소아에서의 요로감염과 방광요관역류에 관한 고찰

임현석,박창로,고철우,구자훈,Lim Hyun-Suk,Park Chang-Ro,Ko Cheol-Woo,Koo Ja-Hoon 대한소아신장학회 1997 Childhood kidney diseases Vol.1 No.1

목적 : 소아기의 요로감염은 신손상을 유발하여 신반흔, 고혈압, 말기신부전증 등을 일으키며 요로감염에 흔히 동반되는 방광요관역류는 이와같은 신손상과 밀접한 관련이 있다. 본 조사는 한국소아에서의 요로감염과 방광요관역류와의 관계를 밝히고 또한 신반흔 발생과의 관련을 규명하고자 시행되었다. 방법 : 대상 환아는 1990년 1월부터 1996년 6월까지 경북대학교병원 소아과에 입원하여 요로감염으로 진단된 291례로 하였고, 신 초음파 검사, 경정맥 신우 조영술, 배뇨성 방광요로 조영술, DMSA 주사 등을 시행하여 방광요관역류 및 신반흔을 확인하였다. 역류의정도는 국제 소아 역류 조사팀에 의한 분류법을 사용하였다. 결과 :대상환아는 남아 177례, 여아 114례로서 총 291례였으며, 1세이하에서는 남아 대 여아비가 134:42로 남아가 훨씬 많았고, 5세이상에서는 11:35로 여아에서 그 빈도가 높았다. 방광요관역류는 64례(22%)에서 관찰되었으며 1등급 4.0%, 2등급 3.0%, 3등급 2.7%, 4등급 5.8% 및 5등급 6.2%였으며 남녀의 차이는 없었다. 원인 균주로는 E.coli가 167례로서 가장 많았으며 방광요관역류의 유무에 따른 차이는 없었다. 합병증으로서는 신결석이 4례에서 관찰되었고 5등급 방광요관역 류 환아 4례에서는 내원당시 말기신부전증의 증세를 보였다. 방광요관역류의 경 중에 따른 신반흔의 빈도는 역류가 없었던 경우 1.2%, 1등급 6.7%, 2등급 27.3%, 3등급 29.4%, 4등급 57.1% 및 5등급 100%로서 총 582개의 신장중49개(8.4%)에서 반흔이 관찰되었으며 역류가 심할수록 이의 빈도가 증가하였다. 연령에 따른 신반흔의 차이는 없었다. 결론 : 본 연구를 요약하면 역류의 정도가 심할수록 신반흔의 빈도가 높으며 그러므로 소아에서의 요로감염과 방광요관역류의 조기발견 및 적절한 치료는 신손상을 예방하는데 있어서 필수적이라 하겠다. Urinary tract infection (UTI) in children has been known to be a cause of renal damage, leading to scar formation, hypertension and renal failure. And vesico-ureteral reflex (VUR), frequently accompanying UTI in young children, has been incriminated as the main factor causing scar formation. This retrospective study has been undertaken to see the relationship among UTI, VUR and renal scar formation. Study population consisted of 291 children (boy 134, girl 42) with UTI, who have been admitted to the Pediatric Department of Kyungpook University Hospital during 6 1/2 year period from January 1990 to June 1996. VUR was diagnosed by VCUG and renal scar by ultrasonogram, DMSA scan (or DMSA SPECT) and IVP. The following result were obtained. Sexual difference showed male predominance (male to female, 134:42) below 1 year of age, and female predominance (male to female, 11:35) over 5 years of age were rioted. VUR has been found in 64 children (22%) and the degree of reflux, classfied by the method proposed by 'International Reflux Study in Children', were as follows ; Grade I : 4.0%, Grade II : 3.0%, Grade III : 2.7%, Grade IV : 5.8% and Grade V : 6.2%. There was no sexual difference E.coli was the most predominant infecting agent occurring in 167 children (57%), and end-stage renal failure was diagnosed at the time of first admission in 5 children with Grade V VUR. Renal scar has been noted in 49 out of 582 kidneys (8.4%), and the incidence of scar foramation according to the degree of VUR were as follow ; Grade 0 (No reflux) : 1.2%, Grade I : 6.7%, Grade II 27.3%, Grade III 29.4%, Grade IV : 57.1%, and Grade V : 100%. In summary, present study shows that renal scar formation in UTI has close correlation with the severity of VUR occurring more frequently in severe reflux, so that early diagnosis and proper treatment of UTI and VUR is of paramount importance in preventing renal damage in children with UTI.

펩토이드 라이브러리와 그 응용

임현석(Hyun Suk Lim) 한국고분자학회 2014 고분자 과학과 기술 Vol.25 No.4

Cyclosporine과 Mitomycin의 일측성 신관류로 초래되는 백서 신병변에 관한 연구

백승인,임현석,신원혜,고철우,구자훈,곽정식,Baek Seung In,Lim Hyun Suk,Shin Weon Hye,Ko Cheol Woo,Koo Ja Hoon,Kwak Jung Sik 대한소아신장학회 1998 Childhood kidney diseases Vol.2 No.2

목 적 : 면역억제제로 사용되는 cyclosporine과 항암제로 사용되는 mitomycin의 신장에 미치는 직접적인 독성여부를 확인하고 이들 약제의 사용으로 초래되는 신장병변의 발생기전을 알아보고자 본 연구를 시행하였다. 대상 및 방법 : 실험동물은 체중 250-300gm의 Sprague-Dawley계 흰쥐를 암수 구별없이 사용하였으며 약물 투여는 Hoyer등이 기술한 방법을 다소 변형한 일측성 신관류 방법을 사용하여 좌측 신장을 대동맥과 대정맥의 혈류로부터 차단하고 좌측 신동맥을 통하여 좌측신을 관류시켰다. Cyclosporine은 4 mL에 2.5 mg, mitomycin은 4 mL에 1.6mg의 농도로 하였고 대조군은 생리적 식염수를 .사용하였으며 혈관 clamping으로부터 감자제거까지 소요된 총 ischemic time은 15분을 초과하지 않았다. 약제 투여후 48시간에 실험 동물을 도살하고 좌측 신장을 적출하여 광학 및 전자 현미경 검사를 시행하였다. 결 과 : Cyclosporine투여군에서는 사구체 내피세포 및 상피세포의 심한 종창이 있었으며 간질내 모세혈관의 내피세포도 심한 종창을 보였다. Mitomycin투여군에서는 사구체 내피세포 및 상피세포의 심한 종창을 보였으며 일부의 모세 혈관에는 혈소판의 응집, 종창 및 탈과립 현상과 섬유소 물질도 포함된 혈전성 미세혈관 병변의 소견을 보였다. 결 론 : Cyclosporine과 mitomycin은 신장 내피세포에 직접적인 손상을 초래하며 그러므로 이들 약제 사용으로 인한 혈전성 미세혈관 병변 (용혈성 요독증)의 발생 기전에는 이들 약제의 신장 내피세포에의 직접적인 손상이 중요한 시발점이 되는 것으로 생각된다.($41.4\%$)이 신초음파에서 이상소견을 보였다. 방광요관역류가 있었던 32명(53역류신장)은 역류정도에따라 Grade $I:25.0\%,\;II:44.5\%,\;III:64.3\%,;IV:92.9\%,\;V:100\%$에서 초기 DMSA 신주사상 이상소견을 보였다. 53역류신장중 전체적으로 DMSA신주사에서 36신장($68.0\%$), 신초음파에서 26신장($49.1\%$)이 이상소견을 보여 유의한 차이를 보였으며(P<0.05). 특히 Grade IV 역류신장에서 유의한 차이가 있었다(P<0.05). 결 론 : DMSA신주사를 이용한 급성신우신염의 진단은 신초음파검사 보다 유용하며, 초기 DMSA신주사 소견상 이상소견을 보인 경우 약 8-12주 후 추적검사를 시행하여 변화를 관찰하고 섭취결손 부분이 남아있는 경우에는 향후 새로운 병소의 출현 혹은 정상화 여부를 보기 위한 추적검사가 필요하리라 사료된다. 방광요관역류 환아에서 DMSA신주사소견은 방광요관역류의 정도가 심할수록 이상소견을 보일 확률이 높으며 신초음파 검사보다 민감도가 높은 것을 알 수 있었다.이는 혈압을 조절시키지 못하였고 저단백식이 항고혈압제투여군은 저단백식이 단독투여군보다 혈압조절 및 단백뇨의 감소 소견은 유의한 차이를 보였으나, mesangial matrix expansion score,대상성 사구체비대는 통계적으로 유의한 차이를 보이지 않았다. 그러므로 만성신부전의 진행을 지연시키는데 있어서 저단백식이와 함께 항고혈압제를 추가하였을 때 항고혈압제에 의한 추가적인 지연 효과는 관찰되지 않았다.학생이 남학생보다 높고, 물리치료과를 타의로 Purpose : The use of cyclosporine and mitomycin in various immunologic or neoplastic disorders has been known to cause wide-ranged nephrotoxic effects including thrombotic microangiopathy. However, the mechanism of nephrotoxicity of these drugs has not been studied adequately, so that present experimental study has been undertaken to find out whether these drugs can cause direct damage to the kidney and to clarify the pathogenetic mechanism of nephrotoxic effect of these drugs. Materials and methods : Sprague-Dawley rats weighing 250-300 gm were used for experimental animals and unilateral renal perfusion technique, modified from the method described by Hoyer et al was used. Isolation of left kidney from systemic circulation was made by clamping aorta and left renal vein and a hole was punctured in the anterior wall of the left renal vein. Cyclosporine (2.5 mg in 4 ml solution) and mitomycin (1.6 mg in 4ml solution) were infused through left renal artery and normal saline was used in control rats. Forty-eight hours after infusion of the drugs, animals were sacrificed and left kidney removed and processed for histologic examination. Total ischemic time of left kidney was less than 15 minutes: Results : Cyclosporine-perfused group showed severe swelling of glomerular endothelial ceil along with swelling of glomerular epithelial cell and interstitial vascular endothelial cell. Mitomycin-perfused group also showed severe swelling of glomerular endothelial and epithelial cells. And in addition to these findings, they demonstrated platelets aggregation, swelling and degranulation of platelets and fibrin accumulation in some of the capillaries, indicating occurrance of thrombotic microangiopathy. Conclusion : present experiment indicates that cyclosporine and mitomycin can cause direct toxic injury to renal endothelial cell. And this direct toxic damage to endothelial cell seems to be an important initiating event for the development of thrombotic microangiopathy.

사출성형해석을 이용한 HEV/EV 구동모터 회전자 철심에 관한 실험적 연구

홍경일,정현석,최계광,김세환,임세종,Hong, Kyeong-Il,Jung, Hyun-Suk,Choi, Kyeo-Gwang,Kim, Se-Hwan,Lim, Se-Jong 한국금형공학회 2015 한국금형공학회지 Vol.9 No.1

The HEV/EV Traction Motor Core manufacturing technology is a core component of Traction Motor Core is a key technology for the manufacture of eco-friendly automotive industry is essential for the competitiveness of the country must obtain the technology. This study was performed to develop a Rotor Core of the HEV/EV Traction Motor using the first time in Korea multi-gate BMC injection molding technique. Executed by the experiment of this study are as follows. Study 1: Developed a multi-gate BMC injection mold for the magnet fixed to the Rotor Core. Study 2: Developed a production implementation and manufacturing technology of the Rotor Core. In this study, the develop products and manufacturing technologies implemented by the BMC injection mold development for Magnet fixed to the Rotor Core and the results are discussed.

하이브리드(HEV) 구동 모터용 모터-코어 금형 개발에 관한 실험적 연구

홍경일,김세환,최계광,정현석,임세종,Hong, Kyeong-Il,Kim, Se-Hwan,Choi, Kyeo-Gwang,Jung, Hyun-Suk,Lim, Se-Jong 한국금형공학회 2015 한국금형공학회지 Vol.9 No.2

The HEV Traction Motor Core manufacturing technology is a core component of HEV Traction Motor Core (Iron Core) is a key technology for the manufacture of eco-friendly automotive industry is essential for the competitiveness of the country must obtain the technology. In this study, the HEV Motor Core of the Rotor manufacturing technology, the Stator manufacturing technology applied to Press Lamination Die and Core(Iron Core) was developed and the results are discussed.

고온-고압 수소 주입된 고망간강의 인장 거동에 미치는 표면 조건의 영향

백한솔(Han-sol Baek),임현석(Hyun-Suk Lim),이승용(Seung-Yong Lee),황병철(Byoungchul Hwang) 한국소성가공학회 2017 한국소성가공학회 학술대회 논문집 Vol.2017 No.5

상부 소화관 이물질의 내시경적 적출에 관한 임상적 고찰

임규성(Kyu Sung Rim),임현석(Hyun Suk Lim),신도영(Do Young Shin),임태희(Tae Hee Rim),김우중(Woo Joong Kim),박충기(Chung Ki Park) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A The clinical review was done on 9 cases with the foreign body in the upper gastrointestinal tract who visited and underwent endoscopic removal of foreign body at Kangnam Sacred Heart Hospital from Dec. 1980 to Aug. 1986. The results were as follow: 1) The age distribution varies from 3 months to 52 years of age, being most prevalent under 5 yrs of age. The ratio between male and female was 2:1, more prevalent in male. 2) The incidence of foreign body in order of frequency was coin, ring, peanut and keyring. Among 9 cases, 7 cases (77.8%) were lodged in the stomach and 2 cases (22.2%) were lodged in the esophagus. 3) In clinical symptom, asymptomatic cases (77.8%) were more common than symptomatic cases (22.2%). 7 cases of foreign body (77.8%) were removed out after 72 hours and 2 cases of foreign body (22.2 %) were removed out within 72 hours.

내시경적 유두절개술 38 예의 임상적 고찰

양재식(Jea Sik Yang),이명구(Myung Goo Lee),임현석(Hyun Suk Lim),김우중(Yoo Joung Kim),박충기(Choong Kee Park),임규성(Kyu Sung Rim) 대한내과학회 1988 대한내과학회지 Vol.34 No.2

N/A The usefulness of EPT, to remove biliary atone is widely approved. So we reporters are willing to investigate and report 39 cases of EPT. out of 420 cases of ERCP performed from September 1983, to April 1987 in Kangnam Sacred Heart Hospital, Seoul, Korea. The results are as follows: 1) The distribution of age was from 24 year to 77 year old, and the sixties were 15 cases (37.7%), the most. The difference of sex could be disregarded; 18 men and 20 women. 2) The histories of cholecystectomy were found in 20 cases out of 39 ones. 3) There were the stones in 38 cases out of 39 cases: The most frequent site was common bile duct in 21 cases. 4) Out of 32 ca of the first EPT. (1) In 6 ca stones were confirmed in stool. (2) In 7 cases stones were confirmed in basket extraction and natural passing at EPT. (3) In 17 cases stones extraction were confirmed at second ERCP, & the improvement of clinical & laboratory. (4) 2 cases were not followed-up. 5) Out of 6 cases failed at first EPT, 2 cases were impacted stones, and managed by operation, 3 cases were incomp1ete excision; we succed at second performance. 1 case was very large stone (6×2×2); we succed in passing the stone at third performance by lithotripsy without significant complication. 6) Size of the removed stones was 0.5 cm to 6 cm. Lots of stones were 1.5 cm to 2.5 cm(12 cases-31.6%) and in 2 cases the stones were over 5 cm. 7) After EPT, it's complication was found in 4 cases (10.5%): in 2 cases transfusion was demanded because of bleeding; in 2 cases operation was performed because of impacted stone.

선종과 동반된 위의 유암종 3 예

김정선,임현선,정인식,선희식,김동빈,이창돈,김성수,한원희,한석원,채현석,정호윤,현영근,채은영 대한소화기내시경학회 2000 Clinical Endoscopy Vol.21 No.5

Carcinoid tumor in the stomach is neuroendocrine tumor originated from enterochromaffin cells in submucosa in the stomach. It is very rare, account for 0.3% of gastric tumor. It is likely to be demonstrated with other tumor in the stomach simultaneously, such as adenocarcinoma. According to paper published in Korea, it is only 4 cases that gastric carcinoid combined with other gastric tumors have been reported. But there has been no reports of gastric carcinoid combined with gastric adenoma, such as our cases. We report 3 cases of gastric carcinoid tumor combined with atypical adenoma, with review of paper presented.