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鄭熺孝,金洪俊,李承烈,朴峻熙 경상대학교 생산기술연구소 2002 工學硏究院論文集 Vol.2 No.-
In a box girder, it is an accepted practice in structural engineering to represent the effect of 'shear lag' by adopting an 'effective width' concept. The actual width of flange plate (b) is replaced by a reduced width (b_e) over which the longitudinal stresses may be considered uniformly distributed and the application of the elementary theory of bending to the transformed girder cross section gives the correct value of maximum longitudinal stress (σ_max). This paper provides how to determine the magnitude of 'shear lag' and 'effective width ratio' in case of orthotropic box girder which is simply supported, symmetrically loaded only.
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鄭熺孝,金洪俊,李承列,黃俊碩 경상대학교 생산기술연구소 2002 工學硏究院論文集 Vol.2 No.-
The purpose of this study is about the possibility of using bamboo to reinforce concrete in comparison with the reinforced concrete in the same experimental condition by conducting concrete using bamboo material and mechanical test of a bamboo. As a substitute material for the reinforced concrete, to check the possibility of using concrete with bamboo material either saving iron resources or developing lighter material was tried. Conclusions of this study can be summarized as follows; In contrast to reinforced concrete, bamboo concrete was failed brittly about cracked state, the failure was occurred by slip between concrete and bamboo before it reached yielding stress of bamboo. In the pullout test, bamboo pullout specimens were crushed by brittle crack and steel bar pullout specimens by pullout failure.
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기계호흡중인 환자에서 동맥혈 가스검사에 의한 예후의 조기평가에 대한 연구
이홍렬(Hong Lyeol Lee),김세규(Se Kyu Kim),장준(Joon Chang),김성규(Sung Kyu Kim),이원영(Won Young Lee) 대한내과학회 1992 대한내과학회지 Vol.43 No.3
N/A Background: Most clinicians caring for acutely ill patients in critical care units today agree that acute respiratory failure is one of the most common life- threatening processes encountered in children and adults. Whether acute respiratory failure presents as an acute exacerbation of advanced chronic obstructive lung disease or develops in patients with previous healthy lungs, it generally requires an intensive management including mechanical ventilation. Early prediction of outcome in such critically ill patients should be considered a high priority so that corrective measures or alternative support methods may be rapidly instituted. The most impotant clinical tool for the diagnosis and monitoring of acute respiratory failure is arterial blood gas measurement. Methods: We examined the arterial blood gas meaurement daily in patients with acute respiratory failure during the first 7days since the start of mechanical ventilation. We calculated each ratio of PaO2/FiO2 PAO2/FiO2 and PaO2/PAD2 from above and compared these values between each patient group. Results: When comparing these ratio parameters between the survival and expired groups in all patients, there was a significant difference from the second day since mechanical ventilation was initiated. When comparing these ratio parameters between the survival and expired groups in the nonpulmonary disease group, a significant difference was noted from the third day since mechanical ventilation was initiated. The values of PaO2/FiO2 and PaO2/PAO2 were higher in the survival group than in the expired group. These values had a tendency of gradual increase in the survival group and a slight decrease or almost no change in the expired group. The value of PAO2/FiO2 was lower in the survival group than in the expired group. This value had a tendency of continuous decrease in the survival group and a slight decrease or almost no change in the expired group. Conclusion: With the careful observation of changing patterns during the firs 7days since initiation of mechanical ventilation, these 3ratio parameters were thought to be helpful in the early prediction of outcome in mechanically ventilated patients due to acute respiratory failure by respiratory diseases and diseases other than the respiratory system.
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이홍렬(Hong Lyeol Lee),김세규(Se Kyu Kim),장준(Joon Chang),김성규(Sung Kyu Kim),이원영(Won Young Lee),조철호(Chul Ho Cho) 대한내과학회 1992 대한내과학회지 Vol.43 No.4
N/A Background: Mechanisms involved in host resistance against malignant tumors have been found to be mediated mainly by cellular effectors. These effector mechanisms include activated macrophages, killer T-cells, natural killer cells and antibody-dependent cellmediated cytotoxicity. Activated macrophages can sup- press DNA synthesis of tumor cells and kill tumor cells in a selective but nonspecific fashiori in vitro. Lipopolysaccharides (LPS) can enhance the cytotoxicity of macrophages and the lipid A which is produced by mild acid hydrolysis of LPS, is responsible for the LPS effect on macrophages. The mechanism by which LPS modifies macrophage physiology is not known, but it is suggested that it acts at the level of the macrophage plasma membrane. LPS may make macrophages tumoricidal by altering the membrane composition or by transmitting a necessary signal from the membrane to the vacuolar system. Methods: We isolated alveolar and peritoneal macrophages by bronchoalveolar and peritoneal lavage in rats. Rat sarcoma cell line (XC) was used as the target cell. As recommended commonly we controlled the effector cell: target cell ratio at 10:1, Three groups were divided as folows; no LPS added group, LPS 5μg/ml added group and LPS 10μg/ml added group, We focused the assay of cytotoxicity on the cytolysis rather than cytostasis by measuring the [3H] thymidine released and calculated the percentage specific cytalysis, By this experiment, we examined the stimulation effect of LPS an the macrophage cytotoxicity and compared the cytotoxicity between alveolar and peritoneal macrophages. Results: The cytotoxicity of alveolar and peritoneal macrophages was significantly enhanced when stimulated both with 5μg/ml and 10μg/ml of LPS. There was no significant difference in macrophage cytotoxicity between two groups each stimulated with 5μg/ml and 10μg/ml of LPS. We could not observe the significant difference in cytotoxicity between the alveolar and peritoneal macrophages, Conclusion: Cytotoxicity was significantly enhanced by stimulation of LPS, in hoth alveolar and peritoneal macrophages but there was no significant difference in cytotoxicity enhancement between 5μg/ml and 10μg/ ml of LPS. Also there was no significant difference in cytotoxicity between alveolar and peritoneal macrophages.
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이홍렬(Hong Lyeol Lee),곽승민(Seung Min Kwak),장중현(Jung Hyun Chang),김세규(Se Kyu Kim),김성규(Sung Kyu Kim),이원영(Won Young Lee),신동환(Won Young Lee) 대한내과학회 1992 대한내과학회지 Vol.43 No.6
N/A Backgrounds: Endobronchial metastasis of extrapulmonary malignancies was defined as those cases in which metastatic foci were grossly evident in the main or lobar bronchi and occurs in less than 5% of all cases. The common extrapulmonary tumors associated with metastatic involvement of a central airway are carcinomas of the breast, kidney, colorectum and malignant melanoma. In the majority of cases, the primary tumor site is clinically apparent before symptoms of endobronchial metastasis. The clinical and roentgenographic features of endobronchial metastasis and primary bronchogenic carcinoma were found to be indistinguishable. Mostly, the histologic appearance of the bronchoscopic biopsy suggests the correct diagnosis but in some instances it may be impossible to differentiate metastatic involvement of the bronchus by an asymptomatic extrathoracic adenocarcinoma from a primary central adenocarcinoma of the lung. In addition to the treatment aspect of neoplasm spread, palliative surgical removal of endohronchial metastatic malignancies are strongly recommended to improve the patients qualify of life and to prevent resultant obstructive complications. Methods: We experienced 5cases of endobronchial metastasis during the recent 1½ years and reviewed the medical records of 12cases previously confirmed as endobronchial metastasis by bronchoscopic bioposies since 1985 to 1990. We investigated the clinical manifestations, primary sites, time intervals and bronchoscopic findings. Results: Breast carcinoma was the most common primary malignancy leading to the endobronchial metastasis. We also found the metastatic cases of hepatocellular carcinoma, sebacious gland adenocarcinoma and mouth floor carcinoma. Mostly patients complained of dyspnea and productive cough and chest X-ray revealed atelectasis. Endobronchial metastasis developed within 3 years in more than half of the cases and the mean time interval was 40,6months. In one prostate cancer and one thyroid cancer, metastasis was diagnosed prior to primary site presentation. On bronchoscopic examination, the right upper lobar bronchus was most commonly involved and subtotal obstruction was the most frequent finding. More than half of the patients expired within 2 years after the diagnosis of endobronchial metastasis. Conclusion: Endobronchial metastasis has unique clinical significance in that it requires differential diagnosis with primary bronchogenic carcinoma and aggressive palliative surgical management. If atypical clinical features are present or atypical cell type is discovered by biopsy of the lesion in lung ca, appropriate diagnostic studies should be undertaken to exlude the possibility of an asymptomatic extrapulmonary tumor before definite therapy is undertaken.
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이홍렬(Hong Lyeol Lee),박규은(Kyu Eun Park),김세규(Se Kyu Kim),장준(Joon Chang),김성규(Sung Kyu Kim),이원영(Won Young Lee) 대한내과학회 1994 대한내과학회지 Vol.47 No.6
N/A Objectives: The humoral hypercalcemia of malignancy(HHM) describes a very specific clinical syndrome due to the production of a peptide or family of peptide hormones which share sequence homology and functional homology with parathyroid hormone. Patients with HHM account for up to 80 percent of malignancy-associated hypercalcemia. The hypercalcemia in lung cancer is mainly mediated by parathyroid hormone-related protein. Typical patients with HHM had little or no skeletal involvement. Hypercalcemia is predominantly associated with epidermoid and large cell anaplastic carcinoma. From a clinical standpoint, patients with hypercalcemia are usually in advanced stages with obviously bulky tumors and, therefore, carry a poor prognosis. Methods: Between January 1987 and November 1993, the patients those who fulfilled the following criteria were chosen as a subjects in this study: ① corrected serum calcium >10.5mg/dl; ② histologically proven primary lung cancer; ③ symptoms which could possibly be attributed to hypercalcemia. We investigated the various clinical features that could characterize the hypercalcemia in lung cancer. Results: Thirty-one patients with lung cancer were hypercalcemic and most of them had squamous cell carcinoma in histologic finding. The incidence between 50 and 69 years of age was higher significantly. The occurrence of hypercalcemia showed a strong positive correlation with the degree of histologic differentiation and the advancement of cancer stage. And the mean serum calcium level also showed a strong positive correlation with the mass size and the performance scale. Some symtoms such as general weakness, anorexia, constipation, consciousness change, and weight loss were more frequent in the patients of higher calcium level. There was no significant difference in effectiveness among the therapeutic regimens for hypercalcemia. Most of patients were hypercalcemic at the time that the diagnosis of lung cancer was made. Most of them died within 1 month after the development of hypercalcemia. Conclusion: The hypercalcemia in lung cancer was found more frequently in men whose ages were between 50 and 69 years old, and in the patients who had poorly differentiated squamous cell carcinoma or the carcinoma in advanced stage. Mean serum calcium level was higher in more symptomatic patients, and in the patients with worse performance scale or larger tumor mass. The prognosis of hypercalcemic patients with lung cancer was extremely poor.
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폐암의 진단에서 경기관지 침흡인술 ( TBNA ) 의 유용성에 대한 연구
이홍렬(Hong Lyeol Lee),김세규(Se Kyu Kim),장준(Joon Chang),김성규(Sung Kyu Kim),이원영(Won Young Lee) 대한내과학회 1995 대한내과학회지 Vol.48 No.2
N/A Objectives: Transbronchial needle aspiration (TBNA) is the newest technique to become available for use with the fiberoptic bronchoscope. But because it is associated with the technical difficulties and problems in the interpretation of cytologic examination, it carries the least application until now and its routine use just like forceps biopsy or washing is not recommended. Even though several indications have been suggested, the role of needle aspiration in the diagnosis of central lesion remains to be determined. The needle, however, would have the advantage of easy penetration through submucosal or peribronchial tissue layers that are difficult to access with biopsy forceps, it can have the unique diagnostic usefulness and it is a safe technique without any significant complications. The purpose of this study was to establish the diagnostic yield of TBNA, especially in patients with peribronchial or submucosal lesion or necrotic endobronchial lesion, to compare the yield to that of forcep biopsy. Methods: Sixty-seven patients who were found to have the lesions suggestive of peribronchial or submucosal tumor or necrotic endobronchial lesion during diagnostic fiberoptic bronchoscopy and fifty-two patients in whom primary or metastatic lung cancers were confirmed from January 1992 to December 1993 at Severance Hospital Yonsei University were included in this study. The TBNA always preceded all the other procedures in order to minimize the possibility of contamination of the aspirated specimen. Interpretation of TBNA result was done with four categories; ① carcinoma of definite cell type, ② carcinoma of uncertain cell type, ③ suspicious of malignancy, ④ negative or unsatisfactory, after correlating the biopsy result. Results: During this period, flexible fiberoptic bronchoscopic examination was done in 1,517 cases and TBNA in 4.4%. Of these patients of TBNA, 62.9% of lesions occurred in the right bronchi, 34.3% in the left bronchi, and 2.8% in the distal trachea. The difference of TRNA yield according to cell type or bronchoscopic appearance of lesion was not significant, but it showed the relatively better result in small cell carcinoma and metastatic lung cancer. The difference of the yield between TBNA and biopsy among any cell type or any bronchoscopic finding was not significant, but the difference between the yield of the biopsy alone and the biopsy combined with TBNA was statistically significant. The cases in which TBNA was the only diagnostic test that disclosed a malignant lesion were 15 (28.8%). For 5 patients in 10, repeated bronchoscopy could have been avoided if at initial bronchoscopy physicians had performed TBNA. Conclusion: Our findings suggest that TBNA is a safe technique that can significantly increase the diagnostic yield of fiberoptic bronchoscopy in the diagnosis of peribronchial or submucosal spread of bronchogenic carcinoma over that of forceps biopsy alone, and can be beneficial for suspected small cell carcinoma and pulmonary metastatic lesions. To obtain the maximal diagnostic yield, needle aspiration should be combined with the forceps biopsy.
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