金剛山댐 建設에 따른 北漢江 上流 水域의 環境 모니터링에 관한 硏究

조규송,김범철,안태석,전상호,이종범 江原大學校 附設 環境硏究所 1989 環境硏究 Vol.6 No.-

Aquatic ecosystem was studies in Lake Paro to monitor the effects of the Keumkangsan Dam construction in North Korea. Water quality, primary prodectivity, and microbes were serveyed bimonthly in 1987. The texture and composition of sediments, and meterological sapects were also investigated. The most remarkable change of water quality was the increase of turbidity. due to the dam construction. Overall chemical and biological aspects were greatly changed because of the high turbidity. The concentration of phosphate increased and subsequently phytoplankto standing corp increased. The effect of phosphate increase was compensated by the decrease of light penetration, and, therefore areal primary prodectivity was not so high as expected from the chlorophyll concentration. From the standing corp of microbes, the trophic state of lake Paro was evaluated as mesotrophy. As for the horizontal variation of microbial activity, the microbial heterotrophy was higher in the upstream regions than in the downstream regions. Sediment types are almost clayey silt and the mean sizes of sediments were homogeneous through the whole lake area. Organic carbon contents of the sediment seemed to be influenced by seasonal variation of primary productivity.

LC, Acute : PE-120 ; Clinical severity according to age groups and risk factors for complicated hepatitis in patients with acute hepatitis A virus infection

( Byung Jun Jeon ),( Bum Su Choung ),( In Hee Kim ),( Dae Ghon Kim ),( Soo Teik Lee ),( Eun Young Cho1 ),( Gum Mo Jung ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Symptomatic acute hepatitis A virus (HAV) infection in adulthood is increasing in Korea recently. The aim of this study was to analyze the clinical severity according to age groups in patients with acute hepatic A and to investigate factors associated with complicated hepatitis A. Methods: We performed a retrospective analysis of 726 patients who were diagnosed with acute viral hepatitis A from January 2005 to September 2011 at three tertiary hospitals at Jeonbuk Province. We analyzed the clinical severity according to age groups, <20 year (n=84), 21-39 years (n=546), ≥40 years (n= 96). Complicated hepatitis was defined as hepatitis combined with one of three major complications, such as severe jaundice (peak total bilirubin level ≥15 mg/dL), acute renal failure, acute liver failure. Results: Of total 726 patients, mean age was 30.1 years, 453 (62.4%) were male, HBsAg was positive in 33 (4.5%). Severe jaundice occurred in 43 (5.95%), acute renal injury occurred in 16 (2.2%), and acute liver failure occurred in 24 (3.3%). The incidence of acute renal insufficiency was significantly increased according to the aging groups were <20: 1.2%(1/84); 21-39: 1.8% (10/546); ≥40: 5.4%(5/96) (p=0.032).The incidence of severe jaundice and hepatic failure were also significantly increased according to the aging groups [<20: 3.7% (3/84); 21-39: 5.2% (27/546); ≥40: 15.6%(13/96), p=0.003, and <20: 0.0% (0/84); 21-39: 3.6% (19/546); ≥40: 5.4% (5/96), p=0.045]. Multivariate analysis showed that old age (≥40years) (p=0.006), female (p=0.002), and HBsAg positivity (p=0.013) were significant risk factors for complicated hepatitis A. Conclusions: Old age group (≥40 years) showed more likely complicated with severe hepatitis A compared to younger age groups. In addition, female and HBsAg positivity were also significantly associated with complicated hepatitis A.

과량의 인슐린 투여로 인한 인위성 저혈당증 1예

김준우,안철우,남주영,김똘미,김영균,추적금,박종숙,박진아,조승현,김동연,김도연,윤수지,이경열,차봉수,김경래,임승길,이현철,허갑범 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2

본 저자들은 인위적인 인슐린 투여로 인한 인간성 저혈당증 1예에서 보존적인 치료로 의식기능은 회복하였으나, 현저한 인지능력 저하를 하였기에 문헌고찰과 함께 보고하는 바이다. Factitious hypoglycemia is a covert attempt to lower the blood glucose concentration with insulin or a sulfonylurea agent. This attempt is mainly performed by the patients themselves. In a large series of diabetics who had overdosed on drug, less than 5% had used insulin for suicidal or homicidal purposes. Additionally, 4 of 204 hypoglycemic episodes were due to a suicide attempt with insulin. The onset of insulin action, its peak level, and duration, and the degree of hypoglycemia, are determined by insulin's pharmacokinetics. However, the final outcomes are not associated with the amount of insulin used. The complications related to insulin overdose are cerebral damage and hypokalemia. Other complications include, pulmonary edema attributed to congestive heart failure and hypertensive crisis, as well as respiratory insufficiency. We report this case with a review of the literature.

이중혈류유발 심폐소생술이 심정지를 유발한 개의 단기 생존율에 미치는 영향

황성오,조준휘,강구현,김성환,문중범,이강현,이승환,윤정한,최경훈,홍은석 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background and Objectives: We previously reported that, compared with standard cardiopulmonary resuscitation(S-CPR), better hemodynamic effects could be achieved by simultaneous sterno-thoracic cardiopulmonary resuscitation(SST-CPR) in which we compressed the sternum and constricted the thorax circumferentially during the systolic period by using a device. This study was designed to assess whether SST-CPR, compared with S-CPR, improve the survival rate of dogs with cardiac arrest. Subjects and methods: Twenty-five mongrel dogs(19∼31㎏) were enrolled in this study. After four minutes of ventricular fibrillation induced by an AC current, animals were randomized to resuscitate with either S-CPR(n=13) or SST-CPR(n=12). Epinephrine(1 ㎎) was injected into the right atrium every three minutes after the beginning of CPR. Defibrillation was attempted after 6 minutes of CPR. Standard advanced cardiac life support was started if defibrillation was not successful. Results: SST-CPR resulted in significantly(p<0.001) higher systolic arterial pressure(91±47 vs 47±24 ㎜ Hg), diastolic pressure(43±24 vs 17±10 ㎜ Hg), coronary perfusion pressure(35±25 vs 13±9㎜ Hg), and end tidal CO2 tension(9±4 vs 3±2 ㎜ Hg). Two of 13 animals(15 %) resuscitated with S-CPR and six of 12 animals(50%) resuscitated with SST-CPR survived until 12 hours after cardiac arrest(p<0.05). Donclusion: SST-CPR, compared with S-CPR, improves the short-term survival rate in canine cardiac arrest.

Histological evaluation of direct pulp capping with DSP-derived synthetic peptide in beagle dog

김재훈,홍준배,임범순,조병훈 대한치과보존학회 2009 Restorative Dentistry & Endodontics Vol.34 No.2

본 연구에서는 DSP (dentln sialoprotein)에서 유래된 합성 펩타이드를 동물실험 모델에 적용하여 치수노출 부위에 서 상아질 재생을 확인하고, 기존 치수복조제와의 성능 비교를 통해 새로운 치수복조제로서의 가능성을 확인하고자 하였다. 6 마리 비글견의 72 개의 치아를 이용하여, 실험적으로 치수를 노출하고 직접 치수 복조술을 시행하였다. 사용한 치수복조제는 (1) Ca(OH)₂ (CH군) (2) DSP 유도 합성 펩타이드 (PEP군) (3) 합성 펩타이드와 Ca(OH)₂ 혼합제(PEP+CH군) (4) White MTA (WMTA군) 이다. 노출된 치수에 치수복조제를 적용한 후 와동은 강화형 글라스 아이오노머로 충전하였다. 시술 후 2 주, 1 개월 및 3개월에 각각 2 마리씩 비글견을 희생시키고 조직시편을 제작하였다. 시편은 H&E 염색 후 광학 현미경으로 치수 염증 반응과 경조직 형성 정도를 관찰하였다. PEP군에서는 17 개의 시편 중 3 개의 시편에서만 경조직 형성을 관찰할 수 있었으며, 대부분의 시편에서 적절한 치수 회복을 관찰할 수 없었다. PEP군은 CH군에 비해 심한 염증반응을 보이고, 경조직 형성은 불량하였다. CH군과 WMTA군은 기계적으로 노출된 치수에서의 염증반응과 경조직 형성에 있어서 유사한 결과를 보였다. The purpose of this study was to investigate the pulpal response to direct pulp capping with dentin sialoprotein (DSP) -derived synthetic peptide in teeth of dogs and to compare its efficacy to capping substances Ca(OH)₂ and white mineral trioxide aggregate (WMTA). A total of 72 teeth of 6 healthy male beagle dogs were used. The mechanically exposed pulps were capped with one of the following: (1) DSP-derived synthetic peptide (PEP group): (2) Ca(OH)₂ (CH group): (3) a mixture paste of peptide and Ca(OH)₂ (PEP+CH group): or (4) white MTA (WMTA group). The access cavity was restored with a reinforced glass ionomer cement. Two dogs were sacrificed at each pre-determined intervals (2 weeks, 1 month and 3 months). After the specimens were prepared for standard histological processing sections were stained with hematoxylin and eosin. Under a light microscope inflammatory response and hard tissue formation were evaluated in a blind manner by 2 observers. In the PEP group only 3 of 17 specimens showed hard tissue formation indication that the DSP-derived synthetic peptide did not induce proper healing of the pulp. Compared with the CH group the PEP group demonstrated an increased inflammatory response and poor hard tissue formation. The CH and WMTA groups showed similar results for di rect pulp capping inmechanically exposed teeth of dogs.

의료환경 변화에 대비한 의학기술부문의 교육방향

최종학,윤범철,조경진,이준협,임국환,고성진,최경호 高麗大學校 倂設 保健大學 保健科學硏究所 2003 保健科學論集 Vol.29 No.1

Under the pressure to open the service market as proposed by World Trade Organization, we can easily expect our educational systems for allied health professions will experience a lot of changes in near future. Accordingly, we compared our current educational systems for allied health professions with the foreign ones and mapped out some strategies predicting the forthcoming enormous changes. Major investigations and analysis are summed up as follows, The educational programs for allied health professions which was started in 1963 in Korea are stilled remained as 2 to 3 school years, while the systems in advanced countries have already been changed or been changing from 2 year to 4 year college levels. We can hardly find the uniform educational system or school years for the allied health professions in the world except for Korea. Fortunately, university level four-year programs for the profession was established in 1979 in Won-joo for the first time in Korea. However, there are still only few four-year programs in this country. To meet the rapidly changing needs we have faced in the health areas we should supply appropriate health personnel through various efforts. Now we would like to suggest followings, <Educational goals for the allied health professions> 1) reconfirming characteristics for the educational goals of health professions 2) extending school years for the allied health professions 3) strengthening clinical training and internship 4) expanding opportunities for the continuing education through lifelong education 5) upgrading from old-fashioned technologies to advanced technologies 6) cultivating competencies of health professionals for the global competition <Suggestions for the Development of Allied Health Professions> 1) reforming the school years of educational programs for the allied health professions to meet the global standards 2) expanding the role of junior college programs for the allied health professions through the development of intensive courses in the professions. 3) diversifying and specializing the allied health professions mainly through 4 year B.S. degree programs.

두가지 혈류 유발방법에 의한 새로운 심폐소생술(이중 혈류 유발 심폐소생술)장치의 개발

황성오,김현,조준휘,오범진,임종천,최경훈,윤정한,이승환,김영식,이강현,이윤선 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: There have been many efforts to augment blood flow during cardiopulmonary resuscitation. These efforts have focused on maximizing the effect of cardiac pump or thoracic pump alone. However, considering that the heart is the biggest blood reservoir and increase of intrathoracic pressure can generate blood flow, simultaneous exploitation of both mechanisms may have synergistic effect. We hypothesized that simultaneous chest constriction in addition to sternal compression by standard CPR may have additive hemodynamic effects by preventing deformation of the chest and increase of intrathoracic pressure. Methods and results: we built a new mechanical device to perform compression and thoracic constriction simultaneously. The device consists of two main elements. Piston in the center is to depress the sternum. Strap is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. To determine strap width to produce optimal hemodynamic effect, we measured hemodynamic parameters with variable widths of strap in two dogs after induction of ventricular fibrillation. Result of the experiment showed that 10cm wide strap was determined to be most effective. We also determined optimal depth of compression to produce maximal hemodynamic effect with animal experiments using two dogs. Animal experiments showed that the highest aortic pressure could be generated when the stemum was depressed to 5 cm. Cardiopulmonary resusciation using a new device could generate higher systolic aortic pressure, coronary perfusion pressure and end-tidal carbon dioxide tension in comparison with standard cardiopulmonary resuscitation in a pilot animal study using two dogs. Conclusion: New cardiopulmonary resuscitation method using a mechanical device designed by us could perform sternal compression and simultaneous thoracic constriction, and generate better hemodynamic effects than standard cardiopulmonary resuscitation in pilot animal experiments.

외상환자에서 전신성 염증 반응 증후군 (Systemic Inflammatory Response Syndrome)의 발생과 혈청 TNF-α와의 관계

김현,이강현,임종천,조준휘,오범진,황성오 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background and purpose: The systemic inflammatory response syndrome(SIRS), as defined recently by critical-care specialists, may result from various etiologies including infection, burn, or trauma. The purpose of this study was to determine whether TNF-αis associated with the development of systemic inflammatory response syndrome caused by multiple trauma. Methods: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study. Multiple blood samples were serially drawn to measure serum TNF-αlevel on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-αwas measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value for serum TNF-α. Results: Serum TNF-αlevels of SIRS group were persistently elevated above reference value until 3 days after on admission. Peak serum TNF-αlevel at 12 hours after admission was higher in SIRS group than non-SIRS group(p<0.05). There was no significant correlation between injury severity score and TNF-αlevels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. Conclusion: The result of this study suggests that persistent elevation of TNF-αand degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.

관상동맥 누공에 의한 급성 심근 경색 1예

서유승,최재웅,송창섭,조용범,양진수,박준섭,정인수 대한내과학회 2003 대한내과학회지 Vol.65 No.2

관상동맥 동정맥루 기형은 매우 드문 질환으로 치료가 불필요한 경우가 대부분이나 coronary steal 현상으로 인해 증상이 발생하거나 합병증이 발생한 환자에 대해선 치료를 요한다. 최근에는 시술에 적합한 누공을 가진 선택된 환자군을 대상으로 카테터를 이용한 중재적 시술이 시행되어 수술적 치료와 유사한 결과를 얻고 있다. 저자들은 젊은 남자에서 관상동맥 동정맥루 기형과 동반된 급성 심근 경색증을 진단하여 비 수술적 방법인 카테타 코일 색전술로 성공적 치료 후 증상 및 심근 재관류에 호전을 보인 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. We report a case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute non-Q wave myocardial infarction. A 27-year-old man visited emergency department because of severe chest pain lasting two hours. The electrocardiogram showed ST segment elevation in precordial leads V3~6. Cardiac enzymes were as follows;CK-MB:36.44 IU/L T-T:0.489 ng/mL, CPK:542 IU/L, and LDH:475 IU/L. The thallium-201 dipyridamole stress perfusion scan showed perfusion defect and reversed redistribution in the anteroseptal wall. The coronary angiogram revealed coronary artery fistula between the proximal left anterior descending artery and main pulmonary artery without significant stenoses of coronary arteries. The result of ergonovine test was negative. After micro-coil embolization to the coronary fistula, symptoms were improved. Follow-up thallium-201 scan showed normalized blood flow in the left anteroseptal wall.

20km와 150km의 도로싸이클 주행이 혈중 렙틴, 지질과 호르몬 수준에 미치는 영향

최용어,권봉안,오재근,김범수,조준용,김문희 한국체육대학교 체육과학연구소 2000 韓國體育大學校附屬 體育科學硏究所論文集 Vol.19 No.1

Serum leptin, glucose, lipid profiles (free fatty acid, triglyceride, total cholesterol) were determined in two groups of subjects undergoing long and short strenous cycle race, 8 men who fasted overnight and then pedaled 20km cycle race and 8 men, 150km cycle race, respectively, Blood samples were collected before race, immediately after cessation of race and 2hr, 6hr after the end of race period. Cyclist pedaling 20km cycle race and cyclist pedaling 150km cycle race showed no statistical differences in leptin level. After 6hr of rest, leptin concentrations were gradually decreased but showed no statistical different in both groups. Epinephrine (p〈.01) and norepinephrine (p〈.001) concentration in comparison to pre-race levels were increased significantly. But insulin concentration in comparison to pre-race levels were decreased significantly (p〈.001). Glucose (p〈.01), free fatty acid (p〈.001), cholesterol (p〈.001) and triglyceride (p〈.01) were increased immediately after cessation of race in both groups.