외상성 관절원판 전위에 의한 청각장애: 증례보고 : 증례 보고 A CASE REPORT

심정환,김영균,안철민 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.2

Fifty nine year-old male patient was referred for the correction of external auditory canal impatency according to anterior bony wall fracture of canal during the otolaryngologic treatment for hearing disorder. At clinical examination there are both temporomandibular joint(TMJ) pain, tenderness and left TMJ noise. We could find that if mouth was opened, external auditory canal impateted, and if closed, patented through otoscopy. We planned exploratory TMJ open surgery under clinical diagnosis of traumatic TMJ meniscus displacement and external auditory canal bony wall fracture, of under clinical diagnosis. During arthroplasty we found that posterior displaced meniscus pressured the fractured external auditory canal so we prepositioned meniscus anteriorly. After arthroplasty, TMJ noise disappeared and hearing funtion recovered. We experienced hearing disorder due to TMJ meniscus posterior displacement, so we present a case report with literature review.

성인 지역사회 폐렴의 원인 미생물에 대한 전향적 다기관 연구 : Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi

김민자,정희진,손장욱,심희선,박대원,박승철,우준희,강재명,김유겸,신완식,김양리,이환종,김지희 대한감염학회 2001 감염 Vol.33 No.1

Background : Despite rigorous investigations, the etiology of community-acquired pneumonia remains unknown in about 50% of hospitalized patients. The diagnosis of the etiological agent is becoming more challenging and more critical as number of newer pathogens have been recognized in recent years. In the 3-year period prospective study we investigated adult patients with community-acquired pneumonia for Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi as potential etiologic agents. Methods : A prospective multicenter study was performed from May 1997 to April 2000. A total of 431 patients with community-acquired pneumonia under the inclusion criteria were examined for specific microbial diagnosis; sputum culture and PCR, and serologic teats including indirect immunofluorescence antibody (IFA) test for Legionella, and hemagglutination tests for Leptosoira, Hantaan virus and O. tsutsugamushi. Etiologic diagnosis was determined on the basis of the review of case record forms and specific laboratory diagnostic criteria. Results : During the study period a total of 385 sputum and 283 serum samples were examined. Legionella pneumonia was diagnosed in 2.3% (10/431) of the cases examined : 1.4% cases with PCR-positive (5/367) and 2.1% with positive IFA test (6/283). Leptospirosis and scrub typhus were diagnosed in 0.4% (1/252) and 2.0% (5/252), respectively. All 5 cases with scrub typhus occurred in late fall, and rash or eschar was not found. None of cases was Hantaan virus infection. Conclusion : The results suggest that Legionella, Leptospira, and O. tsutsugamushi should be considered in the etiologic diagnosis and empirical antibiotic therapy of community-acquired pneumonia. (Korean J Infect Dis 32:24∼31, 2001)

경화제 주입에 의한 치핵치료의 후유증

이동식,심민철,김재황 대한대장항문학회 1997 Annals of Coloproctolgy Vol.13 No.3

후복막강에 발생한 활막육종

채승완,심정원,안혜경,이민철,박영의 대한병리학회 1995 Journal of Pathology and Translational Medicine Vol.29 No.4

시신경 유두를 침범한 급성 임파구성 백혈병 : 1예 보고 Report of One Case

김태운,이건수,이철민,심완섭 충남대학교 의과대학 지역사회의학연구소 1981 충남의대잡지 Vol.8 No.1

A ten-year-old boy with acute lymphoblastic leukemia, probably T-cell type, who had received intrathecal methotrexate for theprophylaxis of meningeal leukemia, acquired impaired vision during maintenance chemotherapy. Ophthalmologic examinations disclosed a leukemic infiltration of right optic disc. It was followed by meningeal leukemia and systemic relapse successively within 2 months. The response of the ocular lesion to systemic chemotherapy was good.

순수 적혈구 형성 부전증 1예

이화영,백일기,신계철,김진민,한민희,심영학 大韓血液學會 1984 大韓血液學會誌 Vol.19 No.2

허혈성 심질환에서 염증지표에 관한 연구

번정득,권영주,박상호,한대희,이상철,강진환,김명구,심규혁,최병조,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background : Atherosclerosis is the chief underlying cause of ischemic heart disease and there is increasing evidence that inflammation is an important determinant of the development of atherosclerosis. We assessed the levels of inflammatory markers in patients with ischemic heart disease and normal group who has normal coronary angiograms. Materials and Methods : Coronary angiography was performed in 142 patients. 107 patients of ischemic heart disease(stable angina pectoris 58, unstable angina pectoris 30, Acute myocardial infarction 19) and 38 normal control subjects. We assessed the level of inflammatory markers, such as CRP, ESR, fibrinogen and leukocyte. Results : CRP, ESR and fibrinogen values of the patients with stable angina pectoris and unstable angina pectoris were higher than that of normal control group, but there were no statistical significance. Leukocyte value of the patients with unstable angina pectoris(9003.3±701.5/mm^(3)) was significantly higher than that of the patients with stable angina pectoris(6685.5±245.8/mm^(3)) and normal control subjects(6394.3±235.1/mm^(3)). CRP, ESR and fibrinogen values of the patients with acute myocardial infarction were also higher than that of normal control subjects. CRP was 3.88±2.05 mg/dL in acute mocardial infarction group, and 0.29±0.15 mg/dL in normal control subject group(p<0.05). Fibrinogen was 541.6±45.1 mg/dL in acute myocardial infarction group, 321.4±25.6 mg/dL in normal control subject group(p<0.05). Leukocyte was 10942.1±737.6/mm^(3) in acute myocardial infarction group, 6394.3±235.1/mm^(3) in normal control subject group(p<0.05). Conclusions : This study demonstrate that CRP, fibrinogen and leukocyte values of acute myocardial infarction group were significantly higher than that of control group and stable, unstable argina pectoris group. Leucokyte values were significantly elevated in unstable angina group, but CRP values were not in unstable angina group.

관상동맥질환 환자에서 스텐트 시술 후 재협착에 관한 연구

강진환,권영주,박상호,한대희,이상철,김명구,변정득,최병조,심규혁,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and aims : In the coronary artery disease, a rate of restenosis was much decreased by placement of coronary stent than when percutaneous transluminal coronary angioplasty has been applied, but there are still important clinical problems of restenosis. There has been many progressive studies about various factors contributed to this restenosis. So, we studied a relation between restenosis after placement of coronary stent in the coronary artery disease and many clinical factors, characteristics of stenotic lesion and procedural factors, and also assessed the restenosis rate of various coronary stents. Methods : Total 58 lesions(46 cases of patients ; man 30, woman 16) were evaluated, which has been performed a follow-up coronary angiography after 6 months (mean 188 days) since coronary stent had been placed. Various stents were implanted and assessed a relation between restenosis and many factors. Results : Of 58 lesions were target stenotic studies, there were 22 of restenotic lesions(37.9%), and the restenosis rate wes statistically significant difference in the relation with diabetes mellitus(p<0.05), group of acute myocardial infarction(p<0.05) among clinical diagnosis of ischemic heart disease(stable angina, unstable angina and acute myocardial infarction) in clinical factors and with high dilation pressure of stent(p<0.05) in procedural factors. When the rate of restenosis was evaluated among implanted stents, it was lowest in the Multilink^(®) stent and highest in the Nir Royal^(®) stent(60%). Conclusion : In this study of restenosis and various factors after placement of stents in the coronary artety disease, factors such as diabetes mellitus, group of acute myocardial infarction and a dilation pressure of stent were significant related with restenosis and the restenosis rate of Multilink^(®) stent was lowest and the highest restenosis rate was of Nir Royal^(®) stent.

응급의학과에서의 인공호흡기 처치

이삼범,도호석,도병수,이창현,심민철,권굉보 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study Objectives : To investigate and resolve the problems related with ventilator management in ED(emergency department). At present the ventilator is essential equipment of ED on university hospital and emergency center in Korea. Design : Retrospective consecutive case series. Setting : University teaching hospital Type of participants : All patients admitted and recieved ventilator management in ED of yeungnam university hospital from Jan. 1994 to jul. 1995. Methods and interventions : Charts of all patients were reviewed to determine the frequency, the types and causes of respiratory failure, the death rate, the mean duration of admission, the complications, and CPR(cardiopulmonary resuscitation) related with ventilator management in ED. We also identified the problems related with ventilator management by ED physicians and nurses through the answers to seven questions that suggested by us about ventilator management in ED. Measurements and main result : There were 34,751 admissions through ED during the study period. Of these 160 patients managed with ventilator in ED. The frequency of ventilator management in ED is increased at 1995(0.73%) that compared with 1994(0.32%). Non-trauma(113 cases) and hypoxic respiratory failure(83 cases) patients are more common than trauma(37 cases) and ventilatory failure Total CPR rate related with ventilator management are 25.3%. The mean duration of admission are 12.56±20.28 days, and the death rates are 45.3%. The incidence of complications occurred during ventilator management in ED are 37 cases. About seven questions suggested by us to 30 ED staffs(ED physician, nurses and paramedics), most frequent answer is the difficulty of keeping ventilator in ED because other department rent ventilator from ED and lost a part of ventilator. Conclusion : As the use of ventilator in ED is increased the emergency physician should be well trained for the indications, complications, setting mode and general problems of machine occurred during ventilator management in ED patients.

대구 상인동 가스참사로 본 지역 응급의료체계에 대한 고찰

이삼범,도호석,도병수,이창현,심민철,권굉보 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Disaster may be defined as a sudden calamitous event associated with great damage or destruction. A more common definition, among emergency-preparedness planners, is a medical occurrence that overwhelms medical care systems and facilities. Most regional disaster plans are formulated to respond to disasters of moderate size. At 07:50 A.M. on 28 April 1995, gas explosion was happened at Sangin-Dong where was going to be under construction of subway in Taegu, Korea. 102 victims had died and 178 victims had moderate or minor injuries. Problems in the organization at the scene, triage, field management, transport to the hospital, and the communication contributed to the confusion in the management of victims. An analysis of this disaster allows several lessons to be learn about perimeter control, command functions, crowd control, and transportation priorities. It will benefit disaster planners in other communities.