혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

컴퓨터를 이용한 혈액학 교육시스템의 개발

이기형,손보라,윤희석,조원덕,김승택 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

연구목적 : 전통적인 의학교육 시스템은 최근 개발되고 있는 여러 가지 영상 진단법 등 시각적 자료를 전달하는데 한계가 있으며, 이러한 한계는 모든 분야에 걸쳐서 나타나지만 특히 혈액학이나 심장학 등 시각적인 자료가 진단에 필수적인 분양에서 두드러진다고 할 수 있다.본 연구는 혈액학 교육에 사용되던 기존의 강의실 교육에 시각적 자료가 첨부된 CD-ROM을 개발하여 혈액학 교육 시스템을 개선하기 위한 것이다. 대상 및 방법 : 기존의 혈액학 교육에 있어서 필수적으로 강의 되어오던 자료를 수집하여 체계적으로 정리하였다.강의 자료에 따라서 필요한 영상 자료를 충북대학교 병원에 입원한 혈액질환 환자들의 검사 자료로부터 수집하여 컴퓨터를 기반으로 한 의학영상 처리 및 분석시스템을 통하여 이미지 파일로 변형하였다.또한 입원 환자들 중 대표적인 증례들을 수집하여 실제 임상 진료와 유사한 형태의 증례를 통한 학습을 할 수 있도록 하였다. 결과: 본 CD-ROM은 혈액학 교육에 필요한 대부분의 영역을 포함한다 각 질환의 병태생리, 진단, 임상양상, 치료 및 예후 등 전통적으로 강의되어 오던 강의록에 이미지 파일로 변형된 영상 자료를 필요한 곳마다 링크시켰다.따라서 학습자는 특별한 장치 없이 텍스트 및 영상을 한 화면에서 볼 수 있어 전통적인 교육 시스템에 비하여 시,공간적인 장점을 갖는다 할 수 있다.또한 입원 환자들로부터 수집된 증례를 통하여 실제 임상 진료와 매우 유사한 경험을 하도록하여 교육효과를 증대시켰다. 결론: 혈액학 교육에 있어서 멀티미디어적 효과를 극대화시켜 질환의 병태생리 등 강의실 교육자료뿐 아니라 진단에 필수적인 시각적 자료를 손쉽게 접할 수 있는 CD-ROM의 개발로 전통적인 강의방법이 갖는 한계를 개선시킬 수 있을 것으로 기대된다. Purpose : The traditional medical education system has its limitations in effectiveness of conveying informations in multiple modalities used in diagnosis of patients with hematologic diseases.This study was performed to develop such a multimedia system using computer based CD-ROM, which includes visual assistant systems, several hematological case studies as well as the traditional text-wise education systems. Materials and Methods: The informations about hematologic diseases were compiled and organized.The main visual data was peripheral blood smears, bone marrow data, and several laboratory results accrued from patients admitted to Chungbuk National University Hospital.Each visual data were transformed through computer-based medical image processing and analyzing system and saved as to JPEG files.Case studies were also acquired from admitted patients and the laboratory data of that patients were used unmodified as possible as. Results : The CD-ROM covers almost all kinds of hematologic diseases that must be included in ordinary medical education courses.The text part includes pathophysiology, diagnosis, clinical features, treatment and prognosis of each hematologic diseases.The essential visual data were linked to each text part and accessible with ease, by one click.Case studies were simulated to actual clinical settings and presented step by step from diagnoses to treatments. Conclusion: A multimedia approach for the study of hematologic diseases has been developed and available in CO-ROM format.This system has advantage over traditional education system in conveying all kinds of visual data which is essential in educating hematologic disorders.

세탁기용 12/8극 외전형 SRM의 설계 및 특성 해석

박보량,김아란,안진우,이동희 경성대학교 공학기술연구소 2012 공학기술연구지 Vol.18 No.-

본 논문에서는 기존의 세탁조와 전동기 사이 기계적인 기어 및 벨트를 이용하여 전동기의 토크를 전달해 세탁하는 간접 구동방식이 아닌 세탁기의 저소음화를 위한 기어 및 벨트를 제거한 직접 구동방식의 외전형 SRM을 설계하였다. 세탁기에서 저속 고토크 특성을 가지는 세탁모드와 고속 저토크인 탈수모드를 모두 만족하는 넓은 가변속 범위 특성을 가지는 외전형 SRM을 설계하고 FEM 특성을 해석하였으며, 제안된 12/8 외전형 SRM이 드럼세탁기의 직접 구동 전동기로 사용될 수 있는 가능성을 확인하였다.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

경피적 중심 정맥 도관의 임상적 적용에 관한 연구

이희경,김영창,이혜경,박보림 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

신생아실에서의 미숙아 및 선천성 기형의 치료의 발달과 함께 중심 정맥의 필요성이 증가되면서 경피적 중심 정맥 확보인 경피적 정맥 도관(PCVC)을 시행하게 되었으며 현재 널리 이용하계 되었다. 1995년 5월에서부터 1997년 4월까지 본원 신생아실에서 경피적 정맥 도관을 시행받은 78례에 대상으로 후향적으로 성공률의 유무, 도관 유지, 문제점, 합병증등을 알아 보아 향후 치료에 도움을 얻고자 본 연구를 시행하였다. 1. 경피적 정맥 도관을 시행한 78례중 64례(80.8%)에서 시술에 성공하였으며 본 시술만 전담하는 간호사에 의해 시행한 1997년 1월에서 4월까지 성공률은 95.3%였다(p<0.001). 2. 73.1%가 총정맥 영양법을 위해 시행되었고 이중 43.6%가 미숙아로 인한 총정맥 영양법을 위해 본 시술이 필요하였으며 17.9%는 항생제를 포함한 장기간의 약제 사용을 위한 정맥 확보를 위해, 9%에서 고농도의 용액의 사용을 위해 시술되었다. 3. 시술 부위는 주관절 정맥이 59.4%로 가장 많았고 액와 정맥이 35.9%로 많았다. 4. 시술후 도관의 위치는 우심방이 44.9%, 상대 정맥이 12.8%, 액와 정맥이 21.8%, 하대 정맥이 1.3%, 무명정맥이 1.3%로 우심방과 상대 정맥에 위치한 경우와 그이외 말초 부위에 위치한 경우를 비교했을 때 우심방과 상대 정맥에 위치한 경우가 도관의 유지기간이 의의있게 길었다(p<0.001). 5. 도관 제거의 이유는 더 이상 수액 제제가 피료치 않아 계획적으로 제거된 경우가 56.3%, 기계적 폐색등으로 제거된 경우가 21.9%, 도관과 관련된 감염으로 제거된 경우가 3%순이었다. 6. 도관 제거후 배양 검사를 시행한 36례중 9례(25%)에서 균이 배양되었고 staphylococcus epidermidis와 candida albicans가 대부분을 차지하였다. Percutaneous central venous catherization(PCVC) is performed commonly as a vascular access procedure for a various indications in the neonatal intensive care unit (NICU). We evaluated a total of 78 PCVC cases performed in the NICU over 2 years from April, 1995 to April, 1997 in terms of age, success rate, indications, insertion sites, indwelling time and causes of removal of catheters, and associated complications including sepsis retrospectively. The results are described below ; 1. Patient ages and body weights at the time of insertion ranged from 1-120 days (average age, 10.9 days) and from 660-4,100 gm(average weight, 2,119 gm) respectively. 2. The overall success rate of insertions was 80.8%, however, the insertions attempted by highly- trained nurse were successful in 95.3 % from Jan. to April, 1997. 3. The most common indication was total parenteral nutrition (73.1%). 4. The insertion sites were cubital vein(59.4%), axillary vein(35.9%), and external jugular vein(3.1%). 5. The locations of catheter tip were right atrium(44.9%), axillary vein(21.8%), superior vena cava(12.8%), and inferior vena cava(1.3%). 6. The indwelling time ranged from 1-52 days (average, 12.6 days). When the catheter tips were placed in the right atrium or superior vena cava, the catheter was placed in the longer duration compared to those of other sites significantly. 7. The causes of removal of catheter were elective (56.3 %), mechanical obstruction(21.9%) and catheter related infection(3%). 8. The cultures of catheter tip were done after removal in 36 cases, among them cultures were positive in 9 cases(25%) the most common causes were S. epidermidis and Candida albicans.

심인성 색전 요인이 없는 뇌경색 환자에서 경식도 심초음파와 Acoustic Quantification을 이용한 대동맥 탄성의 평가

이종민,윤호중,임효영,박지원,김휘열,전희경,문건웅,정욱성,채장성,김재형,최규보,홍순조 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

만성 B형 간염 환자의 급성 악화 후 발생한 피부 결절 다발동맥염과 류마티스관절염

이주현,김민,이준성,장선희,윤보영,이윤우 인제대학교 2009 仁濟醫學 Vol.30 No.-

Cutaneous polyarteritis nodosa(CPAN) is a rare vascular disorder that affects small and medium-sized arteries in the reticular dermis and subcutaneous tissue. It has been described as a distinct clinical entity with benign and a chronic prolonged course without systemic involvement. Hepatitis B virus-related polyarteritis nodosa (HBV-related PAN) is typical form of classic PAN. Its pathogenesis is not well known, but considered an immune complex-mediated disease. The patients with HBV-related PAN often present with malignant hypertension, orchitis, and vascular nephropathy. But, HBV-related CPAN has been rarely reported. Rheumatoid vasculitis is a complication of rheumatoid arthritis that can be lead to variety of clinically significant skin and systemic conditions, It has been reported before or at the time of rheumatoid arthritis diagnosis but is usually seen an average of 10 to 14 years after arthritis onset. The histological features of cutaneous vasculitis in rheumatoid arthritis overlapped both the characteristics of cutaneous necrotizing venulitis and cutaneous polyarteritis nodosa. But polyarteritis nodosa-like rheumatoid vasculitis has rarely been reported. We report a case of rheumatoid arthritis and cutaneous polyarteritis nodosa in a chronic hepatitis B with acute exacerbation.

岩石의 剪斷破壞擧動에 關하여 : size effect의 影響을 中心으로

李喜寶 全北大學校 1984 論文集 Vol.26 No.-

사료용 옥수수 연구 N. 조사료용 CNU 육성 교잡종 옥수수의 수량관련 주요특성

이희봉,정재영,김용일,박보영,지희정,문현귀 충남대학교 농업과학연구소 2006 농업과학연구 Vol.33 No.1

This study was carried out to compare a yield performance about CNU maize hybrids developed at the Maize Genetics and Breeding Lab, in Chungnam National University. Among the hybrids incorporated in the test, CNU 3 and 1 showed higher dry matter per 10a and lower kernel yield per 10a than check hybrid, Kwanganok. Hongchon 5 and Suwon169 showed higher kernel yield than Kwanganok. The average yield of CNU 3 hybrid in dry matter and CNU 4 in kernel yield were 2,106kg/10a and 854kg/10a in regional adaptability test, which were increased 33% and 8% compared with a check hybrid, respectively. Also, these hybrids had better stay green characteristics than check hybrid and showed moderately resistance to corn borer and leaf spot.

선택적 신동맥 색전술을 이용한 신절석술 후의 신출혈 치료 1례

이중화,이보배,윤능수,임승수,박청희 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

A patient with uncontrollable postoperative renal hemorrhage was successfully treated by selective injection of gelfoam into the anterior inferior segmental branch of right renal artery. Follow up arteriography was done 16 days later. It revealed persistent occlusion of the bleeding vessels. This method is a simple effective procedure in cases of renal hemorrhage to diverse etiology without responsive management.