소아에서의 미세수술에 의한 재건술

안희창,전명곤,김정철 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

Microsurgical reconstruction is necessary for children to correct severe trauma and congenital or acuqired deformity. The aim of this study was to evaluate whether or not microsurgical reconstruction is a safe and reliable operation in children and to analyze the differences of microsurgical reconstruction in children compared to adults. The study included 12 children who underwent 13 microsurgical reconstructions among a total of 251 cases of microsurgical reconstruction from May, 1986 to August, 1998. Their ages ranged from 24 months to 14 years and 8 months. There were 7 males and 6 females. The involved sites were 9 legs, 3 hands and 1 face. The causes of microsurgical reconstruction were 9 traumas, 2 congenital anomalies, 1 acquired deformity and 1 cancer. The applied flaps were 4 scapular flaps, 2 rectus abdominis muscle flaps, 1 de-epithelized groin flap, 1 lateral arm flap, 1 forearm tendocutaneous flap, 1 forearm tendocutaneous flap, 1 latissimus dorsi muscle flap, 1 fibula flap, 1 second toe transfer, and 1 wrap-around flap. All patients have had normal growth of the donor and recipient sites without specific complications during an average 2 years follow-up. We concluded that microvascular reconstruction is a very useful and reliable procedure in children if it is performed in consideration of each child's specific characteristics and conditions.

뇌성마비아의 모발내 중금속 함량 분석

안경희,김희상,유창현,윤동환,홍장혁,유승돈,이준원 경희대학교 2001 慶熙醫學 Vol.17 No.1

기저질환이 없는 사람에서 발생한 Campylobacter fetus에 의한 재발성 심내막염 1예

전재범,정진원,김성혜,송문희,오형철,안성기,최상호,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

C. fetus 심내막염은 드물게 발생하는 질환으로 주로 면역능이 저하된 환자에서 발병하고 대동맥판을 침범하는 경우가 많으며 적절한 치료가 되지 않을 경우 치사율이 높다. 저자들은 기저질환이 없던 69세 남자에서 C. fetus 심내막염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 발열로 내원하여 시행한 혈액배양 검사상 C. fetus가 동정되었고 경식도 초음파 검사상 삼첨판에 증식증이 발견되어 심내막염 진단하에 ceftriaxone에 이어 meropenem으로 총 4주간 항생제를 투여받고 호전되었다가 한달 후 다시 재발하였고 판막부전 소견 진행하여 삼첨판 치환술을 시행받고 전신상태 호전되어 퇴원하였다. Campylobacter fetus is a rare cause of endocarditis. To date, only about 30 cases of C. fetus endocarditis have been reported mainly in the elderly with chronic underlying illnesses. Most cases showed tendency to involve aortic valve. This report describes a case of native tricuspid valve infective endocarditis in a 69-year-old man without any underlying disease. Despite adequate antibiotic therapy for 4-weeks, endocarditis recurred and leading to surgical valve replacement.

동기 정류기를 이용한 클램프 모드 포워드 영전압 스위칭 다중 공진형 컨버터

안강순,김희준 漢陽大學校 工學技術硏究所 1996 工學技術論文集 Vol.5 No.1

The Clamp Mode(CM) Forward Zero Voltage Switching Multi Resonant Converter(ZVS-MRC) with self-driven synchronous rectifier is studied. The loss at the synchronous rectification stage of the converter is analyzed using MOSFET piecewise linear model and is compared with the loss at the conventional schottky diode rectification stage of the converter. From the results of the analysis, it is known that the use of MOSFETS as a synchronous rectifier reduces the loss at the rectification stage over the whole load range comparing the use of schottky diodes as a conventional rectifier in the converter. In order to verify the validity of the analysis, we have built a 33W(3.3V/10A) CM Forward ZVS-MRC with self-driven synchronous rectifier, in which switching frequency is 1MHz, and tested. From the experimental results, it is known that the synchronous rectification achieved about IW improvement in the loss at the rectification stage and about 3% in the efficiency at the converter as compared with the conventional schottky diode rectification.

축산 폐수의 효율적 처리를 위한 광합성 미세조류인 Spirulina platensis 배양 공정의 최적화

안주희,김성수,김태호,이준엽,오상집,이진하,이현용 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.4

돈분 폐수의 효율적인 처리를 위해 6 W/㎡, 12 W/㎡와 24 W/㎡의 조도 하에서 온도를 15℃에서 40℃까지 각각 변화시켜, 광합성 미세 조류인 Spirulina platensis의 생육에 관한 최적 생육 조건 결정에 관한 실험을 하였다. 균체의 비생육속도는 30℃까지는 온도 증가에 따라 증가하였다. 균체의 생육에 있어서 온도의 영향을 설명하기 위해서 Arrhenius 식을 이용하여서 얻은 활성화 에너지 값은 13.5kal/mol이었다. 순수 배지에서 배양된 균체의 비생육속도가 0.31(1/day)인 반면 30% 돈분 첨가 배양시 얻은 균체의 비생육속도는 0.24(1/day)였다. 폐수내의 총 질소량과 이의 제거속도로 균체의 폐수 처리 능력을 평가할 수 있었다. 돈분 농도를 달리 첨가한 회분배양에 있어서 70~93%(PO_4^3- -P), 67~93%(inorganic nitrogen), 80~90% (COD) 그리고 37~56%(organic nitrogen)의 감소율을 보였다. 총-질소와 총-인의 1차반응 감소 속도 상수는 각각 0.17(1/day)와 0.14(1/day)로 계산되었다. 20% 돈분을 첨가하는 연속배양에 있어서 회석률이 0.20(1/day)일 때 최대 균체농도가 1.52(g/L)를 유지했다. 돈분처리 후 얻은 균체의 성분은 단백질이 58.7%, 지방 11.0% 그리고 회분이 15.6%였다. The kinetics of growing microalga, Spirulina platensis was investigated to treat swine wastes with optimum growth conditions. Temperature was varied from 15 to 40℃ at three different light intensities, 6 W/㎡, 12 W/㎡ and 24 W/㎡. The specific growth rate was increased as temperature increased up to 30℃. The activation energy was estimated as 13.5 kcal/mol by an Arrhenius relationship. 0.24(1/day) of specific growth rate was obtained from batch cultivation with 30% swine wastes, compared to 0.31 (1/day) from clean culture. It was found that Spirulina platensis was able to reduce 70~93% of PO_4^3- -P, 67~93% of inorganic nitrogen, 80~90% of COD and 37~56% organic nitrogen by adding various concentrations of swine wastes for 12 days of batch cultivation. Rate constants for removing nitrates and phosphates in treating swine wastes were estimated as 0.17 (1/day) and 0.14 (1/day) in the first order reaction, respectively. 1.52(g/L) of maximum cell density was maintained at 0.20(1/day) of dilution rate in continuous culture, adding 20% swine wastes for 30 days. The chemical composition of the biomass obtained from the process showed 58.7% of protein, 11.0% of lipid and 15.6% of ash.

흰쥐 뇌줄기에 분포하는 Nitric Oxide Synthase 신경세포에 관한 면역조직화학적 연구

나준희,허영범,박찬,김정혜,유진화,안희경,이원규 대한해부학회 1999 Anatomy & Cell Biology Vol.32 No.2

강박증 환자에서 신경 심리 검사를 통한 전두엽 기능에 관한 연구

안경흡,김명선,김연수,박은희,박선희,신민섭,류인균,권준수 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.3

연구목적 : 강박증 환자에서 비언어적 기억의 장애, 실행능력(executive function)의 장애, 시공간능력의 장애등의 신경 인지 기능의 장애 및 뇌 영상 연구에서 전두엽-기저핵 신경로의 기능장애가 있다는 결과들이 보고되어 왔다. 저자들은 전두엽의 기능을 반영하는 것으로 알려진 신경 심리 검사를 통하여 강박증 환자의 전두엽의 기능적 변화의 유무 및 기타 인지기능에 미치는 영향에 대해서 평가하고자 하였다. 방 법 : 서울대학교병원 강박증 클리닉에 내원한 32명의 강박증 환자군과 28명의 정상 대조군을 대상으로 강박증상의 중증도에 대한 평가와 함께 한국판 단축형 지능검사(Short-form of K-WAIS)와 주로 전두엽 기능을 평가하는데 민감한 것으로 알려진 신경 인지 기능 검사군(위스콘신 카드 분류 검사, Rey-Os-terrieth Complex Figure test, Controlled Oral Word Association test, 선로 잇기 검사, Luria-Nebraska 신경심리 바테리 중 언어학습능력검사)을 시행하였다. 이 검사들의 결과를 연령과 교육연수를 통제한 후에 ANCOVA로 분석하였다. 결 과 ; 강방증 환자군은 범주적 언어 유창성 점수(ANCOVA, F=15.07, df=58, p<0.001), Rey-Os-terrieth Complex Figure test의 즉각 회상 점수(ANCOVA, F=6.33, df=57, p<0.015), Rey-Os-terrieth Complex Figure test의 지연 화상 점수(ANCOVA, F=5.33, df=57, p<0.022)가 정상 대조군에 비하여 유의하게 저하되어 있었다. 결 론 : 이 결과는 강박증 환자들이 전두엽의 특징적인 기능으로 알려진 실행기능보다는 비언어적 기억능력의 장애 및 언어능력의 장애를 가지고 있음을 시사한다. Objective : Non-verbal memory deficits, impairments in executive function and deficits in visuospartial functions have been repeatedly reported in subjects with obsessive-compulsive disorder(OCD). The present study aimed to evaluate the frontal lobe function using neuropsychological test in subjects with OCD and normal control. Methods : A battery of neuropsychological test(Wisconsin Card Sorting test, Rey-Osterrieth Complex Figure test, Controlled Oral Word Association test, Trail Making test, Verbal Learning test) reflecting frontal lobe function was administrated to 32 OCD patients and 28 healthy comparison subjects. Result : There were no significant differences in age, years of education, or estimated IQ between the groups. Scores in category fluency, immediate recall and delayed recall of Rey-Osterrieth Complex Figure test in OCD subjects were significantly lower than those of healthy comparison subjects(ANCOVA, F=15.07, df=58, p<0.001 ;ANCOVA, F=6.33, df=57, p<0.015 ; ANCOVA, F=5.33, df=57, p<0.022, respectively). Conclusion : OCD patients had selective deficits in task involving non-verbal memory and categorical word fluency relative to healthy comparisons.

심폐소생술시에 호기말 이산화탄소 분압 측정의 이용

이준희,안성태,김경래 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

The effectiveness of ongoing cardiopulmonary resuscitation (CPR) efforts is difficult to evaluate. During a cardiac arrest and attempted resuscitation, there are no readily available noninvasive measurements that identify patients who are likely to have return of spontaneous circulation (ROSC). A number of studies in animals and humans suggest that systemic perfusion during arrest and CPR is related to the end-tidal volume of carbon dioxide, which is an indirect measure of pulmonary perfusion. A clinical study was done to determine whether endtidal carbon dioxide (PetCo₂) monitoring during CPR could be used as a prognostic useful noninvasive indicator of resuscitation and survival. The concentration of expired carbon dioxide was measured continuously with caphnography-BCI Model 9000 Caphnographer/Oximeter (Biochemical International, Inc., Waukesha, WI). to evaluate its clinical applicability, we performed prospective, bedside measurements of the PetCO₂in patients after cardiac arrest and during CPR. We measured the PetCO₂during 20 episodes of adult nontraumatic cardiac arrest and resuscitation in 16 critically ill patients during December, 1994 through February, 1995. Spontaneous circulation was restored in eight victims(40%). The mean PetCO₂of successfuly resuscitated group (ROSC, N=8, 23.6±5.5 mmHg) was higher than that of non-resuscitated group (non-ROSC, N=12, 8.7±3.0 mmHg) (p<0.05). the three patients survived more than 24 hours had a higher mean PetCO₂than that of the 17 patients survived less than 24 hours(28.0±6.0 vs 12.3±6.5 mmHg) (p<0.05). All eight patient who were successfully resuscitated had a PetCO₂of 15 mmHg or greater. No patient with a PetCO₂of less than 15 mmHg was resuscitated. We concluded PetCO₂monitoring during CPR are correlated with resuscitation from cardiac arrest. We also propose that measurement of the PetCO₂may be a practical and noninvasive method for monitoring blood flow generated by precordial compression during CPR, and may be an almost immediate indicator of successful resuscitation.

대퇴 원위부 골격근내 혈관종 1예

김희상,김학준,안경희,윤동환,유승돈 경희대학교 2003 慶熙醫學 Vol.19 No.2

자연임신에서 분만 및 주산기 예후에 대한 임상적 고찰

이윤희,안준모,김태성,박은희,정집광,이석민,이해혁 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Object: To compare pregnancy outcome between term pregnancy and postterm pregnancy. Method: A clinical observation has been made on 60 cases of postterm pregnancies out of 64 cases delivered at the Dept. of Obstetrics & Gynecology, Soonchunhyang University from January 1, 1997 to May 31, 2002. 100 cases of full term deliveries of 37 to 42 gestational weeks conducted in same period were used as the control group for this study. We analyzed their cesarean section rate, fetal weight, placental weight, meconium stain, perinatal morbidity. The statistical significance was defined as P<0.05. Result: The following results were obtained 1. The incidence of postterm pregnancy was 1.34%. 2. The cesarean delivery rate in postterm group(51.7%) was significantly higher than control group(26%). 3. The incidence of large fetus (weight over 4,000gm) in the postterm group(21.7%) was higher than control group(2%). 4. The weight of placenta was 757g and 706g in the postterm group and control group respectively. 5. 1, 5 minute Apgar score lower in the postterm group than control group. Conclusion : To decrease perinatal morbidity and cesarean rate at 42 or more weeks gestation, appropriate labor induction and twice weekly biophysical profile and USF(AI, Doppler) may be indicated.