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,

보행마취(步行麻醉)

김영석,김완식,황호성,이진근,유희구,김흥대 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

An imaginative innovation to shorten hospital stays as a means to reduce patient charges, is out-patient surgery. This procedure also minimized the inconvenience and disruption of the family unit, reduced the opportunities for cross-infection, and freed hospifal beds for the more serriously ill patienta Since the concept of out-patient surgical service was organized, managed, and performed in the Hanyang Medieal Center, we had experience of 132 ambulatory anesthetics during the last two years (from Jan. 1974. to Dec. 1975 ). The results are summarized as follower 1. Preanesthetic examination should be routinely cheeked with Hb., Hct., urinalysis and chest x-ray. 2. Premedication should be administered preanesthetically, atropine sulfate intravenously. 3. ASA class 1 patients should be rhnsen fnr short (less than 1 hour) procedures. 4. Anesthesia is induced with Epontol+S.C.C. and maintained with Halothane+N2O+O2. 5. We suggest that ambulatory anesthesia should be more carefully planned, organized, and managed.

사료의 pH 및 단백질 수준이 자돈의 성장 및 영양소 소화율에 미치는 영향

김지훈,한인규,김진동,조원탁,현충남,이지훈 한국영양사료학회 1999 韓國營養飼料學會誌 Vol.23 No.4

자돈사료내 pH와 단백질 수준의 효과를 알아보기 위하여 2개의 시험을 수행하였다. 시험 1에서는 pH 수준이 자돈의 성장과 영양소 소화율에 미치는 영향을 총 150두의 자돈(L×D×LW ; 8.82㎏ BW 30 ± 2일령)을 이용하여 1) pH 4.7, 2) pH 5.2, 3) pH 5.7 (basal diet), 4) pH 6.2, 5) pH 6.7의 다섯처리를 두었고, 시험 2에서는 pH와 단백질 수준의 효과를 알아보기 위하여 150두의 자돈을 (L×D×LW ; 5.46㎏ BW) 2×3 요인법으로 배치하였다. (조단백질 = 21.5, 24.5%, 사료 pH = 4.5, 5.5, 6.5). 또한 소화율의 측정을 위하여 시험 1에는 25두, 시험 2에는 24두의 자돈에 T-cannular를 설치하였다. 시험 1에서 pH는 자돈의 성장에 아무런 영향이 없는 것으로 나타났다. 낮은 pH사료를 급이한 구에서 사료효율이 약간 좋은 경향이 있었으나, 유의적인 차이는 발견되지 않았다. 회장 및 분소화율도 처리에 의한 효과가 발견되지 않았다. 시험 2에서는 낮은 pH 사료를 급이한 구에서 성장 및 사료효율이 개선되는 경향이 있었다 (P = 0.16). 사료효율은 단백질 수준에 의한 영향이 있었으며 (P<0.05), pH와 단백질 수준간의 상호작용이나 다른 효과는 발견되지 않았다. 회장 소화율도 단백질 수준에 의한 영향은 있었으나, pH의 효과는 methionine의 소화율에만 영향이 있는 것으로 나타났다. 전체적으로 소화율은 pH에 의한 일정한 경향이 발견되지 않았다. 본 시험의 결과는 사료의 pH 조절효과는 자돈의 나이나 사료의 종류에 따라 영향을 받는다는 것을 암시하며, 일반적으로 통용되고 있는 자돈사료는 특별한 산성화 처리가 필요하지 않은 것으로 나타났다. Two experiments were conducted to investigate the effect of diet pH and protein levels on the growth performance and nutrients digestibility in young piglets. In Exp. 1, a total of 150 piglets (Landrace × Duroc × Large White ; 8.82㎏ B W, 30 ± 2 days of age) were allotted into 5 treatments. Treatments were 1) pH 4.7, 2) pH 5.2, 3) pH 5.7 (basal diet), 4) pH 6.2 and 5) pH 6.7. In Exp. 2, the effect of dietary protein and diet pH levels on the growth performance and nutrient digestibility was examined with 150 crossbreds Landrace × Duroc × Large White ; 5.46㎏ BW) piglets in 2 × 3 factorial arrangement. (21.5 and 24.5% CP and diet pH (4.5, 5.5 and 6.5)). Each treatment has 5 replications, 5 heads per replicate. For the digestibility determination, 25 pigs for Exp 1. and 24 pigs for Exp. 2. were fitted with simple T-cannula and individually fed the experimental diet. In Exp. 1, no significant difference was found in any of the criteria measured. Pigs fed low pH diets showed slightly better feed efficiency, but the difference was not significant. Both ileal and fecal nutrient digestibility were not different. A small difference was found in major amino acids digestibility, but there was no constant trend detected. In Exp. 2, pigs fed low pH diet showed a trend (P = 0.16) to grow faster than those fed high pH diet. Feed efficiency was affected by protein level (P<0.05). No other main effect was detected. Protein level affected the ileal digestibility of energy, dry matter, crude fat, methionine and threonine. The effect of pH was found only in methionine digestibility. No other main effect was found in ileal digestibility. It appeared that age of pigs and type of diet could greatly influence the effect of diet pH manipulation. Acidification of commercially available diets might have minimal effect when diet contained high portion of high quality feed ingredients.

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).

기관지내 전이암

김현수,이상수,오미희,이재갑,원구태,홍희승,용석중,신계철 대한내과학회 1991 대한내과학회지 Vol.40 No.4

The lung is the most common site of metastasis of extrapulmonary malignant tumor. According to past reports, metastatic cancer of the lung has been found in about 2% of all patients at autopsy. But these days, a diagnosis of endobronchial metastatic cancer utilizing bronchoscopy only is not easy. Thus we need other means of gathering more informaction, such as past history, discovery of other metastatic sites, and pathologic findings with special staining and electronmicroscope, especially in cases of poorly differentiated adenocarcinoma and epidermoid cancer, which are common types of primary lung cancer. We present 5 cases of endobronchial metastatic cancer. We found endobronchial metastatic cancer 2 cases of cervix cancer (epidermoid, adenocarcinoma), 1 case of colon cancer (adenocarcinoma), hypernephroma (renal cell carcinoma), and bladder cancer (transitional cell carcinoma). Since it was impossiole to diagnose the metastatic adenocarcinoma from the cervix only with lightmicroscopic findings, we could use past history and unusual radiologic and bronchoscopic findings which was thought to be the specific endoscopic finding of metastic endobronchial cancer. The interval between the diagnosis of the primary cancer and endobronchial metastatic cancer was 25.7 months. In the future, development of immunohistochemistry, monoclonal antibody, and molecular biologic techniques will give us diagnostic clue for differential diagnosis of metastatic endobronchial cancer from primary bronchogenic lung cancer.

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.

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.

다른 광물질과 혼합된 크롬 피콜린산 급여가 비육돈의 성장 , 도체특성 , 혈액성상에 미치는 영향

김지훈,한인규,김진동,김대성,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 피콜린 산을 첨가한 사료의 급여가 비육돈의 성장, 도체특성, 혈액성상에 미치는 영향을 알아보기 위하여 수행되었다. 개시체중이 69㎏인 총 513두의 비육돈을 돈방당 16∼21두씩 수용하여 사양시험을 수행하였으며, 9마리가 대사시험에 사용되었다. 처리구는 2개의 단백질 수준별 대조구 (Con 12, Cen 14)와 외산 크롬 피콜린산 (CrP-CaCO₃ ; Prince사 제품). 크롬 제오라이트 (CrP-Zeolite 12, 14), 국산 크롬 피콜린산 1 (CrP-CaCO₃; KIST 개발), 크롬 피콜린산-산화아연 (CrP-CaCO₃-ZnO 12, 14) 그리고 국산 크롬 피콜린산 2 (CrP-CaCO₃ ; M. H. Lee 개발)이었다. 성장성적에 있어서는 일당중체량, 일당사료섭취량, 사료효율 등 모든 조사항목에서 처리구간의 차이가 발견되지 않았으나, 등지방 두께는 크롬 피콜린산 첨가에 의해 감소하는 경향이 발견되었고, 이러한 경향은 출하체중이 무거울수륵 뚜렷하게 나타났다. 도체등급은 크롬 제오라이트구와 크롬 피콜린산-산화아연처리구에서 높게 나타났으며, 혈액내 콜레스테를의 함량도 크롬 제오라이트구와 크롬 피콜린산-산화아연처리구에서 대조구에 비해 유의적으로 감소하였다 (p<0.05). 크롬 피콜린산-산화아연처리구와 크롬 피콜린산구에서 건물 및 단백질 소화율이 향상되었다 (p<0.05). This experiment was conducted to investigate the effects of chromium picolinate in different combinations with minerals on growth, carcass characteristics, serum traits and nutrient digestibility in finishing pigs. Five-hundred and thirteen pigs (69.0 ㎏ of initial weight) were assigned to 9 treatments, each containing three replicates of sixteen to twenty-one pigs each. Additional nine pigs were used in a digestion trial. Treatments were two controls (12% CP and 14% CP), foreign CrP-CaCO₃, two CrP-Zeolite (12% CP and 14% CP), domestic CrP-CaCO₃ 1, CrP-CaCO₃-ZnO (12% CP and 14% CP) and domestic CrP-CaCO₃ 2. ADG was not significantly different among the treatments. Tenth rib backfat thickness tended to be decreased by feeding diet with CrP. Carcass grade was improved by using zeolite and CaCO₃ + ZnO along with CrP in diets. Serum cholesterol level was significantly reduced by feeding diets containing CrP with CaCO₃ + ZnO or Zeolite compared with the control. Supplementation of Cr with CrP-CaCO₃ + ZnO or CrP-CaCO₃ in diets significantly improved the digestibility of crude protein and dry matter (p<0.05). The excretion of nitrogen was lower in pigs fed diets containing Cr regardless of the combinations with minerals. The excretion of phosphorus was lowest in the CrP-CaCO₃ + ZnO group which showed the highest phosphorus digestibility.

운동후 측복통과 함께 발생한 급성 신부전 1 예

김종순,박영주,조종태,이정임,신민호,구천희,박태용,한승수,강진화 대한내과학회 1996 대한내과학회지 Vol.50 No.6

We report a case of acute renal failure with severe loin pain and patchy renal vasoconstriction after exercise. An immediate postcontrast computed tomogram of this case shows multiple patchy areas of poor contrast enhancement in the cortex of the both kidneys. A 24-hours delayed scan without further injection of contrast dye shows multiple wedge-shaped contrast enhancement in the coincident areas of poor enhancement in the immediate scan. The 2 and 5 days delayed scans show that wedge-shaped contrast enhancement becomes disappeared gradually to the renal cortex, and the 8 days delayed scan shows complete disappearance of contrast enhancement. The renal scintigrams with technetium-99m-methylene diphosphonate and dimercaptosuccinic acid show diffuse increased uptakes and multiple patchy photon deficient areas in the both kidneys respectively. The follow-up renal scintigrams show nearly normal findings, This patient had an uneventful hospital course and recovered completely without dialysis.

경막외마취 확산의 비교 관찰

김영석,김완식,황영희,김흥대,김교상,장경덕 대한마취과학회 1981 Korean Journal of Anesthesiology Vol.14 No.1

The segmental spread of epidural analgesia was measured in seventeen surgical patients aged between 17 and 52 years, and in fourteen patients between 60 and 77 years. The upper level in the young was 6.29(±1.56) thoracic vertebra level, but in the elderly was 4(±0.65) thoracic vertebra level at 20 minutes after epidural injection of 1.5% lidocaine 20㎖. A given volume of solution spreads to 0.9, 1.07, 1.54, 2.29 segments greater upper extent at 5, 10, 15, 20 minutes after epidural injection and 0.57, 1.07 segments greater lower extent at 5, 10 minutes in the elder than young. So with increasing age relatively small amounts of solution are required, to produce the same extent of anesthesia in the yonung.