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윤종욱,황정혜,함형석,이한철,노길환,강수정,서지영,김호중,정만표,권오정,이종헌,손희정,Yun, Jong-Wook,Hwang, Jung-Hye,Ham, Hyoung-Suk,Lee, Han-Chul,Roh, Gil-Hwan,Kang, Soo-Jung,Suh, Gee-Young,Kim, Ho-Joong,Chung, Man-Pyo,Kwon, O-Jung,Rhee, 대한결핵및호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.49 No.6
저자들은 항결핵제중 rifampicin 사용 후 발생한 위막성 대장염 1예를 경험 하였기에 보고하는 바이며 전신상태가 좋지 않거나 간질환이 있는 고령의 환자에서 항결핵제 사용 중 심한 설사가 있을 때 이의 가능성을 생각해야 되며 필요한 경우 조기에 진단적 검사를 시행해야 한다고 생각된다. Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous inflammation, which was compatible with tuberculosis, Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin inpatients with severe diarrhea receiving anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.
호흡기 검체에서 분리된 비결핵성 마이코박테리아의 임상적 의의
고원중 ( Won Jung Koh ),권오정 ( O Jung Kwon ),함형석 ( Hyoung Suk Ham ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),김호중 ( Ho Joong Kim ),한대희 ( Dae Hee Han ),김태성 ( Tae Sung Kim ),이경수 ( Kyung Soo Lee ),이남용 ( Na 대한내과학회 2003 대한내과학회지 Vol.65 No.1
목적 : 호흡기 검체에서 비결핵성 마이코박테리아 nontuberculous mycobacteria (NTM)가 분리되었을 때, 오염균 또는 집락균과 NTM 폐질환의 원인균과의 감별을 위해서는 정확한 균 동정과 함께 적절한 임상적, 방사선학적, 미생물학적 기준에 따른 진단이 필요하다, 본 연구는 호흡기 검체에서 분리된 NTM의 균종 분포와 임상적 의의를 알아보고자 하였다. 방법 : 2001년 10월 1일부터 2002년 3월 31일까지 6개월간 진단검사의학 Background : We studied the clinical significance of nontuberculous mycobacteria (NTM) recovered from respiratory specimens for six months in a tertiary referral center. Methods : We identified all NTM isolates from sputum or bronchial washing from Octobe
발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test의 유용성과 의미 분석
임성용 ( Seong Yong Lim ),서지영 ( Gee Young Suh ),경선영 ( Sun Yong Kyung ),안창혁 ( Chang Hyeok An ),박정웅 ( Jung Woong Park ),이상표 ( Sang Pyo Lee ),정성환 ( Sung Hwan Jeong ),함형석 ( Hyoung Suk Ham ),안영미 ( Young Mee A 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.1
연구배경: 발관 실패와 관련된 위험 인자를 살펴보고, 기관내 삽관의 합병증으로 인한 후두부 폐쇄와 PES로 인한 재삽관의 위험성을 발관 전에 미리 예측하기 위한 CLT 검사의 의의 및 제한점을 알아보고자 하였다. 방법: 24시간 이상 삽관과 인공 호흡기 치료 후 발관을 시도한 34명의 연속적인 환자들을 대상으로 발관 실패군에서 성공군과 차이를 보이는 인자를 살펴보고 CLT를 시행해서 PES와 재삽관을 예측하는 CLV, CLP의 기준값을 구하였다. 결과: 총 34명중 발관 실패는 6명(17.6%), PES는 3명(8.8%) 이었고 PES가 있던 3명은 모두 재삽관을 받았다. 발관 실패 환자에서 삽관 기간이 길었고, SAPS II score가 컸으며, 삽관 기간은 CLV, CLP와 역상관관계를 보였다. PES 양성 환자의 평균 CLV은 22.5±23.8㎖로 음성 환자의 233.3±147.1㎖보다 낮았고, CLP도 양성군에서 6.2±7.3%로 음성군의 44.3±24.7%보다 유의하게 낮았다. 가장 신뢰성 있는 CLV, CLP의 기준값은 50㎖, 14.7%였고 CLV의 민감도는 100%, 특이도 93.5%, 양성예측도 60%, 음성예측도 100%였고, CLP의 민감도는 100%, 특이도 87.1%, 양성예측도 42.9%, 음성예측도 100%였다. 결론: 삽관 기간이 길고 중증 질환 환자에서 발관 실패의 가능성이 높다. CLV, CLP가 감소되어 있을 경우 PES로 인한 재삽관 위험이 높아지므로 발관 시 주의가 필요하지만 발관의 불필요한 연기나 시도 자체에 대한 기준은 아닐 것으로 생각된다. Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV (22.5±23.8 vs 233.3±147.1㎖, p=0.020) or CLP (6.2±7.3 vs 44.3±24.7%, p=0.013). The best cut off values for the CLV and CLP were 50㎖ and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50㎖ or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation. (Tuberc Respir Dis 2006; 61: 34-40)
원저 : 기계환기중인 환자에서 기관지내시경 검사에 따른 생리적 변화
편유장 ( Yu Jang Pyun ),서지영 ( Gee Young Suh ),고원중 ( Won Jung Koh ),유창민 ( Chang Min Yu ),전경만 ( Kyeong Man Jeon ),전익수 ( Ik Soo Jeon ),함형석 ( Hyoung Suk Ham ),강은해 ( Eun Hae Kang ),정만표 ( Man Pyo Chung ),김호중 ( 대한결핵 및 호흡기학회 2004 Tuberculosis and Respiratory Diseases Vol.56 No.5
함형석,문상만,우종명 충남대학교 산업기술연구소 2005 산업기술연구논문집 Vol.20 No.1
This paper presents the Beam steering antenna on aircraft. An proposed and advanced printed type monopole antenna which overcomes drawbacks of conventional monopole antennas. On the front part, it has parasitic elements as a reflector to increase directivity gain in one direction. The Beam Steering antenna proposed in this paper has pin diode attached between two parasitic elements and ground, enabling control of beam directivity by the diode switch. The proposed antenna on aircraft shows the characteristics of the back directivity antenna with the gain of 1.5dBd and F.B. ratio 8.8dB, which leads us to conclude that the antenna has advantages in improving the gain and F.B. ratio.
인간 정관 평활근의 포타슘 이온통로 활성조절에 미치는 프로제스톤의 효과
임인자,함형석 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.2
Large conductance Ca^2+-activated K^+(maxi-K) channels were studied using inside-out patches of smooth muscle cells from human Vas deferens. Single smooth muscle cells were obtained through preteolytic enzyme digestion and the patch clamp technique was used. The maxi-K channle showed a single channel conductance of about 150 pS in physiological concentration of K^+ on both sides of patch. The channel activity was dependent on intracellular Ca^2+ concentration change. Progesterone hardly affected the channel activity. As the application time incresed the channel activity was small increased a little but the effects were not statistically significant. Macroscopic recording results were almost the same as single channel recording results. From these results, it is suggested that maxi-K channel activities of human Vas deferens cells were independent of progesterone action.