비정형 기관지 유암종에 의한 이소성 ACTH 증후군 1례

이창훈,천남일,홍세인,정진욱,윤인석,조동혁,강호철,정동진,정민영 全南大醫大 2001 전남의대학술지 Vol.37 No.2

외측 미칩 갑상선에서 발생하여 다발성 전이로 발현된 유두상 갑상선암 1예

천남일,이창훈,홍세인,정진욱,윤인석,조동혁,강호철,정동진,정민영 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4-5

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

승용 디젤엔진용 가변과급기 성능에 관한 연구

진영욱,정진은,조훈기,강우,정재우 한국기술교육대학교 2006 論文集 Vol.13 No.1

A test bench which is consisted of roots blower, air flow meter, driving unit for VGT actuator, transmitters for temperature and pressure, and the rotational speed sensor was developed to evaluate the characteristics of the VGT system. Measurements using VGT of the 2.0 L diesel engine were carried out. The corrected mass flow rate and the pressure ratio for the compressor of the VGT are related directly with the rotational speed, but they are independent of the rack position of the VGT. The pressure ratio and the corrected mass flow rate of the turbine of the VGT are related directly with the rack position of the VGT, but they don't have any relation with the rotational speed. The mechanical efficiency of the VGT is higher than the conventional turbocharger in the wide range. The efficiency at the 0.03 kg/s of the mass flow rate is 4.36 times as high as that of the conventional turbocharger. These data will be used to develop the new engine equipped with the VGT system.

출생전 흰쥐 콩팥에서 콩팥소체 벽상피 분화에 대한 아포프토시스의 역할

이승헌,김영희,김완영,차정호,김진,정진웅 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.6

1차 의료기관에서 코감기에 처방한 향균제

정형준,이훈재,김은실,이진수,정문현 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

Background : Upper respiratory infections (URIs) are common benign illnesses that are associated with significant economic burden, adverse effects of medications, and antimicrobial resistance. These effects have been evaluated chiefly at the tertiary health care centers. The purpose of this study was to investigate the prescribing habits, including antibiotic use, for the management of URIs among the primary care physicians. Methods : Between July and August 2006, 23 medical students visited 122 clinics of primary care physicians for the management of simulated common cold. They were instructed to present symptoms that simulated common cold; clear rhinorrhea and nasal stuffiness that lasted for 3 days, and neither was accompanied with fever nor myalgia. Results : The physicians' specialties were as follows: 43 were general internists; 40, otolaryngologists; 23, general practitioners; 15, family practitioners; and 1, pediatrician. The mean number of prescribed oral medications was 4.71 (S.D.±0.951). Glucocorticoids were prescribed in 10 (8.2%) clinics. Antibiotics were prescribed in 50 (41.0%) clinics - cephalosporins in 17, amoxicillin-clavulanate in 16, amoxicillin in 8, fluoroquinolones in 5, macrolides in 3, and trimethoprim-sulfamethoxazole in 1 clinic. There was no difference in the rates of antibiotic prescription among the specialties. Injections were recommended in 32 (26.4%) clinics. With the exception of chest X-ray recommended in 1 clinic, no laboratory or radiologic evaluation was performed. Conclusion : The antibiotic prescription rate observed in this study is lower than those of the previous studies. Since diagnostic tests are seldom performed, diagnostic ambiguity might be a key cause for the overuse of antibiotics in the management of URI. The reasons for the high rates of prescription of parenteral medications need to be evaluated. 목적 : 상기도 감염은 매우 흔한 질환으로 개개인으로 보면 중요하지 않은 병이나 국가 전체로 보면 비용, 부작용, 항균제 내성에 미치는 영향이 더 문제가 되는 병이다. 이런 영향에 대한 연구가 주로 3차 병원에서만 되므로, 3차 병원에 도착하기 전까지 받은 치료 내역이 연구 결과에 큰 영향을 미칠 수 있지만, 국내에서는 의약분업 후로는 의원에서 감기 처방에 대한 조사가 없어 현재 진료 상황을 알 수가 없다. 이에 의약분업 이후, 1차 의료에 종사하는 의원들을 대상으로 코감기에 관련된 진단의 다양성, 주사제의 사용, 항균제 사용에 대해 조사를 하였다. 재료 및 방법 : 2006년 7월과 8월에 걸쳐 서울, 경기, 인천에 개업하고 있는 일반의, 내과의, 이비인후과의, 가정의를 대상으로 122개 의원을 조사 하였다. 23명의 의과대학생들이 코감기 환자로 모의를 하여 개원의들의 진찰을 받은 후, 진단과 처방을 분석하였다. 코감기 증상은, 3일간 지속한 콧물과 코막힘을 주소로 했고, 발열과 오한은 없었으며, 목아픔과 기침은 약간 있는 정도로 하였다. 결과 : 조사한 의원에서 코감기에 사용한 경구 약제 수는 평균 4.71 (SD±0.951), 과별 차이는 없었다(P=0.99 by chi-square test). 부신피질호르몬은 10개(8.2%) 의원에서 처방하였다. 항균제는 50개(41.0%) 의원에서 처방하였으며, 세팔로스포린 17건, Augmentin 16건, amoxicillin (7) 또는 bacampicillin (1) 8건, 퀴놀론 5건, macrolide 3건, trimethoprim-sulfamethoxazole 1건이 었다. 과별로는 내과 34.9%, 이비인후과 52.5%, 가정의학과 33.3%, 일반외과 39.1%, 소아과 0%였고 통계적 의미는 없었다(P=0.41 by chi-square test). 주사를 권한 경우는 32 (26.4%)예였다. X-선 검사를 권유받은 1건 외에는 검사를 권유받지 않았다. 결론 : 이전 보고보다는 감기에서 항균제 사용률은 낮았으며, 진단을 하기 위한 검사가 적어 진단의 불분명을 극복하기 위한 것도 항균제 남용의 한 원인으로 생각된다. 주사제 처방률도 높은 듯하며 이는 빨리 증상이 호전되지 않을 때 병원을 바꾸는 환자들의 행위에 대한 반응일 가능성이 있으며, 항균제 사용 역시 빠른 증상 호전을 위한 것이어서, 환자의 행동 양상에 대한 조사가 필요하다.

소아기 외과계질환의 통계적 관찰

정용헌,이재호,이건수,서종진 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Child is not little man but rather a father of man. Children are faced to surgical and medical problems reqiring various specialists. Authors analized 1126 pediatric surgical in-patients of Chung-nam National Univ. Hospital from Jan. to Dec. 1988 by departments, age, sex, duration of admission and types of diseases in order to get the information for management of children’s hospital. The results are as follows: 1. Absolute numbers of in-patients by departments are above 200 in general surgery and opthalmology, between 100-199 in plastic surgery, ENT, chest surgery and below 99 in urology and neurosurgery. 2. Male to female ratio as a whole is 1.8:1, male dominant. 3. Duration of admission within 1 week was of 55% as a whole, 87% in ENT, 85% in ophthalmology, 13% in orthopedic surgery. 4. Average duration of admission was 10.8 days as a whole, 4.6 days in ENT, 5.1 in ophthalmology, 29.7 days in orthopedic surgery, and variable by types of diseases. 5. The most frequent disease by departments was hernia in general surgery, fracture in orthopedic surgery, cerebral contusion in neurosurgery, ventricular septal defect in chest surgery, strabismus in ophthalmology, tonsillitis & adenoiditis in ENT.

동기발전기 여자시스템용 고주파 PWM 컨버터 설계

장수진,류동균,원충연,이진국,배기훈,김수석 성균관대학교 2003 학술회의지원논문목록집 Vol.2003 No.-

A synchronous generator is equipped with an automatic voltage regulator(AVR), which is responsible for keeping the output voltage constant under normal operating conditions at various levels. The output voltage of Synchronous Generator is regulated constantly by field voltage control in excitation system. High frequency PWM converter (Buck converter) type excitation system for synchronous generator that can sustain proper output voltage level even at the fault condition happened. The proper operation of the proposed excitation system was verified through the simulations and the experiments.

미세혈관 문합술을 이용한 절단된 귀 재접합 치험례:1례보고

김정헌,이현택,박배근,김동철,황성진 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

The auricle is frequently exposed to trauma due to its protruding anatomical position and it is sometimes severed completely. Many kinds of techniques such as composite graft or cartilage preservation methods for the reattachment or reconstruction of and amputated ear have been tried. But their indications are limited and results are not satisfactory. For the complete survival of ear cartilage and skin of the amputated part, microvascular replantation is known as the best procedure. But cases of successful replantations have been rare until now, because of technical difficulties due to the small size of auricular vessels and uncertain vascular anatomy. In 1980, Pennington et al. reported the first successful microvasclar replantation of a totally avulsed ear using vein graft. After that about 10 cases of world wide successful micro replantation of servered ears were reported. Here, we report a case of a successful replantation of a completely amputated lower half of auricle including the ear lobule due to a human bite. Replantation was done by direct anastomosis of transected peripheral branches of the posterior auricular artery and vein without vein graft. We again emphasize that, in spite of the technical difficulties and long operative time, successful replantation of an amputated ear with microvascular surgery is superior to any other methods of reattachment or reconstruction.

선천성 피부 형성부전증 1례 보고

황성진,박혜림,김희석,김동철,김정헌 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.2

Aplasia cutis congenita is a disorder of heterogeneous group characterized by isolate or multiple, localized or widespread areas of skin defect at birth. Since the first report by Cordon in 1767, it has been relatively rarely reported disorder abroad as well as domestically . It has several clinical subtypes classified by the location and pattern of skin absence, the presence of associated malformations and the mode of inheritance with unknown cause. We had a newborn male infant with this disorder clinically diagnosed, who showed wide full thickness skin defects on right knee and medial surface of ankle from birth, that covered with thin yellowish membrane and showed focal ulcerative area. On his familial history, there were four aplasia cutis congenita patients in the patient's mother in his maternal family side through four generations. Patient mother showed wide spread atrophic scarred looking appearance on her right lower leg. Chromosomal analysis revealed as normal male karyotype. The biopsy of lesions showed ulcerated surface and underlying chronic inflammation with total absence of epidermis. He had no associated congenital anomaly. The lesions healed rapidly for four weeks by conservative treatment as moist wound dressing and systemic antibiotic administrations. As a relatively uncommon skin anomaly, one case of aplasia cutis congenita is reported with review of references.