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박영배,김유호,서정돈,최윤식,이영우,오병희,도문홍,최동주,전은석 대한내과학회 1987 대한내과학회지 Vol.32 No.3
In order to observe the aspects of prosthetic cardiac valve failure, we analyzed 26 cases of Redo operation among 1081 cases of valve replacemant performed from Jan. 1961. to July 1986. The results are as follows; 1) Crude Redo operation rate was 2.4%. 2) The most common cause or prosthetic cardiac valve failure was the primary tissue failure (73%) 8r the PVE was the 2nd (15.4%). 3) Mean valve implantation time was 47.7 months. Implantation time in the child group was shorter than in adult by 6.8 months, In the primary tissue failure group (19 cases) implantation time in the child was 42.8 months 8z in adult, 66.8 months. (P$lt;0.05) In conclusion, the durability of tissue valves was significantly decreased in the child age group because of increased propensity for calcification, so the preference of tissue valves especially in this age group should be reconsidered.
급성 심근경색증 초기 진단에 latex 응집을 이용한 혈청 myoglobin 측정의 임상적 의의
박영배,서정돈,최윤식,이영우,오병희,손대원,임하진,김유우,박명희 대한내과학회 1987 대한내과학회지 Vol.32 No.2
We evaluated the diagnostic usefulness of latexagglutination test for elevated serum myoglobin as a screening test in the early phase of acute myocardial infarction and 21 patients with chest pain mimicking acute myocardial infarction were included in this study. Result was compared with serum myoglobin level measured by radioimmunoassay (RIA) in every case. The Following results were obtained: 1) When serum myoglobin levels measured by RIA below 85ng/㎖ were regarded as normal, this test showed sensitivity of 82%, specificity of 95%. 2) In latex-agglutionation test for elevated serum myoglobin, test results were interpreted as negative, weakly positive and positive. If we regard weakly positive tests as positive, sensitivity was 93% and specificity was 62%. In contrast, if we regard weakly positive tests as negative specificity rose to 100% while sensitivity reduced to 75%. 3) Agreement rate of both test was k=0.59. It is suggested that latex-agglutination test for elevated serum myoglobin is helpful in ruling out acute myocardial infarction when test result is negative, and that it can be used as a screening test in the early phase of acute myocardial infarction because of its rapidity and simplicity in performing the procedure.
한국에서의 Human T-Cell Leukemia Virus Type-1(HTLV-1)에 대한 혈청학적 및 역학에 관한 연구
이영열,이성열,김은실,이홍복,김병국,이문호,박선양,김노경,서철원,규경채,최강원,조한익,고월청,야마구찌이찌세이 대한내과학회 1986 대한내과학회지 Vol.31 No.2
Type-C retrovirus, human T-cell leukemia virus type-l(HTLV-1), has been shown to be associated etiologically with adult T-cell leukemia, which is an endemic disease in southwestern parts of Japan. We examined the seroepidemiological characteristics of antibody to adult T-cell leukemia virus associated antigen (anti-ATLA-antibody) by the indirect immunofluorescent assay and ELISA from the healthy individuals and various diseased patients in the Republic of Korea, a country adjacent to Japan in which HTLV-1 is endemic. The results were as follows. 24 out of 9,603 individuals(0.25%) were seropiositive. The positve rate was 0.17% in males and 0.36% in females, the sex difference was female predominent relatively. HTLV-1 carriers were found 16 individuals in Seoul, 5 in Kyonggi area, 1 in Chungnam and Jonbuk, respectively, but found only 1 individual in Busan city and Jaejoo area close to southwestern parts of Japan. Positive rate to anti-ATLA-antibody seemed to be high in older age, especially at the 50s(0. 4Yo). In conclusion the prevalence rate of anti-ATLA- antibody seemed to be very low in the Republic of Korea adjacent to Japan in which HTLV-1 is endemic and no patient with adult T-cell leukemia has been found as yet. Also we noted that the Republic of Korea is not an endemic area to HTLV-1.
가토에서 CCNU 로 유발된 골수 저형성증의 혈액학적 소견과 골수스캔의 변화에 관한 연구
김승택,이명철,최두혁,고창순,김병국,이문호,박선양,최성재,김노경,최영희 대한내과학회 1986 대한내과학회지 Vol.30 No.1
To understand systematically the hematological changes including the bone marrow changes in chemotherapeutic agent-induced bone marrow hypoplasia and to define the relationship between hematological and bone marrow scan findings and prognosis of the hypoplasia, CCNU (lomustine) was given orally to 44 rabbits to induce hypoplasia of the bone marrow. And serial changes of peripheral blood and bone marrow findings and (111)In Cl(3)((111)In scan)/(99m)Tc tin colloid bone marrow scan((99m)Tc scan) were checked before and after induction of hypoplasia. With assessment of 28 evaluable rabbits, the following results were obtained: 1) Significant hypoplasia of the bone marrow developed around day 4 of CCNU administration and recovered around day 14(cellularity 51,4±13.5% and 24. 5±14.97o before and after CCNU respectively, p<005). Megakaryocyte count was significantly depressed from 95.67,26% to 36.7$gt;31.82%(P$lt;0.005). M: E ratio was decreased from 162±1.19 to 0, 0.5$lt;0. 43(p±0.005). Shift to left(475), maturation a(40%), naked nucleus and degenerated cells(20%), increase of lymphocytes(47%), monocytes and reticulum cells were also found. 2) The uptake ratio of the 99(m)Tc tin colloid bone marrow scan was markedly increased in contrast to the depression of the bone marrow(4.4±2.12 and 14.1±7.06 before and 4 days after CCNU, respectively, p40. 005). Tc scan uptake ratio was inversely related to the cellularity(r=-0.442, p$lt;0.05) and megakaryocyte number of the bone marrow(r= 0.89, p< 0.01) and peripheral blood granulocyte (r = 0. 54. Pg0.01) and platelet count(r=0.40, p$lt;0.05). There was not significant correlation between (111)In scan uptake ratio and hematologic parameters. 3) The amplitude of the change of the (99m)Tc scan uptake ratio was significantly related to the prognosis of the rabbits with experimentally induced hypoplasia of the bone marrow(dead 5.1±2,67, survivors 2,5±0.96, P<0.01). The change of the (111)In scan uptake ratio was not related to the prognosis of these rabbits. In experimentally induced rrow hypoplasia, morphologic changes in addition to the numerical changes of the bone marrow elements were observed. And serial (99)Tc scan of the bone marrow appears to be helpful assessing the severity and predicting the outcome of bone marrow hypoplasia.
소장내용물의 위내역류 및 위내용물 배출시간에 관한 연구
김진호,박승철,이형호,안일민,박영태,김열흥,이창흥 대한내과학회 1986 대한내과학회지 Vol.30 No.2
Radionuclide enterogastric scintigraphy was done with (99m)Tc-DISIDA and (111)In-DTPA in 35cases; control group 5, gastric ulcer group 6, subtotal gastrectomy with Billroth g group 5, and functional gastrointestinal disorder group with or without grossly mixed bile in the gastric juice 19 cases. The results were: 1) Enterogastric reflux was very significantly increased in the subtotal gastrectomy with Billroth II group (p$lt;0, 001), 2) Gastric emptying was significantly delayed in the functional gastrointestinal disorder groups with or without grossly mixed bile (p$lt;0.05, p$lt;0. 001). 3) Enterogastric reflux was not significantly increased in the gastric ulcer group. 4) Enterogastric reflux was not significantly different between the functional gastrointestinal groups with or without grossly mixed bile in the gastric juice. 5) Inverse correlation between the gastric emptying indices and the enterogastric reflux indices was not proved (r=-0.37).
승모판막 질환에서의 Doppler 심초음파도를 이용한 확장기 좌심방-좌심실 평균 압력차에 대한 연구
박영배,서정돈,이영우,김효수,도문흥,오병희 대한내과학회 1987 대한내과학회지 Vol.32 No.2
Diastolic LA and LV pressure gradient was determined with doppler echocardiography in 35 patients with mitral valvular heart disease and was compared with that determined with cardiac catheterization. In 23 patients who underwent mitral valvular replacement, pre and postoperative pressure gradients were observed, Correlation between pressure gradient and pressure half time was investigated with Doppler echocardiography. The results were as follows; 1) 1n total 35 patients with MVHD, mean ΔP in Doppler and cath were 15.8±6.3 (mean±S.D.) mmHg and 17.0±6.7mmHg, respectively, and the correlation coefficient was 0.91. 2) In 15 patients with pure MS, mean ΔP in Doppler and cath, were 15.5±6.1mmHg and 16.1±5.6mmHg, respectively, and the correlation coefficient was 0.90. 3) In 23 patients who underwent MVR, preop ΔP and postop Δ4P were 17.0±6.2mmHg and 2.2±0.9mmHg, respectively, and the difference was significant. 4) In 13 patients with Ionescu Shiley valve, ΔP and T were 2.1mmHgSl.lmmHg, and 110±50msec respectively. In 9 patients with St. Jude valve, ΔP and T1/2 were 2.3±0.7mmHg and 65±22msec, respectively, 5) The correlation coefficient between ΔP and T1/2 was 0.48 in total 35 MVHD and 0.57 in 15 pure MS. The correlation coefficient between ΔP divided by cardiac index and T1/2 f, was 0.63 in 15 pure MS. Therefore, Doppler echocardiography is a useful noninvasive diagnostic tool for measurement of the pressure gradient between LA and LV in MVHD, and can be used to assess the severity of preop, MVHD and postop. result and to follow up patients after operation.
쇼크 업소버의 소음 발생 요인과 진동감쇠 특성에 관한 연구
박태원,신귀수,이기형,김경모,정인성 한국산업안전학회 1998 한국안전학회지 Vol.13 No.4
Shock absorber has a great influence on the performance of the vehicle(ride comfort, manipulation, noise, vibration, turning, stability). Therefore, in this study we consider theoretically about general damper, variable damping oil damper, the control of vehicle Characteristics for the suspension, and undesirable phenomenon. And we measured the vibration/noise characteristics of shack absorber for the real car experimentation, strain change, and noise characteristics of shock absorber using experimental equipment. The study of domestic company and research institute on the vehicle shock absorber is active, but that of basis is not. So we think that they should be accomplished actively. Therefore, this paper will develop theoretical system on the vibration/noise characteristics of shock absorber by theoretical consideration and experimental result analysis of dynamic characteristics of shock absorber that were accomplished in this study. Then we will use it as the optimistic design data for shock absorber development.