• 사물인터넷융복합논문지
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• 제9권3호
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• pp.45-53
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• 2023

본 연구는 간호학과 재학 중인 3학년을 대상으로 이압요법이 지각된 스트레스와 수면의 질에 미치는 효과를 확인하기 위한 비동등성 플라시보 대조군 전후설계이다. 연구의 대상자는 K대학교에서 처치군 30명, 대조군 30명, 총 60명을 선정하여 2022년 3월 2일부터 4월 26일까지 8주간 자료를 수집하였다. 처치군은 귀의 반응점(신문, 심, 시상)에 압봉 스티커를 부착하여 1일 3회 이압을 적용하였고, 플라시보 대조군은 동일한 기간에 동일한 방법으로 귀의 반응점(고관절, 무릎, 발목)에 적용하였다. 자료는 SPSS 23.0 프로그램을 이용하여 처치군과 플라시보 대조군의 시점별 지각된 스트레스와 수면의 질은 independent t-test, 경과에 따른 종속변수의 변화는 repeated measures ANOVA로 분석하였다. 처치군의 지각된 스트레스 점수는 중재 4주 후 2.28점, 중재 8주 후 2.07점으로 유의하게 감소하였고, 수면의 질 점수는 중재 4주 후 3.37점, 중재 8주 후 4.02점으로 유의하게 증가하여 시간이 경과함에 따라 지속 효과가 있는 것으로 확인되었다.

• 한국임상수의학회지
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• 제40권5호
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• pp.382-386
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• 2023

A 2-year-old, 12.5 kg, castrated male, mixed-breed dog was presented with a 1-year history of pruritus and progressive alopecia. On physical examination, no remarkable findings were detected including body condition score (5/9). A dermatological examination of the dog revealed generalized erythema, papules or plaques, especially on the face, auricle, dorsum, and shoulder. A fine-needle aspiration of the dorsum and face lesions revealed various numbers of macrophages with foamy cytoplasm and multinucleated giant cells. A bacterial culture test showed the growth of Staphylococcus pseudintermedius. A complete blood cell count was unremarkable and biochemical abnormalities included hyperglobulinemia (4.8 g/dL, reference interval 2.5-4.5 g/dL), mild hypertriglyceridemia (277 mg/dL, reference interval 10-100 mg/dL) and mild hypercholesterolemia (383 mg/dL, reference interval 110-320 mg/dL). Additional diagnostic tests were performed to identify the underlying cause of hyperlipidemia. Canine pancreatic lipase immunoreactivity (<50 ng/mL, reference interval 0-200 ng/mL) and total T4 (1.4 ㎍/dL, reference interval 1.1-5.6 ㎍/dL) were within the reference intervals. For a definitive diagnosis, skin biopsy specimen was collected from the papular lesions on the dorsum by using a 4 mm biopsy punch. A histopathological examination revealed numerous large macrophages with abundant foamy cytoplasm in the dermis. The foamy macrophages were located diffusely between the collagen fibers. Extracellular amorphous lipid deposits were also presented in the dermal tissue. A definitive diagnosis of cutaneous xanthoma was made based on clinical signs and cytological and histopathological results.

• 대한약리학회지
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• 제11권2호
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• pp.29-40
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• 1975

1. 척수가토(脊髓家兎)에서 nicotine, DMPP, McN-A-343, AHR-602, tyramine, angiotensin및 neostigmine에 의한 심박증가(心搏增加)의 작용점(作用點)을 조사(調査)하였다. 2. 상기약물(上記藥物)에 의한 심박증가(心搏增加)는 reserpine 처리가토(處理家兎)에서는 대단히 약(弱)하였고, Propranolol 투여후(投與後)에는 거의 나타나지 않았다. 3. Tetrodotoxin, guanethidine은 isoproterenol, nicotine, DMPP, tyramine에 의한 심박증가(心搏增加)에는 영향(影響)을 미치지 않았으나 McN-A-343, AHR-602, angiotensin, neostigmine에 의한 심박증가(心搏增加)는 이를 현저(顯著)히 약화(弱化)시켰다. 4. Nicotine, DMPP의 심박증가(心搏增加)는 chlorisondamine으로 McN-A-343, AHR-602의 심박증가(心搏增加)는 atropine으로 각각(各各) 억제(抑制)되었다. 5. Isoproterenol, nicotine, DMPP, McN-A-343, tyramine, angiotensin, neostigmine은 적당량(適當量)을 우심방내(右心房內)에 주입(注入)하였을때 이들을 이정맥내(耳靜脈內)에 주사(注射)하였을 때와 비슷한 반응(反應)을 일으킬 수 있었다. 그러나 AHR-602 우심방내(右心房內) 주입(注入)은 유의(有意)한 심박증가(心搏增加)를 일으키지 않았다. 6. Nicotine, DMPP, neostigmine은 우심방내(右心房內) 주입시(注入時)는 현저(顯著)한 심박증가(心搏增加)를 일으켰으나, 동량(同量)을 우심실내(左心室內)에 주입(注入)하였을때는 증가(增加)를 일으키기 않았다. Isoprotereool 및 tyramine에 대한 반응(反應)은 우심실내(右心室內) 주입(注入)보다도 우심방내(右心房內) 주입시(注入時) 훨씬 컸다. 7. McN-A-343, angiotensin의 우심실내(右心室內) 주입시(注入時)는 우심방내(右心房內) 주입시(注入時)보다도 훨씬 현저(顯著)한 심박증가(心搏增加)를 일으켰고, AHR-602의 우심실내(左心室內) 주입(注入)도 현저(顯著)한 반응(反應)을 일으켰다. 8. Nicotine, DMPP, tyramine은 심장(心臟)의 aenergic nerve의 말단(末端) 또는 extraneuronal norepinephrine-store에 작용(作用)하여, Mcn-A-343, AHR-602, angiotensin은 심장(心臟)의 adrenergic nerve에 작용(作用)하여 심박증가(心搏增加)를 일으키며, nicotine, DMPP, tyramine, neostigmine의 작용점(作用點)은 주(主)로 우심방(右心房)에 McN-A-343, AHR-602, angiotenisin의 작용점(作用點)은 주(主)로 우심실(右心室)에 존재(存在)하는것으로 추론(推論)하였다.

• Journal of Chest Surgery
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• 제31권5호
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• pp.472-480
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• 1998

서울대학교 어린이병원 흉부외과에서는 1990년부터 1996년까지 104례의 기능적 단심실을 가진 선천성심기형 환아에 대하여 심장내 외측통로술을 이용한 완전폰탄술을 시행하였다. 환아의 연령 및 체중분포는 각각 평균 35.9(범위 10-72) 개월, 12.8 (범위 6.5-37.8) kg이었다. 술전진단은 삼첨판폐쇄증(18), 단심실연결을보이는 중복개구심실(53) 및 기타 기능적 단심실을 동반한 복잡심기형(33)이었다, 50례의 환아에 대하여 체폐동맥 단락술 (37), 폐동맥밴딩(13), 외과적 심방중격절제술(15), 동맥전환술(2), 대동맥하 누두부제거술(2), 총폐정맥이상연결증(2), 폐동맥-대동맥봉합술(Damus-Stansel-Kaye, 1) 등의 고식술이 시행되었다. 완전폰탄술식전 19례의 양방향성 체정맥-폐동맥단락술과 1례의 전(全)체정맥-폐동맥단락술(Kawashima procedure)이 진행되었다. 술전 혈역학소견상, 평균 폐동맥압/폐혈관저항은 14.6 (범위 5-28mmHg) / 2.2 (범위0.4-6.9)wood.unit였으며, 폐혈류/체혈류비가 평균 0.9 (범위0.3-3.0)였다. 이완기말심실압은 평균 9.0 (범위 3.0-21.0) mmHg였고 동맥혈의 산소포화도는 평균 76.0 (범위 45.6-88.0) %였다. 수술은 분계능(terminal crest) 2cm 외측으로 우심이부터 우심방-하공정맥경계부에 종절개를 가하고 하공정맥개구부부터 상공정맥개구부 또는 우심이까지 Gore-Tex 인조도관을 이용하여 외측통동을 형성시키는 방법으로 시행하였으며 필요한 경우 통로상에 4-5.5 mm 직경의 구멍을 만들어 주었다. 동시에 시행한 술식은, 폐동맥성형술(22), 심방중격절제술(21), 폐정맥이상연결증 교정(4), 영구적인 인공심박동기거치(3) 등이었고, 32례에 대하여 통로내 구멍을 만들어 주었으며 그중 1례는 조절형(adjustable)으로 시행하였다. 심방-폐동맥 연결 방법으로 시행한 폰탄술 후 4년후에 발생한 재발성 난치성 상심실형 부정맥환아 1례에 대하여 외측통로형의 변환 폰탄술식이 시행되었다. 수술 직후 혈역학 소견상 평균 폐동맥압, 이완기말심실압, 실온에서 동맥혈의 산소포화도가 각각 12.7 (8-21)mmHg, 7.6 (범위4-12)mmHg, 89.9 (범위68-100) %였다. 병원사망율은 6.7 (7/104) %였고 술후 합병증으로 지속적인 늑막삼출(11), 부정맥(8), 유미흉(9), 중추신경계손상(5), 감염 및 염증(5), 급성신부전(4)이 발생하였다. 평균 27.2 (범위1-85) 개월동안의 외래 추적결과 5명의 만기 사망이 있었다. 저자등은 본연구결과를 토대로 심장내 외측통동폰탄술식이 기능적 단심실 환자에 대하여 비교적 낮은 사망율 및 합병증과 우수한 혈역학으로 시행될수 있는 수술방법이란 사실을 입증하였다.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.109-113
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• 2009

Purpose: Materials for ear reconstruction are autogeneous cartilage and artificial implants. Despite their potential for donor site complications, autogeneous cartilage frameworks remain the accepted standard for external ear reconstruction. The purposes of this study were to investigate our ear reconstruction cases for 12 years. Methods: During twelve years from January 1996 to December 2008, 70 patients visited our hospital for ear reconstruction of microtia. Among them, 65 cases used autogenous cartilage frameworks, 3 cases used tissue expander and 2 cases used artificial implants. We investigated sex & age, common site, combined malformation, operation methods & their complications, donor site & their complications, anterior chest wall deformity and aesthetic evaluation. Results: Males were affected more often than females. Male to female ratio was 1.8 : 1. The common site of microtia was right ear (72%). And hemifacial microsomia was the most common associated congenital malformation. Surgical techniques included Tanzer-Ruecker method, Tissue-expander and Artificial framework ($Medpore^{(R)}$). Incidence of complication was higher with Tissue-expander & artificial framework than with Tanzer-Ruecker method. But There are few reports of using Tissue-expander & artificial framework and there was no acceptable statistical difference. And costal cartilage was harvested in ipsilateral side and anterior chest wall deformity reported only 2 cases under 10 year-old patients. Other minor complications reported such as, wound disruption and chest wall scar, but without any serious complications. Aesthetic result was evaluated by surgeons and patients for postoperative satisfaction and clinical evaluation. Conclusion: In ear reconstruction of microtia patient, delicate surgical strategy is important for natural shape and maintenance of postoperative contour. However, many methods were introduced for reconstrucion of microtia, the authors reconstructed an auricle in Tanzer-Ruecker method, Tissue-expander and Artificial famework ($Medpore^{(R)}$) for 70 patients. In our study, we generally chose Tanzer-Ruecker method and this treatment modality was satisfactory for patients and the postoperative result was acceptable for surgeons.

• Journal of Chest Surgery
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• 제9권1호
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• pp.10-19
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• 1976

One hundred and seventy-four patients were treated in this Department since 1956. One hundred and fifteen patients of them were surgically treated. They were classified on the basis of the disease entity as follows; 48 case of thrombo-angiitis obliterance, 8 cases of Leriche syndrome, 12 cases of arterial embolism, 36 arterial aneurysm, 5 arterio-venous fistula, 15 arterial and venous injuries, 8 pulseless diseases, 2 coarctation of aortas, 15 varicose veins, 12 thrombophlebitis, 9 superior venacaval syndromes, 2 inferior vena caval obstructions and Raynaud's diseases. All the cases of the Burger's diseases were males, and half of them were in the fourth decades, 39 cases underwent undergone unilateral or bilateral sympathectomies. All the Leriche syndromes were males aged over fifty. Three cases out of six were suffering from diabetes mellitus. 2 cases underwent aorto-femoral bypass graft with Y-shaped dacrons. And two embolectomies were performed in 2 cases. Eight cases of arterial embolisms among 12 had mitral valvular diseases with auricular fibrillation The most common site of lodgement of emboli was femoral artery. Nine out of 14 underwent embolectomies with Fogarty catheters. There were 14 peripheral arterial aneurysms, 16 thoracic and/or abdominal aortic aneurysms, and 4 dissecting aneurysms. Most frequent cause of peripheral arterial aneurysms were external trauma. Thoracic and abdominal aortic aneurysms were non-traumatic. And four cases of the dissecting aneurysms had significant hypertension and aged over fifty. Among 5 cases of arteriovenous fistulas, 2 cases hand typical Branham's sign, and they were normalized after operation. Eight cases of pulseless disease were females and aged from three to twenty-five. Three out of them were treated surgically using dacron prosthetic grafts, but the results of the surgery were variable and not satisfactory. A case of coarctation of aorta was treated surgically with an excellent result. Fourteen out of 15 varicose veins underwent ligation of the saphenous vein system, exstirpation of the varicose veins, stripping or some combination of these methods. Two cases of superior vena caval syndromes were operated by bypass graft between the left innominate vein and the right auricle. Two cases of inferior vena caval obstructions were operated upon through right atrial route using extracorporial circulation. All the four cases of vena caval obstructions showed excellent results postoperatively. Two cases out of 12 thrombophlebitis underwent thrombectomies. One of two Raynaud's diseases was surgically treated with an excellent result.

• Journal of Chest Surgery
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• 제40권12호
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• pp.855-858
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• 2007

승모판막 치환술 후 발생하는 좌심실파열은 치명적인 합병증이다. 30년 전 국외에서 승모판막에 대한 수술을 받은 병력이 있는 54세 여자 환자가 심한 승모판막 협착증과 심한 삼첨판막 폐쇄부전을 주소로 내원하여 승모판막 치환술 및 삼첨판막륜 성형술을 시행받았다. 심폐기 이탈 후 수술장 내에서 발생한 대량출혈로 심폐기 재가동 상태에서 평가한 결과 좌심방으로부터 3 cm 후방부위의 방실 골짜기에서 발생한 급성 제I형 좌심실 파열로 진단하고 심외막 접근법으로 테프론 펠트를 이용한 일차 봉합술, 심막첨포를 이용한 밀봉 봉합술 및 피브린 접착제를 적용하여 성공적으로 봉합하였으며 환자는 수술 14일째 합병증 없이 퇴원하였다. 이에 승모판막 치환술 후 발생하는 제I형 좌심실 파열에 대한 문헌고찰과 함께 증례를 보고하고자 한다.

• Journal of Chest Surgery
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• 제31권11호
• /
• pp.1031-1036
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• 1998

연구배경 : Medtronic-Hall 기계판막은 세계적으로 흔히 쓰이고 있으나, 우리 나라에는 그에 대한 임상연구가 되어 있지 않다 재료 및 방법 : 1986년 3월부터 1990년 5월까지 Medtronic-Hall 기계판막을 이용한 인공 심장판막 치환 환자 50례를 대상으로 하였다. 환자의 평균 연령은 35세였고 남녀비는 17:33이었다. 결과 : 판막 병변의 원인은 류마티스성이 43례로 대부분을 차지했고 38명의 환자에서 승모판 치환술을 7명에서 중복판막치환술을 그리고 5명의 환자에서 대동맥판막 치환술을 시행하였다. 술전 NYHA 기능 분류는 Class III 혹은 Class IV가 91.5%였지만 술후는 ClassI혹은 Class II가 87.2%로 호전된 양상을 보였다. 심장초음파 검사상 좌심방내경, 수축말기 및 확장말기 좌심실내경은 술후 모두 감소하였고 심박출률은 증가하였다. 술후 합병증은 출혈 3례, 저심박출 증후군 2례, 혈전색전증 1례, 전격성 간염 1례가 있었고 병원 사망례는 3례였다. 혈전색전증의 발생률은 1.5%/환자.년이었고 5년 생존률은 93.65$\pm$0.71%, 10년 생존률은 88.27$\pm$6.4%였다. 결론 : 이상에서 Medtronic-Hall 기계판막은 판막에 관련된 합병증 발생률이 낮고 판막의 내구성도 뛰어나며 혈역학적 수행능력이 타 기계판막에 뒤떨어지지 않는 판막으로 확인되었다.

• 대한수의학회지
• /
• 제47권1호
• /
• pp.7-17
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• 2007

The left main descending artery (LMDA) of left coronary artery (LCA) in rats runs around the left side of conus arteriosus after arising from the aortic sinus and descends to the apex of heart with branching several branches into the wall of left ventricle (LV). The ligation site of LMDA for myocardial infarction (MI) is the 2~4 mm from LCA origin, between the pulmonary trunk and left auricle. The characteristics that rat heart has no interventricular groove on the surface and its coronary arteries run intramyocardially with branching several branches give the difficulty in surgery for MI which resulted in expected size. This study was aimed to elucidate the branching patterns of the left coronary artery for analysis of MI size and for giving the basic data to producing small MI intentionally in 2 male species that are widely used, Sprague-Dowley (SD) and Wistar-Kyoto (WKY), in the world. Red latex casting was followed by the microdissection in 27 and 28 hearts of SD and WKY male rats, respectively. The branching patterns of LMDA were classified into 3 major types and others based on the left ventricular branches (L). The Type I, Type II, Type III and others are shown in 55.6%, 22.2%, 14.8%, and 7.4% in SD, 60.7%, 10.7%, 7.1%, and 21.5% in WKY, respectively. The branching number of the first left ventricular branch (L1) that are distribute the upper one third of LV was 1.2~1.5, and its branching sites were ranging 0.9~2.1 ᒠfrom LCA origin. L2, the second left ventricular branch distributing middle one third of LV, was the number of 1.2~1.4 and branching out ranging 5.1~5.7 mm. L3, the third left ventricular branch of LMDA distributing lower one third of LV, was the number of 1~1.5 and branching out ranging 7.0~9.3 mm from LCA origin. The common branch of L1 and L2 was branched from LMDA with the number of 1.1, and its site was located in the distance of mean of 1.5 mm and 2.8 mm in SD and WKY, respectively. The common branch of L2 and L3 was branched from LMDA with the number of 1, and its site was located in the distance of mean of 7.2 mm and 2.9 mm in SD and WKY, respectively. The right ventricular branches (R) of LMDA were short and branched in irregularly compared with L. The number of 1~4 of R were branched from LMDA. With regarding to the distribution area of L and the ligation site for MI, moderate MI (25~35% of LV) might be resulted in 70.4% and 60.7% in SD and WKY rats. Small MI might be produced intentionally if the ligation would be located at the 4~6 mm from LCA origin in the left side of LMDA. These data wold be helpful to expect the size of MI and to reproduce of small MI, intentionally, in rat hearts.

• Journal of Acupuncture Research
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• 제17권3호
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• pp.125-139
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• 2000

Study of the fourteen meridians that include name of P'ung(風) point. The results were summarized as follows. 1. Pyongp'ung(秉風) is located middle of the supraspinatous fossa(Small intestine Meridian, 手太陽小腸經). we can cute the local area disease and also use to cure the pathway of the Arm greater yang small intestine which is attacked by P'ung(風) disease. 2. Yep'ung(翳風) is located behind the lobule of the auricle, in the depression between the mastoid process and the mandible(Triple Energizer Meridian, 手少陽三焦經). we can cure the local area disease especially hyper yang disease and also use to cure the pathway of the Arm lesser yang triple energizer which is attacked by P'ung(風) and Yo'l(熱) disease. 3. P'ungmun(風門) is located 1.5 chon beside the lower end of the spine of the second thoracic vertebra(Bladder Meridian, 足太陽膀胱經). we can cure the local area disease and also use to cure the pathway of the Leg greater yang bladder which is attacked by P'ung(風) disease. 4. P'ungbu(風府) is located 1 chon above the middle of natural line of the hair at the back of the head, in the depression below the occiptal protuberance(Governor meridian, 督脈). It connects (Liver meridian, 足厥陰肝經) and Yin Link Vessel(陽維脈). we can cure the rigidity and pain in head and nape which is related Yin Link Vessel(陽維脈). 5. P'ungshi(風市) is located on the lateral part of the thigh, 7 hon above the patella(From the greater trochanter to the knee joint is 19 chon, Gallbladder Meridian (足少陽膽經). we can cure the local area disease(leg, knee, etc). 6. P'ungji(風池) is located Below the occipital bone, in the depression on the outer part of the trapezius muscle(Gallbladder Meridian, 足少陽膽經) on a level with P'ungbu(風府) (Governor vessel, 督脈). we can cure the local area disease and also use to cure the pathway of the Leg lesser yang gall bladder which is attacked by P'ung(風) disease.