정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>

위암의 연령에 따른 차이

김영재(Young Jae Kim),이영철(Young Chul Rhee),이만길(man Kill Lee),차호(Ho Cha),정영채(Young Chae Jung) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A Comparative analytic review on clinical, endoscopic and histopathological findings was done in 13 cases of young age (under 29), 446 cases of mid age (30~69) and 39 cases of old age (above 70) stomach cancer who were visited Department of Internal Medicine of Masan Koryo General Hospital from March 1981 to July 1985. The following results were obtained: The peak of age incidence was the 5th decade amounting to 36.8%. The ratio between male and female was 2.6:1. The main chief complaint of each group was epigastric pain and it was followed by epigastric fullness. The most patient had the duration of symptom from 3 months to 6 months. For old-age group, mid-age group, major site of lesion in the antrum, meanwhile body for young-age group. The most frequent type of gastric cancer was type III in each group by Borrmanns classification. For each group, adenocarcinoma was major cases in the view of histopathological findings, and incidence of well differentiated type adenocarcinoma were lower in young-age group than others.

IDIS그룹의 창조와 혁신 성장 메커니즘-사람, 기술, 그리고 M&A가 만들어 가는 글로벌 넘버원

최정철(Jeong-Chul Choi),박기찬(Kichan Park),김영달(Young-dal Kim),박재홍(Jae-hong Park) 한국경영학회 2021 Korea Business Review Vol.25 No.신년 특별호

본 사례연구는 보안장비분야 세계 정상에 오른 창업가의 끊임없는 창조와 혁신의 경영철학과 사업성장의 역정을 살펴보는 데 목적이 있다. 그룹의 모태가 되는 IDIS는 김영달 대표이사가 KAIST 전산학과 박사과정 중 창업하여 세계 최초로 DVR(Digital Video Recorder)제품을 개발하는 등 보안 분야 디지털 기술을 선도하고 있다. 특히 미국항공우주국(NASA) 등 하이엔드 시장에 진출하는 과정에서 기술력을 인정받아 2000년 시드니 올림픽 주경기장과 오페라하우스 전역에 최첨단 보안장비를 설치함으로써 전 세계에 IDIS의 기술력을 알렸다. 그리고 디지털 전환(Digital Transformation) 시대로 패러다임이 급속히 변화하는 환경에서 보안 분야를 주도함으로써 마침내 세계 정상에 올랐다. 무엇보다 보안 분야 세계 정상에 오른 기업의 최고경영자로서 김영달 대표가 새롭게 도전하고 있는 그의 ‘철학이 있는 경영’, 바로 혁신을 꿈꾸는 엔지니어에서 ‘사회적 부’를 창출해 가는데 기여하는 기업가가 되려는 노력은 IDIS그룹의 경영성과에 의해 증명되었다. 성과분석에 있어서도 “기업의 규모가 성장하면 사회적 책임과 역할도 확대되어야 하므로 좋은 일자리를 만들고 구성원의 행복과 지역사회의 발전을 지속적으로 견인해야 한다”는 그의 ‘안정기반 성장전략’에 초점을 두었다. 정상에 오른 기업으로서 IDIS그룹이 보여준 성장전략과 경영성과는 다음의 세 가지로 요약된다. 첫째, 문어발식으로 규모를 확대하는 것이 아니라 일자리 창출과 고용안정 등 사회적 부를 창출하기 위한 전략으로 관련 다각화 M&A를 신중하게 진행했다. 둘째, 창업을 결심했을 때처럼 ‘국내 기술로 글로벌 넘버원이 될 수 있는 기업’을 찾아 M&A를 추진한 결과, 산업용 디스플레이를 개발하는 ㈜코텍, 프린터 관련 기업 ㈜빅솔론과 IDIS의 사내벤처로 창업한 아이디피(주)를 결합하여 사업의 포트폴리오를 성공적으로 구축했다. 셋째, ㈜코텍, ㈜빅솔론의 창업주들이 직접 김영달 대표를 찾아와 인수합병을 제안했고 M&A 이후 R&D 기술력 기반으로 성장시켜가고 있다. 본 사례연구를 위해 다섯 번의 인터뷰와 20시간이 넘는 질문과 토의 중에서도 밝은 미소와 사업에 대한 열정을 잠시도 잃지 않는 그의 인간적 매력 또한 이를 증명해 주었다. The purpose of this case study is to examine the mechanism of successful business growth of an entrepreneur with his philosophy in creativity and innovation. IDIS was founded by CEO Young-dal Kim and its founding members while attending the Ph.D. in Computer Science at KAIST Graduate School. They developed the worlds first DVR product, and are currently leading digital technology in the field of security. In particular, in the process of advancing to high-end markets such as NASA, technological prowess was recognized, and state-of-the-art security equipment was installed throughout the Opera House from the main stadium of the ‘2000 Sydney Olympics’. Since then, the world has begun to be interested in IDIS technology. IDIS finally reached the top of the world by leading the security field in an environment in which the paradigm to the era of digital transformation is rapidly changing. The core of this case is to look at his “management with philosophy” that CEO Kim is taking on a new challenge as the CEO of a company that has reached the top of the world. He now wants to become an entrepreneur who contributes to creating ‘social wealth’ from an engineer who dreamed of innovation. In other words, his philosophy is that social responsibilities and roles should be expanded as the size of a company grows, and companies should continuously create quality jobs and lead the happiness of members and the development of local communities. The strategy and achievements of IDIS Holdings as a top-rated company are summarized in the followings. First, CEO Kim transformed IDIS into a holding company as a strategy to continuously create social wealth, such as job creation and security, rather than just expanding the scale. Second, as a result of finding “a company that can become the global number one with domestic technology,” KORTEK, BIXOLON, and IDP have successfully formed a business portfolio. Third, unusually, the founders personally visited CEO Kim and proposed M&A, and actually all growing successfully after M&As.

Progastrin-releasing peptide as a diagnostic and therapeutic biomarker of small cell lung cancer

오형주,( Ha Young Park ),( Tae Ok Kim1 ),( Chul Kyu Park ),( Hong Jun Shin ),( Hee Jung Ban ),( In Jae Oh ),( Yong Soo Kwon ),( Yu Il Kim ),( Sung Chul Lim ),( Young Chul Kim ),( Soo Hyun Kim ),( Myung G 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-

Background: Progastrin-releasing peptide (proGRP) is a recently identified biomarker of small cell lung cancer (SCLC). We aimed this study for evaluating the usefulness of automated proGRP measurement for diagnosis and treatment monitoring in patients with SCLC. Methods: From January 2011 to December 2013, plasma samples were prospectively collected from 452 [213 non-small cell lung cancer (NSCLC), 104 SCLC, 135 other diseases] patients visited for tissue diagnosis and tested by two-step automated immunoassay using the ARCHITECT proGRP assay kit (Abbott Diagnostics, USA). The cutoff level of proGRP was set at 63 pg/mL. Results: The mean proGRP was higher in SCLC (1823.0 ± 2684.0 pg/mL) than in NSCLC (61.0 ± 341.7 pg/mL) and other diseases (51.5 ± 222.6 pg/mL, p<0.001). The sensitivity of proGRP was 85.7% (90/105) in SCLC and 11.8% (25/212) in NSCLC. The specificity was 90.2%, positive predictive value was 72.5%, and negative predictive value was 95.4% in SCLC. The mean proGRP was higher in extensive disease (2158.1 ± 2980.6 pg/mL) than in limited disease (901.4 ± 1216.0 pg/mL, p=0.033). Among the 39 patients with SCLC could be followed, the mean proGRP levels of 23 responders were significantly decreased after chemotherapy (from 1651.5 ± 1386.4 pg/mL to 290.0 ± 524.8 pg/mL, p<0.001), whereas those of the 16 non-responders were not. (from 572.5 ± 790.3 pg/mL to 494.4 ± 610.9 pg/mL, p=0.583). Conclusion: Plasma proGRP could be a useful biomarker of SCLC for diagnosis and treatment monitoring. And the initial level may represent the tumor extent of SCLC.

청소년 인터넷 중독 검사 방법의 통계적 고찰 및 개선 -Young의 척도를 중심으로

박찬정 ( Chan Jung Park ),김형철 ( Hyung Chul Kim ),고영민 ( Young Min Ko ),현정석 ( Jung Suk Hyun ),김철민 ( Cheol Min Kim ) 한국컴퓨터교육학회 2010 컴퓨터교육학회 논문지 Vol.13 No.4

국내외에서 이루어진 기존의 인터넷 중독 검사에 대한 연구는 다양하며 방대하지만, 대부분의 연구가 중독도 검사를 위한 항목추출이거나 항목들을 이용한 중독도 분석이었지 항목간의 분석을 통한 차별화는 이루어지지 않았다. 본 논문에서는 리즈렐과 데이터마이닝 기법을 이용하여 Young의 인터넷 중독 검사방법을 고찰하고 문제점을 지적한 후, 검사 방법에 대한 대안을 제안한다. 이를 위해 Young의 척도를 이용하여 청소년 440명을 대상으로 설문을 실시하고, 요인분석을 통해 Young 척도의 문제점을 분석한다. 또한, 데이터 마이닝 알고리즘인 J48 및 PART를 이용하여 설문문항들 중에서 인터넷 중독도를 구분 지을 수 있는 항목들을 선별하고 이를 기반으로 인터넷 중독 학생들을 진단하고 처방하는데 활용하는 방법을 제안한다. So far, the researches about the Internet addiction testing are diverse and enormous. However, since the testing factors have the same importance, there is no discrimination among the factors. In our paper, we analyze the problems of the existing researches by using Lisrel and data mining algorithms. Next, we propose an alternative for the Internet addiction testing. In order to accomplish these, we make an questionnaire consisted of Young`s test and then, we asked to 440 primary and secondary school students. In addition, we analyzed the problems of Young`s test with factor analysis and then, we distinguish more important items from others with J48 and PART. Finally, based on this analysis, we propose a method to diagnose addicted students and prescribe them.

흉통의 양상에 따라 분류한 불안정형 협심증 환자의 임상적 소견의 비교

김명수,김성구,정호석,온영근,신원용,김철현,최태명,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background and aims : The clinical syndrome unstable angina pectoris that encompasses a variety of symptoms and clincal presentations of transient episode of myocardial ischemia, was devided to several subgroups. Also, it has variable pathophysiologic factors to cause myocardial ischemia. According to clincal presentation, coronary angiographic finding and prognostic factor, the result of unstable angina pectoris is variable. In fact, there were a few data reported on the prognosis of wide spectrum of patients with unstable angina. However, the precise risk of subgroups according to classitication has not been established because it was difficult to compare between studies. We classified unstable angina pectoris by clinical nature of chest pain, and performed to establish and compare the clinical presentations, coronary angiographic findings, treatement and prognosis of patients with unstable angina within subgroups of classification. Methods : Retrospenctive data for 164 unstable angina pectoris patients admitted to the Internal Cardiology Division of Soon Chun Hyang University Hospital from May 1996 to July 1999 was analyzed. The patients were classified into one of the following categories: Class I, new onset of severe angina; Class II, acceleration of previous chronic stable angina; Class III, angina at rest. Clinical presentations, echocardiographic findings, coronary angiographic findings, treatment and prognosis were compared. Results : From the total 164 patients, the subjects of classes were as follows : Class I, 46 cases (28.1%); Class II, 74 cases (45.1%); Class III, 44 cases (26.8%). In view of age distribution, the 7th decade had the highest incidence, and then, 6th, 8th decades were followed. There was no baseline differences among the 3 classes with respect to gender, number of risk factors. Significantly, class II showed more severe findings in abnormal Q wave 15 cases (20.8%), total occclusive lesion 10 cases (20.8%) and three vessel coronary disease 11 cases (22.9%) than other classes. The change of ST segment was significantly apparent (p<0.02) among class I 28 cases (60.8%), class III 26 cases (59.0%), comparing with class II 30 cases (40.5%). Class III had the higher incidence of one vessel coronary artery disease than class I and III. The heparin treatment was performed in 99 cases (60.1%). The incidence of nonfatal myocardial infarction was much more in class I and III, each 4 cases (8.7%, 9.8%) than in class II 1 cases (1.4%). In-Hospital death was occurred in class I and II, each 1 case. Conclusion : The patients with the acclerated angina from chronic stable angina had more severe coronary artery disease than other classes, but they had better in-hospital prognosis.

물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가

김정철,윤정한,범희승,제갈영종,송호천,민정준,정환정,김성민,허영준,이명호,박영규,정준기 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.2

목적 : 분화갑상선암 환자에 대한 방사성옥소(I-131) 치료는 재발율과 사망률을 감소시키는 효과적인 치료법이지만, 치료용량을 증가시킴으로써 치료율을 향상시킬 수 있는지에 대해서는 아직 논란이 있다. 본 연구에서는 최대허용선량 치료법의 효용성을 검증하고자 하였다. 대상 및 방법 : 임상적 병기가 제3, 4병기이고, 6개월 이후에 I-131 전신스캔(이하 IWBS)과 혈중 thyroglobulin (이하 Tg), anti-thyroglobulin antibody (이하 ATA), 초음파검사 (이하 US) 및 F-18 FDG PET 등을 통해 치료여부를 확인할 수 있었던 58명(남:여=9:49, 평균연령 50±11세)의 유두상갑상선암 환자를 대상으로 하였다. 이중 11명은 제4병기, 47명은 제3병기였으며, 43명(남:여=4:39), 평균연령 50±11세)은 7.4 GBq 이하의 고식적인 저용량치료법으로 치료하였고, 9.25 GBq 이상의 고용량 치료를 받은 환자는 15명(남:여=5:10, 평균연령 50±12세)으로 고용량군에서 남자가 더 많았으나 연령의 차이는 없었다. 고용량군 환자 모두에서 추적용량의 방사성옥소(평균 77±3 MBq)를 경구 투여한 후 혈중 방사능소실곡선을 통해 최대허용선량(maximum permissible dose, 이하 MPD)을 계산하였으며, 7명에서는 말초혈액림프구의 중기염색체분석법에 의해 생물학적으로 MPD를 계산하였다. 14명에서는 치료용량의 방사성옥소를 투여한 후 혈중 방사능소실곡선을 통해 MPD를 계사하였다. 완전치유(complete response, 이하 CR)는 IWBS에서 병소가 없어지고, 혈중 Tg치가 1 ng/mL 이하로 감소한 경우로 정의하였으며, 부분치유(partial response, 이하 PR)는 IWBS에서 병소가 없어졌더라도 혈중 Tg, ATA치가 높거나, US 또는 PET 검사에서 병소가 남아있는 경우로 정의하였다. 치료후 IWBS에서 병소가 오히려 증가하거나 변함없는 경우는 없었다. 방사성옥소 치료에 의한 부작용은 입원기간 중 타액선이 현저하게 붓고 통증이 있거나, 구토를 심하게 하는 경우, 그리고 퇴원후 1개월째 백혈구수가 20% 이상 감소한 경우로 정의하였다. 결과 : 양 군간에 연속적인 수치변화를 비교하는 경우는 paired t-test를 이용하였으며, 대상군간 치료효과와 부작용의 비교는 chi-square test를 이용하였다. p값 0.05 미만을 통계적으로 유의한 차이로 인정하였다. 고용량군 환자 모두에서 추적용량과 치료용량의 방사성옥소 투여 후 혈액의 피폭선량은 각각 0.012±0.3 Gy, 1.66±25 Gy였으며, 방사성옥소 투여 후 혈액에 전달되는 피폭선량은 추적용량보다 치료용량에서 더 많았고 (1.21: 166 rad, p<0.001), 방사성옥소 1 mCi당 혈액에 전달되는 피폭선량은 차이가 없었다(0.58±0.1 vs. 0.56±0.1 rad/37 MBq, p=0.34). 추적용량 방사성옥소 투여 후 구한 MPD는 평균 13.3±1.9 GBq (9.7 ~ 16 GBq) 이였고, 치료용량 방사성옥소 투여 후 구한 MPD는 평균 13.8±2.1 GBq (10.4 ~ 16.3 GBq)로 유의한 차이가 없었으며 (p=0.20), 두 수치간에는 유의한 상관 관계가 있었다(r=0.8, p<0.0001). 7명의 환자에서 말초혈액림프구 중기염색체 분석법으로 MPD를 측정하였는데 혈액의 피폭선량은 1.78±0.03 G였으며, 같은 환자에서 혈중 방사능소실곡선으로부터 구한 피폭선량은 1.54±0.03 G로 유의하게 낮았으나 (p=0.01), 두 측정치 간에는 유의한 상관관계(r=0.86, p=0.01)가 있었다. 저용량 치료군 43명 중 22명(51.2%)에서 완전치유를 보였고 21명(48.8%)에서는 부분치유를 보인 반면 고용량 치료군 15명 중 12명(80%)에서 완전치유를 보였고 3명(20%)에서만 부분치유를 보여 고용량 치료군에서 유의하게 높은 완전치유를 얻을 수 있었다(p=0.05). 한편 부작용 발생빈도는 저용량 치료군 43명 중 13(30.2%), 고용량 치료군 15명 중 6명(40%)로 양군간에 유의한 차이가 없었다(p=0.46). 임상적인 병기, 연령 및 성별에 따라서는 치유의 차이가 없었다(p>0.05). 결론 : 혈중소실곡선으로부터 MPD를 결정하고 이를 토대로 환자 개개인별로 적절한 선량을 선택하여 치료하는 방법은 부작용을 최소화하면서도 치료효과를 높일 수 있는 매우 유용한 치료법이며, 고위험군 분화갑상선 암 환자에게 가장 적절한 치료법이라고 사료되었다. Purpose: Radioiodine (1-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age 50±11 years) of papillary thyroid cancer. Among them 43 patients were treated with ≤7.4 GBq, while 15 patients with ≥9.25 GBq. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up 1-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were 13.3±1.9 and 13.8±2.1 GBq, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were 1.54±0.03 and 1.78±0.03 Gy (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-does group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose 1-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.

HID 램프용 디지털제어 전자식 안정기에 관한 연구

김영동,강원찬,김남오,김형곤,김병철 조선대학교 에너지.자원신기술연구소 2004 에너지·자원신기술연구소 논문지 Vol.26 No.1

In this paper, digitally controlled electronic ballast for the HID lamps driven by proposed frequency conversion method is described. This electronic ballast consists of a buck converter, a low frequency square wave full bridge inverter, a high voltage pulse generator for the lamp ignition, an over current protection circuit and an 8-bit microcontroller. The fuzzy logic digital control operation is carried out by the 8-bit microcontroller. In spite of the limited control bandwidth caused by low operation speed of the 8-bit microcontroller, the good control performance for the constant lamp current in the warm-up period is obtained using the proposed frequency conversion driving method. The HID lamp is controlled in a constant current mode during the lighting warm up process and is controlled in a constant power mode during lighting steady state. A controlled variable power mode is used to extend the lamp lifetime.