상염색체우성 다낭신의 임상경과 및 합병증

이상주,이영모,이한규,최대은,박기현,이강욱,신영태 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Autosomal dominant polycystic kidney disease(ADPKD) is one of most common hereditary disorder. It is potentially fatal and the major mobilities are hypertension and renal failure. To elucidate clinical characteristics and outcomes of ADPKD, 67 ADPKD patients were analyzed retrospectively. The male to female ratio was 48 years for males and 42 years for females. The factors leading to the dignosis of ADPKD were flank or abdominal pain (46%), palpable abdominal mass (24%), incidental findings (18%), gross hematuria and headache. Urinalysis result showed hematuria (31%), proteinuria (19%), pyuria (18%). Among renal complications hypertension (67%) was the most common. Other complications were urolithiasis (16%) upper urinary tract infection (9%), cyst infection (7%). Azotemia was observed in 24% of cases. Echocardiography showed left ventricular hypertrophy in 24% and valvular regurgitation in 18% of cases, but there was no mital valve prolapse. Cerebrovascular events occurred in 6 cases (2 cases of intervertebral hemorrhage and 4 cases of cerebral infarction). Hipatic cyst were observed in 64% of cases. Eighteen cases culminated in end stage renal failure (ESRF) at an of 47. According to this study, the most common complications of ADPKD was hypertension (67%), ESRF (27%), and cerebrovascular event (9%). Hypertension was more frequently observed in increased creatinine group than normal.

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.

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.

고립성 직장결핵 3예

이동수,정강욱,황도연,이형화,김대현,김영성,곽동협 대한내과학회 2003 대한내과학회지 Vol.64 No.1

저자들은 장결핵 중 발생 부위상 드문 곳으로 알려진 직장에 발생한 고림성 결핵을 3예 경험하였기에 문헌고찰과 함께 보고하는 바이다. Isolated rectal tuberculosis commonly involves sigmoid, ascending, or transverse colon. Rectal involvement in tuberculosis is uncommon and poorly characterized. Isolated rectal tuberculosis was defined as focal lesions of rectum in the abscence of demonstrable lesions in the small and large bowel. Diagnosis of rectal tuberculosis was based on characteristic endoscopic appearance of lesions, histopathologic feature of tuberculosis in biopsy material and response to antitubercular therapy. Three patients with isolated rectal tuberculosis were seen at Kwak's hospital. The lesions observed was classified according to macroscopic morphology as follows: ulcerative, hypertrophic and ulcero-hypertrophic. Clinical manifestations were non-specific and consists of rectal bleeding, fever, weight loss, constipation and abdominal pain. One of the three patients had coexisting tuberculous pleurisy. Response to antitubercular chemotherapy was good. (Koeran J Med 64:96-100, 2003)

갑상선 분화암 환자의 경과 관찰에서 수술전·후 혈청 갑상선글로불린 측정의 유용성

이성진,원종철,김하영,한정희,이은주,김상욱,류진숙,문대혁,홍석준,안일민 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

가상교육 시스템의 상호작요적 모형 개발 및 구현

이홍길,방대욱 계명대학교 산업기술연구소 1998 産業技術硏究所 論文報告集 Vol.21 No.1

We proposed and interactive model of virtual education that can be applied on the realization of virtual university, and implemented a virtual education system that is a web system using plug-in programs and that links appropriately the known applications on the Internet. While other virtual education systems focus on a remote educations, our system realizes an interactive education that teachers and students interact each other on virtrual spaces such as virtual lecture room, virtual office, virtual self-studying room. In our system, it is simple to add new functions and is easy to update the system components because most of them are accomplished by the insertion and update of stand-alone Internet programs.

인체 지방 및 간장조직 중 유기염소제류 및 PCB의 확인 및 정량기법 체계화 : 2차년도

이상기,양자열,김기욱,이수연,오승민,김대현,정규혁 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

수평평판에서의 경사각이 자연대류 열전달에 미치는 영향에 관한 연구

천대희,이동욱 大田産業大學校 1997 한밭대학교 논문집 Vol.14 No.1

Servant leadership and Its Effect on Affective Commitment in Local Hospital Organizations

김대원(외 1명) 신라대학교부설 신라리더십센터 2016 신라 리더십 연구 Vol.- No.9

리더십은 모든 조직과 집단에서 규모와 관계없이 조직내 인적 자원의 효율적 관리를 통해 조직이 추구하고자 하는 목표를 효율적으로 달성하는 데 매우 중요한 역할을 한다. 서번트 리더십은 리더 영향력의 출발점을 조직 구성원과의 관계에서 비롯된다고 보는 관점으로, 보다 인간중심적인 부분에 초점을 두고 있는 리더십이다. 본 연구는 병원 조직의 발전을 위해서는 조직운영의 실질적 주체인 관료들 스스로 외부의 지시나 통제와는 상관없이 조직몰입이 필요하다는 가정하에 이의 영향변인으로 서번트 리더십을 선정하여 이들간 관계를 이론적으로 분석하는 데 목적을 두었다. 분석 결과, 서번트 리더십은 병원종사자들의 조직몰입의 중요한 영향변인으로 확인되었다. 따라서 본 연구는 성과지향적 통제 위주의 리더십이 강조되고 있는 현실의 관리체제하에서 병원종사자들의 업무에 대한 자기 주도적 관리와 자율성을 담보하기 위한 서번트 리더십도 병원조직의 효율성 증진을 위한 중요한 변인이 될 수 있다는 가능성을 확인하였다는 점에서 연구의 가치가 있다.

기체 방사성 물질 제거를 위한 첨착 활성탄 필터 시스템 성능에 관한 연구

김대욱,손현철,이명석,이석범,박길문 朝鮮大學校 機械技術硏究所 1999 機械技術硏究 Vol.2 No.1

This paper presents an application of impregnated activated carbon and impregnated activated carbon filters. They are used for the removal of gaseous radioactive materials at radioactive material handling facilities such as nuclear power plants and research facilities. High adsorption efficiencies as well as stability are required for them to remove hazardous radioactive gases such as activated free iodine released during normal operation or accident condition. This research was initiated to enhance the independence of nuclear industry and raise the level of nuclear technology to that of the leading nuclear nations. By attaining the capability of design and development of HVAC system, national technological competitiveness can be achieved. Also, the ground for technology export will be hardened. Therefore, it is well timed to initiate the project to develope those filter systems domestically utilizing all the relevant technologies available.