• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.370-376
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• 2011

Objective : Posttraumatic cerebral infarction (PTCI), an infarction in well-defined arterial distributions after head trauma, is a known complication in patients with severe head trauma. The primary aims of this study were to evaluate the clinical and radiographic characteristics of PTCI, and to assess the effect on outcome of decompressive hemicraniectomy (DHC) in patients with PTCI. Methods : We present a retrospective analysis of 20 patients with PTCI who were treated between January 2003 and August 2005. Twelve patients among them showed malignant PTCI, which is defined as PTCI including the territory of Middle Cerebral Artery (MCA). Medical records and radiologic imaging studies of patients were reviewed. Results : Infarction of posterior cerebral artery distribution was the most common site of PTCI. Fourteen patients underwent DHC an average of 16 hours after trauma. The overall mortality rate was 75%. Glasgow outcome scale (GOS) of survivors showed that one patient was remained in a persistent vegetative state, two patients were severely disabled and only two patients were moderately disabled at the time of discharge. Despite aggressive treatments, all patients with malignant PTCI had died. Malignant PTCI was the indicator of poor clinical outcome. Furthermore, Glasgow coma scale (GCS) at the admission was the most valuable prognostic factor. Significant correlation was observed between a GCS less than 5 on admission and high mortality (p<0.05). Conclusion : In patients who developed non-malignant PTCI and GCS higher than 5 after head injury, early DHC and duroplasty should be considered, before occurrence of irreversible ischemic brain damage. High mortality rate was observed in patients with malignant PTCI or PTCI with a GCS of 3-5 at the admission. A large prospective randomized controlled study will be required to justify for aggressive treatments including DHC and medical treatment in these patients.

• Journal of Chest Surgery
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• 제33권1호
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• pp.32-37
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• 2000

Background: Reconstruction surgery of mitral valve regurgitation is now considered as an effective operative technique and has shown good long-term results. Although reconstructive surgery of mitral valve has been performed since 1970s, we have started only in early 1990s in full scale because of small number of the mitral regurgitation compared to mitral stenosis and lack of knowledge from the viewpoint of patients and physicians. Material and Method: From January 1992 to December 1996, 100 patients underwent repair of the mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age was 39.9$\pm$14.4 years. The causes of the mitral regurgitation were rheumatic in 61, degenerative in 28 and others in 11. According to the Carpentier's pathological classification of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation. Result: There were no operative death but 3 major operative complications: 2patients were postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and 1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred mitral regurgitation. There were no statistically significant risk factors for reoperation. The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related complications. Conclusion: We concluded that mitral valve repair could be performed successfully in most cases of mitral regurgitation even in the rheumatic and combined lesions with very low operative mortality and morbidity. The early results are very promising.

• 전자공학회논문지
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• 제53권12호
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• pp.180-190
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• 2016

본 전향적 예비 임상연구를 통하여 이중 체임버 구조를 기반으로 하는 뇌졸중 환자용 컵을 개발하고 임상적으로 유용한지 검증하고자 했다. 체계적 과정을 거쳐 컵을 개발하고, 남녀 동수의 뇌졸중 환자 16명을 대상으로 개발된 컵을 사용하여 이들의 제한된 운동기능을 보완 할 수 있는지 3차원 동작 분석(3-dimensional motion analysis), 표면 근전도 검사(surface electromyography; sEMG), 3차원 체간 움직임 분석(3-dimensional trunk movement analysis)의 운동 형상학적 방법을 통하여 검증하고자 했다. 실험 결과, 이중 체임버 컵(dual chamber based assistive cups; DC) 데이터 그룹에서 플라시보 컵(placebo-cups; PC)의 경우 보다 어깨부위의 ROM(range of motion)이 더 적게 사용되었고, sEMG에서는 상부 승모근, 삼각근, 삼두근에서 근 활성도가 낮게 나타났다. 체간 분석에서 전방, 후방의 방향에서 체간의 개입이 더 적게 관찰되었다.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.29-34
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• 1993

연구배경 : Ikeda에 의해 임상에 도입된 굴곡성 기관지경은 각종 폐 질환의 진단과 치료에 광범위하게 이용되고 있으며 시술 증례도 증가하고 있으나 외국에서는 결핵균, 비결핵항산균 및 여러 세균들에 의한 기관지경의 교차오염예가 다수 보고되고 있으므로 기관지경의 세척과 소독방법에 대해 주의를 기울여야 한다. 방법 : 1991년 11월부터 1992년 5월 까지 기관지내시경을 시행한 예중에서 기관지세척액에서 비결핵항산균이 배양된 예들을 분석하고 본원에서 화학살균제로 사용하고 있는 2% alkaline glutaraldehyde의 살균작용을 평가하기 위하여 실험실내에서 2% alkaline glutaraldehyde와 비결핵항산균 및 세균을 접촉시킨후 균의 사멸 여부를 알아 보았다. 결과 : 2% glutaraldehyde 소독제 용액에 비결핵항산균은 2% glutaraldehyde 1:1 용액으로 30분간 접촉한 후 균이 자라지 않았으며 그 밖의 세균들은 접촉 바로 후에 자라지 않았다. 위발생 인지후 철저한 기계적 세척과 함께 세척기내에서 30분이상 2% glutaraldehyde에 담가둔 이후로는 위양성이 발생하지 않았다. 결론 : 기관지경 사용후 기계적 세척을 철저히 하는 것이 중요하며 2% glutaraldehyde 용액으로 소독시 비결핵항산균의 소멸을 기대하려면 적어도 30분 이상 접촉이 필요할 것으로 생각된다. 또한 감염조절 방법을 엄격하게 적용한다 하더라도 오염을 완전히 배제할 수 없으므로, 일반적으로 비병원균으로 알려진 균들이 비통상적으로 갑자가 높은율로 검출되면 위발생을 생각하여야 한다.

• Clinical and Experimental Pediatrics
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• 제62권12호
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• pp.444-449
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• 2019

Background: Sixty percent of infants with severe neonatal hypoxic-ischemic encephalopathy die, while most survivors have permanent disabilities. Treatment for neonatal hypoxic-ischemic encephalopathy is limited to therapeutic hypothermia, but it does not offer complete protection. Here, we investigated whether hypoxia-inducible factor (HIF) promotes cell survival and suggested neuroprotective strategies. Purpose: HIF-1α deficient mice have increased brain injury after neonatal hypoxia-ischemia (HI), and the role of HIF-2α in HI is not well characterized. Copper-zinc superoxide dismutase (SOD)1 overexpression is not beneficial in neonatal HI. The expression of HIF-1α and HIF-2α was measured in SOD1 overexpressing mice and compared to wild-type littermates to see if alteration in expression explains this lack of benefit. Methods: On postnatal day 9, C57Bl/6 mice were subjected to HI, and protein expression was measured by western blotting in the ipsilateral cortex of wild-type and SOD1 overexpressing mice to quantify HIF-1α and HIF-2α. Spectrin expression was also measured to characterize the mechanism of cell death. Results: HIF-1α protein expression did not significantly change after HI injury in the SOD1 overexpressing or wild-type mouse cortex. However, HIF-2α protein expression increased 30 minutes after HI injury in the wild-type and SOD1 overexpressing mouse cortex and decreased to baseline value at 24 hours after HI injury. Spectrin 145/150 expression did not significantly change after HI injury in the SOD1 overexpressing or wild-type mouse cortex. However, spectrin 120 expression increased in both wild-type and SOD1 overexpressing mouse at 4 hours after HI, which decreased by 24 hours, indicating a greater role of apoptotic cell death. Conclusion: HIF-1α and HIF-2α may promote cell survival in neonatal HI in a cell-specific and regional fashion. Our findings suggest that early HIF-2α upregulation precedes apoptotic cell death and limits necrotic cell death. However, the influence of SOD was not clarified; it remains an intriguing factor in neonatal HI.

• 생명과학회지
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• 제21권8호
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• pp.1127-1133
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• 2011

본 연구는 65세 이상 79세 사이의 남자고령자를 대상으로 16주간의 태극권 운동프로그램을 통해 신체적, 생리적 변화를 살펴보았으며, 일상생활을 영위하기 위한 신체적, 생리적 건강의 척도가 될 수 있는 건강체력과 신체조성의 변화에 어떤 영향을 미치는지 그 효과를 분석한 결과 다음과 같은 결론을 얻었다. 건강체력 요인의 심폐지구력, 근지구력, 유연성, 평형성은 유의한(p<0.05) 영향을 미치는 것으로 나타났으며, 신체조성 요인의 이완기 혈압과 체지방, 제지방에서 유의한 영향을 미치는 것으로 나타났다. 태극권 운동프로그램이 고령화 시기에 건강체력과 신체조성 요인에서 긍정적인 변화를 가져옴으로써 건강체력관련 요인이 상당부분 개선된 것으로 나타났는데 이와 같은 긍정적인 변화는 남자고령자에 건강한 신체활동을 위해서는 체력을 증진, 유지시키는 것이 중요하다. 특히, 규칙적인 태극권 운동이 어느 정도 영향을 미치는지에 대한 생리학적 기전을 명확하게 규명하기 위해서는 연령별 및 성별에 따라 다양한 측면에서 검토 되어야 할 필요성이 있으며, 고령화 사회에 대비한 구체적이고도 현실적인 연구가 지속적으로 이루어져야 할 것으로 사료된다.

• 한국응용곤충학회지
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• 제35권3호
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• pp.266-272
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• 1996

긴털이리응애와 점박이응애에 대한 fenpyroximate의 독성에 비교하기 위하여 농도별로 처리한 강남콩 엽편에 두 종의 자성충과 난을 접종하여 시험한 결과, fenpyroximate는 점박이응애보다 긴털이리응애에 대하여 독성이 매우 낮았다. 긴털이리응애 자성충은 처리 농도가 증가함에 따라 생존율이 감소하였으나 6.25~50ppm에서 58~74%가 생존하였으며, 산란수는 처리농도 간에 큰 차이가 없었다. 점박이응애 자성충은 6.25~50ppm에서 32~40%가 잔존하였지만 모두 활동불능되었으며, 산란수도 처리농도가 높을수록 감소하였다. 모든 처리농도에서 긴털이리응애 난의 부화나 생존한 유.약충의 발육에는 영향이 없었다. 긴털이리응애 유.약충의 생존율은 농도증가에 따라 감소하였으나 6.25~50ppm에서 16~48%가 성충으로 우화하였다. 그러나 점박이응애의 경우는 6.25~50ppm에서 성충태에 이른 개체가 전혀 없었다. 중독된 먹이를 섭식한 긴털이리응애 자성충은 생존율과 산란수 및 차세대의 성비에 실질적인 변화가 없었다. 또한 긴털이리응애에 상대적으로 영향이 적어 아치사농도라 할 수 있는 6.25~12.5ppm의 농도는 점박이응애의 종합관리에서 긴텅이리응애와 점박이응애의 밀도비율을 조절하는데 유용할 것으로 생각된다.

• 대한임상독성학회지
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• 제14권1호
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• pp.37-46
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• 2016

Purpose: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). Methods: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using ${\chi}^2$-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. Results: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). Conclusion: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.

• 동의생리병리학회지
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• 제20권2호
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• pp.442-448
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• 2006

To obtain the 50% lethal dose (LD50), approximated lethal dose (ALD) and approximated target organs of 'Mahwangyounpae-tang' for further study like repeat dose toxicity, genotoxicity and reproductive toxicity, single dose toxicity was tested in male ICR mouse according to KFDA Guideline 1999-61 [KFDA, 1999] at a dosage level of 2,000, 1,000, 500, 250 and $125\;mg/kg/10m{\ell}$. In this study, mortalities, clinical signs, body weight changes and body weight gains, gross findings and weight of principal organs were detected during and/or after 14 days of single dosing. After 2 or 3 days of dosing, 1 or 2 animals in 2,000 and 1,000 mg/kg-dosing groups were died. Excitation and leaping response were observed as test article-treatment related clinical signs. These abnormal signs were restricted to 2,000 and 1,000 mg/kg-dosing groups and they were recovered to normal within 4 days after dosing in case of survivors. A significant decrease of body weight were observed in some periods of observation in 2,000 and 1,000 mg/kg-dosing group from 1 days after dosing compared to those of vehicle control group. A significant decrease of body weight gains were observed in observation periods in 2,000 and 1,000 mg/kg-dosing group compared to those of vehicle control group. Hypertrophy of heart and decoloration of kidney were observed as test article-treatment related gross findings. These abnormal findings were restricted to 2,000 and 1,000 mg/kg-dosing groups. A significant increase of absolute and relative heart and kidney weight were demonstrated in 2,000 mg/kg-dosing groups. LD50 in this study was detected as 2,242.42 mg/kg. ALD in this study was detected as 1,000 mg/kg and the target organ was considered as the heart and kidney.

• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.30-35
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• 2008

목 적 : 소아에서 치명적인 뇌농양의 선행요인 및 사망률 등 임상 양상에 대하여 알아보고자 하였다. 방 법 : 1997년부터 2006년까지 세브란스병원에서 뇌농양으로 진단된 만 18세 미만의 소아 및 청소년을 대상으로 임상 소견, 검사 결과 및 치료 경과 등을 후향적으로 조사하였다. 결 과 : 최근 10년간 뇌농양으로 진단된 환아는 총 27명이었으며, 이 중 6명(22%)이 치료 중 사망하였고 생존자 중 8명(38%)은 신경학적 후유증이 남았다. 전체 뇌농양 환아 중 1세 미만의 영아가 총 8명(30%)이었으며 영아의 사망률은 38%였다. 뇌농양의 발생부위는 다발성 7례(26%), 전두엽과 두정엽이 각각 6례, 측두엽 5례 순이었으며, 원인균이 분리된 15례 중 사슬알균 5례(33%), 포두알균 4례, 그람음성 장내간균 3례, 진균 2례, 결핵균 1례 등이 포함되었다. 선행요인에는 신경외과술 8례(30%), 선천성 심질환 4례, 중이염과 부비동염 각각 1례, 면역억제치료 1례 등이 있었다. 증상으로는 발열(74%), 두통(37%), 오심/구토, 의식저하 순이었으며 발열, 두통 및 국소적 신경증상의 주요 3증상을 보이는 환아는 2례(7%)에 불과하였다. 전체 뇌농양 환아 중 1세미만의 영아에서 다발성 발생(63%, P=0.011) 및 신경학적 후유증이나 사망의 비율(88%, P=0.033)이 더 높았다. 결 론 : 비교적 증상이 뚜렷하지 않은 영아에서 뇌농양에 의한 신경학적 후유증과 사망률이 더 높으며 따라서 영아에 대한 보다 적극적인 진단과 조기치료가 필요할 것으로 사료된다.