서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

노치 형상 및 냉각속도에 따른 Zr-2.5Nb 압력관의 DHC거동

김상재,김영석,임경수,김성수,정용무 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.1

The objective of this study is to investigate the delayed hydride cracking (DHC) velocity and the incubation time for the water-quenched and furnace-cooled Zr-2.5Nb tube with the different radius of a notch tip. DHC tests were carried out at constant K_1 of 20 MPa√m and 250℃ on the cantilever beam (CB) specimens subjected to furnace cooling or water quenching after electrolytic charging with 57 or 72 ppm hydrogen, respectively. An acoustic emission sensor was attached to the CB specimens to detect the incubation time before the start of DHC. The shape of the notch tip changed from the fatigue crack to the dull crack with its radius ranging from 0.1 to 0.15 mm. The DHC incubation time increased remarkably with the increasing radius of the notch tip, which appeared more strikingly on the furnace-cooled CB specimens than on the water-quenched ones. However, both furnace-cooled and water-quenched CB specimens indicated little change in the DHC velocity with the radius of the notch tip unless their notch tip exceeded 0.125mm. These results demonstrate that the uncleation rate of hydrides at the notch tip determines the incubation time and the DHC velocity becomes constant after the concentration of hydrogen at the notch tip reaches the terminal solid solubility for dissolution (TSSD). This observation agrees well with Kim's DHC model. A difference in the incubation time and the DHC velocity between the furnace-cooled and water-quenched specimens is discussed in terms of the uncleation rate of hydrides at the notch tip and the hysteresis of hydrogen solubility.

관상동맥 혈류의 예비력 측정에서 ATP(Adenosine Triphosphate)와 아데노이신의 비교

김원,탁승제,김한수,신준한,조윤경,최옥경,임경수,최병일 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6

단기교육으로 시행가능한 심실기능평가법

김원,임경수,오병연,홍은석,김영식,김선만,이부수,현석천,김영득 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The initial history, physical examination, and ECG assessment should focus on identification of potentially serious noncardiac or cardiac disorders, including coronary artery disease, congestive heart failure, and electrical instability at the emergency room. additionally, it is essential to define disease severity, stability and need for emergency therapy. echocardiography is a useful tool for this purpose. especially Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic symptoms. So we evaluate the feasibility of the echocardiographic measurement by emergency physicain after short-term course. Method and Results: Twenty volunteers(10 male, 38.8±9.3 years) were included in the study for measurement of myocardial performance index and established parameters of ventricular function using conventional echo-Doppler methods. Myocardial performance index: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The most of mean values of echocardiogrphic parameters were not significantly different between those of cardiologist and those of emergency physicians(p<0.01). The duration for measuring myocardial performance index was shortest among echocardiographic parameters. the validity of echocardiographic parameters measured by emergency physicians was proved relatively good. Conclusion: It is proved to be feasible for emergency physician to perform echocardiographic evaluation of ventricular function after short-term course

한국인 제1형 당뇨병에서 체도 세포질 항체의 양성률 : 항GAD항체, 항ICA512항체, 항phogrin항체의 조합 측정으로의 대체 가능성 Possible Replacement with Combined Measurement of Anti-GAD, Anti-ICA512, and Anti-phogrin Antibodies

김경아,김동준,정재훈,민용기,이문규,김광원,진동규,고경수,김상진,이명식 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:최근 당뇨병의 분류를 새로 제정함에 있어 자가항체가 양성이면 임상형에 상관없이 제1형 당뇨병으로 분류하자는 제안이 나옴으로써 자가항체의 중요성은 더욱 커질 것으로 예상된다. 특히 우리나라와 같이 비비만형인 제2형 당뇨병이 많은 나라에서는 당뇨병의 병인 규명에 자가항체가 중요한 위치를 차지할 것으로 사료된다. 자가항체 중에서 전통적으로 측정되어온 췌도 세포질 항체(ICA)는 표준화하기 어렵고 기술적으로 제한점이 많으며 현실적으로도 췌장 공여자가 적은 점 등이 문제로 알려져 있다. ICA의 대응 항원들로는 GAD(glutamic acid decarboxylase), IA­2(islet­associaated antigen­2;ICA512), IA­2β(phogrin)등이 있다. 이러한 대응 항원에 대한 특이적인 자가항체의 측정은 ICA에 비해 표준화되었으며 최근에는 방사면역측정법(radioimmunoassay;RIA)키드까지 등장하여 손쉽고 정확히 이를 측정할 수 있게 되었다. 연구자들은 한국인 제1형 당뇨병에서 측정법이 표준화 되어 있는 항GAD항체 및 항ICA512항체 조합(combimation)의 조합으로 ICA의 측정을 대신할 수 있는지를 조사하였고 더 나아가 항phogrin항체의 조합 측정으로 임상적 유용성이 있는지 보고자 하였다. 방법: ICA는 면역조직화학 염색법을 이용하였다. 항 GAD항체는 상업화 된 키드(RSR??, United Kingdom)를 이용하였다. 항 ICA512항체와 항phogrin항체의 측정은 in vitro transcription&translation한 후 이를 이용해 방사면역 침전법을 이용하였다. 대상 환자로는 전형적 제1형 당뇨병 76명, 지진형 제1형 당뇨병 22명, 제2형 당뇨병 39명이었으며 각 군간의 연령은 각각 22.8±14.0, 37.9±13.9, 45.3±12.3세였다. 결과:1)전형적인 제1형 당뇨병에서는 ICA의 양성률이 30%, RIA조합만의(항GAD항체 또는 항 ICA512항체 또는 항phgrin항체 한가지에라도 양성인 경우)양성률이 57%이었다. 지진형 제1형 당뇨병에서는 각각 18%, 50%이었다. 제2형 당뇨병에서는 각각 7.7%, 5.1%이었다. 2)각 군에서 ICA가 양성인 군에서 RIA조합 양성률을 보면 전형적 제1형 당뇨병에서는 96%, 지진형 제1형 당뇨병에서는 100%에서 양성이었고 제2형 당뇨병에서는 RIA 조합 양성이 없었다. 각 군에서 ICA가 음성인 군에서도 RIA 조합시 전형적 제1형 당뇨병에서는 40%, 지진형 제1형 당뇨병에서는 39%에서 양성이었고, 제2형 당뇨병에서는 5.6%에서 양성이었다. 3)전형적 제1형 당뇨병에서 ICA가 양성인 군(n=23)에서 96%가 RIA조합 양성이었는데 이때 각각의 RIA유형을 보면 항GAD항체 양성이 87%였다. 한편 항 ICA512항체 양성이 48%, 항phogrin항체 양성이 44%이고 항GAD항체 도는 항ICA512항체 양성이 96%를 차지한다. 지진형 제1형 당뇨병에서는 ICA가 양성인 군(n=4)에서는 항 GAD항체 양성이 3명, 항ICA512항체 양성이 1명이었다. 따라서 기존의 ICA를 RIA조합으로 대체할 수 있을 것으로 사료되었는데 이때 항GAD항체와 항ICA512항체의 조합이 도움이 되겠고 항phogrin항체의 추가적인 검사는 일부의 환자에서만 도움이 되리라 사료된다. 4)이환 기간에 따라 ICA와 RIA조합을 비교시 ICA는 차이가 없었으나 RIA조합의 양성률은 지진형 제1형 당뇨병에서 4년 이상의 이환 기간이 지나면 그 이전보다 떨어졌다. 5)발병 연령에 따라 ICA와 RIA조합을 비교시 ICA 양성률이 전형적 제1형 당뇨병에서 15세 이전에 발병한 그룹에서 그 이후에 발병한 그룹보다 유의하게 높았다. 결론:이상의 결과를 요약하면 항GAD항체 및 항ICA512항체 측정의 조합은 ICA보다 민감도가 높아 기존의 ICA를 대체함은 물론 임상적 이용에서 현격한 우월성을 보이며, 성인에서 발병한 비전형적인 당뇨병의 분류에도 도움이 될 것으로 사료되었다. 추가적인 항phogrin항체의 측정은 임상적 유용성이 없었다. Background : Type 1 diabetes includes all forms of autoimmune-mediated and idiopathic beta-cell destruction leading to an absolute insulin deficiency. Evidence of an autoimune pathogenesis was assessed by studying cytoplasmic islet cell antibodies (ICA), antibodies to glutamic acid decarboxylase (GADA), antibodies reacting with an islet tyrosine phosphatase-related molecule referred to as ICA 512 (ICA 512A), or its homologue phogrin (phogrin-A). In comparison with ICA, the best validation to assess the risk of type 1 diabetes, shows that a combination of antibodies to GADA with ICA 512A has the power to detect a majority of ICA and 97 ~ 100% of subjects who progressed to overt diabetes. These findings suggest the possibility of replacing the laborious ICA test in the screening programs to identify subjects at risk of progressing to type 1 diabetes or for classifying the stage of diabetes at the time of diagnosis. Up to now, it is unclear whether these results are applicable to the slowly progressive type 1 diabetes that appears to be more prevalent in Asian than in western countries. The prevalence of combined autoantibody testing (1≥ of GADA, ICA512A, or phogrin-A) was investigated in the patients with type 1 diabetes (typical and slowly progressive) and type 2 diabetes, and compared with that of ICA which is a more laborious and insensitive test. Methods : The ICA assay was performed using immunoenzymatic staining of frozen human (blood group O) pancreatic sections with serial dilutions of serum samples with peroxidase-labeled protein A. For the GADA determination, commercially available GADA radiommunoassay kits utilizing the ^125I-labeled recombinant GAD65 (RSR®, United Kingdom) as an antigen was used. Either ICA512A or phogrin-A were detected by a radioligand-binding assay after in vitro transcription and translation using the clone ICA512bdc or phogrin c DNA. Serum was obtained from 76 patients with type 1 diabetes(mean age 45.3± 12.3 years). Typical and slowly progressive type 1 diabetes patients had the disease for between 4.0±4.6 and 10.1±9.5 years, respectively at the earliest serum sampling. Results: 1) In typicaltype 1 diabetes, 30% of patients tested positive for ICA and 57% for the combined autoantibody test. In type 2 diabetes, 7.7% and 5.1% tested positive, respectively. 2) Ninety-six percent of ICA-positive patients expressed one or more of the 3 auto-antibody specificities in typicaltype 1 diabetes. Among the 53 ICA-negative patients with typicaltype 1 diabetes, 40% had one or more of these auto-antibodies. In the slowly pregressive type 1 diabetes, 100% of the ICA-positive and 39% of the ICA-negative patients expressed one or more of the 3 autoantibody specificities. 3) Of the 23 patients with ICA-positive typical type 1 diabetes patients, 87% had a positive result for GADA, 48% FOR ICA512A, 44% for phogrin-A, and 96% for GADA or ICA512A. Of the 4 patients with ICA-positive slowly progressive type 1 diabetes, three had a positive result for GADA, and 1 for ICA512A. 4) When the prevalence of combined autoantibody testing was analyzed according to the duration of diabetes, the prevalence in patients tested within 4 years after the diagnosis and more than 4 years after the diagnosis was 61% and 52%, respectively in typical type 1 diabetes. Furthermore, that for the ICA was 37% and 21%, respectively. In the slowly progressive type 1 diabetes, the prevalence of combined auto-antibody testing was 88% and 25%, respectively (p<0.05), while that of ICA was 25% and 13%, respectively. 5) In typical type 1 diabetes, ICA were detected more frequently in patients younger than 15 years of age (48%) than in older patients (23%) (p<0.05), while the prevalence of combined auto-antibody testing -was not different according to the onset age(65% vs 53%). Conclusion : Combined autoantibody testing for GADA and ICA512A is more sensitive that ICA in type 1 diabetes. Therefore, it could replace the laborious ICA measurement and may be useful for discriminating the etiology of adult onset a typical diabetes(J Kor Diabetes Asso 25 :430~445, 2001).

The UN Collective Security System in Perspective - Case of the Korean War-

Kim, Kyoung Soo김경수 숭실대학교부설 사회과학연구소 1987 社會科學硏究 Vol.5 No.-

Headed Reinforcement를 사용한 철근콘크리트 깊은 보의 전단거동

강경훈,이우진,김수봉,서수연,윤승조,김성수 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

Generally, headed reinforcement offers several advantages over straight bar or hooked bar anchorages to develop reinforcement in concrete members. The purpose of this study is to investigate the shear behaviors of reinforced concrete deep beam with headed reinforcement. Five deep beam specimens are designed to study the anchorage capacity of headed reinforcement as well as the contribution of H-bar and V-bar to the shear. Two anchorage types, standard 90-degree anchorage and headed reinforcement, are considered in design. From the tests, it is shown that In the test results, headed reinforcement is able to replace standard 90-degree anchorage as the anchorage method. The evaluation on the contribution of H-bar and V-bar in current design code for deep beam shows that the former is overestimated 75% and the latter is overestimated 17%.

분화된 갑상선암 환자에서 수술 후 재발과 원격전이를 예측하는 혈청 갑상선글로불린치

김경수,류진숙,홍석준,김원배,송영기 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.2

연구배경 분화된 갑상선암의 재발이나 원격전이를 시사하는 혈청 갑상선글로불린치는 보고자들마다 차이가 있고, receive operating characteristics (ROC) 곡선을 이용해서 cut-off value을 구한 경우는 별로 없다. 또한 수술 후 방사성요오드 치료 직전 (Tg-RAI), T₄투여 도중(Tg-on) 및 T₄ 중단 후(Tg-off)에 측정한 갑상선글로불린의 임상적 의의에 대해서도 아직 이견이 있다. 더구나 임상에서 측정된 혈청 갑상선글로불린치의 의미를 해석할 때 보다 큰 의미를 가지는 양성 예측치와 음성 예측치를 조사한 보고는 거의 없다. 방법: 갑상선 유두암 또는 여포암으로 진단되어 갑상선 전절제술 및 고용량 방사성요오드 치료를 시행 받은 후 갑상선 자리에 잔여병소 없이 추적관찰이 이루어지고 있는 242명의 환자들 중, 항갑상선글로불린항체가 음성인 205명의 환자를 대상으로 후향적으로조사하였다. 평균 추I:기간은 5년이었다. Tg-off는 저요오드식이를 2주 이상 시행한 후 ^(131)I-전신스캔과 함께 측정되었으며, 내인성 TSH의 농도가 30 μU/mL 이상으로 상승했을 때 의미 있는 것으로 판정하였다. 재발은 경부 림프절을 포함하여 경부에 새로운 병소가 생겼을 때로, 원격전이는 종격동 림프절을 포함하여 경부 이외의 장기에 병소가 생겼을 때로 정의하였곤, 재발이나 원격전이는 각종 영상학적 또는 병리학적 검사에서 이상소견이 발견되는 경우 있는 것으로 판단하였다. 민감도와 특이도가 가장 높은 Tg의 cut-off value를 구하기 위해 ROC 곡선을 이용하였고, cut-off value에 따른 양성 예측치와 음성 예측치를 구하기 위해 2×2표를 이용하였다. 결과: 재발은 50명 (24.4%)의 환자에서 발생하였고, 원격전이는 17명(8.3%)의 환자에서 발생하였다. 재발이나 원격전이 중 어느 한 가지라도 있는 환자는 52명(25.4%)이었다. ROC 곡선 아래부분의 면적을 통해 알아본 Tg-RAI, Tg-on, Tg-off 검사의 정확도는 서로 비슷하게 높았다. 재발에 대한 혈청 갑상선글로불린치의 cut-off value는 Tg-RAl가 11.8, Tg-on이 1.4,Tg-off가 3.3ng/mL였다. 이때의 민감도는 각각 85.4,82.2, 93.3%였고, 특이도는 각각 89.2, 92.4, 88.0%였으며, 양성 예측치는 각각 71.9, 77.1, 70.0%였고, 음성 예측치는 95.0, 94.4, 97.8%였다. 원격전이에 대한혈청 갑상선글로불린치의 cut-off value는 Tg-RAl가27.4, Tg-on이 2.5, Tg-off가 7.9 ng/mL였다. 이때의민감도는 각각 86.7, 87.5, 92.3%였고, 특이도는 각각86.2, 90.8, 80.2%였으며, 양성 예측치는 각각 34.2,46.7, 25.0%였고, 음성 예측치는 각각 98.7, 98.8,99.3% 였다. 결론: 혈청 갑상선글로불린치는 분화된 갑상선암의 재발이나 원격전이를 예측하는 데 있어 민감도와 특이도가 비교적 높은 검사이나, 음성 예측치가 높은 것에 비해 양성 예측치가 낮은 단점이 있었다. 또한 Tg-on은 Tg-off에 비해 양성 예측치는 높았으나, 음성 예측치는 낮게 나타났다. 따라서 Tg-on이 cut-off value보다 높게 측정되는 경우에는 반드시 전신스캔 등 재발이나 원격전이 여부에 대한 추가적인 검사를 시행하고, Tg-on이 cut-off value보다 낮게 측정되더라도 가능하면 선별검사로서 Tg-off나 recombinant human TSH 자극 후의 혈청 갑상선글로불린치를 주기적으로 측정해야 할 것으로 사료된다. Background: Reports on serum thyroglobulin(Tg) levels being used to predict recurrence or distant metastasis during the follow-up of patients with differentiated thyrod cancer(DTC) has been inconsistent. In addition, there have been few reports that attempt to define the cut-off value of Tg for recurrence or distant metastasis obtained by a receiver operating characteristic (ROC) curve. As well, there are differences in opinions on what the value should be on the first serum Tg level measured just before radioactive iodine(RAI) ablation(Tg-RAI), during thyroxine administration (Tg-on), and after thyroxine withdrawal (Tg-off) during the follow-up. Reports on the positive predictive values(PPVs) and negative predictive values(NPYs) of these Tg values are rare. Methods: A total of 205 patients (42 males, 163 females) with DTC were studied. All patients had undergone total or near-total thyroidectomy. After surgery and RAI ablation, annual thyroxine withdrawal 131I-whole body scan (WBS) with Tg measurements was performed. The mean duration of follow-up was 5.0 (1.4~7.4) years. The most sensitive and specific Tg values)cut-off values) for tumor recurrence and/or distant metastasis were selected by using ROC curves. We also calculated the PPVs and NPVs for rcurrence and/or distant metastasis using two-by-two tables. Results: Cut-off values of Tg-RAI, Tg-on, and Tg-off for recurrence were 11.8, 1.4, and 3.3 ng/mL, respectively. For these values, the sensitivities were 85.4, 82.2, and 93.3%, with the specificities at 89.2, 92.4, and 88.0%. PPVs were 71.9, 77.1, and 77.0% while NPVs were 95.0, 94,4, and 97.8%. The cut-off values for distant metastasis were 27.4, 2.5, and 7.9ng/mL, respectively. For these cut-off values, the sensitivities were 86.7, 87.5, and 92.3%, with the specificities being 86.2, 90.8, and 80.2%. PPVs were 34.2, 46.7, and 25.0% and NPVs were 98.7, 98.8, and 99.3%. Conclusion: All three serum Tg levels were sensitive and specific markers for recurrence and distant metastasis. Their PPVs were low in contrast to the high NPVs. In comparison with Tg-on, Tg-off showed higher sensitivity and NPV as well as lower specificity and PPV. Therefore, in the case of higher Tg-on during the follow-up period, efforts to find recurrence and distant metastasis,such as 131I-WBS, should be done. In addition, regular measurement of Tg-off or Tg after stimulation with recombinant human TSH is recommended as a screening test (J Kor SOC Endocrinol 18:153-165, 2003).

HL-60 백혈병 세포의 성장에 대한 노랑하늘타리의 효과

김상철,박수영,허규희,김세재,강희경 제주대학교 생명과학연구소 2001 제주생명과학연구 Vol.4 No.-

The purpose of the present study is to examine the inhibitory effect of extracts of Trichosanthes kirilpwii var. japonica on the growth of HL-60 cells and to develop an anti-cancer agent using components of its leaves. To examine the inhibitory effect on the growth, metabolic activity was measured with 3-(4,5-dimethylthiazol)-2,5-diphenyltetrazolium bromide (MTT) assay. In results, methanol(MeOH) extract of its leaves and ethylacetate (EtOAc) fraction of MeOH extract markedly inhibited the growth of these cells. At the same time, DNA fragmentation was observed in its extract-treated HL-60 cells. Therefore, inhibitory effect of Trichosanthes kirilpwii var. japonica on the growth of HL-60 seems to arise from the induction of apoptosis.

소장점막의 허혈-재관류 손상에 대한 Capsaicin의 보호효과

김원영,임경수,박형섭 대한응급의학회 2002 대한응급의학회지 Vol.13 No.2

Purpose: Capsaicin, a major ingredient of hot peppers, has a stimulatory effect of the neurons. Ingested capscaicin causes pain and even damages the mucosa with a large dose. On the other hand, it protects the gastric mucosa against many ulcerogenic agents or conditions. In this study, we investigated the effect of oral capsaicin on the ischemia-reperfusion damage of the intestinal mucosa in rats. The involvement of stress proteins such as HSP-70 and HSP-72 in the action of capsaicin was also investigated. Methods: Male Sprague-Dawley rats were given oral capsaicin (20 mg/kg/day) for a designated period. Ischemia of the small intestine was inflicted by clamping the superior mesenteric arteries for 30 minutes under anesthesia. After the ischemic period, the clamp was released and the animal was kept for 1,5, or 24 hours. Then, the intestinal structure was observed under the microscope, and the levels of the heart-shock proteins were determined by using a Western blot. Results and Conclusion: Oral capsaicin protected the mucosa of the small intestine against the ischemia/reperfusion injury. Capsaicin also increased and expedited the ischemia/reperfusion-induced expression of the heat-shock proteins, HSP-70 and 72, in the intestine. The possible linkage between the two events is discussed.