급성 췌장염의 시대적 변화

김배영(Bai Young Kim),김효종(Hyo Jong Kim),정형근(Hyung Keun Chung),김영관(Young Kwan Kim),동석호(Seok Ho Dong),김병호(Byung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: According to the rapid changes in social environment such as increasing alcohol consumption and the marked improvement in diagnostic technique, we expect that there have been major changes in various aspects of acute pancreatitis during the recent 12 years in Korea. Methods: The medical records of 317 patients with acute pancreatitis diagnosed from 1980 through 1992 were reviewed about clinical, laboratory and radiological findings in the three different time period. Results: 1) There has been an increasing incidence in male sex about three folds. 2) There has been an increasing trends in the duration of hospitalization. 3) A significant increase was observed in the proportion of patients with alcoholic pancreatitis in the three different time period; 26.9%, 45.7%, 50.7% respectively. 4) The complication rates have been slightly increased in the three different time period; 46.3%, 47.1%, 59.1% respectively. But, the type of complications has not been changed. 5) There is increasing severity in non-gallstone group, but no significant differences in gallstone group. There is a declining trends in the number of patients with muld severity index, but increasing trend in the number of patients with moderate severity index in non-gallstone group. 6) There was no significant differences in mortality rate. Conclusions: There has been major changes in the etiology ans severity of acute pancreatitis from 1980 through 1992. Especially, significant increase in the proportion of patients with alcoholic pancreatitis was observed in the three differnt time period. These results might be due to socioeconomic changes.

미래사회의 고객니즈 분석을 통한 시나리오 기반의 미래 기술예측 방법론

김영명(Young Myoung Kim),김민관(Min Kwan Kim),이준석(Jun suk Lee),한창희(Chang Hee Han) 한국경영과학회 2011 經營 科學 Vol.28 No.3

Recently, the level of uncertainty in R&D investment for an enterprise has increased due to technological development and industrial changes. Accordingly it is necessary for an enterprise to forecast the future or foresight the future technologies. But, the fact that the methodology used in predicting future technology is suitable for large project makes enterprise difficult to forecast the future technologies or trends. Thus, this study seeks for available methodology for future technology foresight from enterprise standpoint. The methodology proposed in this research is based on the scenario model, especially focused on the customer needs and future society change.

급성 심근 경색중 후 추적 관찰에 관한 연구

박영배,이영우,오동진,고창순,서정돈,서봉관,오병회 대한내과학회 1986 대한내과학회지 Vol.31 No.5

To assess the change in left ventricular function after hospital discharge, 57 patients with acute myocardial infarction were studied before discharge and 26 of them after discharge as well with either or both of treadmill test and radionuclide ventriculography(RNV). Follow-up study patients were 2g men with mean age of 53.1. Their infarct locations were anterior in 16 cases, inferior in 8 cases and anterior and inferior in 2 cases; 21 cases were in Killip class I, 3 cases in II, and 2 cases in III. Follow-up study was performed 2~19 months(mean 7.3 months) after acute myocardial infarction. The results were as follows: 1) Predischarge study showed that a relationship is present between regional wall motion abnormality, Killip class, peak serum CK and left ventricular ejection fraction(LVEF). 2) Predischarge and follow-up treadmill tests showed no significant change. 3) Follow-up RNV showed worsening of regional wall motion only in 1 case: Other cases showed either improvement or no change in regional wall motion. 4) Overall patients showed a significant increase in LVEF on follow-up. By location, only anterior infarction showed a significant increase in LVEF. 5) Killip class I patients showed a significant increase in LVEF on follow-up. 6) Most cases in this study were uncomplicated myocardial infarction and they showed improved LV function(suggested by RNV) on follow-up. Treadmill test also seems to be valuable for evaluationg improvement in exercise capacity on follow-up. So it is recomended that treadmill test or RNV be performed after discharge to evaluate change in LV function objectively.

급성 췌장염의 합병이 추정되는 한국형 출혈열 1예

박영수,김창오,김영근,홍성관,장경희,허애정,염준섭,송영구,김준명 대한감염학회 2001 감염 Vol.33 No.5

The Korean hemorrhagic fever (KHF) is an acute febrile disease with characteristic of fever, bleeding tendency, and renal failure. There are many complications of Korean hemorrhagic fever such as infection, anemia, internal bleeding, hypopituitarism, respiratory, and neurologic complication. A few cases were reported on acute pancreatitis with hemorrhagic fever abroad, but there was no case about Korean hemorrhagic fever with acute pancreatitis in this country. We experienced a case of Korean hemorrhagic fever associated with suspected acute pancreatits. With review of articles, we report a case of 51 year-old woman with KHF, where acute pancreatitis developed during management, (Korean J Infect Dis 33:376∼379, 2001)

확대행렬의 고유치감도를 이용한 미소신호안정도 해석

문채주,장영학,심관식 木浦大學校 工業技術硏究所 1998 工業技術硏究誌 Vol.8 No.-

New eigen-sensitivity theories of the augmented matrix are applied to small signal stability analysis of EPRI one-machine infinite-bus system and New England 10-machine 39-bus test system. First and second order eigenvalue sensitivities are computed for changes of the parameters of line reactance and controllers including exciter, turbine/governor and PSS. It is found in many cases that since eigenvalue trajectories for parameter changes are nonlinear and first order estimate is not adequate for relatively large variation in parameters. Hence second order estimate is essential to guarantee accuracy for wide range of parameter changes.

만성 B형 간염에서 라미부딘 치료중 발생한 Viral Breakthrough 예의 임상 결과

안수현,장윤정,오성남,최도원,백수정,정원석,최창원,김경오,임형준,조남영,박종재,김재선,박영태,이명석,연종은,변관수,이창홍 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.4

목적: 만성 B형 간염의 치료 중 발생하는 약제 내성 변이종은 임상적으로는 치료 중 음전되었던 혈청 HBV DNA가 다시 양전되는 viral breakthrough 로 진단할 수 있다. 현재 약제 내성 변이종이 발생했을 경우라도 라미부딘 치료를 계속 유지하는 것을 권장하고 있으나, viral breakthrough 발생 예들의 장기적 임상경과가 아직도 불명확하여 이것을 일반화하기는 어려운 상황이다. 이에 라미부딘 사용 중 viral breakthrough 가 발생한 예들을 대상으로 그 임상경과를 알아보고자 하였다. 대상과 방법: 9개월 이상 라미부딘을 투약한 만성 B형 간염 환자로 viral breakthrough가 발생한 74명을 대상으로 하였다(남/여 54/20, 평균연령 42세). Viral breakthrough 후 혈청 ALT치, 총 빌리루빈치, HBV DNA 역가, HBeAg, anti-HBe를 정기적으로 검사하면서 임상경과를 관찰하였다. Viral breakthrough 후 라미부딘의 투약기간은 평균 13개 월(1-41개월)이었다. 결과: Viral breakthrough 발생후 혈청 ALT치가 정상으로 유지되었던 환자는 8예(11%)에 불과했고 나머지 66예(89%)에서는 ALT치가 증가하였으며, 이중 30예(41%)에서 급성 악화(ALT 정상 상한치의 5배 이상 상승)를 보였다. 급성악화는 viral breakthrough 후 3개월 내에 19예 (63%)에서 발생하여 3개월 내에 발생한 예가 많았으나 12개월 이상 지나서 나타나는 예도 약 20%에서 있었다. 비대상성 악화는 6예에서 관찰되었다. Viral breakthrough 후 급성악화가 일어난 예와 없었던 예의 비교에서 급성악화를 예측할 수 있는 인자는 발견할 수 없었다. Viral breakthrough 후 발견할 수 없었다. Viral breakthrough 후 HBeAg이 음전된 예는 8예(11%)였으나 그 임상경과는 양호하지 않았다. 결론: 만성 B형 간염 환자 에서 라미부딘 투여 중 발생한 viral breakthrough 예 중 상당수에서 급성악화가 발생하였으며, HBeAg 이 소실되더라도 그 임상경과는 양호하지만은 않았다. Viral breakthrough 발생 후 주의 깊은 임상경과 의 관찰이 요구되며, 앞으로 viral breakthrough 후 급성악화 예에 대한 대규모 연구와 적절한 치료방향의 제시가 이루어져야 할 것으로 생각된다. Background/Aims: Long-term lamivudine therapy can induce the emergence of lamivudine resistant hepatitis B virus (HBV) mutants. Clinically emergence of the mutant is expressed by the reappearance of disappeared HBV DNA in serum. Continued lamivudine treatment has been usually recommended in cases of viral breakthrough. However, the clinical outcome in patients with viral breakthrough is not clear. The aim of this study was to investigate the clinical course of chronic hepatitis B patients after viral breakthrough during lamivudine therapy. Methods: A total of 74 patients with chronic hepatitis B who showed viral breakthrough after at least 6 months of lamivudine treatment were included in this study. They had positive HBeAg and HBV DNA before treatment. The median follow-up duration after breakthrough was 13 months. Results: After viral breakthrough, only 8 patients (11%) maintained normal ALT levels and 66 patients (89%) showed elevation of ALT. 30 patients (41%) showed acute exacerbation of hepatitis (ALT increase over five-times upper normal limit). These acute exacerbations occurred within three months after breakthrough in 19 patients (63%). In the cases of acute exacerbation, 6 patients showed decompensated progression such as elevation of serum total bilirubin. One of them died of hepatic failure. A predictive factor for acute exacerbation was not found. HBeAg seroconversion occurred in 8 patients after viral breakthrough but their clinical course was highly variable. Conclusions: Chronic hepatitis B patients who had viral breakthrough during lamivudine therapy should be followed carefully and regularly in mind of potential clinical deterioration. New strategies are needed to manage the cases of acute exacerbation after viral breakthrough.(Korean J Hepatol 2002;8:389-396)

中風病辨證診斷標準에 의한 臨床的 硏究

任長信,文祥官,高昌男,權正男,曺基湖,金永錫,裵亨燮,李京燮 경희대학교 1997 慶熙醫學 Vol.13 No.3

중증 고혈압증의 임상적 관찰

육동민(Dong Min Yook),곽시영(Si Young Kwak),김성식(Seong Sik Kim),이성숙(Seong Sook Lee),홍관표(Kwan Pyo Hong),최창필(Chang Pil Choi),이재우(Jae Woo Lee),이시래(Si Rhae Lee) 대한내과학회 1987 대한내과학회지 Vol.33 No.2

N/A Clinical studies were carried out in the 110 cases of severe hypertension who had been admitted from January 1979 to August 1985 and the following results were obtained: 1) Underlying diseases of severe hypertension were essential hypertension in 67 cases, renal parenchymal hypertension in 36 cases, and renovascular hypertension in 7 cases. 2) Plasma renin activity was the highest in the group of renovascular hypertension which was 22.07±9.20 ng/ ml/hr, and as a whole, the higher diastolic blood pressure, the higher plasma renin activity was. Plasma renin activity in the group of K-W grade IV retinopathy was higher than those of the other groups. 3) The incidence of ventricular hypertrophy fullfilling voltage criteria and with accompanying ST-T changes on electrocardiolgram was 81.5% in the group of essential hypertension and there was no difference in relation to the level of pressure or fundoscopic changes. 4) The serum creatinine level was the highest in the group of renal parenchymal hypertension (7.93±2.98 mg/dl), and in the group of K-W grade IV retinopathy (6.86±3.50mg/dl), but there was no significant difference in relation to the level of diastolic blood pressure, 5) There were no significant difference in cardiothoracic ratio on chest X-ray in relation to underlying diseases, diastolic blood pressure or fundoscopic changes. 6) The major complications were congestive heart failure (49.1%), hypertensive encephalopathy (17.3%), and cerebrovascular accident (8.2%). 7) In the group of essential hypertension blood pressure was controlled by conservative treatment in 81.0% but in 35.7% in the group of renal hypertension. The patients of chronic renal failure who were treated with dialysis blood pressure was controlled in 87.0%. In all 6 cases with renal transplantation, nephrectomy or renal angioplasty blood pressure was well controlled. 8) In cases refractory to triple antihypertensive regimen blood pressure was controlled by minoxidil in 66.7% and by captopril in 75.0%. 9) In 45 cases who were followed up for more than 6 months diastolic blood pressure was controlled under 100mmHg in 77.8% and there were improvement of renal function, fundoscopic findings and electrocardiographic findings in 20.0%, 33.3% and 16.7%, respectively.

젊은층의 성인남자에서 비만 및 체지방의 분포가 인슐린 대사율 및 인슐린 감수성에 미치는 효과

박경수,이병두,박용수,홍성관,장학철,박도준,박중열,이홍규,고창순,민헌기 대한의학협회 1990 대한의학협회지 Vol.33 No.7

흰쥐에서 사염화 탄소(CCl4)에 의한 간섬유화의 유도

김병호,이정일,김효종,김영관,장린,동석호,장영운,송일한 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6

Experimental model of hepatic fibrosis is importent contributions to the understanding of cellular and molecular mechanisms underlying excessive accumulation of extracellular matrix in the liver. Carbon tetrachloride (CCl₄) is one of the oldest and most widely used toxin for experimental induction of hepatic fibrosis in laboratory animals. In this study, We intended to induce the hepatic fibrosis in the rat by the intragastric CCl₄/ phenobarbtal treatment once a week for 12 weeks and the administration dosage of CCl₄ in each week was determined by the daily body weight change. Liver function and histologic change were examined just after 12-week treatment in group Ia (9 rats, Phenobarbital treatment only) and II (18 rats, CCl₄/phenobarbital treatment), and liver function and the irreversibility o histologic change were examined 12 weeks after 12-week treatment in group Ib (9 rats, phenobarbital treatment only) and III (18 rats, CCl₄/phenobarbital treatment). 1) Death rate after 12-week treatment was 11% in group Ⅰ, 56% in group Ⅱ and 50% in group Ⅲ. and the highest rate was at 1 week. that is 33 o each in group Ⅱ and Ⅲ. 2) Tatal protein, alkaline phosphatase, alanine aminotransferase and portal venous pressure were significantly increased in group Ⅱ compared with that in group Ⅰa, but it was only portal venous pressure that was increased in group Ⅲ than in group Ⅰb, 3) The gross finding of micronodular change was shown in 88% of group Ⅱ, 71% of group Ⅲ, but none of group Ⅰ. The microscopic finding of hepatic fibrosis was found in all of group Ⅱ and Ⅲ, but none of group Ⅰ. The severe form of hepatic fibrosis suggesting cirrhosis was found in group Ⅱ and Ⅲ, 12% and 29% respectively. In our study, mortality rate was high within 1 week after CCl₄ treatment, which resulted in half survival rate after 12-week treatment. We also experienced the loin rate of severe fibrotic changes in surviving rats. In the future, in order to produce a severe irreversible fibrotic change with low mortality in inducing hepatic fibrosis with CCl₄/phenobarbital treatment in the rat, adequate detemination of the initial dose of CCl₄ and appropriate choice of administration route of CCl₄ were thought to be needed.