소아과 입원 환자에 대한 통계적 고찰

정용현,서우식,유재홍,변상현 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

For the purpose of assessing the disease patterns by the body organ system in patients of the pediatric age, we performed a statistical analysis of diseases of patients admitted to the department of pediatrics at Chungnam National University Hospital from January 1990 to December 1994. The results obtained were as follows : 1. Total numbers of in-patients were 8,007, of which 4,923 were male and 3,084 were female. The ratio male to female was 1.60 : 1. 2. Prevalence of the diseases classified by body organ system was in the following order : neonatal diseases (34.6%), respiratory diseases (17.4%), infectious diseases (11.5%), congenital anomalies (5.5%), digestive diseases (5.1%), genitourinary diseases (4.9%), neoplasm (4.7%), blood diseases (3.3%), nervous system diseases (2.8%), metabolic and endocrine diseases (2.4%), circulatory system diseases (2.3%), skin and subcutaneous diseases (1.3%), musculoskeletal and connective tissue diseases (1.2%), mental and behavior disorders (0.4%). 3. Major diseases in each body organ system were as follows : 1) infectious diseases : unspecified acute gastroenteritis (35.9%), viral meningitis (10.4%), Rotaviral enteritis (6.8%), sepsis (6.7%), measles (5.8%). 2) neoplasm ; ALL (34.1%), AML (15.8%), Wilms tumor (12.8%), NHL (8.2%), neuroblastoma (5.6%) 3) blood diseases : allergic purpura (24.2%), aplastic anemia (17.1%), ITP (16.4%), iron deficiency anemia (15.8%). 4) metabolic and endocrine diseases : short stature (22.0%), hypocalcemia (13.8%), metabolic acidosis (9.6%), IDDM (6.4%). 5) mental and behavior diseases : neurosis (47.7%), mental retardation (18.2%). 6) Nervous and sensory system diseases : epilepsy (43.2%), cerebral palsy (12.1%), otitis media (9.3%), encephalopathy (6.2%). 7) circulatory system diseases: congestive heart failure (29.2%), dilated cardiomyopathy (8.0%), rheumatic fever (8.0%), mitral insufficiency (6.8%), hypertension (6.4%). 8) respiratory diseases : pneumonia (40.1%), URI (9.6%), acute tonsillitis (9.4%), asthma (8.5%), acute bronchiolitis (8.3%), croup (7.1%), acute bronchitis (4.1%). 9) digestive system diseases : unspecified hepatitis (22.8%), acute gastritis (13.8%). CAH (12.6%), intussusception (7.8%), constipation (7.1%). 10) skin and subcutaneous diseases : cellulitis (23.1%), lymphadenitis (19.7%), urticaria (15.6%), atopic dermatitis (8.8%), furuncle (8.2%). 11) musculoskeletal and connective tissue diseases : Kawasaki disease (76.8%), JRA (8.5%), SLE (7.0%). 12) genitourinary system diseases : UTI (29.0%), minimal change nephrotic syndrome (27.3%), APSGN (7.6%), APN (4.9%). 13) congenital or chromosomal abnormalities : VSD (38.7%), ASD (10.5%), TOF (8.4%), PDA (5.2%), CHPS (4.5%), Down syndrome (4.1%). 14) neonatal diseases : jaundice (32.0%), prematurity (12.7%), RDS (5.7%), sepsis (4.5%), birth asphyxia (3.0%), SGA (3.0%). 15) Others : febrile convulsion (45.6%), failure to thrive (9.2%), FUO (8.9%), drug intoxication (8.2%). 4. Common diseases for admission in pediatrics were in the following order : jaundice, pneumonia, unspecified acute gastroenteritis, VSD, RDS, URI, acute tonsillitis, acute lymphadenitis, ALL, sepsis, asthma, acute bronchiolitis, UTI.

척수강내 Bupivavacain에 첨가한 소량의 Neostigmin의 진통효과와 부작용

소금영,정종달,김병철,유벙식,안태훈,김훈정,임경준 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background : Spinal cholinergic receptor has been shown to have a antinociceptive action, an effect that can be mimicked by spinal cholinesterase inhibitor. Intrathecal injection of neostigmine cause analgesia and adverse effect in a dose-dependent pattern in the patients. The purpose of this study was to determine whether small doses of intrathecal neostigmine (10, 25 and 50 ㎍) produce analgesia and any side effects. Method : After getting informed consents, 60 patients scheduled for orthopedic surgery of lower extremities under spinal anesthesia were randomly assigned to one of four groups. Using dose-ranging design, patients received either normal saline or neostigmine l0, 25 or 50 ㎍ in a 1-㎎ solution of 5% glucose in normal saline with heavy bupivacaine 12 ㎎. Heart rate, blood pressure, degree of motor and sensory block were recorded. The assessment of postoperative analgesia included time to first rescue, total number of rescue medication and pain score on visual analog scale (VAS) at 1, 3, 6, 9, 12, 24 hour. Nausea and vomiting were assessed by using the visual analog scale at 24 hr postperatively and the incidence of them was recorded postoperatively. Result : There were no significant differences among the four groups in characteristics of spinal blocks. Compared to saline, neostigmine groups significantly prolonged time to first rescue medication and decreased total number of rescue medication and pain visual analog scale score, but incidence of nausea and 24hr nausea VAS score were not increased in neostigmine group compared to control group. Conclusion : These data in patients injected intrathecal neostigmine suggest that analgesia may occur at doses less than neostigmine 50 ㎍ and neostigmine 50㎍ has a better analgesia effect with fewer side effects than other doses for postoperative analgesia.

생쥐모델에서의 망막모세포종 안구 자기공명분광법과 병리소견 : 초기경험

김동훈,김일중,양재한,김정훈,유영석,이봉재 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Purpose: To show various MR spectroscopy and correlated pathologic images of retinoblastoma in nude mouse with a new human retinoblastom cell line (SNUOT-Rbl) which innoculated into intravitreous cavity. Materials and Methods: The established cell line was innoculated into mtravitreous cavity of 14 eyeballs of 7 mice and a transplanted retinoblastoma was examed for 1 month. Tl-weighted image (T1WI), T2-weihgted image (T2WI), and MR spectroscopy were obtained with 1.5 Tesla MRI (Magnetom Vision, Siemens, Erlangen, Germany) and 4.7 Tesla MRI (Bruker, Medizintechnik GmbH, Karlsruhe-Ettlingen, Germany). After scanning, eyeballs were extracted and hematoxylin & eosin stained specimens were examined with the microscope. We compared MR spectroscopy with pathologic findings and evaluated characters of tumors. Results: Innoculated cells into eyeball of mice grew retinoblastoma (8/14, 57%). Eyeball with retinoblastoma protruded externally and showed focal hemorrhage. Tumors showed low (n=3), iso (n=4), high (n=1) signal intensity on TIWI, low (n=5), iso (n=1), high (n=2) signal intensity on T2WI, and well enhancement (n=8) with contrast, Involvement of optic nerve was suspected by MRI and confirmed by pathology (n=1). Conclusion: We could demonstrate MR spectroscopy of transplanted retinoblastoma by new tumor cell line in vivo. This imaging technique facilitate molecular imaging investigation of retinoblastoma.

아젭틴 정(염산아젤라스틴 1 mg)에 대한 아젤라 정의 생물학적 동등성

조혜영,윤지훈,서유리,오인준,이성관,문재동,이용복 전남대학교 약품개발연구소 2001 약품개발연구지 Vol.10 No.-

Azelastine, a phthalazinone derivative, is an antiallergic agent which demonstrates histamine H_1-receptor antagonist activity and also inhibits histamine release from mast cells following antigen and non-antigen stimuli. Thus, azelastine may be useful in the management of both asthma and allergic disorders. The purpose of the present study was to evaluate the bioequivalence of two azelastine hydrochloride tablets, Azeptin^TM (Bu Kwang Pharmaceutical Co., Ltd.) and Azela^TM (Kyung Dong Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). Eighteen normal male volunteers, 22.44±2.01 years in age and 61.99±6.18㎏ in body weight, were divided into two groups and a randomized 2×2 cross-over study was employed. After two tablets containing 1㎎ of azelastine hydrochloride per tablet were orally administered, blood was taken at predetermined time intervals and the concentrations of azelastine in serum were determined using HPLC with fluorescence detector. Pharmacokinetic parameters such as AUC_t, C_max and T_max were calculated and ANOVA test was utilized for the statistical analysis of the parameters. The results showed that the differences in AUC_t, C_max and T_max between two tablets were -6.45%, -2.60% and -7.14%, respectively, when calculated against the Azeptin^TM tablet. The powers (1-β) for AUC_t and C_max were 96.65% and 88.47%, respectively. Minimum detectable differences (Δ) at α=0.05 and 1-β=0.8 were less than 20% (e.g., 14.40% and 17.65% for AUC_t and C_max, respectively). The 90% confidence intervals were within ±20% (e.g., -14.87∼1.97 and -12.92∼7.72 for AUC_t and C_max respectively). Two parameters met the criteria of KFDA for bioequivalence, indicating that Azela^TM tablet is bioequivalent to Azeptin^TM tablet.

전북대학교병원 소아치과에 내원한 교정환자 보호자들의 의삭에 관한 설문조사

소유려,백병주,김재곤,양연미,이용훈 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.3

최근 치의학의 눈부신 발전과 소득의 증가에 따른 일반인의 의식 변화로 외모에 대한 관심도가 높아지고 있다. 본 연구에서는 대학병원에 내원한 동기와 교정치료를 시작하게 된 동기,치료방법 및 치료기간을 파악하여,이를 토대로 보호자와 보다 적절한 의사소통을 위한 정보를 파악하고,보호자들의 교정치료에 대한 기대를 파악하고자 본 연구를 시행하였다. 이를 위해 전북대학교 치과병원 소아치과에 내원한 교정환자의 보호자 150명을 대상으로 조사 연구한 결과 다음과 같은 결론을 얻었다. 1. 본 병원의 소아치과를 찾게 된 이유 중 대학병원이 좋을 것 같아서가 52.1%. 친지나 아는 사람의 권유가 25%. 다른 치과병원의 소개가 16.7%로 나타났다. 2. 내원 전 예상하였던 치료기간 중 2년 이상이 37.5%. 12∼18개월이 12.5%로 나타났다. 3. 교정치료를 받으려는 이유 중 부모가 부정교합을 발견하고 걱정스러워서가 58.3%, 주위사람들의 지적이 12.5%로 나타났다. 4. 소아치과 내원 환자의 치료방법은 구강 내 고정성장치가 41.7%, 가철성장치가 29.2% 구외 장치가 2.1%를 차지했다. 5. 예약 후 치료를 위해 기다리는 시간 중 5∼10분이 39.6%, 15∼30분이 4.1%로 나타났으며,기다리는 시간은 어느 정도까지 괜찮다고 생각하는가에 대해 5∼10분이 60.4%, 15∼30분이 2.1%로 나타났다. Recently, in proportion to the remarkable development of dentistry and income increases it is growing more and more a concern about changed awareness in appearance, In this study, it had a grasp of the purpose for university hospital visiting, the motive of the commencement for orthodontic treatment and a method of the treatment as well as term. Based on these, the aim of this study is to keep more of the information between parent and doctors for mutual understanding and to grasp the characteristics for the needs of orthodontic treatment. In order to conduct researches, there has made a survey of 150 persons among orthodontic patients' parents who visit CBNU hospital, the pediatric dentistry. The study has found the results like these. 1. There was a question about the reason to visit CBNU hospital in the department of pediatric dentistry for orthodontic treatment. 52.1% of respondents, the survey found, were more likely to receive a good medical service. 25% of them were counselled from a relative or an acquaintance. 16.7% of them were recommended by another dental clinic. 2. There was a question about the expected orthodontic treatment period, when at first hospital visiting. 37.5% of the respondents answered that it was a 'more than 2 years', 12.5% of them said 'from 12 months to 18 months'. 3. There was a question about the reason to receive orthodontic treatment. 58.3% of the respondents, the survey found, answered the reason was parents' concern about the malocclusion of their children, 12.5% of them said a the orthodontic problem pointed out by entourages. 4. There was a question about the method of orthodontic treatment for patients who visit the department in pediatric dentistry. 41.7% of the respondents said that it was used as 'an intra-oral fixed appliance', 29.2% of them said 'an intra-oral removable appliance', 2.1% of them said 'an extra-oral appliance'. 5. There was a question about the waiting time for treatment after a dental appointment. 60.4% of the respondents said 'from 5 minutes to 10 minutes', 4.1% of them said 'from 15 minutes to 30 minutes'. There was a question about the extent of an acceptable waiting time. It was answered to 'from 5 minutes to 10 minutes' by 60.4% of them, 2.1% of them said 'from 15 minutes to 30 minutes'.

Self-Focusing을 이용한 공진기 없는 공 쌍안정성

김두철,유영훈 제주대학교 1990 논문집 Vol.31 No.-

We have studied the phenomenon of optical bistability based on the self-focusing. Our experiments were performed with a sodium and single reflecting mirror without cavity. It is found that the results of experimernts are consistent with brief theoretical results and the optical bistability is insensitive to a frequency of input light.

소아 그레이브스병에서 부신호르몬 및 IgE의 변화

리선희,이훈영,유재홍 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Graves' disease is a autoimmune thyroid disease. In pathogenesis of Graves' disease, T cell is known as that helps production of thyroid autoantibodies. Endocrine and immune systems are connected and interdependent. Adrenal gland plays an important role in this network and control the balance between serum levels of dehydroepiandrosterone sulfate(DHEAS) and cortisol. The authors evaluated the change of adrenal androgen, cortisol and immunoglobulin E as immune modulators in Graves' disease. From March, 1999 to August, 2002, Serum DHEAS, 24 hour urine free cortisol(F) and IgE and thyroid autoantibodies(TsAb, TBII, AMA, ATA) examined in 22 Graves' patients Serum IgE increased in 41.2% of all patients(97.41±99.07IU/mL). DHEAS was increased in only 5.5% of all patients, and it was decreased or included in normal range in 94.5% of patients(99.3±91.49μg/dL). DHEAS was correlated with ATA(r=0.517).Twenty-four hour urine free cortisol was increased in 72.2% of patients(64.45±47.59μg/dL), but it had no interrelationship with thyroid autoantibodies. Ratio of DHEAS/F had 2.08±2.06, and it had negative correlation with TsAb and TBII, respectively(r=-0.487, r=-0.565). These data demonstrate that there are change of adrenal hormones(DHEAS and cortisol) and IgE, and dis-equilibrium between two adrenal hormones in children with Graves' disease, and Thse might be some relevant to the T cell immune response induction of Graves' disease.

대량의 각혈로 사망한 장티푸스 1예

한상우,유진홍,권순석,김성훈,박지찬,홍은정,최경성,박용완,장준희,안지원,박유경,강지영,박상미,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

혼합액정(80CB+50CB)의 네마틱-스멕틱 A 상전이 근처의 네마틱상에서 휨 탄성상수(K₃)에 관한 광산란 실험연구

임동건,이민규,변영태,유영훈,김두철 濟州大學校 基礎科學硏究所 1990 基礎科學硏究 Vol.3 No.1

액정 8OCB(octyloxycyanobiphenyl)에 액정 5OCB(pentyloxycyanobiphenyl)를 무게비로 혼합하여 혼합액정 (8OCB+5OCB)을 만들었다. 이 혼합액정은 5OCB의 무게비에 따라 McMillan지수 (??)가 감소하였다. 그리고 Rayleigh 광산란 실험방법을 이용하여, 순수 8OCB와 혼합액정의 네마틱-스멕틱 A 상전이 근처의 네마틱상에서 산란된 빛의 세기를 온도와 함수로 측정하였다. 실험데이타 분석결과는 휨(bend) 탄성 상수에 비례하는 세로방향 상관거리(??)는 McMillan 지수에 관계없이 임계지수 ??=0.66±0.03을 갖고 발산하였다. 이 값은 de Gennes의 모델에서 제시된 ??=0.67과 일치함을 알수있다. By utilizing Rayleigh scattering technique, we have measured the temperature dependence of scattered light intensity near nematic to smectic-A phase transition point in the pure 8OCB(octyloxycyanobiphenyl) and its mixtures contaning 5, 10, 15 weight percentage of 5OCB(pentyloxycyanobiphenyl). From analysis of these data. it is found that the longitudinal correlation length (??) diverges with critical exponent ??=0.66±0.03 independent on McMillan parameter (??). This result is consistent with de Gennes model (??).

인체 췌장암세포주(Capan-1)의 증식에 미치는 amiloride의 억제효과

임대관,김신,김유리,노지훈,이지현,김지연,박무인,정근옥,박건영,구자영 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background/Aims Cytoplasmic alkalinization induced by activation of the Na+/H+anti porter which is stimulated upon the addition of growth-promoting agents, such as insulin, epidermal growth factor, phorbol ester, plays an essential role in the initiation on cell proliferation. In the present study the effects of amiloride, a specific and reversible inhibitor of Na+/H+antiporter, on the growth of human pancreatic carcinoma cell line, Capan-1 cells was examined and the effects of 5-fluorouracil (5-FU) were also studied. Cell cycle analysis was done to examine the mechanisms for the inhibitory effects of amiloride. Materials/Methods The growth of Capan-1 cells were examined by counting cell number on two and four days treatment with 1 μM, 5 μM, 10 μM, 20 μM, 40 μM, 80 μM, 160 μM amiloride, and 0.1 ㎍/㎖, 0.3 ㎍/㎖ 5-FU, after plating Capan-1 cells into 35-mm2 plastic dishes at d density of 10x104 cells/dish. The reversibility of the effects of amiloride was examined on two day to eight days treatment with 20 μM amiloride after seeding 2×104 cells/dish. Cell cycle analysis was done on the sells after four days treatment with 20 μM amiloride. Results Amiloride significantly inhibited the growth of Capan-1 cells in a dose-dependent fashion (p<0.05). The inhibitary effect of amiloride on the growth of Capan -1 cells was firstly shown at the concentration of 5 μM, which is not so higher than the concentration of 0.1-0.2 μM attainable by administration of usual dose of amiloride (5-10㎎). Forty-eight percent inhibition of growth was found at an amiloride concentration of 20μM after 4 days treatment, and ninety-three percent inhibition of growth was found at an amiloride concentration of 160μM after 4 days treatment. The inhibitory effect of amiloride on growth of Capan-1 cells was reversible since removal of amiloride by a media change after 48 hours treatment lead to significantly more growth than amiloride treated group (p<0.05). The reversibility of growth inhibition suggests that amiloride in not a non-specific cytotoxin for Capan-1 cells. Amiloride combined with 5-FU significantly inhibited the growth of Capan-1 cells in a dose-dependent fashion compared to an amiloride or a 5-FU alone (p<0.05). After four days treatment with 20 μM amiloride, the faction of cells in G0-G1 phase, S phase and G2-M phase was 47.3%, 35.8%, 16.9% respectively in the amiloride group (20 μM), and 44.3%, 37.1%, 18.6% in the control group. showing no significant differences between the two groups. Conclusions Amiloride significantly inhibited the growth of Capan-1 cells in a dose-dependent fashion, which was reversible. The reversibility of growth inhibition suggests that amiloride is not a non-specific cytotoxin for Capan-1 cells. The concentration of 5 μM, which is not so higher than the concentration of 0.1-0.2 μM attainable by administration of usual dose of amiloride (5-10㎎), which suggests amiloride or its analogues may be used alone or in conjunction with 5-FU for the treatment of pancreatic carcinoma. Further study is needed to clarify the effects of more potent analogues of amiloride on the growth of human pancreatic carcinoma cells.