전격성 경과를 취한 만성 호산구성 폐렴 환자 1예

윤호상,진춘조,유광하,이상엽,이수인,정상만,김선두,이순제,이길도,전혜정 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Chronic eosinophilic pneumonia(CEP) is a rare disease of unknown etiology characterized by chronic infiltration of the lung with eosinophils. It presents with profound systemic symptoms comprising fever, night sweats, weight loss, dyspnea and blood eosinophilia with nonsegmental air-space consolidation confined to the outer third of the lung, the "photographic negative of pulmonary edema". Histopathologic features of chronic eosinophilic pneumonia are intraalveolar and interstitial infiltrations with eosinophils, histiocytes, giant cells, scattered lymphocytes and plasma cells. Glucocorticoid therapy cause prompt resolution of symptoms as well as disappearans of blood eosinophils, elevated serum Ig E levels and the roentgenographic lesions. Infrequent radiographic findings include nodular infiltrates, consolidations, cavitations, atelectasis and pleural effusions. Deaths from CEP although rare, have been reported, but the majorities of CEP have benign courses and do not need a therapy with ventilator. We report a case of chronic eosinophilic pneumonia, which had a sudden course associated with diffuse pneumonic consolidations on the both lung and bilateral pleural effusion.

식품내의 미생물 분리를 위한 dryfilm 방법의 평가연구

하상도 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.2

본 실험에서는 식품내 미생물을 분리하는 불편한 전통적 agar 배지법을 대처하기 위하여 간편하고 정확한 3M Petrifilm^TM을 이용한 dryfilm 방법을 비교, 평가하였다. 총균수 분리배지인 standard method agar (SMA)와 Petrifilm^TM standard method (PSM, 3M)는 P<0.05 범위에서 우유, 간 쇠고기, 탁주, 밀가루, 어묵의 다섯 가지 식품으로 부터의 균분리 능력에 있어 유의적인 차이가 없었다. 우유와 육류로부터 분리된 coliform 수와 E. coli 수는 brilliant green lactose broth (BGLB)에 의한 MPN법과 Petrifilm^TM coliform count (PCC, 3M)법을 사용했을 때 그리고 EC broth에 의한 MPN법과 Petrifilm^TM E. coli count(PEC, 3M)법을 사용했을 때 각각 P<0.05 범위에서 유의적으로 차이가 없었다. 우유로부터 분리된 coliform 수는 P<0.05에서 violet red bile agar(VRBA)와 PCC(3M)간에 유의적 차이을 보이지 않았으나 육고기 시료를 사용하였을 때 PCC(3M)는 VRBA에 비하여 유의적으로 적은 수의 coliform을 분리하였다. 탁주 시료내의 효모와 밀가루 시료내의 곰팡이를 분리하기 위한 배지인 acidified potato dextrose agar(APDA)와 Petrifilm^TM yeast & mold count(PYMC)를 비교하였는데, 균 분리능력에 유의적 차이를 보이지 않았다. 이 결과로 3M Petrifilm^TM을 이용한 dryfilm 방법이 제조시간이 길고, 불편한 전통적 agar 이용법의 좋은 대처방법으로 사용될 수 있다는 것을 알 수 있다. Dryfilm method by using 3M Petrifilm^TM has been examined to replace conventional agar method for isolation of microorganisms from foods. The objectives of the present study were to evaluate suitability of dryfilm method as a microbilal isolation method and to determine the effect of antimicrobial agent on dryfilm for isolation of microorganisms from foods. Five different foods, milk, ground beef, fishery surimi, Takju and wheat flour were used to isolate the natural microflora in foods and inoculated Escherichia coli. Standard method agar (SMA, Difco) and Petrifilm^TM aerobic count (PAC, 3M) were used to isolate total microorganisms from foods. Violet red bile aga (VRBA), brilliant green lactose bile (BGLB) broth and Petrifilm^TM coliform count (PCC, 3M) were used to isolate coliforms from foods. E. coli broth (EC broth) and Petrifilm^TM E. coli count (PEC, 3M) were used to isolate E. coli from foods. Acidified potato dextrose agar(APDA) and Petrifilm^TM yeast & mold count (PYMC, 3M) were used to isolate yeasts and molds from foods. Total aerobic plate counts isolated from five different foods by SMA and PAC (3M) were not significantly different each other at P<0.05 level and were highly correlated each other (≥0.96). Mugwort extract as an antimicrobial agent did not affect microbial enumeratiion of Dryfilm. Significantly higher number of coliform colonies were formed on VRBA than PCC (3M) form ground beef, but they were not significantly different in coliform colonies from milk samples. PCC (3M) and BGLB were not significantly different for enumeration of coliforms in milk and beef samples. Significantly higher number of E. coli were isolated by EC broth than PEC from ground beef, but these were not significantly different for enumeration of E. coli from milk. Yeast and mold counts isolated from Takju and wheat flour by APDA and PYMC (3M) were not significantly different at P<0.05 level. These data indicate that dryfilm method by using 3M Petrifilm^TM can be successively used as an alternative to conventional agar method for enumeration of microorganisms in various foods.

교정용 각형선재에 부여된 torque가 브라켓에 발생시키는 모멘트에 관한 유한요소법적 분석

하도원,김영석,성재현 대한치과교정학회 2001 대한치과교정학회지 Vol.31 No.3

교정용 각형선재에 부여된 torque가 브라켓에 발생시키는 모멘트에 관한 유한요소법적 분석 본 연구의 목적은 교정치료의 마무리 단계에서 바람직하지 못한 순설측 경사를 가진 한 개 치아의 이동을 원할 때 브라켓 슬롯의 크기와 각형선재의 종류,크기에 따라 부여하여야 할 적절한 임상적 torque(SWA의 각형선재에서 나머지 편평한 부분과 이동을 위해 변형시킨 부분의 단면이 이루는 각도만큼의 torque)의 양을 구하고자 하는 것이다 임상적 torque는 play와 active torque(브라켓에 모멘트를 전달할 수 있는 torque)의 합으로 구성되는데, play는 수학적 공식을 이용하여 계산하였고 arrive torque는 컴퓨터를 이용한 삼차원 유한요소 법으로 구하였다. 유한요소모델은 일렬로 배열된 세 개의 브라켓과 여기에 삽입된 stainless steel, TMA, NiTi 이렇게3가지 종류의 교정용 각형선재로 구성된다. 양쪽의 브라켓을 일정한 각도로 비틀어서 가운데 브라켓에 발생하는 모멘트를 계산하였다. 선재의 크기는 많이 사용되는 각형선재인 .016" X .022", .017" X .022", .017" X .025", .018" X .025", .019" X .025" .020" X .025", .021" X .025"의7개로 디자인하였다. .018" 브라켓에는 .016" X .022", .017" X.022", .017" X .025" 선재를 삽입하여 실험하였고 .022" 브라켓에는 .016" X .022" 선재을 제외한 나머지 전재를 삽입하여 실험하였다. 실험으로 다음과 같은 결과를 얻었다. 1.삽입된 브라켓 슬롯의 크기에 상관없이 같은 크기와 재질의 교정용 각형선재에 같은 active torque를 가하면 동일한 모멘트가 발생하였다. 2.선재의 크기가 증가될 수록 동일한 active torque에 의해 발생되는 모멘트의 양은 증가하였다. 실험에 사용한 가장 굵은 선재인 .021" × .025" 선재는 동일한 재질의 가장 가는 .016" X .022" 전재에 비해 약 1.75배 더 큰 torsional stiffness를 가졌다. 3.선재의 재질에 따라서는 stainless steel, TMA, NiTi순으로 torsional stiffness가 감소하였는데 stainless steel에 비해 TMA는 0.35배, NiTi는 0.16배 였다. 4.브라켓간 거리의 증가와 발생되는 torsional stiffness는 반비례하였다 브라켓간 거리의 증가에 의해 감소되는 torsional stiffness의 비율은 선재의 재질과 상관이 있었고 크기에 따라서는 큰 차이가 없었다. 5.교정치료의 마무리 단계에서 이상적인 순설측 경사이동을 일으키는 임상적 torque의 공식과 값을 구하였다. (주요 단어 : 임상적 토오크, 액티브 토오크, 모멘트, 유한요소법) The purpose of this study was to investigate the ideal clinical torque(In the SWA rectangular wire, the torque by the angle between the plane part and twisted part to move the tooth) of the orthodontic rectangular wire which produce the proper labiolingual movement of the single tooth during finishing stage of the orthodontic treatment. The clinical torque is the sum of the play and the active torque which generates the moment at the bracket. The play is calculated by the formula and the active torque is calculated by the computer aided three-dimensional finite element method. The finite element model was consist of the three brackets which formed a row and 3 kinds of orthodontic rectangular wire(stainless steel, TMA, NiTi) which inserted in brackets. Both sides of the model were twisted and the moment generated in the center bracket was calculated. The sizes of seven wires which were used commonly were .016" X .022", .017" X .022", .017" X .025", .018" X .025", .019" X .025", .020" X .025", .021" X .025". In 018" bracket, 016" X .022", ,017" X .022", .017" X .025" wires were inserted and in 022" bracket, all the sizes of wires except .016" X .022" were inserted and tested. The following conclusion could be drawn from this study. 1.The moment generated on the same size of the wires by the same active torque were equal regardless of the bracket slot size. 2.The moment were increased with the size of the wires. The moment generated on the .021" X .025" wire was about 1.75 times as large as that on the .016" X .022" wire regardless of the material. 3.The moments were increased in the order of the NiTi, TMA, stainless steel. The moment of the TMA wire was 0.35 times as small as that of the stainless steel wire and the moment of the NiTi was 0.16 times as small as that of the stainless steel wire. 4.The moment was decreased as the interbracket distance was increased. 5.To get a desired moment with the specific size and material of the wire on the specific bracket slot, the formula and the results were displayed. Key words : Clinical torque, Active torque, Moment, Finite element method

뇌실외 배액술 시행과 관련된 뇌실염 : 원인균주와 경험적 치료약제의 적절성

도병훈,김신우,오종택,손종원,하상우,이응갑,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 본 연구는 뇌실외 배액술을 시행한 신경외과 환자들에서 뇌실염 발생 빈도, 원인균주와 감수성 추이 및 경험적 치료로 사용되는 항생제인 ceftazidime과 vancomycin의 적절성 여부에 대하여 조사하였다. 재료 및 방법 : 2000년 12월부터 2003년 10월까지 EVD를 시행한 경북대학교병원 신경외과 입원환자 340명 중 뇌실염이 발생한 39명을 대상으로 후향적으로 조사하였다. 결과 : 340명 중 39예 (11.5%)에서 뇌실염이 발생하였고 이들 가운데 4명이 뇌실염과 연관하여 사망하였다(10.3%). EVD 시행일로부터 뇌실염 발생까지는 평균 8.4일이었다. 원인균은 33예(87.1%)에서 확인되었으며 Aci-netobacter (19예, 45%), methicillin-resistant coagulase negative Staphylococcus (9예, 22%), methicillin-resistant Staphylococcus aureus (9예, 22%) 등의 순이었다. 가장 많이 동정된 Acinetobacter 19예 중에서 8예(42.1%)가 ceftriaxone에 내성을 보였으며 현재 경험적으로 널리 사용되는 ceftazidime에 대해서는 11예중 3예(27%)가 내성을 보였다. 결론 : 최근 EVD 시행과 관련된 뇌실염 뇌실염 최근 그람음성 non-fermenter 특히 Acinetobacter에 의한 경우가 증가하고 있으며, 이들 그람음성 non-fermenter는 현재까지 경험적으로 사용되는 ceftazidime에 점차 내성을 보이고 있다. 경험적 치료제에 대한 성공률을 높이기 위해서는 각 병원별 내실염의 원인균주의 감수성에 대한 검사가 필요하겠다. Purpose : To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. Materials and Methods : Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. Results : Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows : Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. Conclusion : These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.

SF_6 플라즈마에 의한 에칭 프로세스의 적용

하장호,정도영,이상호 三陟大學校 2001 論文集 Vol.34 No.1

In this paper, RFICP equipment is designed and manufactured with the aid of high frequency discharge to produce uniform plasma with high density and large diameter. And SF6 gas is used to investigate plasma characteristics. The electron density and temperature, potential dependence of SF6 plasma in accordance with its operating pressure, gas flux and input power are measured by the method of Langmuir probe. The etching characteristics of the plasma is researched in accordance with operating pressure, gas flux, input power to apply to Silicon Wafer which is used in the field of semiconductor process. The proposed RFICP equipment, in this paper, has relatively excellent etching characteristics, and is thought to be element of oxidization-sheath etching facility in semiconductor manufacturing process.

위장관선암에서 Secretory Component의 분포에 관한 연구

김도진,양승하,강상균 순천향대학교 1992 논문집 Vol.15 No.2

Secretory component(SC) is a portion of secretory IgA and acts as a specific receptor to IgA, This component has specificity in glandular epithelial cells only. Also this specificity maintain in adenocarcinoma of organs. Therefore, to understand the correlationship of SC along the differentiation of adenocarcinoma of various organs such as stomach, small and large intestine, and gallbladder, 57 cases were subjected(stomach 27 cases, small intestine 4 cases, large intestine 24 cases, and gallbladder 2 cases). And then performed immunoperoxidase stain by Avidin-Biotion-Comprex method using anti-SC serum, were performed then analyzed their histologic reaction. Results obtained are following as : 1. Rositive reaction of SC in adenocarcinoma of each organ showed 17(63%) of 27 cases in the stomach, 3(75%) of 4 cases in the small intestine, 18(75%) of 24 cases in the large intestine, and 1(50) of 2 cases in the gallbladder. 2. Positive reaction of SC showed difference along the dirrerentiation of the adenocarcinoma of the stomach, bearing 6(86% 0 of 7 well differentiated, all of 8 moderately differentiated and 3(25%) of 12 poorly differentiated cases. 3. In the adenocarcinoma of the large intestine, positive reaction of SC was 13(93%) of 14 cases in well differentiated form, 5(71)% of 7 cases in moderately differentiated, and 1(33%) of 3 cases in pooly differentiated form. 4. Adenocarcinoma of the small intestine showed positive reaction of SC all of well differentiatel form and 1(50%) of 2 cases of moderately differentiated form. Adenocarcinoma of the gallbladder showed positive reaction in 1 of moderately differentiated and negative reaction in 1 of poorly differentiated form. Above findings reveals that adenocarcinoma of each organs has almost simillar positivity rate of SC, but difference according to differentiation of the carcinoma.

現場監督者의 意識과 行動實態에 관한 比較硏究 : 韓國과 日本을 中心으로

李相道,宋瑞日,河正鎭 동아대학교 공과대학 부설 한국자원개발연구소 1981 硏究報告 Vol.5 No.2

This study is to show the way in which supervisors in this country will do after investigating how Korean and Japanese supervisors' consciousness and behavior have been changed under various environment condition of the company.

경피적 겸자 정복 및 골수강내 금속핀 고정을 이용한 쇄골 골절의 치료

홍기도,하성식,정남식,심재천,김경호 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적 : 경피적 겸자 정복 및 골수강내 금속판 고정술을 이용한 쇄골 간부 골절의 치료에 대해 유용성을 규명해 보고자 하였다. 대상 및 방법 : 2002년 1월부터 2003년 7월까지 본원에서 쇄골 간부 골절 환자 중 신경 및 혈관 손상이 없었고, 골절의 분쇄상이 비교적 적었던 총 16례를 대상으로 겸자를 이용한 경피적 정복 후에 골수강에 금속판을 삽입하여 고정하였다. 술 후 유합 정도 및 결과를 임상적, 방사선학적으로 분석하였다. 결과 : 방사선학적으로 골유합을 보인 경우가 총 15례였으며, 술 후 평균 9.1주에 유합 소견을 관찰하였다, 임상적으로 강 등의 기준에 따라 구분한 결과, 우수 이상이 14례로 나타났다. 1례에서 1주 만에 K-강선의 내측전위로 골절부위가 재전위되어 관혈적 정복 및 금속판 내 고정을 시행한 이외에 다른 주요 합병증은 없었다. 결론 : 저자들의 방법은 수술시간이 짧고 간단하며, 연부조직의 추가적 손상이 적어 골유합율이 높고, 수술 반흔을 남기지 않아 수술적 적응을 신중히 고려한다면 쇄골 간부 골절의 치료법의 하나로 유용할 것으로 사료된다. Purpose: To investigate the utility of surgical treatment of clavicle shan fracture using a percutaneous towel clip reduction and intramedullary fixation. Materials and Methods : This study was conducted for total 16 case of patients who had no neurovascular injury and a few comminuted bone fragment among patients with clavicle shaft fracture from January 2002 to July 2003. The method of operation was percutaneous towel clip reduction and intramedullary fixation. The clinical and radiological results were evaluated. Results : Radiologically, 15 cases showed bone unions and the avenge time was 9.1 weeks. According to Kang's criteria clinically, there were 14 cases which were more than an excellence. One case substituted open reduction and nailing fixation due to a medial migration of K-wire and re-displacement of fracture even in 1 week. However, there wasn't any other major complication. Conclusion : Due to its having no additional injury to soft tissues, no scar formations, and its short operation time, percutaneous towel clip reduction and intramedullary fixation will be very useful as one of the treatments of clavicular shaft fracture if it follows correct surgical indications.

사용자 수술명과 수술분류 code(ICD-9-CM) 일치율 향상에 관한 연구 : 수술실 OCS program 사용 활성화를 통하여

최향하,김미영,김도진,유지원,장정화,박수정,박재성 한국의료QA학회 2005 한국의료질향상학회지 Vol.12 No.1

Background : The necessity of unify and standardize codes used at hospital has been emphasized since OCS (Order Communicating System) was adopted. Therefore, the purpose of this study were to standardize operation code by continuous training of the ICD-9-CM code that is used as standard code in OCS program at operating room. Method : In 400 operation data, operation code entered in OCS program at operating room was compared to operation name recorded in medical record. In addition, a matching rate between input data of operation code by medical record department and computing input data of operation code in 3,710 cases was compared for each department. User operation name and operation code were matched and major diagnosis by operation department and operation name were also matched. Results : User operation name was reflected in operation classification code in detail, and operation code entered on user was registered. Input rate and matching rate of operation code were gradually improved after improvement activity. In particular, a matching rate was high at ophthalmology where operation name is segmented. Plastic surgery and orthopedics with a lot of emergency operation and comprehensive operation name show low input rates. Conclusions : As the medical field makes progress in computerlization, awareness of information exchange and sharing becomes higher. Among codes to classified medical institution, codes related to surgical operation are all different by user of hospital and department. Computerlization and standardization is essential. And when efforts of standardization continue in alliance with individual hospital and institution, initiative of preparing medical policy data at a national level will be accelerated.

소아 대퇴골 간부 골절에대한 Nancy정 고정술

홍기도,하성식,정남식,심재천,김재영 대한골절학회 2003 대한골절학회지 Vol.16 No.4