벌자상 후에 발생한 급성심근경색증 2례

민영기,정윤석,박인철,조준필,탁승제 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery ㅑs the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia, We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.

소아의 하악골 골절에 관한 임상적 연구

민승기,최문기,오승환,이동근 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5

The jaws of children differ from those of adults in the aspects of architectural and mechanical properties, sites, form and treatment modality. This study reviews the result of treatment of pediatric mandibular fractures between 1994 and 1998 at dept. of Oral & Maxillofacial Surgery, School of dentistry, Wonkwang University by means of the age and sex distribution, mechanism of injury, location of fractures and associated patterns, fracture management, postoperative complications, any associated injuries to other organ systems. Total number of these study was 61 facial bone fractures in 32 patients. The results were as follows. 1.The pediatric mandibular fractures predominated in the age of 6∼12, and had no sexual predilection. 2.The main cause of pediatric mandibular fractures was the traffic related accidents(56.2%) 3.The condylar fracture only was 23 cases (37.7%) in total 61 sites of mandibular fractures and the symphysis fracture was 20 (32.7%) ; the highest incidence of mandibualr fracture was the symphysis with unilateral condyle combined fracture in 61 total mandibular fracture sites. 4.The major postoperative complication was deviation during mouth opening (41.2%) and the facial asymmetry(17.7%) in second. 5.Soft tissue laceration(53%) was the most associated injury with mandibular fracture and the abdominal injury(12.5%), the head injury(12.5%), and the extrimity injury (6.2%) in order.

세로토닌성 항우울제가 백서의 Schedule-Induced Polydipsia에 미치는 영향

이기철,이정호,박중섭,최영민,전성일,정홍경,하준명,정재현 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

Object : Schedule-induced polydipsia is considered as an animal model of obsessive-compulsive disorder inrats. The authors evaluated the chronic effects of fluoxetine and clomipramine as serotonergic antidepressants and haloperidol as dopaminergic antagonist on the schedule-induced polydipsia in rat.Methods : Spraque-Dawley rats weighing 200-250gm were individually housed, maintained and allowed free access to water for 1 week. And then the rats were placed on a restricted diet. To induce polydipsia, rats were placed in automatic cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT 60s) feeding schedule over 150-minute test session for a day. Water was available at all times during the feeding schedule in automatic cage. After 4 weeks of daily exposure to the FT 60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). 4 groups of rats were administered fluoxetine(5mg/kg/i.p.), clomipramine(5mg/kg/i.p.), haloperidol(0.1mg/kg/i.p.), vehicle(1cc/kg/i.p.) for 3 weeks. Rats were tested once a week to access schedule induced polydipsic behavior. The chronic effects of experimental drugs on schedule induced polydipsic behavior were analyzed with repeated analysis of variance and Scheffe test as a post-hoc comparison.In order to measure water consumption in non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5 gm) of food per day which maintained them at their average body weight.Results and Conclusion : The results were as follows ;1) After 4 weeks of daily feeding procedure with fixed time schedule for 60 seconds per day, the experimental group showed significant differences than the control in the amount of water consumption as compared with their baseline water intakes. At the same periods, there were no differences between the experimental group and the control in body weight. 2) The clomipramine treated group and the fluoxetine treated group showed significant decrease in the amount of water intake as compared with their baseline of polydipsic water intakes for 3 weeks of treatment. However, the haloperidol treated group and the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their baseline of polydipsic water intakes. 3) At 2 weeks of drug treatment, clmipramine treated group(16.88±6.51ml) and the fluoxetine treated group(22.50±10.35ml) showed significantly lower amounts of water intake than the haloperidol treated group (41.25±7.06ml) or vehicle control group(37.50±12.54ml). And also the clomipramine treated group(13.75±5.18ml) and the fluoxetine treated group(18.75±3.54ml) showed significantly lower amounts of water intake than the haloperidol group(35.00±11.65ml) and the vehicle control(34.38±6.78ml) at 3 weeks of drug treatment. Above findings suggest that the fixed time feeding procedure for schedule-induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. The author confirmed that schedule-induced polydipsia was successfully decreased for 3 weeks of administration of clomipramine and fluoxetine but there was no response to haloperidol.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

출산후 여성의 우울성향과 영아 기질, 양육 스트레스 및 대처방식과의 연관성

최영민,이승휘,김영미,이정호,전성일,이기철 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

목 적 : 산후우울증의 발생은 출산 직후부터 1년까지 지속될 수 있고 출산 이후에도 오랜 기간동안 발생 가능성이 있으며, 산후우울증을 단순히 선행하는 감정적 문제, 통제 소재, 사회적지지, 출산과 동반된 생리적 변인만으로 설명할 수 없다. 그러므로 산후우울증은 출산후 산모-영아 상호관계에서 겪게되는 어려운 영아의 기질, 산모가 영아를 양육하면서 겪게되는 양육 스트레스, 그리고 산모의 대처 방식과 연관이 있을 것이다. 본 연구는 산후우울증과 영아 기질, 양육 스트레스, 대처방식을 변인으로 하여 산후우울증과의 연관성을 평가하기위해 산후의 우울성향과 각 변인의 관계를 연구하였다. 방 법 : 연구의 대상은 1996년 7월 16일부터 8월 27일까지 인제 대학교 의과대학 부속 상계백병원 소아과 외래에 예방 접종을 위해 내원한 4개월에서 12개월 사이의 영아를 둔 산모 105명을 대상으로 하였다. Beck우울척도(BDI), 영아기질척도(EAS), 부모 양육스트레스 목록표(PSI), 대처방식척도(WCC)를 사용하여 산후의 우울성향과 이들 변인과의 연관성을 평가하여 다음과 같은 결과를 얻었다. 결 과 : 1) 어머니의 우울성향 점수는 영아의 기질중 부정적 정서성(r=.26 p<0.05), 과도한 활동성(r=.22 p<0.05)과 유의미한 상관 관계를 보였다. 영아의 사회성 척도와는 부적 상관이 있었으나 통계적으로 유의미하지는 않았다. 2) 어머니의 우울성향 점수는 양육 스트레스와는 정적 상관관계가 있었다(r=.44 p<0.001). 3) 어머니의 우울성향 점수와 대처방식과 유의미한 상관관계를 보이지 않았다. 4) 영아의 부정적 정서성과 양육 스트레스는 정적 상관관계가 있었으나(r=.49 p<0.001) 사회성, 활동성과의 상관관계는 유의미하지 않았다. 양육 스트레스와 대처방식과도 통계적으로 유의미한 상관관계를 보이지 않았다. 결 론 : 본 연구 결과, 산모의 산후 우울성향과 첫째, 영아 기질 중 정서성과 활동성이 연관관계가 있고 둘째, 양육스트레스와 연관이 있으나 세째, 대처방식과는 연관이 없었다. 이런 결과는 산후의 우울성향과 각 요인과의 연관성을 살펴볼 때 산후우울증에 더 중요한 영향을 미치는 것은 산모의 대처 방식이라는 어머니 측의 변인보다는 출산과 동반된 양육 스트레스 혹은 영아의 어려운 기질일 것이라고 추론할 수 있다. Objectives : This Study examined the relationship of depressive tendency in postpartum women with psychosocial factors such as infant temperament, parental stress and coping style. Methods : The subjects consisted of 05 postpartum women, each of whom had an infant aged 4 to 12 months. They were assessed on demographic variables and on measures of the depressive symptomatology, infant temperament, parental stress and the coping style using Beck Depression Inventory(BDI), the EAS temperamental survey, Parenting Stress Index(PSI), the Way of Coping Checklist(WCC). And then we assessed the relationship of depressive tendency in postpartum women with psychosocial factors. Results : The results were as follows : 1) Depressive tendency in postpartum women had significant relationship with emotionality(r=.26 p<0.05) and activity(r=.22 p<0.05) of infant temperament. 2) Depressive tendency in postpartum women had significant relationship with parenting stress(r=.44 p<0.001). 3) Depressive tendency in postpartum women had no significant relationship with coping style. 4) Parental stress had significant relationship with emotionality(r=.49 p<0.001) but did not have any relationship with sociability and activity of infant temperament. Parenting stress had no significant relationship with coping style. Conclusion : These results suggest that depressive tendency in postpartum women correlated with emotionality and activity of infant temperament correlated with parenting stress but not correlated with coping style. Infant temperament and parenting stress to child rearing are more significantly correlated with depressive tendency in postpartum women than coping style of postpartum women.

공명초음파분광법을 이용한 광컨넥터용 결합소자의 비파괴 검사

김성훈,조영재,백경윤,양순호,민한기,양인영 朝鮮大學校 機械技術硏究所 2004 機械技術硏究 Vol.7 No.1

본 연구의 목적은 비파괴 평가방법인 공명초음파분광법(RUS)을 사용하여 세라믹제 페롤과 볼렌즈의 결함과 형상오차를 평가하는 것이다. RUS시스템은 스펙트럼에너라이저,파워 엠플리파이어,압전진동자센서와 지지프레임으로 구성되어진다. RUS 시스템에 의한 페롤과 볼렌즈의 비파괴평가를 위해 본 연구에서는 각 시험편에 대한 공진주파수를 측정하였으며,측정된 공진 주파수의 비교분석에 의해 결함의 유 · 무를 판별하였다. 그 결과 페롤의 경우,크랙을 갖는 페롤의 공진주파수 대역이 양품페롤의 공진 주파수 대역보다 고주파대역으로 이동함을 알 수 있었으며,볼렌즈의 경우,시험편 질량이 감소함에 따라 공진주파수 대역이 고주파 대역으로 이동함을 알 수 있었다. 또한 볼렌즈의 공진주파수가 측정되는 대역을 예측할 수 있는 파라메타인 β를 설정하여 그 결과를 고찰하였다. The objective of this paper is to evaluate the defect and shape error of a ceramic ferrule and ball lens by Resonant Ultrasound Spectroscopy(RUS) method. RUS system is consisted of spectrum analyzer, power amplifier, PZT sensor, and support frame. For nondestructive evaluate by using RUS system, first of all, we measured the natural frequency of each specimen, and we decided on the shape and size of flaw by measured natural ferquencies. And then, in the case of ferrule, natural frequency bandwidth of ferrule with crack was higher than acceptable ferrule. As mass of ball lens decreased, natural frequency bandwidth was shifting to high-frequency range. Thus, we discussed on the relationship between β and mass of ball lens, which β is parameter that we can predict measurable natural frequency bandwidth of ball lens.

골수검사를 시행한 철결핍성빈혈의 임상적 고찰

안기완,홍승만,전의섭 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.2

Iron deficiency is a common one of nutritional deficiency, which denotes a deficit in total body iron. resulting from iron requirements that exceed iron supply. It remains the most common cause of anemia, both in the Korea and world wide. The development of iron deficiency progresses in stage. storage iron depletion occurs first. at this stage, a bone marrow aspirate staine with Prussan blue shows marked reduced or absent deposits of iron in macrophages and accompained by a decreased in the level of serum ferritin. in the next stage, the iron binding capacity of the serum rises, followed by a drop in serum iron. the final stage is the development of microcytic and hypochromic in circulating red cells. Bone marrow examinations is not essential diagnostic modality of iron deficiency anemia (IDA), but is necessary for early definitive diagnosis of IDA. So, We studied 65 cases of IDA patients who were performed bone marrow aspiration and biopsy. and 60 cases of normal healthy control from January 1990 to necember 1993 in Cho-sun University. The results of the analysis were as follows : 1) The total number of 65 patients were 26 males and 39 females. The peak incidence was at ages of 21-30 years and mean ages was 34.8 years. 2) Gastrointestinal bleeding was the most common cause of IDA (gastric ulcer 23.1%, duodenal ulcer 9.2%, gastric cancer 9.2% and hemorrhagic gastritis 4.2 %). 3) Most patients showed medical attention because of general (61.5%), gastrointestinal (58.5%) or cardio-pulmonary (36.9%)symptoms. 4) The mean hemoglobin level was 7.71± 0.83 g/dl, Mean corpuscular volume(MCV) 71.63± 4.56 fL, Red cell volume distribution width(RDW) 17.23±0.72 %, corrected reticulocyte 1.49±0.45%, serum iron 35.07±25.45 ug/dl, TIBC 352.44±43.99 ug/dl and serum ferritin 8.93±8.42 ng/ml. The peripheral red cell morphology was mainly microcyhz and hypochromic ficture(89.2% and 87.7%). Bone marrow iron stians showed that the suitable iron was absent, grade 0 in 92.3% and grade 1 in 7.7% 5) All cases were treated with iron preparation and 26.2% with blood transfusion(from 1 unit to 15 units). 69.2% showed complete recovery with therapeutic maneuvers and 30.1% relapse or no reponse which was probably stemmed from uncorretability(9.2%), uncooperability (9.2%), side effect(3.1%) and replapse of underlying diseases(6.2%). IDA is not definitive diagnosis, but one of the clinical sign of etiologic diseases. So, for the definintive treatment. it is important that the etiologic diseases were corrected.

Clozapine 투여로 유발된 무과립구증 1례

이기철,정홍경,이정호,최영민,전성일,최수전 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

저자들은 clozapine 투여 29일이 경과한 시점에서 무과립구증을 보인 20세 여자환자 1례를 치험하였기에 문헌고찰과 함께 보고하였다. 무과립구증은 무균처치와 항생제투여 및 G-CSF와 GM-CSF를 투여하여 무과립구증 상태는 8일만에 회복되었다. Clozapine에 의해 유발된 무과립구증의 원인은 아직까지 확실치 않다. 현재까지 알려진 원인으로는 MHC(major histocompatibility complex region)의 우성인자가 원인이라는 제안과 대사산물이 자유기근으로서 골수세포를 억제한다는 설이 제안되고 있다. 저자들은 clozapine을 투여함에 있어서 환자의 선정, 위험인자들의 고려 및 철저한 CPMS 관리를 제안하고, 일단 무과립구증이 발생하면 즉각적으로 내과적인 도움을 받을 것을 권장한다. We report a 20-year-old female patient who developed clozapine-induced agranulocytosis on the 29th day of clozapine treatment. She recovered from the agranulocytosis on the 8th day of progression after treatment with G-CSF, GM-CSF, antibiotics and associated aseptic procedures. The cause of clozapine-induced agranulocytosis is still un known and it is proposed that the dominant gene of major histocompatibility complex region and the reactive metabolites which suppress the myeloid system may be responsible. We recommend that careful attentions such as the selection of patient, evaluation of the risk factors, and the thorough control of CPMS should be paid. If the agranulocytosis happens, it is helpful to consult to the department of medicine immediately.

Clozapine이 백서의 Schedule-Induced Polydipsia에 미치는 영향

이기철,정홍경,이정호,홍승범,최영민,전성일,정재현,하준명 대한생물치료정신의학회 2000 생물치료정신의학 Vol.6 No.2

Object : This study was designed to evaluate the effects of clozapine which is one of most useful atypical antipsychotics in the schedule-induced polydipsic rat which is an animal model of obsessive-compulsive disorder. Methods : Spraque-Dawley rats were placed in automatic cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT- 60s) feeding schedule over 150-minute test session for 4 weeks. After 4 weeks of daily exposure to the FT-60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). Rats were stratified into clozapine(0.34mg/kg,i.p.), clozapine(14.63mg/kg,i.p.), clomlpramine(5mg/kg,i .p.), and vehicle (1cc/kg,i.p.) group and treated with each drugs for 3 weeks. To identify the non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5gm) of food per day which maintained them at their average body weight. Results : The results were as follows ; 1)After 4 weeks of scheduled feeding procedure, the experimental group showed significant differences than bolus control in the amount of water consumption as compared with their baseline of water intakes for 4 weeks. At the same periods, there were no differences between the experimental group and bolus control in the borty weight. 2)The clomipramine group, the clozapine 0.34mg group and the clozapine 14.63mg group showed significant decrease in the amount of water intake for at 2nd & 3rd week of drug treatment as compared with their baseline of polydipsic water intakes. But, the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their baseline of polydipsic water intakes. Conclusion : Above findings suggest that the fixed time feeding Procedure for Schedule induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. In clinical situation, the authors suggest that atypical antipsychotic drugs which act as serotonin and dopamine receptor antagonist may be helpful to improve the symptoms of the patients with treatment refractory obsessive-compulsive disorder.

하악 제3대구치가 하악 우각부골절 정복술후 감염에 미치는 영향에 관한 연구

최문기,민승기,이동근,오승환 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.3

Any fracture passing through the socket of a teeth is compounded intraorally, even if the fracture is not displaced and the tooth is firm in its socket. Before the advent of antibiotic therapy the danger of infection in a compounded fracture posed severe problems in treatment. Infection is reduced by antibiotic therapy but prolonged use of antibiotics is not justified in an attempt to save a tooth which might eventually be sacrificed. There is still controversy in the management of third molar in mandibualr angle fracture, particularly in regard to their retention or removal at the time of fracture treatment. So we surveyed the 159 patients who were treated with open reduction of mandibular angle fracture containing third molar in fracture line, and compared with the postoperative infection rate depending on time intervals between injury and operation, eruption state of third molar, non-extraction or extraction of third molar related to eruption state, non-extraction or extraction of third molar related to condiition of third molar and its surrounding periodontium and were to propose treatment guidline of third molar in mandibular angle fracture The results obtained were as follows : 1.There were no statistical significance between the time from injury to operation and postoperative infection. 2.There were no statistical significance between eruption state of third molar and postoperative infection. 3.In case of retention of the third molar, there were no statistical significance between eruption state of third molar and postoperative infection, but in case of extraction, postoperative infection was high rate in complete impacted cases. 4.There were no statistical significance between non-extraction or extraction of third molar and postoperative infection depending on condition of third molar. There are no difference in infection rate statistically according to the time from injury to operation, eruption state and condition of third molar, but retention of third molar revealed lowered infection rate in completely impacted cases. By terms of the manegement of third molar, we should extract or preserve third molar in the line of the mandibular angle fracture according to possibility of infection.