응급실에 내원한 환자에서 어지럼증의 원인과 임상양상의 분석

문원식,정경운,위준선,문정미,전병조,김용권,소정일,류진호,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Recently, The number of patients who have been complaining of the vertigo or dizziness has been increasing due to rapid growth of elderly population and senile disease. The differentiation of dizzy patients is not familiar to most emergency physicians. This study was designed to differentiate true vertigo and to investigate the clinical difference among central vertigo, peripheral vertigo, and other causes of dizziness. Methods: The authors analyzed the cases of 237 dizzy patients who visited the emergency department of Chonnam University Hospital during the recent 2 years. For the base of dizziness, associated past illnesses, severity, nystagmus type, and the causes of central and peripheral vertigo. Results: Female patients were 142(59.9%) and male patients were 95(40.1%). The most common age group was the 6th decade. The origin of dizziness was classified as peripheral cause(25.3%), central cause(32.9%), and others(41.8%). As to nature of the dizziness, the rotatory sense was dominant in peripheral vertigo and the floating sense and blurred vision in central vertigo. Peripheral vertigo was triggered by position change of head and body, and central vertigo by the eye movement. Audiograms I showed that most patients with central vertigo had normal hearing, but 46.7% of thoswith peripheral vertigo had an abnormal hearing disturbance. Nystagmus was more prevalent in peripheral vertigo Conclusion: History taking and physical examination played an important role in the diagnosis of dizzy patients. An important part of the diagnosis of a dizzy patient could be to evaluate the peripheral origin, the central origin and others causes. Because central vertigo may be associated with a significant neurological pathology, spectral radiological studies, including MRI and CT, are mandatory to rule out a devastating brain lesion.

3차 병원의 병동에서 시행된 심폐소생술의 분석

류진호,정경운,위준선,문정미,전병조,문원식,김용권,소정일,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. Methods: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. Results: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. Conclusion: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.

형질전환 제초제저항성 벼 밀양 204호의 농업적 특성

정응기,이기환,원용재,박향미,전남수,최준호,구연충,한창덕,은무영,김태산,남민희 Plant molecular biology and biotechnology research 2005 Plant molecular biology and biotechnology research Vol.2005 No.

This study was conducted to investigated the major characteristics of genetically modified rice of "Milyang 204" originated from Dongjinbyeo compared to a non-transgenic rice varieties Dongjinbyeo and Junambyeo. Basta resistant transgenic rice lines carrying bar gene produced by the Yeongnam Agricultural Research Institute were evaluated for their agronomic characters. The transgenic Japonica rice of "Milyang 204" showed inferior phenotypic traits compared to a non-transgenic rice variety Dongjinbyeo and Junambyeo. On the basis of UPOV (Union Internationale Pour la Protaection des Obtentions Vegetables) and NSMO(National Seed Management Office) the transgenic "Milyang 204" showed difference in some traits out of some agronomic traits, such as leaf color, angle of flag leaf, number of spikelets, culm length, white core and white belly compared to the nontransgenic varieties rice.

냉각탑용 수분배기의 특성에 관한 연구

전유신,최석천,이용훈,김세현,정효민,정한식 경상대학교 해양산업연구소 2002 해양산업연구소보 Vol.15 No.-

The main purpose of this research is the investigation of water distributer. The water distributer of this research is installed in evaporative cooling tower system. The performance of this cooling tower system depend on the evaporative surface, and there are many kinds of methods for increasing the evaporative surface. In this research, we introduced the two kinds of spraying system, one is the hole type with hole diameter 1, 2 and 3mm, and the other is the spray nozzle types with nozzle tip diameter of 1 and 2mm. As the experimental results, the case of diameter 2mm showed the best performance.

정신과 입원환자에서의 혈청 콜레스테롤 농도와 공격행동

전태연,도규영,정종현,권용실,김석범 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 혈청 콜레스테롤 농도와 자살 등의 공격행동간의 연관성에 관한 여러 연구가 있었으나 일치된 결과를 보이고 있지 못하다. 이에 저자들은 다양한 진단의 정신과 입원 환자들 중 공격행동을 보인 환자의 콜레스테롤 농도를 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추어 공격행동 및 자살시도와 혈청 콜레스테롤 농도간의 연관성을 알아보기 위하여 본 연구를 시행하였다. 방 법 : 본 연구는 1994년 1월 1일부터 1995년 6월 31일까지 18개월간 카톨릭대학교 의정부성모병원 정신과 병동에 입원하였던 환자 중 콜레스테롤 농도를 얻을 수 있었던 127명을 대상으로 하였다. 대상 환자는 공격행동의 유무에 따라 공격군과 비공격군으로 분류하여 공격군 35명과 비공격군 92명의 자료를 얻었으며, 공격군은 Overt Aggression Scale을 사용하여 평가하였다. 측정된 각 환자의 콜레스테롤 농도는 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추어 4개의 군으로 나눈 후 공격행동 발생비율, 자살시도간의 차이를 알아보았다. 또한 공격행동을 보인 군에서도 각 콜레스테롤군 간의 총 공격 점수를 비교하였다. 결 과 : 1) 각 콜레스테롤군 간의 공격행동 발생비율에는 유의한 차이가 없었다. 2) 공격군에서 각 콜레스테롤군 간의 총 공격 점수는 유의한 차이를 보이지 않았다. 3) 각 콜레스테롤군 간의 자살시도 빈도는 유의한 차이가 없었다. 결 론 : 정신과 입원 환자의 혈청 콜레스테롤 농도를 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추었을 때 혈청 콜레스테롤 농도와 공격행동 및 자살시도에 유의한 연관이 없었다. Objectives : An association between serum cholesterol concentration and violent behavior has been suggested, but has not been consistently demonstrated. This study was conducted in order to evaluate the relation between serum cholesterol concentration and violent behavior in psychiatric inpatients who had been admitted at Uijongbu St. Mary's Hospital, the Catholic University of Korea from January 1994 to June 1995. Methods : We divided the 127 subjects into violent(35 subjects) and non-violent group(95 subjects). According to the percentile distribution of serum total cholesterol in healthy Korean adults, the subjects were classified into four subgroups : Group 1, subjects Whose cholesterol concentrations were below 26% of percentile distribution, Group 2, from 26% to 50%, Group 3, 51% to 75% and Group 4, above 75%. In the four cholesterol subgroups, the authors examined the incidence of violent behaviors and suicidal attempts. Within the violent group, total aggression score of four cholesterol subgroups was compared. Results : 1) Among the four cholesterol subgroups, there were no significant differences in the violent behavior. 2) Within the violent groups, total violent score of the four cholesterol subgroups showed no significant difference. 3) Among the four cholesterol subgroups, there were no significant differences in suicidal attempt. Conclusion : When the serum cholesterol concentrations of psychiatric inpatient applied to the percentile distribution of serum total cholesterol in healthy Korean adult, no association was found between serum cholesterol concentration and violent behavior and suicide attempt.

γ-Alumina에 담지된 산화구리에 의한 SO_2의 제거에 관한 연구

鄭一鉉,尹龍水,全法柱 단국대학교 1992 論文集 Vol.26 No.-

In the case of SO_2 removal from the flue gases by fixed beds of coper oxide in two types or γ-Aluminas with different pore size distribution, the reactive sorption capability were correlated with not only porosity and pore size distribution in the reacting solid but impregnated concentration of the reacting solid but impregnated concentration of the copper oxide. The effect of change of pore structures on the kineticc of gas-solid reaction was investigated through the random pore model. Mathematical model og gas-solid noncatalytic reaction for the concentration vs. time relationship in corporating chemical reaction, product layer diffusion, and the effect of structural change due to chemical reaction has been derived. Numerical solution were obtained to the model equations for various values of the parameters characterizing the pore structure, effective internal diffusion, and the chemical reaction constant. From the results, the conversion was decreased cause of pore closure at the surface of reactiong particles, reduction of porosity and surface area of reaction, and increase of effective diffusion coefficient in the solid with the progress of reaction, Conversion was increased with rised concentration of flue gas since that CuO-SO_2 reaction mechanism assumed to be first order. Total conversion was strongly dependent on the local conversion at surface. According to decreas of impregnated concentration of the copper oxide and increase of the flue gases concentration, total conversion was increased. The conversion was affected by gas flow rate and pore size distribution in the reacting solid.

쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화

정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).

비구조적 퍼지 의사결정지원시스템을 활용한 건설재해 예방대책에 관한 연구

이용준,정성춘,이학기 東亞大學校 建設技術硏究所 2004 硏究論文集 Vol.27 No.2

The hazard factors in building construction project are various and their bad effects with regard to project's efficiency are increasing due to its enlargement and complexity. However. the assessment of the construction safety is commonly dependent upon the statistical and historical information. since the existing systematic tool assisting to the effective decision making for estimating the safety prior to construction phase is inaccurate. In addition. it is true that there are the various difficulties to analyze and diagnosis the construction safety with the probabilistic approach. because there are the many vague factors and limited resources. Therefore. the purpose of this research is to provide the way to establish the efficient preventable countermeasure against the hazard factors. corresponding to the category of the hazard characteristic. by using non-structural fuzzy decision support system for diagnosing effectively the construction project safety.

7두의 개에서 배설성 요로조영술을 통한 신장 기능 평가

최윤정,이기자,최형준,이용진,박성준,송근호,정성목,최호정,이영원 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

Excretory urography is a type of contrast study used to verify and localize upper urinary tract disease. It is an inexpensive and easy way to visualize of anatomic and functional status of the kidney and has been used as a primary imaging modality for the evaluation of urinary tract abnormalities. We describe urological signs of 7 dogs who examined with excretory urography and ultrasonography. Six cases were referred to veterinary medical teaching hospital. Chungnam national university (VMTH, CNU) to evaluate renal function after the treatment for renal failure and one case was referred showing hematuria. In case 1, 2 and 4, blood test and urinalysis was normal and the results of excretory urography presented that renal function were normal range. In case 3, the results of urinalysis, ultrasonography, and excretory urography except blood test presented abnormal kidney and hydronephrosis was diagnosed. In case 5 and 6, blood test, urinalysis, ultrasonography and excretory urography indicated renal failure. In case 7, blood test, urinalysis and ultrasonography presented partially abnormal signs, however, the results of excretory urography was normal range.

자궁경부에 발생한 배아성 횡문근육종 2예

박정열,조준식,김대연,이동헌,김종혁,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.3

횡문근육종은 소아와 청소년기에 가장 흔한 연부조직 육종이다. 발생 부위는 일반적으로 두부 및 경부, 그 다음으로 비뇨생식계이다 조직학적으로 배아성 횡문근육종, 국화상 육종, 폐포성 횡문근육종, 다형성 횡문근육종으로 나누어진다. 횡문근육종의 약 20%가 비뇨생식기에서 발생하고, 50% 이상이 배아성 횡문근육종이다. 여성 생식기의 배아성 횡문근육종은 드문 악성 종양으로,주로 유소아의 질에서 발생하며, 자궁경부에서 발생하는 횡문근육종은 청소년기에 흔하고, 질에서 기원하는 횡문근육종이 자궁경부에 기원하는 경우보다 5배 정도 많다. 폐경기여성에서는 자궁체부에서 가장 흔히 발생한다. 비뇨생식기의 횡문근육종의 치료는 과거에는 골반장기 적출술만으로 치료를 시도하였으나. 서서히 다중 항암화학요법, 방사선요법, 근치적 절제술을 포함한 병합요법으로 바뀌어가고 있으며, 이에 따라 생존율이 현저하게 향상되었다. 이에 저자들은 최근 본원 산부인과에서 자궁경부에 발생한 배아성 횡문근육종 2예를 경험하였기에 문헌 고찰과 아울러 보고하는 바이다. Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and young adult. Genitourinary tract is the econd most common site of rhabdomyosarcoma. Rhabdomyosarcoma can be classified into one of four major types; embryonal, alveolar, pleomorphic and undifferentiated. Embryonal rhabdomyosarcoma of the female genital tract is rare malignant tumor and usually occurs during childhood in the vagina. In rare cases, rhabdomyosarcoma can originate in the uterine cervix, with a peak incidence in the second decade. Recently we have experienced two cases of embryonal rhabdomyosarcoma of the uterine cervix. These cases are presented with a brief review of the literature.