흉부외상이 동반된 다발성 외상환자에서 폐손상 점수가 중환자실 치료에 미치는 영향

한국남 ( Kook Nam Han ),최석호 ( Seok Ho Choi ),김영철 ( Yeong Cheol Kim ),이경학 ( Kyoung Hak Lee ),이수언 ( Soo Eon Lee ),정기영 ( Ki Young Jeong ),서길준 ( Gil Joon Suh ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2

Purpose: Chest injuries in multiple trauma patients are major predisposing factor for increased length of stay in intensive care unit, prolonged mechanical ventilator, and respiratory complications such as pneumonia. The aim of this study is the evaluation of lung injury score as a risk factor for prolonged management in intensive care unit (ICU). Methods: Between June to August in 2011, 46 patients admitted to shock and trauma center in our hospital and 24 patients had associated chest damage without traumatic brain injury. Retrospectively, we calculated injury severity score (ISS), lung injury score, and the number of fractured ribs and performed nonparametric correlation analysis with length of stay in ICU and mechanical ventilator support. Results: Calculated lung injury score (<48 hours) was median 1(0-3) and ISS was median 30(8-38) in study population. They had median 2(0-14) fractured ribs. There were 2 bilateral fractures and 2 flail chest. Ventilator support was needed in 11(45.8%) of them for median 39 hours (6-166). The ISS of ventilator support group was median 34(24-34) and lung injury score was median 1.7(1.3-2.5). Tracheostomy was performed in one patient and it was only complicated case and ICU stay days was median 9(4-16). In correlation analysis, Lung injury score and ISS were significant with the length of stay in ICU but the number of fractured ribs and lung injury score were predicting factors for prolonged mechanical ventilator support. Conclusion: Lung injury score could be a possible prognostic factor for the prediction of increased length of stay in ICU and need for mechanical ventilator support.

간이식 후 발생한 간세포암의 폐 전이에 대한 종양절제술의 역할

김현수(Hyun Soo Kim),서경석(Kyung-Suk Suh),전영민(Young-Min Jun),김태훈(Teahoon Kim),신우영(Woo Young Shin),이남준(Nam-Joon Yi),한국남(Kook Nam Han),김영태(Young Tae Kim),김태유(Tae-You Kim),이건욱(Kuhn Uk Lee) 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.4

Purpose: Liver transplantation (LT) has been advocated as a good management option for patients with hepatocellular carcinoma (HCC). The rate of HCC recurrence after LT is about 20%. Although the median survival time of patients with HCC recurrence is 7∼9 months, the role of surgical treatment for metastatic tumors has been reported on. In this study, we evaluated the role of metastasectomy for treating patients with pulmonary metastasis from HCC after LT. Methods: We retrospectively analyzed 10 patients with pulmonary metastasis after LT and who were treated between April 2005 and October 2007. The underlying liver disease was cirrhosis caused by chronic viral hepatitis. The surveillance protocol for HCC recurrence was as follows: assessing the serum alpha-fetoprotein level every 1 month, chest and abdomen-pelvic computed tomography every 3 months and a bone scan every 1 year or when bone metastasis was suspected. The patients with less than 3 metastatic lesions were recommended to undergo metastasectomy (Group S, n=6) and the patients with more 4 lesions were recommended nonsurgical management, including chemotherapy (Group N, n=4). Results: All the metastatic lesions were detected on the protocol chest CT scans. The median recurrence time was 7.4 months (0.8∼18.2) after LT; this was 11.0 (4.8∼18.2) months for Group S and 2.0 (0.8∼3.3) months for Group N. One patient had a single lesion and the others had multiple lesions on multilobes. The median survival times of Group S were 29.3 (18.5∼41.3) months after pulmonary metastasis and 40.3 (23.3∼48.0) months after transplantation; 5 patients had no recorded evidence of their disease status. The median survival time of Group N was 4.3 (4.0∼6.3) months after metastasis and 6.2 (5.3∼7.1) months after transplantation; all the patients have since died. Conclusion: The survival outcome seemed to be good for the patients who underwent pulmonary metastasectomy for HCC, if it was detected earlier and it was resectable (≤3 lesions). However, further study is required for validating the survival benefit of pulmonary metastasectomy.

Electrokinetic Property and Flotation Characteristics of Scheelite

최형섭,한국남,Hyung Sup Choi,Kook Nam Han Korean Chemical Society 1963 대한화학회지 Vol.7 No.1

本硏究에서는 韓國産 灰重石($CaWO_4$)에 關하여 固相一液相界面에 있어서의 電氣化學的 性質을 電氣泳動法으로 調査하고 한便 浮遊性에 關하여서는 捕收劑로 Dodecyl ammonium chloride(D.A.C.라 略稱)와 Sodium dodecyl sulfate(S.D.S.라 略稱)를 使用하여 Hallimond tube 試驗, 接觸角測定 及 吸着量測定等의 捕收劑 이온이 鑛物表面에 吸着하는데 있어서 電氣的인 相互作用이 重要한 役割을 하고 있다는 것을 實證하였다. 卽 電氣泳動法으로 鑛粒의 水溶液中에 있어서의 mobility를 測定한 結果 灰重石의 境遇에는 $Ca^{++}$ 或은 $WO_4^{--}$이 界面 電氣特性을 決定하는 potental determining ion이라는 것이 確認되었고 水溶液中에 있는 $Ca^{++}$의 增加는 鑛粒界面의 陰電荷를 減少하며 $WO_4^{--}$의 增加는 그 陰電荷를 增加한다는 것을 알수 있다. 이와같은 表面에 "陰이온系"의 S.D.S. 或은 "陽이온系"의 D.A.C.를 作用시키면 當然히 S.D.S.는 $Ca^{++}$의 增加에 따라 吸着量이 增加되어 浮遊性이 增大되고 한便 D.A.C. 때는 反對로 $WO_4^{--}$이 增加하는데 따라 吸着量이 增加되며 따라서 浮遊性도 增大된다고 불수 있고 實地로 捕收劑吸着量의 測定 및 Hallimond tube 實驗은 이것을 立證하고 있다. 이러한 基礎的인 究明은 灰重石浮選理論의 根幹이 되는 것이고 從來의 浮選法 改良에 對한 指針이 될수 있다고 生覺한다. The fundamental investigations of surface properties of scheelite were made by electrophoretic mobility adsorption and contact angle measurements, and results have been correlated with its floatability obtained by Hallimond tube flotation test. The role of the interfacial electrical condition on the adsorption of collectors on mineral surfaces is discussed with the flotation of scheelite. From electrokinetic measurements made on scheelite, $Ca^{++}$ and $WO_4^{--}$ are identified to act as potential-determining ions, thus controlling the surface properties on this mineral. Therefore, at the fixed pH, the scheelite surface become to be less negatively charged with increasing $Ca^{++}$ concentration and more negatively charged with increasing $WO_4^{--}$ concentration in the pulp. Adsorption of collectors then depends strongly on the concentration of $Ca^{++}$ or $WO_4^{--}$ in the solution; anionic collectors are adsorbed on less negatively charged surfaces and cationic collectors on more negatively charged surfaces, which in turn defines the effective flotation range with respective collectors for this mineral.

외상으로 인한 대량 출혈 환자에서의 예후인자 분석

최석호 ( Seok Ho Choi ),서길준 ( Gil Joon Suh ),김영철 ( Yeong Cheol Kim ),권운용 ( Woon Yong Kwon ),한국남 ( Kook Nam Han ),이경학 ( Kyoung Hak Lee ),이수언 ( Soo Eon Lee ),고승제 ( Seung Je Go ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4

Purpose: Hemorrhage is a main cause of death in trauma patients. The goal of this study is to describe the characteristics of trauma patients with massive bleeding and to evaluate the prognostic factors concerning their survival. Methods: This study was performed retrospectively and included trauma patients with massive bleeding who had been treated from March 2007 to August 2012. The inclusion criterion was patients who received more than 10 U of packed red blood cells within the first 24 hours after visiting the emergency department. Based on their medical records, we collected data in terms of demographic findings, mechanisms of injury, initial clinical and laboratory findings, methods for hemostasis (emergency surgery and/or angioembolization), transfusion, injury severity score (ISS), revised trauma score (RTS) and trauma and injury severity score (TRISS). We used the Mann-Whitney U test and Fisher`s exact test to compare the variables between the patients that survived and those that did not. We performed a logistic regression analysis with the significant variables from the univariate test. Results: Thirty-two(32) patients were enrolled. The main mechanisms of injury were falls and motor vehicle accidents. The mean transfusion amount of packed red blood cells (PRBC) was 17.4 U. The mean elapsed time for the first hemostasis (surgery or embolization) was 3.5 hours. The initial technical success rates were 83.3%(15/18) in angioembolization and 66.7%(8/12) in surgery. The overall mortality rate was 34.4%(11/32). The causes of death were bleeding, brain swelling and multiple organ failure. The ISS(25.5 vs 46.3, p=0.000), TRISS(73.6 vs 45.1, p=0.034) and base excess(<-12 mmol/L, p=0.020) were significantly different between the patients who survived and those who did not. Conclusion: The ISS was a prognostic factor for trauma patients with massive bleeding. (J Trauma Inj 2012;25:247-253)

無痛分娩의 理論과 實際

韓國男 亞洲藥品 1987 臨床 醫藥 Vol.3 No.7