혈중 및 호기 일산화탄소를 이용한 일산화탄소 헤모글로빈 농도간의 관련성 연구

김형수,박태혁,손지언,정갑열,김정만,김준연 동아대학교 2001 大學院論文集 Vol.26 No.-

This study was conducted to find a correlation between blood COHb and calculated COHb with expiratory air and related variables such as occupational and smoking factors. Author selected 69 healthy workers in 8 workplaces suspected CO exposure. Basic informations were collected by self-reported questionnaire and medical history taking. Author measured Indirect COHb concentration with expiratory air using Micro II-Smokerlyzer and blood COHb concentration using Oxymeter. The results of the study were summarized as follows : 1. In the smoker, mean blood COHb and calculated COHb with expiratory air were 2.21±0.98% and 2.27±0.97 %, and there was not a statistically significant difference. In the non-smoker, mean blood COHb and calculated COHb with expiratory air were 0.42±0.43 % and 0,65±0.30 %, and there was also not a statistically significant difference. 2. There were positive correlations between blood COHb and calculated COHb with expiratory air in both the smoker (r=0.91, p=0.0001) and non-smoker (r=0.73, p=0.0001). 3. In the smoker, the factors affected COHb were total smoking index (Pack × years) and passed time after the last smoking. 4. In the nonsmoker, the parking and driving groups had higher COHb concentration than others (p<0.05). In conclusion, there was no significant difference between indirect COHb concentration with expiratory air using Smokerlyzer and blood COHb concentration and there was a highly significant correlation between indirect and blood COHb concentrations. Therefore indirect COHb concentration with expiratory air is a useful screening method for CO exposure. Author suggest the resection of smoking during at least 90 minutes before measuring COHb concentration in order to exclude smoking effects.

중독한 추체로 증상을 보인 cyclosporine에 의한 뇌증 1예

강정현,곽승근,신현영,김성은,이정호,이정찬,곽상혁,윤환중,조덕연,김삼용,김제,송창준 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

The use of cyclosporine(CsA), a potent immunosuppressive agent, is associated with numerous side effects. Neurotoxicity was earlier less well known, but with growing experience central nervous system side effects are now reported up to 40% of patients. Among various CsA-induced neurotoxicities, tremor is most common and posterior leukoencephalopathy is well characterized. An encephalopathy presenting with pyramidal weakness, however, seems to be rare and poorly documented. We report here a case of encephalopathy presenting with multiple generalized seizures followed by fluctuating quadriparesis developed a few days after starting CsA and resolved spontaneously after withdrawal of the drug . A 48-year-old woman with aplastic anemia was placed upon immmunosuppressive treatment consisting of antithymocyte globulin(ATG), CsA, and methylprednisolone. Two days after starting the therapy, she developed a generalized seizure. The next day she developed 2 more episodes of seizure and the therapy was stopped. Computed tomogram of the brain was normal. Six days after starting therapy, she developed mild motor weakness and paresthesia of both lower extremities, which progressed to a definite quariparesis confining her to a bed in 3 days. Magnetic resonance imaging(MRI) of the brain revealed asymmetric, bilateral high-signal abnormalites in the subcortical white matter of fronto-temporal areas. After reaching to a maximum with some fluactuation(14 days after starting the therapy) the motor weakness started to be resolved. She was discharged with a almost complete resolution of the weakness 45 days after starting the therapy. Five months later she did well and brain MRI was negative.

수입각증후군에 의한 급성 복증 1례

정은욱,지삼룡,이영태,박지훈,김동기,제인수,채두근,박성재,박은택,이연재,이상혁,설상영,정정명 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Afferent loop syndrome is an uncommon complication of a gastrectomy and Billroth Ⅱ reconstruction. It may cause symtoms at any time from the first postoperative day to many years after the gastrectomy. Afferent loop syndrome is characterized by abdominal pain, vomiting and elevation of serum amylase. Thus, it is difficult to differentiate afferent loop syndrome from other cause of acute pancreatitis. However, the history of gastrectomy can be an important clue for diagnosing afferent loop syndrome. We experienced one case of chronic afferent loop syndrome with acute pancreatitis. After appropriate management, the abdominal pain disappeared and serum amylase level decreased. We report this case with a review of relevant literatures.

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.

자세변화에 대한 뇌성마비아동(경직성 양마비)의 손 기능 차이 비교와 제변수와의 상관관계의 연구

정민예,구애련,권혁철 한국전문물리치료학회 1996 한국전문물리치료학회지 Vol.3 No.3

지역사회 정신보건사업을 위한 환자 발견 체계에 관한 연구 : Case Detection and Delivery Method

남정현,박준혁,박용천,신영전 漢陽大學校 精神健康硏究 1998 精神健康硏究 Vol.17 No.-

제왕절개 수술후 경막외강, 지주막하강 및 전신 투여 morphine이 위장관 기능의 회복에 미치는 영향

임정혁,손수창,최세진 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

Background : This study was designed to evaluate the effect of epidural, intrathecal and intravenous morphine analgesia on the recovery of gastrointestinal function after cesarean section. Methods : Eighty nine patients of ASA I or 2 were classified randomly into 3 groups. Group 1(n=32)received epidural anesthesia with 2% lidocaine and 0.5% bupivacaine, and once in a dose of 4mg morphine immediately after delivery through the epidural catheter. Group 2(n=32) received spinal anesthesia with 0.25% hyperbaric 8.75mg bupivacaine, and 0.25mg morphine and 10㎍ fentanyl at the time that spinal anesthesia was administered. Group 3(n=25) received intravenous morphine after recovery of general anesthesia as a 0.5mg/h background infusion with a lmg bolus and a lockout interval 10min during the first 24 hour. Results : Passing of flatus was noted 48.6±12.1 hours in group 1, 42.2±11.9 hours in group 2, and 50.8±5.9 hours in group 3. There was significant difference between group 2 and group 3(p<0.05).The duration of hospital stay was 94.8±19.7 hours in group 1, 95.7±19.7 hours in group 2 and 100.1±20.7 hours in group 3. Conclusions : Choice of postoperative analgesia may affect the recovery of gastrointestinal function after cesarean section. If convalescence protocols are adjusted to take advantage of the earlier recovery of bowel function, there may be a more shorter hospital stay.

일 농촌지역의 정신지체 역학연구

박준혁,남정현,신영전 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.1

연구논문: 일 농촌 지역의 정신지체 환자의 유병율, 사회 경제적인 특징, 동반질환을 조사하여 농촌지역에서의 정신지체 환자의 현황과 분포 특성을 살펴보고 지역사회 안에서 이들의 관리를 위한 기초자료를 제공하고자 한다. 방 법: 경기도의 1군과 4개 면을 선정하여 이 지역 전체주민 17,237명을 대상으로 정신지체 조사 사업을 시행하였다. 조사는 1차, 2차로 나누어 1차 조사는 사전에 교육을 받은 보건진료소장과 보건요원에 의해 정신지체 환자를 조사하도록 하는 핵심요원조사(Key Informant Research) 방법으로 2차 조사는 보고된 대상자를 확진하기 위해 정신과 전문의 1명 정신과 전공의 2명, 임상심리사 5명이 이들 대상자를 직접 면담하여 진단의 확진과 등급의 정도를 파악하였다. DSM-Ⅳ의 기준과 한국형 웩슬러 지능검사(K-WAIS), 사회성숙도검사(SMS)를 시행하여 진단하였다. 결 과: 조사지역의 정신지체 유병율은 0.42%이었고, 남자가 0.37%, 여자는 0.47%로 여자가 더 높은 유병율을 보였지만 통계적으로는 유의미한 차이는 없었다(χ²=4.3. p=0.23). 등급별로는 경도, 중등도, 중도, 최중도의 비율은 33:47:18:3로써 중등도 정신지체가 가장 많았다. 연령별 유병율을 보면 조사 대상의 20-39세에서 0.69%로 가장 높은 유병율을 보였고, 40세 이상의 유병율은 0.35%로서 두 군 사이에 통계적인 유의미한 차이(χ²=18.64. p=0.00002)를 보였다. 중등도의 정신지체가 전체 정신지체 환자중에서 0.20%로 가장 높은 유병율을 보였다. 정신지체의 일차보호자는 부모가 69%를 차지하였고, 장애자 수첩 소지자는 전체 정신지체의 50%, 평균 교육기간은 3.36년이었다. 결 론: 조사지역의 정신지체 유병율은 0.42%로 우리 나라 과거 유병율 보다 높은 결과였고 등급별 분포에서 경도의 정신지체가 상대적으로 낮은 비율을 보였는데 1차 조사인 핵심요원조사(Key Informant Research)에서 정신지체 발견의 초점을 사회적 적응능력의 저하에 두어, 농촌사회에서 적응력을 갖는 경도의 정신지체가 많이 누락되었을 것으로 추정된다. 중등도의 정신지체가 전체 정신지체 환자 중에서 가장 높은 분포를 보였는데, 이는 중등도 정신지체가 경도의 정신지체보다 사회적 적응능력의 저하가 훨씬 두드러져서 발견 탈락율이 적고 실제로 중도와 최중도보다 빈도가 높기 때문이다. 중도이상의 정신지체는 거의 대부분 40대 이전에 동반된 질환, 여러 가지 내과적 문제로 사망하기 때문에 본 연구에서도 낮은 유병율를 보였고, 전반적으로 정신지체인의 사회적 지지가 매우 부족하였다. Objectives: This study was designed to assess the present conditions of the mental retardation in a rural area by identifying the prevalence, socioeconomic characteristics and combined diseases of the subjects with mental retardation. Methods: For this survey, four regions of a rural area with total population of 17,235 persons were chosen. The surveys were divided into 2 steps. After Key Informant Research(KIR) at first survey, one psychiatric specialist, two psychiatric residents and five clinical psychologists interviewed the high risk group who had been selected in KIR. By this two-step process, final diagnosis and degree of severity were confirmed. Diagnostic criteria of Mental Retardation by DSM-Ⅳ(Diagnostic and Statistical Manual of Mental Disorders-Ⅳ), K-WAIS, Social Maturation Scale were used as diagnostic tools. Results: Prevalence of Mental Retardation in survey areas was 0.42%. The prevalencies in male and female were 0.37% and 0.47%, respectively, which were of no significant statistical difference. The relative ratio of each degree of mental retardation-mild, moderate, severe and profound mental retardation-was 33:47:18:3 respectively. The prevalence of moderate mental retardation was higher than that of any other degrees. By age groups, the prevalence in twenties and thirties was 0.69%, which was the highest of all age groups. The prevalence in forties and over was 0.35%, which was the lower than that of twenties and thirties(χ²=18.64, p=0.00002). Conclusions: Prevalence of mental retardation in survey areas was 0.42%, which was higher than any other previous studies in Korea. The prevalence of mild mental retardation was relatively lower than that of other previous studies, which means that the key informants may not have detected the subjects with mild mental retardations who were relatively socially adaptive in rural areas, because they might have focused on the ability of social adaptation as an important feature in detecting the mental retardations. The prevalence of moderate mental retardation was 0.20%, higher than any other groups, which resulted from low rate of failure in the detection of the moderate mental retardations because of their severe deficits in social adaptation and from the higher prevalence than severe and profound mental retardation in reality. The prevalence of severe and profound mental retardation was low rate because they used to be short-lived due to combined medical illnesses and congenital anomalies. The persons with mental retardation were in low socioeconomic status and had poor supporting systems.

대형 화재로 인한 사상자의 손상 유형과 합병증 : 동인천 라이브호프 화재를 중심으로

신중호,김재광,염석란,신종환,민순식,임용수,양혁준,이근,황성연 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: High risks of fire alway exist for buildings in urban areas, especially those in downtown. Crowds, as well as more complex and larger structures, may cause more victims in the event of fire; therefore, emergency medical service plans must be established for such disastrous events. Methods: On the evening of October 30,1999, a fire broke out in downtown, Dong-Incheon Live-Hof restaurant; 56 people were killed and 76 were injured. Most of them were teenagers. We retrospectively reviewed the medical records of the victims, Results: 1) Among the 56 dead, 54 died from smoke inhalation, one from extensive burns, and one from sepsis during treatment. 2) Among the 76 injured, 70 patients suffered from smoke inhalation, 53 from burns, and 9 from several types of trauma (sprains, contusions, lacerations, abrasions, fractures, etc.). 3) Later complications were laryngeal edema, pulmonary edema, scar contracture, and hypoxic brain damage, and so forth. 4) Post traumatic stress syndrome was unexpectedly more prevalent in mildly to moderately injured survivors and witnesses than in seriously injured survivors. Conclusion: Many complications exist after a fire. Some may be resolved in time, but others may result in permanent sequelae. Early rescue, early triage, and early management during transport by emergency medical service (EMS) personnel can result in fewer complications and a lower mortality rate. Therefore, we propose the establishment of plans to be followed during various major disasters.

이동형 발전기의 접지대책에 관한 연구

金正勳,柳輔赫,魏湲錫 弘益大學校 科學技術硏究所 2000 科學技術硏究論文集 Vol.11 No.-

In this paper, portable and vehicle-mounted generators grounding methods of low-voltage systems is compared to each other. Ungrouded system is better for the safety operation than solidly grounding system. Solidly-grounding method causes so high fault current that its safety voltages is lower than the ungrounded method. This paper also determined the magnitude and duration of the pelniissible body current limit and step voltage for the solidly-grounding and ungrounded system.