외상 환자의 세포 면역학적 변화

지훈상,이한식,민진식 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Thirty trauma patients admitted to our emergency center had lymphocyte phenotypic subsets characterized throughout hospital course. The immunosuppressive disease and CNS injury patients were exclude. There was no mortality in our studied cases. T-lymphocyte(CD-3), T helper(CD-4), T suppressor(CD-8) and B-lymphocyte(CD-19) were quantified by monoclonal antibodies and flowcytometric analysis. Results were analyzed on the day of admission 1st day, 2nd day, 4th day and 8th day among three groups: Injury severity score(ISS) below 15(n=10), 15-25(n=10), over 25(n=10). The patients were compared to 20 healthy controls. The immunologic depression was maximal on 2nd day and nearly recovered on 8th day. ISS over 25 group was most significantly depressed in all subset of T- lymphocyte, but ISS 15-25 group was slightly depressed less than ISS below 15 group. The B-lymphocyte was changed in similar pattern like as all subset of each ISS group, but the initial B-lymphocyte slightly increased comparing controls. Therefore the immunologic depression is affected by severity of trauma, and the severe and mild depression of immune system is included. The patterns of immune depression of T-lymphocyte and its subset were double peak in mild and severe trauma patients. The B-lymphocyte is stimulated in severe trauma patients during the initial stage of injury.

한우법인의 사업유형별 경영분석

이상영,천동원,한원식 한국농업정책학회, 한국축산경영학회 2001 농업경영정책연구 Vol.28 No.3

According to the analysis results on Korean cattle cooperatives, it is considered that the conditions of members' welfare, payment and education were poor because of short establishment period and unexpected financial crisis. However, the representative's farm management ability and planning was well prepared. Viewing the components of investment in the cooperative, while the proportion of investment in kind was getting bigger, investment in cash and in kind were increased by 28.6% and 78.2%, respectively compared with the beginning stage. Most of the investment in kind was destined to land and facilities. Per capita investment was increased by 11.6million won from 21.3million won at the beginning to 32.9million won. The component ratios of fixed capital such as facility and equipment were composed of 36.4% of subsidy, 43.1% of loan and 20.5% of self-support. Results of the economic analysis on the cooperatives by farming system identified that the highest profitability and productivity were achieved by Type II on increasing value-added followed by Type I of concentrating on hanwoo production, Type III on selling input and Type IV on saving input. Investment analysis based on the amount of allowable investment limit also shows that all farming systems except Type II invested over an appropriate level. Most influential factors affecting cooperative's profitability were record keeping and selling type. The effects of the cooperatives' operating system and subsidy on profitability were statistically insignificant.

파라콰트 중독 흰쥐에서 항산화제 U-74389G 의 치료 효과

오진호,정성필,임훈,노성훈,김혜영,김승호,이한식,민진식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: This study was conducted to verify the hypothesis that the suppression of lipid peroxidation with the antioxidant, U-74389G, could improve the survivability of paraquat intoxicated rats. Methods: First, we obtained the 24-h mortality by using several paraquat dosages and calculated the 24-h LD5O in 24 male Wistar rats(250~350 g). To examine the effect of U-74389G, we divided the rats in 4 groups: a control group and U-74389G only group, a paraquat only group, and a paraquat plus U-74389G group(n=10 each). Paraquat, 35 mg/kg, was injected intraperitoneally at 0 h. U-74389G, 10mg/kg, was administered intraperitoneally at 0, 12 h or at 1, 12 h in the respective groups. The rats were observed for 24 hours. At 24 h, plasma and lung, liver, and kidney tissues were obtained after sacrificing the surviving rats to determine the degree of lipid peroxidation by using a thiobarbituric acid reactive substances (TBARS ) quantitative analysis. Results: The 24-h LD50 of paraquat was calculated as 40 mg/kg in our rats. The 24-h mortality was as follows: control group and U-74389G group 0%, paraquat group 30%, and paraquat plus U-74389G group 10%. The TBARS analysis showed no differences between the U-74389G and the control groups. The paraquat group showed significantly increased TBARS levels in the serum and in the kidney and lung tissue compared to the control group(p<0.05). With U-74389G, the increased TBARS levels were significantly decreased in the plasma, kidney, and lung tissues compared to the paraquat group(p<0.05). However, in the liver tissue, there were no significant differences among the groups. Conclusion: A 21-aminosteroid antioxidant, U-74389G, improved the survivablity of paraquat-intoxicated rats through the suppression of lipid peroxidation. Our result suggests the possibility of clinical application of this drug as an antidote for paraquat poisoning.

생물변환 천연식용색소 생산공정기술 개발 : Ⅰ. 홍화 황색소의 안정성에 미치는 pH 및 온도의 영향 Ⅰ. Effect of pH and Temperature on the Stability of the Yellow Pigment from Carthamus tinctorious L.

홍성현,박성길,이종민,한태룡,백영숙,정인식 경희대학교 생명자원과학연구원 1999 硏究論文集 Vol.20 No.-

홍화로부터 열에 의한 안정성을 검토하였다. 황색소의 분해반응은 산성, 중성, 염기성 조건에서 UV/Vis spectral measurement에 의해 조사되었다. 시간변화에 다른 흡광도를 측정해 본 결과 온도가 상승함에 따라 황색소의 분해되는 정도가 점차적으로 증가하는 것을 확인 할 수 있었다. 40℃에서 황색소의 분해 반감기는 pH3.0, pH7.0, 그리고 pH12.0에서 각각 112.1, 39.3 과 25.3 시간이었다. 이것은 황색소가 pH3.0에서 비교적 더 안정함을 말한다. pH3.0, 7.0 그리고 12.0에서 황색소의 activation energy는 각각 519, 15.0 그리고 12.3 kJ/mol이었다 We investigated thermal stability of yellow pigment from Carthamus tinctorious L. Decomposition reactions of yellow pigment were monitored at acidic, neutral and alkaline conditions by UV/Vis spectral measurement. Decomposition of yellow pigment increased as temperature increased Decomposition half lives of yellow pigment at 40℃ were 112.1 39.3, and 25.3 hrs at pH 3.0 , pH 7.0, and pH 12.0, respectively, indicating that yellow pigment is more stable at pH 3.0. The activation energies of yellow pigment at pH 3.0, pH 7.0, and pH 12.0 were 51.9, 15.0, and 12. 3 kJ/mol, respectively.

응급환자에 대한 맥박산소측정기의 임상적 평가

안철민,이한식,조광현,황태식,김성규 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Pulse oximetry is a noninvasive method of measuring blood oxygen saturation even before changes to the cardiopulmonary functions become apparent clinically. Therefore it has been widely excepted in many disciplines as a standard patient monitoring equipment. But its accuracy has been argued at low oxygen saturation levels. To determine the accuracy of the pulse oximetry in the emergency department where the patients presenting with respiratory difficulty are expected to have low oxygen saturation levels. Prospective, cross-sectional, paired measurements of oxygen saturation by two different pulse oxineters(SpO2) against oxygen saturation of arterial blood gas analysis(SaO2) was performed from May 1994 to September 1995 at two different university hospitals. Two pulse oxineters each with its digital probe were applied to the patient for the measurement of SpO2 simultaneously and arterial blood gas was drawn for analysis(ABGA) at the same time to measure SaO2. 98 patients who met the criteria mostly consisted of cardiopulmonary patients. There were no significant differences between mean SpO2(88.1±11.4, 88.2±10.0) of the two pulse oximeters and mean SaO2(88.7±11.4) from the arterial blood gas analysis(p=NS). Strong correlations were found(r=.80). But the regression declined as SaO2 decreased especially SaO2 < 90%. The pulse oximetry is potentially useful in patients with clinical signs of acute hypoxemia and patients receiving interventions that may produce acute hypoxemia, because of their ability to continuously monitor the oxygen saturation. But pulse oximetry along cannot identify the degree of hypoxemia or severity of distress. Therefore patients complaining of respiratory difficulty in an emergengy department, history and physical examination must be performed with pulse oximeter as a guide while backing it up with ABGA.

단순 외상 환자에서 퇴원시 설명문이 환자의 이해도에 미치는 영향

장석준,정상원,최성욱,황태식,이한식 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

The many previous publications have shown the advantages of written discharge instruction over verbal discharge instruction on the basis of comparing the functional illiteracy among emergency department patients. Therefore, authors have conducted a study on the efficacy of written discharge instruction over the verbal discharge instruction of two groups: minor laceration and sprain patients. For the purpose of this study, minor laceration is defined as less than 3 ㎝ laceration on the face or head, or less than 5 ㎝ laceration on extremities. And simple sprains were limited to the extremities. A total of 416 patients who visited Yong Dong Severance Hospital Emergency Care Center were the subject of this study during the period of 2 months from Feb. 1. to Mar. 31. 1996. The study was done prospectively, and patients who entered this study were randomly selected. Simple discharge instruction were made prior to the study and patients were given or verbally told the one of two instruction sets by the emergency medicine resident. After reading or hearing the instructions, each patient was asked to answer four specific questions about them. Statistical significance was examined by t-test and p value of 0.05 or less was considered statistically significant. Mean age for verbal and written instructed group were 26.2 and 25.6 years old. There were 262 and 154 patients in verbal and written instructed group, and the mean score was 2.24±1.20 and 3.42±0.52, respectively. The type of injury was divided into laceration and sprain. Laceration group showed mean score of 2.15±1.23, 3.32±0.51, and sprain group of 2.34±1.16, 3.59±0.50 in verbal and written instruction group, respectively. For the patient younger than 13 years old, discharge instruction was given or described to a guardian. Age less than 13 years old group showed mean score of 2.75±1.11, 3.31±0.48 and more than 13 years old group of 2.10±0.19, 3.34±0.53 in verbal and written instruction group, respectively. The result showed statistical significance between verbal and written instruction group of type of injury and age difference. For the future, simplified written discharge instruction may help and improve the patient`s understanding of the proper management of injury.

응급실 내원시 예상치 못한 사망 환자의 예측 인자

김욱진,서정필,정성필,황태식,이한식 대한응급의학회 1998 대한응급의학회지 Vol.9 No.4

Background: Unexpected deaths of the patients at ED are surprising to the medical staffs as well as the families. It may also increase the possibilities of medico-legal problems. This study was conducted to review the unexpected death in ED and find the predictive factors leading patients to unexpected death. Methods: A retrospective study with reviewing available medical records of 183 patients who were expired at Ed of Shinchon Severance Hospital from Mar. 1997 to Feb. 1998 and 103 patients of Youngdong Severance Hospital from Mar. 1996 to Feb. 1998 was done. Analyses were done on 30 variables of physical findings, laboratory results, procedures and therapies. We used univariate analysis such as t-test and x²-test and multiple logistic regression analysis. Results: Of the total 286 deaths in Ed, 153 cases were enrolled in this analysis. The number of unexpected deaths were 76. Age, mental status, fraction of neutrophil count, BUN level, whether endotracheal intubation was done, use of inotropics were the factors with statistical significance on the univariate analysis, but only comatose mentality, endotracheal intubated case, and use of the inotropics were significant on logistic regression analysis. The longer the ED length of stay, the higher the rate of mortality and unexpected death. Conclusion: This result suggest that medical attention is needed on the patients with comatose decreased mental status, endotracheally intubated case and needing inotropic agents to prevent unexpected deaths shortening the ED length of stay may also be a factor for decrease the unexpected death rate.

자침세포성 빈혈 치험 1 예

홍성표(Sung Pyo Hong),이선주(Sun Ju Lee),이영식(Young Sik Lee),이상인(Sang In Lee),한지숙(Jee Sook Hahn),고윤웅(Yun Woong Ko),한상순(Sang Soon Hahn),윤홍섭(Hong Sup Yoon),이삼열(Samuel Y . Lee) 대한내과학회 1989 대한내과학회지 Vol.36 No.4

N/A Spur cell anemia is intense hemolytic anemia associated with alcoholic liver cirrhosis characterized by spiculated erythrocytes due to a striking increase in cholesterol content and in cholesterol to phospholipid ratio. Several attempts including splenectomy, plasmapheresis and calcium antagonists, have been tried to correct this anemia. Presented here is a case of a 60-year-old man with alcoholic liver cirrhosis who revealed jaundice and severe hemolyic anemia. The peripheral blood smear demonstrated spurred erythrocytes which are caused by serum factor. The cross incubation test, that is, spur cells with normal serum and normal red blood cells with the patient's serum, revealed reversability of the spur cells. The benefits of plasmapheresis were equivocal, while a calcium antagonist, flunarizine, was administered with discernible benefits. The authors suggest that spur cell anemia should be suspected in alcoholic liver cirrhosis with severe jaundice and anemia refractory to transfusion and that the calcium antagonist, flunarizine, is useful to treat it.

視神經乳頭 缺損의 1例

韓根壽,蔡丙植,金在浩,金尙敏 大韓眼科學會 1969 大韓眼科學會雜誌 Vol.10 No.2

경골전면의 피부결손에 대한 하퇴근이동술

한문식,성상철 최신의학사 1981 最新醫學 Vol.24 No.6