자궁내 태아사망의 임상적 고찰

이권해,이정재,조현철,이석민,이임순,이해혁,김권대,이순곤,남계현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Objective: This study was designed to evaluate diagnosis and complication, prognosis during clinical study of cases of intrauterine fetal death. Methods and materials: This is a clinical study of 56 cases of the intrauterine fetal death among 8064 deliveries at Seoul Sunchunhyang university hospital during 5 years from January, 1994 to December, 1998. Results: The incidence was 0.7%. The age distribution of mothers was 18 - 44 years and was highest in the 25 - 29 years range(46.4%). The parity was the most highest in the nulliparous group(51.8%). The most common gestational weeks was 20 - 28 weeks gestational period(46.4%), and most common presentation was cephalic(73.5%). The most common weights of the intrauterine fetal death was from 5,00gm to 1,000g(48.2%). The mode of the most common delivery was the induction of delivery(57.2%). The etiologic factors were: unknown(42.9%), preeclampsia(17.9%), chorioamnionitis(14.3%), congenital anomaly(12.5%), abruptio placenta(7.1%), cord complication(3.6%), placenta previa, death of one for twin. There were 2 cases of maternal complication(DIC, Uterine atony). Conclusion : Intrauterine fetal death should be diagnosised early and treated properly to reduce risk of the maternal complication.

위에 발생한 유암종 (Carcinoid Tumor) : 1예 보고

김남재,김진희,이경태,서광식,정현용,이승민,김석현,이병석,이헌영 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3

A carcinoid tumor of the stomach is uncommon, has no clinical symptoms, and is regarded as a benign. It is also incidentally found in most cases. 48-year-old woman with gastric carcinoid tumor was admitted. She had suffered from a anorexia and a dry mouth for 4-months. A gastroscopy revealed a polypoid mass on the greater curvature of the mid-body of the stomach which was subsequently thought to be an adenocarcinoma. An endoscopic mucosectomy revealed however, that it was a carcinoid tumor. A case of carcinoid tumor of the stomach is here by presented with a brief literature review.

조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

The Safety and Efficacy of Daclatasvir and Asunaprevir with Chronic HCV Genotype 1 Infection and Hemodialysis

( Myeong Jun Song ),( Jung Hyun Kwon ),( Soon Woo Nam ),( Tae Hee Lee ),( Young Woo Kang ),( Ji Woong Jang ),( Seok Hyun Kim ),( Byung Seok Lee5 ),( Sea Hwan Lee ),( Hong Soo Kim ),( Ji Hoon Kim ),( S 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: We aimed to evaluate the efficacy and safety of Daclatasvir (DAV) and Asunaprevir (ASV) in patients with chronic hepatitis C virus (HCV) and chronic renal failure (CRF). Methods: 22 chronic hemodialysis patients with HCV infection at 12 medical centers have prospectively enrolled from Feb, 2016 to Feb, 2017 (NCT02580474). Of those, 9 patients who were followed 12 weeks after treatment ended were included. We evaluated the virological responses at each week 4, 12, 24 and the 12-week sustained virologic response (SVR12). The tolerability and safety of patients were also evaluated. Results: Of these 20 patients, there had no resistance-associated variant of NS5A (NS5A RAVs) and 2 patients showed indeterminate NS5A RAVs. 12 patients (54.5%) completed the 24 weeks treatment of DAV and ASV. 6 patients (27.2%) have continued, but 4 patients discontinued study prior to 12 weeks. Overall, all patients (n=9) achieved SVR12. Virologic response at week 4, 12 and 24 showed 94.4% (17/18), 93.3% (14/15), and 100% (12/12) respectively. DCV and ASV were well tolerated among the majority of patients and discontinuation of the treatment due to adverse events (hypertension, bradycardia, leukemia) was occurred in 3 patients. In two patients with indeterminate NS5A RAVs, one achieved SVR12 but the other showed viral breakthrough and discontinued treatment. Conclusions: In this study, DAV and ASV combination therapy for chronic hemodialysis patients with HCV infection achieved high sustained virological response with few adverse events. Close monitoring of safety and tolerability may be necessary when treating chronic hepatitis C patients with CRF receiving DCV and ASV.

자가 면역성 간염에서 자가항체의 발현 양상과 스테로이드 치료의 효과

박기오,채경훈,허원석,강윤세,정재훈,김연수,문희석,이엄석,김선문,이병석,김남재,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 최근 8년간 본원에서 경험한 자기면역성 간염의 혈액학적 특징과 스테로이드의 치료효과를 알아보고자 본 연구를 시행하였다. 방법 : 1996년 이후부터 2002년까지 충남대학교 병원에서 1999년 International Autoimmune Hepatitis Group(LAHG)에서 제시한 수정 진단 기준안에 의거하여 총 진단점수가 probable 이상에 해당하는 환자들을 대상으로 임상적 특징, 검사실 및 조직 소견과 스테로이드와 azathioprine의 치료 효과를 후향적으로 조사하였다. 결과 : 9예의 환자들은 여성이 78%, 40대가 많았고, 급성 발병이 33.3%, 피로감, 식욕부진 및 황달 등이 나타났으며, 항핵항체가 55.6%에서 그리고 항평활근 항체가 77.8%에서 양성이었고, 동반 질환은 류마치스 관절염이 2예, 특발성 혈소판 감소증 1예, Henoch-Sch nlein 자반증 및 그레브스병이 각각 1예 씩이었다. 7예에 대해서 스테로이드와 azathioprine으로 치료하여 생화학적 임상적 완해가 이루어져서 유효한 치료 결과를 얻었다. 결론 : 자가면역성 간염은 우리 나라에서 원인을 찾을 수 없는 만성 간질환의 경우, 특히 중년여성에서 다른 자가면역성 질환이 동반되었을 때 자가면역성 간염을 의심하여 자가항체 선별검사를 시행해 보아야 할 것으로 생각된다. 향후 다기관 연구를 통하여 좀 더 많은 증례를 모으고 전향적인 연구를 시행하여야 할 필요가 있다. Although autoimmune hepatitis(AIH) is common in western contries, some studties have been reported in Korea. The aim of the study was to analyze the clinical and histological features and expression pattern of the autoantibody and to examine clinical course of AIH in Korea. For 9 patients diagnosed as having AIH in our hospital since 1996, we reviewed medical records and analyzed clinical and laboratory findings retrospectively. They had a probable or definite AIH according to the revised criteria of International AIH group. The mean age was 42.7(21∼68)years and 7(77.8%) were female. Three of them(33.3%) showed acute hepatitis and five of them showed cirrhosis. Fatigue and anorexia were the most frequently complained symptoms(55.6%). Four patients(44.4%) were accompanied with other autoimmune diseases. Antinuclear antibody was detected in 5(55.6%) and anti-smooth muscle antibody was detected in 7(77.8%). Three patients showed focal picemeal necrosis and four showed periportal fibrosis. Among 7 patients who received immunosuppressive therapy, six patients(85.7%) showed initial response. and biochemical and serologic remission were achived in 5(71.4%) and 3(42.8%) patients, AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. AIH should be suspected in female patients with unknown chronic liver disease of unknown etiolgy, especially accompanied with other autoimmune disease. The clinical characteristics of AIH may not be quite different from those of Western countries.

마산 수출자유지역공단 근로자들에 대한 사회의학적 조사연구

이영호,정석주,이수일,김응남,맹광호 가톨릭대학산업의학센타 산업의학연구소 1977 韓國의 産業醫學 Vol.16 No.3

Followings are major findings obtained from a study on the socio-medical studus of the manu-facturing workers in the Masan Free Export Zone. This study was planned to find out socio-medical conditions of the workers which seemed to be essential to the better management of the health of the workers and the working environments. For this study, 6978 workers who are equivalent to 26.9% of total workers in Masan Free Export Zone as of the end of 1976 were sampled and they were asked to answer to the pretested questionnaire. 1) General characteristics; (1) 83.9% of sampled workers were female. (2) 84.9% of workers were less than 25 years of age and female workers who entered in this age group were 93.6%. (3) 91.9% of workers had more than junior high school education and those who finished only junior high school occupied the majority with the proportion of 67.7%. (4) 897.1% of workers were un-married and the proportion for the female was 93.2% (5) Majority (89.6%) were from Yongnam area and 5.2% of workers were from Honam area. (6) 49.1% of workers were living separately from their families and 76.9% of them were self-cooking. 2) Working conditions and working history; (1) 78.1% of workers were receiving from 20,000 won 40,000won as their monthly salaries and those who were receiving from 40,000 won to 60,000 won were the next (12.5%). (2) 34.4% of workers had been working in the present plant for from one to three years and those who had been working for less than one year were 31.9%. (3) Most of workers (91.2%) were working 8 hours a day but 25.3% of precision optical instruments manufacturing workers were working about 10 hours a day. (4) Only 6.2% of workers ever changed their working places during the past one year. 89.0% of them changed once and 9.0%, twice. Male workers changed their working places more often (8.7%) than female workers (5.7%). 3) Present and past history of illness; (1) 6.7% of workers had the sick among their family members and cardiovascular diseases were most common (47.8%) (2) Those who had experiences of sickness lasted more than one week were 7.1% and those who had had operations were 3.3%. (3) 42.0% of workers were complainning at least one physical symptom. Those who were complainning "tingling pain on eye ball" were the most (20.5%), and headache, and dizziness were both the next (16.3%). 4) Smoking, drinking habits and drug dependency; (1) Among all workers, 11.7% (male, 69.5%; female, 0.4%) were smoking and 13.1%(male, 71.9%; female, 2.3%) were drinking alchole. Those who were using drug customarily were only 2.3% and the drugs they were using were aspirin (35.0%), antibiotics (12.5%) and others. 5) Present physical conditions found at the periodic physical examinations; (1) Mean height of male workers was 168.3cm and that of female workers was 158.1cm. Mean body weight of male workers was 60.7kg and that of female workers was 51.3kg. (2) Those who had anormal vision were 10.1% and the frequency of self-awared hearing loss was 4.5%.If the visual power of one or both eyes was less than 0.6, we considered this as and abnormal vision. (3) Those who were informed by the physician that they had hypertension were 8.4% and those whe were informed that they had tuberculosis lesion on the chest were only 0.4%.

논의과정 활용 수업이 초등학생의 학습 동기와 과학태도와 미치는 영향

이하룡,남경희,문성배,김용권,이석희 한국초등과학교육학회 2005 초등과학교육 Vol.24 No.2

The purpose of this study is to examine the effects of science instruction using argumentation, with Tolumin's structure of argument, on students' learning motivation and scientific attitude. In the instruction, well-structured problems selected to be argument, in which interactions among students are stressed. The subjects were classified into two groups: One group is composed of sixty-seven students (experimental group) who were participated in solving processes of the scientific argument tasks, and the other is composed of sixty-nine students (comparative group) who were participated in the traditional teaching method. The results of this study implied that experimental group has a positive effect on students' learning motivation and scientific attitude.

보건관리대행 프로그램 운영평가와 서비스향상 방안에 관한 연구

이도화,옥종석,김남균 인제대학교 인문사회과학연구소 1998 인문사회과학논총 Vol.5 No.1

The occupational health agency system, which was established for the purpose of providing efficient health services with limited resources to the employees of small and medium enterprises, is a traveling group health service system. Though the occupational health agencies have increased in numbers, which is 66 in total in 1998, after the introduction of the occupational health agency system, there have not been proper evaluations and improvements in the system. The purpose of this study is to conduct the evaluation of the occupational health agencies, and to provide suggestions for improvement thereof. Specifically, it attempts (1) to identify the factors related to the perceptions and attitudes of in-house health personnel of small and medium manufacturing firms in Shinpyung-Changrim industrial complex of Pusan regarding occupational health agency system, (2) to examine the actual conditions of occupational health agency services provided by the nurses of the agencies, (3) to identify the problems associated with the occupational health agency system on the basis of the survey results, and (4) to suggest the alternatives to improve the quality of the services. This study used questionnaire method in order to collect the data. The sample occupational health agencies evaluated in this study are 12 institutions in Pusan-Kyungnam region. The main results of the study are as follows: (1) There were weaknesses in service in the areas of approachability, comprehensiveness, technical quality, participation of workers and management, and adequacy of service. The problems in the areas other than approachability were found to be structural, while the latter ones were the problems which occurred during service implementation processes. (2) While the quality of occupational health agency service in general was rather low, there were some variations in the level of service quality according to the institutions. On the basis of the above results, the sugestions for improvement and limitations of the study are discussed in the conclusion.

전립선암의 종양지표로서 전립선특이항원의 진단적 가치

이남규,박영호,최석형 순천향대학교 1994 논문집 Vol.17 No.4

Prostatic specipic antigen(PSA), neutral serine protease secreted exclusively by prostatic epithelial cell, has a number of application in the diagnosis of men with prostatic carcinoma. It is widely recognized that elevated PSA correlates with the presence of carcinoma. We measured serum PSA levels in normal controls, patients with benign prostate hyperplasia symptoms because to evaluate diagnostic value of PSA as a tumor marker for prostatic cancer. Mean values of serum PSA in normal controls and patients with BPH symptoms were 2.83±4.02, 23.48±62.17ng/ml, respectively(p<0.01). We conclude that serum PSA offers simple and objective tumor maker but interpretation of significance of a specific level measured is inexact.

液體種菌 接種에 의한 표고톱밥裁培 效果

이태수,민두식,조남석 충북대학교 농업과학기술연구소 1998 農業科學硏究 Vol.15 No.-

For cultivation on sawdust-bed of oak-mushroom until present time, inoculation of spawn on sawdust bed has been performed by sawdust spawn. But, liquid spawn may have advantages for rapid mass production of spawn, and now, sawdust-cultivation by liquid spawn inoculation should be applied instead of sawdust spawn. Therefore, investigations were performed to evaluate the effect of sawdust-cultivation by liquid spawn inoculation. The results were as follows : 1.When 11 kinds of liquid media were applied, the oak-mushroom culture medium was the most excellent in growth. Most suitable temperature at PDA was 25℃, and 22.5-27.5℃ in range were optimal for liquid culture. In liquid culture, amount of mycelial growth increases rapidly up to 40 days of cultivation. Incubation at fermentor brought yield of 106㎎ dry mycelia per 40㎖ media after 17 days. 2.In 1ℓ -spawn bottle, growth of mycelium by inoculation of 20㎖-liquid spawns were faster than 6g-sawdust spawn in spread of mycelia. On 2kg-bag culture, inoculations of 10㎖-, 20㎖- and 30㎖-liquid spawns were all slower than 20g-sawdust spawn in mycelial spread. So, amount increasement in ampunt of liquid spawn should be discussed. Yields of mushrooms until third sproutings of 2kg-bag culture were 580g in 30㎖-liquid spawn inoculation, but 510g, 486g and 470g from 20g-sawdust spawn, 20㎖-liquid spawn and 10㎖-liquid spawn, respectively. Thus, 30㎖-liquid spawn inoculation was highest in yield. Key words : oak-mushroom, sawdust-bed, liquid spawn.