국산 Lidocaine 알칼리화를 위한 Bicarbonate 혼합시 침전유발 최소량에 대한 고찰

이선호,김현수,곽인숙,안원식,최관호,김광민,손민제 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.5

Background : When local anesthetics for regional anesthesia is used, usually small amounts of bicar-bonate are added for rapid onset. This addition gives the mixed solution a more alkaline pH. The following result is an increased unionized form of the local anesthetic and rapid penetration of the drug into tiissue. Unfortunately, no data about adequate mixing volumes of domestic lidocaine and bicarbonate is available. Methods : We examined six mixing pairs of two kinds of 2% lidocaines and three kinds of 8.4% bicarbonates for minimum volumes of bicarbonate to cause a precipitation of 2% 20 ml lidocaine. Results : The mean volumes of bicarbonate to cause precipitation were 1.54 ml for Kwang-Myung lidocaine with Kwang-Myung bicarbonate, 2.90 ml for Kwang-Myung lidocaine with Dae-Won bicarbonate, 2.73 ml for Kwang-Myung lidocaine with Je-Il bicarbonate, 0.97 ml for Je-Il lidocaine with Kwang-Myung bicarbonate, 1.26ml for Je-Il lidocaine with Dae-Won bicarbonate and 1.39 ml for Je-Il lidocaine with Je-Il bicarbonate. Conclusions : We conclude that the Kwang-Myung lidocaine and the Je-Il lidocaine could cause precipitation when mixing with a smaller bicarbonate volume than foreign textbook recommended. (Korean J Anesthesiol 2000; 39: 726-729)

입원한 입시 스트레스 증후군 환자의임상양상에 관한 정신의학적 연구

신광철,진태원,이영식,이재우,이재광,이길홍 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.3

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

體育敎育의 理解에 觀한 調査硏究 : Focusing on the students of girls' high school 女高生 中心으로

李면榮,申光植,安洵換 덕성여자대학교 학생생활연구소 1987 學生生活硏究 Vol.7 No.-

The purpose of this study is to find how the students of girls' high school understand physical education. Conclusions are as follows. 1. Most students understand that physical education is an education for the whole person who is well balanced in a body and mind. And they think that physical education is health education through physical activities. 2. Students recognize that physical education is good for the healthy growth of body and mind. 3. Students show the difference of attitude according to the physical condition and the favorite sport. 4. Students are not concerned about an interest of physical education. 5. Some studnts like the class of physical education because of mental health it brings. But others do not like it because of their physical weakness. 6. In a school life, physical education gives a positive attitude, cooperation, power of conbination and a diversion. And its role is to raise effieiency to other lasses. 7. Students point out that the quality of physical education (the teaching method and contents)should be improved. 8. Students say that the dificiency of equipment checks the efficient physical education. 9. Students say that the possession of equipment does not fulfill. 10. Most students like to have physical education lesson on Saturday, Wednesday and Monday. 11. Students like to have physical education in the afternoon than in the morning. 12. Students want to learn tennis and swimming. But they can't learn it because there is no equipment in the school.

액체-고체 순환유동층의 상승관에서 액상의 점도가 고체체류량 및 열전달계수에 미치는 영향

이찬기,강석환,신광식,송평섭,강용,김상돈 한국화학공학회 2003 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.41 No.4

직경이 0.102 m이고 높이가 3.5 m인 액체-고체 순환유동층에서 액체의 점도가 고체입자의 체류량과 열전달계수에 미치는 영향을 검토하였다. 밀도가 2,500 kg/㎥인 유리구슬(d_(p)=1.0, 1.7, 2.1 또는 3.0 mm)과 CMC 용액(μ_(L)=0.96-38 mPas)을 각각 고체상과 액체상으로 사용하였다. 액체-고체 순환유동층에서 고체입자의 체류량은 액체의 유속이나 점도가 증가함에 따라 감소하였고 유동입자의 크기나 입자의 순환속도가 증가함에 따라 증가하였다. 액체-고체 순환유동층에서 열전달계수는 액체의 점도가 증가함에 따라 감소하였고 유동입자의 크기나 순환속도가 증가함에 따라 증가하였으나, 액체의 유속이 증가함에 따라서는 큰 변화가 없었다. 액체-고체 순환유동층에서 고체입자의 체류량과 열전달계수는 다음과 같이 실험변수와 무차원군에 의해 상관식으로 얻을 수 있었다. E_(S) = 0.783U^(-0.100)_(L)G^(0.164)_(S)d^(0.302)_(p)μ^(-0.036)_(L) h = 4349.3U^(0.010)_(L)G^(0.099)_(S)d^(0.151)_(p)μ^(-0.015)_(L) ◁그림삽입▷ Effects of liquid viscosity on the solid holdup and heat transfer coefficient have been investigated in the riser of a liquid-solid circulating fluidized beds, whose diameter is 0.102 m and 3.5 m in height. Glass beads (d_(p)=1.0, 1.7, 2.1 or 3.0 ㎜) whose density is 2,500 ㎏/㎥ and aqueous solutions of carboxymethy cellulose (CMC)(μ_(L)=0.96-38 mPas) have been used as the solid and liquid phase, respectively. It has been found that the solid holdup decreases with increasing liquid velocity or viscosity, but it increases with increasing solid particle size or solid circulation rate. The heat transfer coefficient decreases with increasing liquid viscosity but it increases with increasing particle size or solid circulation rate, however, it does not change considerablely with increasing liquid velocity. The solid holdup and heat transfer coefficient have been well correlated in terms of operating variables or dimensionless groups as fellow: ◁수식원문참조▷

석회화 치성 낭종 1례

이상학,염범우,이승훈,한승훈,김응식,김광일 한국의학사 1998 診斷과治療 Vol.18 No.10

Furfural 어류급독성 및 조직병리에 관한 연구

이철우,최성수,최필선,이상협,이길철,박광식 한국환경독성학회 1997 환경독성보건학회지 Vol.12 No.2

Furfural, an organic solvent, is widely used as synthetic component material in producing chemical products. However, furfural has been reported that it shows strong toxicities to human being showing intense stimulus to skin, eyes, mucous membrane and nerve system. It is also known to cause anemia, liver cirrhosis, kidney failure and genetic toxicity in the human being working in the exposed area. LD50 of furfural for peritoneal injected mouse has been known around 20mg/kg, but the acute toxicity on aquatic organisms such as fish, daphnid or algae are not well known, compared to those on rodents. In this experiment, we studied on the fish toxicity of furfural using Japanese Meclaka (Oryzias latipes) and Common Carp (Cyprinus carpio). We also observed histological changes in the fish organs. The LC50s were 12.8 mg/L in Japanese Medaka and 21.8 mg/L in Common Carp, respectively. When Common Carps were exposed to 120 mg/L of furfural concentration for 30 minutes, blood congestion in gills and lysis of secondary lamella were shown. Though the muscle of caudal fin was not completely eroded, its epidermic cells were shown to be necrotic in various parts. Tissue atrophy and cell necrosis were also shown in the liver of Common Carps exposed to furfural. From these results, furfural seems to cause histological damages on liver, an internal organ as well as on external organs such as gills and fins eventhough the fish were exposed for a short-term.

IgA 腎病症에 對한 病理學的 및 免疫病理學的 硏究

이종대,서광선,이충식 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

A clinicopathologic analysis for 88 cases of IgA nephropathy has been carried cut from a series of 333 renal biopsy specimens which were studied at Department of Pathology, College of Medicine, Chungnam National University, during a period of 54 months from October 1983 to March 1988. The results were as follows: 1. IgA nephropathy was 26.4% of renal biopsy specimens and 30.4% of primary glomerulonephritis. It was common in young adults and 77.3% of patients were between 16 years and 39 years. Male to female ratio was 1.1 : 1. 2. Modified classification of Meadow et al. for Henoch-Schoenlein nephritis was adopted for the histologic grading of glomerular lesions. The result was as follows; Grade I 5.7%, Ⅱ 46.6%, M 45.5%, Ⅳ 1.1%, an V 1.1%. The clinical class was possible in 70 cases; Class B38.6 %, C 61.4%. 97.1% of these. 70 cases were within the histologic Grade Ⅲ. 3. The results of immunofluorescent study were as follows; All cases showed granular mesangial deposits of IgA. Complement 3 was found, in same manner as IgA, in 83 0%, fibrinogen 23.9%, IgM 18.23%, and IgG 3.4%. 10.2% of these cases showed clumps of fluorescent deposits involving the mesangium and continuous loops. 4. Among the chief complaints on admission, gross hematuria was observed in 59.1%, microscopic hematruia 39.8%, and proteinuria 69.3%, including nephrotic range protein uria 6.8%. Along the histologic grading, the frequency of gross hematuria was different, as follows; Grade I 100.0%, Grade Ⅱ 65.9%, and Grade Ⅲ 47.5%. Statistically, these differences were significant(P<0.01) On serologic study, hepatitis B surface antigen was positive in 6.7% and level of serum IgA was significantly increased in 27.6%.

분사식 주사기를 이용한 소아환자의 국소마취

이재춘,김대업,이광희,김성형,양계식 大韓小兒齒科學會 2001 大韓小兒齒科學會誌 Vol.28 No.4

소아치과에서 국소마취는 공포의 대상이며, 특히 행동조절이 힘든 소아의 경우 더욱 그러하다. 국소마취에 대한 공포는 주사침의 자입시나 주사액의 주입시 느끼는 동통 만큼이나 주사침 자체의 공포도 크게 차지한다. 주사침 자입시의 동통을 완화하기 위하여, 도포마취제 등이 개발되었으나 이들은 국소마취의 동통을 완화시키는 면은 있으나 주사침 자체에 대한 공포를 없애지는 못하였다. Syrijet Mark Ⅱ??(Mizzy Inc, USA)는 주사침이 없는 치과용 분사식 주사기(jet injection device)로서 소아에서 주사침에 대한 공포를 성공적으로 감소시킬 수 있다고 알려져 있다. 저자들은 여러 행동등급의 소아를 대상으로 Syrijet을 사용하여 국소마취를 시행한 후 동통평가의 척도로서 VAS(visual analogue scale)를 소아에게 적합하게 색생화한 CAS(color analogue scale)을 이용하여 국소마취시의 동통수준을 측정한 결과, 기존 주사침에 의한 국소마취시 보다 국소마취의 동통이 감소된 것을 알 수 있었다. Syrijet의 장점으로는 주사침이 없다는 점, 기존의 술식에서 일회용이었던 미취용 카트리지를 재사용할 수 있다는 점, 신경 및 혈관에 안전하다는 점 등이 있었으며, 단점으로 부피가 크며, 가격이 비싸며, 사용시 숙련성을 요구한다는 점 등이 있었다. Local anesthesia procedure in pediatric dentisty using needle-tipped syringes is stressful and painful for the child patients. The Syrijet Mark Ⅱ (Mizzy Inc. USA) is a jet injection instrument, which uses high pressure to propel fluids into soft tissue without the use of a hollow neeldle, so it seems to be able to reduce the injection phobia of the child patients. The authors compared the Syrijet with the conventional syringe by assessing the pain level after local anesthetic procedures using CAS(color analogue scale) which was developed from VAS(visual analogue scale). The result showed that the pain was reduced by the use of syrijet. The advantages of syrijet were no use of neeldes, the reuse of the anesthetic cartridge, and the safety to nerves and vessels. The disadvantages were the large size, the high price, and the need of skill to use.