두가지 혈류 유발방법에 의한 새로운 심폐소생술(이중 혈류 유발 심폐소생술)장치의 개발

황성오,김현,조준휘,오범진,임종천,최경훈,윤정한,이승환,김영식,이강현,이윤선 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: There have been many efforts to augment blood flow during cardiopulmonary resuscitation. These efforts have focused on maximizing the effect of cardiac pump or thoracic pump alone. However, considering that the heart is the biggest blood reservoir and increase of intrathoracic pressure can generate blood flow, simultaneous exploitation of both mechanisms may have synergistic effect. We hypothesized that simultaneous chest constriction in addition to sternal compression by standard CPR may have additive hemodynamic effects by preventing deformation of the chest and increase of intrathoracic pressure. Methods and results: we built a new mechanical device to perform compression and thoracic constriction simultaneously. The device consists of two main elements. Piston in the center is to depress the sternum. Strap is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. To determine strap width to produce optimal hemodynamic effect, we measured hemodynamic parameters with variable widths of strap in two dogs after induction of ventricular fibrillation. Result of the experiment showed that 10cm wide strap was determined to be most effective. We also determined optimal depth of compression to produce maximal hemodynamic effect with animal experiments using two dogs. Animal experiments showed that the highest aortic pressure could be generated when the stemum was depressed to 5 cm. Cardiopulmonary resusciation using a new device could generate higher systolic aortic pressure, coronary perfusion pressure and end-tidal carbon dioxide tension in comparison with standard cardiopulmonary resuscitation in a pilot animal study using two dogs. Conclusion: New cardiopulmonary resuscitation method using a mechanical device designed by us could perform sternal compression and simultaneous thoracic constriction, and generate better hemodynamic effects than standard cardiopulmonary resuscitation in pilot animal experiments.

한국산 부산입술대고둥(Euphaedusa fusaniana)의 아이소자임 변이

황보학,이준상,조등현 江原大學校 附設 環境硏究所 1994 環境硏究 Vol.11 No.-

Electrophoretic variations in isozymes encoded by 16 loci were studied to estimate genetic variation and to assess phyletic relationships, and biogeographic pattern of distribution of the Euphaedusa fusaniana collected from Sehwa, Aeweol, Samchuck, Tongdosa, Gernundo, and Y?su areas in Korea was discussed with respect to the isozyme variation. The 180 apecimens were examined. Means of allele per locus(?) and polymorphism(?) were 1.528 and 45.5%, respectively and hetrozygosity (?_(D)) was 0.205. Samchuck population showed lower mean value of allele per locus(?=1.46). Higher polymorphism(P=57.14%) was observed among Tongdosa popualtion. Aeweol population showed slightly lower genetic variation (H_(D)=0.15) than others. Average genetic similarities(?) among the six populations was 0.716 Aeweol and Samchuck populations were genetically closer(S=0.903) than others. However the S value between Y?su and Samchuch populations was low(S=0.562). Average genetic distance(?) among the 6populations were 0.267. Both Aeweol and Samchuck populations have closer genetic distance (D=0.067). Genetic distance pattern was similar to genetic similarity pattern.

대구 유니버시아드대회 자원봉사활동에 대한 만족도 연구

황성동,성희자,고강호,전보경,권현수 慶北大學校 社會科學大學 2003 社會科學 Vol.15 No.-

이중혈류유발 심폐소생술이 심정지를 유발한 개의 단기 생존율에 미치는 영향

황성오,조준휘,강구현,김성환,문중범,이강현,이승환,윤정한,최경훈,홍은석 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background and Objectives: We previously reported that, compared with standard cardiopulmonary resuscitation(S-CPR), better hemodynamic effects could be achieved by simultaneous sterno-thoracic cardiopulmonary resuscitation(SST-CPR) in which we compressed the sternum and constricted the thorax circumferentially during the systolic period by using a device. This study was designed to assess whether SST-CPR, compared with S-CPR, improve the survival rate of dogs with cardiac arrest. Subjects and methods: Twenty-five mongrel dogs(19∼31㎏) were enrolled in this study. After four minutes of ventricular fibrillation induced by an AC current, animals were randomized to resuscitate with either S-CPR(n=13) or SST-CPR(n=12). Epinephrine(1 ㎎) was injected into the right atrium every three minutes after the beginning of CPR. Defibrillation was attempted after 6 minutes of CPR. Standard advanced cardiac life support was started if defibrillation was not successful. Results: SST-CPR resulted in significantly(p<0.001) higher systolic arterial pressure(91±47 vs 47±24 ㎜ Hg), diastolic pressure(43±24 vs 17±10 ㎜ Hg), coronary perfusion pressure(35±25 vs 13±9㎜ Hg), and end tidal CO2 tension(9±4 vs 3±2 ㎜ Hg). Two of 13 animals(15 %) resuscitated with S-CPR and six of 12 animals(50%) resuscitated with SST-CPR survived until 12 hours after cardiac arrest(p<0.05). Donclusion: SST-CPR, compared with S-CPR, improves the short-term survival rate in canine cardiac arrest.

외상환자에서 전신성 염증 반응 증후군 (Systemic Inflammatory Response Syndrome)의 발생과 혈청 TNF-α와의 관계

김현,이강현,임종천,조준휘,오범진,황성오 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background and purpose: The systemic inflammatory response syndrome(SIRS), as defined recently by critical-care specialists, may result from various etiologies including infection, burn, or trauma. The purpose of this study was to determine whether TNF-αis associated with the development of systemic inflammatory response syndrome caused by multiple trauma. Methods: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study. Multiple blood samples were serially drawn to measure serum TNF-αlevel on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-αwas measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value for serum TNF-α. Results: Serum TNF-αlevels of SIRS group were persistently elevated above reference value until 3 days after on admission. Peak serum TNF-αlevel at 12 hours after admission was higher in SIRS group than non-SIRS group(p<0.05). There was no significant correlation between injury severity score and TNF-αlevels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. Conclusion: The result of this study suggests that persistent elevation of TNF-αand degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.

관상동맥질환의 중증도와 혈중지질치 및 아포지단백과의 상관관계

임현주,황종현,류재근,정병천,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.1

목적 : 관상동맥질환의 위험인자로서 혈청지질 및 혈장 지단백에 대한 관심이 높아지고 있고 또 아포지단백이 관상동맥 질환을 일으키는데 다른 지질보다 더 중요하다는 연구가 많이 발표되고 있으나 우리나라에서는 아포지단백에 대한 연구가 그리 많지 않은 편이다. 이에 저자등은 혈중지질치와 새로운 위험인자로 알려지고 있는 아포지단백치를 측정하고 이들과 관상동맥질환 중증도와의 상관 관계를 알아보았다. 대상 및 방법 : 관상동맥질환이 의심되어 관상동맥조영술을 실시한 69명의 환자를 대상으로 하였으며 12시간 이상 공복후 혈청을 채취하여 총콜레스테롤, 중성지방, HDL-콜레스테롤, 아포지단백 AI (ape AI), 아포지단백 B (ape B)를 측정하였다. 관상동맥조영상 50%이상의 협착이 있는 혈관의 수 (lesion number), 최대협착을 합한 값 (lesion score), 각 분절의 최대협착을 합한 값 (total score), 가장 심한 협착 값 (peak stenosis) 등으로 관상동맥 중증도를 알아본 다음 이들과 혈청지질치, 아포지단백과의 상관 관계를 비교해 보았다. 상관 관계는 Spearman's correlation coefficient를 구하였다. 결과 : 관상동맥질환의 중증도와 각 지질치 간의 상관 관계를 비교해 보았을때 lesion number와 관계있는 것은 연령 (r=0.2789), 중성지방치 (r=0.2829)이며 lesion score와 관계있는 것은 연령(r=0.2911), 중성지방치0 (r=0.3316), 총콜레스테롤과 HDL-콜레스테롤의 비 (r=0.2361), apo B 치(r=0.2759), apo AI과 apo B의 비 (-0.3154)로 나타났다. Total score는 연령 (r=0.3100), 총콜레스테롤치 (r=0.2452), 중성지방치 (r=0.3022), 총콜레스테롤과 HDL-콜레스테롤의 비 (r=0.2770), apo B치 (r=0.2927), apo AI과 apo B의 비 (r=-0.3408)와 연관이 있었고 peak stenosis는 중성지방 치(r=0.3305), ape B 치 (r=0.2968), apo AI과 apo B의 비 (r=-0.3977)와 관계가 있었다. 연령으로 조정하여 partial correlation을 좌면, 관상동맥조영술상 중증도는 중성지방치 (r=0.3408), apo B 치(r=0.2877), apo AI과 apo B의 비 (r=-0.3460)와 유의한 상관 관계가 있었다. 이중 ape AI과 ape B의 비는 lesion score (r=-0.2640), total score (r=-0.3057), peak stenosis (r=-0.3460)와 유의한 상관관계를 보였다. 결론 : 이상의 결과로 보아 apo B치 그리고 apo AI과 apo B의 비가 관상동맥 중증도의 예견인자로 다른 혈중 지질 치보다 더 유용하다는 것을 알 수 있었다. Objectives : Recently, it was reported that the measurements of apolipoprotein levels may be valuable in the clinical assessment of coronary artery disease severity. However there are a few reports regarding to the relationship between coronary artery disease severity and apolipoprotein levels in Korea. Thus, we measured serum lipid and apolipoprotein levels and studied the relationship between coronary artery disease severity and serum lipids and apolipoproteins levels. Subjects and Methods : The 69 patients who underwent coronary angiography to evaluate chest pain were subjected to this study. We measured the levels of serum cholesterol, triglycerides, HDL cholesterol, apolipoprotein AI(apo AI) and apolipoprotein B(Apo B) and measured the severity of coronary artery disease by lesion number, lesion score, total score and peak stenosis. Then, we studied the relationship between coronary artery disease severity and apolipoproteins and calculated the correlation coefficient. Results : The results were as follows. There are significant correlation(r=0.3) between age, triglycerides, apo B levels, apo AI/B ratio and coronary artery disease severity. In controlling for age, tyiglycerides, apo B levels and apo AI/B ratio shows significant correlation(r=0.3) with coronary artery disease severity. Especially, apo AI/B ratio shows significant correlation(r=0.3) with lesion number, total score and peak stenosis. Conclusion : These results suggest that the apo B levels and the ratio of apo AI/B can be used as significant independent predictor for coronary artery disease severity rather than other serum lipid levels.

경부 결핵성 림프절염의 임상양상과 치료

김상현,황동조,문준환,최병윤,한승훈,최종욱 한국의학사 1999 診斷과治療 Vol.19 No.6

비선형회로의 고조파해석을 위한 Duffing 방정식의 해석적 해법

신중린,황현준 건국대학교 산업기술연구원 1996 건국기술연구논문지 Vol.21 No.-

For the higher quality of electric power supply, investigating the sources and amount of harmonics as well as establishing its counter plan is very important task. The harmonics caused by the nonlinear operation of transmission equipments are not identified yet and have been seldom studied. Sources of harmonics in nonlinear circuit, especially caused by the nonlinear operation of transmission equipments, can be approximately modeled with Duffing's Equation. In this study, a new analytic approach is attempted to get the solution of Duffing's equation for the analytic approach is attempted to get the solution of Duffing's equation for the analysis of harmonics in nonlinear circuits and compared with some conventional methods. Finally some case studies were performed to evaluate the performance of proposed method and conventional methods. The result of this study would be useful to establish the way to analyse the harmonics caused by the nonlinear operation of transmission equipments.

심초음파로 결정된 응급 심낭천자술의 천자부위

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.

회분식반응기에서 스티렌과 알킬아크릴레이트의 공중합의 속도론

설수덕,김남석,황준호,최경선,강현석 동아대학교 공과대학부설 생산기술연구소 1997 生産技術硏究所硏究論文集 Vol.2 No.1

Stylene(St) with Methyl Acrylate(MA), Ethyl Acrylate(EA), and n-Butyl Acrylate(BA) were carried out with benzoylperoxide(BPO) in touene. The copolymer compositions were determined by Elemental Analyzer(EA). The monomer reactivity ratio, r1 and r2 were determined by both the Kelen-Tu¨do¨s method and Fineman-Ross method. The values of r1 and r2 for each monomer pair were as follows : r1(st)=0.57(0.68), r2(MA)=0.09(0.22). The φ factor of the copolymer over all St compositions ranged from 0.64 to 2.33 and increased with increasing St compositions. The copolymerization rates of each monomer pair were determined.