심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

한우 Stearoyl-CoA Desaturase의 cDNA 단편 클로닝 및 mRNA 발현양상

이창수,윤두학,이승환 건국대학교 자연과학연구소 1999 建國自然科學硏究誌 Vol.10 No.1

Single-strand cDNA was prepared from total RNA in liver of Hanwoo cattle using the random primer. A fragment of 675 bp coding for part of the Hanwoo stearoyl-CoA desaturase(SCD) gene was amplified by Reverse Transcriptase-Polymerase Chain Reaction(RT-PCR) using primers based on published rat cDNA sequence. The amplified DNA product was cloned into the pGEM-4Z vector. The insert DNA was sequenced by the Saneer's method. The homology of Hanwoo SCD cDNA sequence was shown to be 98%, 85% and 84% to that of rat, ovine and human, respectively. When the Hanwoo SCD cDNA sequence was translated into peptide. the similarities with rat, ovine and human SCD were 98%, 83% and 87%, respectively. Southern anaiysis of Hanwoo genomic DNA with Hanwoo SCD cDNA generated a single hybridization fragment that was observed in size 2.Okb or 1.Okb by EcoR Ⅰ or Hind Ⅲ digestion. The level of SCD mRNA in Hanwoo cattle was low in liver and high in adipocyte and muscle tissues.

수술-교정 치료 환자의 통제 소재

이신재,안석준,백승학,김태우,장영일,양원식,서정훈,남동석 대한치과교정학회 2002 대한치과교정학회지 Vol.32 No.4

교정치료와 악교정 수술을 필요로 하는 환자가 점증하는 현 시점에 비추어, 이에 대한 기술적인 측면의 발전과는 달리 수술-교정 치료 환자에 대한 정신사회학적 혹은 정신심리적 양상에 대한 객관적인 정보는 그리 많은 주목을 받는 편이 아니었다. 수술-교정치료는 과학적인 치료과정이긴 하지만, 어느 정도 심미적 혹은 예술적인 측면을 지니는 선택 치료의 면모를 지닌다. 그러므로 치료에 대한 환자의 주관적인 느낌은 치료 기술이나 치료의 의학적 성공 여부보다 더 큰 영향을 미칠 수 있다. 그러므로, 수술-교정 (혹은 교정) 치료에 대한 환자의 반응을 예측하기 위한 정신심리적인 정보는 치료에 유용한 지표가 될 수 있다고 가정할 수 있다. 통제 소재에 대한 연구는 인간의 다양한 행동을 예측하기 위한 유용한 지표로 알려져 왔는데, 본 연구에서는 42명의 수술-교정치료 환자와 성별/연령별로 표본 추출된 42명의 통상적 교정치료 환자를 대상으로 삼아 정신=심리적 비교 및 분석의 방법으로 두 가지 종류의 내외 통제 소재(internal/external locus of control) 검사를 시행하였다. 그 결과 수술-교정치료군에서만 남자가 여자에 비하여 낮은 외적 통제(높은 내적 통제)의 경향을 보였다. 결론적으로 수술-교정치료 환자의 정신심리적 기반은 성형 수술 환자와는 달리 교정치료 환자와 유사한 경향을 지닌 것으로 생각되었다. Surgical-orthodontic treatment is an increasingly more common dental procedure whose unique psycho-social or psychological feature has not been fairly quantified objectively. Since the treatment of a surgical-orthodontic (or orthodontic) patient is part science and part art, a subjective recognition of a patient about his or her own treatment may be more important than technical success during and after treatment. Therefore, the knowledge of the patient''s underlying psychological status could be useful in the prediction of patient's response to surgical-orthodontic (or orthodontic) treatment. The purpose of this study was to investigate and evaluate the psychological difference between conventional orthodontic patient and surgical-orthodontic patient by using locus of control (LOC) examination. Locus of control scale has been proven to be extremely useful in the prediction of a variety of human behaviors. Two types of locus of control data (I-score, Internal locus of control score ; E-score, External locus of control score) were obtained for 42 surgical-orthodontic patients and randomly selected 42 conventional orthodontic patients (as a control group) matched for age and gender. No statistically significant difference was observed in the scale of internal and external locus of control between the groups of surgical-orthodontic patients, males showed lower E-score (external locus of control score, higher internal locus of control tendency) than females. The results of this study suggested that the psychological background of surgical-orthodontic patients, in contrast with that of cosmetic surgery patients, has a similar disposition with that of orthodontic patients.

의과대학생에서 임상 수기 수행능력에 대한 자가평가 결과와 임상수행능력 평가시험(CPX) 결과의 비교

이학승 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

본 연구는 의과대학생들이 한 학기 동안 임상실습을 마치고 난 후, 실습지침서에서 요구하고 있는 흔한 임상 증상을 얼마자 자주 경험하였는가를 조사해 보고, 흔한 임상 증상에 대한 학생들의 경험 빈도와 자가 평가한 염상수행능력과의 상관성을 조사해보는 것이었다. 둘째로, 시험문항으로 제시된 임상수기에 대한 의과대학생들의 주관적 자가평가 결과와 객관적 CPX 결과를 비교하여 주관적 평가 결과와 객관적 평가 결과의 상관성을 조사해 보는 것이었다. 그 결과는 다음과 같다. 1. 임상 증상에 대한 학생들의 경험 빈도와 자가평가한 임상수행능력과의 상관성은 경험 빈도가 많을수록 자가평가 점수도 높게 나오는 결과를 보였다. 2. 객관적 CPX 결과와 주관적 자가평가 결과는 상관성이 없는 것으로 나타났다. Purpose: The purpose of this study was to assess the clinical experience state of medical students 3-grade, and compare the self-assessment about their competency on clinical skills and the assessment of instructors through the Clinical Performance Examination(CPX). Methods: Fifty-two medical students who are in 3-grade were included. Their clinical experiences state and the self-assessment of their condidence on clinical skills were evaluated by questionnaires givend before the CPX. After completing the CPX, they evaluated their own performance state to 9 whole clinical skills of the CPX by self-assessment questionnaires, again. The correlation and comparison between self assessments' socre and instructor's score were analyzed. Results: For 19 of 28 clinical skills items listed in the questionnaires, self-assessment of competence by medical students correlated with the frequency of performance(p<0.05). For 9 clinical skills in the CPX, the self-assessment scores did not correlate significantly with the instructors' assessment scores(p>0.05). However, these 9 clinical skills scores from the instructors correlated significantly with the scores of clinical experienceand the final semester grade point averages(p<0.05). Conclusion: There was a significant association between frequency of performance and self-assessed competency. And there was no significant correlation between self-assessed score on competency with instructor's score in the CPX.

원발성 유방암에서 p53 단백발현과 예후와의 상관성에 관한 연구

이학승,이광만,채권묵,문형배 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.1

p53 is a nuclear phosphoprotein which is normally expressed at very low level in all mammalian cells and plays a role in the regulation of cell proliferation. It has also been suggested that normal p53(wild type) serves as a tumor suppressor gene, and inhibits the oncogene-mediated cellular transformation and the rate of cellular proliferation. But, wild type p53 is hardly stained by immunohistochemistry because of its low intracellular concentration and very short half-life. Mutant form of p53 protein is detectable in various human malignancies e.g. colon, stomach, lung and breast cancer by immunohistochemical stain because of its prolonged half-life. In breast cancer, p53 protein expression has been regarded as an unfavorable prognostic factor, but the results of studies about the relationship between the p53 protein expression and prognosis are equivocal. So, author performed this study to evaluate the prognostic significance of p53 expression in 54 patients with primary breast cancer who underwent surgical treatment at Wonkwang University Hospital from October 1985 to September 1991. Follow-up period was 24-91 months (mean: 54.7months). p53 protein was stained by immunohistochemical methods in formalin-fixed, paraffin-embedded tissues using monoclonal antibody(DAKO-p53, DO-7). The prognostic significance of p53 protein was evaluated by positivity and 5-year survival rate, and comparing with well-known prognostic factors of breast cancer. p53 protein was expressed 48.1%(26/54) of primary breast cancers. 5-year survival rate of patients with p53 protein expression was 42.0%, and that of patients without p53 protein expression was 76.4%(p = 0.0277) There was no relationship between p53 protein expression and tumor size, lymph node metastasis, histologic grade or vascular invasion. These results suggest that p53 protein expression is another independent prognostic factor in primary breast cancer.

상악골에 발생한 Monostotic 섬유성 이형성증의 1례

이승학,김경일,김완수,나한조 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

한국인 부정교합자의 하악 치열궁의 크기와 형태

이성준,백승학,김상철,국윤아 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.1

본 연구의 목적은 한국인 부정교합자에서 하악 치열궁간의 형태적 차이를 알아보고자 하였다. Ⅰ급 114명. Ⅱ급 119명, Ⅲ급 135명의 부정교합자를 대상으로 하악 모형의 교합면을 복사한 후 13개의 접촉점 중에서 가장 협측면으로 위치한 부분을 digitize 하였고 각 치아의 브라켓 위치에 해당하는 점을 하악치아의 두께에 의거하여 4개의 선계측과 2개의 비율을 측정하였다. 치열궁의 형태는 square ovoid, tapered형으로 분류하여 그 빈도를 조사한 결과 Angle 분류와 남녀 성별에 따른 특별한 치열궁 형태가 존재하지 않았으나, 특정 치열궁 형태의 빈도는 Angle 분류에 따라 다르게 나타났다. 치열궁 크기의 계측항목에서는 대구치간 폭경에서만 남녀 성별 차이를 보였으며, 치열궁 크기에 있어서 Ⅰ급과 Ⅲ급, Ⅱ급 부정교합군간에는 유의한 차이가 있었다. 치열궁 형태의 분포는 Ⅰ급과 Ⅲ급 부정교합군에서는 square, ovoid, tapered 형태 순이었고, Ⅱ급 부정교합군은 square, tapered ovoid 형태 순이었다. 치열궁 형태의 빈도분포에 있어서는 남녀간의 차이는 없었다. The purpose of this study was to clarify morphological differences among mandibular dental arch forms in Korean malocclusion patients. The sample in this study consisted of 114 Class Ⅰ, 119 Class Ⅱ, and 135 Class Ⅲ malocclusion cases. The most facial portions of 13 proximal contact areas were digitized from photocopied images of the mandibular dental arches. Clinical bracket points were calculated for each tooth based on the data of the mandibular tooth thickness. Four linear and two proportional measurements were undertaken. The dental arches were classified into square, ovoid, and tapered forms to compare the frequency distributions. Our results suggested that there was no single arch form specific to any particular Angle classification or sex. It appeared to be the frequency of a particular arch form that varies among the Angle classifications. In comparison of arch measure between male and female, there was no statistical difference except in the intermolar width. In comparison of arch size measurements among the different Angle classifications, there were statistically significant differences between Class Ⅰ and Class Ⅲ malocclusion groups and between Class Ⅱ and Class Ⅲ malocclusion groups. In comparison of frequency distribution of arch forms in Class Ⅰ and Ⅲ malocclusion groups, the square form demonstrated the highest distribution followed by the ovoid and tapered forms in that order. In the Class Ⅱ malocclusion group, the square form showed the highest distribution, followed by the tapered and ovoid forms in that order. There was no statistical difference in the frequency distribution of arch forms between male and female groups.

석회화 치성 낭종 1례

이상학,염범우,이승훈,한승훈,김응식,김광일 한국의학사 1998 診斷과治療 Vol.18 No.10

상악동 후비공 용종에서 줄기의 경로에 따른 상악동구 전산화단층촬영 소견

이승훈,박동우,이승로,함창곡,이학수,김용수,박충기 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2

Purpose: We evaluate the pathway of the stalk of antrochoanal polyp on the coronal and axial computed tomography scans (CT), comparing with operative findings. Materials and Methods: Fourteen patients (7∼40 years old, median= 12.5 years old, ratio of male to female: 8/6) with antrochoanal polyp were examined, who took the orbitomeatal unit (OMU) CT including both coronal and axial scans as well as the operation. The CT findings and clinical findings were analyzed for the pathway of the stalk of antrochoanal polyp, comparing with the operative findings. Results: The antrochoanal polyps were mostly located on the left side (12/14, 85.7%) and equally passed through the natural and accessory ostia (7/14, 7/14) in our cases. Those that were passing through the accessory ostium were located more inferiorly and posteriorly, with preserving the natural ostium on CT scans, comparing to those via the natural ostium. However, those passing through the natural ostium had a larger stalk that eroded the uncinate process widely. So each ostium was hardly discriminated on CT scans. Conclusions: The pathway of the stalk of the antrochoanal polyp could be more specifically evaluated on both coronal and axial OMU CT scans. So, it could be more hilpful in the presurgical planning.