압박 고 나사로 치료한 대퇴골 전자부 골절 : 고정 실패의 인자에 대한 분석 Analysis of Factors associated with Failure of Fixation

유찬훈,김홍태,변영수,남준모,조영호,문성건 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 압박 고 나사로 치료한 대퇴골 전자부 골절의 고정 실패에 영향을 미치는 요소에 대하여 분석하고자 하였다. 대상 및 방법 : 1995년 5월부터 2000년 7월까지 대퇴골 전자부 골절을 압박 고 나사를 이용하여 치료하고 1년 이상 추시가 가능했던 97예를 대상으로 하였다. 골절의 분류는 Jensen 분류법을, 골다공증의 정도는 Singh 지수를 이용하였다. 술후 방사선 검사에서 경체각, 정복 상태, 지연 나사의 대퇴골 두 내 위치, tip-apex distance(TAD) 및 지연 나사의 활강 거리를 측정하였고 고정 실패에 미치는 영향을 통계학적으로 분석하였다. 결 과 : 97예 중 17예(17%)에서 고정 실패가 발생하였고 그 중 지연 나사의 과도한 활강으로인한 경우가 15례(15.4%), 골두 천공 1얘, 10도 이상의 외반 변형 1예였다. 고정 실패의 발생과 80세 이상의 고령, 불안정성 골절, telescoping 정복, 원위 골편의 내측 혹은 전방 전위, 대퇴골 두 내 지연 나사의 위치와 밀접한 관계가 있었다. 결 론 : 압박 고 나사를 이용한 대퇴골 전자부 골절의 치료에서 고정 실패를 방지하기 위해서는 정확한 정복이 필요하고 대퇴골 두 내에서 지연 나사의 전방 위치를 피하는 것이 좋을 것으로 사료된다. Purpose : This study was performed to analyze the significant factors that may affect failure of fixation in trochanteric fractures of the femur treated with the compression hip screw. Materials and Methods : From May 1995 to July 2000, the authors analyzed 97 cases of trochanteric fracture of the femur treated with the compression hip screw and followed more than one year. We classified the fracture type by Jensen's method. We used Singh index for the degree of osteroporosis. In the post-operative radiograph, we checked neck-shaft angle, state of reduction, position of the lag screw within the femoral head, tip-apex distance, and sliding distance of the lag screw. The relationship between these factors and failure of fixation was statistically analyzed. Results : There were 17 cases(17.5%) of failure of fixation ; 15 cases(15.4%) of excessive sliding of the lag screw, 1 case (1%) of cutting out of the lag screw, and 1 case (1%) of valgus malunion. There were significant relationship between failure of fixation and old age over 80 , unstable fracture, telescoping reduction, anterior or medial displacement of the distal fragment, and anterior placement of the lag screw within the femoral head. Conclusion : Accurate reduction and avoidance of the placement of the lag screw in the anterior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.

오스테나이트계 스테인리스강과 SM45C의 연속파형 Nd:YAG 레이저 용접특성비교

유영태,오용석,노경보,임기건 한국공작기계학회 2003 한국생산제조학회지 Vol.12 No.3

Welding characteristics of austienite 304 stainless steel and SM45C using a continuous wave Nd:YAG laser are experimentally investigated. Laser beam welding is increasingly being used in welding of structural steels. The laser welding process is one of the most advanced manufacturing technologies owing to its high speed and deep penetration. The thermal cycles associated with laser welding are generally much faster than those involved in conventional welding processes, leading to a rather small weld zone. Experiments are performed for 304 stainless steel plates changing several process parameter such as laser power, welding speed, shielding gas flow rate, presence of surface pollution, with fixed or variable gap and misalignment between the similar and dissimilar and plates, etc. The Nd:YAG laser welding process is one of the most advanced manufacturing technologies owing to its high speed and penetration. This paper describes the weld ability of SM45C carbon steel for machine structural use by Nd:YAG laser. The follow conclusions can be drawn that laser power and welding speed have a pronounced effect on size and shape of the fusion zone. Increase in welding speed resulted in an increase in weld depth/aspect ratio and hence a decrease in the fusion zone size. The penetration depth increased with the increase in laser power.

국내 호중구감소성 발열 환자에게 경험적 항진균제로 투여한 Amphotericin B deoxycholate와 Itraconazole 주사제의 비용-확인분석 : 예비보고

이동건,송영구,유진홍,최수미,최정현,박선희,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : 진균감염이 점차 증가되고 있고 이를 치료하기 위한 비용 역시 증가하고 있지만 국내에서는 비용분석에 대한 연구가 거의 없는 실정이다. 본 연구에서는 호중구감소성 발열 환자에게 경험적 항진균제로 amphotericin B deoxycholate (ABV)혹은 정맥내 itraconazole (ITZA)을 투여할 때의 약물경제학적 측면을 후향적으로 비교해보고자 하였다. 재료 및 방법 : 같은 반응률을 보인다고 가정한 비용-확인분석 모델을 이용하여 가톨릭대학교 조혈모세포이식센터에서 혈액종양으로 항암치료 혹은 조혈모세포이식을 시행한 환자를 대상으로 자료를 수집하였다. 항진균제 투여에 대한 정보는 기존에 출판된 논문 및 학회 심포지움자료를 참고하였고, 논문에서 얻지 못한 정보는 가톨릭대학교 성모병원 의무기록실, 정보지원팀, 진료비관리팀의 협조를 받아 2003년 6월 1일부터 11월 30일까지의 자료를 분석하였다. ITZA에 대한 자료는 2003년 11월 제한적으로 1차 약제로 사용할 수 있게 되었던 때의 자료와 경험을 참조하였다. 결과 : 320명의 환자 중 149명(46.5%)에서 경험적 항진균제를 사용하였고 평균 투여일수는 ABV 17.0일, ITZA 9.8일이었다. 이상반응 발현율은 ABV 54%, ITZA 5%였다. ABV 투여환자 중 11명 (7.4%)에서 혈액투석을 평균 6.5일간 시행하였다. ITZA 투여시 간독성으로 혈장분리반출술, 인공간 등이 필요한 경우는 없었다. 경험적 항진균제를 ABV로 시작한 군(ABV군)은 1인당 1,229,495원, ITZA로 시작한 군(ITZA군)은 1인당 1,434,605원이 소요되어 ITZA군에서 205,110원 (16.7%)이 더 소요되었다. 평균 16일간 항진균제를 사용하여 1일 12,819.4원의 차이가 있었다. 결론 : 비용-확인 분석법에서 ITZA군이 ABV군 비해 하루 12,819.4원의 비용이 더 소요되었다. 비록 ITZA군에서 비용이 더 들었지만 1일 약가차이인 4.7배와 비교하여 많이 감소하여 항진균제의 비용을 1일 약가로 비교하는 것보다는 재원일수, 이상반응 발현율 등을 고려하는 총입원비용으로 약물경제학을 비교하는 것이 더 합당할 것으로 사료된다. 그 외에 환자의 예후, 삶의 질, 사회적 간접비용 등을 고려하는 전체적인 약물경제학을 비교하는 잘 계획된 전향적 연구가 추가로 필요하겠다. Background : The increasing incidence of systemic fungal infections and the rising medical cost have focused the need to determine the economic issues of antifungal agents. Nevertheless there have been only few reports about the cost analysis in Korea. We retrospectively investigated to compare the pharmacoeconomic aspects of amphotericin B deoxycholate (ABV) with those of intravenous itraconazole (ITZA) in the empirical treatment of febrile neutropenic patients. Materials and Methods : Through the cost-identification analysis model, on the presumption that two groups would show identical response, we collected data of patients who received hematopoietic stem cell transplantation (HSCT) or chemotherapy in Catholic HSCT center from Jun 1, 2003 to Nov 30, 2003. The literatures about information on antifungal therapy were extensively reviewed. Other unpublished information was provided by information assistant team, cost management team, and medical record unit in the same hospital. Results : Empirical antifungals were given to 149 out of 320 patients (46.5%). The average duration of administration were 17.0 days for ABV and 9.8 days for ITZA. The rates of adverse events were 54% and 5% for ABV and ITZA, respectively. Eleven (7.4%) patients given ABV received hemodialysis for 6.5 days in average. Among patients given ITZA, none developed hepatotoxicity requiring plasmapheresis or artificial liver. It cost 1,229,495 won/patient for the ABV group (starting ABV as empirical antifungal agent) and 1,434,605 won/patient for the ITZA group (starting ITZA as empirical antifungal agent) which was 16.7% more expensive than ABV group. When we compare the average daily cost for 16 days, the ITZA group spent 12,819.4 won/patient/day more than the ABV group. Conclusion : The cost-identification model in this study revealed that ITZA group cost more than ABV group. However, the difference in expense decreased when 1 day-cost was compared (4.7 times greater than ABV). It would be more reasonable to consider the total cost of anti-fungals during the hospitalization rather than 1 day cost in considering pharmacoeconomics. Well designed prospective study considering prognosis of patients, quality of life, and indirect social cost should be warranted.

가스크로마토그래피/질량분석법에 의한 최적화 유도화 과정을 통한 Atrazine의 새로운 분석방법 개발

박승건,김승진,유영재,이용일 昌原大學校 基礎科學硏究所 2003 基礎科學硏究所論文集 Vol.15 No.-

Pesticides, with their high degrees of toxicity constitute a very impOrtant group target compound in environment samples. The use of many pesticides has been restricted or even banned while several years bemuse of their long residue times, persistence and bio-accumulation. Atrazine was derivatized using a single-step procedure by N,O-bis(trimathylsilyl)-acetamide acetonitrile in various solvent systems such as methanol, ethyl acetate, pyridine, and tetrahy&ofuran(Tl). The variables selected for study were the amount of reagents, the temperature and reaction times. The elelctron impact ionization mass spectra of the resulting derivatives are acquired and properly interpreted. Under the optinaized gas chromatographic conditions employed, an enhanced (3 times) peak height and an improved peak shape without any tailing. The purpose of this study was the development and application of GC-MS method for efficient analysis of atrazine.

경호업 종사자의 직무유형과 동기수준 및 직무만족의 관계

안병근,정위곤,전명만,유철수 龍仁大學校 武道硏究所 2002 武道硏究所誌 Vol.13 No.1

The purpose of this study was to analyze the relationship between motivation level, job satisfaction along with private security employees job style. For accomplishing this purpose of the study, the 262 subject were selected by the cluster random sampling method from private security employees in 6 private security companies located in Seoul and Kyoung-gi do. The survey questionnaires were used to collect data. The questionnaire for motivation level was developed by Frills and Knox(1972), Quinn and Shephard(1978) and standardized in Korean language by Young-In, Hur(1995) and the job satisfaction was developed by Rizzo(1970) and standardized in Korean language by Yong-Nam, Joo(1993). The statistical methods utilized in this study for analyzing the collected data were reliability analysis, descriptive statistics, Chi-square, t-test, One-way ANOVA, and standard multiple regression analysis. From the analysis of this study, the following conclusions were obtained: Firstly, the motivation level, job satisfaction along with private security employees are partially different by the socio-demographic characteristics. Secondly, the motivation level is not different by the private security employees job style. Thirdly, the job satisfaction is partially different by the private security employees job style. In detail, in job condition along with job style, safe employees are more satisfaction than security employees. Lastly, the motivation along with private security employees influence on the job satisfaction. In detail, the achievement needs, role conflict, and autonomy influence on the job condition and also the role conflict and autonomy influence on the role value.

쇄골 간부 골절 불유합의 수술적 치료 : 재건 금속판 고정 및 골 이식술 Reconstruction Plate Fixation and Bone Grafting

변영수,유찬훈,안혁수,문성건,신동주,박준우 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 쇄골 간부 골절 불유합에 대하여 관혈적 정복, 재건 금속판 고정 및 골 이식을 시행하고 술후 조기 관절 운동을 허용한 저자들의 경험을 보고하는 것이다. 대상 및 방법: 1997년 1월부터 2001년 12월까지 수술적 치료를 시행한 쇄골 간부 골절 불유합 16예를 대상으로 하였다. 위축성 불유합이 10예, 비후성 불유합이 6예였으며, 수상 후 불유합에 대한 수술까지의 기간은 평균 6.5개월이었다. 수술적 치료로 불유합 부위를 노출시켜 섬유조직을 제거하고 골수강을 천공하였으며, 골편을 정복하고 재건 금속판으로 고정하였으며, 자가 골 이식을 하였다. 수술 후 관절 운동은 1주일 이내에 시작하였다. 결 과: 평균 추시 기간은 22.0개월이었으며, 전 예에서 평균 10.0주에 골유합을 얻었다. 최종 추시 시의 견관절 운동범위는 전 예에서 정상으로 회복되었으며, 나이가 50게 이상인 6예 중 3예에서 동측 견관절에 간헐적인 동통을 호소하였다. 술후 감염, 재검 금속판의 파손, 고정상실, 불유합, 재골절 등의 합병증은 발생치 않았다. 결 론: 쇄골 간부 골절 불유합에 대한 관혈적 정복, 재건 금속판 고정 및 골 이식은 안정성 고정으로 조기 재활이 가능하고 견고한 골유합을 얻을 수 있어 안전하고 확실한 치료방법으로 사료된다. Purpose: The purpose of this study is to present out experience with open reduction, 3.5-㎜ reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fratures. Materials and Methods: Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-㎜ reconstruction plate, and bone-grafting. Postoperative mobilization started within one week. Results: The average duration of follow-up was 22.0 months. All fracture were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 our of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant. Conclusion: The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.

농촌 청소년의 식품 기호도와 영양 섭취 실태와의 관계

이건순,유영상 동아시아식생활학회 1997 동아시아식생활학회지 Vol.7 No.2

The purpose of this study was to investigate the mutual relationship between food preference and nutrient intake status of high school students, based on the their personal characters which are sex, age, family type, number of family, mother's age, occupation, and school career. 439 students were selected with random stratified cluster sampling method. The study used a self-administrated questionnaire and 24-hour recall method for 5 days as instrument tools. Statistical methods applied to analyze the data were frequency, percent, Willcoxon Rank-sum test, Kruskal-Wallies test, χ²-test by contingence table, and Spearman's correlation coefficient in non parametric statistical methods. Some of interesting results are as follows : 1. The correlation between sex and the set of characters of mother's age, school career and income is highly significant. However there is no any significant difference on the kinds of job and the types of family. 2. The relation between the preference of main dishes and the nutrient intake show a significant difference except to the noodles. This marks that preference of main dishes shows a direct proportion with the nutrient intakes except for the fat, vitamin A, vitamin C. 3. The preference of animal food marks a direct proportion with the nutrients such as energy, protein fat, fiber, phosphorus, iron, vitamin B₁, vitamin B₂, and niacin. 4. The preference of vegetable food gives some influence on the nutrient intake but the preference of soup is insignificant, the preference of Kimchi is in reverse proportion, and the preference of vegetable marks a direct proportion with the nutrient intake. 5. The preference of snacks marks a direct proportion with all kinds of nutrients intake except for the vitamin A, and vitamin C.

전기로 더스트의 환경안정적 재활용을 위한 CI 제거에 관한 실험 고찰

박병현,조영민,유정근 경희대학교 환경연구소 2001 環境硏究 論文集 Vol.10 No.-

Steel slag is a kind of industrial waste generating from the steel refining process in an Electric Arc Furnace. The annual production of this waste is more than 200.000 tonnes, and has recently been considered handful. Thus, in order to enhance the reuse of the steel slag, the present work attempted to reduce the chlorine element in the slag by using chemical treatment. Chlorine elements were cleansed by addition of a few solvents such as acetone, methanol and ethanol through dilution with water. Mohr titration was applied to measure the chlorine concentration in terms of reaction time, dilution ratio and temperature. As a result, methyl alcohol was found the most effective at high reaction temperature with a lengthened reaction.

오렌지 껍질로부터 분리된 프라보노이드의 화학요법 감작효과

최철익,변익건,차윤정,김선필,민영돈,유진철,송재경 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : The overexpression of P-glycoprotein (Pgp) or multidrug resistanceassociated protein (MRP) confers multidrug resistance (MDR) to cancer cells. MDR cells could be sensitized to anticancer drugs when treated concomitantly with a chemosensitizer. In this study, orange peel have been screened for the development of chemosensitizers reversing MDR. Materials and methods : Expression of Pgp in AML-2/WT and AML-2/D100 were determined using western blot analysis and RT-PCR. Candidates for chemosensitizers were isolated, purified from orange peel using sephadex LH-20 column chromatography and silica-gel column chromatography, whose structure was determined using ^1H-NMR, ^13C-NMR, ^1H-^1H-COSY, 13C-NMR, EI-Mass, IR. Chemosensitizing effect of NP-28 on AML-2/DX100 over expressing Pgp and MRP was determined by the MTT assay. Membrane toxicity was evaluated by the RBC hemolysis test. Antioxidant effects were examined by using a fluorescence probe (2’-7’-dichlorofluorescein diacetate). Results : A potent candidate, NP-28, has a flavonoid nucleus with some methoxy moiety. NP-28 is believed to have high therapeutic index, being non-transportable inhibitor and possibly, of inhibiting other efflux pumps such as MRP and antioxidant effects. NP-28 is also unlikely to be a substrate of Pgp. NP-28 did not increase Pgp levels. Conclusion : NP-28 has a Chemosensitizing effect to reverse Pgp-mediated MDR by increasing the intracellular accumulation of drugs. Furthermore, they do not increase expression of Pgp, which can allow a long term use without the concern about Pgp activation. NP-28 is anticipated as an ideal second-generation flavonoid chemosensitizer and/or possibly other therapeutic agents by further investigation.

조혈모세포이식 후 발생한 주폐포자층 폐렴에 대한 고찰

주지현,최정현,이동건,백지연,고윤호,이혜정,김세희,신호진,박윤희,박지영,김유진,신완식,김춘추 대한감염학회 2001 감염 Vol.33 No.4

Background : Pneumocytitis cainii pneumonia (PCP) can occur in immunocompromised hosts especially such as AIDS or cancer patients. Although recent research had focused on PCP in AIDS patients, few studies have described the clinical presentations of PCP in recipients of stem cell transplantation (SCT). We evaluated the clinical manifestations of PCP in SCT patients admitted at St. Mary's hospital, Seoul, Korea. Methods : The medical records of 17 PCP patients undergoing SCT between Feb. 1998 and Feb. 2000 were reviewed. The diagnosis of PCP was confirmed through the demonstration of Pneumocytitis cainii via either cytology of brochoalveolar lavage (BAL) or histological technique of lung biopsy. CMV disease and CMV infection were confirmed by BAL culture and antigenemia respectively . Results : Seventeen patients were all recipients of allogeneic SCT and 7 of 17 patients were performed non-sibling SCT. Patients presented with symptoms including brief period (4 ∼23 days) of fever (76%), dyspnea (70%), cough (64%), and signs such as rare(58.8%), Sixteen patients (94%) had been receiving immunosuppressive agent such as cyclosporine A (64%) or Fk506 (35%) without PCP prophylaxis. Eleven patients (64%) were treated with corticosteroid with mean dose of 16 mg/day prednisolone and mean duration of 4.6 months after post-SCT period. Twelve patients were co-infected with CMV. Another co-infected miCroorganisms were Pseudomonas aeruginosa, Mycobacterium tuberculosis, herpes simplex virus, parainfluenza virus, Average duration of treatment with trimethoprim-sulfamethoxazole (TMP/SMX) was 21 ±9 days. Four patients died, and three of them were related with PCP. Conclusion : PCP developed frequently in patients who were taking immunosuppressive drug due to graft versus host disease or were not taking TMP/SMX prophylaxis. High risk patients showing fever, cough, or dyspnea should be considered to take early bronchoscopic intervention for detection of PCP. When treat for PCP, it also be considered to the possibility of coinfection such as CMV. (Korean J Infect Dis 33:273∼279, 2001)