전신마취중 발생한 부적합 수혈 2예 보고

박대팔,김익수,최세진,Park, Dae Pal 충남대학교 의과대학 지역사회의학연구소 1976 충남의대잡지 Vol.3 No.1

Authors have experienced two cases of incompatible blood transfusion during general anesthesia, which was due to technical error and lack of attention.

충남지역 나환자에 대한 사회의학적 조사연구

박연우,오장균,이태용,심운택 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

We studied through February 1989 to August 1989 to investigate the demographic characteristics, disease status and deformity of leprosy patients registered at Chungnam provincial area on December 31, 1988. The results were as follows: 1. Older than 40 years of age occupied 83.3%, and most patients lived at his or her own home as farmer or stock breeder. 2. The infection source was more the extrafamilial than the intrafamilial source and the most common initial symptoms and signs by body site were sensory paralysis on extremities and infiltration on face and macule on trunk. 3. The deformity was higher in male than female, older the age and much more the deformity. 4. The deformity was higher in T type than L type, and more recent onset of disease and shorter the duration between the onset and the register of disease, more lighter the deformity. The settlement villiger than domiciliary and the group of patientnts being treated at health center than leprosy association, the deformity was heavier.

충남대학교병원을 방문한 간질발작환자의 임상상

김재문,정진상 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

We reviewed the medical records and laboratory results of 686 epileptic patients who were diagnosed as having epilepsy and managed at the Chungnam National University Hospital (CNUH) between March 1986 and November 1991. Because of the role of CNUH as a referral hospital in the community, demographic features were heterogeneous and secondary and intractable epileptic patients were relatively common, hence polytheraphv being prevailed for the medical management. Among diagnostic tools, EEG has been used as the most sensitive one but enormous introduction of neuroimaging techniques will enhance the accuracy and the quality of treatment. Of various prerequisites to be solved for the epiletic patients these days, the most important are long-term follow up and appropriate application of the newly developing diagnostic methods, particularly intensive monitoring systems.

A Pathologic Study on Tumors and Tumor-like Lesions of bone

Lee, Choong-Sik 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

1973년 1월부터 1988년 12월까지 한 10년 동안 충남대학교 병원 병리과에서 수술 및 생검술로 의뢰되어 진단된 골 종양및 종양유사성 질환 총 160예를 그 대상으로하여 조직 병리학적 연구를 시행한 결과 다음과 같은 사실들을 알 수 있었다. 1. 양성병변과 약성병변의 비는 59.1:40.9로 양성이 많았다. 2. 성별차이는 전체적으로 1.1:1로 남자에서 약간 많았으며 양성에서는 1.06:1, 악성에서는 1.17:1 이었다. 3. 양성병변중에서는 골연골종이 35.1%로 제일 많았으며 그 다음 내연골종(14.1%), 섬유이형성종(11.3%)의 순이었다. 4. 악성병변 중에서는 골육종이 31.7%로 제일 많았으며 그 다음 거대세포종(22.7%), 전이암(17.5%)의 순이었다. 5. 나이에 따른 분석을 해본결과 양성 골질환은 10대에서 42.3%로 제일 많았으며 그다음 20대가 22.7%, 10세이하가 16.5%의 순으로 많았다. 6. 악성 골질환역시 10대가 28.6%로 제일 많았고 그다음 20대 20.6%, 50대 15.9%의 순이었다. 7. 양성 골질환의 발생부위는 대퇴골과 경골이 19.6%로 같았으며 다음은 수골이 12.3%를 차지하였다. 8. 악성 골질환의 발생부위는 대퇴골이 34.35로 제일 많았으며 경골 15.9%, 상완골 9.5%의 순이었다.

Expression of c-erbB-2 Protein in Human Gastric Adenocarcinoma

Lee, Choong-Sik 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

원발성 위암에서의 c-erbB-2 oncogene의 표현이 환자의 임상적, 병리학적 소견과 어떠한 상관관계가 있는가를 알아보기 위하여 1988년부터 1993년까지 충남대학교 병원 해부병리과에서 원발성 위선암으로 진단되 총 509예중에서 면역화학적 연구와 환자 기록이 용이했던 62에를 가지고 환자의 나이, 성별, 종양의 분화도, 위벽에서의 침윤 정도, 주위 림프절 전이 유무와의 관계를 연구하였다. c-erbB-2 oncogene 양성율은 환자의 나이가 비교적 적은층(35세 이하)에서 많은 층(36세 이상)보다 약 두배를 나타냈다. 비록 수학적 특이성은 없었으나(p=0.059) 경향은 뚜렷하였다. 그 밖의 다른 항목들은 모두 수학적 의의가 없었다. 이상의 결과로 원발성 위암에서의 c-erbB-2 oncogene의 표현은 그 환자의 임상적 예후에 영향을 미칠수 있는 병리학적 소견과 관련이 없는 것으로 생각된다. Using monoclonal antibody for the c-erbB-2 oncoprotein, an immunohistochemical of the expression of c-erbB-2 protein was performed in formalin-fixed paraffine-embedded tissue sections from 62 primary gastric adenocarcinomas. The c-erbB-2 protein expression in which the reaction was localized to the cell membranes was observed in 23(37.0%) cancers. Some nontumor cells show positive reaction in their cytoplasms. The expression was evaluated with patient's age, sex, tumor cell differentiation, depth of invasion and regional lymph node metastasis. For age, the young age group(less than 36 years) showed about two times higher expression(52%) than the older age group(over 35 years; 28%).However, there was not a significant association between c-erbB-2 protein staining and age(p=0.059). Other variables revealed no statistical significances.

家族機能度指數(Family APGAR Scores)에 關한 基礎調査 硏究

姜星圭,沈雲澤 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.1

This study was investigated the Family APGAR. Scores which was introduced in 1978 as a utilitarian screening instrument for family function by Dr. Smilkstein. The Family APGAR Index Questionnaire consisted of five items : adaptation, partnership, growth, affection and resolve. The Index Score is ranged from 0 to 10 and is divided into three groups; severly dysfunctional 0-3, moderately dysfunctional 4-6, and highly functional 7-10, for evaluating the family function. For this study, 466 high school students were chosen and divided into two groups; Three-choice response format group (Group I) and five-choice response format group (Group Ⅱ ). For comparison, 200 reformatory students whose age were similar to the Group I were selected. The retest was carried out after an interval of two weeks to Group I . The results of this study are as follows. 1. In Group I, the mean Family APGAR Score is 5.45±2.17. The range of inter-item correlations are 0.18-0.34 and item to total correlations are 0.55-0.63. 2. In Group I , 31.4;% belongs to highly functional families, 48.3% moderately dysfunctional families and 20.3% severely dysfunctional families by Smilksteins' classification. 3. The three-choice response format results in good scale qualities and is simpler although fivechoice response format yields some improvement in psychometric qualities of the instrument. 4. The difference in Family APGAR Scores between high school students group and reformatory students group is statistically significant (P<0.01). 5. The coefficiency of test-retest reliability after and interval of two weeks is 0. 3225, which is statistically significant (P<0.001). As a result, this study suggested the possibility that the Family APGAR Scores could be applied to the Korean for evaluating family function.

Parkinson's Disease : Clinical Experiences in 72 Consecutive Patients

Chung, Chin-Sang,Han, Moon-Gang,Wie, Bong-Ae 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

충남대학교병원 신경과에서 1985년부터 1989년까지 진료한 Parkinson씨병 환자 72예를 대상으로 이 질환의 일반적 특징 및 임상적 특징을 고찰하였다. 대상환자들이 성별분포는 유의한 차이가 없었으며 평균발병연령은 57.9세였으며 67%의 환자가 50대와 60대에 발병하였다. 소위 이 질환의 3대 증상이라고 일컫는 안정시 진전, 경직, 운동완서 등은 거의 모든 환자에게 관찰되었으며 이외에 기도진전이 21예에서 함께 관찰되었다. 기억장애는 11예에서 보였는데 Hoehn-Yahr분류상 3기이상의 환자에서 관찰되었다. 그러나 심한 치매환자는 없었다. 기타 증상으로는 자율신경계장애증상, 동통성 증상, 수면장애, 정서장애 등이 있었다. 이 질환의 진행정도를 Hoehn-Yahr분류법에 의하여 측정하였으나 발병시기나 유병기관과는 상관관계가 없었다. 따라서 이 질환은 진행과정은 개인차가 많은 것으로 판단되었다. Levodopa장기치료시 흔히 관찰되는 것으로 알려진 wearing-off현상이나 on-off현상은 관찰되지 않았다.

악성 골종양 및 병적골절에서 보조적 Bone Cement를 이용한 치험례

윤승호,김옥년 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

Methylmethacrylate has been used in the treatment of bone tumor and pathologic fracture Which was difficult or impossible by conventional methods such as currettage, en bloc resection, bone graft, and prosthetic replacement or amputation of extremity. We had been treated the 11 cases of bone tumor and pathologic fraeture by the use of ploymethacrylate bone cement and review the results during a period of 3 years from January, 1979 to Jaunary, 1982 and reported it with the review the literature. The results were as follow: 1. Among the 11 cases, giant cell tumor was 5 cases, metastatic tumor was 3 cases, osteogenic sarcoma was 2 cases, and fibrous dysplasia was one cases. 2. The complication and undesirable effect were fracture, deep infection and tissue necrosis in early and joint stiffness near the lesion and death which was disease associated. 3. This procedure were adjunctivel performed upon the metalic internal or intramedullary fixation and compositively by filling on the dead space after currettage with or without bone graft, and this procedure was not difficult and obtained an effective fixation and stabillity. 4. The use of methylmethaerylate bone cement has long been accepted by many orthopedic surgeons and the benefits afforded to the patient are good in our clinical study.

再活 患者에 대한 調査 硏究 : 忠南地域 肢體不自由兒의 社會醫學的 實態 A Sociomedical Study on the Handicapped Children in Chungnam Area

蘇喜永,朴仁淑 충남대학교 의과대학 지역사회의학연구소 1982 충남의대잡지 Vol.9 No.2

The purpose of this study was to investigate the actual factors of handicapped children in view of the social medicine and to help improving their circumstances. The subjects for research was 115 children admitted in S rehabilitation center in Chungnam. Data had been collected by questionaire as per parallel study in February 1981 and then analysed statistically. The results were as follows: 1. On sex ratio, males were predominant with 1. 67 : 1. 2. 16.53% of father's occupation was commercial business, while 37.40% of mother's was housewife. 3. The largest number of educational level of father's was high school with 17.40%, and the next was above college with 14.79%. Non education was the largest number of mother's with 16.53%, the next was middle school with 14.79%. 4. The most greatest aspiration of future showed professions with 26.08%, and the next was artist with 16.52%, scholar with 12.17%. 5. The onset of defect that showed 1-5 years with 50.44% was the highest, and the next was 0-6 month with 33.92%. 6. The most common cause of handicapped children was revealed poliomyelitis as 47.83%, and cerebral palsy was the next in order as 38.26%. 7. The most common affected site was lower extremity with 51.31%, and the next was upper and lower extremity with 32.18%. 8. Among 60% subjects with assistance apparatus for ambulation, 31.30% were ambulatory with assistance of wheelchair, and 18.26% with crutch. 9. The most frequent experienced therapeutic measures showed acupuncture, herb, and physical therapy. 10. The largest complained.. problems was common cold with 49.56%, the dermatologic abscess with 32.17%, and anemia with 9.56%.

허혈성 신손상 모델에서 iNOS 유전자 발현에 관한 연구

이강욱,신영태 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Athough the exact pathogenetic mechanism of the renal ischemia-reperfusion injury (I-R injury) has not been clearly elucidated yet, the reactive oxygen species (ROS) and leukocyte infiltration have been suggested to contribute to this renal injury process. Inducable nitric oxide synthase (iNOS) has been also thought to be one of the important mediator involved in renal damage. The suppression of renin-angiotensin system (RAS) by angiotensin converting enzyme inhibitor (ACEI) and angiotensin Ⅱ AT1 receptor antagonist (AT1 RA) has been reported to be effective on the attenuating renal injury process in the renal injury process of many animal models and human renal diseases. In order to evaluate the change of the levels of iNOS gene expression in unilateral I-R injured renal cortical tissue, competitive RT-PCR was performed for the iNOS mRNA in Sprague-Dawley rats (60 minutes of ischemic time by non-traumatic vessel clamp and 24 hours of reperfusion time). The plasma renin activity (PRA) and angiotensin Ⅱ (A-Ⅱ ) level were measured at the time of sacrifice by radioimmunoassay. Also, we evaluated the effect of RAS suppression by ACEI or AT1 RA (enalapril, losartan, respectively) which was administered for the seven days previous to the surgery(enalapril 100 mg/L, losartan 250 mg/L in drinking water) and injected intraperitoneally (50 mg/kg, 100 mg/kg BW, respectively) just after surgery in the enalapril treated I-R injury group (I-R E) and losartan treated group (I-R L). On light miscroscopic examination, I-R injured renal tissue showed typical findings of acute tubular necrosis, such as necrosis, swelling and denudation of proximal tubular cells. Compared to sham operated group, I-R injured renal tissues showed significantly increased level of iNOS gene expression 24 hours after I-R renal injury(p<0.05). The level iNOS gene expression of I-R E and I-R L was significantly lower than that of untreated I-R injury control group (I-R C, p<0.05, p<0. 05, respectively). The levels of PRA and AII of I-R injured groups were also significantly elevated compared to sham group. However, there was no significant difference between I-R C, I-R E, and I-R L groups (p>0.05). In conclusion, we speculate that the early activation of RAS and elevated gene expression of iNOS contribute to the early pathogenetic mechanism of IR renal injury process and RAS suppression by ACEI or AT1 RA may attenuate the renal injury process in this model.