첫 경련이 간질 중첩증으로 발현된 소아의 특성

박석우(Seok Woo Park),장지연(Ji Yeon Chang),권영세(Young Se Kwon),홍영진(Young Jin Hong),손병관(Byong Kwan Son) 대한소아신경학회 2003 대한소아신경학회지 Vol.11 No.2

목 적 : 간질 중첩증은 신속한 치료를 요하는 신경학적 응급 질환으로 때로는 심각한 신경학적 후유증이 발생할 수 있으므로 원인 질환과 예후에 영향을 미치는 인자들에 대해 정확한 이해가 필요하다. 이에 저자들은 첫 경련이 간질 중첩증으로 발현된 소아의 원인, 임상 양상, 치료, 예후 및 신경학적 후유증의 발생 빈도의 연관 관계를 알아보고자 이 연구를 시행하였다. 방 법 : 1996년 7월부터 2002년 6월까지 인하대학교병원 소아과 및 응급실에서 첫 발작이 간질 중첩증으로 진단받은 1개월에서 5세 사이의 환아 25명을 대상으로 나이에 따른 분포, 원인 질환, 경련 형태, 지속 시간, 사용 약물, 뇌파 및 MRI의 소견, 예후를 기록지를 통하여 후향적으로 분석하였다. 결 과 : 1) 대상 환아의 남녀의 비는 2.1:1이었고 대상 환자 25명 중 남아 17명(68%), 여아 8명(32%)이었으며 연령은 20±1.6개월로 대부분 3세 이상(80%)에서 발생하였다. 2) 경련 형태는 전신 강직-간대형이 60%, 전신 강직형 16%, 부분 간대형이 16%, 부분 발작형이 8%이었다. 3) 원인 질환과 예후는 증후성인 경우가 64%였으며 특발성인 경우가 36%였다. 증후성의 경우 발열이 40%, 중추 신경계 감염이 20%, 허혈성 손상이 4%이었으며 원인 질환이 있는 경우와 그렇지 않은 경우와의 통계학적 유의성은 없었다. 4) 경련의 지속시간은 30분-1시간이 17례(68%), 1-2시간이 4례(16%), 2시간 이상이 4례(16%) 이었다. 지속 시간이 짧을수록 예후가 좋은 경향을 보였다. 5) 사용 약물은 phenobarbital, phenytoin, midazolam, valium, valproic acid이었다. 약물 한 가지로 조절된 경우 13례(52%), 두 가지로 조절된 경우 11례(44%), 세 가지로 조절 된 경우 2례(4%)이었으며 세 군간의 예후를 비교해 보았을 때 한 가지로 조절된 군이 다른 군 보다 예후가 좋은 경향으로 나타났다. 6) 뇌파는 20례에서 시행하였는데 정상 7례(35%)이었고, 13례(65%)는 비정상이었다. 비정상은 전기적인 지속경련을 보인 경우 6례(30%), 배경파 이상을 보인 경우 6례(30%), 국소적인 간질파를 보인 경우 1례(5%)이었다. MRI는 19례에서 시행하였는데 정상 소견 10례(53%), 이상 소견 9례(47%)이었다. 7) 원인이 발열인 경우에서의 예후는 정상을 보인 경우가 6례, HHE를 보인 경우가 2례, 복합 부분 발작을 보인 경우가 1례, 정신 지체를 동반한 뇌성 마비가 1례였다. 결 론 : 첫 경련이 간질 중첩증으로 발현된 소아는 대부분 3세 이하였다. 경련 시간이 1시간 이내, 한 가지 항경련제로 경련이 조절되는 경우는 예후가 좋았고, 경련 시간이 1시간 이상이거나, 여러 가지 항경련제를 사용하거나, 원인 질환이 있는 경우는 예후가 나빴다. Purpose : Status epilepticus(SE) is a pediatric and neurologic emergency associated with significant morbidity and mortality. Prompt recognition and management are needed for successful outcomes. We evaluated, clinical manifestations, treatment and prognosis of the patients whose first seizure attacks were presented as SE. Methods : According to the department of pediatrics and the emergency room in Inha University Medical Center, there were a total of 25 children between 1 month and 5 years old who were diagnosed as status epilepticus from July 1996 to June 2002. Also, their medical records were reviewed and analyzed interms of age distribution, accompaning diseases, the types and duration of convulsion, medications, EEG and MRI findings and prognosis. Results : Twenty-five cases were studied. The mean age at the time of the diagnosis was 20±1.6 months and 80% of the patients were less than 3 years old. The most common type of the status epilepticus was generalized tonic clonic seizure comprising 15 cases(60%). 64% of the patients were symptomatic: fever(40%), CNS infection(20%), ischemic injury(4%) while 36% were idiopathic. Seizure attacks were terminated within an hour in seventeen patients(68%) and they controlled by one antiepileptic drug in thirteen patients(52%). Of the 20 EEGs, abnormal findings were shown in 13 cases(65%); namely, electrical seizure(30%), abnormal background(30%), and focal epileptiform discharge(5%). Of the 19 brain MRIs, abnormal findings were shown in 9 cases(47%). Conclusion : The children whose first seizure attack were presented as SE were less than 3 years old. The prognosis is good in that most of the seizure attacks were terminated within an hour and controlled by one epileptic drug. However those seizure attacks with longer duration, multiple antiepileptic druge and underlying causeare had poor prognosis.

신경섬유종증 환자에게서 발생한 특발성 혈소판 감소증 1예

권세훈,김형호,강지인,장재혁,원경준,장재현,김상용,배학연 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Idiopathic thrombocytopenic purpura is a disease characterized by thrombocytopenia in peripheral blood with positive anti-platelet antibody titer, no splenomegaly, the presence of megakarocyte. The causes of idiopathic thrombocytopenic purpura were usually related to autoimmune disease, infection and drugs. A 46-years-old man was admitted for evaluation of abdominal mass. He has many cafe-au-lait spots and nodules in almost skin for 30 years. Several years ago, he palpated mass in Lt. inguinal area. hIe has known the abdominal mass after checking abdomen CT in local clinic and visited our hospital for evaluation of abdominal mass. At admission, laboratory tests showed hemoglobin 12.5 g/dL, hematocrit 38.4 %, WBC 5,460 /㎣ (neutrophil 64.5%, lymphocyte 21.7%, monocyte 4.1%, eosinophil 5.4%), reticulocyte 0.7%, Platelet 52,000 /㎣, total protein 6.51 g/dL, albumin 3.80 g/dL, alkaline pohsphatase 161 IU/L, AST 110.7 IU/L, ALT 64.9 IU/L, total bilirubin 0.44 ㎎/dL, BUN 18.4 ㎎/dL, creatinine 0.79 ㎎/dL. Peripheral blood smear showed normocytic normochromic anemia, thrombocytopenia. Bone marrow aspiration smear showed normoplastic myeloid and erythroid precursor. The bone marrow biopsy section shows normocellular marrow (35%) for his age and mildly increasing myeloid cell lineage. We have experienced a case of idiopathic thrombocytopenic purpura in a patient being in neurofibromatosis and therefore reporting it with documentary records. 저자들은 신경섬유종증 환자에서 특별한 원인을 발견할 수 없었음에도 특발성 혈소판 감소증이 발생한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

GaAs 부동전자채널 전계효과 트랜지스터의 전기적 특성

권영세,김창태 公州大學校工科大學生産技術硏究所 1993 論文集 Vol.1 No.-

본 연구에서는 새로운 GaAs 트랜지스터인 부동전자 채널 FET를 제안하고 제작 결과를 보였다. 선택적 유기금속화학증착법을 이용하였으며 채널을 삼각형 빈공간의 바로 위에 형성시킴으로써 유효케이트 길이를 줄일 수 있는 구조를 가진다. 선택적 결정성장 특성을 알아보았고 이론적 모델을 제시하였다. Schottky 및 p-형 게이트를 가진 소자의 DC특성을 보였으며 저잡음 소자 및 DCFL의 단위소자로서의 응용 가능성을 보였다. We have fabricated a new GaAs FECFET(Floated Electron Channel FET) and have used selective MOCVD technique for device fabrication. Because the active channel is formed on the triangular void, the device has very short channel length. We have also characterized and modelled the facet shapes of the overgrown layer in selective MOCVD. Finally the DC output characteristics of the two FECFET with Schottky and p-type gate are described. We think that this device can be applied to the low noise FET or an unit device of DCFL.

E-learning의 정서적 반응 및 학습성과가 전이성과에 미치는 영향 : 직무몰입의 매개효과를 중심으로

권오영,임효창,김세종 한국직업능력개발원 2008 직업능력개발연구 Vol.11 No.3

최근 정보통신기술의 발달에 따라 기업 교육훈련 체계가 전통적인 소집형 교육에서 e-learning으로 전환되고 있다. 기업교육의 궁극적인 성공은 교육을 이수하고 난 뒤 현업에 돌아가서 자신이 배웠던 교육내용을 실무에서 적극적으로 사용함으로써 전이성과를 높이는 데 있다. 본 연구는 기업교육의 전이성과에 영향을 주는 제 요인들을 살펴보는 것이 연구목적이다. 전이성과 결정요인으로 기업교육의 일차적 성과인 정서적 반응과 학습성과를 가정하고, 이들 간의 관계에 영향을 미치는 직무몰입의 매개효과를 실증 분석하였다. 이를 위하여 국내 기업교육 전문업체 C사와 직장인 재교육 교육기관인 K기관으로부터 최근 3개월에서 6개월 사이에 e-learning을 이수한 피교육자를 대상으로 설문조사를 실시하였다. 그리고 구조방정식모형에 의한 분석결과를 제시하고 토의하였다. 분석 결과, 직무몰입의 매개효과가 검증되었으며 분석 결과에 대한 해석 및 토론을 하였다. The development of information technologies has contributed virtual training as one of important education methods. E-Learning in firms provides trainees with more education opportunities in diverse ways. It has developed a range of innovative services with an one-stop solution of education within the electronic sector. Also under the e-learning environment, trainees can undertake customized training packages at anytime and any places. Moreover, information technology allows both the trainers and other trainees to be decoupled in any of the elements of time, Place, and space. This study explores the relationship between reaction/learning performance and transfer performance, and analyzes the mediating effect of individual characteristics on training effectiveness in e-learning settings. Based on the previous literature conducted on the traditional training environment, four sub-hypotheses are developed and tested by questionnaires survey data. The collected data have been analyzed by SPSS12.0 Results indicate that 1) reaction to the e-learning program are revealed as factor affecting the improvement of the transfer performance; and 2) mediating effects of personal characteristics(job involvement) are partially identified. The contribution and limitations of this research are also discussed with future studies.

염산증기 흡입에 의해 발생한 화학성 폐렴 1예

장재혁,원경준,권세훈,하성일,권용은,이승일,윤성호 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

A 38-year-old man with dyspnea admitted to the emergency department after exposure to hydrochloric acid in pharmaceutical product manufacturer. Crackle was auscultated in both lung fields in initial physical examination. Chest radiograph showed consolidation and diffuse parenchymal infiltration in both lung fields. Arterial blood gas analysis showed severe hypoxia. This patient was treated by mechanical ventilation, corticosteroid, antibiotics and bronchodilators and was improved completely in a week after the admission. The authors report a rare case of chemical pneumonitis caused by hydrochloric acid.

주의력 결핍 과잉행동 장애 아동에서의 집단 프로그램의 치료 효과

심세훈,오창근,권자영,정유숙,홍성도 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background : The authors attempted to introduce group program for improving interpersonal relationship and evaluate the effects of that program. Material and Methods : This program had been held twice a week for 8 weeks for children and parents training had been for times on the treatment and continued from 2001 to 2002. Twenty-five ADHD children in school age were selected as subjects from child psychiatric clinic of a general hospital in Seoul. Treatment outcomes were evaluated by comparing at pre- and post- treatment using the various rating scale. Result : According to the results of statistical analysis, paired t-test, the score of total self-concept including popularity was increased and family environment and parenting stress were improved significantly. These results suggest that this program is useful for its orginal goal. The parents evaluated also that children's total problem behaviors were decreased. Conclusion : These results suggest that the designed and performed group program in this study would be effective in facilitating ADHD children's emotional and interpersonal growth, and decreasing their parents stress. Finally they would have healthy interpersonal reationship.

참치 뼈를 이용한 Hydroxyapatite 세라믹 복합체의 합성 및 생체 친화성(제3보) : 인공체액에서의 Hydroxyapatite 세라믹 복합체간의 결합의 전자현미경 관찰 SEM Photographs of Bonding Properties between Hydroxyapatite Ceramics Composites in the Simulated Body Fluid

김세권,최진삼,이창국,변희국,전유진,이응호,박인용 대전산업대학교 반도체기술연구소 1999 半導體技術硏究所報 Vol.1 No.-

참치 뼈에서 추출한 hydroxyapatite를 출발물질로 여러 가지 세라믹 복합체를 제조하여 인공체액에서의 hydroxyapatite 복합체간의 화학결합을 조사하였다. hydroxyapatite 복합체들은 인공체액에서 4주 후부터 화학 결합성질을 나타내었다. 결합강도는 bioglass가 가장 강하게 나타났으며, 조성에 따른 의존성은 관찰할 수 없었다. 인공체액에서 복합체들은 이들의 경계면에서 불균일 핵생성 및 성장에 의해 화학적 결합으로 이루어졌다. Chemical bonding was investigated in the simulated body fluid of several selected hydroxyapatite-containing composites. The hydroxyapatite-containing composites chemically bonded with each other in the simulated body fluid after 4 weeks. Bioglass was strongly bonded in the simulated body fluid, but bonding strength was not depended on composition. Their composite bodies were chemically bonded by heterogeneous nucleation and growth at the interfaces of the specimens in the simulated body fluid.

코일로 치료한 다발성 폐동정맥 기형 1예

김영훈,장재현,권세훈,장재혁,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

A 29 year old female patient came with grade NYHA Fc IV dyspnea of 1 month. No abnormality was heard during auscultation. Arterial blood gas analysis done due to shortness of breath showed a decreased PO_(2) of 64.6 mmHg. Computerized tomography(CT) was checked due to multiple nodules seen in both lower lung fields of the chest X-ray. CT revealed multiple pulmonary arteriovenous malformations in both the mid and lower lung fields. Dyspnea was uncorrected by the application of oxygen. Coil embolization showed improvement of PO2 and dyspnea. The CT follow up at 9 months after the procedure showed no progression of the arteriovenous malformation without any additional symptoms nor dyspnea.

상염색체 우성 다낭종신에 동반된 일차성 알도스테론증 1예

정순일,이상수,김현진,이종덕,박동준,강미정,최영미,권수인,장세호,양중일 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.6

We report the case of a 34-year-old woman with autosomal dominant polycystic kidney disease associated with primary aldosteronism due to left adrenal adenoma. Although autosomal dominant polycystic kidney disease could mask hypokalemia and hypertension, refractory hypertension and hypokalemia were the clues that led to this diagnosis. The diagnosis of primary hyperaldosteronism was based on the presence of hypokalemia with excessive urinary potassium excretion and characteristic hormonal changes. Under laparoscopy, left adrenalectomy was performed. After surgery, plasma renin activity, plasma aldosterone titer, and serum potassium level normalized with only partial correction of the blood pressure. This could be explained by the persisting underlying polycystic kidney disease. We conclude that extrarenal causes in a hypertensive and hypokalemic patient with polycystic kidney disease may be ruled out.

게잡이 원숭이에 있어 rHuEPO(HM10760)의 단회 투여 후 혈액학 및 혈액생화학적 변화

김충용(Choong-Yong Kim),이현숙(Hyun-Sook Lee),이필수(Pil-Soo Lee),하창수(Chang-Su Ha),권세창(Se-Chang Kwon),이관순(Gwan Sun Lee),송창우(Chang-Woo Song),한상섭(Sang-Seop Han) 한국독성학회 2006 Toxicological Research Vol.22 No.1

Changes in hematology and serum biochemistry after treatment of recombinant human erythropoietin (rHuEPO, HM10760) were screened in 4 male cynomolgus monkeys (Macaca fascicularis). Four monkeys, composed of a treatment group of HM10760 and a positive control group of Aranesp<SUP>®</SUP>, were subcutaneously administered at same dose of 100 ㎍/㎏. Both groups did not show any change in body weights and food consumption for 4 weeks compared with those of pretreatment. Both groups did not show any change in total leukocyte count (WBC) and platelet count, while both groups showed increased platelet distribution width (PDW) percentage in HM10760 group during a period from day 5 to day 59 and in Aranesp<SUP>®</SUP> group during a period from day 9 to day 26. Both groups showed increases in red blood cells (RBC), hemoglobin (HGB), and hematocrit (HCT) approximately 10 days after treatment compared with those of pretreatment (day 0). The increased levels of RBC, HGB, and HCT were much higher in HM10760 than in Aranesp<SUP>®</SUP> by the increases of 3.2%~ 12.5% for RBC, 3.8%~17.1% for HCT, and 1.85%~11% for HGB. Both groups showed increases in red cells distribution width (RDW) and reticulocyte (RET) compared with those of pretreatment, showing the highest peak from day 9. The increased level of RET lasted up to day 14 in Aranesp<SUP>®</SUP> group, while it lasted up to day 23 in HM10760 group. The increased level of RDW lasted up to day 59, it was much higher in HM10760 by the increase of 10.1%~17.6% than in Aranesp<SUP>®</SUP> group. In serum biochemistry, both groups showed a decrease in chloride level compared with those of pretreatment. These findings indicated that HM10760 increased RBC, HGB, HCT, RDW, and RET compared with those of pretreatment, and the increased levels were much higher in HM10760 than in Aranesp<SUP>®</SUP>.