소화기 Behcet병: 13예의 임상분석

정희원,유빈,문희범,이인철,김병식,박건춘,김진천 대한대장항문학회 1995 Annals of Coloproctolgy Vol.11 No.1

심한 정신병적 증상을 나타낸 전신성 홍반성 루푸스 3례

문혜원,강민희,송정수,박원,김철응,이정섭,배재남 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

전신성 홍반성 루푸스(systemic lupus erythematosus, 이하 SLE)는 원인을 알 수 없는 자가항체 및 면역복합체로 인하여 여러 장기의 손상을 초래하는 질환이다. SLE의 신경정신의학적 증상에 대하여는 1872년 Kaposi에 의해 처음 기술되었다. 이때에 나타나는 임상적 양상은 상당히 다양하여 정신증, 우울증, 뇌졸증과 인지기능장애등을 포함한다. 이들은 종합적인 정신과적 평가를 위해 종종 협의진료가 의뢰되고 있다. SLE의 정신병적 증상은 환자의 사망률을 높이고 좋지 않은 예후를 시사하는 지표가 될 수 있기 때문에 조기 진단 및 치료가 요구된다. 그러나 SLE의 중추신경계 침범에 대한 명확한 진단기준이 마련되어있지 않고, 증상의 다양성과 변동성은 진단을 더욱 어렵게한다. 저자들이 경험한 심한 정신병적 증상을 보인 SLE 3례의 경우, 이들은 지남력 장애, 환시, 환청, 망상, 불안정한 기분을 보였고 자주 충동적이 되거나 난폭해져 자신 또는 타인에게 위험을 초래할 수 있었다. 현재까지 SLE의 정신병적 증상에 대하여 잘 알려져 있지는 않지만, 문헌고찰을 통해 발병기전, 분류진단, 임사양상, 치료등에 대하여 알아보았다. Systemic lupus erythematosus(SLE) is a disease of unknown etiology in which multiple organs are damaged by pathogenic autoantibodies and immune complexes. Neuropsychiatric manifestations in SLE were first described by Kaposi in 1872. These are so diverse that they include psychosis, depression, stroke, seizure and cognitive dysfunction etc.These patients are frequently consulted for psychiatric evaluation. Neuropsychiatric manifestations in SEL re also among the leading causes of morbidity and mortality and associated with poor long-term outcome. So it is essential to recognize and intervene these symptoms early. But the clear diagnostic criteria for CNS involvement in SLE have not been formulated, and diversity and fluctuation of illness make it difficult to confirm it. The authors reported three cases of SLE with severe neuropsychiatric manifestation. These patients showed symptoms such as disorientation, auditory and visual hallucibation, delusion and mood instability. They became frequently impulsive and violent and had risks to injure themselves or others. Although CNS involvement in SLE is not well known, we reviewed the pathogenesis, classification, diagnosis, clinical manifestation and treatment of them.

중·고등학생들의 보건교육 요구도 조사연구

문기내,남철현,김귀희,위광복,박경옥,이미경,심규범,장영진 慶山大學校 保健福祉硏究所 2003 保健福祉硏究 Vol.8 No.-

This study was conducted to examine middleㆍhigh school 720 students in seven regions of middleㆍsmall city and town, Myon for 2 months from March 2 through April 30, 2002 in order to realize a side of school health education in middleㆍhigh school and health education need as well as health education specialist in school in the future. The results of this study can be summarized as follows. 1. Health condition is now 'normal' is 51.0%, 'good' is 45.0%, 'not good' is 4.1% and health condition of children is good as much as education level of mother is higher. 2. Experience to learn health education in school for one year recently is 'no' is 39.6%, 'don't know' is 32.6%, 'yes' is 27.8% and it represents health education in school doesn't work well and experience to learn health education is lower and lower in town and Myon. 3. Health education ways to work in school now are 'Movie, Video, Slide' is 40.7%, 'education as groups of nurse-teacher' is 38.6%, 'to distribute health education material and book' is 7.7%, 'education by setting an example' is 3.4%, 'the others' is 9.7%. 4. Time of appropriate health education for one time is 'about a hour' is 56.7%, 'about 30 minute' is 33.8%, 'about two hour' is 7.6%, it represents this situation is because of what students' time is lack and burden about a curriculum in an education administratin and school classed of a focused school score. 5. The average score of satisfaction of health education in school is 16.99±0.58, 'men' is 1.79±0.60, 'women' is 1.61±0.55 as the distinction of sex, satisfaction level of men is higher than women. 6. Learning route about health information is 'through mass media' is 59.9%. 'through family, friend' is 15.0% 'health education lecture' is 7.2%, 'printing media' is 6.1%, 'medical institution' is 5.6%, 'the others' is 5.1%, 'public health center' is 1.0%, 'through mass media' is the highest percent as each 59.1% and 60.6% in all of men and women. 7. The most efficient education way of health education is 'movie, video, slide' is 32.6%, 'health education specialist who works school' is 21.9%, 'school health education by nurse-teacher' is 16.0%, 'way through mass communication' is 11.6%. 8. The appropriate health education specialist in the future is 'health education specialist who has qualifications' is the highest as 64.5%, 'nurse-teacher' is 12.4%, 'medical personnel(doctor, a physician of oriental medicine etc.,)' is 11.0%, 'staff in public health center' is 7.2%, people in other regions(health and medical professor etc.,) is 7.0%, it represents school health education is not actual and is formal now in second hand. 9. The most necessary health education program is 'program of stress solution' is the highest as 24.9%, 'program of no smoking' is 22.7%, 'sexual education program' is 19.8%, 'school violence program' is 8.8%, 'isolate from their friends prevention program' is 8.0%, solution program of stress which gives student by school score was very necessary. Therefore, school health education is formal and inefficient because school education focuses on an entrance exam, so middleㆍhigh school students decrease concern and interest about health education. Furthermore, reliance is gotten down about nurse-teacher who takes charge of school health, a charged person of school health education wants more chargeable health education staff. And a solution program of stress that gives students by school score was very necessary. According to active concern and planned, systematic school health education is necessary to give right health knowledge, health maintenanceㆍpromotion and setting of appropriate health education specialist is very urgent.

난소 및 난소 종양 염전의 초음파 소견

오연희,이현경,이원재,이성우,박수성,윤혜원,임문환,심재철,김용탁,김성숙,김정란 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Acute torsion of the ovary and ovarian mass is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. The sonographic findings in 14 cases of surgically proven torsion of the ovary and ovarian mass are described. Mostly cystic ovarian mass, engorged vessel, dilated uterine tube, beak-like echo(torsion site), smooth mass wall thickening an free-fluid collection in cul-de-sac are described. More significant in terms of specificity were the demonstration in 6 cases(42.9%) of the smooth mass wall thickening and in 8 cases(57.1%) of a free fluid in the cul-de-sac. We report the sonographic findings of ovary and ovarian mass torsion that may suggest the preoperative diagnosis of this condition.

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.

혈청 Fructosamine에 대한 임상적 유용성에 관한 연구

김철,김용태,노상현,홍순표,김미송,장숙진,박희완,문대수 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

Diabetes mellitus is a universal health problem and may occur at any age. The traditional biochemical measurements for initially detection patients with diabetes mellitus are random estimations of blood and urine glucose concentrations. Despite their common use both tests are fairly non-specific, being influenced by wide variety of condition. Measurement of the HbA_(1c) in a random blood specimen is a more simple screening test for diabetes, and widely used as an index of diabetic control. But unfortunately, it has difficulties with methodology. Fructosamine has been described as a new parameter for the estimation of glycosylated protein, It is based on the reduction potential of ketoamines in an alkaline medium and measures colorimethcally the concentration of all glycosylated semm proteins belonging to the class of fructosamine. It reflects the time-integrated glucose concentration over the previous 1 to 3 weeks and can be used for the follow up of diabetes mellitus. We measured serum fructosamine concentration and compared with any other items. The results are summehzed as follows : 1. Within-run and between-run imprecision were assessed by 20 analysis of 3 differential fructosamine concentration in control sera. The respective coefficients of variation were 2.9%, 6.6% in low concentration, 2.2%, 5.1% in medium concentration and 3.3%, 4.7% in high concentration. 2. The serum fructosamine concentration were 2.26±0.21 mmol/L in normal control subjects(n=29) and 3.35±0.65 mmol/L (n=62) in patients with diabetes mellitus (p<0.001). 3. In diabetic patients (n=62), the serum fructosamine concentrations correlated less significantly with glucose (Y(fructosamine) = 0.01×(glucose)+2.52, r=0.54, P<0.001) and more significantly with HbA_(1c) (Y(fructosamine) = 0.22×(HbA_(1c))+1.71 , r=0.63, P<0.001). 4. The concentrations of fructosamine in serum and EDTA plasma were not significently diferent (P<0.01). So, Plasma is as well suited to fructosamine determinations as serum(Y(serum) = 0.95×(Plasma)+0.25, r=0.96). 5. No interference was observed with lipemic sera (cholesterol) in detection of serum fructosamine(P=0.393).

공구형상인자에 따른 공구응력 변화 특성

이영문,손재환,김선일,정희철 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

In this study, a series of FE-simulations, using the DEFORM software, on tool stersses of orthogonal cutting are carried out. As cutting input conditions, the tool shape factor such as tool relief angle and the cutting velocity are changed in the analyses. The results reveal that the patterns of stress distribution are same, that is signs of stress are divided at the points, wherever the chips leave the tool. And as the relief angle increases the more sterss concentration occurs at the tool tip.

자기장이 있는 경우 결합무질서를 갖는 3D XY 모델의 상전이

류희문,차민철 한양대학교 이학기술연구소 2002 이학기술연구지 Vol.5 No.-

본 연구에서는 몬테칼로 시늉내기 방법을 사용하여 자기장에 의한 쩔쩔맴이 있는 경우 결합무질서가 있는 3차원 XY 모델의 상전이를 살펴본다. 그 결과 쩍쩔맴이 f = 1/2 인 경우 자기장 방향의 상관관계거리를 결정하는 임계지수로 z = 1.0이고, 자기장에 수직한 방향의 상관관계거리 임계지수로 v = 0.67을 얻었다. We have studied the phase transition in a bond-disordered 3D XY model using Monte Carlo methods in the presence of frustration due to a magnetic field. As a result, we obtain z = 1.0, which is the critical exponent characterizing the correlation length along the magnetic field, and v = 0.67, which is the correlation length exponent, when frustration is f = 1/2.

가령에 따른 백서 악관절 원판의 형태 및 미세구조적 변화

배용철,성재현,경희문,서혜경 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.2

백서에 있어서 가령에 따라 악관절 원판에 가하여지는 기계적 부하의 변화에 따른 악관절 원판의 형태, 탄성섬유 및 세포의 미세구조의 적응등의 변화양상을 관찰하기 위하여, 생후 1일, 7일, 17일, 27일, 55일, 1년 이상군의 백서의 악관절 부위를 적출하여 광학 및 전자현미경으로 관찰하여 다음과 같은 결론을 얻었다. 악관절 원판의 형태는 1일 및 7일군에서는 중앙부의 얇은 부위가 전후방으로 상당히 길게 뻗쳐 있고 전부 및 후부의 최대 풍융부를 향한 경사가 완만하여 하악와 및 하악과두에 적합되지 않는 양상을 보였으나, 17일군부터는 전부 및 후부가 하악와쪽으로 풍융해짐과 동시에 중앙부의 얇은 부위가 전후방으로 좁아지고 전부 및 후부의 최대 풍융부를 향한 경사가 급하여져, 악관절 원판이 하악과두를 감싸는 형태를 취하여 하악와 및 하악과두에 적합되어 가는 양상을 보였다. 가령에 따라 세포밀도는 점점 감소하였으며, 1일 및7일군에서는 세포내 골지장치, 과립성 내형질망, 유리 리보솜 등의 세포질 및 세포간 기질을 활발하게 합성하는 세포 소기관들이 발달 되어 있었으나 세포질내 세사는 발달되어 있지 않았다. 17일, 27일 및 55일에서는 기질합성에 관여하는 세포 소기관의 발달과 아울러 손가락 모양의 세포돌기, 용해소체, 사립체등의 세포간 기질의 개조에 관여하는 세포 소기관이 발달된 세포가 다수 관찰되었으며, 가령에 따라서 세포질내 세사가 점점 축적되어지는 양상을 보였고, 섬유성 물질에 둘러 싸인 chondroid cell들이 증가하였다. 1년이상군에서는 대부분이 세포가 chondroid cell로 구성되어 있었으며 세포질내의 대부분을 세사가 차지하고 세포내 소기관이 거의 발달되지 않는 등 대사 활동이 미약하며 주로 기계적 부하에 적응하기 위한 구조로 이루어져 있었으며 때로는 변성과정에 있는 세포도 다소 관찰되었다. The purpose of this study was to investigate changes in the shape and ultrastructrue of the articular disc of the rat mandibular joint with aging. Mechanical stress applied to the articular disc changes during neonatal, suckling, juvenile, adult and senile stages. Mandibular joints of 6 groups of rats (1-,7-,17-,27-,55-day and over-1-year groups) were removed en bloc and processed for light and electro microscopic study. The changes in the shape of articular disc were examined by light microscope in each group. Structural and ultrastructural changes in the articular disc were examined by light and electron microscope in each group. The results were as follows: In the 1-day and 7-day groups, the articular disc was long and slender in shape and the articular disc was not fitted with the shape of the mandibular fossa and condyle. However, after that time, the anterior and posterior portions of the articular disc were more bulged and the middle portion was shorter and biconcave. Thus the articuler disc was well fitted with the shape of the mandibular fossa and condyle. The cell density decreased wth aging. In the 1-day and 7-day groups, the Golgi apparatus, rough endoplasmic reticulum and free ribosome, which are involved in the synthesis of intracellular and extracellular matrix. were developed. In the 17-day, 27-day and 55-day groups, not only the cell organelles involved in the synthesis of the intracellular and exracellular matrix but also the cell organelles involved in the remodeling of the extracellular matrix(i.e., finger-like cell process, lysosome and mitochondria) were well developed. With advancing age, intracytoplasmic microfilaments were more accumulated and condroid cells increased. In the over-1-year group, the majority of cells of the articular disc were chondroid cells. The majority of cytoplasmic compartment were filled with intracytoplasmic microfilaments and cell organelles were not developed. Therefore, metabolic activites of the cell was markedly reduced and cells contained structures enduring mechanical stress, and cells which were in the process of degeneration were observed occasionally.

植物凝集素 Sophola japonica와 赤血球에 의한 사람 唾液의 型分類에 關한 硏究

吳熙哲,文國鎭 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.3

Since it was discovered that the human saliva could be classified by using the serological characteristics of Sophola japonica extract, agglutination inhibition tests of phytagglutinin, Sophola japonica , and human red blood cells were carried out, using 300 human saliva specimens. The relationship of the newly classified saliva types with the established saliva, blood, and serum types was compared statistically. The results obtained could be summarized as follows : 1. Human saliva could be classified into two groups. One group inhibited the agglutination activity of Sophola japonica extract to human red blood cells and the other did not. Among the investigated 300 human saliva specimens, the frequency of the former was 21% and the latter was 79%. 2. The classification and distribution of new saliva types, inhibitor and non-inhibitor, showed no constant relation with those of the known saliva types, secretor and non-secretor, and the saliva types which were classified by the agglutination inhibition pattern of Sophola japonzca extract and human blood cells. 3. The classification and distribution of the new saliva types showed no constant relation with those of the known blood groups, such as ABO, MN, H and Cl, respectively. 4. There was no serological relationship between the human serum types classified by IPO, NPO and ICO, NCO with phytagglutinin mentioned above.