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저나트륨 혈증의 급속교정후 일시적인 회복후에 발생한 삼투성 탈수초 증후군
박동우,이명호,김호중,박근태,한상웅,이영주,민경환,노우균,문희식 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.4
In literatures, most of the studies of severe hyponatremia during or following its treatment has been concentrated with special references to the rate of correction and its neurologic outcomes. But, there is relatively few ones analyzing the diverse clinical manifestations of neurologic symptorns or complications during the course of treating severe hyponatremia. We experienced a catastrophic course related to hyponatremia in a 51 year woman with severe rheumatoid arthritis, who underwent knee joint replacement, and this case revealed the initial transient neurologic recovery for 3 days by the initial rapid correction of hyponatremia, then followed by delayed deterioration of osmotic demyelination syndrome leading to locked-in syndrome. Reported cases with similar clinical course(biphasic course) in the world lituratures were reviewed with special interests in the initial maximum rate of correction of hyponatremia and radiologic findings. This review suggests that clinicians treating the patients with severe symptomatic hyponatremia should be aware of the possibility of delayed neurologic sequelae despite the recovery of neurologic status as well as the degree of hyponatremia in the early treatment course of hyponatremia.
NIgA 신병증을 동반한 자가면역성 간염과 원발성 담관성 간경변증의 Overlap Syndrome 1 예
한동수,이명호,장세진,조균석,기춘석,전용철,박문향,김호중,노우균,손주현 대한소화기학회 1999 대한소화기학회지 Vol.32 No.6
The case in which patients present clinical, biological, and histological features of both primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH) is rare. Such overlap syndrome is believed to be associated with a poor prognosis. We report a case of PBC-AIH overlap syndrome associated with IgA nephropathy. The patient showed hepatitic and nephritic features including easy fatigability, pruritus, icteric sclera and gross hematuria. The liver biopsy showed chronic hepatitis with piecemea necrosis and bridging necrosis. The clinical data of high titers of antinuclear antibodies and antimi tochondrial antibodies, elevated serum IgM and recurrent pruritus, suggest mixed features of AIH and PBC. IgA nephropathy was confirmed by renal biopsy. High dose of corticosteroids was effective initially, but clinical symptoms were relapsed after tapering the administration of corticosteroids. Thus, azathioprine was administered at a dose of 2 mg/kg/day. A dramatic improvement was noted in clinical conditions and liver tests.
박경남,한동수,이민호,조윤주,최호순,조용현,손주현,기춘석,함준수,전용철,윤병철,노우균 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.6
Pancreatic pseudocysts were complicated in 10-27% of acute pancreatitis and 11-41% of chronic pancreatitis. Asymptomatic pseudocysts require no treatment, but symptomatic pseudocysts should be decompressed. Surgical management had been the traditional approach to treating pancreatic pseudocysts. Endoscopic transpapillary or transduodenal cystoenterostomy were recently suggested as an alternative to surgery in order to avoid surgical complications. The success rates of endoscopic treatment was 65-94%, procedure related morbidity was 6-21% and mortality was 0-5%. We reported two cases of patients with pancreatic pseudocysts which were treated with endoscopic cystogastrostomy and proceeded to drain through stent and ENPD catheter.
특발성 문맥압 항진증에 동반된 십이지장 정맥류 출혈 1예
박경남,한동수,이민호,최호순,윤병철,손주현,이오영,기춘석,함준수,노우균,전용철,송승찬,문광호,손동현,문희식 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.2
Bleeding duodenal varices are a rare complication in patients with portal hypertension. Cirrhosis followed by portal vein obstruction and splenic vein obstruction are the most common causes. Although the prognosis of bleeding duodenal varices is usually poor, an awareness of its characteristic presentation may enable diagnostic and therapeutic proce- dures to be performed rapidly with an increased likelihood of a reaching successful out- come. In this study, we report a case of bleeding duodenal varices in a 23-year-old woman with idiopathic portal hypertension who was also suffering with recurrent melena. Panendoscopy identified prominant tortuous varices with central erosion in the 3rd portion of the duodenum and no esophageal and gastric varices. The varices were successfully treated by distal splenorenal shunt.
송승찬,신진호,강석우,박경남,최호순,박근태,문희식,기춘석,이성희,윤병철,노우균,조균석,이민호 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.3
Tetrodotoxin is a neurotoxin produced by about 90 species of puffer fish and causes paralysis of central nervous system and peripheral nerves by blocking the movement of all monovalent cation. Ingestion of tetrodotoxin produces clinical manifestations such as paresthesias(within 10-45 min), vomiting, lightheadedness, salivation, muscle twitching, dysphagia, difficulty in speaking, convulsion and death that expressed by cardiopulmonary arrest with loss of brain stem reflex sometimes. Tetrodotoxin prevents or delays ischemia induced neuronal death by way of following 3 mechanisms. Firstly, it reduces the energy demand of the brain tissues. Secondly, it delays or even prevents anoxic depolarization. Finally, it deminishes ischemia induced cell swelling and cerebral edema. We report a case of puffer fish poisoning which presented with cardiopulmonary arrest and loss of brain stem reflex, but completely recovered by aggressive cardiopulmonary resuscitation.
노기덕(Ki Deok Ro),한상윤(Sang Yun Han),주형관(Hyung Gwan Ju),강좌운(Ja Un Kang),배태범(Tae Beom Bae),노우균(Woo Kyun Noh) 대한기계학회 2015 大韓機械學會論文集B Vol.39 No.9
본 연구는 상류측에 작은 정삼각주를 가진 원주의 유동장 특성을 양 항력측정 실험과 PIV를 이용한 가시화 실험으로 파악한 것이다. 실험 파라메터는 원주의 직경에 대한 정삼각주의 폭비(H/B=0.2~0.6) 및 원주의 전면에서부터 정삼각주까지의 거리 (G/B=0~3) 로 했다. 정삼각주의 폭비를 고정시킨 경우 원주의 항력감소율은 간격비가 증가할수록 증가하다 감소하는 특성을 보였다. 또한 같은 간격비에서는 정삼각주의 폭비가 클수록 원주의 항력감소율이 컸다. 원주의 Strouhal 수는 간격비가 증가할수록 증가하다 감소하는 특성을 보였다. 정삼각주을 설치한 경우 원주 상류측과 하류측에 정체영역이 나타났으며, 그 크기는 상류측은 삼각주의 폭비가 클수록 증가하는데 비해, 하류측은 거의 일정했다. In this study, we investigate the Characteristics of the flowfields of a circular cylinder having a small triangular prism at the upstream side. We measure the fluid force on the circular cylinder and obtain a visualization of the flow fields using particle image velocimetry (PIV). The experimental parameters employed were the width ratios (H/B = 0.2~0.6) of the triangular prisms to the circular cylinder"s diameter, and the gap ratios (G/B = 0~3) between the circular cylinder and the triangular prism. We observed that the drag reduction rate and Strouhal number of the circular cylinder increased and then decreased with G/B in the case of the same H/B. The drag reduction rate increased with H/B in the case of the same G/B. In the case where the circular cylinder had a small triangular prism, the stagnation regions were represented in the upstream and downstream sides of the circular cylinder.