Bromocriptine 과 Cyproheptadine 이 Corticotropin-releasing Factor(CRF) 로 자극된 ACTH 분비에 미치는 효과

김진우,최영길,김영설,김광원,김선우,양인명,윤현구,우정택 대한내과학회 1986 대한내과학회지 Vol.31 No.5

Our study was desinged to observe the ACTH response to ovine CRF in healthy men and to observe the effect of bromocriptine or cyproheptine on ACTH and cortisol response induced by ovine CRF in healthy men. We have hypothesis that if hromocriptine or cyproheptatine inhibits the secretion of ACTH induced by ovine CRF, they decrease the secretion of ACTH in the pituitary level. The result were followings: 1) Plasma ACTH reached a peak of 1.5 and 1.6 times the basal level in response to ovine CRF at 10 min, and 30 min, respectively and decreased to the basal level at 90 min. 2) Cyproheptadine or bromocriptine did not inhibit the response of ACTH to ovine CRF. 3) We suggest that cyproheptadine or bromocriptine does not inhibit the ACTH secretion in the normal pituitary gland.

소아의 상완골 원위부 과간 골절

이우석,정환용,김우식,김용찬,전택수,김남현,김규태 대한골절학회 2004 대한골절학회지 Vol.17 No.4

상완골 원위부 과간 골절은 소아에서는 매우 드물게 발생되는 골절로 대부분 주관절의 굴곡상태로 주관절 후방부에 직접적인 충격에 의해 발생하는 것으로 보고되고 있다. 전위가 없거나 경미한 경우 도수적 정복술 혹은 도수적 정복술 후 경피적 핀고정술을 시행하며, 전위가 심한 골절이거나 도수적 정복술이 불가능한 경우 관혈적 정복술 후 핀고정술을 시행하는 것으로 알려져 있다. 저자들은 전위된 상완골 원위부 과간 골절 환아 2예에서 각각 도수적 정복술과 관혈적 정복술 후 K 강선 고정술을 시행하여 만족한 결과를 얻었기에 보고하는 바이다. Intercondylar fractures of the distal humerus are very rare in children. The pattern of the fracture would suggest that the mechanism of injury involves a fall directly on the flexed elbow. Most agree that the undisplaced fracture can be managed conservatively. With increasing displacement and comminution, the opinions tend to differ. We suggest that closed reduction with percutaneous K wire pinning and open reduction with percutaneous K wire pinning offer a satisfactory methods by which to treat displaced intercondylar fracture in children.

주산기 저산소성 허혈성 뇌병증의 최신지견

김우택 동국대학교 의학연구소 1998 東國醫學 Vol.5 No.-

국문초록최근 관심이 고조되고 있는 주산기 저산소성 허혈성 뇌병증에 대한 최신 지견들을 살펴보아서 향후 주산기 가사로 인한 저산소성 허혈성 뇌병증을 조기 발견하고 조기 치료함으로서 영구적인 신경 정신학적 후유증을 막거나 최소화하는 데 도움이 되고자 한다.뇌세포 손상은 산소와 에너지의 결핍 때문에 세포막의 기능이 저하되고, 정상적인 이온 농도를 유지 못하고, 세포 부종이 생기며, 뇌세포의 괴사가 발생하는 일차적 뇌손상과 재관류나 재산소화 후에 산소와 에너지의 공급 때문에 세포막은 정상적으로 기능을 하나, 핵내효소가 활성화되어 DNA를 분해하고, 세포질을 농축시키는 고사가 생기는 이차적 뇌손상으로 나눌 수 있다. 그것은 흥분성 신경전달물질인 글루타민산염이 연접 부위에 과다 유리되어 글루타민산염 수용체를 활성화시켜 세포내로 칼슘이 급격히 유입되어 뇌손상을 입히고, 다른 기전들은 산소 유리기, 산화질소, 사이토카인, 면역반응, 대식세포, 성장인자 등이 관련되어 있다.임상증상은 신경원에 미토콘드리아의 부종으로 인한 세포질내 공포 때문에 선택적 신경원 괴사가 발생되고, 대뇌기저핵과 시상 부위에 비정상 수초 형태인 대리석 모양을 나타내고, 만삭아에서는 방시상 대뇌손상과 미숙아에서는 뇌실 주위의 백질연화증이 잘 생기며, 국소적 괴사에 의한 초점성 및 다초점성 허혈성 뇌 괴사 등이다.저혈당증, 저산소증, 산혈증, 암모니아 혈증등 대사산물을 측정한다. 뇌파검사법, 테크네튬 주사법, 단일 광자 방출 컴퓨터 단층촬영법, 뇌초음파 검사법, 컴퓨터 단층 촬영 주사법, 자기공명 영상법, 뇌간 유발전위법, 자기공명분광검사법, 근적외부 분광검사법, 양전자방출 단층촬영법, 두개내압 감시법 등을 이용하여 보다 조기에 진단하고 조기에 예후를 결정할 수 있다.지금까지 임상적으로 효과가 입증된 치료 약제는 아직 없으며, 보존적 치료로 적절한 관류나 환기를 유지하고, 체온, 혈당과 칼슘치, 그리고 산-염기 평형상태를 정상적으로 유지하며, 경련을 치료해야 하는 것이 중요하다. 그리고 잠재적 치료방법으로 산소유리기 억제제, 흥분성 신경절달 물질의 길항제, 칼슘이온 통로 차단제, 산화 질소 생산 억제제, 성장인자, 글루코콜티코이드, 페노바르비틀 등이 있고, 나트륨 통로 차단제, 아데노신 유사제, GABA 수용체 촉진제, k-opioid 수용체 길항제, 자유 지방산 축적 억제제, 유전자 표현 변화, 신경원조세포 및 간세포 이식 등도 현재 연구중이다.주산기 가사에 의한 저산소성 허혈성 뇌병증은 뇌성마비, 학습장애, 지능장애 및 간질 등과 같은 장기적인 신경학적 후유증을 남길 수 있으며, 산과력 및 분만력, 임상 증상 및 최신 진단 검사법을 사용하여 뇌손상의 심한 정도를 조기에 증명하고 예후를 판단해야한다. 그러기 위해서 뇌손상을 일으키는 기전에 대해 좀 더 명확히 밝히고, 주산기 가사의 위험성 인자를 가진 신생아를 조기에 진단하고, 앞으로 있을 수 있는 신경학적인 후유증을 조기에 예측할 수 있는 진단을 개발하며, 현재 연구중이거나 실험적으로 시도되고 있는 약물들을 하루 빨리 임상적으로 적용하여 영구적인 후유증이 생길 수 있는 주산기 저산소성 허혈성 뇌병증을 조기에 치료하여 뇌손상을 줄여야겠다. AbstractThis review reveals the new knowledge of perinatal hypoxic-ischemic encephalopathy and it is usefulness to inhibit or diminish permanent neuropsychotic sequeles through early diagnosis and early treatment.The following injuries to neonatal cell after hypoxic-ischemic encephalopathy are two-fold; Primary injuries are followed by sequential responses with depletion of oxygen and energy, loss of function in neuronal cell membranes, edema of neuronal cells, and necrosis of neuronal cells. Secondary injury are followed by sequential responses with lysis of DNA due to activation of endonuclease, and apoptosis of neuronal cells. The mechanisms of neuronal cell injuries are due to excitotoxicity of glutamate receptors, oxygen radicals, nitrogen oxides, cytokines, immune responses, macrophages, and growth factors.The main clinical manifestations are selective neuronal necrosis due to the vacoules in the cytoplasm, status marmoratus in basal ganglia and thalamus, parasagittal cerebral injury in full-term neonates, periventricular leukomalsia in preterm neonate, and focal ischemic brain necrosis.The clinical stages of Sarnet and Sarnet and measurements of metabolites after insult are helpful to diagnose. In addition, there are a lot of diagnostic tools such as electroencephalogram, technetium scan, single photon emission computed tomography, head ultrasound, computed tomography scan, magnetic resonance imaging, brain stem evoked potential, magnetic resonance spectroscopy, near-infrared spectroscopy, positron emission tomography, and intracranial pressure monitoring.Although numerous articles have been devoted to the descriptive events that occur in hypoxic ischemic encephalopathy, the mechanisms that control it have remained largely elusive. Therefore, the following conservative treatments have been used; prevention of perinatal asphyxia, maintenance of ventilation and perfusion, maintenance of normal level of glucose and body temperature, and control of convulsion and brain edema. Pharmacologic agents under experimental investigation are oxygen-free radical inhibitors, excitatory amino acid antagonists, calcium channel blockers, inhibitors of nitric oxide production, monosiaglogangliosides, growth factors, glucocorticoids, and phenobarbitals.In conclusion, we have to try to prevent the injuries of neuronal cell through early diagnosis with newly advanced techniques and early treatment with newly developed agents.

생활사건, 사회지지, 대처방식에 대한 전환장애와 신체화장애와의 비교연구

김승기,김현우,권택술 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.5

This study was designed to compare conversion disorder, somatization disorder patients to the matched controls about life events, social support, and coping skills. The number of subjects were 22 with conversion disorder, 21 with somatizaion disorder and 19 normal controls. Stress items. Interpersonal social-support assesement items, and The ways of coping checklist for clinical assesement were administered to all subjects to evaluate each relevant areas. In life events, conversion disorder patients and somatization disorder patients showed significantly hight moderate events than normal controls. In social support and coping skills, patients with conversion disorder or somazation disorder were significantly lower than controls. Conversion disorder showed to have less active coping but more passive coping than those with somatization disorder. Conversion disorder patients reported more life events than somatization disorder patients along with lacking in social support and coping skills. Somazation disorder patients showed much higher superior support-seeking score than conversion disorder patients. These differences may be considered to play some role in showing different clinical manifestations in the somazation disorder and conversion disorder.

지주막하 출혈을 동반한 용혈성 요독 증후군 1례

김웅흠,김우택,이창연,김동욱,박성기,장무환 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Hemolytic uremic syndrome is characterized by Coombs-negative microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure in infant and children. At present, E. coli 0157 : H7 and other verotoxin-producing E. coli(VTEC) seem to be a major cause of this illness. The majority of patients have a prodrome of bloody diarrhea, and acute renal failure develops several days to weeks later. Although an optimal treatment remains unknown, the general management of hypertention and renal failure with early and frequent dialysis is the mainatay of treatment, and intravenous administration of immunoglobulin G is like to be effective. We experienced a case composed of bloody diarrhea, seizures, coma, and anuria in 1 year old girl who was diagnosed as HUS and recovered renal function completely with slight impairment of cognitive ability and behavioral function. We presented this case with a review of literatures.

소장내 위석에 의한 장폐쇄증으로 발생한 급성신부전 1례

김승민,남지형,김준섭,이용국,최재혁,강혁주,탁우택,이정호,정호근 東國大學校醫學硏究所 2007 東國醫學 Vol.14 No.1

Gastric bezoars are concretions or hard masses of foreign matter found in the gastrointestinal tract. It may induce many complications including intestinal obstruction. No report has been proposed on a case of prerenal ARF induced by intestinal obstruction by small-bowel bezoar. Therefore, we report a case of the patient with ARF associated with small-bowel bezoar, who initially visited with the symptoms of nausea and frequent vomiting. 위석(bezoar)은 여러 가지 이물 및 내재성물질이 위장관내에서 혼합되어 응고물을 형성한 것을 말하며, 가장 흔한 형태의 합병증으로 장폐쇄증이 올 수 있으나, 그로 인하여 신부전의 양상으로 나타나는 경우는 흔하지 않다. 이에 저자들은 내원 당시의 병력 및 이학적 검사만으로 장폐색의 원인이 위석임을 의심할 수 없었던 비전형적인 소견을 보인 소장내의 위석에 의한 장폐쇄증과 이로 인해 발생한 급성신부전의 예를 경험하였기에 이에 보고하는 바이다.

에드워즈 증후군 2례

김우택,김웅흠 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

We have seen two cases of Edwards syndrome, one is the female neonate who was born to a 22-year-old mother and a 30-year-old father at Dong-guk university Kyung-ju hospital and the other is the male neonate who was born beteeen a 38-year-old mother and a 40-year-old father at Dong-guk university Kyung-ju hospital and had a healthy 7-year-old sister. They had the multiple anomalies that were charaterized by intrauterine growth retardation, microcephalic skull with flat occiput, microphthalmia, low-set and malformed ears, micrognathia, shield chest & webbed neck, flexion deformity of fingers, simian crease, narrow pelvis, and rocker-bottom feet with short and big toes. Chromosomal analysis revealed 47,XX,+18 and 47,XX, + 18 respectively in these cases. A brief review of relevant literatures is made briefly.

조도 센서를 이용한 단일 광원 대응 실내 위치 추정 기술

김택성, 황영수, 우상희 忠北大學校 農業科學硏究所 2017 農業科學硏究 Vol.33 No.1

In this paper, we tried to acquire the spatial information of unmanned mobile objects from the changes of measured values of illuminance sensor attached to unmanned moving objects in the indoor environment restricted by place and time. Therefore, the correlation of illuminance sensor according to single light source according to the position of unmanned mobile object is deduced. From this correlation, indoor positioning technique of unmanned mobile object is developed. As a result, the correlation between the illuminance sensor and the illumination position increased as the illuminance became closer to the light source. The correlation between data of illumination sensor and location of unmanned vehicles was increased as the distance from the light source was increased. There was less relationship between direction of sensor and distance from the light. The relationship between the distance from the light source and the data of illumination sensor was shown as a sixth polynomial equation. The illumination sensor under single light source might be used for indoor location information of unmanned vehicles. The additional experiment of finding position need to be verified to the in multiple source using illumination sensor.

巨峰葡萄에 對한 4CPA 와 GA_3處理가 果房의 着粒 無核化 및 品質에 미치는 影響

金圭來,邊宇澤 慶北大學校 1983 論文集 Vol.36 No.-

This study was experimented on the effects of time and concentration of the first and second applieation of 4CPA and GA3 on the berry set, seedlessness and quality of cluster in Kyoho grape. The results were as follows; In ratio of normal berry, seedlessness, weight of cluster, ratio of berry cracking and berry abscission after harvest in 25 treatments of the first and second different treatment stages with 4CPA (15ppm) and GA3(25ppm) alone and in combination, two treatments of mixed plot with 4CPA and GA3 in combination at fullbloom and 5 days before fullbloom at first and with GA3(25ppm) alone at 10 and 20 days after fullbloom at second were the most effective. and two treatments of GA3 plot applied with GA3(50ppm) alone 5 days before fullbloom at first and with GA3(25.50ppm) alone 10 days after fullbloom at second were effective in decreasing order. And then two treatments of 4CPA plot with 4CPA(15ppm) alone at fullbloom at first and with GA(25ppm) alone at 10 and 20 days after were also effective. In ratio of normal berry and quality in 29 treatments of different concentrations with 4CPA and GA3 alone and in combination, the plot treated with GA3 100ppm at fullbloom was the most effective, mixed (first; 4CPA(25ppm)+GA3(15ppm), second; Ga3(25ppm) and GA3 plot (first; GA3(25ppm), second; GA3(50ppm) and first; GA3(15ppm) second; fullbloom at second GA3(25ppm)) were shown as decreasing order. From above results, in high ratio of normal berry, increased weight of cluster and berry, seedless ratio, of berry cracking and mechanical berry absission after harvest, the plot treated with GA3 100ppm at fullbloom was the effective, and then the plot treated with 4CPA(15ppm) and GA3(25ppm), 4CPA(25ppm) and GA3(15ppm) in combination at fullboom or 5 days before fullbloom at first, and with GA3(25ppm) alone at 10 or 20 days after fullbloom at second were effective on seedless ratio, weight of cluster and normal too, but it is believed that this study must be continued because of shot berry formation and high mechanical berry abscission by berry cracking after harvest.

韓國 醫療 서어비스 QC 活性化 方案 : K病院 事例를 中心으로

金俊鎬,鄭禹澤 청주대학교 산업경영연구소 1988 産業經營硏究 Vol.10 No.1