腹部疼痛에 應用되는 經?에 對한 文?的 調査

金良奎,崔容泰 慶熙大學校韓醫科大學韓醫學硏究所 1981 慶熙韓醫大論文集 Vol.4 No.-

교통사고 발생요인에 따른 인적 피해정도 분석

양관철,이태용,류기하 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

To know the severity and frequency of motor vehicle injuries by the attributing risk fators, the auther analyzed the automobile injury risk factors by human factor, motor vehile factor and physical/social environmetal foctors. The 541, cases were randomly sampled from motor vehicle accidents in Taejon Area during one year through 1990. The results were summarized as follows : 1. Of the total 541 injuries 37.5% belonged severe case and 62.5% were slightly injured case. 2. The high risk factors of severe motor vehicle injuries were as follows Human factors : 20s' -30s' age groups, over 6 years driving carriers, careless of passer by, overspeed, drunken driving. Motor vehicle factors : Cab, driving speed of over 60Km/hr, the accident of car vs human. Road factors : Straight road, cross work, the road of residential and rural area Environmental factors : Winter time, cloudy, raniny and snowy weather around midnight hours.

제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

신경섬유종증 환자에서 상완신경총 병변의 소견을 보인 척추 신경섬유종

양충용,박효인,박순아,박종태,정선관,신용일 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

본 증례는 50세 여성의 제 1형 신경섬유종 환자로서 척추 신경섬유종에 의해 초기 상완신경총 병변 소견을 보였다. 약 4개월 동안 후경부통, 좌측 견관절, 좌측 상완의 마비를 보였으며, 초기 전기진단학적 검사상 경수 5번과 6번 신경근을 중심으로 쇄골상부 신경절전성 상완신경총 병변이 관찰되었다. 그러나, 액와 자기공명영상, 초음파검사, 단순 방사선검사, 골주사 등의 영상학적 검사에서는 심한 흉추 척추 전-측만증과 경수 뇌경막에 확장 소견을 제외하고는 상완신경총 병변의 소견은 관찰되지 않았다. 7개월경과 후, 좌측 상지 및 양측 하지의 근력 저하, 경수 4번이하의 감각 저하, 경도의 흉통을 동반한 호흡곤란이 진행되었다. 응급으로 시행된 경수 자기공명영상에서 좌측 경수 3번과 4번에 경막내 액와-속질의 신경종양이 진단되었다. 수술적 처치를 시행하였으며, 거시적 관찰상 척수 신경섬유종이 진단되었다. 급격히 진행하는 척수 신경섬유종은 초기에 상완신경총의 신경근 병변의 소견을 보일 수 있으므로, 신경섬유종증 환자에서 상완신경총 병변의 진단에 세심한 주의를 요한다. We observed a patient with symptom similar to brachial plexus lesion caused by spinal neurofibroma in a 50-year-old female with a history of neurofibromatosis-1(NF-1). She presented with posterior neck, left shoulder and left upper arm paralysis of 4 months duration. The initial electrodiagnostic study(EDS) revealed supraclavicular preganglionic brachial plexus lesion of mainly involved left C5 and C6 roots. However, radiological imagings including axillar MRI, ultrasonography, cervical plain radiography and bone scintigraphy showed no definitive brachial plexus disease except cervical dural dilation and severe thoracic scolio-Iordosis. On 7 months after the first admission, she had aggravated muscle weakness on the left upper arm and both lower extremities, sensory impairment below C4 and respiration difficulty with the chest pain. Emergency MRI showed intradural axillar-medullary neurogenic tumor at the left C3-C4. Subsequently, the patient was treated with surgical resection. Grossly specimen examination displayed the presence of a spinal neurofibroma. In rapidly progressing spinal neurofibroma represented firstly as root lesion of brachial plexus in EDS, the physician should pay scrupulous care to evaluate the cause.

대동맥 이첨판과 승모판 이탈증을 동반한 대동맥 판하부 협착 1예

김용화,장경식,양태영,임영국,안기완,홍순표 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Discrete subaortic stenosis is a rare cardiac disorder especially in Orientals which occupies eight to ten percent of aortic stenosis, It occurs mainly before age of eighteen and accompanies with aortic valve abnormalities such as aortic stenosis, supravalvrlar stenosis, bicuspid valve and muscular hypertrophic subaortic stenosis, and other cardiac abnormalities such as ventricular septal defect, pulmonary stenosis and coarctation of aorta. There is no report of discrete subaortic stenosis accompanied with mitral valve prolapse. The major complications of discrete subaortic stenosis are aortic insufficiency, and subacute bacterial endocarditis. We report a case of asymptomatic nineteen-year-old male of discrete subaotic stenosis with bicuspid aortic valve and mitral valve prolapse, which is comfirmed by two-dimensional and Doppler echocardiography including transesophaigeal echocardiography.

체외순환 없이 시행한 관상동맥우회술의 조기성적

원태희,최세용,양인숙 이화여자대학교 의과대학 2005 EMJ (Ewha medical journal) Vol.28 No.1

Background : The advances in surgical techniques and stabilizing devices have made the off-pump coronary artery bypass (OPCAB) popular, and good results have been published. We analyzed the early results of OPCAB performed in our hospital. Materials and Methods : Between January 2004 and December 2004, 23 patients underwent OPCAB. There were 14males and 9 females with mean age of 62.6± 10.3years. Preoperative diagnoses were unstable angina in 13(57%), acute myocardial infarction in 9(39%), and stable angina in 1(4%). Preoperative angiographic diagnoses were three-vessel disease in 12 (52%), two-vessel disease in 8(35%), one-vessel disease in 1(4%), and left main disease in 2(9%). Results : The mean number of grafts was 2.6 ±0.9 per patient. Vessels accessed were left anterior descending artery in 23, diagonal branch in 14, obtuse marginal branch in 9, right coronary artery in 12, and posterior descending artery in 1. Left internal mammary artery were used in 22 patients and bilateral internal mammary arteries were used in 1 patient. There was no operative mortality. Postoperative complications were cerebral vascular accident in 1, postoperative bleeding which required operative management in 2, arrhythmia including atrial fibrillation in 5, and minor operative wound problem in 1. Pre-discharge graft patency was evaluated in 11 patients. One internal mammary artery graft was occluded in 11 internal mammary artery graft evaluated. The patency rate was 91%. Seventeen saphenous vein grafts were patent in 19 saphenous vein grafts and the patency rate was 89%. Conclusion : Our result of OPCAB is promising and OPCAB is suggested to be the ideal technique with less morbidity and mortality.

3차 의료기관 응급실로 내원한 안면부 열상 환자에 대한 임상적 고찰

김양원,안성훈,류석용,김홍용,전병민,김기태 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: Facial laceration is a common clinical problem in the emergency room that is frequently associated with other craniofacial injuries. It elicits an emotional response from the patient because of the underlying concern of permanent scar and secondary facial disfigurement, so they demand prompt and adequate treatment. The aim of this study is to analyze the incidence, etiology, depth, and site of facial lacerations to provide basic data for further understanding. Method: This study reviewed 1,043 facial-laceration patients treated in the emergency room at Pusan Paik Hospital between March 1999 and February 2000. This retrospective study was done by reviewing and analyzing the sex and age distributions, the monthly and daily distributions, the causes of injury, the types of injury, the sites of injury, the lengths of the lacerations, and associated injuries. Results: The sex ratio of men to wemen was 2.4:1, and the 0~10 age group was at the top of the age distribution. The number of patients was the highest on sundays and during March. About 9.2% of the patients visited the emergency room between 10:00 P.M. and 11:00 P.M. Falls(38.1%) were the most common cause of facial laceration, and deep laceration(51.8%) was the most common type of facial laceration. The most common laceration site was the forehead, followed by the chin and the nose. The most common associated craniofacial injury was facial bone fracture(39%), Facial-lacerations were sutured by plastic surgeons(80%), emergency physicians(10%), and oromaxillofacial surgeons(10%). We found statistical significance in the types and lengths of lacerations between men and women, among age groups(p<0.05). Conclusion: Facial laceration is one of the most common craniofacial injuries in the emergency room. By now, most lacerations have been repaired by plastic surgeons, But, the causes of lacerations are diverse and many patients are admitted due to the associated injuries. Therefore, emergency physicians should participate more aggressively in the care of facial-laceration patients to improve the outcome of the patients.

자전거 교통류 특성에 관한 연구

손영태,양충헌 명지대학교 산업기술연구소 2001 産業技術硏究所論文集 Vol.20 No.-

The purpose of this paper is to study the fundamental characteristics of bycycle flows. Several experiments were conducted to obtain the characteristics of bycycle flows, speed variation along a curve radius, bicycle driver's traveling territory and saturation flow rate at signalized intersection. Bicycle facilites are categoried into uninterrupted and interrupted, the capacity of uninterrupted is approximately 5000bic/h. and that of the interrupted (at signalized intersection) is approximately 3000 bic/h. When a curve radius is over 20m , bycycle speed is not increasing. Bicycle driver's traveling territory is used to occupancy area. it is the same concept as pedestrian's. Bicycle occupancy area is to be divided into circulation zone, comfort zone and collision zone. Circulation zone is over 2.212×4.1m and collision zone is less than 0.96×2.47m. Comfort zone is defined as intermediate state between two zones.

댐 건설전후 유역의 장기유출특성변화의 분석 : I.GIS를 이용한 NWS-PC 모형의 매개변수 추정

윤용남,유철상,안재현,양인태,고덕구 江原大學校 附設 環境硏究所 1998 環境硏究 Vol.15 No.-

본 연구에는 CIS를 이용하여 장기유출 해석 모형의 하나인 NWS-PC모형의 매개변수를 얼마나 적절히 추정할 수 있는가에 대해 알아보았다. 수치표고모형, 수치토양도 및 인공위성영상을 분석하여 얻은 토지이용도 등을 기본 자료로 이용하였고 소유역별 특성값을 GIS를 이용하여 추출하였다. 이러한 특성치들은 Amstrong(1978)에 의거하여 소유역별 모형의 매개변수를 추정하는데 직접이용된다. NWS-PC 모형의 경우 추정된 매개변수는 가능한 값의 범위로 주 This study is to see how effectively the NWS-PC model parameters can be estimated using GIS. Basic informations such as DEM(Digital Elevation Model) ,digital soil map, land use information from satellite image are provided and analyzed for estimating the sub-basin characteristics in GIS. These charcateristics are used to estimate the model parameters for each sub-basin. The model parameters estimated based on Amstrong(1978) are given as a possible range, which will be fixed through the calibration procedure. In this study, we used the1974 data for calibration and the 1979 event for verification. From the calibration procedure, we could find that the parameters related with infiltration and water tend to have the minimum value of the range and that the parameters related with exfiltration of water tend to have the maximum value of the range This result seem to reflect the hydrologic characteristics of Keum-river basin, which could be used to fix the model parameter without difficult calibration procedure. The simulation results show that the relative error of calculated discharge to observed discharge to be within approximately 10% . Therefore, the model with the parameters calibrated was considered to be adaptable for long-term runoff analysisf or Keum-river basin.

여재 특성에 따른 생물막여과 공법의 처리특성에 관한 연구

강용태,양희천,송근관,권혁원 동아대학교 건설기술연구소 1999 硏究報告 Vol.23 No.2

In the biofilteration process, the removal of turbidity, color, KMnO₄consumpion, NH₄^(+)-N and UV254 reached 98%, 95%, 70%, 85%, 79% respectively. The stable removal efficiency was obtained by the direct filteration after coagulant dosage, though the influent was muddy and highly polluted. The exhausted GAC was used as the media of biofilter, which obtained stable removal efficiency compared with the other medias such as GAC, ZEOCARBON. Effluent of sorptived THMs was not found after 45 days during filter run time. And the case of dual media filteration was prior to single media filteration in the headloss development and quality of effluent. In the case of the ozone dosage rate was determined the color of biofilteration in the AAWTS system. 1㎎/L ozone dosage was proper when the color was below 8 unit.