• 제목/요약/키워드: Blood Features

검색결과 463건 처리시간 0.043초

High Resolution HC$_3$N Observations toward the Central Region of Sagittarius B2

  • H.S-Ching;Oh, M.ishi;M.Morimoto
    • 한국우주과학회:학술대회논문집(한국우주과학회보)
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    • 한국우주과학회 1993년도 한국우주과학회보 제2권2호
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    • pp.17-17
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    • 1993
  • The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70${\pm}$1.32mmHg/min)compared to CF dialyzers(4.32${\pm}$0.55mmHg/min)(p<0.05). However, there was no observable difference in the UFR between the two dialyzers. Neither APD nor UFR showed any significant increase with an increasing number of reuses for up to more than 20reuses. A substantial number of failures observed in APD(larger than 20mmHe/min)on the reused dialyzers(2 out of 40 CP and S out 26 C-DAK) were attributed to the Possible damage on the fibers. The CF 15-11 HFDs which failed APD test did not show changes in the UFR compared to normal dialyzers indicating that APD is a more sensitive test than UFR test to evaluate the integrity of the fibers. 30527 T00401030527 ^x For quantitative measurement of reflected light from a clinical diagnostic strip, a prototype old reflectance photometer was designed. The strip loader and cassette were made to obtain more accurate reflectance parameters. The strip was illuminated at 45˚c through optical fiber and the intensity of reflected light was determined at rectanguLat angle using a photodiode. The kubelka-munk coefficient and reflection optical density were determined ar four different wavelengths(500,550,570 and 610nm) for blood glucose strip. For higher concentration than 300mg/41 about glucose, a saturation state of abforbance was observed at 500,550 and 570nm. The correlation between glucose concentration and parameters was the best at 610nm. 30535 T00401030535 ^x Radiation-induced fibrosarcoma tumors were grown on the flanks of C3H mice. The mice were divided into two groups. One group was injected with Photofrin II, intravenously (2.5mg/kg body weight). The other group received no Photofrin II. Mice from both groups were irradialed for approximately 15 minutes at 100,300, or 500 mW/cm2 with the argon (488nm/514.5 nm), dye(628nm) and gold vapor (pulsed 628 nm) laser light. A photosensitizer behaved as an added absorber. Under our experimental conditions, the presence of Photolfrin II increased surface temperature by at least 40% and the temperature rise due to 300 mW/cm2 irradiation exceeded values for hyperthermia. Light and temperature distributions with depth were estimated by a computer model. The model demonstrated the influence of wavelength on the thermal process and proved to be a valuable tool to investigate internal temperature rise. 30536 T00401030536 ^x We investigated the structural geometry of thirty-eight Korean femurs. The purpose of this study is to identify major geometrical differences between Korean femurs 3nd others that we believe belong to Caucasians so that we would be able to get insights into the femoral component design that fits Asians including Koreans. We utilized computerized tomography (CT) images of femurs extracted from cadavers. The CT images were transformed into bitmap data by using a film scanner, and then analyzed by using a commercially available software called Image v.1.0 and a Macintosh IIci computer.The resulting data were compared with already published data. The major results show that the geometry of the Korean femurs is significantly different from that of Caucasians: (1) the anteversion angle and the canal flare index are greater by the amount of approximately 8˚ and 0.5, respectively, (2) the shape of the isthmus cross section is more round, and (3) the distance between the teaser trochanter and the proximal border of the isthmus is shelter by about 15 mm. The results suggested that the femoral component suitable for Asians should be different from the currently-used components designed and manufactured mostly by European or American companies. 30537 T00401030537 ^x It is well known that nonlinear propagation characteristics of the wave in the tissue may give very useful information for the medical diagnoisis. In this paper, a new method to detect nonlinear propagation characteristics of the internal vibration in the tissue for the low frequency mechanical vibration by using bispectral analysis is proposed. In the method, low frequency vibration of f0( = 100Hz) is applied on the surface of the object, and the waveform of the internal vibration x (t) is measured from Doppler frequency modulation of silmultaneously transmitted probing ultrasonic waves. Then, the bispectra of the signal x (t) at the frequencies (f0, f0) and (f0, 2f0) are calculated to estimate the nonlinear propagation characteristics as their magnitude ratio, w here since bispectrum is free from the gaussian additive noise we can get the value with high S/N. Basic experimental system is constructed by using 3.0 MHz probing ultrasonic waves and the several experiments are carried out for some phantoms. Results show the superiority of the proposed method to the conventional method using power spectrum and also its usefulness for the tissue characterization. 30541 T00401030541 ^x This paper describes the implementation of a computerized radial pulse diagnosis by aids of a clinical expert. On this base, we composed of the radial pulse diagnosis system in korean traditional medicine. The system composed of a radial pulse wave detection system and a radial pulse diagnosis system. With a detection system, we detected Inyoung and Cheongu radial pulse wave and processed it. Then, we have got the characteristic parameters of radial pulse wave and also quantified that according to the method of Inyoung-Cheongu Comparison Radial Pulse Diagnosis. We defined the jugement standard of radial pulse diagnosis system and then we confirmed the possibility for realization of automatic radial pulse diagnosis in korean traditional medicine. 30545 T00401030545 ^x Microspheres are expected to be applied to biomedical areas such as solid-phase immunoassays, drug delivery systems, immunomagnetic cell separation. To synthesize microspheres for biomedical application, "two stage shot growth method" was developed. The uniformity ratio of synthesized microspheres was always smaller than 1.05. And the surface charge density (or the number of ionizable functional groups) of the microspheres synthesized by "two stage shot growth method" was 6~13 times higher than that of the microspheres synthesized by conventional seeded batch copolymerization. As a previous step for biomedical application, adsorption experiments of bovine albumin on microspheres were carried out under various conditions. The maximum adsorbed amount was obtained in the neighborhood of pH 4.5. Isoelectric point of bovine albumin is pH 5.0, so experimental result shows that it shifted to acid area. The adsorption isotherm was obtained, the plateau region was always reached at 2.Og/L (bulk concentration of bovine albumin).The effect of the kind and the amount of surface functional group was also examined. 30575 T00401030575 ^x A medical image workstation was developed using multimedia technique. The system based on PC-486DX was designed to acquire medical images produced by medical imaging instruments and related audio information, that is, doctors' reporting results. Input information was processed and analyzed, then the results were presented in the form of graph and animation. All the informations of the system were hierarchically related with the image as the apex. Processing and analysis algorithms were implemented so that the diagnostic accuracy could be improved. The diagnosed information can be transferred for patient diagnosis through LAN(local area network). 30592 T00401030592 ^x In the conventional infrared imaging system, complex infrared lens systems are usually used for directing collimated narrow infrared beams into the high speed 2-dimensional optic scanner. In this paper, a simple reflective infrared optic system with a 2-dimensional optic scanner is proposed for the realization of medical infrared thermography system. It has been experimentally proven that the intfrared thermography system composed of the proposed optic system has the temperature resolution of 0.1˚c under the spatial resolution of lmrad, the image matrix size of 256 X 240, and tile imaging time of 4 seconds. 30593 T00401030593 ^x In this paper, MIIS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemented system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression/decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network. 30594 T00401030594 ^x In this paper, computerized BEAM was implemented for the space domain analysis of EEG. Trans-formation from temporal summation to two-dimensional mappings is formed by 4 nearest point inter-polaton method. Methods of representation of BEAM are two. One is dot density method which classify brain electrical potential 9 levels by dot density of gray levels and the other is colour method which classify brain electrical 12 levels by red-green colours. In this BEAM, instantaneous change and average energy distribution over any arbitrary time interval of brain electrical activity could be observed and analyzed easily. In the frequency domain, the distribution of energy spectrum of a special band can easily be distinguished normality and abnormality. 30608 T00401030608 ^x Laboratory information system (LIS) is a key tool to manage laboratory data in clinical pathology. Our department has developed an information system for routine hematology using down-sized computer system. We have used an IBM 486 compatible PC with 16MB main memory, 210 MB hard disk drive, 9 RS-232C port and 24 pin dot printer. The operating system and database management system were SCO UNIX and SCO foxbase, respectively. For program development, we used Xbase language provided by SCO foxbase. The C language was used for interface purpose. To make the system use friendly, pull-down menu was used. The system connected to our hospital information system via application program interface (API), so the information related to patient and request details is automatically transmitted to our computer. Our system interfaced with fwd complete blood count analyzers(Sysmex NE-8000 and Coulter STKS) for unidirectional data tansmission from analyzer to computer. The authors suggests that this system based on down-sized computer could provide a progressive approach to total LIS based on local area network, and the implemented system could serve as a model for other hospital's LIS for routine hematology. 30609 T00401030609 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that is consisted of calcium phosphate and collagen. To use as the structural matrix of the composite, collagen was purified from human umbilical cord. The obtained collagen was treated by pepsin to remove telopeptides, and finally, the immune-free atelocollagen was produced: The cross linked atelocollagen was highly resistant to the collagenase induced collagenolysis. The cross linked collagen demonstrated an improved tensile strength. 30618 T00401030618 ^x This paper is a study on the design of adptive filter for QRS complex detection. We propose a simple adaptive algorithm to increase capability of noise cancelation in QRS complex detection with two stage adaptive filter. At the first stage, background noise is removed and at the next stage, only spectrum of QRS complex components is passed. Two adaptive filters can afford to keep track of the changes of both noise and QRS complex. Each adaptive filter consists of prediction error filter and FIR filter The impulse response of FIR filter uses coefficients of prediction error filter. The detection rates for 105 and 108 of MIT/BIH data base were 99.3% and 97.4% respectively. 30619 T00401030619 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed and produced a composite that is consisted of calcium phosphate and collagen. Human umbilical cord origin pepsin treated type I atelocollagen was used as the structural matrix, by which sintered or non-sintered carbonate apatite was encapsulated to form an inorganic-organic composite. With cross linking atelocollagen by UV ray irradiation, the resistance to both compressive and tensile strength was increased. Collagen degradation by the collagenase induced collagenolysis was also decreased. 30620 T00401030620 ^x We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate. 30621 T00401030621 ^x Explosive evaporative removal process of biological tissue by absorption of a CW laser has been simulated by using gelatin and a multimode Nd:YAG laser. Because the point of maximun temperature of laser-irradiated gelatin exists below the surface due to surface cooling, evaporation at the boiling temperature is made explosively from below the surface. The important parameters of this process are the conduction loss to laser power absorption (defined as the conduction-to-laser power parameter, Nk), the convection heat transfer at the surface to conduction loss (defined as Bi), dimensionless extinction coefficient (defined as Br.), and dimensionless irradiation time (defined as Fo). Dependence of Fo on Nk and Bi has been observed by experiment, and the results have been compared with the numerical results obtained by solving a 2-dimensional conduction equation. Fo and explosion depth (from the surface to the point of maximun temperature) are increased when Nk and Bi are increased.To find out the minimum laser power for explosive evaporative removal process, steady state analysis has been also made. The limit of Nk to induce evaporative removal, which is proportional to the inverse of the laser power, has been obtained. 30622 T00401030622 ^x N1 and N2 gross neural action potentials were measured from the round window of the guinea pig cochlea at the onset of the acoustic stimuli. N1-N2 audiograms were made by means of regulating stimulant intensities in order to produce constant N1-N2 potentials as criteria for different input tone pip frequencies. The lowest threshold was measured with an input tone pip I5 dB SPL in intensity and 12 KHz in frequency when the animal was in normal physiological condition. The procedure of experimental measurements is explained in detail. This experimental approach is very useful for the investigation of the Cochlear function. Both noN1inear and active functions of the Cochlea can be monitored by N1-N2 audiograms. 30623 T00401030623 ^x In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research. 30624 T00401030624 ^x A new method of digital image analysis technique for discrimination of cancer cell was presented in this paper. The object image was the Thyroid eland cells image that was diagnosed as normal and abnormal (two types of abnormal: follicular neoplastic cell, and papillary neoplastic cell), respectively. By using the proposed region segmentation algorithm, the cells were segmented into nucleus. The 16 feature parameters were used to calculate the features of each nucleus. A9 a consequence of using dominant feature parameters method proposed in this paper, discrimination rate of 91.11% was obtained for Thyroid Gland cells. 30625 T00401030625 ^x An electrical stimulator was designed to induce locomotion for paraplegic patients caused by central nervous system injury. Optimal stimulus parameters, which can minimize muscle fatigue and can achieve effective muscle contraction were determined in slow and fast muscles in Sprague-Dawley rats. Stimulus patterns of our stimulator were designed to simulate electromyographic activity monitored during locomotion of normal subjects. Muscle types of the lower extremity were classified according to their mechanical property of contraction, which are slow muscle (msoleus m.) and fast muscle (medial gastrocneminus m., rectus femoris m., vastus lateralis m.). Optimal parameters of electrical stimulation for slow muscles were 20 Hz, 0.2 ms square pulse. For fast muscle, 40 Hz, 0.3 ms square pulse was optimal to produce repeated contraction. Higher stimulus intensity was required when synergistic muscles were stimulated simultaneously than when they were stimulated individually. Electrical stimulation for each muscle was designed to generate bipedal locomotion, so that individual muscles alternate contraction and relaxation to simulate stance and swing phases. Portable electrical stimulator with 16 channels built in microprocessor was constructed and applied to paraplegic patients due to lumbar cord injury. The electrical stimulator restored partially gait function in paraplegic patients. 30626 T00401030626 ^x Two-Dimensional modelling of the Cochlear biomechanics is presented in this paper. The Laplace partial differential equation which represents the fluid mechanics of the Cochlea has been transformed into two-dimensional electrical transmission line. The procedure of this transformation is explained in detail. The comparison between one and two dimensional models is also presented. This electrical modelling of the basilar membrane (BM) is clearly useful for the next approach to the further. Development of active elements which are essential in the producing of the sharp tuning of the BM. This paper shows that two-dimension model is qualitatively better than one-dimensional model both in amplitude and phase responses of the BM displacement. The present model is only for frequency response. However because the model is electrical, the two-dimensional transmission line model can be extended to time response without any difficult. 30627 T00401030627 ^x A method has been proposed for the fully automatic detection of left ventricular endocardial boundary in 2D short axis echocardiogram using geometric model. The procedure has the following three distinct stages. First, the initial center is estimated by the initial center estimation algorithm which is applied to decimated image. Second, the center estimation algorithm is applied to original image and then best-fit elliptic model estimation is processed. Third, best-fit boundary is detected by the cost function which is based on the best-fit elliptic model. The proposed method shows effective result without manual intervention by a human operator. 30628 T00401030628 ^x The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan's method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements. 30638 T00401030638 ^x A new neural network architecture for the recognition of patterns from images is proposed, which is partially based on the results of physiological studies. The proposed network is composed of multi-layers and the nerve cells in each layer are connected by spatial filters which approximate receptive fields in optic nerve fields. In the proposed method, patterns recognition for complicated images is carried out using global features as well as local features such as lines and end-points. A new generating method of matched filers representing global features is proposed in this network. 30659 T00401030659 ^x An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3,000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented. 30768 T00401030768 ^x In this paper, we describe the design methodology and specifications of the developed module-based bedside monitors for patient monitoring. The bedside monitor consists of a main unit and module cases with various parameter modules. The main unit includes a 12.1" TFT color LCD, a main CPU board, and peripherals such as a module controller, Ethernet LAN card, video card, rotate/push button controller, etc. The main unit can connect at maximum three module cases each of which can accommodate up to 7 parameter modules. They include the modules for electrocardiograph, respiration, invasive blood pressure, noninvasive blood pressure, temperature, and SpO2 with Plethysmograph.

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피부병의 형상의학적 치료 (Treatment of Skin Diseases in Hyungsang Medicine)

  • 석민희;황원덕;정행규;이용태
    • 동의생리병리학회지
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    • 제18권3호
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    • pp.646-669
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    • 2004
  • By treating skin diseases with Hyungsang medicine and reviewing the clinical cases of them through classifying skin diseases into general care and into Hyungsang medical care, the writer came to the conclusion as followings. The skin is a house of Kyungnak, and it' s a place which Ki comes in and out, which human body controls conditions of his physiological function and which doctors can make a diagnosis from seeing it. The skin is subject to lung and large intestine in the point of organ, but in the point of movement, to spleen and stomach. Skin diseases come from unbalance of Ki and Hyul, mostly from fever in blood and also from Dam, Wind, Dampness and Dryness because of including fire. Generally skin diseases are treated according to classifying into distinctive symptoms, region, cause or time being occurred, and concomitant symptoms. After being divided into man and woman, age and youth, fatness and leanness, Jung Ki Shin Hyul type, visceral figures, Yukkyung shapes on Hyungsang medicine method, the remedy of skin diseases which is combined common meditation with Hyungsang medical method is efficacious. In distinguishing into man and woman, age and youth, man gets sick mainly by drinking liquor and exhausting Jung, woman is taken ill generally by indigestion and Damwha, especially by drinking liquor. Young child gets ill mostly from inherent weakness, but in many cases he is occurred by disturbed digestion, so he must be taken care of ingesting food. The aged becomes ill from weakening, so he must be treated according to reasons of diseases. To fatness and leanness, skin diseases are showed symptoms by weakened Yang, insufficient Yin or excess fever on the theory of upper and lower parts, by unbalance of Ki and Hyul on the theory of left and right, by Dryness and Dampness on the theory of front and rear and by insufficiency of vitality and combined fever on the theory of inside and outside. Therefore doctors must cure the symptoms according to the theory of upper and lower, left and right, front and rear and inside and outside. In type of Jung Ki Shin Hyul, the balances between Jung-Hyul and Shin-Ki are important points. Concretely Jung type comes to easily shortage of Jung or gathering abnormally Dampness and Dam, Ki type is easy to make a mass with Ki or to be deficient of Ki, Shin type comes to press seven emotions togather or to be insufficient of Yin and fever inside, and Hyul type is inclined to be deficient of Hyul and to become feverish or to be deficient of Ki. Therefore on the ground of the above reasons skin diseases come into existence. Inclusively in Jung-Hyul type , Ki must be moved on the base of full Jung-Hyul, so Wukmijiwhangtang or Samultang is prescribed basically. In Shin-Ki type , Jung-Hyul is saved on the base of moving Ki, so Hyangsosan or Yijintang is the proper prescription. Considering the visceral figures, doctors judge for diagnosis and remedy by putting together the elements, that is, great and small sizes of a set of features (eye, ear, mouth, nose), color and temper. The yukkyung types are classified according to many or few of Ki-Hyul, and then skin diseases appear by being inclined toward one side between Ki and hyul, or among the six atmospheric elements(wind, cold, heat, dampness, dryness, and fire). Especially because Yangmyung type is full of much Ki and Hyul, and also has much fever in stomach, he gets skin symptoms frequently. So his prescription is based on taking off fever in stomach, and also he must be careful about regimen certainly.

건강한 너구리(Nyctereutes procyonoides)들의 심전계 지표에 대한 평가 (Evaluation of Electrocardiographic Index in Healthy Raccoon Dogs (Nyctereutes procyonoides))

  • 홍원우;김종택;양동근;남효승;현창백
    • 한국임상수의학회지
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    • 제30권6호
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    • pp.456-458
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    • 2013
  • 포획된 건강한 너구리들의 심전도의 기준값을 평가하는 것이 본 논문의 주된 목적이다. 41마리의 방목되고 있는 다 자란 너구리들이 강원대학교 야생동물구조센터에 의해 구조되었으며 본 논문에 이용되었다. 어떠한 화학적 보정도 사용하지 않고 6-유도 심전도를 측정하였다. 평균 심박수는 $146.10{\pm}43.31$ 박동수/분 이었다(95% 신뢰구간 132.84~159.36 박동수/분). 평균 호흡수는 $35.73{\pm}11.56$ 호흡수/분 이었다(95% 신뢰구간 32.19~39.27 호흡수/분). 평균 수축기 압력은 $136{\pm}29.26mmHg$ 이었다(95% 신뢰구간 127.99~145.91 mmHg). 모든 너구리들의 심전계의 특징들을 또한 평가하였다. P-파의 평균 너비와 높이는 $38.2{\pm}4.0ms$ (범위 28-40 ms) 와 $0.128{\pm}0.039mV$ (범위 0.09~0.20)이었다. QRS파의 평균 너비와 높이는 $48.5{\pm}7.2ms$ (범위 36-60 ms) 와 $1.330{\pm}0.650mV$ (범위 0.15~2.30)이었다. 평균전기축 (QRS)은 $-91^{\circ}{\sim}+96^{\circ}$ ($10^{\circ}{\sim}60^{\circ}$; 95% 신뢰구간)이었다. 평균 교정 QT 간격(QTc)은 $273.7{\pm}32.7ms$ (범위 212-333 ms)이었고, PR간격은 $76.1{\pm}10.0ms$ (범위 50-82 ms)이었다. 본 논문은 포획된 건강한 너구리들의 심전도(ECG)의 기준값을 제공하는 최초의 논문이다.

극소 저체중 출생아에서 식이 불내성을 임상적 특징으로 하는 알레르기성 장염 (Feeding Introlerance Due to Allergic Enterocolitis in Very Low Birth Weight Infants)

  • 고유미;김진규;안소윤;유혜수;전가원;김은선;장윤실;박원순
    • Neonatal Medicine
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    • 제18권2호
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    • pp.204-210
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    • 2011
  • 목적: 극소 저체중 출생아에서 식이 불내성은 매우 흔하나, 괴사성 장염 외에는 원인에 대한 연구가 미흡하다. 본 연구기관에서는 식이 불내성이 지속되는 극소 저체중 출생아 중 알레르기성 장염을 의심하여 치료한 경험이 있어 이의 임상상을 분석하고자 하였다. 방법: 2009년 1월부터 2010년 7월까지 삼성서울병원 신생아 중환자실에 입원하였던 출생 체중 1,500 g 미만의 미숙아들 중에 식이 불내성을 보이고, 말초혈액 검사상 중등도 이상의 호산구증(${\geq}$1,000 cells/$mm^3$)이 동반되는 경우에 신생아 괴사성 장염이 배제된 상태에서 식이 제한 모유 혹은 가수 분해 분유에 반응하였던 경우들을 조사하였다. 결과: 연구대상 181명 중에서 식이 불내성을 나타낸 환자는 총 161명(88.9%), 호산구 증가증을 나타낸 환자는 119명(65.7%), 중등도 이상의 호산구 증가증을 나타낸 환자는 85명으로 47%의 유병률을 보였다. 알레르기성 장염으로 진단받은 환자는 17명으로 9.4%의 유병률을 보였다. 식이 불내성 환자 중 알레르기성 장염군(n=17)과 비알레르기성 장염군(n=144)과의 비교에서 평균 재태 주수, 출생 체중, 입원 기간, 항생제 사용 기간, 증상 발생일, 정맥 영양 기간은 차이가 없었으나, 최대 호산구 %의 평균값은 두 질환군에서 통계학적으로 유의하게 차이가 있었다. 알레르기성 장염으로 진단 받은 환자들 중 식이 제한모유로 2명인 12%에서 증상의 호전을 보였고, Extensively hydrolyzed formula로 10명(59%)에서 증상의 호전을 보였다. Free amino acid-based formula로 5명(29%)에서 증상의 호전을 보였다. 결론: 극소 저체중 출생아에서 식이 불내성이 있는 경우 알레르기성 장염의 가능성을 고려할 수 있고 이 경우 식이 변경을 통해 적극적인 식이 진행이 가능하였다.

OPCAB 시행 전 Clopidogrel 사용이 술 후 출혈경향에 미치는 임상적 고찰 (The Effect of Preoperative Clopidogrel on the Postoperative Bleeding after OPCAB)

  • 박권재;우종수;방정희;정상석
    • Journal of Chest Surgery
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    • 제42권3호
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    • pp.311-316
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    • 2009
  • 배경: 광범위한 clopidogrel의 사용으로 인해 관상동맥우회로술 전 많은 경우에서 clopidogrel 복용 환자들을 경험하게 된다. 그러나 clopidogrel은 그 고유한 약리 작용으로 인하여 술 후 출혈과 관련한 합병증을 일으킬 수 있다. 저자들은 술 전 clopidogre니 사용이 무심폐기하 관상동맥우회로술(off-pump coronary bypass grafting, OPCAB)후의 수혈 요구량, 지혈을 위한 재수술율 및 출혈과 관련한 재입원율 등에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 이 연구는 2005년 1월부터 2007년 11월까지 단일 수술자에 의해 시행된 무심폐기하 관상동맥우회로술을 받은 환자 중, 수술 전 clopidogrel을 복용하고 있던 103명의 환자를 대상으로 하였다. 이 중 clopidogrel을 수술 5일 전에 복용을 중단한 군을 그룹 1 (n=45)으로 하고, 수술 5일 이내에도 계속 복용한 군을 그룹 2 (n=58)로 나누어 출혈과 관련한 재수술율 및 재입원율, 혈액 투여량, 술 후 출혈양 등을 비교 검토하였다. 결과: 두 군 간의 인구학적 특성, 심초음파, 혈액학적인 특성은 비슷하였다. 술 후 출혈양은 통계적으로 유의하게 차이가 나지는 않았지만, 술 후 수혈양은 그룹 2에서 더 많았다(p=0.018). 지혈을 목적으로 한 재수술율과 출혈과 연관된 재입원율은 그룹 1에서는 각각 0%, 0%였고, 그룹 2에서는 6.9%, 5.2%였다. 그러나 두군 간의 통계적인 차이는 없었다. 결론: 무심폐기하 관상동맥우회로술 시행 전 clopidogrel의 계속적인 사용은 술 후 주요한 출혈을 일으키지는 않지만 어느 정도는 출혈에 영향을 주고, 술 후 수혈양은 증가시켰다. 응급인 경우가 아니라면 술 전 clopidogrel을 일정 기간 끊는 것이 술 후 회복에 좋으리라 생각된다.

진폐증의 예후에 영향을 미치는 인자 (The Prognostic Factors in Progression of Pneumoconiosis)

  • 김형주;장안수;김상국;최수인;박상후;양승원;서정평;이승;박홍배;손명호
    • Tuberculosis and Respiratory Diseases
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    • 제47권1호
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    • pp.57-65
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    • 1999
  • 연구배경: 진폐증은 공기중에 있는 광물성 분진을 흡입함으로써 발생하는 폐의 조직반응을 의미하는 질병으로 우리나라에서 진폐증의 탄광부 진폐증이 주종을 이루고 있다. 그러나 일단 이환되면 별다른 치료방법이 없어 대증요법에 의존하고 있다. 따라서 진폐증은 예방이 중요하지만 기존의 환자들의 관리도 소홀히 할 수 없을 것이다. 이에 저자들은 진폐증으로 진단된 환자들의 소견을 분석하여 경과와 예후에 관계된 요인을 밝히고자 임상적 고찰을 시행하였다. 방법: 1995년 6월부터 1997년 6월까지 서남의대 남광병원에서 진폐정밀진단을 실시했던 외래환자 77명, 임상 증상이 심하여 1995년 이후로 입원하고 있는 입원환자 10명, 1995년 이후 입원중 사망한 입원사망 환자 8명 등 총 95명의 대상으로 시행하였던 병력, 흉부X-선사진, 폐기능검사, 심전도검사, 결핵균에 대한 객담도말 및 배양검사, 일반 혈액검사 등을 분석하여 다음과 같은 결과를 얻었다. 결과: 대상환자 모두 남자였으며, 직업은 대부분 탄광부였고, 평균나이는 57.4세, 평균분진노출기간은 18.8년이었다. 대상환자의 주요 임상증상은 호흡곤란(100%), 객담(71.6%), 흉통(55.8%), 기침(23.2%), 객혈(6.3%)순 이었고, 호흡곤란의 정도는 82.1%의 대상환자들에서 Morgan-Seaton Grade 2 이상이었다. 흉부 X-선사진상 소음영은 82.1%, 대음영은 17.9%를 보였으며 소음영은 t/t형 (37.2%), q/q형 (25.6%), r/r 형(11.5%) 순이었고, 대음영은 B형이 42.2%로 제일 많았다. 폐기능검사상 69.1%에서 환기기능장애를 보였는데 제한형 40.3%, 혼합형 19.5%, 폐색형 8.3% 순 이었다. 그리고 흉부 X-선상 조밀도가 증가할수록 $FEV_1$이 현저하게 저하하였다 (p<0.01). 흉부 X-선상 37.9% 에서, 객담 항산성 도말검사에서는 15.8% 에서 결핵양성을 보였는데 폐결핵이 양성인 경우 환자의 입상상태가 심하였으며 호흡곤란의 정도도 심하였다 (p<0.0l). 입원사망 환자들은 흉부 X-선사진상 100%, 객담 항산성 도말검사에서 75%의 결핵균 양성율을 보였고 75%에서 만성폐성심의 소견을 보였으며 반복되는 호흡기감염으로 급성호흡부전과 폐성심 등의 합병증이 사망원인이었다. 결론: 진폐증환자에 있어서 폐결핵의 이환이 진폐증의 경과나 예후에 결정적인 영향을 미친다고 사료됨으로 진폐증이 발병된 환자에서 결핵의 합병을 예방하는 것이 중요하다고 생각된다.

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소아 및 청소년 2형 당뇨병의 임상적 특징 (Clinical Characteristics of Type 2 Diabetes in Children and Adolescents)

  • 이성용;신충호;양세원
    • Clinical and Experimental Pediatrics
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    • 제45권6호
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    • pp.754-763
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    • 2002
  • 목 적 : 소아, 청소년기의 당뇨병은 대부분 1형 당뇨병으로 진단되어지나 최근에는 소아, 청소년에서도 2형 당뇨병이 전세계적으로 증가하고 있고 우리나라의 경우도 같은 양상을 보인다고 생각된다. 저자들은 소아, 청소년의 2형 당뇨병의 임상 양상에 대하여 고찰해 보고자 하였다. 방 법 : 1987년부터 2000년까지 서울대학교병원 소아과에서 2형 당뇨병으로 진단 받은 소아, 청소년 환자 33명을 대상으로 하였다. 당뇨병의 진단기준에 합당한 환자 중에서 체질량지수 25 이상의 비만을 보인 경우, 2형 당뇨병의 가족력을 가진 경우, 진찰상 흑색 극세포증을 보인 경우, 그리고 혈청 혹은 소변 C-peptide가 정상 혹은 증가된 경우 등의 2형 당뇨병의 진단을 지지하는 소견들 중 2가지 이상을 보이고 항GAD 항체가 음성일 경우를 임의적으로 2형 당뇨병으로 진단하였다. 또한 인슐린 치료가 필요하지 않거나 인슐린 치료를 받다가 끊을 수 있었던 경우는 위의 지지소견 들이 2가지 미만인 경우에도 2형 당뇨병으로 진단하였다. 대상 환자 33명의 병록지를 후향적으로 검토하여 환자들의 진단 당시의 임상 양상, 인구 통계학적 양상, 검사결과, 치료방법 및 반응 등에 대해 임상적인 고찰을 하였다. 인슐린 치료를 받은 환자 중 2년 이상 인슐린을 사용한 군과 2년 안에 인슐린을 끊을 수 있었던 군의 임상적 양상에 대해 비교하여 보았다. 결 과: 진단시 나이는 평균 $13.4{\pm}1.8$세로 10대 초반이 다수였다. 23명의 환자 중 16명(69.6%)이 진단 시 사춘기에 해당하였다. 평균 체질량지수는 $24.3{\pm}4.2kg/m^2$이었고 $25kg/m^2$ 이상의 비만을 보인 경우가 32명 중 16명(50%)이었다. 2형 당뇨병의 가족력이 있는 경우가 33명 중 24명(72.7%)이었다. 흑색극세포증은 6명(18.2%)에서 관찰되었다. 진단 당시 다음, 다뇨등의 증상을 보인 경우가 14명(42.4%)이었고, 요당이나 고혈당이 우연히 발견되어 진단된 경우가 19명(57.6%)이었다. 치료방법으로는 인슐린 단독치료가 25명(75.8%), 경구 혈당강하제 단독사용이 3명(9.1%)이었고, 두 가지를 같이 사용한 경우가 3명(9.1%), 운동과 식이요법 외에 약물치료를 하지 않은 경우가 2명(6%)이었다. 15명(45.5%)이 인슐린을 사용하지 않았거나 끊을 수 있었다. 진단 당시 다음, 다뇨와 같은 전형적인 당뇨병의 증상은 2년 이상 인슐린을 쓴 군에서 유의하게 많았다(P<0.05). 결 론: 소아, 청소년에서의 2형 당뇨병은 증상의 발현이 뚜렷하지 않으며 사춘기, 비만, 가족력과 관계가 깊었다. 소변과 혈청에서의 C-peptide 농도 측정에서 증가 또는 정상 소견이 보일 경우, 췌세포 자가 항체가 음성인 경우 2형 당뇨병으로 진단할 수 있으나 좀 더 나은 1형 당뇨병과의 감별방법 개발이 필요하다고 생각된다. 다수의 2형 당뇨병 환자에서 초기에 인슐린 투여를 필요로 하였고 혈당 조절이 호전된 후 끊을 수 있었으나 진단 시 증상을 보이는 경우 인슐린을 지속적으로 필요로 하는 경우가 많았다.

조기위암에서 복강경 및 개복 위아전절제술에 따른 영양학적 및 면역염증반응의 비교 (Comparison of the Nutritional Status and the Acute Inflammatory Reaction between Laparoscopy-assisted Distal Gastrectomy and Conventional Open Distal Gastrectomy for Early Gastric Cancer)

  • 채현동
    • Journal of Gastric Cancer
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    • 제10권1호
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    • pp.19-25
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    • 2010
  • 목적: 복강경하 보조 위 절제술이 위암 치료에 사용되기 위해서는 기술적인 측면 외에 수술적 치료와 관계하는 영양학적 및 면역학적 요소가 함께 고려되어야 한다. 이에 본 연구에서는 조기위암 환자에서 복강경하 위아전절제술의 영양학적 및 면역학적 측면에서의 안정성에 대해 알아 보고자 본 연구를 시행하였다. 대상 및 방법: 2006년 4월부터 2009년 5월까지 조기위암으로 복강경하 위아전절제술을 시행한 87예와 개복 위아전절제술을 시행한 30명의 환자를 대상으로 임상 정보와 혈청학적 검사를 후향적으로 비교 분석하였다. 결과: 두 군 간의 술 전 임상병리학적 요인에는 차이가 없었으며, 복강경하 위아전절제술군에서 총 백혈구수는 개복군에 비해 술 후 1일째와 3일째 더 증가 정도가 낮았으며(P=0.001, P=0.008), CRP는 술 후 1일째와 3일째에서 증가 정도의 차이를 보이지 않았으나(P=0.632, P=0.139), 술 후 5일째의 감소 정도는 통계학적 차이를 보였다(P<0.001). T4/T8 ratio는 복강경하 위아전절제술군에서 술 후 3일째 감소 정도가 적었으나(P=0.003), Albumin의 감소 정도는 통계학적 차이를 보이지 않았다(P=0.157). 결론: 복강경 위아전절제술은 개복 위절제술에 비해 Albumin을 이용해 비교한 영양학적 측면에서 장점은 없었으나, 술 후 총 백혈수의 증가, CRP 감소, 및 T4/T8 ratio 감소 등의 전신 면역 및 염증 반응에서 우월함을 알 수 있었다.

소아에서 발생한 허혈성 소장결장염 (Ischemic Enterocolitis in Children)

  • 이병기;박재홍
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제10권2호
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    • pp.138-146
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    • 2007
  • 목 적: 허혈성 소장결장염은 소장과 대장의 장벽에 육안적으로 괴사 반 또는 분절 괴사를 보이고 현미경적으로는 점막 및 점막하층에 허혈성 변화를 일으키는 급성 질환이다. 다양한 임상증상을 보이며 대증 치료로 호전되기도 하지만 장괴저, 독소혈증, 사망 등 중증 경과를 밟기도 한다. 원인은 확실히 밝혀지지 않았지만 장 미세순환의 장애나 과민반응이 주된 병리 기전으로 설명되고 있다. 방 법: 부산대학교병원 소아과에 복통, 혈변, 토혈, 구토 또는 복부팽만 등의 급성 복증으로 내원한 환자중 방사선 검사 소견, 수술 소견, 내시경 소견, 조직병리 소견 등이 괴사 반 또는 분절 괴사의 소견을 보이고 장간막 동맥의 폐쇄의 소견이 없으며 장의 허혈이나 괴사의 다른 기계적 또는 전신적 요인이 없는 허혈성 소장결장염에 합당한 6명의 임상 소견을 후향적으로 분석하였다. 결 과: 1) 남아가 4명, 여아가 2명이었다. 2) 연령 분포는 생후 6주에서 6세까지였다. 3) 만삭에 가까운 1명을 제외하고 모두 만삭아였고 부당경량아 1명을 제외하고는 정상 출생 체중아였다. 4) 증상으로는 선혈변 또는 토혈 5예, 구토, 설사, 복통 또는 보챔이 각각 4예, 복부팽만과 발열 3예였다. 5) 침범 부위는 하행 결장 2예, 하행 결장 및 S상 결장 1예, S상 결장 1예, 전 대장1예, 십이지장 구부 및 위 유문부가 1예였다. 6) 병변의 형태는 궤양 3예, 천공 2예, 괴사 반이 2예, 협착 1예, 심한 막성 상피 탈락 1예였다. 7) 치료로는 천공 부위의 일차 봉합 2예, 보존적 치료(수액 요법, 총 정맥 영양, 항생제 투여, 히스타민 길항제 투여 등) 4예였다. 8) 1예에서 급성 신부전이 동반되었고 사망자는 없었다. 결 론: 허혈설 소장 결장염은 사망에 이를 수 있는 급성 복증 질환으로 소아에서는 매우 드물지만 임상적으로 의심되면 적극적인 검사를 통하여 조기 진단과 적절한 집중치료가 요구된다.

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국제 전립선 증상 점수(I-PSS)를 이용한 하부요로증상의 유병률 및 고혈압과의 관계 (Prevalence of Lower Urinary Tract Symptoms and Association of Hypertension with I-PSS)

  • 하지영;조동영;양상국;장성훈;이건세;이원진;유병연
    • 농촌의학ㆍ지역보건
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    • 제25권2호
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    • pp.265-273
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    • 2000
  • 농촌 지역 사회의 40대 이상의 남성 300명을 대상으로, 번역의 타당성과 신뢰도가 검증된 국문 I-PSS를 이용하여, 하부요로 증상의 유병률, I-PSS와 혈압의 관계를 조사하여 다음과 같은 결론을 얻었다. 1. I-PSS를 이용한 증상접수 8이상인 하부 요로증상의 유병률은 40, 50, 60 및 70대에서 각각 20.5, 32.2, 40.6 및 72.0%로 관찰되었으며 증상점수 20 이상의 중증군은 각각 0.82, 5.6, 11.0%로 미국, 일본에 비하여 높게 나타났다. 2. 평균 I-PSS와 연령과의 관계는 연령이 증가함에 따라 증가하였으며(r=0.29, p=0.0001), 무학인 군이 전문대 이상인 군에 비하여 I-PSS가 유의하게 높게 관찰되었다(p<0.05). 3. 평균 I-PSS와 배뇨만족도 사이에는 유의한 상관관계(r=0.63, p=0.0001)를 보였으나 I-PSS(평균 8.2)에 비해 상대적으로 불편감이 없는 배뇨만족도(평균 1.9)를 나타내었다. 4. 고혈압군의 평균 I-PSS는 7.85이었으며 정상혈압군의 평균 I-PSS는 8.39이었으나 I-PSS와 혈압과의 관계는 고혈압군과 정상 혈압군 간에 유의한 차이를 보이지 않았다(p>0.05).

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