Mycobacterium abscessus에 의한 슬관절 감염1예

류숙원,이창규,허진,신규성,김장수,배숙영,장은아,서인범,김영기,이갑노 대한임상병리학회 2001 대한임상병리학회지 Vol.21 No.5

객체 지향 프로그램 분석을 위한 그래프 표현 도구의 설계

류희열,김진숙 동의공업대학 1998 論文集 Vol.24 No.1

Many software engineering tools and techniques rely on graphic representations of software, such as control flow graphs, data flow graphs, program dependence graphs, or system dependence graphs. These methods can't represent Object-Oriented Paradigms, such as class. object, inheritance, polymorphism, dynamic binding. In this research, we developed an Object-oriented Program Dependency Graph Representation Tool (OPDGRT). It represents Object-Oriented Paradigm. It analyzes C++ source programs and generates class dependence graphs, class hierarchy graph, and procedure dependence graphs that are stored in the information repository. Each of them can be reused, It constructs an OPDG that is composed of each of them. Other features of OPDG are (1) the representation is compacted: (2) the number of vertices is decreased: (3) the memory size and graph complexity is decreased: (4) the representation is easy to extend for the incremental development of the program, It can be used for the subsystem of testing, debugging, and maintanance tools for Object-Oriented Program.

붕어의 발육 및 생식에 미치는 비소의 영향

남성숙,이철우,류지성,박응로,남규찬,류홍일,전성환,나진균,최덕일,박광식 한국환경독성학회 2001 환경독성보건학회지 Vol.16 No.2

To evaluate the arsenic effect of fish endocrine disruption, crucian carp (Carassius auratus) were treated with 0.5 mg/L and 3.0mg/L of As₂O₃ for 14 days and gonadal development was examined by histological analysis. In ovaries from female crucian carps exposed to 3.0mg/L, immature follicles and atretic follicles were appeared while various normal developmental stages of oocytes were shown in control group. Body weight and Gonadosomatic Index (GSI) of treated carp were also decreased compared to control group. However, no other significant histological changes in liver or kidney were shown in this exposure scheme, This means that reproductive organs are more sensitive than other organs and arsenic may exert endocrine disrupting effect through inhibiting the development of reproductive organ in fish.

수술실 오염도감소를 위한 수술실공조시스템에 대한 연구

김천숙,박은정,강규식,김지은,안기량,권진형,유시현,주영철,권순정 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Background: The OR(operating room) should provide an optimum environment that is safe for the patient and the working personnel. The air ventilation system of OR has been studied to decrease the contamination of air. We investigated the flow and contamination of the air in OR at our hospital. Method: Cultures in OR were made and the number of bacteria and fungi were calculated. A two-dimensional model for the cross-section of an operation room is developed for the CFD (computational fluid dynamics) analysis. The characteristics of air flow in the empty operation room and in the occupied operation room are calculated by using a CFD program. Results: The current air ventilation system of our hospital does not deliver the clean air to the operating site efficiently in occupied OR. Conclusions: We suggested a new location of air ventilation system which improves air venting with little increase of the cost of equipment.

요하지통 환자에서 두 개의 캐눌라를 이용한 박동성 고주파 신경근 응고술의 임상 연구

김천숙,배재영,배덕구,강규식,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Dorsal root ganglion(DRG) block by the local anesthetics and steroids which has done classically in low back pain(LBP) patients with radiculopathy has high incidence of recurrence rate and side effects of steroids. Recently a new technique of pulsed radiofrequency thermocoagulation(P-RFTC) was introduced and substituted for it because of the benefits such as relatively low recurrence rate, low risk of nerve injury and comfort during the procedure. We experienced 15 patients who had LBP with radiculopathy and no or little response to epidural steroid injection. When we performed DR ganglionotomy by P- RFTC under the C-arm guide in these patients, we tried to approach the exact DR ganglion using tow cannulas - the one for obtaining patient's subjective symptoms and injection of contrast dye, the other for making a RF lesioning after identifying the impedance of sensory and motor stimulation. In conclusion, DR ganglionotomy by P- RFTC using two cannulas in LBP patients is an easy and safe procedure with satisfactory results.

완전 포상기태 이후 발생한 지속성 융모질환의 치료경험 2례.

이진희,류은석,김윤숙,김종수,최승도,선우재근,배동한 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1

Persistent tumor develops in approximately 20% of patients with a complete mole, and chemotherapy is required to achieve remission. Following evacuation of hydatidiform mole, careful hCG monitoring is mandatory since it is the most reliable and sensitive method for the early detection of gestational trophoblastic disease. In carefully selected patients in whom the risk of developing gestational trophoblastic disease is significant or when the availability of hCG testing is suboptimal, chemoprophylaxis has been shown to decrease the risk of gestational trophoblastic tumor. We report here two cases of patient, 16-year-old and 45-year-old women who experienced unusual course after the evacuation of a complete mole and markedly elevated serum β-hCG levels. The patient developed persistent gestational trophoblastic disease and were successfully treated with EMA-CO and hysterectomy.

혈당측정기 GlucoDr™ System의 평가

박철영,류미숙,우정택,김성운,김진우,김영설,안규정 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2

연구배경: 당뇨병 환자에서 엄격한 혈당조절은 환자의 예후와 밀접한 관련이 있다. 혈당조절을 철저히 하기 위해서는 자가 혈당 측정기의 사용이 필수적이라 할 수 있다. 또한 저혈당이 빈번하게 발생하거나, 위험요소가 있는 환자들에게도 유용하게 사용될 수 있다. 이에 저자들은 전기화학감지법의 원리를 이용하여 국내에서 처음 생산된 자가혈당측정기인 GlucoDr™ blood Glucose Testing System(ALL Medicus, Co, Korea)를 현재 국내에서 시판되고 있는 다른 제품과 비교, 평가하여 임상적 유용성을 살펴보고자 하였다 방법: 혈당측정기준장비는 YSI 2300 STAT Plus(YSI Incorporated, USA)를 사용하였으며 GlucoDr™외에 Glucocard(KDK, Japan), Precision QID(Abbott Laboratories, Co, USA), Glucotrend(Roche, USA), Surestep(Lifescan, USA)의 다른 혈당측정기를 같이 평가하였다. 정밀도, 직선성, 비교방법과의 상관관계 평가, 검체량에 따른 영향, 헤마토크리트에 따른 영향, 검사자에 따른 영향, 항응고제에 따른 영향들을 평가하였다. 결과: 본 연구에서의 주된 평가대상인 GlucoDr™의 평가결과, 정밀도를 나타내는 검사 내, 검사 간 변이계수는 8%이내였으며, 45~500mg/dL 범위에서 R²=0.9906, 0.9984 정도의 직선성을 나타내었다. 본 연구에 있어 비교방법으로 이용한 YSI 2300 STAT Plus와의 상관관계 및 정확도는 y = 1.0058x + 0.453, R = 0.9853인 것으로 나타났다. 검체량이나 검사자 및 항응고제에 따른 측정값에는 유의할만한 차이가 없는 것으로 나타났으나, 헤마토크리트가 증가 또는 감소함에 따라 최소 10%에서 최대 26% 가량의 영향을 받는 것으로 관찰되었다. 결론: GlucoDrTM는 국내 사용되는 다른 혈당측정기와 비교하여 유용할 것으로 생각된다. Background: Self-monitoing blood glucose devices are sidely used in monitoring and point-of-care testing for the management of diabetic patients. We performed the present study to evaluate the performance of the GlucoDr™ blood glucose testing system using an electrochemical technique. Method: The GlucoDr™ was evaluated for linearity, precision, comparison of method, the effect of sample volume, hematocrit concentration, reapplication, operator and application methods. Results: The GlucoDr™ showed good linearity for glucose concentrations ranging from 52mg/dl to 475mg/dl(r²=0.971). The single day, and day-to-day, CV were within 8%. Excellent correlation was found between the GlucoDr™ and YSI 2300 STAT Plus(y=1.0058x + 0.453, r²=0.9710). The sample volume, reapplication, operator and application method produced no significant effect on the test result. An overestimation in the glucose values was found with low hematocrit concentrations. There was no significant effect by the anticoagulants, with the exception of citrate. Conclusion: The GlucoDr™ showed good linearity, precision and correlation with the reference method and provided rapid and reliable result for blood glucose levels. Therefore, the GlucoDr™ seems appropriate for clinical use in the management of diabetic patients.

전립선비대증과 전립선암의 감별진단에 있어서 Free / Total PSA의 역할

홍범식,류진숙,안한종 大韓泌尿器科學會 1997 Korean Journal of Urology Vol.38 No.12

분화된 갑상선암 환자에서 수술 후 재발과 원격전이를 예측하는 혈청 갑상선글로불린치

김경수,류진숙,홍석준,김원배,송영기 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.2

연구배경 분화된 갑상선암의 재발이나 원격전이를 시사하는 혈청 갑상선글로불린치는 보고자들마다 차이가 있고, receive operating characteristics (ROC) 곡선을 이용해서 cut-off value을 구한 경우는 별로 없다. 또한 수술 후 방사성요오드 치료 직전 (Tg-RAI), T₄투여 도중(Tg-on) 및 T₄ 중단 후(Tg-off)에 측정한 갑상선글로불린의 임상적 의의에 대해서도 아직 이견이 있다. 더구나 임상에서 측정된 혈청 갑상선글로불린치의 의미를 해석할 때 보다 큰 의미를 가지는 양성 예측치와 음성 예측치를 조사한 보고는 거의 없다. 방법: 갑상선 유두암 또는 여포암으로 진단되어 갑상선 전절제술 및 고용량 방사성요오드 치료를 시행 받은 후 갑상선 자리에 잔여병소 없이 추적관찰이 이루어지고 있는 242명의 환자들 중, 항갑상선글로불린항체가 음성인 205명의 환자를 대상으로 후향적으로조사하였다. 평균 추I:기간은 5년이었다. Tg-off는 저요오드식이를 2주 이상 시행한 후 ^(131)I-전신스캔과 함께 측정되었으며, 내인성 TSH의 농도가 30 μU/mL 이상으로 상승했을 때 의미 있는 것으로 판정하였다. 재발은 경부 림프절을 포함하여 경부에 새로운 병소가 생겼을 때로, 원격전이는 종격동 림프절을 포함하여 경부 이외의 장기에 병소가 생겼을 때로 정의하였곤, 재발이나 원격전이는 각종 영상학적 또는 병리학적 검사에서 이상소견이 발견되는 경우 있는 것으로 판단하였다. 민감도와 특이도가 가장 높은 Tg의 cut-off value를 구하기 위해 ROC 곡선을 이용하였고, cut-off value에 따른 양성 예측치와 음성 예측치를 구하기 위해 2×2표를 이용하였다. 결과: 재발은 50명 (24.4%)의 환자에서 발생하였고, 원격전이는 17명(8.3%)의 환자에서 발생하였다. 재발이나 원격전이 중 어느 한 가지라도 있는 환자는 52명(25.4%)이었다. ROC 곡선 아래부분의 면적을 통해 알아본 Tg-RAI, Tg-on, Tg-off 검사의 정확도는 서로 비슷하게 높았다. 재발에 대한 혈청 갑상선글로불린치의 cut-off value는 Tg-RAl가 11.8, Tg-on이 1.4,Tg-off가 3.3ng/mL였다. 이때의 민감도는 각각 85.4,82.2, 93.3%였고, 특이도는 각각 89.2, 92.4, 88.0%였으며, 양성 예측치는 각각 71.9, 77.1, 70.0%였고, 음성 예측치는 95.0, 94.4, 97.8%였다. 원격전이에 대한혈청 갑상선글로불린치의 cut-off value는 Tg-RAl가27.4, Tg-on이 2.5, Tg-off가 7.9 ng/mL였다. 이때의민감도는 각각 86.7, 87.5, 92.3%였고, 특이도는 각각86.2, 90.8, 80.2%였으며, 양성 예측치는 각각 34.2,46.7, 25.0%였고, 음성 예측치는 각각 98.7, 98.8,99.3% 였다. 결론: 혈청 갑상선글로불린치는 분화된 갑상선암의 재발이나 원격전이를 예측하는 데 있어 민감도와 특이도가 비교적 높은 검사이나, 음성 예측치가 높은 것에 비해 양성 예측치가 낮은 단점이 있었다. 또한 Tg-on은 Tg-off에 비해 양성 예측치는 높았으나, 음성 예측치는 낮게 나타났다. 따라서 Tg-on이 cut-off value보다 높게 측정되는 경우에는 반드시 전신스캔 등 재발이나 원격전이 여부에 대한 추가적인 검사를 시행하고, Tg-on이 cut-off value보다 낮게 측정되더라도 가능하면 선별검사로서 Tg-off나 recombinant human TSH 자극 후의 혈청 갑상선글로불린치를 주기적으로 측정해야 할 것으로 사료된다. Background: Reports on serum thyroglobulin(Tg) levels being used to predict recurrence or distant metastasis during the follow-up of patients with differentiated thyrod cancer(DTC) has been inconsistent. In addition, there have been few reports that attempt to define the cut-off value of Tg for recurrence or distant metastasis obtained by a receiver operating characteristic (ROC) curve. As well, there are differences in opinions on what the value should be on the first serum Tg level measured just before radioactive iodine(RAI) ablation(Tg-RAI), during thyroxine administration (Tg-on), and after thyroxine withdrawal (Tg-off) during the follow-up. Reports on the positive predictive values(PPVs) and negative predictive values(NPYs) of these Tg values are rare. Methods: A total of 205 patients (42 males, 163 females) with DTC were studied. All patients had undergone total or near-total thyroidectomy. After surgery and RAI ablation, annual thyroxine withdrawal 131I-whole body scan (WBS) with Tg measurements was performed. The mean duration of follow-up was 5.0 (1.4~7.4) years. The most sensitive and specific Tg values)cut-off values) for tumor recurrence and/or distant metastasis were selected by using ROC curves. We also calculated the PPVs and NPVs for rcurrence and/or distant metastasis using two-by-two tables. Results: Cut-off values of Tg-RAI, Tg-on, and Tg-off for recurrence were 11.8, 1.4, and 3.3 ng/mL, respectively. For these values, the sensitivities were 85.4, 82.2, and 93.3%, with the specificities at 89.2, 92.4, and 88.0%. PPVs were 71.9, 77.1, and 77.0% while NPVs were 95.0, 94,4, and 97.8%. The cut-off values for distant metastasis were 27.4, 2.5, and 7.9ng/mL, respectively. For these cut-off values, the sensitivities were 86.7, 87.5, and 92.3%, with the specificities being 86.2, 90.8, and 80.2%. PPVs were 34.2, 46.7, and 25.0% and NPVs were 98.7, 98.8, and 99.3%. Conclusion: All three serum Tg levels were sensitive and specific markers for recurrence and distant metastasis. Their PPVs were low in contrast to the high NPVs. In comparison with Tg-on, Tg-off showed higher sensitivity and NPV as well as lower specificity and PPV. Therefore, in the case of higher Tg-on during the follow-up period, efforts to find recurrence and distant metastasis,such as 131I-WBS, should be done. In addition, regular measurement of Tg-off or Tg after stimulation with recombinant human TSH is recommended as a screening test (J Kor SOC Endocrinol 18:153-165, 2003).

Di-2-ethylhexyl phthalate 처리 남아프리카산발톱개구리에서의 vitellogenin 발현

박응로,이철우,류지성,남성숙,전성환,나진균,최덕일,박광식 한국환경독성학회 2001 환경독성보건학회지 Vol.16 No.1

The estrogenic potency of di-2-ethylhexyl phthalate (DEHP) using reverse transcriptase-PCR response of liver vitellogenin mRNA in male African clawed frog (Xenopus laevis) was studied. Male frogs were injected with DEHP at dose of 300 ㎍/kg and 300 mg/kg body weight through the dorsal lymph sac. After 4 days, using suitable pair of RT-PCR primers, vitellogenin mRNA induction in the liver was measured and DEHP showed vitellogenin mRNA induction in only the group treated with 300 mg/kg. Any significant histological abnormalities by the exposure of DEHP was not shown in both testis and liver.