식도정맥류 출혈의 내시경적 결찰술후 재출혈의 예측인자

탁원영 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 간경변증 환자에서 발생한 식도정맥류 출혈의 치료로 최근에는 고무밴드를 이용한 내시경적 정맥류 결찰술이 널리 이용되고 있다. 그러나 결찰술을 시행한 후에 재출혈을 일으키는 인자에 대해서는 별로 보고된바 없다. 이에 저자는 간경변증 환자에서 식도정맥류 결찰술 후에 재출혈에 관계하는 인자들을 알아보기 위하여 본 연구를 시행하였다. 대상 및 방법 : 1994년 1월부터 1996년 9월까지 경북대학교병원 소화기내과에서 식도정맥류 출혈로 내시경적 정맥류 결찰술을 시행한 환자중 추적 경과 관찰이 가능했던 133예를 대상으로 하여 재출혈 유무에 따른 임상적 특징을 분석하였다 결과 : 1) 대상환자의 시술전 Child-Pugh 분류상 A, B, C가 각각 38, 70, 25예였고 간암이 동반된 경우가 30예였으며, 이중 9예에서 간문맥혈전증이 있었다. 시술중 활동성 출혈 소견이 있던 경우는 45예(33.8%)였다. 2) 재출혈 시기를 시술후 6개월, 12개월, 24개월로 나누어 보았을 때, 누적재출혈율은 6개월내에 21.0%(28예), 12개월내 34.8%(40예), 24개월내에 63.1%(53예)였고 재출혈 빈도는 시술후 경과 기간과 직선적인 상관관계를 보였다. 3) 시술중 활동성 출혈소견이 있는 경우에서는 없는 경우에 비해 6개월 이내의 재출혈율이 의미있게 높았고, 간암이 동반된 경우에 12개월, 24개월 이내의 재출혈율이 유의하게 높았으며, 간문맥 혈전이 동반된 경우에는 기간에 관계없이 재출혈율이 유의하게 높았다. 4) 시술후 베타차단제를 복용한 경우는 복용하지 않은 경우에 비해 6개월, 12개월 이내의 재출혈율이 의미있게 낮았으며 (p<0.01, p<0.05), 시술전 위정맥류가 동반된 경우에도 없는 경우에 비해 낮은 재출혈 빈도를 보였다. 5) 시술 당시의 Child-Pugh 분류와 재출혈율 사이에는 유의한 상관관계는 없었다. 결론 : 이상의 결과로 간경변증 환자에서 식도정맥류 출혈시 내시경적 정맥류 결찰술을 시행한 후에 생기는 재출혈에는 시술당시의 활동성 출혈 소견 유무와 간문맥 혈전증, 위정맥류의 동반여부가 영향을 미치며, 시술후 베타차단제 투여 여부도 중요한 인자로 생각된다. Objectives : Endoscopic variceal ligation(EVL) is widely used for control of esophageal variceal bleeding. But there is little information about predictve factors of rebleeding after EVL. The purpose of this study is to assess factors related to rebleeding after EVL. Methods : The 133 cirrhotic patients, underwent EVL due to esophageal variceal bleeding, were evaluated retrospectively about clinical characteristics according to presence or absence of rebleeding. Results : 1) Cumulative rebleeding rate in 6, 12 and 24 months was 21.0%, 34.8% and 63.1% respectively, and frequency of rebleeding had linear correlation with time after EVL. 2) In the cases of active bleeding during EVL, rebleeding rate within 6 months was significantly higher than without active bleeding. 3) In the patients with primary liver cell carcinoma(PLCC), rebleeding rate within 12, 24 months was significantly higher than without PLCC. 4) In the patients with portal vein thrombosis, rebleeding rate was higher than without portal vein thrombosis regardless of time. 5) In the patients who took β-blocker after EVL, rebleeding rate within 6, 12 months was significantly lower than the other and in the patients with cardiac varices, rebleeding rate was significantly lower than the other. 6) There was no correlation between initial Child-Pugh class and rebleeding rate regardless of time. Conclusion : In this study, we presumed that rebleeding rate after EVL in liver cirrhosis patients with esophageal variceal variceal bleeding is influenced by presence or absence of active bleeding during EVL, associated portal vein thrombosis and gastric varices and by use of β-blocker after EVL.

컴퓨터비젼에 의한 자동차용 Head Lamp Cover 형상인식

탁영봉,김대원 경상대학교 생산기술연구소 2001 工學硏究院論文集 Vol.1 No.-

The computer vision technique was used to recognize the shape of automobile head lamp cover. To acquire a clear input image, two lightings were utilized to make the total reflection from the bottom of the jig on which transparent lamp covers were laid. The threshold value of the input image was obtained by the optimal adaptive thresholding of the Otsu method. The contour of a sample was extracted from the binarized image after being pre-processed, and then it's centroid was found out using the coordinate of each point. The interior of the contour was colored, and it's area was calculated by counting the pixels of the area. The length between the centroid and the contour was traced by rotating from 0˚ to 360˚. Using this polar-sampling graph, the feature values to recognize the type of a sample were extracted. comparing the feature values of a sample with those stored in teaching mode recognizes as an identical object if the error is within the predetermined tolerance of 5%. The feature data was obtained by teaching a sample 5 times each for 20 different samples. In on-line test, the recognition rate of 95% was obtained, but it will still be improved if we can reproducibly acquire clear input image by fixing the location of the jig.

5-FU 투여후 백서 가슴샘에서 일어나는 형태학적 및 생화학적 변화

손영탁,김선,정옥,한승로,김수일,이영호,김원식 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Thymus is a lymphoid organ forming T-cells from hematogenous stem cells. Apoptosis of thymocytes in the cortex of thymus is so rapid that cannot find easily with routine histological techniques. In this experiment, TUNEL immunohistochemistry and TEM were used to detect apoptotic changes after 5-fluorouracil treatment in the thymus of the rat. In addition, SDS-PAGE was carried to reveal protein changes along the apoptotic changes. The results were as follows ; 1. Thymocytes in the cortex were decreased markedly and many apoptotic cells were found in the cortex on DAT 3. 2. Relatively small-sized apoptotic bodies induced by 5-FU were detected on DAT 3 at the cortex, and clustered in partly. 3. On DAT 6, new germinal centers formed in the peripheral cortex, and many apoptotic bodies of various size and shapes were detected in the germinal center. 4. In SDS-PAGE, a protein with molecular weight of 123kDa was increased on DAT 6. According to the above results, it could be concluded that 5-FU acted directly on the thymocytes and induced apoptotic changes on DAT 3. But, on DAT 6, the period of recovery, new germinal centers were formed in the cortex, in which active B cell production to compensate the loss of thymocytes was noticed. To make new T-cells from B-cells and to eliminate unnecessary B-cells, vigorous apoptosis in the germinal centers should occur, and 123kDa proteins which considered as integrins should act as transmembrane signaling molecules in this process.

모발의 부위별 분석을 통한 Methamphetamine 남용자의 복용시기 추정에 관하여

유영찬,정희선,최화경,진원택,이한선 內務部 國立科學搜査硏究所 1996 國立 科學 搜査 硏究所 年報 Vol.28 No.-

사회 경제적 배경에 따른 청소년의 스포츠 가치관 연구

김수현,원영신,윤여탁 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

This study is intended to investigate the values in sports of the juveniles as socioeconomic background. Three major facotrs are set to accomplish this research. In this study, stratified cluster random sampling method was used and 1320 high school students who live in Seoul were extracted but collected 1116 students. In this study questionnaires were re-arragned to suit to this study based by normally using questions to ask socioeconomic background, and by the re-arranged questions by 4 Korean scholars and researchers from the Evarett(1962), the Allport, the Vernon, and the Lindzey(1960) to ask values in sports. To analyse the data, the mean, the standard deviation, t-test, one-way ANOVA, and discriminant analysis were used. The conclusions of this study are following. First, the values in sports are differ according to the charactors of the students. Second, There are difference in the values in sports according to the socioeconomic background. Third, this study shows the values in sports could be classified and predict partly subjective social classes.

신경병증성 통증 모델쥐 뒤뿌리신경절의 Nitric Oxide Synthase 아형 및 NADPH-diaphorase 발현에 관한 연구

정성균,김수일,양은진,류택근,권오유,박경란,이영호,김원식 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

Injury to peripheral nerve somtimes lead to neuropathic pain. Nitric oxide(NO) is increased in the dorsal root ganglia (DRG) of neuropathic pain models, and L-NAME, a nitric oxide synthase (NOS) inhibitor, reduces neuropathic pain. However, it is not known that underlying mechanism of NO involvement in development and maintanence of neuropathic pain. It was found that there were three NOS isoforms-nNOS, eNOS, and iNOS. It is also necessary to investigate NOS isoforms in neuropathic pain. The aim of this study is to investigate NOS isoforms and NADPH-diaphorase expressions and underlying mechanism of NO involvement in neuropathic pain. The 5^th lambar (L5) DRG were obtaind after tight ligation of L5 an L6 spinal nerves for 7 days. Toluidine blue stain, immunohistochemistry for nNOS, eNOS, and iNOS, and NADPH-diaphorase histochemistry were performed. All specimens were observed under light microscope. nNOS expression was increased significantly in the cytoplasm of the DRG of ligated side at 7 day post-ligation (7D PL). eNOS expression was also increased in the blood vessel, a few neurons or satellite cells, and cell membrane of Schwann cells in the DRG of ligated side at 7D PL. iNOS expression was increased in a few blood vessels and cytoplasm of small neurons in the DRG of ligated side at 7D PL. NADPH-diaphorase expression was increased significantly in the neurons of the DRG of ligate side at 7D PL, but NADPH-diaphorase expressions were weak or absent in the blood vessel and Schwann cell in the contralateral DRG and the DRG of ligated side at 7D PL. It is suggested that NOS isoforms may be closely related to development and mantanence of neuropathic pain in order of nNOS>eNOS>iNOS.

만성 활동성 간염에 있어서 Ursodeoxycholic acid의 치료효과

김성록,안병철,윤영미,탁원영,곽규식,최용환,정준모 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.4

The purpose of this study is to evaluate the clinical and biochemical effects of SGD-F^(R)(UDCA, Vitamin B_1, Vitamin B_2 complex) in chronic active hepatitis. Observed cases were given orally after each meal(three times a day) for 4 weeks. The results were as follows: 1. Among subjective symptoms, improvement rate showed in easy fatigability 86.7%, anorexia 68.0%, indigestion 80.0%, nausea and vomiting 72.7%, RUQ pain 83.3%. 2. Biochemical parameters such as SGOT, SGPT, showed to be improved significantly after the 4 weeks treatment.(p<0.01) 3. There was no specific side effect during the study period in all cases. In conclusion, SGD-F^(R) capsule may be safe and effective for chronic active hepatitis.

위장질환에 따른 H.pylori 감염빈도와 검사방법의 비교분석

김대현,조재현,금민수,최성곤,이창형,탁원형,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : H. pylori가 위장관 질환의 병인에 깊은 관련이 있어 이의 적절한 진단 및 치료가 중요하게 대두되고 있다. 이에 저자들은 소화기 증상을 주소로 내원한 환자들을 대상으로 내시경 검사를 실시하여 H. pylori검출을 위한 CLO검사, IgG 항체검사 및 H&E 염색 등을 시행하여 각 질환별로 H. pylori 감염의 양성율을 알아보고 검사법에 따른 민감도 및 특이도를 그 유용성에 대하여 조사하였다. 대상 및 방법 : 1996 4월에서 8월까지 경북대학교병원에 소화기증상을 주소로 내원한 총 313명의 환자를 대상으로 내시경 검사를 실시하여 H. pylori 검출을 위한 CLO 검사, IgG 항체검사, 조직염색 검사를 실시하였다. 결과 : 전체 대상 환자수는 313명이었고 연령별 분포는 16세부터 80세 까지 다양하였으며 그중40대, 50대, 60대가 각각 69예(22%), 73예(23.3%), 65예(20.8%)로 전체 환자중 66%를 차지하였다. 남녀비는 2.07 대 1로 남자가 많았다. 대상환자의 평균나이는 52±15세였고, 전체 대상환자에서 H. pylori 양성군과 음성군의 평균나이는 각각 50±15세, 54±15세 였고, 궤양환자군에서 H. pylori 양성군과 음성군사이의 평균나이는 각각 49±14.8세, 55±13.8세로 나타났다. 각 질환별분포는 위염이 72명(23%), 십이지장 궤양이 85명(27.2%), 위궤양이 80명(25.6%), 위암이 20명(6.4%), 비궤양성 소화불량이 13명(4.2%), 기타가 43명(13.7%)이었으며, H. pylori 감염 양성율은 위염이 71%, 십이지장 궤양이 86.8%, 위궤양이 58.3%, 위암이 75%, 비궤양성 소화불량이 75%였으며 특히 유문륜 궤양에서는 100%의 양성율을 보였다. 소화성 궤양군과 비궤양군에서의 H. pylori 양성율을 비교해 본 결과 궤양군에서는 73.1%, 비궤양군에서는 72%로 통계학적으로 차이는 없었다(P=0.91). 소화성 궤양환자에서 출혈이 동반된 군과 동반되지 않은 군에서의 H. pylori 양성율을 비교해 본 결과 출혈이 동반된 군에서의 양성율은 54.5%였고, 출혈이 동반되지 않은 군에서는 77.5%의 양성율을 보여 출혈이동반되지 않은 군에서 통계학적으로 유의하게 높았다(P=0.014). 나이에 따른 양성율을 알아본 결과 50세 이하에서는 78.5%였고, 50세 이상에서는 67.5%로서 양성율이 낮았으나 통계학적으로 유의성은 없었다(P=0.052). 각 검사법에 따른 민감도 및 특이도는 전체 환자중에서는 CLO검사가 88.9%, 96.1%, IgG항체검사 90.8%, 58.5%, H&E 염색검사 86.9%, 79.2%로서 민감도는 비슷하게 나왔으나 CLO검사는 상대적으로 특이도가 다른 검사법에 비해 높았다. 궤양군에서의 CLO검사의 민감도와 특이도는 92.0%, 95.6%였고, 비궤양군에서의 민감도와 특이도는 84.3%, 96.8%로서 비궤양군에서는 CLO검사의 민감도는 약간 낮았다. 나이에 따른 CLO 검사의 민감도 및 특이도는 50세 이하에서는 91.5%, 93.1% 였고, 50세 이상에서는 86.3%, 97.9%로서 50세 이상에서는 상대적으로 CLO검사의 민감도가 낮았다. 결론 : 본 연구에서는 위장질환에 따른 H. pylori 양성율을 알아보았는데, 다른 보고에서 처럼 높게 나왔으며, 진단 방법으로 사용한 CLO검사, IgG항체 검사, 조직염색검사 등은 모두 비교적 높은 예민도를 나타냈고, 그중 CLO검사가 간편하고 경제적이라는 면에서 임상적으로 유용한 검사로 여겨지나 상대적으로 CLO검사의 민감도가 낮은 비궤양성 질환과 50세 이상의 환자군에서는 CLO검사 외에 다른 검사방법을 병행함으로써 H. pylori의 진단율을 높일 수 있을 것으로 사료된다. Background: Gastric colonization by Helicobacter. pylori is common among patients with peptic ulcer and gastritis. And various diagnostic tests are available in confirming H. pylori infection. The aim of this paper is to estimate the prevalence of H. pylori infection in Gastroduodenal disorders and compare the sensitivity and specificity of the most widely available tests. Methods: A total of 313 patients were tested for H. pylori infection by IgG Ab, CLO test and H&E stains. Results: The prevalence of H. pylori infection was significantly higher in duodenal ulcer(86.8%) than in gastric cancer(75%), gastritis(71%) and gastric ulcer(58.3%)(P=0.009). The sensitivity and specificity of each test was as follows: CLO test(88.9%, 96.1%), IgG Ab test(90.8%, 58.5%), H&E stain(86.9%, 79.2%). Sensitivity of CLO test in peptic group was 92.0%, whereas in non-peptic group, it was 86.3%. Sensitivity of CLO test in age under 50 was 91.5%, that over 50 it was 86.3%. Conculsions: There is a strong association between H. pylori and gastrointestinal disorders. CLO tests have relatively high sensitivity and specificity, especially in peptic group and younger age(below 50 yr)group. But in those patients in which CLO tests are less sensitive (age>50 or non-peptic group), more than one test may be necessary to diagnose the presence of the organism.

48-Week Safety and Efficacy of Switching to Tenofovir Alafenamide (TAF) from Tenofovir Disoproxil Fumarate (TDF) in Asian Patients with TDF Risk Factors (RF)

( Won Young Tak ),( Sang Hoon Ahn ),( Seung Woon Paik ),( Jia-Horng Kao ),( Hie-won Hann ),( Fung Scott ),( Trinh Huy ),( Nguyen Tuan Trong ),( Gaggar Anuj ),( Flaherty John ),( Yee Leland J ),( Jump 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: In a recent Phase 3 study (Study 4018) in HBV patients suppressed on TDF treatment, switching to TAF demonstrated noninferior efficacy to continued TDF with superior bone and renal safety at Week 48. This study aims assess the safety and efficacy of switching to TAF from TDF in patients of Asian descent with risk factors for TDF toxicity as per current EASL and AASLD guidelines. Methods: Virally suppressed patients (HBV DNA <20 IU/mL at screening) on TDF were randomized (1:1) to switch to TAF or continue TDF for 48 weeks in a double-blind fashion. Viral suppression and changes in bone (BMD by DXA) and renal (creatinine clearance [eGFR_CG]) parameters were assessed over 48 weeks. Results: Among the 400 Asian patients enrolled, 288 (72%) had at least 1 TDF RF. At Week 48, similar proportions with ≥1 RF had HBV-DNA <20IU/mL (TAF 97%; TDF 97%) and normal ALT by 2018 AASLD criteria (TAF 76%; TDF 73%). TAF subjects with ≥1 RF had increases in eGFR_CG compared to decreases on TDF [median (Q1, Q3) change; TAF: +2.6 (-2.01, 7.34); TDF: -2.7 (-7.56, +15.79); P<0.0001)]. Among patients with ≥1 RF, improvements were seen in BMD for TAF vs. continued declines in TDF patients at both spine (P<0.0001) and hip (P<0.0001). Conclusions: Virally suppressed Asian patients with CHB and risk factors for TDF who switched to TAF showed improved bone and renal safety while efficacy was well-maintained.

Phase I/II study of first-line combination therapy with sorafenib plus resminostat, an oral HDAC inhibitor, versus sorafenib monotherapy for advanced hepatocellular carcinoma in east Asian patients

Tak, Won Young,Ryoo, Baek-Yeol,Lim, Ho Yeong,Kim, Do-Young,Okusaka, Takuji,Ikeda, Masafumi,Hidaka, Hisashi,Yeon, Jong-Eun,Mizukoshi, Eishiro,Morimoto, Manabu,Lee, Myung-Ah,Yasui, Kohichiroh,Kawaguchi, Springer-Verlag 2018 Investigational new drugs Vol.36 No.6