신부전이 동반된 당뇨병 환자에서 발생된 침습성 모균증 : 수술과 Liposomal amphotericin B 및 GM-CSF 병합 요법에 의한 성공적인 치험 1예

이원영,오기원,임국희,장재혁,이동건,최정현,강무일,신완식,차봉연,이광우,손호영,강성구 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.4

저자들은 신부전이 동반된 당뇨병 환자에서 발생된 부비동형 모균증에 대하여 수술과 함께 liposomal amphotericin B 및 GM-CSF의 복합치료를 하여 성공적으로 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Mucormycosis (zygomycosis) primarily affects diabetic or immunocompromised patients and typically progresses rapidly, necessitating surgical excision and antifungal therapy with amphotericin B. Large doses of amphotericin B are needed for cure, but it has the risk of causing significant renal toxicity. The recent development of liposomal amphotericin B allows antifungal therapy to be administered with potentially improved efficacy and reduced nephrotoxicity. We have experienced a case of paranasal mucormycosis successfully treated with surgery, liposomal amphotericin B and GM-CSF. A 59-year-old male suffering from diabetes mellitus for 6 years was admitted with pain at left maxillary area. He was diagnosed as mucormycosis after cytologic exam on the necrotic nasal mucosa, which showed typical hyphae. He have had diabetic nephropathy with macroproteinuria and had rapidly rising serum creatinine levels with the amphotericin B treatment: creatinine levels reverted to basal level with the use of liposomal amphotericin B. Despite surgical excision and continued antifungal therapy, his infection was not effectively controlled. Therefore, GM-CSF was administered additionally to improve phagocytic activity of leukocytes. He was finally cured after receiving a combination of aggressive surgery, liposomal amphotericin B and GM-CSF. To our knowledge, this is the first detailed clinical description of the treatment of mucormycosis with liposomal amphotericin B in Korea.

현대화 온실의 투자분석

이광원,임재환,이두희 충남대학교 농업과학연구소 1997 농업과학연구 Vol.24 No.2

The number of modernized green houses have been increased to produce high quality and high-pay off farm products. The unit investment costs per pyeong(3.3058㎡) for building a glass house was estimated at 449 thousand won. On the other hand, the unit prices for the PC house with iron frame and the vynil house with automatic control system were revealed 365 thousand won and 93 thousand won respectively. The main objective of the study was to identify the financial feasibility of the green house investment prevailed in rural area. At present, some farmers have selected the green house without any consideration of profitability of crops and accessibility of their farming practices and technology. For the soundness of green house cultivation and management, the indices of finacial efficiency for the modernized green houses were necessary. The decesion making criteria such as NPV(Net Present Value), IRR(Internal Rate of Return), B/C Ratio and Payback Period were analyzed for the individual high investment facilities considering the present farmer's technology and on-farm benefits and costs. The results of the feasibility analysis of green houses were as follows: 1. In case of 100% private burden of the investment costs, NPV revealed only positive value for the vinyl house with automatic system and IRR for the house was also estimated at more than 10% and B/C Ratio was amounted to more than 1.0. On the other hand, the other glass and PC houses showed negative NPV and unacceptable B/C ratio and IRR. 2. In case of the following terms and conditions as 50% Government subsidy, 20% loans and 30% farmers burden of the total investment cost, all the green houses showed acceptable IRR. B/C Ratio and NPV. 3. The financial feasibility of the glass house was acceptable in tomato cultivation rather than in cucumber cultivation. The payback periods of cucumber were represented as 8.9 years for glass house, 8.5 years for PC house and 4.1 years for vinyl house with automatic system respectively. In conclution, the glass and PC house cultivation of high value vegetables were only acceptable under the Government subsidy and loan systems from the view point of farmer's financial situations. On account of the unacceptable economic rate of return, the government subsidy and loan policy for glass house cultivation should be transfered to the vinyl and pc houses in the future.

KAERI 부지 주변의 환경선량 측정을 위한 온라인 감마선량 감시시스템

이정호,박두원,이원윤,이현덕,최용호,김삼랑,홍광희,이창우 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.2

환경감마선량 변동을 감시하기 위해 한국원자력연구소 부지 주변에 온라인 감마선량 감시망을 구성하였다. 모니터링 포스트에 설치된 전리함 검출기에 의해 측정된 자료는 무선전송방식으로 중앙통제소에 전송되어 실시간으로 감시된다. 무선전송 방식은 자료의 전송, 처리 및 자자에 신뢰도가 높고 경제적이었다. 감시시스템은 급격한 선량증가시 조기경보체제와 연결할 수 있게 하였다. On-line gamma monitoring system around KSERI-site was set up to monitor the radiation fluctuations in environment. Data on gamma exposure rates measured by the ionication chamber in the monitoring posts are transmitted to a computer of central control station with radio telemetry transmission and reliable on handing and storing of data. This monitroing system can triger an early warning system in the event of abnormal radiation levels.

Cilostazol이 제2형 당뇨병 환자의 심혈관 합병증과 혈청지질에 미치는 영향

이영숙,이영미,김광원,최경업,이숙향 한국병원약사회 2002 병원약사회지 Vol.19 No.4

PURPOSE: Cliostazol, a phosphodiesterase Ⅲ inhibitor, is an antiplatelet agent for treatment of ischemic symptoms of peripheral vascular disease in the diabetes. In addition, it has been claimed to have beneficial effect on plasma lipid level. The objective of this study was to evaluate retrospectively the effect of cilostazol administration on cardiovascular events and serum lipid levels in patients with type 2 diabetes mellitus (DM). METHODS: DM patients on cilostazol for longer than 6 months were evaluated from September, 1996 to June, 2000 for lipid profile, HbA1c, postprandial glucose, urinary albumin excretion, cardiovascular events. Dosage of cilostazol was 100㎎/day with range of 50-200㎎/day. Primary outcome variable was any cardiovascular events during treatment and secondary variables were changes in lipid level, urinary albumin excretion and adverse events. Lipid level was compared between the groups with or without lipid lowering agents. Patients were evaluated for bleeding events in combination with other antiplatelet agents, such as aspirin, ticlopidine and warfarin. RESULTS: Total 180 patients were included Mean age was 60.8±9.9 years; number of male patient, 90(50%); DM duration, 12.4±8.1 years; family history of DM, 61(33.9%); family history of cardiovascular events, 15(8.3%) and smoking, 32(17.8%). The cardiovascular events were noted in 8 cases out of 180 (4.4%). Systolic blood pressure and age were risk factors in correlation with cardiovascular events. During treatment with cilostazol, there were no significant changes in blood glucose. Among 19 patients with serum lipid profile before and after cilostazol treatment, there were no significant changes in serum lipid levels with LDL-cholesterol reduced form 130.8±30.3 ㎎/㎗ at baseline to 120.0±43.1 at 1 yr and 125.4±27.3 at 3 yr (p=0.052). Bleeding event was in 1 case of co-administration with other antiplatelet agents that were aspirin (87), ticlopidene(7), warfarin(2) CONCLUSION: Cilostazol has been used for peripheral vascular disease in DM patients with antiplatelet activity and lipid lowering effect in part. Small effect on lipid level can be expected by itself or in combination with other lipid lowering agents and the cardiovascular can be prevented in patients with type 2 DM.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

국산 Lidocaine 알칼리화를 위한 Bicarbonate 혼합시 침전유발 최소량에 대한 고찰

이선호,김현수,곽인숙,안원식,최관호,김광민,손민제 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.5

Background : When local anesthetics for regional anesthesia is used, usually small amounts of bicar-bonate are added for rapid onset. This addition gives the mixed solution a more alkaline pH. The following result is an increased unionized form of the local anesthetic and rapid penetration of the drug into tiissue. Unfortunately, no data about adequate mixing volumes of domestic lidocaine and bicarbonate is available. Methods : We examined six mixing pairs of two kinds of 2% lidocaines and three kinds of 8.4% bicarbonates for minimum volumes of bicarbonate to cause a precipitation of 2% 20 ml lidocaine. Results : The mean volumes of bicarbonate to cause precipitation were 1.54 ml for Kwang-Myung lidocaine with Kwang-Myung bicarbonate, 2.90 ml for Kwang-Myung lidocaine with Dae-Won bicarbonate, 2.73 ml for Kwang-Myung lidocaine with Je-Il bicarbonate, 0.97 ml for Je-Il lidocaine with Kwang-Myung bicarbonate, 1.26ml for Je-Il lidocaine with Dae-Won bicarbonate and 1.39 ml for Je-Il lidocaine with Je-Il bicarbonate. Conclusions : We conclude that the Kwang-Myung lidocaine and the Je-Il lidocaine could cause precipitation when mixing with a smaller bicarbonate volume than foreign textbook recommended. (Korean J Anesthesiol 2000; 39: 726-729)

한라산 주변에 발생하는 Karman Vortex Street 재현

권지혁(Kwon Ji-hyuk·Lee),이연원(Lee Yeon-won),김영덕(Kim Young-duk),박광열(Park Kwang-yul) 한국풍공학회 2006 한국풍공학회지 Vol.10 No.1

늦가을과 초본 사이 제주도 후면에 Karman vortex street가 발생한다. 이러한 vortex가 발생하기 위해서는 기온 역전층과 5 ~ 13 m/s의 지속적인 바람이 필요하다는 것을 밝히기 위한 많은 연구들이 있었다. 이러한 vortex clouds는 발생 후 주 풍향의 방향을 이동하게 된다. Karman vortex street는 기상학에서 매우 흥미로운 주제이다. 본 연구에서는 LES 난류 모델을 이용하여 Karman vortex street에 관한 해석을 수행하고 수치해석을 통해 얻은 결과와 기상 데이터가 일치함을 보였다. From late autumn to the beginning of the spring, the phenomena of the Karman vortex street have been frequently observed in the wake of Mt. Halla in the Jeju island. Some researches revealed that the necessary conditions for development of these vortex clouds are a strong low-level inversion of temperature and a persistent wind speed of 5 to 13m/s. After the cloud is formed, the vortex clouds are shed from alternating sides of Jeju island and then move downwind with main airflow stream. The Karman vortex street in the wake of the Jeju island was one of the interesting topics in meteorology. In this study, CFD using LES turbulence model was developed to investigate the Karman vortex street and the results of CFD showed a good agreement with weather data.

생태시범도시 조성을 위한 계획모형 구축에 관한 연구

이광국(Lee Kwang-Kug),김청원(Kim Chung-Won) 한국주거환경학회 2005 주거환경(한국주거환경학회논문집) Vol.3 No.1

  The security of municipal competitiveness is the most important in the age of limitless competition of localization and globalization. The authority of city planning which has been exercised by central governments was mostly or is being transferred to local governments. At this point of time, it is no exaggeration to say that the creation of abundant and advanced municipal environment for 21st century ahead wholly depends on the efforts of local governments.<BR>  The ecological model project was introduced as a connecting support and link between central and local governments. The ecological model project will play a role in city policies ahead as a win-win strategy. Therefore, this study is aimed at establishing the most preferentially required planning model during the propulsion of the ecological model city project.<BR>  For the planning model establishment of the ecological city project, the security of purpose coincidence and public interest are required because the ecological city project is focused on efficient propulsion not like existing city development projects. For this, fund raising, citizen participation and citizen corporation should be preferentially considered from the aspect of project performance possibility. Also, the introduction of an evaluation monitoring system for appropriateness evaluation is needed.<BR>  From the result of the planning model establishment of this study, the model was divided into 11 stage procedures such as problem recognition, suggestion & announcement of proposed sites for the project, evaluation & selection of proposed sites, drawing up of project performance guideline, drawing up & presentation of project plan, selection of project"s main body, drawing up of detailed project plan, examination & authentication of detailed project plan, project execution, evaluation & authentication of project execution, evaluation & authentication of after management.

증후성 단독 중뇌동맥협착의 예후

이수주,이광호,정진상,조수진,이원용,이한보 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

입원한 입시 스트레스 증후군 환자의임상양상에 관한 정신의학적 연구

신광철,진태원,이영식,이재우,이재광,이길홍 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.3