혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

포스트-텐션 프리캐스트 외부 넓은 보-기둥 접합부의 비탄성 거동

박상욱,최윤철,김영찬,김대중,임재형,권기혁,문정호,이리형 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

Experimental results from the cycle lateral load tests for post-tensioned precast wide beam-column connections were presented. Six exterior beam-column assemblages of half scale were tested in the laboratory. The specimens consist of U-shaped precast wide beams and concrete columns. The continuity at the beam-column joint is achieved with the topping concrete and post-tensioning. The specimens were designed with parameters of the beam-to-column depth ration and the number of tendons within column core. The test results showed that the post-tensioned precast wide beam-column connection satisfied the provisional standard by ACI of acceptance criteria for concrete special moment frames.

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

인슐린 비의존성 당뇨병에 동반된 심상성 천포창 1 례

이상준,박진용,임태형,윤영호,권순대,남창욱,허규찬,박근용,구본식,김상표,장종억 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

저자들은 인슐린 비의존형 당뇨병 환자에서 통증성 구강내 미란 및 전신성 수포성 미란을 동반한 심상성 천포창 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Various skin conditions such as diabetic dermopathy, necrobiosis lipoidica diabeticorum, bullosis diabeticorum, granuloma annulare occur frequently in diabetes, although common lesions may be associated by chance. Pemphigus vulgaris(PV) is a blistering skin disease seen predominantly in elderly patients. This disorder is characterized by the loss of cohesion between epidermal cells with the resultant formation of intraepidermal blisters. These blisters rupture easily, leaving denuded areases that may crust and enlarge peripherally. In half or more of patients, lesions begin in the mouth: approximately 90% of patients have oromucosal involvement at some time during the course of their disease. But the relationship of this disorder with diabetes is not clear. We experienced a case of pemphigus vulgaris associated with NIDDM in 67 years old woman who was admitted due to painful oral ulcer and control of blood glucose, so we present this case with a review of literatures.

계면활성제 초분자막의 분자구조가 나노마찰거동에 미치는 영향

김용욱,강용수,임종주,박상권 한국공업화학회 2002 응용화학 Vol.6 No.1

Under boundary lubrication conditions, the molecular structure of boundary lubricant plays a important role in reducing the coefficient of friction and increasing the efficiency of various machinery. In this study, the friction forces of surfactant supramolecular film were measured by employing a friction force microscopy(FFM) in order to provide a better understanding on effect of molecular structure of surfactant supramolecular film on nano-tribological behavior.

천측두 동맥류 1예

강성호,임대준,김동욱,김보형 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-

Superficial temporal artery aneurysm is a rare entity, which is related to blunt trauma. It was diagnosed with history, physical examination and CT or angiography. Aneurysm is simply treated with excision and ligation. We report a case with review of literature.

차세대 인터넷 도입을 위한 경계 라우터의 성능분석에 관한 연구

이수욱,황성호,임해진 三陟大學校 2004 論文集 Vol.37 No.-

The IPv6(Internet Protocol version 6), a next generation internet protocol. was standardized to solve the problems of the IPv4(Intemet Protocol version 4). However. the IPv4 could not be actually converted to the IPv6 at one time. Therefore. the transition mechanism is thought to be very much important to be compatible with the IPv4 naturally and convert to the IPv6 network gradually. Despite of the development of various kinds of the transition mechanism, the IPv6 network was not expanded. The research was mainly made not for current system environment but for technical purposes. This paper investigated the performances through the transition mechanism and examined proper ways being applicable to current environment.

1999년에 발생한 기상재해 유형별 벼 수량반응조사 연구

주영철,임갑준,한상욱,박중수,조영철,김순재 한국농림기상학회 2000 한국농림기상학회지 Vol.2 No.1

The objectives of this study were to investigate weather conditions which induced discolored grains and viviparous germination, and to evaluate yield responses following viviparous germination during mid- and late- ripening stage, the submergence during reproductive growth stage, and lodging in the yellow ripe stage. Weather conditions which caused glume discoloration at heading stage were 21.3-26.4℃ in average temperature, 75.2-98.4% in relative humidity, 19.3 in transpiration coefficient and 10.8-13.8 m/sec. in wind speed. Yield reduction was 26-27% and 10∼17%, respectively, when the glume discoloration rates were 63.2-65.7% and 38.3-45.2%, obviously due to the decrease in percent of fertile grain and ripening ratio. Weather conditions during continuous rain for 7 days were 96% in relative humidity, 18.9℃ in average temperature, 21.9℃ in maximum temperature, and 16.8℃ in minimum temperature, causing the most viviparous germination in Juanbyeo(45.5%), followed by Jinbubyeo(14.5%), Bongkwangbyeo(14.2%), and Obongbyeo(12.6%). Lateral tillers started to occur when the submergence at the depth of 1.5-2 m lasted one day during the reproductive growth stage. The submergence for 2-3 days at 3-4 m of water depth induced 269-571 lateral tillers/㎡, supporting 32-52% of the total yield. The rice yield in the paddy fields which were left under the lodging conditions until harvesting was not different compared to that of the paddy fields which were kept upright by tieing them together after lodging, but perfect grain ratio decreased about 9.1% in the transplanting culture and 12.5% in the direct seeding culture on dry paddy field because of the increase in immature grains.

固定化 微生物을 이용한 難分解性 有害化學物質의 分解 除去

李秉學,林洛俊,尹盛都 단국대학교 1994 論文集 Vol.28 No.-

Degradation and removal of poisonous materials by immobilized microorganism was investigated. Microorganism which was isolated from activated sludge by enrichment culture method was adsorbed on activated carbon and then entrapped with alginate. Optimum immobilizing condition was determined by means of batch culture method. Packed bed bioreactor was used for continuous treatment of various phenol waste water. From the results the following phenomena were obtained. 1. Immobilized biocatalyst which shown best degradation rate and stabilization was prepared with 2% activated carbon and 1% microorganism. 2. As transient inflow in the packed bed bioreactor, in order to the highest degradation efficiency, it preper to use calcium alginate bead. 3. Degradation efficiency of phenolic waste water by composite immobilized biocatalyst (activated carbon-alginate) was influenced by quantity of microorganism and an increment of adsorptivity of activated carbon entrapped in the immobilized biocatalyst. 4. The optimum degradation condition of phenolic waste water which was determined to the mineral salts as nitrogen source and 1.5% glucose was contained at 30℃.

인터넷 기반 원격 의료 진단 시스템 개발

이경태,임형주,김상욱 강원대학교 정보통신연구소 2002 정보통신논문지 Vol.6 No.-

Radiologic images are widely used in hospitals for diagnosing and treating patients' diseases. The radiologist accurately reads radiologic images, and thus helps diagnose patients correctly. The number of radiologists is much smaller than is necessary, however. In some small or rural hospitals, there are no radiologists residing there. In these cases, correct diagnosis and treatment are infeasible. Also, radiologists are not resident at hospitals all day long[1][2][3]. Thus, emergency patients would suffer from the absence of radiologists at night. XRay21 Inc. and Data & Knowledge Engineering Lab. at Kang won National University have been working together since 2000 in order to alleviate the problems above. Currently, the advances of the computer and network technology make it possible to connect a lot of radiologists and hospitals together through the Internet. By fully utilizing the Internet environment, we have developed a telemedicine system, thus permitting remote diagnosis of radiologic images. This paper presents the technical experiences obtained in developing the system.