외상성 관절원판 전위에 의한 청각장애: 증례보고 : 증례 보고 A CASE REPORT

심정환,김영균,안철민 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.2

Fifty nine year-old male patient was referred for the correction of external auditory canal impatency according to anterior bony wall fracture of canal during the otolaryngologic treatment for hearing disorder. At clinical examination there are both temporomandibular joint(TMJ) pain, tenderness and left TMJ noise. We could find that if mouth was opened, external auditory canal impateted, and if closed, patented through otoscopy. We planned exploratory TMJ open surgery under clinical diagnosis of traumatic TMJ meniscus displacement and external auditory canal bony wall fracture, of under clinical diagnosis. During arthroplasty we found that posterior displaced meniscus pressured the fractured external auditory canal so we prepositioned meniscus anteriorly. After arthroplasty, TMJ noise disappeared and hearing funtion recovered. We experienced hearing disorder due to TMJ meniscus posterior displacement, so we present a case report with literature review.

두경부 악성종양 절제술 후 유리피판을 이용한 재건술 40예의 고찰

백정환,손영익,김성민,추광철,하범준,심영목 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.7

牙山人工湖의 理化學的水質調査

沈英燮,羅圭煥,洪思澳 成均館大學校 1978 論文集 Vol.25 No.-

The surface and bottom of the water quality in the Asan artificial reservoir have investigated in 6 sites according to the geographycal view points during 3 seasons, summer, autumn and winter. As compared the water quality of two areas near the dike with upper area at 4km distance from dike, it was not found any difference. Vertical variation of water quality was not found certainly difference between the surface and the bottom. Because the depth of this reservoir was no more than 3m, the water temperature was 1℃ high in the surface than bottom in summer, the conductivity increase 7.5μ? high in surface but in autumn and winter the conductivity increase in the bottom especially 12μ? and 13.2μ?. The another items of water quality didn't found any difference. According to the seasonal variation of water quality, the water temperature was 25.6℃ in summer, 17.4℃ in autumn and 4℃ in winter. The concentration of Cl^- was 26.6ppm in summer and gradually increase in autumn and winter especially 103.6ppm and 267.9ppm. The total hardness exhibit much the same tendency with Cl^- and most high in winter as 134.9 ppm. The content of K and Na was lower in summer but most high in winter especially 10.0 ppm and 159.3 ppm. The water quality of the Jin wi river which is one of the water source in this reservoir was severely polluted with industrial waste water. The content of total hardness 152ppm, conductivity 565μ?, the content of COD 6.7ppm, the content of Na 550ppm and the content of Fe 1.4ppm.

정신분열병 환자의 우울증에서 Paroxetine과 삼환계 항우울제 병용치료

심주철,공보금,박정환,윤영란,신재국,김정익,안동성,김용관,차인준,김영훈 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

저자들은 마산동서병원에 입원중인 우울증이 동반된 정신분열증 환자 10명을 대상으로 사용중인 항정신병약물에 paroxetine과 저용량의 삼환계 항우울제를 6주간 병용투여한 후 우울증상에 대한 효과와 치료의 안전성 및 약물상호작용을 알아보았다. Paroxetine은 고정량의 항정신병약물과 삼환계 항우울제에 부가하여 일일 20㎎을 6주간 병용하게 하였으며, 임상상태는 HDRS, HARS, UKU Side Effect Rating Scale등의 평가척도를 사용하여 평가하였다. 또한 약동학적 약물상호작용은 삼환계 항우울제들의 혈장농도를 HPLC로 측정하여 분석하였다. 결과는 다음과 같다. 1) 10명의 전체 대상환자에서의 HDRS 평균점수는 TCA와 paroxetine 병용투여 6주후에 통계적으로 유의하게 감소되었다. 이중 40%의 환자에서는 병용투여 6주후에 HDRS 점수상 50% 이상의 감소를 보여, 일부의 환자들에서는 정신분열병에 동반된 우울증상의 치료에 소량의 삼환계 항우울제와 paroxetine의 병용치료가 효과가 있음을 확인하였다. 2) 두 명의 환자에게서 심각한 약물독성이 발생하였다. 이중 한 명은 삼환계 항우울제의 높은 혈중농도로 인한 항콜린성 위기(anticholinergic crisis) 소견을 보였으며, 다른 한 명은 인지기능 및 의식수준은 명료하였으나 망상과 환각증상이 약화되는 소견을 보였다. 따라서 본 연구에서 시도된 복합적 약물치료의 경우, 삼환계 항우울제의 혈중농도의 측정을 포함한 세심한 임상적 추적이 필요하다고 생각된다. 3) 기저치의 amitriptyline과 그 대사물인 nortriptyline의 농도합. imipramine과 대사물인 desipramine의 농도합은 각각 47.8-226.5ng/㎖. 80.5-395.6ng/㎖였으며 일반적으로 이들 약물들의 단독사용시에 문헌에 보고된 혈중농도를 훨씬 상회하고 있었다. 이는 병용투여된 항정신병 약물 약시 강력한 CYP2D6 효소억제제로서 기저치의 삼환계 항우울제들의 혈장농도를 이미 상당히 증가시켰던 것으로 판단되며, 그러한 결과로 인해 본 연구에서는 paroxetine이 이전의 문헌보고들과는 달리 뚜렷하게 삼환계 항우울제들의 혈장농도를 증가시키지 못하였다. 본 연구는 SSRI와 삼환계 항우울제의 병합 투여가 우울증의 개선 효과를 빠르게 하고, 치료역을 넓히고, 약물상호작용의 결과 paroxetine이 삼환계 항우울제의 혈중농도를 증가시킨다는 기존의 연구결과를 이용하여 정신분열병 우울증상의 치료에 parotextine과 소량의 삼환계 항우울제를 병용하는 방법을 시도해 본 연구이다. 저자들은 이러한 약물치료가 일부의 환자들에게서 효과가 있음을 관찰하였으나, 항정신병약물과 삼환계 항우울제를 병용투여 할 경우는 물론 이에 paroxetine과 같은 선택적 세로토닌 재흡수 억제제를 병용할 경우 복합약물상호작용의 결과로 약물독성의 위험성이 크며 세심한 주의가 필요함을 경험하였다. Depression is well-known to comorbid with several psychiatric disorders. Many schizophrenics also suffer from depression in the course of their illness. Combined therapy of SSRI and tricyclic antidepressants were reported to have benefits in some depressed patients. Paroxetine, a potent CYP2D6 inhibitor, increases the blood levels of tricyclic antidepressant markedly. Using paroxetine, we tried this combined therapy in the treatment of depressive symptoms in 10 chronic schizophrenic inpatients and evaluated its efficacy and drug interactions between paroxetine and tricyclic antidepressants. The following results were obtained : 1) The mean score of Hamilton's Depression Rating Scale(HDRS) was reduced significantly after 6 weeks-trials of this combined therapy for the mild depressive symptoms in 10 chronic schizophrenics. In four patients, 50% or more reductions in the scores of HDRS were noticed at final evaluation. 2) Two among our 10 subjects experienced severe toxic behavioral problems. Anticholinergic crisis with toxic confusion due to high blood levels of tricyclics was found in one patient and the other showed rapid clinical deterioration in his psychotic symptoms such as delusion and hallucination without any consciousness alternation. 3) Baseline plasma levels of tricyclics before adding paroxetine were higher than expected in our chronic schizophrenic subjects maintained with their antipsychotic medications. Several antipsychotics were also known as a potent CYP2D6 inhibitors and to increase the blood levels of tricyclics. Because the blood levels of tricyclics had already increased significantly by the use of antipsychotics, adding paroxetine to antipsychotics and tricyclic antidepressant in our subjects could increase the blood levels of tricyclics not so much as previously reported in the literatures.

일차 구개성형술 후 발생된 지속적인 술후출혈

심정환,김영균,채병국 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.5

A 11-month-old infancy was referred for treatment of cleft palate. The patient's congenital deformities had included oronasal fistula on the soft palate and bifid uvula. Furrow double-opposing Z-plasty was performed under general anesthesia. However, postoperative bleeding developed at ward. Despite the pressure of operative wound, venous oozing continued and hemoglobin concentration and RBC were decreased (Hb: 5.5g/dL, RBC :1.98×106/mm3). The patient was pale and confused and transferred to Surgical Intensive Care Unit(SICU) We could not keep the peripheral venous line and there was a high risk of hypovolemic shock. Emergency transfusion was performed through the central femoral venous line and emergency operation for bleeding control was carried out. We explored the operation site and found bleeding point from the posterior pharyngeal wall. Electrocoagulation and surgicel packing were carried out and bleeding was stopped.

브랜드 퍼스낼리티에 관한 실증적 연구

심영환,이경미 한양대학교 산업경영연구소 1999 産業經營硏究 Vol.11 No.-

비선형 시스템의 진화형 신경회로망 제어기의 구현

심영진,박두환,김태우,지석준,이준탁 동아대학교 정보기술연구소 2000 情報通信硏究所論文誌 Vol.8 No.1

The stabilization control of Inverted Pendulum(IP) system is difficult because of its nonlinearity and structural unstability. Futhermore, a series of conventional techniques such as the pole placement and the optimal control based on the local linearizations have narrow stabilizable regions. At the same time, the fine tunings of their gain parameters are also troublesome. Thus, in this paper, an Evolving Neural Network Controller(ENNC) which its structure and its connection weights are optimized simultaneously by Real Variable Elitist Genetic Algorithm(RVEGA) was presented for stabilization of an IP system with nonlinearity. This proposed ENNC was described by a simple genetic chromosome. And the deletion of neuron, the determinations of input or output neuron, the deleted neuron and the activation functions types are given according to the various flag types. Therefore, the connection weights, its structure and the neuron types in the given ENNC can be optimized by the proposed evolution strategy. And the proposed ENNC was implemented successfully on the ADA-2310 data acquisition board and the P-III microprocessor in order to stabilize the nonlinear system. initial values and the external disturbances applied to pendulum. Its main hardwares were made of the ADA-2310 data acquisition board and the P-III microprocessor. Through the simulation and experimental results, we showed that the finally acquired optimal PENNC was very useful in the stabilization control of nonlinear(IP) system.

산복도로에서 보는 釜山港 景觀의 構圖的 特徵 에 관한 硏究

심은경,강영조,김승환,남정칠,박승범,이기철,박한우 동아대학교 건설기술연구소 2000 硏究報告 Vol.24 No.1

This study is to clarify the characteristics of the type of view on a prospect from the road view, approach to the purpose of the maintenance plan of the road view. First, in the viewpoint of view is understanding meaning of the road, the method come into contact with a road view. Second, in the view appear an object land is grouping to the road view and presentation to a point in dispute and a settlement. This study have the keynote to different a form of view depend on viewpoint in a point view of prospect of road view, it will be presentation of practice method to the maintenance plan of the road view of the future.

모터 제어ㆍ감시를 위한 Monitoring Device 개발

정도영,박영록,심낙순,박종국,허규환 삼척대학교 산업과학기술연구소 2001 産業科學技術硏究論文集 Vol.6 No.1

A motor used as power source by factory has a relay panels up to recently. But they have the problems of operating and maintenance, such as mechanical contracts, etc. They also need some additional relays to check the over load, over currents and ground faults. But in the development of computers the relay panels to control motor are changed by electrical motor controllers with microprocessor or DSP. They can check the event, the over load, over currents and ground faults and also supervise the trend and state of operating. In this paper, a monitoring devices for the control and supervision of motor has been presented and developed.

확대관의 형상에 따른 원관내의 유속분포에 관한 연구

윤영환,심인보 國立 昌原大學校 産業技術硏究所 1998 産技硏論文集 Vol.12 No.-

An expanded pipe is an important device in designing energy system such as combustion chamber, heat exchanger and turbulence generator. In this study, mean velocity distribution and turbulent, fluctuation component of u' in the expanded pipe of which diffuser angles are ½θ=90。, 60。, 30。 and 15。 from 16㎜φ pipe to 32㎜φ pipe are measured by LDV system. Reynolds number of the experiments are from 8,000 to 60,000 approximately based on diameter and mean velocity of the large pipe. From the experiments, velocity profile at 150mm downstream from the diffuser become closer to fully developed velocity profile as Reynolds number becomes greater and the diffuser angle becomes smaller. However, turbulent fluctuation components of u' were almost uniform or homogeneous at the same location across cross section of the pipe for almost measuring condition. Therefore, these experimental data could be utilized in design of turbulence generator with parameters of velocity. angle of the diffuser and distance from the diffuser. Furthermore, velocity profiles and turbulent fluctuation components at 50㎜ upstream from the diffuser are also measured in order to use these data as inlet condition in numerical computation for comparison between experimental and computational data in an expanded pipe.