응급실에 내원한 환자에서 어지럼증의 원인과 임상양상의 분석

문원식,정경운,위준선,문정미,전병조,김용권,소정일,류진호,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Recently, The number of patients who have been complaining of the vertigo or dizziness has been increasing due to rapid growth of elderly population and senile disease. The differentiation of dizzy patients is not familiar to most emergency physicians. This study was designed to differentiate true vertigo and to investigate the clinical difference among central vertigo, peripheral vertigo, and other causes of dizziness. Methods: The authors analyzed the cases of 237 dizzy patients who visited the emergency department of Chonnam University Hospital during the recent 2 years. For the base of dizziness, associated past illnesses, severity, nystagmus type, and the causes of central and peripheral vertigo. Results: Female patients were 142(59.9%) and male patients were 95(40.1%). The most common age group was the 6th decade. The origin of dizziness was classified as peripheral cause(25.3%), central cause(32.9%), and others(41.8%). As to nature of the dizziness, the rotatory sense was dominant in peripheral vertigo and the floating sense and blurred vision in central vertigo. Peripheral vertigo was triggered by position change of head and body, and central vertigo by the eye movement. Audiograms I showed that most patients with central vertigo had normal hearing, but 46.7% of thoswith peripheral vertigo had an abnormal hearing disturbance. Nystagmus was more prevalent in peripheral vertigo Conclusion: History taking and physical examination played an important role in the diagnosis of dizzy patients. An important part of the diagnosis of a dizzy patient could be to evaluate the peripheral origin, the central origin and others causes. Because central vertigo may be associated with a significant neurological pathology, spectral radiological studies, including MRI and CT, are mandatory to rule out a devastating brain lesion.

대형유통상업시설 개발을 위한 소비자 선택기준에 관한 연구 -용인/분당 지역 대형백화점을 기준으로-

정문오 ( Moon Oh Jeong ),김재환 ( Jae Hwan Kim ),김용일 ( Yong Il Kim ),이상엽 ( Sang Youb Lee ) 한국부동산분석학회 2009 不動産學硏究 Vol.15 No.3

Today`s distribution market has many structures such as department stores, large discount stores, traditional markets, and internet shopping malls, and the choice variety of the consumers` purchase behavior increased. For this, this study conducted research about consumer choice criteria about department stores among many distribution market structures and consumer satisfaction in Yong-In and Bun-Dang area. The degree of importance about choice criteria for department stores in general was analyzed, and for the degree of importance items, degree of preference about the actual department stores in Yong-In and Bun-Dang area was additionally analyzed. The selection of factors for department store choice criteria was ultimately done by consulting with researchers of the previous studies and distribution specialists, and the survey was conducted from an outside survey institute, and the relative importance was evaluated by AHP method. Also, additional research was conducted on the actual consumer preference of department stores located in Bun-Dang and Yong-In area about each choice criteria item. From the analysis results, the factors that are considered in priority in choosing a department stores and actual preference of department stores were analyzed, and the consumer characteristics and new perception standard were identified.

3차 병원의 병동에서 시행된 심폐소생술의 분석

류진호,정경운,위준선,문정미,전병조,문원식,김용권,소정일,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. Methods: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. Results: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. Conclusion: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.

정수장슬러지의 고형물량에 대한 예상치의 비교

문용택,김정현 대한상하수도학회 2003 상하수도학회지 Vol.17 No.1

The quantity of residuals generated from water treatment plants depends upon the raw water quality, dosage of chemicals used, performance of the treatment process, method of sludge removal, efficiency of sedimentation, and backwashing frequency. Sludge production by the physical separation of SS occurs under quiescent conditions in the primary clarifier, where suspended solids are allowed to settle and to consolidate on the clarifier bottom. Raw primary sludge results when the settled solids are hydraulically removed from the tank. The relative solid and liquid fractions of a slurry are most commonly described by the solids concentration, expressed as ㎎/L or percent solids. The purpose of the present investigation is to correlate predicted value with practical value on the quantity of alum coagulant sludge.

외상 후 뇌 지방색전증 1예

문정미,소정일,김용권,류진호,허탁,서정진,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Post-traumatic fat embolism was first reported by Zenker in 1862, Von Bergmann reported the first clinical diagnosis of the fat embolism syndrome in 1873. Fat embolism has been associated with traumatic or non-traumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. The diagnosis of fat embolism syndrome is based on the patient's history, is supported by clinical signs of pulmonary, cerebral, and cutaneous dysfunction, and is confirmed by the demonstration of arterial hypoxemia in the abscence of other disorders. Two different mechanisms cause fat to embolize: direct entry of deposit fat into the blood stream and agglutination of endogenous or exogenous plasma fat. MRI can detect a cerebral fat embolism with a higher sensitivity than cerebral CT. We report a case of post-traumatic cerebral fat embolism without pulmonary involvement, and we present a review of the literature. A 16-year girl had a traffic accident and pelvic bone fracture. Forty eight hours later severe trauma become stuporous without a focal neurological deficit. The patient received supportive therapy, and her condition improved throughout her hospital course. She was discharged with good condition after a 30-day hospital stay.

제2형 당뇨병 환자에서 Voglibose와 Acarbose의 비교임상연구

정인경,정재훈,민용기,이명식,이문규,김광원,정윤이,박중열,홍성관,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:아카보스와 보글리보스는 ­glucosidase inhibitors로써 비록 약리학적 작용이나 부작용에 있어서 두 약물간에 차이가 있다는 것은 잘 알려져 있으나 당뇨병 환자를 대상으로 아직 이에 대한 두 약물간에 직접적인 비교에 대해 연구된 바는 없었다. 이에 저자등은 국내 2형 당뇨병 환자에 대해 유효성과 부작용 발현에 대해 두 약제를 비교하고자 무작위법에 의한 위약 대조군의 이중 맹검법 연구를 시행하였다. 방법:시험 약제 투여 4주간의 관찰기를 설정하여 공복혈당의 변화가 30㎎/dL 이하이고, 식후 혈당이 200㎎/dL 이상인 환자로 기타 제외 기준에 해당하지 않은 환자 53명을 대상으로 하여 보글리보스 군(24명)과 아카보스 군(29명)으로 무작위로 나누었다. 치료기간은 총 8주로 하였으며, 4주간 간격으로 혈청학적 검사와 부작용을 분석하여 치료 효과가 부작용을 평가하였다. 결과:1)혈당 변화:보글리보스군은 식후 1시간 혈당이 치료 후 4주, 8주째 의미 있게 감소하였도, 아카보스군은 식후 1시간과 2시간 혈당이 치료 후 4주, 8주째 의미있게 감소하였다. 또한 관찰기 혈당에 대한 치료 4주째 감소량은 아카보스군에서 더 큰 경향을 보였으나, 치료 8주째에는 두 군 간의 강하정도에 의미있는 차이가 없었다(p=0.569). 2)인슐린 치의 변화:보글리스 군은 식후 1시간 인슐린 치가 치료 전에 비해 치료 4주, 8주째 감소하는 경향을 보였고, 공복 인슐린이나 식후 2시간 인슐린치는 치료전 후에 의미 있는 차이가 없었다. 아카보스군에서는 치료 전후로 공복 인슐린, 식후 1시간과 2시간 인슐린치에 의미 있는 차이를 보이지 않았다. 두약제 간에 치료 전과 치료 8주사이의 식후 2시간 인슐린의 감소량이 보글리보스 군에서 의미있게 높았다(p=0.040). 3)당화혈색소:보글리보스 군은 치료 전에 비해 치료후 당화혈색소가 감소하는 경향을 보였고, 아카보스군은 치료 전에 비해 의미있게 감소하였다. 당화혈색소 변화량은 두 군간에 의미 있는 차이는 없었다(p=0.412). 4)지질대사의 변화:중성지방, 콜레스테롤, 고밀도 진단백 콜레스테롤에 대해 두 군간에 의미 있는 차이는 없었다. 5)부작용:소화기계 부작용의 빈도는 치료 4주째 보글리보스 군에서 의미 있게 낮았으나(p=0.028), 치료 8주째 부작용의 빈도는 두 군간에 의미 있는 차이가 없었다(p=0.215). 결론:2형 당뇨병 환자에서 보글리보스와 아카보스의 두 약제의 임상적 유효성과 부작용발현에 대해 비교한 결과 치료 후 8 주 후 혈당강화효과는 두 약제간에 유사한 효과를 보였으나 보글리보스군에서 4주째의 초기 위장관 부작용이 적었다. Background : Acarbose and voglibose are alpha-glucosidase inhibitors. Although different pharmacological effects and adverse abdominal events associated with the two drugs have been reported, no study directly compared acarbose and voglibose in diabetes has been undertaken. To compare the pharmacological effects and gastrointestinal adverse events between two drugs, a randomized, placebo-controlled, double-bind study was performed in type 2 diabetes patients. Methods : The period of study was 12 weeks(observation period: 4 weeks; treatment period: 8 weeks). Fifty-three patients were randomized into two groups(the acarbose group: 24 patients; the voglibose group: 29 patients). The serum glucose, insulin, fructosamine, HbA_1c, cholesterol, triglyceride and the incidence of adverse events were measured. Results : 1) The reduction of glucose from before treatment to 4 weeks after treatment was significantly higher in the acarbose group, but the change before treatment and 8 weeks after treatment in the two groups was similar(p=0.569). 2) The insulin significantly decreased after voglibose treatment(p=0.040). 3) HbAa_1c level tended to decrease in voglibose group, and there was a significant decrease after acarbose treatment. However, the change in HbA_1c level before and after treatment was similar between the two groups(p=0.412). 4) The two drugs did not cause any other changes in the total, HDL-cholesterol and triglyceride. 5) The number of patients with gastrointestinal adverse events was significantly low 4 weeks after voglibose treatment (p=0.049), but the incidence in the two groups was similar after 8 weeks(p=0.215). Conclusions : Acarbose and voglibose significantly improved postprandial hyperglycemia in diabetes. The incidence of gastrointestinal adverse events was low 4 weeks after voglibose treatment(J Kor Diabetes 26:134~145, 2002).

IL-β의 인슐린 분비 자극효과와 그 과정에 관여하는 인자들

정인경,오승훈,강동묵,정재훈,민용기,이명식,이문규,김광원 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경: IL­1β는 용량과 노출시간에 따라 인슐린분비에 대해 상반되는 효과를 가지고 있다. IL­1β의 인슐린 분비 억제효과는 제1혁명 당뇨병의 자가면역 기전과 관련되어 잘 알려져 있으나 인슐린 자극효과에 대해서는 아직 명백히 밝혀지지 않았다. 이에 저자 등은 IL­1β의 다양한 농도에 따라 백서의 췌도세포에서 인슐린 분비에 미치는 영향을 살펴보고, 그 기전으로 인슐린 생합성, iNOS의 발현, 칼슘통로의 활성도 변화여부를 알아보고자 하였다. 방법:200∼300g인 수컷 Sprague­Dawley 백서의 췌도를 변형된 Lacy&Kostianovsky's 방법으로 분리한 후 IL­1β의 다양한 농도(0, 0.5, 5, 50, 500pmol/L)에 2, 6, 24시간 노출시켜 췌도세포의 형태, 생존능을 관찰하고 인슐린 분비능 및 췌도세포내 인슐린 함량을 측정하였으며, 전전구 인슐린 mRNA발현, iNOS mRNA발현을 RT­PCR을 통해 확인하였고, 세포의 칼슘 통로 활성도 변화 여부를 측정하였다. 결과:1) IL­1β에 노출되 췌도의 생존능:2시간 노출시는 대조군과 차이가 없었으나, 6시간 고농도군과 24시간 모든 군에서 생존능이 감소되었다. 2)인슐린 분비능은 IL­1β를 2시간 5poml/L이상의 고농도와 6시간 0.5pmol/L 저농도 처리시 대조군에 비해 의미있게 증가하였으나, 6시간과 24시간 5poml/L이상의 고농도에서는 의미있게 인슐린의 분비가 억제 되었다. 3)췌도내 인슐린양의 변화는 IL­1β의 시간과 농도에 따라 배지내의 인슐린 변화와 비슷한 경향을 보였으나 통계학적으로 의미있는 차이는 없었다. 4)전전구인슐린의 mRNA발현은 2시간 50pmol/L이상 고농도의 IL­1β에서 의미있게 증가하였고, 6시간 처리군에서는 의미있는 차이는 없었으나, 24시간에서 IL­1β의 용량의존적으로 억제되었다. 5)iNOS mRNA는 IL­1β 처리 후 2시간부터 발현되기 시작하여, 6시간에 최고에 달한 후 24시간에는 점차 감소하였다. IL­1β의 처리시간과 무관하게 5poml/L이상의 고농도에서 용량에 따라 발현이 증가하였다. 6)칼슘통로 활성도는 IL­1β의 농도나 시간에 따라 유의한 차이가 없었다. 결론: IL­1β는 단시간 고용량이나 장기간 저용량에서 인슐린 분비와 생합성을 증가시키며, 이런 효과는 iNOS나 칼슘 통로 활성도 변화와는 무관한 것으로 생각된다. Background : The inhibitory effort of IL-1β on the insulin secretion has been validated in pathogenesis of type 1 diabetes, but complex results about the stimulatory effect of IL-1β have been reported. The aims of this study are to clarify the effects of IL-1βon insulin secretion of pancreatic islets and to investigate the mechanisms in terms of preproinsulin synthesis, inducible NOS expression, and calcium channel activity. Method : Islets were isolated from male Sprague-Dawley (SD) rat by modified Lacy-Kostianovsky's method. After islets were treated with different concentrations (0, 0.5, 5, 50, 500 pmol/L) and exposure time (2, 6, 24 hours) of IL-1β, morphology, viability, static stimulation of insulin to glucose, insulin content, preproinsulin mRNA expression, iNOS mRNA expression and calcium channel activity were measured. Results : 1) Viability o islets was reduced in high concentrations of long term exposure of IL-1β. 2) Insulin secretion was stimulated in islets treated with 5, 50, and 500 pmol/L of IL-1β for 2 hours. 3) Insulin content was not significantly different regardless of concentration and exposure time of IL-1β. 4) Preproinsulin mRNA expression increased in islets treated with 50, 500 pmol/L of IL-1β for 2 hours. After 24 hours, it decreased in dose dependent manner. 5) iNOS mRNA expression was detectable after 2 hours in the presence of IL-1β, peaks at 6 hour and decreased after 24 hours. It was increased above 5 pmol/L of IL-1β in dose dependent manner. 6) Activities of the voltage-dependent Ca^2+ channels were not different among groups. Conclusion : IL-1β plays a positive role in terms of insulin secretion and insulin synthesis in high concentration of short term or low concentration of long term. These effects of IL-1β might be neither dependent of iNOS pathway nor Ca^2+ channel activity (J Kor Diabetes Asso 431~443, 2000).

大麻 低마약형 신품종 "청삼"의 육성경위 및 주요특성

문윤호,이봉호,정병춘,김용웅,김길용 한국국제농업개발학회 2002 韓國國際農業開發學會誌 Vol.14 No.2

대마의 저 마약형 신품종을 육성하고자 대마초의 환각성분에 대한 국내의 문헌을 수집하여 고찰하여 저마약형 대마 신품종 "청삼(Cheungsam)"을 육성하였던 바 이것들을 요약하면 다음과 같다. 가. 목포시험장에서 1997년 네덜란드 CPRO에서 도입한 44품종의 저 마약형 유전자원중 IH3이 THC 함량이 낮고 개화일수도 한국재래종과 비슷하여 경장과 섬유수량도 다른 도입품종들에 비해 크고 많아 육종재료로 유망시 되었다. 나. 저 마약형인 IH3를 모본으로 하고 한국 재래종을 부본으로 교배한 1대잡종 품종을 육성하여 무안 등 4개 지역에서 지역적응시험을 실시한 결과 특성이 우수하고 저 마약형으로 분류되어 이를 "청삼"으로 명명하여 신품종으로 등록하였다. 다. "첨상" 품종은 섬유수량은 190kg/10a로 재래종의 177kg/10a에 비하여 7% 중수되었고, 환각성분인 THC(Δ-9-Tetrahydrocannabinol)함량이 0.34%로 재래종의 1.74%보다 적고 환각억제성분인 CBD(Cannabidiol)함량은 1.34%로 재래종의 0.57%보다 많아 저 마약형으로 분류할 수 있다. 라. "청삼" 종자를 IH3의 자웅이주종자를 이용하여 채종하면 종실수량이 103kg/10a이지만 자성종자 채종기술을 이용하여 채종하면 146kg/10a로 채종량이 42% 증가하였다. In order to develop a new variety of fiber hemp(Cannabis sativa L.) with non-drug type, the authors reviewed several literatures about marihuana or hemp, and bred a new variety with non-drug type. This variety was named as "Cheungsam" and resitered as a recommening variety in Korea. This paper introduce the breeding history and characteristics of the fiber hemp variety "Cheungsam" with non-drug type. Among the 44 introduced germplasms from CPRO, Netherland, only IH3 was suitable variety because of it's good traits including low THC content, similar flowering days to Korean local variety and good fiber yield. IH3 and Korean local variety were crossed to develop a new non-drug type hemp, and we developed a new variety named "Cheungsam". This variety have good plant characteristics and fiber yield with low THC content. The average fiber yield of "Cheungsam" was 190kg/10a in regional fiber yield trials, which was 7% higher than that of "Korean local variety". "Korean local variety" contains 1.74% of THC which is the psychoactive ingredient and 0.57% of CBD the anti-psychoactive ingredient, thus that cultivar was sorted to drug type hemp. But "Cheungsam" contains 0.34% of THC and 1.34% of CBD so that sorted as a non-drug type hemp. If farmers want to harvest more seed of "Cheungsam", using female seed of IH3 is better than that of the dioecious seed because of the high seed yield.

濟州地方에서 播種期가 풋마늘의 生育 및 收量에 미치는 影響

文貞珠,韓元琢,朴庸奉,宋昌訓 제주대학교 1992 논문집 Vol.34 No.-

This study was carried out to investigate the proper planting date and variety for early production of garlic in Cheju Island. The results obtained are as follows: 1) The emergence rate was accelerated when garlic was planted in August or later. Days to emergence increased when planted Septenber or later. 2) Jabong garlic showed the tallest plant height and the earlier the planting date (20 July), the plant height and leaf sheath length increased but the later the planting date (20 September), the height and sheatdh decreased. 3)There was no big differnce in leaf number among the vaieties and planting date. 4)The leafy garlic variety which can be harvested from Decenber to January was Jabong garlic,Namdo was Fevuary and Chejujaerae was March. 5)On Cheju Island, leafy garlic could be planted from July 20 to early September.

뇌졸중후 우울증

문석우,서정석,남범우,최진영 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

In recent years, depression is most commonly reported psychiatric condition after stroke, poststroke depression(PSD) has attracted world-wide interest. This review focuses on the major research themes that have emerged. Pooled data from studies, have wide variation in results is due to different criteria for patient selection, different evaluation methods, diagnostic criteria and poststroke intervals, conducted throughout the world have found prevalence rates for from 18% to 65%. The diagnosis of PSD is most appropriately based on a structured mental state exam and DSM-N criteria for depression due to stroke with major depressive-like episode or depressive features. Rarely, poststroke patients may also develop bipolar mood disorder. The treatment of PSD, single antidepressant showing efficacy and electroconvulsive theraphy(ECT) and behavioral therapies have also effective. The progression of recovery following stroke can be altered by treating depression, which has been shown to improve recovery in activities of daily living(ADL) and cognitive impairment and to decreased mortality. The mechanisms underlying the association of stroke and mood disorder are important areas for future investigation.