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서기현(Gi-Hyun Seo),강효석(Hyo-Suk Kang),이희진(Hee-Jin Lee),박민용(Mignon Park) 한국지능시스템학회 2010 한국지능시스템학회 학술발표 논문집 Vol.20 No.2
본 논문에서는 기존의 차량 자동변속기 시스템을 효율적으로 제어하기 위해 뉴럴 네트워크 알고리즘을 적용하였고, 시뮬레이터 기반으로 설계하여 그 성능을 효과적으로 보여주었다. 가속 페달에 최대의 힘을 가했을 때, 속도대비 효율적인 RPM과 연료 소비를 위해 뉴럴 네트워크 학습 알고리즘으로 최적의 변속 구간을 선정하는 방식을 사용하였다. 제안된 자동변속기 시스템의 향상된 성능을 보여주기 위해 기존의 자동변속기 및 퍼지 자동변속기 시스템과 비교하였고, 시뮬레이터로 그 결과를 보여 주었다.
미만성 폐포출혈을 동반한 전신성 홍반성 루푸스 환자에서 Plasmapheresis를 이용한 치험
고재현 ( Jay Hyun Koh ),송서영 ( Seo Young Song ),이창근 ( Chang Keun Lee ),서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),고은미 ( Eun Mi Koh ),송재훈 ( Jae Hoon Song ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.2
Pulmonary alveolar hemorrhage (PAH) is a rare and often fatal presenting feature of systemic lupus erythematosus (SLE) and enters the differential diagnosis of diffuse lung disease in patients with SLE. Reported mortality rates are extremely high, between 70 and 90 percents. Because death frequently occurs within the first several days of the hemorrhage, the diagnosis needs to be established promptly and treatment should be initiated immediately. Treatment of alveolar hemorrhage has included various combinations of corticosteroids, cytotoxic agents, and plasmapheresis, but survival rates have been extremely low despite aggressive therapy. We experienced a case of diffuse alveolar hemorrhage in a 29 year-old SLE male patient. PAH was diagnosed by hemoptysis, anemia, infiltration on chest X-ray and hemosiderin-laden macrophages in bronchoalveolar lavage. After high dose intravenous steroid, cyclophosphamide intravenous therapy and plasmapheresis, the condition of patient was markedly improved. He was discharged and received monthly intravenous pulse cyclophosphamide. He has done well since, showing no further pulmonary hemorrhage with steroid tapering.
초기 류마티스 관절염에서 적혈구 침강속도, 혈청 C-반응성 단백과 방사선학적 진행의 상관관계
고재현 ( Jay Hyun Koh ),김재형 ( Jae Hyung Kim ),이창근 ( Chang Keun Lee ),전찬홍 ( Chan Hong Jeon ),서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),안중모 ( Joong Mo Ahn ),고은미 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.4
Objective: To investigate the clinical usefulness of serial measurement of erythrocyte sediment rate(ESR) and C-reactive protein(CRP) for monitoring the radiological progression in early rheumatoid arthritis(RA). Methods: Thirty one patients with RA according to the 1987 ACR criteria, with joint symptoms for less than one year, and who had not previously received disease modifying antirheumatic drugs(DMARDs) were assessed from Oct. 1994 to Aug. 1998 in retrospective study. Area under curve(AUC) of ESR and CRP were calculated in these patients. Joint damage in the hands was assessed by modified Sharp`s method. Results: Male to female ratio was 1: 3.4. Median age of this group was 45.8±13.2 years. Patients who had positive rheumatoid factor were 82%. Mean duration until first visit was 271.9±145.8 days. At the first clinic visit, mean ESR and CRP were 50mm/hr and 2.0mg/dL. Mean erosions and joint space narrowing score by modified Sharp`s method were 55.2 and 12.4, respectively. Correlation analysis showed that ESR AUC and CRP AUC were significantly associated with radiologic progression. Conclusions: Elevated over-time ESR and CRP provide a convenient short term correlation with radiologic outcome(i. e. erosions). Elevated over-time ESR and CRP can be used as a guide for therapy.
전신성 괴사성 혈관염에서 다발성 단신경염의 임상적 고찰
김진석 ( Jin Seok Kim ),차훈석 ( Hoon Suk Cha ),서기현 ( Gi Hyun Seo ),안홍준 ( Hong Joon Ahn ),이창근 ( Chang Keun Lee ),고재현 ( Jae Hyun Koh ),김현숙 ( Hyeon Sook Kim ),최동철 ( Dong Chull Choi ),고은미 ( Eun Mi Koh ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
Background: The vasculitides are heterogeneous clinical syndromes characterized by inflammation of blood vessels. There are no pathognomonic symptoms. Mononeuritis multiplex is an acute or subacute asymmetric sensory motor syndrome involving discrete peripheral nerves and is known to occur in many illnesses including certain types of systemic vasculitis. Our purpose was to evaluate the clinical manifestations and significance of mononeuritis multiplex in systemic necrotizing vasculitis. Patients & Methods: Eight patients who were diagnosed as systemic necrotizing vasculitis at Samsung Medical Center between 1995 and 1997 were reviewed. Vasculitis was diagnosed by ACR criteria for each vasculitis and microscopic polyangiitis was diagnosed by the Chapel Hill Consensus Conference on the nomenclature of systemic vasculitis. Three were diagnosed as Churg-Strauss syndrome, 3 as polyarteritis nodosa, and 2 as microscopic polyangiitis. In most cases, vasculitis was confirmed by a biopsy specimen showing infiltration of granulocytes, lymphocytes, and/or plasma cell into vessel walls. Occasionally, polyarteritis nodosa was confirmed by mesenteric or renal arteriography which showed microaneurysms. EMG/NCV was performed in seven patients who had neuropathy. Results: Seven of the eight patients presented with mononeuritis multiplex and one had no neuropathy. Four patients presented with neuropathy as the first symptom, and three developed neuropathy within 3 weeks after the onset of vasculitis symptoms. The peroneal nerve and sural nerve were involved in all seven patients. The median nerve, ulnar nerve and posterior tibial nerve were involved in four, two and six patients, respectively. All seven patients had lower extremity involvement. Two showed only lower extremity involvement and five had both lower and upper extremity involvement. Isolated upper extremity involvement was not seen. All patients with mononeuritis multiplex were improved by treatment with cyclophosphamide and steroid therapy. Conclusion: Mononeurtis multiplex is a common manifestation of vasculitis and occurs early in the course of systemic vasculitis. Prognosis of mononeuritis multiplex is excellent, although it may take up to one year to recover.
김진석 ( Jin Seok Kim ),차훈석 ( Hoon Suk Cha ),고재현 ( Jay Hyun Koh ),서기현 ( Gi Hyun Seo ),이창근 ( Chang Keun Lee ),김병준 ( Byoung Joon Kim ),최화정 ( Hwa Jung Choi ),한정호 ( Joung Ho Han ),오원환 ( Won Hwan Oh ),고은미 ( E 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.3
Objective: The synovium in rheumatoid arthritis(RA) is characterized by an increase in the thickness of lining layer and infiltration of cells into the sublining area. Histomorphologic studies of RA have indicated that initial destruction is more closely related to the presence of transformed appearing proliferating synovial cells than to the presence of subsynovial or periarticular inflammation. Based on the fact that synovial lining cells have some properties of transformed appearing cells, we examined the expressions of Fos, Jun and Myc oncoproteins in the synovial tissue from patients with rheumatoid arthritis and osteoarthritis. Methods: Synovial tissues from 15 patients with RA and 15 with osteoarthritis(OA) were studied by the immunohistochemical staining technique. Nine of 15 RA sped men were from arthroscopic synovectomy and the other 6 were from total knee replacement arthroplasty. Result: In all specimen studied, Myc and Fos were expressed in the synovial lining cells and Myc, Fos and Jun were expressed in the sublining cells, including lymphocytes, other inflammatory cells and blood vessels. Lymphocytes in the diffuse infiltrates showed increased expression of three oncoproteins compared to lymphocytes in the nodular aggregates. When oncoprotein expressions in RA were compared to OA, Fos and Myc expressions in the synovial lining cell layer were significantly higher in RA than in OA and Jun, Fos and Myc expressions in inflammatory cells were significantly higher in RA than in OA. The expressions of Fos and Myc were significantly correlated with the degree of synovial hypercellularity. In RA, the expressions of all three oncoproteins were increased in synovectomy group than joint replacement group. Conclusion: We observe that there are increased expressions of Myc, Fos and Jun in RA synovium than OA. These changes are more prominent in synovectomy group than joint replacement group, which suggest the differential expression of oncoproteins according to disease progression.
스테로이드 치료로 호전을 보인 폐동맥 고혈압을 유발한 특발성 섬유화성 종격동염
정보용 ( Bo Yong Jung ),어성준 ( Sung Jun Eo ),박은서 ( Eun Seo Park ),김영통 ( Young Tong Kim ),최재성 ( Jae Sung Cho ),오미혜 ( Mi Hye Oh ),서기현 ( Gi Hyun Seo ),나주옥 ( Joo Ock Na ),이상도 ( Sang Do Lee ),어수택 ( Soo Taek Uh 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.1
Idiopathic fibrosing mediastinitis is, an uncommon cause of pulmonary hypertension this is characterized by excessive fibrosis of the mediastinum with an unknown etiology. Steroid therapy has been suggested for individuals with progressive symptoms, bu there is littlet data demonstrating the efficacy of such therapy are lacking. We present a case of pulmonary hypertension secondary to a compression of a main pulmonary artery by fibrosing mediastinitis which was confirmed by a biopsy with a thoracotomy. The chest CT scan and 2D echocardiography performed before and after a trial of steroid therapy demonstrated improvement after steroid therapy. (Tuberc Respir Dis 2006; 61: 74-79)
이창근,김재준,고은미,김진석,서기현,차훈석,고재현,안홍준 대한내과학회 1999 대한내과학회지 Vol.57 No.1
Rheumatoid vasculitis is a necrotizing arteritis of unknown causes that affect a subset of patients with rheumatoid arthritis. Vasculitis associated with rheumatoid arthritis was first recognized in 1898. It was described frequently in the 1940s through 1960s but is now rarely diagnosed. Typical clinical features include constitutional symptoms, mononeuritis multiplex, skin infarction, ulceration, peripheral gangrene and visceral infarction. Gastrointestinal involvement occurs in 10 to 38% of cases of rheumatoid vasculitis and may include bowel infarction, ulceration, perforation, colitis, stricture, or bleeding. Ischemia of the intestine is the end result of interruption or reduction of its blood supply. However, the clinical manifestations of intestinal ischemia range from mild chronic symptoms to a catastrophic acute episode, depending on the vascular supply involved, the extent of the occlusion or ischemia, and the rapidity of the process. Physicians caring for patients with rheumatoid arthritis should be aware that intestinal ischemia or infarction may occur without overt clinical evidence of systemic rheumatoid vasculitis. Herein we describe a case of rheumatoid vasculitis manifesting as ischemic colitis which was intractable to medical therapy and led to subtotal colectomy.