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중독한 추체로 증상을 보인 cyclosporine에 의한 뇌증 1예
강정현,곽승근,신현영,김성은,이정호,이정찬,곽상혁,윤환중,조덕연,김삼용,김제,송창준 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1
The use of cyclosporine(CsA), a potent immunosuppressive agent, is associated with numerous side effects. Neurotoxicity was earlier less well known, but with growing experience central nervous system side effects are now reported up to 40% of patients. Among various CsA-induced neurotoxicities, tremor is most common and posterior leukoencephalopathy is well characterized. An encephalopathy presenting with pyramidal weakness, however, seems to be rare and poorly documented. We report here a case of encephalopathy presenting with multiple generalized seizures followed by fluctuating quadriparesis developed a few days after starting CsA and resolved spontaneously after withdrawal of the drug . A 48-year-old woman with aplastic anemia was placed upon immmunosuppressive treatment consisting of antithymocyte globulin(ATG), CsA, and methylprednisolone. Two days after starting the therapy, she developed a generalized seizure. The next day she developed 2 more episodes of seizure and the therapy was stopped. Computed tomogram of the brain was normal. Six days after starting therapy, she developed mild motor weakness and paresthesia of both lower extremities, which progressed to a definite quariparesis confining her to a bed in 3 days. Magnetic resonance imaging(MRI) of the brain revealed asymmetric, bilateral high-signal abnormalites in the subcortical white matter of fronto-temporal areas. After reaching to a maximum with some fluactuation(14 days after starting the therapy) the motor weakness started to be resolved. She was discharged with a almost complete resolution of the weakness 45 days after starting the therapy. Five months later she did well and brain MRI was negative.
허옥순,이재관,이정성,서정혁,주인선,허수정,김세은,김정근,신영희,유미자,김지연,심규창,김성환 식품의약품안전청 1998 식품의약품안전청 연보 Vol.2 No.-
신속 · 정밀하고 효율적인 짠류농약 검출을 위하여 극싱칼럼 (Extrelut-3')을 사옹한 SPE법을 시도하였다. 시료는 채소류체 사용하는 농약중 잔류성이 있고 식품공전상 시험 전처리가 각각 다른 Chlorothalonil등 6종의 농약을 선정하고 그들 표준액에 대한 PPIR수준의 농도로추출용라의 종류 및 용매량 등의 추출조건을 달리하여 회수율 등을 측정한 결과 최적의 분석조건을 얻었다. 1) 추출 용매량은 증가할수록 추출 수율이 높았고,용매 종류에 대한 추출수율은 각 농약별로 다소 차이는 있었으나 극성 정도가 비교적 높은 Ethyl acetate애서 평균 추출수율이 가장 높았다 2) 최대 평균회수율은 Ethyl acetate 60mL를 사웅할 경우로서 93.6%였다. 3)표준액을 시료에 첨가한 시험에서도 역시 Ethyl ace늘to가 푼출수율이 가장 높았으며 불순물 분리제거 효과도 LLE법 보다 월등히 우수하였다. 4) 각 농약별 검출한계는 치소 0.001ppin으로 농산물 중 미량 잔류하는 농약을 검출할 수 있을 것으로 사료된파. 그러므로 SPE법은 LLE법보다 경제적인 방법으로 판명되었으며, 앞으로 농산물 중 잔류농약 분석에서 LEE법을 대치할 쑤 있을 것으로 기대된다. Solid-phase extraction by polar column(Extrelut-3') was attempted to develope the fast and efficient method of detecting pesticide of farm product.5·ix kinds of pesticide used in farming fieldfrequently and different in pretreatment, were chosen from Korea Food Cord. Optfmal analysis condi-tions were determiBed from t31e recovery rate of standard pesticides according to extraction solvent andextraction volurae. Extraction yietd was increased as solvent polarity and extraction volume. Maximumrecovery rate was acquired at 93.6% when 60mL of ethyl acetate was used as eluent. Tllis method wasmore effective than liquid-liquid partition extract·ion method to eliminated the impurity and had 0.001ppm of detection limit. Therefore. solid-phase eEl=raction was expected to be economical substitute fortraditional liquid-liquid extT·action method.
곽상혁,신현영,김성은,이정호,이정찬,강정현,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1
Although acute lymphoblastic leukemia(ALL) is one of the most frequently encountered cancer in children, only about 20% of patients who were diagnosed leukemia are ALL in adults. During past 30 years, the result of treatment of ALL in children have been markedly improved, but in adults, the result of treatment of ALL is not so good as that in children. In recent, morbidity of ALL has been increased in KOREA, but studies of long-term survival are rare. So a retrospective clinical analysis was made in patients who were diagnosed for adult acute lymphoblastic leukemia between March 1988 and February 1997, in Chungnam National University Hospital. The result of treatment, prognostic factors of survival and duration of complete remission were analyzed. In 44 patients who were newly diagnosed as ALL in Chungnam National University Hospital, total 31 patients who have received chemotherapy more than two weeks were analyzed. All patients were treated by vincristine, daunorubicine, and prednisolone in phase I induction chemotherapy. At the 28th day of phase I induction chemotherapy, bone marrow aspiration biopsy was performed and achievement of complete remission was estimated. Within one or two weeks after completion of phase I chemotherapy, phase II induction chemotherapy was done. In phase II induction chemotherapy, cyclophosphamide, cytosine arabinoside and 6-mercaptopurine were administerd. During phase II induction chemotherapy, CNS prophylaxis with intrathecal methotrexate administration and intracranial irradiation. After completion of phase I and phase II of induction chemotherapy, 4 cycles of consolidation chemotherapy were made in utilization of VP-16 and cytosine arabinoside in standard risk group, and in utilization of methotrexate with leucovorin rescue and L-asparaginase in the high risk group. And then maintenance chemotherapy with 6-mercaptopurine and methotrexate was continued till two years later from the day of treatment start. The median survival time was 15.8 months (95% C.I. 6.0-18.8 months) and the long-term survival (more than 5 years after diagnosis) rate was 28.0%. The rate of complete remission was 83.9% ( 26 of 31) and the median of the complete remission duration was 15.8 months (95% C.I. 5.6-25.9 months). The rate of relapse was 69.2%. Good prognostic factor for overall survival time was the fraction of blast cells less than 75% in bone marrow at diagnosis (P=0.001) in univariate analysis. In multivariate analysis, age below 40 (P=0.003) and blast cells less than 75% in hone marrow at diagnosis (P=0.003) were good prognostic factors for overall survival time. Good prognostic factors for disease free survival in univariate analysis were the fraction of blast cells less than 75% in bone marrow (P=0.003), absence of fever (P=0.013), and absence of hepatomegaly (P=0.025), all at diagnosis. In multivariate analysis, good prognostic factors for disease free survival were platelet count more than 50,000/uL, blast cells less than 75% in bone marrow at diagnosis (P=0.004), serum LDH level below 500U/L (P=0.016). The result of treatment of ALL in adults has been improved but is not satisfactory in comparison with that in children. Despite of marked improvement of the rate of complete remission, the rate of relapse still not so much improved. So intensified consolidation chemotherpy or allogenic bone marrow transplantation or autologous bone marrow transplantation is necessary for improvement of survival of adult ALL.
강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-
과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.
이중정,이충원,우병욱 대한보건협회 2003 대한보건연구 Vol.29 No.2
The purpose of the study was to see how prevalent the risk behaviors of korean university students using Youth Risk Behavior Surveillance System(YRBSS) developed by the Centers for Disease Control and Prevention(CDC). Translation and modification for Korean students of the YRBS were carried out March 2000 and the modified YRBS were administered to students of 4-year college in Daegu metropolitan city. The number of students used at final analysis was 619(male : 212(freshmen: 101, senior students : 111) female : 407(freshmen : 146, senior students : 261)) Over 50% of university students rarely or never used safety belt and there were no significant difference between freshmen and .senior students. 363 of students had ridden a bicycle during 12 months preceeding the survey. Of these students, almost student(male : 99%, female : 100%) were rarely or never wore a bicycle helmet. During the 12 months preceding the survey, 22.8% male freshmen had felt so sad or hopeless almost every day for 22weeks in a row that they stopped doing some usually activities and there were no significant difference between freshmen and senior students. Male student in grades 2. 3 and 4(89%) were significantly more likely than freshmen(42%) to have ever tried cigarette smoking. Almost male students had had >1 drinks of alcohol during their lifetime(lifetime alcohol use) and almost male freshmen(%%) and senior student(%%) had 2 1 drinks of alcohol on 2 1 of the 30 days preceding the survey(current alcohol use). These results suggest that some risk behaviors be very prevalent in a korean university students and priority health-risk behaviors, which contribute to the leading cause of mortality and morbidity among youth and adult, often are establish during college age, extend into adulthood, are interrelated.
정전기력 구동 마이크로 액츄에이터를 이용한 Si 소재 탄성특성의 온도의존성 평가
鄭聖勳,李世昊,鄭增鉉,權東一 대한금속재료학회 2002 대한금속·재료학회지 Vol.40 No.8
Electrostatically actuated testing devices were used to estimate the elastic modulus of single-crystalline Si for microeletromechanical systems. The devices were moved laterally by alternating electrostatic force at a series of frequencies, and then a resonance frequency was determined, with temperature cycling, by detecting the maximum displacement. The elastic modulus was calculated from the detected resonance frequency by Rayleigh's energy method. The elastic modulus decreased with heating and then increased with cooling, but after thermal cycle the specimen showed a permanent change to a value lower than the initial one. This phenomenon can be explained, to some extent, by the temperature-dependent variation in interatomic force of Si atoms, but the permanent change in elastic modulus implies that it may also be caused by the formation of a thermal oxide layer on the Si with increasing temperature. Composite bending theory was invoked to analyze the oxide effect and the thickness of the oxide layer formed during thermal cycling was estimated from the permanent change in the resonance frequency. The existence of the oxide layer was confirmed by field emission scanning electron microscopy. Finally, the method for compensating the decreasing elastic modulus with increasing temperature were proposed by using the temperature coefficient of elastic modulus.
투스텝 수직점프와 제자리 수직점프시 각 신체 분절의 기여도에 관한 연구
이정흔,오정환 忠南大學校體育科學硏究所 1995 體育科學硏究誌 Vol.13 No.1
The purpose of the study is to compare the contribution factors of two step jump with those of the original place vertical jump at the instant of each jump by three mentional imaging analyzer for undergraduate students. All of the results are followed as; 1. At the instant of two step vertical jump, taken time of the weight interval was shot. 2. Line speed of the body segment was appeared hands, forearms, respectively at the instant the original place vertical jump, the speed of forearms was faster than that of hands. 3. The angle of each joint appeared greater at the instant of two step vertical jump than at the instant of the original place vertical jump when arms positioned backswing. 4. The angle speed of the joint was appeared hip joint, knee joint, ankle joint, respectively at the instant of the original place vertical jump, but the angle speed of the arm was appeared the fastest of all. 5. The vertical speed of body center was appeared fater at the instant of two the original place vertical jump. 6. The ground reaction force was appeared greater at the instant of the original place vertical jump than at the instant of two step vertical jump. 7. The inertial force exerting each segment was appeared the lower leg, the thigh, the foot segment, respectively, at the instant of the original place vertical jump and two step vertical jump. 8. At the instant of the original place vertical jump and two step vertical jump, hands, forearms, brachium, trunk, and head didn't propell toward vertical upward, but they reacted against upward of the vertical by the weight of each segment. 9. At the instant of the original place vertical jump and two step vertical jump, inertial force exerting at each segment was appeared to help the vertical upward movement in the foot segment, and the thigh segment
경북 일부 지역 비닐하우스 농사자와 일반 농사자와 농부증 실태 및 관련요인
이중정,양진훈,,황인섭 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2
비닐하우스 농사자와 일반 농사자의 농부증 유병률의 차이를 비교하고, 농부증의 유병과 관련된 요인들을 규명하기 위하여, 2003년부터 2005년까지 경상북도 고령군과 안동시 지역을 대상으로 인구학적 특성 및 생활습관력, 농부증 증상 유무, 그리고 농작업 특성을 조사하였다. 연구 대상자 총 394명 중 비닐하우스 농사자는 203명(51.5%), 그리고 일반 농사자는 191명(48.5%)였으며, 남자는 51.3%, 여자는 48.7%였다. 하루 평균 농사를 짓는 시간은 일반 농사자에 비해 비닐하우스 농사자가 길었다. 농약 살포 시 마스크와 방제복 착용류은 비닐하우스 농사자의 경우 일반 농사자에 비해 매우 낮았다. 농부증 양성률은 33.0%로 비닐하우스 농사자와 일반 농사자 간에 유의한 차이를 보이지는 않았다. 그리고, 8가지 농부증 신체증상 중 요통을 호소하는 경우가 가장 많았다. 농부증과 관련된 요인을 분석한 결과, 비닐하우스 농사자의 경우 남자에 비해 여자에서, 농사지은 총 기간이 40년 이상으로 긴 경우, 하루평균 농사짓는 시간이 10시간 이상으로 긴 경우에 농부증 양성률이 유의하게 높았으며, 일반 농사자의 경우에는 남자에 비해 여자가, 그리고 농약 살포 횟수가 적을수록 농부증 양성률이 유의하게 높았다. 다중 로지스틱 회귀 분석 결과 비닐하우스 농사자의 경우, 남자에 비해 여자가 3배 이상, 하루평균 농사짓는 시간의 경우 10시간 미만인 경우에 비해 10시간 이상인 경우가 2.6배, 그리고 일반 농사자의 경우에는 남자에 비해 여자에서 농부증 양성률이 4배 이상 높은 것으로 나타났다. 비닐하우스 농사자의 경우 일반 농사자에 비해 농사시간이 많을 뿐 아니라 운동률이 매우 낮고 수면시간이 상대적으로 적으며 농약 사용시 보호장구의 착용률이 낮으며, 비닐하우스 농사자와 일반 농사자 모두 남성에 비해 여성에서 농부증의 위험이 높아 이에 대한 대책 마련이 시급히 이루어져야 할 것이다. Objectives: This study was performed to estimate the risk factors affecting the farmers' syndrome of vinylhouse and non-vinylhouse farmers in the Gyeongbuk Province rural area. Methods: As a cross-sectional study, a questionnaire survey was conducted from 2003 to 2005. Data was collected from 243 vinylhouse farmers and 236 non-vinylhouse farmers. The data from 394 subjects were used for the final analysis. We surveyed their lifestyle, 8 components of farmers' syndrome and characteristics of farm work. Results: For the vinylhouse and non-vinylhouse workers, 32.0% and 34.0% were positive for farmers syndrome, while 48.3% and 43.5% were suspicious, respectively. The differences between the two groups were not significant. For both groups, the most frequent symptom of farmers' syndrome was lumbago, followed by paresthesia of hand or foot, and shoulder stiffness. Among the vinylhouse workers, the rates of wearing protective equipment and washing the skin after spraying pesticide were significantly lower than among the non-vinylhouse workers. From multiple logistic regression analysis, the risk factors significantly associated with farmers' syndrome were sex {odds ratio (OR)=3.12, 95% confidence interval (CI)=1.42-6.89} and hours of farming per day (OR=2.63, 98%CI=1.22-5.65) among vinylhouse workers. However, sex (OR=4.24, 95%CI=1.87-9.65) was the only the risk factor significantly associated with farmers' syndrome among the non-vinylhouse workers. Conclusions: In conclusion, educational programs and attention to the female farmers were needed in particular. In addition, it was recommended that the farmers wear protective equipment continuously from opening the coverlets of the pesticide container to the completion of pesticide spraying, and wash the skin immediately after contact with pesticides.