비외상성 두개내 출혈 환자에서 심근손상의 발생과 예후에 미치는 영향

강구현,황성호,이강현,조준휘,김성환,문중범,박해상,이서영,이성수,김헌주 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Objective: The aim of this study was to investigate the clinical significance of myocardial injuries in patients with nontraumatic intracranial hemorrhage by identifying the occurrence of myocardial injury and defining its correlation with subsequent cardiovascular events. Subjects and methods: One hundred twenty-four patients with nontraumatic intracraninal hemorrhage presented to the emergency department within six hours from onset of symptoms were enrolled. Brain CT, serial electrocardiography, and echocardiography were done at the emergency center. Blood samples for troponin I and creatine kinase(CK)-MB were drawn immediately and eight hours after admission, Troponin I and CK-MB were measured using a chemiluminescent immunoassay, respectively. Results: Electrocardiographic and echocardiography abnormalities were found in 65 cases(52.4%) and 21 cases(17%), respectively. Serum troponin I and creative kinase-MB were increased in 35 cases (28.2%) and in 58 cases(46.8%), respectively. Abnormal findings of echocardiography and ECG, as well as elevated levels of serum troponin I and creative kinase-MB, were associated with an increased risk of cardiovascular event and survival. Logistic regression analysis revealed that an abnormal echcocardiographic finding and elevation of serum troponin I were factors associated with the occurrence an adverse cardiovascular event and that electrocardiographic abnormalities and initial mental status were factors associated with poor prognosis. Conclusion: This study reveals that actual myocardial injury develops in a significant proportion of patients with nontraumatic intracranial hemorrhage and that the development of the myocardial injury is associated with an adverse cardiovascular event that occurs during admission.

다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

박대원,정희진,엄중식,황병연,김성범,이재갑,이연주,정혜원,정성주,박재형,이진수,손장욱,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.

좌전하행지 관동맥 개구부위의 망사형의 관(Slotted Tube)스텐트와 나선형 코일(Coil)스텐트 삽입후 단기 및 장기 암상 경과의 비교

박훈기,박성욱,이일수,이상곤,김진우,이근,정상식,이철환,홍명기,김재중,박승정 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6

토끼 간조직의 Stimulatory Guanine Nucleotide 결합 단백의 αsubunit 에 대한 cDNA 염기서열에 관한 연구

이상훈,노연희,한중수,고재경 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.1

G proteins, a family of guanine nucleotide-binding protein superfamily, are involved in transmembrane signaling systems as transducers. In this study cDNAs encoding αsubunit of the stimulatory G protein (G α ) from rabbit liver were cloned and their nucleotide sequences were determined : a λgt 11 cDNA library from total cellular poly (A)' mRNA in rabbit liber was screened for recombinant λDNA that codes for G α with labeled probe. The probe used was an EcoRI digested 3' end fragment of cDNA for G α from olfactory neuroepithelium of rat. Six of the approximately recombinant clones were screened by in situ hybridization and by autoradiography, detecting sixteen positive clones. These clones were tested using polymerase chain reaction (PCR) technique and thirteen of them were turned out to have two sets of conserved sequence in αcDNA. Four clonse among them were selected form analysis of their cDNA sequences, showing the presence of two types of cDNA, namely and with the total length of nucleotide sequence of1.392bp and 1.613bp, respectively . From nucleotide sequence analysis the amino acid residues of -1 and α-2 were deduced : they contain 335 and 386 amino acid residues (including the initiator methionine), respectively. The calculated molecular weights for and were 38.9kd and 44.6kd, respectively. The significant difference in size between two cDNAs for G αseemed to be due to the assumption that alternative promoter and leading exon might be involved in transcribing the mRNA for . Two types of cDNA from rabbit liver shared over 95% of amino acid homology with that from rat olfactory neuroepichelium if deleted portions are not counted. More information on the cDNAs could be obtained through further studies such as Sl nuclease protection experiment, expression and mutation study.

두개강내 추골동맥의 박리성 동맥류 : 2부검례 보고

이상용,조갑래,서중석 大韓法醫學會 2000 대한법의학회지 Vol.24 No.1

Two autopsied cases of dissecting aneurysms of intracranial vertebral artery are reported and the appropriate literature is reviewed to investigate the pathological characteristics and pathogenesis. The location and pathological features of the aneurysms are similar in the two cases. The aneurysms in both cases are confined to the intracranial vertebral artery and massive subarachnoid hemorrhage in basal cistern develop caused by the rupture of the arterial wall. And the aneurysms show mainly subadventitial dissection and display intimal thickening, disruption of internal elastic lamina, and degeneration of the media. Based on their pathological investigation of these two cases and a review of reported cases, the authors propose that weakness of internal elastic lamina may be responsible for initiating dissection in susceptible individuals and hypertention is one of contributing factors that result in weakness of internal elastic lamina.

산업용 로봇의 실시간 운용을 위한 역기구학 해석

이용중,이상태,박형준 한국공작기계학회 1998 한국생산제조학회지 Vol.7 No.1

This study solves the inverse kinematics problem of industrial FANUC robot. Because every joint angle of FANUC robot is dependent on the position of end-effector and the direction of approach vector, arm metrix T_6 is very complicated and each joint angle is a function of other joint angles. Therefore, the inverse kinematics problem can not be solved by conventional methods. Noticing the fact that if one joint angle is knows, the other joint angles are calculated by the algebraic methods, θ_1 is calculated using neumerical analysis method, and solves inverse kinematics problem. This proposed method, in this study, is more simpler and faster than conventional methods and is very useful in the real-time control of the manipulator.

기능성 소화불량증환자에서 Winstal® 투여에 관한 임상경험

이창형,김영탁,금민수,권중구,안병철,윤영미,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.3

목적 : 기능성 소화불량증은 소화, 흡수등 장관의 기능적인 이상과 관련되어 있을 것으로 생각되며 복합소화효소제(Winstal®)를 투여하여 그 임상효과를 평가하고자 본 연구를 실시하였다. 대상 및 방법 : 1994년 3월 부터 6월까지 경북대학교병원 내과를 방문한 기능성 소화불량증을 호소하는 환자 20명을 대상으로 Winstal®을 1회 1정씩, 1일 3회 식후 30분내에 경구로 2주간 투여하였다. 결과 : 소화불량증의 증상은 복부불쾌감, 복부팽만감, 식욕부진 및 오심, 복부동통, 공기연하증, 고창 및 구토순이었으며, 증상의 개선은 복부불쾌감이 76.4%(13/17)로 가장 높았으며, 그 다음으로 복부팽만감 및 공기연하증이 66.5%(10/15, 6/9)이었고, 오심 61.5%(8/13), 식욕부진 53.8%(7/13), 복부동통 41.6%(5/12), 고창 37.5%(3/8)이었다. 각 환자별 종합적인 증상의 개선도는 현저한 개선이 2예(10%), 중등도 개선이 3예(15%), 약간개선이 11예(55%), 불변이 4예(20%)이었으며 종합적인 유효율은 80%(16/20)이었다. 부작용은 한 예에서도 관찰되지 않았다. 결론 : 본 제제는 기능성 소화불량증 환자의 증상개선에 추천할 만한 유효한 약제로 생각된다. Dyspepsia is a common symptom in gastroenterologic practice and trigger for numerous consultations with physician. The treatment of chronic functional dyspesia is unsatisfactory. This study was performed to evaluate the efficacy of the digestive compound (Winstal®) on 20 functional dyspepsia patients. On open trial, all patients were given 6 tablets daily for 2 weeks and we evaluated the efficacy of this preparation according to the degree of the improvement. The improvement of symptoms was 76.4%(13/17) in abdominal discomfort, 66.5%(10/15, 6/9) in abdominal distension and aerophagia, 61.5%(8/13) in nausea, 53.8%(7/13) in abdominal pain, and 37.5% (5/12) in flatulence, respectively. Overall effectiveness of subjective symptoms was 80% (16/20) and there were no untoward effects of the preparations during this study. As a result, We think that this preparation is an effective one to relieve symptoms of functional dyspepsia.

이축시험법에 의한 알루미나 세라믹스의 열충격파괴거동

이중현,박성은,이형직,이홍림 연세대학교 산업기술연구소 2001 논문집 Vol.33 No.1

The flexure strength distribution was observed with ball-on-3 ball test after thermal shock in 25℃ distilled water. Commercial alumina specimen(AES-11) was used, and after thermal shock and flexure test crack distribution was observed by dye-penetration. Statistical method for failure probability and comparison of failure probability of ball-on-3 ball test with that of 3-point bending test were studied. The nearest crack distance from the center of the specimen and crack density were considered as the factors affecting ball-on-3 ball test strength, and the nearest crack distance from the center of the specimen had a stronger effect on the flexure strength than crack density.

방사선 조사 후 대뇌결질에 분포한 Neuropeptide-Y 양성신경세포에 관한 면역조직화학적 연구

이상욱,김종중,정윤영,정종달,오윤경 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background and Objectives : Severe irradiation on the cerebral cortex of the human and animals may result in functional alterations of central nervous system. The purpose of this study, the irradiation effects on the cerebral cortex of the rats after brain irradiation was to investigate the change of distribution and morphology of neuropeptide-Y(NPY) neurons. Materials and Methods : Radiation was produced by the linear accelerator 6MV X-ray, and the animals were categorized into control and experimental groups and we use 45 Sprague-Dawley rats weighing about 200~250gm. The head areas of the animals were positioned within the radiation field of 12㎝ × 20㎝ and with the radiation depth of 1.5㎝. Sodium chloral hydrate-anesthetized rats were exposed to the radiation with the dose rate of 240 cGy/min. The total dose was 1800 cGy. Animals were sacrificed on 2 hours, 5 hours, 1 day, 3 days, 7days after brain irradiation. Under anesthesia, animals were perfused with 4% paraformaldehyde-1% glutaraldehyde solution. On one or two hours after the perfusion, brain were taken out and refixed over night in the same fixative. Using ABC immunohistochemistry, morphology and distribution of neuropeptide-Y immunoractive(NPY-IR) neurons were studied on the cerebral cortex of the control and brain-irradiated rats. We used light, transmission electron and confocal laser scanning microscope. Results : The following results were obtained : 1. On control group, NPY-IR neurons were found in all layers of the primary sensory and motor cerebral cortex, and the NPY-IR neurons were concentrated within the layer II, III, IV, V and VI. The typical NPY-IR perikarya was bipolar and multipolar shape. 2. On 2 hours, 5 hours, 1 day after X-irradiation, decreased number of NPY-IR neurons were detected in the primary sensory and motor cerebral cortex of the rats. Also shrunken and transformed NPY-IR neurons were detected in the primary sensory and motor cerebral cortex of the rats. 3. On 3 days and 7 days after X-irradiation, morphology and distribution of NPY-IR neurons in the primary sensory and motor cerebral cortex was generally restored. 4. In optical serial section analysis of NPY-IR neurons, high fluorescence intensity were observed in a part of the 8~11 sections of the control and all irradiated groups. In optical single section analysis of NPY-IR neurons, red color(high fluorescence intensity) was observed in a part of 6, 7 sections of the control and all irradiated groups. 5. By electron microscopy, NPY-IR neurons on 2 hours, 5 hours, 1 day after X-irradiation rats exhibited severe alterations of their organelles concerning intracellular material transport ; such as disappearance of microvilli and basal infoldings, reduction of invaginating pits on the basal and apical plasma membranes, reduction of transformed vesicles and shrunken Golgi complexes, etc. Conclusion : From the above results, it was concluded that the release of neurotransmitters and transcapillary leakage of blood substance were occurred on 2 hours, 5 hours, 1 day after X-irradiation, but the condition was generally restored on 3 days and 7 days following X-irradiation.

정상 관동맥을 가진 심장 점액종 환자에서 발생한 급성 심근 경색증 1예

이정민,이현승,전은정,윤호중,정욱성,오용석,김철민,김재형,최규보,홍순조,이교영,심상인 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9