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)

우심방을 침범한 거대 비호지킨씨 림프종 1예

강상범,진승원,이은경,박용현,최용호,김용주,박준철,김재형,홍순조,최규보,권종범,원용순,박건,이은희 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

상온재생 유화아스팔트 개질 혼합물의 배합방법 및 특성에 관한 실험적 연구

박승범,권혁준,이봉춘,김선용 충남대학교 산업기술연구소 1999 산업기술연구논문집 Vol.14 No.2

Recently, the quantities of waste asphalt concrete at construction sites have much increased greatly, but maintaining a filling-up and final disposal place is a difficult problem. Therefore, we are faced with a worsening environmental problem brought about present illegal measures. One of the most effective recycling method is cold recycling. This method will satisfies treatment and recycling of construction waste is a very important question in the preservation of environmental and natural resources. So, in this paper, we dealt cold recycling modified mixtures using emulsified asphalt to concern the effect of adding reclaimed asphalt concrete 30, 40, 50%, and using SBR Latex for modified mixtures.

炭素纖維補强 매트릭스 複合體(CFRC)의 物理的 特性(Ⅰ)

박승범,권순욱 忠南大學校 産業技術硏究所 1988 산업기술연구논문집 Vol.3 No.2

In order to examine the physical properties of carbon fiber reinforced composites with the short random carbon fibers, experimental studies of fresh and hardened CFRC were carried out, The types of fiber used are pitch-based carbon fiber and high modulus PAN type carbon fiber. To examine the effects of the types, lengths, constents of CF and matrices, the following two types of CFRC were tested ; air cured CFRC and autoclaved CFRC. According to the test results, it can be concluded that the reinforcement of CF were considerably effective in improving tensile strength, flexural strength and toughness of cement matrices compared to conventional cement mortar.

회전근 개 병변에서 골 단일광자방출전산화 단층촬영과 단순 방사선 사진의 비교

박진영,박선건,김승철,임종범 단국대학교 2000 論文集 Vol.35 No.-

purpose : The increased uptake on the bone scan represents the zone of increased bon metabolism. Single photon emission computerized tomography(SPECT) is more precise in detecting lesions of increased uptake than planar bone scan. The purpose of this study is to examine applicability of bone SPECT to shoulder lesions and to analyze the efficacy of SPECT compared with simple X-ray in rotator cuff lesion. Materials and Methods : Subjects were 21 patients with of rotator cuff lesion confirmed by surgical(arthroscopic or open) procedure. Increased uptake(bone SPECT) and sclerosis of greater tuberosity and anterior acromion on X-ray were considered positive. Results : For acromion, sensitivity of the bone SPECT was 90.9% and specificity was 50.0%. For greater tuberosity, sensitivity was 92.3% and specificity 37.5%. For acromioclavicular joint, sensitivity was 80.0% and specificity 81.3%. Conclusion : This study demonstrates that the uptake of radioisotope in shoulder is increased in patients with painful partial or total rotator cuff tear. And extrinsic mechanical pressure seems to be the cause of rotator cuff lesion of the shoulder.

粘土鑛物의 混入이 Mortar의 性狀에 미치는 影響에 關한 實驗的 硏究

朴承範,權吳憲 충남대학교 공업기술개발연구소 1976 工業技術開發硏究所論文集 Vol.3 No.2

This paper discribes an experimental study on the properties of Cement-Bentonite mortar for grouting. Recently, low strength cement mortar mixed with clay minerals has been widely employed in foundation treatment, cutoff wall and curtain, strengthening soft soil layer, etc. The experiments were intended to clarify the properties of the cement mortar with the bentonites which were available in the local market. Of the study, fluidity, tendency of segregation and compressive strength of mortar were analyzed with two kinds of clay minerals, namely, A and B-Type Bentonite.

전문 마라톤화용 기능성 개발을 위한 운동역학적 연구(Ⅰ)

박승범,서국웅,김용재 한국운동역학회 2001 한국운동역학회지 Vol.11 No.3

Various approaches can be used to study a special field such as biomechanical aspects of marathon shoes. A runner who wants to buy a pair of running shoes is confronted with a wide range of models, ranging from inexpensive to expensive, from soft to hard, and from red to yellow. These marathon shoes may have special features like wedges or exchangeable damping elements which visually underline the special quality of the shoes. Advertisements for running shoes in marathoner's magazines explain their products by using words such as "support", "rearfoot control", "cushioning", "shock distributor" and "heel stabilizer". One aspect of marathon shoes biomechanical design is the protection and /or the reduction of injuries. In other words, it is aspect of forces acting on the human body, and also the effects these forces produce in this system. The problems can be studied using theoretical techniques using mathematical models and some of these are discussed int below. A marathon shoe must fit not only overall length and ball width, but with respect to several other aspects such as the instep, arch, top lines, and heel and toe curve. A marathon shoes must fit your biomechanical needs very, very well. Match the support in the shoe as closely as possible to your pronation factor, or how much motion your feet experience when on the ground. Marathon shoes must fit your feet even better than the proverbial glove. They swell from the ramped-up circulation that accompanies continuous activity, and may actually spread out a bit as the 26 bones and dozens of tendons, ligaments and muscles in each foot adapt to several hours of pounding. Marathon shoes should be racing flats only if you think you can win. What makes no sense is to think that is significant when compared with how hard your shoes have to work during the last few miles to support your rapidly fading body. Lightweight shoes mean lightweight support. A large variety of elements which have various names, such as inserts, arch supports, arch cookies, orthotics, and orthoses, can be put into a shoes. The inserts for the sports shoe market consist of many different types of plastics and E.V.A(Ethylene Vinyl Acetate). Another type of insert is the built-in insert which is incorporated into or onto the sole of the shoe. This is a rather rare form of conventional shoe construction. Changes in midsole geometry and material are only one of various strategies which can be used to alter the properties of a running shoe. Heel counters, heel stabilizers, insoles, inserts, additional wedges, and different lasts are some additional strategies used in running shoe construction. Many of them are used in combination with others which may introduce additional problems in quantifying their effects. An athlete can use external elements to influence load and stress on his body. The two most important ones are the running shoe and the surface. On the other hand, he or she can use internal elements which anre muscles, tendons, ligaments, and so forth, and his or her running style. Careful exercise and control of these elements is an important factor in the attempt to reduce running injuries.

鐵筋 콘크리트 "L" joint의 耐震應答 特性에 關한 硏究

朴承範 충남대학교 공업교육연구소 1981 論文集 Vol.4 No.2

最近 地震荷重 및 이와 類似한 震動荷重에 對한 鐵筋콘크리트 部材의 安全한 設計施工問題가 대두되어 이에 關한 여러 硏究가 進行되고 있으며, 보나 거어더가 柱, 壁體 등과 상호교차되는 個所의 脆性硏究 및 破壞問題에 對한 對策이 切實히 要望되고 있다. 이에 本 硏究에서는 鐵筋콘크리트 보와 柱로 이루어지는 "L"形 鐵筋콘크리트 joint部材의 模擬地震荷重 條件下에서의 動的 應答特性을 究明하고자 反復荷重에 따른 joint區域과 보 및 기둥의 破壞性狀을 考察하였다. 特히 耐震構造物 설계에 主要 要素인 延性(μ)이 0.5, 1.0, 3.0일 때 각각 3回씩 그리고 μ=5.0일 때 部材가 完全히 파괴될 때까지 반복하여 荷重을 作用시키면서 이 때의 部材의 極限强度 및 그 變形性能을 LVDT System을 사용하여 調査分析하였으며, 균열性狀은 勿論 配筋效果에 對하여도 이를 究明하고자 努力하였다. 本 硏究 結果 무엇보다도 部材의 伸縮彎曲, 剪斷變形 等의 變形性能의 改善 및 보의 휨破壞에 對한 補强, 그리고 joint 區域의 剪斷補强은 耐震構造物 設計를 爲하여 重要 事項임을 확인하였다.

다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

박대원,정희진,엄중식,황병연,김성범,이재갑,이연주,정혜원,정성주,박재형,이진수,손장욱,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.