Effect of Siryungtang, Steroid, Interferon-γand Cyclosporin-A on Mitogen Induced Interleukin-4 Activity in Minimal Change Nephrotic Syndrome

Cho, Byoung Soo 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Byoung-Soo cho. Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea. Effect of Siryungtang, Steroid, Interferon-γand Cyclosporin-A on Mitogen Interleukin4-Activity in Minimal Change Nephrotic Syndrome. Proceedings of International Symposium on East-West Medicine, Seoul. 183-186, 1999. -We have reported that patients with childhood minimal change nephrotic syndrome (MCNS) express higher levels of IL-4 mRNA expression by mitogen activated T cells using Northern blot(Cho,et al, JASN 1:518,2:590). Siryungtang(SA-1) is an oriental medicine shich has long been used in chronic renal diseases. In order to evaluate the efficacy of SA-1 on IL-4 sctivity from the monouclear cells isolated from the MCNS patients(n=5) and controls(n=5). Cells were adjusted to 2×107cells/ml with 10% FCS-RPMI and added test drugs such as SA-1, steroid(hydrocortisone, HC), CsA, IL-4& combination of SA-1+HC,SA-1+CsA&SA-1+IFN-γand mitogens(PHA-P:20㎕/ml, Con-A:20㎕/ml & PMA:50ng/ml) were added. Cells were cultured at 37℃,5% CO2 incubator for 24,48 & 72hrs. Results were as follows. 표 Mean ³[H]thymidine incorporation(cpm) was higher in controls(44,920±7,482cpm)that in patients with MCNS(30,495±2.135). However ³[H]thymidine incorporation was reduced by adding SA-1,HC, CsA & IFN-γ,or which CsA was the most effective, by combination treatment with SA-1 to steroid and CsA, significant additive effects were noted in MCNS group. In conclusion SA-1 has a steroid and CsA sparing effect and could reduce side effects of steroid and Cas significantly if clinically applicated.

응급실 내원 환자 14,836례의 통계적 고찰

조수형,조남수,임경준 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Cases of 14,836 patients who visited the emergency room at the Chosun University Hospital from January 1 to December 31, 1994 were analyzed statistically according to sex, age, department, admission, discharge and used transportations. The results were as follows: 1) Considering sexual distribution, male patients were 52.3% and female patients were 47.7%. 2) According to age categories, 4th decade of life was most frequent. 3) According to the department distribution, internal medicine accounted for 22.7%, orthopedic surgery 15.4%, neurosurgery 12.4% and pediatrics 11.7%. 4) The rate of patients admitted via emergency room was 38.0% of total number of patients visited emergency room. The department distribution was as follows: internal medicine 24.1%, neurosurgery 13.7%, orthopedic surgery 12.1%, general surgery 10.5%. 5) 62.0% of patients visited emergency room were discharged. The department distribution was as follows: internal medicine 21.9%, orthopedic surgery 17.5%, pediatrics 13.3%. 6) The number of DOA patients was 212(14.3%) and it showed highest rate in December. 7) A car and taxi were the most frequently used transportation(70%) but the used rate of hospital, 119 and 129 ambulance tended to increase. 8) Emergency room was visited most frequently from 20 to 24 hours. 9) Consumed time from arrival to emergency care of the relevant department was within one hour(67%).

Takayasu′s 동맥염에 의한 쇄골하 동맥류(1예)

조남수,조수형,박광철 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Takayasu's arteritis is a non-specific inflammatory process that involves the aorta and its main branches, the etiology of which remains unknown. This arteritis occurs predominantly in young Asian women, although there have been many documented cases in males and non-Asians. Criteria for the diagnosis of Takayasu's arteritis were developed by The Subcommittee on Classification of Vasculitis of the American College of Rheumatology in 1990, of which a modified version is shown in Table 1. The presence of three or more of the six criteria shown demonstrated a diagnostic sensitivity of 90.5% and a specificity of 97.8%. Takayasu's arteritis is known as 'pulseless disease,' and this non-specific inflammatory arteriopathy typically produces segmental arterial narrowing and occlusion with resultant end-organ ischemic consequences, including upper extremity digital necrosis, stroke, visceral ischemia and renal failure. Previously reported sites of aneurysm formation include the thoracic and abdominal aorta, as well as the innominate, the carotid and the superior mesenteric arteries, but rarely the subclavian artery. A 26-year-old man presented with a progressively enlarging and tender pulsatile mass at the base of the left neck, intermittent Claudication of the upper limbs in association with a decreased brachial artery pulse and a bruit over the subclavian artery. Computed tomography and aortography demonstrated a 4 cm × 5 cm aneurysm of the left subclavian artery. There was no evidence of occlusive disease. An aneurysmectomy with 8 mm hemashield graft interposis was performed. Pathology revealed a chronic, active inflammatory process. Aneurysm formation is an unusual complication of Takayasu's arteritis. Emergency department physicians must carefully observed patiens with symptomatic upper extremity pain and paresthesia and must consider whether those symptoms might be due to the formation of a subclavian artery aneurysm due to Takayasu's arthritis

응급의학과의 인식 및 발전 방향에 대한 연구조사 : 광주광역시 및 전라남도 지역을 중심으로

조수형,조남수,김성중 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: The present study was performed in order to identify the possible future location of the Department of Emergency Medicine and future demand for and supply of manpower through a survey of the heads of Kwangju City and Chollanam-do hospitals. The survey covered the degrees of recognition and understanding, the necessity, the future prospects, and the direction of development of the Department of Emergency Medicine. Methods: A total of 33 large-scale general hospitals were selected in county districts having more than 200 sickbeds as of November 1999. Among them, the heads of 29 hospitals responded to the survey. The survey had a total of 31 questions, including 6 questions on the status of the emergency room. Six(6) questions concerned the degree of recognition of the Department of Emergency Medicine. Six(6) questions concerned the degree of understanding of the Department of Emergency Medicine. Six(6) questions concerned the necessity for the Department of Emergency Medicine, and 7 questions concerned the future prospects and direction of development. The results of the survey were analyzed. Results: 1) As to the question of the degree of recognition, the Department of Emergency Medicine was known to all. That is, 50% of the respondents were well aware of the department, and 50% a little, Nineteen(19) respondents(65%) answered that it was convenient to have the Department of Emergency Medicine in a university hospital, among which 16 respondents(55%) answered that it was because of the rapid treatment of emergency patients. 2) As to the question of the degree of understanding, particularly, the areas of medical examination and treatment by the Department of Emergency Medicine, 15 respondents answered that it was for the treatment of patients who needed to receive emergency treatment, while 12 respondents answered that it was for the diagnosis and treatment of all patients who visited the emergency room. Only 7 respondents(24%) answered positively as to the possibility of the Department of Emergency Medicine using thrombolysis medicine. 3) All except for one respondent had a positive view on the necessity for the Department of Emergency Medicine, and all except for 3 respondents wanted to have specialized doctors in emergency medicine work at the corresponding hospital. As to the type of schedule, 10 hospitals(34%) wanted to have only night shifts, and 11 hospitals(38%) wanted to have both day and night shifts. Most hospitals needed two or more workers in the field. 4) As to the question of the direction of development, many respondents were of the opinion that the hiring of specialized doctors in emergency medicine would not be of greatly help to the finances of the hospital due to increased labor costs. It seems that improvement of the medical system to improve hospital financing is a required prerequisite for the development of the Department of Emergency Medicine. Also, 21 respondents(83%) were of the opinion that it would take a considerable amount of time to activate the Department of Emergency Medicine with respect to the future prospects of the department. Conclusion: It was shown in the present survey that the heads of hospitals in Kwangju City and Chollanam-do recognized the Department of Emergency Medicine in a positive way, but it was necessary to establish both a delivery system for emergency medicine and collaboration with and support by other medical areas for its future development. It was estimated that in the future, more than 55 doctors specializing in emergency medicine would be needed as medical manpower for the general hospitals in the districts.

Microstructure‑Strengthening Interrelationship of an Ultrasonically Treated Hypereutectic Al–Si (A390) Alloy

Soo‑Bae Kim,Young‑Hee Cho,Jae‑Gil Jung,Woon‑Ha Yoon,Young‑Kook Lee,Jung‑Moo Lee 대한금속·재료학회 2018 METALS AND MATERIALS International Vol.24 No.6

Ultrasonic melt treatment (UST) was applied to an A390 hypereutectic Al–Si alloy in a temperature range of 750–800 °Cand its influence on the solidification structure and the consequent increase in strength was investigated. UST at such a hightemperature, which is about 100 °C above the liquidus temperature, had little effect on the grain refinement but enhanced thehomogeneity of the microstructure with the uniform distribution of constituent phases (e.g. primary Si, α-Al and intermetallics)significantly refined. With the microstructural homogeneity, quantitative analysis confirmed that UST was found tosuppress the formation of Cu-bearing phases, i.e., Q-Al5Cu2Mg8Si6, Al2Cuphases that form in the final stage of solidificationwhile notably increasing the average Cu contents in the matrix from 1.29 to 2.06 wt%. A tensile test exhibits an increasein the yield strength of the as-cast alloy from 185 to 208 MPa, which is mainly associated with the solute increment withinthe matrix. The important role of UST in the microstructure evolution during solidification is discussed and the mechanismcovering the microstructure-strengthening interrelationship of the ultrasonically treated A390 alloy is proposed.

급성 약물 중독에 대한 임상적 고찰

조수형,조남수,김용배 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

A clinical observation was made on 194 cases of drug intoxication to Chosun University hospital via emergency room during one year from January 1994 to December 1994. The observed results were summarized as follows; 1. The ratio of drug intoxicated patients to total patients of emergency room was 1.3%(194 patients of the total 14,836 patients) 2. Female was slightly more than male (54% : 46%) and the age group of the third decade was of the largest proportion. 3. In monthly distribution, September had the largest propotion(14.4%). The largest proportion of the time interval on arrival to emergency room and of presumed time of poisoning was night(8 p.m. ∼12 p.m.). 4. Suicidal attempt was the most common motive of drug intoxication(82.5%). 5. The most common drug of intoxication was S.H.T.(sedatives, hypnotics, tranquilizer)(24.7%). 6. The abnormal signs on arrival to emergency room were tachycardia, tachypnea, hypertension in order of frequency. 7. The observed abnormal laboratory findings on arrival to emergency room were leukocytosis(97 cases), glucosuria(21 cases), proteinuria(10 cases) in order of frequency. 8. The outcome of the patients were recovery(42.8%), against discharge(35%), hopeless discharge(16%), death(6,2%).

광주·전남 지역 병원간 응급 의료 전달 체계에 대한 연구 : 조선대학교 병원 응급의료센터를 중심으로

조남수,조수영 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background: To provide basic data to help construct regional EMSS. Methods: Using a questionnaire, the authors investigated prospectively the data of 766 patients transferred directly to Emergency Medical Center of Chosun University Hospital from other hospitals from April 1 to May 31, 2000. Results: 1) Transfer records; Transfer records of 407(53.1%) patients were faithful, 159(20.7%) patients were unfaithful. 47(6.2%) patients made a phone call to the emergency room or the Department of Emergency Medicine, 9(1.2%) patients to other departments, and 144(18.8%) patients were others. 2) The distribution of the region; A regional distribution of 766 patients transferred to Chosun University Hospital. The transfer took less than 1 hour in 134 patients, it took 1~2 hours in 150 patients, 2~3 hours in 222 patients and 3 hours or more in 260 patients. 3) The mode of transfer; Of the 766 patients, 8(1.1%) patients were transferred by foot, 78(10.2%) patients by a 119 rescue ambulance, 428(55.9%) patients by a hospital ambulance, 31(4.0%) patients by an emergency rescue party, 149(19.5%) patients used private cars, 67(8.8%) patients used public transportation and 5(0.6%) patients were transferred by others means. 4) The reason of transfer; 138(18%) transferred patients from primary hospital or secondary hospital wanted the transfer. 306(39.9%) patients were transferred due to inducement, 162(21.1%) patients due to the absence of specialized departmental doctors, 64(8.4%) patients due to emergency surgery, 46(6%) patients due to bed deficit and 50(6.5%) patients due to other reasons. 5) Diagnosis and treatment in ER; Among all transferred patients, 6 patients were in pericardiocentesis, 103 patients in CT(brain), 61 patients in MRI(brain), 65 patients CT(other part), 10 patients in MRI(other part), 15 patients in closed thoracostomy, 148 patients in central vein catheterization, 5 patients in 4-vessel angiogram and 152 patients in endotracheal intubation. 6) The result of treatment; 458(59.8%) patients were admitted, 148(19.3%) patients to ICU, 15(2%) patients were admitted to a delivery room, 14(1.8%) patients were transferred to an other hospital, 30(3.9%) patients were in a mortuary, 101(13.2%) patients were discharged and 221 patients were admitted for an emergency operation. Conclusion: For effective and well organized EMSS the following are required. Communication prior to the patients transfer. Reinforcement of ambulance equipment and training of emergency staff for long distance transfer of a serious case. A detailed record of early state and treatment of transferred patients. The standardizational the transfer records which contains first aid treatment including fluid treatments, address and early vital signs of patients. Investigation and study for newlydeveloped transfer records.

서남해안 지방에서 발생한 Vibrio vulnificus 감염의 임상적 고찰

조남수,김춘호,김성중,김용배,조수형,안태훈 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: V. vulnificus infection in found between May and October when the man who has hepatic disorder or immunity disorder eats raw shellfish and it causes the systemic symptoms such as sudden fever, chilling, shock and stupor and local skin lesions like bleb and necrosis. This disease has 46∼61% of fatality rate in spite of intensive treatment. This study conducts the examination of history, epidemic study, ingesting raw fish and bacteriologic investigation in the patients with similar clinical symptoms to the above and examines the diagnostic dorrelations. Method: It is conducted with 31 cases who admitted at emergency medical center of Chosun University Hospital from May of 1995 to September of 1998 and are suspected to have V.vulnificus infection. It analyze bacteriologic examination, the survey of residence, eating raw shellfish, hepatic disorder, alcohol drinking habits and skin lesion. Results: 1) The rate of male and female is 15.5:1 and in the age, 18 cases are in fifties, seven are in forties and six are over sixties. 2) Clinically, V.vulnificus is detected in 20 of 31 cases which is suspected to have V.vulnificus infection and it is not detected in 5 cases. Other bacteria are detected in 6 cases and they include staphylococcus aureus, pseudomonas species, β-hemolytic streptococcus and E-coil. 3) In local distribution, Kohung has 10 cases, Shinan and Mokpo have six, Haenam and Kangjin have five, Yongkwang and Muan have five, Naju and Yongam have five and Kwangju has one. 4) Eating fishes and raw shellfishes is found in 31 cases. In the kind of shellfishes, eating raw clam is 10 cases, raw thin-shelled surf calm is 8 cases, raw oyster is 5 cases and sliced raw fish is 4 cases and pickled sea foods are 4 cases. 5) The cases with hepatic disorder are 23 and 15 cases with heavy alcohol drinking Carrier are included. The cases with Diabetic Mellitus are four and those with pulmonary tuberculosis are two. Two cases have not basal diseases. 6) On the opinion of skin lesion, 20 cases show vesicular necrosis, 7 cases have dendriform erythema, 3 cases have papule and one case doesn't show clear skin lesion. Conclusion: When V.vulnificus infection is detected, it is fatal and those who have hepatic disorder or heavy alcohol drinking habit must avoid eating fishes and shellfishes raw in summer. It is important to have emergency treatment for the patient whose V.vulnificus infection is suspected. It is considered that the administration of initial antibiotics is effective by generalizing the clinical symptom, epidemic opinion and patient history even before the results of bacteriologic confirmed.

응급실에서 기관내 삽관후 발생한 후두육아종 1례

조남수,김용배,조수형,송민엽,송성용 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Endotracheal intubation has been used widely for the maintenance of airway in the emergency patient and CPR in the acute airway obstruction patient and to treat respiratory insufficiency. Endotracheal intubation has many advantages but it may cause several complications which rate about 4% of endotracheal intubation patient. Among these complications, laryngeal granuloma is a relatively rare complication arising about 1 case per 10,000∼20,000 cases. Authors report a case of laryngeal granuloma which developed after endotracheal intubation required during emergency treatment. Case: A 55-year old female patient visited Chosun University Hospital Emergency Room complaining of dyspnea, cyanosis and sweating on Feb. 8th 1995. According to past history, she had a little obesity, dyspnea on exercise and mild hypertension. At arrival, blood pressure was 240/110mmHg, pulse rate 150 rates/min, respiratory rate 12/min, body temperature 36.5℃ and cyanosis with sweating on whole body was observed. And the mental state was semicoma. At 5 minutes after arrival, sudden respiratory arrest developed and immediate endotracheal intubation which emergency treatment was performed it was difficult to intubate endotracheally due to short neck and obesity. At 1 hour after arrival, general condition of the patient recovered well and extubation was done. The patient was transferred to internal medicine department and discharged after 12 days of medical treatment. At 2 months after discharge, the patient felt a progressive hoarseness and foreign body sensation of larynx. She was diagnosed as laryngeal granuloma at ENT department of Chosun University. She underwent the surgical operation and discharged in good health after 7 days of admission.

Effect of Ultrasonic Melt Treatment on Solidification Microstructure of Al–5Ti–1B Alloy Containing Numerous Inoculant Particles

Soo‑Bae Kim,Jae‑Gil Jung,Young‑Hee Cho,Su‑Hyeon Kim,Kwangjun Euh,Jung‑Moo Lee 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.7

The effect of ultrasonic melt treatment (UST) on the solidification microstructure of an Al–5Ti–1B alloy containing highvolumefractions of Al3Tiand TiB2particles is investigated for various UST times with different melt holding times. Theas-cast Al–5Ti–1B alloy is composed of TiB2and polygonal Al3Tiparticles (present prior to UST), plate-like Al3Tiparticles,and Al grains (formed during UST and/or solidification). The UST causes a size reduction and homogeneous distributionof the TiB2-agglomerated region containing many submicron-sized TiB2particles pushed to the grain boundaries. The USTslightly decreases the size and improves the distribution of polygonal Al3Tiparticles enriched in the TiB2-agglomeratedregion. Unlike the TiB2and polygonal Al3Tiparticles, which exhibit a minor refining effect, the plate-like Al3Tiparticlesshow a significant refinement with UST application. The UST has a significant effect on the size distribution of Al grains byinducing the formation of medium-sized grains at the expense of small and large grains; however, it only has a slight effecton grain refinement. The degree of microstructure modification increases with increasing UST time but decreases with meltholding time after UST. The mechanisms for the refinement and dispersion of the TiB2and Al3Tiparticles and Al grains arediscussed considering fragmentation, nucleation, and growth behaviors induced by the UST and subsequent solidification.