• Journal of Chest Surgery
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• 제25권2호
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• pp.176-182
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• 1992

From April 1977 to March 1991, 44 patients have undergone excision of intracardiac myx-omas, 36 cases were located in the left atrium[81.6%], 3 cases in the right atrium[6.6%], 2 cases in the right ventricle[4.5%], 3 cases in the left ventricle[6.6%], There were 32 female and 12 male. The mean age of patients was 39.6$\pm$12.3 years[ranged 11 to 67 years]. The major preoperative symptoms included exertional dyspnea in 35[79.6%], palpitation in 23[52.3%], syncopal episodes in 9[20.4%], and signs of systemic illness; low-grade fever, weight loss, arthralgia, headache and so on. The diagnosis was made by echocardiography alone in 7[15.9%], and by combination of angiography and echocardiography in 37[84.1%]. The weight of the tumor ranged from 15 to 115gm[mean weight, 47.6$\pm$27.6gm], and the volum of the tumor was 129.1cm3[$\pm$149.0]. Follow-up time ranged from 0.6 to 9 years[mean follow-up, 65$\pm$3.22 years]. There were no early and late deaths during the follow-up period. Tumor recurred in one patient with left atrial myxoma 8 years later, who underwent successful reoperation. Postoperative complications occurred in 12 patients: episodes of sup-raventricular arrhythmia in 7, convulsion in 2, wound problem in 2, tricuspid valve regurgitation in 1, massive bleeding in 1, and intubation granuloma in one. In conclusion, surgical excision of the myxoma can be considered curative with excellent long-term result.

• 감성과학
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• 제21권1호
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• pp.129-142
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• 2018

수면은 인생의 약 삼분의 일을 차지하는 중요한 활동이다. 그동안 많은 연구들을 통해 수면이 개인의 인지 및 정서에 차지하는 중요성이 밝혀졌지만, 수면이 타인과의 관계에 어떤 영향을 미치는지에 대해서는 상대적으로 알려진 바가 적다. 본 연구는 수면이 청소년의 또래 친밀감에 기여할 가능성을 검토하였다. 또한 수면이 기억 응고화에 핵심적이라는 선행 연구들을 토대로 수면의 이러한 관계적 효용이 긍정적인 사회적 기억에 의해 설명될 것이라고 가정하였다. 연구 결과, 예상대로 중학생 수면의 질은 이들이 또래 관계에서 느끼는 친밀감을 예측하였으며, 이는 부분적으로 사회적 일화를 긍정적으로 기억하는 데 기인하였다(연구 1). 이러한 현상은 고등학생에게서도 동일하게 나타났다. 수면의 질이 높은 고등학생일수록 또래와 친밀한 관계를 맺는 경향이 있었으며, 이는 사회적 일화 기억의 긍정성 수준에 의해 부분적으로 설명되었다(연구 2). 인과성을 알아보기 위해 연구 2에서 일주일 간격을 두고 기억 과제를 반복 실시한 결과, 잠을 잘 잔 학생들은 그렇지 않은 학생들에 비해 자신의 사회적 일화를 더 긍정적으로 기억하는 모습을 보였다. 반면, 수면의 질은 비사회적 기억의 긍정성 변화와는 유의한 관련성을 보이지 않았다. 수면의 대인적 기능 및 중요성에 대해 논의하였다.

• 대한한의학방제학회지
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• 제18권2호
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• pp.267-277
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• 2010

Objective : Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke like episodes (MELAS) syndrome is a progressive neurodegenerative disorder. The typical presentation of patients with MELAS syndrome includes features such as mitochondrial encephalomyopathy, lactic acidosis, and stroke like episodes. Other features, such as seizures, diabetes mellitus, hearing loss, cardiac disease, short stature, endocrinopathies, exercise intolerance, and neuropsychiatric dysfunction are clearly part of the disorder. Approximately 80% of patients with the clinical characteristics of MELAS syndrome have a genetic mutation. This progressive disorder is reported to have a high morbidity and mortality. This case report is intended to estimate clinical effects of oriental meedicinal treatment of MELAS syndrome. Methods : A 44 year old female patient diagnosed as MELSA syndrome was treated with general oriental medicinal therapy including acupuncture, moxibustion, cupping, pharmacupunture and herbal medication in 20XX in Wonkwang Medical Center Gwangju. And the changes in symptoms and signs were evaluated as time dependently. Results : Although there is currently no curable treatment and MEALS syndrome is tend to progress, our treatment showed improvement in general weakness, gait disturbance and pain in the patient. Conclusion : Our case report suggests that various oriental medicinal treatment could be effective for improvement of MELAS syndrome and may represent a new potential therapeutic approach to control the disease. It could be applied to improve general condition, prevent relapse, enhance the quality of life and reduce complaints in the patient.

• Journal of Preventive Medicine and Public Health
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• 제53권2호
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• pp.82-88
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• 2020

Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

• 한국수학교육학회지시리즈C:초등수학교육
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• 제3권1호
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• pp.1-36
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• 1999

The case of four classrooms analyzed in this study point to many commonalities in the challenges of reforming mathematics teaching in Korea and the U. S. In both national contexts we have seen the need fur a clear distinction between implementing new student-centered social practices in the classroom, and providing significant new loaming opportunities for students. In particular, there is an important need to distinguish between attending to the social practices of the classroom and attending to students conceptual development within those social practices. In both countries, teachers in the less successful student-centered classes tended to abdicate responsibility fur sense making to the students. They were more inclined to attend to the literal statements of their students without analyzing their conceptual understanding (Episodes KA5 and UP 2). This is easy to do when the rhetoric of reform emphasizes student-centered social practices without sufficient attention to psychological correlates of those social practices. The more successful teachers tended to monitor the understanding of the students and to take proactive measures to ensure the development of that understanding (Episodes KO5 and UN3). This suggests the usefulness of constructivism as a model (or successful student-centered instruction. As Simon(1995) observed, constructivist teachers envision a hypothetical learning trajectory that constitutes their plan and expectation for students learning from the particular if the trajectory is being followed. If not, the teacher adjusts or supplements the task to obtain a more satisfactory result, or reconsider her or his assumptions concerning the hypothetical learning trajectory. In this way, the teacher acts proactively to try to ensure that students are progressing in their understanding in particular ways. Thus the more successful student-centered teacher of this study can be seen as constructivist in their orientation to student conceptual development, in comparison to the less successful student-centered teachers. It is encumbant on the authors of reform in Korea and the U. S. to make sure that reform is not trivialized, or evaluated only on the surface of classroom practices. The commonalities of the two reform endeavores suggest that Korea and the U. S. have much to share with each other in the challenges of reforming mathematics teaching for the new millennium.

• 한국과학교육학회지
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• 제23권5호
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• pp.458-469
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• 2003

이 연구는 과학적 가설 지식의 생성 과정을 귀납적으로 기술하구 분석하여 하나의 바탕이론을 제시하고자 하였다. 이것을 위해 과학적 현상의 원인을 설명하는 과제를 피험자들에게 제시하고, 피험자들이 과제를 해결하는 과정에서 표상한 지식과 사고 유형을 발성 사고법과 심층면접을 통해 프로토콜로 생성하게 한 후, 이것에서 규칙성을 찾아 귀납적으로 기술하는 연구 방법을 이용하였다. 이 연구의 결과는 가설 지식 생성 과정에서 의문상황, 가설적 설명자, 경험상황, 원인적 설명자, 최종가설지식 등 5가지의 중간적 지식들이 생성됨을 보여주었다. 또, 지식 탐색, 의문상황과 경험상황 비교, 설명자 차용, 설명자 조합, 설명자 선택, 설명자 확인 등 6가지 유형의 사고가 가설 지식 생성에 관여한다는 것도 보여주었다. 또한 과학적 가설 지식은 '의문상황${\righallow}$경험상황${\righallow}$원인적 설명자${\righallow}$가설적 설명자${\righallow}$가설' 순으로 중간적 지식들의 표상되는 과정을 통해 생성되며, 이러한 과정은 귀추적 추론 뿐만 아니라 귀납과 연역 추론도 함께 관여하는 복잡한 사고 과정임을 보여주었다.

• 한국병원경영학회지
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• 제14권1호
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• pp.36-61
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• 2009

This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

• 한국과학교육학회지
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• 제21권2호
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• pp.279-288
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• 2001

본 연구에서는 인지 갈등 유발 전략(CCS)과 사회적 합의 형성 전략(SCS) 하에서 진행된 소집단 토론의 상호작용 양상을 비교하였다. 과학 개념을 학습하는 4개 소집단 16명의 학생들을 대상으로 개별 진술, 상호작용 단위, 에피소드 수준에서 언어적 상호작용을 분석하였다. 토론 1회 당 전체 개별 진술이나 지식구성 진술은 CCS 집단에 비해 SCS 집단에서 많이 나타났다. 특히, 가설의 비교 평가나 토론 활동지는 SCS 집단 학생들의 메타인지적 진술을 증가시키는 데 효과적이었다. SCS 집단에서는 다수 참여형 및 정교화 상호작용이나 탐구형 에피소드의 빈도가 상대적으로 높아, 많은 학생들이 소집단 토론에 참여하였고 상호작용적인 정교화 토론이 진행된 것으로 나타났다. 상호작용이나 에피소드의 질적인 측면에서도 SCS 집단이 CCS 집단보다 우수하였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제9권1호
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• pp.85-91
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• 2006

주기성 구토증의 심하에 추적 관찰 중 주기적인 발열, 아프타성 구내염, 인두염 및 경부 림프절염 등의 특징적인 임상증상을 보여 소아에서 주기적 발열을 일으키는 원인들을 증상과 검사실 소견을 통 해 배제함으로써 PFAPA 증후군으로 진단된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• International Neurourology Journal
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• 제22권4호
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• pp.268-274
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• 2018

Purpose: To describe a technique for urodynamic diagnosis of detrusor sphincter dyssynergia (DSD) using urethral pressure measurements and examine potential associations between urethral pressure and bladder physiology among patients with DSD. Methods: Multiple sclerosis (MS) and spinal cord injured (SCI) patients with known DSD diagnosed on videourodynamics (via electromyography or voiding cystourethrography) were retrospectively identified. Data from SCI and MS patients with detrusor overactivity (DO) without DSD were abstracted as control group. Urodynamics tracings were reviewed and urethral pressure DSD was defined based on comparison of DSD and control groups. Results: Seventy-two patients with DSD were identified. Sixty-two (86%) had >20 cm $H_2O$ urethral pressure amplitude during detrusor contraction. By comparison, 5 of 23 (22%) of control group had amplitude of >20 cm $H_2O$ during episode of DO. Mean duration of urethral pressure DSD episode was 66 seconds (range, 10-500 seconds) and mean urethral pressure amplitude was 73 cm $H_2O$ (range, 1-256 cm $H_2O$). Longer (>30 seconds) DSD episodes were significantly associated with male sex (81% vs. 50%, P=0.013) and higher bladder capacity (389 mL vs. 219 mL, P=0.0004). Urethral pressure amplitude measurements during DSD were not associated with significant urodynamic variables or neurologic pathology. Conclusions: Urethral pressure amplitude of >20 cm $H_2O$ during detrusor contraction occurred in 86% of patients with known DSD. Longer DSD episodes were associated with larger bladder capacity. Further studies exploring the relationship between urethral pressure measurements and bladder physiology could phenotype DSD as a measurable variable rather than a categorical observation.