• 대한간호학회지
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• 제16권1호
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• pp.55-66
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• 1986

내과외래를 내방한 만성폐쇄성 호흡기질환환자를 대상으로 호흡근육훈련이 호흡근육에 미치는 효과를 조사하기 위해서 자료수집을 하였다. 근력+지구력훈련과 근력훈련을 각각 두군에게 6-주 동안 실시하였다. 근력훈련은 DHD Medical Products사 제품의 흡기근육훈련도구로 매일 30분씩 대상자의 가정에서 실시하였고, 근지구력훈련은 일정한 기온이 유지되는 서울대학교병원복도를 12분 동안 걷게하는 운동을 주 2회 시행하였다. 이 훈련들의 효과를 평가하기 위하여 매주 최대흡기력(PImax), 참을 수 있는 흡기력(SIP), 최대환기량(MW) 및 기관지염-폐기종 증상 체크목록(BESC)과 환자의 건강상태와 계속 훈련여부를 결정하기 위해서 폐기능 검사와 vital signs을 매주 검사하였다. 그리하여 다음과 같은 성적을 얻었다. 근력＋근지구력훈련군은 훈련전에 비해서 훈련후에 유의한 차이가 없었으나 근력훈련군은 SIP가 증가되고 BESC는 감소되었으며 , 두 군간의 비교에서는 BESC에서 훈련후에 유의한 차이가 있었다. 호흡근육훈련은 가정에서 간단하게 시행할 수 있는 근력훈련이 근력＋근지구력훈련보다 효과가 좋았다. 그러나 측정도구들의 타당도 신뢰도의 평가, 더 많은 수의 연구대상자, 더 효과적인 근지구력훈련의 개발에 관한 연구가 이루어져야겠다.

• 대한한방내과학회지
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• 제18권2호
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• pp.229-235
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• 1997

Background and Purpose : The aim of the present study was to investigate the prodromes of stroke in already attacked patients and to prove the traditional hypothesis that some symptoms were to be prodromes of stroke in the oriental medicine. Methods : The questionnaire which was based on symptoms of traditional hypothesis was distributed to subacute stroke patients who were confirmed by Brain CT or MRI in Oriental Medical Hospital, Kyung Hee University, except patients with indistinct onset, symptoms proved any other disease. Results : Eighty-three patients(82.2%) felt some prodromal symptoms and fifty-nine patients (58.4%) underwent a change in their life within one week before onset. Most common prodromal symptoms was the weakness or numbness of limbs, single or unilateral. Conclusion : Our results suggest that the prodromal symptoms before stroke can be regarded as predicting sign. And we think that these research may contribute to preventing stroke and relapse.

• Clinical and Experimental Pediatrics
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• 제45권6호
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• pp.754-763
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• 2002

목 적 : 소아, 청소년기의 당뇨병은 대부분 1형 당뇨병으로 진단되어지나 최근에는 소아, 청소년에서도 2형 당뇨병이 전세계적으로 증가하고 있고 우리나라의 경우도 같은 양상을 보인다고 생각된다. 저자들은 소아, 청소년의 2형 당뇨병의 임상 양상에 대하여 고찰해 보고자 하였다. 방 법 : 1987년부터 2000년까지 서울대학교병원 소아과에서 2형 당뇨병으로 진단 받은 소아, 청소년 환자 33명을 대상으로 하였다. 당뇨병의 진단기준에 합당한 환자 중에서 체질량지수 25 이상의 비만을 보인 경우, 2형 당뇨병의 가족력을 가진 경우, 진찰상 흑색 극세포증을 보인 경우, 그리고 혈청 혹은 소변 C-peptide가 정상 혹은 증가된 경우 등의 2형 당뇨병의 진단을 지지하는 소견들 중 2가지 이상을 보이고 항GAD 항체가 음성일 경우를 임의적으로 2형 당뇨병으로 진단하였다. 또한 인슐린 치료가 필요하지 않거나 인슐린 치료를 받다가 끊을 수 있었던 경우는 위의 지지소견 들이 2가지 미만인 경우에도 2형 당뇨병으로 진단하였다. 대상 환자 33명의 병록지를 후향적으로 검토하여 환자들의 진단 당시의 임상 양상, 인구 통계학적 양상, 검사결과, 치료방법 및 반응 등에 대해 임상적인 고찰을 하였다. 인슐린 치료를 받은 환자 중 2년 이상 인슐린을 사용한 군과 2년 안에 인슐린을 끊을 수 있었던 군의 임상적 양상에 대해 비교하여 보았다. 결 과: 진단시 나이는 평균 $13.4{\pm}1.8$세로 10대 초반이 다수였다. 23명의 환자 중 16명(69.6%)이 진단 시 사춘기에 해당하였다. 평균 체질량지수는 $24.3{\pm}4.2kg/m^2$이었고 $25kg/m^2$ 이상의 비만을 보인 경우가 32명 중 16명(50%)이었다. 2형 당뇨병의 가족력이 있는 경우가 33명 중 24명(72.7%)이었다. 흑색극세포증은 6명(18.2%)에서 관찰되었다. 진단 당시 다음, 다뇨등의 증상을 보인 경우가 14명(42.4%)이었고, 요당이나 고혈당이 우연히 발견되어 진단된 경우가 19명(57.6%)이었다. 치료방법으로는 인슐린 단독치료가 25명(75.8%), 경구 혈당강하제 단독사용이 3명(9.1%)이었고, 두 가지를 같이 사용한 경우가 3명(9.1%), 운동과 식이요법 외에 약물치료를 하지 않은 경우가 2명(6%)이었다. 15명(45.5%)이 인슐린을 사용하지 않았거나 끊을 수 있었다. 진단 당시 다음, 다뇨와 같은 전형적인 당뇨병의 증상은 2년 이상 인슐린을 쓴 군에서 유의하게 많았다(P<0.05). 결 론: 소아, 청소년에서의 2형 당뇨병은 증상의 발현이 뚜렷하지 않으며 사춘기, 비만, 가족력과 관계가 깊었다. 소변과 혈청에서의 C-peptide 농도 측정에서 증가 또는 정상 소견이 보일 경우, 췌세포 자가 항체가 음성인 경우 2형 당뇨병으로 진단할 수 있으나 좀 더 나은 1형 당뇨병과의 감별방법 개발이 필요하다고 생각된다. 다수의 2형 당뇨병 환자에서 초기에 인슐린 투여를 필요로 하였고 혈당 조절이 호전된 후 끊을 수 있었으나 진단 시 증상을 보이는 경우 인슐린을 지속적으로 필요로 하는 경우가 많았다.

• 대한간호학회지
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• 제23권4호
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• pp.569-584
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• 1993

This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC＋ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.314-322
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• 2010

목 적 : 경남권역 응급의료센터인 마산삼성병원을 내원한 소아청소년 응급환자들을 후향적 방법으로 내원 양상을 분석하여 향후에 지역 응급 진료의 질 향상에 기여하고자 본 연구를 시행하였다. 방 법 : 2007년 1월 1일부터 2008년 12월 31일까지 2년 동안 마산삼성병원 응급센터로 내원하였던 19세 미만 소아청소년 환자 14,065명 의 의무 기록지를 통해 연구하였다. 결 과 : 남녀비는 1.5:1로 남자가 더 많았고, 연령은3세 미만이 49.6%였다. 내원 환자는 5월, 일요일, 하루 중에는 20시에서 21시 사이가 가장 많았다. 기후와의 관련에서 하루 내원 환자 수는 황사가 있을 때 3배, 맑은 날 또는 10 mm 미만의 비가 내린 경우는 10 mm 이상 비가 내렸을 때보다 4배 더 많았다. 주된 진료담당과는 전체의 62.0%가 소아과였다. ICD-10 질병 분류에서 손상 중독 및 외인에 의한 경우 22.4%, 단일 증상 및 질환으로는 발열이 13.1%로 가장 많았다. 최종 진료 처리 형태로는 퇴원이 73.8%, 입원은 25.7%였다. 15세 이상 19세 미만의 청소년인 경우 전체 연령과 다른 점은 응급의학에서 50.0%를 담당하였고, 손상 중독 및 외인에 의한 경우 36.9%, 단일 증상 질환으로는 복통이 10.9%로 가장 많았다. 또 최종 입원한 경우는 30.6%로 전체 연령보다는 더 많았고 내원 환자수가 일교차가 클수록 비례하여 더 많았다. 결 론 : 응급센터를 내원한 소아 환자 수는 남자, 3세 미만, 5월, 일요일, 20-21시 사이, 황사가 없는 맑은 날, 손상 중독 및 외인에 의한 경우 및 발열인 경우가 가장 많았다. 청소년이 소아환자와 다른 점은 일교차가 클 수록, 복통으로 내원하는 경우가 더 많았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권5호
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• pp.401-407
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• 2009

Purpose : This study was designed to evaluate the clinical aspect of cysts which arised in the oral and maxillofacial region. Patients and Methods : We reviewed clinical record, radiograph, histopathologic and operative report of 155 patients who had been diagnosed as cysts and treated at the department of oral and maxillofacial surgery in Chonnam National University Hospital from January 2003 to December 2008. Gender, age, classifiaction, anatomic distribution, clinical sign and symptoms, treatment, complications and recurrence rate were studied. Results : 1. Among 155 patients, the male patients(64.5%) were more than the female(35.5%). 2. The average age ofthe patients was 37.2 years(ranging from 5 to 79 years). 3. In pathologic classification, radicular cyst and dentigerous cyst were most common cysts, irrespective of 73 cases(48.3%) and 35 cases(23.2%). 4. The frequently involved cystic regions were followed as mandibular molars(38.1%), and maxillary incisors(30.2%). 5. The frequent sequence of clinical symptoms was edema(29.9%), no symptom(18.9%), tenderness(13.9%), pain(11.5%) and abscess(9.4%). 6. The most prevalent treatment was the combination operation, such as cyst enucleation with extraction or endodontic treatment of the causative tooth(76.8%) 7. Among 155 cases, 2 cases that were treated using enucleation method were recurred(1.3%).

• Toxicological Research
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• 제18권1호
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• pp.87-98
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• 2002

This study was conducted to evaluate the safety of a recombinant human Factor VIII(GC-$\gamma$ AHF) manufactured by Korea Green Cross Company with different technology according to the Regulation of Korean Food and Drug Administration (l 998. 12. 3). In acute toxicity test, both genders of Sprague-Dawley rats and Beagle dogs were administered intravenously with GC-$\gamma$ AHF of three doses (3,125, 625 and 125 IU/kg), and single dose of 3,125 IU/kg, respectively. No dead animal and abnormal autopsy findings were found in Control and GC-$\gamma$ AHF treated group. Therefore, the 50% lethal dose ($LD_{50}$) of GC-$\gamma$ AHF was conidered to be higher than 3,125 IU/kg in rats and dogs. In the four weeks repeated intravenous toxicity study, GC-$\gamma$ AHF was administrated intravenosly to both genders of rats and dogs with 3 doses (500, 150, 50 IU/kg). There were neither dead animals nor significant changes of body weights during the experimental Period. In addition, no significant GC-$\gamma$ AHF related changes were found in clinical sign, urinalysis and other finding. Statistically changes were observed in hematological, biochemical and organ weight parameters of treated groups: however these changes were not dose dependent. No histopathological lesion were observed in both control and treated animals. Above data suggest that no observed adverse effect level of test materials in rats and dogs might be over 500 IU/kg/day in this study. In ocular irritation test, any injury on iris, conjunctiva and cornea in rabbits were not observed. The acute ocular irritation index (A.O.I.), mean ocular irritation index (M.O.I.) and Day-7 individual ocular irritation Index (I.O.I.) of GC-$\gamma$ AHF were 0. In the primary skin Irritation test, the primary irritation index (P.I.I.) oj GC-$\gamma$ AHF were 0. Therefore, the GC-$\gamma$ AHF is considered not to have the primary skin and eye toxicity in rabbits. In active systemic anaphylaxis (ASA) test, GC-$\gamma$ AHF and GC-$\gamma$ AHF emulsified with Freund's complete adjuvant (FCA) did not induce any symptom of anaphylactic shock in guinea pigs. In passive cutaneous anaphylxis (PCA) test, after sensitization with antisera of GC-$\gamma$ AHF sensitized mice, blue spots were observed on the hypodermis of back of rats, but diameter of each spot was smaller than 5 mm in each test groups except the positive control group. Based on the results of this study, GC-$\gamma$ AHF is not conidered to have any antigenic potential. In conclusion, at levels of up to 500 IU/kg, GC-$\gamma$ AHF did not produce treatment-related toxicity under the conditions of these acute-, four week repeated-toxicity, primary skin and eye toxicity, and antigenicity test.

• 식물병연구
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• 제12권3호
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• pp.178-184
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• 2006

2002년과 2003년 중부 이남의 콩 재배지에서 지상부에 황화 증상을 보이며, 지제부에 붉은 색의 자낭각이 형성된 콩을 채집하여 검은뿌리썩음병균을 분리하였다. 분리한 병원균으로부터 유성세대의 자낭각, 자낭, 자낭포자를, 무성세대의 분생포자와 소낭을 관찰하였다. 자낭각의 크기는 $357.9(312.5{\sim}391.5.7){\times}474.3(419{\sim}535){\mu}m$로 적갈색의 구형 또는 난형이었으며, 자낭(크기: $90.9{\times}15.0{\mu}m$)은 무색투명한 곤봉상의 모양을 나타내고 있었다. 자낭안에 8개의 자낭포자가 형성되었는데, 무색투명하며 1-3개의 격벽을 지닌 약간 굽은 긴 형태로 크기는 $36.87(31.1{\sim}49.4){\times}5.22(4.5{\sim}6.1){\mu}m$이었다. 무성생식세대에서 만드는 분생포자는 긴 원통형이며 색깔은 투명하고, 크기는 $73.24(68.1{\sim}77.6){\times}5.76(4.9{\sim}6.8){\mu}m$로 자낭포자보다 컸다. 소낭의 모양은 둥근 모양이며 크기는 지름이 $8.46(6.2{\sim}10.0){\mu}m$로 관찰되었으며, 이는 Crous의 결과와 일치하였다. ITS와 $\beta$-tubuline 유전자의 염기서열을 조사하여 phylogenetic analysis를 수행한 결과, 국내에서 분리한 18개의 병원균과 일본에서 분양받은 10개의 병원균 모두 Cylindrocladium parasiticum으로 동정되었다.

• 한국안광학회지
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• 제13권3호
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• pp.19-28
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• 2008

목적: 한국인 소프트 콘택트렌즈 착용자에서 나타나는 증상을 이해하고 증상과 눈물검사값과의 상관성을 조사하고자 하였다. 방법: 안과적 질환이 없고 소프트 콘택트렌즈 착용기간이 18.60${\pm}$16.92개월인 착용자 62명(남: 20명, 여: 42명, 평균연령은 23.95${\pm}$4.38세)을 대상으로 설문지 검사 및 3 종류의 눈물검사를 시행하고, 자각적 증상과 타각적 증상을 조사하여 상관성을 분석하였다. 결과: 소프트 콘택트렌즈 착용 중 나타난 자각적 증상의 빈도와 정도는 건조감, 충혈, 피곤함의 순으로 나타났다. 증상의 빈도는 건조감은 모래가 들어간 느낌과, 충혈은 열감과, 피곤함은 이물감과 상관성이 높았고, 증상의 정도는 눈부심은 시력변동과, 이물감은 모래가 들어간 느낌의 상관성이 높았으며 이러한 증상은 McMonnies' 설문검사값과 상관성이 있었다. 타각적 증상으로 결막충혈과 윤부충혈은 병적인 수준은 아니지만 주된 증상으로 나타났고 각결막염색은 발생빈도는 낮지만 눈물막파괴시간이 짧을수록 통계적으로 유의하게 발생빈도가 증가하였다. 결론: 한국인 소프트 콘택트렌즈 착용자의 경우 건조감, 충혈 및 피곤함을 많이 느끼고 이러한 증상은 서로 상관성을 갖고 있으며 콘택트렌즈 착용기간과 상관성이 있으나 자각적 증상과 타각적 증상의 발생은 상관성이 없는 것으로 사료된다.

• 대한두경부종양학회지
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• 제15권1호
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• pp.70-75
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• 1999

Objectives: This study was designed to evaluate the methods of diagnosis and treatment of thyroid nodules. Materials and Methods : We performed a clinical review of patients with thyroid nodules, who were surgically treated at the Department of Surgery, College of Medicine, Chosun University from January 1996 to December 1998. Results: 1) The patients were divided into two groups; 65 patients(80.2%) with benign nodular disease and 16 patients(19.8%) with malignant disease. 2) The sex distribution showed a preponderance of females with a ratio of 5.2:1 in benign nodular disease and 3:1 in malignant disease. Benign nodules were more prevalent in patients in their 40's as compared to malignant nodules in patients in their 50's and 60's. 3) The most common duration of illness was 3 months, occurring in 45.7% of the total cases. 4) The most prominent symptom and sign was a palpable nodule in the anterior aspect of the neck. 5) The location of the nodule was ; 41 cases in the right lobe, 29 cases in the left lobe, and 11 cases in both lobes. 6) Thyroid scanning of 40 patients revealed cold nodules in 90.6% of benign nodules and in all malignant disease. 7) Fine needle aspiration cytology were performed in 32 cases of the 81 patients. Comparing with postoperative pathological findings, the results were the same in 87.5% of 32 cases. 8) Intra-operative frozen section study was performed in 56 cases of the 81 patients. Comparing with postoperative pathological finding, the results were same in 96.4% of the 56 cases. 9) The histopathological classification revealed that adenomatous goiters were the most common benign disease and papillary carcinomas were the most common malignant disease. 10) The most frequently employed operation for benign nodules and malignant disease was unilateral total lobectomy. When the metastasis was confirmed, lymphadenectomy and radical neck dissection was performed in malignant disease. 11) Important postoperative complications were transient hoarseness, transient hypocalcemia, hypothyroidism, wound bleeding, and hoarseness. Conclusions: The results of this study suggest that palpable nodules in anterior aspect of neck is revealed cold nodule by thyroid scanning and malignancy by fine needle aspiration cytology, which should be removed surgically. There is no difference in complication and survival rate with type of operation and lymphatic dissection. Therefore, procedure of operation is dependent on the site of nodule and involvement of lymph node.