Coats 氏病의 1例

金元植,鄭鳳朝,金正煥,金千金,李益煥,金箕洪 大韓眼科學會 1969 大韓眼科學會雜誌 Vol.10 No.4

응급센터로 내원한 발작성심실상성빈맥 환자에 대한 아데노신의 투여효과

김홍용,김경환,윤영철,이경호,김원율,김병옥 대한응급의학회 1998 대한응급의학회지 Vol.9 No.2

Background: Adenosine has gained wide popularity in the emergency medical service system(EMS) since its approval for use in the treatment of paroxysmal supraventricular tachycardia(PSVT). But, few study about its efficacy and safety have been reported in this country. Therefore we had studied the efficacy of adenosine in the patients with PSVT in the emergency department(ED). Method: A prospective outcome study was performed from July, 1996 to June, 1997 at the Sanggye Paik Hospital, Inje University. PSVT was diagnosised based on emergency physician's interpretation of the 12 channel ECG. Patient's age, sex, symptoms, systolic blood pressure, heart rate, elapse time to sinus rhythm and side effects were recorded. Results: Twenty seven cases received adenosine for diagnosed PSVT in the ED for 1 year. The cases were 6 man and 21 women. The mean age was 53.4 year old. Three cases were considered unstable PSVT. In twenty six cases(96.3%) were converted to normal sinus rhythm after adenosine therapy. None of the patients who converted to sinus rhythm had recurrent PSVT or required additional mediation. Various adverse effects of adenosine were noted in all patients but were transient and clinically insignificant. Conclusion: Intravenous adenosine is an effective, safe and urgent treatment in terminating PSVT and no significant side effects were happened in emergency department.

Angiotensin Concerting Enzyme 유전자의 유전적 다형성(Genetic Polymorphism)이 관상동맥 질환 위험인자에 따른 혈중 Plasminogen Activator Inhibitor-1의 농도에 미치는 영향

김덕경,김종원,권현절,류재춘,박승우,김준수,이상훈,홍경표,박정의,이원로 대한고혈압학회 1996 대한고혈압학회지 Vol.2 No.2

에이즈 환자의 거대세포바이러스 감염증

김홍빈,박상원,김남중,최희정,신동현,오명돈,김우호,정흠,최강원 대한감염학회 1998 감염 Vol.30 No.4

배 경 : 거대세포바이러스 감염은 인간면역부전바이러스 (Human Immunodeficiency Virus, HIV) 감염자에서 발생하는 가장 중요한 기회감염증의 하나이다. 특히, 국내에서는 95%이상의 국민이 거대세포바이러스의 1차감염을 경험한 상태이므로 에이즈 환자에서 거대세포바이러스 질환의 빈도가 높을 것으로 예상된다. 대상 및 방법 : 1987년 10월부터 1996년 9월까지 서울대학교 병원에서 추적 관찰하였던 128명의 HIV 감염자를 대상으로 하였다. 이들 환자의 의무 기록에서 임상 자료를 얻었다. 거대세포바이러스 망막염은 안과 전문의의 임상적인 소견으로 진단하였으며, 위장관 등 망막이외 부위의 거대세포마이러스 질환은 조직학적으로 확인된 경우에 한하였다. 결 과 : 대상환자 128명의 추적관찰기간은 중앙값이 6(0∼59)개월 이었으며 7명 (5.4%)에서 거대세포바이러스 질환이 발생하였다. 거대세포바이러스 질환은 망막염이 6예, 식도염이 2예, 대장염이 1예, 폐렴 및 부신감염이 1예, 범발성 감염이 1예였다. 거대세포바이러스 질환의 발생빈도는 CD4+ 림프구 수가 적을수록 높았으며, CD4+ 수가 200/㎣미만인 환자 중 15% (6/33)에서 거대세포바이러스 질환이 확인되었다. 11예 중 9예를 ganciclovir로 치료하였으며 이중 7예에서 호전 또는 진행의 억제가 확인되었다. 추적관찰이 가능한 6예 중 3예 (50%)에서 재발하였다. 결 론 : 국내 에이즈 환자에서 거대세포바이러스 질환은 비교적 흔한 기회감염증이다. Background : Cytomegalovirus (CMV) infection is one of the important opportunistic infections in immunocompromised patients. In Korea, seroprevalence of IgG against CMV is over 95%. Therefore, CMV diseases are expected to be a prevalent opportunistic infection in AIDS patients. in Korea. Methods : We reviewed the medical records of 128 patients with HIV infection who visited the Seoul National University Hospital during the period from Nov. 1987 TO Sep. 1996. All the patients were examined by one ophthalmologist and the diagnosis of CMV retinitis were made by funduscopic findings. Other CMV diseases were diagnosed when histopathologic examinations showed the characteristic cytomegalic cells. Results : Median duratior, of follow-up was 8 months. Eleven CMV diseases were found in 7 patients (5.4%): 6 patients ahd retinitis, 2 esophagitis, 1 colitis, 1 pneumonitis, and one patient developed disseminated infection. Fifteen percent (6/33) of the patients whose CD4+ lymphocyte counts were less than 200/㎣ at baseline developed CMV diseases. Out of the 9 cases treated with ganciclovir, 7 improved or were stabilized. No patient received maintenance treatment and 3 had relapsed. Conclusion : CMV diseases are common opportunistic infections in AIDS patients in Korea.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

황색포도구균의 균혈증에서 초기 항생제 치료가 예후에 미치는 영향

김성한,박완범,이기덕,강철인,최영주,김홍빈,박상원,김의석,오명돈,김의종,최강원 대한감염학회 2002 감염 Vol.34 No.5

Cisplatin과 Tobramycin이 白鼠 Corti器에 미치는 영향에 關한 電子 顯微鏡的 硏究 : Ultrastructural Study

김동환,신태균,김무강,김홍선,김원식 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.1

In order to study the morphological changes of Corti’s organ in the rat treated with cisplatin and tobramycin, thirty-three rats, weighing between 200∼250g, were used, and divided into 4 groups, i.e., 3 rats were used for control, and 30 rats were used for 3 experimental groups. Each experimental group was divided into cisplatin-treated, tobramycin-treated, and both cisplatin and tobramycin treated group with 10 rats. Rats were injected with a single dose of 7.7㎎/㎏ of cisplatin intraperitoneally and 50㎎/㎏/day of tobramycin for 2 days intramuscularly, respectively or both. Treated rats were sacrificed on the 3rd and 5th day after the first injection. Results were as follows; 1. Cisplatin-treated group: Outer hair cells of Corti’s organ were degenerated with the formation of vacuoles and appearance of lysosomes, however, inner hair cells showed mild vacuolization. 2. Tobramycin-treated group: NO pathological changes were found in Corti’s organ. 3. Combined cisplatin and tobramycin treated group: Outer and inner hair cells showed vacuolization, appearance of lysosomes, myelin figures and multivesicular body. There were also multivesicular body in the inner phalangeal cell and myelin figure in the Reissner’s membrance. 4. Degeneration of Corti’s organ in the combined treated group was more sever than those of the single cisplatin-treated or tobramycin-treated group. 5. NO pathological differences of Corti’s organ in duration of postinjection were manifested in any groups. It can be concluded that cisplatin induces toxicity to inner ear and cisplatin enhance toxicity more in continued treated with tobramycin.

Clinical Outcome of Modified Cervical Lateral Mass Screw Fixation Technique

Kim, Seong-Hwan,Seo, Won-Deog,Kim, Ki-Hong,Yeo, Hyung-Tae,Choi, Gi-Hwan,Kim, Dae-Hyun The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.52 No.2

Objective : The purpose of this study was 1) to analyze clinically-executed cervical lateral mass screw fixation by the Kim's technique as suggested in the previous morphometric and cadaveric study and 2) to examine various complications and bicortical purchase that are important for b-one fusion. Methods : A retrospective study was done on the charts, operative records, radiographs, and clinical follow up of thirty-nine patients. One hundred and seventy-eight lateral mass screws were analyzed. The spinal nerve injury, violation of the facet joint, vertebral artery injury, and the bicortical purchases were examined at each lateral mass. Results : All thirty-nine patients received instrumentations with poly axial screws and rod systems, in which one hundred and seventy-eight screws in total. No vertebral artery injury or nerve root injury were observed. Sixteen facet joint violations were observed (9.0%). Bicortical purchases were achieved on one hundred and fifty-six (87.6%). Bone fusion was achieved in all patients. Conclusion : The advantages of the Kim's technique are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known techniques. The Kim's technique can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

체성감각유발전위검사를 이용한 척추기형교정수술 시의 수술중 감시

김철,이창헌,김창효,석세일,김진혁,김원중,홍기혁 大韓再活醫學會 1999 Annals of Rehabilitation Medicine Vol.23 No.3

3분과 : 가선집재작업에서의 작업 생산성 및 비용 분석

한원성 ( Won Sung Han ),한한섭 ( Han Sup Han ),김남훈 ( Nam Hun Kim ),차두송 ( Du Song Chu ),조구현 ( Koo Hyun Cho ),민도홍 ( Do Hong Min ),권기철 ( Ki Cheol Kwon ) 한국임학회 2014 한국산림과학회지 Vol.103 No.1

본 연구에서는 임목수확작업에 사용되는 집재기계의 작업효율성을 분석하여 경사가 급한(20° 이상) 작업조건에 적합한 가선계 집재기계를 선정하는데 기초 정보를 제공하고자, 타워야더(RME-300T), 트랙터부착형 집재기(일명: 춘천집재기), 트랙터윈치(FARMI) 등에 의한 집재작업에서의 작업생산성 및 비용을 비교 분석하였다. 평균 흉고직경이 20 cm, 집재거리 60 m, 가로집재거리 10 m, 그리고 기계이용률이 70%인 동일한 작업 조건에서 작업이 이루어질 경우, 타워야더의 1일 집재작업 생산성은 33.04 m3/일, 트랙터부착형 집재기는 38.47 m3/일, 그리고 트랙터윈치는 14.17 m3/일으로 분석되었으며, 이에 따른 집재작업비용은 각각 25,105원/m3, 20,520원/m3, 37,835원/m3으로 나타났다. 동일한 작업조건에서 집재거리에 따른 각 집재기계별 작업효율성을 비교하였을 경우, 집재거리가 40 m 이내로 짧을 경우에는 트랙터윈치에 의한 집재작업이 효율적이며, 40~140 m의 집재거리에서는 춘천집재기가, 140 m 이상의 장거리 집재작업에서는 타워야더가 가장 효율적인 것으로 나타났다. This study was conducted to provide field-based harvesting study information which can be used to select an optimal cable system for certain work conditions on steep grounds (>20° ground slope) in Korea. Toaccomplish this study objectives, we evaluated three cable yarding systems (RME-300T tower-yarder, Chuncheontower-yarder, FARMI tractor winch) working in typical work conditions for their yarding productivity and operational efficiency. Those yarders are commonly used for removing logs or trees on steep grounds in Korea. Under the same work conditions (average DBH of tree to be cut, 20 cm; yarding distance, 60 m; lateral yardingdistance, 10 m; and machine utilization rate, 70%), the average productivities were 33.04 m3/day, 38.47 m3/day, and 14.17 m3/day for RME-300T, Chuncheon tower-yarder, and FARMI, respectively. Our standardized cost comparison study also showed that the yarding cost was highest at 37,835 won/m3 with FARMI, followed byRME-300T at 25,105 won/m3 for the same work conditions. We found the lowest yarding cost with the Chuncheon tower-yarder at 20,520 won/m3 which was resulted primarily from high yarding productivity at theyarding distance (60 m). Our analysis suggested that a small machine such as FARMI could be a low-costyarding machine option for a cable yarding job with a short yarding distance (40 m or less). The Chuncheontower-yarder is well suited for a mid-range yarding distance job in Korea, ranged between 40 to 140 m. Ifyarding distance were longer than 140 m, the RME-300T tower yarder appears to be most cost-effective.