中風의 治療에 있어 淸熱法에 對한 文獻的 考察

강화정,문병순 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The literatual study on the therapy for cleaning away heat with apoplexy therapy, the result were obstained as follows. 1. In apoplexy therapy, therapy for clearing away heat is used excessive heart - fire by overacting of the five emotions, liver fire, deficiency of kidney - fluid, wind - heat. 2. The fire of aetiology of apoplexy is used therapy for clearing away heat, in aspect of viscera and bowels, divided into heat-fire, liver-fire, deficiency fire of kidney yin, wetness-phlegm of spleen heat. The treatment is clear away heart-fire, clear away liver-fire, clear away spleen-heat and sthenic water. 3. Symptom of excessiveness symptom-complex is used therapy for clearing away heat that are fever, flushed face, halitosis, heart burn, easy anger, apoplestic stroke, unconsciousness, trismus, paratysis, constipation, red tongue with yellow coat, taut-smooth pulse or full rapid pulse and symptom of insufficiency symptom - complex that are dizziness, tinitus, blurring of vision, deficiency sleeping, dreaminess, lassitude of the loins and legs, hemiplegia, red tongue with white coat or thin - yellow coat, taut- therapy-rapid pulse. 4. Therapy for norish vital essence - clearing away heat is availed in excessive fire caused by deficiency of yin of the liver and kidney, therapy for break through phlegm - clearing away heat in stagnant, heat, therapy for waking up a patient from unconsciousness - clearing away heat in stagnant heat, therapy for waking up a patient from unconsciousness - clearing away heat yang type sthenia - syndrom of coma of apoplexy involving viscera and bowels. 5. Commonly used recipes of therapy for clearing away heat are Yang gyoksan(凉膈散), Bang pungtongseongsan(防風通聖散), Sotongseongsan(小桶聖散), Jibodan(至寶丹), Supungsungisan(授風腥氣散), Woowhangchengshimwhan(牛黃淸心丸), Chengungsekgotang(川芎石膏湯), Samwhatang(三化湯) etc in excessiveness symptom - complex, and are Yukmihiwhangweon(六味地黃元), Jiwhangtang(地黃湯), Palmiji whangtang(八味地黃湯) etc in insufficiency sumptom - complex.

양이온교환수지에 대한 Co(Ⅱ), Ni(Ⅱ), Cr(Ⅲ) 및 Fe(Ⅲ) 이온의 흡착 특성 : 원자로 일차 냉각재 계통내 탈염공정에의 적용 Application to the Demineralizing Process in a Primary Coolant System of PWR

강소영,이병태,이종운,문승현,김경웅 대한방사선 방어학회 2002 방사선방어학회지 Vol.27 No.1

가압경수로 일차냉각수내 탈염공정의 효과적 운용을 위하여 Amberlite IRN-77 양이온 교환수지의 특성 및 Co(II), Ni(II), Cr(III), Fe(III) 이온의 흡착거동을 연구하였다. 용존 금속이온 농도가 약 200 mgL^-1 인 용액 100 mL에 대하여 이온교환수지 투입량은 약 0.6g이 가장 적절하였으며, 이온교환 반응 속도 측정 결과 대부분의 흡착은 반응 1 시간 이내에 신속히 발생하였다. 수지에서의 양이온 교환은 Langmuir 흡착등온선을 잘 따르는 것으로 나타났으나, Fe(III)의 경우, 다른 금속과는 달리 쉽게 평형에 이르지 못하였으며 이는 공기와 오래 접촉한 결과 철산화물 또는 수산화물을 형성하며 용액 중으로부터 침전되기 때문인 것으로 관찰되었다. 전자가가 동일한 Co(II)와 Ni(II)가 동시에 포함된 모의 조제용액에 대하여 흡착실험을 한 결과, 각 이온은 거의 동일한 흡착 거동을 보였다. 그러나 전자가가 큰 Cr(III)이 첨가된 경우, 이들은 기존에 수지에 흡착되어 있던 전자가가 낮은 금속들을 탈착시키고 대신 흡착하는 경향을 보였다. 따라서 이온교환수지를 이용한 효과적인 탈염 공정을 위해서는 용존 금속 상호간의 경쟁적 흡착관계의 규명이 필요한 것으로 여겨진다. Characteristics of Amberlite IRN-77, a cation exchange resin, and the mechanisms of its adsorption equilibria with Co(II), Ni(II), Cr(III) and Fe(III) and Fe(III) ions were investigated for the application of the demineralizing process in the primary coolant system of a pressurized water reactor (PWR). The optimum dosage of the resin for removal of the dissolved metal ions at 200 mgL^-1 was 0.6 g for 100 mL solution. Most of each metal ion was absorbed onto the resin in an hour from the start of the reaction. Each metal adsorption onto the resin could be well represented by Langmuir isotherms. However, in the case of Fe(III) adsorption, continuous formation of Fe-oxide or -hydroxide and its subsequent precipitation inhibited the completion of the equilibrium between the metal and the adsorbent. Cobalt(II) and Ni(II), which have an equivalent electrovalence, were adsorbed to the resin with a similar adsorption amount when they coexisted in the solution. However, Cr(III) added to the solution competitively replaced Co(II) and Ni(II) which were already adsorbed onto the resin, resulting in desorption of these metals into the solution. The result was likely due to a higher adsorption affinity of Cr(III) than Co(II) and Ni(II). This implies that the interactively competitive adsorption of multi-cations onto the resin should be fully considered for an efficient operation of the demineralizing ion exchange process in the primary coolant system.

Clozapine이 인체내에서 인간조직적합성항원에 미치는 영향

강병조,김문두,곽경필 경북대학교 의학연구소 2000 경북대학교병원의학연구소논문집 Vol.4 No.1

The histocompatibillty antigen (human leukocyte antigen : HLA) has been used for organ transplantation, discrimination of one's real children and transfusion, etc. The objective of this study was to find out how dozapine affects HLA class I and II type in the humanbody when therapeutic doses are applied. The subject consists of 3 persons for lass I and class II They were administered for about 3 months with clozapine 157-250mg/day (mean dally dose 200mg). Analysis of HLA lass I type was the microcytotoxicity test of Terasaki and class II type was PCR method of Erhich. The results were as followings: Two of 3 were changed in HLA-A, B, C type. All three were not chanced in HLA-DR type. In conclusion, the short-term application, about 3 months, of therapeutic dose of clozapine is not considered to bring about changes in DNA level.

악성 갑상선 우연종의 임상상 및 초음파 소견의 진단적 가치

강한욱,김광원,이병완,강보현,김형훈,김범진,정재훈,민용기,이명식,이문규 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 최근 갑상선 초음파 검사의 빈번한 시행으로 갑상선 우연종의 발견이 증가하고 있다. 이러한 갑상선 우연종은 임상적으로 어떻게 접근하고 치료를 해야 하는지 적지 않은 문제가 되고 있다. 본 연구에서는 직경 1.5㎝ 이하의 갑상선 우연종의 유병률, 입상적 특징 및 초음파 특성, 그리고 가장 효율적인 진단적 접근에 대해 알아 봤다. 방법: 1999년 1월부터 2000년 12월까지 삼성서울병원 내과 및 일반외과로 갑상선 결절을 주소로 내원한 1457명을 대상으로 후향적 연구를 시행하였다. 우연히 발견된 직경 1.5㎝ 이하의 갑상선 결절을 가지는 환자들에서 갑상선 결절의 촉지 유무, 갑상선 기능검사, 항갑상선 항체, 갑상선 초음파 및 미세침 흡인세포검사, 99m^Tc 갑상선 스켄, 수술 조직검사 및 병기를 검토하였다. 결과: 분석한 갑상선 결절 1475예 중 갑상선 우연종의 유병률은 13.4%(198예)였다. 갑상선 우연종에서 악성률은 28.8%(57예)으로 나왔다. 양성 및 악성 갑상선 우연종에서 나이, 성별, 갑상선 기능검사, 결절 크기에는 의미 있는 차이는 없었다. 갑상선 스켄은 갑상선 우연종의 감별에 적합하지 않았다. 갑상선 결절의 초음파 지표 점수만이 양성 및 악석 갑상선 우연종의 감별에서 초음파 지표 점수의 민감도는 88.9%, 특이도는 74.4%, 양성 예측률은 92.4%로 나왔고 진단적 정환도는 85.5%였다. 갑상선암으로 수술을 받은 50명중 stage 1은 34명, stage 2는 6명, stage 3은 10명으로 대부분의 악성 갑상선 우연종은 낮은 TNM 병기로 나타났으나, 상당수에서는 국소 침범의 소견을 보였다. TNM 병기의 3기 환자 전부는 45세 이상이였고, 주로 갑상선암의 피막 침범에 의한 것이었다. 임파절 전이는 6명의 환자에서 나왔다. 결론: 악성 갑상선 우연종은 비교적 흔히 접할 수 있는 질환이며 양성 우연종과는 임상적으로 구별이 안 된다. 악성 갑상선 우연종은 발견 당시 대부분 낮은 병기이나, 갑상선의 피막 침범 및 임파절 전이가 상당수에서 발견되었다. 갑상선 우연종의 초음파 소견은 향후의 진단 방향을 제시하는 중요한 길잡이가 될 수 있다. 초음파 지표 점수 2점 이상의 갑상선 우연종에서만 초음파 유도 미세침 흡입검사를 권장한다. Background: High-resolution ultrasonography has made the detection of asymptomatic small thyroid possible. Recent increases in the detection of incidentalomas have created a clinical dilemma on how to properly manage such incidental nodules. We investigated the prevalence, clinical and ultrasonographic characteristics, and optimal diagnostic approach toward incidentally detected benign and malignant thyroid nodules of less than 1.5㎝ in size. Methods: A retrospective review was undertaken on the 1,475 patients who had visited Samsung Medical Center, Seoul Korea between January 1999 and December 2000. The review consisted of a physical examination of the thyroid gland, thyroid function test, antithyroid antibodies, thyroid ultrasonography, fine-needle aspiration biopsy, pathology and TNA staging of the incidentally detected thyroid nodules of less than 1.5㎝ in size. Results: The prevalence of thyroid incidentalomas was 13.4% and the malignancy rate within them was 28.8%. There were no significant differences in age, sex, thyroid function test and size between the benign and malignant incidentalomas. Ultrasonographic characteristics showed meaningful diagnostic value for the detection of malignancy in incidentalomas. Most malignant incidentalomas were of a low stage. Conclusion: Occult thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodules less than 1.5㎝; however, ultrasonographic findings can be used to decision of optimal management strategies (J Kor Soc Endocrinol 17:649∼656, 2002).

정신분열병 환자에서 Olanzapine이 인지기능에 미치는 영향

강병조,김양태,김문두,이승재,박영우 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Objects : The purpose of this study was to test the effects of olanzapine on cognitive functions in schizophrenic patients. Methods : The subjects were 16 haloperidol-medicated schizophrenic patients and 15 risperidone-medicated schizophrenic patients, who participated in an eight-week crossover study from haloperidol and risperidone to olanzapine. Results : The patients in the group of crossover from haloperidol to olanzapine showed significant improvement in Parkinson scale of ESRS and other cognitive functions except for verbal fluency. Negative scale of PANSS and cognitive functions such as verbal memory, verbal fluency, visual memory and executive function were significantly improved in patients In the group of crossover from risperidone to olanzapine. Conclusions : These data suggest that olanzapine has some superior cognitive benefits relative to haloperidol and risperidone, but a larger sample replication study is necessary.

약물유도 추체외로증상 발현에서의 혈중칼슘이온과 마그네시움 이온의 역할

강병조,김문두 대한생물치료정신의학회 1996 생물치료정신의학 Vol.2 No.1

Objects : The purpose of this study is to evaluate the role of serum Ca and Mg ions on the occurrence of drug-induced extrapyramidal symptoms among schizophrenic patients Methods : The subjects of this study were composed of 22 schizophrenic patient those who with extrapyramidal symptoms(N=14) and without extrapyramidal symptoms(N=8). We examined relationships between drug free cacium and magnesium ion level and EPS onset calcium and magnesium ion level among patients with extrapyramidal symtoms. And we compare drug free calcium and magnesium levels between EPS group and nonEPS gruop. additionally, we evaluated the relationships among halopendol dosage and drug free and halopendol average and EPS onset calcium and magnesium ion levels by correlation analysis. Results : Drug free calcium and magnesium levels in both group were not significantly different, there are no significant corelation among halopendol dosage, drug free, EPS onset calcium and magnesium ion levels in both groups. As halopendol administerd, calcium and magnesium levels were not significantly change Conclusion : we can not find significant relation between drug free calcuim and magnesium ion levels and the occurrence of extrapyramidal symptoms in out study design.

용접공들의 망간 폭로와 건강장해에 관한 연구

문덕환,강동묵,손병철 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the degree of manganese exposure and its health hazards effect on welders in manufacturing industry. Methods : The author measured airborne, blood and urine concentrations of manganese and blood chemistry, and also observed clinical symptoms and signs on 60 welders for case and 60 non-welders for control working in manufacturing industry by age maching method. Results : The geometric means of blood and urine concentrations of manganese were 1.13±1.38 ㎍/㎗ and 2.52±1.37㎍/ℓ for Welders group, 1.09±1.68 ㎍/㎗ and 1.86±1.34 ㎍/ℓ for Non-welders group. Airborne concentration of manganese was 0.15±1.66㎎/㎥ for exposured group, and the urinary mean concentration of manganese was statistically significant difference between exposured and non-welders group (P<0.05). Clinical signs in welders group were palmomentle reflex(23.3%), tremor(20.0%) and grabellar sign(5.0%). Symptoms in welders group were fatigue(66.7%), amnesia(66,7%), excessive sweating(51.7%), nervousness(51.7%), general weakness(48.3%) and arthralgia(46.7%) and so on, and there was statistically significant difference compared to non-welders group(P<0.05). Manganese effects on blood chemistry were not observed. There were statistically significant correlation between manganese concent- ration in blood and urine(r=0.269), airborne and urine(r=0.601) and airborne and blood(r=0.268). Conclusion : The author suggest that further studies are followed to evaluate the health status of welders whose blood and urine manganese concentrations were below normal reference level, and to establish the questionnaire and the diagnostic tools for early detecting the chronic manganese poisioning on welders.

직렬보상기(SSSC)와 송전계통의 상호응동 해석

강중구,한병문 명지대학교 대학원 1999 대학원논문집 Vol.3 No.-

This paper describes performance analysis techniques for SSSC using computer simulations with EMTP and experiments with a hardware scaled-model. A switching-level simulation model with EMTP was developed for the SSSC connected in series with the transmission line. The increase of transmission capability and dynamic performance was analyzed with the simulation model. The simulation results were reverified by experimental works with a hardware scaled-model. The developed analysis techniques can be used for designing and evaluating actual system of SSSC.

관해유도 항암요법을 받는 백혈병 환자에서 진균 감염증의 예방 : 무작위 배정법과 이중 눈가림법에 의한 Fluconazole과 Nystain의 효과에 관한 다기관 공동연구 A Randomized, Double-blind, Multicenter Trial to Compare Fluconazole with Nystatin

최강원,오명돈,배현주,백경란,박선양,김병국,신완식,강문원,진종률,박종원,김춘추,김동집,한지숙,민유홍,이선주,고윤웅 대한화학요법학회 1993 대한화학요법학회지 Vol.11 No.2

Fluconazole의 진균 감염증 예방 효과와 안전성에 관하여 3개 대학병원에서 관해유도화학요법을 받는 급성 백혈병환자를 대상으로 무작위 배정법과 너도나도 누가림법에 의하여 연구하였다. 모두 62명의 환자에게 fluconazole(100㎎ bid) 또는 nystatin(1,000,000IU/day)을 무작위로 투여하였다. 투약은 관해유도화학요법과 같은 날짜에 시작하여 호중구수가 1,000㎣이상으로 회복되거나 진균 감염증이 확인되거나 의심되어 Amphotericin-B를 시작하거나, 약과 관련된 부작용이 나타날 때까지 계속하였다. 진균 colonization은 fluconazole군에서 감소하였으나 nystqatin군에서는 증가하였다, 표재성 진균감염증으로 nystatin군에서 C. albicans 진균혈증 1례와 C.parasilosis 진균혈중 1례가 발생하였다. 경험적 항진균요법으로 Amphotericin-B를 투여한 경우는 fluconazolerns 34명중 7례(21%), nystatinrns 28명중 10례(36%)였다(p<0.05). Fluconazole군과 nystatin군 사이에 부작용이나 사망률에 차이는 없었다. 결론적으로, fluconazole은 관해유도화학요법을 받는 급성 백혈병환자에서 진균의 colonization을 줄이는데 효과적이고 안전한 항진균제이다. We made a randomized, double-blind, multicenter trial to compare the efficacy and safety of fluconazole with nystatin for prevention of fungal infections in patients with acute leukemia. Sixty-two adult undergoing remission induction chemotherapy for cute leukemia were enrolled. Patients were randomly assigned to receive either fluconazole (100㎎ bid) or nystatin(1,000,000IU×6/day) with corresponding placebo. The study drug was started in initiation of chemotherapy and continued until recovery of neutrophil counts(>1,000/㎣), development of proven or suspected invasive fungal infection, or the occurrence of drug-related toxicity. Fungal colonization decreased in fluconazole(F) group, however increased in nystain(n) group. Superficial fungal infection occurred in 1 of 34 F group, whereas invasive fungal infection developed in 3 of 28 N group. Empirical amphotericin-B therapy was given in 7 of 34(21%) F group and 10 of 28(36%) N group(p>0.05). The incidence of drug-related side effects and overall moratlity were similar in both study groups.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.