심장수술 시 농축적혈구, 자가수혈기 혈액, 체외 순환기 혈액에서의 유리 혈색소 농도 비교

송장호,구승우,백종화,정용보,이정순,최인철 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: Intraoperative autotransfusion or residual blood in a cardiopulmonaty bypass (CPB) circuit has been used to reduce the need for an homologous blood transfutsion during cardiac surgery. However, it may contain some free hemoglobin released from damaged cells. The load of blood containing free hemoglobin may cause renal dysfunction. We measured the amount of free hemoglobin in backed blood, cell saver blood and CPB blood to evaluate what is the least hemolytic blood transfused in cardiac surgery. Methods: This study was performed in 20 patients undergoing cardiac surgery. In each patient, the banked blood, intraoperative salvaged blood with a cell saver and CPB residual blood were sampled at the end of the operation. The concentration of free hemoglobin, hemoglobin and platelet counts were measured in these blood samples and percent of hemolysis was calculated (%hemolysis = [free hemoglobin] / .free hemogloben + hemoglobin]) Results: In salvaged blood with a cell saver, CPB residual blood and banked blood, hemoglobin concentrations were 20.1 ± 2.7 g/dl, 8.0 ± 1.1 g/dl, and 22.2 ± 2.7 g/dl, respectively. Free hemoglobin concentrations were 336.6 ± 239.5 mg/dl, 49.2 ± 26.8 mg/dl, and 279.5 ± 167.5 mg/dl respectively. Platelet counts were 26.1 ± 22.2 × 10^3/mm^3, 116.8 ± 56.5 × 10^3/mm^3, and 94.9 ± 43.6 × 10^3/mm^3 respectively. % Hemolysis were 1.6 ± 1.1%, 0.6 ± 0.4%, and 1.2 ± 0.7% respectively. In the comparison between the salvaged blood with a cell saver and CPB residual blood, free hemoglobin concentration, % hemolysis, and platelet counts had positive correlations (r = 0.8, 0.7, and 0.6). Conclusions: In twenty cardiac surgeries, CPB residual blood had a lower free hemoglobin level than the other two blood groups. The platelet counts in CPB residual blood were higher than those in cell saver blood but did not differ from those in banked blood. Therefore, CPB residual blood was the least hemolytic blood among the three blood groups when a transfusion was performed in cardiac surgery. (Korean J Acesthesiol 2002; 43: 588~593)

간경변증 환자에서 Escherichia coli 균혈증 합병 시 간기능 장애에 따른 C-reactive protein 생성 능력에의 영향

박완범,강철인,김동민,이기덕,장희창,김홍빈,오명돈,이효석,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : C-reactive protein(CRP)은 간에서 생성되는 급성 반응물질이다. 하지만 간부전증 환자에서 CRP의 반응이 간기능에 따라 어느 정도 영향을 받는지는 별로 알려진 바가 없다. 본 연구에서는 간기능에 따른 CRP 생성 능력을 평가하고자 하였다. 방법 : E. coli 균혈증이 있는 간경변증 환자 30명을 대상으로 하였고 간기능은 균혈증이 발생하기 전 2개월 이내에 측정된 혈청 빌리루빈, 혈청 알부민, 프로트롬빈시간, Child-Pugh 점수로 평가하였다. 대조군 A는 간질환이 없으면서 E. coli 균혈증이 발생한 환자 30명으로 하였고 대조군 B는 간경변증이 있으면서 급성 감염의 증거가 없는 환자 30명으로 하였다. 환자군과 대조군 간에 CRP의 최대값을 비교하였다. 결과 : CRP의 최대값은 환자군에서 7.3±5.0㎎/dL, 대조군 A에서 17.9±8.3㎎/dL로 환자군에서 유의하게 낮았다.(P<0.001). 간경변증 환자에서 CRP의 생성은 Child-Pugh 점수에 비례하여 감소하였으나(P=0.004) Child=Pugh class C의 간기능을 가진 환자군에서도 대조군 B와 비교하여 의미있는 CRP의 생성을 보였다(5.3±3.2 vs. 0.5±0.4㎎/dL, P<0.001). 결론 : 간기능부전 환자에서 CRP 반응은 간기능 저하 정도에 따라 둔화되지만 심한 간기능 장애를 가진 환자에서도 CRP의 생성은 유지된다. Background : C-reactive protein (CRP) is an acute phase reactant produced in the liver. To assess the influence of liver dysfunction on the production of CRP, we evaluated CRP response to E. coli bacteremia in patients with or without liver cirrhosis (LC). Methods : 30 LC patients who developed spontaneous peritonitis with E. coli bacteremia were enrolled in the study. Baseline values of total bilirubin, serum albumin, and prothrombin time were obtained within 2 months prior to infection. Liver dysfunction was categorized according to the Child-Pugh score. 30 patients with E. coli bacteremia who had no underlying liver dysfunction were included as a control group. Matched-control of 30 LC patients without evidence of acute infection was also included. The peak CRP values were compared among the groups. Results : In the patients with E. coli bacteremia, the mean value of peak CRP was 7.3 (+/- 5.0) ㎎/dL in LC patients, 17.9 (+/- 8.3) mg/dL in patients without liver dysfunction (p<0.001). In the advanced LC patients with Child-Pugh class C, the level of CRP was 5.2 (+/- 3.3) ㎎/dL in patients with E. coli bacteremia, 0.5 (+/- 0.4) ㎎/dL in patients without acute infection (P<0.001). Child-Pugh score had correlation with decrease of CRP (linear regression test, P=0.004). Conclusion : CRP response during E. coli bacteremia was attenuated but maintained even in patients with advanced liver dysfunction.

하계 실내 및 실외환경의 공기 중 휘발성 유기화합물 농도 및 개인노출

양원호,손부순,박종안,장봉기,박완모,김윤신,어수미,윤중섭,류인철 한국환경과학회 2003 한국환경과학회지 Vol.12 No.9

Volatile organic compounds (VOCs) are present in essentially all natural and synthetic materials from petrol to flowers. In this study, indoor and outdoor VOCs concentrations of houses, offices and internet-cafes were measured and compared simultaneously with personal exposures of each 50 participants in Asan and Seoul, respectively. Also, factors that influence personal VOCs exposure were statistically analyzed using questionnaires in relation to house characteristics, time activities, and health effects. All VOCs concentrations were measured by OVM passive samplers (3M) and analyzed with GC/MS. Target pollutants among VOCs were Toluene, o-Xylene, m/p-Xylene, Ethylbenzene, MIBK, n-Octane, Styrene, Trichloroethylene, and 1,2-Dichlorobenzene. Indoor and outdoor VOCs concentrations measured in Seoul were significantly higher than those in Asan except Ethylbenzene. Residential indoor/outdoor (I/O) ratios for all target compounds ranged from 0.94 to 1.51 and I/O ratios of Asan were a little higher than those of Seoul. Relationship between personal VOCs exposure, and indoor and outdoor VOCs concentrations suggested that time-activity pattern could affect the high exposure to air pollutant. Factors that influence indoor VOCs level and personal exposure with regard to house characteristics in houses were building age, inside smoking and house type. In addition insecticide and cosmetics interestingly affected the VOCs personal exposure. Higher exposure to VOCs might be caused to be exciting increase and memory reduction, considering the relationship between measured VOCs concentrations and questionnaire (p<0.05).

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

Transfer of ultrathin molybdenum disulfide and transparent nanomesh electrode onto silicon for efficient heterojunction solar cells

Kang, Sung Bun,Kwon, Ki Chang,Choi, Kyoung Soon,Lee, Rochelle,Hong, Kootak,Suh, Jun Min,Im, Min Ji,Sanger, Amit,Choi, In Young,Kim, Soo Young,Shin, Jae Cheol,Jang, Ho Won,Choi, Kyoung Jin Elsevier 2018 Nano energy Vol.50 No.-

<P><B>Abstract</B></P> <P>Two-dimensional transition-metal dichalcogenides (TMDCs) are very promising for photovoltaic (PV) applications due to their excellent light absorption properties and appropriate bandgap energy, Although multifunctional applications of TMDCs in photovoltaic devices have been achieved, the photovoltaic conversion efficiency under 1 sun is still very low with small active area because of their inexpedient high sheet resistance and limitation of synthesis techniques. In this study, we demonstrate uniform synthesis of 4-in. wafer-scale MoS<SUB>2</SUB> thin films by thermal decomposition of solution precursors. The solar cells are fabricated by transferring n-MoS<SUB>2</SUB> thin films on p-Si substrates to form p-n heterojunctions and then transferring Au nanomeshes prepared in a novel surface treatment as transparent top electrodes onto MoS<SUB>2</SUB>. The circular n-MoS<SUB>2</SUB>/p-Si heterojunction solar cell exhibited a power conversion efficiency of 5.96% at a diameter of 0.3 in. and proved to be easily scalable to 1-in. diameter with 5.18% efficiency. To the best of our knowledge, the solar cells of this study are the most efficient and the largest in all types of solar cells based on TMDC reported so far. Finally, based on finite difference time-domain simulation, we proposed a strategy for implementing n-MoS<SUB>2</SUB>/p-Si heterojunction solar cell with efficiency higher than 15% by introducing optimal doping control of n-MoS<SUB>2</SUB> and efficient anti-reflection layers.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The large scale, uniform (4-in.) MoS<SUB>2</SUB> thin films are synthesized. </LI> <LI> High transparent, low sheet resistances electrodes are fabricated in a novel way. </LI> <LI> The efficient MoS<SUB>2</SUB> based solar cells are developed by all transfer process including top electrodes. </LI> <LI> The highest, largest MoS<SUB>2</SUB> p-Si/ heterojunction solar cells are demonstrated. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P> <B>The highest performance (5.96%), largest area (1 in.) n-MoS2/p-Si solar cells with transparent electrodes fabricated by a novel way.</B> The transparent electrodes lowers the series resistance of the fabricated solar cells, facilitating the collection of photo-generated carriers from the junction. In our knowledge, we have achieved the highest photovoltaic performance at largest active area by using transparent nanomesh electrode among TMDC based solar cells.</P> <P>[DISPLAY OMISSION]</P>

IN738LC 합금의 열간 노출 및 재생 열처리에 따른 미세조직과 응력 파단 특성의 변화

최백규,주동원,김인수,장중철,조창용,Choe, Baek-Gyu,Ju, Dong-Won,Kim, In-Su,Jang, Jung-Cheol,Jo, Chang-Yong 한국재료학회 2001 한국재료학회지 Vol.11 No.10

Effects of thermal exposure and rejuvenation treatment on the microstructural evolution and the stress-rupture properties of IN738LC have been investigated. The role of precipitates on the stress- rupture properties has been analyzed through microstructural observations. Thermal exposure at $982^{\circ}C$ for 1000 hours gave rise to precipitation of $\sigma$ phase and coarsening of ${\gamma}$'. The microstructural degradation with thermal exposure at $982^{\circ}C$ deteriorated stress rupture properties of the alloy. All the existing phases except MC carbides have completely dissolved into the matrix with homogenization treatment at $1200^{\circ}C$ for 2 hours. Microstructure and stress-rupture properties of the thermal exposed specimens have been successfully rejuvenated by the proposed treatment.

요로결석 환자에서 Pethidine, Nalbuphine, Ketorolac의 진통효과 비교

장석준,박인철,정성필,최성욱,이한식 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Ureter stone cause severe flank and abdominal pain. In emergency room, these patients require rapid pain relief and diagnosis. Therefore, authors have conducted a study on the efficacy of three types of commonly used analgesics including non opioid analgesics; intramuscular ketorolac 30mg and nalbuphine 10mg was compared with pethidine 50mg in 74 patients who visited SEVERANCE hospital emergency care center with complaint of flank colicky pain from Jan1. 1996 to Mar 31. 1996. Pain was assessed before the drug administration, and then at 10min, 20min, 30min time interval after the first dose. Visual analogue scale was used to assess the pain intensity and scale was self drawn by each patient during the time of pain assessment. Additional need of rescue analgesia and adverse effecfs of first-line analgesia was also recorded. Statistical significant was confirmed using ANOVA and Chi square test. The difference in the decrease of pain intensity was not significant among the three analgesics(P=0.65). Rescue anagesia was required in 37.1% of pethidine, 42.8% of nalbuphine, 16.6% of ketorolac and totally 33.8%. The incidence of all types of adverse event of pethidine, nalbuphine and ketorolac were 14.2%, 14.2% and 5.5% in respectively. The results of this study have shown that non opioid analgesics are as effective as opioid analgesia. Therefore, non opioid analgesics can be tried first line of pain relief drug of renal coliky pain with minimal adverse effects.

IN738LC 합금의 열간 노출 및 재생 열처리에 따른 미세조직과 응력 파단 특성의 변화

최백규,주동원,김인수,장중철,조창용,Choe, Baek-Gyu,Ju, Dong-Won,Kim, In-Su,Jang, Jung-Cheol,Jo, Chang-Yong 한국재료학회 2001 한국재료학회지 Vol.11 No.11

Effects of thermal exposure and rejuvenation treatment on the microstructural evolution and the stress-rupture properties of IN738LC have been investigated. The role of precipitates on the stress-rupture properties has been analyzed through microstructural observations. Thermal exposure at $982^{\circ}C$ for 1000 hours gave rise to precipitation of $\sigma$ phase and coarsening of r'. The microstructural degradation with thermal exposure at $982^{\circ}C$ deteriorated stress rupture properties of the alloy. All the existing phases except MC carbides have completely dissolved into the matrix with homogenization treatment at $1200^{\circ}C$ for 2 hours. Microstructure and stress-rupture properties of the thermal exposed specimens have been successfully rejuvenated by the proposed treatment.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

下水 슬러지중의 重金屬 細菌浸出

변은숙,조인철,최장승,Poon, Calvin P.C.,박승조 동아대학교 환경문제연구소 1996 硏究報告 Vol.19 No.2

This study has been carried out to remove metals and to improve dewatering efficiency in anaerobically digested sewage sludge using several conditions. The results from these experiments are as followings ; In continuous experiments, conditions of maximum metal solubilization were recycling rate of 20%, ferrous sulfate ammounts of 4.0g/l. The maximum metal solubilizations were observed since 48 hours. Solubilization rates of Zn, Mn were 98.3 %, 94.71 % respectively. Sulfuric acid dosage for metal solubilization are 1.26g in chemical method and 0.07g in bacterial leaching on a dry weight basis. Therefore sulfuric acid dosage was reduced about 18 times in bacterial leaching compared to that of chemical methods. In 660 mmHg, specific resistance coefficient of raw sludge was 4.91 × 10¹²cm/g. At acid treatment, specific resistance coefficient of sludge was 3.17 × 10¹²cm/g. At bacterial leaching, specific resistance coefficient of sludge was 1.94 × l0¹¹cm/g. Therefore dewatering abilities of sulfuric acid were increased about 2.7 times in bacterial leaching vs. chemical methods.