순환기 내과로 자문의뢰된 환자의 임상상

황진용,최지용,손상균,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.4

목적 : 순환기내과 영역은 많은 과로부터 자문의뢰를 받는 영역으로 알려져 있다. 특히 최근 우리나라의 순환기질환의 유형이 변화되고 입원환자가 고령화되면서 동반된 심질환의 유병율도 증가하고있다. 이에 저자들은 타과로 입원하여 순환기내과로 자문의뢰되는 환자의 임상상과 3차병원인 경북대학교병원에서의 순환기내과자문의 유용성 등을 평가하여 향후 순환기질병에 대한 협의진료에 도움을 주고자 본 연구를 시행하였다. 방법 : 1995년 3월부터 순환기내과로 공식자문의뢰된 첫 100명을 대상으로 전향적으로 연령, 의뢰이유, 최종진단명, 수술과의 관련성 여부, 순환기내과의 최종조치, 타과의 순응도 등을 조사하였다. 결과 : 1) 자문을 의뢰한 환자는 평균 58±16(15-89, 중앙치 61)세였고 60세이상의 환자가 57%로 고령의 환자가 많았다. 2) 내과계열 25%, 외과계열 75%로 외과계열의 자문이 많았고 일반외과가 26%로 가장 많았고 내과의 다른 분과가 12%, 신경외과 12%, 정형외과 11%, 흉부외과 11%, 신경과 11% 등의 순이었다. 외과계열중 수술을 시행한 경우는 58례로 이중 응급수술이 13례였다. 술전 위험도 평가를 위한 자문이 38례에서 있었는데 순환기적인 문제로 수술을 받지 못한 경우는 2례(1례는 허혈성 심질환, 1례는 심낭질환)이었다. 이때 응급수술을 제외한 입원일과 술전 자문일파의 간격은 평균 3±7일(입원일-42일)이고 술전 자문일과 수술일과의 간격은 평균 6±4일(1-16일)이었다. 3) 타과의 의뢰이유는 심전도 이상이 36례, 높게 측정된 혈압이 20례, 순환기질환의 과거력 17례, 환자의 증상 때문인 경우가 10례였고 심전도의 이상중에는 부정맥이 18례, 이상 Q파 6례, ST절 이상이 5례, 각차단이 3례의 순이었다. 순환기과거력 중에는 허혈성 심질환이 6례, 현재 혈압은 정상이나 고혈압의 과거력이 있는 경우가 4례 순이었고 환자의 증상은 흉통 6례, 호흡곤란이 3례, 기절이 1례였다. 4) 자문후 최종진단이 가능했던 91례를 진단별(총 97 진단명)로 나누어 보면 고혈압이 28례, 부정맥이 16례, 허혈성 심질환이 14례, 판막질환이 11례, 순환기질환이 아닌경우가 19래였다. 이들중 추적진료가 필요하다고 응답한 경우가 57례였으나 순환기내과 외래에 1번이상 추적진료한 경우는 32례(56%)로 환자의 순응도는 낮았다. 결론 : 순환기내과의 자문의뢰는 고령자에게 많았고 수술과 관련된 경우가 많았으며 심전도의 이상이 의뢰이유로 가장 많았으며 진단별로는 고혈압과 부정맥이 가장 많았다. 그리고 순환기적인문제로 수술을 받지 못한 경우는 드물었고 자문후 지속적인 추적진료를 위해 환자의 교육이 필요하겠다. Objective : Clinical characteristics of the patients with cardiovascular diseases in the general hospital have been changed and prevalance of co-existing cardiovascular disease in the patients who were admitted for non-cardiac diseases has been increased remarkably as the proportion of elderly patients increased rapidly in Korea. We evaluated clinical features of the patients consulted for cardiological evaluation and effectiveness of the consultation in the setting of tertiary general hospital, Kyungpook University Hospital. Method : One hundred patients were studied between January 1995 and January 1996. They were evaluated for the reason of consultation, final diagnosis, final recommendation from cardiologists and its impact on the management of the patients, and compliance of the consulting departments. Results : 1) The ages ranged between 15 and 89 (mean 58±16, median 61) years, 57 patients were male and 43 female. Fifty seven patients were older than 60 years. 2) Consultations from surgical parts were 75 patients. Consultation from general surgery was most frequent (26%), followed by other divisions of internal medicine (12%), neurosurgery (12%) and orthopedic surgery (11%), chest surgery (11%), neurology (11%), obstetrics and gynecology (8%), urology (4%), ophthalmology (2%), dermatology (2%), ENT (1%). Among 75 patients from surgical parts, operation was done on 58 patients, including 13 emergency cases. Preoperative cardiac risk evaluation was the reason of consultation in thirty eight patients, of which operation could not be done in only 2 patients (one had severe ischemic heart disease, the other large pericardial disease). Interval between consultation day and operation day was 6±4 days (1-6 days). 3) Reasons for cardiac consultation were electrocardiographic (ECG) abnormalities in 36 patients, high blood pressure in 20 patients, previous cardiovascular diseases in 17 patients, symptoms of the patients in 10 patients. Among EGG abnormalities, arrhythmias was the reason in 18 patients, abnormal Q waves in 6 patients, ST-T segment abnormalities in 5 patients, bundle branch block in 3 patients. Among previous cardiovascular disease, presence of ischemic heart disease was the reason in 6 patients, previous hypertension in 4 patients. Chest pain was the reason of the consultation in 6 patients, dyspnea in 3 patients, syncope in 1 patient. 4) Definite diagnoses could be made in 91 patients with 96 diagnoses which were hypertension and its complications in 28, arrhythmia with underlying disease in 16, ischemic heart disease in 14. valvular heart disease in 11, non-cardiovascular disease in 19. Cardiological follow up was recommended in 57 patients. However, 25 patients (44%) were lost to follow-up. Conclusion : Cardiological consultation was frequent in the elderly patients. Most frequent reason for consultation was EGG abnormalities. Hypertension or arrhythmia was most common final diagnosis. Inoperability due to cardiovascular problems were rare.

급성하벽심근경색에서 전흉부유도 ST절 하강의 의의

정병천,배호상,곽동훈,김영태,배용학,황종현,임현주,류재근,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 급성하벽심근경색증 환자에서 심전도상 흔히 동반되는 전흉부유도 ST절 하강의 의의를 알아보았다. 방법 : 심근경색후 24시간에서 48시간에 얻은 심전도를 기준으로 52명의 급성하벽심근경색증 환자를 전흉부유도에서 ST절의 하강이 있는 군과 없는 군으로 나누었으며 심도자, 관상동맥조영술, 심초음파도 및 방사성 핵종을 이용한 좌심구혈율 측정 등을 시행하였다. 결과 : 1) 좌심실확장기말압은 전흉부유도에서 ST절의 하강이 있는 경우에서 16.9±5.33mmHg로 없는 경우의 11.0±4.02mmHg보다 유의하게 높았다(p<0.05). 그러나 운동량 및 좌심구혈을은 흥부 유도상 ST절의 하강이 있는 경우 7.6±3.0 METs 및 53.9±9.1%로 없는 경우의 9.1±2.7 METs 및 54.6±9.5%보다 낮았으나 통계적 유의성은 없었다(p=0.180, p=0.823). 2) 관상동맥조영술상 전흉부 ST절의 하강이 동반된 군에서는 유의한 좌전하행지나 좌회선지의 협착이 있는 경우가 60.9% 및 57.9%로 ST절의 하강이 없는 군에서의 34.5% 및 7.7%와 비교해 좌관상동맥에 협착이 동반된 경우가 많았다(p=0.050, p=0.001). 3) 관상동맥조영술상 세 혈관질환의 빈도는 흉부유도상 ST절의 하강을 보인 23예에서 10예로 ST절 하강이 없었던 29예중 2예에 비하여 유의하게 많았고(P=0.007), 단 혈관질환의 빈도는 ST절의 하강을 보인 군에서 23예중 5예로 ST절 하강이 없었던 29예중 17예에 비하여 유의하게 적었다(P=0.002). 두 혈관질환의 경우에는 각각 8예와 10예로 양군간에 유의한 차이가 없었다. 4) 흉부유도상 ST절 하강의 빈도는 단 혈관질환 22예 중 5예에서, 두 혈관질환 18예중 8예, 세 혈관질환 12예 중 10예에서 관찰되어 협착이 있는 관상동맥의 수가 많을수록 ST절의 하강이 나타나는 빈도가 많음을 보였다(p=0.00308). 그러나 흉부유도상 나타난 ST절의 하강을 모두 합하여 구한 ST절 하강의 합은 협착이 있는 관상동맥의 수와 통계적인 유의성이 없었다. 5) 심초음파도상 좌심실 하벽의 벽운동은 ST절 하강을 보인 군에서는 akinesia가 83.3%, hypokinesia가 11.1%, 정상 벽운동이 5.6%로, ST절 하강이 없었던 군에서의 dyskinesia가 3.6%, akinesia가 39.3%, hypokinesia가 25.0%, 정상 벽운동이 32.1%와 비교하여 ST절의 하강이 있는 군에서 유의하게 벽운동의 장애가 빈번함을 보였다(p=0.03891). 그러나 좌심실전벽, 측벽 및 중격부위에서는 유의한 벽운동의 차이가 없었다. 결론 : 급성하벽심근경색증 환자의 전흉부유도에서 ST절의 하강이 동반되는 경우 다혈관 질환의 가능성이 높으며 좌심실확장기말압이 상승되었고 운동능력은 감소되어 있었다. 또한 심초음파도상 좌심실하벽의 벽운동장애도 심하였다. 따라서 전흉부 ST절의 하강을 동반한 급성하벽심근경색증 환자는 전흉부유도에 ST절 하강이 없는 경우보다 예후가 불량할 것으로 생각되며, 보다 적극적인 치료가 필요할 것으로 생각된다. The purpose of this study was to determine the significance of precordial ST segment depression appearing during acute inferior myocardial infarction and to assess the correlation of that with angiographic finding. 52 patients were allocated into two groups based on the existence of precordial ST segment depression : 23 patients with ST segment depression and 29 patients without ST segment depression. The extent of coronary artery disease as well as the prevalence of significant stenosis (≥70%) in left anterior descending artery were more frequent in patients showing precordial ST segment depression than in patients not showing them (p=0.050) and the result were similar in cases of left circumplex artery (p=0.001). On echocrdiographic examination of left ventricular (LV) wall motion, it showed more severely decreased inferior LV wall motion in patients showing precordial ST segment depression than in patients not showing them (p=0.03891) even though the other segment of LV wall motion didn't show the statistical difference between both groups. The other cardiac parameters such as LVEDP, exercise amount (METs) and ejection fraction were tend to showing bad profile in patients with precordial ST segment depression. From the above results, we could deduce that patients with precordial ST segment depression have relatively large infarction or concomitant left coronary artery disease, so they need more caution and intensive theraphy.

Hepatic Cirrhosis Occurring in a Young Woodchuck(Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus(WHV)

Kyu-shik Jeong,정원일,Jae-yong Chung,Mi-young An,Chae-yong Jung,Gyoung-jae Lee,Jong-soo Kang,Byeong-cheol Kang,Young-heun Jee,Bruce H Williams,Young-oh Kwon,Da-hee Jeong 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

Cirrhosis Occurring in a Young Woodchuck (Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus (WHV)Da-hee Jeong, Won-il Jeong, Jae-yong Chung, Mi-young An, Chae-yong Jung, Gyoung-jae Lee1, Jong-soo Kang1, Byeong-cheol Kang2, Young-heun Jee3, Bruce H Williams4, Young-oh Kwon5 and Kyu-shik Jeong*College of Veterinary Medicine, Kyungpook National University, Daegu 702-701, Korea1Shinwon Scientific Co., LTD, Research Institute, Suwon, Korea2Clinical Research Institute, Seoul National University, Seoul 110-744, Korea3College of Veterinary Medicine, Jeju National University, Jeju 690-756, Korea

琴湖江 隣近 部落 地下水의 理化學的 所見

蔡龍坤,張鳳基,金斗熙 慶北大學校 醫科大學 1987 慶北醫大誌 Vol.28 No.2

This study was carried out to investigate of physico-chemical status of drinking ground water near by the Gum-ho river basin, from February, 20 to March, 20, 1986. The ground water for testing was sampled 26 sites which are eleven wells, twelve electric pumps, and three simple piped water. Out of 23 kinds of phsico-chemical factors investigated, hydrogen ion, alkalinity, nitrate nitrogen, sulfate, copper, zinc, hexavalent chromium, arsenic, mercury, and lead were within allowable values for drinking. However, total hardness (sites Ⅴ-1 and Ⅵ-1), turbidity(site Ⅴ-2), ammonia nitrogen(site Ⅲ-2), chlorine(sites Ⅲ-2, Ⅲ-4, Ⅳ-1, Ⅴ-1 and Ⅵ-6) iron (site Ⅳ-2), manganese(sites Ⅱ-1 and Ⅲ-2) cadmium(sites Ⅰ-1 and Ⅲ-2), were higher than allowable value. The shorter straight distance from Gum-ho river side to sampling points, the higher concentration of alkalinity, carbon dioxide and sulfate(p<0.05). The concentration of sulfate, arsenic, and lead were negatively correlated with depth of ground water (p<0.05). In comparision of water supplying style and chemical contents; ammonia nitrogen, sulfate, lead, arsenic and mercury were higher in the well water than in the simple piped water(p<0.05). The pollution of ground water was high negative correlation with the distance of contamination sources such as toilet, cattle shed, rice field, etc.

소세포종양에 관한 면역조직화학적 및 전자현미경적 연구

서재홍,임성철,김용임,양정열 대한병리학회 1997 Journal of Pathology and Translational Medicine Vol.31 No.11

스포츠의 환경문제에 대한 정책비판과 해결 방안

채용기,이정식 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

The purpose of this is study was to discuss the operation and task of is ports environment policy in korea. This paper attempt to discuss factors contributing to circumstances and endeavor to imply possible is solution for environmental policies related to is port. The back ground and current is situation were analyzed and future recommendations made. mindful that a clean and healthy environment is essential for those taking part in is port and that many is port organizations and participants contribute actively to environmental protection. However, these was no consideration and program related to resolution on is port and environment in korea. Since 1990s, the is strategic choices and legislation for environmental issues have is systemized by the government level otherwise, the policies for is port and the environment have not is et is systematically because there has not tried undertake research and investigate way to measure environmental impact of is port. korea is port-environment policy has not any is social conditions to discuss on the problems itself such as man, is structure equipment, is kill and burdget more is seriously and reasonably. and the affairs between related stations was duplicated and was net provided with policy accepted to sectional traits korea is ports-environmental policy contained the is everal problems as is such. 1. korea is port-environment has political backwardness such as the day after the fair. 2. korea is port-environment affairs was scattered. 3. korea is port-environment is systems is centralized systematically. And in order environment policy, we should observe the Several principles as such. 1. we should observe important thesis of human being respet. 2. we should compose the multiple and system. 3. we should exclude the variable of environment-problems at first. 4. we should observe the principle of the causer responsibilities.

레티노산 함유 폴리락탄산 나노입자의 제조 및 약물 방출

채지만,이경만,김인숙,이용복,신상철,오인준 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.5

To develop an intravenous delivery system of all-trans retinoic acid (ATRA) for the cancer therapy, poly(L-lactic acid) nanoparticles were prepared and characterized. Emulsification-solvent evaporation method was chosen to prepare submicron sized nanoparticles. Spherical nanoparticles less than 200 nm in diameter with narrow size distribution were pre-pared, and the entrapment efficiency of drug was more than 95%. The endothermic peak at 183°C and X-ray crystallographic peak of ATRA appeared in the nanoparticle system, suggesting the inhibition of crystallization of ATRA by polymer adsorption during the precipitation process. ATRA was released at 37℃ for 60 days and the release rate was dependent on the concentration of drug incorporated in the nanoparticles. While ATRA was unstable in the light, it was very stable at 4℃. These results suggest the usefulness of PLA nanoparticles as a sustained and prolonged release carrier for ATRA.

태백지역 관광개발의 분야별 발전전략

채용식 한국관광정책학회 1998 觀光政策學硏究 Vol.4 No.2

The purpose of this paper is as follows : First, to search for the centripetal point to pay full attention to the matters which still remain in this tourism-oriented region. Second, to revise a counterplan most suitable to facilitate the development of TAEBAEK region by examing various opionions for the development of this area, thus suggesting a starting point to widen the possibility for the activation of the tourism industry in TAEBAEK, the recovery of regional economy, and the regional development. Third, in addition, to establish a Korean-type mining region with a view to developing tourism industry in Korea as well as Kangwon Province, thus suggesting an alternative to solving the matters concerning the regional development. Finally to realize the proper localization of the mining region with mutual agreement among TAEBAEK residents concluded by selecting and researching the major pending issues in this area.

질산성 질소 선택적인 음이온교환수지의 합성

채용곤 대구보건대학 2002 대구보건대학 論文集 Vol.22 No.-

The functional group of commercially available ion exchange resins is known to be NMe₃, of which selectivity prefers SO₄^(2-) ion to NO₃^(-) ion. Based on the fact that SO₄^(2-) ion occupies a larger space than NO₃^(-) ion in the chemical compounds, a new ion exchange resin was developed by the use of NEt₃ and N(CH₂CH₂OH₃)₃ as functional groups and subsequently determined the physicochemical properties of the newly developed ion exchange resin. As indicated at the results, the selectivity of this ion exchange resin preferred NO₃^(-) ion to SO₄^(2-) ion.

전류-턴 곱을 이용한 역률제어용 인덕터의 설계

정용채 남서울대학교 2007 남서울대학교 논문집 Vol.13 No.4

The core selection plays an important role in the inductor design. Inparticular, the ampere-turn product is proportional to the power handingcapacity. Thus, in this paper, the inductor design procedure for a powerfactor correction(PFC) is proposed using an ampere-turn product. Moreover,the design method is explained in detail. To confirm the design result, some simulation results are presented. Key Words : Ampere-Turn Product, PFC, Inductor Design, Core Selection