Mirizzi 증후군의 변형된 분류와 치료

김형철,강길호,채만규,김성용,백무준,이문수,박상흠,이문호,김창호,송옥평,조무식,박희주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Purpose : The Mirizzi syndrome is relatively rare and preoperative diagnosis of this disease is difficult. In 1978, Morelli suggested the subclassification of the Mirizzi syndrome into acute or chronic form. We experienced 5 cases of acute form. We analysed clinical features, preoperative radiologic findings and operative findings of 18 cases including acute forms which were diagnosed as Mirizzi syndrome and should suggest the modified classification of Mirizzi syndrome for choice of appropriate treatment. Method : From January 1995 to December 1998, 18 cases, of which 8 cases were diagnosed at Soonchunhyang University Chunan Hospital, and 10 cases were reported in the Korean Journal were retrospectively analysed with regard to clinical features, preoperative radiologic findings and operative findings. According to the clinical features, whole cases were divided into type Ⅰ(acute form) and type Ⅱ(chronic form) and then each type of cases were subclassified according to preoperative radiologic findings and operative findings. Results : Of 18 cases there were 5 cases in type Ⅰ(27.8%), 13 cases in type Ⅱ(72.2%). Type Ⅱb was most common. Type Ⅰa cases were treated only with cholecystectomy. We applied cholecystectomy, T-tube choledochostomy and patch technique in type Ⅰb and thpe Ⅰc cases. Cholectystectomies including removal of gallstones and internal drainage procedures were done in type Ⅱ chronic forms. Conclusion : The acute form(Type Ⅰ) of Mirizzi syndrome was suggested by Morelli might be subclassified into typeⅠa,Ⅰb and Ⅰc following the presence of the necrotic defect in common hepatic duct. Through the modified classification of Mirizzi syndrome based on clinical feature, preoperative radiologic findings and operative findings, we can choice appropriate treatment.

Flowable 및 microfill 복합레진으로 충전된 제 5급와동에서 load cycling 전,후의 미세변연누출 비교

강석호,김오영,오명환,조병훈,엄정문,권혁춘,손호현 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.2

Low-viscosity composite resins may produce better sealed margins than stiffer compositions (KempScholte and Davidson, 1988; Crim, 1989). Flowable composites have been recommended for use in Class V cavities but it is also controversial because of its high rates of shrinkage. On the other hand, in the study comparing elastic moduli and leakage, the microfil had the least leakage (Rundle et al. 1997). Furthermore, in the 1996 survey of the Reality Editorial Team, microfills were the clear choice for abfraction lesions. The purpose of this study was to evaluate the microleakage of 6 composite resins (2 hybrids, 2 microfills, and 2 flowable composites) with and without load cycling. Notch-shaped Class V cavities were prepared on buccal surface of 180 extracted human upper premolars on cementum margin. The teeth were randomly divided into non-load cycling group (group 1) and load cycling group(group 2) of 90 teeth each. The experimental teeth of each group were randomly divided into 6 subgroups of 15 samples. All preparations were etched, and Single bond was applied. Preparations were restored with the following materials (n=15) : hybrid composite resin [Z250(3M Dental Products Inc. St.Paul, USA), Denfil(Vericom, Ahnyang, Korea)], microfil [Heliomolar RO(Vivadent, Schaan, Liechtenstein), Micronew(Bisco Inc. Schaumburg, IL, USA)], and flowable composite[AeliteFlo(Bisco Inc. Schaumburg, IL, USA), Revolution(Kerr Corp. Orange, CA, USA)]. Teeth of group 2 were subjected to occlusal load (100N for 50,000 cycles) using chewing simulator(MTS 858 Mini Bionix Ⅱ system, MTS Systems Corp., Minn, USA). All samples were coated with nail polish 1mm short of the restoration, placed in 2% methylene blue for 24 hours, and sectioned with a diamond wheel. Enamel and dentin/cementum margins were analyzed for microleakage on a sclale of 0 (no leakage) to 3 (3/3 of wall). Results were statistically analyzed by Kruskal-Wallis One way analysis, Mann-Whitney U-test, and Student-Newmann-Keuls method. (p=0.05) Results: 1. There was significantly less microleage in enamel margins than dentinal margins of all groups. (p<0.05) 2. There was no significant difference between six composite resin in enamel margin of group 1. 3. In dentin margin of group 1, flowable composite had more microleakage than others but not of significant differences. 4. There was no significant difference between six composite resin in enamel margin of group 2. 5. In dentin margin of group 2, the microleakage were R>A=H=M>D>Z. But there was no significant differences. 6. In enamel margins, load cycling did not affect the marginal microleakage in significant degree. 7. In dentin margins, load cycling did affect the marginal microleakage only in Revolution. (p<0.05)

부산지역 외상성 척수손상환자 발생의 변화추이

강경문,김기찬,정호중 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Objective: To identify trends in the epidemiologic and injury data of person with traumatic spinal cord injury (SCI). Method: Review of medical records of 312 patients with traumatic spinal cord injury from 1996 to 2005 at the four university hospitals and one training hospital in Busan was performed. The epidemiologic informations of this study were compared to those of the past study conducted between 1986-1993 and 1996-2005. Results: Average age(42.8) at injury was rised. Male-to-female ratio was 3.5:1, the population of males has decreased significantly in recent years(1996-2005). The leading cause of traumatic SCI was traffic accident. Tetraplegia accounted for 52.2% of all traumatic SCI, 47.8% were paraplegia. Complete injury decreased compared to the past occupying 41% of all the injury while tetraplegia increased. Traumatic spinal cord injury occured most commonly in August, summer, the time of 6 A.M to midday and on Saturday. Conclusion: This study showing the recent characteristics of traumatic SCI in Busan revealed increase in the average age at injury, the rate of females and incomplete injury. The most frequent time of onset was from 6 AM to midday.

Corynebacterium hofmannii에 依한 전신감염 1예

문대혁,최강원,박석건,이광호 대한감염학회 1984 감염 Vol.16 No.1

Corynebacterium of hoffmannii is a part of normal pharyngeal flora. Human infection caused by C. hofmannii is very rare. All reported cases involve prosthetic or native cardiac valve. This patient sufered from chronic alcohlism, diabetes mellitus, and acute suppurative inflammation of brain, meninges and soft tissue. And he failed to show any clinical response to various antimicrobial therapy and died after discharge.

한국인 만성 긴장형두통 환자에서 바이오피드백을 활용한 자율적 이완훈련의 효과

강은호,안주연,구문선,박주언,유범희 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.3

Objectives : We aimed to evaluate the efficacy of biofeedback-assisted autogenic training for chronic tension-type headache, and to determine the relationship among the changes in electromyography (EMG) activity, headache activity, and mood states according to the psychophysiological treatment. Methods : Chronic tension-type headache patients aged from 20 to 40 years (n=35) were randomized to the treatment group receiving biofeedback-assisted autogenic training (8 sessions) or the monitoring-only control group. EMG activities, headache index, and various psychological variables were examined. Results : We found greater treatment response rate (≥50% reduction in headache index) in patients with biofeedback-assisted autogenic training than in the monitoring group (61% vs. 18% ; χ²=6.882, df=1, p=0.01). There were no significant changes in the mean values of the pretreatment EMG activities across the sessions m either group (all p’s>0.1). Mood states including anxiety and depression improved over time in the both groups, with the improvements being more prominent in the treatment group. Moreover, the reduction in depression level predicted treatment outcome in terms of headache index (95% confidence interval : 0.272-0.966, p=0.039). Conclusion : These results show that biofeedback-assisted autogenic training is effective for the treatment of chronic tension-type headache in a Korean population. Changes in mood states may be closely associated with the clinical outcome in the treatment of chronic tension-type headache using biofeedback-assisted autogenic training.

질소시비수준 및 Ryegrass 유혼파가 겉뿌림 초지개량에 미치는 효과 : Ⅰ. 정착율, 식생구성율 및 건물수량에 관한 효과

강호준,김문철 濟州大學校 農科大學 動物科學硏究所 1992 動物科學論叢 Vol.7 No.1

This experiment was carried out to determine the effect of improvement of oversown pastures, treated with four nitrogen(N) application levels(0, 100. 200. 300 kg/ha) and three species mixtures (A:orchardg-rass+ ladino clover: B: orchardgrass+ ladino clover+ perennial ryegrass; C: orchardgrass+ ladino clover+ perennial ryegrass+ Italian ryegrass). The establishment of perennial ryegrass, Italian ryegrass, and ladino clover were increased with inc-reased N applications. but the ryegrass mixed with orchardgrass and ladino clover decreased the establi-shment of ladino clover. With the increase of N application levels, orchardgrass, perennial ryegrass and Italian ryegrass in com-parison on botanical composition were getting better, while the native plants established already were de-creased. The botanical composition of newly sown pasture plants was increased as cutting times progres-sed. The dry matter(DM) yield of pasture species increased significantly with N application up to 300 kg/ha. There was no significance among mixture treatments, although the DM yield of basic treatment(0rchardg-rass + ladino clover) was higher than other treatments. However, when compared DM yields on each cut-ting times, newly oversown pastures in A treatment was shown to be significantly higher only on 2nd outting time than other treatrnents(P<0.05). The DM yield of native plants survived in basic species mix-ture was significantly less than those of other mixtures(P<0.05). Results of this study indicate that for improving oversown pastures, at least 300 kg/ha N application should be applied, and basic mixture (orchardgrass+ ladino clover) has more advantage than treatments mixed with ryegrass.

뉴로-퍼지기법을 이용한 덕트와 실내온도 제어에 관한 연구

강문호 선문대학교 첨단과학기술연구소 1999 첨단과학기술연구소 논문집 Vol.4 No.-

본 연구에서는 입출력 궤환선형화 방식과 결합된 간접 적응퍼지 제어기를 이용하여 덕트와 룸이 연계된 공조계통의 파라미터 불확실성에 대처하고 견실한 온도제어를 행할 수 있는 제어기법을 제시한다. 설계된 제어기는 제어지 파라미터들을 추정해나가는 적응화 기법을 Takagi-Sugeno형 퍼지제어기와 결합한 형태로서, 일종의 뉴로-퍼지제어계를 구성한다. 시뮬레이션은 Simulink 윈도우상에서 구성된 객체지향모델을 통해 수행하여, 별도의 프로그램 코딩이 없이 시스템 구조변경이 가능하고 다이얼로그박스를 통해 간단히 파라미터들을 변경할 수 있도록 하였다

Hydrogen Behavior in Ti-Added Reduced Activation Ferritic-Martensitic Steels

Kang‑Mook Ryu,Dae Geon Lee,Joonoh Moon,Chang‑Hoon Lee,Tae‑Ho Lee,Jae Sang Lee,Dong‑Woo Suh 대한금속·재료학회 2021 METALS AND MATERIALS International Vol.27 No.3

Hydrogen behavior and corresponding mechanical degradation were examined in TaTi-RAFM and EUROFER97 steels. Increased Ta content with Ti addition decelerates the hydrogen diffusion but increases the solubility in the lattice. It ismainly led by the higher fraction of Ta-rich MC carbides and dislocation density in TaTi-RAFM steel. Overall activationenergy of hydrogen trapping of investigated steels is evaluated to be 25.3 ~ 25.6 kJ/mol in the tempered condition. The activationenergy increases to nearly 30 kJ/mol when the steels are re-austenitized and quenched. Higher activation energy withincreased dislocation density indicates that the dislocation provides for trap site with higher activation energy than Ta-richMC carbide. Mechanical degradation by hydrogen with respect to the yield strength, tensile strength and uniform elongationcould not be observed in all investigated steels. The presence of hydrogen only has influence on the loss of post-uniformelongation. For a given charging time, the loss of post-uniform elongation is more remarkable in TaTi-RAFM steel due tothe larger hydrogen uptake.

휘가론과 에스렐 葉面撒布가 溫州蜜柑의 落果 및 果實品質에 미치는 影響

文斗吉,高康豪,韓海龍 濟州大學校 亞熱帶農業硏究所 1993 亞熱帶農業硏究 Vol.10 No.-

장마기 이전에 약제를 살포할수 있는 화학적 적과방법을 확립하기 위하여 탱자에 접목한 宮川早生 溫州蜜柑 (Citrus unshiu. Marcovitch cv. 'Miyagawa')을 공시하여 휘가론(5-chloroindazol-8-acetic acid ethylester)과 에스렐(2-chloroethylphosphonic acid)의 적과효과를 '87∼'92년 6년간 시험한 결과를 요약하면 다음과 같다. 1. '87∼'90 4년간 시험에서 제 1차 생리낙과가 거의 끝나는 6월 15일전후 (과경 10∼16㎜인 시기)에 휘가론 50mg/l 살포로 최종착과수를 20∼30%정도 감소시키는 적과효과를 얻을수 있었다. 그러나 무처리구의 최종엽과비가 14이하로 착과과다인 경우는 휘가론 단독살포만으로는 목표엽과비에 접근하기 어려웠다. 2. 만개 후 20∼25일인 6월 13∼15일에 엽면살포한 휘가론 (50mg/l)과 에스렐 (5∼200mg/l)의 낙과촉진 효과는 相加的으로 작용하여 두 약제 혼용살포구에서 그리고 에스렐 농도가 높을수록 낙과가 많았다. 3. 50mg/l이상 농도의 에스렐은 낙엽율을 증가시켰는데 휘가론 혼용은 에스렐의 의한 낙엽증가를 경감시켰다. 4. 착과안정기의 엽과비는 '91년도는 대조구 14에 비해 에스렐 25mg/l 단독살포구 36, 휘가론 50mg/l 가용 에스렐 12.5mg/l 살포구에서 39가 되었으며 '92년도는 대조구 10.5에 비해 에스렐 10∼40mg/l 단독살포구에서 17∼18, 휘가론 50mg/l 가용 에스렐 5∼20mg/l 살포구에서 14∼24였다. 5. 만개 후 15일부터 1주 간격으로 5주간에 걸쳐 에스렐 20mg/l의 살포시기를 달리한 결과 모든 처리에서 살포 후 2주째에 낙과가 급증되었다. 최종낙과율은 비록 살포일 사이에 유의차는 인정되지 않았지만 살포시기가 가장 빨랐던 6월 8일 살포구와 가장 늦었던 7월 8일 살포구와 가장 늦었던 7월 6일 살포구에서 많았다. 6. 화학적 적과의 실증실험에서 '91년도는 대조구의 착과안정기 엽과비가 16.9였는데 비하여 휘가론 50mg/l 살포구는 21.6 휘가론 50mg/l+에스렐 50mg/l 혼용구는 196.5로서 에스렐 50mg/l 가용은 적과과다에 의한 착과과소 상태를 초래했다. '92년도 시험에서는 대조구의 엽과비가 12.2였는데 비하여 휘가론 50mg/l 과 에스렐 20mg/l 단용구 및 혼용구의 엽과비가 각각 15.2, 15.6, 21.3이였으며 휘가론 혼용은 에스렐에 의한 낙엽율 증가를 경감시켰다. 7. 적과정도에 따라 과실크기가 증가하였으며 특히 과육중의 증가가 인정되었으나 착과과소상태의 경우를 제외하고는 과즙의 감미비에는 별 영향이 없었다. 8. 만개 후 20∼25일이 되는 6월 10∼15일경과경이 10∼15mm인 시기에 휘가론 50mg/l의 단독살포 또는 착과정도에 따라 20mg/l 전후의 에스렐을 혼합 살포함으로써 적절한 적과효과를 얻을 수 있다고 생각되었다. In order to establish the chemical fruit-thinning method of applying thinning agents before rainy season, the effect of Figaron (5-chloroindazol-8-acetic acid ethylestel) and Ethrel (2-chloroethylphosphonic acid) was evaluated in 'Miyagawa' Satsuma mandarin (Citrus unshiu Marcovitch cv. Miyagawa) grafted on trifoliate orange stock during '87-'92. The results obtained are summarized as follows: 1. Foliar spray of Figaron (50mg/l) on about June 15 accelerated fruit-drop, resulting in the decrease in the number of fruits by 20-30%. In case of over-fruit load less then 15 of final leaf-fruit ratio in Control, however, it was calculated that the ideal leaf-fruit ratio could not be obtained by the application of Figaron alone. 2. When foliar-sprayed on June 13-15 (20-25 days after full bloom), Figaron (50mg/l) and Ethrel (5-200mg/l) additively accelerated fruit-drop, resulting in more fruit-drop by more concentrated Ethrel with Figaron. 3. Higher concentration of Ethrel more than 50mg/l increased leaf-drop ratio, and the effect was reduced by Figaron. 4. The numbers of leaves per fruit in '91 were 14, 36 and 39, respectively, in the plots of Control, 25mg/l Ethrel only, and 12.5mg/l Ethrel with 50mg/l Figaron. Those in '92 were 10.5, 17-18 and 14-24, respectively, in plots of Control, 10-40mg/l Ethrel only, and 5-20mg/l Ethrel with 50mg/l Figaron. 5. Foliar spray of 20mg/l Ethrel on 5 different days at one-week interval from 15 days after full-bloom resulted in the remarkable increase in fruit-drop ratio in the second week after spray. Though significant difference in the final fruit-drop ratio among the dates of spray was not statistically recognized, the highest was observed in the plots of June 8 and July 6. 6. In the practical test of chemical fruit-thinning in '91, the numbers of leaves per fruit after June drop were 16.9 and 21.6, respectively, in the plots of Control and 50mg/l Figaron, and that in the plot of 50mg/l Ethrel with 50mg/l Figaron was 196.5, resulting in too few fruits from excessive thinning effect. Those in '92 were 12.2, 15.2, 15.6, and 21.3, respectively, in the plots of Control, 50mg/l Figaron, 20mg/l Ethrel, and 20mg/l Ethrel with 50mg/l Figaron. Leaf drop caused by Ethrel was reduced by the addition of Figaron. 7. The size and weight of fruit, especially pulp weight, increased according to the degree of fruit-thinning, while the Brix/acid ratio in juice was not affected except in the case of too few fruits caused by excessive thinning. 8. It was suggested that practical fruit-thinning could be attained by the foliar spray of 50mg/l Figaron or the mixture of 50mg/l Figaron and 20mg/l or so(depending on the degree of fruit load) of Ethrel on June 10-15, or 20-25 days after full bloom.

수박종자의 크기가 묘의 소질 및 수량에 미치는 영향

강호종,채윤석,이상우,문국이 진주산업대학교 농업기술연구소 2007 農業技術硏究所報 Vol.20 No.-

수박종자의 크기에 따른 발아율과 배축 굵기, 뿌리발육상태, 접목묘 생육 및 과실 품질에 미치는 영향에 대한 연구결과를 요약하면 다음과 같다. 1. 종자 크기별 발아율은 대립은 97%, 중립은 94%, 소립은 91.9%로 종자의 중량이 큰 대립종자 일수록 발아율이 높았다. 2. 종자의 크기별 배축 굵기는 대립이 1.63mm, 중립이 1.45mm, 소립이 1.29mm로 종자의 중량이 클수록 배축이 굵고 뿌리무게도 무거운 것으로 나타났다. 3. 종자의 크기별 접수의 소질은 종자의 중량이 큰 것일수록 좋은 경향이 있었으나 초장, 엽장 등은 소립종자에서 유의적인 경향이 나타났다. 4. 종자의 크기별 접목묘 소질은 대립종자에서 유의적인 차이를 보였고, 뿌리중량은 중립종자에서 다소 높은 경향이었으나 통계적 유의성은 인정되지 않았다. 5. 종자 크기별 착과 절위별로 과중은 자만 7~8절에서 6.6kg, 자만 9~ 10절에서 7.4kg, 자만 11~13절에서 7.2kg으로 자만 9~10절에 착과시킨 처리구가 가장 좋았다. 6. 접목융합의 정도에 따라 생육과 과실의 품질에 유의성이 있었다. 7. 종자의 크기가 클수록 발아율과 배축 굵기, 균일도 등이 높아 접목작업이 용이하여 접목능률을 향상시켰다. Effects of seeds size(small, medium and large) in watermelon(citrulus vulgaris schard) on seed germination, seedlings growth and the quality of fruit were investigated. The results are as followings. The seeds of watermelon were classified according to the weight of seeds into 3 groups, small (〈34mg), medium(44-35mg) and large( 〉45mg). Germination rate increased from 91.9% to 97% as the seed size increased. Hypocotyle thickness increased from 1.1mm to 1.5mm as the size of seeds increased. The heavier root weight was the larger the seeds were. The quality of seedlings improved as the seed size increased. Fruit quality was better at larger seed. At the same time, the efficiency of grafting improved since larger seeds produced higher uniformity at germination rate and hypocotyl thickness. The fruit weight was 6.6kg at 7-8 node, 7.4kg at 9-10kg and 7.2kg at 11-13kg.