중증 외상환자에서 염기 결핍수치의 유용성

문준동,김수진,문철규,최성혁,전정민,이성우,홍윤식 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: This study's objective was to determine the prognostic value of the base deficit measured in the emergency department(ED) and to determine whether base deficit can provide information not provided by advanced injury scoring system. Methods: This study was a retrospective analysis of data collected for two years. Thirty-two severe trauma patients who were admitted to the Emergency Department of Korea University Hospital were included in this study. The patients were divided into two groups: the normal base deficit group(-3 mmol/L to 3 mmol/L) and the elevated base deficit group(>3 mmol/L). The base-deficit value, age, sex, head injury, organ failure rate, and survival were considered, and the also Revised Trauma Score(RTS), Acute Physiology And Chronic Health Evaluation(APACHE II), and Injury Severity Score(ISS) were measured. Result: The elevated base-deficit group showed a lower survival rate and a higher organ failure rate compared to the normal base deficit group. Logistic Regression showed a strong association between base deficit and mortality rate. Among the previous injury scoring Systems(RTS, APACHE II, ISS), base deficit had the strongest correlation with RTS. By using base deficit value and the RTS together, we obtained a higher positive predictive value than that obtained by using base deficit or RTS alone. Conclusion: The admission value of the base deficit in the ED is a useful tool in predicting the outcome in severe trauma patients, and it can be an adjunct to previous injury scoring systems. As an advanced injury scoring System is developed in the future, the base deficit may have some significant role.

The prediction of the tooth size in the mixed dentition for Korean

Moon, Sung-Hwan,Kim, Seong-Oh,Yu, Hyung-Seong,Choi, Byung-Jai,Choi, Hyung-Jun,Lee, Jae-Ho 大韓小兒齒科學會 2006 大韓小兒齒科學會誌 Vol.33 No.2

이번 연구의 목적은 혼합치열기 아동에서 미맹출된 견치와 소구치의 크기를 예측하는데 있어서 한국인에 맞는 방정식을 만들기 위함이다. 미맹출 치아의 크기를 예측하는 것은 혼합치열기 교정 진단과 치료계획 수립에 있어서 매우 중요하다. 미맹출된 견치와 소구치 크기를 예측하는 방법은 몇가지가 있지만 그중에서도 가장 흔하게 쓰이는 것이 모이어의 예측표와 다나카와 존스턴의 방정식이 있다. 하지만 그것들은 백인을 위해서 제작된 것이고 치아 크기는 인종에 따라서 다르다고 알려져 있다. 이번 연구에서는 치아크기를 측정하여 하악 영구 절치의 크기 합과 견치 및 소구치의 크기 합 사이의 상관관계를 구하고 회귀방정식을 이용해서 한국인에 맞는 예측표를 만들었다. 연세대학교 치과대학에 재학중인 178명의 한국 학생(남 108명, 여 70명, 평균연령 21.63)을 대상으로 실험하였다. 영구치의 근원심 폭경을 석고모형상에서 calipers를 이용해서 측정하였다. 성별간의 치아 크기는 차이가 있었다(p<0.05). Correlation coefficient는 0.57에서 0.64의 범위였고, standard errors of the estimates 는 여성에서 0.6으로써 남성보다 우수하였다. r^(2)값은 0.27에서 0.41의 범위를 나타내었다. Estimating the size of unerupted teeth is an essential aspect of orthodontic diagnosis and treatment planning in the mixed dentition. Several methods were introduced and used for the prediction. The most common methods among these would be Moyers probability chart and Tanaka and Johnston equations. These are currently used widely, but they were developed for Caucasians. Because there are clear racial differences in teeth size, the objectives of this study were to produce correlation coefficients between the combined mesiodistal widths of the permanent mandibular incisors and those of the canines and premolars for each quadrant, and prediction tables with regression equations, specifically for Korean. 178 young adults (70 women, 108 men, mean age 21.63 years) were selected from the College of Dentistry, Yonsei University, Seoul, Korea. The mesiodistal crown diameters of the permanent teeth were measured with calipers. Significant sexual dimorphism was found in tooth sizes. The correlation coefficients between the total mesiodistal width of the mandibular permanent incisors and those of the maxillary and mandibular canines and premolars were found to be between 0.52 and 0.64. The standard error of the estimatation was better (0.60) for women and the r^(2) values ranged from 0.27 to 0.41 for both sexes, Prediction tables were prepared for Korean. This study showed larger canine and premolar diameters than Tanaka and Johnston's and Moyers' studies which might be due to the racial differences. Further investigations with a larger sample size will be needed for more representative data on the Korean population.

S-344 : The Role of Skeletal Muscle Mass in Development of Metabolic Syndrome

( Byung Sam Park ),( Jun Sung Moon ),( Ji Sung Yoon ),( Kyu Chang Won ),( Hyoung Woo Lee ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Introduction: It has been well known that abdominal adiposity is related with insulin resistance and greater risk of metabolic disorder. Skeletal muscle plays central role in insulin mediated glucose disposal of whole body, but we only know a little about the association between skeletal muscle mass and MetS (MetS). The aim of this study is to clarify the clinical role of skeletal muscle mass in developing MetS through using skeletal muscle parameters by body impedance analysis (BIA). Methods: 1,042 healthy adults aged from 20 to 75 years who visited Yeungnam university health promotion center from Jun. 2008 to Jun. 2010 were enrolled. 204 subjects who had prior MetS or chronic disease that can affect to skeletal muscle mass were excluded. After 24 months from baseline, the metabolic parameters were assessed and the development of MetS was diagnosed using modified NCEP-ATP III criteria. From the BIA (Inbody 720), we obtained skeletal muscle mass (SMM, Kg), body fat mass (BFM, Kg), and visceral fat area (VFA, cm2). Then, we had defined as follows; percent of skeletal muscle mass (SMM%, %): SMM (kg)/weight (Kg), skeletal muscle index (SMI, Kg/m2): SMM (Kg)/height (m)2, skeletal muscle to body fat ratio (MFR): SMM (kg)/BFM (Kg) and skeletal muscle to visceral fat ratio (SVR, Kg/cm2): SMM (Kg)/VFA (cm2) Results: Mean follow up periods were 28.7±5.4 months. Among total 838 subjects (46.9±9.9 years, M:F=477:361), 88 (10.5%) were newly diagnosed MetS. 5th quintile of the SMM%, MFR and SVR was associated with decreased risk of development of MetS after adjusting for confounding factors. Conclusion: Decreased skeletal muscle mass may play critical role in development of the MetS and not absolute amount of skeletal muscle mass but relative ratio to body composition may be more important.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

3차원 분석틀을 이용한 중학교 과학(화학 부분) 교과서의 탐구활동 내용 연구

전성애,진성호,문성배 부산대학교 사범대학 과학교육연구소 1999 科學敎育硏究報 Vol.26 No.-

This study was covered with the analysis of five kinds of the middle school science textbooks(chemistry part) based on the 6th curriculum, particularly, inquiry part was analyzed by the three dimension framework which consists of inquiry content dimension, inquiry process dimension and inquiry context dimension and the results are as follows : 1. In the analysis of the contents of the middle school science textbooks(chemistry part), the average number of total pages is 197.6. The illustration and picture are contained 0.66 in number per a page, and the average number of further readings is 5.8. 2. In the analysis of the inquiry content dimension of inquiry activities, the total number of themes in five kinds of textbook is 222. and the number of inquiry activities in five kinds of textbook is diverse : A text book is 51, B textbook 49, C text book 50, D textbook 37 and E textbook 35. 2. for the analysis of inquiry process dimension 'inter-preting data and formulating generalization(42.4%)' category is generally most emphasized and the categories of 'observation and measuring (38.1%)' 'seeing a problem and seeking ways to solve it (7.8%) and building, testing and revising the theoretical model (11.7%)' follow in order 4. As for the analysis of the inquiry context dimension, the scientific context occupies 94.2%, the individual context 0.4%, the social context 2.7% and the technical context 2.7%. It shows that the proportion of STS(Science-Technology-Society) related contents in inquiry activities is 5.8%. Therefore, we propose that STS related contents would increase the proportion for the next revised the textbook.

노인외상환자의 예후 인자

문철규,전정민,최성혁,문준동,이성우,홍윤식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: It has been documented that certain prognostic factors may affect the outcomes of the old aged victims by trauma. Considering that trauma is the sixth most common cause of death in people over the age of 65 years and there is a rapid growth of elderly population, it is paramount to understand the prognostic factors when dealing with geriatric trauma patients. Hypothesis and Goals: It can be hypothesized that the prognostic factors should be determined independently between populations being consisted of different races, countries, socio-economic states, cultures, or so on. Thus, the study was designed to evaluate the factors affecting the outcomes of elderly Korean trauma patients. Methods: One hundred forty six patients aged over 65 years were retrospectively reviewed, who visited the Emergency Center of Korea University from January, 1997 to June, 1998. Of 146 patients, 7 were excluded due to discharge against advice or transfer to the other hospitals. Parameters analyzed were age, sex, mechanism of injuries, body region injured, Injury Severity Score (ISS), previous medical illness, hospital morbidity, duration of hospital stay, and cost. Each patient was classified into improved or not-improved group depending on the outcomes, and young-old or old-old group depending on the age. The factors affecting the hospital stay in improved patients were analyzed in the parameters of previous medical illness, hospital morbidity, multiple injuries, ISS, and age. All statistical tests were conducted with two-tailed levels of 0.05. Results: Of 139 patients, the mean age was 74±7.1 years, mean ISS 9.3±7.26, mean hospital stay 27±27.1 days. Most commonly injured body region was the extremities due to fall from a level surface. Rate of previous illness showed 0.94 medical diseases per person and were aggravated after trauma in 39 patients (60.9%). Hospital morbidity rate was 0.46 incidents per person. There were no differences in age and duration of hospital stay between the improved and the not-improved group. Substantial differences were noted in affected body region, incidence of previous illness, and hospital morbidity between the groups (p=NS). Not-improved group had higher ISS(p<0.05). ISS, previous illness and hospital morbidity affected the duration of hospital stay in the improved group. Hospital stay was 40±25.1 days in patients with ISS over 6 while 6±8.6 days in those with ISS 5(p<0.05). Hospital stay in the improved was 26±26.9 days while 31±24.8 days in the improved old-old group (p=NS). Hospital stay in the young-old minor trauma (ISS5) patients with previous illness and hospital morbidity was 26±10.1 days while 4±7.3 days in those without previous illness and hospital morbidity (p<0.05). Conclusion: Previous medical illness and hospital morbidity, not age, are predictive of outcomes of geriatric trauma patients with respect to hospital stay. As most of the hospital morbidity was a trauma-induced aggravation of previous medical illness and hospital morbidity contributing poor outcomes can be potentially avoidable, routine aggressive care for the geriatric trauma patients with previous medical illnesses is needed.

태양열 건조기에 관한 연구

전상문 大田産業大學校 1996 한밭대학교 논문집 Vol.13 No.1

To develop heating water that is high efficiency and lower price, natural conveclive soalr energy system which is puling onmarkt modiket convectire solar energy system. For the cast down of maunfacture and increasing of the system efficency, brazen pipe in heat exchanger of rediation correction system switched to smaller size, collector with brazen switched to aluminum film which is 70μ thickness, and doped with silicon carbonblack high priced heat storage thak subsituted to low priced polyethylene drum, and reconstructed heat exchanger with staituted to low priced polyethylene drum, and reconsrucbed heat exchanger with stainless steel which is attached fins and check valve for forced convection of heat transfer media. For enhancement of heat storage efficiency poly propylene bag with Na_2SO_4 hydration heat. The solar energy system which is improved in this research was simple manufactring porcess and increase of heat efficiency due to forced convection system. In this results, it can be conclude that this system is move valuable in economically than conventional solar energy system.

Effect of Mn and C on Age Hardening of Fe–Mn–Al–C Lightweight Steels

Sung‑Won Park,Jun Young Park,Kyong Mox Cho,Jae Hoon Jang,Seong‑Jun Park,Joonoh Moon,Tae‑Ho Lee,Jong‑Ho Shin 대한금속·재료학회 2019 METALS AND MATERIALS International Vol.25 No.3

The effects of Mn and C content on the age hardening of Fe–Mn–Al–C lightweight steels, which have austenitic or duplex(austenite and ferrite) microstructures, were investigated. An increase in Mn content induced a delay of the age hardeningthat is caused by the formation of intra-granular κ-carbides. In order to interpret the effect of Mn content, first-principlescalculations were conducted using the supercells of Fe24Al8C8,Fe24Al8C7,Fe24(Al7Mn)C8, and Fe24(Al7Mn)C7. The calculationsshowed that an increase in Mn content could be the source of the delay of the intra-granular κ-carbide formation bysuppressing C atom’ occupation of the vacancy at the body-centered site of L12. An increase in C content accelerated theformation of intra-granular κ-carbides, which induced the intense age hardening, and coarse inter-granular κ-carbides, whichresulted in significant decrease in impact absorbed energy due to inter-granular fracture.

포도알균 균혈증 환자에서 사망 예측 위험인자

문수연,이미숙,손준성,이희주,이상오 대한감염학회 2008 감염과 화학요법 Vol.40 No.3

Background : Staphylococcus aureus is a common cause of severe infection and frequently results in death or disability. We investigated potential risk factors influencing clinical outcome in S. aureus bacteremia (SAB). Materials and Methods : Our study is based on retrospective chart review for episodes of SAB from 168 patients, identified between January 2003 and December 2005. Twenty patients were excluded: 2 patients with infective endocarditis and 18 patients with metastatic lesions. Demographic, underlying diseases, sources of SAB, antimicrobial therapy, laboratory, and microbiologic characteristics were identified. Outcome was classified as death or survival 12 weeks after onset of SAB. Results : A total of 97 patients had survived and 51 patients died 12 weeks after the onset of SAB. Death group was older (66.4±13.6 vs. 59.4±14.9 years, P=0.007) and had higher Acute Physiology and Chronic Health Evaluation II system score (17.5±6.3 vs. 13.5±5.1, P<0.001) and the acute physiology score (11.1±5.5 vs. 8.0±4.3, P<0.001). Patients with nosocomial SAB (36 (70.6%) vs. 49 (50.5%), P=0.03] and ineradicable primary source of SAB (46 (90.2%) vs. 66 (68.0%), P=0.005] were more vulnerable to death. Multivariate analysis shows that hospital acquisition [adjusted odds ratio (OR)=2.93), ineradicable primary source (adjusted OR=5.74) and high APACHE II score (adjusted 0R=1.22) lead to higher mortality rate from SAB. Conclusion : Our study shows hospital acquisition, ineradicable primary source, and high APACHE II score are the risk factors related to death from SAB. On the other hand, methicillin resistance or initially ineffective antimicrobial therapy is not much correlated with mortality rate from SAB. 목적 : 황색포도알균은 중증 감염의 흔한 원인이며, 사망하거나 합병증이 발생하는 경우가 종종 있다. 본 연구를 통해 황색포도알균 균혈증 환자에서 임상적 결과에 영향을 미칠 수 있는 위험인자를 확인해 보고자 한다. 재료 및 방법 : 본 연구는 2003년 1월부터 2005년 12월까지 3년간 168 명의 환자에서 발생한 황색포도알균 균혈증에 대해 후향적 의무기록 조사를 바탕으로 이루어졌다. 성별, 나이, 기저 질환, 황색포도알균 균혈증의 원발 병소, 항생제 사용력과 미생물학적 특징에 대한 자료를 모았으며, 균혈증 발생 당시 질환의 중증도는 acute physiology score (APS)와 APACHE II 점수(acute physiology and conic health evaluation II system, APACHE II score)를 이용하여 측정하였다. 결과는 균혈증 발생 12 주 후 사망과 생존으로 나누어 분석하였다. 결과 : 황색포도알균 균혈증 발생 12 주 후 97명의 환자가 생존하였으며, 51명이 사망하였다. 사망 환자 군이 나이가 더 많았으며(66.4±13.6 vs. 59.5±14.9세, P=0.007), APACHE II 점수(17.5±6.3 vs. 13.5±5.1, P<0.001)와 APS (11.1±5.5 vs. 8.0±4.3, P<0.001)가 높았다. 병원 내 감염에 의한 황색포도알균 균혈증 환자[36 (70.62%) vs. 49 (50.5%), P=0.030]와 제거 불가능한 원발 병소를 지닌 경우[46 (90.2%) vs. 66 (68.0%), P=0.005] 사망위험성 이 높았다. 다 변량 분석에 의하면 병원 내 감염[adjusted odds ratio (OR)=2.93]과 제거 불가능한 원발 병소(adjusted OR=5.74), 높은 APACHE II 점수(adjusted 0R=1.22)에 의해 황색포도알균에 의한 사망률이 증가하였다 결론 : 본 연구에서 병원 내 감염과 제거 불가능한 원발 병소, 높은 APACHEH 점수가 황색포도알균 균혈증에 의한 사망과 관련된 위험인자이다. 반면, 메티실린 내성과 초기 부적절한 항생제 사용은 황색포도알균 균혈증의 사망률과 연관성이 없었다.

위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예

김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.