뇌졸중 후 중추성 통증 환자에 대한 동서협진이 진통과 재활에 미치는 영향

이현종,김수영,이상훈,서동민,이두익,김건식,이재동,이윤호,양형인,박재경,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP Patients who were treated with electroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain from stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from 7.7±1.7 to 4.4±2.0 with pain treatment(p<0.05). In accordance with improvement of pain scores, RS and MBI scores were also improved from 2.88±0.95 to 2.13± 1.01 and from 83.0± 16.9 to 94.7±9.5(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.

중심 정맥 삽관법에 의한 동정맥루: 증례 및 문헌 고찰

이 근,원형섭,양기창,박철완,김상일,정호성,이종호 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

A 36-year old woman with end stage renal failure and hypertension was transferred from a university hospital to our emergency department due to a enlarging right cervical mass associated with a palpable thrill and a bruit. Over a 2 month period, she required hemodialysis for severe azotemia at a university hospital in Seoul. 3 days after a difficult attempt at a internal jugular cannulation, she developed a progressive swelling in the right lower cervical area. An arch and primary branch arteriogram revealed a arteriovenous fistula between right innominate artery and internal jugular vein with a large intervening pseudoaneurysm. She underwent vascular surgery within 1 week of injury and subsequent postoperative angiogram showed complete resolution of the fistula. This rare condition is reported with a review of the literature.

원광대학교병원 응급실에 내원한 치과 응급 환자에 대한 임상적 연구

이동근,민승기,양찬영,문철,김종구 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

This is a retrospective clinical study on 3,243 patients who had visited the Emergency Room of Wonkwang University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years from Jan. 1, 1996 to Dec. 31, 2000. The obtained results were as follows : The total number of patients was 3,243 and the ratio of sex was 1.86:1. The highest monthly incidence was shown in October and March to 19%, and the age distribution peaks was the 3rd decade(24.7%), followed by the 1st(21.7%) and the 4th decade(15.7%). The percentage of admission were 4.8%. The frequent cause of admission were facial bone fracture(70%), infection(16%), soft tissue injury(14%). Trauma(70.9%) was the most frequent cause in dental emergency patients, odontogenic infection(24.3%), oral hemorrhage and TMJ dislocation were next in order of frequency. About the cause for trauma, traffic accident was the most, and fall down, slip down injury and assault were followed. Soft tissue injury group(56%) was the most prevalent, followed by tooth injury group(27%) and facial bone injury group(17%). In facial bone injury group, the mandibular fracture(55%) showed the highest incidence followed by zygomaticomaxillary complex fracture, nasal bone fracture, maxilla fracture, and zygomatic arch fracture. In the mandibular fracture, symphysis(40%) was the most common location followed by condyle(29.4%), angle(22.1%), and body area(8.5%). Tooth fracture showed the highest incidence as 35% followed by subluxation(29%), avulsion(20%), and concussion(16%). In infection patients group, the ratio of admission was 5.8% and the major visiting cause was acute pulpitis(32.3%). The major treatment method was the incision and drainage(30%) followed by endodontic treatment(28%), curettage(22%), extraction(7.8%), and so forth. In TMJ dislocation group, the highest incidence age was 3rd decade and 4th decade(51%). In post-operative bleeding group, the major cause of bleeding was non-fulfillment of doctor's instruction and bleeding was almost stoped by only gauze biting.

방사선을 조사한 생쥐 장기에서의 Superoxide Dismutase 분포에 대한 연구

김양균,전현우,차종희,고광삼,이근배 朝鮮大學校 附設 醫學硏究所 1986 The Medical Journal of Chosun University Vol.11 No.1

The cytosolic and mitochondrial supreoxide dismutases (EC 1.15.1.1) were investigated in various organs, thyroid gland, lung, heart, liver, spleen and kidney, of normal and irradiated mice. The mouse organs were fractionated into cytosolic and mitochondrial fractions by differential centrifugation, and the supsroxidp dismutase was measured by the method of McCord and Fridovich. The mouse organs contain two types of superoxide dismutase ; one is localized in the cytosol and contains cupper and zinc, the other in the mitochondria and contains manganese. Superoxide dismutasc activity was found in all organs of mouse investigated, and maximal activity of enzyme was observed in liver. most of superoxide dismutase activity, 79-86%, was present in the cytosolic fraction, and the rest was associated with mitochondria. The activity of cytosolic superoxide dismutase was most prominent in the liver among those tissues assayed. However, that of mitochoadrial enzyme was highest in the heart. Thc specific activity of superoxide dismutase in mitochondria was found about 2-5 folds greater than that of the enzyme in cytosol and cyanide inhibit the activity of cytosolic enzyme but not mitochondrial enzyme, In irradiatcd mice, the enzyme activity and the specific activity of superoxide dismutase in cytosol and mitochondna of various organs were decreased with minimal value on 7th and l4th day after exposured by whole body-irradiation.

Southern Blot Hybridization법을 이용한 악성 림프종의 면역유전형에 관한 연구

전호종,기근홍,김윤신,이미숙,이미자,장원재,장숙진,박영진,정춘해,정종훈,양성훈,이광민 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.2

Immunogenotyping using gene rearrangement analysis has emerged as a precise laboratory aid in the diagnosis and classification of malignant Iymphoid neoplasms. The lineage and clonality of the malignant Iymphoid neoplasms can be identified by the demonstration of rearrangements of antigen receptor genes of the immunoglobulin and T-cell receptor genes. The analysis of the gene rearrangements on the malignant Iymphoid neoplasms are also useful as a sensitive unique clonal markers to detect early recurrence in patients with malignant Iymphoid neoplasms after treatment. To analyze the sensitivity and specificity of gene rearrangements in the diagnosis of malignant Iymphoid neoplasms. 24 cases of malignat Iymphoma were examined by Southern blot hybridization using CTβ-T cell receptor β chain gene-DNA probe and JH-immunoglobulin heavy chain gene-DNA probe. The results of the immunogenotypings using Southern blot hybridization disclosed high correlation between the immunophenotyping using immunohistochemical stain with monoclonal antibodies (B-cell Iymphoma 84.2%. T-cell Iymphoma 75% ). The analysis of the gene rearrangement of the angioimmunoblastic lymphadenopathy(AILD) and unclassifiable Iymphoma using immunohistochemical stain could resolve the monoclonality and lineage . Rearranged bands to the CTβDNA probe were observed in one case out of 2 cases of AILD. One case of unclassifiable Iymphoma showed rearranged bands to the CTβ DNA probe. There were no rearrangements in reactive follicular Iymphoid hyperplasia and paracortical Iymphoid hyperplasia. In conclusion, DNA gene rearrangement study should be applied to differentiate the clonality and cell lineage in the malignant Iymphoma with indistinctive immunophenotype.

스티렌 폭로 근로자들의 기중 및 혈중 스티렌과 요중 만델산의 관계 분석

정호근,강성규,양정선,김기웅,이종성,조영숙,박인정 大韓産業醫學會 1994 대한직업환경의학회지 Vol.6 No.1

The concentration of styrene in air in blood and mandelic acid in urine were checked for the 60 workers with normal liver function, exposed to styrene. Styrene in air were sampled with personal air sampler at least 4 hours and analyzed by gas chromatography. Blood and spot urine were collected at the end of shift with a vacuum tube and a polythylene bottle and analyzed by gas chromatography and high performance liquid chromatography. Means of air and blood styrene and urine mandelic acid were 8.16 ppm(geometric mean), 0.199 mg/L, and 0.519 g/g creatinine, respectively. The concentration of styrene in air and mandelic acid in urine were high in the FRP factories and low in polymerization factory. Styrene in blood showed large difference by the working process. Styrene in air showed a good correlation with mandelic acid in urine(r=0.6369) and styrene in blood(r=0.6371). The mandelic acid in urine and styrene in blood corresponded to exposure of 50 ppm styrene were 0.890 g/g creatinine and 0.434 mg/L. However, hippuric acid in urine did not show any correlation with styrene in air. Urine mandelic acid excretion expected ratio showed a tendency to decrease according to obesity index and to increase with alcohol consumption.

급성 지주막하 출혈에 동반된 관상동맥 연축에 의한 심근경색증 1예

부귀범,박근호,양종태,이동민,장성종,김건영,장경식 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

In many cases, acute cerebrovascular disease is accompanied by abnormal electocardiograms. Also, though rather uncommon, acute myocardial infraction is also seen. The mechanism of its occurance is uncertain but it is thought to be related to coronary artery spasms, an abnormal autonomic nervous system, and a catecholamine increase. A female patient of 34 years of age came to the hospital because of sudden headache accompanied by substernal chest pain. A subarachnoid hemorrhage due to a cerebral aneurysm rupture had occured, and there was ST segment elevation in lead II, III, and aVF of the electrocardiogram. A cardiac enzyme test, an echocardiography, and a coronary angiography were performed, and she was diagnosed to have acute myocardial infarction due to coronary artery spasm. Clipping of the aneurysm was performed. With the use of nitrate and an angiotension converting enzyme inhibitor, the condition of the patient improved.

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

대형 화재로 인한 사상자의 손상 유형과 합병증 : 동인천 라이브호프 화재를 중심으로

신중호,김재광,염석란,신종환,민순식,임용수,양혁준,이근,황성연 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: High risks of fire alway exist for buildings in urban areas, especially those in downtown. Crowds, as well as more complex and larger structures, may cause more victims in the event of fire; therefore, emergency medical service plans must be established for such disastrous events. Methods: On the evening of October 30,1999, a fire broke out in downtown, Dong-Incheon Live-Hof restaurant; 56 people were killed and 76 were injured. Most of them were teenagers. We retrospectively reviewed the medical records of the victims, Results: 1) Among the 56 dead, 54 died from smoke inhalation, one from extensive burns, and one from sepsis during treatment. 2) Among the 76 injured, 70 patients suffered from smoke inhalation, 53 from burns, and 9 from several types of trauma (sprains, contusions, lacerations, abrasions, fractures, etc.). 3) Later complications were laryngeal edema, pulmonary edema, scar contracture, and hypoxic brain damage, and so forth. 4) Post traumatic stress syndrome was unexpectedly more prevalent in mildly to moderately injured survivors and witnesses than in seriously injured survivors. Conclusion: Many complications exist after a fire. Some may be resolved in time, but others may result in permanent sequelae. Early rescue, early triage, and early management during transport by emergency medical service (EMS) personnel can result in fewer complications and a lower mortality rate. Therefore, we propose the establishment of plans to be followed during various major disasters.

생체분해성 안과제형의 안구내흡수정도와 안독성

민병무,김용백,박근성,송규상,양준묵,이성복,조항진,길숙종,김승영,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

An improved retinal tack can be used to fix the retina in complicated retinal detachment and proliferative vitreoretinopathy. We used the retinal tack made by biodegradable polyglycolic acid, polylactic acid and copolymers. The tacks with polyglycolic acid were placed in the retina the right eyes of 10 rabbits as group 1, with polylactic-polyglycolic acid copolymers as group 2 in each left eyes. We examined the absorption rates and degree of intraocular inflammation at 1 day, 1, 2, 4, and 8 weeks and compared both eyes. The tacks were absorbed with time in both eyes, but more rapid in copolymers. And there was no inflammation in both eyes. Now, this study will be a base on the drug delivery system in intraocular pharmacological and surgical management.