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Paraquat 중독환자의 초기검사로서 sodium dithionite를 이용한 소변내 paraquat검출의 임상적 의의
윤갑준,임경수,이진웅,김영식,이부수,박덕우,김선만,이강현,황성오,안무업 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1
Background : Mortality from paraquat intoxication depends upon plasma paraquat concentration. To know the severity of paraquat intoxication is important for directing therapeutic modality and predicting prognosis. Sodium dithionite test for urinary paraquat provides an easy and simple method to determine the severity of paraquat intoxication in emergency department. purpose : To determine whether the result urinary paraquat test by sodium dithionite can predict outcome in patients with paraquat intoxication in emergency department. Subjects : 48 patients(male 31, female 17, mean age 37 years) who had exposure to paraquat and presented within 24 hours after exposure. Result : Thirty five patients were positive in paraquat urine test and thirteen patients were negative. Clinical manifestations were more severe in positive patients than in negatives. Complication was much more in positives than in negatives. 28 of 35 patients(80%) in positives and 2 of 13 patients(15%) in negatives died. Conclusion : Positive test for urinary paraquat is associated with high mortality and morbidity from paraquat intoxication, and qualitative test for urinary paraquat by sodium dithionite is an useful method to determine the severity of paraquat intoxication in emergency department.
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.
조현석,장준혁,김경호,윤종화,김갑성 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.7 No.2
편측 안면경련은 편측 안면근의 불수의적, 간헐적 수축으로서 심할 경우 안면 근력 약화 및 강직현상등이 나타나기도 하는 질환이다. 서양의학에서 편측 안면경련의 병태생리에 대한 가설은 크게 두가지로 대별되는데, 첫째는 중추성 가설(핵가설)이고, 둘째는 말초성가설이다. 치료방법은 대별하여 내과적 치료와 외과적 치료의 나눌 수 있는데, 외과적 치료가 다양하게 시행되어 왔으며, 근래에는 두개강내 미세혈관 감압술이 시행되고 있다. 韓醫學에서는 眼瞼痙攣울 眼胞振跳, 胞輪振跳라고 하고, 眼眉跳라고도 하며, 그 외 目瞬, 目跳, 眼皮跳 등의 이름으로도 불리운다. 外因으로는 風邪가 經絡에 侵入하는 것이며, 內因으로는 肝血虛한 中의 風邪가 兼하기 때문이다 따라서, 국부경혈 자침과 함께 장부변증에 따라 肝, 膽經 경혈의 사용과 합께 耳鍼T의 시술이 유용할 것으로 사료된다. Hemifacial spasm including blepharospasm is characterized by spontaneous clonic and tonic muscle spasm on one side of the face with synkinesis. Though the etiology of hemifacial spasm is not entirely understood, generally there are two. One is nuclear hypothesis and the other is peripheral hypothesis. There are two ways of treatment of hemifacial spasm. One is internal medicine and the other is operative method. In oriental medicine, hemifacial spasm is very similar to diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), or Anmido(眼眉跳) in symptoms. The diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), Anmido(眼眉跳) is related to the function of liver(肝) and risk factors are regarded as Pung(風). The acupuncture therapy of hemifacial spasm is based on Liver meridian(LV), Gallbladder meridian(GB), And ear-acupuncture is recommended as a good method for hemifacial spasm.
성인 뇌막염환자에서의 뇌척수액 CRP (C-Reactive Protein)의 임상적 의의
윤갑준,임경수,김영진,어영,박진현 대한감염학회 1989 감염 Vol.21 No.4
Cerebrospinal fluid C-reactive protein (CSF_CRP) was prospectively studied in 37 consecutive adult patients, using qualitative latex slide agglutination test and quantitative fluorescence polarization immunoassay (FPIA). The patients were categorized into the following groups: (1) acute or presumed bacterial meniningitis (n=4):(2) acute or presumed viral meningitis (n=4):(3) tuberculous(n=6): and(4) neurological symptoms without meningitis (n=23). On the initial lumbar puncture, the CRP measured by latex slide agglutination was positive in 100% of the patients in group 1, as compared with 0%, 83% and 0% in group 2-4, respectively. Latex slide CRP agglutination test was able to detect bacterial meningitis with a sensitivity of 100%, a specificity of 86%, a positive predictive value of 44%. and a negative predictive value of 100%. The CSF-CRP values by FPIA method in group 1 did not differ from those of each of the other groups. And all groups had values less than 2 ㎎/㎗ by FPIA. The measurement of CRP in CSF by latex slide agglutination test was a useful differential diagnostic tools between group 1 and group 2, but other differential tests were required for distinguishing bacterial from tuberculous meningitis.