조혈모세포이식술이 골수기질세포의 기원 및 조골세포로의 증식 및 분화에 미치는 효과

강무일,조성원,오은숙,백기현,이원영,오기원,김혜수,한제호,윤건호,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

Investigation of the April 2000 forest fire damage in Kang-won Province, Korea, using RADARSAT data

Kang, Sung Chul,Seo, Jin Won,Lee, Tae Hee,Park, Sang Eun,Hong, Suk Young,Moon, Wooil M. 대한원격탐사학회 2000 International Symposium on Remote Sensing Vol.16 No.1

The series of forest Fires in Kangwon Province in April, 2000, were one of the mast serious ones in the Kang-won Province in recent years. The fire damaged areas are extensive and this paper investigates the utility of the satellite image data, particularly the RADARSAT SAR data. One of the main objectives of this study included evaluation of potential usefulness of the C-band RADARSAT data in the detection of forest fires in mountainous areas. Among several fire damaged sites, the area near Samchuk (city) was selected as the main study area and mufti-temporal RADARSAT(raw) data were acquired and the processed results were comparatively investigated with the IRS-1c data acquired shortly after the fire. To identify the burnt area from the undamaged background in the optical imagery, supervised classification and NDVI processing were carried out and tested with the IRS-1C data. For this experiment, several sets of raw RADARSAT standard and Fine mode (S4, F3, ascending orbit) data were processed and the final image was formed. In addition to the final image, sigma nought (σ°) was catnputed and compared for the burnt area against the undamaged areas. Because of the steep slopes in the study area and subsequent deviation from the flat surface scattering models, the fire scars in the sigma nought (σ°) image were not apparent. However, fire scars are slightly detected in the difference and ratio images obtained from the signal intensity data acquired at different dates (bath before and after fire). Texture analysis of the image data including the burnt areas were carried out using the Multiplicative Markov Random-Field (MMRF) algorithm. The detection of the fire damaged area from both standard mode and fine mode RADARSAT was not as straightforward as in optical data. However, Previous studies with ERS-1 S_AR and RADARSAT data in Indonesia and in the North American Plains indicate that C-band SAR data provide us with an effective tool for studying the forest fire damages. However, the application of C-band SAR data to the analysis of the forest fire areas requires careful processing of the data with realistic scattering models.

동종골수이식 후 혈당 및 혈중 지질농도의 변화양상 및 관련인자

이원영,강무일,오은숙,오기원,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘주 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.6

연구배경:골수이식은 비교적 젊은 연령의 환자들을 대상으로 하며 면역억제제의 사용기간이 비교적 짧으므로, 주로 고령의 만성 질환 환자에서 시행되는 고형장기이식에서와는 달리 당대사 및 지단백 대사에 있어서 많은 차이점이 있을 것으로 추측된다. 저자들은 전향적 연구를 통하여 골수이식 후 시기별로 혈당 및 혈중지단백 변화 양상을 알아보고 이와 관련된 임상인자들을 규명하고자 하였다. 방법:1998년 10월부터 1999년 8월까지 가톨릭대학교 성모병원에서 동종골수이식을 시행한 환자들 중 43명을 대상으로 이식 전 및 이식 후 1, 2, 3, 4주와 3개월, 6개월에 공복 혈당, 혈중 총 콜레스테롤, 중성지방, 고밀도지단백을 측정하여 골수이식 후 시기별 변화를 관찰하고 여러 임상인자들에 따른 차이를 알아보았다. 결과:1. 공복혈당은 골수이식 수 첫4주 동안 상승하였고 이후 감소하였으나 이식 6개월 시점의 평균 공복혈당은 이식 전보다 유의하게 높게 관찰되었다. 혈중 총 콜레스테롤은 이식 후 1주에 최고치를 형성하였고 이후 기저수준으로 회복되었다가 이식 수 3,6개월에 다시 증가하여 기저치에 비해 유의하게 높았다. 혈중 중성지방은 이식 후 1개월까지 유의하게 증가하였고 이후 감소하여, 3,6개월에는 기저치와 유의한 차이가 관찰되지 않았다. 혈중 고밀도지단백은 이식 후 2,3주에 이식 전보다 유의하게 감소하였고 이후 이식 전 수준으로 회복되었다. 혈중 저밀도지단백은 총 콜레스테롤의 변화와 매우 유사하였다. 2. 골수이식 후 6개월 시점에서 공복 혈당이 126㎎/dL이상인 환자는 7명(16%)이었다. 이들 환자들과 공복혈당 126㎎/dL 미만의 환자 36명을 비교한 결과, 공복혈당이 126㎎/dL 이상인 환자군에서 스테로이드 평균 투여량이 많았고 고밀도지단백이 유의하게 낮았다. 3. 이식편대숙주질환이 발생한 환자는 그렇지 않은 환자보다 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤이 더 낮았고, 3개월의 공복혈당이 더 높았다. 혈연골수이식 환자군은 비혈연골수이식 환자에 비해 투여된 스테로이드 용량이 더 적음에도 불구하고 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤 수치가 더 높았다. 스테로이드 고용량 투여군(하루 평균 7.5㎎기준)은 저용량군보다 이식 후 3개월 시점의 공복혈당이 더 높았으나 나머지 시점의 혈당, 혈중 지질농도에 있어서는 유의한 차이가 관찰되지 않았다. 결론:골수이식 후 초기시기에 주로 당 대사 및 지질대사이상이 관찰되며 이는 면역억제제 투여와 관련이 있음을 알 수 있었다. 면역억제제가 고용량 투여되는 합병증 발생 시 이들 대사이상에 관심을 기울여 대처해야 할 것이다. Background: In bone marrow transplantation(BMT), recipients are usually younger and immunosuppressants are open used in shorter period than in solid organ transplantation. Therefore, there might be a difference in glucose and lipid metabolism between BMT and solid organ transplantation. However, the serial changes of metabolic parameters following BMT have not been studied. Therefore, the aim of this study is to investigate the serial changes of blood glucose, lipids and the putative factors that are related with these changes after BMT. Methods: We have prospectively investigated 43 patients who underwent allogeneic BMT. Fasting plasma glucose(FPG), total cholesterol, triglyceride and high-density lipoprotein(HDL) were measured before BMT, and at 1, 2, 3, 4, 12 weeks and 6 months after BMT. The serial changes of these metabolic parameters according to clinical factors including type of BMT, mean daily steroid dosage, and occurrence of graft versus host disease (GVHD) were examined. Results: 1. Mean FPG level increased during 4 weeks after BMT and remained above basal value at post-transplant 6 months. Total Cholesterol level was increased during initial 4 weeks after BMT and was above basal value at post-BMT of 3 and 6 months. Triglyceride level was progressively increased during initial 4 weeks after BMT, but returned to basal value there after. HDL-cholesterol level was significantly decreased during initial 4 weeks after BMT, but returned to basal value there after. 2. Patients with FPG above 126 mg/dL and the other patients, the former received larger amounts of daily steroid and had lower HDL-cholesterol level. 3. The changes of metabolic parameters were different according to type of BMT, steroid dose, and occurrence of GVHD. Conclusion: Although there was increase of FPG, TC, TG and decrease of HDL-C during initial 4 weeks after BMT, these metabolic changes recovered slowly thereafter. Immunosuppressants are thought to be associated with these changes. Further observation will be needed for the long-term effect of BMT on metabolic changes(J Kor Diabetes Asso 24:689~698, 2000).

단백뇨 없는 Mesangial IgM Nephropathy 1예

이강휴,강경표,김원,강명재,박성광,강성귀 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

An 51-year-old woman presented with microscopic hematuria without protenuria for long time. Laboratory studies demonstrated the presence of red blood cells in urine, a normal serum IgM level, the absence of antinuclear antibodies, and a normal complement level. Renal biopsy revealed that some glomeruli are enlarged with endocapillary cell proliferation and a few glomeruli exhibit prominent vascular pole of the tufts and segmental increase in mesangial cell and matrix. Immunofluorescence studies demonstrated segmental granular deposits for IgM. Electron microscopy showed well-preserved foot process associated with focal effacement. Biopsy findings were consistent with IgM nephropathy. We present this case to promote understanding of the pathogenesis of IgM nephropathy. (Korean J Nephrol 2002;21(2):317-321)

골수이식 후 골밀도 및 골대사의 변화 : 2년 추적관찰 2-Year Prospective Study

이원영,강무일,오은숙,오기원,한제호,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

Flavobacterium meningosepticum에 의한 균혈증 1예

장성원,유진홍,진승원,김선우,김연식,박순민,이대훈,최민호,최주연,신완식,강문원,강지민 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.1

1996년 6월 카톨릭대학교 부천성가병원에 뇌경색으로 입원했던 61세 남자 환자의 혈액에서 Flavobacterium meningosepticum을 분리하였다. 환자는 폐렴을 동반한 패혈증의 예로 ceftriaxone과 metronidazole을 투여하였으나 입원 48시간만에 사망하였다. Flabovacterium meningosepticum is a rae cause of nosocomial infection which shows multi-drug resistance. It mainly invades patients with impaired immunity. Recently, we experienced a case of F. meningosepticum bacteremia in a patient with chronic debilitated state owing to stroke. The clinical progress was so rapid that he died within 48 hours. Blood culture revealed F. meningosepticum which showed characteristic yellow colony in blood agar plate.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

CM전문회사의 현장관리조직 운영실태 분석

신원상(Shin, Won-Sang),이강민(Lee, Kang-Min),손창백(Son, Chang-Baek) 대한건축학회 2014 大韓建築學會論文集 : 構造系 Vol.30 No.8

This study is aimed at offering basic data for enhancing the organizational structure and productivity of on-site construction management (CM) employees. To accomplish the objective, the organizational operation system and employee evaluation of domestic CM companies were analyzed by site scale to promote efficient operation. The findings are as follows. First, in terms of CM workforce, the employees handling architecture, electricity, and machines represented the highest proportion. As for qualification, top engineers were dispatched to both large-scale and small-scale CM sites more than any other employee. Second, the results on CM organizational productivity are as follows. The per capita sales increased as the service payment increased. In terms of scale, the site worth less than a billion won had per capita sales of 76 million won, about 5 times less than the site worth 5 billion won or more whose per capita sales were 371 million won. The monthly per capita sales also increased as the service payment increased. However, the difference was minimal, about a half of the difference in per capita sales. These findings would be useful for companies that have no systematic criteria for CM organization selection and evaluation.

c-형강 및 ebb & flow 방식에 따른 경제성 분석

강승원(Seung Won Kang),박천호(Chun Ho Pak),조용성(Yong Sung Cho) 한국원예학회 2007 원예과학기술지 Vol.25 No.3

관비재배와 저면관수인 ebb & flow, C-형강의 재배방식에 따른 고품질분화 생산을 위한 재배농가의 경제성을 분석하였다. 이를 위해 화훼농가의 비용구조를 분석하였고 자본 회수기간 및 내부수익률의 추정, 관수에 따른 인건비 절감 효과를 분석하여 재배방식에 따른 경제성을 비교하였다. 10a(991.7m²) 규모의 자동온실에 대해 관비재배방식을 선택한 시클라멘 재배농가의 총 비용은 9,993.8만원으로 추정되며, 이 중 시설비는 74%(7,410만원)를 점하고 연간 2,583.8만원의 경영비를 지출할 것으로 예상된다. 반면, C-형강방식을 선택한 재배농가는 초기 시설비용으로 약 8,520.0만원(총비용의 약 70%)을 지출하고, 매년 경영비로 3,597.0만원을 지출할 것으로 추정된다. 한편, 투자자금에 대한 자본회수 기간을 분석한 결과 10a 규모의 자동온실에서 시클라멘을 재배하는 농가에서 관비재배방식 혹은 C-형강방식을 선택할 경우에는 초기시설투자비 회수기간이 약 4 년 정도 소요될 것으로 예측되며, ebb & flow 방식을 선택할 경우에는 약 5년 정도의 시간이 소요될 것으로 예상된다. 또한, 내부 수익률을 추정한 결과 ebb & flow시설과 C-형강시설을 5년과 6년씩 사용한다고 가정할 경우, ebb & flow시설의 내부 수익률은 각각 9%와 14%로 나타났고, C-형강시설의 경우에는 각각 13%와 17%로 나타나 시중의 저축성예금 수신금리 4.82%와 비교하여 경제성이 높은 것으로 분석되었다. Economical efficiency for production of high quality-potted plants was analyzed by types of irrigation system such as conventional fertigation, ebb & flow, and C-channel as subirrigation systems. After cost structure was analyzed, payback period of capital, internal rate return (IRR), and effects of reduced labor cost were estimated. The gross cost of cyclamen-producing farmers using hydroponic systems in automated greenhouses (10a) was about 100 million won. Of the gross cost, installation and operation costs occupied 74% and 25%, respectively. In the C-channel subirrigation system, gross cost was 120 million won approximately. Installation and operation costs occupied 70% and 30%, respectively. Payback period of capital was 4 years for fertigated irrigation and C-channel subirrigation system, whereas it was 5 years for ebb & flow. IRR of ebb & flow and C-channel subirrigation systems was higher than the interest rates of 4.82%, indicating economic efficiency.

우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계

강혜영,강대룡,장영화,박성은,최원정,문성환,양규현,Kang, Hye-Young,Kang, Dae-Ryong,Jang, Young-Hwa,Park, Sung-Eun,Choi, Won-Jung,Moon, Seong-Hwan,Yang, Kyu-Hyun 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.