Mirizzi 증후군의 변형된 분류와 치료

김형철,강길호,채만규,김성용,백무준,이문수,박상흠,이문호,김창호,송옥평,조무식,박희주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Purpose : The Mirizzi syndrome is relatively rare and preoperative diagnosis of this disease is difficult. In 1978, Morelli suggested the subclassification of the Mirizzi syndrome into acute or chronic form. We experienced 5 cases of acute form. We analysed clinical features, preoperative radiologic findings and operative findings of 18 cases including acute forms which were diagnosed as Mirizzi syndrome and should suggest the modified classification of Mirizzi syndrome for choice of appropriate treatment. Method : From January 1995 to December 1998, 18 cases, of which 8 cases were diagnosed at Soonchunhyang University Chunan Hospital, and 10 cases were reported in the Korean Journal were retrospectively analysed with regard to clinical features, preoperative radiologic findings and operative findings. According to the clinical features, whole cases were divided into type Ⅰ(acute form) and type Ⅱ(chronic form) and then each type of cases were subclassified according to preoperative radiologic findings and operative findings. Results : Of 18 cases there were 5 cases in type Ⅰ(27.8%), 13 cases in type Ⅱ(72.2%). Type Ⅱb was most common. Type Ⅰa cases were treated only with cholecystectomy. We applied cholecystectomy, T-tube choledochostomy and patch technique in type Ⅰb and thpe Ⅰc cases. Cholectystectomies including removal of gallstones and internal drainage procedures were done in type Ⅱ chronic forms. Conclusion : The acute form(Type Ⅰ) of Mirizzi syndrome was suggested by Morelli might be subclassified into typeⅠa,Ⅰb and Ⅰc following the presence of the necrotic defect in common hepatic duct. Through the modified classification of Mirizzi syndrome based on clinical feature, preoperative radiologic findings and operative findings, we can choice appropriate treatment.

후륜 에어 서스펜션을 장착한 대형상용차의 동특성 해석

문일동,오재윤,권혁조,이승호 전북대학교 공학연구원 ( 구 전북대학교 공업기술연구소 ) 2002 工學硏究 Vol.33 No.-

This paper develops a computational model using ADAMS for dynamic characteristic analysis of a large-sized commercial vehicle with an air suspension system at rear axle. The air suspension system is composed of an air spring and a half-long tapered leaf spring. Its ADAMS model has 24 rigid bodies and 15 degree-of-freedom. For its modeling, 24 rigid bodies are connected by 10 cylindrical joints, 4 translational joints, 9 spherical joints, 2 universal joints, and 4 revolute joints. For the analysis of handling performance, a double lane change maneuver simulation is performed using the full vehicle ADAMS model with a trunnion suspension or air suspension at rear axle. The simulation is performed with a constant speed of 50, 60, and 70kph respectively. In the simulation, lateral acceleration, roll angle, and yaw rate at the mass center of frame and cab are measured for the handling analysis. For the analysis of ride performance, a bumpy ride simulation is performed using the model. The simulation is performed with a constant speed of 20kph. The bump used in the simulation has the height of 50, 80, and 100㎜ respectively. In the simulation, vertical displacement and pitch angle at the mass center of cab are measured for the ride performance analysis.

GPS를 이용한 2차로 고속도로에서의 추월시거 산정방법에 관한 연구

임채문,김정민,박영환,이주호 大邱大學校 科學技術硏究所 2001 科學技術硏究 Vol.8 No.2

This study applied GPS(global positioning system) into the field of traffic and transportation, measured overtaking mechanism at two lane highway. After the analysis of the collected data from the measurement, it was constructed passing sight model which is based on AASHTO(american association of state highway and transportation officials) model and; as the result, passing sight distance was computed. To accomplish this goal, speed and position information for leading and following vehicles were recorded under actual highway conditions. Each vehicle's distance, speed, and acceleration characteristics were calcuated using the passing algorithm equations proposes. The computed value of acceleration was 1.37m/sec2. This value was twice as large as the value calculated earlier(0.6m/sec2). This study proposed 326m as passing sight distance at maximum speed(80km/hr) in 88 Olympic highway.

톨루엔을 포함한 유기용제의 직업적 폭로로 인한 신경내분비계 영향

이채언,이종태,정의화,손혜숙,문덕환,전진호,강정학,이창희,김휘동,김종한,정귀옥 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2

Long term occupational exposure to solvent mixtures may cause adverse effects to the central nervous system with neurobehavioral symptoms. And some organic slovents have been suggested to cause impairment of tuberoinfundibular dopaminergic activity and neurochemical mechanisms controlling pituitary secretion. For the purpose of assessing neuroendocrine effects in occupational solvents exposure, hormonal study settings (shoes-manufacturing industry & fishing products industry) and compared with nonexposed controls(33 men, 85 women). Male workers exposed to solvent mixtures had significantly lower plasma level of follicle-stimulating hormone(FSH) than nonexposed male controls. While female workers exposed to solvent mixtures had significantly lower plasma levels of growth hormone(GH), and thyroid-stimulating hormone(TSH) than nonexposed female controls. The results of significant decrease in plasma concentrations of pituitary hormones(FSH, GH, and TSH) in workers exposed solvent mixtures indicate that occupational exposure to solvent mixtures may induce neuroendocrine effects through an effect on hypothalamic pituitary axis.

도시간선가로의 공사중 교통류 특성분석과 적용성에 관한 연구

임채문,이주호,박영환,이영우 대구대학교 과학기술연구소 2001 科學技術硏究 Vol.8 No.1

Since almost roadway improvements are for the public convenient, negative effects by them are ignored. But now due to the increase of traffics demand and limitation of road supply, the positive management scheme and treatment plan on the constructions must be considered. The links operating interrupted flow are intend to yield the traffic between the out flow and inflow part effect zone of street section, we build the delay model using the time gap between under construction and not. And in the case of besides the traffic effect zone, that is street section's occupying construction. This work purpose on only setting up the capacity, delay models, and traffic effect zones as the basic study to find methods for minimizing the traffic delay work zones, and thus it is true that it is incorrPlete of the political, administrative reviews. In future there must be advanced the incomplete in this study, and groping for the various alternatives to minimize the traffic delay by the road occupying construction, with developing the various sets of detailed analyzing models, that is analysis on the street strength, crossroads geometrical forms of crossroads, public traffics, pedestrians, occupying types.

151종 생약제 추출물이 B형 간염 바이러스 표면 항원(HBsAg)과 항체(HBsAb)의 결합반응 그리고 HBV DNA polymerase 활성에 미치는 효과 : 한국산 각종 생약제를 이용한 B형 간염치료제의 개발

정태호,김정철,김문규,이인선,채성철,김승래,정준모,이인수,김승호,함경수 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3

세계인구 43억명 중 B형 간염 바이러스 보균자는 2억 1천 5백만명이며 이중 78%인 1억 6천만명 이상이 아시아 대륙에 집중되어 있다. 한국도 B형 바이러스 간염의 침윤지대이다. 본 연구는 B형 바이러스 보균자 혹은 만성간염을 치료할 수 있는 생약제를 탐색할 목적의 일환으로 한국에서 시판하는 생약제 151종을 구입하여 증류수로 추출하고 여과한 후 냉동건조하여 HBs 항원에 대한 결합능, HBV DNA polymerase억제능, tumor necrosis factor(TNF) 유리에 미치는 영향, 그리고 galactosamine 유발 간염에 대한간장보호 작용을 조사하였다. 151종의 생약제중 0.16㎍/㎖ 농도에서 간염 vaccine 내에 함유된 HBs 항원과 결합하는 생약제는 지유, 가자, 복분자, 대황, 정향, 빈량, 산수유, 소목, 마황, 쇄양, 후박, 목과, 양강, 오약, 산사, 목단피 등 16종이었다. 이들 생약제중 대황(Rheum palmatum L. 大黃), 가자(Terminalia chebula R. 訶子), 지유(Sanguisorba officinalis L. 地楡), 복분자(Rubus coreanus M. 覆盆子)는 HBV DNA polymerase 활성도를 비교적 강하게 억제하였으며 빈량(Areca catechu L. 빈랑), 정향(Eugenia caryophyllata T. 丁香), 목과(Chaenomeles japonica L. 木瓜), 산수유(Cornus officinalis S. 山茱萸)는 약하게나마 HBV DNA polymerase 활성을 억제하였다. 또한 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 대상으로 TNF 유리에 미치는 영향을 조사한 결과 소목을 제외한 8종의 생약제 모두가 대식세포를 자극하여 TNF를 유리시켰다. 그리고 장차 임상에 사용함을 전제로 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 galactosamine 유발 간염(백서)에 투여하여 간기능 검사에 미치는 효과를 조사하였으나 간기능 검사상으로는 특별한 보호작용을 나타내지 못하였으며 생약제 단독 투여로서는 간기능에 대하여 나쁜 영향을 주지 않았다. Hepatitis B virus infection is major cause of acute and chrome hepatitis, cirrhosis of liver, and hepatocellular carcinoma. There are over 200 million carriers of hepatitis B virus in the world, nearly 80 % of whom live in the South East Asia, Korea is also highly endemic area of hepatitis B virus infection. This study was performed to evaluate the effect of extracts of traditional Korean herbal medicines on hepatitis B virus. 151 traditional herbs were extracted, filtered and lyophilized. Using 151 herbal extracts we tested binding capability to the HBs Ag, inhibition of HBV DNA polymerase, release of tumor necrosis factor (TNF), and protection against galactosamine induced liver damage. Among 151 herbs, 16 herbs (Sanguisorba officinalis L., Terminalia chebula R., rubus coreanus M., Rheum palmatum L., Eugenia caryophyllata T., Areca catechu L., Cornus officinalis S., Caesalpinia sappan L, Ephedra sinica S., Cynomorium songaricum R., Machilus thunbergii S., Chaenomeles japonica L., Alpinia officinarum H., Lindera strychnifolia V., Crataegus pinnatifida B., Paeonia suffruticasa A. ) had binding capability to HBs Ag which contained in the commercial hepatitis vaccine, at 16 ug/㎖ of concentratioa Among the above 16 herbs, Rheum palmatum L., Terminalia chebula R., Sanguisorba officinalis L., Rubus coreanus M. significantly inhibited the HBV DNA polymerase activity, and Areca catechu L., Eugenia caryophyllata T., Ephedra sinica S., Caesalpinia sappan L., Chaenomeles Japonica L., Cornus officinalis S. also inibited the HBV DNA polymerase activity but less effective. All of the herbs, except Caesalpinia sappan L., which inhibited the HBV DNA polymerase activity, actively stimulated the mononuclear cells to release tumor necrosis factor(TNF) in whole blood culture system. The herbs which inhibited the HBV DNA polymerase activity, did not show any protective effect in galactosamine-induced hepatitis in rats, but there was no direct toxic effect when herbs were administered alone.

양방향 2차로 도로의 기하구조에 따른 서비스수준 분석에 관한 연구

임채문,이주호,김대식,신승우 대구대학교 산업기술연구소 2003 産業技術硏究 Vol.14 No.3

Ⅱn this study, the Highway zones that have a passing lane or a concession lane out of annexed lanes to bi-directional two lane Highway were investigated. Characteristics of the highways according to geometrical structure were analyzed and LOS analysis was performed for each zone. The results are as follows; 1. The correction index for existing heavy vehicles should be considered in field limit speed because of the enhancement of the vehicle speed. 2. When analyzing traffic flow, it is more desirable to establish concession zones rather than to have more passing lanes, which are easily influenced by opposite side traffic flow. As this study investigated annexed lanes of highways only, those of local roads should be studied further.

한랭작업 근로자들의 건강위해에 관한 연구

박호추,정설미,문덕환,이종태,김대환,김정호,최재일,황용식,이용희,이채언 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.1

In order to evaluate the status of cold exposure and its health hazards of workers at cold storage workplaces and to provide basic data for effective health care, the author measured core temperature and also observed clinical symptoms and signs, past and present history, and general health examination data on 99 cold exposed workers for exposure group and 96 non-exposed workers for control group working at 2 food refrigerating companies in Pusan area from January 6, 1998 to February 24, 1998. The results were as follows: 1. There was statistically significant difference in water intake between the exposure and control group and increased urine volume, urine frequency in exposure group without statistically significant difference. 2. Past and present illness in exposure group were hypertension (18.2%), hepatopathy (8.1%), gastro-intestinal disease(7.1%), arthritis (4.0%), intervertebral disc herniation(4.0%), and so on, and hypertension, arthritis was statistically significant difference compared to control group. 3. Symptoms in exposure group were fatigue(89.9%), headache (64.6%). drowsy(63.6%), neck stiffness(59.6%), excessive food intake(59.6%). general weakness(58.6%), hunger(58.6%), numbness(54.5%), and so on, and there was statistically significant difference between the exposure and control group except fatigue, drowsy. 4. As results of clinical test abnormality rate of the systolic, diastolic blood pressure and electrocardiogram were significantly higher in exposed group than control. 5. Core temperature in exposure group was statistically significantly lower than control group and the highest statistically significant inverse correlation with the working hours and working frequency of daily mean cold storage. As above results, the author suggested that the further studies should be conducted to evaluate the health status of workers about chronic health effects in cold workplaces and to establish effective health care methods for them.

질소산화물의 급성 노출로 인한 폐 손상 1례

김정호,김대환,손병철,이창희,김정원,문덕환,이채언,김주인 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Lung injuries due to exposure to nitrogen oxides can occur in various process in industry. We experienced a case of chemical pneumonitis induced by accidental inhalation of nitrogen oxides emitted from the bath in an acid dipping operation. Case : Dyspnea, cough and blood-tinged sputum production, cyanosis, and tachypnea occurred after exposure to oxides of nitrogen. There were bilateral diffuse ground glass opacities in simple chest radiography and high resolutional computed tomography, hypoxemia in arterial blood gas analysis, mixed ventilation defect and reduced diffusion capacity in spirometry. As an oxygen and supportive therapy, after hospitalization, was given, the patient recovered completely from the lung injury on the 8th day after admission. There was no evidence of delayed onset of bronchiolitis obliterance or pulmonary edema in a follow-up for about 6 months. Conclusions : Acid dip operation require more efficient hooding and exhausting system for the prevention of lung injuries caused by inhalation of nitrogen oxides. Also health education for worker need.

도로 공사중의 교통류 특성분석과 적용성에 관한 연구 -고속도로와 일반국도를 중심으로-

임채문,이주호,박영환 대구대학교 과학기술연구소 2000 科學技術硏究 Vol.7 No.2

It is the actual condition that the increasing traffic delay and accident caused by inefficient management on various construction by occupying the roadways. Since almost roadway improvements are for the public convenient, negative effects by them are ignored But now due to the increase of traffics demand and limitation of road supply, the positive management scheme and treatment plan on the constructions must be considered. Thus, to the extent of this study divides uninterrupted flow into freeways and the Highway, yielding the time spread between under construction and not, that is delay time, we build capacity and delay model in the change of traffic volume and occupying length.