소아 흉통의 원인질환에 따른 임상양상

장국찬,김은영,노영일,양은석,문경래,박영봉 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

목적: 소아에서의 흉통은 흔히 접하게 되며 일반적으로 좋은 경과를 보인다. 가장 흔한 원인으로 특발성, 골격계이상, 위장관계 질환 등이 다양하게 언급되고 있으며 감별진단이 쉽지 않아 여러 검사를 시행하게 된다. 자세한 병력청취와 진찰이 진단에 가장 중요하다고 하지만 통계적 의의를 보고한 바는 드물다. 이에 흉통 원인을 분류하고 각각의 임상양상을 파악하여, 병력 청취와 진찰소견의 감별진단에 대한 유용성과 시행 검사들의 의의를 알아보고자 하였다. 방법: 2004년 3월 부터 2007년 8월 까지 조선대학교 병원 소아청소년과에 흉통을 주소로 방문한 환아 77명을 대상으로 하였다. 연령, 성별, 흉통의 위치, 지속시간, 양상, 빈도, 방문까지 걸린 시간, 동반증상, 유발인자의 각 항목과 원인 질환과의 관련성을 분석하였다. 흉부방사선, 심전도, 심초음파, 24시간 Holter, 운동부하 심전도, 상부 위장관 조영술, 24시간 pH 검사, 위내시경, 심근효소를 검사 하였다. 결과: 평균 나이는 10.2±2.8세로 6세에서 11세까지가 48명(62.3%)으로 가장 많은 분포를 보였고 남아 42명(54.5%), 여아 35명(45.5%)이었다. 흉통의 위치는 좌측이 32명(41.6%), 양상은 콕콕 찌르는 것이 27명(35.1%)으로 가장 많았고 지속시간은 1분미만이 36명(46.8%), 1-5분 사이가 28명(36.4%)으로 대부분 5분 미만이었다. 흉통 원인은 특발성이 27례(35.1%)로 가장 많았고, 위장관 질환 23례(29.9%), 늑골 연골염 12례(15.6%), 심혈관 질환 7례(9.1%), 정신신체화 질환 6례(7.8%), 폐질환 2례(2.6%)였다. 여아에서 연령이 높을수록 정신신체화 질환의 빈도가 높았다(P= 0.046). 흉골 하부 통증을 호소한 17명 중 13명(76.5%)이 위장관 질환으로 통계적으로 유의하였다(P= 0.023). 정신 신체화 질환은 6명에서, 위장관 질환도 20명(86.9%)에서 흉통지속시간이 5분 미만이었으나 통계적 의의는 없었다. 흉통 양상 중 타는 듯한 양상을 호소한 7명중 6명에서 위장관 질환이 원인이었으나 통계적 의의는 없었다. 선택 시행 검사 중 심초음파는 32명중 3례(9.4%), 24시간 Holter 검사는 13명중 5례(35.7%), 24시간 pH 검사는 28명 중 16례(57.1%)에서 이상소견을 보였다. 결론: 소아 흉통 환자 중 연령이 높은 여아에서는 정신 신체화 장애를, 흉골 하부 통증을 호소한 경우는 위장관 질환을 먼저 생각하는 것이 좋다고 판단된다. 흉통원인으로 위장관 질환의 빈도가 높고 시행검사들의 진단율을 볼때, 소아 흉통 환아 에서는 상부 위장관 조영술 등 위장관 질환의 검사를 기본적으로 시행하는 것이 좋을 것으로 생각된다. Purpose: Chest pain in children is usually benign. Chest pain in children results from a wide variety of causes. Differential diagnosis of causes is not easy and then many diagnostic approach is trying. Careful history and physical exams must guide the assessment of children with chest pain. The purpose of this study intends to evaluate children with chest pain and usefulness of careful history, physical examination and several diagnostic examinations. Methods: From March 2004 to August 2007, 77 patients presented with chest pain were enrolled. we evaluated age, sex, characteristics of chest pain (location, duration, description, frequency), accompanying symptoms, increasing reasons and relationship with cause of chest pain. Chest x-ray and ECG were checked in all patients. Cardiologic and gastrointestinal evaluations were checked when considered necessary. Results: The male and female ratio was 0.55:0.45, mean age 10.2 ± 2.8 year. Common ages of chest pain were 10 to 12 years old (38case, 49.3%). The location was on the left precordium in 32cases (41.6%) of the patients. The most common diagnostic findings of chest pain were idiopathic(27cases, 35.1%), gastrointestinal disorder (23cases, 29.9%), costo chondritis (12cases, 15.6%), cardiovascular disorder (7cases, 9.1%), psychosomatic disorder(6cases, 7.8%) and pulmonary disorder (2cases, 2.6%). Older children in female were more likely to have a psychosomatic cause (P= 0.046). The patients complained chest pain on substernal area were 17cases and 13cases (76.5%) were diagnosed as gastrointestinal disorder (P= 0.023). Positive findings of echocardio graphy, 24hr Holter ECG and 24hr pH monitoring were present in 3 (9.4%), 5 (35.7%) and 16 (57.1%) of the patients respectively. Conclusion: Gastrointestinal disorders are common causes and positive diagnostic rate of gastrointestinal evaluation is relatively high in children with chest pain. Old girls are more likely to have a psychosomatic disorder and substernal pain is the reliable sign to be considered as a gastrointestinal disease in children with chest pain. Hence, Diagnostic approach of gastrointestinal disease such as upper GI should be performed basically in mostly children with chest pain.

Prednisolone과 Prednisone의 임상약동학적 평가

신재국,윤영란,차인준,이경훈,장인진,신상구,박찬웅 大韓臨床藥理學會 1994 臨床藥理學會誌 Vol.2 No.1

Fe基 非晶質形成에 미치는 半金屬(P, C, B)의 影響

鞠辰善,陳永喆 全北大學校 1996 論文集 Vol.42 No.-

The effects of Metalloids(P, C, B) addition on the amorphous formation range, thermal stability and crystallization behavior of Fe_100-XC_X, Fe_100-XP_X, Fe_100-XB_X, (X=14, 17, 20at%)alloys were investigated by the XRD, SEM, TEM and DSC. The results were summarized as follows; 1. Binary Fe-P and Fe-B alloys were amorphized in the composition range of 17 to 20at%P and 14 to 20at%B by melt spinning. On the other hand, binary Fe-C alloys were not amorphized in the composition range of 14 to 20at%C because of precipitation bcc-Fe and Fe_3C. 2. The value of T_g/T_m was estimated over 0.45 when the content of P is 17at%, 20at% and that of B is 14at%, 17at% and 20at%. In this value(T_g/T_m ≥ 0.45), it was shown that amorphization is possible.

퍼지구조모델링법을 이용한 중소기업의 평가기준에 대한 의식구조분석

박영화,황승국,이상완 동아대학교 공과대학부설 생산기술연구소 1998 生産技術硏究所硏究論文集 Vol.3 No.2

This paper intends to analyze the consciousness structure for the criteria of medium and small enterprise using Fuzzy Modeling method on the basis of fuzzy theory. As the subject of this study, 15 middle management who play the leading role each enterprise was chosen. Also, they were answered the questionare of 14 items which can be comsidered for evalustion of medium and small enterprise. Using Fuzzy Structural Modeling method, we derived the graphic structure for their consciousness from the evaluation of the 14 items.

퍼지回歸分析을 利用한 材料費의 評價

黃承國,朴盈滿,姜鎬郁 慶南大學校 附設 工業技術硏究所 1991 硏究論文集 Vol.9 No.-

本論文은 自動車關聯産業에서의 서브어셈블리에 대한 單位當總投入材料費와 總純材料費와의 關係를 評價하는 問題를 다룬다. 投入材料費와 純材料費사이에 퍼지니스가 存在한다고 看做하여, 可能性모델을 根據로 하는 퍼지線形回歸分析을 利用하여 各서브에셈블리의 係數를 퍼지數로 求하는 材料費評價問題를 解決하고자 하는 새로운 手法이다. This paper purposes to estimate the relation between total input material cost and total net material cost of sub-assembly in an automotive industry. We suggest a new method to estimate the parameters of each sub-assembly which has fuzzy numbers. We used the fuzzy linear regression analysis based on possibility model in the material cost problem.

植物凝集素 Trichosanthes kirilowii Max. 및 랫트 赤血球에 의한 사람 血淸型에 관한 硏究

朴永勝,文國鎭 고려대학교 의과대학 1987 고려대 의대 잡지 Vol.24 No.1

Some plant extracts are known to have biological activities as phytagglutinins (PHA's) and, in recent medicolegal studies, human sera were classified by their agglutination inhibiting properties to animal red blood cells. Trichosanthes kirilowii Max. acts as pan-PHA to rat red blood cells. Therefore the author carried out agglutination inhibition test on Trichosanthes kirilowii Max. extract to rat red blood cells with 862 human sera, 51 stained sera, 24 stained whole blood specimens, and the results are compared with known blood and serum types. The results are obtained as follows; 1. Human sera could be classified into two groups. One group inhibited agglutinating activities of Trichosan thes kirilowii Max. extracts to rat red blood cells and the other did not. 2. The distribution of the former was 5% and the latter was 95%. 3. The agglutination inhibiting phenomena of human sera on Trichosanthes kirilowii Max, extract to rat red blood cells showed no constant relation with known blood and serum types such as ABO, H, CI, ab.C, CCI, PVI, and TKI-M respectively. 4. This new classification of human sera is considered to be applicable to individual identification of blood strains.

역률 개선용 칩을 사용한 플라이백 방식의 능동역률 보정기

정영국 대불대학교 1998 論文集 Vol.4 No.1

In this paper, Implementation of flyback type active power factor corrector using a power factor control chip has been proposed. The ML4813 chip made by Micro-linear is used to implement a discontinuous mode flyback power factor regulator for power factor improvement and harmonic reduction. It is the only controller that is optimized for control of a discontinuous flyback type active power factor corrector with low cost and low power voltage control mode. PWM duty ratio of controller is constant at any given line and load condition and over voltage/over current comparator inside controller is used to protect switching device. To verify the validity of the proposed system, the experiment has been achieved in detail under steady state conditions. With the proposed flyback circuit, near unit power factor and harmonic reduction of dc power supplies for power electronics applications are easily achievable with a minimum of external components.

植物凝集素 Agastache rugosa에 의한 사람尿의 型分類에 關한 硏究

朴永學,文國鎭 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.1

Agastache rugosa agglutinnin used in this study reacts as panphytagglutinin on human red blood cells. Agglutination inhibition tests of phytagglutinin, Agastache rugosa and human red blood cells and chicken red blood cells were performed respectively, using 268 cases of human urine, and compared them with the known saliva types, blood groups and serum types and compared them with type of saliva which was classified by Agastache rugosa agglutinin and ABO, MN blood groups and which was classified by Agastache rugosa agglutinin. The results could be summarized as follows; 1. Human urine could be classified into two groups. One group inhibited agglutination activities of Agastache rugosa agglutinin to human red blood cells and the other did not. Among the investigated 268 human urines, the frequency of the former was 25% and the latter was 75%. 2. Among 268 urine specimens tested, 20% inhibited the agglutination activities of Agastache rugosa agglutinin to chicken red blood cells, while 80% did not. 3. The human urine type classified by the agglutination inhibition status of Agastache rugosa and human red blood cells showed close correlation with which was classified by the agglutination inhibition status of Agastache rugosa agglutinin and chicken red blood cells. But all of that two classification had no constant relation with the human saliva type which classified by Agastache rugosa. 4. The distribution of each of the two above-mentioned human urine type had no relation with ABO and MN blood groups.

수술 고위험군에서 양측 내경동맥 협착증에 대한 동시 스텐트 시술

윤영섭,심원흠,편욱범,전국진,박경진,장양수,조승연 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.9

齒科用 Amalgam合金의 壓縮强度에 關한 實驗的 硏究

鮮于良國 대한치과기재학회 1982 대한치과재료학회지 Vol.9·10 No.1

The purpose of this paper was to study the compressive strengths of 4 different dental amalgam alloys. Two Korean made alloys and other two Japanese alloys were crushed as the test specimens, namely SH-S, SH-F, SP-S and GC-S respectively. The cylinder shape specimen were prepared with 4mm in diameter and about 8mm in length in accordance with the A.D.A. specification No.1. The crosshead speed of 0.05mm per minute was applied to crush the specimen. The model of the universal testing mechine was the Instron Model 1125. The results were as follows: 1. The compressive strength of the SH-F group showed the lowest values. The order from low to high was as follows: SH-F, SP-S, SH-S, GC-S. 2. SH-S group showed higher strength value than SP-S group and lower than GC-S group. 3. The spherical alloys showed higher strength values than the lathe-cut alloys.