• Journal of Chest Surgery
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• 제35권8호
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• pp.594-598
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• 2002

아미오다론은 일반적인 항부정백 약물로 잘 치료되지 않는 상심실성 부정맥이나 심실성 부정맥의 치료에 효과적이라고 알려져 있는 요오드화된 벤조푸루란 유도체이다. 아미오다론으로 치료받은 환자들에게서, 속발되는 수술적 치료는 흔히 동반되는 과정이지만, 애석하게도 아미오다론으로 수술중과 수술후에 야기될 수 있는 합병증에 대해서 정확한 자료를 가지고 있지 못한 것이 현실이다. 일부 보고들에 따르면, 아미오다론으로 치료받던 환자들에게서 알파 교감 수용체와 베타 교감 수용체에 차단을 야기하고, 이는 수술후 혈역학적 지지에 더 많은 심근 자극과 에피네프린등의 약물을 필요로 하게 된다고 알려져 있다. 또한, 심각한 사망률과 유병율을 야기하는 아주 심각한 형태의 급성호흡부전증을 야기하게 된다고 알려져 있다. 본 교실은 승모판막치환술 후에 아미오다론으로 인하여 유발된 급성호흡부전증으로 사망한 환자를 경험하였기에 간략한 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제11권3호
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• pp.326-332
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• 1978

There appears some conduction defects frequently after total correction of Tetralogy of Fallot. Common defect is right bundle branch block due to surgical intervention. We experienced complete A-V block which occured 3 months later after total correction of Tetralogy of Fallot in a 8 year old boy. The patient was completely free of any A-V block after the operation for 3 months, and sudden onset of A-V block with coupled premature ventricular contractions resulted him in shock state during the attack of severe bronchopneumonia for 4 days prior to the second visit. Emergency implantation of Cordis demand type temporary pacemaker was necessary to control the complete heart block with bradyarrhythmia and frequent ventricular fibrillation. Permanent cardiac pacemaker was implanted two weeks later as indicated with Cordis Stanicor lambda demand pacemaker, and the patient was discharged uneventfully on the 8th post implantation day with the heart rate of 72/min. Another 3 months after the implantation, the patient was transported to this hospital as dead on arrival after an accidental fall from a 2 meter height, and all possible cardiopulmonary resuscitation was performed for 60 minutes at the emergency room in vain. Autopsy was done to find out the cause of sudden death and the etiology of complete heart block. Microscopic focal infarctions with scar formation were noted along the course of conduction system in the interventricular septum, which might be the main cause of complete heart block during the attack of severe bronchopneumonia complicated with acute bacterial endocarditis. The tip of the pacemaker wire was slipped from the granulation scar at the apex of the right ventricular cavity, and this might be the direct cause of pacing failure and death.

• 지역사회간호학회지
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• 제13권2호
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• pp.260-271
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• 2002

Objectives: The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul. Methods: Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA. Results: 1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal. state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups. Conclusion: A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.

• Journal of Chest Surgery
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• 제44권4호
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• pp.273-278
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• 2011

Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. Materials and Methods: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age $67.7{\pm}11.7$ yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system ($EBS^{(R)}$Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). Results: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time $20.8{\pm}26.0$ min). The mean time from vascular access to the initiation of ECMO was $17.2{\pm}9.4$ min and mean support time was $3.8{\pm}4.0$ days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration $50.1{\pm}31.6$ days). Patients survived on average $476.6{\pm}374.6$ days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). Conclusion: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.

• 한국실내디자인학회논문집
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• 제22권3호
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• pp.154-163
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• 2013

Current principles of designating a smoking area within a non-smoking area rely on mere compartmentalization. This causes non-smokers aversion against smokers and smokers complaints about anti-smoking policies, which means both of them are not satisfied with the current scheme. In addition, such a system, far from the original intent of the law, does not provide appropriate respect for people's rights. The biggest problem of the current scheme is that smoking areas are not separated from non-smoking areas. Japan has continued installing independent smoking areas since 2002 and witnessed a decrease in the smoking rate. The country's success is attributable to: the state's active intervention in connection with enterprises; continuous environmental improvements and creation of goods; 'smoking etiquette' campaigns; and the sociality and group consciousness of Japanese people. It is recognized that the synergy of the designation of independent smoking areas and such multi-faceted efforts has led to the nation's accomplishment. Hence, it is required to install independent smoking areas in non-smoking areas in Seoul in order to respect the rights of smokers and non-smokers and resolve conflicts between them. It is not suitable to merely model after Japan's case, however, studies and guidelines that are tailored to Korea's own environment and social atmosphere are required. To ensure that the people recognize the necessity for smoking areas, a social consensus is formed and proper smoking areas are established in a systemic manner, a system for that purpose should connote a symbol of the social consensus and consequent guidelines should take physical elements, human activities and semantic assignment into consideration. This study aims to present basic guidelines to install separated smoking areas, which will keep distance between smokers and non-smokers, form a social consensus and establish a sound smoking culture. These would ensure that the rights of both smokers and non-smokers are fully respected and that government policies are trusted by the people.

• 대한물리의학회지
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• 제14권4호
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• pp.133-142
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• 2019

PURPOSE: This study examined the effectiveness of an active lifestyle on the HRV and fitness of the older female adults. METHODS: Eighty female older adults (72.68±3.78 years) were sampled from a senior wellness institute. Accelerometers were distributed to each participant to have the device attached to them for one week, and the physical activity data (Energy expenditure in Kcal) of each participant were analyzed. Participants were divided into 3 groups (<1,000 Kcal vs 1,000 to 1,500 Kcal vs ≥1,500 Kcal) based on the amount of weekly physical activity. Before and after data analysis, the HRV was measured at resting state and the Senior Fitness Test was performed. RESULTS: One way ANOVA showed a significant difference in the HRV between the three groups. Group A (≥ 1,500 Kcal) was superior in HF and HF/HF + LF whereas Group C (<1,000 Kcal) showed high level of LF, LF/HF, and LF/HF+LF. The same statistics revealed significant differences in fitness. Most of the fitness variables were superior in Group A and B compared to Group C. Significant correlations were observed between physical activity and both HRV and in fitness. CONCLUSION: Theses results suggest that an active lifestyle may be an effective intervention for the prevention of both cardiometabolic disorder and improvement of the fitness level in older female adults.

• 대한물리의학회지
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• 제14권4호
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• pp.143-152
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• 2019

PURPOSE: This examined the effects of a sling exercise based on music on the cognition, physical performance of patients with dementia. METHODS: Thirty subjects with dementia volunteered to participate in this study. All subjects were allocated randomly to either the experimental group or control group, with 15 subjects in each group. All subjects underwent the exercise program for an average of 60 minutes per day for 16 weeks. The experimental group performed sling exercise based on music, and the control group performed the general exercise program. Assessments were made using the Korean version of mini-mental state examination (MMSE-K), 10 m walk test (10MWT), Tinetti mobility test (TMT), and Katz's Index of Independence in activity daily living (KIIADL) to detect changes in the cognitive level and physical performance before and after the 16-week training period. A paired t-test was conducted to compare the within-group change before and after the intervention. An independent t-test was performed to compare the between-group difference. The statistical significance level was set to α=.05 for all variables. RESULTS: The experimental group showed significant within-group changes in the MMSE-K, 10MWT, TMT, and KIIADL (p<.05). The control group showed a significant change in only the KIIADL (p<.05). A significant difference was observed between the experimental group and the control group regarding the change in MMSE-K and KIIADL after the interventions (p<.05). CONCLUSION: A music-based sling exercise program effectively improves cognition, physical performance, and ADL in patients with dementia. Further studies with a wider range of subjects and scientific equipment will be needed to strengthen the results of this study.

• 정신신체의학
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• 제9권1호
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• pp.93-102
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• 2001

이완반응은 갚은 휴식상태를 말하며, 소위 스트레스반응으로 불리는 투쟁-도피 반응의 생리적 변화와 반대되는 생리적 변화를 일으키게 된다. 따라서 인위적으로 이완반응을 일으킴으로써 이러한 스트레스 반응을 상쇄시킬 수 있다. 이러한 이완반응을 일으킬 수 있는 복식호흡, 명상, 점진적 근육이완기법, 자율이완훈련, 생체되먹이기법 등의 다양한 이완기법들이 제시되어 왔으며, 이들은 다양한 신체, 정신 질환뿐만 아니라 정상적인 스트레스 관리 프로그램에 있어서도 마음과 신체의 안녕을 위해 유익한 도움을 줄 수 있음이 알려져 있다. 이러한 이완기법들은 스트레스 관리를 위한 전체적 과정의 한 부분으로 이해되어야 할 것이며, 자신에 맞는 적절한 기법을 찾아 지속적인 훈련을 함으로써 효과적인 스트레스 관리 방법으로서의 역할을 할 수 있을 것이다. 이에 본 저자는 명상, 점진적 근육이완기법, 자율이완훈련 및 기타 이완기법에 대한 보다 구체적이고 실제적인 방법을 제시하고자 한다. 스트레스와 관련된 다양한 신체, 정신 질환들에 대한 치료적 접근을 함에 있어서, 전통적 치료 방법에 병합하여 이완기법을 사용함으로써 스트레스와 질병 사이의 조절자로 이용할 수 있을 것이다.

• 한국콘텐츠학회논문지
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• 제11권12호
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• pp.335-346
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• 2011

본 연구의 목적은 상부 위장관 질환군별로 영향 요인과 소화기 증상의 차이를 비교해보고자 한 것이다. 본 연구는 2003년 10월부터 2004년 10월동안 서울소재 일개 건강검진센터를 방문하여 건강검진을 시행한 20-79세 수진자들의 Helicobactor Pylori 및 위내시경 결과와 건강문진표 전산자료를 연구 대상으로 하였으며, 대상 자료 중에서 중복 사례와 제외 기준에 해당된 건수를 제외한 최종 2,708건을 $x^2$ 검정 및 ANOVA test로 분석하였다. 상부 위장관 질환군별로 유의한 차이를 보인 영향요인은, 인구사회학적 요인으로 성별, 연령, 직업, 생활습관 요인으로 흡연, 음주, 병태생리적 요인으로 H. pylori 감염여부, 심리적 요인으로 스트레스 등이 있었다. 상부 위장관 질환군별 유의한 차이를 보인 소화기 증상은, "위에 음식물이 남아 있는 듯한 느낌이 든다", "공복 시에나 식후에 속이 쓰리다", "신물이 자주 넘어 온다"는 항목이었다. 이상의 본 연구 결과는 일상생활에서 흔히 접하게 되는 상부 위장관 질환별 특성 파악에 유용한 자료를 제시함으로써, 상부 위장관 질환과 관련된 건강증진 중재 개발의 기초 자료로 활용될 수 있을 것으로 본다.

• Journal of Korean Neurosurgical Society
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• 제42권6호
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• pp.436-440
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• 2007

Objective : Spinal cord hemangioblastoma is an uncommon vascular neoplasm with a benign nature and is associated with von Hippel-Lindau (VHL) disease in 20-30% of patients. Total removal of these tumors without significant neurological deficit remains a great challenge. The purpose of this study was to investigate the efficacy of VHL mutation analysis and to evaluate surgical outcome of patients with spinal cord hemangioblastomas. Methods : This study included nine patients treated for spinal cord hemangioblastomas at our institute between December 1994 and March 2006. There were four male and five female patients. Mean age was 37.8 years. The mean follow-up period was 22.4 months. Magnetic resonance imaging (MRI) of the complete neuraxis was done in all cases and VHL mutation analysis was performed in three cases for a definite diagnosis. Results : Six patients had intramedullary tumor, and the remaining patients had intradural extramedullary lesions. Five patients were associated with VHL disease. The von Hippel-Lindau mutation analysis was done in three patients and two of them showed VHL gene abnormality. Tumors were located in the cervical cord in five cases and in the thoracic cord in four cases. All patients underwent surgical intervention, and total removal was achieved in six cases. All patients showed improvement or, at least, clinically stationary state. Surgical complications did not develop in any cases. Conclusion : Spinal hemangioblastoma in this series has been safely and effectively removed via a posterior approach. Postoperatively, clinical outcome was excellent in the majority of cases. The VHL mutation analysis was useful in patients with family history and in those with multiple hemangioblastomas.