발열이 있는 호중구 감소증 환자에서의 위험도 예측인자

정중식,권운용,김규석,임용수,이중의,서길준,윤여규 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. Methods: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. Results: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17,2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr < 75㎖/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). Conclusion: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-prediction factors in febrile neutropenia at the time of visiting the emergency department.

시스틴 결석 : 증례 보고 A Case Report

이길용,노준,정충식 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2

Cystine calculi is the consequence of cystinuria, an autosomal recessive defect of the transepithelial of cystine and dibasic acids in the kidney and intestine. The hardness and frequent reccurrence of cystine stones present a special challenge to the urologist. we report a case of 15-year-old man who had a cystine calculi, which was successfully treated with percutaneous lithotripsy (PCNL), extracorporeal shock wave lithotripsy (ESWL) &edical therapy include high fluid intake, alkalinization and chelating agent.

DNA 증거의 집단유전학적 분석을 위한 SAS시스템

이효정,이혜승,한길로,이재원,황적준 大韓法醫學會 2000 대한법의학회지 Vol.24 No.1

DNA analysis has become one of the most powerful tools in forensic inference for human identification and is now used worldwide. It is used to be statistical technique for the individual identification of a civil and criminal action. The purpose of this article is computerization of the statistical technique for the population study and DNA evidence analysis. The system using SAS/AF and SAS/SCL is the graphic user interface and the correspondence of the changed experimental circumstances

백서 Paraquat 두여에 의한 간과 폐 조직의 산화성 손상에서 Vitamin C와 Deferoxamine의 항산화 효과에 관한 연구

정연권,서길준,정중식,정성은,최국진,윤여규 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The toxicity of paraquat has been known to be caused by oxygen free radicals which leads to the lipid peroxidation and multiple organ failure. Although vitamin C has been known to be a potent antioxidant, recently there are numerous data which have shown that a low dose of vitamin C may act as a prooxidant due to the stimulation of the Fenton reaction with metal ions, which produces hydroxyl radicals. It has been reported that a deferoxamine in paraquat intoxication could reduce the production of the hydroxyl radicals by the inhibition of the Fenton reaction through the reduction of iron ion in tissue. The aim of this study was to evaluate the effect of the high and low dose of vitamin C and deferoxamine on lipid peroxidation and plasma TNF-α in paraquat intoxication. Methods: Female Sprague -Dawley rats were divided into seven groups: control group which was not given paraquat(20 mg/kg), P group which was given paraquat only, PVH group given paraquat and high dose of vitamin C(100 mg/kg), PVL group given paraquat and low dose of vitamin C(10 mg/kg), PVHD given paraquat, high dose of vitamine C and deferoxamine(100 mg/kg), PVLD given paraquat, low dose of vitamin C and deferoxamine, and PD given paraquat and deferoxamine. Animals were killed at 6 and 24 hours after treatment. Malondialdehyde(MDA), superoxide dismutase(SOD) and glutathione(GSH) contents, catalase activity, plasma TNF-α, and histologic changes in the lung and liver tissue were measured. Results: The lung histology in the PVH and PD or PVHD groups showed the significant decreases in the alveolar edema and interstitial thickness compared to the P group. The liver histololgy in the PVH and PVHD groups demonstrated marked differences in the central venous and sinusoidal dilatation compared to that of the P group. While the MDA levels of the lung and liver in the PVH and PD groups showed the significant reduction compared to that of the P group at 6 hours after treatment, all groups showed the significant changes compared to the P group at 24 hours. There was no significant change of the SOD levels of the lung and liver at 6 hours among all groups. At 24 hours, the SOD levels of the lung in PVH, PVL, and PVHD groups showed the significant increases compared to the P group. The increase of the SOD level in groups combined with deferoxamine, however, revealed a little reduction. The SOD level of the liver in PVH group only significantly increased compared to the P group at 24 hours. There was no significant change of the GSH level of the lung and liver among all groups at 6 hours. At 24 hours, the GSH level of the lung and liver were significantly increased in both PVH and PD group and PVH group, respectively, compared to the P group. Although the catalase activity of the lung was not significantly increased, that of liver was signiflcantly increased in both PVHD and PD groups compared to the P group at 6 hours. The catalase activities of the lung and liver were significantly increased in PVH, PD, and PVHD at 24 hours. The concentrations of the plasma TNF-α were slightly decreased at 6 hours and slightly increased at 24 hours compared to that of the P group, but they were not significant. Conclusion: This study showed that although the low dose of vitamin C had no effect, the high dose of vitamin C revealed a decrease of the MDA level and an increase of SOD, GSH, and catalase activity in the lung and liver tissues, and the effect of the high dose of vitamin C increased with time. The administration of the deferoxamine with or without high dose of vitamin C, however, significantly showed the inhibition of the lipid peroxidation and antioxidant effect and low dose vitamin C decreased the effect of deferoxamine. The effects of the vitamin C and deferoxamine on plasma TNP-α were not clearly shown.

패혈증 백서 모델에서 비타민-C의 효과

이중의,신상도,표창해,서길준,정성은,윤여규 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : Multi-organ failure from sepsis is very lethal disease entity, which is suspected to be caused by activated inflammatory cells. Inflammatory cells activated by endotoxins generate oxidants and cytokines such as TNF-α and IL-6, which in turn stimulate macrophages and neutrophils. Augmented inflammation makes an organ-injury deteriorate into an organ-failure, which may progress to multi-organ failure. This study is designed to evaluate the therapeutic effects of vitamin-C, a scavenger of oxidants, in sepsis. Methods : Male Sprague-Dawley rats were divided into 3 groups : a control group, a group injected intrapetoneally with LPS(lipopolysaccharide), and a group injected intraperitoneally with LPS and vitamin-C. Each eight rats were sacrified 24 hours and 48 hours after injection, and samples of the blood, the liver and the lung were obtained. Biochemical assays of TNF-α level in the blood and malondialdehyde(MDA)level, catalase activity and nitric oxide synthase(NOS)activity in the liver and the lung tissues were performed. Results : Serum TNF-α level, tissue lipid peroxidation and tissue i-NOS activity were dramatically increased, and tissue catalase activity was exhausted rapidly in sepsis. High dose vitamin-C administration decreased serum TNF-α level, tissue lipid peroxidation and tissue i-NOS induction, and protected against catalase exhaustion. Conclusion : high dose vitamin-C therapy was proved to have definite antioxidant effect in septic condition.

그라인더(grinder) 사용에 의한 Hand-Arm Vibration Syndrome(HAVS)의 6예

임상혁,김록호,양길승,양정인,김상섭,전형준,박시복 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.3

목 적 : 수지증상이 있는 진동공구 작업자 8명에 대해 객관적이고 체계화된 진단방법을 이용하여 수지진동 증후군을 진단하고자 시행하였다. 방 법 : 과거병력, 가족력 등의 문진과 혈액 및 소변, 방사선 검사를 통해 다른 원인에 의한 레이노씨병을 배제하였고, 공구 측정 결과를 이용하여 작업과의 관련성을 보았으며, 냉수 침지검사와 근전도 검사를 통하여 수지진동 증후군을 진단하고자 하였다. 결 과 : 수지증상이 있는 진동공구 작업자 8명에 대해 과거병력, 가족력, 약물복용 및 과거 직업력 등 레이노씨병을 유발하는 요인에 대하여 조사하였고 특이점은 발견하지 못하였다. 다른 원인에 의한 레이노씨병을 배제하기 위해 혈액 및 소변, 방사선 검사를 하였고 8명 모두에서 특이 소견을 발견하지 못하였다. 위의 문진과 검사결과로 다른 원인에 의한 레이노씨병을 배제할 수 있었다. 해당사업장의 진동 공구 측정결과를 근거로 피검자의 공구가 ISO의 허용기준을 초과함을 알 수 있었다. 냉수 침지검사와 근전도 검사를 이용하여 피검자 8명중 6명이 말초 혈액순환 장해와 말초 신경염이 있는 것으로 진단되었다. 위의 내용을 근거로 6명은 진동에 의한 수지 진동 증후군으로 진단할 수 있었다. 결 론 : 수지증상이 있는 진동공구 작업자 8명에 대해 객관적이고 체계화된 진단방법을 이용하여 수지진동 증후군을 진단하였다. 해당 사업장의 진동 공구 작업자의 진동에 대한 검진이 필요할 것으로 생각된다. Objectives : To confirm the HAVS In workers exposed to hand-arm vibration with using the objective diagnostic methods. Methods : Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes. Results : 8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases (primary Raynaud's disease, secondary Raynaud's disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7.9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS. Conclusions : So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, hand- arm vibration acceleration level, cold provocation test, electromyography.

A comparative study of pulp vitality following vital pulpotomy using calcium hydroxide-based sealants in beagle dogs

Gil Joon Jung, Se Eun Kim, Chun-Sik Bae, Kyung Mi Shim, Seok Hwa Choi, Seong Soo Kang1 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.4

Vital pulpotomy is a very useful method for disarming of canine tooth, tooth fracture, periodontitis, and malocclusion in veterinary dentistry. Calcium hydroxide is the material commonly used as a liner during vital pulpotomy. This creates a mineralized barrier by stimulating osteoblastic hard tissue repair, arrests the inflammatory response, and soothes dentin. However, the powder or mix type calcium hydroxide materials have many disadvantages due to complicated procedures for use and are hard to handle when vital pulpotomy is followed under general anesthesia in animals. This study was conducted in order to compare the effect of mix and premixed paste type calcium hydroxide as a liner in vital pulpotomy. Six beagle dogs underwent hemisection on the mesial root of the mandibular first molar and vital pulpotomy on the distal root of the first molar. On the distal root of the left and right mandibular first molar, mix type (DYCAL®, Dentsply, USA) and premixed paste type calcium hydroxide (VITAPEX®, Morita, Japan) were used as liners, respectively. Radiological evaluation was performed at immediate, 4, 12, and 20 weeks after vital pulpotomy. According to the results, all teeth had well-formed dentinal bridges, and there were no periradicular lucency, lamina dura loss, or anomalies of the pulp cavity. According to these results, on vital pulpotomy in animals, premixed paste type calcium hydroxide was easy to handle and decreased the anesthesia period due to a more convenient application procedure. A further study of many clinical cases is needed for evaluation of side effects and other problems.

A comparative study of pulp vitality following vital pulpotomy using calcium hydroxide-based sealants in beagle dogs

Gil Joon Jung,김세은,배춘식,Kyung Mi Shim,최석화,강성수 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.4

Vital pulpotomy is very useful method for disarming of canine tooth, tooth fracture, periodontitis, and malocclusion in veterinary dentistry. And calcium hydroxide is the commonly used material as liner during vital pulpotomy. This creates a mineralized barrier by stimulating osteoblastic hard tissue repair, arrests the inflammatory response, and soothes dentin. However, the powder or mix type calcium hydroxide materials have many disadvantages because of complicating procedure to use and are hard to be handled when vital pulpotomy is followed under general anesthesia in animals. This study was performed to compare the effect of mix and premixed paste type calcium hydroxide as liner on vital pulpotomy. Six beagle dogs had hemisection on mesial root of mandibular first molar and were performed vital pulpotomy on distal root of first molar. On the distal root of left and right mandibular first molar, mix type (DYCAL®, Dentsply, USA) and premixed paste type calcium hydroxide (VITAPEX®, Morita, Japan) were used as liner, respectively. The radiological evaluation performed at immediate, 4, 12 and 20 weeks after vital pulpotomy. In results, all teeth had dentinal bridges formed well, there were no periradicular lucency, lamina dura loss and anomalies of pulp cavity. Following this results, on vital pulpotomy in animals, premixed paste type calcium hydroxide was easy to handle and decrease the anesthesia period by more convenient application procedure. Further study is needed for many clinical cases to inspect side effects and other problems.

원인 미상의 급성 간염에서 Erythrovirus B19 감염에 관한 연구

정길만(Gil Man Jung),오성남(Sung Nam Oh),김효정(Hyo Jung Kim),김윤홍(Yoon Hong Kim),연종은(Jong Eun Yeon),김종헌(Jong Hun Kim),송진원(Jin Won Song),송기준(Ki Joon Song),백낙주(Nak Joo Baek),이명석(Myung Sek Lee),김재선(Jae Seon Kim) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.5

Background/Aims: Erythrovirus B19 is associated with erythema infectiosum in children and acute arthropathy in adults. Moreover, it causes transient aplastic crisis in hemolytic anemia, chronic anemia in immunocompromised patients, and nonimmune fetal hydrops in pregnant women. Recently, acute hepatitis or fulminant hepatitis in children and adults has been reported infrequently in association with erythrovirus B19 infection. Therefore, we tried to evaluate the relationship between erythrovirus B19 and acute hepatitis of unknown etiology. Methods: Patient group included 70 patients with acute NANBNC hepatitis of unknown etiology, who were admitted to Korea University Guro Hospital from March 1995 to May 1999 (mean age, 48 years; M:F=1:1.7). Control group included 30 patients with chronic liver disease of unknown etiology admitted during the same period. (mean age, 49 years/ M:F=1.1:1). Nested PCR for erythrovirus B19 DNA was performed for sera of the patient and control groups. Results: Among the patient group, only one case was positive for erythrovirus B19 DNA PCR. The nineteen-year- old young man died of fulminant hepatitis of unknown etiology. Among the control group, none was positive for erythrovirus B19 DNA. Conclusions: These results suggest that erythrovirus B19 may be a cause of acute hepatitis of unknown etiology in Korea. In the future, a largescale investigation will be needed to clarify the role of erythrovirus B19 in young patients with acute or fulminant hepatitis of unknown etiology. ( Korean J Gastroenterol 2002; 39: 356-360)

A development of the automated system for adjusting the 6 D.O.F circular fixator

Sang-Gil Jung,Bum-Seok Park,Hyung-Joon Sim,Jae-Ho Jang,Chang-Soo Han,Jung-Soo Han 제어로봇시스템학회 2004 제어로봇시스템학회 국제학술대회 논문집 Vol.2004 No.8