횡문근융해증과 급성 신부전 및 범발성 혈관내 응고장애를 동반한 열사병 1예

최대은,박수진,권오경,이한규,이영모,이상주,나기량,이강욱,신영태 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40% and central nervous system dysfunctions that results in delirium, convulsions, or coma. Heat stroke is subdivided into two forms, classic and exertional. Since strenuous exercise is one of the major exacerbating and precipitating factors, the incidence of exertional heat stroke is high among young adult, especially military personnel undergoing military training. Exertional heat stroke commonly causes rhabdomyolysis, lactic acidosis, acute renal failure, shock and pulmonary edema. We report a case of heat stroke with rhabdomyolysis, acute renal failure, disseminated intravascular coagulopathy(DIC) after strenuous exercise. A 18 year old man was admitted to the hospital because of loss of consciousness. He was a wrestler and he had tried to lose 6kg in weight by jogging and strenuous exercise on that summer day with hot temperature. The development of this illness was favoured by much clothes inappropriate for that environmental condition with a purpose to enhance sweating, and by restricted intake of water and food. On admission, the blood pressure was 80/50mmHg, and body temperature was 39.4℃ with stuporous mentality. Laboratory finding were as follows : in complete blood cell count, hemoglobin was 16.7g/dL and platelet count was 158,000/ mm³. In blood chemistry, AST 1061U/L, ALT 201U/L, BUN 30mg/dL, Cr 2.2mg/dL, LDH 941IU/L, CK 696IU/L were resulted. In arterial blood gas analysis, pH 7.39, pCO₂ 30mmHg pO₂ 86mmHg, HCO₃ 18.4mEq/L, O₂ saturation 96.7% were resulted. In urinalysis, specific gravity 1.025, protein 3+, erythrocyte 2+ were resulted. In brain imaging study, brain CT finding was normal. After appropriate treatments with rapid cooling, hydration and supportive care, he improved with alert mental status. On 2nd hospital day, in laboratory result, thrombocytopenia and coagulopathy were appeared and renal insufficiency was aggravated. So he was treated with platelet concentrate and fresh frosen plasma for DIC, and enough hydration for appropriate urine volume preservation. After all, On 22nd hospital day, he fully recovered and discharged. Nowadays, with followed for some duration, he is wellbeing with no complications.

예비수학교사의 신념에 따른 교수학적 내용지식(PCK)과의 관련성에 관한 연구

고상숙,김은호,문정윤,배지은,정대진 이화여자대학교 교과교육연구소 2011 교과교육학연구 Vol.15 No.4

This study investigated the relationship between PCK (Pedagogical Content Knowledge) and pre-service mathematics teachers' mathematical beliefs, and the effects of PCK on their teaching. The data were collected through pre & post interviews, a questionnaire, and classroom observations of six pre-service mathematics teachers who were taking their field practica in their senior year. The results indicate that the pre-service mathematics teachers' differing beliefs about the nature of mathematics affected their PCK. This study showed the relationship between their beliefs about teaching and the learning of mathematics and PCK. It is recommended that more opportunities for PCK development, as well as for modifications in of their beliefs have to be offered in education programs for pre-service mathematics teachers. 본 연구의 목적은 예비수학교사들의 수학적 신념과 수업에서 발현된 교수학적 내용지식(PCK)의 특징을 알아보고, 이를 통해 수학적 신념에 따른 PCK의 관련성에 대해 분석하는 것이다. 이 연구는 교육실습 중인 예비수학교사 6명을 대상으로 실시한 PCK 설문지, 인터뷰 자료, 수업관찰 자료를 분석하는 질적 연구 방법을 토대로 하였다. 연구결과, 예비수학교사들의 다양한 수학 본질에 대한 신념은 PCK에 서로 다른 영향을 주었으며, 수학 교수-학습에 대한 신념과 PCK사이에는 밀접한 관련성이 있음을 볼 수 있었다. 따라서 신념과 교수학적 내용지식(PCK)을 함께 발달시킬 수 있는 예비교사 연수 및 지원 프로그램의 확충이 필요하다.

양산시 하수관거의 불명수 산정을 위한 유량 및 수질특성

최호은,김한석,정연화,김대용,성낙창 東亞大學校 建設技術硏究所 2008 硏究論文集 Vol.31 No.2

The objective of this study were to investigated the water quantity and quality characteristics of sewer infiltration/inflow(I/I) computation in Yangsan City. infiltration/inflow(I/I) were evaluated the water-use evaluation, average daily minimum flow-water quality evaluation and minimum daily flow evaluation. Flow meter for infiltration/inflow(I/I) evaluation was used the FLO-TOTE II. Contaminant came into very low concentration at all sampling points as BOD5 standard. Also, I/I evaluation during dry weather on maximum daily infiltration flow-water quality evaluation, maximum-minimum daily flow evaluation, average daily-minimum flow-water quality evaluation is desirable than water-use evaluation. Because that infiltration/inflow(I/I) amount is much different than other evaluation methods.

건강인에서 결핵균 30-kDa항원이 말초혈액 임파구증식에 미치는 영향

최대경,고석신,김화중,조은경,백태현,신철식 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

T lymphocytes are thought to play a central role in cell mediated immune response. To Study the T lymphocyte proliferative response to 30-kDa antigen purified from Mycobacterium tuberculosis H37Rv, peripheral blood lymphocytes isolated from healthy subjects were stimulated with the 30kDa antigen, crude antigen or PHA. Healthy subjects were divided into three groups so that PPD(+), PPD(±) and PPD(-). The proliferations of lymphocytes were measured by the incroporation of ^3H-thyrnidine. The results were summarized as follows: 1. For the PPD(+) person, at concentration of < 1 ㎍/ml, the proliferative response to 30-kDa antigen resulted in a mild reduction but crude antigen showed relatively rapid reduction. For the PPD(-) person, decreasing the concentration of the both antigens showed rapid reduction of proliferation 2. The lymphocytes proliferations to 30-kDa antigen and crude antigen were significantly increased in PPD(+) group when compared to those in PPD(-) group, but PHA response was no significant difference. 3. The sensitivity and specificity of lymphocyte proliferation assay to 30-kDa antigen and crude antigen when compared with skin test results were 92.3%, 100% and 76.9%, 50%, respectively.

누에 배자와 난소의 초대 배양에 있어서 세포의 분화형태

최광호,손홍대,조은숙 東亞大學校生命資源科學大學附設 農業資源硏究所 1997 農業生命資援硏究 Vol.6 No.1

곤충 세포의 초대 배양에 있어서 그 분화양상을 관찰하기 위하여 누에 배자와 난소를 초대 배양하였다. 그 결과 몇 가지 상이한 세포형이 관찰되었는데 배자 초대 배양의 분화형태는 상피형 세포와 망상조직을 형성하는 섬유상 세포가 관찰되었고, 난소에서는 주로 상피형 세포가 관찰되었다. 또한 두 조직 모두에서 거대 세포보다는 작지만 다소 큰 세포 형태가 관찰되었다. This study was carried out to investigation for differential charaterization of the cells in primary culture with insects. In the process of primary culture with embryos and larval ovaries of silkworm, Bombyx mori, three types of cells were observed. Fibroblast-like cells which formed network and epitherial-like cells migrated from embryos. But in case of ovaries, fibroblast-like cells were not found. Somewhat large cells but smaller than giant-cells were observed in the cultured embryos and ovaries.

방광의 이행상피암에서 p53과 PCNA 분포에 관한 연구

최은정,강상균,양승하,김대중,김의한 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Immunohistochemical studies were carried out to observe the expression of p53 protein and PCNA in transitional cell carcinoma (TCC), then analyzed according to the tumor grade and progression. 38 cases of TCC consist of 13 cases grade Ⅰ, 12 cases grade Ⅱ and 13 cases grade Ⅲ respectively. Results obtained are as follows. 1. p53 protein expression was seen in 60% of cases(15 out of 38 cases) In the poorly differentiated area and infiltrated lesion, tumor cell showed more strong positive reaction of p53 protein compared with well differentiated area. 2. All of 38 cases of TCC showed PCNA positive expression. The more strong positivity was seen in the poorly differentiated area and the more intense positive reaction was noted in the basal layer of the tumor nests. 3. The above results showed that positivity of p53 protein and PCNA are closely related with tumor cell differentiation(grade) and progression. It is concluded that positive reaction of p53 protein and PCNA may contribute to detection of tumor growth and prognosis of patient.

골수염의 진단에 있어서의 Tc-99m Hexamethylpropylene amine oxime 백혈구 스캔의 임상적 유용성

최상호,김양수,정준원,정진원,추은주,서동대,배인규,양승오,우준희,류지소 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

배경 : 골수염의 진단에 있어 Technetium-99m을 이용한 삼상 골스캔(Tc-99m MDP스캔)은 단순방사선 검사상 정상소견을 보이는 경우에 쓰이는 1차적 검사로 매우 높은 민감도를 보인다. 그러나 Tc-99m MDP 스캔은 골절이나, 정형외과적 삽입물, 신경병적 관절병변과 같이 뼈의 재형성이 증가되는 상황에서도 양성소견을 보여 특이도가 낮은 단점이 있다. 이러한 단점을 보완하고자 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 유용성을 알아보고자 하였다. 대상 및 방법 : 골수염이 의심되어 Tc-99m HMPAO 백혈구 스캔을 시행했던 15명의 의무기록을 후향적으로 분석하였다. 골수염의 확진은 임상관찰 소견과 배양검사 결과와 병리소견을 기준으로 하였다. 결과 : 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 민감도와 특이도는 각각 100%와 78%였고 Tc-99m HMPAO 스캔의 경우는 100%와 18%였다. 가장 흔한 원인균은 methicillin-resistant S. aureus였다. Tc-99m MDP 스캔에서 양성소견을 보였던 환자중 3명의 환자가 Tc-99m HMPAO 백혈구 스캔에서 음성 소견을 보였으며 이 환자들은 추적관찰상 골수염이 없는 것으로 확인되었다. 결론 : Tc-99m HMPAO 백혈구 스캔은 골수염의 존재를 진단하는데 있어 민감도와 특이도가 높으며, 특히 뼈의 재형성이 증가되어 Tc-99m MDP 스캔의 특이도가 낮게 나타나는 상황에서 유용하리라 사료된다. Background Three phase bone scintigraphy, performed with technetium-labeled diphosphonates (Tc-99m MDP scan), is the very sensitive radionuclide procedure of choice for diagnosing osteomyelitis. But, Tc-99m MDP scan is less specific when bone remodeling is increased. To overcome this limitation, we evaluated the diagnostic value of technetium-99m hexamethylpropyleneamine oxime (HMPAO) labeled leukocyte scan in osteomyelitis. Methods : We retrospectively reviewed 15 patients with suspected osteomyelitis who performed Tc-99m HMPAO labeled leukocyte scan. The diagnosis of osteomyelitis was based on clinical course and bacterial culture, and pathologic findings. Results The sensitivity and specificity of Tc-99m HMPAO leukocyte scan was 100% and 78%, and those of Tc-99m MDP scan was 100% and 18%, respectively. The most common organism was Methicilein-Resistant S. aureus. Among the patients that showed persistent accumulation on Tc-99m MDP scan, three patients showed no uptake on Tc-99m HMPAO leukocyte scan and these patients were confirmed that had no osteomyelitis. Conclusion : Tc-99m HMPAO leukocyte scan is a useful test for determining the presence or absence of osteomyelitis, especially under condition that bone remodelin is increased.

공황장애환자에서 광장공포증 동반여부에 따른 스트레스대처방식의 차이

최은영,제영묘,이대수,정영인 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

In an attempt to know the factors affecting the development of agoraphobia following panic attacks, the author investigated whether there are differences between coping strategies of panic disorder with and without ago-raphobia. Thirty-seven patients meeting the criteria of DSM-IV panic disorder were divided into 2 subgroups, one group with agoraphobia, another without agoraphobia. Questionaires for the severity of panic symptoms, and of anticipating anxiety for panic attacks, multidimensional coping scale for stress were administered to panic subjects. The results were summarized as follows. 1) Group of panic disorder with agoraphobia complaints trembling or shaking more than group of panic disorder without agoraphobia. 2) There was no differences of degree for the severity of anticipating anxiety between two groups. 3) Group of Panic disorder with agoraphobia had higher score on BDI than Group of panic disorder without agoraphobia. 4) Group of panic disorder with agoraphobia had lower score on active coping, positive interpretation, acceptance than group of panic disorder without agoraphobia, and the differences of these strategies between two groups were not correlated with the score on BDI at the time of investigation. In conclusion, these results suggest that the coping strategies for stress may be a predictor of agoraphobia in patients with panic disorder.

실험실적 당뇨성 흰쥐에서 acetaminophen의 대사에 관한 연구

임은주,윤병재,윤병재,조희숙,김대재,최종원 경성대학교 환경문제연구소 2000 環境硏報 Vol.10 No.1

Acetaminophen is one of the most important drugs used for the treatment of mild to moderate pain when an anti-inflammatory effect is not necessary. Phenacetin, a prodrug that is metabolized to acetaminophen, is more toxic than its active metabolite and has no rational indications. In this study, we were observed activities of free radical generating enzymes, free radical scavenging enzymes and glutathione-related enzymes as well as detoxification mechanism of against acetaminophen-induced hepatotoxicity in STZ-induced hyperglycemic rat. Activities of cytochrome p450, cytochrome b5, aminopyrine demethylase and aniline hydroxylase were changed by the treatment acetaminophen in hyperglycemic rats. It was also observed that activities of conjugating enzymes as sulfotransferase and UDP-glucuronyltransferase was slightly changes against acetaminophen-induced in hyperglycemic rats. Acetaminophen results in the significantly decrease in the level of hepatic glutathione concentration and √-glutamylcysteon, synthetase activities in hyperglycemic rats. And, glutathine S-transferase, superoxide dismutase and glutathione peroxidase activities were significantly increased against acetaminophen-inducedas in hyperglycemic rats. Glutathione reductase and catalase were not affected for experimental state. Furthemore, acetaminophen highered serum alanine, aspartate aminotransferase, sorbitol dehydrogenase, √-glutamylpeptidase, alkaline phosphatase and lactate dehydrogenase activities in hyperglycemic rats. Key Words: Hepatotoxicity, D/M, Acetaminophen, Glutathione, Glutathlone S-transferase, √-glutamylcystein synthetase

P2P(Peer-to-Peer)의 비즈니스 모델 적용에 관한 연구

김영대,최은영 호남대학교 2005 호남대학교 학술논문집 Vol.26 No.1

In these server oriented network forms, users allowed to approach a certain server only in slave and passive way, and are limited in sharing informations. The P2P is the new solution of these limitations. But there is no verification about the possibility and validity of P2P as the business model, So, this study proposes the Possibility validity problems and prospect of P2P. and this paper will help to make the environmental system and to solve problems in the security and efficient business adaptation of P2P, which enables P2P to be a standard model.