히스토아크릴을 이용한 십이지장 궤양 출혈의 지혈 후 발생한 급성췌장염

유재훈,문원,노지훈,구동영,조영화,김기수,윤준모 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

Upper gastrointestinal bleeding is common and potentially life threatening medical emergency. Emergency endoscopy is the first choice of diagnostic and treatment measure for patients with active upper gastrointestinal bleeding. Histoacryl should be considered a second-line treatment modality when conventional treatments were failed. However, it might cause several complications. Herein, we report a case of acute pancreatitis developed after histoacryl injection therapy for active duodenal ulcer bleeding. A 71-year-old man was admitted with melena and hematemesis. On emergency endoscopy, a 2 cm sized active ulcer with bleeding from an exposedvessel was seen at the duodenal bulb. Attempts to arrest the bleeding with hemoclipping and submucosal epinephrine injection were tried, but failed. We changed the method to endoscopic histoacryl injection, and obtained hemostasis immediately. A few hourslater, after successful hemostasis, patient complained diffuse abdominal pain. Ultrasonography revealed hyperechoic heterogenous diffuse pancreatic enlargement and right pararenal space fluid collection, this ultrasonographic findings and elevated serum pancreatic enzymes are compatible with acute pancreatitis.

최근 8년간(2001-2008) 서울대학교치과병원 소아치과의 진료현황 및 수익분포 변화에 대한 조사

손유진,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008. 소아치과 전문 지역 의원의 증가, 소아치과에 대한 보호자의 인식 변화, 치의학의 발전, 소아치과 진료 범주의 확대 등에 의해 최근 소아치과의 진료 양상이 크게 변화하고 있다. 이러한 변화 양상을 파악하고 앞으로의 대학병원 소아치과 및 소아치과 전문 지역 의원의 진료분담에 대한 방향성을 제시하고자 본 연구를 시행하였다. 2001년 1월 1일부터 2008년 12월 31일까지 서울대학교치과병원 소아치과에 내원한 모든 초진 및 재진 환자를 대상으로, 서울대학교치과병원 종합의료정보시스템(OCS)을 통하여 1년간의 외래환자집계 및 수가코드별 진료 행위 건수 및 수익 분포를 조사하여 다음과 같은 결과를 얻었다. 1. 내원환자의 수는 2001년부터 2005년까지 대체로 증가하다 2006년에 감소하였으며 그 이후에는 2006년도와 별다른 변화가 없었다. 2. 2001년에는 예방치료가 6.84%, 수복치료가 49.96%, 치수치료가 9.64%, 외과치료가 10.78%, 교정치료가 22.78%를 차지하였으나, 2008년에는 예방치료가 15.40%, 수복치료가 28.97%, 치수치료가 3.28%, 외과치료가 14.83%, 교정치료가 37.52%를 차지하여 수복치료와 치수치료의 비율은 감소하고 예방치료와 교정치료는 증가하였다. 3. 수복치료의 비율에 있어서 아말감과 글라스 아이오노머 수복 및 기성금관수복의 비율은 감소하였고, 레진의 비율은 증가하였다. 4. 진정요법하 치과치료는 2005년까지 증가하다 2006년, 2007년에는 감소하였고, 2008년에 다시 증가하였다. 5. 전신마취하 치과치료는 2001년부터 2008년까지 꾸준히 증가하였다.

Silorane-based 복합레진의 색안정성에 관한 연구

손유진,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

본 연구의 목적은 silorane-based 복합레진의 색안정성을 기존의 methacrylate-based 복합레진과 비교하여 평가하는 것이다. Silorane-based 복합레진인 P90(3M ESPE, USA), methacrylate-based 복합레진인 Tetric Ceram(Ivoclar Vivadent, Liechtenstein), Z250, Z350(3M ESPE, USA)을 이용하여 시편을 제작하고, 증류수, 커피, 레드 와인, 카레 용액에 담가 1일, 3일, 7일, 14일, 21일, 28일 후 색 변화를 분광광도계로 측정하고 실험 전후의 색상차이(ΔE*_(ab))값을 산출하여 다음과 같은 결과를 얻었다. 1. 카레 용액 > 레드 와인 > 커피 > 증류수의 순으로 레진 시편의 변색이 크게 나타났다. 2. 네 가지 종류의 레진을 비교하였을 때, Z350 > Z250 > Tetric Ceram > P90의 순으로 변색이 크게 나타났다. 3. 카레 용액의 경우 네 종류의 레진 모두에서 침지 1일 이후 수용도 역치 이상(ΔE*_(a)b>3.3)의 변색이 나타났다. 4. 레드 와인의 경우 Z350, Z250, Tetric Ceram에서 침지 1일 이후, P90에서는 침지 28일 이후에 수용도 역치 이상의 변색이 나타났다. 5. 커피의 경우 Z350에서 침지 1일 이후, Z250에서 침지 3일 이후, Tetric Ceram에서 침지 7일 이후에 수용도 역치 이상의 변색이 나타났으나 P90에서는 침지 28일 이후에도 수용도 역치 이상의 변색이 나타나지 않았다. The objective of this study was to evaluate the color stability of new silorane-based composite resin compared with methacrylate-based composite resins after immersion in 3 staining solutions. One silorane-based composite(Filtek P90) and 3 methacrylate -based composites(Filtek Z250, Filtek Z350, Tetric Ceram) were evaluated. Twenty disk-shaped specimens(10×2mm) of each of 4 composite resins were prepared. The specimens were then divided into 4 groups of 5 specimens each and immersed in 3 staining solutions( coffee, red wine, curry solution) or distilled water(control) for 28-day test period. Color of the specimens was measured with a spectrophotometer(Color Eye 7000A) using CIE L*a*b* color space relative to CIE standard illuminant D65 at baseline, 1day, 3days, 7days, 14days, 21days and 28days after staining. The color differences( ΔE*_(ab)) were calculated. The results were obtained as follows ; 1. The mean color changes(ΔE*_(ab)) of the composites were greatest in curry solution, then red wine, coffee and distilled water, in decreasing order. 2. The mean color changes(ΔE*_(ab)) of the composites were greatest in Z350, Z250, Tetric Ceram and P90, in decreasing order.

원발성 피부 CD30 양성/ALK 음성 퇴형성 대세포 림프종 1예

이은주,김협,서영준,서기범,이증훈,박장규,김유찬,김춘옥 대한피부과학회 2003 大韓皮膚科學會誌 Vol.41 No.5

Primary cutaneous CD3O(Ki-1) Positive anaplastic large cell Iymphoma(ALCL) is a rare subset of cutaneous Iymphoma. with a much better prognosis. ALCL is a heterogeneous process that may have a T-cell, B-cell, or indeterminant(null) phenotype and which may or may not express the anaplastic Iymphoma kinase(ALK) oncoprotein. We report a case of ALCL in a 72 year old man. About 4 months ago, multiple erythematous firm ulcerative mass and satellite nodules developed on the right lower leg. The skin lesions rapidly increased in number and size. Some lesions became painful and centrally ulcered. The histologic findings showed a diffuse infiltrate of large Iymphocytes with large nuclei, prominent and multiple nucleoli, and ample cytoplasm. Immunohistochemical stainings for CD3O, CD5 were positive but stainings for LCA, CD3, CD45RO, CD2O, cytokeratin, EMA, and ALK were negative. Therefore, we diagnosed our case as CD+/30ALK- ALCL (Korean J Dermatol 2003;41(5) : 666~669)

15세기 조선온실건축의 기능 및 실내환경 특성에 관한 연구

조동우,유기형,유수훈 대한건축학회 2004 대한건축학회논문집 Vol.20 No.12

Choson Greenhouse consisted of three sidewalls using yellow soil except the south side, the window with oiled Hanji to transmit sunlight that is sloped to the south And Goodle was raised on the floor level, the soil of 40cm thickness was stored up, and the soil of 45cm thickness was finally spread to set vegetables in Choson Greenhouse A kitchen range that was attached in the internal wall between the greenhouse and the kitchen was installed to control the temperature & humidity The heated-air flow goes through fire passageway under Doodle, and exhausts through the smokestack When the water in the kettle boils up on the kitchen range, steam flows to the inside of greenhouse through a pipeline The latent heat of steam can make the temperature and humidity control in the greenhouse To find whether Choson Greenhouse provides functions and thermal environment for planting or not, the thermal performance was measured and analyzed in the greenhouse As measurement results, sunlight entered in the greenhouse, passing through the oiled Hanji cover As it reached the soli of floor and wall surfaces, and it absorbed the sunlight's energy Once absorbed, some of the energy passed back into the atmosphere, but much of it remained trapped in indoor space by the greenhouse effect We found that Choson Greenhouse keeps warm to grow plants with the rise in temperature, and the oiled Hanji is distinctly suitable for a role of thermal insulation, sunlight transmittance Also, the thermal performance was compared a Hangi-covered greenhouse model with a vinyl-covered greenhouse model The Hangi-covered greenhouse model was better for ventilation, thermal insulation and humidity control than the vinyl-covered greenhouse model Therefore, Greenhouse m early Choson dynasty can be fairly evaluated as the extraordinary farming facility compared to nowadays greenhouses

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

폐렴 구균(Streptococcus pneumoniae)에 의한 척수 경막외 농양 1예

이지영,위유미,손경목,기현균,문치숙,오원섭,백경란,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

폐렴구균은 보통 폐렴이나 뇌막염을 일으키는 균으로 척수 경막외 농양을 일으키는 경우는 매우 드물다. 본 저자들은 폐렴 구균에 의한 척수 경막 외 농양을 경험하여 보고하는 바이다. 과거 건강했던 36세 남자 환자로 사다리에서 낙상한 후 요통 및 고열, 신경학적 이상으로 내원하여 자기 공명 촬영 결과 척수 경막 외 농양으로 진단받고 항균제 투여와 함께 응급 수술을 시행하였다. 농 배양 결과 페니실린 감수성인 폐렴 구균이 분리 되었고, 수술 요법과 항생제 투여 후 농양은 치유되었으나 신경학적 이상은 호전 없는 상태로 타원으로 전원되었다. Pneumonia and meningitis are the most frequent manifestations of pneumococcal infections. Pneumococcal spinal epidural abscesses have been rarely reported. Spinal epidural abscess by Streptococcus pneumoniae has been diagnosed among the patients with diabetes mellitus, alcoholism, corticosteroid therapy, intravenous drug use, chronic renal failure, AIDS, and history of spinal surgery. Recently, we experienced a case of pneumococcal spinal epidural abscess after spinal trauma. A 36-year-old male patient was admitted with back pain, fever, and paraplegia which occurred 5 days after the trauma. Spine MRI revealed spinal epidural abscess at the level from T2 to T9. He was treated with antimicrobial agents and surgical exploration for spinal epidural abscess. Pus culture grew S. pneumoniae which was susceptible to penicillin. Despite early surgical treatment, neurologic sequelae remained. Considering the high mortality and morbidity of pneumococcal spinal epidural abscess, early diagnosis and aggressive treatment including surgical intervention and antibiotics therapy should be implemented immediately.

충남대학교 공업기술 계열 교사 연수 프로그램에 대한 만족도 분석

류창열,최유현,김판욱,김기수,김태훈,이창훈 忠南大學校 工業敎育硏究所 2005 論文集 Vol.27 No.1

The purpose of this study was to analyze the educated teachers' satisfaction of the in-service education programs of industrial technical and technology teachers in Chungnam National University. This study was carried out through survey to accomplish the purpose. The number of questionnaires collected was 86. This study used the SPSS program to conduct a descriptive analysis of the data. The results of this study were as follows: (1) The satisfaction about 'teachers' participation', 'utilization of audiovisual materials and instruments' and 'level of professor and lecture' was relatively high. (2) The satisfaction about 'environments of in-service education programs', 'evaluation of achievement', and 'efficacy of lectures' was relatively low.

유해화학물질의 계통분석

박성우,박유신,이진훈,김남이,김유나,임미애,이상기,유재훈,진광호,신호상,노동석 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-