한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

국립공원 관리를 위한 해양생태계 장기 모니터링 프로그램의 발전 방향

이채린(Chae-Lin Lee),유재원(Jae-Won Yoo),정병관(Byungkwan Jeoung),김창수(Chang-Soo Kim),안동식(Dong-Sik Ahn),김성태(Sungtae Kim),성은주(Eun-Ju Sung),김성현(Sung-Hyun Kim),정수영(Su-Yeoung Jeong),박영석(Young-Seuk Park) 국립공원연구원 2021 국립공원연구지 Vol.12 No.2

생태계 변화의 모니터링은 효율적 생태계 관리를 위한 기초 정보 수집을 위해 중요한 과정이다. 많은 생태 현상과 그 과정은 오랜 시간에 걸쳐 진행되므로 국립공원의 지속적인 보전 및 효율적 관리를 위해 생태계 모니터링은 장기적으로 이루어질 필요가 있다. 본 연구는 국내외 장기 모니터링 프로그램 사례 분석을 통해 성공적인 장기 모니터링을 위한 방법으로써, 최적화된 모니터링 설계, 표준화된 운용방안 마련, 인적 자원 및 DATA 관리 체계 수립, 안정적인 재정 마련 및 후속지원 등을 제시하였다. 이를 바탕으로, 현재 10년 넘게 수행되고 있는 ‘HS호 유류유출 사고 해역 장기 모니터링 프로그램’의 발전 방향으로 적응형 모니터링 방식이 적용된 표준화된 프로토콜의 정립, QA/QC와 지속적인 자료 관리, 조사 항목의 연계성 강화 등의 구체적 방안을 제안한다. Monitoring ecosystem changes is an important process for collecting basic information for ecosystem management. Since many ecological phenomena and their processes take place over a long period of time, it is necessary to conduct long-term monitoring of ecosystems for the continuous conservation and efficient management of national parks. This study suggested an optimized monitoring design, standardized operation plan, human resource and data management system, stable financial preparation and follow-up support as methods for successful long-term monitoring through case analysis of domestic and foreign long-term monitoring programs. Based on this, it proposes specific measures such as establishing a standardized protocol with adaptive monitoring methods, continuous data management with QA/QC, and strengthening the linkage of investigation items in the development direction of the “HS oil spill accident long-term monitoring program” that has been conducted for more than a decade.

하수처리장 적용을 위한Semi-카플란 수차가 장착된 마이크로수력발전 시스템

채규정(Kyu Jung Chae),김동수(Dong Soo Kim),천경호(Kyung Ho Cheon),김원경(Won Kyoung Kim),김정연(Jung Yeon Kim),이철형(Chul Hyung Lee),박완순(Wan Soon Park) 大韓環境工學會 2013 대한환경공학회지 Vol.35 No.5

소수력발전은 하수처리장 에너지 자립을 위한 효과적인 대안이다. 본 연구는 유량변동이 크고 유효낙차가 낮은 중소형하수처리장(기흥레스피아) 적용을 위해 피치조절형 세미카플란(semi-kaplan) 마이크로수력발전의 적용 타당성을 평가하였다. 가변피치 semi-kaplan 수차는 유량조절을 위한 가이드베인은 생략하고 피치조절형 런너를 장착하여 기계적 결함은 줄이면서 유량변동이 큰 처리장에 특화된 기술이다. 마이크로수력발전 시스템은 설계조건(유량 0.35 m3/s, 유효낙차 4.7 m)에서 90.2%의 수차효율 달성이 가능하였고 발전용량은 13.4 kW로 산정되었다. 설비가동률 74%로 가동 시 연간 약 86.8 MWh 에너지 생산을 통해 2.1%의 에너지 자립이 가능하고 이는 연간 49톤의 CO₂ 감축효과와 맞먹는다. 경제성 평가결과 초기 건설공사비가 200,000,000원 이하인 경우에는 내부수익률은 6.1%, 순현가는 15,539,000원, 편익-비용률은 1.08, 투자회수년은 15.5년으로 경제성이 충분한 것으로 나타났다. Small scale hydropower is one of most attractive and cost-effective energy technologies for installation within sewage treatment plants. This study was conducted to evaluate the potential of a semi-kaplan micro-hydropower (MHP) system for application to sewage treatment plants with high flow fluctuations and a low head. The semi-kaplan MHP is equipped with an adjustable runner blade, and is without a guide vane, so as to reduce the incidence of mechanical problems. A MHP rating 13.4 kWp with a semi-kaplan turbine has been considered for Kiheung Respia sewage treatment plant, and this installation is estimated to generate 86.8 MWh of electricity annually, which is enough to supply electricity to over 25 households, and equivalent to an annual reduction of 49 ton CO₂. The semi-kaplan turbine showed a 90.2% energy conversion efficiency at the design flow rate of 0.35 m3/s and net head of 4.7 m, and was adaptable to a wide range of flow fluctuations. Through the MHP operation, approximately 2.1% of total electricity demand of Kiheung Respia sewage treatment plant will be achievable. Based on financial analysis, an exploiting MHP is considered economically acceptable with an internal rate of return of 6.1%, net present value of 15,539,000 Korean Won, benefit- cost ratio of 1.08, and payback year of 15.5, respectively, if initial investment cost is 200,000,000 Korean Won.

제4형 가족성 고중성지방혈증 임산부에서 발생한 급성 췌장염 1례

박관응,윤채중,김영학,진영기,윤성호,권용은,김태원,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

Plasma levels of cholesterol (TC) and triglyceride(TG) physiologically increase during pregnancy. The lipid increment is 23-53% above the pregravidic level for TC and 2- to 3-fold of the prepregnancy level for TG. If the TC and TG are higher than normal values in pregnancy, the patient must be carefully monitored. Acute pancreatitis is the main consequence of hyperlipidemia and occurs either during pregnancy, in the third trimester, or in the puerperium. Mortality is high both for the mother (21%) and the fetus (20%). We report a case of 28 year-old pregnant woman at 29 weeks gestation with hypercholesterolemia (TC = 357 ㎎/dl) and severe hypertriglyceridemia (TG = 1300 ㎎/dl). The patient was admitted to the hospital because of severe epigastric pain, nausea and vomiting. Total serum cholesterol was increased and trigyleride was markedly increased. The electroporesis pattern of serum lipoprotein showed increase in pre-beta lipoprotein fraction, suggesting IV hypertriglyceridemia pattern. According to a review of the literature, the incidence of pancreatitis during pregnancy is 1 in 1000 to 3000 pregnancies. Severe hypertriglyceridemia in pregnancy should be treated with a careful restriction of calories and fat: for preventing acute pancreatitis, hospitalization for intravenous fluid therapy and plasma exchange must be required.

지지전해질이 포함되지 않은 용액에서 미세구조 전극을 이용한 Fe(CN)^(3-)_(6) 이온의 전기화학적 산화환원에 관한 연구

채원석,박종삼 대진대학교 1999 大眞論叢 Vol.7 No.-

We attempted to develop a new electrochemical method that is possible to measure in low concentration or without supporting electrolyte. Three electrodes integrated with millimeter gap each other were applied to make up a bundle. The milli-structured electrode(MSE) was molded in soft glass and to be all platinum-wires of 1.96 x 10^(-3) cm^(2); working and reference electrode, and 7.85 x 10^(-3) cm^(2); counter electrode. The distance between electrodes was below millimeter. We confirmed through the redox reaction of Fe(CN)^(3-)_(6) what our MSE was a possible electrode to carry out as a electrochemical probe in low or without supporting electrolyte solution.

일부 도시지역 노인들의 우울과 일상생활능력에 관련된 요인

박원규,이태용,정용준,오장균,이동배,조영채 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

This study was performed to provide the basic data and related factors available for the assessment of the degree of ADL and depression among older persons, manifesting their physical and psychological status. The subjects included the old people aged more than 65 years old who reside in urban areas. The interviews were delivered to 693 individuals in Taejon metropolitan city during the two-month period from June to July, 2000, and Zung Self-Rating Depression Scale and IADL developed by Older American Resources and Services of Duke medical college, were employed for the assessment of depression and IADL, respectively. The collected data were statistically processed by SPSSWIN(ver 10.0) and led to the following results. The degree of depression among 635 subjects showed that 26.6% had mild depression, 8.2% moderate and 0.6% severe while 64.6% were normal. In terms of IADL, 6.9% had impossible IADL when not aided by others, 37.0% needed some help, 56.0% possible IADL, and the higher depression scores, the significantly higher IADL scores. Based on general characteristics, depression scores were significantly higher in the female group, the older, the lower educated, the ones without cohabitants, without a spouse, without making expenses of living on their own, and IADL scores were lower, meaning the lower capability for performing daily activities, in the male group, the older, the higher educated, the group without a spouse, without making expenses of living on their own. Based on daily activities and psychological characteristics, depression scores were higher in the group who don't go out, who don't have recreational or friendly gatherings, who aren't satisfied with the lives of the past or present, who have a sense of isolation, and who don't have the will to live, and IADL scores were lower in the group who don't go out, who don't have recreational or friendly gatherings, who aren't satisfied with the lives of the past or present, who have a sense of isolation. and who don't have the will to live. Multiple regression analysis revealed that the explanatory variable having effects on depression symptoms included, with the explanatory power of 57.5%, the confidence in life, the degree of education, the subjective index of health, the sense of isolation, the exercise, the degree of IADL, the gender, the level of satisfaction with life, whether they eat breakfast or not, the concern about life, the smoking, the going out, the presence of spouse or not. The explanatory variables having effects, with the explanatory power of 28.9%, on IADL scores included the degree of depression symptoms, the age, the presence of friends or not, the frequency of outgoing, the level of education, the degree of obesity, the confidence in life, the level of satisfaction with life, the drinking or not. The study results showed that the higher depression scores had a tendency to be associated with the decreased capabilities of performing daily activities, and that the factors related to depression and/or IADL, included the confidence in life, the level of education, and the level of satisfaction with life. However, the more detailed and decisive results on the factors related to depression and IADL of the older persons are considered to require continuing efforts and comparisons among a variety of the older population.

자가 면역성 간염에서 자가항체의 발현 양상과 스테로이드 치료의 효과

박기오,채경훈,허원석,강윤세,정재훈,김연수,문희석,이엄석,김선문,이병석,김남재,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 최근 8년간 본원에서 경험한 자기면역성 간염의 혈액학적 특징과 스테로이드의 치료효과를 알아보고자 본 연구를 시행하였다. 방법 : 1996년 이후부터 2002년까지 충남대학교 병원에서 1999년 International Autoimmune Hepatitis Group(LAHG)에서 제시한 수정 진단 기준안에 의거하여 총 진단점수가 probable 이상에 해당하는 환자들을 대상으로 임상적 특징, 검사실 및 조직 소견과 스테로이드와 azathioprine의 치료 효과를 후향적으로 조사하였다. 결과 : 9예의 환자들은 여성이 78%, 40대가 많았고, 급성 발병이 33.3%, 피로감, 식욕부진 및 황달 등이 나타났으며, 항핵항체가 55.6%에서 그리고 항평활근 항체가 77.8%에서 양성이었고, 동반 질환은 류마치스 관절염이 2예, 특발성 혈소판 감소증 1예, Henoch-Sch nlein 자반증 및 그레브스병이 각각 1예 씩이었다. 7예에 대해서 스테로이드와 azathioprine으로 치료하여 생화학적 임상적 완해가 이루어져서 유효한 치료 결과를 얻었다. 결론 : 자가면역성 간염은 우리 나라에서 원인을 찾을 수 없는 만성 간질환의 경우, 특히 중년여성에서 다른 자가면역성 질환이 동반되었을 때 자가면역성 간염을 의심하여 자가항체 선별검사를 시행해 보아야 할 것으로 생각된다. 향후 다기관 연구를 통하여 좀 더 많은 증례를 모으고 전향적인 연구를 시행하여야 할 필요가 있다. Although autoimmune hepatitis(AIH) is common in western contries, some studties have been reported in Korea. The aim of the study was to analyze the clinical and histological features and expression pattern of the autoantibody and to examine clinical course of AIH in Korea. For 9 patients diagnosed as having AIH in our hospital since 1996, we reviewed medical records and analyzed clinical and laboratory findings retrospectively. They had a probable or definite AIH according to the revised criteria of International AIH group. The mean age was 42.7(21∼68)years and 7(77.8%) were female. Three of them(33.3%) showed acute hepatitis and five of them showed cirrhosis. Fatigue and anorexia were the most frequently complained symptoms(55.6%). Four patients(44.4%) were accompanied with other autoimmune diseases. Antinuclear antibody was detected in 5(55.6%) and anti-smooth muscle antibody was detected in 7(77.8%). Three patients showed focal picemeal necrosis and four showed periportal fibrosis. Among 7 patients who received immunosuppressive therapy, six patients(85.7%) showed initial response. and biochemical and serologic remission were achived in 5(71.4%) and 3(42.8%) patients, AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. AIH should be suspected in female patients with unknown chronic liver disease of unknown etiolgy, especially accompanied with other autoimmune disease. The clinical characteristics of AIH may not be quite different from those of Western countries.

우리나라 現行 財務狀態變動表의 有用性에 관한 實證的 檢證

朴範鎬,蔡奎學,孫 敏,李 悠,吳瑗善,全夏成 홍익대학교 경영연구소 1988 경영연구 Vol.12 No.-

프로세스 접근 방법을 적용한 ISO 9001, ISO/TS 16949시스템의 효율적 제조설비 관리 방안

박채원,김광섭 대한설비관리학회 2004 대한설비관리학회지 Vol.9 No.4

Many of companies all over the world have been certified ISO 9000 which is customer focused since last ten 10 years, and industrial sector specific certifications have been developed, such as ISO/TS 16949 which are specific requirements added to ISO 9001 for the automotive industrial sector. Requirements for manufacturing machine/equipment contol addressed in ISO 9000, ISO/TS 16949 are considered to be significant. And ISO 9001 pro-motes the adoption of 'Process approach' which is one of 'Quality management 8 principles' when developing, implementing and improving the effectiveness of a quality management system, to enhance customer satisfaction by meeting customer requirements. And I think that it is important to adopt 'Process approach' when implementing machine/equipment contol for performance improvement. I sincerely hope that my study for adoption of Process approach for r performance improvement to be helpful to individual, companies and related association.

반복작업에 의해 발생한 척골관 증후군 1례

김정원,박인선,이영준,김유창,김필자,강동묵,이채언 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : To report cubital tunnel syndrome due to repetitive motions. Methods : A worker complaining muscle weakness and atrophy of the right hand intrinsic muscles admitted to a hospital. We evaluated him with blood tests, neurophysio-logic studies (NCV & EMG), plain X-ray and US at the both elbows. We investigated his occupational history, and videotaped his work motions based on the work cycle at his previous work site. Finally, an ergonomics expert analyzed the motions using rapid upper limb assessment (RULA). Results : NCV & EMG studies reveals slow conduction velocity on both ulnar nerve across the elbow, more severely in the right side. US shows us compatible finding with diffuse neuritis of both ulnar nerves at both elbows. RULA score is 7. Conclusion : We confirmed that the worker's symptoms were related to his previous jobs demanding repetitive motions using the elbow joints. It is necessary that we should prepare appropriate measures to evaluate, prevent, rehabilitate, and help injured workers to return to work.