응급실에서의 노인환자의 섬망

박신율(Sin Youl Park),우정민(Jungmin Woo) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:It is known that delirium is common among elder patients and is associated poor clinical outcomes. As elderly patients are increasing in emergency department(ED), the prevalence of delirium should be on the rise. However delirium has been under-recognized by medical team. Our study was designated to evaluate the frequency, the clinical effect and risk factors of delirium of hospitalized elder patients in ED. Methods:We retrospectively reviewed elderly patients admitted to general ward after over 24 hours hospitalization in ED between January 2008 and December 2008. examined the frequency and assessed the clinical effect and risk factors. Results:Among 414 patients, 42 patients(10.1%) developed delirium in ED over 12 month period studied. The development of delirium in ED was associated with significant poor outcomes ; increased hospital mortality and prolonged hospital stays. Independent risk factors of delirium were stroke, metabolic derangements, dementia, hemodynamic instability, depression. Conclusion:ED environment can be important risk factors of delirium, thus ED physician should try to recognize and correct the possible risk factors of delirium earlier and in particular, should try to reduce exposure time to the ED environment in elderly patients.

순차패턴과 연관규칙을 이용한 고혈압 환자 관리 시스템 개발

박남열 ( Nam Youl Park ),홍재신 ( Jae-sin Hong ),박두순 ( Doo-soon Park ),홍민 ( Min Hong ),이화민 ( Hwa-min Lee ),정영식 ( Young-sik Jeong ) 한국정보처리학회 2009 한국정보처리학회 학술대회논문집 Vol.16 No.1

최근 의료 패러다임은 치료에서 예방과 관리의 개념으로 변화하고 있다. 특히 우리나라 성인 인구 중 20~30%에서 발견되는 만성질환은 예방과 관리가 더욱 필요한 성인병이다. 본 논문에서는 만성 질환 중 지속적인 치료와 예방 그리고 관리가 필요한 고혈압 환자들을 관리하기 위하여 생체 데이터, 검진 데이터, 문진 데이터, 생활 습관 등을 이용하여 순차패턴 방법을 적용한 고혈압 환자에 대한 약제 처방 시스템과 연관규칙을 적용하여 고혈압 환자들에게 24시간 관리가 가능하도록 하는 고혈압 환자 관리 시스템을 개발한다.

Slide Session : OS-END-31 ; Endocrinology : Whole-Exome Sequencing Reveals Strong Genetic Pre-dictors of Antithyroid Drugs Induced Agranulocytosis

( Sin Gi Park ),( Jong Bhak ),( Jong Soo Kim ),( Tae Hyung Kim ),( Jee Hyun An ),( Sang Youl Rhee ),( Hee Kyung Kim ),( Min Joo Kim ),( Hyun Jeong Jeon ),( Taekeun Oh ),( Hyung Jin Choi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Agranulocytosis is a rare but life-threatening side effect of antithyroid drugs. Several reports, including familial cases, suggested that there could be substantial genetic susceptibility determinants which could predict the risk of antithyroid drug induced agranulocytosis. However, no tests are currently available to predict the risk of antithyroid drug induced agranulocytosis. Methods: In this study, we performed whole-exome sequencing to comprehensively identify the genetic variations responsible for antithyroid drug induced agranulocytosis. For discovery stage 1, whole-exome sequencing was performed for seven antithyroid drug induced agranulocytosis cases. Variant based approach and gene based approach were performed to discover candidate variants or genes for antithyroid drug induced agranulocytosis. For HLA loci, HLA-sequence-based typing was performed. For validation stage 2, Sanger sequencing and HLA-sequence-based typing were performed for eight additional independent antithyroid drug induced agranulocytosis cases. Antithyroid drug users without agranulocytosis side effect, Korean local healthy controls and public HLA database were used as control group. Results: Discovery stage genome-wide association study results revealed strong signals in chromosome 6 (P=2.7×10-8) and chromosome 19 (P=1.7×10-14). HLA typing of seven discovery cases and eight validation cases revealed several HLA types, which showed strong association with antithyroid drug induced agranulocytosis (odds ratio=4.6-6.3, P=3×10-3-5×10-5). Gene based approach indicated several candidate genes for antithyroid drug induced agranulocytosis. In these genes, several loss of function variants were found, which were common among antithyroid drug induced agranulocytosis cases, but these variants were very rare among controls (P=2.0×10-3-1.8×10-4). Conclusions: In conclusion, several strong genetic predictors of antithyroid drug induced agranulocytosis were discovered. To avoid the risk of life-threatening agranulocytosis side effect, these pharmacogenomics markers could be tested in clinic before initiation of antithyroid drugs.

호흡훈련을 적용한 연하치료가 뇌졸중 환자의 연하기능과 호흡기능에 미치는 영향

박선희(Park Seon-Hee),고주연(Ko Joo-Yeon),허진강(Hur Jin-Gang),김희수(Kim Hee-Soo),정신호(Chung Sin-Ho),유영열(You Young-Youl) 대한치료과학회 2012 대한치료과학회지 Vol.4 No.2

Objective: The purpose of the present study was to examine the effects of respiratory training (RT) and Sham training (ST) on the swallowing functions and respiratory functions of stroke patients with dysphagia. Method: From July through September 2012, 24 patients with dysphagia due to stroke in R Rehabilitation Hospital located in Gyeonggi-do were divided into two groups of 12 patients each and administered with traditional swallowing therapy for 30 minutes and either RT or ST for 15 minutes five times per week for six weeks. Results: In the comparisons between the two groups, although the experimental group showed improvement compared to the control group, the differences were not significant. As for the correlations between swallowing functions and respiratory functions, significant correlations were shown between RIOC and FVC, between RIOC and FEV1, and between RIPS and FEV1⁄FVC. Conclusion: It could be seen that administering both traditional swallowing therapy and respiratory therapy are more effective to patients with dysphagia due to stroke.

Synthesis and Characterization of Dye-sensitized Solar Cell Using Photoanode of TiO2 Nanoparticles/Ti-Mesh Electrode

Min Woo Park,Ki Young Chun,Joo Sin Lee,Dong Joo Kwak,Youl Moon Sung,Yong Taek Hyun 대한금속재료학회 ( 구 대한금속학회 ) 2009 ELECTRONIC MATERIALS LETTERS Vol.5 No.3

The photoanode of a dye-sensitized solar cell (DSC) utilizing Ti-mesh electrode is fabricated for high-efficiency, low-cost solar cell application. Ti-mesh electrode replaces transparent conducting layer (TCO). The TCO-less DSC is composed of a glass/dye sensitized TiO2 layer/Ti-mesh electrode/electrolyte/metal counter electrode. The Ti-mesh electrode with high conductivity can collect electrons from the TiO2 layer and allows the ionic diffusion of I-/I3 - through the mesh hole. Thin Ti-mesh(~40 μm in thickness) electrode material is processed using the rapid prototype method. Both the photocurrent (6.02 mA/㎠) and fill factor (0.303) are low, and these can be further improved by controlling the pore size and thickness of the mesh, and the contact between the TiO2 particles and the Ti-mesh metal, respectively.

고콜레스테롤혈증 토끼에서 녹차추출물의 동맥경화 치료효과

채희열(Hee-Youl Chai),권운(Woon Kwon),김태명(Tae Myoung Kim),김한얼(Haneul Kim),이남진(Nam Jin Lee),신지순(Ji-Soon Sin),이덕근(Deok Keun Lee),박종범(Jong Bum Park),박승경(Sung-Kyeong Park),황석연(Seock-Yeon Hwang),김윤배(Yun-Bae Kim 한국실험동물학회 2004 Laboratory Animal Research Vol.20 No.3

Cholesterol-lowering and antiatherosclerotic effects of green tea extract were evaluated in hypercholesterolemic rabbits produced by feeding on high-cholesterol diet. Male New Zealand White rabbits were fed on only hypercholesterol diet containing 1% cholesterol and 2% corn oil for 2 weeks, and then green tea extract (1%) or lovastatin (0.002 %) were added to the diet for additional 8 weeks. Blood cholesterol level was greatly increased by 2-week feeding on the hypercholesterol diet to 25 fold (mean 1,057.8 ㎎/㎗) of control level (42.5 ㎎/㎗), and maintained high for additional 8 weeks, in spite of slight reduction to 92.2 % of initial hypercholesterolemia. Such a hypercholesterolemia was significantly reduced by 8-week feeding on green tea extract and lovastatin to 62.6% and 67.4% of initial levels, respectively. Low-density lipoproteins were also markedly enhanced by hypercholesterol diet for 2 weeks to 34 fold (mean 533.3 ㎎/㎗) of control (15.8 ㎎/㎗), and increased further by 181.9 ㎎/㎗ during 8-week feeding on the diet. Compared to no effect of green tea extract (181.3 ㎎/㎗), lovastatin (63.0 ㎎/㎗) significantly attenuated the increase in the level of low-density lipoproteins during 8 weeks. On the other hand, triglycerides were not affected by hypercholesterol diet, and the level of high-density lipoproteins, which had been increased (3.6 fold of control) by hypercholesterol diet, were not considerably affected by green tea extract or lovastatin. Interestingly, thick atheromatous plaques on the wall of aorta of rabbits fed on hypercholesterol diet were markedly attenuated by green tea extract or lovastatin, leading to the decreases in athrosclerosis indices to 1.75 and 1.25, respectively, from 2.25 of rabbits fed on hypercholestrol diet alone. In addition, green tea extract lowered lipid deposition in hepatocytes, showing restricted distribution of foamy hepatocytes. Taken together, it is suggested that green tea extract exert antiatherosclerotic effect by reducing blood cholesterol level.

구강암 환자에서 보존적 경부청소술의 효과

김방신(Bang-Sin Kim),허다니엘(Daniel Hur),김경락(Kyung-Rak Kim),양지웅(Ji-Woong Yang),정연욱(Younwook Jeoung),국민석(Min-Suk Kook),오희균(Hee-Kyun Oh),유선열(Sun-Youl Ryu),박홍주(Hong-Ju Park) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.6

Introduction: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. Materials and Methods: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). Results: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. Conclusion: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.

생쥐 두개골에서 동종골 이식 시 면역억제에 대한 cyclosporine A의 효과

김방신(Bang-Sin Kim),박상묵(Sang Mook Park),김경락(Kyung-Rak Kim),정연욱(Younwook Jeoung),한만승(Man-Seung Han),국민석(Min-Suk Kook),박홍주(Hong-Ju Park),유선열(Sun-Youl Ryu),오희균(Hee-Kyun Oh) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.5

Introduction: This study examined the effect of cyclosporine A (CsA) on the allogenic cranial bone graft in the mice. Materials and Methods:Twenty eight 12-week-old male ICR mice weighing 40 g were used. The experimental group was injected subcutaneously with CsA (10 mg/kg/day) diluted in Caster oil for 7 days prior to the graft until sacrifice. The control group was injected with the same solution without CsA. Two full-thickness bone defects with a diameter of 3 mm were made with a trephine bur in the parietal bone lateral to the sagittal suture. A calvarial defect of a mouse was grafted with allogenic calvarial bone disc from another mouse. The experimental and control groups were injected with CsA and the solution without CsA in the same manner before surgery, respectively. The mice were sacrificed at 1 week, 2 weeks and 4 weeks after the bone graft, respectively. Results: In the experimental group, fibrous connective tissues and small amounts of inflammatory cells were observed. At 2 weeks after the allograft in the experimental group, new bone formation in fibrous collagenous tissue and around the allogenic bone was noted. At 4 weeks after the allograft, new bone formation was active along and at the periphery of the mature allogenic bone. The proliferation of blood vessels increased in bone marrow. In the control group, fibrous tissues and inflammatory cells were observed around the allogenic bone and existing bone at 1 week. At 2 weeks after the allograft, the proliferation of blood vessels accompanied by inflammatory cells were scattered in the fibrous connective tissues. New bone formation around the allogenic and existing bone could be observed. At 4 weeks after the allograft, inflammatory cells were severely infiltrated around the allogenic bone. Osteoclasts were scattered along the allogenic bone and induced bone resorption. Conclusion: These results suggest that the daily administration of CsA (10 mg/kg/day) induces efficient immunosuppression without serious complications,and this protocol might be useful for the experimental model of allogenic bone grafts.

Recurrent hemoptysis in a 26-year-old woman with a ground-glass opacity lesion of the lung

( Jong Ha Kim ),( Sin-youl Park ) 영남대학교 의과대학 2020 Yeungnam University Journal of Medicine Vol.37 No.1

Hemoptysis is a major reason for emergency department (ED) visits. Catamenial hemoptysis (CH), a rare condition of thoracic endometriosis, can cause recurrent hemoptysis but is difficult to diagnose in the ED due to the scarcity of cases and nonspecific clinical findings. We report a case of a 26-year-old woman who presented to the ED with recurrent hemoptysis since 2 years without a definite cause. Her vital signs and blood test findings were unremarkable. Chest computed tomography (CT) did not show any specific lesions other than a non-specific ground-glass opacity pattern in her right lung. She was on day 4 of her menstrual cycle and her hemoptysis frequently occurred during menstruation. Although there was no histological confirmation, based on her history of hemoptysis during menstruation and no other cause of the hemoptysis, the patient was tentatively diagnosed with CH and was administered gonadotropin-releasing hormone. She had no recurrence of hemoptysis for 3 months. While CH is difficult to diagnose in the ED, the patient’s recurrent hemoptysis related to menstruation was a clue to the presence of CH. Therefore, physicians should determine the relationship between hemoptysis and menstruation for women of childbearing age presenting with repeated hemoptysis without a definite cause.

Fatal poisoning cases due to benfuracarb or furathiocarb ingestion

Sang Ki Lee,Ja Youl Yang,Ki Wook Kim,Mee Jung Park,Yoo Sin Park,Hee Sun Chung,Young Chan Yoo 환경독성보건학회 2005 한국독성학회 심포지움 및 학술발표회 Vol.- No.-