젊은 남자에게 발생한 통상성 간질성 폐렴과 동반된 폐암 1예

박종숙,이준혁,박성우,장안수,박춘식,박재성,백상현,고은석,신화균 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Usual interstitial pneumonia(UIP) is relatively rare disease of lung parenchyme under the age of 50. Lung cancer is reported to occur as a complication of UIP, but has not been reported in young age patient with UIP in Korea. A 35-year-old man was admitted to the hospital because of dyspnea, cough and mild fever. He had been suffered from dyspnea during 3 years. The dyspnea worsened recent 1 month ago. He had been treated with pneumonia at another hospital during 4 months before this admission. Chest radiographs and High resolution CT showed subpleural and basal dominant reticular opacities in both lung with no change until now. He was smoker and his occupation was car engine-man dealing with benzene. UIP is suspected by history and radiologic findings. Operation for open lung biopsy was performed to obtain lung specimen via video-assisted thoracoscopic surgery. Patient's pathologic examination showed UIP combined with adenocarcinoma in RLL superior segment and posterobasal segment and RLL lobectomy was done. After operation, the patient has been in cancer free condition so far. We report a case of UIP combined with lung cancer in young man with brief review of the literature.

인공관절 치환술 후 발생한 대퇴 골절 치료에서 금속판 내고정의 문제점

박명식,최병완,배현경,박종혁 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 최근 빈도가 증가하고 골절양상도 복잡해지는 인공관절 수술 후 발생한 대퇴 골절의 발생 빈도와 금속판을 이용한 치료 시의 문제점을 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법: 1985년부터 1998년까지 시행된 1,275 (1,188 일차 치환, 97 재치환술)례의 고관절 치환술 시행 환자 중 52명에서 발생한 52ㄹㅖ의 대퇴부 골절을 대상으로 조사하였다. 이를 안정성 여부와 스템 끝 주위의 골절 위치에 따라서 근위부 (Ⅰ), 중심부 (스템 주위) (Ⅱ), 언위부(Ⅲ)로 구분하였고 이를 다시 비전위성 (A), 전위성 (B), 불안정성 삽입물 (C)으로 세부나였다. 치료의 방법으로 삽입물이 안정성을 가진 근위부 골절 (제 1형)에서는 부목 고정이나 환상 강선 고정을 시행하였으며, 스템 끝 (제 2형)이나 원위부 (제 3형) 골절에서는 금속판과 나사못 등을 사용하고 대퇴골 과상부인 슬관절 주변의 골절인 경우 외고정 장치 장착을 하였다. 금속판 고정을 한 경우는 골이식술을 시도하였다. 결 과: 인공관절 치환 후 발생한 골절의 빈도는 4.1%이었고, 이 중 술 중 골절은 1.5%, 술 후 골절은 2.6%이었다. 골절의 평균 유합기간은 3.1개월이었다. 금속판을 이용하여 치료한 경우 2례의 불유합과 3례의 재골절 중 1례는 골절 유합 후 보행 도중 낙상에 의하여, 1례는 골절부 유합 후 금속판 제거 후 발생하였으며, 1례는 체중 부하 도중 발생한 골절이었다. 제 Ⅲ형 골절의 경우 전례에서 스템의 이완 소견은 볼 수 없었다. 결 론: 저자들은 인공고관절 치환술 후 발생한 대퇴골 골절 치료에서 금속판 내고정 후 5례의 비교적 많은 합병증을 경험하였다. 이 중 2례는 부적절한 짧은 금속판의 선택과 조기 보행, 나머지 3례는 금속판 및 나사못과 관련된 골절로서 스트레스가 집중되는 부위인 대퇴 스템 원위단이나 금속판의 근위부는 재골절의 위험이 있으므로 골절의 치료에 있어서 골이식이나 긴 금속판 사용, 골유합시까지 외부충격에 보호 등으로 재골절의 위험 빈도를 해결해야 한다. Purpose: The purpose was to evaluate the postoperative periprosthetic femur fracture of hip arthroplasty and relative problems of management using plate fixation. Material and Method: We reviewed 37 cases of femoral fractures out of 1,270 (1,183 primary hips and 97 revision hips) hips which received hip arthroplasty during the observation period(1985~1998). We classified them according to the stability and the location of the fractures related to the stem tip: Proximal (Ⅰ), middle (around stem)(Ⅱ) and distal(Ⅲ). Then we subclassified the fractures as cortical perforation or a fissure, undisplaced (A), displaced(B) and unstable prosthesis (C). we managed periprosthetic fracture with splint applied or cerclage proximal fracture (type Ⅰ), plate fixation and bone grafts in the step tip(type Ⅱ) or distal fracture (type Ⅲ). Un unstable fractures, we revised them with long fluted stems. Result: The average union time is 3.1 months (range, 2~6.2 months). After management of fracture with plate showed 5 complications, two nonunion and three refractures. The causes of nonunion are weight bearing and a too short plate. The causes of refracture are screw fixation and empty hole just distal to stem tip. The other caused by the roles of stress riser in proximal screw of blade plate in management of supracondylar fracture. Conclusion: We recommend the use of cerclage band system of fixed in a more proximal site in long plate and bone graft. In unstable prosthesis, we had taken a best results after revised with distal fluted stem, in which we don't need further distal stability like a additional cerclage or locking screw and additional bone graft.

염색체이상에 관한 연구(611례 분석)

박종우,구선회,민혁기 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

From March, 1988 to October, 1993, we studied chromosomal analysis from peripheral blood to investigate chromosomal abnormalities in 611 patients showing multiple congenital anomaly, growth or mental retardation, repeated pregnancy losses, infertility, amenorrhea, pubertal failure, ambiguous genitalia, fetal anormaly, malignant disease and others. 82 chromosomal abnormalities were recognized as follows. 1. The rate of chromosomal abnormality is 13.2%. Among them, autosomal abnormality is 67% and sex chromosomal abnormality is 33%. 2. 22 cases of 47, XY,+21, 21 cases of 47, XX,+21, 3 cases of 46, XX, t(14;21)(qll;qll), and 1 case of 46, XX, t(15;21)(q11;q11) were found in Down syndrome. 3. 13 cases of 45, X, 4 cases of 46X, i(Xq), 2 cases of 46X, i(Xq)/45, X, 1 case of 45, X/46, Xr(X), and 1 case of 45, X/47, XXX were found in Turner syndrome. 4. 6 cases of Kleinfelter syndrome were found. 5. 4 cases of reciprocal translocation, 3 cases of Robertsonian translocation and 2 cases of ring chromosomes were found.

마늘成分이 肝 Glutathione S-Transferase 및 Glutathione peroxidase 活性에 미치는 影響

朴鍾珉,李相日,金善業,許瑾,金碩煥,徐赫珪 嶺南大學校 環境問題硏究所 1985 環境硏究 Vol.5 No.2

Garlic (Allium sativum L.) is a widely distributed plant used in all parts of the world not only as a spice but also as a popular remedy for several thousand years Recent studies have shown that garlic components may regulate the many metabolism in liver. Therefore, the present work was undertaken to study the effect of garlicjuice, allicin fraction and heat-treated allicin fraction on the hepatic glutathione s-transferase and glutathione peroxidase which protect against toxic compound and lipid peroxide in liver. The results obtained were summarized as follows. By the treatment of garlic juice, glutathione s-transferase and glutathione peroxidase activity was increased in hepatic cytosolic fraction compare with control group. The enzyme activtiy is more increased by treatment with boiled garlic juice compared with fresh garlic juice in rats. The effect of allicin fraction and heat-treated allicin fraction on the hepatic glutathione s-transferase was observed that these components inhibited the enzyme activity in vitro, whereas the enzyme activity was strongly inhibited heat-treated allicin fraction than allicin fraction. These observation led us to conclude that the garlic components which are a stable substance in heat may regulate the hepatic glutathione s-transferase and glutathione peroxidase activity.

정신질환자 수용시설환자의 정신과적 입원치료 경험 유무에 따른 비교연구

박민철,오상우,권혁일,박남진,김종주 圓光大學校 醫科學硏究所 1986 圓光醫科學 Vol.2 No.2

We have visited the asylums in Chollapukdo for two months since March of 1985. We conducted a comparative study between the patients who has been previously hospitalized and who has not been hospitalized for psychiatric problems. We individually interviewed 489 patients using the interview schedule. The results are shown as follows: 1. The group who were young, single and highly educated have been more hospitalized than the groups who were old, married and little educated. However, no significant difference was made by sex and districts. 2. The group who lived alone or were deserted from the family has been rarely hospitalized. 3. The group, who has been entered the asylum by the family or who explained the reason as treatment, has been more hospitalized previously than the group entered by the others or who said that they came due to alcohol. 4. While the group who has been hospitalized showed tendency to accept having their psychiatric disorders, but the group who has not been hospitalized showed tendency to deny having their disorders. 5. The group who named their disorders psychoses or schizophrenia has been more hospitalized than the group who named them alcoholics. 6. The group hospitalized previously has been also treated in other ways besides psychiatric treatment, and chronic patients with the duration of more than three years has been relatively hospitalized previously. 7. While the group who has been previously hospitalized was relatively indicated for hospitalization, but the other group was not relatively indicated.

Coating을 시행한 뇌동맥류 파열환자의 예후

박종혁,석종식,목진호,박관,김영백,민병국,황성남,최덕영 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.6

In rare occasions in which aneurysmal neck clipping is nearly impossible, coating is employed. During the period from 1985 to 1992, 312 patients with aneurysm underwent surgery ; aneurysmal neck clipping were performed in 284 cases while coating only in 28. The reasons that coating was required were ; wide and broad neck in 13, perforators arising from the neck in 4, neck tearing during dissection in 3, very friable neck in 2, severe adhesion with surrounding structures in 3, and small aneurysm without enough room for clipping in 3. In twenty-three cases, cotton wisp and bioglue were used as coating materials. In another five cases, the aneurysmal wall was reinforced using Surgicel or Gelfoam. Patients were followed for 24 months on average of all the patients. Four had last contact Six died(4 due to rebleeding and 2 due to pneumonia). Fourteen were good and 4 were moderately disabled. There were no rebleeding incidences during first three months' follow-up after coating. We thus concluded that coating an aneurysm offers some protection from rebleeding, particularly when the rebleeding risk period is over.

원광의대 부속 제 2병원 신경정신과 환자에 대한 통계적 고찰

박민철,김종주,박남진,오상우,권혁일,권영숙,박종호 圓光大學校 醫科學硏究所 1986 圓光醫科學 Vol.2 No.2

We examined 1,856 patients who visited Won Kwang Neuropsychiatric hospital since July 11 of 1984(since the hospital opened) until June 11 of 1986. We researched diagnostic and other distributions of inpatients and outpatients. The study revealed as follows : 1. Of total patients males visited this hospital more than females as 52.7%. Most of them(67.1 %) resided in Iri, Iksan and Kimje. In the point of insurance, insured patients and uninsured patients except medicaids were 73 %. Males(60%) were more insured medically than females (55.4%). While insured patients relatively resided in urban area, but uninsured patients except medicaids did in rural area. 2. Of outpatients neurotic disorder was the most as 35.1%, secondly schizophrenic disorder and thirdly affective disorder, but of inpatients schizophrenic disorder was the most as 41.4%, secondly neurotic disorder thirdly affective disorder. 3. Alcohol abuse (98.2 %), paranoid disorder, convulsive disorder and child mental disorder were mostly found in males, but neurotic disorder (59 .6 %), affective disorder and other psychotic disorder were mostly found in females. 4. In unmarried ones schizophrenic disorder ( 43 .6 %), neurotic disorder, other psychotic disorder were common, but in married ones neurotic disorder (55.1 %), schizophrenic disorder, affective disorder were common. 5. On the distribution of age schizophrenic disorder was found the most in the twenties (28.4 %), next in the thirties and in the forties, but neurotic disorder was found the most in the thirties, next in the twenties and in the forties. 6. On the distribution of age at onset schizophrenic disorder develops mostly during the twenties (45.5 %), secondly during the teens and thirdly during the thirties, but neurotic disorder develops mostly during the thirties and the twenties (53.1 %). 7. On the duration of hospitalization 34.4% of the patients was hospitalized during less than 15 days, 22.0% during 60-90 days and 80.4% during less than 3 months. 8. In the result of treatment 41.2% of the patients was improved and 31.7% a little improved. In total 72.9% of the patients got helped therapeutically.

대류경계층에서 난류흐름에 관한 수치해석적 연구

박종혁,이우범,이정전 國立 麗水大學校 環境問題硏究所 1998 環境硏究論文集 Vol.1 No.-

As turbulent flow include a complex physical process in the convective boundary layer(CBL), it is difficult to explain the physical phenomena exactly. Therefore, it is possible to explain the model in a simple and limited way. For the explanation of the CBL turbulence, enormous amounts of data are required concerning in CBL turbulence. A method to study the structure and characteristics of CBL is numerical simulation of important parts of the flow field i.e. through large eddy simulation(LES). In this study, turbulence in the CBL uniformly heated from below and topped by a layer of uniformly stratified fluid is investigated for flows by numerical simulation(LES). LES uses a finite-difference method to integrate the three-dimensional grid-volume-averaged Navier-Stokes equation for a Boussinesq fluid. In LES, the contribution of the large-carrying structures to momentum, heat and energy transfer are computed exactly, and only the effect of the smallest scales of turbulence is modeled. The purpose of this study is to analyze the velocity and temperature distributions in CBL turbulence in order to study the dispersion of atmospheric pollutant by LES.

Al-Si합금용탕과 Al₂O₃의 젖음성에 관한 연구

朴昌宣,金鍾贊,朴相俊,權赫茂 忠南大學校 産業技術硏究所 1992 산업기술연구논문집 Vol.7 No.1

The purpose of this study is to obtain basic infotmation on the wettability of pure-Al/Al₂O₃, Al-alloy/Cu, Al-alloy/Ni and Al-12%Si/Al₂O₃systems, by using the Sessile drop method. The wettability of Al alloy-melt on Al₂O₃increases with increasing temperature from 750℃ to 850℃ for Al-12%Si-y% (Cu, Zn and Mg) (y:0∼2)/Al₂O₃system, the contact angle decreases with increasing Cu, Zn and Mg content. The wettability of Al alloy on Cu and Ni-palte is better than that on Al₂O₃-plate : this is attributed to the interfacial reaction between the Al aiioy and the metal substrate.

농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례

박태혁,김정일,손지언,김종국,김형수,정갑열,김준연 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례 보고. 방법 : 피로감, 전신무력감, 어지럼증, 보행장애 등의 증상을 주소로 내원한 브롬화메틸을 사용하여 방역작업에 종사하는 건강한 20세와 18세의 근로자를 대상으로 혈액검사, 신경정도 및 근전도검사, 뇌자기공명영상 등의 임상검사와 작업력조사를 시행하였다. 결과 : 1례에서 뇌자기공명영상에서 연수와 소뇌의 양측 측충부의 고신호강도가 관찰되었고 11일 후의 추적조사에서 동일 부위의 고신호강토가 감소된 소견이 관찰되었으며 뇌병증으로 최종 진단되었다. 다른 1례는 신경전도검사에서 다발성 신경병 소견과 뇌유발전위검사에서 우측 하부 뇌간부위 병소가 관찰되었고 뇌병증 및 말초신경 병으로 최종 진단되었다. 결론 : 근로자들의 증상은 소독과정에서 브롬화메틸 노출로 인한 신경 병으로 판단되며 훈증소독과방역작업에 종사하는 근로자들의 실태조사와 안전에 대한 대책이 시급하다고 하겠다. Objectives : To report two cases of neuropathy due to methyl bromide intoxication. Methods : Workers, engaged in the fumigating process, complained fatigue, general weakness, ataxia, and hypersomnia. We evaluated them with blood tests, neurophysiologic studies and MRI and investigated their occupational history. Results : Increased signal intensities were found in the medulla oblongata and paraver mian of cerebellum in MRI and after 11 days, high signal intensities were reduced in the following MRI. In the other case, polyneuropathy and rlght lower brainstem lesion were observed In the NCV and BAEP studies. Conclusions : We confirmed that worker's symptoms were related to methyl bromide exposure in the fumigation. It is necessary that we should evaluate present condition of fumigating process and prepare appropriate methods to protect workers engaged in the fumigation.