만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

Methotrexate 치료를 받고 있는 활동성 류마티스 관절염 환자에서 etanercept의 유효성과 안전성에 관한 연구

최병렬,강태영,정청일,이혜순,엄완식,김태환,전재범,유대현,배상철 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 류마티스 관절염을 앓고 있는 한국인 중에 기존 DMARDs로 치료 실패하였고, 고정용량의 MTX를 복용하고 있는 환자들에 있어서 etanercept의 유효성과 안전성을 평가하고자 하였다. 방법 : 기존 DMARDs로 치료 실패한 활동성 류마티스 관절염 환자 76명을 대상으로 하여 단일군, 공개시험을 하였다. 대상 환자들은 고정용량의 MTX를 복용하면서 etanercept 25 mg을 1주일에 두 번 피하 주사하였으며 12주간 투여하였다. 유효성은 ACR 20, ACR 50,조조강직 시간으로 평가하였고, 약제의 안전성은 이상반응 등으로 평가하였다. 결과 : 대상 환자는 총 76명으로 평균 연령은 45.2세, 남자 5명, 여자 71명이었다. 84.4%인 54명이 12주째에 ACR 20을 만족하였고, 53.1%인 34명이 12주째에 ACR 50을 만족하였다. 조조 강직 시간은 치료 전 203.3분에서 치료 12주째 42.6분을 평균 74.5% 호전되었다. 가장 흔한 이상반응은 주사부위 반응이었다. 이외에도 상기도 감염, 오심, 안면부종 등이 발생하였으나 심각한 부작용은 없었다. 결론 : etanercept는 효과적이고, 안전한 류마티스 관절염 치료 방법이며 특히 MTX치료에도 불구하고 활동성인 류마티스 관절염에 기대되는 치료라고 할 수 있다. Background : This study was performed to investigate the efficacy and safety of etanercept in active rheumatoid arthritis patients with stable dose of methotrexate in Korean. Methods : In a 12 week, single arm, open trial, we assigned 76 patients with active rheumatoid arthritis who had an inadequate response to disease-modifying antirheumatic drugs. Patients received twice-weekly subcutaneous injections of etanercept 25 ㎎ while containing to receive methotrexate at a stable dose of 7.5~25 ㎎ per week. The clinical response was defined as the percent improvement in disease activity according to the criteria of the American Collage of Rheumatology (ACR) at 12 weeks. Results : Etanrecept led to significant improvements in disease activity and was safe and well tolerated. At 12 week, 84.4% of the patients receiving 25 ㎎ of etanercept achieved a 20% ACR response, and 53.1% of those receiving etanercept achieved a 50% ACR response. The most common adverse event was injection-site reaction. Other advanse events were upper respiratory infection, nausea, and facial edema, but there were no serious adverse events associated with etanercept. Conclusion : In active rheumatoid arthritis patients, etanercept was safe, well tolerated, and provided rapid clinical improvements.

Poster Session:PS 1216 ; Cardiology : Pseudoaneurysm Formation with Bursting Stent Fracture at Common Iliac Artery: Endovascular Aneurysm Repair

( Dae Hwan Bae ),( Joo Hee Lee ),( Sang Yeub Lee ),( Jang Whan Bae ),( Kyung Kuk Hwang ),( Dong Woon Kim ),( Myeong Chan Cho ),( Sang Min Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Percutaneous balloon angioplasty and stent placement is a standard treatment for the patients with iliac artery stenosis and occlusion. We present a case in which a large arterial pseudoaneurysm with bursting fracture of stent which was implanted 7 years ago for the left common iliac artery (LCIA) stenosis. A 72 year-old man who has treated in local orthopedic hospital for spinal stenosis was transferred to our hospital due to suspicious isolated LCIA aneurysm, of which maximal diameter was 3. 5cm on computed tomography (CT). Because CT had been checked for the evaluation of spine, image quality of iliac artery was very poor. Therefore, scheduled 3 demensional lower extremity CT angiography (LECT) and aortoiliac angiography (AIAG) were performed after admission. LECT revealed new abnormal findings that were pseudoaneurysm, not isolated de novo aneurysm with embedded metal fragment and thrombus at LCIA and implanted stent with patency on left external iliac artery (LEIA). AIAG showed LCIA pseudoaneurysm with bursting stent fracture with disintegration. We found that balloon-expandable stents (Corinthian®, cordis) were implanted for stenotic lesion of LCIA and LEIA each other 7 years ago. Conventional covered stent implantation such as Viabahn® (Gore) for the lesion was not considered, because the possibility of type Ia endoleak would be high from large diameter 13mm of LCIA ostium on LECT. Because the patient refused surgical replacement for LCIA pseudoaneurysm, endovascular repair with Endurant® (Medtronic) iliac limb stent-graft was tried. AIAG showed good fi ow without endoleak but revealed fi lling defect on left tibioperoneal trunk (LTPT) which was considered migrated thrombus due to forceful manipulation of delivery system. After the stent-graft implantation, the patient was discharged and followed LECT 1 month later. LECT showed implanted stent-graft without endoleak and resolved thrombus at LTPT.

Development of Improved EMC Filter for EFT in Power Supply

Dae Hwan Bae,Dong Il Kim,Jae Man Song 한국전자파학회JEES 2001 Journal of Electromagnetic Engineering and Science Vol.1 No.1

Simultaneous Occurrence of Immune-Mediated Thrombocytopenia and Myocarditis After mRNA-1273 COVID-19 Vaccination: A Case Report

Bae Dae-Hwan,Kim Min,Lee Dae In,Lee Ju-Hee,Kim Sangmin,Lee Sang Yeub,Bae Jang-Whan,Hwang Kyung-Kuk,Kim Dong-Woon,Cho Myeong-Chan 대한의학회 2022 Journal of Korean medical science Vol.37 No.21

With the global spread of severe acute respiratory syndrome coronavirus 2, several vaccines were developed; messenger RNA (mRNA) vaccines have recently been widely used worldwide. However, the incidence of myocarditis following mRNA vaccination is increasing; although the cause of myocarditis has not yet been clearly identified, it is presumed to be caused by a problem in the innate immune system. Immune-mediated thrombocytopenia (ITP) after vaccination is rare but has been reported and is also assumed to occur by the same mechanism. We report the first case of simultaneous myocarditis and ITP after mRNA vaccination. A 38-year-old woman presented with chest pain, mild dyspnea, and sweating after vaccination with mRNA-1273 vaccine (Moderna) 4 days prior to admission. Upon admission to the emergency department, cardiac enzymes were elevated; blood test performed 5 months ago showed normal platelet count, but severe thrombocytopenia was observed upon admission. After administration of intravenous immunoglobulin, the platelet count improved; subsequently, myocarditis was observed on endomyocardial biopsy. Thus, myocarditis and ITP were judged to have occurred simultaneously due to the expression of the innate immune system markers after mRNA vaccination. The patient was discharged on day 6 of admission.

In vivo에 의한 미색류 콘드로이틴황산의 기능성 화장품 소재로서의 가능성

김배환(Bae-Hwan Kim),안삼환(Sam-Hwan Ahn),최병대(Byeong-Dae Choi),강석중(Seok-Joong Kang),김영림(Yong-Lim Kim),이후장(Hu-Jang Lee),오명주(Myung-Joo Oh),정태성(Tae-Sung Jung) 한국식품영양과학회 2004 한국식품영양과학회지 Vol.33 No.4

단회경구독성시험에서 미더덕 및 멍게 유래 crude 콘드로 이틴황산의 LD_(50)는 2 g/㎏ 이상으로서 판명되어, 단회경구 독성 측면에서는 안전한 원료로 판단되었다. 비록 기니픽을 이용한 감작성시험은 미더덕 유래 crude 콘드로이틴황산만을 사용하여 실시하였고, 시험 농도는 GAGs의 임상 사용 예정량이 0.03~0.15%임을 고려하여 inductiuon 농도는 임상사용 예정량의 10배인 3.0%, challenge 적용 농도를 0.3% 이하로 잠정 설정하여 3.0%, 0.3%, 0.03% 농도에서 실시하였다. 그 결과 0.03% 및 0.15% 농도에서는 반응을 나타낸 개체가 없었으나, 양성대조군과 비교할 때 0.3% 농도에서는 24시간 후에는 10% 그리고 48시간 후에는 5%의 반응율을 나타냈지만 사용가능범위에 해당되어 미더덕의 GAGs은 감작성 측면에서 안전성이 높은 원료로 0.3%이하 농도에서는 사용 가능하다고 판단되었다. 토끼를 이용한 안점막 자극시험에서는 미더덕과 멍게 유래 crude 콘드로이틴황산 및 bovine trachea 콘드로이틴황산의 3.0% 적용시 모두 A.O.I.가 기준치 이하로 나타나 실제 사용시 눈에 자극성이 없음이 판명되었다. 토끼를 이용한 피부일차자극 시험에서는 미더덕 및 멍게 유래 crude 콘드로이틴황산을 3.0% 및 1.5%는 무자극을 보였지만, 멍게 유래 crude 콘드로이틴황산에서는 미약하게 보이던 피부반응이 미더덕 유래 crude 콘드로이틴황산에서는 3.0% 적용에서 다소 강한 반응을 보였다. 광독성 및 광감작성을 위한 UV 흡광 실험결과 미더덕 및 멍게 유래 crude 콘드로이틴황산과 대조군으로서 사용한 표품 콘드로이틴황산 모두 자외선영역(280~420 ㎚)에서 흡광을 보이지 않아서 광독성 및 광감작성 시험을 시행하지 않았다. 실험동물을 사용하여 조사한 결과 화장품 원료로서의 미더덕 및 멍게 유래 crude 콘드로이틴황산은 3.0% 이내에서는 사용이 안전함이 증명되었고, 멍게가 미더덕 유래의 콘드로이틴황산에 비교하여 생체반응에 나은 것으로 나타닜다. Crude chondroitin sulfates extracted from midduck tunics (Styela clava) and munggae tunics (Halocynthia roretzi) were examined in vivo in order to be utilized as a cosmetic material which was followed by an in vitro assay. Examinations, such as acute oral toxicity, skin sensitization, acute eye irritation, and primary skin irritation, were performed with a variety of laboratory animals. Phototoxic and photosensitization tests were not conducted since all chondroitin sulfates failed to absorb U.V. light at the range of 280 to 420 nm. In acute dermal and eye irritation, both specific clinical signs and dead cases were not demonstrated during the test period, but crude chondroitin sulfates from midduck and munggae tunics, and standard chondroitin sulfate from bovine trachea were showed 2.5, 1 and 1.25 of acute ocular irritation index (A.O.I.), respectively. In the case of skin sensitization, crude chondroitin sulfate from midduck tunics exhibited neither specific clinical signs nor dead cases in the entire course of the examination. While in acute oral toxicity, crude chondroitin sulfates from both midduck and munggae tunics found neither specific clinical signs nor dead cases during the test, and LD50 was suspected to be over 2 g/㎏. Based on this study, it was proven that crude chondroitin sulfates from either midduck or munggae tunics can be used safely as a cosmetic material.

증 례 : 분지형 점액분비성낭종 환자에서 발생한 침윤성 췌장암의 심각한 임상 경과: 증례 3예

배대환 ( Dae Hwan Bae ),양지열 ( Ji Youl Yang ),김근모 ( Keun Mo Kim ),김형우 ( Hyung Woo Kim ),윤웅수 ( Woong Su Yoon ),조병하 ( Byung Ha Cho ),김진영 ( Jin Young Kim ),한정호 ( Joung Ho Han ),박선미 ( Seon Mee Park ) 대한췌담도학회 2015 대한췌담도학회지 Vol.20 No.4

Branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMN) without malignant features rarely developed into invasive cancer. However, invasive cancer is aggressive once an invasive change occurs. We report three cases of invasive cancers which developed in patients with BD-IPMN and they showed grave clinical courses. All patients were diagnosed with BD-IPMN < 3 cm without malignant features on imaging. Invasive cancer was detected at 2.5 years, 3.0 years, and 4.0 years after BD-IPMN detection in each patient. The intervals of invasive cancer and the last follow-up were 9 months, 3 years, and 1.5 years in the three patients, respectively. All patients were diagnosed with locally advanced pancreas invasive cancers and were treated with palliative chemotherapy or conservative management. The patients died at 3 months, 9 months, and 10 months after the diagnosis of invasive cancers, respectively. We report three cases of invasive cancer developed in BD-IPMN patients and followed fatal courses.

갑상선 기능저하성 근육병

장대국 ( Dae Kook Chang ),김태환 ( Tae Hwan Kim ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),김성윤 ( Seong Yoon Kim ),오영배 ( Young Bae Oh ),전재범 ( Jae Bum Jun ),고희관 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1

Hypothyroidism may be accompanied by different rheumatic syndromes such as neuropathy, arthropathy and myopathy. Severe myopathy with high elevations of creatine kinase (CK) is rarely seen in hypothyroidism. Authors experinced a case of myopathy with hypothyroidism, similar to rheumatoid arthritis or polymyositis-like syndrome. We have treated with thyroid hormone replacement (Levothyroxine sodium 100ug/day) for 10 months. The initial serology resulted in: free T4 0.51ng/dl, TSH 110uIU/ml, LDH 465 units, and CK 4385 units. After treatment, we gained free T4 1.60ng/dl, TSH 0.14uIU/ml, LDH 110 units, and CK 80 units and musculoskeletal symptoms are much improved. We report this patient with a review of literatures.

고속영상처리용 고성능 케이블 컨넥터에 관한 연구

배대환(Dae-Hwan Bae),김동일(Dong Il Kim),정세모(Se-Mo Joung),민경식(Kyeng-Sik Min) 한국항해항만학회 1997 한국항해항만학회 학술대회논문집 Vol.1997 No.1

오늘날 개인용 컴퓨터의 성능 향상에 따른 고속 영상처리용 VGA Card의 고속화에 따라 영상신호 케이블을 통한 광대역 방사 전자파의 증가를 억제하고, 전자파 내성시험 중 정전기 내성(IEC1000-4-2)을 갖는 영상 신호용 케이블 컨넥터의 개발에 있어 체계적인 대책이 요구되고 있다. 본 논문에서는 픽셀수에 따른 영상신호의 주파수 대역폭을 측정하여 영상처리에 장해를 주지 않는 범위에서 차단하고져 하는 주파수 대역을 정한 후, 기존 케이블의 특성임피던스를 주파수별로 구함과 동시에 일반적으로 케이블에 취부시켜 사용하고 있는 페라이트 비드의 장착에 따른 부하 효과를 해석하여 보다 체계적이고 경제적인 대책에 목적을 두었으며, 기존의 케이블의 특성을 개선하기 위해 삽입되었던 대형 페라이트 비드를 소형화시켜 설계, 제작하여 영상품질을 저하시키지 않는 케이블 커넥터의 성능 평가를 실험으로 입증했다. In this paper, it has been carried out to solve a kind of EMC problems in high performance personal computer which has high speed VGA card used for general purpose. For this purpose an ideal filter has designed which is composed of feedthrough capacitors and small ferrite beads attached to the connector in order to meet the EMC requirements for a wide band video signal up to 500MHz of PC video output. An equivalent circuit is proposed, a static and dynamic characteristics for insertion loss are measured. Thus ideal parameters have been obtained to suppress emission from de to 1GHz frequency band on condition that colour image is not degraded. The video cable proposed here, may be applicable for IEC 1000-4-2 and more high speed commercial products in lower price.

IEC61000 - 4 - 4에 의한 인입선 Break - box 내의 EMC대책용 필터 개발에 관한 연구

배대환(Dae-Hwan Bae),김동일(Dong-Il Kim) 한국통신학회 2000 한국통신학회 학술대회논문집 Vol.2000 No.7