침강성 탄산칼슘 현탁액의 분산 안정성에 관한 연구

박명재,안지환,김환,Park, Myung-Jae,Ahn, Ji-Whan,Kim, Hwan 한국세라믹학회 2001 한국세라믹학회지 Vol.38 No.4

본 연구에서는 탄산화법으로 침강성 CaCO$_3$분말을 제조하고 제조된 CaCO$_3$현탁액의 분산안정성을 연구하였다. CaCO$_3$현탁액의 pH 변화와 고분자전해질 PMAA와 PAA의 첨가에 따른 입자크기, 유동학적 특성(점도), zeta potential 및 현탁액의 침강속도 등을 측정하였다. 탄산화법에 의해 약 0.1$\mu\textrm{m}$ 크기와 비표면적이 23.57$m^2$/g인 단분단 calcite형 CaCO$_3$분말을 제조하였다. pH가 11인 CaCO$_3$현탁액에 0.01 wt% PMAA가 첨가된 경우에 우수한 분산안정성을 나타내었는데 이는 CaCO$_3$입자표면에 PMAA의 흡착에 의한 electrosteric 안정화기구와 CaCO$_3$입자들 사이의 정전기적 반발력에 의한 것으로 판단된다. PMAA와 PAA 첨가량 변화에 따른 pH 6, 9, 11의 CaCO$_3$현탁액의 침전높이를 측정한 결과 PMAA와 PAA의 농도가 0.15 wt% 부근에서 분산안정성을 보였는데 이는 CaCO$_3$입자들 사이간의 분산제에 의한 뚜렷한 경계를 갖는 흡착층이 형성되었기 때문으로 생각되며 따라서 CaCO$_3$현탁액의 최적 분산안정성을 위해서는 적절한 pH 조절과 PMAA 및 PAA의 첨가가 필요함을 알 수 있다.

의과대학생의 청진 교육에 있어서 멀티미디어 이용의 효과

박명재(Myung Jae Park),이명구(Myung Goo Lee),김동규(Dong Kyu Kim),모은경(Eun Kyung Mo),현인규(In Gyu Hyun),정기석(Ki Suck Jung) 대한내과학회 1998 대한내과학회지 Vol.54 No.6

N/A Background: Auscultation of lung sound is a fundamental component of physical examination of respiratory disease. It is difficult to teach lung sound to the medical student because of the observer variability and the lack of objective recording in auscultation. Multimedia education has became available in many fields due to rapid development of computer and its software. So we made multimedia program to teach the lung sound and evaluated the effect of this program on the self study of the lung sound hy medical students. Method: We developed the multimedia title Auscultation of lung sound by integrating lung sounds, wave form display, radiographic findings and some explanations about various lung sounds including normal and abnormal lung sounds. Thirty students attending in the 2nd year of Medical school at the Hallym University was randomly divided into two groups. Each group studied on their own using either tape or multimedia title for one week. After the study, they were tested to describe the lung sound of real patients who were admitted to the Chun Cheon Sacred Heart Hospital. Multimedia group was asked to answer the questionnaire on multimedia title. Results: 1) Test score of auscultation on real patients The mean score of tape group and multimedia group was 1.20±1.08 and 1.54±0.74 respectively. But there was no significant difference between two groups (P=0.34). 2) Summary of questionnaire Twelve out of 15(80%) students answered that multimedia title helped them to understand the lung sound and three students (20%) answered that this program was very helpful. For the visual display of wave form, eight out of 15 (34%) students answered that it was helpful and three out of 15 (34%) students answered that it was very helpful. Eighty seven percent of the students answered that visual display of sound wave form helped them to understand the lung sound. Fourteen out of 15 students answered that multimedia program was interesting and provocative, All student answered that they will recommend this title to other colleagues. Conclusion: Even though there was no stastical significant difference between two self study methods but student of multimedia group showed narrow range of score than tape group. Answer to the questionnaire sup- ported the usefulness of multimedia for the self study of lung sound. Therefore we conclude that this program is helpful in the self-learninig of lung sound for medical students.

가정산소치료의 보험급여 실시 이후 처방 실태 다기관 조사 -만성기도폐쇄성질환 임상연구센터 제3세부과제 만성기도폐쇄성질환 진료지침 개발/보급 연구-

박명재 ( Myung Jae Park ),유지홍 ( Jee Hong Yoo ),최천웅 ( Cheon Woong Choi ),김영균 ( Young Kyoon Kim ),윤형규 ( Hyoung Kyu Yoon ),강경호 ( Kyung Ho Kang ),이승룡 ( Sung Yong Lee ),최혜숙 ( Hye Sook Choi ),이관호 ( Kwan Ho Lee 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.2

Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3±13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56±0.68 L/min at rest, 2.08±0.91 L/min during exercise or 1.51±0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18±10.48% and 91.64±7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85±6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414±15,618 won/month and 40,352±36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.

기관골 신생증 2예

박명재 ( Myung Jae Park ),우인숙 ( In Sook Woo ),모은경 ( Eun Kyung Mo ),이명구 ( Myoung Koo Lee ),현인구 ( In Kyu Hyun ),정기석 ( Ki Suck Jung ),박해정 ( Hae Jung Park ),양익 ( Ik Yang ),심정원 ( Jung Won Shim ) 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.5

우리나라 일차 진료의사의 만성폐쇄성폐질환(COPD) 진료실태조사

박명재 ( Myung Jae Park ),최천웅 ( Cheon Woong Choi ),김승준 ( Seung Joon Kim ),김영균 ( Young Kyoon Kim ),이승룡 ( Sung Yong Lee ),강경호 ( Kyung Ho Kang ),신경철 ( Kyeong Cheol Shin ),이관호 ( Kwan Ho Lee ),이진화 ( Jin Hwa L 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: COPD는 전세계적으로 유병률, 이환율 및 사망률이 급격히 증가하는 질환으로 환자의 삶의 질을 호전 시키고 사회, 경제적인 질병부담을 줄이기 위해 경증 COPD 환자를 조기에 진단하여 적절히 치료하는데 일차진료의사의 역할이 중요하다. 근거중심을 바탕으로 개발된 GOLD와 같은 COPD 진료지침은 이 목적을 위해 유용하나 우리나라의 진료실태가 반영되지 않은 문제점이 있다. 근거중심을 바탕으로 우리나라 진료실정이 반영된 진료지침을 개발하기 위해 우리나라 일차진료의사들의 진료 실태를 조사하여 보고한다. 방법: 진료실태는 웹을 기반으로 COPD의 진단, 치료, 위험인자, 교육, 진료지침에 대한 25개의 설문을 포함 제작하였고 총 217명의 일차진료의사가 설문조사에 동의하고 참여하였다. 참여자의 의사경력은 평균 17.7년이며 76.5%가 내과를 전공하였고 지역적으로는 63.6%가 서울, 경기지역에서 진료를 하고 있었다. 결과: 비교적 높은 비율(61.8%)로 폐기능검사기를 보유하고 있지만 실제 진료 시 활용도는 낮은(35.8%) 편임을 알 수 있었다. 안정 시, 급성악화 시 COPD의 치료에서 경구제제의 처방빈도가 흡입제제에 비해서 모두 높았다. COPD의 주요 위험인자인 흡연에 대해서는 흡연여부 확인율, 금연권유율 등이 90% 이상으로 높았으나 금연을 위한 처방에서 금연 성공률이 높은 니코친대체제와 부프로피온의 병용 처방률이 4.3%로 낮았다. COPD 진료지침에 대한 인지도는 56.7%였고 그대로 따르는 경우는 7.3%로 국내 진료실태를 반영한 진료지침의 개발이 요구되며 진료지침의 보급과 확산을 위해서는 진료지침책자를 포함한 인쇄자료의 보급이 효과적임을 알 수 있었다. 결론: 우리나라 일차진료의사들의 COPD 진료실태는 진단에서 폐기능검사의 보유율에 비해 사용률이 낮고 치료에서 흡입제에 비해 경구제제의 처방을 선호하는 경향을 보였다. GOLD 진료지침에 대한 인지도는 높으나 그대로 따르는 일차진료의사는 적으므로 이번 진료실태조사 결과를 바탕으로 근거중심이지만 국내실정을 반영한 COPD 진료지침의 개발 및 보급이 필요하리라 생각된다. Background: The incidence of chronic obstructive pulmonary disease (COPD) is increasing and the disease is becoming an important cause of morbidity and mortality worldwide. It is important to implement evidence-based guidelines by primary care physicians (PCPs) to establish qualified management of COPD patients. The aim of this survey is to investigate the pattern of COPD management among PCPs and to apply it to the development of Korean COPD guidelines. Methods: A web-based questionnaire was prepared that consisted of 25 questions on the pattern of COPD management. A total of 217 PCPs participated in the survey from June 2006 to May 2007. Results: Many PCPs (61.8%) possessed a spirometer, but the application rate was relatively low (35.8%) and more than half of the COPD patients (57%) did not receive a diagnosis based on spirometry. Administration of oral medication was preferred than the administration of inhaled medication for both stable COPD and acutely exacerbated COPD. More than 90% of the PCPs endorsed educational measures to quit smoking and vaccinate against influenza. It was noted that 56.7% of the PCPs were aware of the GOLD guidelines, but only 7.3% tended to fully implement the recommendations of the guidelines in daily practice. Conclusion: The results of the survey indicate that despite the high awareness rate of the current COPD guidelines, deficits exist among the PCPs with respect to the diagnosis and treatment of COPD. The results of this survey should be applied for the development of new COPD guidelines in order to decrease the discrepancy between the guidelines and the daily practice of the PCPs. (Tuberc Respir Dis 2008;64:109-124)

비특이성 간질성 폐렴에서 발생한 자발성 종격동기종, 피하기종과 대장기종

박명재 ( Myung Jae Park ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

Pneumatosis intestinalis or spontaneous pneumomediastinum are rarely associated with nonspecific interstitial pneumonia (NSIP). However, the development of both conditions in the same patient simultaneously has not been reported previously. A 56-year-old man with NSIP developed spontaneous pneumomediastinum accompanied by subcutaneous emphysema and pneumatosis intestinalis after the treatment with intravenous high dose steroid. The development of spontaneous pneumomediastinum, subcutaneous emphysema and pneumatosis intestinalis in this patient was possibly due to the factors such as NSIP, high dose steroid therapy and subclinical dermatomyositis. Treatment with corticosteroid and cyclosporin gradually improved his exacerbated NSIP and pneumomediastinum, subcutaneous emphysema, pneumatosis intestinalis. (Tuberc Respir Dis 2008;64:138-143)

상표소 (桑??)는 무엇인가? (약명(藥名), 이명(異名), 채집(採集), 수치(修治)에 관하여)

박명재 ( Park Myung Jae ),서영배 ( Seo Young Bae ) 대전대학교 한의학연구소 2016 한의학연구소 논문집 Vol.25 No.1

Objectives : Since the Korean pronunciation of the Mantidis Oothea(桑??) is not unified, it is necessary to unify pronunciation of this particular herb. According to ancient herbal literature, genuine Mantidis Oothea has been regarded as the product which is attached to mulberry tree. However, all forms of Mantidis Oothea need to be used as a medicinal ingredient. Methods : The current study explores pronunciations of the herbal medicinal names, Collection, and the herbal processes of the Mantidis Oothea. There are approximately about 30 herbal manuals dealing with the Mantidis Oothea after Shen Nong`s herbal manual(神農本草經) was published. Results & Conclusions : 1. Sangbicho(桑??), Sangpyeojo(桑?條), Sangpyeocho(桑??), and other names have been used as a name of medicinal ingredient for the Mantidis Oothea. 2. The Other names of medicinal ingredient for the Mantidis Oothea were Sik woo(蝕?), Danglangja(螳螂子), Danglanglan(螳螂卵), Danglangso(螳螂巢), Danglangwa(螳螂窩), Danglanggag(螳螂殼), etc.. 3. The name of medicinal ingredient for the Mantidis Oothea should not be pronounced as Sangpyoso but Sangpyocho. 4. The name of medicinal ingredient for the Mantidis Oothea was originated from a type of the egg case, eating habit , therapy of the Mantidis Oothea and so on. 5. Collecting real thing of The Mantidis Oothea does not really matter whether it is attached to the mulberry tree or not. 6. The herbal processes of the Mantidis Oothea is to kill the eggs, so typical methods were to steam, roast, boil with vinegar and so on. In addition, the main effect seemed to be protection from the diarrhea.

폐렴경과 중 순환 호중구의 Respiratory Burst 활성도 변화

이재명 ( Jae Myung Lee ),이종민 ( Jong Min Lee ),김동규 ( Dong Gyu Kim ),최정은 ( Jeong Eun Choi ),모은경 ( Eun Kyung Mo ),박명재 ( Myung Jae Park ),이명구 ( Myung Goo Lee ),현인규 ( In Gyu Hyun ),정기석 ( Ki Suck Jung ),박찬정 ( 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.5

폐렴진단에 있어서 Protected Specimen Brushing 의 역할

이재명(Jae Myung Lee),김동규(Dong Kyu Kim),최정은(Jeong Eun Choi),김동환(Dong Hwan Kim),모은경(Eun Kyung Mo),박명재(Myung Jae Park),이명구(Myung Goo Lee),현인규(In Gyu Hyun),정기석(Ki Suck Jung) 대한내과학회 1997 대한내과학회지 Vol.53 No.2

N/A Objectives: Culture of sputum is apt to be contaminated through oral cavity and proximal airway. Therefore, identification of true etiologic agents by sputum culture is not always reliable. In order to differentiate the pulmonary infection from non-infectious disease and to identify the true etiologic agent of acute pulmonary infection, we used PSB(Protected Specimen Brushing) and evaluated the efficacy of PSB. Methods: In 168 patients with acute febrile illness with pulmonary infiltrations(male 106, female: 61, mean age: 49.5±17.6), we performed PSB via a bronchoscope and compared the results along with blood culture and sputum culture. Protected specimen brush was introduced through biopsy channel of bronchoscope and was rotated within the purulent secretions. Tip of the brush was severed with aseptic technique and was immersed in 1cc of Ringer's lactate solution and vigorously mixed for 1 minute. The specimen was submitted for quantitative culture within 15 minutes and was regarded positive culture if colony forming units were above 10³/ml. Results: Using PSB for the diagnosis of pulmonary infection, sensitivity was 71.1% and specificity was 84.296. PSB was helpful in identifing true etiologic agent among several potentially pathogenic organisms. Using PSB for the diagnosis of UAP (ventilator associated pneumonia), sensitivity was 72.4% and specificity was 100%. Conclusion: Use of PSB can be a helpful method for the diagnosis of pulmonary infection and identification of its etiologic agents.

농촌 지역에서 발생한 치명적 약물 중독에 관한 임상적 관찰

김명환(Myung Hwan Kim),박명재(Myung Jae Park),김순길(Soon Kil Kim),박인석(In Seok Park),오도연(Do Yun Oh),표석주(Sok Joo Pio),김선주(Sun Joo Kim),홍세용(Sae Yong Hong) 대한내과학회 1988 대한내과학회지 Vol.35 No.6

N/A We analysed 255 cases of acute drug intoxication in patients who were admitted to the Department of Internal Medicine, Chun An Soon Chun Hyang University Hospital from January 1983 to December 1987. The following results were obtained: 1) The most common drugs were agricultural chemicals in 197 cases (77%), the remainder were hypnotics in 21 cases (8%), rodenticides and chemicals in 13 cases (5%), each, and unknown drugs in 9 cases (4%), in order of frequency. 2) The overall sex incidence ratio was 1.63 male to 1 female with a male preponderance and patients were most commonlyaffected in the 3rd decade (30%). Monthly incidence was highest in July and there was an increasing tendency in the number of cases admitted annually. 3) The causes of intoxication were suicidal attempts in 137 cases (54%), unknown in 97 cases (38%), accidental intoxication in 18 cases (1%), in order of frequency. 4) The highest mortality was observed in patients of organophosphorous and paraquat intoxicalion. The mortality rate was 95% in paraguat intoxication and 79% in organophosphorous intoxication. 5) In cases of organophosphorous intoxications, the mortality rate was 78% in 3 days after acute intoxication and 73% for paraguat intoxication in the same period. 6) The most common cause of death was respiratory failure (76%) in organophosphorous intoxication and respiratory failure (48%) and renal failure (45%) in paraquat intoxication.