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최승필,박승현,정시경,박규남,김영민,김세경,이운정,이환 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2
Overcrowding of emergency department is a serious and growing problem at St. Mary's Hospital. This has motivated the development of short-stay unit(SSU) as an alternative ward to routine hospital admission and ED discharge. In our hospital a SSU begun to admit patients in January 6, 1997. The SSU received 247 patients from the ED during the eight month interval(January 6, 1997 to August 31, 1997). To examine the utilization of the SSU in ED, we retrospectively analyzed 247 patients admitted in SSU from the ED, and compared the average hours per patient with acute gastroenteritis spent in the ED during the 2-month intervals before(July-August 1996) and after(July-August 1997) the establishment of the SSU. The following results were obtained; 1. The total patients consist of EM 92(37.2%), GS 48(19.4%), IM 24(9.7%), PS 21(8.5%), OS 20(8.1%), OBGY 14(5.7%) and others 28(11.3%) 2. The results of EM patients admitted in SSU from ED 1) Sex ratio of male to female was 1:1.1 and the mean age was 37.3±16years 2) In diagnosis, acute gastroenteritis was 29 cases(31.5%), multiple contusion 14 cases(15.2%), drug intoxication 12 cases(13%), limb laceration 6 cases(6.5%), tendon rupture of hand 6 cases(6.5%), and others 19 cases(20.6). 3) Mean length of stay in ED was 9.18 hours. 4) Among 92 patients to the SSU, 79 patients(85.9%) were discharged, 11 patients(11.9%) formally admitted to hospital and 2 patients(2.2%) transferred to otherhospital. The mean hospital stay time of the patients admitted to SSU was 2.6 days. 3. There was a significant reduction in the average stay time spent in the ED by treat-and-releasing patients with acute gastroenteritis after the establishment of the SSU(from 14.65±9.6 to 7.52±5.4 hr/patient, p<0.001). Conclusively, the establishment of the SSU can shorten the average stay time that treat-and-releasing patients spend in the ED, and reduce the number of admitted patients waiting in the ED.
위에 발생한 유암종 (Carcinoid Tumor) : 1예 보고
김남재,김진희,이경태,서광식,정현용,이승민,김석현,이병석,이헌영 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3
A carcinoid tumor of the stomach is uncommon, has no clinical symptoms, and is regarded as a benign. It is also incidentally found in most cases. 48-year-old woman with gastric carcinoid tumor was admitted. She had suffered from a anorexia and a dry mouth for 4-months. A gastroscopy revealed a polypoid mass on the greater curvature of the mid-body of the stomach which was subsequently thought to be an adenocarcinoma. An endoscopic mucosectomy revealed however, that it was a carcinoid tumor. A case of carcinoid tumor of the stomach is here by presented with a brief literature review.
응급센터에서 기관내 삽관을 시행하지 않은 호흡곤란 환자의 동맥혈 이산화탄소분압과 호기말 이산화탄소분압의 연관성분석
김형국,박승현,오동렬,박규남,이원재,황두영,최승필,이운정,정시경,김세경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4
Background: The end-tidal carbon dioxide tension(ETCO₂) is defined as a partial pressure of carbon dioxide at the end of an exhaled breath. The purpose of this study is to determine the correlation between ETCO₂and arterial carbon dioxide tension(PaO₂) in nonintubated patients with respiratory distress in emergency department(ED). Methods: A prospective non-blind study was performed in ED of our university hospitals. Participants included all nonintubated adult patients with respiratory distress requiring arterial blood gas analysis. ETCO₂was measured with a capnography monitor during tidal volume breathing. ETCO₂were recoreded at the time of arterial blood gas sampling. The correlation between ETCO₂and PaCO₂was analyzed in all patients and in subgroups by simple linear regression. Results: Sixty patients were enrolled. In all patients, ETCO₂was 5.72mmHg lower than PaCO₂and correlated well with PaCO₂(r²=0.716). ETCO₂correlated best with PaCO₂in patients who were either acidotic or non-smoking. Conclusion: ETCO₂correlate well with PaCO₂in nonintubated patients with respiratory distress in ED. ETCO₂may be sufficient to reflect PaCO₂in selected patients and obviate the need for repeat arterial blood gas determination.
흰쥐에서 심정지후 Pentoxifylline이 뇌의 허혈-재관류 손상에 미치는 효과
정시경,김영민,오동렬,최경호,박승현,이운정,박규남,유은영,이원재,김세경 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2
Background: Two major events occurring in the cerebral hemodynamics after successful resuscitation from cardiac arrest are reactive hyperemia and postischemic hypoperfusion. In this study, we examined the effect of Pentoxifylline(PTX) on the rat brain following cardiac arrest. Methods: Fourteen rats were anesthetized and artificially ventilated. Cardiac arrest was produced by chest compression and clamping of tracheal tube for 3 minutes in ketamine anesthetized rats. Circulation was restored by standard cardiopulmonary resuscitation methods. In 7 rats, PTX 10mg/kg was infused at 10min after cardiac arrest(PTX group). In the other 7 rats, same amount of normal saline was infused(control group). Results: In both groups, hemodynamic variables, neurologic deficit(ND) score and histopathologic findings of hippocampal CA1 neurons were observed. Hemodynamic variables and ND score were not significantly different between two groups. Delayed ischemic neurons of hippocampal CA1 were decreased in PTX group(2.2±2.4%) compared with control group(9.1±1.2%). Conclusions: We conclude that PTX prevented development of delayed ischemic neurons in hippocampal CA1 after cardiac arrest. PTX may be useful in emergency situations following cardiac arrest.
( Seung Jeung Nam ),( Young Ok Kim ),( Tea Kyung Ko ),( Jin Ku Kang ),( Kwang Hoon Chun ),( Joong Hyuck Auh ),( Chul Soon Lee ),( In Kyu Lee ),( Sung Hoon Park ),( Byung Chul Oh ) 한국미생물 · 생명공학회 2014 Journal of microbiology and biotechnology Vol.24 No.10
Phytate is an antinutritional factor that impacts the bioavailability of essential minerals such as Ca2+, Mg2+, Mn2+, Zn2+, and Fe2+ by forming insoluble mineral-phytate salts. These insoluble mineral-phytate salts are hydrolyzed rarely by monogastric animals, because they lack the hydrolyzing phytases and thus excrete the majority of them. The β-propeller phytases (BPPs) hydrolyze these insoluble mineral-phytate salts efficiently. In this study, we cloned a novel BPP gene from a marine Pseudomonas sp. This Pseudomonas BPP gene (PsBPP) had low sequence identity with other known phytases and contained an extra internal repeat domain (residues 24-279) and a typical BPP domain (residues 280-634) at the C-terminus. Structurebased sequence alignment suggested that the N-terminal repeat domain did not possess the active-site residues, whereas the C-terminal BPP domain contained multiple calcium-binding sites, which provide a favorable electrostatic environment for substrate binding and catalytic activity. Thus, we overexpressed the BPP domain from Pseudomonas sp. to potentially hydrolyze insoluble mineral-phytate salts. Purified recombinant PsBPP required Ca2+ or Fe2+ for phytase activity, indicating that PsBPP hydrolyzes insoluble Fe2+-phytate or Ca2+-phytate salts. The optimal temperature and pH for the hydrolysis of Ca2+-phytate by PsBPP were 50°C and 6.0, respectively. Biochemical and kinetic studies clearly showed that PsBPP efficiently hydrolyzed Ca2+-phytate salts and yielded myo-inositol 2,4,6-trisphosphate and three phosphate groups as final products. Finally, we showed that PsBPP was highly effective for hydrolyzing rice bran with high phytate content. Taken together, our results suggest that PsBPP has great potential in the animal feed industry for reducing phytates.
CASE REPORT : Eruptive Anetoderma in a Patient with Systemic Lupus Erythematosus
( Nam Ji Jeong ),( Seung Bae Park ),( Myung Im ),( Young Joon Seo ),( Jeung Hoon Lee ),( Young Lee ) 대한피부과학회 2014 Annals of Dermatology Vol.26 No.5
Anetoderma is a rare cutaneous disorder characterized by a loss of normal elastic tissue that presents clinically as atrophic patches located mainly on the upper trunk. Recent studies suggest immunological mechanisms may play a role in this process. Furthermore, a secondary form of macular atrophy occurs in the course of infectious diseases (e.g. syphilis and tuberculosis) and autoimmune disease (e.g. systemic lupus erythematosus [SLE]). Here, we report the case of a 20-year-old woman previously diagnosed with SLE, who presented with numerous well-circumscribed atrophic macules on the face and upper trunk. Histopathological examination showed decreased elastic tissues in the reticular dermis and mononuclear cells adhering to elastic fibers, consistent with anetoderma. Thus, the eruptive anetoderma localized widely on the face and upper trunk may have been caused by an autoimmune response of SLE. (Ann Dermatol 26(5) 621∼623, 2014)