褥瘡에 대한 治驗 1 例 報告 : an External Therapy with ASTRAGALI RADIX Powder

허영란,문성호,최중길 대한본초학회 2000 大韓本草學會誌 Vol.15 No.2

Pressure sore is the ulceration and necrosis of the skin and underlying tissue usually occurred on the bony prominence of the body after prolonged or repeated pressure. Recently, the incidence of the pressure sore has been increased due to the development of the industry, increased number of the traffic accident and the cerebrovascular accident. Authors reviewed 4 sites of a patient who had received external application with ASTRAGALI RADIX powder for the pressure sore. Pressure sore of the patient was improved in about 4 months. ASTRAGALI RADIX has two effects: promoting tissue regeneration(生?) and evacuating the pus by administering tonics(????). So ASTRAGALI RADIX is proper for the external application of the pressure sore.

휴통과 ST분절상승을 보이는 환자에서 급성심근경색증과 비심근경색증의 심전도 분석

류진호,김용권,소정일,허탁,민용일 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: ST segment elevation in patient with chest pain was seen in acute myocardial infarction and in numerous other non-infarction syndromes. The causes of non-infarction syndrome were left ventricular hypertrophy, BER(benign early repolarization), and left bundle branch block in cardiac origin and were hyperkalemia and hyperventilation syndrome in metabolic origin and were others. Furthermore, the differentiation of electrocardiogram between acute myocardial infarction and non-infarction syndrome was very difficult. So, we compared and analysed characteristics of ST segment elevation of acute myocardial infarction and non-infarction syndrome that suggested the clue of early diagnosis of coronary artery disease. Method and Materials: We retrospectively reviewed the electrocardiogram of 961 patients with chest pain who visited the emergency center from January 1999 to December 1999. Acute myocardial infarction was diagnosed by clinical finding, electrocardiogram, cardiac enzyme, echocardiogram, and myocardial spect. Left ventricular hypertrophy, BER, and left bundle branch block in cardiac origin of non-infarction syndrome were diagnosed by electrocardiographic criteria suggested by William J. Brady. Acute myocarditis, acute pericarditis, and hyperventilation syndrome were diagnosed by clinical finding. Results: Among 961 patients with chest pain, 236(24.6%) patients manifested ST segment elevation who were diagnosed acute myocardial infarction in 162(68.6%) patients and non-infarction syndrome in 74(31.4%) patients. The causes of non-infarction syndrome in 74 patients were left ventricular hypertrophy(32:13.6%), BER(28:11.9%), left bundle branch block(11:4.7%), and others(3:1.3%). Three others were acute myocarditis, acute pericarditis, and hyperventilation syndrome. Electrocardiographic characteristics of ST segment elevation of non-infarction syndrome manifested almost same finding compared to William J. Brady' criteria. Conclusion: ST segment elevation in patient with chest pain visited emergency department was seen in acute myocarction(68.6%) and the other non-infarction syndromes(31.4%). Significant number of patients were not associated with acute myocardial infarction. Therefore, we must completely understand characteristics of ST segment elevation in acute myocardial infarction and the other non-infarction syndreomes to diagnose fatal early coronary artery disease and to avoid unnecessary thrombolytic therapy.

진상전류 추정에 의한 태양광 발전시스템의 최대출력제어

우정인,신동률,허태원,박지호,노인배 東亞大學校 大學院 1997 大學院論文集 Vol.22 No.-

Photovoltaic power may vary depending on the various solar cell has an optimal generating point to be able to get the maximum power tracking, in order to get the more power recovery on the switching control system. However the V-I characteristics of the solar array at the frequency have hysteresis, in such high frequency region the conventional controller based on no hysteresis can not be responsible for control of the photovoltaic power system. Therefore, in this paper we proposed a maximum power tracking technique to improve the operation in the region of high frequency[5KHz-30KHz] with added C-R differential circuit for zero cross switching. The distinguishing characteristics of this method is to be controlled by the estimated values of resistive current and sensed photovoltaic terminal voltage do not depend on the operating frequency. the experimental result of the power system is controlled by the proposed sampling.

ATM망에서 ABR서비스를 위한 효율적인 전송률 할당 알고리즘에 관한 연구

천재호,윤상호,김명균,허정석 울산대학교 1999 공학연구논문집 Vol.30 No.2

ATM망에서 ABR 서비스는 CBR, VBR에 할당된 대역폭을 제외한 나머지를 이용해서 데이터를 전송한다. 오디오 또는 비디오 데이터와 같이 실시간 전송이 필요한 서비스들을 전송지연이 제한되는 CBR이나 VBR 트래픽을 이용하여 제공할 수 있지만, 이런 경우에는 전송 대역폭을 효율적으로 사용하지 못하는 단점이 있다. 본 논문에서는 실시간 데이터를 ABR 서비스를 이용하여 효율적으로 전송하기 위한 ABR 대역폭 할당 알고리즘을 제안한다. 제안된 알고리즘은 MCR을 보장하며, MCR에 비례해 전송률을 할당한다. 그리고 접속의 상태를 만족(satisfied)상태와 불만족(bottlenecked)상태로 구분하고, 만족 상태인 접속이 사용하지 않는 대역폭을 불만족 상태인 접속이 사용할 수 있도록 하여 대역폭 활용도를 높인다. 또한 제안된 알고리즘은 큐 제어 함수를 사용해서 큐 길이를 일정한 범위로 유지함으로써 셀의 전송지연을 일정하게 한다. 본 논문에서는 시뮬레이션을 통해 제안된 알고리즘의 성능을 분석하고, 기존에 제안된 ATM 포럼[1]및 Kalampoukas 알고리즘[2]과 비교를 하였다. On ATM networks, ABR services are provided using the remained bandwidth after allocating CBR and VBR traffic. Realtime services such as transmitting audio or video data may be provided using CBR and VBR which have a constrained transmission delay, but in those cases, the communications bandwidth may be wasted. This paper proposes an efficient ABR rate allocation algorithm to transfer real-time data using ABR service. The proposing algorithm guarantees MCR and allocates bandwidth to each connection proportional to its MCR. The proposing algorithm divides the connections in two groups, a satisfied state group and a bottlenecked state group, and enhances bandwidth utilization by allowing the remained bandwidth after allocating to the connections in the satisfied state to the connections in the bottlenecked state. The proposing algorithm uses the queue control function to keep the queue length within some boundary, which makes the transmission delay constant. We simulate and compare the performance of the proposing algorithm with that of the algorithms proposed by ATM Forum[1] and Kalampoukas[2].

3차 병원의 병동에서 시행된 심폐소생술의 분석

류진호,정경운,위준선,문정미,전병조,문원식,김용권,소정일,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. Methods: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. Results: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. Conclusion: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.

자발성 뇌지주막하출혈 환자에서 Cardiac Troponin Ⅰ를 이용한 심근손상의 발생율

김용권,류진호,소정일,문원식,전병조,허탁,민용일 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patients with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). Methods : A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. Results : Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). Conclusion : The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.

물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가

김정철,윤정한,범희승,제갈영종,송호천,민정준,정환정,김성민,허영준,이명호,박영규,정준기 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.2

목적 : 분화갑상선암 환자에 대한 방사성옥소(I-131) 치료는 재발율과 사망률을 감소시키는 효과적인 치료법이지만, 치료용량을 증가시킴으로써 치료율을 향상시킬 수 있는지에 대해서는 아직 논란이 있다. 본 연구에서는 최대허용선량 치료법의 효용성을 검증하고자 하였다. 대상 및 방법 : 임상적 병기가 제3, 4병기이고, 6개월 이후에 I-131 전신스캔(이하 IWBS)과 혈중 thyroglobulin (이하 Tg), anti-thyroglobulin antibody (이하 ATA), 초음파검사 (이하 US) 및 F-18 FDG PET 등을 통해 치료여부를 확인할 수 있었던 58명(남:여=9:49, 평균연령 50±11세)의 유두상갑상선암 환자를 대상으로 하였다. 이중 11명은 제4병기, 47명은 제3병기였으며, 43명(남:여=4:39), 평균연령 50±11세)은 7.4 GBq 이하의 고식적인 저용량치료법으로 치료하였고, 9.25 GBq 이상의 고용량 치료를 받은 환자는 15명(남:여=5:10, 평균연령 50±12세)으로 고용량군에서 남자가 더 많았으나 연령의 차이는 없었다. 고용량군 환자 모두에서 추적용량의 방사성옥소(평균 77±3 MBq)를 경구 투여한 후 혈중 방사능소실곡선을 통해 최대허용선량(maximum permissible dose, 이하 MPD)을 계산하였으며, 7명에서는 말초혈액림프구의 중기염색체분석법에 의해 생물학적으로 MPD를 계산하였다. 14명에서는 치료용량의 방사성옥소를 투여한 후 혈중 방사능소실곡선을 통해 MPD를 계사하였다. 완전치유(complete response, 이하 CR)는 IWBS에서 병소가 없어지고, 혈중 Tg치가 1 ng/mL 이하로 감소한 경우로 정의하였으며, 부분치유(partial response, 이하 PR)는 IWBS에서 병소가 없어졌더라도 혈중 Tg, ATA치가 높거나, US 또는 PET 검사에서 병소가 남아있는 경우로 정의하였다. 치료후 IWBS에서 병소가 오히려 증가하거나 변함없는 경우는 없었다. 방사성옥소 치료에 의한 부작용은 입원기간 중 타액선이 현저하게 붓고 통증이 있거나, 구토를 심하게 하는 경우, 그리고 퇴원후 1개월째 백혈구수가 20% 이상 감소한 경우로 정의하였다. 결과 : 양 군간에 연속적인 수치변화를 비교하는 경우는 paired t-test를 이용하였으며, 대상군간 치료효과와 부작용의 비교는 chi-square test를 이용하였다. p값 0.05 미만을 통계적으로 유의한 차이로 인정하였다. 고용량군 환자 모두에서 추적용량과 치료용량의 방사성옥소 투여 후 혈액의 피폭선량은 각각 0.012±0.3 Gy, 1.66±25 Gy였으며, 방사성옥소 투여 후 혈액에 전달되는 피폭선량은 추적용량보다 치료용량에서 더 많았고 (1.21: 166 rad, p<0.001), 방사성옥소 1 mCi당 혈액에 전달되는 피폭선량은 차이가 없었다(0.58±0.1 vs. 0.56±0.1 rad/37 MBq, p=0.34). 추적용량 방사성옥소 투여 후 구한 MPD는 평균 13.3±1.9 GBq (9.7 ~ 16 GBq) 이였고, 치료용량 방사성옥소 투여 후 구한 MPD는 평균 13.8±2.1 GBq (10.4 ~ 16.3 GBq)로 유의한 차이가 없었으며 (p=0.20), 두 수치간에는 유의한 상관 관계가 있었다(r=0.8, p<0.0001). 7명의 환자에서 말초혈액림프구 중기염색체 분석법으로 MPD를 측정하였는데 혈액의 피폭선량은 1.78±0.03 G였으며, 같은 환자에서 혈중 방사능소실곡선으로부터 구한 피폭선량은 1.54±0.03 G로 유의하게 낮았으나 (p=0.01), 두 측정치 간에는 유의한 상관관계(r=0.86, p=0.01)가 있었다. 저용량 치료군 43명 중 22명(51.2%)에서 완전치유를 보였고 21명(48.8%)에서는 부분치유를 보인 반면 고용량 치료군 15명 중 12명(80%)에서 완전치유를 보였고 3명(20%)에서만 부분치유를 보여 고용량 치료군에서 유의하게 높은 완전치유를 얻을 수 있었다(p=0.05). 한편 부작용 발생빈도는 저용량 치료군 43명 중 13(30.2%), 고용량 치료군 15명 중 6명(40%)로 양군간에 유의한 차이가 없었다(p=0.46). 임상적인 병기, 연령 및 성별에 따라서는 치유의 차이가 없었다(p>0.05). 결론 : 혈중소실곡선으로부터 MPD를 결정하고 이를 토대로 환자 개개인별로 적절한 선량을 선택하여 치료하는 방법은 부작용을 최소화하면서도 치료효과를 높일 수 있는 매우 유용한 치료법이며, 고위험군 분화갑상선 암 환자에게 가장 적절한 치료법이라고 사료되었다. Purpose: Radioiodine (1-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age 50±11 years) of papillary thyroid cancer. Among them 43 patients were treated with ≤7.4 GBq, while 15 patients with ≥9.25 GBq. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up 1-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were 13.3±1.9 and 13.8±2.1 GBq, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were 1.54±0.03 and 1.78±0.03 Gy (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-does group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose 1-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.

급성췌장염을 동반한 특발성 양측성 횡격막 마비 1례

박주경,소정일,류진호,김성근,허탁,민용일 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Bilateral diaphragmatic paralysis(BDP) is a rare disorder, which can be secondary to spinal cord injury, motor neuron disease, myopathy, noninfectious polyneuropathy, infection, iced saline cardioplegia performed during cardiac surgery, or idiopathic causes. There may be typical presentations such as dyspnea, paradoxical respiratory movement, and hypercapnic respiratory failure. It needs to exclude above secondary causes to consider idiopathic bilateral diaphragmatic paralysis. We report a 51-years-old man who presented with idiopathic bilateral diaphragmatic paralysis combined with acute pancreatitis. We couldn't find out the association of these two clinical conditions. The patient was improved by mechanical ventilation.

Quantification of Mobilization Grade for Mean Peak Force During Central Posteroanterior Mobilization of C3- C5 in Asymptomatic College Students

( Ho Jung An ),( Seo Yoon Heo ),( Jung Hyun Choi ),( Wan Suk Choi ) 국제물리치료연구학회 2017 Journal of International Academy of Physical Ther Vol.8 No.4

The purpose of this study was to measure the mean peak mobilization forces to the cervical spine 3-5 with grade III and grade IV of posteroanterior (PA) mobilization. Asymptomatic 25 college subjects were participated in the trial and eligible physical therapists performed cervical mobilization. The mean peak mobilization force was measured during the PA mobilization with grade III and grade IV by attaching a flexible force transducer over the C3-C5 spinous process. Three cycles of PA mobilization were performed in each spine and the therapist took approximately 2.5s to complete mobilization. After applying the grade III mobilization to the C3-C5, 30 minutes later, the grade IV mobilization was applied to the same area again. There were no significant differences between C3, C4 and C5 during grade III as well as grade IV. Upon comparing the mean peak force of grade III with mean peak force of grade IV at the C3, C4 and C5 respectively, an insignificant difference was also observed. The mean peak mobilization force was 4.53±1.79 N at the C3, 5.10±1.91 N at the C4, and 5.17±2.63 N at the C5 during grade III force was applied. The mean peak mobilization force was 4.40±1.56 N at the C3, 5.53±2.01 N at the C4, and 5.38± 2.73 N at the C5 during grade IV force was applied. This study suggested that the mean peak force of the grade III and grade IV mobilization in the C3-C5 was similar each other, also there was no difference between mean peak force of grade III and grade IV on C3, C4 and C5.

Thermochemical analysis for the reduction behavior of FeO in EAF slag <i>via</i> Aluminothermic Smelting Reduction (ASR) process: Part Ι. Effect of aluminum on Fe & Mn recovery

Heo, Jung Ho,Park, Joo Hyun Elsevier 2017 CALPHAD, computer coupling of phase diagrams and t Vol.58 No.-

<P><B>Abstract</B></P> <P>We investigated Fe recovery from EAF slag by means of Aluminothermic Smelting Reduction (ASR) at 1773K, especially the quantitative effect of initial Al/FeO molar ratio upon the Fe recovery. Both calculated and experimentally measured system temperatures continuously increased with increasing initial Al/FeO molar ratio. Furthermore, to predict the reduction behavior we calculated variations in the slag composition by using FactSage™ 7.0 software. FeO and Al<SUB>2</SUB>O<SUB>3</SUB> contents in molten slag varied sharply within the first 5min of the reaction and stabilized soon thereafter. The aluminothermic reduction of FeO appeared to proceed rapidly and in good stoichiometric balance, based upon the mass balance between the consumption of FeO and MnO (ΔFeO and ΔMnO) and the production of Al<SUB>2</SUB>O<SUB>3</SUB> (∆Al<SUB>2</SUB>O<SUB>3</SUB>). Adding an optimal amount of Al (Al/FeO molar ratio ~ 0.8) yielded a Fe recovery of about 90%. Furthermore, the Mn could also be reduced from the EAF slag in the case of excess Al addition (Al/FeO≥0.8). The solid compound spinel (MgO·Al<SUB>2</SUB>O<SUB>3</SUB>) was precipitated from the slag during the FeO reduction, as confirmed by means of XRD analysis and thermochemical computations. Herein, the mechanism of ASR reaction between FeO in molten slag and Al is explained in several steps.</P>