치과용 국소마취제에 포함된 Epinephrine이 당뇨 환자의 소수술시 혈당에 미치는 영향에 관한 연구

윤형진,임재석,Yun, Hyung-Jin,Rim, Jae-Suk 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.5

Recently, the number of diabetic patients have been increased with westernized living way and meal habitation. The regulation of blood sugar concentration is very important for diabetic patients to keep homeostasis and, to prevent acute or chronic complications. Epinephrine combined with lidocaine is used in dental clinic extensively. And epinephrine combined with lidocaine also effects on decreasing the blood leakage volume by constricting micro vessle and arteriole. But, So far there are few researches about the effect of epinephrine contained in dental local anesthetic agent on the blood sugar of diabetes during minor oral surgery. The purpose of this study was intended to investigate whether epinephrine which combined with dental local anesthetics influence body glucose level in diabetes patients by glucose monitoring. The subject of this study were 38 diabetic patients and 38 normal adults, each patient was checked body glucose after a meal 2 hours later with resting state, and injection 1:100000 epinephrine with dental lidocaine 54 ml or lidocaine 54 ml only. And then the body glucose level was checked 5 minutes and 30 minutes after injection. The results were analyzed by two way ANOVA test (p<0.05). The results were as follows: In the experimental group 1, the mean of the blood sugar level was 180.3 mg/dl before an anesthetic injection, 182.8 mg/dl after 5minutes of the anesthetic injection and 182.2 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the experimental group 2, the mean of the blood sugar level was 237 mg/dl before an anesthetic injection, 234.5 mg/dl after 5minutes of the anesthetic injection and 231.8 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 1, the mean of the blood sugar level was 117.6 mg/dl before an anesthetic injection, 119.1 mg/dl after 5minutes of the anesthetic injection and 129.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 2, the mean of the blood sugar level was 104.2 mg/dl before an anesthetic injection, 102 mg/dl after 5minutes of the anesthetic injection and 105.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05).

태양열 집열기 매니폴드 형상에 따른 열전달 촉진에 관한 해석

노세현(Se Hyeon Noh),김병련(Byung Ryeon Kim),김동현(Hyun Dong Kim),윤형진(Hyung Jin Yun),김태균(Tae Kyun Kim),홍성주(Sung Ju Hong),박찬우(Chan Woo Park) 대한설비공학회 2021 대한설비공학회 학술발표대회논문집 Vol.2019 No.-

위 선암과 식도 편평상피암이 병발한 중복암 1예

이정호,김정란,이동철,김성자,김상범,이영헌,양창헌,윤형진 東國大學校醫學硏究所 1994 東國醫學 Vol.2 No.-

원발성 중복암이란 한 환자의 서로 다른 조직에서 발생하고, 조직학적으로 서로 다른 두가지 이상의 원발성 암종이 나타나는 것을 말한다. 최근 원발성 중복암에 관한 보고가 증가하고 있는 추세이며 특히 식도암의 경우 중복암의 발생이 높은 빈도로 보고되고 있다. 저자들은 56세 남자환자에서 상부 소화관 내시경 검사와 조직 검사로 식도 편평상피암과 위 선암이 병발한 중복암 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Double primary cancer is defined as the case of primary malignant tumors of different site origins, which are different histologically in each other. The number of reported cases of double primary malignant tumors have increased in recent years. There are several reports on the high incidence of second additional cancer in patients with esophageal cancer. We have experienced a case with double primary malignant tumors of different site of origins such as esophgeal squamous cell carcinoma and gastric adenocarcinoma, which were diagnosed by biopsies with gastric fiberoptic endoscopy and we report this case with review of literature.

만성 위축성 위염및 구강상피 위축을 동반한 악성빈혈 1례

윤형진,배한익,이정호,김성철,전창호,양창헌,이창우 東國大學校醫學硏究所 1994 東國醫學 Vol.2 No.-

악성빈혈은 가장 흔한 비타민 ??의 결핍질환으로 위점막 위축으로 인한 내인자의 분비저하로 발생되며, 근래 환자의 혈청, 타액, 위분비액내의 내인자와 벽세포에 대한 항체를 증명해 냄으로써 위점막의 위축을 자가면역기전으로 설명하려는 경향이 있다. 저자들은 최근 설통 및 흉부 압박감을 주소로 내원한 60세 여자환자가 만성 위축성 위염을 동반한 거적아구성빈혈의 소견을 보이면서 항내인자와 하위벽세포항체가 검출되고, 비타민 ??의 비경구 투여후 급속한 회복을 보여 악성빈혈로 진단하고 이에 문헌고찰과 함께 보고하는 바이다. Pernicious anemia is the most common vitamin ?? deficiency, in which intrinsic factor secretion ceases owing to atrophy of gastric mucosa. On the basis of incomplete evidence, recently pernicious anemia thought to be caused by an autoimmune reaction against gastric parietal cell. A 60 year old female had been admitted to the Department of Internal Medicine, Dong guk University Hospital with chief complaints of sore-tongue and chest pressure. Microscopic examination of peripheral blood and bone marrow disclosed macro-ovalocytic, anisocytic red cell apperance, hypersegmented neutrophils, and hypercellular marrow with megaloblastoid erythropoiesis. Gastroendoscopy with biopsy shows the finding of chronic atrophic gastritis over body to fundus. By using indirect immunofluorescent techniques, we detected the antiparietal cell antibody and antiintrinsic factor antibody. Based on the above findings, a case of pernicious anemia associated with chronic atrophic gastritis could be diagnosed.

아스피린 유발성 기관지 천식 환자에서의 아스피린 탈감작 치료 2예

이형연,윤형진,김성철 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Some asthma patients are intolerant to aspinin.In these patients ingestion of aspirin causesymptoms of rhinitis, and/or urticaria, bronchospasm whthin 1 to 2 hours, which may be fatal. We conducted oral aspirin test and desensitization in two patients with aspirin induced asthma. One of these patients was admitted due to acute asthmatic attack which develop after ingestion of one tablet(500mg) of aspirin, which followed by acute repiratory failure with cyanosis and severe hypoxia which needed intubation and ventilatory care. And the other was occasionally experienced rhinorrhea, generalized itching and dyspnea after the URI medications including aspirin. They were received increasing doses of aspirin in every two hours until a fall in FEV_1 of 20% and experience asthmatic episode. Asprin desensitization, defined as the ability of the patients to ingest 650mg of aspirin, was successfullly achieved with careful managements at third day of aspirin administration. After desensitization the patient can be tolerant 650mg aspirin of without experiencing respiratory symptoms or decreasing in lung function. These two patients could be successfully desensitized to aspirin with safety. Even though there is no exact mechanism about asprin intolerance, most likely to be related to the ability of aspirin to inhibit cyclooxygenase pathway. Therefore enhanced lipoxygenase metabolism perhaps plays a crucial role. Aspirin desensitization enable the aspirin sensitive patients to use aspirin or other NSAIDs with safety.

과인슐린혈증을 보인 Nesidioblastosis 1 예

박성진,이정호,정민영,김정란,이예봉,김성숙,윤형진,구정완,김종목,김탁관,서정욱 대한내과학회 1994 대한내과학회지 Vol.47 No.5

Nesidioblastosis, a condition characterized by diffuse islet cell hyperplasia arising from the ductal epithelium, is often associated with hyperinsulinemic hypoglycemia. This is the most common cause of persistent neonatal hypoglycemia and is extremely rare in adults. A 38-year-old man had suffered from intermittent hypolycemic symptoms for 5 years, and had been relieved by carbohydrate ingestion. Plasma immunoreactive insulin levels and I/G ratio were inappropriately high during prolonged fast. Abdominal CT scan, angiography, and frozen section provided no evidence of a tumor. Pathologic examination of the resected pancreas revealed irregularly sized islets and scattering of small endocrine cell clusters throughout the acinar tissue and ductuloinsular complex and distinct islet cell hypertrophy are present.

십이지장 구부에 발생한 Carcinoid 종양 1예

이창우,김정란,이승석,김성철,양창헌,윤형진,서정욱 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.2

Carcinoid tumors are well-differentiated epithelial neoplasms that usually can be diagnosed without difficulty based on their distinctive histologic patterns. These tumors are composed of variable numbers of calls that contain endocrine secretory granules in their cytoplasm, which can be identified by histochemistry, immunohistochemistry, and electron microscopy, Carcinoid tumors of the duodenum are relatively rare, the reported incidence being 2.0-8.9% of all gastrointestinal carcinoid tumors dianosed in Western countries. The rate of occurrence among all duodenal tumors is 3-5.5%. We experienced a case of carcinoid tumor of the duodenum in a 53 year-old male patient. He was admitted to our hospital because of epigastric pain. On the gastrofiberscopic examination, 0.7 cm sized Yamada type II polyp with central ulceration was noticed on the duodenal bulb. The biopsy specimen revealed carcinoid tumor. He was treated with polypectomy.

IgM, Lambda 형 단일클론 감마병증이 동반된 만성 림프구성 백혈병 1 예

이동철,이정호,이영현,이승석,김정란,양창헌,하경임,이상구,윤형진,김종목,김탁관 대한내과학회 1996 대한내과학회지 Vol.50 No.3

It appears that chronic lymphocytic leukemia (CLL) has a world wide distribution, but the incidence of CLL has known to be low in Korea. Hypogammaglobulinemia is common in chronic lymphocytic leukemia, but monoclonal gammopathy is rare. So we present a case of B-cell chronic lymphocytic leukemia associated with monoclonal gammopathy (IgM, λ type). A 60-year-old male patient visited Dongguk University Hospital due to blood-tinged sputum, cough and dyspnea for 3 to 4 weeks. Physical examination revealed inspiratory rales on the right lower lung field, non-tender 5 finger breaths sized splenomegaly and both inguinal lymphadenopathy. Radiologic study showed a single lung abscess accompanied by acute bacterial pneumonia on the right lower lobe. The peripheral blood smear and bone marrow examination presented many mature appearing small sized lymphocytes. The bone marrow biopsy revealed nodular lymphocyte infiltrates. On the immunohistochemical stain, these cells exhibited anti-CD19 phenotype. The lymph node was largely flooded by small monotonous mature lymphocytes. Serum protein electrophoresis and immunoelectrophoresis showed monoclonal gammopathy(lgkl, λtype, 3.7g/dL). The immunophenotyping study of lymphocytes demonstrated CD19 (+), CD20 (+), HLA-DR (+) but CD5 We concluded that this patient's diagnosis is B-cell chronic lymphocytic leukemia with monoclonal gammopathy.