In MS patients, patients without preoperative AF showed significant difference in postoperative deceleration time. The Mitral valve gradient maximal decreased immediately after the mitral valvular replacement. PTH was higher than normal value preoperatively, however returned to normal value after operation, and showed constantly decreasing pattern after the operation (MS group: p=0,003,MSR group:p==0.000). Pr改ence of AF did not influence changes of PTH. The end-diastolic left ventricular dimension decreased postoperatively in MR patients (p=0乂)04乂 It also decreased in MS and MSR, however there were no statistical significance. There was no significant changes between the end-systolic left ventricular dimension, LV dimension and thickness of the IVS, End-diastolic left ventricular dimension decreased postoperatively (MR:p=0.020, MSR: p=0.016, MSR with AF:p=0.001), Conclusion : The postoperative EF after MVR may differ depending on stenosis or insufficiency of the valve. Although EF could be used as a direct prognostic factor for improvement of hemodynamics in MS, in case of MR, it requires development of corrected EF, which incorporates other indices. After MVR, changes in the indices of hemodynamics were incorporated in the early postoperative period, and postoperative long-term follow up results showed persistence of the earlier changes. Presence of AF does not seem to significantly affect the recovery of heart function after MVR. Pre- and postoperative Echocardiography, as a non-invasive evaluation method, may serves to predict effect of surgery and post-operative prognosis.
근막통 증후군을 지닌 조선업근로자들에서 스트레스생활사 정도에 따른 통증의 비교
송혜란,김진하,이용환 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1
Background : Myofascial pain syndrome is a regional pain syndrome which is abruptly developed by psychological stress or physical stress causing direct muscular trauma or muscular tension. Shipbuilding workers are suffering from pain caused by the hard works treating heavy materials or keeping in an uncomfortable position for a long time in addition to the psychological stress which happened on the life events. This study was performed to survey the psychological feature and the degree of pain according to the stressful life event values of the shipbuilding workers who are suffering from the myofascial pain syndrome. Methods : The study subjects were 61 workers who worked at one of the shipbuilding industrial company. They were diagnosed as a myofascial pain syndrome in April 2002. For the close examination these workers visited in the department of occupational environmental medicine of the Kosin University. They were classified as high stressful group and low stressful group using Holmes and Rahe stressful life event values. We compared high stressful group with low one by visual analogue scale (VAS乂 Results : In high stressful and low stressful groups according to stressful life event values, mean age was 43.7 years and 43.4 years,and mean working duration was 13.9 years and 143 years respectively, which doesn't show significant difference statistically. There was no significant difference in alcohol drinking in those two groups,on the other hand, in high stressful group the frequency of smoking is higher as 21 (87,5%)people than in low stressful group as 16 (43.2%)people,The number of patients who reported severe pain which affected the daily life is 12 (50%) in high stressful group and 17 (45.9%) in low stressful group, and the number of patients who felt pain even by the small amount of daily activity is 5 (20.8%) in high stressful group and 13 (35J%) in low stressful group, which shows no statistical significance. The duration of pain more than 5 hours was 17 (70.8%) and 26 (70.3%) in each group, and visual analogue scale was higher in high stressful group than in low stressful group as 6.3 points and 5.6 points each without statistical significance. As a result of physical examination, the number of palpable trigger points was 14 (58.3%) in high stressful group and 27 (73,0%) in low stressful group. As a r於ult of EMG, the case of positive findings was 8 (33.3%) in high stressful group and 13 (35J%)in low stressful group. Conclusion : As a result of citifying the stressful life event values into high stressful group and low stressful group in the case of myofascial pain syndrome,objective findings(EMG, palpable trigger point) were not significantly different between high stressful group and low stressful group, but visual analogue scale was higher in high stressful group than in low stressful group. Therefore,it is assumed that in order to reduce the pain considered the most severe problem in the case of myofascial pain syndrome, we should analyze the cause of stress caused by daily lives and need proper psychological treatment and intervention as well as reduce the burden on the parts of body. Background : Myofascial pain syndrome is a regional pain syndrome which is abruptly developed by psychological stress or physical stress causing direct muscular trauma or muscular tension. Shipbuilding workers are suffering from pain caused by the hard works treating heavy materials or keeping in an uncomfortable position for a long time in addition to the psychological stress which happened on the life events. This study was performed to survey the psychological feature and the degree of pain according to the stressful life event values of the shipbuilding workers who are suffering from the myofascial pain syndrome. Methods : The study subjects were 61 workers who worked at one of the shipbuilding industrial company. They were diagnosed as a myofascial pain syndrome in April 2002. For the close examination these workers visited in the department of occupational environmental medicine of the Kosin University. They were classified as high stressful group and low stressful group using Holmes and Rahe stressful life event values. We compared high stressful group with low one by visual analogue scale (VAS乂 Results : In high stressful and low stressful groups according to stressful life event values, mean age was 43.7 years and 43.4 years,and mean working duration was 13.9 years and 143 years respectively, which doesn't show significant difference statistically. There was no significant difference in alcohol drinking in those two groups,on the other hand, in high stressful group the frequency of smoking is higher as 21 (87,5%)people than in low stressful group as 16 (43.2%)people,The number of patients who reported severe pain which affected the daily life is 12 (50%) in high stressful group and 17 (45.9%) in low stressful group, and the number of patients who felt pain even by the small amount of daily activity is 5 (20.8%) in high stressful group and 13 (35J%) in low stressful group, which shows no statistical significance. The duration of pain more than 5 hours was 17 (70.8%) and 26 (70.3%) in each group, and visual analogue scale was higher in high stressful group than in low stressful group as 6.3 points and 5.6 points each without statistical significance. As a result of physical examination, the number of palpable trigger points was 14 (58.3%) in high stressful group and 27 (73,0%) in low stressful group. As a r於ult of EMG, the case of positive findings was 8 (33.3%) in high stressful group and 13 (35J%)in low stressful group. Conclusion : As a result of citifying the stressful life event values into high stressful group and low stressful group in the case of myofascial pain syndrome,objective findings(EMG, palpable trigger point) were not significantly different between high stressful group and low stressful group, but visual analogue scale was higher in high stressful group than in low stressful group. Therefore,it is assumed that in order to reduce the pain considered the most severe problem in the case of myofascial pain syndrome, we should analyze the cause of stress caused by daily lives and need proper psychological treatment and intervention as well as reduce the burden on the parts of body.
김종인,조성래 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1
Background: Pulmonary aspergillosis usually results from the colonization in the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life threatening disease causing massive hemoptysis. Here we reviewed our surgical results for 45 cases of pulmonary aspergillonias. Methods: We reviewed 45 cases which were surgically treated from 1986 to 2003 retrospectively. This investigation were designed to illustrate distribution of age and sex, symptom and sign, underlying disease, anatomic location of lesion, roentgenographic findings of aspergilloma, surgical indication and operative procedures, postoperative complications. Results: Peak incidence of age lies 4th and 5th decades. Most common presenting symptom was hemoptysis (77.3%),and pulmonary tuberculosis (24 cases) was the most common underlying disease. The anatomic location of lesions were 23 cases in right side,21 cases in left side,and 1 case in both side and more in upper lobes(32 cases) than in lower lobe (14 cases乂 The most common chest roentgenographic finding was cavity with fungal ball in 30 cases and simple aspergilloma in 29 cases,complex aspergilloma in 17 cases according to roentgenographic classification by Belcher and Plummer. The performed operative procedures were lobectomy (conventional and video assisted thoracic surgery) in 33 cases, segmentectomy in 3 cases, pneumonectomy in 3 cases, wedge resection in 3 cases, cavernostomy with myoplasty in 3 cases, and bilobectomy in 1 case. There were 20 complications, empyema with bronchopleural fistula in 7 cases, wound infection in 7 cases, prolonged air-leakage in 2 cases, reoperation due to massive hemorrhage in 2 cases,recurred aspergilloma during follow-up in one case and postoperative death due to acute respiratory distress syndrome in 1 case. Conclusion: Surgical resection is the treatment of choice for symptomatic aspergilloma with acceptable complications, even though it has only minimal hemoptysis.
폐경전후 및 폐경후 골감소에서 호르몬대체요법과 Fluocalcic Effervescent 병합치료 후 골밀도 및 골대사의 생화학 지표의 변화
어완규,이창원 고신대학교(의대) 고신대학교 의과대학 학술지 2004 고신대학교 의과대학 학술지 Vol.19 No.1
Background : Sodium fluoride stimulates bone formation and has been used to treat osteoporosis for decades despite debate about the antifracture efficacy. For women with low bone mass, the ideal therapy should not only inhibit bone resorption but stimulatneously stimulate bone formation to increase the bone mass above the fracture threshold. We thus performed an intervention study to investigate the effect of a low dose fluoride prospectively, in combination with HRT, on bone mineral density (BMD) and biochemical markers of bone turnover. Methods : Thirty perimenopausal or postmenopausal osteopenic women were enrolled, and were treated with Fluocalcic effervescent (disodiummonofluorophosphate [MFP] 100mg + calcium carbonate 1,250mg) 1 tablet BID and conjugated equine estrogen (HRT) 0.625mg QD for 12 months in Department of Internal Medicine, Kosin University Gospel Hospital from January 2001 to December 2002. BMD and chemical markers of bone turnover, serum alkaline phosphatase, serum osteocalcin, and urine deoxypyridinoline (DPD), were evaluated before and 12 months after starting treatment. Results : Serum alkaline phosphatase, serum osteocalcin, and urine DPD after 12 months were not significantly different from those of pre-treatment values. The post-treatment BMD's were correlated with pretreatment BMD's, but they were not correlated with all the pretreatment chemical markers of bone metabolism. Changes of the BMD of L2-L4 were not correlated with the changes of chemical markers except urine DPD. Pretreatment markers, BMD of L2-L4, serum osteocalcin, serum alkaline phosphatase, and FSH were correlated with changes in BMD of L2-L4. There was no chemical markers correlated with the change in BMD of femoral neck. Conclusion : Twelve-month treatment with MFP and HRT was not associated with improvement in BMD. Pretreatment markers, BMD of L2-L4, serum osteocalcin, serum alkaline phosphatase, and FSH may predict changes in the BMD of L2-L4.
장재호,권영호,김재도,손정환,박찬재,이영구 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1
Objectives : Hyperbaric oxygen(HBO) therapy has been used to treat CO poisoning and decompression sickness, and at now it contains domains of general surgery, plastic surgery,otorhinolaryngology. In orthopaedic field, it can also be used in many disorder through the effe功 of increasing oxygen tension of tissue, vasoconstriction and bacteriocidal effect. Authors attempted to evaluate the effect of hyperbaric oxygen therapy in the orthpaedic field. t Methods : Authors have analyzed clinical outcome of total 79 cases (crushing injuries, flap surgeries,chronic osteomyelitis, diabetic foot,postoperative ischemic wound, atherosclerosis & Buergers* * disease, infection wound, compartment syndrome) in orthpaedic field treated by hyperbaric oxygen therapy in Kosin Medical College Gospel Hospital from May,1998 to December, 2005. Patients of crushing injuries, flap surgeries,chronic osteomyelitis, diabetic foot, postoperative ischemic wound, atherosclerosis & Buergers' disease, compartment syndrome received HBO therapy in 2.0 ATA per 80 minutes a day, and patients of infection wound received HBO therapy in 2,8 ATA per 104 minutes a day. Results : Crushing injuries,flap surgeries, chronic osteomyelitis, diabetic foot,postoperative ischemic wound, atherosclerosis & Buergers' disease, infection wound, compartment syndrome were treated by hyperbaric oxygen therapy and received averagely 1L5 times. Transient tinnitus was observed as a side effect in one case. Conclusion : Hyperbaric oxygen therapy can be applied to many cases of orthopaedic surgery,especially in ischemic change, swelling and infections as an adjuvant therapy, However it required double blind test with the control group to evaluate the objective outcome.
요통 환자에서 카이로프랙틱 수기치료와 경막_ 주사요법의 비교
장재호,김정렬 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1
Objectives: To compare the pain patterns after applying chiropractic manipulation and epidural injection in back pain patients, and to investigate the pain-relieving effects of chiropractic manipulation. Materials and Methods: A follow-up observation has been made after applying chiropractic manipulation in 42 patients with back pain admitted through OPD, from March, 2004 to February, 2005. The patients were comprised of 16 cases of intervertebral disk herniation, 7 cases of spinal stenosis, 1 case of ankylosing spondylitis,18 cases of non-specific chronic back pain. Pain decrement levels were compared to those of another 42 patients who were admited in the some period, treated their back pain by epidural steroid injection, and the effects of chiropractic manipulation and epidural injection were observed. Results of this study was evaluated using Short-Form McGill Pain Questionnaire, Roland-Morris Questionnaire, and RAND-36 Questionnaire. Results: In the Short-Form McGill Pain Questionnaire, the Pain Relating Index in chiropractic manipulation was on average 11.9 before operation and on average 3.1 after operation, while the PRI in epidural injection recorded an average 11,8 before operation and 5.3 after operation. The Visual Analog Scale showed pain decrement from 62 to 1.9 in manipulation, and from 6.8 to 3J in epidural injection. The Present Pain Index decreased from 2.9 to 1.5 in manipulation, and from 2.4 to 1,5 in epidural injection. In the Roland-Morris Questionnaire, which questions the level of limitation in the daily living due to pain, the decrement of level on average from 8.8 to 4,0 in manipulation, while the decrement was from 10.5 to 4.1 in epidural injection. Conclusion: Chiropractic manipulation can be used extensively as a non-invasive method of treatment.
Morphine과 Fentanyl이 포함된 환자조절진통이 Atracurium에 의한 근이완의 회복에 미치는 영향
김세환,김정호,김두식,류시정,장태호,김경한,한옥식 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1
Background : Even minor degrees of residual neuromuscular block can compromise the muscles involved in maintaining patency of the airway, and can attenuate the ventilatory response to hypoxia. Opioids in patien卜controlled analgesia (PCA) may also cause respiratory problem. The purpose of this study is to evaluate the influence of PCA on the SpO2, TOF(train-o卜four) ratio and head-raising tests following intraoperative atracurium blocks. Methods : 60 patients aged from 20 to 65 in ASA class I and II were divided into control and PCA groups. Patients received atracurium for tracheal intubation(0.5 mg/kg) and maintenance of relaxation (0.2-03 mg/kg/hr乂 Pyridostigmine ().15 mg/kg and glycopyrrolate 0.2 mg for reversal of block. PCA group received infusion of drug-mixture(80 ml) 1 ml hourly after bolus dose of morphine 5 mg. Drug-mixture consisted of fentanyl 600 ug,morphine 30 mg, ketorolac 90 mg and saline for vehicle The results of SpC)2, TOF ratio and 5 sec-head raising tests 20min after administration of reversal drugs were evaluated. Results : IV-PCA with morphine and fentanyl did not depress the SpO2)TOF ratio and the ability to raise the head. Conclusions : IV-PCA with morphine and fentanyl shows no deleterious effects on the recovery of atracurium block.