Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

연구논문 : 만성 바이러스간질환에서 간섬유화의 다양한 비침습 혈청표지자검사의 비교

김선민 ( Sun Min Kim ),손주현 ( Joo Hyun Sohn ),김태엽 ( Tae Yeob Kim ),노영욱 ( Young Wook Roh ),은창수 ( Chang Soo Eun ),전용철 ( Yong Cheol Jeon ),한동수 ( Dong Soo Han ),오영하 ( Young Ha Oh ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4

목적: 만성 바이러스간질환에서 병의 경과와 예후를 평가하고 치료반응을 예측함에 있어 간섬유화의 진단은 중요하다. 최근 간섬유화 평가에 표준방법이지만 침습적 간생검을 대신하여 여러 가지 비침습적 진단법이 이용되고 있고, 또한 새로운 검사법들이 개발되고 있다. 저자들은 만성 B형 및 C형간염 환자를 대상으로 임상에서 광범위하게 흔히 시행하는 혈액검사와 임상 소견을 이용한 아래와 같은 진단법들만으로 간섬유화를 얼마나 정확하게 평가할 수 있는지 알아보고, 단일 검사로 간섬유화를 평가하는 데 유용하다고 알려져 있는 hyaluronic acid(HA)와 IV형 콜라겐 농도와 비교하여 그 임상적 유용성을 평가하였다. 대상과 방법: 2002년 3월부터 2007년 2월까지 만성 바이러스간 질환으로 간생검을 시행받은 225명의 환자(HBV 180명, HCV 43명, HBV+HCV 2명)를 대상으로 분석하였다. 간생검을 시행하는 날에 말초혈액검사, 혈액응고검사, 혈청생화학검사를 시행하고, 혈중 HA, IV형 콜라겐 농도를 측정하였다. 간섬유화의 정도는 F0(섬유화가 없음), F1(문맥역 섬유화), F2(문맥주변부 섬유화), F3(섬유성 격막) 및 F4(간경변증)의 4단계로 구분하였다. 대상 환자를 F0-1, F2-4 혹은 F0-2, F3-4의 두 집단으로 분류하여 두 집단을 구분하고자 할 때 AAR(AST/ALT ratio), API(age-platelet index), APRI(AST to platelet index), CDS(cirrhosis discriminant score), platelet count, HA, IV형 콜라겐의 예측능을 area under the receiver operating characteristic curve (AUROC)값을 이용하여 비교하였다. 결과: 대상환자의 섬유화의 단계는 F0 집단은 17명, F1 집단은 40명, F2 집단은 61명, F3 집단은 74명, F4 집단은 33명이었다. 의미 있는 간섬유화를 F2 이상으로 판단할 때, 의미 있는 섬유화의 예측에 대한 AUROC 값은 APRI=0.822, CDS=0.776, platelet count=0.773, API=0.756, HA=0.749, IV형 콜라겐=0.718, AAR=0.642 순이었고, F3 이상의 광범위한 섬유화 예측에 대한 AUROC값은 CDS=0.835, platelet count=0.795, API=0.794, HA=0.766, AAR=0.711, IV형 콜라겐=0.697, APRI=0.691 순으로 관찰되었다. 결론: 만성 바이러스간질환에서 간섬유화를 평가하는 데 임상 소견 및 혈액검사를 이용한 방법들이 비침습적 진단법 중 단독 검사로도 유용한 것으로 알려져 있는 혈중 HA와 IV형 콜라겐 농도와 비교하여 우월하거나 대등하였다. 특히 APRI는 다른 인자들에 비해 F2 이상의 의미 있는 섬유화를 예측하는 데 가장 유용하였고, CDS는 F3 이상의 광범위한 섬유화를 예측하는 데 가장 유용하였다. Background/Aims: The aim of this study was to determine the clinical performances of noninvasive serum markers for the prediction of liver fibrosis in chronic viral liver diseases. Methods: We analyzed a total of 225 patients with chronic viral liver diseases (180 with hepatitis B virus, 43 with hepatitis C virus, and 2 with hepatitis B+C virus) who underwent a liver biopsy procedure at the Hanyang University Guri Hospital between March 2002 and February 2007. Serum was also obtained at the time of liver biopsy. Liver fibrosis was staged according to the scoring system proposed by the Korean Study Group for the Pathology of Digestive Diseases. Various noninvasive serum markers were evaluated, including the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), age-platelet (AP) index, AST/platelet ratio index (APRI), cirrhosis discriminant score (CDS), platelet count, hyaluronic acid (HA), and type IV collagen. Results: There were 17, 40, 61, 74, and 33 patients at stages F0, F1, F2, F3, and F4, respectively. The overall diagnostic accuracies of each marker, as determined by the area under receiver operating characteristics curves, were APRI=0.822, CDS=0.776, platelet count=0.773, AP index=0.756, HA=0.749, type IV collagen=0.718, and AAR=0.642 for predicting significant fibrosis (≥F2); and CDS=0.835, platelet count=0.795, AP index=0.794, HA=0.766, AAR=0.711, type IV collagen=0.697, and APRI=0.691 for predicting extensive fibrosis (≥F3). Conclusions: Conclusions: All noninvasive serum markers evaluated in this study were useful for predicting significant or extensive liver fibrosis in chronic viral liver diseases. In particular, APRI was most useful for the prediction of significant fibrosis, and CDS was most useful for the prediction of extensive fibrosis. (Korean J Hepatol 2009;15:454-463)

고착협 내탈립 기계수확 적응 장류⋅두부용 콩 품종 ‘새금’

김현태(Hyun Tae Kim),한원영(Won Young Han),이병원(Byung Won Lee),고종민(Jong Min Ko),이영훈(Yeong Hoon Lee),백인열(In Youl Baek),윤홍태(Hong Tai Yun),하태정(Tae Joung Ha),최만수(Man Soo Choi),강범규(Beom Kyu Kang),김현영(Hyun Yeong K 한국육종학회 2019 한국육종학회지 Vol.51 No.4

The soybean cultivar, ‘Saegeum’, has been developed for preparing soy-paste and tofu. The soybean cultivars ‘Daepung’ and ‘SS98207-3SSD-168’ were crossed in 2003 to obtain ‘Saegeum’. Single seed descent method was used to advance the generation from F3 to F5, and the plant lines with promising traits were selected from F6 to F7 by pedigree method. The preliminary yield (PYT) and advanced yield trials (AYT) were conducted from 2009 to 2010, and the regional yield trial (RYT) was conducted in 12 regions between 2011 and 2013. The morphological characteristics of ‘Saegeum’ were as follows: determinate plant type, white flower, tawny pubescence color, and brown pod color. Flowering and maturity dates were August 2, XXXX and October 17, XXXX, respectively. Plant height, first pod height, number of nodes, number of branches, and number of pods were 79 cm, 18 cm, 16, 2.3, and 44, respectively. The seed characteristics of ‘Saegeum’ were as follows: yellow spherical shape, yellow hilum, and the 100-seed weight was 25.4 g. ‘Saegeum’ was resistant to bacterial pustule and SMV in the field test, and its lodging resistance was mildly strong, whereas its shattering resistance was excellent. The ability of this cultivar to be processed into tofu, soybean malt, and other fermented products was comparable with that of ‘Daewonkong’. The yield of ‘Saegeum’ in the adaptable regions was 3.02 ton ha-1. Thus, ‘Saegeum’ is adaptable to mechanized harvesting because of its high first pod height, as well as lodging and shattering resistance. (Registration number: 5929)

총경동맥 폐쇄시간에 따르는 국소 뇌혈류 변화 : 실험적 연구 An Experimental Cat Model

강준기,성태경,조병일,백민우,김문찬,허춘웅,하영수,송진언 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.3

The microvasculature of the brain is also quite susceptible to ischemic insult, and substantial portions of the brain are not reperfused after restoration of the blood supply following overtime of critical ischemic periods. The purpose of this series of experiments was to determine the effects of ischemia on subsequential regional cerebral blood flow measurements and cortical electric activities following reperfusion after ischemia and also to define the proper time of vascular occlusion without irreversible neural damage. Cerebral ischemia was induced in cat by bilateral common carotid occlusions for periods of 10, 30, to 60 minutes, and the blood supply was reperfused for 3 hours after clamp-off. Regional cerebral blood flow(rCBF) was measured by hydrogen clearance technique following ischemia, restoration of blood supply and electroencephalogram recovery could be predicted according to the rCBF. Forty adult cats weighing 2.7 to 4.0㎏ were used in this study. The animals were divided into 4 groups of 10 cats each : normal control, 10 min-clamped, 30 min-clamped, and 60 min-clamped groups. The results obtained were as follows : 1) The mean rCBF was 24.6±7.0㎖/100g/min in control group. 2) Bilateral carotid occlusions resulted in a reduction of the rCBF(12.4±4.1㎖/100g/min) to 50% of control flow on both hemispheres. 3) Sequential changes of the rCBF after reperfusion : (1) There was restored the rCBF(21.3±5.1㎖/100g/min) to control flow in the 10 minutes-clamped group. (2) There was a 85% recovery of control flow in the 30 minutes-clamped group. (3) There was a only 25% recovery of control flow in the 60 minutes-clamped group. 4) A close correlation was found between cortical electrical activity and rCBF suggesting a threshold relationship. (1) The changes of cortical electric activity began to notice at rCBF less than 17.4±4.7㎖/100g/min. (2) The recovery of cortical electric activity noted at rCBF more than 10.2±2.3㎖/100g/min. 5) There was no evidence of ischemic involvement at the cortex, white matter and basal ganglia in the 10 minutes clamped group, but demonstrated a dense wedge shaped infarct at the cortex and uncus herniation in the 60 minutes clamped group. The rCBF and cortical electric activity restored to normal values in reperfusion within 10 minutes after occlusion of both common carotid arteries.

락탐화합물의 고리 확장 연구 : 입체 선택성과 Mechanism에 관한 연구 Study of Stereoselectivity and Mechanism

하진렬,최경민,김지아,원태진,신동수,이민주,안철진 昌原大學校 基礎科學硏究所 2002 基礎科學硏究所論文集 Vol.14 No.-

The ring expansion chemistry is one of the most important methods to prepare five-and six-membered heterocylic compounds. We have studied about γ-lactam ring expansion with stereoselectivity from β-lactam derivative. To do this chemistry, proton of N-benzyl group in β-lactam derivatives is eliminated by LDA and make carbanion.This anion make unstable 4-membered lactam intermediate, and then the ring is opened by homo clevage or hetero cleavage for releasing ring strain, followed by recyclization to one carbon to make γ-lactam ring with stereoselectivity in β-, γ- positions.

모듈화된 계층의 구조를 갖는 시뮬레이션 모델에서의 모델간 연결 방법론과 그 적용 예

하경재,정민수,조대호 慶南大學校 附設 基礎科學硏究所 1995 硏究論文集 Vol.7 No.-

대량의 지식베이스를 처리하는 시스템의 모델링을 하기 위해서는 큰 규모의 데이터베이스에 저장되어 있는 정보를 효과적으로 접근할 수 있어야 한다. 본 논문에서는 데이터가 계층의 구조를 갖고 모듈화 되어 있는 능동적인 기억소자(Processor/memory pair)에 저장되어 있는 시스템의 모델링에 사용할 수 있는 단계적접근(level access)방법론을 어떻게 유사추론 시스템(analogical reasoning system)에 적용 할 수 있는가를 보여준다.

급성 연쇄상구균 감염후 사구체 신염에 동반된 고혈압 뇌증 1례

하태선,차상훈,이경은,엄정민 충북대학교 의과대학 충북대학교 의학연구소 1999 忠北醫大學術誌 Vol.9 No.2

고혈압성 뇌병증은 고혈압 환자에서 고혈압과 관련된 두통, 경련, 시각장애 및 다른 신경학적 장애를 동반하는 증후군이다. 증례는 13세 여자환아로 급성 연쇄상구균 감염후 사구체 신염에 동반된 고혈압성 뇌병증 환자였다. 내원시 혈압은 150/110 mmHg 였고 내원당시 검사소견상 단백뇨, 혈뇨, C3의 감소 소견을 보였다. 내원 2일째 자기공명영상을 시행하였고 스핀에코 T2 강조영상에서 양 후두엽과 후 측두엽에 고신호의 이상 부위들이 발견되었다. 치료후 실시한 자기공명영상은 정상 소견을 보였다. 본 저자들은 급성 사구체 신염 환자에서 자기공명영상으로 고혈압성 뇌병증을 진단하고 치료한 1례를 문헌고찰과 함께 보고하는 바이다. Hypertensive encephalopathy is a syndrome consisting of headache, seizures, visual changes, and other neurologic disturbances in patients with elevated systemic blood pressure. We experienced a 13-year-old girl who presented with the manifestations of hypertensive encephalopathy in acute post-streptococcal glomerulonephritis. She visited our hospital because of generalized tonic-clonic seizure after severe headache. On admission her blood pressure was 150/110 mmHg and initial laboratory findings revealed proteinuria, hematuria and decreased C3 level and, T2-weighted MR image showed increased T2 signal in both occipital lobes, suggesting cerebral edema. On follow-up MRI, pathologic lesions were improved. We described a case of hypertensive encephalopathy in acute post-streptococcal glomerulonephritis diagnosed by MRI with a brief review of some related literatures.

선각 평블록 조립공장 일정계획을 위한 혼합 유전 알고리즘

하태룡,문치웅,주철민,박주철 한국경영과학회 2000 經營 科學 Vol.17 No.1

This paper describes a scheduling problem of the panel block assembly shop in a shipbuilding industry Because the shipbuilding is a labor intensive industry, the most important consideration in a panel block assembly shop is the workload balancing, which balances man-hour, weight and welding length and so on it should be determined assembly schedule and workstation considering a daily load balancing and a workstation load balancing simultaneously To solve the problem, we develop a hybrid genetic algorithm Hybrid genetic algorithm proposed in this paper consists of two phases The first phase uses the heuristic method to find a initial feasible solution which provides a useful information about optimal solution The second phase proposes the genetic algorithm to derive the optimal solution with the initial population consisting of feasible solutions based on the initial solution Finally, we carried out computational experiments for this load balancing problem, which indicate that developed method is effective for finding good solutions

外傷性 肝臟破裂과 肝膽道出血患者의 肝動脈結柴에 依한 治療

孫鍾夏,咸泰元,林敏一,裵振善,韓萬靑 대한적십자사 1974 적십자병원지 Vol.1 No.1

편마비 환자에서 정량적 감각기능 검사로 측정한 온도감각역치

배하석,심은결,윤태식,이정민,김성민 이화여자대학교 의과대학 2009 EMJ (Ewha medical journal) Vol.32 No.1

Objectives:Hemiplegic patients with unilateral cerebral lesions suffer from sensory deficit as well as motor deficit. But clinical assessment of thermal sensation is one of the least reliable components of neurological examination and is difficult to quantify. Methods:We measured thermal sensory thresholds of cold sense, warm sense, cold pain and hot pain in hemiplegic patients with thermal sensory analyzer(TSA). To investigate and quantify the thermal sensory deficit of hemiplegic patients, we compared the measurements with normal con-trols, between body regions, and between hemiplegic and sound side. Results:Hemiplegic patients showed impaired thermal sensory thresholds in all modalities compared to their sound side and normal controls. Conclusion:Quantitative sensory test using thermal sensory analyzer can be useful to quantify the thermal sensory deficit and follow up the progress.