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      • 평면형 Bi-Sb 다중접합 열전변환기의 특성

        이현철,유호종,김진섭,함성호,신장규,이종현,이정희,권성원,박세일 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

        A planar Bi-Sb multijunction thermal converter for the precise measurements of ac voltage and current has been fabricated and its characteristics was discussed. In order to convert ac power into heat, a bifilar thin film Pt-heater, which could cancel its Thomson and Peltier effects, was prepared on the Si_(3)N_(4)/SiO_(2)/Si_(3)N_(4) diaphragm for the thermal isolation between heater and silicon substrate. To convert the temperature or the heat generated by the heater into dc voltage and current, hot and cold junctions of the Bi-Sb thermopile, which has a large difference in Seebeck coefficients, were formed on the dielectric diaphragm and the silicon substrate, respectively. The respective thermal sensitivity of the thermal converter with a bifilar heater was about 10.1 mV/mW and 14.8 mV/mW in the air and vacuum, which is about eight times higher than that of commercial 3-dimensional thermal converter. In the case of ac 2 V-input voltage, the ac-dc voltage transfer difference was about ±2.0 ppm, and in the case of ac 10 mA-input current, the ac-dc current transfer difference was about ± 0.6 ppm, in the frequency range from 10 Hz to 10 kHz.

      • KCI등재

        Bortezomib과 Dexamthasone으로 치료한 골수외 형질세포종 4예

        백종현,이은영,장리라,손창배,신은경,서정아,이지숙,이호섭,이상민,신성훈,김양수 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

        Despite the use of aggressive local and systemic treatment including autologous stem cell transplantation in multiple myeloma, extramedullary recurrences are common and the prognosis of these patients is poor. Many novel drugs such as thalidomide, lenalidomide and bortezomib improve the response of treatment of multiple myeloma, but some reports failed to describe thalidomide has effect in extramedullary plasmacytoma. Recent data report on the successful treatment plasmacytomas with bortezomib in patients with advanced multiple myeloma. We treated 4 relapsed or refractory extramedullary plasmacytomas with bortezomib at our institution. We recognized all these extramedullary plasmacytomas decreased and showed more than partial response. This report lends support to the efficacy of bortezomib in the treatment of plasmacytoma and describes the safe use of bortezomib. Responses may, however, be of short duration. Therefore, despite our limited experience, we propose that bortezomib may be considered a therapeutic option for such patients who have risk of radiation therapy

      • 다발성 골수종 환자에서 자가 조혈모세포 이식 중 장기간 비경구적 영양요법 후 발생한 베르니케 뇌증의 1례

        이호섭 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

        급성 백혈병, 림프종, 다발성 골수종을 포함한 다양한 혈액종양 질환을 치료하기 위한 최선의 방법은 조혈모세포 이식으로 알려져 있다. 그러나, 조혈모세포 이식에 따른 부작용들도 많은 것으로 알려져 있는데, 특히 오심, 구토, 설사, 구내염 등의 증상 때문에 식이 섭취의 부족으로 인해 영양 결핍이 초래될 수 있다. 그 중에서 비타민 B1 (thiamine) 의 결핍에 따른 베르니케 뇌증의 발생이 드물지만 있을 수 있다. 저자는 다발성 골수종 환자에서 자가조혈모세포 이식 시행후 발생한 베르니케 뇌증의 1 례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Wernicke’s encephalopathy is an acute neurologic disease which results from vitamin B1 (thiamin) deficiency. Clinical symptoms are ataxia, opthalmoplegia and mental change. This disease affects the thalamus, midbrain and mammillary bodies. The diagnosis of Wernicke’s encephalopathy is made with brain Magnetic resonance imaging (MRI) and its clinical symptoms. but The confirming test is not known as yet. Most common causes of this disease are chronic alcoholism, total parenteral nutrition, total gastrectomy, and severe anorexia but rare cases reported about occurrence of Wernicke’s encephalopathy after chemotherapy or hematopoietic stem cell transplantation. An author present a case of Wernicke’s encephalopathy developed after autologous stem cell transplantation followed by total parenteral nutrition in a patient with multiple myeloma.

      • 병기 2기와 3기 직장암 환자에서 수술 후 항암화학요법과 동시방사선화학요법

        이호섭,김양수 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

        Background : Postoperative adjuvant therapy has been required in patients with operable rectal cancer because of risk of recurrence after surgery. Adjuvant therapies are known to chemotherapy (CTx), radiotherapy, and concurrent chemoradiotherapy (CCRT). Purpose of our study to compare the suvival rate, recurrence rate and toxicities between postoperative adjuvant CTx and CCRT in patients with rectal cancer after surgical treatment. Materials and Methods : This study involved 45 patients (CCRT; 15, median age; 58 years, range; 39-73) and CTx; 30, median age; 55 years, range; 36-67) with rectal cancer of stage II and III between April 2002 and May 2008. Treatment included six cycles of chemotherapy at 4-week intervals with fluorouracil 425mg/m2 and leucovorin 20mg/m2 administering continuous infusion for 24 hours during 5 days in CCRT group. Radiotherapy started on day 1 of the third chemotherapy cycle in CCRT. In CTx group, treatment included the same cycles of chemoterapy, and drug doses as in CCRT group. Results : Disease free survival (DFS) and Overall survival (OS) for 3 years were 68.4% and 70.8% in CCRT group and 82.5% and 80.5% in CTx group, respectively (DFS; P-value 0.997, OS; P-value 0.880). Recurrence rate including local recurrence and distant metastasis were 26.7% in CCRT group and 23.3% in CTx group (p-value 0.806). Local recurrence rates were 0% in CCRT group and 16.7% in CTx group (p-value 0.094). We investigated hematologic and non-hematologic toxicites. The incidence of radiation related proctitis was 26.7% in CCRT group and 0% in CTx group. But other toxicities were not significantly different between CCRT group and CTx group. Conclusion : DFS and OS were not different between CCRT group and CTx group in patients with rectal cancer of stage II and III. But local recurrence rate was lower in CCRT group than in CTx group. Toxicities were not differrent between CCRT group and CTx group, except the higher frequency of radiation related proctitis in CCRT group.

      • KCI등재

        혈액암환자에서 조혈모세포 이식 후 따르는 헤르페스 바이러스 감영 양상

        이호섭,탁희상,신성훈,김양수,남성진,김혜수,박진희,정수현,김성빈,김예나 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

        배경 : 헤르페스바이러스과에는 단순포진 바이러스(HERPES SIMPLEX VIRUS, HSV), 수두대상포진 바이러스 (VARICELLA-ZOSTER VIRUS, VZV), 엡스타인-바 바이러스 (EPSTEIN-BARR VIRUS, EBV), 그리고 거대세포 바이러스 (CYTOMEGALOVIRUS, CMV) 등이 있다. 헤르페스바이러스 감염은 혈액암환자에서 조혈모세포 이식 환자에서 전파 (dissemination), 이차감염, 세균 중복 감염의 심각한 합병증을 일으킬 수 있다. 하지만 항암약물치료를 받는 림파종 환자에서 항 바이러스 약제의 사용 용량과 기간에 대한 concensus는 없다. 헤르페스바이러스 감염에 대한 발생율과 위험인자를 후향성으로 분석하였다. 방법 : 고신대학교 복음 병원에서 1995년 6월부터 2009 년 2월 사이에 새롭게 진단되어 조혈모세포 이식을 받은 전체 58명의 환자들이 후향적으로 현 연구에 등록했다. 헤르페스 바이러스 감염은 임상적 진단, 혈청학적 검사 또는 병리학적 진단에 기초하여 확진한다. 환자들의 특성은 다음과 같다: 평균 연령은 44세 (범위 19-62세)였고 남녀비는 30:28이었다. 등록된 질환은 백혈병 (n=9, 15.5%), 림프종 (n=30, 51.7%), 다발성 골수종 (n=12, 20.7%), 재생불량성 빈혈 (n=6, 10.3%) 그리고 골수이형성증후군 (n=1, 1.7%)이 포함되었다. 결과는 chi-squre test나 independent samples T test를 사용하여 분석되었다. Multivariate analysises에 대해 logistic regression test를 사용하였다. 결과 : 15명의 환자들 (25.9%)에서 조혈모세포 이식후 헤르페스 바이러스 감염이 발생하였다. 조혈모세포 이식 5년간 누적 발생율은 53.9%였다. Univariate analyses에서 헤르페스 바이러스 감염에 대한 유의한 위험 인자는 없었다. 하지만 조혈모세포 이식후 생존 기간(40.18 ± 30.14 months vs 20.06 ± 26.67 months, p=0.018)은 헤르페스 바이러스 감염의 낮은 발병율과 유의한 관련성이 있었다. 이식 편대 숙주질환 (GVHD)의 존재 (37.5% in developed GVHD vs 0% in no GVHD, p=0.200), 동종조혈 모세포 이식에서 면역억제요법의 기간 (15.98 ± 14.02 months vs 6.78 ± 3.67 months, p = 0.374)은 헤르페스 바이러스 감염에 대한 위험인자가 아니었다. 결론 : 조혈모세포 이식 후 생존 기간은 어사이클로비어 예방을 받은 혈액암 환자에서 헤르페스 바이러스 감염의 낮은 발병율과 연관성이 있는 것으로 보인다. 저용량의 어사이클로비어 예방은 헤르페스 바이러스 감염의 고위험군인 조혈모세포 이식을 받은 혈액암 환자에 필요하리라 생각된다. Background : Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection (HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with hematologic malignancy following hematopoietic stem cell transplantation (HSCT). But there was no consensus on the dose and duration of antiviral agents prophylaxis in patients undergoing chemotherapy. We retrospectively analyzed the incidence and the risk factors for HVI. Method : A total of 58 patients who newly diagnosed and received HSCT with prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, Korea between June 1995 and February 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 44 years (range 19-62 years) with a female-to-male ratio of 30:28. The enrolled diseases included leukemia (n=9, 15.5%), lymphoma (n=30, 51.7%), multiple myeloma (n=12, 20.7%), aplastic anemia (n=6, 10.3%) and myelodysplastic syndrome (n=1, 1.7%). The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysis, we used logistic regression test. Results : Fifteen patients (25.9%) developed HVI after HSCT. The cumulative incidence of HVI was 53.8% at 5 years after HSCT. In univariate analysis, there was no significant risk factor for HVI. The presence of graft-versus-host disease (GVHD) (37.5% in developed GVHD vs. 0% in no GVHD, p=0.200), duration of immunosuppressive therapy (IST) in allo-SCT (15.98 ± 14.02 months vs. 6.78 ± 3.67 months, p = 0.374) were not risk factors for HVI. Conclusion : The incidence of HVI was similar to that in historical other studies. There was no risk factor associated with development of HVI. Most of the HVI occurred within the first 24 months after transplantation. So long term use of antiviral prophylaxis may be needed to prevention of HVI after HSCT.

      • KCI등재

        농업용 저수지의 부영양화와 수질관리방안

        이광식,윤경섭,김형중,김호일 한국환경농학회 2003 한국환경농학회지 Vol.22 No.2

        1990년부터 2001년까지 농업용수 수질측정망 조사자료를 분석하고, Chl-α 농도와 유효저수량/만수면적비를 이용하여 498개 저수지에 대하여 유형을 분류하고, 각 유형에 대한 수질개선방안을 제시하기 위하여 본 연구를 수행하고 다음과 같은 결론을 얻었다. 우리 나라 농업용 저수지의 Chl-α 농도는 유효저수량/만수면적비(ST/WS)에 민감하게 반응하였으며, ST/WS비가 클수록 Chl-α 농도는 감소하는 경향을 나타내었는데, 저수지의 부영양화를 억제하기 위해서는 ST/WS비를 최소 5~6 m 이상, 가능하면 10m 이상이 되도록 건설ㆍ보수하는 것을 좋을 것으로 판단된다. 우리나라 저수지를 Chl-α 농도 25 mg/m³, ST/WS비 5m를 기준으로 유형을 분류하고 그 특성을 고찰한 결과 ST/WS비가 작고 부영양화가 진행된 종합정비형인 Ⅰ형 저수지는 호소의 지형학적 특성과 외부에서의 부하가 모두 복합적으로 부영양화에 영향을 준 것으로 판단되며, 동일한 형상이라도 부영양화가 진행되지 않은 호내정비형인 Ⅱ형 저수지는 상대적으로 외부 유입이 적은 것으로 나타났다. 반면에 지형학적 특성상 수질관리에 유리한 ST/WS비가 큰 관리형인 Ⅳ형 저수지는 대부분이 부영양화가 아직 진행되지 않았으며, 유역으로부터 높은 부하량을 나타내는 유역정비형인 Ⅲ형는 부영양화가 이루어 졌으나 전체 저수지의 약 5% 미만으로 극히 드문 것으로 나타나 ST/WS비가 큰 경우 상대적으로 외부유입으로 인한 부영양화는 작은 것으로 나타났다. 수질개선사업우선순위(안)는 Ⅰ형(종합정비형) → Ⅲ(유역정비형) → Ⅱ형(호내정비형) → Ⅳ형(관리형)의 순으로 정비해 나가는 것이 바람직할 것으로 판단된다. 또한 농업용수 수질기준 항목 중 COD 농도를 유기오염 지표뿐 아니라 부영양화를 나타내는 지표로써도 함께 고려하여 세분화한 결과 현행 8 mg/L에서 10 mg/L 이상을 대책기준, 6~10 mg/L을 우려기준, 6 mg/L이하는 안전기준으로 세분하고, 이에 따라 수질개선사업을 실시하는 것이 효율적일 것으로 판단된다. A total of 498 agricultural reservoirs ranging from 164 × 10³ to 253 × l0^(6) ㎥ in storage volume were investigated from 1990 to 2001 with respect to Chl-a, COD concentration and pollutant loading of BOD, TN, and TP. The lakes and reservoirs could be classified to 4 types using the relationships between the ratio of storage volume per water surface area(ST/WS) and Chl-a concentration. It is recommended that the improvement of polluted lakes should be performed in the order of integrated consolidation type→watershed consolidation type→in-lake consolidation type→management type and reservoir should be constructed to be over 5∼6 m in depth(STWS ratio) for preventing the eutrophication of agricultural reservoirs. We propose that water quality criteria for agricultural water is changed from less than 8 ㎎/L to less than 6㎎/L for safety value, 6-10 ㎎/L for concern value, and more than 10 mg/L for countermeasure value in COD concentration, respectively.

      • KCI등재
      • Interleukin-2가 Mouse간의 인산염분해효소의 활성에 미치는 영향

        이규식,김원규,정호삼,강성섭 한양대학교 의과대학 1989 한양의대 학술지 Vol.9 No.1

        In recent years, interleukin-2, a lymphokine produced by antigen or mitogenstimulated lymphocytes, has been intensively with the development of immunooncology and chemoimmunotherapy of the malignant tumor. Interleukin-2 mediates antitumor effect by stimulating the proliferation of helperand cytotoxic T cells, augmenting the cytolytic activities of cytotoxic T-lymphocytes and differentiating T-lymphocytes into a lymphokine-activated killer cell in vivo. Thus interleukin-2 induces the therapeutic effects on various sarcoma and carcinoma and regresses the pulmonary, hepatic and peritoneal metastases of various tumors. Although interleukin-2 is very effective for the treatment of various malignancy, it develops many side effects including fever, chill, malaise, mental confusion, diarrhea, vomiting and oliguria and causes pulmonary, hepatic and renal toxicities. Especially interleukin-2 results in increase of capillary permeability with weight gain, pulmonary edema, and ascites. In this experiment, the author studied the effect of interleukin-2 on the mouse liver, histochemically observing the changes in the activities of alkaline phosphatase, acid phosphatase and adenosine triphosphatase. Male mice, DDY strain, weighing 20gm, were used as experimental animals. The experimental animals were sacrificed at 3, 6, 12, 24 and 48 hours after intraperitoneal administration of two milions unit of interleukin-2 per kilogram of body weight. The specimens obtained from the liver were fixed in 10% neutral buffered formalin solution for 24 hours at 4℃ and sliced at 16㎛ thickness in a frozen cryostat. The activities of alkaline phosphatase and acid phosphatase were observed by the Gomori's method and the activity of adenosine triphosphatase was observed by the Wachstein and Meisel's method for histochemical study. The results obtained were as follows. 1. The acid phosphatase activity was strong positive at 12 hours and 24 hours groups in the central and portal zones of the liver lobules, but weak positive and moderate positive at 48 hours group in the central and portal zones of the liver lobules, respectively. 2. The alkaline phosphatase activity was weak positive at 6 hours and 12 hours groups and moderate positive at 48 hours group in the central and portal zone of the liver lobules. 3. The adenosine triphosphatase activity was trace positive in the central zone and weak positive in the portal zone of the liver lobules at 6 hours group but moderate positive at 48 hours group in the central and portal zones of the liver lobules. Consequently, it is suggested that interleukin-2 induce degenerative changes of the hepatocytes of the mouse, but it is recovered with time.

      • KCI등재

        精神症狀에 대한 韓國人의 態度調査

        元鎬澤,洪元植,張煥日,陳聖太,金光日,李基南,嚴龍燮,金明正 大韓神經精神醫學會 1973 신경정신의학 Vol.12 No.1

        Korean psychiatrists are more apt to take the abnormal drinking behavior lightly and regard the psychosomatic symptoms as more serious, comparing with American psychiatrists. On the other hand, physicians as well as adults from the population in Korea are less concerned about the neurotic and psychosomatic symptoms and alcoholic behavior as psychiatric problems. It is the authors' concern to understand such differences in opinion about abnormal behaviors from the cultural and social psychiatric view point. The authors used Dohrenwend's questionaire form of 45 mental symptoms and three additional items i. e., homosexual behavior, symptom of senile psychosis and delusion of jealousy following the authors' interests. Each item was rated by three point cale (psychiatrically very serious=2 points, somewhat serious=1, not serious at all=0) and evaluated with critical ratio. As a preliminary study, the reliability of this questionaire was confirmed by the test-retest method; Spearman's rho was 0,93. The subjects in this study consist of 50 psychiatrists, 49 physicians, 54 herb practitioners and 154 adults from the normal population(60 urban samples and 94 rural samples). The collection was carried out by individual interviews for the physicians and normal samples, by letters for the psychiatrists and the herb practitioners. And the data of American psychiatrists compared in this study were quoted from Dohrenwend's report(27). This study has two parts: one is the cross-cultural comparison between American psychiatrists and Korean ones, the other is intracultural comparison among psychiatrists, physicians, herb practitioners and normal population samples. Inspite of the general notion that Korean psychiatry has been much oriented to American psychiatry for over twenty years, there are definite differences in opinion about the severity of abnormal behaviors between American and Korean psychiatrist, especially about alcoholic behavior and psychosomatic symptoms. Such differences are possibly interpreted as arising from the cultural differences. The American psychiatrists seem to be more concerned about alcoholic behavior probably due to the strict attitude of people and/or the fact that the United States reveals the highest incidence of alcoholism throughout the world. The Korea psychiatrists, however, have much tolerable attitude toward alcoholic behavior according to the cultural tradition. Solitary drinking is hardly found in Korea; drinking in Korea is a suitable way of interpersonal contact. They drink slowly and are not so intensively dependent upon alcohol itself. Dependency need to alcohol can be diffused to the other persons. And they take alcohol with many kinds of side-dishes. These drinking manners seem to be cultural virtues for low incidence of alcoholism in Korea. Thus, Korean psychiatrists as well as adults from normal population have highly tolerable attitude toward alcoholic behavior. Even when some person reveals a destructive behavior after drinking, they grant it as a personal charm. Korea psychiatrists, therefore, are not so nervous about the alcoholic behavior. On the other hard, the psychosomatic problems seem to be serious in Korean mental patients. They are easily apt to express their emotional problems as somatic symptoms possibly due to the disease concept of oriental herb medicine that has a high tendency of projection of emotional conflicts unto the soma. So most of Korean people are not aware that psychosomatic symptoms are originated from the emotional problems, and quite contrary to it, the psychiatrists may be highly conscious of psychosomatic symptoms. Another significant difference is seen in suicidal idea and suspiciousness: American psychiatrists regard them as more serious, and reversely Korean psychiatrists regard them as less serious. Such a pattern may also be derived from the socio-cultural differences. When Koreans are either dissapointed or delighted, they say frequently "I want to die" or "It's funny to death" and so on. This idiomatic expression is far from the real death wish but rather an expression of magnification. And the suicidal idea itself is frequently seen in normal population even suicidal attempt is evaluated as abnormal in Korea. With such reasons, Korean psychiatrists may notice suicidal idea as less serious than American psychiatrists. And the suspiciousness may be a way of living for the people under the historical turmoil and vigorous aculturation, that it is perceived as not so abnormal. The next problem is the marked discrepancy of opinion about abnormal behaviors among psychiatrists, physicians, herb practitioners and normal population samples. The agreement of physicians, herb practitioners, urban samples and rural samples with the psychiatrists on the relative severity of symptoms revealed as Spearman's rho of 0.79, 0.59, 0.58 and 0.44 respectively. It is the main point of problem that physicians are less aware of neurotic symptoms which can appear in the somatic illness, and of psychosomatic symptoms as psychiatric problem. Possible reason is that Korean physician have been oriented to the somatic medicine without proper psychosomatic orientation. On the other hand, the herb practitioners are apt to ignore the severity of psychotic symptoms and on the other, regard the neurotic and psychosomatic symptoms as much as psychiatrists' opinion. And the samples of normal population regard the neurotic symptoms as more serious than the psychotic symptoms, and are not aware of the psychosomatic symptoms as psychiatric problems. Physicians, herb practitioners and samples from the normal population underestimate the alcoholic behavior more than psychiatrists do. The alcoholism according to physicians' opinion is rather somatic problem than psychological one. The herb practitioners and adults from normal population manifest the prominently tolerable attitude toward alcoholic behavior. In conclusion, two kinds of problems can be suggested. One is that the difference between Korean and American psychiatrists in the evaluation on the severity of abnormal behaviors, is possibly due to sociocultural differences. The other is the intracultural difference among psychiatrists, physicians, herb practitioners and adults from normal population. Such a difference suggests that there is a considerable cultural lag in the disease concept and attitude between the modern psychiatry and the cultural tradition. This discrepancy can result in the undesirable wandering of patients for seeking the treatment and some hardship in modern psychiatric practitioning in Korea.

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