• 한국정보통신학회논문지
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• 제13권3호
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• pp.537-545
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• 2009

최근 육상에서 원격진료에 대한 많은 연구와 기술개발이 수행되어 왔으나 해상에는 적용되지 않고 있다. 본 논문에서는 해상의 선박에서 긴급한 응급의료 지원상황이 발생했을 때 환자의 생체정보를 측정하여 원격지에 있는 의사에 게 전달하고 진료 받기 위한 원격 진료 시스템을 설계하고 구현하였다. 현재 해상에서 응급상황이 발생 시 주로 무선통신이나 위성 전화를 통한 단순한 문답에 의한 의학 자문에 의존하고 있다. 본 논문에서는 이를 개선하기 위해 전문적으로 진단에 필요한 환자의 기초 신체상태 즉, 혈압, 맥박, 호흡, 심전도, 체온 및 영상 등을 선박 내 현장에서 측정한 후 전문 의료진에 원격 전송함으로써 보다 정확한 처방이 가능하고 보다 높은 의료서비스를 제공할 수 있도록 개발하였다. 개발된 시스템으로 해상상의 응급환자에게 의료 서비스의 질을 높여 응급상황에 적절히 대처할 수 있다고 본다.

• Journal of Chest Surgery
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• 제25권5호
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• pp.469-479
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• 1992

Searching for the clinical effects of colloid solutions that used to increasing the oncotic pressure of priming solutions at the cardiopulmonary bypass, 29 patients [who were diagnosised as simple VSD around 10kg of body weight and scheduled to be operated from June 1990 to December 1990 at Sejong General Hospital] were divided randomly and prospectively to the two groups: A group [15] was received 4gm% albumin as addition to the priming solutions and B Group [14] the same amount of Ringer`s lactated solution. 34 clinical parameters [Body weight, sex, age, body surface area, Qp/Qs, pulmonary arterial pressure, cardiopulmonary bypass time, anesthetic time, intraoperatively infused crystalloid and colloid amount, hemoglobin, hematocrit, serum sodium concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum protein, serum albumin concentration, urine output, central venous pressure, postoperatively infused colloid amount, immedediate post-operative peak inspiratory pressure, cardiac index, blood pressure and pump flow during cardiopulmonary bypass, inotro-pic assist, diuretics, extubation period, total drain amount, duration of ICU] were measured and compaired between the two groups. There were no differences of preoperative and operative clinical parameters. And postoper-atively, practically there were no nearly differences at the clinical outcomes between the two groups, but some parameters [cardiac index, PIP, BP and pumpflow during CPB, etc] contributed to being preferable to the Group A at certain times [P<0.05]. Conclusively, it might be thought that the priming solution of cardiopulmonary bypass added by colloid solution had some beneficial effects on the patients, especially younger and associated with complex anomaly to be expected taken longer time of cardiopulmonary bypass, and more studies about the neonatal and complex anomaly cases were needed in that points.

• 대한지역사회영양학회지
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• 제8권1호
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• pp.91-101
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• 2003

The purpose of this study was to investigate the compliance and need for diet therapy among diabetics and their caregivers. A total of 625 respondents participated in this survey. Appropriate management for long-term blood glucose control and difficult-to-manage cases appeared to be diet therapy, physical activity, medical treatment and folk remedies, in that order. The most important educational avenues for diet therapy were books, magazines and TV, Most respondents were educated in diet therapy within a year after diagnosis and had practiced diet therapy for over four years. The most common diet therapy Practices were food selection and Quantity control. Of the specific problems in practicing diet therapy, time and labor, taste, and meal planning appeared to be equally difficult factors. The prevailing diet therapy skills were controlling food amounts at breakfast and supper, and selecting food for lunch and refreshments. Respondents practicing both skills were about 20% of the participants; this shows the need to improve the current situation. The nutrients most frequently considered in diet therapy practice were simple sugars (sugar and sweet goods) , total fats and cholesterol. Since the perception of the role of dietary fiber among respondents was very low, nutrition education about the importance of dietary fiber and food sources of dietary fiber was needed. Diabetics seemed to be concerned about diabetic menus. Three difficult problems in planning diabetic menus were daily menu planning, patient's preferences, and the calculation of calories. As a means of nutrition counseling, they preferred interviews. The higher the educational status and the lower the age, the higher the preference was for internet or PC counseling. Therefore, it is necessary to develop nutrition educational programs so that diabetics can obtain practical knowledge of diet therapy. Furthermore, it is also necessary to develop additional means of informing diabetics about menu planning, while still considering Korean dietary behavior.

• Journal of Nutrition and Health
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• 제39권2호
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• pp.133-144
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• 2006

The purpose of this study was to evaluate the nutritional status and to identify related factors in elderly hemodialysis patients. Sixty-four patients who were registered in Asan Medical Center, Seoul, Korea, participated in the study. The data was collected between September and December, 2003. General characteristics were obtained with the use of an interviewer-administered questionnaire. Anthropometric and biochemical data, 3-day dietary records and dietary habits were also obtained. The results of this study were analyzed with t-test or $X^2$-test using SPSS package program. The percentage of elderly hemodialysis patients who were undergoing mild to severe malnutrition (MN group) and were normal nutrition (NN group) by subjective global assessment (SGA) criteria were 46.9% and 53.1 %, respectively. Appetite (p < 0.05) and dietary cholesterol intakes (p < 0.05) were significantly lower in MN group than the NN group. Body mass index (BMI, p < 0.001), lean body mass (LBM, p < 0.05), triceps skinfold thickness (TSF, p < 0.01), mid ann circumference (MAC, p < 0.01) and mid ann muscle circumference (MAMC, p < 0.05) were also lower in the MN group than the NN group. There were also significant differences in blood urea nitrogen (BUN, p < 0.05), creatinine (p < 0.05), prealbumin (p < 0.001) and C-reactive protein (CRP, p < 0.05). SGA was negatively correlated with serum BUN, creatinine and pre albumin, dry weight, BMI, LBM, total body water, TSF, MAC and MAMC, and positively correlated with age. In stepwise multiple regression analysis, SGA was related to BMI, CRP, age and BUN. In conclusion, almost half of the subjects were in malnourished status and had lower values in anthropometric and biochemical data. Our results suggest that SGA is a simple and adequate method for assessing the nutritional status in elderly hemodialysis patients and adequate dietary guidelines based on individual nutritional status are needed in the patients.

• Journal of Obesity & Metabolic Syndrome
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• 제23권3호
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• pp.156-161
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• 2014

전 세계적으로 비만 인구는 증가 추세에 있고 그중 소아 청소년의 비만 유병률이 급속한 증가 추세에 있다. 소아 청소년 비만은 성인비만으로 이어지며 당뇨병, 고지혈증, 고혈압, 대사증후군과 같은 만성질환을 동반하는 것으로 알려진다. 소아 청소년의 비만은 체력, 신체활동, 좌식생활의 증가 및 서구화된 식이 습관과 같은 생활습관과 밀접한 관련이 있다. 따라서 균형 잡힌 식이습관과 유산소성 운동 그리고 적절한 저항성 운동을 개입시키고 좌식시간을 수정하는 것이 비만 치료에 권고된다. 본 미니 종설에서는 소아 청소년 비만 치료에 효과적인 수단으로써 다각적인 신체활동 전략에 대해 고찰하였다.

• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.287-293
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• 2005

Objective: To evaluate the usefulness of serum concentrations of macrophage migration inhibitory factor (MIF) of patients with ovarian cysts for differential diagnosis of endometrioama. Method: From Jan. 2003 to Dec. 2004, preoperative serum MIF levels were assessed in 28 women with endometrioma, 32 with benign epithelial tumor, 23 with functional and simple cysts, 22 with benign mature cystic teratoma, and 25 women without ovarian tumor as control. MIF levels were determined using an ELISA (Quantikine Human MIF immunoassay, R&D Systems, Inc., USA). Results: Mean MIF levels were higher in all groups with benign tumors than control (all p<0.01), but there was no significant difference between benign tumor groups (p=0.95). There was no significant correlation between MIF levels and tumor volume, body mass index (BMI) (p=0.635, 0.674 respectively) Serum MIF level had significant correlation with count of WBC and neutrophils (p=0.008, 0.024 respectively), but had no correlation with count of lymhocytes and monocytes (p=0.688, 0.294 respectively). Conclusions: This study showed a marked increase in MIF concentrations in the peripheral blood of patients with endometrioma, but there was no significant difference with other benign tumors. Serum MIF level had significant correlation with count of WBC and neutrophils. These suggest serum MIF level has no usefulness for differential diagnosis of endometrioma from other benign ovarian cysts.

• Journal of Chest Surgery
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• 제54권5호
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• pp.383-388
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• 2021

Background: Achieving external access to and manual occlusion of the left atrial appendage (LAA) during minimally invasive mitral valve surgery (MIMVS) through a small right thoracotomy is difficult. Occlusion of the LAA using an epicardial closure device seems quite useful compared to other surgical techniques. Methods: Fourteen patients with atrial fibrillation underwent MIMVS with concomitant surgical occlusion of the LAA using double-layered endocardial closure stitches (n=6, endocardial suture group) or the AtriClip Pro closure device (n=8, AtriClip group) at our institution. The primary safety endpoint was any device-related adverse event, and the primary efficacy endpoint was successful complete occlusion of blood flow into the LAA as assessed by transthoracic echocardiography at hospital discharge. The primary efficacy endpoint for stroke reduction was the occurrence of ischemic or hemorrhagic neurologic events. Results: All patients underwent LAA occlusion as scheduled. The cardiopulmonary bypass and aortic cross-clamp times in the endocardial suture group and the AtriClip group were 202±39 and 128±41 minutes, and 213±53 and 136±44 minutes, respectively (p=0.68, p=0.73). No patients in either group experienced any device-related serious adverse events, incomplete LAA occlusion, early postoperative stroke, or neurologic complication. Conclusion: Epicardial LAA occlusion using the AtriClip Pro during MIMVS in patients with mitral valve disease and atrial fibrillation is a simple, safe, and effective adjunctive procedure.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.344-349
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• 2019

Background Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. Methods Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. Results Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. Conclusions Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.

• 한국임상약학회지
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• 제31권2호
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• pp.125-135
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• 2021

Background: Generally, pharmacokinetics (PK) models could be stratified into two models. The compartment PK model uses the concept of simple compartmentalization to describe complex bodies, and the physiologically based pharmacokinetic (PBPK) model describes the body using multi-compartment networking. Notwithstanding sharing a theoretical background in both models, there was still a lack of knowledge to enhance compatibility in both models. Objective: This study aimed to evaluate the compatibility among PBPK, lumping model and compartment PK model with voriconazole PK case study. Methods: The number of compartments and blood flow on each tissue in the PBPK model were modified using the lumping method, considering physiological similarities. The concentration-time profiles and area under the concentration-time curve (AUC) parameters were simulated at each model, assuming taken voriconazole oral 400 mg single dose. After that, those mentioned PK parameters were compared. Results: The PK profiles and parameters of voriconazole in the three models were similar that proves their compatibility. The AUC of central compartment in the PBPK and lumping model was within a 2-fold range compared to those in the 2- compartment model. The AUC of non-eliminating tissues compartment in the PBPK model was similar to those in the lumping model. Conclusion: Regarding the compatibility of the three PK models, the utilization of the lumping method was confirmed by suggesting its reliable PK parameters with PBPK and compartment PK models. Further case studies are recommended to confirm our findings.

• 대한정형외과학회지
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• 제56권3호
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• pp.266-271
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• 2021

임신 및 수유와 연관된 골다공증은 젊은 여성에서 골다공증성 척추 압박골절을 일으킬 수 있는 희귀한 질환이다. 환자들은 주로 요통을 호소하며, 이는 임신과 출산, 수유에 의한 통증으로 오인되기 쉬워 빠른 진단과 치료가 어렵다. 저자들은 요통을 주소로 내원한 29세 여자 환자와 31세 여자 환자에 대해 신체 진찰, 단순 방사선 검사, 전신 골주사 검사, 자기공명영상 검사, 골밀도 검사, 혈액 검사 등을 통하여 임신과 수유에 연관된 골다공증성 척추 압박골절을 진단하였으며, 테리파라타이드(teriparatide) 주사와 흉요천추 보조기 착용, 칼슘과 비타민 D 제제 복용을 통해 증상이 호전된 2예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.