흉추 경막외강으로 침윤한 흉선종 1례 : Metstasis to Thoracic Epidural Space

최정훈,백욱성,박대곤,오경구,최천식,배상도 高麗病院 1987 高醫 Vol.10 No.-

횡문근융해증과 급성 신부전 및 범발성 혈관내 응고장애를 동반한 열사병 1예

최대은,박수진,권오경,이한규,이영모,이상주,나기량,이강욱,신영태 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40% and central nervous system dysfunctions that results in delirium, convulsions, or coma. Heat stroke is subdivided into two forms, classic and exertional. Since strenuous exercise is one of the major exacerbating and precipitating factors, the incidence of exertional heat stroke is high among young adult, especially military personnel undergoing military training. Exertional heat stroke commonly causes rhabdomyolysis, lactic acidosis, acute renal failure, shock and pulmonary edema. We report a case of heat stroke with rhabdomyolysis, acute renal failure, disseminated intravascular coagulopathy(DIC) after strenuous exercise. A 18 year old man was admitted to the hospital because of loss of consciousness. He was a wrestler and he had tried to lose 6kg in weight by jogging and strenuous exercise on that summer day with hot temperature. The development of this illness was favoured by much clothes inappropriate for that environmental condition with a purpose to enhance sweating, and by restricted intake of water and food. On admission, the blood pressure was 80/50mmHg, and body temperature was 39.4℃ with stuporous mentality. Laboratory finding were as follows : in complete blood cell count, hemoglobin was 16.7g/dL and platelet count was 158,000/ mm³. In blood chemistry, AST 1061U/L, ALT 201U/L, BUN 30mg/dL, Cr 2.2mg/dL, LDH 941IU/L, CK 696IU/L were resulted. In arterial blood gas analysis, pH 7.39, pCO₂ 30mmHg pO₂ 86mmHg, HCO₃ 18.4mEq/L, O₂ saturation 96.7% were resulted. In urinalysis, specific gravity 1.025, protein 3+, erythrocyte 2+ were resulted. In brain imaging study, brain CT finding was normal. After appropriate treatments with rapid cooling, hydration and supportive care, he improved with alert mental status. On 2nd hospital day, in laboratory result, thrombocytopenia and coagulopathy were appeared and renal insufficiency was aggravated. So he was treated with platelet concentrate and fresh frosen plasma for DIC, and enough hydration for appropriate urine volume preservation. After all, On 22nd hospital day, he fully recovered and discharged. Nowadays, with followed for some duration, he is wellbeing with no complications.

생물막 공정에서 질소제거효율 향상을 위한 유기성담체의 효용성 검토

최동욱,최영균,김대영,김윤중,정태학 대한상하수도학회 2003 상하수도학회지 Vol.17 No.3

Availability of organic media for improving nitrogen removal efficiency in a biofilter process was studied. Although, aerobic and anoxic phase could be clearly divided during the operation of single-stage biofilter process and nitrification efficiency was about 80%, denitrification efficiency was very low due to depletion of organic substrate in anoxic phase. However, the deficiency could be improved by addition of organic media in anoxic phase from the simulated result. Nitrogen removal efficiency in a biofilter process packed with organic media in anoxic phase was predicted to be 29% higher than that packed with inorganic media. In addition, about 79% of nitrogen removal efficiency could be obtained from a column test using organic media innoculated by activated sludge. Improvement in nitrogen removal efficiency was responsible for organic leaching from the organic media and the leaching rate was 0.21㎎COD/g-org.media/day.

혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

포스트-텐션 프리캐스트 외부 넓은 보-기둥 접합부의 비탄성 거동

박상욱,최윤철,김영찬,김대중,임재형,권기혁,문정호,이리형 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

Experimental results from the cycle lateral load tests for post-tensioned precast wide beam-column connections were presented. Six exterior beam-column assemblages of half scale were tested in the laboratory. The specimens consist of U-shaped precast wide beams and concrete columns. The continuity at the beam-column joint is achieved with the topping concrete and post-tensioning. The specimens were designed with parameters of the beam-to-column depth ration and the number of tendons within column core. The test results showed that the post-tensioned precast wide beam-column connection satisfied the provisional standard by ACI of acceptance criteria for concrete special moment frames.

갑상선 유두상 암종과 유두상 증식에 대한 S-100 단백 및 EMA 발현에 대한 연구

강대영,김경희,최정목,송규상,강동욱 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

The diagnosis of papillary carcinoma of the thyroid is readily achieved based on a defined aggregate of histopathologic features. A papillary architecture is an imporant but not pivotal component of the diagnosis. The classic nuclear features are the essential diagnostic element. However, both papillary architecture and nuclear features may be encountered in other conditions and produce problems in histopahologic interpretation. A papillary architecture may be found within a follicular or an oncocytic neoplasm of within the nodules of hyperplastic nodular goiter. Moreover, there may be scattered cells within several thyroid lesions that display some of the nuclear characteristics of papillary carcinoma. The distinction of these lesions from papillary carcinoma is important for differential diagnosis. Thus, the availability of supportive diagnosic evidence would be helpful. Immunoreactivity for S-100 and epithelial membrace antigen was investigated in 16 papillary thyroid carcinomas(PTC), including three examples of the follicular variant, 16 cases of papillary hyperplasis, 8 follicular adenomas, and 6 follicular carcinomas. The degree of reaction was rated on a four point scale: +++, most cells(>51%) have positive staining; ++, 11-50% of cells have positive staining; +, less than 10% of cells have positive staining; -, no positive staining is present. The results are summarized as follows: 1) All the papillary carcinomas showed intense nuclear and cytoplasmic expression of S-100 (+++; 7 cases, ++; 9 cases), and EMA was expressed(++; 7 cases, ++; 6 cases, +; 3 cases). 2) In the cases of papillary hperplasia, papillary foci were generally negative for S-100 and EMA(12/16 ; -). In some areas, they were focal, of weak intensity, and showed preferential apical cytoplasmic location of oncocytic change. 3) Four of eight follicular adenomas expressed S-100(++;2 cases, +; 2 cases), whereas four were completely negative. EMA was also expressed(++; 2 cases, +; 3 cases). 4) Follicular carcinoma showed variable expression of S100 and EMA Five of six follicular carcinomas expressed S-100(++; 2 cases, +; 3 cases), whereas one was negative. EMA was also expressed(++; 2 cases, +; 1 case). In conclusion, in the distinction of papilary carcinoma from papillary hyperplasia, we would recommend an initial histological appraisal, with immunohistochemical staining of S100 and EMA in difficult cases.

급성 acetaminophen 중독의 임상적 고찰

손대곤,최성욱,장석준 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Acetaminophen-a common analgesics easily available without doctors prescription in our country-overdosed patient is one of most commonly encountered in the ED. But, acetaminophen is relatively safe drug and treatment of acetaminophen overdosage has been well established. But for the proper management of these patients, two following restrictions should be overcome. The first, serum acetaminophen level should be available immediately for proper disposition of the patients. The second one is the use of the antidote (NAC:N-acetyl cysteine, Mucomyst??) to the potentially toxic patients without delay and adequate dosage and route of administration of the NAC should be familiar to the emergency physician. Except a few hospital, serum acetaminophen level is not available in our country. This pitfall can make emergency physician delay the use of the NAC or misuse of the NAC. To overcome of this pitfall, we reviewed patients who admitted in our hospital due to acetaminophen overdosage from July 1. 1993 to June 30. 1995. Total 18 patients enrelled in our study, 4 male, mean age 25.5 years old, and mean ED presentation time after ingestion was 6.25 hours. Acetaminophen single ingestion was 14 cases and mixed ingestion was 4 cases. With the exception of the one case who ingested 3g of acetaminophen, all patients received 72 hour oral NAC as an antidote for poisoning of acetaminophen. Both NAC and MDAC(multiple dose activated charcoal) was used in 8 cases. 「Serum acetaminophen level was obtained in 12 cases」. "Three patients had showed hepatotoxicity-liver enzyme(SGOT/SGPT) level above 200 IU-recovered during hospitalization.` No fatal hepatotoxicity was noted in our study. Fourteen adjustment disorder, one personality disorder and three major depression was their final psychiatric diagnosis. Their mean hospital day was 7.2 days. In the conclusion, as the efficacy of NAC as an antidote decreases after 8 hours, treatment must be started immediately following all potentially toxic dose of acetaminophen. Administration can be stopped if the acetaminophen concentration is below the treatment line but it is important to avoid potentially fatal delay.

톡소포자충 감염마우스의 Cytokine 및 Heat shock protein 생산 분석

노형준,최인욱,신대환,이영하 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

T. gondii frequently causes severe congenital defects and life-threatening disease in immunocompromised individuals. Cytokines. nitric oxide (NO) and heat shock proteins (HSP) are important to control the parasite multiplication and host resistance. However. there were only fen reports about HSP70 in toxoplasmosis. Moreover. we do not know the cytokines and HSP70 production in case of NO inhibition. Therefore. this study was performed to analyze the production of NO. HSP70 and cytokines after adminstration of aminoguanidine (AMG. suppressor of NO production) in mice infected with T. gondii. BALB/c and C57BL/6 mice were injected with either 5 brain cysts of Me49 strain of T. gondii or 50㎍ of AMG for 2 weeks every day. and then mice were sacrificed at day 4. 7. 14 and 28. HSP70 production in the brain and spleen of both mice strains mere decreased after treatment with AMG. however Toxoplasma-infected ones were significantly increased. HSP70 production of Infection/AMG-treated group of C57BL/7mice was significantly decreased in comparison to Infection group. Whereas Infection/AMG-treated group of BALB/c mice showed similar HSP70 production compared to Infection group. After T. gondii infection. the IFN-γ and TNF-α mRNA expression in the brain and spleen was significantly increased in BALB/c or C57BL/6 mice. IFN-γ mRNA expression in the brain and spleen of Infection/AMG-treated BALB/c mice were not significant differences compared to those of infected ones. however there were significant differences in the spleen of C57BL/6 mice. TNF-α mRNA expression in the spleen of Infection/AMG-treated BALB/c or C57BL/6 mice were significantly decreased in comparison to those of infected ones. Taken together. HSP70. IFN-γ and TNF-α production were significantly increased in Toxoplasma-infected BALB/c and C57L/6 mice. After treatment with NO inhibitor in infected C57BL/6 mice, the production of HSP70 and IFN-γ were significantly decreased. whereas BALB/c mice were not significant differences of HSP70 and IFN-γ production between Infection and Infection/AMG-treated group.

2차원적 전기영동에 의한 톡소포자층 당단백 항원의 분석

황일영,최인욱,신대환,이영하 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Serious disease due to Toxoplasma gondii occurs in congenitally infected children and in immunosuppressed patients, particularly in the case of HIV infection. Glycoproteins modulate the physicochemical properties, and are involved in biological and immunological activities. Although there are many reports about the immune responses after T. gondii infection, there are few reports to identify the glycoproteins from T. gondii. For this reason, we purified the glycoproteins from tachyzoites and cysts of T. gondi and then evaluated the antigenic characterizations of toxoplasmic glycoproteins. Tachyzoites of T. gonii were purified by Percoll-gradient centrifugation. Glucosamine was the major monosaccharides released from the tachyzoites of T. gondii by acid hydrolysis methods. In order to define the antigenicities of both strains, we did 2-dimensional electrophoresis(2-DE). Over 40 protein spots were reproducibly separated in tachyzoites of T. gondii by 2-DE in range of the pH 5-8. Glycoproteins were isolated from tachyzoites of T gondii by Con A-Sepharose 4B affinity chromatography. The major bands of glycoproteins were approximately 22 kDa, 30 kDa and 38 kDa in tachyzoites of T. gondii.

전극제조법과 용매 조성의 비가 고분자 전해질 연료전지의 전극 성능에 미치는 영향

임재욱,최대규,류호진 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.7

In this study, we have investigated the effect of electrode fabrication methods, catalyst slurry composition and electrode and membrane-electrode-assemble(MEA) preparation conditions on the performance of electrode in polymer electrolyte membrane fuel cells(PEMFCs). We have changed the amount of platinum loading, electrode fabrication method(spraying and brushing) and the composition of electrode catalyst slurry. Better electrode performance was obtained with the increase in the platinum loading. The performance of the fabricated electrode by spraying method was higher than that by brushing method. The electrode catalyst slurry using 1:1, IPA and NBA solvents gave best performance. By optimising electrode preparation conditions, a current density of 700 mA/㎠ at 0.6 V was obtained, at 80℃, with H_(2) O_(2) reactants at 1 atm.