비침습적 지표들을 이용한 관상동맥 중증도 평가

윤세희 ( Se Hee Yoon ),배장호 ( Jang Ho Bae ),김기영 ( Ki Young Kim ),현대우 ( Dae Woo Hyun ),김완호 ( Wan Ho Kim ),구훈섭 ( Hoon Sup Koo ) 대한내과학회 2005 대한내과학회지 Vol.69 No.5

목적 : 관상동맥 경화증이 있는 환자군에서 관상동맥 경화의 정도와 비침습적 동맥 경화 지표와의 사이에 상관관계가 있는지 알아보고, 이들 지표들간의 상관관계가 있는지 알아보고자 이 연구를 시행하였다. 방법 : 관상동맥 조영술상 병변이 확인되고 비침습적 동맥경화 지표(경동맥 내중막 두께, 동맥 경직도, 내피세포 기능)를 동시에 시행한 연속적인 275명의 환자(평균 연령; 60세, 남자; 140명)를 대상으로 하였다. 관상동맥 경화의 정도는 50% 이상의 협착이 있는 주요 관상동맥 수에 따라 0, 1, 2, 3으로 분류하여 동맥 경화지표에 따른 상관관계를 비교하였다. 관상동맥의 협착이 10% 이상 50% 미만인 경우를 0으로 하였다. 경동맥 내중막 두께는 고해상도 초음파와 MATH software를 이용하여 반자동으로 측정하였고, 내피세포 기능은 상완 동맥 혈류의존 확장능(FMD, %)을 구하여 측정하였고, 동맥 경직도는 맥파속도를 대동맥, 하지 동맥, 상지 동맥에서 각각 측정하여 분석했다. 결과 : 경동맥 내중막 두께는 0군(n=125), 1군(n=75), 2군(n=38), 3군(n=21)에서 각각 0.85±0.16㎜, 0.88±0.15㎜, 0.91±0.19㎜, 0.98±0.18㎜로 관상동맥 경화의 정도에 따라 유의하게(r=0.211, p=0.001) 증가되는 경향을 보였다. 동맥 경직도와 내피세포 기능은 관상동맥 경화 정도에 따른 유의한 변화가 관찰되지 않았다. 경동맥 내중막 두께는 이들 지표들 중 대동맥의 경직도와만 서로 유의한 상관관계를 보였고(r=0.179, p=0.004), 대동맥 경직도는 하지와 상지의 동맥 경직도와 유의한 상관관계를 보였으나 다른 지표들과는 상관관계가 없었다. 내피 세포 기능과 상관관계는 이들 지표들 중에는 관찰되지 않았다. 결론 : 관상동맥 경화가 있는 환자군에서 관상동맥 경화의 정도와 상관이 있는 비침습적 지표로는 경동맥 내중막 두께였으나 독립적 인자는 아니었고, 이들 환자군에서 경동맥 내중막 두께는 대동맥 경직도와 유의한 상관관계가 관찰되었다. Background : We performed this study to evaluate the association between the extent of coronary atherosclerosis and the noninvasive atherosclerosis surrogates such as carotid intima-media thickness (IMT), endothelial function, and arterial stiffness in patients with coronary atherosclerosis. Methods : The study population was consisted of 275 consecutive patients (mean age; 60 yrs, 140 males), who had coronary atherosclerosis by coronary angiography. The extent of coronary atherosclerosis was classified to 0 (n=125), 1 (n=75), 2 (n=38), 3 (n=21) according to the vessel number narrowed by more than 50%. Carotid IMT was semi-automatically measured using MATH software and high-resolution ultrasound. Endothelial function was measured by flow-mediated brachial artery dilation (FMD, %). Arterial stiffness was measured by obtaining pulse wave velocity in the aorta, upper and lower extremities. Results : Carotid IMT was significantly (r=0.211, p=0.001) increased according to the extent of coronary atherosclerosis (0.85±0.16㎜, 0.88±0.15㎜, 0.91±0.19㎜, 0.98±0.18㎜, respectively). However, there was no significant association between the other surrogates and the extent of coronary atherosclerosis. Carotid IMT also showed the significant association with the aortic stiffness (r=0.179, p=0.004). There was not any more significant association among the other surrogates in this study. Conclusions : The extent of coronary atherosclerosis is associated with carotid IMT but not independently, only out of several noninvasive atherosclerosis surrogates in patients with coronary atherosclerosis. And carotid IMT is also associated with the aortic stiffness in this study population. (Korean J Med 69:493-502, 2005)

Icodextrin 복막투석 환자에서 혈당 측정

윤세희 ( Se Hee Yoon ),최낙원 ( Nak Won Choi ),윤성로 ( Sung Ro Yun ) 대한내과학회 2008 대한내과학회지 Vol.74 No.2

목적: GDH-PQQ를 이용한 혈당계로 icodextrin을 사용하는 복막투석 환자에서 혈당을 측정했을 경우 maltose 등의 다당류도 혈당으로 인식되어 실제 환자의 혈당보다 높게 측정될 수 있다. Accu Chek Active는 본원에서 사용하는 혈당계로 GDH-PQQ 방법을 사용하며 이를 이용하여 혈당을 측정하고 혈당 조절 중 저혈당 증세를 보이는 경우를 수 차례 경험하였다. 본 연구에서는 본원 검사실에서 측정한 혈당과 Accu Chek Active을 이용하여 측정한 혈당 수치를 비교 분석하였다. 방법: 2006년 2월 현재 건양대학교 병원에서 밤에 icodextrin으로 복막투석을 하고 있는 환자 7명을 대상으로 외래에서 12차례에 거쳐 검사실 검사와 Accu Chek Active검사를 비교하였다. 7명의 환자는 입원하여 06시, 11시, 16시, 21시에 각각 두 가지 방법으로 혈당을 검사하였다. 4명의 환자는 icodextrin을 4.25% 투석액으로 바꾸어 2일 동안 두 가지 방법으로 혈당을 측정하여 차이를 구하였다. 결과: Icodextrin으로 복막투석을 하는 환자에서 Accu Chek Active로 측정한 혈당과 검사실 검사는 평균 54±14 mg/dL(최소값: 22 mg/dL, 최대값: 85 mg/dL)의 혈당 과평가가 관찰되었다. 밤동안에 icodextrin을 사용하는 환자에서 Accu Chek Active을 이용하여 혈당 측정 시에 새벽에 icodextrin 투석액을 배액한 후에도 일중 변동은 거의 없었으며 50~56 mg/dL의 혈당 차이를 나타냈다. Icodextrin 투석액을 중단한 후 2일 동안 Accu Chek Active로 측정한 결과 48시간 후에 평균 26±30 mg/dL로 측정 값의 차이가 감소하는 것을 알 수 있었다. 결론: Icodextrin으로 투석을 하는 복막투석 환자에서 혈당 측정 시 GDH-PQQ을 이용한 혈당 측정계를 사용하면 혈당이 과평가 될 수 있으며 이를 고려하여 혈당검사 및 당조절을 해야겠다. Background/Aims: Icodextrin (glucose polymer) is metabolized by a-amylase to oligosaccharides such as maltose and maltotriose. The presence of these metabolites could have an effect on the enzymatic glucose measurement especially the glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) based method. Patients treated with icodextrin are at risk for inaccurate blood glucose measurements. In this study we measured the blood glucose with different methods and analyzed the results to determine the test accuracy. Methods: The blood glucose was measured, in seven outpatients and in seven inpatients using icodextrin, by the glucose hexokinase laboratory technique method as well as the GDH-PQQ method (Accu Chek Active) at the same time. To estimate an icodextrin residual effect, after discontinuing icodextin, the blood glucose was measured by the two methods after 48 hours in 4 inpatients. Results: In seven outpatients the blood glucose was overestimated by the Accu Chek Active method (mean difference 68 mg/dL, p value 0.012). In seven inpatients the mean difference in the glucose was 56 mg/dL at 6am, 52 mg/dL at 11am, 52 mg/dL at 4pm, and 50 mg/dL at 9pm by the two different methods. In the four inpatients after changing their dialysate, the mean difference in the glucose was 58 mg/dL after 10 hours, 45 mg/dL after 24 hours, 24 mg/dL after 34 hours, and 26 mg/dL after 48 hours. Conclusion: Blood glucose was overestimated by the GDH-PQQ method and the inaccuracies were observed for more than 48 hours. (Korean J Med 74:170-175, 2008)

지속성 외래 복막투석 환자에서 발생한 Candida Zeylanoides 복막염 1예

윤세희 ( Se Hee Yoon ),이고은 ( Go Eun Lee ),양동주 ( Dong Ju Yang ),최낙원 ( Nak Won Choi ),윤성로 ( Sung Ro Yun ) 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1

혈청 보체 C3가 감소된 특발성 원섬유성 사구체신염

윤세희 ( Se Hee Yoon ),강구흠 ( Gu Hm Kang ),윤성로 ( Sung Ro Yun ),최낙원 ( Nak Won Choi ),김윤미 ( Yun Mi Kim ),임범진 ( Bum Jin Lim ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.3

A 72-year-old woman presented with generalized edema and proteinuria. Renal biopsy disclosed highly organized fibrillary deposits in subendothelial area by electron microscopy. The microfibrils were 14 nm in diameter and randomly arranged. They did not have a microtubular appearance. These materials were negative for Congo red staining. Cryoglobulinemia or paraproteinemia including light chains was not found. So we can diagnose her as fibrillary glomerulonephritis (GN). In fibrillary GN serum complement levels are usually normal except in rare cases with systemic disease. Here we present a rare case of fibrillary GN with unusual hypocomplementemia.

키토산-폴리우레탄 혼합용액(混合溶液)으로 처리(處理)된 면직물(綿織物)의 KES에 의한 태분석(態分析) (2)

윤세희 ( Se Hee Yoon ),전동원 ( Dong Won Jeon ),김종준 ( Jong Jun Kim ) 한국패션비즈니스학회 2004 패션 비즈니스 Vol.8 No.1

The purpose of this study is to investigate the change of handle when cotton fabric is treated with chitosan-polyurethane mixed solution and crosslinked with epichlorohydrin in order to form three-dimensional crosslinks in the molecules, which in turn would improve the wash-fastness of the chitosan-treated fabrics. The application of epichlorohydrin decreased the EM(Tensile extensibility) and WT(Tensile energy) values, indicating the stiffness increased in the treated fabrics due to the 3-dimensional crosslinking. The crosslinking of the cotton fabric samples resulted in the increase in T.H.V. effectively for the use of summer dress shirt fabric.

다발성 폐공동을 형성한 베체트병

윤세희 ( Se Hee Yoon ),손지웅 ( Ji Woong Son ),정청일 ( Chung Il Joung ),최유진 ( Eu Gene Choi ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.1

Behcet`s disease is a systemic vasculitis of an unknown etiology involving the arteries and veins of all sizes. There are reports showing that a pulmonary artery aneurysm or thromboembolism and superior vena cava thrombosis are present in 5-10% of patients with Behcet`s disease and that lung parenchymal lesions are mainly airway consolidations resulting from hemorrhage or infarction. We encountered a patient with increasing pulmonary cavitary changes and localized aspergilloma. The patient was a 43-year-old man diagnosed with Behcet`s disease with a history of recurrent oro-genital ulceration and uveitis, and who was administered methotrexate, colchicines, prednisolone. During the follow up he developed progressive dyspnea upon exertion and finger clubbing. Therefore further evaluations were performed. Chest computed tomography showed more advanced consolidations and cavitations than the previous film with the previously known aspergilloma still observable. An open lung biopsy was carried out to determine the presence of malignant changes, which revealed nonspecific vasculitis. Azathioprine was added resultion in an improvement of symptoms. (Tuberc Respir Dis 2006; 61: 65-69)

키토산-폴리우레탄 혼합용액(混合溶液)으로 처리(處理)된 면직물(綿織物)의 KES에 의한 태분석(態分析) (1)

윤세희 ( Se Hee Yoon ),전동원 ( Dong Won Jeon ),김종준 ( Jong Jun Kim ) 한국패션비즈니스학회 2004 패션 비즈니스 Vol.8 No.1

Chitosan, the natural biodegradable polymer derived from chitin by de- acetylation, has been widely applied to the textile finishing processes for excellent anti-microbial characteristic and handle improvement of fabric. The purpose of this study is to investigate the change of handle when cotton fabric is treated with chitosan-polyurethane mixed solution. The viscosity values of chitosan solutions were 8cps and 50cps, and the wet-pick-up% was maintained at 90%. In case of mixing with water soluble polyurethane, the mixture ratio of chitosan and polyurethane was settled on the solid content ratio of 1:0, 1:0.5, 1:1, 1:2. Also the change of physical properties by neutralization in NaOH solution was studied. The results can be summarized up as follows : 1. Extensibility(EM) and tensile energy(WT) of cotton fabric treated with chitosan are decreased, but bending rigidity(B) is remarkably increased. With the addition of polyurethane, the decrease of EM and WT is weakened and the increase of B is weakened. The case of neutralization is similar to the case of polyurethane addition. 2. By treating fabric with chitosan, FUKURAMI(Fullness and softness) is decreased, but KOSHI(Stiffness), SHARI(Crispness), HARI(Anti-drape Stiff ness) are increased. With the addition of polyurethane, the decrease of FUKURAMI is diminished and the increase of KOSHI, SHARI, HARI are diminished. 3. As the viscosity of chitosan solution increased, the air permeability value increased. The addition of polyurethane decreased the air permeability.

칸딘스키 작품에 나타난 색채심리에 관한 연구

윤세희(Yoon Se Hee),안현정(Ahn Hyun Jung) 휴먼이미지디자인학회 2020 한국휴먼이미지디자인 Vol.2 No.2

본 연구는 인류 최초의 의도적인 추상화를 그렸고 특히 추상화 이론을 확립한 추상화의 대표적인 화가인 칸딘스키의 작품에 작가의 색채심리가 어떻게 나타나는가에 대한 연구이다. 이에 본 연구는 먼저 색채 전반에 관한 이론적 배경으로서 칸딘스키의 색채의 특성 및 상징과 인간의 심리에 미치는 작용을 고찰하였고, 칸딘스키의 탄생에서 타계까지 알아보며 주요 사건과 심리상태에 따른 대표작품 <철로와 성이 있는 무르나우 풍경, 1909>, <즉흥26, 1912>, <모스크바Ⅰ, 1916>, <구성Ⅷ, 1923>, <완화된 비약, 1944>를 선정하여 작품 속에 나타난 작가의 심리에 대해 알아보았고, 다음과 같은 결론에 도달하였다. <철로와 성이 있는 무르나우 풍경>에서는 목판화 양식에서 벗어나 유화로 그린풍경화로 처음으로 변화를 시도한 시기와 야수주의와 나비파 작품에 영향을 받아 작가의 심리가 따뜻함과 강렬한 대조를 활용하여 불안정함으로 표현되어 졌다는 것을 알 수 있었다. <즉흥26, 1912>에서는 ‘청기사파’의 활동과 전시를 계획하고 새로운 인간관계에 적극적으로 참여하면서 추상화로 가는 길에 결정적 시기의 영향을 받아 연상적 지시물을 점차 거듭난 것에서 순수한 색을 통한 표현으로 이 시기 그의 그림에서 칸딘스키의 진보적인 움직임의 심리가 나타났다는 것을 알 수 있었다. <모스크바Ⅰ, 1916>에서는 러시아 예술계와 밀접한 관계를 유지하였고, 당시 장교의 딸인 니나와 결혼한 시기로서, 이 작품에서는 소박하고 밝은 색채와 전체 분위기 속에서 드러나듯 희망적이고, 낙관주의적인 양상이 두드려지며 그의 의도와 상관없이 죽음을 연상시켰던 청기사파 이후 희망적이고 기쁨에 넘친 미래관, 지상낙원을 이루고자 했던 심리를 작품에 표현하고자 했던 것을 알 수 있었다. <구성Ⅷ, 1923>에서는 어렵게 독일 베를린으로 돌아온 칸딘스키가 당시 추상회화의 반대되는 경향인 베를린 미술계의 영향을 받아 바우하우스 수업에서 기술적이고 기능적인 과정을 지향하며 분석적 수업과 강한 합리주의 방침에 따라 제작되어 작가의 심리의 영향을 미쳐 뮌헨 모스크바 시절 그림에서 보였던 열정적 색채는 사라지고, 차갑고 조화롭지 않은 색채가 사용됐다는 것을 알 수 있었다. <완화된 비약, 1944>에서는 이 시기 칸딘스키는 작은 아파트에서 은둔생활을 하며 소박한 환경에서 작업하면서 영혜를 뒤돌아보는 노년의 평온한 언어로서 칸딘스키의 유작인 이 작품은 색채가 가라앉은 느낌인 데다 전쟁 시기 다른 어떤 그림만큼이나 외적이거나 내적인 위협이 없고, 칸딘스키가 끝까지 확신한 내적 세계가 잘 표현되어진 것을 알 수 있었다. 본 연구를 연구하는 데 있어 칸딘스키의 작품으로만 색채심리를 분석하는데 제한점이 있었는데 이러한 한계점을 보완하면 보다 정확하게 분석할 수 있을 것이라 기대한다. This study attempted to investigate color psychology in the paintings of Wassily Kandinsky, who painted intentional abstract paintings for the first time in human history and established the theory of abstract painting. For this, his color concept, associated images, and psychological actions were reviewed as a theoretical background colors. Then, his lifetime from birth to death and his mental state in his works (‘Murnau View With Railway and Castle (1909),’ ‘Improvisation 26 (1912),’ ‘Moscow I (1916),’ ‘Composition Ⅷ (1923),’ ‘Tempered Elan (1944)’) were examined, and the results found the followings: ‘Murnau View With Railway and Castle (1916)’ is a landscape painted with oil, escaping from woodprint patterns. It was confirmed that the painter’s unstable mental state was expressed with a strong contrast with warmness under the influence at the time of his first attempt for change, fauvism, and Les Nabis paintings. In ‘Improvisation 26 (1912),’ the activities and exhibitions of Der Blaue Reiter (The Blue Rider) were planned. With active participation in new interpersonal relationships, there is an influence on the way of abstract paintings during a critical period. Then, associated referents are gradually reborn and expressed with pure colors and shapes. The boats deformed in a diverse manner in his paintings revealed his progressive mindset. In ‘Moscow Ⅰ (1916),’ a close relationship with the Russian art world was maintained. At that time, he married Nina, the young daughter of a colonel. This painting reveals hopeful and optimistic patterns with humble and bright colors. Regardless of his intention, there was an attempt to express his desire to have a hopeful and happy future and achieve a heaven on earth as compared to the death-associated Der Blaue Reiter (The Blue Rider). In ‘Composition Ⅷ (1923),’ he returned to Berlin and pursued a descriptive and skillful course during the Bauhaus under the influence on the Berlin art industry, which was against abstract painting at that time. The passionate colors which were observed during the Munich and Moscow years disappeared due to the analytical class and the strong rationalism policy. Instead, cold and disharmonious colors were used. In ‘Tempered Elan (1944),’ he lived in a small apartment, secluded from the world. This posthumous work was created in a humble environment with peaceful language. It reveals his clear inner world very well without any internal or external threats from war with the use of calm colors. This study has some limitations in analyzing his color psychology. Once they are overcome, however, it is anticipated that the analysis of his paintings could become more precise.

증례 : 신장 ; 비스테로이드 소염제 복용 후 발생한 신경색

윤세희 ( Se Hee Yoon ),김용림 ( Yong Lim Kim ),박선희 ( Sun Hee Park ),김찬덕 ( Chan Duck Kim ),최지영 ( Ji Young Choi ),윤성로 ( Sung Ro Yun ) 대한내과학회 2012 대한내과학회지 Vol.82 No.5

Nonsteroidal anti-inflammatory drugs (NSAIDs) are popular in general practice. Their adverse renal effects have been well documented. Common NSAID-related renal side effects range from dysfunctional renal hemodynamic responses, nephrotic syndrome, electrolyte disturbances, acute interstitial nephritis, chronic interstitial nephritis with papillary necrosis, and acute flank pain syndrome to acute renal failure. Decreased prostaglandin synthesis can lead to renal ischemia and hemodynamically related acute renal failure. Cases of acute renal failure syndrome accompanied by severe loin pain after anaerobic exercise (ALPE) or binge drinking have previously been reported in individuals taking NSAIDs. However, severe flank pain after high-dose NSAID treatment in the absence of other conditions (exercise or volume contraction) is rare. We report a case of a 51-year-old man who suffered from severe pain in both flanks after NSAID treatment. Computed tomography revealed hypodense lesions in both kidneys. (Korean J Med 2012;82:618-622)

복막투석으로 인한 복막염 환자에서의 세균배양법에 따른 민감도 차이

윤세희 ( Se Hee Yoon ),이고은 ( Go Eun Lee ),양동주 ( Dong Ju Yang ),최낙원 ( Nak Won Choi ),윤성로 ( Sung Ro Yun ) 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1