비외상성 두개내 출혈 환자에서 심근손상의 발생과 예후에 미치는 영향

강구현,황성호,이강현,조준휘,김성환,문중범,박해상,이서영,이성수,김헌주 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Objective: The aim of this study was to investigate the clinical significance of myocardial injuries in patients with nontraumatic intracranial hemorrhage by identifying the occurrence of myocardial injury and defining its correlation with subsequent cardiovascular events. Subjects and methods: One hundred twenty-four patients with nontraumatic intracraninal hemorrhage presented to the emergency department within six hours from onset of symptoms were enrolled. Brain CT, serial electrocardiography, and echocardiography were done at the emergency center. Blood samples for troponin I and creatine kinase(CK)-MB were drawn immediately and eight hours after admission, Troponin I and CK-MB were measured using a chemiluminescent immunoassay, respectively. Results: Electrocardiographic and echocardiography abnormalities were found in 65 cases(52.4%) and 21 cases(17%), respectively. Serum troponin I and creative kinase-MB were increased in 35 cases (28.2%) and in 58 cases(46.8%), respectively. Abnormal findings of echocardiography and ECG, as well as elevated levels of serum troponin I and creative kinase-MB, were associated with an increased risk of cardiovascular event and survival. Logistic regression analysis revealed that an abnormal echcocardiographic finding and elevation of serum troponin I were factors associated with the occurrence an adverse cardiovascular event and that electrocardiographic abnormalities and initial mental status were factors associated with poor prognosis. Conclusion: This study reveals that actual myocardial injury develops in a significant proportion of patients with nontraumatic intracranial hemorrhage and that the development of the myocardial injury is associated with an adverse cardiovascular event that occurs during admission.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

자기베어링시스템 강성의 실험적 고찰을 통한 안정화 특성에 관한 연구

강성구,강종규,홍준희 한국공작기계학회 2004 한국공작기계학회 추계학술대회논문집 Vol.2004 No.-

Due to the lack of stiffness and difficulties of control, it is hard to achieve well balanced magnetic levitation. In this paper, we analysis the current and position stiffness change according to bias current through experiment. Then, compensation equations were presented. After obtaining PD gain for each bias current and PD gain region through levitation experiment, we consider the characteristics.

레이저 가공에서 빔변수가 미치는 영향에 관한 연구

강경구,방세윤,윤경구,황경현,이성국 동국대학교 산업기술연구원 1997 산업기술논문집 Vol.9 No.-

레이저 가공시 조사되는 레이저 빔의 특성을 나타내는 변수 - 예를 들면, 빔의 형상, 초점면과 소재사이의 거리, 빔 강도 분포, 빔의 발산각, 실제 빔이 퍼져가는 양상이 이상적인 Gaussian 빔에 비해 얼마나 큰지를 나타내는 beam quality factor 등 - 이 가공결과에 큰 영향을 미치는 것은 경험적으로 잘 알려져 있다. 특히 원적외선 레이저로 천공, 에칭 또는 엑사이머 레이저로 ablation 가공을 수행할 때는 이러한 빔특성 변수의 영향이 극대화된다. 본 연구에서는 중요한 빔특성 변수의 영향을 가능한 독립시켜 정성적 및 정량적으로 파악하기 위해 연속발진 모드의 레이저빔 사용시 열전도에 의한 손실을 고려하였으며, 문제를 단순화해 빔 또는 가공소재의 상대적인 움직임이 없는 천공 (또는 에칭제거)의 경우에 대하여, 수치모사를 통해 여러 가지 빔 변수의 변화가 가공결과에 미치는 영향을 살펴보았다. 레이저 빔의 초점의 위치를 표면에서 멀리하면 가공깊이는 감소하게 되며, 같은 간격일 때는 소재의 내부에 위치시키는 것이 다소 유리하다. 또한 빔의 발산각이 작고, beam quality factor 값이 1에 가까울수록 깊은 가공을 얻을 수 있음을 파악하였다. In laser machining such as drilling with CO_2 or Nd:YAG laser, and etching or ablation with Excimer laser, one of the most important parameters affecting the machining results is known to be beam characteristics. In this paper a study is performed through a numerical simulation with the appropriate model to investigate the effects of beam parameters qualitatively and quantitatively, especially in the process of laser drilling of ceramics and ceramic composites. Results of different beam conditions reveal that the machined hole becomes deeper as (ⅰ) the beam divergence gets smaller,(ⅱ) beam quality factor approaches unity, and (ⅲ) beam focus lies nearer to the surface of the workpiece.

Staphylococcus lugdunensis에 의한 감염성 심내막염 1예

최성호,박현구,변승운,구동회,강호석,장항제,김양수,우준희,김영휘,최상호 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CNS) that is commonly found on the human perineal skin. Contrary to other CNS, S. lugdunensis is a rare contaminant in cultures and has the potential to cause clinically significant infections, including infective endocarditis. Infective endocarditis due to S. lugdunensis have been known to resemble endocarditis due to S. aureus because of its aggressive clinical course and high mortality. We report a case of infective endocarditis caused by S. lugdunensis in a 21-year-old woman. She was cured of the infection with surgical and antibiotic therapy. S. lugdunensis에 의한 감염성 심내막염은 국내에서보고가 없었던 매우 드물지만 다양한 합병증과 높은 사망률을 보이는 감염증이다. 저자들은 S. lugdunensis가 수술적 치료와 항생제 치료로 완치된 감염성 심내막염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

간 이식 환자에서 발생한 파종성 Scedosporium apiospermum 감염 1예

박현구,최성호,강호석,송주형,정지훈,소민욱,최상호,김양수,우준희 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

저자들은 다발성 뇌 농양을 동반한 치명적인 파종성 S. apiospermum 감염이 발생한 간 이식 환자를 경험하였다. 본 증례의 환자는 voriconazole로 치료하는 호전경과를 보이다가 진균성 뇌 동맥류 파열로 사망하였다. S. apio-spermum은 비교적 드문 진균으로 병리학적으로 Aspergillus spp.와 매우 유사하고 amphotericin B에 내성을 나타내므로 진단과 치료가 적절하게 이루어지지 못할 가능성이 많고 면역 기능 저하 환자에서 혈행성 전파를 통한 파종성 감염이 용이하게 발생하므로 높은 사망률을 나타낸다. 이식 환자를 비롯한 면역 기능 저하 환자에서 진균감염이 의심될 때 S. apiospermum과 같은 드문 진균에 의한 감염증도 감별진단에 포함해야 하겠다. Sedosporium apiospermum is a saprophytic fungus commonly found in soil and polluted water. This organism is known as a cause of mycetoma, which may occur in immunocompetent hosts following trauma. However, in immunocompromised patients, S. apiospermum can also cause life-threatening invasive disease, including central nervous system infection or disseminated infection. We report a fatal case of disseminated S. apiospermum infection in a 46-year-old woman after liver transplantation. Eight days postoperatively, she developed pneumonia, followed by altered mentality in the 15 days. A head CT demonstrated multiple brain abscesses. Sputum and stereotactic-aspirated brain abscess culture yielded S. apiospermum. Despite treatment with voriconazole, the patient died of intracranial hemorrhage.

1980년대(1981-1990) 전·후반기 피부과 외래환자의 통계적 비교 관찰

은 철,강승구,권상진,정성재,조지형,권철욱,김영진,김재홍 한양대학교 의과대학 1997 한양의대 학술지 Vol.17 No.1

To study the prevalence of common dermatoses 37,638 and 30,286 new outpatients who visited dermatology clinic with Hanyang University Hospital from January 1981 to December 1985 and from January 1986 to December 1990, respectively. Among the 37,638 outpatients in the first 5 years, the total number of male patients were 18,107(48.1%) and female patients were 19,531 (51.9%). Among the 30286 outpatients in the last 5 years, the total number of male patients were 14,705 (48.6%) and female patients were 15,581 (51.4%). In the both periods, the most frequent age groups was 21-30 (27.3%,25.2% respectively). The 15 common dermatoses, bacterial infection, seborreic dermatitis, drug eruption, verruca, syphilis, psoriasis, herpes zoster, and hypopigmentary disorder, in order of frequency. In thelast 5years, dermatophytosis, contact dermatitis, urticaria, acne, other eczema, atopic dermatitis, seborrheic dermatitis, bacterial infection, drug eruption, verruca, gerpes zoster, psoriasis, hypopigmentary disorder, scabies and syphilis were the 15 common dermatoses, as frequency. In both periods, the dermatosis which showed annually increasing tendency was dermatophytosis and those of decreasing tendency was bacterial infection. In the both periods, dermatophytosis, urticaria, bacterial infection, seborrheic dermatitis, verruca, and hypopigmentary disorder occurred most frequently during the summer season, and the incidence of other ecxema, scabies, atopic dermatitis, and herpes zoster increased during the winter season.

혈액투석 환자에서 대퇴신경범증으로 발현된 장골근 및 요근 농양 1예

이준상,강동구,신상열,윤재호,조영일,고성은,유영범,전혜정,진춘조,송종오 대한신장학회 2004 대한신장학회잡지 Vol.23 No.1

A. 高校 科學 (生物·地球科學) 및 數學科 探究學習의 評價模型 定立과 評價紙 開發

李相協,權炳奎,林在圭,孫文求,吳岱燮,楊洪準,梁承榮,姜用熙,林成圭,金正遠,金吉民,兪正在 경북대학교 과학교육연구소 1982 科學敎育硏究誌 Vol.6 No.-

Currently the evaluation of high school science and mathematics learning has been too much knowledge-centered without concerning the inquiring ability or scientific attitude. This study, therefore, was made for the purpose of establishing of evaluation model for high school science (biology and earth science) and mathematics learning and its evaluation items. In this paper, the research was done about three fields, biology, earth science and mathematics. 1. For the biology, the evaluation methods of inquiry learning were studied with the foreign references, and proper evaluation items were suggested. 2. For the earth science, after analizing 5 kinds of earth science textbook of current using in high school, essential 19 items were selected. 5 of them were tested in test group and control group, then, the results were analized. 3. For the mathematice, the teaching elements of「Set」and「Flow chart」in mathematics (Ⅰ) were selected and structured. Detailed teaching objects were established and evaluation items were introduced.

Environmental exposure of heavy metal (lead and cadmium) and hearing loss

Gu Hyeok Kang,Jun Young Uhm,Young Gon Choi,Eun Kye Kang,Soo Young Kim,Won Oh Choo,Seong Sil Chang 대한직업환경의학회 2018 대한직업환경의학회지 Vol.30 No.-

Background: Lead and cadmium have been identified as risk factors for hearing loss in animal studies, but largescale studies targeting the general human population are rare. This study was conducted to investigate the link between heavy metal concentrations in blood and hearing impairment, using a national population-based survey. Methods: The study participants comprised 6409 Koreans aged 20 or older, who were included in the Fifth and Sixth Korea National Health and Nutrition Examination Surveys (KNHANES 2010–2013). Hearing impairment was categorized into two types, low- and high-frequency hearing impairment, using pure tone audiometry. Lowfrequency hearing impairment was defined as having a binaural average of hearing thresholds for 0.5, 1, and 2 kHz exceeding 25 dB, and high-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 3, 4, and 6 kHz exceeding 25 dB. The blood levels of heavy metals (lead and cadmium) were classified into quartiles. Cross-sectional association between hearing impairment and the level of heavy metals (lead and cadmium) was examined in both sexes. Multivariate logistic regression was used to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Among men, the prevalence of low- and high- frequency hearing impairment was 13.9% and 46.7%, respectively, which was higher than the prevalence among women (11.8% and 27.0%, respectively). Regarding lead, the adjusted OR of high-frequency hearing impairment for the highest blood level group versus the lowest group was significant in both men (OR = 1.629, 95% CI = 1.161-2.287) and women (OR = 1.502, 95% CI = 1.027-2.196), after adjusting for age, body mass index, education, smoking, alcohol consumption, exercise, diagnosis of diabetes mellitus, hypertension, and noise exposure (occupational, loud, firearm noises). No links were found between blood lead levels and low-frequency hearing impairment, or between blood cadmium levels and low- or high-frequency hearing impairment in either sex. Conclusions: The present study findings suggest that even exposure to low-level lead is a risk factor for highfrequency hearing loss. A prospective epidemiologic study should be conducted to identify the causal relationship between human health and exposure to heavy metals, and efforts to reduce heavy metal exposure in the general population should continue.