B 형 간염 Virus-Associated Hemophagocytic Syndrome 1 예

김진우,임경수,최영미,정인석,박두복,김호균,정영기 대한내과학회 1991 대한내과학회지 Vol.40 No.6

Virus-associated hemophagocytic syndrome (VAHS) is a nonneoplastic generalized histiocytic proliferation with marked hemophagocytosis associated with systemic viral infections such as Epstein-Barr virus, cytomegalovirus, adenovirus, herpes virus. etc. High fever, liver dysfunction, coagulation abnormality, and peripheral blood cytopenias are characteristic findings. Hepatosplenomegaly, lymphadenopathy, bilateral pulmonary infiltrations, and skin rash are often present. We report a case of Hepatitis B virus-associated hemophagocytic syndrome with a brief review of literature.

Castleman 씨 병에 동반된 신유전분증

김연수,한진석,이정상,김병국,이중건,정윤철,이진학,최영진,안규리,김성권,이현순 대한내과학회 1994 대한내과학회지 Vol.46 No.2

Castlemam's disease is an asymptomatic and benign lymph node hyperplasia which is frequently manifested as mediastinal mass in over 70% of cases. Amyloidosis is rarely associated with Castleman's disease. Recently we experienced a patient with nephrotic syndrome due to renal amyloidosis who had been previously diagnosed as Castleman's disease of retroperitoneal lymph node enlargement. A 47-year old woman was admitted because of generalized edema and chest tightness. Five months ago she diagnosed as Castlman's disease-plasma cell type, of retroperitoneal lymph node enlargement. The patient was followed up through outpatient department without any specific medication. Physical examination showed pale conjunctivae, palpable mass on epigastric area and pretibial pitting edema. The hemoglobin, leukocyte count and erythrocyte sedimentation rate were 96 g/L, 5.9×109/L and 127 mm/hour, respectively. The blood urea nitogen was 3.6 mmol/L and creatinine was 88 umol/L. The urinalysis showed 3 positive for albumin. Twentyfour hour urine contained 16.6 grams of protein. A computerized tomographic (CT) scan of the abdomen disclosed multiple lymph node enlargement at mesentery. Percutaneous needle biopsy of kidney showed massive infiltration of pale pinkish amorphous material in the glomerular tuft forming large nodules. Ultrastructural examination exhibited heavy deposition of amyloid fibrils in the mesangium and perpendicular to glomerular basement membrane. Polarizing microscopy with Congo-red stain revealed prominent yellow green birefringence in glomeruli, tubules and interstitium.

급성 골수성 백혈병(M6)에 합병된 중추성 요붕증 1 예

김성연,조보연,이홍규,고창순,민헌기,김병국,김노경,신찬수,이명식,강덕현,조종태 대한내과학회 1989 대한내과학회지 Vol.37 No.2

Leukemia is known to be an extremely rare cause of diabetes insipidus. We report a case of diabetes insipidus as a complication of leukemia. An 18 year-old man was admitted because of polyuria polydipsia and fever. Bone marrow aspiration and biopsy revealed the diagnosis of acute erythroleukemia (AML, M6). On the water deprivation test, the diabetes insipidus was confirmed to be of the central type. He was managed with intranasal vasopressin for diabetes insipidus with good response. Induction chemotherapy was administered without response, and the patient died of septicemia and respiratory failure 2 months after initial diagnosis. A short review of the literature related to this subject is also presented.

경막외마취 확산의 비교관찰 제 1 보 Bupivacaine-Lidocaine

김영석,김완식,김인규,김흥대,안기량,김교상 대한마취과학회 1980 Korean Journal of Anesthesiology Vol.13 No.1

Epidural anesthesia is widely practiced for lower abdominal operation and delivery in many hospital and its complication in minimal compared with spinal anesthesia. Lidocaine has been used extensively for epidural anesthesia with very satisfactory results. It has a very rapid onset of action, producing complete analgesia and has a reasonable duration of action(about 1-1½hr). A concentration of 1. 5% lidocaine causes effective sensory and autonomic blockade but it is unlikely to produce motor paralysis. More recently, bupivacaine(0.5%) has tended to supplement lidocaine as the drug of choice of epidural anesthesia. Firstly, the duration of action is longer. Secondly, it has better affinity for the tissue so that less will be absorbed into the circulation, thus reducing the risk of a toxic reaction. Thirdly, when used with a continuous technique, there is much chance of tachyphylaxis. Using a standardized anesthesia technic, we compared level of sensory anesthesia with a 0. 5% bupivacaine and 1. 5% lidocaine uder elective and emergency surgery. When equal volume of local anesthetic solution were injected(20 ml of 0.5% bupivacaine and l. 5% lidocaine) there were no statistically significant differences in sensory level in bupivacaine and lidocaine, but the duration of anesthesia in bupivacaine from 2 to 3 times longer than lidocaine.

중등도 및 중증고혈압에서 Nifedipine 설하투여의 강압효과에 관한 연구

김영훈,서순규,최인석,김열홍,안희권,심완주,노영무 대한내과학회 1986 대한내과학회지 Vol.31 No.5

In order to assess the efficacy of sublingual nifedipine in the acute treatment of moderate to severe hypertension, a single blind test was done in 30 patients, 10 males and 20 females, aged 40 to 76 years, with moderate to severe hypertension. The patients with mean sitting blood pressure(BP) of more than J40 mmHg received sublingual placebo, and BP and pulse rate(PR) were measured in sitting position 10,20 and 30 minutes after the sublingual placebo was given. The patients with post-placebo 30 minutes sitting mean BP of less than 13pmmHg were excluded from the study. The placebo treatment period was followed by the administration of 10mg of sublingual nifedipine, and BP and PR were measured 10,20,30 and 45 minutes after nifedipine was given. BP decreased with placebo treatment(p$lt;0. 01 by paired t-test, preplacebo vs. post-placebo 30 minutes). With sublingual nifedipine BP started to fall in 10 minutes and reached the lowest levels in 30 or 45 minu1es. The systolic BP decreased from 198.0±21.4mmHg to 159±20.4mmHg, diastolic BP from 122.5±13.0 mmHg to 103.2±14.4 mmHg and mean from 147.7±13.4 mmHg to 121.7±14.8 mmHg 45minutes after nifedipine(p$lt;0.01 by paired t-test). The average fall in systolic BP/diastolic BP/mean BP 45 minutes after nifedipine was 39/19/26 mmHg(p$lt;0. 001, by paired t-test). The maximal fall in systolic BP correlated better with pretreatment value(r=0.42) than the maximal fall in diastolic pressure(r=0.21), PR increased from 79±12 to 87±11/minute with nifedipine(p$lt;0.001, by paired t-test). Side effects were mild facial flushing(16.7%) and palpitation (3.3%). The findings suggest that a dose of 10mg of sublingual nifedipine is a simple, effective and safe method for the acute treatment of moderate to severe hypertension and can be used as a non-injecting alternative agent for the treatment of hypertensive emergency.

한국형 출혈열 후유증으로 발생된 만성 신우신염

김연수,한진석,이정상,김성권,진호준,안규리,오국환,오윤규 대한내과학회 1997 대한내과학회지 Vol.52 No.4

It has been known that most patients with Korean Hemorrhagic Fever (KHF) were recovered without any significant renal complication. But several cases of renal hypertension, chronic pyelonephritis, and chronic renal failure after KHF have been reported. Recently, we experienced one case of chronic pyelonephritis as a sequela of KHF, which has been diagnosed at the 78th month of illness. This case showed reduced thickness of renal parenchyme, small and irregular shaped kidney, focal loss of normal cupping of calyces, and accumulation of radiacontrast media at distal calyes by IVP. This case suggested that chronic pyelonephritis may develop as a sequela of KHF,

한글 WORD PROCESSOR 에 관한 연구

김현욱,김덕진,양정윤,김낙빈,김영천,이순흠 고려대학교 공학기술연구소 1984 고려대학교 생산기술연구소 생기연논문집 Vol.20 No.1

A Hanguel word processing software which could be ported into a general purpose microcomputer that has Z-80A CPU and FDOS operating system has been described in this paper. This software consists of input routine, processing routine, and output routine. In the input routine, Hanguel inputted linearly by the ASCII keyboard is combined into a character, and is displayed on the CRT screen in two-dimensional form. In the processing routine, any function among (1) editing (2) updating (3) printing (4) deleting could be selectively performed. In the output routine, Hanguel characters could be selectively printed in the 3 different sized character forms, i.e., 16×16 dot, 24×24 dot, and 32×32 dot size.

크롬 피콜린산 또는 카르니틴이 첨가된 사료급여가 비육돈의 성장 및 도체특성에 미치는 영향

김지훈,한인규,김대성,배극환,양종석,손현수,현영 한국영양사료학회 1999 韓國營養飼料學會誌 Vol.23 No.5

본 시험은 여러 가지 광물질과 혼합된 크롬 피콜린산이나 카르니틴을 첨가한 사료의 급여가 비육돈의 성장 및 도체특성에 미치는 영향을 조사하기 위하여 실시되었다. 평균체중 60.69±1.11 kg인 삼원교잡종 (Yorkshire×Landrace×Duroc) 비육돈 암수 180마리를 대조구, CFC{CrP + Fe₂O₃ + CaCO₃}, CFZC{CrP + Fe₂O₃ + ZnO + CaCO₃}, CZC-1 {CrP (1/300) + ZnO(9/300) + CaCO₃(290/300)}, CZC-2(CrP(1/300) + ZnO(14/300) + CaCO₃ (285/300)} 그리고 카르니틴구 등 6처리구에 성별로 배치하였다. 크롬 피콜린산이나 카르니틴에 의한 성장개선은 발견되지 않았다. 수퇘지에 있어서는 CFZC 처리구가 CZC-2 처리구보다 유의적으로 사료효율이 좋았다 (p<0.05). 도체특성에 있어서도 전체적으로 처리구간의 유의적인 차이는 발견되지 않았으나, 수퇘지에서는 CFZC 처리구가 대조구에 비해 등지방두께가 않았고 (p<0.05), 가장 좋은 도체등급은 CZC-2 처리구에서 나타났다. A study was conducted to investigate the effect of feeding diets containing chromium picolinate (CrP) or carnitine on growth and carcass characteristics in finishing pigs. A total of 180 cross bred pigs (Yorkshire x Landrace x Duroc; initial body weight of 60.7±1.1 kg) were assigned to 6 treatments : Control, CFC{CrP + Fe₂O₃ + CaCO₃}, CFZC{CrP + Fe₂O₃ + ZnO + CaCO₃}, CZC-1 {CrP (1/300) + ZnO(9/300) + CaCO₃(290/300)}, CZC-2(CrP(1/300) + ZnO(14/300) + CaCO₃ (285/300)} and camitine. No significant improvement was found in average daily gain (ADG), average daily feed intake (ADFI), and feed/gain ratio (F/G) by feeding diets containing chromium picolinate. The feed efficiency of male pigs fed with CFZC was better than pigs fed CZC-2 diet during the entire period (p<0.05). No differences were found in carcass characteristics between treatments expect that backfat thickness was reduced in male pigs fed the CFZC diet compared to the control (p<0.05). The best carcass grade was found in pigs fed CZC-2 the diet.

늑막조직생검으로 진단한 Pleural Paragonimiasis 1 예

김기영,이승환,박진현,이재갑,용석중,신계철,홍욱균,김향인,진춘조 대한내과학회 1991 대한내과학회지 Vol.40 No.5

We report a 28-year old female patient with pleural paragonimiasis who did not have the usual diagnostic triad for this parasitic disease. She did not have chronic hemoptysis, there were no pulmonary infiltrations, and stool, sputum and pleural fluid examinations did not yield paragonimus ova. The diagnosis was made on the basis of ova found in the pleural biopsy. Paragonimus pleural effusion was resolved with frequent thoracentesis and oral praziquantel therapy.

소아마취의 임상통계학적 고찰

김완식,박동호,황영희,김흥대,안기량,석민호,김지영,장경덕,서병태 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.1

Midazolam maleate, a water soluble banzodiazepine unlike diazepam, was synthetized by Walser and Fryer in 1975. In order to ealuate the effectiveness as an induction agent for general anesthesia, 22 elective surgical patients belonging to ASA classification 1 and 2 were selected. And ten patients (male 7, female 3, average 33.5 years old) were induced with midazolam maleate 0.2mg/kg and twelve patients (mdale 7, female 5, average 32.5 years old) with diazepam 0.3mg/kg. The results were summarized as follows. 1) Anesthesia was induced in all of midazolam group by one intravenous injection, but only 6 patients of diazepam group could induced by one injection and the other 6 patients needed 2 or more injections. 2) The changes of blood pressure and pulse rate after induction and intubation were almost similar in the two groups, but greater individual variation was seen in diazepam group. 3) A buring sensation following intravenous injection was noted in 11 cases of diazepam group, but none in midazolam group and no phlebitis in either group. From the above results, diazepam and midazolam are almost similar in nature but midazolam is definitely effective as an induction agent and has less side effects. Therefore midazolam maleate is regarded as a more effective agent than diazepam as an induction for general anesthesia.