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김성환,황성오,이강현,조준휘,강구현,문중범,이승환,윤정한,최경훈,김영식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3
Background: The aim of this study was to determine whether the conventional subcostal approach is suitable for emergency pericardiocentesis in patients with cardiac tamponade or impending cardiac tamponade. Methods: This study was a prospective, observational study conducted at the emergency department of a tertiary hospital, Patients who had symptomatic pericardial effusion and who needed emergency pericardiocentesis in the emergency department were included in this study. We measured the epicardium-to-pericardium distance at the subcostal, parasternal, and apical area with two-dimensional echocardiography to determine the appropriate puncture site for pericardiocentesis. An epicardium-to-pericardium distance of more than 1.0 cm was considered as the primary safety factor in determining the Puncture site for pericardiocentesis. The skin-to-pericardium distance was considered as secondary safety factor. Results: Ninety-five consecutive patients(55 males and 40 females; total mean age: 53 year old) with cardiac tamponade or impending cardiac tamponade were enrolled in this study. The puncture site for pericardiocentesis, as determined by echocardiography, was the subcostal area in 43 patients(45%), the apical area in 40 patients(42%), the left parasternal area In 11 patients(12%), and the right parastemal area in one patient(1%). Pericardiocentesis failed in 2 patients(2%) with the subcostal approach and in one patient(1%) with the apical approach. The average epicardium-to-pericardium distance was 31 ±21 mm in patients with the subcostal approach and 21±8 mm in patients with other approaches. There were no differences in the amount of pericardial fluid and in the intraperical pressure among patient groups according to puncture site. There were two procedure related complications: a puncture of the right ventricle with the subcostal approach and a ventricular tachycardia with the apical approach.
기니픽과 마우스에서 천연형 재조합 사람 Erythropoietin (EPO) , DA-3285 의 항원성
김범준(Bum Jun Kim),남석우(Suk Woo Nam),박종선(Jong Sun Park),강경구(Kyung Koo Kang),김원배(Won Bae Kim),한정환(Jeung Whan Han),이병무(Byung Mu Lee),이향우(Hyang Woo Lee),홍성렬(Sung Youl Hong) 한국응용약물학회 1996 Biomolecules & Therapeutics(구 응용약물학회지) Vol.4 No.4
Antigenicity of DA-3285, human recombinant erythropoietin which was produced from mammalian cells, was examined in guinea pigs and mice. In active systemic anaphylactic test, mild anaphylactic signs were observed in guinea pigs sensitized subcutaneously with DA-3285 or DA-3285 incorporated with complete Freund`s adjuvant(CFA) when challenged with high dose(1000 IU/Kg) of DA-3285. Other groups showed negative responses. In mouse-rat passive cutaneous anaphylaxis test, 20% sera of mice immunized with DA-3285 or DA-3285 mixed with aluminum hydroxide(alum) showed mild positive responses. In the case of indirect haemagglutination reaction(IHA) test, when sheep red blood cells coated with DA-3285 was incubated with mouse serum, all the serum samples were showed negative responses. These results suggest that DA-3285 has a very weak antigenic potential and probably would not induce systemic allergic reactions in clinical uses.
( Kyoung Hee Kim ),( Tae Yun Park ),( Eun Sun Kim ),( Keun Bum Chung ),( Sang Min Lee ),( Jae Joon Yim ),( Chul Gyu Yoo ),( Young Whan Kim ),( Sung Koo Han ),( Seok Chul Yang ) 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.3
Background/Aims: Home oxygen therapy (HOT) costs a great deal every year and demand for the service is growing. In Korea, health insurance has covered HOT since November 1, 2006. The objective of this study was to evaluate clinical features of patients who used long-term HOT due to chronic respiratory failure and to determine the appropriateness of oxygen prescriptions. Methods: Between November 2006 and April 2010, patients prescribed long-term HOT were enrolled in the study at a tertiary university referral hospital and their medical records and telephone survey information were evaluated. In total, 340 patients were evaluated retrospectively. Results: Regarding the initial indications for HOT, their mean PaO2 was 49.8 mmHg and mean SpO2 was 82.2%. Underlying diseases included chronic obstructive pulmonary disease (COPD, 19.8%), lung cancer (12.6%), and interstitial lung disease (11.2%). The admission rate within 1 year was 53.4% and the average number of admissions was 1.64/patient. Other underlying diseases for which oxygen was prescribed, despite not meeting the insurance coverage criteria, were lung cancer (36.6%) and interstitial pneumonia (16.6%). Conclusions: Home oxygen prescriptions have increased since health insurance coverage was extended. However, cases of oxygen prescriptions frequently do not meet the coverage criteria. It is important to discuss extending the coverage criteria to other disease groups, such as interstitial lung disease and lung cancer, in terms of costeffectiveness. Further, physicians prescribing oxygen therapy should be educated regarding the criteria.
이윤민,송석환,최기범,이승구,Lee, Yoon-Min,Song, Seok-Whan,Choi, Ki-Bum,Rhee, Seung-Koo 대한미세수술학회 2011 Archives of reconstructive microsurgery Vol.20 No.2
Purpose: As clinical manifestations of thoracic outlet syndrome are vague pain or symptoms in upper extremity, the diagnosis of the disease is delayed or misdiagnosed as cervical HNP, shoulder pathologies, or peripheral neuropathies. In that reason, many patients spend time for unnecessary or ineffective treatments. We report the results of our thoracic outlet syndrome cases, which were treated by conservative care or surgical treatment. Materials & Methods: Twenty five cases, diagnosed as thoracic outlet syndrome since 1999, were reviewed retrospectively. Physical examinations including Adson's and reverse Adson's test, hyperabduction test, costoclavicular maneuver, and Roo's test, plain radiography of shoulder and cervical spine, MRI of neck or brachial plexus, and EMG were checked. If subjective symptoms were not improved after conservative treatments over three months, surgical treatment were performed. Nine patients were performed operative treatment and the others had conservative treatment in outpatient clinic. Postoperative improvement of symptoms and the follow up period, and the results of conservative care were reviewed. Results: Among five physical examinations, mean 1.75 tests were positive, and EMG has little diagnostic value. MRI were performed in twenty cases and compression of brachial plexus were found in 6 cases (30%). Ten patients out of 16 conservative treatment group had excellent improvement of symptoms, and 5 had good results. Eight patients out of 9 operative treatment group had excellent improvement with mean 5.1 months of follow-up period. Conclusion: Diagnosis of thoracic outlet syndrome is difficult due to bizarre and vague symptoms. However if the diagnosis is suspected by careful physical examinations, radiologic studies, or nerve conduction studies, conservative care should be done as initial treatment and at least after three months, reassess the patient's condition. If the results of conservative treatment is not satisfactory and still the thoracic outlet syndrome is suspected, surgical treatment should be considered. Conservative treatment and operative technique are the valuable for the treatment of this disease.