Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

영흥대교 유지관리 및 상태평가 시스템 개발

주관정(Joo Guan Jung),김동욱(Kim Dong Wook),천영철(Chun Young Chul),여영건(Lu Yung Chien) 대한토목학회 2005 대한토목학회 학술대회 Vol.2005 No.10

초음파 공명 분광법(RUS)을 이용한 SiC 입자강화 Al 기지복합재료의 탄성계수 해석

홍순형,주영상,정용무,정현규 韓國非破壞檢査學會 1999 한국비파괴검사학회지 Vol.19 No.3

SiC 입자강화 2124Al 금속복합재료의 강화재 부피분율에 따른 탄성 stiffness를 초음파 공명 스펙트로스코피(resonant ultrasound spectroscopy: RUS) 방법을 이용하여 측정하였다. RUS 방법은 한 개의 소형 시편으로 9개의 독립변수를 가진 사방정계(orthorhombic) 탄성계수를 간단한 실험으로 측정가능함을 보여주었다. SiC 강화재 부피분율 변화에 따른 탄성계수를 측정하였는데 이 경우 초기 추정 탄성계수를 구하기 위해서 부피분율에 따른 미세조직 사진으로부터 강화재의 형상(aspect ratio)과 방향을 고려한 유효 aspect ratio 개념을 도입하였고, Mori-Tanaka 이론식에 의한 계산결과를 이용하였다. 이로부터 계산된 공진주파수와 RUS의 측정 공진주파수 사이를 최소화함으로 정확한 탄성계수를 측정하였다. 측정된 stiffnesses로부터 공학적 탄성계수인 Young's modulus를 계산하였으며, 계산된 Young's modulus와 압출방향으로 인장시험한 Young's modulus를 비교분석하였다. SiC 입자의 부피분율이 증가함에 따라 탄성계수가 증가함을 나타내었고, 탄성 stiffness의 거동은 강화재가 많이 첨가될수록 횡등방성(transversely isotropic) 이 강하게 나타났으며 이것은 압출공정에 의해 강화재 입자의 방향성 재배열에 기인한다. 한편 일정크기 시편에 있어서 기본 공진주파수가 강화재 부피분율에 따라 고주파수 영역으로 이동하는 현상이 관찰되었으며, 이로 부터 비파괴적으로 강화재 부피분율을 예측할 수 있는 가능성을 제시하였다. The dynamic elastic properties of metal matrix composites were investigated by resonant ultrasound spectroscopy(RUS). The composites used in this study consisted of 2124 aluminum alloy reinforced with different concentrations of SiC particles. RUS can determine the nine independent elastic stiffness(C )for the orthorhombic symmetry on a small specimen simultaneously. The elastic constants were determined as a function of the volume fraction. A concept of effective aspect ratio, which combine the aspect ratio and the orientation of reinforcement, was used to calculate the initial moduli from Mori-Tanaka theory for the input of RUS minimization code. Young's moduli can be obtained from the measured stiffnesses. The results show that the elastic stiffness increases with increment of the particle content. The behavior of elastic stiffness indicates that the particle redistribution induced by the extrusion process enlarges the transversely isotropic symmetry as the fraction of reinforced particles increase. This relationship could be used for determination of the volume fractions of reinforcement as a potential tool of nondestructive material characterization.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

만선신부전 환자에서 관상동맥조영술 소견에 관한 연구

한대희,김성구,박상호,김성한,조원영,방덕원,조윤행,정의룡,은영근,권영구 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background : Patients with chronic renal fialure have a substantially elevated risk of death from cardiovascular diseases than do the general population. the patients with chronic renal failure are at significantly increased freqeuncy of hypertension, hyperlipidemia, and diabetes mellitus which are known to the risk factors of the coronary artery diseases, and the prevalence of the coronary artery diseases in chronic renal failure patients is highly associated with the hemodynamic disorder and metabolic abnormalities. therefore we expected that the coronary angiographic findings in patients with chronic renal failure should be different from the general population (control groups) and investigated the risk factors contributing to coronary artery diseases. Method : we have retrospectively compared the coronary angiographic findings of 44 patients with chronic renal failure on hemodialysis with that of 88 patients in the general population and investigated the factors contributing to the development and acceleration of coronary artery diseases in patients with chronic renal failure Result : Hypertension and diabetes mellitus which is risk factors for coronary artery disease is significantly increased in patients with chronic renal failure, in coronary angiographic finding the severity of the lesion is worse. the incidence of PCI or CABG of patients with chronic renal failure is more than that of control group but statistically no difference between patients with chronic renal failure and control group. the sex, the duration of disease, the duration of dialysis, serum creatinine in patients with chronic renal failure have no correlation to the prevalence of coronary artery disease and severity of lesion. hyperglycemic patients with chronic renal failure have high incidence of coronary artery disease and are worse in the severity of lesion Conclusions : There is significantly increased the pevalence and severity of involving multiple coronary artery diseses in hyperglycemic patients with CRF.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

익산지역 초등학교 고학년의 비만지표별 비만도와 식습관에 대한 연구

주은정,김인숙,김영순,서은아 대한지역사회영양학회 2001 대한지역사회영양학회지 Vol.6 No.1

The purpose of this study is to determine the prevalence of obesity and to examine the eating habits of elementary school students in Iksan city. The study was carried out on 292 students(male : 151, female : 141) in May of 1997. The average height and weight of the subjects were 141 cm and 37 kg in males and 142 cm and 36 kg in females, which were similar to the average of Chonbuk. A Weight/Length Index(WLI), Broca Index, Ro¨hrer Index(RI), Body Mass Index(BMI) and Waist Hip Ratio(WHR) were used as an obesity index to classify degree of obesity, WLI, Broca Index and RI were proper for judging child obesity and strict judgments were conducted in the order of RI, WLI and Broca Index. The subjects were classified as 30.8% underweight, 43.5% normal, 8.2% overweight and 17.5% obese by WLI and there were significant differences between height (p < 0.05) and weight(p < 0.01) according to obesity degree among the four groups. 50.3% of the boys and 55.3% of the girls ate regularly, and the main reason they didn't eat breakfast(78.4%) was due to lack of time. The frequency of snacks were 1-2 times a week(40.4%), fruits(40.4%) from market and supermarket(68.2%). According to the survey 84.6%, 77.4%, 78.1%, 69.9%, 59.9% and 86.6% of subjects didn't eat meat, fish, soysauce, instant food, sugar and seaweed respectively. Seaweed, meat, and soysauce showed low preferences. 69.5% and 74.7% of the subjects drink milk and ate kimchi respectively. By analyzing eating habits according to the degree of obesity, the rate of skipping breakfast(p < 0.01), and eating meat or fish(p < 0.05) were high in the overweight and obese groups of girls. In the boys case, the rate of not eating food in sugar(p < 0.05) was high in the obese group. Obese children need to correct their eating habits. This reasserts the importance of nutrition education in children through teachers, parents, and dietitions. The findings of this study may be applied to nutrition education to ensure better physical fitness for children.

영국 애틀리 정부의 대 말라야 정책 : 정부와 기업의 갈등과 이해 Governments and Business with regard to British Malayan Policy, 1945-1951

정영주 한국서양사학회 2004 西洋史論 Vol.0 No.80

This paper seeks to make an assessment of the nature of the interactions between the British and Malayan governments and British private firms with business interests in Malaya during the Attlee governments. The purpose of this research is to analyse the role of London government as a main decision-maker, for some scholars, such as Caldwell, Rudner, Puthucheary, recognise it as the only decision-making organization. This research focuses on the matters regarding the implementation of the Malayan Union Constitution, labour disputes, and the Malayan Emergency. My findings suggest : firstly, the London government was hardly a forceful metropole, but reconciled with Malays when changing constitutions and respected the opinions of British administrators on the spot ; secondly, the difference between business and governments upon labor disputes were apparent. Business could not convince the governments to act upon strikes and demonstrations which were disturbing to their production. In terms of labour problems British government took a legal and gradual approach, whereas business wanted to apply coercive measures. Thirdly the studies on the series of issues regarding the Emergency undertaken here confirm taht business did enjoy a certain degree of influence and privilege in terms of access to information and communication with the governments. But on the other hand, despite their contribution and lobbying, they certain issues about which business was able to exert little influence. The reason lies in the fact that success in Malaya was more significant to Britain than it was elsewhere, not least because Malaya was the basis of British interests in SEA, and the USA was watching, and so was India. From the point of view of Britains political elites, governing should be firmly based on principles that should not be swayed by any convenience, or by pressure exerted by business. In this sense, Caldwell too narrowly focused on Britain's economic interest in Malaya while neglecting its governing responsibilities and the consequent pressure on the British government upon progressivism, and the liberal attitude within the Malayan administration. Indeed, businesses still trusted that the governments would not neglect business interests. However this trust was borne more of confidence that governments would continue to seek to uphold businesses' contribution to the national interests of both metropole and Malay, rather than their will and ability to protect business interests per se.

NFI-C 결손 생쥐의 상아모세포 분화과정에서 DSPP와 BSP mRNA의 발현

정현구,이창섭,,이상호,이난영,김홍중,박주철 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.4

NFI-C는 정상적으로 상아모세포, 골모세포에 존재하며,NFI-C가 결손된 경우 치근상아질을 형성하는 상아모세포의 분화에 이상이 있다고 알려져있다. 본 연구는 NFI-C(-/-) 생쥐에서 치관 및 치근의 상아질을 형성하는 상아모세포의 표현형을 상아모세포에 특이적으로 발현하는 DSPP와 골모세포에 특이적으로 반응하는 BSP 유전자를 이용한 in-situ hybridization을 통하여 연구하여 다음과 같은 결과를 얻었다. 1.NFI-C(-/-) 생쥐의 구치에서 치관 상아질은 정상적으로 형성되었으나, 치근 상아질은 형성되지 않았다. 2.NFI-C(-/-) 생쥐의 하악 절치의 순측 상아질은 비교적 많이 형성되었으나, 설측의 상아질은 형성되지 않았다. 3.NFI-C (-/-) 생쥐의 하악 절치의 상아모세포는 형태가 변화되었으며, 형성된 상아질 내에 세포가 함입되는 양상을 보였다. 4.NFI-C (-/-)생주의 구치에서 치관부위의 상아모세포에서는 DSPP가 강하게 발현되었으나. 치근부위의 상아모세포에서는 발현되지 않았다. 또한 NFI-C(-/-) 생쥐에서 절치의 순측 상아모세포에서는 DSPP가 약하게 발현되었다. 5. 정상 생쥐에서 절치의 상아모세포에서는 BSP가 발현되지 않았으나. NFI-C (-/-) 생쥐에서는 BSP가 강하게 발현되었다. 이상의 결과를 종합하여 볼 때 NFI-C가 결손된 경우 상아모세포가 골모세포로 분화되는 표현형의 변화를 보이는 것으로 사료된다. Nuclear factor I (NFI) exists in the odontoblast and osteoblast.NFI-C null mice demonstrated aberrant odontoblast differentiation, abnormal dentin formation, and molar lacking roots. The purpose of this study was to examine phenotype of the aberrant odontoblast in NFI-C null mice and to evaluate the expression of DSPP and BSP mRNAs in NFI-C null mice with in-situ hybridization. The results were as follows: 1.In the NFI-C (-/-) mice, the crown dentin of molar showed normally formation, but there was no root dentin. 2.In the NFI-C (-/-) mice, the labial dentin of mandibular incisors showed relatively a lot of dentin formation, but the lingual dentin showed defect. 3.In the NFI-C (-/-) mice, the odontoblast of mandibular incisors revealed abnormal shape and trapped in osteodentin-like mineralized tissue. 4.In the NFI-C (-/-) mice, the odontoblast in the crown dentin of molars showed strong expression of DSPP, the odontoblast in the root dentin of molars was not expression of DSPP. In the NFI-C (-/-) mice the odontoblast in the mandibular incisors showed weekly expression of DSPP. 5.In the wild mice, the odontoblasts of mandibular incisors were not expression of BSP, but in the NFI-C (-/-) mice the odontoblast of mandibular incisors showed strong expression of BSP. These results suggest that odontoblst in the NFI-C (-/-) mice changes the phenotype into osteoblast.