경피내시경하 위루술(PEG)을 시행한 중풍후유증 환자 1례에 대한 증례보고

임승민,안정조,최영,조현경,오병렬,설인찬 대전대학교 한방병원 2002 惠和醫學 Vol.11 No.1

According to the case study of patient with seguela of C.V.A who was treated by Percutaneous Endoscopic Gastrotomy(PEG), his chief complaint is the dysphagia. We treated him by a viewpoint of oriental medicine and got the good clinical symtom.

지속적인 기립 작업에 의한 만성 하지 정맥 부전증 1예

정철,임현술,유선희 東國大學校醫學硏究所 2003 東國醫學 Vol.10 No.1

저자들은 10년 간 자동차 부품 조립공장에 근무하면서 지속적인 기립 작업에 의하여 하지 정맥류가 발생하였고 이후 하지 정맥 혈전증이 합병되어 통증과 부종을 수반하는 만성 하지 정맥 부전증으로 업무상 질병이 인정된 증례를 보고하는 바이다. 환례는 44세 여자로 1966년부터 우측 하지에 정맥류가 발생하였고 2001년 6월부터 시작된 하지 통증과 부종으로 2001년 7월 25일 정확한 진단을 위해 병원을 방문하였다. 과거력상 2001년 7월초 진단된 결핵 이외에는 혈관질환 등 기타질환을 앓거나 약물을 복용한 것이 없었고, 가족력과 사회력 조사에서도 정맥류와 관련된 특이한 점은 없었다. 환례는 현 직장에 1991년 입사하여 10년 간 동일한 조립공정 업무를 수행하였다. 작업은 계속 한 자세로 서서 일하는 형태였으며, 하루 총 작업식간은 8시간이었다. 진찰 소견상 우측 하지 후슬와부에 정맥류가 관찰되었고, 압박시 하지 통증과 부종이 관찰되었다. 입원시 실시한 우측 상행 하지정맥 조영술 검사상 호가장된 다수의 정맥이 장딴지에서 보이고 오금정맥이 하부 하지부에서는 불투명화 되지 않아 약 1개월간 병원에 입원하여 혈전증에 대한 항응고제 치료를 시행 받았다. 환례와 동일한 작업을 하는 동료근로자는 12명으로 작업 후 하지 통증은 모두 경험하였다고 하였으며, 이들 중 1례는 하지 정맥류가 관찰되었다. 프로트롬빈시간은 입원일 9.8초였다가 이후 정상으로 회복하여 퇴원시 11.5초를 보였으며, 활성 부분트롬보플라스틴시간도 입원 당시 퇴원시 33.4초로 회복되었다. 하지 통증 및 부종은 입원 중 점차 감소하였고 내원 당시 방사선 검사상 관찰되었던 하지 정맥 혈전도 소실되었다. 본 환례를 통하여 장시간 서서 일하는 근로자는 하지 정맥류에 대한 발생 가능성을 염두에 두고, 하지 통증이나 부종이 동반될 경우 혈전 여부 검사를 시행하여야 할 것이며, 그 원인추구에 있어서 반드시 직업관련성을 조사해 보아야 할 것이다. 작업장내 장시간 서서 하는 작업이 있을 경우에는 정기적인 검진을 통해 유소견자를 가려내고, 혈전증 예방을 위해 한 쪽 다리는 교대로 올려놓을 수 있는 발받침대를 설치하거나 작업 전 압력 스타킹을 신게 하는 등의 작업환경 개선에 대한 노력을 강조하여야 할 것이다. We report a case of chronic venous insufficiency with a history of 10 year standing work. The authors reviewed the clinical and hematologic features of the case. We also reviewed the job contents of her workplace. The worker was a 44-year old female who had worked in a mobile accessory factory for 10 years (1991-2001). She had been founded right leg varicous vein since 1996. The varicose veins induced severe pain and edema on June 2001. By venography, thrombus were detected and finally diagnosed as venous thrombosis on 25th July 2001. She regarded the occupational disease by longstanding work of standing position. She received anticoagulant treatment by one-month admission, and then improved the symptom and hematologic laboratory results. To prevent chronic venous insufficiency, we must modify working environments, begin comprehensive medical surveillance, educate workers on risk of lower leg venous problems, and increase workers awareness of safety regulations in the workplace.

인공타액에서 염소이온과 황이온 농도가 치과용 귀금속계 합금의 변색 및 부식저항에 주는 영향 : 1. 시판 치과용 귀금속계 합금 1. DENTAL COMMERCIAL NOBLE METAL BASED ALLOYS

임범순,문현정,김철위 대한치과기재학회 1998 대한치과재료학회지 Vol.25 No.2

The object of this study was to study effect of Cl- and S²- ions on tarnish and corrosion resistance of dental noble metal alloys in the artificial saliva. Twenty-four commercial dental noble metal based alloys(five for high-Au based alloys, seven for low-Au based alloys, four for Pd-based alloys, and eight for Ag-Pd based alloys) were investigated by the Potentiostat and the Spectrophotometer. Modified Fusayama's artificial salivas with various concentrations of Cl- ion(1.22, 12.22, 24.44, and 61.10 mM/ℓ) and S²- ions(0.01, 0.10, 0.20, 0.35, 0.50, 1.00, 5.00, 10.0, and 20.0 mM/ℓ) were used as electrolytes for test. From the experiments, the following results were obtained. Concentration of Cl- ion in artificial saliva did not in fluence the potentiodynamic polarization curves for dental noble metal alloys. On the other hand, concentration of S²- ion in artificial saliva strongly influenced the potentiodynamic polarization curves for dental noble metal alloys ; corrosion potentials were decreased up to 500 mV and current densities were increased by 100 times. In color change measurements after potentiodynamic polarization curve test, the values of ΔE for high-Ae and Pd-based alloys were increased as the concentration of S²- increased up to 1.00 mM and then were reached a plateau at higher concentration of S²-. For low-Au and Ag-Pd based alloys, the values of ΔE were drastically decreased as the concentration of S²- increased up to 1.00 mM and then were reached a plateau at higher concentration of S²-. By determining the color of an alloy before and after exposure to a test solution, the color changes were ranged of 4∼6 for high-Au and Pd-based alloys and 20∼35 for low-Au and Ag-Pd based alloys.

지속적인 기립 작업에 의한 만성 하지 정맥 부전증 1예

정철,임현술,유선희 약업신문사 1984 의약정보 Vol.10 No.1

유기용매에서 치과용 콤포짓트 레진의 시효처리에 따른 표면조도 및 색 변화

임범순,김철위,문현정 대한치과기재학회 1999 대한치과재료학회지 Vol.26 No.1

The purpose of this study was to evaluate the degree of color stability and examine the surface change of esthetic restorative materials in various organic solutions. Ten esthetic restorative materials were used : three chemical-cured composite resins(HPC, PAS, and PAL), four light-cured composite resins(CHA, Z100, AEL, and FLO), three light-cured polyacid modified composite resins(HYT, DYR, and COM). Specimens were prepared as disks of 14mm in diameter and 1.2mm in thickness. After polymerization, specimens were immersed in six different solutions(distilled water, artificial saliva with mucin, 0.1 mole acetic acid solution, 10% hydrogen peroxide solution, and 50% and 75% ethanol) for 1,7,14,21,28,56,84,112, and 140 days. The specimens were maintained at 37℃ throughout the study. Color was measured by CIE L*a*b* against to CIE standard illuminant C reflected on spectrophotometer(CM-3500d, Minolta, Japan.) with specular component exclusive(SCE). After various treatments, the surface of specimens was examined by Surface Roughness Tester(Surtronic 3P, Rank Taylor Hobson Ltd., England.). From the experiment, the following results were obtained. In distilled water, specimens showed an acceptable color stability except for CFS. The water hardening glass ionomer cement, CFS, showed the highest color change(△E>5.0). Color stability of specimens in artificial saliva with mucin was similar to that in distilled water. CFS and KTM showed high color change(△E>5.0) and it would not be acceptable in the clinical situation. In acetic acid solution, all of the glass ionomer cements and compomer specimens showed high color change due to the dissociation of metal-polyacrylate by chemical reaction with H+ ions. CFS, FLC, and FLT showed high color change in ethanol. Color change of specimens in 50% ethanol was higher than that in 75% ethanol. 10% hydrogen peroxide solution resulted in high color change for chemical-cure glass ionomer cements and destroyed the specimens. FLC and CPG showed high color change due to oxidation of residual reaction accelerator and inhibitor by hydrogen peroxide.

Gullian Barre Syndrome 患者 1例에 대한 症例報告

임승민,안정조,최영,조현경,김민상,유병찬,오병렬,김윤식,설인찬 대전대학교 한방병원 2002 惠和醫學 Vol.11 No.1

Gullian Barre Syndrome is an acute symmetric polyradiculoneuropathy that typically presents as a progressive flaccid paralysis. The pathology is believed to be caused by both cellular and humoral immune processes The possibility of death is 3-5% and About 20% of patients require mechanical ventilaton. Recently We have experienced a patient who had suspected Gullian Barre Syndrome for 60days, his condition weakness and pain was impoved through the herb and acupucture Therefore I reported it for the treatment.

한국, 미국, 중국 청소년의 의복 행동에 관한 연구

임숙자,이지현,문정미,장춘희 이화여자대학교 생활환경대학 인간생활환경연구소 2002 인간생활환경연구소 논집 Vol.- No.1

The purposes of this study were to determine similarities and diferences in the clothing behavior of Korean, American and Chinese Adolescents. Photographs and questionnaires were conducted for this study and the results are as follows. 1) By analyzing the questionnaire survey, Korean adolescents considered their friends advise more when purchasing clothing while Chinese adolescents depended on their parents. In clothing elements, American adolescents considered attractiveness to other sex more than other two countries. 2) For the Photograph analysis, Many bright and vivid color clothing were seen from Chinese adolescents and dull achromatic colored clothing was noticeable from Koreans. Jeans were favored by all three countries but chino pants were only noticeable from Korean adolescents. Even though it is said 'It is one world ond market', this study shows that it is very important to consider the cultural differences among countries.

유전자변형식품의 환경 및 인체 영향에 대한 문헌 고찰

정철,임현술 東國大學校醫學硏究所 2004 東國醫學 Vol.11 No.1

유전자변형농작물(eMO: Genetically modified organism)은 기존의 작물보다 독성 살충제의 사용을 줄일 수 있고 원하는 영양분을 함유한 농작물을 다수확 할 수 있기 때문에 궁극적으로 환경오염을 감소시키고 전 세계를 기아로부터 해방시킬 수 있다고 주장하는 지지자들이 있다. 그러나 비판적인 시각을 가진 사람들은 유전자변형농작물의 잠재적인 위험성에 대해 두려워할 뿐만 아니라, 그 이로움의 정도가 실제로 얼마나 될지를 의심하고 있다. 현재까지 유전자변형농작물의 건강영향이나 환경오염에 대해서 명백하게 밝혀지지 않은 채 양측 입장이 서로 논쟁중이다. 그러나 이 문제는 먹거리에 대한 문제이고 우리의 실생활에 유전자변형농작물이 많은 부분 들어와 있는 현실이므로 무턱대고 논쟁을 지켜보기만 할 문제는 아니다. 유전자변형농산물을 많이 수입하고 있는 우리나라도 더 이상 방관만 하고 있을 수 없는 입장이다. 우리나라에서도 유전자변형농작물을 많이 수입하고 있어서 농림부가 콩, 옥수수, 콩나물에 대한 유전자조작 농산물 표시제를 법제화하였고 식품의약품안전청도 식품에 표시제를 법제화하고 있는 현실이다. 만일 유전자변형농작물의 유해성이 밝혀지고 이에 대한 제한이 있을 경우 수입한 옥수수나 콩 등을 이용하고 있는 국내 식품산업은 물론 제약, 생활용품 및 수출시장에도 막대한 피해를 초래할 것으로 우려하고 있다. 그러나 대다수의 국민들은 유전자변형식품의 소비에 대해 잘 모르고 있는 현실이고 이 같은 시점에서 유전자변형식품의 건강영향에 대한 기존의 연구문헌들을 고찰하여 현재까지의 연구내용들을 정리하는 일은 매우 필요한 일이다. 이는 앞으로 연구들에 있어 기초 자료로 활용할 수 있고 국민들에게 올바른 유전자변형식품 소비에 대한 판단의 근거가 될 수 있을 것이다. There are supporters who assert themselves that the genetically modified organisms can decrease the environmental pollution and emancipate the starving people all over the world by reducing the pesticides use and harvesting the well nourished crops. But, the critics are afraid of latent danger and are doubtful of real advantages of the genetically modified organisms. Until now, there is a controversy on the influence on health and environmental pollution of the genetically modified organisms. We should be concerned about the genetically modified organisms because it penetrates into our dinner table recently and our country imports the large amounts of the genetically modified organisms. The Ministry of Agriculture and Korea Food and Drug Administration lay down the making law of the genetically modified organisms especially about beans, corns and bean sprouts. If it has clarified about the harmfulness of the genetically modified organisms and it has limited in national trade, the Korea industry of food processing, pharmacy, living necessaries and exportation would confronted by the serious damage. But, the majority of people takes no interest in the genetically modified organisms. At this point of time, it requires the literature inquiry about the influence on health of the genetically modified organisms. It should provide the base on decision of consuming the genetically modified foods.

갑상선암 예측에 있어 초음파적 변수 분석

임현정,최영식,박요한,오경승,이강대 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background: The introduction of high resolution sonography has made it possible to detect nodules in the thyroid gland. However, there has been no reliable sonographic sign for distinguishing between benign and malignant thyroid conditions. The aim of present study was to evaluate ultrasonographic (US) parameters in predicting thyroid cancer. Methods: One hundred fifty three patients who underwent thyroidectomy at Kosin Medical Center from January, 2000 to April, 2002 were included in the study. All patients were checked high resolutional US before surgery. Of the 153 patients 89 were malignant tumors and 64 benign. Malignant US parameters were defined as calcification, irregular margin, more taller than wide, and fat line obliteration. Calcification pattern was classified with single, punctated, and amorphous calcification. The US characteristics to predict malignancy were evaluated by means of multiple logistic regression analysis. Results: All of the malignant sonographic parameters such as calcification, 53 (89.8%) were thyroid carcinoma. The incidence rate of malignancy was 55.9% in solitary nodules and 65.7% in multiple nodules (p=0.303). Even though nodule size was less than 1.5㎝, the incidence of malignant tumor was 69.5% (p=0.04). Of 53 malignant nodules with calcification, the incidence of single, punctated, and amorphous calcification pattern was 6 (11.3%), 22 (41.5%), 25(47.2%), respectively. The sensitivity, specificity, positive and negative predictive value, and accuracy of sonographic parameters were 76.4%, 87.5%, 89.5%, 72.7% and 81.0%, respectively. Upon the correlation of US-guided FNA cytology with pathologic diagnosis, the sensitivity of ultrasound-guided FNA cytology in differentiating benign and malignant nodule was 85.9%, the specificity 100% and overall diagnostic accuracy was 91.2%. The sensitivity, specificity, and accuracy of US parameters associated to follicular neoplasm, all were 75.0%. Conclusion : All the malignant US parameters including calcification, irregular margin, and more tall than wide showed high level of sensitivity, specificity and accuracy. Of these parameter, calcification and irregular margin were more significants. The more presence of calcifications with punctated and amorphous pattern could suggest the higher possibility of malignancy. However, further study is needed for clinical application of malignant US parameters in the thyroid tumors.

관상동맥질환의 중증도와 혈중지질치 및 아포지단백과의 상관관계

임현주,황종현,류재근,정병천,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.1

목적 : 관상동맥질환의 위험인자로서 혈청지질 및 혈장 지단백에 대한 관심이 높아지고 있고 또 아포지단백이 관상동맥 질환을 일으키는데 다른 지질보다 더 중요하다는 연구가 많이 발표되고 있으나 우리나라에서는 아포지단백에 대한 연구가 그리 많지 않은 편이다. 이에 저자등은 혈중지질치와 새로운 위험인자로 알려지고 있는 아포지단백치를 측정하고 이들과 관상동맥질환 중증도와의 상관 관계를 알아보았다. 대상 및 방법 : 관상동맥질환이 의심되어 관상동맥조영술을 실시한 69명의 환자를 대상으로 하였으며 12시간 이상 공복후 혈청을 채취하여 총콜레스테롤, 중성지방, HDL-콜레스테롤, 아포지단백 AI (ape AI), 아포지단백 B (ape B)를 측정하였다. 관상동맥조영상 50%이상의 협착이 있는 혈관의 수 (lesion number), 최대협착을 합한 값 (lesion score), 각 분절의 최대협착을 합한 값 (total score), 가장 심한 협착 값 (peak stenosis) 등으로 관상동맥 중증도를 알아본 다음 이들과 혈청지질치, 아포지단백과의 상관 관계를 비교해 보았다. 상관 관계는 Spearman's correlation coefficient를 구하였다. 결과 : 관상동맥질환의 중증도와 각 지질치 간의 상관 관계를 비교해 보았을때 lesion number와 관계있는 것은 연령 (r=0.2789), 중성지방치 (r=0.2829)이며 lesion score와 관계있는 것은 연령(r=0.2911), 중성지방치0 (r=0.3316), 총콜레스테롤과 HDL-콜레스테롤의 비 (r=0.2361), apo B 치(r=0.2759), apo AI과 apo B의 비 (-0.3154)로 나타났다. Total score는 연령 (r=0.3100), 총콜레스테롤치 (r=0.2452), 중성지방치 (r=0.3022), 총콜레스테롤과 HDL-콜레스테롤의 비 (r=0.2770), apo B치 (r=0.2927), apo AI과 apo B의 비 (r=-0.3408)와 연관이 있었고 peak stenosis는 중성지방 치(r=0.3305), ape B 치 (r=0.2968), apo AI과 apo B의 비 (r=-0.3977)와 관계가 있었다. 연령으로 조정하여 partial correlation을 좌면, 관상동맥조영술상 중증도는 중성지방치 (r=0.3408), apo B 치(r=0.2877), apo AI과 apo B의 비 (r=-0.3460)와 유의한 상관 관계가 있었다. 이중 ape AI과 ape B의 비는 lesion score (r=-0.2640), total score (r=-0.3057), peak stenosis (r=-0.3460)와 유의한 상관관계를 보였다. 결론 : 이상의 결과로 보아 apo B치 그리고 apo AI과 apo B의 비가 관상동맥 중증도의 예견인자로 다른 혈중 지질 치보다 더 유용하다는 것을 알 수 있었다. Objectives : Recently, it was reported that the measurements of apolipoprotein levels may be valuable in the clinical assessment of coronary artery disease severity. However there are a few reports regarding to the relationship between coronary artery disease severity and apolipoprotein levels in Korea. Thus, we measured serum lipid and apolipoprotein levels and studied the relationship between coronary artery disease severity and serum lipids and apolipoproteins levels. Subjects and Methods : The 69 patients who underwent coronary angiography to evaluate chest pain were subjected to this study. We measured the levels of serum cholesterol, triglycerides, HDL cholesterol, apolipoprotein AI(apo AI) and apolipoprotein B(Apo B) and measured the severity of coronary artery disease by lesion number, lesion score, total score and peak stenosis. Then, we studied the relationship between coronary artery disease severity and apolipoproteins and calculated the correlation coefficient. Results : The results were as follows. There are significant correlation(r=0.3) between age, triglycerides, apo B levels, apo AI/B ratio and coronary artery disease severity. In controlling for age, tyiglycerides, apo B levels and apo AI/B ratio shows significant correlation(r=0.3) with coronary artery disease severity. Especially, apo AI/B ratio shows significant correlation(r=0.3) with lesion number, total score and peak stenosis. Conclusion : These results suggest that the apo B levels and the ratio of apo AI/B can be used as significant independent predictor for coronary artery disease severity rather than other serum lipid levels.