외안각 절제술과 경결막 절개에 의한 안와 접근법

정종철,김성범,서지훈,송민석,전창훈,최세훈,김현민 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

Various surgical approaches to the orbits have been used. But the transconjunctival approach, also called the inferior fornix incision, provides adequate access to the orbital floor with esthetic results. Additionally, transconjunctival approach with lateral canthotomy allows more wide surgical field and good access to the orbital area. Generally, preseptal approach is more used rather than postseptal approach in the transconjunctival incision for the prevention of fat herniation during surgery. There are some complications in transconjunctival approaches but these complications can be prevented with careful surgical techniques. We report clinical results in 12 patients who were treated by preseptal transconjunctival incision with lateral canthotomoy for the treatment of orbital trauma. We were satisfied with this technique for reduction and reconstruction of the orbital trauma and we could also observe relatively good esthetic results.

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.

석탄 비산재로부터 제올라이트의 합성 및 중금속 흡착능 평가

이창훈,유지호,신형상,정일래 서울産業大學校 2005 논문집 Vol.54 No.3

본 연구에서는 국내 영동화력발전소에서 발생하는 석탄 비산재(coal fly ash)로부터 KOH 용액을 사용한 수열반응을 통하여 제올라이트를 합성하고 중금속 흡착능을 평가하였다. 수열 합성 실험은 일정온도 조건 (100 ℃)에서 알칼리농도([KOH]:1 ~ 4 N), 고액비(S/L: 1/2 ~ 1/20 g/cm³) 및 반응시간 (1 ~ 96 hrs) 등의 합성조건을 달리하여 수행하였다. 그 결과 [KOH] = 3 ~ 4 N, 고액비(S:L) = 1:5 ~ 1:10, 반응시간 48 ~ 96 hr에서 200 ~ 240meq/100g의 CEC 값을 가진 제올라이트 생성물을 얻었다. XRD 분석결과 주요 결정상은 K-Chabazite이었으며 약 40%의 결정도를 보였다. 혼합 중금속(Cu, Cd, Cr, Pb)용액 (개별 중금속 농도 100mg/L, pH 5.0)을 대상으로 한 제올라이트 생성물의 중금속 흡착능르 평가한 결과, 제올라이트 첨가량 3g/200ml 이상에서 모든 중금속에 대하여 95% 이상의 제거율을 보였으며, 타 흡착제(천연제올라이트, 상업용 이온교환수지 등)와의 비교에서도 우수한 흡착능을 보였다.

Water glass로부터 ZSM-5의 합성

우훈희,홍지숙,서정권,이관영,이정민 한국공업화학회 2002 응용화학 Vol.6 No.2

In order to seek optimum conditions for ZSM-5 formation in the absence of organic template,the effects of both starting composition and water glass as silica source were examined. Water glass was most inexpensive among silica sources, but this was difficulty in reactant control because of contained much alkali ingredient, Considering environmental problem and economic performance,chose alkali drawing-out method to use methanol newly to remove alkali ingredient of waterglass. Characterization of ZSM-5 was carried out by means of XRD, SEM.

老人 低血壓에 對한 文獻的 考察

郭益勳,김종대,鄭智天 동국대학교 한의학연구소 1995 東國韓醫學硏究所論文集 Vol.4 No.-

This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are deficiency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc..In the view of the occidental medicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular syatem's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A. etc‥, and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang the deficiency of Qi in middle jiao, and deficiency of Shen-Oi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Fu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Qi and relieving menta1 stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishingthe San help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberia Rhizoma, Polygalae Radix, Liriopis Tub er, Polygonati Sibirici Rhizoma, Lycii Fructus, Schigandrae Fructus and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of 'extremity, spontaneous perspiration, and therapy and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70% . 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril ete‥) and pungent food(chinese green onion, fress ginger, pipers fructns etc‥), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

Lesch-Nyhan 증후군 환아의 자해 예방 : A CASE REPORT

이지현,김지훈,김재문,정태성,김신 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.2

Lesch-Nyhan 증후군은 purine의 대사장애를 보이는 질환이다. 신생아에서 대략 1:100,000 정도의 이환율을 보이는 X염색체 열성 유전 질환으로 남자에서 흔하며, purine의 대사에 관여하는 효소인 hypoxanthine guanine phospho ribosyl transferase(HGPRT)의 결손 또는 활성 감소 결과, 과도한 요산 형성 및 과요산혈증(hyperuricemia)이 일어난다. 이 질환은 임상적으로 정신지체, 무도증(choreoathetosis), 경련성 뇌성 마비, 심각한 자해 행위가 특징이다. 이 중 자해행위는 입술과 혀, 손가락을 깨무는 경우가 흔하고, 혀와 손가락이 완전히 절단될 수도 있다. 이 경우 자해로 인한 통증뿐 아니라, 상처 부위로의 2차 감염 및 연조직 결손으로 인한 심미성이 문제가 된다. 본 증례는, 상하악 유전치의 입술 깨물기 습관에 의해 하순이 심하게 손상된 Lesch-Nyhan 증후군 환아로서, mouth guard를 이용한 보존적인 방법과 소아정신과와의 협진을 통한 신경학적 약물치료로 자해에 의 한 손상을 방지하여, 단기간에 비교적 만족할 만한 결과를 얻었기에 이를 보고하는 바이다. Lesch-Nyhan syndrome is a rare disorder of purine metabolism, first described in 1964. The incidence is estimated to be 1:100,000 birth. It is an X-linked recessive disorder in which affected males have a virtually complete deficiency of the enzyme hypoxanthine guanine phosphorybosyl transferase(HGPT) . This enzyme deficiency gives rise to excessive uric acid production and consequent hyperuricemia. Lesch-Nyhan syndrome is clinically characterized by mental retardation, choreoathetosis, spastic cerebral palsy, and severe self-mutilation behavior. Patient with Lesch-Nyhan syndrome mostly bite their lip, tongue and finger. In severe cases, partial or total amputation of the lip and tongue is common. Self-inflicted bites are often further complicated by secondary infection to injuried site as well as pain. And tissue loss by biting results in esthetic problems. This report presents a Lesch-Nyhan syndrome patient with self-mutilation, who have a destruction of perioral tissue, especially the lower lip. He was treated successfully with soft mouth guard, psychological and pharmacological method.

淸肝散이 急性 Ethanol 中毒에 흰쥐의 肝損傷에 미치는 影響

곽익훈,김종대,정지천,신억섭 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

Chunggansan(淸肝散) was tested for the effects on detoxication mechanism of alcohol. Chunggansan was treated firstly into samples, and then ethanol intoxicated animal models were set with them. In vitro, the level of lipid peroxide in tissue of liver proportionally decreased with the level of concentration of extract prepared from Chunggansan. In vivo, after the extract was administered to the animal model for seven days, the level of lipid peroxide in liver dependently decreased in proportion of concentration. The glutathione percentage purposely induced acute ethanol intoxicated samples, followed by Chunggansan pre-medicating administration, increased in compare with the group treated with only ethanol. Also, the enzyme activities of ALT, AST, and r-GTP in liver decreased.

중소규모 사업장 근로자의 직무스트레스로 인한 결근, 조퇴 현황과 한국형직무스트레스 하부요인과의 관련성

김정훈,박신구,김동현,김환철,임종한,이의철,이동훈,이지영 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

목적: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴의 현황과 한국형 직무 스트레스 하부 요인과의 관련성을 알아보고자 하였다. 방법: 중소규모 사업장 83곳 근로자들에 대해 한국형 직무스트레스요인 평가도구-단축형(KOSS-SF)과 사회 일반적 특성, 직업적 특정 및 직무스트레스로 인한 결근이나 조퇴 경험여부 등을 묻는 구조화된 자가 기입식 설문을 실시하였고, 응답한 4,350명에 대해 최종 분석을 시행하였다. 직무스트레스로 인한 결근, 조퇴와 한국형 직무스트레스 하부 요인들과의 관련성을 확인하기 위하여 로지스틱 회귀분석을 시행 하였다. 결과: 직무 스트레스로 인한 결근, 조퇴를 한 근로자는 남자에서 7%(196명), 여자에서 8%(113명) 로 조사되었고 한국형 직무 스트레스 하부요인과의 관련성에서는 남, 여 모두 직무요구, 관계갈등, 조직체계, 보상부적절, 직장문화 영역의 스트레스가 높은 군에서 통계적으로 의미있게 직무스트레스로 인한 결근, 조퇴율이 증가하였다. 결론: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴와 한국형 직무 스트레스 하부요인과의 관련성은 남자에서는 조직체계 영역이 가장 높았고, 여자는 직장문화 영역에서 가장 높은 관련성을 보였다. Objective: The aim of this study was to examine the actual conditions of absence and early leave due to job stress of 4,350 workers in 83 small and medium scale industries, and its relationship to job stress factors using Korean Occupational Stress Scale-Short Form (KOSS-SF). Methods: A structured self-reported questionnaire was used to assess each respondent's Sociodemographics, job stress, experience of absence and early leave due to job stress. Seven KOSS-SF domains of job stress were used. We estimated the relation of absence and early leave due to job stress and job stress factors using logistic regression analyses. Results: Absence or early leave due to job stress occurred in 7% of male workers and 8% of female workers. Multiple regression analysis revealed a significantly positive association job stress-related absence/early leave and job demand, interpersonal conflict, organizational system, lack of rewards and occupational climate. Conclusions: Absence and early leave due to job stress is significantly attributed to organizational System and lack of reward for men, and occupational climate and organizational system for women.

하악골에 발생된 Low grade 골육종:증례보고

조현이,정종철,김호성,최재욱,성대경,서지훈,김성범,이계혁 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

Osteosarcoma is a primary malignant tumor arising most often in the long bone, but rare in jaw bone. Especially osteogenic sarcoma of the mandible is a rare tumor, comprising less than 0.5% of all head and neck tumors. Osteosarcoma occurs cheifly in young persons, and presenting very survival rates. Histopathologically this tumor can be classified three types, osteoblastic, fibroblastic, chondroblastic and classified from low grade to high grade by anaplasia or mitosis of the tumor cells. Sometimes, the exact diagnosis of osteosarcoma is difficult especially in low grade osteosarcoma, even if clinical or radiographical findings suggest to osteosarcoma. So suspcious to malignant bone tumor in clinical or radiological findings, biopsy should be taked from deep portion and multiple area, and sharing the patient history and radiographs with pathologist will assist in the development of the diagnosis. We report a case of low grade osteosarcoma on the mandible initially difficulty in accurate diagnosis. The patient visited our hospital for routine dental treatment but radiographic findings displayed ill-defined radiolucency with osteoid formation on the mandible. Final diagnosis was difficulty in initial biopsy but subsequent biopsy taked from deep portion presented infiltrative growth and mitosis of the tumor cell in some area with small osteoid bone formation, so we could reach final diagnosis as low grade sarcoma. We treated this patient with bloc resection of the mandible and immediate reconstruction with iliac corticocancellous block.

Methylphenidate 투약에 따른 주의력결핍 과잉운동장애 아동의 정량화 뇌파의 변화

이병대,정성훈,이만기,장수민,백지령,임효덕 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1