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      • Genetic Algorithm을 이용한 철근콘크리트보의 최적설계

        안지현,이차돈 中央大學校 建設環境硏究所 1999 環境科學硏究 Vol.9 No.2

        Simple Genetic Algorithm (SGA) is refined to take into account for the optimization of reinforced concrete beams under positive and negative moments. GA has beneficial aspects compared to conventional numerical or analytical optimization techniques in that ; it can handle discrete variables, does not need continuity or derivatives of a function, has more probabilities of convergence to global minimum; and is relatively easy to include the equations in structural design code. Considered in optimization are : discrete set of widths, depths and number of rebars both in positive moment and in negative moment region for beam members. In addition to the strength constraints, requirements for reinforcement arrangement including minimum cover thickness and necessary spacings between rebars in a beam section are considered. Within a reasonable and finite number of searching, the developed algorithm was able to yield optimum solutions for reinforced concrete beams.

      • 재발성 복부 통증을 호소한 환자에서 복벽에 발생한 자궁내막증 1예

        홍현진,박성한,이준식,배용목,김지연,안광순,박선자 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.1

        Endometriosis is the abnormal growth of endometrial tissue outside the uterine cavity. Endometriosis in the abdominal scar following cesarean section is very rare condition among the extrapelvic endometriosis. The frequency of abdominal wall endometriosis secondary to cesarean section is from 0.03% to 0.8% in some reports. It is difficult to diagnosed in spite of the typical symptoms. The typical symptom is aching swelling in the area of the surgical scar, which is influenced by the phases of menstruation. The definitive diagnosis is established by pathologic analysis. Surgical excision remains the treatment of choice. The majority of patients presented from 1 to 2 years after the precipitating operation. We experienced an unusual case of abdominal wall endometriosis presented over 10 years after cesarean section, who was admitted to our hospital complaining of recurrent left lower abdominal pain. So, we report this case with a brief review of the concerned literatures.

      • Celecoxib 유도체인 PCX-계열 화합물의 항염증 및 혈관신생 억제 작용

        소지현,안은경,전혜진,임은주,박은희 숙명여자대학교 약학연구소 2005 약학논문집-숙명여자대학교 Vol.22 No.-

        This study aimed to evaluate the pharmacological efficacies of PCX-series compounds, which were synthesized as prodrugs of celecoxib, a COX-2 selective inhibitor. Celecoxib, PCX-1, PCX-2, PCX-3, PCX-7, PCX-15 and PCX-16 provide potent anti-angiogenic activity in chorioallantoic membrane (CAM) assay. In addition, celecoxib, PCX-2, and PCX-16 showed anti-angiogenic activity in a dose-dependent manner. PCX-2 inhibited swelling in the carrageenan-induced rat paw edema test 24 hours after the administration. In the acetic acid-induced writhing test, PCX-7 and PCX-15 were verified to provide more potent analgesic effect than celecoxib 12 hours after the administration, and PCX-2 showed potent analgesic effect 24 hours after the administration. In the carrageenan-induced rat air pouch model, PCX-2 significantly decreased exudate volume, number of leukocyte and NO level. In the ulcerogenic activity test, PCX-2, PCX-7, PCX-15, and PCX-16 showed significantly less ulcer formation than indomethacin. Especially, PCX-7 showed the highest safety in the GI safety test. These findings provide novel pharmacological knowledge on pharmacological actions of celecoxib and its PCX-series compouds.

      • KCI등재후보

        Propofol 정맥 주사 시 Metoclopramide의 통증 완화 효과

        김수진,박은지,안승원,김웅,김미운,임현술 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

        Background: Propofol is a good induction agent. but it has a disadvantage of pain on intravenous injection. Pretreatment of metoclopramide or lidocaine have been reported to reduce pain on injection. thus, we have evaluated the quantity and quality of anagesic effect of metoclopramide and lidocaine. We observed differences in quality of pain according to venous cannula sizes and intravenous injection sites as well as nausea and vomiting in the postoperative state. Methods: Eighty patients scheduled for an elective operation by general anesthesia were chosen according to ASA (Ⅰ or Ⅱ) and divided into four groups randomly. Each group was injected through venous cannulas with normal saline (control group), metoclopramide 5 mg (group 1), netoclopramide 10 mg (group 2), or 2% lidocaine 40 mg (group 3) respectively. Then, propofol was injected of a 2 mg/kg dose with 0.5 ml/sex to all groups and we asked questions about injection pain after 10 seconds. Results: Pain relief was shown in all groups compared with the control. but metoclopramide 10 mg and lidocaine 40 mg pretreatment groups showed significant pain reief. Pain was relieved significantly when the drug was injected in the antecubital area. Postoperative nausea and vomiting were not observed. Conclusions: Metoclopramide 10 mg or lidocaine 40 mg pretreatment to induction by propofol revealed a good analgesic effect for propofol injection pain. (Korean J Anesthesiol 2002; 43: 558~565)

      • SCOPUSKCI등재

        당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

        김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

        연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

      • 우측 대장에 발생한 연소성 용종 1예

        이준식,박성한,홍현진,안광순,김지연,배용목,이은영,박선자 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

        Juvenile polyp, also known as a retention polyp because they contain mucin cysts, is a relatively common hamartomatous lesion in chlidhood. It occurs in 1-2% of children and young adults; however it is uncommon in adulthood. Juvenile polyp is rare in the first year of life and is thus presumed to be acquired and not congenital. It is pedunculated, 2-3 cm in size, red-tan in colour, smooth and always shows fluid filled cystic spaces on cut surface. Histologically, Juvenile polyps are hamartomatous with distended, mucus-filled glands, often with cystic dilatation and edematous lamina propria containing abundant vasculature. The most common manifestation is rectal bleeding produced by auto-amputation of the polyp. Juvenile polyp has been considered not to be at increased risk of developing carcinoma. However, atypical epithelium is observed in some lesions, especially in larger polyps, which may give rise to adenoma and subsequent malignant transformation. Therefore the diagnosis of solitary juvenile polyp should not be made only with colonoscopy and biopsy, but should be totally resected endoscopically for pathologic evaluation. About 90% of the lesions are solitary and localized within 20cm from anal verge. In Korea, there are some reports of juvenile polyps located in the rectosigmoid colon. We report one case of juvenile polyp in adolescent that presented as a hematochezia & abdominal pain, which is located at right colon.

      • KCI등재

        Programmed death-1 (PD-1) ligand 1 and PD-1 ligand 2 expressions and their clinical relevance in colorectal cancer

        Jee Hyun Ahn,Hyun Yong Lee,Dong Hyun Kang,Geum Jong Song,Tae Sung Ahn,Myoung Won Son,Moon Soo Lee,Moo-Jun Baek 대한종양외과학회 2017 Korean Journal of Clinical Oncology Vol.13 No.2

        Purpose: Programmed death-1 and its ligands (PD-L1 and PD-L2) can induce T-cell apoptosis in many solid tumors, although there is limited information regarding their roles in colorectal cancer. Methods: We used immunohistochemistry to retrospectively examine expressions of PD-L1 and PD-L2 in paraffin-embedded specimens from 104 patients with colorectal cancer. Results: Among the 104 included patients, 31 patients (29.8%) had positive PD-L1 expression and 73 patients (70.2%) had negative PD-L1 expression. Positive PD-L2 expression was observed in 83 patients (79.8%) and negative PD-L2 expression was observed in 21 patients (20.2%). Positive PD-L1 expression group showed higher overall survival rate (OS) and disease-free survival (DFS) than negative PD-L1 expression group. However, the overall survival and DFS were not significantly different between positive and negative PD-L2 expressions group. The multivariate analyses revealed that short OS was independently associated with positive PD-L1 expression (hazard ratio [HR], 2.781; 95% confidence interval [CI], 1.284–6.026; P=0.01), regional lymph node status (HR, 2.611; 95% CI, 1.258–5.418; P=0.01), and distant metastasis (HR, 4.279; 95% CI, 1.449–12.638; P=0.009). In addition, short DFS was independently associated with positive PD-L1 expression (HR, 2.846; 95% CI, 1.393–5.815; P=0.004) and regional lymph node status (HR, 2.310; 95% CI, 1.122–4.758; P=0.023). Conclusion: Although prospective multi-center studies are needed to validate our findings, we found that PD-L1 expression predicted OS and DFS among patients with colorectal cancer.

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