한방적 치료 접근을 통한 Evans 증후군 치험 1례

박상은,최인선,장자원,홍상훈,서상호,Park, Sang-Eun,Choi, In-Sun,Jang, Ja-Won,Hong, Sang-Hoon,Seo, Sang-Ho 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.3

Evans syndrome, as originally described, refers to autoimmune hemolytic anemia accompanied by thrombocytopenia. The autoantibodies in Evans syndrome are directed specifically against red cells, platelets, or neutrophils and are not crossreacting. The incidence of autoimmune hemolytic anemia is estimated to be approximately 10 cases per million people. Many patients have associated disorders, such as lupus erythematosus and other autoimmune disease, chronic lymphadenopathy, or hypogammaglobulinemia. In Oriental Medicine, the approach to Evans syndrome is made in view of deficiency of blood. The ailment was treated through methods of Oriental Medicine. Acupucture and herbal medicine were administered to patients diagnosed with Evans Syndrome by ecchymosis at the lower limb after continued gingival bleeding. As a result significant improvement in RBC, Hb, Hct, and PLT were observed and complaints abated.

양과자 3가지

박상은,Park, Sang-Eun 대한제과협회 1998 베이커리 Vol.11 No.-

복합성 외측 반월상 연골판 파열에서 슬와건을 한시적 지주로 시행한 구제적 성격의 관절경 봉합술의 임상 결과

박상은,김상길,Park, Sang-Eun,Kim, Sang-Kil 대한관절경학회 2010 대한관절경학회지 Vol.14 No.1

This study was undertaken to document the clinical results and technical aspects of arthroscopic repair including popliteus tendon as a post for the treatment of complex lateral meniscus in young people indicated as total meniscectomy. From June 2004 to May 2006, we prospectively studied arthroscopic repairs on 32 young people knees with symptomatic complex lateral meniscus that was treated by all inside repair technique using Popliteus tendon as a post. Clinical results were evaluated using Lysholm knee scores preoperatively and at final follow-up. 2nd look arthroscopy or MRI was taken at final follow-up. 80% of patients carried out MRI or 2nd look arthroscopy under permission. Most patients who follow up were able to return to their previous life activities with little or no limitation, and no reoperation was required after an average follow-up of 42.8 months. Mean Lysholm knee scores improved from 65.4 (range, 55 to 75) preoperatively to 93.9 (range, 79 to 100) at the final follow-up (P<.001). 80% meniscus healing was found on arthroscopic or MRI follow up. Conclusively, arthroscopic repair using Popliteus tendon as a post is effective for treating young people with complex lateral meniscus tear as a salvage procedure. 이 연구는 반월상 연골판 절제술의 적응증이 되는 복합성 외측 반월상 연골판 파열에서 슬와건을 바탕으로 시행한 구제적 성격의 관절경 봉합술의 임상 결과와 기술적인 방면에 대한 고찰을 위해 시행하였다. 2004년 6월부터 2006년 5월까지 32 사례의 젊고 증상이 있는 복합성 외측 반월상 연골판 파열 환자들을 all inside 방법으로 봉합하였다. 연구는 전향적으로 시행되었으며, 평균 연령은 29.2세(범위, 17~42)이었으며 평균 관찰기간은 42.8개월(범위, 24~50)이었다. 임상 결과는 라이슬럼 스코어(lysholm knee score)와 2차적으로 시행한 관절경 혹은 자기공명영상을 이용하여 평가되었다. 추적관찰은 약 80%에서 시행할 수 있었다. 추적 관찰된 환자들 대부분이 제한 없이 일상생활을 할 수 있었으며 평균 42.8개월의 추적관찰 동안에 재수술을 시행한 경우는 없었다. 평균 라이슬럼 스코어는 수술 전 65.4(범위는 55에서 75)에서 수술후 최종 추적관찰에서 평균 93.9(79에서 100사이)으로 증가되었다(p<.001). 80%에서 관절경으로 혹은 자기공명영상에서 병변의 치유가 확인되었다. 결론적으로 슬와건을 바탕으로 시행한 관절경적 외측 반월상 연골판 봉합술은 복합성 외측 반월상 연골판 파열을 가지고 있는 젊은 환자에서 구제적 성격의 시술로서는 효과적이었다.

돼지 방광 평활근에 있어서 P_2X-purinoceptor의 작용

박상은,홍용근,심철수,전석철,김주헌,Park, Sang-eun,Hong, Yong-geun,Shim, Cheol-soo,Jeon, Seok-cheol,Kim, Joo-heon 대한수의학회 1997 大韓獸醫學會誌 Vol.37 No.1

The experiments were carried out to elucidate the relationships between neurogenic effects of electrical transmural nerve stimulation and effect of adenosine 5'-triphosphate(ATP) to purinoceptor on the urinary bladder smooth muscle of pig. The results were as follows : 1. The contractile responses induced by electrical transmural nerve stimulation(10V or 20V, 0.5msec, 10sec) were the frequency(2~64Hz) dependent manner. 2. The contractile response induced by carbachol was responsed with a dose-dependent manner and the maximum contractility was $10^{-4}M$. 3. The contractile responses induced by ATP were increased in a dose-dependent manner ($10^{-5}{\sim}10^{-3}M$). 4. The contractile response induced by electrical transmural nerve stimulation(10V, 2~32Hz, 0.5msec, 10sec) was partially blocked by the treatment with atropine($10^{-5}M$), and was powerfully inhibited by 3 times of addition with ATP($10^{-5}M$). 5. The contractile response induced by electrical transmural nerve stimulation(10V, 2~32Hz, 0.5msec, 10sec) was partially blocked by the treatment with atropine($10^{-5}M$), and was completely blocked by the desensitization of the $P_{2X}$-purinoceptor using ${\alpha}$, ${\beta}$-methylene ATP($5{\times}10^{-5}M$). These results suggest that purinergic nerve was innervated, and ATP and acetylcholine was released by the electrical transmural nerve stimulation in urinary bladder smooth muscle of pig.

하지 관절경 수술에 대하여 시행된 항응고 요법에 의한 혈액 응고 검사의 변화 : Enoxaparin versus Rivaroxaban

박상은,백영웅,김종대,Park, Sang Eun,Back, Young Woong,Kim, Jong Dai 대한관절경학회 2012 대한관절경학회지 Vol.16 No.2

Purpose: To compare coagulation test results of the arthroscopic surgery patients who received thromboprophylaxis with typical two kinds of anticoagulation drugs, we performed coagulation tests before and after surgery with two groups and then compared the results. Materials and Methods: Forty-seven patients who underwent arthroscopic surgery were randomly divided into two groups to rivaroxaban and enoxaparin group, and we performed coagulation tests before and 5 days after arthroscopic surgery to two drugs groups in order to investigate about the difference in clotting capacity. Results: Preoperative coagulation tests did not differ significantly between the two groups. However, coagulation tests after 5 days of the surgery, the level of prothrombin time-international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT) increased, particularly in patients with rivaroxaban compared with enoxaparin (P<0.05). Conclusion: Anticoagulation for arthroscopic surgery with a drug is effective and has safe range in terms of bleeding tendency, but in the rivaroxaban group, there was one patient who showed high bleeding tendency with abnormal range. Therefore it should be careful of using rivaroxaban for thromboprophylaxis. 목적: 관절경 수술을 시행 받은 환자의 항응고 요법이 응고능에 미치는 영향과 대표적 항응고 약물 사이에 차이가 있는지 알아보기 위하여 항응고 약물 중 두 종류를 선택하여 사용한 환자들의 혈액 응고 검사를 수술 전후에 시행하여 수술 전 후 및 두 약물 간에 차이가 나타나는지에 대해 알아보았다. 대상 및 방법: 관절경 수술을 시행한 47예의 슬관절 혹은 고관절 환자를 대상으로 하였으며 환자군을 무작위로 enoxaparin과 rivaroxaban을 사용한 두 그룹으로 나누어 수술 전 및 수술 후 5일째 응고 검사를 시행하여 수술 전후 및 두 약물간의 결과를 비교하였다. 결과: 수술 전 시행한 응고 검사에서는 두 그룹간의 유의한 차이가 없었으나(P>0.05) 수술 후 5일째 시행한 응고 검사에서는 prothrombin time-international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT)에서 증가 소견을 보였고 특히 rivaroxaban 환자군의 수치가 증가한 것으로 나타났다(P<0.05). 결론: 관절경 수술의 약물을 통한 항응고 요법은 혈액 검사를 통한 결과에서 출혈 경향 면에서 안전한 범위에서 수술전과 비교하여 통계적으로 유의한 차이를 보였으나 rivaroxaban을 사용한 환자 군에서 응고능의 정상 범위를 넘어서는 환자가 있어 rivaroxaban의 사용에 주의를 요할 것으로 생각된다.

초대칼럼-자원외교와 흑묘백묘(黑猫白猫)-피상적 접근 경계하고 현장경험과 정부정책 결합해 실질적인 성과 모색해야

박상은,Park, Sang-Eun 대한석유협회 2008 석유와 에너지 Vol.267 No.-

국내 M&A의 활성화를 위한 방안

박상은,Park, Sang-Eun 벤처기업협회 2003 벤처다이제스트 Vol.27 No.-

기술거래와 M&A-국내 M&A의 활성화를 위한 방안

박상은,Park, Sang-Eun 벤처기업협회 2003 벤처다이제스트 Vol.26 No.-

국내 M&A의 활성화를 위한 방안

박상은,Park, Sang-Eun 벤처기업협회 2003 벤처다이제스트 Vol.28 No.-

뇌졸중환자의 정구성정색소성 빈혈에 대한 사육탕가미방의 임상적 효과

박상은,홍수현,장자원,송수진,홍상훈,서상호,Park, Sang-Eun,Hong, Su-Hyun,Jang, Ja-Won,Song, Su-Jin,Hong, Sang-Hoon,Seo, Sang-Ho 대한한방내과학회 2005 大韓韓方內科學會誌 Vol.26 No.4

Objective : Normocytic Normochromic Anemia is one of the most common cases in clinics of all types of morphological Anemia. This study is aimed at examining significant curative effects of Sayuktanggami-bang on Cerebral vascular accident(CVA) patients with Normocytic Normochromic Anemia. Methods : For this study to examine the effects of Sayuktanggami(四六湯加味方), Patients were divided into 2 groups. Group A(experimental group) consisted of 19 cases prescribed Sayuktanggami-bang, Group B (control group) consisted of 15 cases prescribed other herbs. Before presciption, They were tested for CBC, AST, ALT, Total protein, Cholesterol, TG, HDL, BUN, Creatinine, Uric acid, Na, K, Cl while fasting, then were given the herbs over two weeks. They were checked again for changes over those two weeks. Results : In cases of group A, the statistical significance of CBC changes before and after treatment were recognizable : RBC(p<0.01), Hb(p<0.01), Hct(p<0.01). In comparing CBC changes between group A and group B which developed cerebral infarction group, a type of CVA, the significance of curative effects in group A is recognizable over group B before and after treatment : RBC(p<0.01), Hb(p<0.01), Hct(p<0.05). Cytotoxic reaction was nonexistant. Conclusion : Results of this study suggest that Sayuktanggami-bang has curative effects for CVA patients with normocytic normochromic anemia.