KAL기 추락에 의한 대량재해의 개인식별

강신몽,이원태,고영창,최상규,김윤희,이홍석,서재관,윤중진,이혜경,최득린,김종열,윤창육,변명식,이장홍 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

Individual identification is an important part in medicolegal field especially in mass disaster. At July, 27, 1989, KAL KE-803 was crashed on landing at Tripoli International Airport, Liba. The plane was caught in fire and sixty eight Koreans were sacrified. The majority of victims were severely charred and injured. The authors examed all dead bodies and successfully identified all the cases through visual, anthropological, odontological, radiological and pathological methods including fingerprint and blood typing.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

The Safety and Efficacy of Daclatasvir and Asunaprevir with Chronic HCV Genotype 1 Infection and Hemodialysis

( Myeong Jun Song ),( Jung Hyun Kwon ),( Soon Woo Nam ),( Tae Hee Lee ),( Young Woo Kang ),( Ji Woong Jang ),( Seok Hyun Kim ),( Byung Seok Lee5 ),( Sea Hwan Lee ),( Hong Soo Kim ),( Ji Hoon Kim ),( S 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: We aimed to evaluate the efficacy and safety of Daclatasvir (DAV) and Asunaprevir (ASV) in patients with chronic hepatitis C virus (HCV) and chronic renal failure (CRF). Methods: 22 chronic hemodialysis patients with HCV infection at 12 medical centers have prospectively enrolled from Feb, 2016 to Feb, 2017 (NCT02580474). Of those, 9 patients who were followed 12 weeks after treatment ended were included. We evaluated the virological responses at each week 4, 12, 24 and the 12-week sustained virologic response (SVR12). The tolerability and safety of patients were also evaluated. Results: Of these 20 patients, there had no resistance-associated variant of NS5A (NS5A RAVs) and 2 patients showed indeterminate NS5A RAVs. 12 patients (54.5%) completed the 24 weeks treatment of DAV and ASV. 6 patients (27.2%) have continued, but 4 patients discontinued study prior to 12 weeks. Overall, all patients (n=9) achieved SVR12. Virologic response at week 4, 12 and 24 showed 94.4% (17/18), 93.3% (14/15), and 100% (12/12) respectively. DCV and ASV were well tolerated among the majority of patients and discontinuation of the treatment due to adverse events (hypertension, bradycardia, leukemia) was occurred in 3 patients. In two patients with indeterminate NS5A RAVs, one achieved SVR12 but the other showed viral breakthrough and discontinued treatment. Conclusions: In this study, DAV and ASV combination therapy for chronic hemodialysis patients with HCV infection achieved high sustained virological response with few adverse events. Close monitoring of safety and tolerability may be necessary when treating chronic hepatitis C patients with CRF receiving DCV and ASV.

중환자실에서 기계적 환기를 시행받는 환자들의 기관내삽관 튜브의 기낭내압

이영주,윤장운,문봉기,이규완,박미미,이영석 아주대학교 1997 아주의학 Vol.2 No.2

Background and Objectives : High volume, low pressure (HVLP) cuffed tubes have been substituted for low volume, high pressure (LVHP) cuffed tubes in order to reduce complications created by the cuffed endotracheal tubes contact with the tracheal wall. Several physidans, however, prefer to use the LVHP cuff for habitual or economic reasons. Even so, careless cuff Inflation of the HVLP cuff could also induce complications. The purposes of this study were to see whether there are any differences between the usual intracuff pressure (UICP) and the Optimum intracuff pressure (OICP), to compare the OICP of three groups, and to study the correlation between the OICP and the peak inspiratory pressure (PIP) of three kinds of endotracheal tubes under mechanical Ventilation. Methods : 82 adult patients, upon admission of the ICU, were divided into 3 groups with different cuffed tube types according to the following: Portex Profile group (n=66), HVLP cuffed tube; Portex Regular group (n=11), LVHP cuffed tube; Rusch Red group (n=5), LVHP cuffed tube. We used the Portex cuff pressure manometer for Portex Profile group, the Hewlett-Packard pressure transducer for Portex Regular, and Rusch Red group to measure the intracuff pressure (ICP). The OICP was measured with the minimal leak technique (MLT). Intracuff pressure difference (ICPD) was calculated by subtracting OICP from UICP. Results : UICP and OICP of Portex Profile group were 33.12±22.25 ㎝H₂O, 22.02±12.5㎝H₂O, Portex Regular group, 70.09±30.88 ㎝H₂O, 69.45±30.41 ㎝H₂O and Rusch Red group, 378.40±38.60 ㎝H₂O, 337.60±74.45 ㎝H₂O. Significant difference was shown among the groups (p < 0.05). The significant difference of the PIP was not seen among the groups. Significant correlation between OICP and PIP (regression = 0.463, p < 0.01) was demonstrated only in Portex Profile group. ICPD of three groups were as high as 84 ㎝H₂O to as low as -56 ㎝H₂O. About 40% of the patients showed the allowable range. Conclusions : This study suggests that routine check-ups of ICP are needed when the patients are admitted to the ICU. The OICP of the HVLP cuffed tube is 1/3 -1/15 of the LVHP cuffed tube. Therefore, the routine use of the HVLP tube is highiy recommended. The OICP shows positive correlation with the PIP. This suggests to make every effort to reduce the PIP.

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.

단순 외상 환자에서 퇴원시 설명문이 환자의 이해도에 미치는 영향

장석준,정상원,최성욱,황태식,이한식 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

The many previous publications have shown the advantages of written discharge instruction over verbal discharge instruction on the basis of comparing the functional illiteracy among emergency department patients. Therefore, authors have conducted a study on the efficacy of written discharge instruction over the verbal discharge instruction of two groups: minor laceration and sprain patients. For the purpose of this study, minor laceration is defined as less than 3 ㎝ laceration on the face or head, or less than 5 ㎝ laceration on extremities. And simple sprains were limited to the extremities. A total of 416 patients who visited Yong Dong Severance Hospital Emergency Care Center were the subject of this study during the period of 2 months from Feb. 1. to Mar. 31. 1996. The study was done prospectively, and patients who entered this study were randomly selected. Simple discharge instruction were made prior to the study and patients were given or verbally told the one of two instruction sets by the emergency medicine resident. After reading or hearing the instructions, each patient was asked to answer four specific questions about them. Statistical significance was examined by t-test and p value of 0.05 or less was considered statistically significant. Mean age for verbal and written instructed group were 26.2 and 25.6 years old. There were 262 and 154 patients in verbal and written instructed group, and the mean score was 2.24±1.20 and 3.42±0.52, respectively. The type of injury was divided into laceration and sprain. Laceration group showed mean score of 2.15±1.23, 3.32±0.51, and sprain group of 2.34±1.16, 3.59±0.50 in verbal and written instruction group, respectively. For the patient younger than 13 years old, discharge instruction was given or described to a guardian. Age less than 13 years old group showed mean score of 2.75±1.11, 3.31±0.48 and more than 13 years old group of 2.10±0.19, 3.34±0.53 in verbal and written instruction group, respectively. The result showed statistical significance between verbal and written instruction group of type of injury and age difference. For the future, simplified written discharge instruction may help and improve the patient`s understanding of the proper management of injury.

자동차용 실리콘 가속도센서의 개발(Ⅱ)

이종현,신장규,이상룡,천희곤,조찬섭,심준환,류인식,박석홍,허정준,박기열 경북대학교 센서기술연구소 1994 연차보고서 Vol.1994 No.-

자동차의 air-bag 장치에 실용될 수 있는 압저항형 단결정 실리콘 가속도센서 칩을 개발하기 위하여 결정 실리콘 미세구조의 제조방법을 확립하고, 단위공정의 검증을 통하여 일괄공정에 의한 PROTO-TYPE 칩을 만드는 기술을 연구하였다. 단결정 실리콘 미세구조는 선택확산법을 이용하여 정확히 선택된 영역에만 air-gap을 형성하여 미세구조의 측면식각을 방지하는 선택확산법에 의한 실리콘 마이크로머시닝 기술로 제조하였다. 일괄공정을 위한 단위공정확립을 위하여 PROTY-TYPE 8빔 브릿지형 가속도 센서를 제조하였다. 제조된 칩의 가속도에 따른 출력전압은 선형성을 나타내고 있으며, 감도는 약 50 ㎶/V·g로 나타났다. 이 감도는 50G용 가속도센서의 사양을 만족하지 못했다. 이는 공정에 의한 문제라기 보다는 가속도센서의 시뮬레이션에 의해 설계한 구조가 이미 원하는 감도에 못 미친다는 것으로 생각된다. 따라서 2차 공정으로 제조될 가속도센서의 파라미터를 SuperSAP 유한요소 패키지를 이용하여 실리콘 미세구조부의 파라미터에 따른 특성을 시뮬레이션하였다. 설계된 50G용 가속도센서의 mass Pad의 반경 및 빔 길이, 빔 폭, 빔 두께, 그리고 mass의 각 파라미터 값은 700 ㎛, 120 ㎛, 5 ㎛, 1.0 ㎎ 이었다. 반도체 공정기술, 관성질량 제조법 및 선택확산을 이용한 마이크로머시닝을 사용하여 일괄공정으로 8빔 브린지형 가속도센서를 제조하였다. We researched the establishment of the silicon microstructure fabrication technique to develop a piezoresistive type silicon acceleration sensor chip and the technique to make a proto-type chip by the verification of the unit-process. Silicon microstructure is fabricated silicon micro-machining by selective diffusion method. This method prevent a side-etching of microstructure because selective diffused region is only formed an air-gap. We fabricated a proto-type 8-beam bridge-type acceleration sensor to establish the unit-process for the batch-process. The output voltage of the chip represented linearity with acceleration, and the sensitivity was about 50 ㎶/V·g. But this sensitivity dosen't satisfy the requirements of a practical acceleration sensor. The cause of this result is assumed not process problem, but the structure designed by simulation isn't suitable already. Threfore, the characteristics of parameters of the acceleration sensor that will be fabricated by 2nd-process is simulated by SuperSAP finite-element package. The determined parameter values of beam length, beam width, beam thickness, mass, and mass radius are 120 ㎛, 5 ㎛, 1.0 ㎎, and 700 ㎛, respectively. We fabricated 8-beam bridge-type acceleration sensor by batch-process using a semiconductor process technique, proof-mass fabrication method, and micromachinig using selective diffusion.

외상후 발작의 위험인자에 대한 조사

이재학,배학근,윤석만,도재원,이경석,윤일규,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Risk Factors for Posttraumatic Seizure The authors evaluate the risk factors for posttraumatic seizures. this prospective study was performed in a series of 470 head injured patient from January 1996 to Decomber 1998. The patients who were dead within 1 week of injury or children from 3 years old and under were excluded. There were 358 male and 112 female with a mean age of 35.2±22.8 years (range, 4-88 years). The results were as follows : 1). Of the 470 patients, pasttraumatic seizure occurred in 48 patients(10.2%): early seizure in 28(6%) and late seizure in 20 patients(4.2%). 2). The clinical risk factors for posttraumatic seizure were poor consciousness at admission, presence of brainstem herniation signs, poor GCS score, and posttraumatic amnesia more than 24 hours after trauma(p<0.001). 3). The radiological risk factors for posttraumatic seizure were subdural hematoma(p<0.001), intracerebral hematoma (p<0.02), mutiple intracranial CT lesions(p<0.001), or delayed lesions on follow-up CT scans(p<0.001). the incidence of seizure increased according to the severity of diffuse brain lesion(p<0.001), and the seizure rate in mass lesion was higher than that in diffuse lesion(p<0.001). 5). Hypoxia and coagulopathy had a statistically significant influence on posttraumatic seizure(p<0.05). Hypoxia had a infuence on occurrence of late seizure(p<0.05). 6). The incidence of posttraumatic seizure signiticantly increased in surgical group compared with coservative group(p<0.001) and significantly increased in patient who underwent decompressive craniectomy compared with those who underwent craniotomy(p<0.001) 7). Preventive administration of antiepileptic drugs decreased the incidence of early seizure, but did not affect on the reduction of late seizure. 8). Multivariate logistic regression analysis showed the subdural hematoma, GCS score, delayed lesion, and intracerebral hematoma in order of importance for seizure risk. in conclusion, the risk factors affecting on the occurrence of seizure were clinical status at admission, CT lesions, and severity of diffuse brain inJury. Considering that hypoxia affected on the late seizure, it is necessary to detect and treat it immediately after trauma. In addition, the patients who underwent decompressive craniectomy should be carefully followed to evaluate the risk of late seizure. Even though preventive administration of antiepileptic drugs had a tendency to decrease the incidence of early seizure, it is unclear whether administration of antiepileptic drugs can reduce the incidence of posttraumatic seizures. Prospective study will be needed in the selected patients.

Linear motor의 2次 導體板의 速度變化에 따른 諸特性에 관한 硏究

張錫明,李殷雄 충남대학교 공업교육연구소 1978 論文集 Vol.1 No.2

Linear motors, for several years the subject of much speculation, have at last reached the stage where their practical application to high speed transport systems and the other many industrial filds is within sights. However, the essential difference between Linear induction motors and ordinary induction motors is the fact that the air gap is open in the former, while it is closed in the latter. In this study, the characteristic equation of a double sided short stator Linear induction motor excited by equivalent current sheet having a linear current density was derived using Maxwell's electromagnetic field thory with its entry, and exit, end effects taken in to consideration. According to the treatment of several physical phenomena in the air gap i.e. the magnetic flux density distributions thrustforce, forward travelling wave with decay, the fundamental data in this study are made reference to improve the characteristics of Linear induction motors, effectual electric-thrustforce energy conversion devices.

흰쥐에서 출혈량에 따른 비장세포 증식력과 말초임파구 아형의 변화

이한식,정성필,김욱진,조영순,장석준 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Hemorrhage itself has been shown to produce abnormalities in immunity, particularly depression of the lymphocyte function. In order to better examine the amount of hemorrhage required to suppress the lymphocyte function, we determined the effect of graded fixed-volume hemorrhage on splenocyte proliferation and the lymphocyte subpopulation. Methods: Male Sprague-Dawley rats(weight,350∼400 g) were anesthetized, subjected to hemorrhages of 7.5 ㎖/㎏, 15 ㎖/㎏, and 22.5 ㎖/㎏ by percutaneous cardiac puncture with ㎖/㎏ needles, After 1, 2, 4, and 7 days, animals were killed to obtain the blood and spleen. The splenocyte proliferative capacity was measured by using the tritiated thymidine incorporation technique, and the peripheral lymphocyte subpopulation was determined using flow cytometry with the following monoclonal antibodies: T cell(CD3+), T helper cell(CD4+),7 cytotoxic cell(CD8+), and B cell(CD45RA+). Results: Hemorrhage of 7.5 ㎖/㎏ did not induce depression of splenocyte proliferation. However, for hemorrhage greater than 15 ㎖/㎏, the splenocyte proliferative capacity was significantly depressed at 2 days after hemorrhage and recovered at 4 days. Hemorrhage induced no changes in the relative percentage of lymphocyte subpopulations and in the number of each cell in peripheral blood. Conclusion: This study suggests that cellular immunity is depressed at 48 hrs after a hemorrhage greater than 15 ㎖/㎏ without any change in the peripheral lymphocyte subpopulation.