건강성인에서 성별 및 연령별 혈청지질의 정상치 - 특히 이상지혈증의 빈도를 중심으로 -

권삼(Sam Gweon),구성모(Seong Mo Koo),조봉기(Bong Kee Cho),정기제(Gih Jeh Jeong),이중기(Choong Ki Lee),정의룡(Eui Ryong Cheong),류재근(Jae Kean Ryu),이봉렬(Bong Ryeol Lee),채성철(Shung Chull Chae),전재은(Jae Eun Jun),박의현(Wee Hyun 대한내과학회 1996 대한내과학회지 Vol.50 No.2

N/A mg/dl) in men and women was 36.8 and 44.0%, respectively and that of high LDL-cholesterol(≥160 mg/dl) was 26.6% in men and 35.2% in women. Their frequencies were increased with age in both sexes. 4) There were no significant, differences in the mean values of total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol and atherogenic index by residency. The frequency of high total cholesterol(≥200mg/dl) in Taegu and its rural area was 40.7% and 35.5%, respectively. Conclusion: These findings suggest that the mean concentrations of total cholesterol, triglyceride and LDL-cholesterol in men and women vary with age. The frequency of hypercholesterolemia (≥200 mg/dl) in men and women was about 40%, and increased with age. Values of HDL-cholesterol were not affected by age and sex

고립성폐결절의 임상적 관찰

권삼 ( Sam Gweon ),조용근 ( Yong Geun Cho ),이원식 ( Won Sik Lee ),정태훈 ( Tae Hoon Jung ),허주희 ( Joo Hee Huh ),이중기 ( Choong Ki Lee ) 대한결핵 및 호흡기학회 1989 Tuberculosis and Respiratory Diseases Vol.36 No.1

기관지천식에서 Salbutamol 흡입이 환기기능 및 동맥혈의 산소분압에 미치는 영향

유덕종(Deok Jong Yoo),최정윤(Jung Yoon Choe),권삼(Sam Gweon),이원식(Won Sik Lee),정태훈(Tae Hoon Jung),박희명(Hi Myung Park) 대한내과학회 1987 대한내과학회지 Vol.33 No.4

N/A Effects of salbutamol inhalation were studied in 26 cases of bronchial asthma with particular reference to its main site of action in airways and influence on arterial oxygen tension (PaO2). In l7 cases out of 26, analy of forced expiratory volume and maximal expiratory flow volume curves were made before and 15 minutes after the drug administration, and in 9 of them, physiological dead space (VD/VT) and alveolar-arterial oxygen tension gradient (P(A-a)O2) were also determined 30 minutes after the medication. In the remaining 9 cases, serial determinations of PaO2 were made for 120 minutes following the drug inhalation. Salbutamol inhalation induced a significant improvement in almost all flow parameters and reduction in airway resistance. The alterations of PaO2 a whole, were inversely related to those of P(A-a)O2 whereas the changes in arterial carbon dioxide tension and VD/VT were variable. These facts suggest that in patients with bronchial asthma salbutamol inhalation improves large and small airways function and the changes in PaO2 is mainly results form the alteration of ventilation/perfusion ratio.

장티푸스로 인한 비장농양 1례

박동일,권삼,강승완 東國大學校醫學硏究所 1994 東國醫學 Vol.2 No.-

비장에 생기는 농양은 매우 드문 질환으로서 복강내 발생하는 농양중 적절한 치료를 하지 않았을 경우 치명적일 수 있다. 장티푸스 감염은 골, 폐, 갑상선, 간, 비장, 신장, 심장, 내장, 피부 등 여러장기에 침범하여 합병증을 유발할 수 있는데 장티푸스에 의한 비장농양은 매우 드문 것으로 알려져 있다. 18세 남자환자가 10일간의 고열과 좌상복부 동통을 주소로 내원하여 이학적검사상 중등도의 비장종대와 둥근종괴가 촉지되었다. 혈액배양에서 살모넬라 균이 검출되었으며 복부초음파 및 컴퓨터단층촬영상 비교적 경계가 명확한 저밀도의 낭종이 관찰되었다. 페프라신 항생제 및 CT 유도하에 경피적 천자 흡인 및 배농술로 지방절제없이 성공적으로 치료하였다. Splenic abscess is an uncommon, but frequently fatal condition among the intraperitoneal abscesses. Salmonella infection can lead to various organ involvement, including bone, lung, thyroid, liver, spleen, kidney, heart, pericardium, intestine and skin, and cause a variety of complications. But splenic abscess caused by Salmonella typhi is rare. An 18-year-old student was admitted due to high fever and left upper abdominal pain of 10 days duration and with moderate splenomegaly on physical examination. The blood culture was positive for Salmonella typhi. Abdominal ultrasonography and CT scan showed a well defined large splenic and a small liver abscess. We treated him with antibiotics(Peloxacin) and CT-guided percutaneous aspiration and drainage successfully. Although splenectomy remains the traditional treatment for bacterial splenic abscess, CT-guided percutaneous drainage may be appropriate in carefully selected patients. We report a case of splenic abscess by Salminella typhi with a review of the literature.

DDS에 의한 methemoglobinemia 2례

최성민,권삼,김우택,백영수,강승완,신현종,권경배,김두권 東國大學校醫學硏究所 1994 東國醫學 Vol.2 No.-

메트헤모글로빈혈증은 순환혈액의 적혈구내에 메트헤모글로빈이 과량 존재하여 전신적 청색증이 생기는 것을 말하여, 임상적으로 심폐질환이 없이 산소투여로 호전되지 않는 청색증이 특징이다. 이 메트헤모글로빈은 헤모글로빈의 산화 유도체로서 제 2철 상태로 산화된 형태이고, 호흡 작용에 가치가 없는 비기능적 헤모글로빈이다. 이로 인하여 혈액이 초코레이트 색조를 띠게 된다. 정상적인 사람에서도 적혈구내에 메트헤로글로빈이 존재하나 메트헤모글로빈 HbM이 혈중내에 존재하거나 적혈구내에 메트헤모글로빈을 환원시키는 효소의 결핍시 생길 수 있으나 비교적 희귀하며, 후천성으로는 대개 약물 및 감염에 의해 발생되며, 그중 우리나라에서는 나병치료에 효과가 있다고 알려진 DDS를 오용함으로서 적지 않게 발생하고 있다. 저자들은 취급 부주의로 DDS를 오용해서 생긴 메트헤모글로빈혈증 2례를 본원에서 경험하였기에 문헌고찰과 함께 보고하는 바이다. 증례 1의 경우는 16개월된 남아로 평소 심폐질환 없이 건강했으며, 방에서 놀다가 집에 비치된 DDS를 먹고 자다가, 복용 3시간 후부터 보채기를 시작하였고 입술과 양손에 청색증이 발견되어 본원 응급실을 통해 입원하였다. 환아에서 채취한 말초 혈액은 초크레이트 색조를 띄었고 메트헤모글로빈치는 전 핼색소의 30.0%였다. 제 2병일째 0.45㎛의 Nalgene syringe filter(Nalge Co.)로 자체 무균 조작 제조한 1% 메틸렌 불루 1.5ml를 2번 정맥 주사한 결과 메트헤모글로빈치가 10.6%로 감소되고 제 4병일째부터 청색증이 없어지고 메트헤모글로빈치가 1%로 감소되었다. 증례 2의 경우도 20개월된 남아로 평소 심폐질환 없이 건강했으며, 방에서 DDS가 들어 있는 약병을 가지고 노는 상태로 발견되었는데, 그 당시에는 특별한 이상은 발견되지 않았지만, 그 다음날 입술과 손발바닥에 경미한 청색증이 나타났고, 잘 놀지 않고 보채며, 이틀 후에도 청색증이 계속 지속되고 잘 먹지 못해 본원 외래를 통해 입원하였다. 환아에서 채취한 말초 혈액은 초코레이트 색조를 띄었고 메트헤모글로빈치는 전 혈색소의 20.8%이었다. 제 2병일째 메트헤모글로빈치는 20.2%였으며 청색증은 조금 감소되어 보여서 비타민 C만 300mg을 투여하기 시작했다. 메트헤모글로빈치는 제 3병일째 9.5%, 제 5병일째 4.1%로 감소되었으며 청색증은 더 이상 나타나지 않았다. Methemoglobinemia is characterized by generalized cyanosis without cardiac and pulmonart diseases. Methemoglobin is yielded by oxidation of hemoglobin iron to the ferric state, is nonfunctional and imparts a chocolate hue to the blood. The blood of normal healthy persons contains methemoglobin, but the intraerythrocytic methemoglobin-reducing system maintains its concentration at less than 2% of the total hemoglobin. Methemoglobinemia is caused by the inherited disorders of methemoglobin metabolism and the accidental ingestion of oxidizing agents and infection. We experienced two cases of methemoglobinemia due to accidental ingestion of DDS who were admitted to the department of pediatrics at DongGuk University Hospital. Case 1 concerns a 16 month-old boy who had cyanosis around the lips and hands without cardiac and pulmonary diseases. He took some pills containing DDS and was admitted 3 hours after taking them due to irritability and cyanosis. At admission, his level of methemoglonbin was 30.0% of the total hemoglobim, after two injections of methylene blue which was purified by 0.45m of Nalgene syringe filter(Nalge Co.), its level was decreased to 10.6% of the total hemoglobin, and then it reached a normal level the 4th day after admission. Case 2 concerns a 20 month-old who also had cyanosis around the lips without cardiac and pulmonary diseases. He also took some pills containing DDS from first aid kit used to treat dermatitis and was admitted about 2 days after taking them due to poor oral intake, irritability and cyanosis. At admission, his level of methemoglobin was 20.2% of the total hemoglobin. After the treatment with ascorbic acid its level was decreased to 9.5% of the total hemoglobin, and then it reached 4.1% of the total hemoglobin the 5th day after admission. So, we report it with a brief review of relevant literature.

중증 위장관형 탄저병 3 예

이창우,이영현,김정란,전창호,김성자,정병욱,양창헌,하경임,윤형진,권삼,김종목,김탁관,이승석,강승완 대한내과학회 1995 대한내과학회지 Vol.49 No.4

Anthrax, a zoonotic disease of herbivorous animals transmissible from animals to man, occurs primarily in three forms: cutaneous, inhalation (or pulmonary), and gastro-intestinal. It is caused by Bacillus anthracis, a gram-positive, aerobic, spore-forming bacillus, The complications of anthrax shuch as meningitis and septicemia usually occur secondary to one of the primary form. Among three forms, gastrointestinal anthrax caused by the ingestion of Racillus anthracis-contaminated food is rare and is associated with high mortality. There are two clinical presentations of gastrointestinal antrax: abdominal (or intestinal) and oropharyngeal. We present three patients who have a rare clinical form of severe gastrointestinal anthrax caused by ingestion of meat or products of cattle which died from anthrax, Case one had fever, nausea, vomiting, abdominal pain and massive ascites recovered completely with surgery and antibiotic therapy. The other two patients died of possible complications due to gastrointestinal anthrax (sepsis in the second case and hemorrhagic meningitis in the third case)within several hours in the hospital. Bacillus anthracis was isolated from the blood culture of all three patients.