급성심근경색후 발생한 심실중격결손 2례

김태희,이재호,김애란,허민영,문치숙,정수룡,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Ventricular septal defect remains an infrequent but devastating complication of acute MI. Approximately 1∼3% of cases of acute myocardial infarction are complicated by ventricular septal rupture in the prethrombolytic era and the incidence has decreased to 0.2% with reperfusion therapy. This mechanical complication usually occurs within the first 10 to 14 days when necrotic tissue is most abundant and the collateral coronary circulation is not well developed. This lesion is generally associated with complete coronary obstruction rather than severe stenosis. Rupture of the ventricular septum is a severe mechanical complication of acute myocardial infarction, usually resulting in death unless surgical repair is performed. The bad prognosis of this event within the first 2 weeks indicates the need for early surgical rapair. This complication is more frequent after the first acute myocardial infarction in the elderly and secondary to a transmural myocardial infarction. We report two cases of ventricular septal rupture after acute myocardial infarction.

관상동맥질환을 동반한 모야모야병 1례

김동기,이영태,김기향,김성만,김대경,김두일,김동수 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Moyamoya disease is an occlusive intracranial arteriopathy with an abnormal cerebral vascular collateral networks. Although this disease is known to be associated with stenosis of extracranial arteries, such as the renal artery, a case associated with stenosis of the coronary artery is extremely rare. We report a case of coronary artery occlusive disease affected by Moyamoya disease. The patient was a 38-year-old female experiencing intermittent headache and exer tional chest pain. Cerebral MRI showed complete obstruction of both internal carotid arteries and abnormal cerebrovascular systems which confirmed Moyamoya disease. Coronary angiography showed a significant stenosis of left anterior descending coronary artery ostium with TIMI grade I collateral blood flow from the normal right coronary artery. After coronary artery stenting and medical treatment for headache, her subjective symptoms were relieved. In Moyamoya patient, an evaluation of the extracranial (especially coronary artery) vascular system should be considered if there are some evidences of coronary artery disease.

부산지역 수돗물과 지하수의 중금속 농도

김준연,손지언,김형수,김두희,원미숙,김인식,이혜령 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

This study investigated mean airborne CO concention of 15 workplaces, suspected of CO exposure and conducted self-reported questionnaire completion and indirect COHb concentration measure using Micro II Smokerlyzer to healthy 702 adult subjects from 1999 May to 1999 September in order to find a relation of CO exposure and occupational factors, socioeconomic factors, and health related behaviors and confirm the related conditions in the screening test for CO exposure. The results of this study were summarized as follows : 1. In the CO exposed and non exposed group, COHb concentrations of the smokers were 2.55±0.96% and 2.21±0.97% and that got a statistically significant difference, There were not statistically significant differences in the age and total smoking index. Passed times after the last smoking, Working time/day, and working duration were statistically significant difference (p〈0.05). 2. In the CO exposed and non exposed group, COHb concentrations of non-smoking group were 0.94±0.35% and 0.68±0.47% and that got a statistically significant difference. There were not statistically significant differences in the age and working duration but Working time/day was a statistically significant difference(p〈0.05). 3. In the CO exposed group, r-square of multiple regression of the smokers was 38.5 % and passed time after the last smoking, working time/day, and job category were statistically significant differences (p〈0.05). And r-square in the CO non-exposed group was 38.3 % and age, passed time after the last smoking, and total smoking index were statistically significant difference. 4. In the CO exposed group, r-square of multiple repression of the non-smokers was 66.3% and job category and airborne CO concentration were statistically significant differences(p〈0.05). But r-square of non-smokers in the CO non-exposed group was 1.0% and there was not a statistically significant difference(p〈0.05). 5. In the smokers of CO exposed and non exposed groups, relation of COHb concentration and passed time after the last smoking was expressed as exponential function, Y = 2.9182e-0.0083x and r-square of this function was 37.4%. Therefore it was more than 150 minutes that passed time after the last smoking was when COHb concentrations were measured as less than 1%. In conclusion, variable, that was statistically significant to COHb concentraion in the both CO exposed and non-exposed smokers, was a passed time after the last smoking. We suggest that you have to restrict the smoking of smokers at least 150 minutes in the exposed and non exposed group before COHb concentration measure in order to exclude smoking effects

관상동맥내 스텐트 삽입후 발생한 관상동맥류 2례

제인수,허민영,문치숙,이재호,정수룡,조길현,이영민,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3

Coronary artery aneurysms are detected with increasing frequency because of the routine use of coronary angiography in the diagnosis and management of coronary artery disease. Although some coronary artery aneurysms are congenital or inflammatory, most are atherosclerotic. The prognosis of atherosclerotic coronary artery aneurysm may depend on the morphology of the aneurysm or the presence of coexisting obstructive disease. Coronary artery aneurysms have been also reported to occur after ballon angioplasty, directional athrectomy, laser angioplasty, and stent implantation with a frequency of 2% to 4%. The long-term outcome of post-intervention coronary artery aneurysm is unknown. We report two cases of the development of a coronary aneurysm 6 months after stent implantation as a treatment of severe obsructive coronary artery disease.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

안근성 중증근무력증이 동반된 갑상선 기능항진증의 임상상 : Report of Six Cases

서지영,김두만,김현규,최철수,임성희,유재명,최문기,유형준,박성우,김형철,송홍기,김덕환 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

이산월쉬함수를 이용한 디지털 PID 제어기의 대수적 파라미터 결정 방법에 관한 연구

金潤相,李明珪,沈在先,安斗守 성균관대학교 1998 학술회의지원논문목록집 Vol.1998 No.-

This paper presents an efficient algorithm which can determine the three types of PID parameter directly and sirnultaneously. The proposed algorithm is an algebraic method to obrain controller parameters using discrete Walsh functions, which makes controller design procedure systematic and straightforward. Also, by salving a set of linear equations derived for parameter determination, the proposed method does not involve any trial and error procedure, hence the difficulty of conventional approach can be avoided Simple examples are given to demonstrate the effectiveness with our proposed manner.

소아에서 Fogarty 카테터를 이용한 일측폐 환기 마취 경험

유수봉,강효석,임지훈,김두식,류시정 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

Thoracic surgery may be greatly facilitated by causing selective atelectasis of the lung being operated on (one-lung ventilation anesthesia). But the tube used for one-lung ventilation is greater outer diameter than conventional endotracheal tube when compare to each other with same inner diameter, so in some young children it is impossible to one-lung ventilation using double lumen tube or bronchial blocker tube because of narrow vocal cord. We performed one lung ventilation anesthesia using conventional endotracheal tube and Fogarty catheter as a bronchial blocker in 11-year old women who received lung biopsy surgery and left lower lobectomy.

때죽나무 열매의 脂質成分에 관한 硏究

金龍斗,申秀澈,徐在信 順天大學校 1983 論文集 Vol.2 No.1

때죽나무 열매의 一般成分과 diethyl ether로 抽出한 組脂肪質에 대한 몇가지 物理化學的 特徵들, 脂肪質의 構成 및 脂肪酸의 組成을 分析한 結果를 要約하면 다음과 같다. 1. 一般分析値는 水分 8.52%, 組蛋白質22.5%, 組脂肪質 43.65%, 炭水化物 22.5%, 灰分이 2.83%였다. 2. 油脂의 比重은 0.928∼0.935, 굴절율은 1.4828∼1.4840, 요오드값은 109.2∼110.4, 비누화값은 191∼199, 산값은 1.1∼2.7, 에스테르값은 189∼195, 불검화물은 3.4%로 불검화물은 다른 植物性 油脂보다 높았다. 3. 脂肪質의 構成은 中性脂質이 98.4%,糖脂質 1.1%, 燐脂質은 0.5%였으며 中性脂質에서 esterified sterol, triglyceride, free fatty acid, free sterol, diglyceride, monoglyceride등 6가지 성분을 분리, 확인하였으며 이중에서 triglyceride 含量이 가장 많았다. 4. 脂肪酸의 組成은 palmitic acid와 stearic acid등의 포화지방산이 12.3%정도였으며 불포화지방산인 oleic acid가 41.5%, linoleic acid 42.3%, linolenic acid 3%가 含有되어 있었다. The lipid components, fatty acid compositions, physical and chemical characteristics of crude oil in Styrax japonica seed were determined and proximate compositions of it were also analyzed. The results were summerized as follows: 1. Proximate components of the seed were shown to be 8.52% moisture, 22.5% crude protein, 43.65% crude fat, 22.5% carbohy drates, 2.83% ash. 2. Physico-chemical characteristics of the seed oil were determined as follows:specific gravity 0.928∼0.935, refractive index 1.4828∼1.4840, iodine value 109.2∼110.4, saponification value 191∼199, acid value 1.1∼2.7, ester value 189∼195, unsaponifiable content 3.4%. The unsaponifiable content of the lipid is more than that of other vegetable oil. 3. Lipid components were 98.4% neutral lipid, 1.1% glycolipid, 0.5% phospholipid. The neutral lipids were fractionated and identified as six components:esterified sterols, triglycerides free fatty acids, free sterols, diglycerides, monoglycerides, and triglycerides is the most content of those. 4. Fatty acid compositions were quantitatively determined by GLC to give 9.7% palmitic acid, 2.6% stearic acid, 41.5% oleic acid, 42.3% linoleic acid, 3% linolenic acid and arachidonic acid were presented in small quantities.