• Journal of Chest Surgery
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• 제39권10호
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• pp.775-778
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• 2006

비후형 심근증은 심근의 부적절한 비대로 유발되며 호흡곤란, 흉통, 실신, 그리고 급사에 이르기까지 다양한 임상 양상을 보인다. 이러한 증상은 주로 좌심실유출로의 협착으로 인해 발생하며 이를 해결하기 위해 심실중격절제술이 고안되었다. 하지만 기존의 고전적인 중격절제슬은 대동맥절개술을 통해 진행되었으며, 이는 심실 중격의 중앙부위에 병변이 존재할 경우 시야 확보의 어려움과 병변으로의 접근이 용이하지 않아 극히 일부분의 심실중격절제술만을 시행할 수밖에 없었다. 따라서 좌심실 유출로의 협착 및 승모판막의 수축기전방운동 등이 완벽하게 해결되지 않는 경우가 흔하였고 이러한 경우 환자의 증상 호전과 생존기간의 연장에도 한계가 있었다. 본 증례에서는 이러한 환아에게서 좌심실 심첨부의 절개를 통해 비후된 유두근과 건삭을 포함한 광범위 중격절제술(extended septal myectomy)을 시행하였다. 수술 후 환아의 증상은 호전되었으며 심초음파 및 방사선학적 소견상 특별한 문제없이 10개월째 외래 경과 관찰 중이다.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.163-169
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• 2010

Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

• 대한후두음성언어의학회지
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• 제26권1호
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• pp.25-33
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• 2015

Background and Objectives:The objective of this study was to investigate the features of post-thyroidectomy subjective voice disorder by Voice Handicap Index (VHI) and Voice Symptom Scale (VOISS) through aerodynamic analysis and to investigate the appropriate voice therapy intervention. Materials and Methods:Twenty post-thyroidectomy patients who had no recurrent laryngeal nerve paralysis through laryngeal stroboscopy were enrolled for this study. Acoustic and aerodynamic evaluations were performed before operation, 2 weeks and 3 months after operation. Subjective voice evaluation was performed by VHI and VOISS. Aerodynamic evaluation was compared and analysed by maximum phonation time(MPT), phonation threshold pressure(PTP), mean air flow rate(MFR), etc. Subjective voice evaluation was surveyed through VHI and VOISS. To evaluate patients' symptoms related to functional voice disorder, scores on physical domain in VHI and VOISS were selected to be compared for each session. Results: The 10 out of 20 participants who complained of voice symptoms had no significant difference with pre-operation in acoustic evaluation, but all showed higher scores on 2 weeks and 3 months after operation compared to pre-operation, in VHI-physical domain and selected questionnaires in VOISS. They reduced MPT and increased PTP value simultaneously. Laryngeal massage and breathing training were simultaneously treated to them, 5 participants resulting in improvement in MPT and PTP compared to pre-treatment. Conclusion:Patients who complained voice change with no organic damage after thyroidectomy were all shown to have reduced MPT and increased PTP in some by aerodynamic evaluations. Reduced MPT may imply some problem in air flow beneath glottis. Increased PTP suggests much more effort in vocalization mechanism than pre-operation. Comparing aerodynamic evaluations in post-thyroidectomy may provide information on behavioral interventions. Additionally, study on laryngeal massage and breathing training simultaneously treated to patients with such voice disorder is needed to be conducted with larger number of participants.

• 치위생과학회지
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• 제18권2호
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• pp.124-129
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• 2018

본 연구는 골관절염의 유병률이 증가하는 시기인 성인을 대상으로 악관절 증상과 요추질환의 관련성 분석을 통해 구강 건강 및 일반적인 건강 향상을 위한 보건정책개발에 도움이 되고자 수행하였다. 대표성이 있는 국민건강영양조사 자료 중 제5기 3차년도(2012년) 자료를 활용하였으며 연구목적에 적합한 만 50세 이상을 대상으로 건강설문 및 요추관절 방사선 검사를 완료한 3,017명을 연구대상으로 분석을 수행하였다. 악관절 증상의 여부는 16.1%가 최근 1년간 악관절 부위에서 이상 증상을 한 가지 이상 경험했다고 답하였다. 요통의 경우 20.6%가 최근 3개월 동안 요통이 있다고 답하였으며, 요추관절 방사선 영상 진단결과에 따른 요추 골관절염이 있는 사람은 30.6%로 나타났다. 악관절 증상을 경험한 사람의 경우 요통 유병위험률이 정상군에 비해 1.70배(95% CI, 1.30~2.22) 증가하는 것으로 나타났으며, 요추 골관절염 유병 위험률은 정상군에 비해 1.20배(95% CI, 0.86~1.68) 증가하는 것으로 나타났다. 본 연구결과 성인의 악관절 증상이 요추 골관절염 유병위험률과의 관련성에서는 유의하지는 않았지만 요추질환의 전형적인 증상인 요통에는 영향을 미치는 것을 알 수 있었다. 따라서 성인들의 악관절 증상에 대한 적절한 치료 및 예방을 한다면 요추질환 유병률을 낮추고, 삶의 질을 높이는 데 중요한 작용이 될 것으로 판단된다. 또한 향후 악관절 장애와 요추질환에 대한 적절한 관리프로그램 개발 및 체계적인 지원이 필요하다고 생각된다.

• 지역사회간호학회지
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• 제14권1호
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• pp.106-119
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• 2003

This study was executed to develop the model of the format of the day care center which supplies the total service on the health care in the day time and social program related with the work and to evaluate the processing courses which was adjusted for 3 years from March 1999 to December 2001 in order to improve the quality of life of the family who experience dementia, dementia prevention, and the old and the burden of daily activities. The processing courses of this business model were evaluated to the confirmation on the health condition, application of the nursing processes, and the precise medical examination, and 20 sorts of social programs. The methods used in this model were the simplified MMSE-K, Ability for ,Daily Life(ADL), Instrumental Activities of Daily Living(IADL), and nursing process, and so on. The execution effects of this model are as follows. 1. It can contribute to the delay in the dementia process of the old people who are related with the dementia and maintenance and improvement of the health by confirming the stopping of the process of the dementia as the objective estimation method while the dementia symptom is maintained as the current condition through the medical and social total services. 2. The reduction of the burden for the daily care of the subject people and their families for the old people who are concerned with the dementia helped to improve the quality of life of the subject people and their family by enabling them to have jobs. 3. It enabled them to positively cope with the demand for the health and nursing of the local residents related to the old people. 4. It enabled them to enhance the recognition for the socialization of the local social organization and residents for the old people. 5. It enabled them to reinforce the related system among the local social organizations, and develop and provide the various social programs which are proper for the old people.

• Tuberculosis and Respiratory Diseases
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• 제64권3호
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• pp.219-223
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• 2008

저자들은 대량 객혈로 내원한 환자에서 폐 출혈과 함께 반복적인 심인성 폐부종, 카테콜라민 유도성 심부전이 합병된 드문 형태의 갈색세포종을 경험하여 이러한 임상 증상시 폐나 심장 질환 외에 갈색세포종에 대한 고려가 필요할 것으로 생각되어 문헌고찰과 함께 보고하는 바이다.

• 한국안전학회지
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• 제25권6호
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• pp.169-179
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• 2010

The aim of this study was to investigate occupational and individual risk factors and working conditions in relation to musculoskeletal symptoms in street cleaners. Investigation was conducted through a survey of 395 male street cleaners employed by the government office in Seoul, Gyeonggi and Chung-Nam from July to August of 2009. The control group was comprised of 143 male drivers and security guards. Risk factors for musculoskeletal symptoms in street cleaners were investigated by multiple logistic regression analysis and also evaluated ergonomic risk factors by assessing working conditions of 4 street cleaners. As a result of symptom questionnaires, all of the prevalent rates of musculoskeletal symptoms in street cleaners had significantly higher results than those of the control group(p<0.05). On binary logistic regression analysis of musculoskeletal symptoms, street cleaners showed significant higher odds ratio as 18.84(95%CI: 6.56-54.12) in the arm/elbow, 10.49(95%CI: 4.29-25.65) in the hand/wrist compared to the control group. Both absence of rest breaks and exposure to ergonomic risk factors showed to be important internal risk factors of musculoskeletal symptoms among street cleaners. The exposure levels of QEC(Quick exposures checklist) in street cleaners were revealed to be higher on the shoulder/arm, wrist/hand, and neck than back, or from stress. The findings appear to show that street cleaners were high-risk group of work-related musculoskeletal disorders. Therefore street cleaners require a holistic interventional strategy, including adequate arrangement of rest breaks, improvement of working tools and control of individual risk factors such as obesity and smoking.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.100-100
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• 1993

구개인두성형술은 만성 코골음 및 폐쇄성 수면 무호흡증의 치료를 위해 널리 이용되고 있는 수술이며 수술 직후의 치료 효과 및 합병증에 대한 연구는 많이 이루어져 있으나 5년 이상의 장기 추적 관찰에 관한 연구는 드물게 보고 되고 있다. 이에 저자들은 1985년부터 1987년까지 구개인두성형술을 시행한 총 37명의 환자중 추적관찰이 가능했던 25명의 환자(남:18명, 여:7명)를 대상으로 수술전, 수술후 8주 및 수술후 5년이 지난 환자의 주관적 증상을 비교 평가 하였으며 중상의 변화와 함께 체중의 증감도 같이 조사하여 다음과 같은 결과를 얻었다. (1) 수술후 5년된 25명의 환자에서 코골음은 10명(40%)에서 완전히 사라졌고 정도의 차이(Grade 1 - 3)는 있지만 3명을 제외한 나머지 모두에서 호전을 보였다. (2) 수술전 AI>20이었던 15명의 환자에서 발견된 수면 무호흡증은 추적 관찰용 수면 다원 검사상 13명의 환자에서 Grade 0 - 1 (Oxygen saturation 86%)로의 호전을 보였고 수술후 5년이 지난뒤에도 증상의 변화 및 체중 변화는 없었다. (3) 수술 5년후에도 문제가 되는 합병증으로는 물을 급히 마실 때에만 코끝에 물방울이 비치는 정도의 구개인두부전 3례, 인두 비대칭 1례, 인두 건조감이 5례에서 관찰되었다. 그외 비인두 협착, 미각 상실, 및 호흡 순환계의 장애 둥 심각한 합병증은 발견되지 않았다.

• Journal of Acupuncture Research
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• 제27권1호
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• pp.87-100
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• 2010

Background : Recently a discussion about Qi including a study about the effect or the theory of acupuncture is getting prevailing in various angles. In most of studies about acupuncture stimulus, 'Filiform acupuncture'(毫鍼) is used. A study about Nine kinds of acupuncture(九鍼), except 'Filiform acupuncture'(毫鍼) has not been reported yet, and there is no study about using a special acupuncture made for controling Qi either. Objectives : 'Dong Chu Gold Chim(DCG-chim, 東樞金鍼)' can be used for patients who are scared of a pain because it is a medical Qi-gong tool and non-invasive stimulus one. To assess a effect of Qi-gong operation using DCG-chim objectively Methods : The present study was performed to elucidate the effects of DCG-chim stimulation of an acupuncture point Baihui($GV_{20}$) on the Electroencephalogram(EEG). Twenty healthy subject were treated with DCG-chim one time accompanied by the light and vertical pressure and EEG were measured during five minutes for three times (before, during and after treatment). The EEG results of DCG-chim treatment were compared with those of 'Filiform acupuncture(毫鍼)'. Results : EEG power spectra changed significantly after both kind of acupuncture stimulation. Significant increase of $\alpha$ wave and decrease of $\beta$ wave were observed but interestingly, Mid-$\beta$ and SMR of $\beta$ wave which mean the state of concentration were increased with statistically significant. According to these results, DCG-chim stimulation of Baihui($GV_{20}$) seems to lead to relaxation with antianxietic effect and improvement of concentration at the same time. Conclusions : It would be expected that the doctor can apply DCG-chim for treating anxiety, tension, symptom caused by stress and also can use it clinically for patients who have needlphopia or children as a non-invasive procedure. It is suggested that additional studies about the effect of DCG-chim on other acupuncture points and comparison study about the effect of DCG-chim with those of the finger-pressure treatment using other tool should be done in the future.

• 대한한방부인과학회지
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• 제31권1호
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• pp.84-98
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• 2018

Objectives: The purpose of this pilot study was to examine the feasibility of recruiting women into a clinical trial designed to examine the effects of acupuncture and electroacupuncture in treating overactive bladder (OAB) in menopause women. We tried to determine if there was preliminary evidence to suggest that acupuncture may be effective in reducing OAB symptoms and improving disease-specific quality of life. We also tried to determine the appropriate treatment duration of OAB, with safety of performing acupuncture and electroacupuncture treatment. Methods: This study was a randomized clinical trial. 7 menopause women were randomly assigned to a electroacupuncture group (EA group) (n=4) or acupuncture group (AC group) (n=3) and received electroacupuncture or acupuncture treatment twice a week (16 sessions) in 8 weeks, and follow up assessment was performed after the end of treatment. Overactive Bladder Symptom Score (OABSS), 3-day bladder diary, and King's Health Questionnaire (KHQ) were performed 4 times (at baseline (visit 0), the middle of treatment (visit 8), after the end of treatment (visit 16), and at 4 weeks of follow-up (visit 17)) and analyzed. 2 subjects were dropped out, and finally 5 subjects completed the study. Statistical analysis was performed using SPSS 18.0 for window program. Results: There was an significant improvement in night-time frequency after the treatment (visit 17) in PP (Per-protocol) group analysis (p=0.042). In additional ITT (Inter-to-treat) group analysis, the OABSS (p=0.042) and night-time frequency (p=p=0.017) were improved significantly after the treatment (visit 17). But there was no significant difference of KHQ before and after the treatment. Also there was no significant difference between EA and AC group after the treatment (visit 16, 17). Conclusions: The results of this pilot study suggested that it was feasible to recruit subjects and perform the study procedures, after reconstructing several details of study protocol in performing further clinical trial.