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다양한 신경학적 이상을 나타낸 glufosinate ammonium(바스타$^{(R)}$) 급성 경구 중독 1례
백진휘,김준식,이현규,박현주,하충건,노형근,Paik Jin Hui,Kim Jun Sig,Yi Hyeon Gyu,Park Hyun Joo,Ha Choong-Kun,Roh Hyung-Keun 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2
BASTA is an herbicide which contains glufosinate ammonium as a main component with an anionic surfactant, polyoxyethylene alkylether sulfate, and nonselectively inhibits glutamine synthetase. It became a wildly used herbicide in Korea and its intoxication is now increasing. A 42-year old woman ingested about 300ml of BASTA in a suicide attempt. She showed unconsciousness and respiratory distress in the beginning, and later developed multiple generalized convulsions, low blood pressure, fever and diabetes insipidus. Although she became alert 12 days after the ingestion, she showed retrograde amnesia for a period of about recent 10 years. A neuropsychological test on day 22 revealed frontal lobe dysfunction, visual memory disturbance and slight decrease in visuospatial function. All these neurological abnormalities that might occur due to glufosinate ammonium were almost improved in the follow-up test performed a month later.
지기환,이정,윤창호,하충건,Ji, Ki-Hwan,Lee, Jeong,Yun, Chang-Ho,Ha, Choong-Kun 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.2
Metronidazole is an antimicrobial drug widely used against various types of infectious agents, including protozoa, amoeba, Helicobacter pylori, and anaerobes. Metronidazole may produce some adverse effects on hematologic, immunologic, neurologic and other systems. We report a case of reversible metronidazole-induced encephalopathy. The toxic dose of metronidazole and the onset of encephalopathy were variable. Two patients showed abnormally high signal intensity in the bilateral dentate nucleus of cerebellum, and characteristic abnormalities were detected by brain magnetic resonance imaging (MRI) and T2-weighted images, fluid-attenuated inversion recovery images and/or diffusion weighted imaging (DWI). Discontinuation of metronidazole resulted in the improvement of the neurologic symptoms over a period of two to three weeks. We followed up the brain MRI with DWI in one case following obvious clinical improvement, and the previously detected lesion had disappeared.
다양한 신경학적 이상을 나타낸 glufosinate ammonium(바스타®) 급성 경구 중독 1례
백진휘 ( Jin Hui Paik ),김준식 ( Jun Sig Kim ),이현규 ( Hyeon Gyu Yi ),박현주 ( Hyun Joo Park ),하충건 ( Choong Kun Ha ),노형근 ( Hyung Keun Roh ) 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2
BASTA is an herbicide which contains glufosinate ammonium as a main component with an anionic surfactant, polyoxyethylene alkylether sulfate, and nonselectively inhibits glutamine synthetase. It became a wildly used herbicide in Korea and its intoxication is now increasing. A 42-year old woman ingested about 300ml of BASTA in a suicide attempt. She showed unconsciousness and respiratory distress in the beginning, and later developed multiple generalized convulsions, low blood pressure, fever and diabetes insipidus. Although she became alert 12 days after the ingestion, she showed retrograde amnesia for a period of about recent 10 years. A neuropsychological test on day 22 revealed frontal lobe dysfunction, visual memory disturbance and slight decrease in visuospatial function. All these neurological abnormalities that might occur due to glufosinate ammonium were almost improved in the followup test performed a month later.
이상열,임병훈,하충건 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1
The anterior interosseous nerve syndrome is a compressive neuropathy of a motor branch of the median nerve, caused by tendinous bands (deep head of pronator teres, arcade of flexor superficialis, thickened lacertus fibrosus etc, trauma, enlarged bursae, tumors, anomalous muscles such as Gantser's muscle or palmaris brevis. On clinical examination, there is weakness or paralysis of the flexor pollicis longus, flexor digitorum profundus of the index finger, and the pronator quadratus muscles with a history of pain in the proximal forearm. The patients will assume a weakness of pinch or an unusual posture of pinch without sensory deficit because of loss of function of these muscles, hyperextending the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. We experienced two cases of anterior interosseous nerve syndrome with typical clinical manifestations, confirmed by electrodiagnostic studies. In both cases causative anatomical structures were released through surgical exploration. A case was caused by a sharp edge of the flexor superficialis arcade, another case by the tendinous portion of deep head of pronator teres muscle and a thickened lacertus fibrosus. Both cases revealed partial recoveries after postoperative 3 months.
자발성 뇌실출혈의 원인 및 임상적 고찰 : Etiology and Clinical Analysis
하충건,김재일,정진명 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12
Spontaneous intraventricular hemorrhage(IVH) is divided into primary IVH(PIVH) and secondary IVH(SIVH). PIVH is further divided into primary confined IVH(PCIVH) and primary junctional IVH(PJIVH). To evaluate the difference in clinical, etiological and prognostic aspects on the type, location and extent of IVH, we analyzed retrospectively total 53 cases with IVH diagnosed by brain CT for a period of 3 years. We excluded traumatic IVH and IVH due to germinal matrix hemorrhage in premature infant. The incidence of IVH was 23.9%(53 cases) of total 222 hemorrhagic strokes. PIVH and SIVH were 12 cases(PCIVH 8, PJIVH 4) and 41 cases respectively. Age of onset was more younger in PCIVH. All except 3PCIVH was abrupt in mode of onset. The main initial manifestation was headache in PIVH, and altered mentality in SIVH. Most of them whose mentality had been intact on initial examination or improved during the clinical course was PIVH with relatively small amount of hematoma. Sixteen cases with focal neurologic deficits were all SIVH without exception. Meningeal irritation signs were observed in 30 cases, who all showed presence of blood in the fourth ventricle irrespective of the type of IVH. The etiology of IVH was hypertensive intracranial hemorrhage in 23 cases(PIVH 3, SIVH 20), rupture of aneurysm 16(PIVH 2, SIVH 14), bleeding from arteriovenous malformation 5(PIVH 2,SIVH 3), respectively. Other minor causes were complication of anticoagulation. bleeding tendency due to liver cirrhosis, intracranial metastasis of leukemia and Moyamoya disease, and unknown in 4 cases. Distribution of IVH was lateral ventricle only in 14 cases(PIVH 5), the fourth only 3, lateral and the third 9(PIVH 2), the third and the fourth 2, all ventricle in remainder 25 cases. The better mentality was on initial examination and the smaller amount of hematoma was on CT, the better prognosis was revealed. Patients with PIVH had better prognosis than those with SIVH. But there was no definite difference in prognosis on the etiology of IVH.
열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구
배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2
Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.