Immobilization with Ketamine HCI and Tiletamine-Zolazepam in Cynomolgus Monkeys

Myung-cheol Kim,Sung-hyeok Hong,Soo-jin Lee,Young-suk Kim,Jae-il Lee 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

with Ketamine HCl and Tiletamine-Zolazepam in Cynomolgus MonkeysJae-il Lee, Sung-hyeok Hong, Soo-jin Lee, Young-suk Kim and Myung-cheol Kim*Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon 305-764, KoreaReceived March 4, 2003 / Accepted July 2, 2003J. Vet. Sci. (2003), 4(2), 187-191JOURNAL OFVeterinaryScience*Corresponding author: Myung-cheol Kim Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon 305-764, Korea Tel: +82-42-821-6757, Fax: +82-42-822-4216 E-mail: mckim@cnu.ac.kr

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로

김철민,송준영,김자형,김기수,홍수종 대한소아과학회 2002 小兒科 Vol.45 No.9

유산양 유방염에 대한 Chitosan 약침의 치료 효과

황수현,서진석,김덕환,김명철,신상태,전무형,南三郞,김영찬,이우근,표수일 충남대학교 수의과대학 동물의과학연구소 1999 動物醫科學硏究誌 Vol.7 No.-

To improve the therapeutic method for mastitis, treatment effect of chitosan pharmacopuncture was examined in three milking goats(A,B and C). Mastitis was artificially induced in two milking goats(A and B) and one goat(C) was naturally infected case with mastitis. The acupoint used was Yang-Ming and chitosan suspensions(provided from Tottory University, Japan: 30㎎ of chitosan/㎖)were injected to the acupoint with 5㎖/time for 3 days, respectively. As for the change of somatic cells in milk along with chitosan pharmacopuncture, they showed a decreasing tendency after increase on the 3rd day in all udders of B. In addition, as for the change of total leukocyte counts of peripheral blood with chitosan pharmacopuncture, they showed a decreasing tendency after increase on the 3rd day in B and C except A which showed a increasing tendency until on the 7th day. In the change of neutrophil/lymphocyte(N/L) ratio, increasing tendency was seen in A and C but increasing tendency after slight decrease was observed in B. Further, in the change of serum total protein and A/G ratio, serum total protein content was decreased after slightly increase on the 3rd day in A, and they were decreased after increase until on the 7th day in B and C, respectively. As for the change of A/G ratio, different pattern increasing tendency was shown in A, B and C.

Increased Urinary KIM-1 and Tubular KIM-1 Expression in IgA Nephroapathy (초)

( Mi Seon Seo ),( Soon Hyo Kwon ),( Moo Young Park ),( Soo Jung Choi ),( Jin Seok Jeon ),( Hyun Jin Noh ),( Jin Gook Kim ),( Dong Cheol Han ),( Seung Duk Hwang ) 대한내과학회 2010 대한내과학회 추계학술대회 Vol.2010 No.-

산재보상을 신청한 뇌심혈관질환의 특성 분석

유재홍,하은희,김수근,김정연,김용규,이의철,이철호,손준석 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 이 연구는 뇌 · 심혈관 질환으로 업무상재해를 신청한 사례 중에서 승인된 사례와 불승인된 사례의 특성을 비교하여 뇌 · 심혈관 질환의 업무상 재해여부를 판단하는데 필요한 기초 자료를 제공하고자 한다. 방법: 2000년부터 2004년까지 근로복지공단에 업무상 재해로 요양이 신청되어 승인여부가 결정된 뇌 · 심혈관 질환자 12,309명을 대상으로 하였다. 승인여부와 관련된 특성을 확인하기 위해 연도별, 업종별, 규모별, 직업별, 성별, 연령별, 질환별, 생존유무별 그리고 기존질환 유무에 대하여 카이제곱 검정과 다변량 로지스틱 회귀분석을 이용하였다. 결과: 다변량 로지스틱 분석에서 뇌 · 심혈관 질환의 불승인에 대한 승인의 비차비는 광업을 기준으로 하였을 때에 전기가스 상수도업이 4.18(95% CI=1.43~12.17), 건설업이 2.39 (95% CI=1.22~4.69), 제조업이 2.10 (95% CI=1.08~4.07)이었고, 장치기계조작원 및 조립원에 비하여 서비스 근로자 및 상점과 시장 판매근로자 군이 1.90(95% CI=1.47~2.47), 전문가 군이 1.83(95% CI=1.50~2.23), 기술공 및 준전문가 군이 1.63(95% CI=1.35~1.97), 입법 공무원과 고위 임직원 및 관리자 군이 1.62(95% CI=1.24~2.12)이었고, 여성이 남성에 비하여 1.31(95% CI=1.13~1.53), 심장질환에 비하여 뇌혈관질환이 2.75(95% CI=2.42~3.13), 사망한 경우가 생존한 경우에 비하여 6.01(95% CI=4.89~7.38)이었다. 결론: 우리나라에서 뇌심혈관질환으로 업무상 재해를 신청하는 건수는 증가하고 있고 승인율은 비교적 높았으며 승인에 영향을 미치는 요인으로는 업종, 규모, 직종, 성, 연령, 질환, 생존유무 등이 확인되었다. 특히 업종과 직종에 따라서 승인율의 차이가 큰 것이 어떠한 요인의 영향 때문인지에 대한 검토가 필요하고, 특히 뇌실질내 출혈의 경우에 다른 질환에 비하여 승인율이 매우 높았던 것은 업무수행성에 대한 인정기준의 잘못된 적용의 결과 이므로 시정이 필요하겠다. Objectives: This study was performed to provide fundamental data to judge whether or not cerebro and cardiovascular diseases are work-related, by comparing the characteristics between approved and non-approved cases among the worker's compensation claims. Methods: We collected 12,309 cerebro and cardiovascular disease claims based on the worker's compensation records of the Labor Welfare Corporation from 2000 to 2004. The approved and non-approved cases were analyzed according to factors such as the calendar year, industry, company size, occupation, gender, age group, classification of cerebro and cardiovascular diseases, fatality and underlying diseases. We used x²-test and multivariate logistic regression for the analysis. Results: According to multivariate logistic regression, electricity gas and water supply (OR=4.18, 95% CI=1.43~12.17), construction (OR=2.39, 95% CI=1.22~4.69) and manufacturing (OR=2.10, 95% CI=1.08~4.07) industries had a higher approval rate than mining and quarrying industries. Service workers and sales & marketing department workers (OR=1.90, 95% CI=1.47~2.47), professionals (OR=1.83, 95% CI=1.50~2.23), technicians and associate professionals (OR=1.63, 95% CI=1.35~1.97) and legislators and senior officials and managers (OR=l.62, 95% CI=1.24~2.12) had a higher approval rate than plant and machine operators and assemblers. Female workers had a higher approval rate (OR=1.31, 95% CI=1.13~1.53) than male workers. Cerebrovascular diseases had a higher approval rate (OR=2.75, 95% CI=2.42~3.13) than cardiovascular diseases. Fatal cases had a higher approval rate (OR=6.01, 95% CI=4.89~7.38) than surviving cases. Conclusion: For cerebro and cardiovascular diseases, workers' compensation claims are increasing, approval rates are relatively high and factors such as industry, company size, occupation, gender and fatality are related. A remarkable difference in the approval rate was found according to industry and occupation, suggesting the need for further study to identify which factors influence the approval rate. The approval rate for intracerebral hemorrhage arising in the course of employment (COE) was significantly higher than that arising out of employment (AOE), suggesting the need to correct the approval criteria.

단무지 공장에서 발생한 질식 사고의 원인과 방사선학적 소견: 중례보고 및 가스분석 결과

박충기,김만구,김흥철,안범규,박만수,황우철,최철순,강익원 江原大學校 附設 環境硏究所 1994 環境硏究 Vol.11 No.-

목 적:단무지 공장에서 질식사고를 일으켰던 가스의 종류를 알아내고, 이러한 가스중독의 방서선학적 소견을 소개하기 위하여 본 연구를 하였다. 대상 및 방법:단무지 공장에서 발생한 질식 사고자 3예중 생존자 1예를 대상으로 단순흥부X-선검사와 CT 소견을 분석하였으며, 가스의 종류를 알아내기 위하여 단무지를 유리병에 넣어 발생된 가스를 가스크로마토그래픽을 이용하여 분석하였다. 결 과:단무지 공장에서 발생한 질식사고자중 생존한 1명의 방사선학적 검사에서 신속히 호전되는 폐경결(consolidation)을 볼 수 있었으며 이는 폐부종의 소견임을 알 수 있었다. 협기성 상태에서 단무지를 담은 유리병의 상층부 가스를 실험 분석한 결과 이산화탄소, 에칠알코올이 다량으로 검출되었으나 독성가스는 주로 황화수소이였다. 결 론:단무지 공장의 질식 사고자에서 폐방사선학적 소견은 폐경결을 보이는 폐부증으로서 이는 실험을 통해 단무지에서 발생되는 유독가스인 황화수소 때문임을 입증하였다. Purpose: To identify the main toxic gas released from salted radish in rice bran(Dan-M-Ji) and to introduce the radiological findings of the patient who was exposed to the gas. Materials and Methods: Chest radiographs and CT scans of one survivor among three men who were exposed to the gas from Dan-Mu-Ji were reviewed. Gas obtained from the closed bottle containing Dan-Mu-Ji was analized by using the gas chromatography. Results: The radiographlc examinations of the survivor were suggestive of pulmonary edema with it's rapidly improving consolidations in both lung. The headapace gas within the bottle containing Dan-Mu-Ji was mainly composed with carbon dioxide, ethyl alcohol and hydrogen sulfide, of which hydrogen sulfide was considered the main toxic gas released. Conclusion: Under the anaerobic condition, Dan-Mu-Ji released toxic hydrogen sulfide. Inhalation of hydrogen sulfide might produce non-cardiogenic pulmonary edema.

중환자실에 입원한 세균성 폐렴환자에서 반정량적 procalcitonin 검사의 유용성

이승화,김철홍,김지연,박선욱,김용욱,현인규,우흥정,김현수 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Background : In pulmonary infection, serum procalcitonin levels increase rapidly, probably in response to sepsis-related cytokine release from neuroendocrine cells of bronchial epithelium and inflammatory cells. We applied procalcitonin assay in critically ill patients with bacterial pneumonia. Materials and Methods : Patients admitted to the intensive care unit (ICU) and show diffuse infiltrations in their chest X-ray were included. Quantitative bronchoalveolar lavage (BAL) culture (≥10⁴ CFU/mL) was performed in all cases on the 5^(th) day of ICU admission. We excluded patients with structural lung disease, non-infectious lung infiltrations, and atypical infections such as Mycobacterium tuberculosis, Pneumocystis jiroveci, and viruses. Serum procalcitonin levels were measured semi-quantitatively by using PCT-Q kit. Results : A total of 28 adult patients (M:F=23:5) were included: 11 (39.3%) medically-ill patients, 7 (25%) surgically-ill patients, and 10 (35.7%) burn patients. Serum procalcitonin level was <0.5 ng/mL in half of the cases (14/28) and ≥0.5 ng/mL in the remaining half of the cases. Compared to those with serum procalcitonin level of <0.5 ng/mL, patients with serum procalcitonin level of ≥0.5 ng/mL had more frequent mechanical ventilation, higher CRP/APACHE II scores/number of organ failure (P<0.05), and showed increased tendency for death (P=0.052). Positive bacterial BAL cultures were noted in 17 cases (60.7%). Of these, 7 cases (41.2%) showed serum procalcitonin level ≥0.5 ng/mL. Conclusions : High serum procalcitonin level seems to be closely associated with the severity and poor prognosis in critically ill patients with bacterial pneumonia. However, pneumonia could not be excluded with low level of procalcitonin among ICU patients.

水位 急變化를 고려한 河川 增築 堤體의 浸透 擧動

金英默,陸喆洙 대전산업대학교 1999 한밭대학교 논문집 Vol.16 No.1

To study seepage behaviors a model was designed and designed and was applied to some cases of enlargement of river embankment. The model is simulated and analysed by finite element method. The materials of enlargement are coarse sand, fine sand, and weathered residual soil. Usually, the embankment of small rivers is made of these materials. The aim of this study is to aid for selection of desirable materials for enlargement of old embankment in small rivers. The results of seepage behavior by finite element method are similar to the results of the experiment. The seepage behavior is unstable at the rapid rise and drawdown water level in uniform landfills. The enlargement of outward slope using some sands shows stable seepage behavior in the old embankment made of weathered residual soils. The enlargement of inward slope by some residual soils is more stable seepage behavior in the old embankment made of some sand soils. In this case, the flow of the outward slope is mainly unsaturated flow, and the pore water pressure of the outward slope is low or negative. The outward part of embankment seems to serve as filtration in the stable case of seepage behavior.