• 핵의학기술
• /
• 제20권2호
• /
• pp.54-61
• /
• 2016

1. 목적 성조숙증은 2차성징의 발달이 여아에서는 8세 이전 남아에선 9세 이전에 조기 2차성징이 출현하는 증상으로 골단의 조기 폐쇄를 일으켜 결국 최종 성인 신장의 감소를 가져오는 질환이다. 본 연구는 성조숙증으로 내원한 여아들의 GnRH(Gonado-tropin-releasing Hormone) 자극검사 결과와 의무기록을 후향 분석하여 진단별 차이를 알아보고자 하였다. 2. 방법 2015년 2월부터 2015년 12월까지 분당서울대병원 소아청소년 내분비내과를 내원한 여아 118명을 대상으로 하였다. 의무기록을 후향 분석하여 대상 환아들은 진성 성조숙증(true precocious puberty) 57명, 조기사춘기(early puberty) 39명, 유방 조기발육군(premature thelarche) 22명을 진단별로 분류하였다. 진단 당시의 신장, 체중, Tanner stage, 골연령, 역연령, 부모의 키, GnRH 검사에서 LH, FSH와 E2 (Estradiol) Basal 값도 함께 조사하였다. 성선 자극호르몬 결과값 LH (Basal,30min,45min,60min) FSH(Basal,30min,60min)을 비교하여 각 그룹별 LH, FSH Peak치 분포도와 LH 최고치/LH 기저치 비율에 대한 평균${\pm}$표준편차와 LH 최고치/FSH 최고치 비율에 대한 평균${\pm}$표준편차를 비교하여 각 3그룹 간 유의확률(P-value) 값을 구하였다. 골연령의 측정은 Greulich-Pyle법(왼쪽 수근골 X선 사진을 촬영하여 골성숙도를 평가하는 방법- 6개월 단위의 표준손목사진을 보고 비교해서 골연령을 유추하는 방식)을 이용한 소아 청소년 내분비내과 교수가 직접 판독한 결과로 사용하였고 GnRH 검사는 합성 LHRH 100 ug을 정맥 주사하여 LH는 Basal, 30분, 45분,60분 후에 채혈된 결과값과 FSH는 Basal, 30분, 60분후에 채혈된 결과값을 조사하였다. 3. 결과 진성성조숙증그룹의 평균 키는$131{\pm}14.85$, 평균체중은 $8.80{\pm}4.93$, 평균역연령은 $7.1{\pm}0.81$, 평균 골연령은 $9.9{\pm}0.9$, 조기사춘기 그룹의 평균키는 $134{\pm}5.10$, 평균체중은 $28.50{\pm}4.43$, 평균역연령은 $8.05{\pm}0.03$, 평균 골연령은 $10.0{\pm}0.62$, 유방조기발육군의 평균 키는 $129{\pm}6,01$ 평균체중은 $28.65{\pm}5.98$, 평균역연령은 $7.02{\pm}0.58$ 평균 골연령은 $8.04{\pm}1.29$로 세 그룹간에 키와 체중 비교 시 유의한 차이가 없었고 역연령(P < 0.0001), 골연령( P< 0.0001), 골연령과 역연령과의 차이(P < 0.0002 )에서는 그룹간 유의한 차이가 있었다. 각 그룹별 LH, FSH Peak치 분포도 비교시 진성성조숙증 그룹은 LH 30분-82.5%, 45분-12.3%, 60분-5.3%, FSH 30분-8.8%, 60분-91.2%로 높은 Peak치를 보였고 조기사춘기 그룹은 LH 30분-79.5%, 45분-17.9%, 60분-2.6%, FSH 30분-7.7%, 60분 -92.32%로 높은 Peak치를 나타내었다. 유방조기 발육군 그룹에서는 LH 30분-30%, 45분-59%, 60분-9.09%, FSH 30분 -0%, 60분-100%로 Peak치를 나타내었다. LH Peak/LH basal ratio 비교시 진성성조숙증 그룹은 $19.09{\pm}17.15$, 조기사춘기 그룹은 $15.23{\pm}10.88$ 유방조기 발육군 그룹은 $4.93{\pm}4.36$으로 3 그룹간 유의한 차이를 보였다(P < 0.0001). LH Peak/FSH Peak ratio 비교시 진성성조숙증 그룹은 $1.222{\pm}0.77$, 조기사춘기 그룹은 $1.34{\pm}1.23$ 유방조기 발육군 그룹은 $0.3{\pm}0.09$로 3 그룹간 유의한 차이(P < 0.0001)를 보였다. 4. 결론 여아들의 진성성조숙증을 진단하기 위한 GnRH Test 검사는 자극 후 30분과 60분 사이에 LH 최고치가 기저치에 비해 2~3배 이상 증가 되어 있거나 또는 5~10 IU/L 이상 증가되었을 때 유용한 판정 자료로 이용 될 수 있는 핵의학 연속검사라고 사료되어진다.

• 대한한방부인과학회지
• /
• 제20권4호
• /
• pp.123-131
• /
• 2007

Purpose: To find the correlation between ambient temperature change and the efficacy of acupuncture on the postmenopausal hot flash. Methods: 52 patients entered a randomized clinical trial which was to verify the efficacy of acupuncture on postmenopausal hot flash. Participants were treated with optimal/minimal acupuncture in the course of 13 weeks. 34 of 52 visited for the temperature-rising period(Group 1), while 18 of 52 for the temperature-falling period(Group 2), 100mm hot flash VAS and average temperature were taken 18 times from each person. Linear mixed effects model was used to find the correlation between temperature and hot flash VAS score(p-value<0.05). Group1/2, optimal/minimal acupuncture, age, age of menarche, height, weight, percent body fat, BMI, waist-hip ratio, past history of hysterectomy and HRT were also examined. Results: Period of treatment had influence on the hot flash VAS. As time went by, hot flash decreased(p<.0000). Participants who underwent minimal acupuncture showed higher hot flash VAS(p=0.0479) and as waist-hip ratio rose, hot flash increased(p<.0000). As the temperature rose, hot flash VAS score became lower(p=0.0143) and it was because 34 of 52 participants were treated for the temperature-rising period. Group 1/2 had no interrelation with hot flash(p=0.5741). Conclusion: Hot flash diminished as participants were treated with acupuncture, independently of whether the ambient temperature rises or falls.

• Clinical and Experimental Pediatrics
• /
• 제61권2호
• /
• pp.59-63
• /
• 2018

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

• 한국추진공학회:학술대회논문집
• /
• 한국추진공학회 1999년도 제13회 학술강연논문집
• /
• pp.33-33
• /
• 1999

The Coanda effect is the tendency for a fluid jet to atach itself to an adjacent surface and follow its contour without causing an appreciable flow separation. The jet is pulled onto the surface by the low pressure region which develops as entrainment pumps fluid from the region between the jet and the surface. Then the jet is held to the wall surface by the resulting radial pressure gradient which balance the inertial resistance of the jet to turning. The jet may attach to the surface and may be deflected through more than 180 dog, when the radius of the Coanda surface is sufficiently large compared to the height of the exhaust nozzle. However, if the radius of curvature is small, the jet turns through a smaller angle, or may not attach to the surface at all. In general, the limitations in size and weight of a device will limit the radius of the deflection surface. Thus much effort has been paid to improve the jet deflection in a variety of engineering fields. The Coanda effect has long been applied to improve aerodynamic characteristics, such as the drag/lift ratio of flight body, the engine exhaust plume thrust vectoring, and the aerofoil/wing circulation control. During the energy crisis of the seventies, the Coanda jet was applied to reduce vehicle drag and led to drag reductions of as much as about 30% for a trailer configuration. Recently a variety of industrial applications are exploiting another characteristics of the Coanda jets, mainly the enhanced turbulence levels and entrainment compared with conventional jet flows. Various industrial burners and combustors are based upon this principle. If the curvature of the Coanda surface is too great or the operating pressure too high, the jet flow will break away completely from the surface. This could have catastrophic consequences for a burner or combustor. Detailed understanding of the Coanda jet flow is essential to refine the design to maximize the enhanced entrainment in these applications.

• Journal of Yeungnam Medical Science
• /
• 제30권2호
• /
• pp.90-94
• /
• 2013

Background: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. Methods: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. Results: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. Conclusion: The study results showed that serum basal LH levels are useful for screening CPP in girls.

• Tuberculosis and Respiratory Diseases
• /
• 제56권1호
• /
• pp.77-84
• /
• 2004

연구배경 : 혈액투석을 받고 있는 만성신부전 환자들에서 수분저류나 폐포 모세혈관의 투과성 증가에 의한 폐부종이 폐기능장애에 중요한 역할을 한다. 그러나, 현재까지 혈액투석을 받고 있는 만성신부전 환자들에서 혈액투석이 단기간에 폐기능에 미치는 영향이나 기관지확장제에 대한 반응을 연구는 없었다. 이 연구에서는 만성신부전으로 혈액투석을 받고 있는 환자들에서 혈액투석이 폐기능에 미치는 영향 및 체중변화와 기관지확장제에 대한 반응의 상호관련성을 알아보고자 하였다. 방 법 : 만성신부전으로 혈액투석을 받고 있는 30명의 환자들을 대상으로 혈액투석간 체중증가, 혈액투석 후 체중감소와 간편폐기능검사 결과에 근거한 $FEV_1$, FVC, $FEV_1/FVC$, 기관지확장제에 대한 반응을 분석하였다. 결 과 : 대상 환자 30명의 혈액투석 전 $FEV_1$, FVC 각각 예측치의 $89{\pm}22%$, $86{\pm}19%$였고 혈액투석 후 환자들의 $FEV_1$, FVC는 각각 예측치의 $100{\pm}23%$, $94{\pm}18%$였다. 혈액투석간 체중증가와 혈액투석 전기관지확장제에 대한 반응, 혈액투석 후 체중감소와 혈액투석 후 기관지확장제에 대한 반응 사이의 유의한 상관관계는 없었다. 혈액투석 후 기관지확장제에 대한 반응도는 혈액투석 전과 비교하여 유의한 차이는 없었다. 결 론 : 혈액투석 후 폐기능은 향상되지만 체중변화와 기관지확장제에 대한 반응도의 상호관련성은 없었다.

• 한국운동역학회지
• /
• 제25권1호
• /
• pp.21-28
• /
• 2015

Objectives : The purpose of this study was to compare differences in muscle activities according to distance changes, and success or failure in relation to approaches during a round of golf in order to obtain basic data on golf swings. Methods : To achieve our research goal, we asked eight professional golfers playing for the Korea Professional Golfers' Association (height: $1.76{\pm}0.05m$, weight: $73.87{\pm}9.21kg$, career duration: $12.87{\pm}4.48yr$) to perform approach swings at distances of 30, 50, and 70 m. Results : No differences were observed in the muscle activity of the extensor carpi radialis that were caused by the distance changes. In addition, we found that the wrist extensors seemed unaffected by the increase in approach distance. Also, we found that the powers of the approach shots were driven by efficient movements rather than by the strength of the arms. We confirmed that when the distance of the approach increased, the golfers should perform their back-swing tops and follow-through right from the right to the left pelvic limb. To achieve successful approach swings despite distance changes, golfers should first work on the activity of the erector spinae to prepare for rotatory power in the P1 section. Moreover, golfers should increase the activity of the erector spinae on the left when they need to deal with the distance improvements in the P2 and P3 sections. Conclusion : In the light of the discussion above, we may infer that despite approach distance changes during a round of golf, ideal swings can be realized by consistent activities of the wrist extensor muscles and improved performances of the pelvic limb muscles. Furthermore, this study suggests that golfers should improve the consistency of muscle activities in all the other body parts to achieve the ideal swing.

• 한국운동역학회지
• /
• 제27권1호
• /
• pp.19-23
• /
• 2017

Objective: The aim of this study was to investigate the relationship between the ball velocity and the upper extremity kinematics for both dominant and non-dominant side in inexperienced participants about an overarm throwing task. Method: Seven women who are inexperienced in overarm throwing participated in this study (Age: $25.1{\pm}2.4years$, Height: $160.8{\pm}3.5$; Weight $56.5{\pm}7.8$). Participants visit the laboratory for three days with one day rest between test sessions. Whole body 3-dimensional (3D) motion capture was recorded during the overarm throwing trials with ten cameras Vicon motion analysis system (T-10, T40, Oxford Metrics Ltd, UK). Total 45 overarm throwing were recorded for each side for each test session. Ball speed also was measured 3 meters away behind the subjects and recorded for every trial. Results: Mean ball velocity was higher for dominant hand compared to non-dominant hand (p <.05). Trunk segment variables (maximum angles and angular velocities) showed the most consistent relationship with the ball velocity. Conclusion: The importance of the trunk segment during the throwing activities can be seen in some individuals. But inconsistent results between subjects emphasize the importance of the individuals' movement patterns especially for bilateral sports. The future studies should be conduct about the sequence of segments, kinetic variables and effect of training.

• 한국식품영양과학회지
• /
• 제34권2호
• /
• pp.202-208
• /
• 2005

본 연구에서는 청소년기 남녀 중학생의 건강과 관련된 임상 증상에 따른 식습관, 영양지식, 영양태도를 알아보기 위하여 조사를 실시하였다. 좋지 않은 건강상태를 나타내는 임상증상 중 자주 생긴다고 답한 항목이 1개 이하인 경우를 건강군, 2개 이상의 항목에서 자주 생긴다고 답한 경우를 비건강군으로 분류하여 각 조사 항목을 비교 분석한 결과를 요약하면 다음과 같다. 전체 대상자들(524명)의 평균 연령은 14.0세였으며, 신장은 남학생 162.0 cm, 여학생 157.2 cm였고, 체중은 남학생 53.4 kg, 여 학생 49.4 kg으로 신장과 체중 모두 남학생이 높았다. 신장과 체중으로부터 산출한 체질량지수(BMI)는 남학생 20.3 kg/$m^2$, 여학생 20.0 kg/$m^2$로 모두 정상 범위에 속하였다. 건강군(289명)과 비건강군(235명)의 평균 연령, 체중, 신장, 체질량지수는 유의적인 차이를 보이지 않았다. 체형 인식, 만족도, 체중조절 시도여부를 비교한 결과 본인의 체형에 대한 인식은 건강군과 비건강군 간에서 유의적인 차이를 보이지 않았으나, 체형만족도에서는 유의적인 차이를 보여 본인의 체형에 만족하지 않는다는 비율이 건강군 여자의 33.1%에 비하여 비건강군 여자는 46.2%로 높게 나타났다(p<0.05). 지난 1년간의 체중조절 시도 여부에 대하여서도 비건강군 여자의 59.5%가 체중을 감소시키기 위하여 노력하였다고 답하여 건강군 여자의 38.5%에 비하여 유의적으로 높았다(p<0.01). 남학생의 경우에는 체형만족도와 체중 조절 경험에 있어서 두 군간 유의한 차이를 보이지 않았다. 영양지식과 영양태도 점수를 비교한 결과 건강군과 비건강군간에 유의적인 차이를 보이지 않았다. 끼니별 식사빈도를 조사한 결과 여자의 경우 아침식사를 주4회 이하로 하는 경우가 건강군은 30.7%였으나, 비건강군의 경우 44.0%로 높았다(p<0.05). 저녁 식사는 주 4회 이하의 식사를 하는 경우가 건강군은 10.7%인 반면, 비건강군은 18.8%로 아침 과 저녁 식사 모두 여자 비건강군의 결식률이 유의적으로 높게 나타났다(p<0.01).외식빈도는 남자의 경우 주 3회 이상에서 비건강군이 56.5%로 건강군의 42.7%보다 유의적으로 높았으며, 간식빈도는 여자의 경우 건강군에 비하여 비건강군이 유의적으로 높았다(p<0.05).식사의 구성을 조사한 결과 유의적인 차이를 보이지는 않았으나 비건강군이 건강군에 비하여 세 끼 식사의 구성이 불량하다고 답한 비율이 높은 경향을 나타내었다. 본 연구 결과를 통하여 건강의 이상 여부를 반영하는 임상증상의 빈도가 높은 청소년기 남녀 중학생의 경우 아침과 저녁의 결식빈도 및 외식과 간식의 빈도가 높았고, 아침식사의 질과 체형만족도가 낮은 것으로 나타나 청소년의 건강과 식습관 및 체형만족도가 상호 관련성이 높은 것으로 나타났다. 따라서 본 연구 결과는 성장기 청소년의 건강 유지를 위하여 바람직한 식습관의 중요성을 재인식할 수 있었으며, 올바른 식습관 확립을 위한 영양교육의 중요성이 재확인되었다.

• 대한물리의학회지
• /
• 제10권2호
• /
• pp.89-94
• /
• 2015

PURPOSE: The aim of this study was to determine the effect of device considering Mckenzie type for the subjects with forward head posture (FHP). METHODS: The subjects were 35 patients with FHP (mean age was $23.7{\pm}2.8$ years; mean height; $172.1{\pm}11.7$, mean weight; $65.8{\pm}13.9$, mean NDI(Neck Disability Index; $3.7{\pm}3.2$, mean FHP; $6.7{\pm}2.2$). We measured the posture with the Body style S-8.0(LU Commerce, South Korea) to evaluate the FHP. We collected the surface EMG(Myosystem 1400, Noraxon, USA) data to quantify changes in normalized activation levels of muscles in SternoCleidoMastoid muscle(SCM), Scalenus Anterior(SA), Trapezius upper fiber(TU) and Splenius Cervicis(SC), during the subjects were instructed to glide their head into a "chin-in" position for a retraction without and with device. RESULTS: The condition with device significantly decreased the %RVC of SA($90.84{\pm}40.54$), SCM($74.98{\pm}43.65$) and TU($67.60{\pm}47.83$) compared to the condition without device(SA;$100.39{\pm}56.32$, SCM;$119.03{\pm}109.26$, Trapezius;$80.55{\pm}39.27$). But the %RVC of capitis($65.87{\pm}47.83$) with device was increased($70.82{\pm}52.78$). There was significant difference in the %RVC between SCM and Trapezius muscle in two conditions. CONCLUSION: New device for FHP reduces the EMG activities of the TU, SCM and SA muscle. We have to develop the function of feedback to facilitate the motion in the future.