급성호흡곤란증후군 환자의 기계환기치료

진재용 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Acute respiratory distress syndrome(ARDS) is characterized by refractory hypoxemia due to intrapulmonary shunt. It's main pathologic feature is collapses of gas-exchange units. Mechanical ventilation with positive end-expiratory pressure has long been the most important mode of treatment of this syndrome, for which no specific treatment was proved effective. Recently, with the acknowledgement that mechanical ventilation itself can induce lung injury, the principle of ventilatory treatment of this syndrome has changed widely, which can be expressed as lung-protective strategy. The lung-protective strategy consists of two components. One is low tidal volume ventilation which is required to avoid end-inspiratory over-distension of relatively normal gas-exchange units, and the other is to address relatively high level of positive end-expiratory pressure(PEEP) (open-lung approach) which is thought to be required to prevent cyclic collapse and opening that can lead to capillary or alveolar epithelial disruptions. A decremental PEEP trial on deflation curve can give the information on optimal PEEP level for open lung state(open lung PEEP). Best oxygenation is likely to predict open-lung PEEP during a decremental PEEP trial. The determinants for oxygenation during mechanical ventilation include FiO2, PEEP level and mean airway pressure, so respiratory rate or inspiratory time can also influence oxygenation. In some patients the liberations from mechanical ventilation are tedious and pressure support mode is particularly beneficial in these patients.

南部 梅實樹 害蟲種類 및 主要 害蟲의 天敵 硏究

金奎眞,金容在 全南大學校 農業科學技術硏究所 1999 農業科學技術硏究 Vol.34 No.-

우리나라 南部地方의 梅實栽培地에 發生하는 害蟲의 種類를 梅實生育段階別로 調査한 結果, 越冬期로부터 開花, 着果期에 이르는 開花期 害蟲으로서는 總 3目 17科 32種이 調査되었으며 Lepidoptera 8科 15種, Coleoptera 5科 8種, Homoptera 4科 9種이었다. 이 中 比較的 發生量이 많거나 發生頻度가 높은 害蟲으로서는 Lepidoptera의 노랑쐐기나방(Monema flavescens), 검정주머니나방(Mahasena aurea), 복숭아순나방(Grapholita molesta), Coleoptera의 애점박이꽃무지(protaetia oricntalis), 복숭아거위벌레(Rhynchites heros), Homoptera의 뽕나무깍지벌레(Pseudaulacaspis pentagona), 복숭아가루진딧물(Hyalopterus pruni), 복숭아혹진딧물(Myzus persicae), 붉은테두리진딧물(Rhopalosiphum rufiabdominale)이었다. 梅實生育期 害蟲(幼果生育, 成蟲, 收穫期)은 總4目 21科 47種이 調査되었는데 Coleoptera 4科 9種, Lepidoptera 10科 23種, Homoptera 6科 14種, Hemiptera 1科 1種이었다. 이 中 Coleoptera의 복숭아거위벌레(Rhychiles heros), 애점박이꽃무지(Protaetia orientalis), Lepidoptera의 노랑쐐기나방(Monema flavescens), 파랑쐐기나방(Latoia cansocia), 애모무늬잎말이나방(Adoxophyes orana), 복숭아순나방(Grapholita molesta), 검정주머니나방(Mahasens aurea), Homoptera의 뽕나무깍지벌레(Pseudalacaspis pentagona), 샌호제깍지벌레(Comstockapis perniciosa), 가루깍지벌레(Pseuducoccus comstoeki), 복숭아가 루진딧물(Hyalopterus pruni), 목화진딧물(Aphis gossypii)등이 發生量이 많거나 發生頻度가 높았다. 主要害蟲인 뽕나무깍지벌레의 寄生性 天敵으로 Hymenoptera의 Aphytis diaspidis, Archenomus orientalis, Apterencyrtus mocrophagus 3種이 捕食性 天敵으로서 Coleoptera의 애홍점박이무당벌레(Chilocorus kuwanae), 홍점박이무당벌레(Chilocorus rubidus), 무당벌레(Hormonia axyridis) 3種이 調査되었다. 진딧물類의 天敵으로서 Coleoptera의 무당벌레(Harmonia axyridies), 칠성무당벌레(Coccinella septempunctata), 꼬마남생이무당벌레(Propylea japonica), Neuroptera의 풀잠자리(Chrysopa sp.), Hymenoptera의 진디벌(Aphidius ervi) 等이 調査되었다. This study was carried out to investigate insect pests and natural enemies of key insect pests on prunus trees in south region of Korea from 1998 to 1999. The results obtained are summarized as follows. The insect pests on the prunus trees surveyed in overwintering and flowering stage were surveyed total of 32 species, 17 families, and 3 orders. In Lepidoptera 15 species, Coleoptera 8 species and Homoptera 9 species were investigated. Among them high frequency and population density were Monema flavescens, Mahasena aurea, Grapholita molesta of Lepidoptera, Protaetia orientalis, Rhynchites heros of Coleoptera and Pseudaulacaspis pentagona, Hyalopterus pruni, Myzus persicae, Rhopalosiphum rufiabominale of Homoptera. The insect pests in young fruit, immature and matured fruit stage surveyed were total of 48 species, 21 families, and 4 orders. In Coleoptera 9 species, Lepidoptera 23 species, Homoptera 14species and Hemiptera 1 species were investigated. Among them high frequency and population density were Rhychiles heros, Protaetia orientalis of Coleoptera. Monema flavescens, Latoia consocia, Adoxophyes orana Grapholita molesta, Mahasena aurea of Lepidoptera and Pseudalacaspis pentagona, Comstockapis perniciosa, Pseudococcus comstock, Hyalopterus pruni, Aphis gossypii of Homoptera. The natural enemies of Pseudalacaspis pentagona as main key insect pest in prunus trees surveyed were Aphytis diaspidis, Archenomus orientais and Apterencyrtus mocrophagus of Hymenoptera, Chilocorus kuwanae, Chilocorus rubidus and Hormonia axyridis of Coleoptera were investigated. The natureal enemies of aphids observed were Harmonia axyridies, Coccinella septempunctata, Propylea japonica of Coleoptera, Chrysopa sp. of Neuroptera and Aphidius ervi of Hymenoptera.

三槽式便所를 設置한 濟州道內 一部落民의 寄生蟲感染率 推移

蘇鎭琸,李根泰,鄭坪林,李在興,李定熙,金英漢,洪淳億 최신의학사 1968 最新醫學 Vol.11 No.8

Three compartment stool tank system was established in March, 1965 to each of the houses . of Yongheungri, Cheju-do. The trend of parasites prevalence, faithfulness of the people to paractice the system and effectiveness of the system for destruction of ascaris eggs were examined. 1. Only 22 houses among 65 utilized the system for 3 years. The remained 43, gave up to practice; 10 because of the destruction of the cemented tank and 33 due to the shortage of. food stuffs, for hogs. In this island, the people have been raised hogs with human excrets. 2. The prevalence of ascaris infection in the village and in Sinwom-ri, a control village where the human feces were used as food stuffs for hog, were as follows: Yongheung(%) Sinwom(%) March 1965 before medication 52.0 43.0 Dec. 1965 after medication 15.1 21.2 Feb. 1968 22.7 30.8 3. Ascaris eggs in the 3rd compartment, were destroyed 94-100%, whereas the eggs in semi-formed feces in hog sty survived 94%.

퇴행성 척추질환으로 오인된 척수 종양

조용재,김승범,진동규,서의교,김상진 대한척추신경외과학회 2004 Neurospine Vol.1 No.1

Objectives: Symptoms arising from spinal cord tumor are often insidious in onset and nonspecific in nature. To make the subtle initial signs and symptoms of these tumors more apparent to clinicians, we retrospectively analyzed the data of spinal cord tumor patients who were misdiagnosed as degenerative spine disease. Methods: We reviewed history, symptom, sign, radiological study, and pathologic diagnosis of 19 spinal cord tumor patients who had been operated as degenerative spine disease, especially duration and description of symptoms and sign before an accurate diagnosis was made. Results: Average duration of delay before an accurate diagnosis was made was 178.4 days(range: 23~303). Common symptom and signs on neurologic examination included aggravation of pain(8 cases; 47.1 %), and neurologic decline(9 cases; 52.9%) The misdiagnosis included a herniated lumbar disc(16 cases; 94.1%), lumbar stenosis(1 case; 5.9%). Inappropriate treatment for these misdiagnoses included 5 percutaneous lazer discectomies, 9 discectomies, 3 chemonucleolysis, 2 posterior lumbar interbody fusions with cages. Conclusion: When a patient has symptoms that appear to be out of the ordinary, surgeons should suspect other spinal disease including the spinal cord tumor.

PLD 박막의 물리적 성질

한용진,조봉균,정재훈,이수빈,박해윤,이태기,채희백,홍진수 순천향대학교 기초과학연구소 1998 순천향자연과학연구 논문집 Vol.4 No.2

Thin amorphous carbon films were deposited by a Q-switched Nd;YAG 532nm with beam power density of ?? on the high purity graphite (99.7%). The pressure of vacuum chamber was ?? Torr. In order to estimate the quality of the Pulsed Laser Deposition films one of the most important optical properties, bandgap energy, was characterized by transmission and reflection in the range of the visible, and an optical direct bandgap energy of 2.45eV and indirect bandgap energy 0.36eV were obtained. Surface morphology of amorphous film was investigated by AFM (Atomic Force Microscopy). Its surface roughness is 70nm. Comparing our results with the published values in the literature we have confidence that our films show the good quality for optical properties.

파라데이컵을 이용한 플라즈마 분석

정재훈,채희백,한용진,이수빈,홍진수 순천향대학교 기초과학연구소 1998 순천향자연과학연구 논문집 Vol.4 No.2

A faraday cup has been used to obtain informations of various carbon ions in plasma generated during PLD(Pulsed laser deposition). We propose an analytical expression for the velocity distributions of carbon ions ejected in laser ablation. Under the applied voltage the Maxwell-Boltzmann distribution on a stream velocity was adopted to describe the measured velocity distributions. The kinetic ion energies are calculated to be in the range of 605.9eV to 30.7eV. The number are inverse proportional to their kinetic energies : ?? in the oder named.

Langmuir probe를 이용한 플라즈마 진단

이태기,한용진,정재훈,채희백,이수빈,홍진수 순천향대학교 기초과학연구소 1998 순천향자연과학연구 논문집 Vol.4 No.2

The plasma parameters such as temperature and plasma potential was found by the use of a Langmuir probe. It is well known that the properties of the laser-produced plasma plume have an effection those of thin films. Thus, to understand the deposition processes of thin films and to deposit thin films having specific properties it is to necessary to probe the plasma, so we used Langmuir probe. The second harmonic of a Q-switched Nd:YAG laser have 6ns pulse-width and the peak intensity of focused laser beam on the high purity(99.7%) graphite target was nearly ??.

폐결핵으로 오인된 알레르기성 기관지폐 아스페르길루스증 1 예

김태년,함초롬,진재용,김민경,이성순 白中央醫療院 2004 仁濟醫學 Vol.25 No.1

Allergic bronchopulmonary aspergillosis(ABPA) is characterized by asthma and hypersensivity reaction to Aspergillus fumigatus. The typical symtoms of ABPA are fleeting pulmonary infiltrates, eosinophilia, wheezing, fever and brownish sputum. Some exacerbations of ABPA mimic bacterial pneumonia, pulmonary tuberculosis with pulmonary infiltrates, mucopurulent sputum and fever. Out case was misdiagnosed as pulmonary tuberculosis and recurrent pneumonia previously, so treated by antituberculous drugs and antibiotics. We report a case of ABPA mimicking pulmonary tuberculosis.

Definitions of Chronic Obstructive Pulmonary Disease and Chronic Obstructive Pulmonary Disease Exacerbation: A Modified Delphi Survey

( Yong Bum Park ),( Jin Hwa Lee ),( Seung Won Ra ),( Hye Yun Park ),( Ji Ye Jung ),( Young Ae Kang ),( Chin Kook Rhee ),( Deog Kyeom Kim ),( Kwang Ha Yoo ),( Yong Il Hwang ),( Seong Yong Lim ),( Jae S 대한결핵 및 호흡기학회 2023 Tuberculosis and Respiratory Diseases Vol.86 No.3

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) update 2023 proposed new definitions of chronic obstructive pulmonary disease (COPD) and COPD exacerbation. However, an agreement on the definitions has not been made, either internationally or domestically. This study aimed to reach an agreement between experts on the new definitions of COPD and COPD exacerbation in South Korea. Methods: A modified Delphi method was used to make an agreement on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023. We performed two rounds of the survey including 15 Korean experts on COPD, asthma, and tuberculosis. Results: More than two-thirds of the experts agreed on 12 of the 13 statements related to the definitions of COPD and COPD exacerbation in the two rounds of the survey. The experts agreed on the definitions of COPD and COPD exacerbation that should be revised in line with the definitions proposed by the GOLD update 2023. However, the experts showed an uncertain opinion on the statement that the definition of COPD includes patients with persistent airflow obstruction due to bronchiectasis. Conclusion: Based on this Delphi survey, experts’ agreement was made on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023.

관동맥연축에서 서방형 칼슘길항제인 Diltiazem 과 Verapamil 의 치료효과 : Ergonovine Echocardiography 를 이용한 무작위 비교 연구

송재관(Jae Kwan Song),박성욱(Seong Wook Park),제수정(Soo Jung Je),김재중(Jae Joong Kim),두영철(Young Cheoul Doo),김원호(Won Ho Kim),진재용(Jae Yong Chin),김형호(Hyeong Ho Kim),정상식(Sang Sig Cheong),박승정(Seung Jung Park),이종구(Jo 대한내과학회 1994 대한내과학회지 Vol.46 No.3

N/A Background: Detection of left ventricular regional wall motion abnormality with two dimensional echocardiography during ergonovine injection (Ergonovine Echocardiography: Erg Echo) is a useful noninvasive diagnostic method of coronary vasospasm, and as it can be used repeatedly, comparison of the therapeutic efficacy of the prescribed drugs for the patients with variant angina may be possible with this method. The purpose of this study were to compare the antispasmotic action of short-term medication of two currently available sustained-releasing (SR) calcium antagonists (Diltiazem vs Verapamil) with Erg Echo, to investigate the factors determining the drug efficacy and to determine if the results of repeated tests of Erg Echo after shortterm medication correlate with the clinical response. Methods: Forty patients with angiographicallyproven coronary vasospam and positive Erg Echo without medication were randomly assigned into group I and II. Diltiazem SR 90mg b.i,d. was prescribed in the patients of group l and Verapamil SR 120 mg b.i.d. in group II. Isosorbide-5-mononitrate (ISMN, Elantan 20 mg b.i.d.) was commonly given in both groups. After medication of 4 days Erg Echo was repeated, and if follow up results were positive doubling of the dosage of prescribed calcium channel antagonists (i.e. Diltiazem SR 180 mg or Verapamil SR 240 mg b.i.d.) was done and the second follow up test of Erg Echo was performed after another 4 days. Clinical follow-up was done with the dosage of negative Erg Echo, and during 9 (±3) month follow-up period one patient of group I and two of group II were lost and final analysis was done with total 37 patients (19 in group I and 18 in group II). Results: Among 37 patients with variant angina, 32 were male and the mean age was 53 (±8). Sex ratio, mean age, body weight, clinical activity of variant angina assessed by the frquency of chest pain attack, number of spasm-documented coronary vessels, dosage of ergonovine for positive response in baseline Erg Echo and number of the patients with concomitant fixed coronary stenosis were not significantly different between both groups. After 4 day medication coronary vasospasm was not provoked with ergonovine injection in 13 patients of group I, and the positive rate of Erg Echo after medication was 32% (6/19) in group I, which was not significantly different from that (50%, 9/18) of group II (p=0.66). In 15 patients coronary vasospasm was provoked with ergonovine injection despite the medication, and ergonovine dose for positive response rose from 146±84 microgram (mcg) to 218±75 mcg with medication. Patients with 'mixed disease' (coronary vasospasm and concomitant fixed disease) showed higher positive result of Erg Echo after medication than the patients with pure spasm (p=0.001). During open label follow-up of 9±3 months, there was neither case of acute myocardial infarction nor that of sudden cardiac death. Recurrent chest pain with medication was observed in 6 patients of group I and 7 of group II (p=0.90), and recurrent chest pain during follow-up was more frequently observed in patients with positive Erg Echo after 4 day medication than those with negative test (p=0.01). In group II medication was modified to control the high activity of variant angina (chest pain attacks more than 5 per week) in 3 patients and verapamil SR was withdrawned in 4 patients due to side effects (2 cases of impotence, each case of constipation and peripheral edema), while there was no case of drug modification or withdrawl of diltiazem SR (p<0.05) in group I. Conclusion: Although there was no significant difference of short term medication on prevention of coronary vasospasm provoked by ergonovine injection, during long term follow-up of variant angina, diltizem SR with ISMN was superior to verapamil SR with ISMN in control of chest pain and absence of side effects. Erg Echo after short term medication was useful in comparison of drug efficacy, investication of the fact