신 이식 환자에서 사이클로스포린 제제로서 산디문 , 임프란타 , 네오프란타의 대체 투약에 있어서 임상적 효과에 관한 연구

송승찬,김호중 대한신장학회 1997 춘계학술대회 초록집 Vol.1997 No.-

복어중독에 의한 가사 상태에서 소생한 1예

송승찬,신진호,강석우,박경남,최호순,박근태,문희식,기춘석,이성희,윤병철,노우균,조균석,이민호 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.3

Tetrodotoxin is a neurotoxin produced by about 90 species of puffer fish and causes paralysis of central nervous system and peripheral nerves by blocking the movement of all monovalent cation. Ingestion of tetrodotoxin produces clinical manifestations such as paresthesias(within 10-45 min), vomiting, lightheadedness, salivation, muscle twitching, dysphagia, difficulty in speaking, convulsion and death that expressed by cardiopulmonary arrest with loss of brain stem reflex sometimes. Tetrodotoxin prevents or delays ischemia induced neuronal death by way of following 3 mechanisms. Firstly, it reduces the energy demand of the brain tissues. Secondly, it delays or even prevents anoxic depolarization. Finally, it deminishes ischemia induced cell swelling and cerebral edema. We report a case of puffer fish poisoning which presented with cardiopulmonary arrest and loss of brain stem reflex, but completely recovered by aggressive cardiopulmonary resuscitation.

급성신부전을 동반한 급성신우신염의 임상상의 특징

송승찬(Seung Chan Song),이재웅(Jae Woong Lee),이오영(Oh Young Lee),양석철(Suk Chol Yang),한동수(Dong Soo Han),손주현(Ju Hyun Son),김순길(Soon Kil Kim),김호중(Ho Jung Kim) 대한내과학회 1997 대한내과학회지 Vol.53 No.3

N/A Background: Acute renal failure (ARF) due to acute pyelonephritis (APN) in patients in the absence of obstructive uropathy, diabetes, or chronic renal failure was reported rarely (12 cases in the last 25 yrs in Clin Inf Dis, 1992; 243-6 by SR Jones)2). Acute renal failure is a rare complication of acute pyelonephritis in patients who do not have urinary obstruction. Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure, and when clinicians weigh the possible consequences of bacteriuria, renal failure is not considered to be a reasonable possibility. Methods : We observed 6 patients of acute pyelonephritis associated with acute renal failure as an initial manifestation on admission in the past 6 months. The analysis of clinical features of these 6 patients (APN+) compared to 7 patients of APN without ARF (APN-) revealed following data. Results: All were female in both groups. The mean age was 331.7 years in APN+ and 48+6 years in APN-, respectively (p, ns). All in both APN- and APN+ were caused by E. coli. But, none in both groups except 1 in APN- had bacteremia. The previous history of UTI was present in 5 in APN-, but none in APN+. Duration of clinical symptoms before admission (8.4±0.5 vs. 4.4±1.0 days, P<0.05) and admission days (24.2±1.8 vs. 11.1±1.5 days, p=0.000) were significantly longer in APN+. On admission, HUN and serum creatinine was 45±2.7mg/dL and 3.5±0.2mg/dL in APN+, respectively. No one in APN+ required dialysis, and subsequently recovered renal function with prompt antibiotic therapy resulting in no significant difference compared to that of APN on discharge (serum creatinine, 1.0±0.1 vs. 0.9±0.1mg/dL). No differences in leukocytosis and serum electrolyte levels on admission were present. However, significant anemia was noted in APN+ (hemoglobin, 9.0±0.7 vs. 11.9±0.2gm/dL). The days of fever and leukocytosis before disappearance were not different in both groups, but those of flank pain (12.8±1.5 vs. 5.7±0.7 days, P=0.001) and pyuria (16±1.9 vs. 6.4±0.6 days, P=0.000) significantly longer in APN+. Upon ultrasonography, all in APN+ showed enhanced echogenicity, but I in APN . (P=P value, NS=not significant) Conclusion: Upon these data, we concluded that ARF associated with APN as an initial manifestation was accompanied by several distinct clinical characteristics, which could be used for the early recognition of its unusual occurrence and subsequent appropriate management including antibiotics leading to a favorable outcome.

신이식 환자에서 산디문 임프란타와 네오프란타의 대체 투여의 임상적 효과

김호중,송승찬 대한신장학회 1997 Kidney Research and Clinical Practice Vol.16 No.4

Clinical trial of cyclosporines produced from two different manufacturers were performed in thirty three renal transplant patients for 16 months divided into 2 phases. A 1:1 conversion on a milligram-to-milligram basis was used for switching from Sandimmune(Sandoz Pharma Ltd, Switzerland) to Implanta(Hanmi Pharma Co, Korea) as the first phase and from Implanta to its microemulsion formulation, Neoplanta, as the second phase. Throughout two phases, the cyclosporine dose, blood pressure and hemoglobin were not changed significantly. Serum creatinine was reduced from the baseline(1.76±0.5mg/dL) only during the middle 2 months of the first phase(month 3:1.57±0.4mg/dL, P$lt;0.05, month 5: 1.58±0.4mg/dL, P$lt;0.05), but it was not changed significantly during the second phase at all. However, blood urea nitrogen(BUN) was increased from baseline throughout the second phase, significantly. Cyclosporine trough level was reduced from baseline(180.87±57.5 ng/mL) during the late 3 months of the first phase(month 6: 1314 61.2ng/mL, P$lt;0.05, month 7: 137.27±82.1ng/mL, P$lt;0.05, month 8: 135.06±58.2ng/mL, P$lt;0.05), while those were increased from baseline to during the early 2 months (month 1: 172.48±64.1ng/mL, P$lt;0.05, month 2: 170.12±49.6ng/mL, P$lt;0.05) and returned to baseline during the remaining 6 months of the second phase. No one developed rejection, but 8 admissions in 7 patients occurred due to cyclasporine nephrotoxicity related elevation of serum creatinine(n=2 in the first phase, n=3 in the second phase), cellulitis in leg(n= 1), partial colectomy for colon cancer(n=1) and reduction of fractured arm(n=l), respectively. Mild abdo- minal discomfort in 2 patients and nausea with fishy smell on cyclosporine intakes in 3 patients during the early first phase were noted transiently, but no one developed such adverse side effects during the second phase. In conclusion, there vere no discernible differences in safety and effectiveness in cyclosporine products from two different manufacturers. Furthermore, the comparable ets between the conventional cyclosporine(Implants) and the microemulsion formulation(Neoplanta) were noted without requiring the dose reduction after the 1:1 conversion.

궤양성 대장염과 동반된 상장간막정맥 및 간문맥 혈전증 1예

김병훈,한동수,조윤주,송승찬,전용철,손주현,안명주,박경남 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

Kirkpatrick 평가모형을 응용한 군 고급학위과정 위탁교육 평가에 관한 연구

임유신(Yooshin Im),최원석(Wonseok Choi),송승찬(Seungchan Song) 육군사관학교 화랑대연구소 2013 한국군사학논집 Vol.69 No.1

The specific purposes of the study are to identify the merits and demerits of the commissioned education program and to provide the basic information necessary for its improvement, though the appraisal of the university specialized-degree program in the commissioned education. The results of this study are as follows: 1) The evaluation result of the goal achievement showed that the commissioned education program helped the learners to learn knowledge in a special field of study, to improve their potential abilities and to enhance communication ability. On the other hand, the result implied that the program did not improve problem-solving ability, self-directed learning ability and sharing social value. 2) The graduates of the commissioned education were quite satisfied with the knowledge that they acquired and the academic advisors that they met. It also reported that the experiences of the commissioned education program have been useful for doing on one's current job and making the human networks necessary for the army. 3) The evaluation results of the educatees' applicability and working environment showed that the graduate-officers' applicability was reported high. For the working environment, feedback/performance coaching and positive personal out comes seemed to be high, while opportunities to use the learned contents and supervisors' support to be low. Finally, suggestions and implications have been made for the policies in the commissioned education.

궤양성 대장염과 동반된 상장간막정맥 및 간문맥 혈전증 1예

전용철,박경남,한동수,김병훈,손주현,안명주,조윤주,송승찬 대한소화기학회 1998 대한소화기학회지 Vol.32 No.3

Thromboembolism is a infrequent extraintestinal complication of inflammatory bowel disease. Especially, portal vein and superier mesenteric vein thrombosis are rare complications of ulcerative colitis and its mortality is invariably fatal. The mechanism of thrombolic complications in inflammatory bowel disease remains enigmatic. Moreover, the clarification of the hypercoagulable state remains elusive. This report describes the case of 27-year-old-female with active ulcerative colitis. The patient revealed portal vein and superior mesenteric vein thrombosis with ascites detected by abdominal ultrasound exammation and computed tomography and successfully treated with combined anticoaulation therapy.

풍선 확장술로 치유된 선천성 총담관 막양구조 (Web)

박경남,한동수,이민호,최호순,조용현,함준수,이성희,전용철,송승찬,문광호,기춘석,윤병철,손주현 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.3

The web of the common bile duct is an extremely rare anomaly and the cause of the obstructive jaundice. We experienced a case of the congenital web of common bile duct in a 42 years old male who complained of jaundice for 10 days prior to admission without choledocholithiasis and cholangitis. An endoscopic retrograde cholangiopancreatography revealed a common bile duct web (transverse, diaphragmatic type) and the diagnosis was confirmed by an endoscopic forcep biopsy. We reported a case of the congenita1 web of the common bile duct which was treated with a stent insertion and balloon dilatation.

담도·췌장 당뇨병 환자에 있어서의 담낭 운동 장애에 관한 연구

기춘석,박경남,이민호,함준수,윤병철,박경근,손주현,한동수,이오영,송승찬,박준용 대한소화기학회 1995 대한소화기학회 추계학술대회 Vol.1995 No.-

N/A

대장내시경검사의 전처치로서 항콜린제 사용에 관한 연구 : 전향적, 이중맹검법으로

박경남,한동수,이민호,최호순,박준용,손주현,이오영,함준수,전용철,송승찬,기춘석,윤병철,이종희 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

Background: Use of antispasmodic medication prior to colonoscopy is controversial but someone believes antispasmodic may improve visualization of colonic mucosa and ease colonoscope insertion. So, we designed a study to assess the effect of premedication with the antispasmodic, hyoscine-N-butyl bromide(Buscopan') on the performance of colonoscopy. Methods: This study was prospective, double blinded, randomized, controlled study, One hundred three consecutive patients were randomized to receive intravenous buscopan lml(n=52) or placebo(n=51) combined with our standard initial medication(me- peridine 50 mg and midazolam 2 mg). Insertion of colonoscopy was timed, and 100 mm visual analogue scales (VAS) were used for asscssing difficulty of procedure, colonic motility, frequency of positional change, frequency of external compression, difficulty of assistance and degree of discomfort experienced by the patients. Results: There were no significant differences of intubation time between buscopan group(mean time, 7.23 min., range 2~15) and placebo group(7.07 min., range 3-25), (p=0.83) and withdrawal time between buscopan group (6.46 min., range 2-22) and placebo group(6.76 min., range 2 25), (p=0.69). Also, there was no significant differences in intubation time between males and females(buscopan; males 7.00 min., females 7.60 min., p=0.34, placebo; males 7.0~5 min., females 7.08 min., p 0.44). The VAS scores checked by endoscopist(p=0.29), assistant(p=0.32) and patient (p=0.15) were not significantly different in both groups. There were no significant differences in intubation time, VAS scores nf endoscopist, assistant, and patients. Conclusion: Premedication with intravenous bu.opan has no advantage on colonoscopy procedure. Use of antispasmodic medication prior to colonoscopy was not considered as recommendable agent.