응급실로 내원한 흉부 외상 환자의 흉곽 골절 진단에 있어 흉부 컴퓨터단층촬영과 비교한 골스캔의 유용성

정상인,정원석,박용진,김선표 대한응급의학회 2014 大韓應急醫學會誌 Vol.25 No.4

Purpose: Thorax computed tomography (CT) is the diagnostictest for chest trauma patients in the emergency department. Thorax CT has high diagnostic accuracy for rib, sternum fractures. However, rib, sternum fractures are often missed by thoraxCT. In this study, the accuracy of thorax CT as a diagnostictest of rib, sternum fractures was examined by comparing thediagnosis of rib, sternum fractures by bone scan. Methods: A total of 112 patients who had visited the emergencydepartment due to chest trauma and who had undergoneboth thorax CT and bone scan from January 1, 2010,to June, 30, 2013 were examined. We examined thepatients’characteristics, vital signs and cause of traumathrough a retrospective analysis of medical records, andthorax CT and bone scan were read by a radiologist and anuclear medicine specialist. Results: Among 112 patients, 62 patients (55.3%) weremale, 50 patients (44.7%) were female, and mean age was56. There were 59 patients who had no fracture on thoraxCT and were regarded as contusion. In 59 patients, 28patients (47.5%) were diagnosis rib, sternum fracturesdetected by bone scan. Sex (p=0.188), age (p=0.624), andcause of trauma (p=0.389) were not significant predictorsfor rib, sternum fractures. However, combined fracture(p=0.043) showed significant correlation. In this study, thesensitivity, specificity, positive predictive value, and negativepredictive value of thorax CT in diagnosis of rib, sternumfractures were 64.5%, 93.9%, 96.2%, and 52.5%. Conclusion: Thorax CT has low sensitivity (64.5%) andlow negative predictive value (52.5%) in detection of rib,sternum fractures. Although thorax CT shows no thoraxfracture, when patients have persistent pain or they needaccurate diagnosis, we may recommend bone scan fordetection of rib, sternum fractures and accurate diagnosis.

교역자의성공비결

정상인 신학지남사 1930 신학지남 Vol.12 No.2

한탄바이러스가 사람제대 정맥내피세포 유래 세포주의 혈액응고에 미치는 영향

정상인,서정국,강응택,유석희,최철순,양용태 대한바이러스학회 1992 Journal of Bacteriology and Virology Vol.22 No.2

The pathogenesis of disseminated intravascular coagulation (DIC) and bleeding tendency in patients with hemorrhagic fever with renal syndrome (HFRS) is not well understood. In order to explore the pathogenesis of DIC and bleeding tendency in patients with HFRS, human umbilical vein endothelial cell line (ATCC CRL 1730 HUV-EC-C, referred HUVEC) were infected with Hantaan virus 76-118, and then the procoagulant activity of infected HUVEC was investigated. The infection of cultured HUVEC cells with Hantaan virus was revealed by immunofluorescent antibody technique. Plasma coagulation time with total procoagulant activity of infected HUVEC was markedly decreased to 62sec, 54sec, and 97sec after 6hr, 12hr and 18hr respectively in contrast to the normal coagulation time of >200sec. Prothrornbinase complex formation of infected HUVEC was increased to 0.310+0.113/min(O.D.) after 12hr in comparison with the normal control of 0.108+0.047/min (O.D.). Thrombomodulin expression in infected HUVEC was reduced to 27.5 % and 65.6 % after 6hr and 12hr of inoculation respecitively. Activity of platelet adherence on infected HUVEC was increased at 24 hours postinfection compared with normal, uninfected HUVEC. By 72hours postinfection, activity of platelet adherence was decreased to the level of control cells. These results indicated that the tissue factor activity and the formation of prothrombinase complex were markedly increased in HUVEC by the Hantaan virus infection, while the thrombomodulin activity was decreased by infection. And the activity of platelet adherence was increased by infection with Hantaan virus. Thus the infection of endothelial cells with Hantaan virus to could partly responsible for the pathogenesis of DIC and bleeding tendency in patients with HFRS.

사랑과 간섭

정상인 중앙대학교 1983 無影燈 Vol.8 No.-

日本の家族支援 (子育て支援) 制度について - 虐待防止と少子化對策から見た子育て支援制度 子どもの權利基盤型地域ネットワ-クの必要性について -

정상인 한국가족복지학회 2005 International Journal of Family Welfare Vol.1 No.-

Surfactants가 세균증식에 미치는 영향

정상인,문언수,김기정,김민희,최철순 중앙대학교 의과대학 의과학연구소 1995 中央醫大誌 Vol.20 No.4

Pulmonary surfactant is a surface-active material lining the alveolar of the lung and a lipid-protein complex consisted of about 90% lipids and 5~10% surfactant-specific proteins. Pulmonary surafctant has been shown to play an important role in bacterial clearance at the alveolar surface in the lung as well as in contributing to lung mechanics. The antimicrobial activity of the surfactant against a number of bacterial species reported. Surfactant replacement is a potential life saving therapy in respiratory distress syndrome. The most striking acute effect has been obtained with modified natural surfactant preparations containing both surface active lipids and proteins SP-B and -C. The clinical application of artificial surfactants has been steadily increased. However their effect on the bacteria has not been widely studied. The mechanism of damage on bacteria treated with surfactants has not been clarified. S. pneumoniae, H. influenzae and N. meningitidis are quite common pathogens in neonatal sepsis. In the respiratory distress syndrome, 5~10% of patients were infected with pneumonic bacteria. Especially, clinical characteristics of the infection with H. influenzae were similar to those by early onset group B streptococcus including those respiratory distress syndrome. Surfactant has been reported to be bactericidal for group B streptococcus. The phenomenon of surfactant inactivation is caused by adult respiratory distress syndrome, neonatal respiratory distress syndrome and meconium aspiration syndrome. One aspect of meconium aspiration syndrome is severe respiratory distress syndrome characterized by hypoxia, intrapulmonary shunting, and decreased lung compliance. The precise mechanism of surfactant inactivation by meconium is unknown. However biophysical inactivation of surfactant by meconium has been reported. Antimicrobial effects of surfactant by meconium has not been studied in depth. The purpose of this study was to investigate effects of artificial surfactant on the growth of S. pneumoniae and N. meningitidis. Exponential growing S. pneumoniae and N. meningitidis were mixed with differentiated concentration of surfactants. Mixed solutions of bacteria-surfactant were incubated at 37℃ during 90 min. Then, the mixtures was serially diluted with physiological saline. Each dilution of mixture was streak-cultutred on chocolate agar medium. And the number of viable bacteria was determined by colony counting after 18 hour incubation. The mixture of bacteria-surfactants was processed for transmission electronmicroscopic observation. Artificial surfactant(Exosurf and Surfactant-TA) almost completely inhibited the growth of S. pneumoniae and N. meningitidis at the concentration of 100%. The growth of S. pneumoniae was also inhibited at 10% concentration. There is no apparent difference between treatment of two surfactants in the growth suppression of the tested organisms. surfactants resulted in the damage of S. pneumoniae and N. meningitidis. And the damages were characterized by distortion of cell membrane and bleb formation. This study suggested that artificial surfactants would reduce the severity of bacterial pneumonia in hyaline membrane disease and meconium aspiration syndrome with bacterial infection.

MDCK 세포에서 Hantaan Virus의 증식에 관한 연구

정상인 중앙대학교 의과대학 의과학연구소 1989 中央醫大誌 Vol.14 No.2

This study was intended to establish the susceptibility of Madin and Darby Canine Kidney (MDCK) cells for the propagation of Hantaan virus and to evaluate the applicability of MDCK cell system for the measurement of fluorescent antibody titers in sera from patient with Hemorrhagic fever with renal syndrome (HFRS). Through the experiments, observations were made with development of specific fluorescent antigen in MDCK cells following inoculation with Hantaan virus, blocking of appearance of such a specific fluorescent antigen in MDCK cells when Hantaan virus was pretreated either with convalescent patient's serum or immune rat serum, comparison of growth patterns of Hantaan virus in MDCK, A-549 and Vero E6 cells, demonstration of characteristic 3 segments of single-stranded viral RNA in Hatitaan virus incoulated MDCK cells and finally, applicability of MDCK cell system of the titration of fluorescent antibody in convalescent sera from patients with HFRS. The results are summarized as follows: 1. On 8 day after Hantaan virus inoculation, specific granular fluorescent antigens developed, exclusively in the cytoplasm of MDCK cells when observed by the indirect fluorescent antibody technique. Such fluorescent antigens in MDCK cells were very much similar to those in both Vero E6 and A-549 cells inoculated with the same virus, except that the occurrence of nonspecific fluorescence was far less in MDCK cells. 2. Both the percentages of cells exhibiting specific fluorescence and the intensities of such fluorescence increased significantly through the first and second passage of MDCK cells inoculated with Hantaan virus. 3. Such development of virus-specific cytoplasmic fluorescent antigens in MDCK cells was specifically inhibited by the pretreatment of inoculating virus either with convalescent serum from patients with HFRS or with immune rat serum. 4. The growth pattern of Hantaan virus in MDCK cells was fairly similar to those in Vero E6 cells and A-549 cells. The infectivity titers measured during 2 weeks after virus inoculation were also comparable. The maximum titers attained were 10^3 to 10^4/0.3 ml levels. 5. Existence of viral single-stranded RNA in 3 segmented pieces in MDCK cells infected with Hantaan virus was demonstrated in this study. These three RNA segments in virus-infected MDCK cells proved to be identical with the ones in infected Vero E6 cells. 6. Measurciiients of fluorescent antibody titers in the use of Hantaan virus infected MDCK cells resulted in the comparable titrations of convalescent sera from patients with HFRS. The results of such titrations were in full agreement with those obtained with both A-549 cells and Vero E6 cells inoculted with Hantaan virus. It was concluded that in addition to A-549 cells and Vero E6 cells, MDCK cell culture proved to be susceptible and sensitive for the propagation of Hantaan virus.

Antisense Technology를 이용한 탄저균 치사 독소 발현억제

정상인,안장훈,김기정,김원용,박철민,김미정 대한미생물학회 2005 Journal of Bacteriology and Virology Vol.34 No.4

치자.Fructose gardeniad.수용성 추출액 첨가배지에서의 각종 세균의 Crocin반응

정상인 중앙대학교 의과대학 1982 미생물학 교실 Vol.1982 No.7

치자(Fructose gardeniae) 수용성 추출액 첨가배지에서의 각종 세균의 Crocin 반응

정상인,최철순,양용태 중앙대학교 의과대학 의과학연구소 1982 中央醫大誌 Vol.7 No.4

Lee and Son(1955) observed that certain stains of mycobacteria grown on Ogawa medium containing soluble extract of fruit of Fructose gardeniae produced dark violet pigment around the colonies (referred to crocin reaction). Thereafter, the crocin reactions with atypical mtcobacteria, (Choi et al.,1974) β-hemolytic streptococci(Seok et al.,1976) and Bacillus subtilis(Kim, 1978)have been reported. In this study the crocin reaction of various human pathogenic bacteria was investigated. In addition, with Lancefield groups of β-hemolytic streptococci the diagnostic value of presumptive tests of Lancefield grouping, a modified CAMP test and crocin test was studied. In thw summary, of 9 species of gram-positive bacteria tested, all strains of Bacillus subtilis and 12 strains of 44 strains β-hemolytic streptococci were positive in the crocin reaction. respectively. Of 13 species of gram-negative enteropathogens, Enterobacter aerogenes was a single species that was positive in the crocin reaction. The crocin reaction was not observed with small gram-negative bacilli, i.e.,B.abortus,B. bronchiseptica, B. pertussis, Y.peslis, P. multocida and H. vaginalis. In the crocin reaction with Lancefield groups of β-hemolytic streptococci, positive reactions were observed with group B,D and G, but neither group A nor C showed the crocin reaction. All strains of groupp B,D and G streptococci which produced green hemolysis on human blood agar showed positive crocin reaction, whereas they all showed negative CAMP reaction. The growth of the most species of bacteria, except for B. abotus, B,pertussis and H. vaginalis appeared to be enhanced resulting in the development of larger colonies on the BHI agar containing soluble extracts of fructose gardeniae and the most clocies showed mucoid type appearance. This results indicated that the crocin test would of value for a rapid differentiation of pathogenuc strains of B. anthracis from nonpathogenic strains of B. subtilis, of Lancefield group A of β-hemolytic streptococci from other groups, and of Enterobacter aerogenes from other rapid lactosefermenting gram-negative enterpathogens, i.e., Escherichia coli and Klebsiella pneumoniae.