Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

재건축사업의 건설사업관리 프로세스 모델 연구

하한기,박태근 목원대학교 건축도시연구센터 2004 建築·都市環境硏究 Vol.12 No.-

The new policy of the cities and residential areas arrangement is solving those problems from July 1, 2003, and the policy takes the system of planning and development to redevelop the cities. And the redevelopment business is very complicated like establishment a guild, operating, building diagnostics, making a plan of business and operating, design procedure, clearance. So they need to get specialists each part. "CM Process Model for Re-Construction Project" can be applied to decision tool of owner for improvement of Construction Management. So this study expects that the model can be a standard one for computerization of Construction Management and development of BPR methods and simplification of business procedures.

중·고 필드하키 선수들의 스포츠 상해에 관한 연구

하태열,이기광,정종윤 창원대학교 체육과학연구소 2002 경남 체육연구 Vol.7 No.2

중·고 필드 하키선수들에게 발생하는 스포츠 상해 유형을 규명하기 위하여 2000년 제1회 중·고 연맹 회장기 대회에 참가한 남·여 하키 선수 434명을 대상으로 한 설문 조사를 분석한 결과 다음과 같은 결론을 얻었다. 첫째, 상해 빈도는 신체 부위별로 다리, 팔, 머리, 몸통 순으로 나타났다. 남·여별로는 다리부위에서는 여자, 상지부위에서는 남자가 부상 빈도가 높게 나타났다. 학교별로는 팔, 다리 부위의 부상빈도에 있어서 고등학교가 중학교보다 높게 나타났다. 위치별로는 GK가 다른 위치의 선수들보다 상대적으로 팔부위의 부상 빈도는 높고 다리 부위의 부상 빈도는 낮은 것으로 나타났다. 둘째, 상해 증상에 있어서는 피부와 근육상해가 뼈와 관절 상해 빈도의 약 3~4배 정도로 높게 나타났다. 위치별로는 유의한 차이가 나타나지 않았으나. 남자와 고등학교가 여자와 중학교에 비해서 피부와 근 상해의 빈도가 높은 것으로 나타났다. 셋째, 상해 이유에 있어서 본인 부주의에 의한 상해원인은 남자는 지나친 승부욕, 여자는 정신력 부족이 가장 높게 나타났으며, 고등학교는 과도한 연습, 중학교는 정신력부족이 가장 높게 나타났다. 시설결함에 의한 상해원인은 모두 장비 불량으로 인해 상해발생이 가장 높게 나타났으며, 장소부적응에 의한 상해원인에 있어서 모두 타구장 부적응에 의한 상해발생률이 가장 높은 것으로 나타났다.

일부 도시지역 성인들의 혈중지질치의 참고치 및 저콜레스테롤혈증에 미치는 요인 분석

유기하,이동배,이태용,조영채,김수영 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Data from 3.982 adults participating in a health examination in a university hospital were analysed to determine the reference values of hyperlipidemia and hypolipidemia, and those were compared with American data. Also health related behaviors affecting hypocholesterolemia were investigated. 29.3% of the males diseased subjects, and as were 25.6% of the females in their twenties, 69.5% of the males in their 60s and 78.6% of the females in their 50s. The rate of diseased subjects tended increase with increasing age. The rates of the diseased were 60.1% for males and 55.2% for females. Among cardiovascular risk factors, the proportion of hyperlipidemia was 46.6%, fat liver 42.2%, hypertension 21.8%, glucose intolerance 13.7%, abnormal EKG 11. 0%, obesity 2.9% and anemia 1.7% for male subjects and hyperlipidemia was 31.2%, fat liver 29. 5%, anemia 27.5%, hypertension 21.1%, abnormal EKG 15.7%, obesity 7.3% for females in that order. The rates of cardiovascular risk factors were higher in males than in females except for anemia, abnormal EKG and obesity. The total cholesterol levels of 95 percentile for males and females were 227.0 mgldl, 226.0 mg/dl and the 5 percentile levels for males and females were 134.0 rag/dl, 131.0 mgldl, respectively. The LDL cholesterol level of 95 percentile for males and females were 150.0 mg/dl, 147.0 mgldl, and the 5 percentile were 53.0 mgldl, 51.0 mg/dl, respectively. The HDL cholesterol 95 percentile levels for males and females were 82.0 mg/dl, 83. 0 mg/dl, and those of 5 percentile were 36.0 mg/dl and 39.0 mg/dl, respectively. These data show that the mean levels of total cholesterol, triglyceride, LDL cholesterol were related to increased age in both sexes, and were slightly higher in the females than in the males over all ages, but those of HDL cholesterol decreased. The high cholesterol level group was associated with age, the amount of alcohol consumption, smoking and body mass index. But that was not associated with meat intake and regular exercise. No significant difference were found among the rates of all diseases except for diseases and anemia up to 160 mg/dl of cholesterol level in both sexes. Sex, regular exercise and glucose intolerance were revealed as influencing factors in the low serum cholesterol levels, but disease and abnormal EKG had a lowing effect for the low cholesterol risks. In conclusion, the reference values of Korean serum lipids were 5-25 mg/dl lower than Americans. The cut-off value to diagnosis hypolipidemia for the Korean is recommended as below 140 mg/dl of serum total cholesterol. The hyperlipidemia cut-off value should above 220 mg/dl of serum total cholesterol.

지구성 운동이 중년여성의 혈중지질농도에 미치는 영향

朴麟基,崔大雨,李明秀,徐在河,趙炳俊,金泰亨 충남대학교 체육과학연구소 2000 體育科學硏究誌 Vol.18 No.1

The purpose of this study was to identify the effect of endurance exercise program on the middle-aged women. Six subjects were recruited from among volunteers responding to advertisements placed around the university community. All subjects, with no experience in regular physical activity participated in an interventional training consisting of swimming and stretching three days a week for 10weeks. Pre-and post blood lipid levels, such as Total Cholesterol(TC), High Density Lipoprotein Cholesterol(HDL-C), Low Density Lipoprotein Cholesterol(LDL-C), and Triglyceride(TG) were measured. A paired t-test showed results that were significant the .05 level were HDL-C , LDL-C, TG, and TC/HDL-C Ratio. The main finding of the study was that the role of endurance training, as prescribed in our study has the effect of making improvements in blood lipid levels for the middle-aged women. 1. After a 10week period of endurance exercise, the Total Cholesterol(TC) level was higher than that of pre-test. But the difference no showed the statistical significance. 2. After a 10week period of endurance exercise, the High Density Lipoprotein Cholesterol(HDL-C) Low Density Lipoprotein Cholesterol(LDL-C). Triglyceride(TG) level was higher than that of pre-test. and the difference showed the Statistical significance. In conclusion, even though there was significant in blood lipid levels after endurance exercise, swimming has a beneficial on improving in the middle-aged women.

漸進的·急進的 運動負荷가 血液의 pH, Sugar 및 Lactate에 미치는 影響

姜炯基,辛元太,白永守,殷熙寬,宋基成,河哲秀 漢陽大學校 體育科學硏究所 1986 體育科學 Vol.6 No.6

The purpose of this study is to in-vestigate the effects of gradual and radical exercise load on the treadmill for PH, Sugar and Lactate in Blood by selecting 14 subjects in H university, All subjects began exercise by 6mPH for 4 minutes at start and increased exercise speed up to HR 140 by increasing every minute as gradual load. And subjects began exercise by 9mPH at first and increased load up to HR 140 as radical exercise load. The results are as follows: (1) In PH in Blood, gradual exercise load is lower than radical training in all subjects. (p<0.05) (2) In Sugar in Blood, radical exercise load is higher than gradual exercise load in all subjects. (p<0.05) (3) In Lactic Acid in Blood, gradual training is higher than radical exercise load in all subjects. (p<0.01) (4) In Lactic Acid, all subjects showed high value and its is also in Sugar, than the method of exercise load is according to anaerobic energy metabolism.

앙와위 및 복와위 요추 전산화 단층촬영의 비교 연구

김영태,조기홍,김재민,하호균 건국대학교 의과학연구소 1993 건국의과학학술지 Vol.3 No.-

For evaluating the lumbar disc space, the fact that the postmyelography computed tomography was more accurate than computed tomography or myelography was well know. But the technical difficulty is limitation of gantry angle. The prone position scanning may help to lessen this trouble. A prospective computed tomographic scanning was performed in both the prone and supine position on 43 patients, who had low back pain. The angle between the vertebral end plate and vertical line was measured in both position at ??, ?? and ?? interspaces. The adavantages of prone scanning in spinal aligment was noted at L5-S1 disc space(79.1%) and also more desirable if computed tomography was performed with metrizamide. With above advantages, the evaluation of bulging annulus was become more easier.

사례 기반 학습을 이용한 지능형 판매 지원 에이전트 시스템의 설계 및 구현

신하철,김재호,김기태 중앙대학교정보통신연구소 2000 정보통신연구소논문집 Vol.2 No.1

전자 카탈로그를 이용한 인터넷 정보의 접근은 일반화되고 있지만 수많은 정보의양과 다양성 때문에 고객이 원하는 효율적인 상품 검색을 방해하는 원인이 되고 있다. 또한 수시로 변경되는 상품 카탈로그를 처음 접근하는 고객이 원하는 상품 정보를 찾아내기란 쉬운 일이 아니다. 이러한 문제점들의 가장 근복적인 이유는 전문적인 상품 카탈로그가 다양한 속성들로 되어 있기 때문에 각 고객의 관심분야와 검색 습관은 같은 고객의 요구사항을 기존의 웹 브라우저만을 이용하여 만족시키지 못한데 기인된다. 본 논문에서는 이러한 문제를 해결하기 위해 사례 기반 학습 개념을 이용하여 각 고객의 관심 분야를 반영하고 고객 편의의 정보검색을 도와주는 지능형 판매 지원 시스템(Intelligence Sales support Agent System, ISAS)을 설계하였다. Although the access of internet information is generalized using electronic catalog, because of the number of amount and variety of information, the customers can't effectively search the merchandise that they need. Also it is difficult searching the merchandise information that the customer need, if they access merchandise catalog first. The reason of this problem is that the existing web browser is not satisfied the customer's requirement like their interests and search habits, because professional merchandise catalogs consist of variable attributes. In this paper, we designed Intelligence Sales support Agent System that reflects the customer's interests and assists the effective information search using case-based reasoning, to solve this problem.

『金匱要略』의 重要 註釋書에 대한 硏究

廉龍河,河基泰,玄東煥,尹相柱,金俊錡,崔達永 동국대학교 한의학연구소 2000 東國韓醫學硏究所論文集 Vol.9 No.-

「금궤요약」은 韓醫學 最高의 雜病專門書로서 그 중요성이 널리 인정되고 있지만, 우리나라에서는 그에 대한 註解나 연구가 미흡한 실정이다. 따라서 著者는 앞으로의 硏究와 敎育의 基本資料로 삼기 위하여 本書의 重要 註繹書에 대하여 정리하였다. 「금궤요약」에 대한 최초의 注繹은 元明間趙良仁의 「금궤요약연의」「개정금궤요약주」等이 유명하다. 日本에서는 「금궤요약주해」을 효시로 「금궤요약방론친주」, 「良沙正經證匯」, 「금궤요약집성」, 「금궤요약집의」, 「금궤옥함요약술의」등의 注本이 있다. Jinguiyuolue(금궤요약), written by Zhong-Jing Zhang(張仲景) in late Han(漢) Dynasty, is very foundamental Cannon of Oriental Medicine. Many Doctors commented on the book from Yuan(元) Dynasty ir! Chian and from Edo(江戶) Period in Japan, but there are a few studies in Korea. So we studied on the commentaries of the book, which published in the three countries, for improving research and education of it in our country.