• Clinical and Experimental Pediatrics
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• 제50권1호
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• pp.74-78
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• 2007

목 적 : 전신성 홍반성 낭창(systemic lupus erythematosus, SLE)은 장기간에 걸쳐 다양한 임상경과를 나타내며 여러장기를 침범하는 자가 면역성 질환으로 유전적, 환경적, 면역학적 요인 등에 의한 면역 조절계의 이상으로 생각되고 있다. 소아에서는 갑작스럽게 발병하며, 경과가 빠르게 악화되며 여러 장기를 동시에 침범한다. 따라서 소아에서 조기 진단하여 조기 치료하는 것이 SLE의 예후 개선에 더욱 중요한 점으로 생각된다. 이에 저자들은 소아에서 발생한 SLE 환아의 임상 양상, 검사 소견, 예후에 대해 전반적으로 고찰하여 질환의 진단 및 예후의 향상을 기대하고자 한다. 방 법 : 1996년 1월부터 2005년 12월까지 10년간 신촌 세브란스 병원 소아과에서 전신성 홍반성 낭창으로 진단받은 45례의 환아를 대상으로 의무기록을 후향적으로 고찰하였다. 결 과 : 진단 당시 평균발병 연령은 $10.8{\pm}3.8$(0-15)세였으며 10-15세 사이에서 호발(68.9%)했으며 환아의 남녀비는 1:4였다. 진단시 초기증상으로 안면 부종(51.1%), 나비모양 홍반(44.4%), 발열(28.9%), 관절통(15.6%), 빈혈(13.3%) 및 광과민성(11.1%)순 이였다. SLE의 ARA 진단 기준중 항목별 양성률은 형광항핵항체(97.8%), 항ds DNA항체(82.2%), 루프스 신염(71.1%), 나비형 홍반(71.1%) 및 혈액학적 이상(66.7%)의 순이었다. 진단 당시 루프스 신염이 동반 되었던 경우는 45례 중 23례(51.1%)였으며 치료 중 8례가 루프스 신염으로 새로 진단되어 그 빈도가 71.1%로 조사되었고 신생검상 WHO class IV 병변인 미만성 증식성 사구체 신염(43.8%)이 가장 많았다. 2례는 완치되었으며, 2례 모두 신생아 루프스였다. 우리나라 아동에서 외국에 비하여 발열, 광과민성, 입궤양, 관절통, 늑막염은 적게 관찰되는 양상을 보였다. 결 론 : 소아에서 전신성 홍반성 낭창의 임상 양상과 예후는 다양하다. 장기적인 추적 관찰이 필요하며 예후의 향상을 위해 조기 진단과 적극적인 치료가 중요하며, 향후 이 질환에 대한 심도 있는 연구가 지속되어야 할 것이다.

• 한국임상약학회지
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• 제15권2호
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• pp.149-159
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• 2005

Purpose: To determine the extent and rate of prescription drug therapy, especially polypharmacy and the prevalence of potentially inappropriate medication use in Korean elderly ambulatory patients based on an explicit criterion. Methods: Performed a retrospective study of 65 years or older ambulatory patients visiting a university hospital based clinic from January 2002 to April 2004. Study determined the patterns of drug prescription per Anatomical Therapeutic Chemical Classification and the potentially inappropriate medication usage based on explicit Beers criteria. Results: Of the 4,042 elderly patients the mean number of prescription was $2.2{\pm}2.0$, which was similar between genders and all age groups within the elderly. 10.7% of patients were prescribed with more than 5 medications concurrently. The most frequently prescribed medication was the drugs used for treating nervous system diseases (44.3%), followed by alimentary tract/metabolism disorders (27.6%), cardiovascular disease (10.7%), blood/blood forming disorders (4.3%), respiratory disorders (6.5%), and musculoskeletal diseases (3.2%). A total of 511 elderly (13%) was prescribed with medication that met the criteria for=1 potentially inappropriate drugs for the elderly. This proportion was similar between genders and all age groups within the elderly. Among these 511 elderly patients the mean number of potentially inappropriate drugs prescribed was $5.1{\pm}3.3$ drugs. Potentially inappropriately prescribed drugs included amitriptyline (76 cases), diazepam (69 cases), ketorolac (57 cases), short acting nifedipine (44 cases), triazolam (38 cases), and hydroxyzine (38 cases). Conclusion: Potentially inappropriate drug prescribing in Korean ambulatory elderly patients are common. Education programs and interventions aimed at optimizing the prescribing and dispensing of the most appropriate drugs are needed.

• 대한중풍순환신경학회지
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• 제15권1호
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• pp.72-79
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• 2014

A 44-year-old male complained of chest pain. Two years ago he was diagnosed with angina pectoris for stenosis of coronary artery in coronary angiography. Despite of medication, his chest pain aggravated to cardiovascular society classification class III. His electrocardiogram, cardiac enzymes were normal. Accordingly we diagnosed him with unstable angina. And we pattern differentiated him with heart heat syndrome considering his other symptoms. He wanted conservative care instead of coronary artery intervention generally recommended for treating unstable angina. We treated him for 13-days with tongxinluo, modified daochi-san, acupuncture, smoking prohibition which were thought to be effective for treating unstable angina based on experimental, clinical studies. Within the therapeutic period, frequency of chest pain and frequency of taking nitroglycerin were on the decrease.

• 한국임상약학회지
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• 제26권4호
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• pp.324-329
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• 2016

Background: With the development of information and communication technology, there is a growing number of people looking for health information on the internet. This pilot study was performed to analyze the pattern of pharmacist consultation on the internet portal site. Methods: Questions and answers posted on the portal site "Naver Jisik-iN" from March 1st to 31th in 2016 were collected. Medications asked were categorized into prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others. Medications were subcategorized into 14 according to the anatomical therapeutic chemical classification system. Questions were divided into 10 categories based on Hepler's drug-related problems. Results: Of the 955 cases, females accounted for 59.5% and inquirers from 11 to 40 years old, 89.4%. The number of prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others were 428 (44.8%), 328 (34.3%), 31 (3.3%), 2 (0.2%), 122 (12.8%), and 44 (4.6%), respectively. Questions for drugs acting on alimentary tract and metabolism took up 27.4% followed by those on nervous system, 13.6% and anti-infectives for systemic use, 12.2%. Pharmacist consultation regarding drug information, drug interaction, and adverse reaction occupied 47.9%, 15.2%, and 12.3%, respectively. Conclusion: Health counseling through online is predicted to increase steadily, so pharmacists should broaden their boundaries beyond off-line pharmacies to meet social needs.

• 한국도서관정보학회지
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• 제10권
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• pp.157-191
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• 1983

The purpose of the study is to build a general cost a counting model for university libraries, to clarify the possible areas of its a n.0, pplication by employing job cost accounting and process cost accounting methods. System analysis is performed as to the fields of acquisition, processing (cataloging & classification), and book shelving system. The existing operation processes and time required for each operation of these three systems are analyzed, from which detailed system flowcharts were drawn and job descriptions and the content of job were identified. The results of the study can be summarized as follows: (1) The processing time of one book in each systems: Oriental books. a. Acquisition system. the time required the time required in case of job cost case of job cost accounting after purchasing, 8 min. 21 sec. the time required in case of process cost accounting 15 min. 7 sec. b. Processing system. the time required for non-duplicate, 34 min. 40 sec. the time required for duplicate, 8 min. 49 sec. the time required for purchasing of more than the time required two copies at a time. 4 min. 44 sec. c. Book shelving system. the time required. 1 min. 43 sec. Western books. a. Acquisition system the required in case of job cost accounting, 9 min. 1 sec. the time required in case of process cost accounting. 15 min. 7 sec. b. Processing system. the time required for non-duplicate, 32 min. 58 sec. the time required for duplicate, 9 min. 26 sec. the time required for purchasing of more than two copies at a time. 5 min. 33 sec. c. Book shelving system. the time required. 1 min. 43 sec. (2) Total sum of processing time and processing cost per book. Oriental books (including material cost) the time required. cost. a. non-duplicate, 51 min. 30 sec. 2, 791 won b. duplicate, 25 min. 39 sec. 1, 580 won c. purchasing of more than two copies as a time, 21 min. 34 sec. 1, 368 won Western books(including material cost) a. non-duplicate, 49 min. 48 sec. 3, 189 won b. duplicate, 26 min. 16 sec. 1, 846 won c. purchasing of more than two copies at a time. 22 min. 23 sec. 1, 388 won

• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.59-71
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• 2024

Background: Restoration of external (ER) and internal rotation (IR) after Grammont-style reverse shoulder arthroplasty (RSA) is often unreliable. The purpose of this systematic review was to evaluate the influence of RSA medio-lateral offset and subscapularis repair on axial rotation after RSA. Methods: We conducted a systematic review of studies evaluating axial rotation (ER, IR, or both) after RSA with a defined implant design. Medio-lateral implant classification was adopted from Werthel et al. Meta-analysis was conducted using a random-effects model. Results: Thirty-two studies reporting 2,233 RSAs were included (mean patient age, 72.5 years; follow-up, 43 months; 64% female). The subscapularis was repaired in 91% (n=2,032) of shoulders and did not differ based on global implant lateralization (91% for both, P=0.602). On meta-analysis, globally lateralized implants achieved greater postoperative ER (40° [36°-44°] vs. 27° [22°-32°], P<0.001) and postoperative improvement in ER (20° [15°-26°] vs. 10° [5°-15°], P<0.001). Lateralized implants with subscapularis repair or medialized implants without subscapularis repair had significantly greater postoperative ER and postoperative improvement in ER compared to globally medialized implants with subscapularis repair (P<0.001 for both). Mean postoperative IR was reported in 56% (n=18) of studies and achieved the minimum necessary IR in 51% of lateralized (n=325, 5 cohorts) versus 36% (n=177, 5 cohorts) of medialized implants. Conclusions: Lateralized RSA produces superior axial rotation compared to medialized RSA. Lateralized RSA with subscapularis repair and medialized RSA without subscapularis repair provide greater axial rotation compared to medialized RSA with subscapularis repair. Level of evidence: 2A.

• 대한방사선기술학회지:방사선기술과학
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• 제23권2호
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• pp.21-26
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• 2000

The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The followings are the results ; 1) The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. 2) There were twice as many male patients, with a ratio of 288 : 135 men to women. 3) 101 patients suffered from single herniated discs, while 322 patients suffered from multi-herniated discs. 4) Of single herniated disc injuries, 52 patients had protruded discs (52%), while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between $C_4{\sim}C_5$, and 51 patients (50%), and had the same injury between $C_5$ and $C_6$. 5) Of multi-herniated disc injuries, 140 patients had protruded discs(44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs(17%). 36 patients(11%), herniated discs $C_3{\sim}C_6$ ; 69 patients (21%), herniated discs $C_3{\sim}C_7$ ; 47 patients(15%) herniated discs $C_4{\sim}C_6$ and 67 patients(20%) herniated discs $C_5{\sim}C_7$.

• Journal of Korean Neurosurgical Society
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• 제44권6호
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• pp.358-363
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• 2008

Objective : This study was performed to assess the efficacy of GKS in patients with ten or more brain metastases. Methods : From Aug 2002 to Dec 2007, twenty-six patients (13 men and 13 women) with ten or more cerebral metastatic lesions underwent GKS. The mean age was 55 years (32-80). All patients had Karnofsky performance status (KPS) score of 70 or better. According to recursive partitioning analysis (RPA) classification, 3 patients belonged to class I and 23 to class II. The location of primary tumor was lung (21), breast (3) and unknown (2). The mean number of the lesions per patient was 16.6 (10-37). The mean cumulated volume was 10.9 cc (1.0-42.2). The median marginal dose was 15 Gy (9-23). Overall survival and the prognostic factors for the survival were retrospectively analyzed by using Kaplan Meier method and univariate analysis. Results : Overall median survival from GKS was 34 weeks (8-199). Local control was possible for 79.5% of the lesions and control of all the lesions was possible in at least 14 patients (53.8%) until 6 months after GKS. New lesions appeared in 7 (26.9%) patients during the same period. At the last follow-up, 18 patients died; 6 (33.3%) from systemic causes, 10 (55.6%) from neurological causes, and 2 (11.1 %) from unknown causes. Synchronous onset in non-small cell lung cancer (p=0.007), high KPS score (${\geq}80$, p=0.029), and controlled primary disease (p=0.020) were favorable prognostic factors in univariate analysis. Conclusion : In carefully selected patients, GKS may be a treatment option for ten or more brain metastases.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1013-1024
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• 1989

One hundred and seventy two patients of primary lung cancer, confirmed by tissue diagnosis at the Dept. of Thoracic and Cardiovascular Surgery in Korea University Hospital between June 1973 and August 1988, were evaluated and restaged with New International TNM classification, and the actuarial survival rate was obtained using Kaplan-Meier equation. The results of analysis were as follows. 1. Male to female ratio was 3.8:1, and prevalent age groups were sixth and seventh decades [76.4 %]. 2. The most common subjective symptom was cough [55.2 %], and 67.4 % of all patients were visited to hospital less than 6 months of symptoms. 3. Positive rates for tissue diagnosis were 100% in open chest or metastatic lymph node biopsy, 80 % in mediastinoscopic biopsy, 60 % in pleural biopsy, 59 % in pleural fluid cytology, 36% in bronchoscopic biopsy, and 22 % in sputum cytology. 4. The order of frequency of cell type was squamous cell carcinoma [53.0%], adenocarcinoma [22.0 %], small cell carcinoma [14.5 %], and so on. 5. Operability and resectability were 44% and 62% respectively, but they were improved recently. 6. Open and closure was done in 44 % of operated patients, uni or bilobectomy in 38 % and pneumonectomy in 24 %. 7. Overall operative mortality rate was 2.6 %. 8. The order of frequency of stage level was S3b [42.0 %], S3a [25.1 %], S1 [15.6%], and so on. 9. Distant metastasis, i.e. stage 4, was noted in 9.5 % of cases, and the sites of frequency were bone, brain, skin, and so on. 10. Actuarial survival rate was 1 year 48.2%, 2 year 36.9%, 3 year 31.2%, and 5 year 20.8%. According to above listed factors, 5 year survival rate was highest in squamous cell carcinoma, lobectomized cases, stage 1, NO in TNM system, and resectable cases. But T factor in TNM system and radiation therapy in nonresectable cases did not show statistical significance in life expectancy.

• 비파괴검사학회지
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• 제36권1호
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• pp.35-44
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• 2016

본 연구에서는 발아여부를 고속 대량으로 측정 가능한 초분광 영상 시스템 기반의 비파괴 선별기술을 개발하고자 하였다. 수박의 건전종자 96립과 퇴화종자 96립을 초분광 단파적외선 시스템을 이용하여 측정하였으며, 종자발아검증은 국제종자검정협회(ISTA)규정에 맞추어 5~14일 동안 $25^{\circ}C$에서 BP(between paper)법을 이용하여 실시하였다. 스펙트럼 데이터는 초분광 영상 시스템을 이용하여 데이터를 획득하였으며, 종자 판별모델 개발에는 PLS-DA(partial least square - discriminant analysis)를 적용하였다. PLS-DA분석법을 이용한 종자의 발아여부 판별 결과는 mean normalization을 이용하여 데이터 전처리를 이용할 경우가 가장 우수했으며, calibration의 경우 94.7%의 분류 정확도를 보였으며, validation의 경우 84.2%의 분류 정확도를 나타내어 평균적으로 90.8%의 정확도를 보였다. 이러한 결과는 종자가 퇴화하면서 야기되는 구성성분물질의 차이로 인한 것으로 사료되며, 두 그룹의 분류에 주요한 영향을 끼친 요인의 파악 및 적용을 통해 종자선별기의 개발이 가능함을 보였다.