• 한국간담췌외과학회지
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• 제27권1호
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• pp.20-27
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• 2023

There are many variations and unclear definitions of the appropriate timing of laparoscopic cholecystectomy (LC) after endoscopic retrograde cholangiopancreatography (ERCP), and there is still a lack of consistency about the appropriate timing. Inappropriate timing can be associated with serious comorbidity and can affect the patients. This meta-analysis was conducted to assess the operative outcomes and morbidity to provide a benefit to the patients based on the best timing of LC after ERCP. Randomized controlled trials (RCTs) and retrospective studies were identified from the PubMed and Scopus databases from inception to July 2021. A meta-analysis was performed to estimate the treatment effects on operative outcomes and morbidity. Four RCTs and four retrospective studies met our inclusion criteria. A meta-analysis indicated that patients who received LC after ERCP on the same day or within 72 hours had about 0.354 days shorter length of hospital stay with a shorter operative time of about 0.111-1.835 minutes and a lower risk of complications around 37%-73%. Our evidence suggests that the appropriate timing of LC after ERCP is either the same day or within 72 hours for treating cholelithiasis patients based on the severity of disease.

• 치위생과학회지
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• 제10권3호
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• pp.177-183
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• 2010

탄성 고무인상재의 종류인 폴리설파이드(polysulfide), 폴리이써(polyether), 부가중합형 실리콘(addition silicone)에서 점주도(consistency)가 Type III인 인상재를 각각 1종류 선택하여 증류수 $3.3{\mu}l$를 떠뜨려 접촉각을 측정하고, 세 종류의 인상체에 치과용 경석고를 부어 작업모형을 만들고 표면을 관찰하였다. 접촉각 측정은 전자동접촉 각 측정시스템(DM-700, KYOWA, Japan)을 이용하였고 작업모형의 표면관찰은 전계 방사형 주사 전자현미경(JSM-6700F, JEOL Ltd., JAPAN)을 이용하여 다음과 같은 결론을 얻었다. 1) 초기 접촉각의 평균과 표준편차는 부가중합형실리콘, 폴리이써, 폴리설파이드 제품이 각각 $91.3^{\circ}{\pm}20.5$, $90.0^{\circ}{\pm}2.2$, $101.5^{\circ}{\pm}2.3$로 평균값은 유사하게 나타났으나 부가중합형실리콘의 표준편차값에서 큰 차이를 보여줬다. 이는 술자의 술식에 따라 항상 일정한 특성을 보여주지 않는 다는 것이다. 2) 시간이 흐를수록 부가중합형실리콘 제품은 다른 두 종류에 비해 접촉각이 급속히 감소함을 관찰 할 수 있었고, 초기접촉각이 $91.3^{\circ}$이며 25초 후 $29.4^{\circ}$로 급격히 감소했다. 3) 폴리이써 제품은 초기접촉각이 $101.5^{\circ}$에서 25초 후의 접촉각 $90.7^{\circ}$이였고, 폴리설파이드 제품은 초기접촉각이 90.0에서 25초 후의 접촉각 84.2로 변화가 거의 일어나지 않았고 그 각도도 부가중합형실리콘에 비해 컸다. 4) 세 종류의 탄성고무인상재에서 시간이 흐름으로써 관찰된 접촉각은 유의성이 있었다(p<0.001). 5) 작업모형의 표면관찰에서 부가중합형실리콘이 가장 치밀했고, 그 다음 폴리설파이드, 폴리이써 순서였다. 따라서 탄성고무 인상재에 있어서 접착각이 작은 부가중합형 실리콘은 폴리이써나 폴리설파이드 제품에 비해 더 치밀한 작업모형을 얻을 수 있었고 세 종류의 인상재접착각에서 큰 유의성을 보였다. 그러나 부가중형 실리콘은 접촉각의 편차가 커 술자의 주의가 필요한 것으로 나타났고 폴리설파이드 제품과 폴리이써 제품은 20~25초 후 접촉각이 최초 접촉각과 큰 차이를 보이지 않아 소수성 제품으로 인상채득 시 주의가 요망되는 것으로 보여진다. 향후 Vitro 상태에서 인상재에 영향을 미치는 여러가지 요인들에 대한 계속적인 연구의 필요성을 느낀다.

• Journal of Nutrition and Health
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• 제30권5호
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• pp.465-477
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• 1997

The purpose of this article is to know the effects on bowel function of the kind of fiber and the amount of fiber in SD-rats. To do this experiment, we select of $\alpha$-cellulose as n insoluble cellulose source and alginic acid and pectin as soluble cellulose source. The rats diets contained callolose camcentrations of 1.0%, 3.6%, 6.0% and 10.0%. After that, we raised the SD-rats for 4weeks and measured the amount of food intake, body weight, the food effciency ratio, the length of liver and stomach the weight of the intestines, the transit time through the intestines, pH in feces, and the amount of bile acid and Ca, Mg, pp. 1) The amount of food intake was 15.75-31.00g/day. It was highest in the 10.0% cellulose group and the lowest in the 3.6% and 6.0% alginic acid group (p<0.05). The body weights of rats were 277.50-349.809. It was highest in the 1.0% pectin group and lowest in the 3.6% alginic acid group, 6.0% cellulose group, and 10.0% pectin group. It had differences according to the content fiber and the kind of dietary(p<0.01). The food efficiency ratio was (p<0.01). The higher the content of dietary fiber, the lower the calory and the food efficiency ratio. 2) Transit time was 446.0-775.0 minutes and it showed signidicant ifferences according to the content and kind of dietary fiber(p<0.01). It was long in the 1.0% cellulose group and 1.0% pectin group but short in the 10.0% alginic acid group. As the content of dietary fiber increased, the transit time through the intestines was shortened. The length of small intestine was 101.03-120.40cm and there were no difference cegardloss of the content and kind of fiber. The length of the large intestine was 20.92-25.42cm and there were significant differences according to the content and kind of the fiber. High-fiber diets resulted in increases in the length of the large intestine. 3) The weight of the liver was 8.68-10.96g and there were no differences according to the content and kind of fiber. The weight of stomach was 1.28-1.74g and there were no differences resulting from the kind of dietary fiber, but it was highest in the 10.0% alginic acid group. The weight of the small intestine was 5.52-8.04g with no difference resulting from to the kind of fiber. It was highest in the 10.0% the alginic acid group and lowest in the 1.0% alginic acid group(p<0.05). The weight of large intestine was 2.50-3.30g with no differences related to the kind of dietary fiber. It was heaviest in the 6.0% and 10.0% alginic acid groups and in the 10.0% pectin group with differences related to the content of fiber(p<0.05). 4) The pH of the feces was 5.82-6.86 according to the kind of dietary fiber, alginic acid group was high at 6.66, the cellulose group was 6.26. but the pectin group was low at 6.30. There were difference according to the content of fiber, but no consistency. The content of bile acid was 6.25-34.77umol per 1g of dry feces. According to the kind of dietary fiber, the alginic acid group was low at 12.91umol, cellulose group was 18.64umol and, the pectin group was the highest at 27.78umol(p<0.001). Based on the content of dietary fiber, alginic acid group was low at 1.0%, but high at 3.6% pectin group(p<0.001). 5) The amount of feces was 1.00-5.10g/day. The weight of rat feces was 2.23g/day in the alginic acid goup, 2.75g/day in the cellulose group, and 1.82g/day in the pectin group. According to the content of fiber, cellulose group was high at 10.0% but alginic acid group was 1.0%, and there were significant difference according to the dietary fiber. The more the content of fiber, the more increase the content of feces in alginic acid, cellulose and pectin group. The content of Ca in the feces was 80.10-207.82mg/1g of dry feces. In the dietary fiber, alginic acid group was 193.08mg, cellulose group was 87.5mg, pectin group was 138.16mg. In the content of fiber, alginic acid group was high at 1.0% and 3.6% but low at 10.0% of Pectin group. The content of Mg was 19.15-44.72mg/1g of dry feces. According to the kind of dietary fiber, alginic acid group was 35.33mg, cellulose group was 23.60mg, and pectin was 36.93mg. According to the content of fiber, pectin group was high at 1.0% and low at 10.0% of cellulose group. The content of P was 1.65-4.65mg/1g of dry feces. According to the kind of dietary fiber, alginic acid group 2.23mg/g dry feces, cellulose group was 2.29mg/g, pectin group wa 4.08mg/g dry feces. In the content of fiber, pectin group was high at 6.0% and low at 6.0% alginic acid group, but there were significant difference among the analysis value. The conetnt of Ca and MG was higher in soluble alginic acid group and pectin group than in insoluble cellulose group. The high the content of the dietary fiber, the lower the food efficiency ratio and the short the transit time through intestine with the increase of the length of large intestin as well as the higher level of the stomach, the small intestine and the large intestine. According to the content of the dietary fiber, the amount of the feces, Ca, Mg and P was increased but the length the small intestin, the weight of liver, pH of the feces and the amount of bile acid showed no differences and consistency.

• Journal of Hospice and Palliative Care
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• 제8권1호
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• pp.37-44
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• 2005

목적: 조혈모세포이식환자의 입원 후 수면양상의 변화 및 수면장애를 파악함으로써, 조혈모세포이식 환자의 수면을 위한 간호중재를 개발하기 위한 기초자료를 제공하기 위하여 시도하였다. 방법: 서울 C대학병원에 2002년 8월부터 2003년 8월까지 조혈모세포이식를 위해 입원한 환자 52명을 대상으로, PSQI와 수면양상 설문지를 이용하여 조사하였다. 조사된 자료는 SAS프로그램을 이용하여, 입원전과 입원 후의 PSQI 차이는 paired t-test로, 입원시와 퇴원시의 수면양상의 변화는 카이검정과 Fisher's exact test로 분석하였다. 결과: 대상자의 입원 후 한 달 동안 PSQI점수는 11.8점으로 입원 전 한달 동안의 5.3점보다 유의하게 높았다(t=11.41, P=0.0000). 7개의 항목 즉 수면의 질, 수면지연, 수면기간, 수면의 효율성, 수면장애, 수면제 복용, 일상생활의 장애 모두에서 입원 후 한달 동안의 PSQI점수는 입원 전 한달 동안에 비하여 유의하게 높았다. 대상자의 입원시와 퇴원시의 수면양상을 살펴보면 취침시각, 잠드는데 걸리는 시간, 기상시각, 총 수면시간, 낮잠 시간, 밤에 자다 깨는 횟수, 수면제 사용 횟수, 잠이 안 오면 하는 일, 수면을 취할 수 없는 이유 등에서 유의한 차이가 있었다. 결론: 조혈모세포이식환자는 입원 후 PSQI에 의한 수면의 질 점수가 입원 전에 비해 유의하게 높아, 입원기간동안 수면에 어려움이 많은 것을 알 수 있었다. 수면양상도 입원시에 비해 퇴원시 취침 시간, 잠드는데 걸리는 시간, 기상시각, 총 수면시간, 낮잠시간, 밤에 자다 깨는 횟수, 수면제사용횟수, 잠이 안 오면 하는 일, 수면을 취할 수 없는 이유의 항목에서 유의한 변화가 있음을 알 수 있었다.%), 산재형 47명(17.0%), 가정형 34명(12.3%)의 순으로 나타났다. 결론: 본 연구의 결과 입원환자 가족의 호스피스에 대한 인지 및 요구도는 전반적으로 높았으며 일반적 특성에 따라 호스피스 인지 및 요구도에 차이를 보였다. 따라서 대상자의 일반적 특성을 고려한 개별적이고 다양한 접근을 시도할 수 있는 호스피스 교육 및 중재 프로그램을 개발하여 수행해야 할 것이다.'(10면)이나, 비참석가족들은 '외로움(7명)', '경제적 문제/역할수행상의 어려움'(7명)의 빈도였다. 대처방법에서는, '영적 승화'(13명), '일상생활에의 몰두'(10명), '애도과정에의 몰입(계속 슬퍼함)'(3명)으로 응답하였다. 병원으로부터 사별가족모임의 초대장을 받았을 때의 느낌에 대해서는 '반가움과 고마움'(21명), '슬픔'(4명), '괴로움'(4명), 무응답(11명)이었다. 비 참석 가족들은 '반가움과 고마움'(4명)이었다. 사별가족 모임 참석에 대한 망설임의 유무와 이유에 대해서는, '망설이지 않았다'(34명)가 '망설였다'(6명)보다 높게 나타났다. 사별가족모임에 참석한 후의 소감, 개선사항, 아쉬운 점에 대한 질문에는, 대부분의 응답자들이 '의미 있는 시간이었다', '사별가족에 대한 배려와 관심에 대해 감사한다.'라는 긍정적인 응답이 있었고, '고인에 대한 회상을 할 수 있는 자리여서 좋았다.' '사별가족모임이 일년에 한 번이 아니라 계속적으로 있었으면 한다.', '한편은 슬프고 한편은 기쁘다.' 등의 의견이 있었다. 사별 후 느끼는 가장 큰 어려움에 대해 참석가족은, '우울감'(10명), '외로움'(7명)의 빈도가 높았고, '그리움'(1명), '경제적/역할상 어려움'(4명), 무응답(6명)으로, '우울감'이 가장 큰 어려움으로 나타났다

• Ocean and Polar Research
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• 제30권4호
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• pp.519-536
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• 2008

The relatively tranquil area within the Gogunsan Archipelago was for the first time investigated preliminarily with respect to modern sedimentological processes in association with the emplacement of the Saemangeum Dyke. Basic sedimentological observations, bathymetry and surface sediments were performed twice during 2006-2008 to compare the results and elaborate changes during that period of time. In addition, sediment dynamical observations were carried out with latest measuring equipment along two transects crossing the entrances of the archipelago, including 12-hour onboard measurements of current, suspended sediments, temperature, and salinity. This dataset was used to reveal hydrodynamic characteristics for spring season April-May and to estimate the direction and relative magnitude of the net flux of suspended sediments. There occurred three depositional areas (A to C) within the archipelago, where sediment texture was also changed. In area A, around Yami Island and the dyke, and area B, in the center of the archipelago, surface sediments became coarsened over the two-year period; sand content increased 5% at the expense of silt content in the former, whereas silt content increased 3% at the expense of clay content in the latter. By comparison, area C in the western entrance of the archipelago shows a textural trend of fining with more silt and clay (combined increase of 5%) at the expense of sand content. The accumulation of sediments in areas A and B is attributable to the sand and silt resuspended from the seabed sediments off sector 4 of the dyke during the winter. The origin of the fine materials depositing on area C is uncertain at present, although suspended sediments moving offshore around the archipelago may be one of the most likely candidates for the source. The temperature of seawater increased rapidly from $9-10^{\circ}C$ in April to $14-16^{\circ}C$ in May, whereas salinity remained more or less constant at 31-32%o during the two months. Both of these parameters showed little variations with depth through a tidal cycle, suggesting good mixing of seawater without any help of significant waves. The consistency of salinity during a tidal cycle also indicates no insignificant effects of freshwater from the rivers Mangyung and Donjin emitting through the opening gap near Sinsi Island. The suspended sediment concentrations were higher at the entrance between Sunyu and Sinsi islands than at the entrance between Hoenggyong and Sinsi islands, ranging from 20 and 30 mg/l and from 5 and 15 mg/l, respectively at the sea surface. Although tidal currents were variable across a transect between Sunyu and Sinsi islands, the currents across the entrance between Hoenggyong and Sinsi islands flowed consistently in the same direction all over the transect during a tidal cycle. The estimation of net flux of suspended sediments indicates that suspended sediments are transferred to the Gogunsan Archipelago mainly through a relatively deep trough adjacent to Sinsi Island toward the shallow area around Yami Island and the dyke.

• 한국인구학
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• 제18권2호
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• pp.1-22
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• 1995

이 논문은 평균초혼연령을 계산하는 여러 방법들의 특성과 차이점을 논의하고, 1970-1990년 기간 한국 여자의 자료를 이용하여 이들 계산 방법상의 차이가 평균초혼연령 측정치에 미치는 영향을 구체적으로 제시하였다. 또한 연구의 기초자료인 인구센서스와 표본조사결과 자료의 비교성에 대한 통계적 검정결과를 제시하고 있다. 주요 결과를 보면, 한국의 혼인행태에 관한 연구에서 주로 사용되는 지표인 Hajnal의 SMAM은 한 특정기간의 혼인행태에 근거한 측정치가 아니다. 이 때문에 생기는 편의(Bias)는 1970-1990년 기간 한국 여자의 경우 0.3세 미만으로 나타나, 이 기간 혼인형태의 변화를 고려할 때 예상보다 작은 것으로 생각할 수 있다. 그러나 더 큰 편의를 가져올 가능성을 배제할 수 없다. 또한 편의의 방향은 혼인연령이 상승하는 추세에 있을 때 평균연령을 높이는 영향을 주는 것으로 보인다. 한국의 자료사정에서는 단순평균방법과 Agarwala 방법에 의한 평균초혼연령 측정치(ASMAM)를 목적에 따라 이용하는 것이 바람직하다. ASMAM은 두 센서스 자료에서 계산된 연령별 혼인율 추정치를 근거로 함으로 같은 자료를 이용하여 얻은 조혼인표에서 계산할 수 있는 평균초혼연령과 일치한다. 인구센서스와 표본조사에 의한 연령별 미혼인구구성비의 시계열 자료들은 각기 일관성 있는 추세를 보이고 있으나, 같은 시점에서 두 결과자료를 비교했을 때 주요 연령계층에서 통계적으로 유의한 차이(\alpha=0.05)가 있는 것으로 검증되었다. 또한 이러한 차이는 표본틀이나 조사표 설계상의 문제가 아니며 그 원인에 대한 별도의 연구가 필요하다.

• 대한간호학회지
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• 제26권1호
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• pp.15-32
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• 1996

The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

• 대한소아치과학회지
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• 제35권4호
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• pp.766-770
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• 2008

치은섬유종증(Gingival fibromaotsis)은 치은조직의 섬유성 증식을 나타내는 드문 구강질환이다. 원인은 명확히 규명되지 않았으나 상염색체 우성 또는 열성의 유전성이거나 특발성일 수 있다. 주로 영구치 맹출 시기에 나타나기 시작하나, 드물게 유치열기나 출생시부터 이환되는 경우도 있다. 치은은 서서히 증식하여 치아의 해부학적 치관부위를 덮거나 구개 변이를 일으켜 혀 운동장애를 야기하거나 입술 폐쇄를 방해하기도 한다. 이 증례의 환아는 14개월 된 여아로 출생 시부터 계속된 치은증식을 주소로 내원하였다. 특별한 가족력이나 의학적 병력은 없었고, 임상 유전검사 결과 알려진 어떤 증후군으로 진단되지 않았으나, 신체발달이 지연되어 있었다. 펀치 생검을 하였으며, 조직검사명은 치은섬유종증이었다. 가족력이 없어 특발성 치은섬유종증으로 진단하였다. 환아의 연령 및 전신 상태를 고려해 치은 절제술 등의 외과적 치료는 연기하기로 하였다.

• 산업진흥연구
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• 제5권2호
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• pp.27-32
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• 2020

본 연구는 조선시대 왕릉 석인상의 크기에 관한 연구로서 분석 결과를 요약하면, 석인상의 문인석, 무인석은 1600년대에는 크기가 증가하였다가 1700년대에는 크기가 다소 감소하였으나 1800년대에는 석인상의 크기가 증가하는 것으로 평균 분석 결과 확인되었다. 조선 왕릉의 석인상은 당시 인물을 반영하고 있으며, 이를 통하여 그 시대 인물상의 전형을 살펴볼 수 있다. 왕릉은 일관성과 고유성을 지니고 있으며, 석인상의 크기에 관한 규범은 시대별 변화를 보이고 있었다. 지배계급의 권위적 상징의 건축물로서 의식과 법제에 따라 왕릉이 축조된 국가적 공사였다. 조선시대 묘의 석인상 크기는 능의 석인상에 비하여 약 90cm의 차이로 작았으며 조선전기에 제작된 석물은 지위에 따라 석물의 크기에 차등을 두었다고 한다. 본 연구에서는 조선 왕릉 석인상의 연대별 석물 크기를 확인하는데 본 연구의 의의가 있다.

• 복식
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• 제31권
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• pp.61-73
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• 1997

Kon-myuh was worn by the ancient Chinese and Korean rulers as ceremonial dress during special rituals such as worshipping heaven and ancestors marriage or funerals. kon-myun consists of two major parts-Myun and kon-bok (the main bodypiece) as well as other articles of clothing(skirt footgear etc), There were regulations set in ancient books describing in detail the make of the kon-myun number of ryu and symbol to be used all which applied to each ruler depending on rank and status. This study is aimed at examining the consistency of the korean and Chinese in following the regula-tions as seen in relics which have been recovered from the past. Based on historical findings it seems that Korean Kon-myun came to Korea from China during the Three Kingdoms period. It was also worn in the Koryo and Chosun Dynas-ties and the Taehan Empire. In studying Konmyun in Korea the researcher studied a book from the early Chosun dynasty, Kukjo-oryeuiseory and a book from the late Chosun Dynasty Kukjo-sangrye-bopyun to find the guidelines and rules applying to the Kon-myun tradition. Slight difference were found across time in the supplementary articles of clothing as seen in Uigwe Pokwan-doseols explanations and drawings of Kon-myun. The researcher used uigwes of funerals of kings of the Chosun Dynasty and observed change over this period of time. However there was a clear consist-ency: the king's Kon-myun consisted of 9ryu-myun 9chang-bok while that of the prince consisted of 8ryu-myun 7chang-bok. For the Taechan Empire the researcher used Tae-han Yae-jun which shows the emperor's kon-myun to have consisted of 12ryu-myun 12chang-bok. To study how the regulations were put into practice relics were uncovered from the periods being studied. A portrait of King Ik-Jong remnants from King Ko-jong's Kon-bok and a photograph of Emperor Sun-jong all were in close adherence to the regulations outlined in the books. In China Kon-myun was worn by emperors from the Han to the Ching Dynastices. The researcher investigated Kon-myun es-pecially in the Ming Dynasty. The Kon-myun regulations as read in Tai-ming-hui-chan changed through all four periods. To study the faithfulness of practice to low Ding-ling the tomb of Emperor Shin-jong who ruled during a period of the Ming Dynasty was unearthed and the remains of the Emperor's Kon-myun were analyzed. The Kon-myun consisted of 12ryu-myuh 18chang-bok and there were other differences I color symbols and wearing method when compared to the regulations. It can be concluded that the Chinese Kon-myun tradition was not in strict adher-ence to the regulations established by law books. This is in contrast to the Korean Kon-myun tradition which showed little devi-ation. Further study is needed to understand why there was this difference in tradition and ritual.