결핵균 약제감수성 검사의 비용효율성에 관한 다기관 연구

정석훈,이대동,최재철,김선주,신정환,정윤성,이은엽,오승환,배길한,장철훈 대한감염학회 2005 감염과 화학요법 Vol.37 No.1

목적 : 우리나라에서의 결핵균 감수성 검사는 검출 균주의 일부에서만 시행되고 있다. 본 연구에서는 모든 검출 균주들에 대해서 감수성검사를 실시하면서, 진료에 필요한 결과를 충분히 제공하고 경제적이면서 현실적인 감수성검사 방안을 제시하고자 한다. 재료 및 방법 : 5개 대학병원에서 일정기간 연속적으로 의뢰된 502균주의 감수성 결과를 분석하였다. 검사결과의 해석 및 2차 약제 감수성검사의 필요성은 NCCLS approved standard M24-A의 권고 기준에 따라 판단하였다. 결과 : 최소한 1가지 이상의 약제에 내성을 보인 경우는 초치료 환자의 10% (38/363), 재치료 환자의 61%(85/139)였으며, 다약제 내성을 보인 경우는 초치료 환자의 3% (11/363), 재치료 환자의 44% (61/139)였다. NCCLS 권고에 따라 2차 약제에 대한 감수성 검사를 시행하지 않아도 되는 경우는 초치료 환자의 96%, 재치료환자의 47%였다. 결론 : 초치료 환자는 95%에서 1차 약제에 대한 검사만으로 충분하므로 필요한 경우에만 2차 약제를 추가로 검사하고 재치료 환자에서는 1, 2차 약제를 동시에 검사할 필요가 있을 것으로 생각한다. Background : The anti-mycobacterial susceptibility test is performed on only a small percentage of clinical isolates in Korea. The aim of this study is to propose an anti-mycobacterial susceptibility testing scheme, which is not only economic and practical but also fully informative to physicians. Materials and Methods : The anti-mycobacterial susceptibility test results of 502 strains, isolated from five university-affiliated hospitals, were analysed. The interpretation of the results and the need for second-line drug susceptibility test were judged according to the recommendation of NCCLS M24-A guidelines. Results : The isolates from 10% (38/363) of treatment-navie patients and 61% (85/139) of retreatment patients showed resistance to at least one of the anti-mycobactial agents; 3% (11/363) and 44% (61/139) of isolates from each group were multi-drug resistant. According to the recommendation by NCCLS, the percentage of patients not needing the susceptibility test results for second-line drugs were 96% for treatment-naive and 47% for re-treatment patients. Conclusion : Since the susceptibility test against first-line drug is sufficient for 95% of treatment-navie patients with tuberculosis patients, susceptibility test against second-line drugs may be performed only when it is necessary. As for the re-treatment patients with tuberculosis, susceptibility test for both first-line and second-line drugs should be performed simultaneously.

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

파노라마 방사선사진에서 하악관과 이공의 관찰되는 정도

정성진,최의환,김재덕 대한구강악안면방사선학회 2001 Imaging Science in Dentistry Vol.31 No.3

Purpose : To determine the head position that the superior border of the mandibular canal as well as mental foramen can be more clearly visualized in panoramic radiography Materials and Methods : Ten dry mandibles were radiographed bilaterally using PM 2002 CC panoramic machine. A 20 mm thick aluminium filter was added to the slit collimator to obtain radiographs with acceptable density. The specimens were tilted by 2, 4, 6, 8, and 10 degrees downward with and without radiopaque markers. Radiopaque markers were inserted into the mandibular canals and the mental canals of each side of the specimens to serve as reference image when assessing the radiographs. The visibility of the mandibular canal and the mental foramen was estimated by 4 observers on all radiographs. The obtained results were analyzed statistically. Results : Mandibular canals were significantly more clearly visible in the radiographs with 4 and 6 degree downward position on both sides (P〈0.05). Mental foramens were significantly more clearly visible in the radiographs with 4, 6, and 8 degree downward on right side and 6 degree downward on left side (P〈0.05). There was not significant difference between right and left sides. Conclusion : Panoramic radiographs with 4 to 6 degree downward tilting could be valuable in locating the mandibular canal as well as the mental foramen. (Korean J Oral Maxillofac Radiol 2001; 31 : 153-8)

아크릴 부목을 이용한 하악골 골절의 새로운 치료법

정두성,박재현,김진환,최준 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

As modern society becomes increasingly complex, there has been a steady increase in violence, as well as in automobile and industrial accidents. This has resulted in an increased incidence of facial injuries, including mandibular fractures. Many methods have been advocated to achieve reestablishment of normal feature and function. The choice generally depends upon such factors as location of the fractures, displacements, status of the dentition and favorability of the fracture line. Many cases of mandibular fracture are treated by intermaxillay fixation using an arch bar or bite block(acrylic splint)for rapid bone union and minimal displacement. However, there had been some problems, such as discomfort to patients, limitation to eating and weight loss, poor oral hygiene, and temporomandibular joint ankylosis. As a consequence, we have modified the shape of the acrylic splint and method of fixation for circum-mandibular fixation instead of intermaxillary fixation. Acrylic splints are rigid, strong, easily adjusted and repaired, translucent, lightweight and well tolerated by the oral mucosa. The splints are properly secured to each tooth and bind all the teeth together as a single unit. Authors have used modified acrylic splints as tools of circum-mandibular fixation in 12 cases of mandibular symphysis and body fracture from May 1997 to August 1998, achieving the results of very good occlusal relationship, oral hygiene and comfort to patients.

一柱門의 建築形式에 關한 硏究

정대열,이재환,이용대,예명해 대구대학교 과학기술연구소 2001 科學技術硏究 Vol.8 No.2

The purpose of this study is to discover the architectural type of 「Il-joo-moon」 It deals with 「Il-joo-moon」 that has been built before 1910 in Gyoung-sang province. This study analyzes type of member, jointing method, frame structure method by dividing 「Il-joo-moon」 into four parts such as roof, bracket system, frame structure, podium. The results of this analysis are as follows 1) Roof: The 「Pal-ssac」 style of roof and the 「Matt-bae」 style of roof are dominant and double caves mainly appears. 2) Bracket system: The arrangement of bracket system can be divided into one-line-arrangement and two-line-arrangement. As far as 「Chul-mock-soo」 concerned, 3 or 4 「Chul-mock-soo」 is predominent. 「Tong-jae-gong」 has been used to connect front and back bracket system for some 「Il joo-moon」. When it comes 「jae-gong」, 「Sue-soe」 style, 「Yon-bong」 style and 「Yon-hwa」 style are mainly seen. 3) Frame structure: There are 5 forms in classifying frame structure depending on the jointing method of main-column, diagonal member, sub-column etc. and weight transmission method. 4) Podim: Natural foundation stone is majority. It is judged that 「Il-joo-moon」 has no podium or natural ones, however, it has recently been converted into artificially processed podium in many cases.

공복 시 Caffeine 투여 후 일회성 운동이 흰쥐의 인슐린 및 골격근의 GLUT-4 발현에 미치는 영향

정일규,오명진,김영표,김종오,윤재석,서태범,윤진환 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.5

This study was done to investigate the effects of caffeine ingestion on the expression of GLUT-4 in rats' skeletal muscle(soleus m) and blood insulin level after 12 hr fasting condition and one hour treadmill running. Total 19 rats(Sprague-Dawley) who were 7week Did were used for experimental subjects and raised for 1week in the room controled the air temperature and relative humudity(22℃ and 50%). They were divided three groups ; 12hr fasting group(F group, n=5), fasting+exercise group(FE, n= 7) and fasting+caffeine+exercise group(FCE group, n=7). FG and FCE group performed treadmill running for one hour and the treadmill speed was 18m/min that was supposed to be moderate exercise to rats. Each Dr rats in FCE group was forced to he given the caffeine solution(5mg/kg, Sigma Chemical co.) through stainless steel tube directly to their stomachs one hour before treadmill exercise. Immediately after treadmill running, we anesthetized them with the mixed solution(Ketamin 80g/kg and Rompun 5ml/kg) to draw 3ml blood from heart four insulin analysis and then obtained the rats' soleus muscle for GLUT-4 expression. We found that FCE group showed significantly higher GLUT - expression then the other groups and FE group showed the lowest GLUT-4 expression. This rusults suggest that the endurance type of exercise in fasting condition inhibit the GLUT-4 expression in working muscle and the caffeine helped to facilitate the GLUT-4 expression during endurance type of exercise. The future studies needed to confirm the action of caffeine to increase the GLUT- 4 and the mechanism.

신경회로망을 이용한 이면비드 폭 예측에 관한 연구

정재원,김일수,박창언,김학형,서주환,김인주,심지연 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

The development of robotic welding process is a very complex assignment because the system is affected by a number of process parameters which are very difficult to determine or predict in practice. The full automation welding has not yet been achieved partly because the mathematical model for the process parameters of a given welding task is not fully understood and quantified. Several mathematical models to control welding quality, Productivity, micro structure and weld properties in arc welding processed have been studied. However, it is not an easy task to apply them to the various practical situations because the relationship between the process parameters and the bead geometry is non-linear and also they are usually dependent on specific experimental result. Practically, it is difficult, but important to know how to establish a mathematical model that can predict the result of the actual welding process and how to select the optimum welding condition under a certain constraint. In this paper, an attempt has been made to develop an neural network model to predict the back-bead width as a function of key process parameters in the GMA (Gas Metal Arc) welding and to compare the developed models with the experimental results

흰쥐 시각교차위핵에서 Galanin 면역반응 축삭종말의 분포와 신경연접구조

박환태,백선용,김봉선,김진정,김재봉 대한해부학회 1992 Anatomy & Cell Biology Vol.25 No.4

흰쥐와 햄스터의 생체리듬과 관계된 신경핵에서 Fos 면역양성물질 발현에 관한 연구

박환태,박인식,백선용,김봉선,김진정,김재봉 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.1

재조합 BMP-7 유전자가 전달된 HEK 293 세포에 의한 누드 마우스에서의 뼈형성

정수연,장원태,장연실,안면환,김재룡,송인환 영남대학교 의과대학 2003 Yeungnam University Journal of Medicine Vol.20 No.2

To induce bone formation at ectopic site by tissue engineering and gene therapy, we transplanted collagen sponges containing rhBMP-7 transduced HEK 293 cells in the hypodermis of nude mice. Bone formation was investigated by histological and electron microscopic method at 3, 6, and 9 weeks after transplantation. At 9 weeks after transplantation, eosinophilic bony tissue was observed in the implanted collagen sponge and was confirmed as bone tissue by Von Kossa stain. In the transmission electron microscopic observation, the cells in newly formed bone tissue had eccentrically located nucleus and well developed rough endoplasmic reticulum (rER). Therefore, the cells were evaluated as osteoblasts. Those results suggest that it is possible to form a bone tissue in the ectopic site by transplantation of rhBMP-7 transduced HEK 293 cells. This will be contributed to push more advanced gene therapy for bone formation. However, the HEK 293 cell is unable to apply to the clinical gene therapy. Therefore it is worth to find more compatible cells for clinical application. In addition, collagen sponge is considered as an excellent scaffold and/or carrier for gene therapy and a good biomaterial for tissue engineering.