심폐소생술중 심실기능 및 판막운동의 평가

이부수,김영식,이강현,황성오,임경수,박금수,윤정한,안무업,최경훈 대한응급의학회 1994 대한응급의학회지 Vol.5 No.2

Background : Mechanism of blood flow during cardiopulmonary resuscitation(CPR) in humans remains controversial and poorly understood, although cardiac or thoracic pump theory was proposed. We investigated cardiac movement, ventricular function and atrioventricular valve motion with aid of transesophageal echocardiography during precordial compression during CPR in humans. Methods and results : During CPR transesophageal echocardiography was performed in 14 patients with non-traumatic cardiac arrest. Manual precordial compression during CPR was performed according to American Heart Association guidelines. Mitral valve closed in 9 and did not close in 5 patients during "compression systole". Tricuspid valve closed during compression systole. Compression vector directed to right ventricle, basal portion of interventricular septum and left atrium. The heart rotated clockwise and the apex was more displaced than the base("swing motion"). Fractional shortening(FS) and ejection fraction(EF) of right ventricle exceeded those of left ventricle(FS : 55±9% vs 18±8%, p<0.05), EF : 79±9% vs 37±16%, p<0.05). FS and EF of left ventricle was higher in patients with systolic mitral valve closure than patients with persistent systolic opening of mitral valve(FS : 21±7 vs 13±7%, EF : 45±12 vs 22±12%, p<0.05), but FS and EF of right ventricle was not different. Conclusion : During precordial compression, the heart rotated clockwise and displaced. Systolic function of right ventricle exceeded left ventricle. Marked compression of right ventricle and systolic closure of tricuspid valve suggested that right ventricle functioned as a pump generating blood flow during precordial compression. Closure of mitral valve was dependant on systolic function of the left ventricle.

혼수상태의 외상환자에서 초음파를 이용한 흉부 및 복부손상의 진단

임경수,이강현,이진웅,이부수,황성오,유수영,강성준 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

The need for rapid diagnosis and treatment of life-threatening thoracic and intra-abdominal injury result in controversy over the appropriate triage of unconscious blunt trauma patients. To aid in early decisions for these patients, a prospective analysis of 98 patients with glasgow coma scale(GCS) scores≤8 was undertaken. Although intra-thoracic and intra-abdominal injuries were frequently identified based on systolic blood ressure, the use of clinical signs alone resulted in more missed injuries than did using the emergency ultrasonography. In normotensive patients(n=34), intra-thoracic injuries was identified in one patient(2.9%), and intra-abdominal injuries were in 7 patients(20.6%). In shock(systolic blood pressure<90mmHg) Pa-tients(n=64), thoracic injuries and intra-abdominal injuries were diagnosed in 8(12.5%) and 27 patients(42.3%), thoracic and abdominal combined injuries were identified in 11 patients(17.2%). The sensitivity, specificity, and accuracy of emergency ultrasonography were 96.3%, 91.7%, 94.9%. This study suggests that all unconscious trauma patients undergo immediate emergency ultrasonography to prevent missing life-threatening injuries.

다발성 외상환자에서 필수적 단순 방사선검사의 의의

임경수,황성오,임종천,이부수,이강현,이진웅 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

In the guidelines of Advanced Trauma Life Support(ATLS), essential plane roentgenograms (chest AP vIew, cervical spine lateral view and pelvis AP view) are recommanded when primary survey and resuscitation phase are finished in care of multiple injured patients. A prospective study was carried on 376 multiple trauma patients who admitted to Wonju Christian Hospital from July, 1995 to October. We analyzed clinical significance of essential X-ray in multiple trauma patients, and classified the patients by their status of mentality. The one is alert group when their Glasgow Coma Scale(GCS) is over 13 point, the other is disoriented mentality group when their GCS are below 12 point. The alert group was redivided by presence of clnical symptoms and/or signs, and clinical significances of essential X-ray were analyzed. Among the 376 patients, 330 patients are alert group that their GCS score is over 13 point and 46 patients are disoriented group who's GCS were below 12 point. The detection rate of abnormality in essential X-ray is higher in disoriented group than alert group(cervical-spine lateral view : 13.5% vs 3.0% cheat AP view : 0.4%, pelvis AP view : 0%). This study suggests that their are no needs of taking essential X-ray in patients who is alert in mental state and have no clinical symptoms and/or signs.

건축공사시방서에서의 KS규격의 국제인증방안에 관한 연구

김경식,이재섭,김용수,이규진,조용훈,최완철,전재열,이현수,구재동,이기환 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

The purpose of this research is make out construction specifications for International Construction. Using off-shore products incur cost increase and longer delivery term of construction. and inconvenient on International Construction. Expand the range of additional local products conforming to performance. Life Cycle Cost. maintainability. operability. user's acceptability, etc.. And this study is suggest the standard formats and the techniques for construction specification.

횡문근융해증과 급성 신부전 및 범발성 혈관내 응고장애를 동반한 열사병 1예

최대은,박수진,권오경,이한규,이영모,이상주,나기량,이강욱,신영태 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40% and central nervous system dysfunctions that results in delirium, convulsions, or coma. Heat stroke is subdivided into two forms, classic and exertional. Since strenuous exercise is one of the major exacerbating and precipitating factors, the incidence of exertional heat stroke is high among young adult, especially military personnel undergoing military training. Exertional heat stroke commonly causes rhabdomyolysis, lactic acidosis, acute renal failure, shock and pulmonary edema. We report a case of heat stroke with rhabdomyolysis, acute renal failure, disseminated intravascular coagulopathy(DIC) after strenuous exercise. A 18 year old man was admitted to the hospital because of loss of consciousness. He was a wrestler and he had tried to lose 6kg in weight by jogging and strenuous exercise on that summer day with hot temperature. The development of this illness was favoured by much clothes inappropriate for that environmental condition with a purpose to enhance sweating, and by restricted intake of water and food. On admission, the blood pressure was 80/50mmHg, and body temperature was 39.4℃ with stuporous mentality. Laboratory finding were as follows : in complete blood cell count, hemoglobin was 16.7g/dL and platelet count was 158,000/ mm³. In blood chemistry, AST 1061U/L, ALT 201U/L, BUN 30mg/dL, Cr 2.2mg/dL, LDH 941IU/L, CK 696IU/L were resulted. In arterial blood gas analysis, pH 7.39, pCO₂ 30mmHg pO₂ 86mmHg, HCO₃ 18.4mEq/L, O₂ saturation 96.7% were resulted. In urinalysis, specific gravity 1.025, protein 3+, erythrocyte 2+ were resulted. In brain imaging study, brain CT finding was normal. After appropriate treatments with rapid cooling, hydration and supportive care, he improved with alert mental status. On 2nd hospital day, in laboratory result, thrombocytopenia and coagulopathy were appeared and renal insufficiency was aggravated. So he was treated with platelet concentrate and fresh frosen plasma for DIC, and enough hydration for appropriate urine volume preservation. After all, On 22nd hospital day, he fully recovered and discharged. Nowadays, with followed for some duration, he is wellbeing with no complications.

Plant regeneration from callus of Iris odaesanensis Y. N. Lee native to Korea via organogenesis

Bae, Kee-Hwa,Yoo, Kyoung-Hwa,Lee, Mi-Hyun,Jeong, Jae-Hun,Choi, Yong-Eui,Yoon, Eui-Soo The Korean Society of Plant Biotechnology 2013 식물생명공학회지 Vol.40 No.3

Iris odaesanensis Y. N. Lee. is an important endangered and native plant belonging to the family Iridaceae in Korea. This study describes a method for rapid micropropagation of this species via from leaf, rhizome and root explants derived calli. Leaf, rhizome and root explants were cultured on Murashige and Skoog (MS) medium supplemented with 2,4-dichlorophenoxy acetic acid (2,4-D) for callus induction. Rhizome explants yielded calli at a frequency of 72% when cultured at 1.0 mg/l 2,4-D. Calli were maintained at 1.0 mg/l 2,4-D. These calli were transferred to MS medium supplemented with 0, 0.5, 1.0, and 2.0 mg/l 2,4-D in combination with 0, 0.5, 1.0, and 3.0 mg/l BA for adventitious shoot induction. The highest number of adventitious shoot (228.9 per petri-dish) were formed at 1.0 mg/l 2,4-D and 1.0 mg/l BA. WPM medium was the best to convert calli into plantlets, where up to 98.2% of calli were regenerated into plantlets. This in vitro propagation protocol should be useful for conservation of this endangered plant.

糞便檢査에 있어서 세로판 厚層塗抹法과 簡易食鹽水浮游法의 比較檢討

李駿商,張基浩,朱炅煥,金洙鎭,林漢鍾 고려대학교 의과대학 1979 고려대 의대 잡지 Vol.16 No.1

Experiments had been made to evaluate more efficient method in stool examination for various helminth ova. Authors examined 2,016 nationwidely collected stool specimens by the two methods, cellophane thick smear method and brine floatation method. The results were as foliows; 1. Of 2,019 specimens examined by cellophane thick smear method, the positive rates of following helminth ova were; Ascaris lumbricoides (fertilized) 27.3% Ascaris lumbricoides (unfertilized) 13.6%, Trichuris trichiura 39.0%, Hookworm 0.1%, Enterobius vermicularis 0.05% Hymenolepis nana 0.04%, Taenla spp. 1.3% Clonorchis sinensis 1.1% and Metagonimus yokogawai 5.7%. And, A. lumbricoides (fertilized) 27.0%, A. lumbricoides (unfertilized) 3.8%, T. trichiura 38.1%, Hookworm 2.0%, Trichostrongylus orlentalis 0.6%, E. vermicularis 0.2%, H. nana 0.8%, and M. yokogawai 0.05% by brine floatation method. 2. The causes of inferior positive rates in some helminth ova by cellophane thick smear method were shortly discussed and suggest some opinions in improvement of detection ability. 3. The positive rates of following helminth ova were superior in cellophane thick smear method to those of brine floatation method: A. lumbricoides(fertilized), Taenia spp., C. sinensis and M. yokogawai. And, the positive rates of following helminth ova were superior in brine floatation method: Hookworm T. orientalis, H. nana and E. vermicularis. 4. Cellophane thick smear method has been known to be one of the most effective methods in mass stool examination. But, this method is not so effective in detection of certain species of helminth ova. Therefore, employment of brine floatation method added to cellophane thick smear method is desirable for the better result of mass stool examination.

Coxiella burnetii에 대한 항체의 검출을 위한 Enzyme-Linked Immunosorbent Assay의 정립

이경호,박주영,박윤선,김수기,신운섭,고춘명 대한감염학회 1994 감염 Vol.26 No.4

본 연구에서는 지금까지 진단이 내려지지 않았던 C. burnetii 감염증 환자들을 보다 빠르고 간편하며 정확하면서도 대량으로 검사할 수 있는 방법으로서 C. burnetii 단백항원을 이용한 효소면역측정법을 정립하고자 하였다. 본 실험에서 정립한 효소면역측정법은 간접 방법으로서 C. burnetii phase I에 대한 IgG를 검출하기 위해 고안되었다. C. burnetii 단백질 항원의 적정 농도는 야성 대조혈청의 흡광도와 음성 대조혈청에서의 흡광도의 차이가 가장 크게 나는 농도인 1ug/ml을 적정항원농도로 결정하였으며, 검사 혈청의 적정희석 농도도 역시 양성대조항원의 OD 값과 음성대조항원에서의 OD값의 차이가 가장 크게 나면서 비교적 background activity가 적은 혈청의 희석 농도인 1:300을 적정 혈청 희석 농도로 결정하였다. 이 때 각각의 야성 혈청이 0.185의 흡광도를 가질 수 있는 가장 높은 혈청 희석 농도의 로그값과, 같은 혈청을 1:300으로 희석했을 때의 흡광도 사이에 상관계수 r값이 0.95인 직선적 관계가 성립하여, 하가지 혈청 희석 농도(1:300)에서 결정된 ELISA값이 그 혈청의 항체가를 양적으로 표시하였다. 효소면역측정법의 양성 판정 기준은, IFA에서 C. burnetii에 대한 항체가 음성으로 확인된 혈청 100개를 대상으로 ELISA를 시행하여, 이들의 흡광도의 산술평균치와 표준편차를 구한 결과, 신뢰구간 95%에서 최고치인 0.185를 ELISA 야성 판정의 기준인 cut-off value로 정하였다. 위애서 정한 기준에 의해 ELISA를 시행하엿을 때, IFA에서 양성으로 판명된 혈청 모두에서 양성으로 나타나 민감도가 매우 높은 것으로 나타났다. 다음으로 ELISA 방법의 특이도를 조사하기 위해서, IFA 검사에서 음성으로 확인된 혈청(혈청 희석 농도 1:10에서 음성)을 대상으로 ELISA를 시행한 결과, blocking agent로서 1% BSA를 사용했을 때는 9.3%, 5% NGS는 11.3%, 그리고 blocking을 전혀 하지 않았을 때는 15.3%의 위양성율을 나타내어, BSA와 NGS 상이에는 통계학적으로 차이가 없었으나, blocking을 하지 않는 것 보다는 하는 것이 위양성율이 적은 것으로 나타났다. 그러나, 이것은 어디까지나 IFA기준이며, 절대적인 의미에서의 위양성율을 의미하는 것은 아니다. 결론적으로 본 연구에서 정립한 효소면역측정법은 매우 높은 민감도를 갖고 있으므로 Q fever가 의심되는 환자를 screening하기 위한 적절한 방법으로 사료된다. Currently, the indirect immunofluorescence assay(IFA) is used for detecting antibodies to Coxiella burnetii. Although reliable, this method is time-consuming, and the results are subject to interpretation. To develop an alternative test, we used an enzyme-linked immunosorbent asssy (ELISA) because it was faster, less complicated, and more objective than the IFA. The ELISA, unlike the IFA, can also be automated. In this study an indirect ELISA using C. burnetii protein antigens was developed to detect immunoglobulin G to C. burnetii phase I. A linear relation was found between the logarithms of absorbance values of sera at a dilution of 1/300 and the titres as determined by an end point dilution ELISA. The finding of linear relation (r=0.95) confirmed that an ELISA value determined with a single serum dilution (1:300) can be interpreted quantitatively as the titer of antibody in that serum. A serum dilution of 1:300 was used in all subsequent tests because at this dilution the difference between absorbance values for positive and negative sera was greatest: a serum sample was regarded as positive if the OD? value was ≥0.185 (absorbance threshold) at this dilution. The results obtained by the ELISA were compared with those by the IFA established already. The results indicate that the assay provides a sensitive, alternative method for diagnosing Q fever, but it needs reevaluation for the specificity because of its high false-positive rates.

素問·刺法論에 對한 硏究

李載胎,鄭憲瑩,琴坰樹,朴炅 한국전통의학연구소 1999 한국전통의학지 Vol.9 No.1

This fasciale, a remainder of So Moon(素問) with Bon Byung Ron(本病論), is a part of the theory of the Five Circuit Phases and the Six Atmospheric Influences(五運六氣學) that studied and discussed the rules of the weather change in ancient oriental medicine. The change in weather is one of the most important factors which influence man's health therefore the theory is worth while to study further. This fascicle explains the cause of diseases occured by irregular and exceptional change of weather and acupunctural treatment methods to prevent and cure those kinds of disease as its title -Ja Bup Ron(刺法論)-suggests. During Tang Dynasty(唐) when Wang Ping(王氷) commentated the So Moon(素問) only the title of this fascicle was kept but the contents of it was lost differing from Seven volumes of the Five Circuit Phases and the Six Atmospheric Influences(運氣七篇). However in the times of the North Song Dynasty(北宋) when Kao Pao-Heng(高保衡), Lin I(林億) and the other scholars studied and compared medical books this fasciale and another lost fasciale-Bon Byung Ron(本病論) appeared with theirs notes. So these two fascicles called Lost Volumes of So Moon(素問遺篇). But we can infer these two fascicles were written by a certain Taoist during the ninth and tenth century A.D. - the former times of Kao Pao-Heng(高保衡), Lin I(林億) and the other scholars studied and compared medical books during the North Song Dynasty(北宋) since Wang Ping(王氷) because this fascicle connots the Taoism training methods such as Pe Gi(閉氣), Jon Sang Bup(存想法) and Oi Dan Bup(外丹法) and so on. This thesis runs as follows; Chapter 1 deals with acupuncture treatment to prevent and cure UI(鬱) disease occuerd by Sung Gi Bu Jun(升之不前) of the Six Atmospheric Influence(六氣). Chapter 2 deals with acupuncture treatment to prevent and cure diseases due to Bul Chun Jung(不遷正) and Bul Toi Wui(不退位) of the Six Atmospheric Influence(六氣). Chapter 3 deals with acupuncture treatment of an epidermic(疫癘) due to the deviation of the Five Ciecuit Phases from the regularity(五運失守). Chapter 4 deals with the symptomes of an epidemi and the preventive treatments such as Jon Sang Bup(存想法), Vomitory treatment(吐法), respiratory treatment(汗法) and So Kum Dan Bang(小金丹方). Chapter 5 deals with the interaction among the five viscera and the six bowels as well as the principle of the acupuncture.

근관충전방법에 따른 폐쇄효과의 비교

이동경,윤수한,배광식 大韓齒科保存學會 1998 Restorative Dentistry & Endodontics Vol.23 No.1

The purpose of this study was to evaluate the sealing ability of various canal filling methods. Palatal roots of ninety extracted human maxillary molar teeth were resected at cementoenamel junction. Eighty of them were randomly assigned to four experimental groups, ten were served as positive and negative controls. All canals were prepared to #40 using Profile. Experimental groups were obturated by lateral condensation technique, Thermafil technique, Continuous Wave of Condensation Technique, and down-pack & back-fill technique of Obtura-Ⅱ, each with root canal sealer. Control groups were not obturated. Teeth were immersed in resorcinol-formaldehyde resin for 5 days at 4℃, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were then ground horizontally at 1.5mm(level 1), 2.5mm(level 2), 3.5mm(level 3) from the anatomical apex and examined with a stereomicroscope at ×40 magnification. The gap between the canal wall and the filling material, which was obtained by calculating the ratio of the area of the resin to the total area of the canal and was analyzed statistically(Rank-sum test). The results were as follows : 1. At the level 1, there was the greatest leakage in the Thermafil group and Obtura-Ⅱ group, and the difference between the Obtura-Ⅱ group and Continuous Wave of Condensation Technique group was statistically significant(p<0.05). 2. At the level 2, there was the least leakage in the Continuous Wave of Condensation Technique group, but there was no statistically significant difference between each group(p>0.05). 3. At the level 3, there was no statistically significant difference between each group(p>0.05).