The incidence of ischemic stroke increases with age due to improvements in health care and living conditions. With increasing proportion of old age, the proportion of old age is rapid expansion in acute ischemic stroke patients. Young and old age groups in acute ischemic stroke patients have different risk factors and clinical features. But, many patients of old age are excluded from active treatment like thrombolysis due to hemorrhagic transformation, poorer clinical outcome etc. So we studied clinical features, risk factor, outcome in ≧80 years old patients compared with <80 years. We enrolled 1,445 patients, who diagnosed acute ischemic stroke in Chosun university hospital, from January 2013 to December 2015. Patients were divided into two groups: ≧80 years versus <80 years. We compared with two groups about risk factors, stroke subtypes, thrombolysis, complications in hospital, initial National Institutes of Health Stroke Scale (NIHSS) score, prognosis. Of the total 172 patients, 54(31.4%) patients were 80 years or older. Symptomatic hemorrhage and asymptomatic hemorrhage was not different between both groups [over 79 years patients: 4/54 (7.4%) vs. under 80 years patients: 10/118 (8.5%), p>0.302], [16.7% vs. 17.7%, p>0.701]. There were no difference in mortality and favorable prognosis at 3 months later between both groups [over 79 years patients: 5/54 (9.3%) vs. under 80 years patients: 5/118 (4.2%), p=0.290], [over 79 years patients: 13/ 21 (24.1%) vs. under 80 years patients: 56/86 (47.5%), p=0.803]. There was difference in early neurological improvement rate(improvement > NIHSS 3) and degree of improvement (NIHSS at discharge - NIHSS at admission) were significant[over 79 years patients: 24/54 (44.4%) vs. under 80 years patients: 77/118 (65.8%), p=0.012], [2.69 vs 5.55, p=0.017]. Intracranial hemorrhage(symptomatic and asymptomatic) and favorable prognosis are not different significantly between two groups. Elderly patients is not a absolute contraindication for intravenous thrombolysis. For intravenous thrombolysis in elderly ischemic stroke patients, we need more study to exclude the poor prognostic factors and to consider of gain of patients.

Salivary gland tumors are relatively rare. Their relative infrequency, and highly variable biologic behavior make some difficulty, but some features can be drawn regarding the incidence, pathology, and pattern of behavior of the various benign and malignant tumors of salivary glands. The present study aims to provide a clinical characteristics of salivary gland tumors. We analyzed retrospectively clinical features of the 80 patients. The most common site of both benign and malignant was parotid gland. The most common presenting symptoms was palpable mass. Histopathologically, the most common type was pleomorphic adenoma in benign tumor and mucoepidermoid carcinoma in malignant tumor.

Recently, renal traumas caused by traffic and industrial accidents have risen sharply due to rapid industrialization and an increase in automobiles. The evaluation of patients with suspected renal trauma relies mainly on clinical assessment, urinalysis and imaging studies. We retrospectively reviewed the medical records of 76 patients who presented to our hospital with renal trauma between January 2008 and December 2014. According to the review, A total of 76 patients presented to our hospital with suspected renal trauma. There were 61 male and 15 female between 2 and 83 years old. By cause, traffic accident was the most common cause of injury, accounting for 39 cases. The remaining injuries were caused by falls in 26 cases, assault in 8 cases and sports-related trauma in 3 cases. Surgical exploration was required in 18 patients for renal or associated injuries. We are of the opinion that close and prompt cooperation with other associated medical departments is mandatory in order to reduce morbidity and mortality caused by multiple injury. Accurate renal injury staging was essential to successful management of traumatized patients.

폐암에 대한 방사선치료는 단독치료 또는 병용치료 시에 효과적인 치료이다. 연구에 의하면 최적의 방사선치료 이용률은 61%에서 74% 범위로 추정되고 있으나, 우리나라의 방사선치료 이용률은 낮은 것으로 조사되어 이에 대한 연구가 필요하다. 본 연구는 부산, 경남 지역에서 폐암환자의 방사선치료 이용률을 조사하여 방사선 이용의 적절성을 평가하고 방사선치료 이용관련 인자를 밝히고자 하는 것이다. 본 연구는 폐암으로 진단된 부산, 경남 지역 인구를 대상으로 하였다. 연구를 위하여 2개의 병원에 등록된 환자 1,036명의 환자 자료를 수집하여 최종적으로 연구에 적합한 897명을 대상으로 연구를 수행하였다. 연구는 적정 이용비율과 실제 방사선치료 비율을 비교하였고, 방사선치료 이용의 적정성과 관련인자를 확인하고자 하였다. 연구대상자 897명 중에서 503명(56%)은 내과적 치료가 시행되었고, 394명(44%)는 방사선치료가 시행되었다. 전체 폐암환자의 방사선치료 이용률은 42%이었다. 조직학적 분류에 의한 비소세포 폐암의 비율은 33%이었고, 소세포 폐암은 90%이었다. 폐암의 방사선치료 이용과 관련 인자는 연령, 조직학적 유형, 임상병기, 의뢰의사, 임상검사이었다. 부위(site)별 방사선치료 이용률을 비교했을 때 근치적 흉부치료는 42%이었고, 완화적 치료는 26%이었다. 조직학적 유형의 비교에서 소세포 폐암의 이용률은 낮았고 특히 병기 Ⅲ기에서 이용률은 가장 낮았다. 부산, 경남지역에서 방사선치료의 이용률은 적정한 이용률 보다 낮게 나타났다.이용률 차이는 환자요인, 종양요인, 의료 서비스 요인으로 설명할 수 있었다. 이용률 개선을 위해서는 아웃리치 서비스(outreach service) 프로그램의 개발과 다 학제적 팀의 활성화가 필요하다.

Guillain-Barré syndrome can be classified with several subtypes along with the union of each symptom. Autoimmune mechanism is accepted for pathogenesis. It is often difficult to predict the causative antibodies of the various types of Guillain- Barré syndrome, because there are considerable mismatches of causative antibody to clinical phenotype as well as phenotype or antibody heterogeneities. We investigated the clinical characteristics of the patients with positivity of anti-gangliosides antibody in the serum. Nineteen patients were enrolled who showed the positivity of anti-GM1 antibody, anti-GQ1b antibody and anti-GD1b antibody, who had visited the department of neurology of Chosun University Hospital. We classified the three patient groups; 8 patients had positivity for anti-GM1 antibody, 10 patients for anti-GQ1b antibody and 8 patients for GD1b antibody. The result of statistical analysis showed no clinical difference within the groups. Therefore, prediction of causative autoantibody can be risky when we considered only the symptoms and course of disease of Guillain-Barré syndrome.

본 연구는 PET/CT의 이미지 추가 정보를 통해 이미지 재형성과 합성기능을 바탕으로 TPS 임상 적용과 기초 자료 활용 및 지속적인 연구 개발을 위하여 True-D 기법과 MIM 소프트웨어를 접목하여 각각의 영상 간 합성 작업을 기반으로 이미지의 폭 넓은 활용으로 임상에서 판독에 소용되는 시간 및 비용을 줄이고 효율적 진단 및 방사선치료 시 종양 표적 결정에 유효한 도구로 사용하고자 함이며 정밀한 치료효과 판정에 활용하여 임상에서 판독에 소요되는 시간과 불필요한 추가 검사를 줄일 수 있을 것으로 기대하며 종양환자 판독 보고서 작성 및 PACS 등 타 소프트웨어와의 호환성 개발로 PET/CT 기기의 성능평가에 활용 될 것으로 기대한다.

In this study, the clinical safety and toxicology of oral ingestion of supplement capsules containing ginsengradix was investigated in healthy young volunteers. This study was a pilot randomized, double blinded, placebo controlledtrial. The healthy volunteers were divided into 6 groups of 20 each (10males and 10 females). They took the ginseng powderfor 35 days (3g/day) for safety evaluation. There were measured general healthy levels such as hematological, biochemical andelectrocardiographic parameters. After the first week, besides Korean white ginseng the other treatments led to an significantincrease of white blood cells. Korean red ginseng increased UREA (blood urea nitrogen) in healthy volunteers, but it didn’texceed the range of normal values, and in the subsequent process of treatment there is no effect of elevating UREA. After thethree weeks, Korean white ginseng showed relatively low the content of blood glucose and low-density lipoprotein cholesterol.After the five weeks, compared with the other treatments, Korean red ginseng increased white blood cells, platelet distributionwidth and average volume of platelet. Korean white ginseng decreased low-density lipoprotein cholesterol. American ginsengdecreased blood creatinine in healthy volunteers. In conclusion, through test the blood routine, urine routine, liver function,renal function, blood glucose, blood lipid and electrocardiogram, the healthy volunteers continuous taking ginsengfor 35 days (3g/day) is safe and reliable, and have no obvious adverse reactions and side effects.

메치실린내성 황색포도상구균(MRSA)은 가장 중요한 지역 사회 병원성 균주의 하나로서 항생제 내성 문제가 세계적으로 대두되고 있다. 감염 치료에 대한 부작용과 내성이 적은 새로운 항생제의 개 발에 많은 관심과 연구가 필요하다. Cinnamomum camphora는 제 주도에서 자생하는 녹나무과의 식물이다. 민간에서는 신경 쇠약, 간질, 방광염, 신우 신염, 당뇨, 암과 당뇨병 치료제로 이용되고 있 다. 본 연구에서는 80% 에탄올을 이용하여 녹나무잎을 추출물하여 임상에서 분리한 메치실린 내성 균주에 대한 항균활성을 연구하였 다. 그 결과 녹나무잎 추출물에서 높은 항균활성을 관찰 할 수 있었 고, 항생제와의 병용처리 녹나무잎 추출물의 MIC와 MBC의 범위는 156-313 ㎍/㎖와 313-625 ㎍/㎖로 판독되었고, oxacillin의 병용 처리의 범위는 1288-256 ㎍/㎖와 128-512 ㎍/㎖, 그리고 ampicillin 의 병용처리 범위는 ㎍/㎖와 8-128 ㎍/㎖로 판독되었다. 녹나무잎 추출물과 항생제의 병용처리는 MRSA 항균활성에 대한 상승효과 가 높게 나타났다.

A total of 57 patients with basilar apex aneurysms were treated at our hospital from January 1990 to May 2011. The 57 patients were comprised of 18 male and 39 female patients aged from 31 to 81 years old (Mean age: 58.4 years old). Twenty nine cases were treated surgically and 28 cases underwent endovascular coiling. Medical and surgical records, postoperative angiographies, and follow up angiographies were reviewed retrospectively. Basilar apex aneurysm remains the ultimate challenge to neurovascular surgeons. Mortality and morbidity of endovascular coiling cases was relatively lower than that of surgical cases.

본 연구는 미만성 18F-FDG 갑상선 섭취를 보이는 PET/CT 영상에서 최대 표준섭취계수(SUVmax)와 갑상선 자가 항체(anti-TPO Ab, anti-TG Ab, TSH)들 사이의 임상적 상관관계를 하시모토 갑상선염과 그레이브스병 중심으로 분석하였다. 이를 위하여 2010년 5월부터 2013년 4월까지 건강검진에서 PET/CT 검사를 시행한 환자 1,097명을 대상으로 미만성 FDG 갑상선 섭취 여부를 분석하여 갑상선 기능 검사와 초음파 검사를 추가적으로 시행하였다. 결과적으로 미만성 18F-FDG 갑상선 섭취를 보이는 자가 면역 갑상선 질환 환자는 39명(3.6%)이 발견되었으며 하시모토 갑상선염은 43.6%, 그레이브스병은 23.1% 이었다. 하시모토 갑상선염은 anti-TPO Ab와 anti-TG 수준이 높은 역가의 양성 반응을 보였으며 SUVmax와 anti-TPO Ab간 상관계수가 통계적으로 유의하였다(r>0.4, p<0.05). 또한 그레이브스병은 대부분의 갑상선 자가 항체의 수준이 높은 역가의 양성 반응을 보였으며 SUVmax와 TSH간 상관계수가 통계적으로 유의하였다(r>0.5, p<0.01). 따라서 미만성 18F-FDG 갑상선 섭취 증가에 따른 SUVmax 수준이 높을수록 하시모토 갑상선염은 anti-TPO Ab 수준이, 그레이브스병은 TSH 수준이 비례적으로 증가됨을 알 수 있었고 이러한 상관관계는 자가 면역 갑상선 질환에 대한 부대 징후를 판단할 수 있는 가장 영향력 있는 척도로서 임상적 적용이 가능할 것으로 판단하였다.

This study was conducted in order to determine the relationship between thinking styles and stress of clinical practice among nursing students. Data were collected from 151 nursing students through self-report questionnaires, and analyzed by descriptive statistics, t-test, ANOVA, Scheffe’s Test, and Pearson's correlation using SPSS18.0. The thinking styles were relatively high in ‘hierarchic’ style and ‘clinical practice environment’ was the highest in stress of clinical practice. Relationship between thinking styles and stress of clinical practice showed correlation in the sub-scales. ‘External’ style differed significantly according to ‘undesirable role model’, ‘interpersonal conflict’, and ‘conflict with patient’. ‘Internal’ style was negative significantly different according to ‘interpersonal conflict’. In conclusion, development of nursing intervention for stress of clinical practice which considers thinking styles is needed.

IMRT는 정밀한 입체조형 방사선량 분포를 얻을 수 있어서 종양의 모양에 맞추어 방사선량을 집중함으로써 종양에 들어가는 총방사선량을 증가시킬 수 있다. 그에 따라 적절한 증례에서는 국소제어율과 완치율 향상을 기대할 수 있다. 또한 여러 가지 표적에 대한 차별화된 방사선량을 분포시킬 수 있어서 종양부위를 포함 하면서도 동시에 종양 주위의 중요한 정상 장기를 보호 할 수 있으므로 국소 부작용을 감소시켜 환자의 삶의 질을 향상시킬 수 있다. IMRT는 일반적인 방사선치료보다 더 많은 방향에서 치료하고, MLC를 조절하여 세기를 조절한다. 치료할 부위는 MLC를 열고 보호해야 할 부위는 MLC를 닫고, 점진적으로 치료하기 때문에 선형가속기에서 사용되는 모니터단위(monitor unit, MU)는 일반적인 방사선치료보다 3-10배 많게 되므로 치료시간이 길게 된다. 그러므로 환자가 치료시간 동안 자세고정이 잘 되어야 IMRT를 시행할 수 있다. 또한 정상조직의 선량분포는 고선량을 받는 용적은 감소하고, 저선량을 받는 용적은 증가하게 된다. IMRT를 합리적으로 이용하게 되는 중요한 이유는 방사선치료에 의한 부작용의 감소이다. IMRT의 이용은 두경부암과 전체 유방을 치료해야 하는 유방암에서 근거수준1의 임상적 증거가 있어서 논쟁의 여지가 없으며, 전립선암 등 다른 부위의 종양들에서도 여러 수준의 임상적인 증거들이 있다. 생존율의 향상, 종양제 어율의 증가, 그 외 치료 유효성의 지표들에 대한 결과는 전반적으로 아직 확실한 결론이 나오지 않아서 앞으로 더욱 임상 연구가 필요하다.

Prevalence of Mycoplasma pneumoniae pneumonia in preschool children has shown a recent increase and macrolideresistant Mycoplasma pneumoniae pneumonia has been reported. We investigated the clinical features of Mycoplasma pneumoniae pneumonia among children of different ages and different years for the most recent seven years. Retrospective analysis was performed on the clinical data of 735 children who were hospitalized due to Mycoplasma pneumoniae pneumonia between January 2006 and December 2012. The children were divided into three groups according to age: the A group (<3 years), B group (≥3 years and <7 years), and C group (≥7 years). In addition, the children were divided into two groups according to the year in which the disease had developed: the early period (2006 and 2007 year), and the late period (from 2010 to 2012 year). The infant group (A group) presented mainly with a shorter duration of fever and more frequent wheezing. In the late period, the interval until improvement after a macrolide was prescribed increased. Clinical features of Mycoplasma pneumoniae pneumonia differed among children of different ages, particularly between infants and school-aged children.

The principle of treatment of type 2, 3 odontoid process fracture is controversial. The debate is in regard to which is effective between conservative treatment and surgery. We enrolled 41 patients with type 2, 3 odontoid process fracture from January 2007 to December 2011 at Chosun University Hospital. Patients in Group I (GI) received a halo vest and those in Group II (GII) underwent surgery by ant. screw fixation. The bone fusion was classified according to stable bone union, fibrous union, and unstable non-union. Patients in GI received halo vest for a mean period of 4.9 months and those in GII received a neck collar for a mean period of 3.8 months. Tweleve patients in GI and 17 patients in GII had stable bone union. Three patients in GI and two patients in GII had fibrous union. Five patients in GI and two patients in GII had non-union. The halo vest was a good conservative treatment for type 2, 3 odontoid process fracture : however, low bone fusion rate is a problem in particularly old age. However, ant. screw fixation is a better treatment in regard to short surgical time, short fusion time, and high bone fusion rate.

Syncope is a common symptom, with 15% to 25% of children and adolescents experiencing at least one syncopal episode by young adulthood. In most cases, syncope is a symptom of benign diseases however may be a symptom of severe cardiac disease that results in sudden death. The purpose of this study is to analyze the etiologies and clinical characteristics of syncope in children and adolescents. We retroprospectively analyzed 51 patients with syncope. A total of 51 patients were included in the study and the ratio of males to female was 1: 1.04. The mean patient age was 12.7±3.1 years. Abrupt standing was the most common state of patients with syncopal attack. The etiologies of syncope were noncardiac syncope (60.7%), cardiac syncope (2%), neuropsychiatric syncope (25.5%), and unknown (11.8%). Abnormality of the head-up tilt test was more common in noncardiac syncope than the others [38.7% (12/31) vs 5% (1/20) (p=0.007)]. Further, EEG is a useful diagnostic test for neuropychiatric syncope [41.6% (5/12) vs 2.7% (1/36) (p=0.002)]. Therefore, detailed history taking and physical examinations were useful tools to diagnose the etiology of sycope. The head-up tilt test is an effective diagnostic test in noncardiac syncope and EEG is a valuable test in neuropychiatric syncope, especially in seizure.

We analyzed the surface changes in each forest type based on multi-temporal satellite imagery and climate data analysis on the mountainous regions of Gangwon-do as the case study. As a result of forest type classification using satellite imagery, the area of coniferous forests was decreased, but the area of deciduous forests and the mixed forests were increased. The annual mean temperature in the study area generally risen, and the rise in the annual mean temperature in Wonju particularly displayed a notable rise in 1992. Temperature change in the seasons resulted in a greater rise rate in winter and autumn, compared to other seasons. Such annual mean temperature rise affected the change in forest type distribution, thus directly and indirectly affecting the decrease in the surface area of coniferous forests, and also greatly affecting the expansion of distribution and the growth of mixed forests and deciduous forests. The surface change analysis of each forest type using the post-classification comparison method showed considerable change from coniferous forests to deciduous forests and mixed forests, as a result of the change in forest type based on the increased annual mean temperature after 1990. Furthermore, the change in deciduous forests significantly occurred in mixed forest regions. With these results, future forest type data are expected to be used as the main index of climate change vulnerability assessment, and more accurate quantitative results are expected to be deduced with the assessment of other climatic elements and relationships with different forest types.

The greenhouse gas emission according to the energy consumption is the cause of global warming. With various climates, it is occurs the direct problems to ecosystem. The various studies are being to reduce the carbon dioxide, which accounts for more than 80% of the total greenhouse gas emissions. In this study, estimate the carbon usage using potential biomass extracted from forest type map according to land-use by satellite image, and estimate the amount of carbon dioxide, according to the energy consumption of urban area. The CO2 adsorption is extracted by the amount of forest based on the direct absorption of tree, the other used investigated value. The CO2 emission in Jecheon was 3,985,900 TCO2 by energy consumption. At the land cover classification, the forest is analyzed as 624,085ha and the farmland is 148,700ha. The carbon dioxide absorption was estimated at 1,834,850 Tons from analyzed forest. In case of farmland, it was also estimated at 706,658 Tons.

Spinal epidural lipomatosis (SEL) is a rare condition of adipose tissue accumulation in the epidural space. A total of 2,309 subjects from March 2011 to April 2012 were studied. We found different morphologic “variants” of dural sac compression in grade III. The trifid type, resembling the letter “Y", was the most common form. The round type and the localized mass in lateral recess were seen in other cases. Surgical decompression was performed regardless of morphologic variants in SEL grade III with neurologic symptoms. All patients recovered from neurologic symptoms. In subjects who received adequate conservative treatment, decompressive surgery could be helpful in treatment of SEL grade III with neurologic symptoms.