혈액투석 환자에게서 발생한 재생불량성 빈혈 1예

정지용,윤나라,강대웅,오종찬,장재현,선길홍,박경희,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Aplastic anemia is a disease characterized by pancytopenia in the peripheral blood and hypocellular bone marrow with the fatty infiltration. The causes of the acquired aplastic anemia were usually related to drugs and immune-related diseases. A 34-years old man was admitted due to general weakness. He has been going hemodialysis for 2 years because of end stage renal disease (ESRD) due to chronic glomerulonephritis. At admission, laboratory tests showed hemoglobin 6.2 g/dL, hematocrit 18.0 %, WBC 5,710mm (neutrophil 71.8%, lymphocyte 19.1%, monocyte 5.9%), reticulocyte 1.9%, platelet 93,000/mm, Fe 12.8 ug/dL, TIBC 204 ug/dL, ferritin 941.47 ng /ml, haptoglobin 0.72 g/L, vitamin B12 508.17 pmol/L, folate 24 ng/mL, total protein 6.54 g/dL, albumin 3.76 g/dL, Alk. pohsphatase 79 IU/L, AST 30.0 IU/L, ALT 39.7 IU/L, total bilirubin 0.57 mg/dl, BUN 79.4 mg/dl and creatinine 10.18 mg/dl. Peripheral blood smear showed the normocytic normochromic anemia with anisocytosis. Anemia was diagnosed but it was irresponsive to the recombinant human erythropoietin (EPO) and blood transfusion. In the bone marrow aspiration smear were there the hypoplastic myeloid and erythroid precursors. The bone marrow biopsy section showed the hypoplasia of all components (10-20%) and the fatty infiltration. We have experienced one case of the idiopathic aplastic anemia in a patient going through hemodialysis and we just report it with documentary records. 저자들은 혈액 투석 중인 환자에서 약물, 면역계 이상등의 원인을 발견할 수 없었음에도 재생 불량성 빈혈이 발생한 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.

백서 치주 골결손부에 calcium carbonate 이식 및 pulsed Nd : YAG 레이저에 의한 치은상피 제거후 접합상피 치유양상 YAG laser in rat peiodontal bone defect filled with calcium carbonate

정철웅,정현주 전남대학교 치과대학 1995 전남치대논문집 Vol.7 No.1

The purpose of this study was to evaluate whether removal of gingival epithelium with pulsed Nd : YAG laser could inhibit the downgrowth of junctional epithelium after alloplastic material grafting in periodontal bone defect. The periodontal bone defects were created surgically on the palatal aspect of the upper right and left molar teeth in 30 rats and filled with resorbable calcium carbonate(Biocoral 450?? : Inoteb, France). The control sites(right molar area) was sutured. The test side (left molar area) received controlled de-epithelization of the oral and sulcular epithelium with pulsed Nd : YAG laser(Sunrise Master?? : Sunrise Technologies, U.S.A.) under the mode of 1.75W, 15Hz, 116mJ/pulse and was sutured. The control and test sites were evaluated clinically and histologically, at 1, 3, 7, 14, and 28 days postoperation. Clinically, the gingiva showed normal color and shape at the 5th day in the control site and at the 10th day in the test sites. Histologically, the junctional epithelium was formed at the 7th day in the control sites and at the 14th day in the test sites, and the long JE attachment were observed at the 28th day in both sites. The attachment of connective tissue to root surface was observed initially at the 7th day in the control sites and at the 14th day in the test sites, and completed at the 28th day in both sites. In summary, these results showed that the removal of oral epithelium using pulsed Nd : YAG Laser could not prevent epithelial downgrowth after alloplastic material implantation in rat periodontal bone defect.

Selective Serotonin Reuptake Inhibitor 치료에 의한 성부작용에 관한 연구

김정웅,김승현,조숙행 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 선택적 세로토닌 재흡수 차단제(SSRI)를 포함한 대부분의 항우울제들은 성기능성과 부작용을 나타낸다고 보고되고 있다. 성부작용에 관한 보고된 빈도는 질문 방식과 보고자에 따라서 다양하여, 자발적인 보고로는 낮은 빈도인 반면에, 직접적인 의사의 질문이나 설문지에는 빈도가 증가한다. 본 연구는 성반응주기의 단계에 따른 구체적인 설문지를 이용하여 성부작용의 빈도와 양상, 성부작용과 연관되어 있는 요인들을 조사하고자 하였다. 방 법 : 77명의 불안장애, 우울장애 환자들을 대상으로 성반응주기에 따른 각 단계에 따른 성기능의 6가지 측면인 성욕, 성적 흥분, 성교통 절정감, 발기, 사정에 대한 세가지 SSRI의 효과에 관하여 횡단면 연구를 시행하였다. 각각의 환자들에서 성기능부작용척도, 우울척도(BDI), 상태불안척도(S-A), 특성불안척도(T-A)를 측정하였으며, SSRI의 종류, 용량 및 사용기간, 기타 부작용, 우울과 불안정도와의 관련성을 조사하였다. 결 과 : 성욕감퇴, 성적흥분감퇴, 절정감지연 혹은 결여 등 성부작용의 모든 항목에서 여성은 남성보다 SSRI의 관련된 성부작용이 더 많았고, 통계적으로 유의하였다.(p<.05). 또한 심각도의 면에서도 여성들에서 남성들보다 유의하게 심하였다. 성부작용의 빈도는 성에 따라 다양하였으나, 여성에서는 절정감지연 혹은 결여, 남성에서는 사정장애가 가장 많았다. 성부작용의 빈도는 불안장애 환자들보다는 우울장애 환자들에서 높은 경향을 보였으나, 통계적으로 유의하지는 않았다. 하지만, 우울장애 환자들은 불안장애 환자들보다 성욕감퇴와 성적흥분감퇴 측면에서 보다 높은 빈도를 보였다(p<.05). 통계적 의미는 없었으나, sertraline에서 paroxetine보다 성부작용의 빈도가 다소 높았다. 결 론 : SSRI를 투여받는 환자들에서 남성보다 여성환자들에서 성부작용이 더 많고 심각함을 보임에도 불구하고, 여성들은 성 문제를 얘기하는 것을 꺼리므로, SSRI를 투여받은 여성환자들의 성부작용에 대하여 관심을 가질 것을 시사한다. Objective : Adverse effects on sexual functions induced by antidepressant medications including selective serotonin reuptake inhibitors(SSRIs) have been reported. The reported incidences of sexual dysfunctions varies with the way of questioning, with relatively low on self reporting and high on direct questioning and symptom questionnaires. The purpose of this study was to evaluate the frequency and nature of sexual dysfunctions during SSRIs treatment in outpatients with depressive disorder and anxiety disorder. Methods : Seventy seven patients on SSRI therapy(fluoxetine, sertraline, and paroxetine) were enrolled in this study. The six aspects of sexual function were investigated : sexual desire, sexual excitement, sexual pain, orgasm, erection and ejaculation. BDI. S-A, T-A and questionnaires on sexual side effects and on other side effects of SSRIs were measured. The frequency and the severity of sexual dysfunctions were measured. Sexual side effects and other side effects of SSRIs were analyzed in association with the duration and the dose of SSRI treatment and the severity of depression and anxiety. Results : The frequency of sexual dysfunction during SSRI use in our study was 38.96%. Women reported more sexual dysfunction(sexual, desire, sexual excitement, orgasm). Also, women's sexual dysfunction was more intense. The most common sexual dysfunction was delayed orgasm(or anorgasmia) in women and ejaculatory difficulty in men. In patients with depressive disorder, the frequency of sexual dysfunction was higher than in patients with anxiety disorder, which was not statistically significant. Conclusions : These findings suggest that SSRIs-associated female sexual dysfunction occurs substantially higher and is more severe than expected. It is important to pay attention to female sexual dysfunction during treatment with SSRIs. The sexual problems must be questioned directly for prompt detection of them and promotion of treatment compliance with SSRIs.

진단 초음파를 이용한 정상 성인의 정중신경 측정

이정아,임길병,이홍재,정웅태,황현오 최신의학사 2003 最新醫學 Vol.46 No.11-12

말기신부전 환자에서 혈액투석 전후의 QT간격분산 비교

강대웅,정지용,윤나라,안치용,김종오,신병철,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Background: Some cases of QT interval, corrected QT interval (QTc), QT dispersion (QTd) and corrected QT dispersion (QTcd) have been reported in ESRD, but these results are variable and the influence of a hemodialysis is still controversial, In this study, we investigated the effect of hemodialysis on QT and QTc interval and QT and QTc dispersion in patients with ESRD 15 min before and 15 minute after each hemodialysis. Methods: Sixty-seven patients with ESRD (men 33 & women 34) on three-times stable hemodialysis (>3 months) were randomly enrolled. Fifty control subjects with a similar age and normal renal function were enrolled from this hospital. Routine biochemical studies were measured pre- and post dialysis, at the time of the ECG. Plasma Na+, K+, BUN, creatinine, ionized calcium and phosphate were checked. Twelve-lead electrocardiographs were performed at 10㎜/mv and 50㎜/s using a HewIett-Packard Pagewriter 100, before and after a single hemodialysis session.The QT interval was measured from the onset of the QRS complex to the end of the T wave. If the end of the T wave was not clear in a particular lead then it was excluded from analysis. When U waves were present, the end of the T wave was taken as the nadir between the T and U waves. Each QT interval was corrected for heart rate using Bazett's formula (QTc==QT/√(RR)) (ms). The difference between maximal and minimal QT interval duration was defined as QT dispersion (QTd) in each of the 12 leads. Result: This study demonstrates that QT, QTd, QTcd is higher in hemodialysis patients compared with control subjects, and QT and QTd rise postdialysis to levels comparable to those seen acutely following myocardial infarction, when patients are at greatly increased risk of potentially fatal ventricular arrhythmias, Conclusions: QT interval and QT dispersion, markers of risk for arrhythmias and sudden death, are elevated in hemodialysis patients, and rise postdialysis. QT interval and QT dispersion is an easily obtainable, noninvasive, simple, inexpensive, and widely available method of risk stratification in uremic patients receiving chronic dialysis. Additional studies are needed to clarity whether increased postdialysis QT dispersion results in an increased occurrence of arrhythmias.

최근 10년간 원광의대병원에서 시행한 소아 심장혈관 수술의 임상적 고찰

윤향석,정수미,최두영,오광수,오연균,김종덕,양현웅,이삼윤,김형곤,최종범,최순호,노병석 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

We reviewed 10 years experiences of the clinical aspects and early postoperative results in 544 pediatric patients(age less than 16 years old). Among them. 529 cases had the congenital heart diseases, and 15 had the acquired diseases. Open heart surgery was performed in 413 patients. 115 cases were treated with non-open heart surgery. 16 with interventional catheterization. Annual increase of the cardiac patients was not significant in recent 10 years, except slight increase in 1994. The mean age of the study patients had been evidently changed to younger year by year. Total mortality rate of the open heart surgery was 6.4%. The cyanotic congenital heart diseases were high in early postoperative mortality by 25.7%, whereas 4% in acyanotic group. The age group less than one month was most highest in surgical mortality(66.7%). There were no deaths in patients with patent ductus arteriosus(103 cases), atrial septal defect(83 cases) or pulmonary stenosis(17 cases). Among 220 patients with ventricular septal defects(VSD). 10(4.5%) were died early postoperatively. In cyanotic group, the patients with pulmonary atresia with ventricular septal defects(PAVSD), transposition of the great arteries(TGA), interrupted aortic arch(IAA), complex cardiac anomalies with isomerism seemed to be most susceptible to an early death.

포름알데히드 含有 廢水가 嫌氣性 處理에 미치는 影響

박광석,노현웅,박정호,박승조 동아대학교 환경문제연구소 1997 硏究報告 Vol.20 No.1

The effects of formaldehyde in anaerobic digestion were : 1. In the cases of batch assay, the methanogenic bacteria were tolerated the toxic when raw and pretreated wastewaters were injected 3 and 5 ml respectively to serum bottle, but shocked when 5 and 10 ml respectively. 2. When raw, pretreated + glucose, and pretreated wastewaters were applied to UASB reators, the results of VLR were obtained 8-10, 3-5, and 2-4 kg cod/㎥ ·d respectived. Result of raw wastewater was the most optima of three. 3. The correlations VLR with bio-gas were obtained 90.5, 46.4 and 34.6% respectively in raw, pretreated + glucose, and pretreated wastewaters. Result of raw wastewater was the most optima of three. 4. In batch assay, pretreatment wastewater is better than raw water, but in continuous assay, raw wastewater is better than pretreatment wastewater. This reason is consideated that unsoluble salt of 373 mg/l is accumulated within UASB reactor, and carries out inhibition to anaerobic bacteria.

혈액투석중인 말기신부전 환자에서 Fludrocortisone acetate (FCA) 투여 후 혈청 칼륨 저하 효과

류봉관,강대웅,정지용,윤나라,신병철,박경희,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Background: Hyperkalemia is a commonly encountered problem in dialysis patients with end-stage renal disease. In this study we evaluated the effect of mineralocorticoid therapy (fludrocortisono acetate) on serum potassium level in the serum of hyperkalemic end-stage renal disease patients. Methods: Fourteen patients on hemodialysis receiving fludrocortisone acetate (FCA) 0.1 mg/day were observed for 2 months periods. Consecutive monthly biochemical profiles were compared for the druration of the pre-and post-treatment of FCA. Result: Fourteen patients with mean age (±SE) of 51.5 years (4 males and 10 females) and mean hemodialysis period of 51.9 months were studied. Mean serum potassium levels significantly fell (p<0.05) during the post-FCA period (5.2±0.66 mEq/L) compared with potassium levels during the pre-FCA (5.8±0.43 mEq/L) period. Pre-and post-FCA values were not different for sodium, chloride, protein, albumin, AST/ALT, glucose, blood nitrogen, creatinine, phosphate and calcium. Conclusions: FCA appears to decrease serum potassium value in patients with end-stage renal disease. These results suggested that FCA could be effective to treat hyperkalemia without any adverse effect in patients undergoing hemodialysis.

서초동(서울시 서초구)의 거미상

김주필(Joo Pil Kim),정혜리(Hye ri Jeong),김대희(Dae Hee Kim),박동우(Dong Woo Park),서재웅(Jae Woong Seo),이현우(Hyun woo Lee) 한국거미연구소 2017 한국거미 Vol.33 No.1

2016년 3월 31일부터 7월 31일까지 서울특별시 서초구 서초동에 위치한 서울고등학교 교정 일대를 서울고등학교 환경생물부 부원들이 채집 조사한 결과 20과 43속 53종의 거미가 조사 연구되어 이에 보고하는 바이다. From March 31st to July 31st in 2016, members of an environmental biology club at Seoul High School located in Seocho-gu, Seoul, Dae-Hee Kim, Dong-Woo Park, Jae-Woong Seo and Hyun-woo Lee, collected 20 families 43 genera 53 species of spiders and report the result of the study here.

産婦人科 患者에서 分離된 Ureaplasma urealyticum의 生物學的 性狀

梁熙燦,崔大卿,張明雄,白太鉉,朴鼎圭 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

Isolation rates of Ureaplasma urealyticum from vaginal swab of 216 patients, 105 prostitutes and 100 college females was investigated. Also, minimal inhibitory concentration of isolated strains about tetracycline and minocycline was studied. The results were summarized as follows; 1. Out of 70 vaginitis patients, isolation rates of Ureaplasma urealyticum and Mycoplasma hominis were 34.3% and 15.7%, respectively. 2. Out of 54 cervicitis patients, isolation rates of Ureplasma urealyticum and Mycoplasma hominis were 37.0% and 11.0%, respectively. 3. Out of 92 other gynecological patients, isolation rates of Ureaplasma urealyticum and mycoplasma hominis were 44.6% and 16.3%, respectively. 4. Out of 105 prostitues, isolation rates of Ureaplasma urealyticum and Mycoplasma hominis were 54.3% and 75.2%, respectively. 5. Out of 100 college students, isolation rates of Ureaplasma urealyticum and Mycoplasma hominis were 23.0% and 7.0% respectively. 6. In the susceptibility patterns of isolated Ureaplasma urealyticum, resistant strains about tetracycline in patients, prostitues and college students were 75.2%, 73.6% and 69.5%, respectively 7. In the susceptibility patterns of isolated Ureaplasma urealyticum, resistant strains about minocycline in patients, prostitues and college students were 91.7%, 87.7% and 73.9%, respectively.