기종성 신우신염 1례

이재욱,구정태,서정일,양창헌,이정호,이동철,이영현,이활,이경섭 동국대학교 경주대학 1997 東國論集 Vol.16 No.1

기종성 신우신염은 주로 당뇨병환자나 폐쇄성 요로질환을 가진 환자에 발생하며 특징적으로 신실질 및 그 주위조직에 가스를 형성하면서 심한 조직괴사를 일으키는 매우 드문 급성 화농성 신감염으로 사망률이 높은 질환이다. 이 질환은 1989년 Kelly와 MacCallum에 의해 처음 보고된 이래 외국문헌에 약 90례 정도가 보고되어 있으며 국내에는 28례가 보고되어 있다. 수액 및 전해질 보충, 인슐린 투여를 통한 적절한 혈당조절 및 항생제 투여등의 내과적 치료와 절개배농 및 신적출술등의 수술적 치료 방법이 있다. 내과적 치료로 가스의 감소가 없는 경우에는 즉각적인 수술적 치료를 시행하여야하므로 이 가스변화에 대한 추적관찰이 중요하다 하겠다. 본 저자들은 당뇨병환자에서 발생한 기종성 신우신염 1례를 내과적 요법을 치험하였기에 문헌고찰과 함께 보고하고자 한다. Emphysematous pyelonephritis is rare, life-threatening infection of the renal parenchyma and perirenal tisseue. This disease is characterized by the production of intrarenal and perirenal gas and is frequently encountered in patients with diabetes mellitus or urinary obstruction. We experienced a case of emphysematouse pyelonephritis in a 62 years old women with poorly controlled diabetes mellitus who had been managed with medical theraphy. So we report this case with a review of the referenced literatures.

Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

素問·脈解篇에 對한 硏究(Ⅱ)

李玗珍,鄭憲瑩,琴坰樹,朴炅 대한한의진단학회 1998 大韓韓醫診斷學會誌 Vol.2 No.2

In Mac Hae Pyun(脈解編), pathological mechanisms are explained on the basis of the so-called "Eum-Yang (陰陽)"theory. In this paw, sentenses referred in "Hwang Je Nae Kyung(黃帝內經)" are construed as "soyue(所謂), and the six kyung diseases(六經病)-TaeYang(太陽)·YangMyung(陽明). SoYang(少陽)·TaeEum(太陰)·SoEum(少陰)·GuiIEum(厥陰)- are interpreted as elements belong to each month. Summerizing the contents of the "Mac Hae Pyun(脈解編)" in reference to the contents of successive generation note, the contents were as follows; What attracts our attention in chapter Ⅰ is pathologic explanations on the diseases which are catagorised as "the diseases of the TaeYang Meridian(太陽經脈病)", such as the edema of lumber and pain of gluteaI(종요수통), badger(跛), pain of nape(項强), sonitus(이오), insanily(顚狂), anepia(음) and anepia-badger(음비). What attracts our attention in chapter Ⅱ is pathologic explanations on the diseases which are catagorised as "the diseases of the YangMyung Meridian(陽明經脈病)", such as the pain of cardia and hypochondrium(心脇痛), cannot rotate body(不可反側), hyperpraxia(躍). What attracts our attention in chapter Ⅲ is pathologic explanations on the diseases which are catagorisedr as 'the diseases of the SoYang Meridian(少陽經脈病)", such as algor(振寒), paranalgesia(脛腫而股不收), arthma and edema(上喘而爲水), pain of thorax(胸痛少氣), pallor(??), agitated(獨閉戶??而居), psychosis(乘高而歌??依而走), headache and rhinostegnosis and edema of of celiac(頭痛????腹腫). What attracts our attention in chapter IV is pathologic explanations on the diseases which are catagorisedl as 'the diseases of the TaeEum Meridian(太陰經脈病)", such as meteorism(脹滿), eructation(噫), vomiting(嘔吐). What attracts our attention in chapter Ⅴ is pathologic explanations on the diseases which are catagorised as "the diseases of the SoEum Meridian(少陽經脈病)", such as the pain of lumber(腰痛), vomiting and tussis and arthma(구토해흠천식), vertigo(目無所見). anger(善怒), pallor(恐怖), anorexia(惡聞食臭), blackface and emptysis(面黑咳血), rhinostegnosis(????). What attracts our attention in chapter VI IS pathologic explanations on the diseases which are catagorisedl as "the diseases of the GuilEum Meridian(厥陰經脈病)", such as hernia and hypogastrium edema of female(퇴산귀인소복종), pain of lumber and vertebral(腰脊痛), hernia and dermedema(퇴륭산??창), fauces xeransis(익건).

素問·刺法論에 對한 硏究

李載胎,鄭憲瑩,琴坰樹,朴炅 한국전통의학연구소 1999 한국전통의학지 Vol.9 No.1

This fasciale, a remainder of So Moon(素問) with Bon Byung Ron(本病論), is a part of the theory of the Five Circuit Phases and the Six Atmospheric Influences(五運六氣學) that studied and discussed the rules of the weather change in ancient oriental medicine. The change in weather is one of the most important factors which influence man's health therefore the theory is worth while to study further. This fascicle explains the cause of diseases occured by irregular and exceptional change of weather and acupunctural treatment methods to prevent and cure those kinds of disease as its title -Ja Bup Ron(刺法論)-suggests. During Tang Dynasty(唐) when Wang Ping(王氷) commentated the So Moon(素問) only the title of this fascicle was kept but the contents of it was lost differing from Seven volumes of the Five Circuit Phases and the Six Atmospheric Influences(運氣七篇). However in the times of the North Song Dynasty(北宋) when Kao Pao-Heng(高保衡), Lin I(林億) and the other scholars studied and compared medical books this fasciale and another lost fasciale-Bon Byung Ron(本病論) appeared with theirs notes. So these two fascicles called Lost Volumes of So Moon(素問遺篇). But we can infer these two fascicles were written by a certain Taoist during the ninth and tenth century A.D. - the former times of Kao Pao-Heng(高保衡), Lin I(林億) and the other scholars studied and compared medical books during the North Song Dynasty(北宋) since Wang Ping(王氷) because this fascicle connots the Taoism training methods such as Pe Gi(閉氣), Jon Sang Bup(存想法) and Oi Dan Bup(外丹法) and so on. This thesis runs as follows; Chapter 1 deals with acupuncture treatment to prevent and cure UI(鬱) disease occuerd by Sung Gi Bu Jun(升之不前) of the Six Atmospheric Influence(六氣). Chapter 2 deals with acupuncture treatment to prevent and cure diseases due to Bul Chun Jung(不遷正) and Bul Toi Wui(不退位) of the Six Atmospheric Influence(六氣). Chapter 3 deals with acupuncture treatment of an epidermic(疫癘) due to the deviation of the Five Ciecuit Phases from the regularity(五運失守). Chapter 4 deals with the symptomes of an epidemi and the preventive treatments such as Jon Sang Bup(存想法), Vomitory treatment(吐法), respiratory treatment(汗法) and So Kum Dan Bang(小金丹方). Chapter 5 deals with the interaction among the five viscera and the six bowels as well as the principle of the acupuncture.

Interleukin-1β에 의한 사람 정상 코점막 상피세포의 분비기능 및 형태 변화

김경수,윤주헌,최진우,이정권,문형진,박준호,전희선 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.11

국내 승용차에서의 CO와 NOx의 배출 특성

이상권,전은경,정철헌 한국외국어대학교 외국학종합연구센터 부설 기초과학연구소 1997 기초과학연구 Vol.6 No.-

국내 자동차 시장의 급속한 성장으로 발생한 각종 환경 오염 문제중 배출가스의 관련 대책을 효율적으로 추진하기 위해서는 자동차로부터 배출되는 각종 오염물질의 배출 특성을 정확히 파악하는 것이 중요하다. 따라서 본 연구는 국내 휘발유 차량의 일산화탄소(CO)와 질소산화물(NOx)의 배출 특성을 차량별, 연식별, 주행거리별, 주정차후 공회전에 따라 분류하여 조사하고 배출 특성과 경향을 분석하였다. 본 연구 결과, 공회전시 배출되는 Gasoline차량의 CO농도는 평균 3,000ppm, NOx는 약 40ppm을 나타냈다. Emissions of carbon monoxide and nitrogen oxides from domestic passenger cars were investigated using a portable gas analyzer (model: Kane-May Quintox). For the investigation, gasoline fuel cars were randomly selected among vehicles located in Kyung-Gi Do. The results showed that the emission concentration of CO ranged from 2,000 ppm to 3,000 ppm and NOx, from 40 to 50 ppm. In addition, the relationship between pollutant emissions and vehicle ages appeared to be very poor.

이상 유동에서 영상 복원을 위한 EIT system 회로의 안정성 평가

이보안,현종관,이헌주,김신,김경연 濟州大學校 産業技術硏究所 2001 산업기술연구소논문집 Vol.12 No.1

The EIT(Electrical Impedance Tomography) system is one of the methods for tomographv technologies. The EIT measurement is less expensive than other methods because the system is relatively simple and easy to construct compared to other methods. In this study. the real voltage values were compared to theoretical values. The rmse(root mean square error) of measured data was 2.99%. So that. this EIT system circuit was a accuracy circuit for a reconstruction algorithm.

경구 및 흡입에 의한 탄화수소(휘발유) 중독 2예

이경원,이정헌 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Hydrocarbon poisoning is one of the most common poisonings accounting for about 3% of all poisonings in the USA. Hydrocarbons are a broad group of organic compounds consisting of hydrogen and carbon atoms. Many household products contain hydrocarbons. The primary complication of hydrocarbon poisoning results from involvement of the respiratory and the central nervous systems. Other reported complications include cardiac arrthymia, hepatocellular damage, renal failure, peripheral neuropathy, intravascular hemolysis, cutaneous injury, sudden death, and so on. We experienced two cases of acute poisoning caused by hydrocarbons: one was a 64-year-old man with cardiac arrhythmia after ingestion of gasoline and the other was a 61-year-old man with aspiration pneumonia after inhalation of combustion gas of gasoline. We report these cases and present a literature review.

靈樞·五邪에 對한 硏究

李載胎,鄭憲瑩,琴坰樹,朴炅 대한한의진단학회 1998 大韓韓醫診斷學會誌 Vol.2 No.2

Young Chou O Sa(靈樞 五邪) described the symptoms of a disease when injurious factors permeated the five viscera and the location of a meridian point and the acupuncture in curing them according to the five viscera. When there are injurious factors within the lungs, you ought to acupuncture Woon Moon Hul(雲門穴), Joong Bu Hul(中府혈穴), Pae Soo HuI(肺輸穴 B13), and Geol Boon Hul(缺盆穴 S12), when there are injurious factors within the liver, acupuncture Hang Gan HuI(行間穴 LIV2) and Jok Sam Ri HuI(尺三里穴 S36), within the spleen, do acupuncture Yong Chul HuI(湧泉穴 K1) and Gon Ryun HuI(崑崙穴 B60), and when there are injurious factors within the heart, do so in the place of Shin Moon Hul(神門穴 H7).