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신현우,김천호,김득경,신창호,신경욱 國立金烏工科大學校附設生産技術硏究所 1994 産業技術開發硏究 Vol.10 No.-
The paper describes a CMOS analog circuit design tool, K_ACD(Kumoh_Analog Circuits Designer), and design results. The K_ACD was developed for automatic design of fundamental analog circuit blocks such as comparator, unbuffered OP AMP, and buffered OP AMP. For given specifications and process parameters, it computes bias currents, transistor sizes, voltage gain, and power dissipation, then SPICE simulations are automatically carried out. Some design examples show usefulness of the K_ACD in analog circuit designs.
심정지환자에서 epinephrine투여시 혈중 catecholamine의 변화
임경수,황성오,이부수,이강현,이진웅,임종천,김영식,김선만,김 현 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1
Background : Cardiac arrest is a potent stimulus for the release of endogenous catecholamine and high plasma catecholamine concentration has been reported during cardiopulmonary resuscitation(CPR). Few data were present about the clinical effect of high plasma catecholamine and endogenous catecholamine response to exogenous epinephrine administration during CPR. Purpose : This study was designed to evaluate endogenous catecholamine response to cardiac arrest and exogenously administered epinephrine during CPR. Method : In 21 cardiac arrest victims, blood sample for epinephrine and norepinephrine was drawn before and 1 minute after each epinephrine administration during CPR. 1mg of epinephrine was administered immediately after intravenous access and 3 minute interval during CPR. Plasma catecholamines were quantitated by high-performance liquid chromatography. Result : Baseline plasma epinephrine concentraqtion was higher in patients with cardiac arrest than normal controls (985±1627 vs 194±173 pg/ml, p<0.05). Baseline plasma norepinephrine concentration was also elevated in patients with cardiac arrest than normal controls, although statistically insignificnat(1965±4915 vs 360±250 pg/ml). Plasma epinephrine concentration in cardiac arrest patients was significantly elevated after exogenous administration of epinephrine, but its response was blunted after the third does of epinephrine. Plasma norepinephrine concentration in cardiac arrest patients was also elevated, but its response was observed only after the first epinephrine administration. Plasma epinephrine concentration was persistently higher in patients with return of spontaneous circulation (ROSC) than patients without ROSC. there was no significant difference of plasma norepinephrine concentration whether spontaneous circulation was restored or not. Endogenous epinephrine response to exogenous epinephrine was not observed in patients having prolonged arrest time over 20 minutes. Conclusion : Results of this study suggests that significant amount of catecholamine is released by exogenous epinephrine administration in spite of high plasma catecholamine concentration, and degree of endogenous catecholamine response influences resuscitation outcome.
박현경,박성준,김명천,고영관 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3
Background: lawsuits associated with medical troubles are increasing rapidly. Beginning with 69 cases in 1989, the annual rate of increase has reached above 36%. After the system of emergency medical specialist was born in 1995, it was expected that medical lawsuit cases would increase due to the importance of the emergency medical specialist's role to the emergent patients. Methods: A database was established for medical lawsuits(1982~1998, n=254), and lawsuits involving the emergency department(1982~1998, n=16) were selected from that database. Results: In criminal cases, the prosecutor's win rate was one out of four(25%). In civil cases, the prosecutor's win rate was 8 out of 10(80%); that is, the rate was higher than in general medical cases. Conclusion: To reduce the number of lawsuit following medical troubles in the emergency department, we should give careful attention and appropriate cure to patients who visit the emergency center.
두가지 혈류 유발방법에 의한 새로운 심폐소생술(이중 혈류 유발 심폐소생술)장치의 개발
황성오,김현,조준휘,오범진,임종천,최경훈,윤정한,이승환,김영식,이강현,이윤선 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2
Background: There have been many efforts to augment blood flow during cardiopulmonary resuscitation. These efforts have focused on maximizing the effect of cardiac pump or thoracic pump alone. However, considering that the heart is the biggest blood reservoir and increase of intrathoracic pressure can generate blood flow, simultaneous exploitation of both mechanisms may have synergistic effect. We hypothesized that simultaneous chest constriction in addition to sternal compression by standard CPR may have additive hemodynamic effects by preventing deformation of the chest and increase of intrathoracic pressure. Methods and results: we built a new mechanical device to perform compression and thoracic constriction simultaneously. The device consists of two main elements. Piston in the center is to depress the sternum. Strap is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. To determine strap width to produce optimal hemodynamic effect, we measured hemodynamic parameters with variable widths of strap in two dogs after induction of ventricular fibrillation. Result of the experiment showed that 10cm wide strap was determined to be most effective. We also determined optimal depth of compression to produce maximal hemodynamic effect with animal experiments using two dogs. Animal experiments showed that the highest aortic pressure could be generated when the stemum was depressed to 5 cm. Cardiopulmonary resusciation using a new device could generate higher systolic aortic pressure, coronary perfusion pressure and end-tidal carbon dioxide tension in comparison with standard cardiopulmonary resuscitation in a pilot animal study using two dogs. Conclusion: New cardiopulmonary resuscitation method using a mechanical device designed by us could perform sternal compression and simultaneous thoracic constriction, and generate better hemodynamic effects than standard cardiopulmonary resuscitation in pilot animal experiments.
결장직장암 환자의 임상적 고찰 : 조선대학교 부속병원의 10년 간의 결과
나은종,문성표,장정환,김권천,민영돈,김성환,조현진,김정용,김경종 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2
Background and Objectives: The colorectal cancer rates 4th in the total cancer prevalence in Korea. The clinical patient demographics were considered with the incidence rate of the colon and rectal cancer. The clinicopathological factors were analyzed for the 5 year survival rate. Materials Methods: Of the 282 patients who were operated from Jan. 1, 1992 to Dec. 31, 2001 and diagnosed by pathological biopsy as colo-rectal cancer, 234 patients were followed up. The age, sex, location of the cancer, TNM stage, operation method, histopathological classification, metastatic region, complications after operation and the survival rate were investigated. Results: Of the 234 patients, male and female consisted of 120 cases (51.3%) and 114 cases (46.7%), with an average age of 61.6 years. The average follow up period was 52.3 months and the peri operative mortality was 5.6%. The site of the cancer was most frequent at the rectum with 127 cases (54.3%). The patients were classified according to the TNM stages with 38 cases of stage 1 (16.2%), 98 cases of II (41.9%), 72 cases of III (30.8%) and 26 cases of IV (11.1%). The 5 year survival rate in the age group older than 50 was 63.3 % and 73.5% in the group younger than 50. In regard to the operation type, the 5 year survival rate was 65.4% for elective operation and 65.8% for emergency operation. The 5 year survival rate for well differentiated, moderately differentiated, poorly differentiated cancer, and mucinous adenocarcinoma was 73.7%, 60.2%, 58.3%, and 92.6%, respectively. The 5 year survival rate of each of the TNM stage is 81.1%, 74.8%, 57.0%, and 11.5% for Classes I, II, III, and IV, respectively. Conclusion: The clinical factors were analyzed for the 5 year survival rate with no statistical significance for the age, sex, and location of the cancer. The TNM stage and histopathological differentiation were statistically significant. The colon cancer showed better prognosis compared to the rectal cancer.
( Kyung Hyun Cheon ),( Kyu Sik Jung ),( Gi Hong Choi ),( Young Nyun Park ),( Jun Yong Park ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
Background: Synchronous development of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC)has been reported rarely, especially when it is in the form of double primary cancer. In literature review, there have been only 35 reported cases of synchronous HCC and ICC, and most of these tumors developed from livers with hepatitis C infections. Here, we present synchronous development of HCC and ICC in different sites of the liver with chronic B-viral hepatitis. Case: Two patients who had been followed with chronic B-viral hepatitis were referred for hepatic mass. One patient (Case 1, 66-year-old woman) had 6.4cm-sized multinodular hepatic mass in left lobe and a small nodule in right lobe. Another patient (Case 2, 68-year-old woman) had 4.3cm-sized hypervascular mass in the right lobe and 1.1cm sized nodule in the left lobe. Radiological examination including CT and MRI was performed and pre-operative diagnosis of both cases was HCC with metastatic nodule. Thereafter, patients underwent curative resection of tumors. However, unexpectedly, pathological examination of surgical specimen revealed that ICC and HCC existed independently in the other side of same liver in both patients. Conclusions: These cases not only suggested that double cancer of HCC and ICC could arise from liver with HBV infection, but also emphasize the importance of intensive diagnostic approach when the separate tumor existed in the same liver.
( Kyung Hyun Park ),( Sang Ho Cheon ),( Ji Ho Lee ),( Hee Soo Kyung ) 대한슬관절학회 2012 대한슬관절학회지 Vol.24 No.1
Purpose: This study evaluated the incidence of a venous thromboembolism (VTE) after total knee arthroplasty (TKA) using multidetector row computed tomography-indirect venography (MDCT-indirect venography) and assessed the efficacy of anti-coagulation therapy. Materials and Methods: We enrolled 118 patients with 126 cases of TKA. The average age of the patients was 68.4 years. We used 64 channel MDCT-indirect venography for the detection of VTE. We treated selectively proximal deep vein thrombosis (DVT) or pulmonary thromboembolism (PTE) cases according to the results of MDCT-indirect venography. We re-evaluated the change in VTE using follow-up MDCT-indirect venography after 3 months. Results: We identified VTE in 35.7%. DVT only was identified in 22.2% including 8 cases of proximal DVT and 20 cases of distal DVT. PTE without DVT was identified in 4.8%, and combined DVT and PTE in 8.7%. All patients with PTE were asymptomatic, but 4 DVT patients had signs of leg swelling. After anti-coagulation therapy, 20 patients showed complete resolution in 16 cases, improvement in 3 cases and one case showed a new distal DVT. Conclusions: The incidence of VTE after primary TKA was 35.7% in Korea. Furthermore, anti-coagulation therapy for proximal DVT and PTE patients may be a useful method for preventing the occurrence of a fatal PTE.