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      • KCI등재

        혈관질환 정보관리 시스템

        김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

        As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

      • KCI등재

        사지 임파부종에 대한 임상적 분석

        김동익,허세호,이병붕,김은숙,문지영,황지혜 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

        Purpose: Given the increased frequency of operative therapy and radiation therapy on breast cancers and uterine cancers, there is very little information on lymphedema associated with these treatments in Korea. Thus, the authors conducted this study to describe and analyze the data which they had obtained from the patients. Method: A retrospective study was undertaken on 840 patients who registered to the Lymphedema Clinic of Samsung Seoul Hospital throughout the period of February 1995 to August 2001. Result: Out of 840 patients, 205 patients (24%) were confirmed as having primary lymphedema, while 635 patients (76%) had secondary lymphedema. The ratio of male to female for primary lymphedema was 1 :1.8(Male : Female), while secondary lymphedema demonstrated to be 1:21 (Male : Female), demonstrating a female preponderance. Secondary lymphedema mostly developed after undergoing treatment for uterine cancer (341 patients, 53.7%) and breast cancer (226 patients, 35.5%) The lesions of occurrence for both primary and secondary lymphedema were mainly in the lower extremities than the upper extremities. In regards to the degree of clinical edema, a large number of the patients, that is 633 patients (76%) had progressed to Stage Ⅱ~Ⅲ. Among the patients who developed edema after undergoing treatment for cancers, only 43 patients (7%) were provided information on the possibility of developing lymphedema, while the majority of the patients had no knowledge about this possibility. When the patients' subjective experiences were investigated on the degree of the edema, there was no significant increase in pain despite an increase in the degree of the edema (P<0.05), nevertheless, a significant increase was found in cosmetic problems (P>0.05). Conclusion: As a general rule, complete recovery from chronic lymphedema is not expected. However, early detection of lymphedema and timely appropriate treatment as well as aggressive patient education on lymphedema and its related complications can prevent its progression.

      • 만성폐쇄성폐질환의 중증도와 폐고혈압 및 폐성심으로 진행과의 상관관계

        김형호,박철진,이준,장광표,하성일,이재록,하재화,권세훈,권용운,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

        Background: From many previous studies, Pulmonary hypertension is the known independent predictive factor of the mortality in COPD. Also pulmonary hypertension is the major cardiovascular complication of COPD and is associated with the progression to cor pulmonale and poor prognosis. Author want to analyze the correlation between pulmonary hypertension and the severity of COPD which are classified by forced expiratory volume in one second, and the extent of progression to corpulmonale. Methods: Retrospectively we investigated the medical records of 118 patients with COPD who had pulmonary function test and echocardiogaphy more than one times during one-year follow-up (from June, 2005 to May, 2006) at respiratory division in chosun university hospital, and then 50 patients were enrolled in this study. We classified the severity from FEVl in pulmonary function test based on the GOLD guideline, also this was comparably analyzed with RVSP, RVIDd, Visual Grading from echocardiography. Results: 16 patients out of 50 were classified as moderate severity, 25 patients were severe, and 9 patients were very severe group. RVSP was higher in more severe groups than less severe groups but when it comes to pulmonary hypertension that RVSP is over 35 mmHg, there was no valid difference lies in those groups. As FEVl decreases RVSP and RVIDd increases, and observed relationship between RVSP which was classified as below 35 mm and above 35 mm groups and visual grading which was classified as normal and dilatated groups revealed valid correlation, Conclusion: As pulmonary function decreases, progression to pulmonary hypertension and cor pulmonale increases but there was no remarkable difference of prevalence in above moderate severity groups. 연구배경 폐고혈압은 이전의 많은 연구에서 만성폐쇄성폐질환에서 독립적인 사망의 예측인자로 알려져 있다. 또한 폐고혈압은 만성폐쇄성폐질환의 주요한 심혈관계 합병증이며, 폐성심으로의 진행 및 불량한 예후와도 관련되어 있다. 이에 저자는 폐고혈압과 1초간 노력성호기량으로 분류되는 만성폐쇄성폐질환의 중증도 및 폐성심으로의 진행 정도를 비교 분석하여 이들의 상관관계를 밝혀보고자 한다. 방법 2005년 6월부터 2006년 5월까지 1년 동안 본 병원 호흡기 내과에서 폐기능검사와 심장초음파 검사를 각각 1회 이상 시행한 적이 있는 118명에 한하여 의무기록을 후향적으로 조사하여 이 중에서 50명을 대상으로 하였다. 폐기능검사 시행 결과 얻은 1초간 노력성호기량을 바탕으로 GOLD guideline에 따라 중증도를 분류하였으며 이를 심초음파 시행 결과 얻은 우심실수축기압, 확장기말 우심실내부간격, 시각등급과 비교분석하였다. 결과 대상 환자 50명중 16명은 중등증, 25명은 중증, 9명은 최고중증 그룹으로 분류되었다. 우심실수축기압은 중증도가 높은 그룹에서 낮은 그룹에 비해 더 높게 나타났으나 폐고혈압에 해당하는 우심실수축기압이 35 mmHg이상인 환자에 있어사는 각 그룹간에 유의한 차이를 보이지 않았으며, 확장기말 우심실내부간격, 시각등급 또한 중증도와 유의한 차이를 보이지 안항ㅆ다. 1초간 노력성호기량이 감소함에 따라서는 우심실수축기압, 시각등급은 증가하였으며 우심실수축기압을 35mmHg 미만과 이상인 그룹으로, 시각등급을 정상과 확장이 있는 그룹으로 분류하여 비교한 결과에서는 유의한 상관관계를 나타냈다. 결론 폐기능이 감소할수록 페고혈압 및 폐성심으로의 진행이 증가하였으나 폐기능검사에서 중등도 이상의 그룹에서 유병률의 차이는 크지 않았다.

      • KCI등재

        범하수체 기능저하증을 동반한 일차성 중추성 림프종의 1예

        김원영,김원,조규종,홍정석,이미우,장성은,오세현,임경수 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

        A primary central nervous system lymphoma(PCNSL) is defined as a lymphoma limited to the cranial-spinal axis without systemic involvement. PCNSLs were formerly very rare, only 0.5∼ 1.2% of all intracranial neoplasms, and were usually associated with acquired immuno-deficiency syndrome(AIDS) and other immune-compromised states. Recently, there has been a clear rise in the incidence of this disease among normal individuals. We describe a 77-year-old female with hyponatremia who presented with a confused mental state. Computed tomography(CT) of the brain demonstrated a suprasellar mass with enhancement. We evaluated the basic hormonal studies and the magnetic resonance imaging(MRI). A ventricular biopsy was done, and the result was a diffuse, large, B-cell-type malignant lymphoma. She presented panhypopituitarism and partial central diabetes insipidus. She received chemotheraphy and was discharged in an improved condition. We report a case of panhypopituitarism due to PCNSL and give a review of the literature.

      • KCI등재

        근관세정 방법에 따른 수산화칼슘 제재의 제거 효율 비교

        은재승,박세희,조경모,김진우 대한치과보존학회 2009 Restorative Dentistry & Endodontics Vol.34 No.6

        The purposes of this study were to compare the efficacy of irrigation systems by removing a calcium hydroxide (Ca(OH)₂) paste from the apical third of the root canal and the effect of the patency file. Sixty single rooted human teeth were used in this study. The canals were instrumented by a crown-down manner with .04 taper ProFile to ISO #35. Ca(OH)₂ and distilled water were mixed and placed inside the root canals. The teeth were divided into 6 groups according to the root canal irrigation system and the use of patency file as follows: group 1 - conventional method: group 2 - EndoActivator : group 3 - EndoVac; group 4 - conventional method, patency: group 4 - EndoActivator, patency; group 6 - EndoVac, patency. All teeth were irrigated with sodium hypochlorite. After the root canal irrigation, the teeth were split in bucco-lingual aspect. Percentage of the root canal surface coverage with residual Ca(OH)₂ until 3 mm from working length was analyzed using Image Pro Plus ver. 4.0. Statistical analysis was performed using the One-way ANOVA, t-test and Scheffe's post-hoc test. Conventional groups had significantly more Ca(OH)₂ debris than EndoActivator, EndoVac groups. There was no significant difference between EndoActivator, and EndoVac groups. Groups with patency file showed more effective in removing Ca(OH)₂ paste than no patency groups. but. it was no significant difference. This study showed that EndoActivator and EndoVac systems were more effective in removing Ca(OH)₂ paste from the apical third of the root canal than conventional method. 이 실험의 목적은 근관 내에 충전된 수산화칼슘의 제거 시 치근단 1/3에서 기존의 근관세정법과 EndoActivator, EndoVac system의 세정 효율을 비교하고, 근관 세정 중 치근단공 개방 확인의 영향에 대해 평가하고자 함이다. 60개의 단근치를 사용하였고 ISO #35까지 근관성형 후 수산화칼슘을 충전하였다. 근관 세정법과 치근단공 개방 확인 유무에 따라 6개 실험군으로 나누어 세정하였다. 실험 치아를 양분하여 치근단 3 mm에서 근관 면적에 대한 잔존 수산화칼슘 면적의 백분율을 측정하였다. 실험결과 EndoActivator, EndoVac군이 기존의 근관 세정법 군에 비해 유의하게 높은 제거효율을 나타냈으며 (p<0.05), 치근단공 개방 확인 유무에 따른 유의한 차이는 나타나지 않았다. 이 실험 결과에 따르면 기존의 근관세정법으로 효과적인 세정이 불가능했던 근관의 치근단 1/3부위에서 EndoActivator, EndoVac system과 같은 근관 세정법이 효과적인 대안이 될 수 있다는 결론을 얻었다.

      • KCI등재

        영어 광고에 대한 언어학적 연구 및 교육적 활용

        김수정,장세은,김은일,남정미 새한영어영문학회 2007 새한영어영문학 Vol.49 No.4

        There have been great interests in 'what to teach', i.e., teaching materials, followed by 'how to teach', i.e., teaching methodology in English teaching fields. Along this trend, much attention has been put on authentic materials to compensate for traditional textbooks. The authentic materials should not only develop learners' communicative skills, but also help understand the culture of target language and foster learners' critical thinking (Erkaya 2005). In this respect, advertising English is considered a useful material for authenticity and up-to-date lexicon in English teaching. The purpose of this study is two-folds. First, it examines linguistic aspects of advertising English. About 300 advertisements, listed in four major English magazines in the 2000s, were examined. Various linguistic tactics or strategies were employed in advertising English. Phonological aspects are characterized with alliteration, rhyme, pun, humor, repetition of certain sounds. Morpho-syntactically, simple and colloquial vocabularies are preferred. Neologisms, adjectives and proverbs are commonly used. Imperatives and ellipsis are used to draw people's attention. Semantic ambiguity and paradox are frequently adopted. Advertising English, at the same time, displays a paralinguistic aspect of target language's culture. Secondly, this study seeks how advertising English can be employed in English teaching. Through the real classroom teaching using advertising English as an authentic material, students felt it increased their motivation and interests in class and helped understand English culture. Finally, this study proposes a lesson plan where English learners are encouraged to present or design English abvertisement.

      • KCI등재

        주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

        김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

        Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

      • KCI등재후보

        국내 환자에서 분리된 Orientia tsutsugamushi에서 doxycycline 내성

        김은실,김미경,이혜명,길세희,정문현,이진수,강재승 대한감염학회 2008 감염과 화학요법 Vol.40 No.5

        Background : Doxycycline has been the drug of choice for the treatment of scrub typhus. However, scrub typhus with poor response to doxycycline was first reported in Thailand in 1996. To date, it is not known whether doxycycline resistant scrub typhus is present in Korea. To investigate the doxycycline resistance of scrub typhus in Korea, we performed an experiment to evaluate the degree of growth inhibition of Orientia tsutsugamushi at the minimal inhibitory concentration (MIC) of doxycycline. Materials and Methods : 37 isolates of Orientia tsutsugamushi were collected from Korean patients with scrub typhus during 10 year period (from 1997 to 2007). 34 isolates consisted of Boryong serotype or related serotypes. These strains were stained with FS15, a monoclonal antibody against the linear epitope on the protein located at the outer membrane of O. tsutsugamushi. Three isolates were confirmed as serotype Gilliam, which was stained by anti-Gilliam antibody. The antibody-stainable 35 isolates were incubated in media containing 0.1 and 0.2 ug/mL of doxycycline for 3 days. Then the growth indices of Orient/a were measured by flow cytometry. If the growth index was greater than 10%, the isolate was tentatively classified as an isolate resistant to doxycycline and its MIC was measured. Results : Demographic and treatment data were similar to the results of previous reports. Infection was mainly observed in Inchon and the Chungcheongnam province. No patient showed delayed response to antibiotics. Of 35 hospitalized patients, 4 (11.4%) were managed at the intensive care unit and 1 (2.9%) died of nosocomial pneumonia. All the 2 patients whose isolates were serotype Gilliam Yonchon/Ikeda-like strain were managed at the intensive care unit. Six of the 34 isolates from Korean patients exhibited growth indices greater than 10% at the MIC of doxycycline; however, the MICs of these isolates did not exceed 0.2 ug/mL. One isolate of serotype Gilliam showed an MIC of 0.0125 ug/mL, which seemed to be underestimated due to weak fluorescence of the anti-GiIIiam antibody. Conclusions : Although the number of tested isolates is small, insensitivity of scrub typhus to doxy-cycline is not a major reason for treatment failure in Korea. Serotype Gilliam, especially Yochon/Ikeda-like strain may be associated with severe form of scrub typhus. More studies concerning the antibiotic susceptibility for serotype Gilliam are warranted.

      • KCI등재

        자가혈관내피세포를 도포한 인조혈관의 개발

        김동익,이윤신,김덕경,허세호,이병붕,김지은 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

        Purpose: Small calibered prosthetic vascular grafts are prone to low patency rates after bypass surgery due to its high thrombogenicity and neointimal hyperplasia. Endothelial cells are known to inhibit thrombus formations, platelet aggregation and smooth muscle cells proliteration. The purpose of this study was to examine the development of autologous endothelial cell seeded prosthetic vascular graft. Method: The autologous endothelial cells (ECs) were harvested from canine external jugular veins. Approximately 5*10^4 ECs were obtained through passage 5 to 6 under the static condition. The cultured ECs were seeded into the polytetrafluoroethylenc (PTFE) graft and cultured for 3 days before implanting into the canine carotid artery.The PTFE graft was harvested at 6 weeks after implantation. Result: The primary cultured ECs were treated with Factor VⅢ/WF, CD3]/PECAM-1 antibodyand confirmed with fluorescence micrograph, The gratf patency rates were 2/6 (33%) in the control gratf and 5/6 (83%) in the ECs seeded graft at 6 weeks after implantation. the entire luminal surface of the EC seeded graft was covered with ECs. Only the vicinity of the anastomosis site was covered with ECs in the control graft. Conclusion: This is a pilot study for the development of autologous endothelial cell seeded prosthetic vascular graft. The results of our study demonstrate that the endothelialized PTFE are better than ninendothelialized PTFE.

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