단기교육으로 시행가능한 심실기능평가법

김원,임경수,오병연,홍은석,김영식,김선만,이부수,현석천,김영득 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The initial history, physical examination, and ECG assessment should focus on identification of potentially serious noncardiac or cardiac disorders, including coronary artery disease, congestive heart failure, and electrical instability at the emergency room. additionally, it is essential to define disease severity, stability and need for emergency therapy. echocardiography is a useful tool for this purpose. especially Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic symptoms. So we evaluate the feasibility of the echocardiographic measurement by emergency physicain after short-term course. Method and Results: Twenty volunteers(10 male, 38.8±9.3 years) were included in the study for measurement of myocardial performance index and established parameters of ventricular function using conventional echo-Doppler methods. Myocardial performance index: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The most of mean values of echocardiogrphic parameters were not significantly different between those of cardiologist and those of emergency physicians(p<0.01). The duration for measuring myocardial performance index was shortest among echocardiographic parameters. the validity of echocardiographic parameters measured by emergency physicians was proved relatively good. Conclusion: It is proved to be feasible for emergency physician to perform echocardiographic evaluation of ventricular function after short-term course

Modulation of Gene Expressions and Enzyme Activities of Methionine Sulfoxide Reductases by Cold, Aba or High Salt Treatments in Arabidopsis

Oh, Jee-Eun,Hong, Suk-Whan,Lee, Yunsook,Koh, Eun-Ji,Kim, Kideok,Seo, Youngwon,Chung, Namhyun,Jeong, Moonsoo,Chang,Chang, Cheolseong,Lee, Byoungcheon,Kim, Kyoung Heon,Lee, Kwangwon,Lee, Hojoung 생명자원연구 2005 생명자원연구 Vol.13 No.-

Gas Chromatography를 이용한 Methoxime tert.-butyldimethylsilyl 유도체로서 α-Keto Acids의 분석에 관한 연구

金京禮,金正浩,金正漢,吳昌桓,黃恩卿 성균관대학교 약학연구소 1991 成均藥硏論文集 Vol.3 No.1

Abstract-Thirteen α-keto acids which are biochemically important were converted to methoxime(MO) derivatives with MOX and then to tert.-butyldimethylsilyl(TBDMS) derivatives using MTBS-TFA in isooctance prior to dual capillary column GC analysis. Single symmetric peaks were obtained for each MO TBDMS α-keto acids on the dual chromatograms. Optimum methoximation required heating at 60℃ for 2 hours and TBDMS derivatization required heating for 30 minutes. MO α-keto acids were stable during the tert.-butyldimethylsilylation and the methoximation of carbonyl group prevented silylation of enols. Mass spectrometric analysis of MO TBDMS derivatives was performed for structure identification. Base peaks at [M-57], intense ions at m/z=89, and weak ions at [M-15] were present in all spectra. The ions at m/z=89 were characteristic for α-keto acids.

일렬 자가조혈모세포이식을 받은 다발성 골수종 환자에서 발생한 뇌 톡소포자충증 1례

김계형,송경호,전재현,박완범,박상원,김홍빈,김남중,김인호,오명돈 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant recipients, usually associated with allogeneic hematopoietic stem cell transplantation (HSCT). We report a case of cerebral toxoplasmosis in a patient with multiple myeloma, following tandem autologous stem cell transplantation. A 55-year-old Korean male presented with weakness in both legs that had progressed to both arms. A magnetic resonance imaging scan of the brain revealed multiple, variablesized ring-enhancing lesions with surrounding edema in the cerebral hemispheres and brain stem. Stereotactic biopsy revealed bradyzoites of Toxoplasma gondii in the brain tissue. The patient received trimethoprim-sulfamethoxazole, followed by pyrimethamine and sulfadiazine, accompanying treatment for progressive multiple myeloma. Cerebral toxoplasmosis should be considered as one of the differential diagnoses in patients with neurologic signs following autologous HSCT.

반복적인 부비동염으로 내원한 Good 증후군 1예

송경호,김계형,김충종,박경운,전상훈,김홍빈,김남중,오명돈,최강원 대한감염학회 2007 감염과 화학요법 Vol.39 No.5

Good 증후군은 흉선종과 면역결핍이 동반되는 질환으로, B세포의 감소로 인한 범저감마글로불린혈증과 CD4^(+)T세포의 감소로 인한 세포성 면역저하가 동시에 나타나는 것을 특징으로 한다. 본 증례는 18개월 전부터 발생한 반복적인 부비동염을 주소로 내원한 43세 남자 환자로, 내원 1년 전 흉선종절제수술을 시행받았으며, 면역학적 검사상 범저감마글로불린혈증과 T세포의 감소 등의 이상 소견이 발견되었다. 정주 면역글로불린과 경험적 항생제(amoxicillin/clavulanic acid) 사용 후 부비동염이 호전되었으며, 예방접종과 정기적인 면역글로불린 투여 후 특이 합병증없이 경과 관찰 중이다. Good's syndrome is the association of thymoma with immunodeficiency, characterized by hypogammaglobulinemia, B-cell lymphopenia and variably defects in cellular immunity with CD4^(+) T-cell lymphopenia and an inverted CD4^(+):CD8^(+) T-cell ratio. We report a 43-year-old male patient who presented with a 18-month history of productive cough and postnasal drip. One year ago, he underwent the operation for resection of a thymoma. Despite of appropriate management, sinusitis relapsed multiple times. He was found to have hypogammaglobulinemia with nearly absent B cells(4/μL). The CD4^(+) T-cell count was 554/μL with an inverted CD4^(+):CD8^(+) T-cell ratio of 0.6. His symptoms and signs improved with antibiotic treatment and monthly administration of intravenous immunoglobulin (IVIG, 400 mg/kg).

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

골내 고정 장치용 초내식성 오스테나이트 및 듀플렉스 스테인리스강 가공재의 특성

오근택,강국진,박용수,김경남 大韓齒科器材學會 2003 대한치과재료학회지 Vol.30 No.3

Nickel is one of the most common causes of allergic contact dermatitis and hypersensitivity. In case of stainless steel as biomaterials, the higher the corrosion resistance and the lower the nickel content, the better it is or the human body. However, because nickel plays an essential role in the stabilization of the austenitic phase and the corrosion resistance of stainless steel, it is difficult to remove the nickel from the constituents of stainless steels completely. Therefore, the purpose of this study was to investigate corrosion resistance, cytotoxicity, and mechanical property of super stainless steels, which had high corrosion resistance by synergistic effect of Mo(or W) and N, with respect to nickel content and to evaluate their potential for orthodontic applications. Super austenitic stainless steel(SR-50A) had high nickel content of 22% and super duplex stainless steels nickel contents of 6~10%. Super austenitic and duplex stainless steels had nitrogen contents of above 0.2%. Also, these steels had high Mo or W contents which were able to increase the localized corrosion resistance. In terms of hardness, super stainless steels, which had Vickers hardness values of 374~400 Hv in cold-rolled state and 186~285 Hv in annealed state, exhibited higher values than 316L S. S.. Duplex stainless steels exhibited higher mechanical properties than austenitic stainless steels. In terms of corrosion resistance, super stainless steels exhibited lower passive current density(2.3~3.8 ㎂/cm^2) than pure Ti(6.6㎂/cm^2) in the body-simulated solution and similar potentiodynamic polarization behaviors. Pitting corrosion occurred in 316L S. S. but not in the others. Thus these steels were considered to have high corrosion resistance in the human body. In terms of cytotoxicity, SR-5OA and SAF2507 exhibited none cytotoxicity and the others slight. This results indicated that the cytotoxicity of alloys containing nickel had no relation with nickel content because SR-5OA with the highest nickel content exhibited none cytetoxicity In conclusion, it is considered that super stainless steels with high corrosion resistance and good biocompatibility can be used for orthodontic applications because of the enhanced passive film by high addition of Mo, W, N, etc.

소아환자의 진정요법 효과와 그와 연관된 변수에 대한 연구

김경희,김종수,김승오 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

소아치과에서 진정요법은 chloral hydrate와 hydroxyzine을 함께 경구투여하는 방법이 가장 보편적이고, 진정의 심도가 술자가 원하는 정도에 미치지 못할 때에는 midazolam이나 N_(2)O/O_(2)를 병용투여하는 경우가 종종 있다. 본 연구는 chloral hydrate와 hydroxyzine을 이용한 진정요법의 효과와 안전성을 평가하고, 경구투여만으로 적절한 진정 수준을 얻지 못하여 N_(2)O/O_(2)를 병용투여한 경우, N_(2)O/O_(2)의 치료시간과 부작용에 대한 영향 그리고, 진정요법 효과에 영향을 줄 수 있는 변수들(연령, 성별, 체중, patient compliance, waiting time 등)을 확인할 목적으로 시행하였다. 2004년 12월부터 2005년 9월까지 단국대학교 치과병원 소아치과에서 chloral hydrate와 hydroxyzine을 이용하여 진정요법하에 치료받은 평균연령 30±8개월(12-51개월), 체중 13±2kg(9.5-18kg)의 총 94명(남아-46명, 여아-48명)의 환아들을 대상으로 조사하였다. 진정요법의 효과, 체중, 연령, 병용투여 방법에 따라 군을 분류하여 성별, 연령, 체중, patient compliance, waiting time, 치료시간, 치료양(RBVU), 부작용 등을 평가하였다. 진정요법 성공률은 85%였다. 진정요법에 성공한 그룹이 실패한 그룹보다 N_(2)O/O_(2)로 수면을 유도하여 사용하는 경우가 많았고, 치료시간이 길었다. 36개월, 14kg미만인 환아는 경구투여만으로 수면에 이를 수 있었고, waiting time이 짧았다. 36개월 이상인 환아는 N_(2)O/O_(2)를 사용하여 수면을 유도하는 경우가 많았다. 연령과 N_(2)O/O_(2)사용시간, N_(2)O/O_(2)사용과 치료시간사이에는 상관관계가 존재한 반면, 체중과 N_(2)O/O_(2)사용시간사이에는 상관관계가 없었다. 치료시간 연장, N_(2)O/O_(2) 사용여부와 부작용 발생간에서는 통계학적으로 유의한 차이는 확인되지 않았다. The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. Midazolam IM or IN and N_(2)O/O_(2) inhalation is sometimes administered with chloral hydrate and hydroxyzinecombination when deeper and longer sedation is needed. The purpose of this study was to assess the outcome and safety of chloral hydrate, hydroxyzine and N_(2)O/O_(2) in the sedation of a large number of uncooperative pediatric dental patients and to identify variables associated with their effectiveness. In a nine-month retrospective study, 171 records of sedation performed in 94 healthy children(male 46, female 48) with mean age of 30±8 months were reviewed. The authors analyzed several variables such as age, sex, weight, methods of drug delivery, waiting time after drug delivery, treatment rendered, treatment time, adverse events, sedation outcome. Eighty five percent of sedation had success behavioral outcome. Sedation sessions rated success used more N_(2)O/O_(2) administration and had longer treatment duration than sedation sessions rated failure. A children patient under 36 months of age had enough sleep by on1y oral administration and the mean waiting time of this case was significantly shorter than that of a children patient over 36 months of age. There was a clear correlation between age and N_(2)O/O_(2) using time, but no correlation between weight and N_(2)O/O_(2) using time. There was no statistically significant difference among variables of treatment duration, N_(2)O/O_(2) administration and adverse event.

부가중합형 실리콘 인상재의 표면 친수성이 미세부 재현성에 미치는 영향

오영일,황수영,이덕연,김경남,김광만 大韓齒科器材學會 2003 대한치과재료학회지 Vol.30 No.3

The purpose of this study was to investigate the relationship between surface hydrophilicity and detail reproducibility of die stone for hydrophilic polyvinyl siloxane impression materials modified with nonionic surfactants. Hydrophilic polyvinyl siloxane impression materials were prepared with a polydimethylsiloxane composition and nonionic surfactants. The surfactants used were nonylphenoxy poly(ethyleneoxy) ethanol homologs of varying ethyleneoxy chain length. These homologs are designated NP4, NP6, and NPIO according to the mole number of ethyleneoxy group of 4, 6, and 10, respectively. The contact angle, consistency, and detail reproducibility for hydrophilic polyvinyl siloxane impression materials were tested. The incorporation of nonionic surfactant into polyvinyl siloxanes enhanced their hydrophilicity and consequently led to significant reduction in contact angles. Significant differences in contact angle were found among the samples (P < 0.05). The contact angle was lowest when NP4 was incorporated even though NP4 is less hydrophilic than NP6 and P1O. This implies that the exposed surfactant concentration on the surface was highest when NP4 was used. The consistency of surfactant-modified silicone impression materials were not affected by the type of surfactants used in this study. However, NP4-modified polyvinyl siloxane impression material showed the highest quality reproduction of the thinnest line, indicating highest wettability with gypsum among the samples. In conclusion, the surface concentration of surfactant on the silicone impression material was a crucial factor in determining wettability. The suface hydrophilicity of surfactant-modified silicone impression materials was of major relevance to the detail reproduction of die stone.

AVPU scale과 Glasgow Coma Scale의 상관관계 : 외상환자의 의식상태 평가법 THE EVALUATION METHODS OF MENTAL STATUS IN TRAUMA

김 현,임경수,이강현,김영식,김선만,황성오 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Background: The emergency treatment of multiple trauma patient includes rapid evaluation of mental status, triage and resuscitation. The principles of Advanced Trauma Life Support consist of primary survey & resuscitation, secondary surveys and definitive cares. In primary survey, the mental status is evaluated by AVUP scale, and GCS(Glasgow coma scale) is used in secondary survey because the calculation of GCS needs more times than AVPU scale. Purposes: Is there a correlation between AVPU scale and GCS as an evaluation method of mental status in trauma? Subjects: 434 injured patients(male 321, female 113, mean age 35.9 years) who had visited the emergency center of Wonju Christian Hospital was evaluated prospectively. The mental status was evaluated by AVPU scale and GCS by emergency physician as soon as the patients was admitted to emergency center. Results: Alert patients as AVPU scale were ranged from 14 to of GCS, patients who responded to verbal command were from 9 to 14 of GCS, patients who responded to pain stimuli were from 4 to 10 of GCS, and patients who did not respond to pain stimuli were from 3 to 5 of GCS. The linear correlation of AVPU scale and GCS was seen(r2=0.90). Conclusion: This study suggest that AVPU scale was vey closely correlated with GCS.