근긴장성 이영양증 환자 1례에 대한 보고

권용욱,조종훈,정필현,강석 東國大學校醫學硏究所 1997 東國醫學 Vol.4 No.-

근긴장성 이영양증은 1909년 Steinert에 의해 처음으로 보고된 질환으로 상염색체 우성유전으로 발현되며 근긴장증 이외에 전신증상이 함께 나타나는데, 전두두 대머리, 긴 얼굴, 안검하수, 역전된 미소모양의 입술등이 보이고 식도, 대장, 자궁 등의 평활근도 침범하여 연하곤란, 구음장애, 변비, 분만장애 등을 일으킬 수 있다. 또한 심장비대와 심장전도의 이상을 동반하는 경우 이로 인한 부정맥이 주요 사망원인이 될 수 있다. 이러한 특징적인 임상증상 외에 근전도 검사상 일명 dive bomber sound 또는 motorcycle sound를 보이는 운동단위전위가 특징적으로 관찰된다. 본 교실에서는 좌측 근위약을 호소하고 원위부보다 근위부 근력이 더 심하게 약화되어 있는 근긴장성 이 영양증 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Myotonic dystrophy, first described by Steinert in 1909, is an autosomal dominant multisystem diease. Most patients note the insidious onset of weakness in the limb muscles or difficulty relaxing muscles after a strong contraction. The evidence of Multisystem involvement includes early frontal balding, less than average intelligence, posterior subcapsular cataracts, abnormal cardiac conduction and testicular tubular cell atrophy. In addition, there is wasting of the facial musculature, including the temporalis, masseter, and stemocleidomastoid muscles, which produces a characteristic long face with ptosis, hollow temples, and a hanging jaw. Electromyography is extremely helpful in making the diagnosis. The presence of myotonic discharges in affected muscles is characteristic finding in electromygraphy. Both the amplitude of the potentials and the frequency of the discharges wax and wane. The sound of the discharges is quite characteristic and in their recognition which is similar to a dive bomber sound or motorcycle sound. We recently experienced a case of myotonic dystrophy who complained unusual symptoms such as the left side weakness, proximal muscle weakness rather than distal muscle weakness. So we report this case with review of the literatures.

상심실성 빈맥환자에서 관상정맥동의 형태비교

현대우,김윤년,박소영,한성욱,허승호,김기식,김권배 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.4

지방간에서 발생한 폐 지방색전증의 병리학적 및 임상적 의의에 대한 연구

권태정,강현욱 大韓法醫學會 2001 대한법의학회지 Vol.25 No.1

Fat embolism is the presence of fat globules in the peripheral circutation and in the lung, brain, kidney, pearl, and so on -not in the fine emulsion of a metabolic lipemia but in globules large enough to obstruct arterioles and capillaries. The fat droplets can deride from fractures of long bone due to disruption of the fatty marrow from extensive bruising of the soft tissue, and from fat tissue in burns. Fat embolism has also been reported in patients suffering from various diseases including alcoholism, fatty liver, diabetes mellitus and pancreatitis. We investigated 19 autopsies with fatty liver of varying degrees to establish a correlation between fatty change of limier and pulmonary fat embolism. Among 19 cases, 3 cases with moderate to severe fatty change of elver, and 1 case with submassive hepatic necrosis and mild fatty change showed Grade II pulmonary fat embolism. In histologic section with Sudan III stain, the arteries and capillaries of lung were occupied and distended by round, oval, or staghorn fat globules. The alveoli may contain edema fluid and blood Although the pulmonary fat embolism occuring in the presented cases didn't cause death on its own, one should be aware that a life-threatening mobilization of fat into the lungs and ever into the systemic circulation is possible In fatty fiver and submassive hepatic necrosis.

임상검체에서 분리된 그람 음성 세균들에 대한 Isepamicin의 시험관내 항균력

권현희,박수진,소민욱,박현구,최성호,김미나,최상호,정진용,우준희,김양수 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : The increasing incidence of multidrug-resistant gram-negative bacteria causing nosocomial infections is an important clinical problem. Isepamicin is a recently developed aminoglycoside which has been known to have potent activity against gram-negative organisms. We evaluated the in vitro activities of isepamicin and other aminoglycosides against a large number of gram-negative organisms. Materials and Methods : We tested the in vitro antimicrobial activities of isepamicin, amikacin, gentamicin, and tobramycin against 566 gram-negative organisms collected between January 2006 and June 2006 in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined and interpreted according to the recommendations of Clinical and Laboratory Standard Institute (CLSI). The breakpoint MIC used for interpretation of isepamicin was MIC≤16 ㎍/mL as susceptible, 32 ㎍/mL as intermediate, and 64 ㎍/mL as resistant. Results : The MIC_(50)/MIC_(90) of isepamicln for Escherichia coli, Klebsiella pneumon/ae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae were 1/2, 0.5/>128, 4/16, 16/>128, and 1/2 ㎍/mL, respectively. The susceptibilities for E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, and E. cloacae were 100%, 86.4%, 89.7%, 50.0%, and 96.6%, respectively. For E. coli, K. pneumoniae, P. aeruginosa, and E. cloacae, isepamicln had better in vitro activities than gentamicin and tobromycin, and had similar activities with amlkacin. For A. baumanii, all four tested aminoglycosides had similar in vitro activities. Conclusion : Isepamicin had excellent in vitro activities against gram-negative organisms, except A. baumanii. The overall in vitro activities were similar with amikacin. 목적 : 그람 음성 세균은 다양한 지역사회 및 병원 획득 감염의 원인균이다. 최근에는 병원 감염을 일으키는 그람 음성 세균에서 항균제 내성균의 출현과 확산이 큰 문제가 되고 있다. Isepamicin은 최근에 소개된 gentamicin B의 유도체로 외국에서의 연구에 의하면 그람 음성 세균들에 대한 항균력이 우수함이 보고 된 바 있다. 본 연구에서는 우리나라의 임상 균주들을 대상으로 그람 음성세균에서 isepamicin의 시험관내 항균력을 기존의 아미노배당체 제재들과 비교하여 평가하고자 하였다. 재료 및 방법 : 2006년 1월에서 6월 사이에 서울아산병원 환자에서 분리된 Escherichia coli 113 균주, Klebsiella pneumoniae 110 균주, Pseudomonas aeruginosa 117 균주, Acinetobacter baumannii 108 균주, 그리고 Enterobacter cloacae 118 균주를 대상으로 isepaimcin, amikacin, gentamicin, tobramycin에 대한 최소억제농도(minimal inhibitory concentration, MIC)를 한천 희석법(Mueller-Hinton Agar)을 이용하여 측정하였다. 감수성여부는 CLSI 기준에 따랐으며, isepamicin은 MIC≤16㎍/mL를 감수성, MIC=32 ㎍/mL를 중등도 내성, MIC≥64 ㎍/mL를 내성으로 판정하였다. 결과 : Isepamicm의 E. coli, K. pneumoniae, P. aeruginosa, A baumannii, E. cloacae에 대한 MIC_(50)/MIC_(90)은 각각 1/2, 0.5/>128, 4/16, 16/>128, 1/2 ㎍/mL였고, 항균제 감수성률은 차례대로 100%, 86.4%, 89.7%, 50.0%, 96.6%였다. 기존 아미노배당체 제재들과 비교하면 E. coli, K. pneumoniae, P. aeruginosa, E. cloacae에서는 amikacin과 비슷한 감수성률을 보였고, gentamicin과 tobramycin보다 높은 감수성률을 보였다. A baumannii의 경우 isepamicin의 감수성률이 50.0%로 비교적 낮았지만 amikacin, gentamicin, tobramycin도 각각 50.0%, 46.3%, 47.2%의 감수성률을 나타내어 4가지 항균제가 모두 비슷한 항균력을 보였다. 결론 : Isepamicin은 그람 음성 세균들에 있어 기존의 아미노배당체 제재들과 비교했을 때 amikacin과는 동등한 시험관내 항균력을 보이고 gentamicin, tobramycin보다 뛰어난 시험관내 항균력을 보여 사용이 유망한 아미노배당체 중 하나라 생각된다.

급성 ST 분절 상승 심근경색증의 표준진료지침 설계

권선옥,김우식,오명기,나종천,이홍기,조욱현,최석구 인제대학교 2006 仁濟醫學 Vol.27 No.-

The use of critical pathways for a variety of clinical conditions has grown rapidly in recent years, particularly pathways for patients with acute myocardial infarction. We intend to determine the impact of a clinical pathway on ST-elevation myocardial infarction (STEMI) and to evaluate the efficacy and safety of facilitated percutaneous coronary intervention (PCI) compared with primary PCI. Low risk STEMI patients (ST elevation >0.1mV in more than 2 limb leads or ST elevation >0.2mV in contiguous precordial lead, chest pain lasting more than 30 min without response to nitroglycerin) will be included. All patients will be also treated medically according to critical pathway. STEMI is one of the common diseases in emergency medicine and so it is necessary to establish realistic treatment guidelines. The use of critical pathways will improve the quality of care.

Escherichia coli 패혈증 환자에 합병된 대칭적 하지 말단 괴사증 1예

남해성,유진홍,권순석,민준기,조현선,박민경,심병주,남유정,이지인,김진수,길욱현,조근종,신완식 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

We have encountered a rare case of symmetrical peripheral gangrene complicating Escherichia coli sepsis in a 47-years-old male. He was successfully treated with antibiotics, anticoagulants, and vasodilator. To our knowledge, this is the first report on symmetrical peripheral gangrene complicating E. coli sepsis in Korea.

EDM 가공 공정에서 세장비 극대화를 위한 미세구멍의 최적가공 조건 결정

정종혁,이현욱,권원태 한국공작기계학회 2009 한국공작기계학회 춘계학술대회논문집 Vol.2009 No.-

Demand of micro holes has been increased fast, especially in the area of inkjet nozzle, micro turbine and optical parts. However, the micro hole with 40㎛ exit diameter and aspect ratio of 10 has yet to be reported. In this study, an endeavor was made to manufacture the micro hole under over 40㎛ exit diameter at stainless steel plate with 40㎛ thickness. To accomplish the goal, the relationship between machining parameters and machined result was identified. It was found that the entrance clearance was proportional to the discharge power, when discharge energy was kept constant and resistance had to be as high as possible at the given condition to minimize the machining time. 40㎛ average diameter of the micro hole with over 10 aspect ratio was achieved under the condition of 60V, 680pF, 500Ω, 1.5㎛ and 1500rpm.

연속냉간압연의 두께제어 모델 개발에 관한 연구

손준식,김일수,권욱현,최승갑,박철재,이덕만 한국공작기계학회 2001 한국생산제조학회지 Vol.10 No.5

The quality requirements for thickness accuracy in cold rolling continue to become more stringent, particularly in response to exacting design specification from automotive customers. One of the major impacts from the tighter tolerance level is more unusable product on the head end and tail end of tandem mill coils when the mill is in transition to or from steady state rolling condition. A strip thickness control system for a tandem cold steel rolling mills is composed with blocked non-interacting controller and controllers for strip thickness and tension control of each rolling stands. An intelligent mathematical model included an elastic deformation of strip has been developed and applied to the field in order to predict the rolling force. The simulated results showed that the effect of elastic recovery should be included the model, even if the effect of elastic compression was not important.

직업성 요통 환자에서 항 제 I 형 교원질 항체역가의 의의

이종민,권용욱,김수근,임현술,김지용,정준호 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.1

항혈청 투여에 따른 돼지 전염성 설사병 예방효과 : Ⅰ.혈청학적 결과, RT-PCR 검사, 형광항체검사 Ⅱ.Serological Results, Rt-PCR for Fecal and Small Intestin, FA Test

지영철,한정희,권혁무,한태욱,정현규,박봉균 한국수의병리학회 2002 한국수의병리학회지 Vol.6 No.1

The purpose of this study was to investigate to potective effects against porcine epidemic diarrhea virus (REDV) infection in piglets by administration of the PEDV antiserum orally at 2 hrs, 24 hrs and 36 hrs after birth. six piglets adiminstered the antiserum were experimentally infected with PEDV at five-day-old. Control group were four piglets infected with PEDV only. Serum antibody titers aginst PEDV were examined by serum neutralization (SN) test, dectection for PEDV or PEDV antigen from feces and small intestines was tested by reverse transcrption-polymerase chain reaction (RT-PCR) and indirect immunoflurescence (IFA). The results obtained were as follows; 1. The piglets administered the PEDV antiserum showed higher antibody titers than those of control group and sustained during the experimental period. 2. The detection rate of PEDV in feces and small intestines by RT-PCR were 26.2% and 16.7% in PEDV antiserum treated group and 48.1% and 75.0% in control group, respectively. 3. The detection rate of PEDV antigen in the small intestine by IFA were 0% in PEDV antiserum treated group and 50.0% in control group, respectively. It was concluded that oral administration of antiserum against PEDV to piglets was effective in preventing PEDV infection.