사후분해 시체에 대한 법의학적 접근

최영식,이상용,김유훈,조갑래,이봉우,양경무,정낙은,서중석,이한영,이원태,강현욱 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2

Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.

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.

Rocuronium의 애별투여방법이 모지내전근의 이완에 미치는 영향

최영균,김승수,이원진,조광래,이상은,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 인제대학교 2009 仁濟醫學 Vol.30 No.-

Objective : There are controversies in pnmmg technique of rocuronium whether it can or can't shorten the onset time. We want to compare the effects of two different priming doses and intervals of rocuronium. Materials and Methods : After giving propofol, 50 patients were randomly assigned to 5 groups. Group I received a placebo, followed 3 min later by rocuronium 0.6 mg/kg. Priming doses and intervals of Group II, Ill, N, V were 0.06 rng/kg and 2 min, 0.12 mg/kg and 2 min, 0.06 rug/kg and 3 min, 0.12 mg/kg and 3 min, respectively. Total dose of rocuronium was 0.6mg/kg. Train of four (TOF) count or ratio and 1st twitch height of TOF (T1) were monitored with 15 secondsintervals. TOF ratio of each groups just before bolus injection, duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were compared. Results : Duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were decreased in priming groups compared to Group 1 (P < 0.01) In group V, significant depression of TOF ratio just before bolus injection was seen (P < 0.05). Conclusion : Priming technique with rocuronium is effective method to shorten the onset of neuromuscular block. But priming dose of rocuronium itself could cause hypoxia and aspiration in awake patients and should be used carefully. Priming dose of rocuronium 0.06 mg/kg and 2 minutes interval maybe relatively safe method.

동종 골수이식을 시행받은 환자에서 폐색성 세기관지염에 의하여 발생한 자발성 기종격동과 피하 기종

이병환,이제중,이연경,안재숙,김여경,황호인,박무림,조상희,정익주,김형준 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.2

저자들은 만성골수성백혈병으로 동종 골수이식과 이식편 부전으로 인하여 추가적인 말초혈액 조혈모세포이식을 시행 받은 환자에서 만성 이식편대숙주질환과 그 폐 합병증인 폐색성 세기관지염에 동반된 자발성 기종격동과 피하 기종이 병발한 1예를 경험하였기에 이를 보고하는 바이다. Obstructive lung disorders following after allogeneic bone marrow transplantation (BMT) in association with graft- versus-host disease (GVHD) contribute significant morbidity and mortality. We report a case of a 28-year-old man who developed spontaneous pneumomediatinum and subcutaneous emphysema complicating bronchiolitis obliterans after allogeneic BMT. He received an allogeneic BMT for chronic phase of chronic myeloid leukemia. Five months after BMT, he was boostered by allogeneic peripheral blood stem cells from the same donor due to graft failure. One month after the boostering, chronic GVHD developed and were treated with cyclosporine and steroid. The patients developed spontaneous pneumomediatinum and subcutaneous emphysema secondary to severe bronchiolitis obliterans 4 months after boostering donor cells. The air-leak syndromes were recovered by conservative management, including high-flow oxygen.

Laparoscopic single-port access right adrenalectomy using lee's port : A case report

Sung Hoon Choi,Ho Kyoung Hwang,Chang Moo Kang,Woo Jung Lee 대한외과학회 2010 대한외과학회 학술대회 초록집 Vol.2010 No.11

수평면 회전식 풍력발전기에 대한 유체역학적 해석

이상무 동양대학교 2001 동양대학교 논문집 Vol.7 No.1

This paper discusses the horizontally rotating wind power generator.Quasi static analysis are applied to evaluate its performance.Translational velocity, which varies on the distance from the rotation center, is assumed constant to apply the fluid dynamic lift and drag coefficients.The analysis shows that the horizontally rotating wind power generator is effective in low rotation speed.In high rotation, the reverse torque reduces the total effective torque.It is recommended to give efforts to reduce the reverse torque for the acceptable performance of the horizontally rotatting type generator.

2 Parameter Criterion을 이용한 안정성 평가에 관한 연구

이종형,유덕상,박무수 國立金烏工科大學校附設生産技術硏究所 1997 産業技術開發硏究 Vol.13 No.-

In this paper, the following results about character stics of surface fatigue crack are obtained by △p decreasing experiment and crack generation using SPPS 42 of pipe-use carbon steel. The △Kthe of surface crack is smaller than the △Kth of through crack. Therefore, if the △Kth of through crack is used as defect estimation, it becomes dangerous. The validity of Engineering safety is represented establishing fatigue fracture estimation diagram by the 2 parameter criterion of threshold and fatigue limit.

경재소 (京在所)와 유향소 (留鄕所)

이성무 국제비교한국학회 1995 비교한국학 Comparative Korean Studies Vol.1 No.-

This essay is the study on correlation between "Kyungjae-so (autonomic organ of authoritative grade in Chosun Dynasty) and "Ryuhyang-so" (autonomic organ of non-authoritative grade in Chosun Dynasty).

광대역 고출력 공간 전력 증폭 소자에 관한 연구

이성호,권세웅,이병무,윤영중 연세대학교 산업기술연구소 2002 논문집 Vol.33 No.2

In this paper, spatial amplifier using wideband printed dipole antennas is proposed for spatial power combining. The input and output printed dipole antennas have wide bandwidth of 22 %(5.44 ㎓∼6.75 ㎓) and 26.3 %(5.2 ㎓∼6.78 ㎓), respectively. Gain of the designed amplifier is 9.5 ㏈ at 6 ㎓. As a result, the proposed spatial amplifier using wideband printed dipole antennas and amplifiers shows that the gain is 16.8 ㏈ at 6 ㎓ and 3-㏈ gain bandwidth is 1.04 ㎓.

국제기구 및 외국에서 농산물중 농약잔류 허용기준의 설정절차

이미경,홍무기,박건상,최동미,임무혁,이서래 한국환경농학회 2005 한국환경농학회지 Vol.24 No.1

This study was undertaken to find out necessary measures to improve the tolerance setting system of pesticide residues on food crops in Korea which is scientifically reasonable and harmonizable with international standards. Information on tolerance setting systems of pesticide residues by Codex Alimentarius Commission, Joint FAO/WHO Meeting of Experts on Pesticide Residues, USA, EU, Japan and Taiwan was collected and analyzed. On the basis of information in the above countries, necessary actions to be taken by the Korean regulatory authorities were recommended with respect to priority setting, maximum residue limits (MRLs) setting based on field residue data, group MRLs, minor crop problems, quantitation limit and dietary intake assessment.