대장내시경검사에서 비특이적 염증형태로 나타난 대장선암 1예

박재현,장병익,이호찬,김성준,박준석 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.2

Colon cancer is the second most common malignancy in Korea. It is classified as superficial type, the mass type, the ulcerative type, the ulceroinfiltrative type, the diffuse infiltrative type and the unclassified type according to the colonoscopic findings. We report here on a case of colon cancer that was initially misdiagnosed as acute infectious colitis at the initial presentation. A 64-year-old man visited to Yeungnam University Hospital for watery diarrhea and lower abdominal pain. Colonoscopy revealed long segmental edematous mucosa and hyperemic mucosa with stenosis in the transverse colon. He was diagnosed as having acute infectious colitis according to the colonoscopic finding. However, two days later after colonoscopy, he visited the emergency room for hematochezia. We performed computerized tomography (CT) and obtained blood samples to find the origin of the bleeding. We found thickening of the transverse colon lumen and ascites on the CT finding and an elevated level of tumor markers; we also obtained the results of the colonoscopic biopsy that was done via colonoscopy. He was finally diagnosed as having colon cancer with carcinomatosis, a poorly differentiated adenocarcinoma.

트랙타 부착 대형이앙기 개발 및 재배적 실용성

박성태,장익주,정창화,김상열,김재현,문헌팔,양세준,김순철 한국국제농업개발학회 2002 韓國國際農業開發學會誌 Vol.14 No.3

쌀 생산비를 줄이고 대경지 규모화 영농에 적응할 수 있는 농기계 개발을 목적으로 연구개발한 대규모 경지적응 트랙터 부착 대형벼이앙기의 구성과 특징 및 개발시작기의 재배적 실용성 평가결과를 요약정리하면 다음과 같다. 1. 트랙터 부착 12조 대형벼이앙기는 크게 바퀴자국 제거로타리, 문짝형 정지판, 이앙장치부 등으로 구성되어 있다. 2. 트랙터 부착 12조 이앙기는 트랙터 동력을 이용하여 로타리, 정지 및 이앙작업이 동시에 이루어 질 수 있도록 개발하였다. 3. 바퀴자국을 없애는 날은 기존의 로타리 날을 교체하면 되도록 반달형 날로 제작하였다. 4. 이앙기는 이동시는 접을 수 있도록 설계 제작되어 대형화가 가능하므로 기존 6조 승용이앙기에 비하여 이앙작업 능력이 1.5배 이상이었다. 5. 트랙터 부착 대형벼이앙기는 트랙터와 같은 큰 동력원을 이용할 수 있으므로 측조시비기, 긴매트모 탑재 등 다양한 작업기 및 기능을 추가로 부착 가능하도록 설계되었다. 6. 트랙터 부착 대형벼이앙기는 어린모 및 중묘이앙시 결주율은 3.0∼4.3%로 기계이앙기 결주 허용범위 5% 미만이었다. 하지만 무경운 논에서는 이앙작업은 가능하나 부묘율이 다소 높은 점은 보완이 필요하다. To develop a labor saving rice cultivation technology, a new tractor attached rice transplanter has been developed for large scale farming and its field performance was evaluated. The rice transplanter consists of three major parts such as rotary for removing tractor tire furrow, door-shaped soil leveling plate and transplanting equipment. The rice transplanter is operated using the power of the tractor and performs rotary, harrow and seedling transplanting simultaneously. A half moon shaped rotary blade was found to be very efficient to remove tire furrow developed during seedling transplanting and the original rotary blade can be replaced easily with existed rotary blade. The seedling transplanting part of the transplanter was designed to fold into small size and the transplanting efficiency of the transplanter was found to be 1.5 times higher than that of the conventional riding type six row transplanter. Since the transplanter is operated through a strong power of the tractor, the additional attachment such as fertilizer application apparatus and long mat rice seedling carrier is possible. Based on the field performance of the transplanter, although the missing hill percentage showed roughly with 3.0∼4.3% for 10-day and 30-day old seedlings but the percentage is less than 5% which is maximum missing hill permit in the transplanting rice. Seedling transplanting in no-tillage field condition is acceptable but floating seedling percentage is still high and thus further technology improvement for minimizing floating seedling percontage is needed.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

급성 전방 십자 인대 손상의 관절경적 치료

이광진,양준영,이장익 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The anterior cruciate ligament (ACL) of the knee is a primary anterior stabilizer and secondary rotatory stabilizer of this joint. Anterior cruciate ligament insufficiency can lead to degenerative arthritis and functional instability, and is also associated with a high incidence of meniscal tears. The relatively poor results generally obtained with conservative treatment of torn ACLs have led orthopaedic surgeons to either primary repair or reconstruction of this joint. The treatment of acutely torn anterior cruciate ligament remains a controversial subject. The purpose of this study is to compare the result of primary repair and arthroscopic reconstruction. Authors compared the results of 20 primary repairs(Group I) and 20 arthroscopic reconstructions(Group II) that were treated from January 1988 to December 1994. The results were as follows : 1. 34 males and 6 female ; the average age was 33 years. 2. Most common injury mechanisms were traffic acident(28 case) and sports injury(10 case). 3. Most common associated injury was medial collateral ligament rupture. 4. Group I showed postoperatively 12 negative anterior drawer test, 11 negative Lachman test and 11 negative pivot shift test and Group II showed postoperatively 17 negative anterior drawer test, 16 negative Lachman test and 17 negative pivot shift test. 5. In postoperative Lysholm knee scoring scale, group I showed 82 points and Group II showed 94 points. 6. In postoperative KT-20001 arthrometer, 12 cases in Group I and 17 cases in Group II showed less than 3mm in 20-D. 7. In postoperative KT-2000 arthrometer, 11 cases in Group I and 16 cases in Group II showed less than 3mm in MMD.

MySQL을 이용한 방명록 DB 구현

강선영,양의장,조준익 군산대학교 정보통신기술연구소 2000 情報通信技術硏究論文集 Vol.4 No.-

These days, Internet is a fantastic business in the world, We realized a sample database using MySQL which is freeware in the acdademy. In realization, we tested a sample program in the Web browser. Also HTML is acted well in the Web browser. The Web programming which tested in this paper was very simple and easy. We tested a datagram to upload, modify, and delete in the Web browser.

도시 거주 노인 수면 습관 및 불면증상의 요인 : 인구학적,질병 및 정신증상의 관련성

홍진표,안준호,윤영국,박종익,이소영,함봉진,김장규,한오수,조맹제 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 본 연구는 국내 노인의 습관을 조사하고 불면 증상과 연관 있는 인구학적, 질병학적 요인을 알고자 했다. 방 법 : 1997년 12월부터 1998년 1월까지 약 1개월에 걸쳐 2단계 층화집락표본추출의 역학조사법을 통해 선정된 3개 4개동 거주의 만 65세 이상 노인을 대상으로 수행되었다. 대상자 중 723명에서 등답을 받았으며 응답률은 73.8였다. 대학생인 설문조사요원들을 훈련시킨 뒤, 이들로 하여금 대상지역의 노인거주가정을 방문하여 개개 노인을 대상으로 반구조화된 면담으로 수면습관 및 불면증상 설문을 실시하였으며 그 외 한국어판 노인정신장애평가척도, 삶의 질 척도를 이용한 설문조사와 과거 질병력을 청취조사하게 하였다. 결 과 : 국내 노인들은 평균 오후 10시 16분에 자리에 누워 오전 5시22분에 일어나서 총 7시간 6분의 수면시간을 보였다. 노인의 11.7%가 거의 매일 밤 불면증을 14.8%가 간헐적 불면증을 호소하였다. 남자에서는 연령이 증가할수록 침상에 누워있는 시간이 증가하고, 또, 입면시까지 소요되는 시간과 수면 중의 각성회수가 증가되었으나 여성에서는 명확하지 않았다. 단변수 분석에서 요통, 중풍 병력의 환자에서 불면증상이 심했다. 다변량분석 결과 불면 증상과 관련 깊은 요인으로 남자에게서는 고령과 우울증상이 여자에게서는 남자의 위험요인에다 신체통증과 피부병력이 추가로 관련이 있었다. 결 론 : 지역 거주 노인에서 불면 증상은 매우 흔한 증상이며 우울증상과 명확한 상관관계를 보이고 있었다. 불면증을 극복하기 위해 불면증 위험요인의 인과관계에 대한 추후 연구가 필요하다. Objectives : The purpose of this study is to analyze sleep habit and investigate the association between insomnia and demographic, health and psycho-behavioral symptomatology in Korean urban elderly Method : A total of 723 community residents aged 65 years or older were surveyed by two stage, random cluster sampling method. The response rate was 76.2%. Interviewers performed door to door visits and administered a questionnaire about sleep, past medical history, and several scales as the Psychogeriatric Assessment Scale(PAS), the short form Quality of Life Scale (SF-36) and etc. Results : The mean scores are as follows : retiring time was ten-sixteen p.m., wake-up time was five twenty two a.m., duration of sleep was seven hours and six minutes. Among the elderly, 11.6% and 14.8% of the subjects reported chronic and intermittent difficulty in sleeping, respectively. The patients with back pain and history of stroke complained of more insomnia symptoms in univariate analysis. In ANCOVA analysis, insomnia symptoms were associated with an old age, depressive symptoms in male. Bodily pain and history of dermatologic disease were additional risk factors in female. Conclusions : The data suggest insomnia is one of most common health problems among elderly Koreans living in the community. Strong positive relationship between depressive symptoms and insomnia were found. Further research is needed to explore the causal relationship between insomnia and risk factors.

보존적 치료 및 수술적 치료에 의한 상위 경추 골절 및 탈구의 안정성

이준규,안재성,양준영,이장익 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

In general, hangman's fracture, odontoid Type III fractures, and most miscellaneous axis fractures are effectively managed with nonoperative methods (typically, the halo vest with its rigid external immobilization). Halo apparatus is a reliable instrument for the management of cervical spine injury, including that of odontoid fractures and other C1-2 injuries. Surgical fusion is the usual alternative to the halo device. Posterior wiring with or without fusion using autogenous iliac bone graft is probably the most common surgical treatment of cervical spine fracture and dislocation. The purpose of this study was to compare with stability of each others and to estimate the atlanto-dental interval and space for available in patients who were received conservative treatment and operative treatment due to upper cervical spine fracture and/or dislocation. 25 patients who were recieved conservative and operative management due to fracture and/or dislocation of the upper cervical spine (Cl and C2) during 1990. Jan. to 1997. May. were defined as a patient group. 12 patients were received conservative treatment. 13 patients were received operative treatment. In patient group who were received conservative treatment, the average of ADI and SAC was within normal range. In patient group who were received operative treatment, the average of ADI and SAC was within normal range. The patient group with the ADI and SAC of normal range were stable with good bone union at the last follow-up examination. Also the patient group was received fusion as their initial treatment for injuries incurred 1 month to 8 month prior to hospitalization were stable with good bone union.

간문부 담관암 환자에서 경피경관 양측성 금속 배액관의 효과

김금래,김주형,박원규,장재천,조재호,김태년,김준화,장병익 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: The purpose of this study was to determine the effectiveness of percutaneously place self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self-expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cased of Bismuth type Ⅱ,21 cases of Bismuth typeⅢa 8 cases of Bismuth type Ⅲb and 15 cases of Bismuth type Ⅳ. Stent placement was technically successful in all patients All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage of 91.9% There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60 ~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method of palliation of patients with hilar cholangiocarcinoma.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

Interaction Between Si and N in Solidified Austenitic Fe in 1373–1473 K

Jun Ik Jang,Youngjo Kang 대한금속·재료학회 2021 METALS AND MATERIALS International Vol.27 No.11

In order to investigate the thermodynamic interactions between Si and N in austenitic Fe, equilibrium experiments of Fe–Sifoils and N2gas with controlled partial pressure were carried out at 1373, 1423 and 1473 K. Based on the equilibrium concentrationof N in the Fe foil with different Si content, the first order interaction coefficient between Si and N in austeniticFe could be determined in 1373–1473 K and its temperature dependency was found to be as follows. In the austenitic Fe,Si and N have a positive interaction coefficient value, which has a repulsive relationship with each other. Using interactionbetween Si and N, the precipitation behavior of various nitrides is to be predicted.