한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

건강한 성인에서 발병한 칸디다와 연관된 위궤양 1례

박지훈,이상혁,김희,이재호,박성재,지삼룡,양성연,박은택,이연재,설상영,정정명,강미선 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Fungus such as Candida albicans is a normal flora that is frequently found in the oral cavity, gastrointestinal tract, genitourinary tract, vaginal mucosa in a normal person. However, candida can cause opportunistic infection in an immune compromised host. Candidiasis has broad spectrum of disease from mucocutaneous infection to invasive or disseminated infection. But, it is rarely reported that candida is associaed with gastrointestinal tract disease in a healthy adult. The case of gastric ulcer associated with candida particularly in a health adult is reported with relevant literature.

간세포암의 고주파 열치료 후 천자침 경로를 통한 전이 1례

조영완,박석주,진한영,김준영,이재익,강명주,박정하,윤정희,박성재,지삼룡,이연재,이상혁,설상영 인제대학교 2006 仁濟醫學 Vol.27 No.-

Radiofrequency ablation(RFA), as a form of minimally invasive therapy for hepatocellular carcinoma, has become an important treatment modality. Because of limitation of surgery, RFA has become standard therapy for hepatocellular carcinoma in some situations. But there are some complications of RFA such as bleeding, infection, hematoma, adjacent organ thermal damage including intestinal perforation, needle track seeding, and so on. There are few reports in the literature that systematically evaluate the incidence of needle tract seeding and its associated risk factors. And only 2 cases of needle tract seeding of hepatocellular carcinoma after RFA were reported in Korea. We report a case of needle tract seeding of hepatocellular carcinoma after RFA.

바터 팽대부에 생긴 유암종 1예

강명주,지삼룡,박석주,이재익,조영완,김준영,박성재,박은택,이연재,이상혁,설상영,배상균 인제대학교 2006 仁濟醫學 Vol.27 No.-

Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi and gastrointestinal tract. Within the gastrointestinal tract, appendix is the most common location for carcinoid, followed by the distal small intestine, the rectum, and the stomach. Among these, primary involvement of the ampulla of Vater is extremely rare. We report a case of carcinoid tumor of ampulla of Vater. A 62-year-old man presented with epigastric soreness. Gastroduodenal endoscopy showed hyperemic bulging mass on ampulla of Vater and diagnosed as carcinoid tumor by histologic finding, with immunohistochemical study. In ^(111)In-octreoscan, tumor had regional lymph node metastasis, but no evidence of distant metastasis. Pancreatoduodenectomy with lymph node dissection was performed.

수입각증후군에 의한 급성 복증 1례

정은욱,지삼룡,이영태,박지훈,김동기,제인수,채두근,박성재,박은택,이연재,이상혁,설상영,정정명 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Afferent loop syndrome is an uncommon complication of a gastrectomy and Billroth Ⅱ reconstruction. It may cause symtoms at any time from the first postoperative day to many years after the gastrectomy. Afferent loop syndrome is characterized by abdominal pain, vomiting and elevation of serum amylase. Thus, it is difficult to differentiate afferent loop syndrome from other cause of acute pancreatitis. However, the history of gastrectomy can be an important clue for diagnosing afferent loop syndrome. We experienced one case of chronic afferent loop syndrome with acute pancreatitis. After appropriate management, the abdominal pain disappeared and serum amylase level decreased. We report this case with a review of relevant literatures.

상아질 표면 처리에 의한 상아질과 복합레진의 결합에 관한 연구

윤동호,박상진 大韓齒科保存學會 1992 Restorative Dentistry & Endodontics Vol.17 No.1

The purpose of this study was to compare the shear bond strengths to ground dentin surfaces of four dentinal bonding agents in 193 teeth. Various dentin surfaces treated with four dentin bonding agents were attached with two restorative composite resins. The effevtiveness of the bonding were tested by the monitoring the shear bond strength. The shear bond strengths were measured after 2 hours and 24 hours after surface conditioning with four dentin bonding agents. Effects of EDTA, the additive illumination, and sealer treatments without primer on bond strength to dentin sufraces were assessed. In addition the effects of the thickness of specimens ranging from 0.65 mm to 1.95 mm and the ratio of catalyst and base paste on the bond strength of chemical cure composite resin were estimated. The shear bond strength was determined by testing specimens in the Instron universal testing machine(Model No.1122) at a crosshead speed of 1.0mm/min Following conclusions were drawn: 1. The highest mean shear bond strengths of chemical cure composite resin to dentin conditioning with dentin bonding agents aged 2 hours were obtained, and then that was decreased with time followed by EDTA treatment. 2. In light cure composite resin, the shear bond strength was increased following dentin conditioning with bonding agents with time, irradiation time and EDTA treatment except in SB group. 3. The thicker the composite resin specimen was, the less the shear bond strength in chemical cure composite resin was. 4. In light cure composite resin, there was a little change in shear bond strength following dentin conditioning with bonding agents. 5. In chemical cure composite resin, the shear bond strength was the highest in the ratio of 1/1 of catalyst and base part. 6. Without a dentin primer, shear bond strength to dentin conditioned only with UB sealer was the hightest among four sealers in light cure composite resin.

척수압박으로 발현된 급성 골수성 백혈병에 동반된 과립구성 육종 1 례

윤상준,김영곤,김희종,박유환,정춘해,김양수,김태균,박영진,전호종 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

저자들은 척수압박으로 하지마비를 보인 환자에서 수술 후에 급성 백혈병에 동반된 과립구성 육종으로 진단된 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Granulocytic sarcoma(GS) is an uncommon tumor composed of immature cells of the granulocytic series. Most case of GS occur in the course of acute leukemia and the blast crisis of chronic leukemia, Rarely, however, it may present before leukemia becomes clinically apparent. It may also occur in patients with myeloproliferative disoders. GS has been reported that it occurs in 3% to 9% of patients with acute myelogenous leukemia(AML) and the incidence of GS is reported to be higher in patients with t(8;21). GS occurs relatively commonly in africa and has been reported to affect 10-25% of black children presenting with AML. This is very rare case of granulocytic sarcoma with AML(FAB M5) presented with spinal cord compression which was supported by decompression laminectomy.

실리카지지 루테늄에서 일산화탄소와 산소 공동흡착에 관한 FTIRS 연구

박상윤,윤구식,윤동욱 울산대학교 2002 자연과학논문집 Vol.12 No.1

살리카 지지 루테늄에서 일산화탄소의 압력, 루테늄 함량, 흡착온도를 변화시키면서 적외선 스펙트럼을 관찰했다. 또한 실리카 지지 루테늄에서 일산화탄소와 산소의 혼합기체의 분압비를 변화시키면서 적외선 스펙트럼을 관찰했다. 실리카 지지 루테늄에 일산화탄소를 흡착시켰을 때 2004.2-2038.9 ㎝^-1, 2077.5∼2089.0 ㎝^-1, 2141.1∼2145.0 ㎝^-1 세 흡수띠가 관찰되었다. 관찰된 스펙트럼에서 흡수띠의 위치는 문헌에 보고된 바와 거의 일치한다 2077.5∼2089.0 ㎝^-1와 2141.1∼2145.0 ㎝^-1 두 흡수띠의 흡수세기가 산소의 분압을 증가시켰을 때 증가했다. 본 연구의 결과는 실리카 지지 루테늄에 일산화탄소와 산소 혼합기체를 흡착시켰을 때 나타나는 ∼2130 ㎝^-1, 흡수띠와 ∼2080 ㎝^-1 흡수띠는 각각 산화된 루테늄 원자와 그 영향을 받는 루테늄 원자에 흡착된 일산화탄소에서 CO의 신축진동에 의한 것이라는 Brown 등의 주장을 뒷받침한다. The infrared spectra for CO adsorbed on silica supported ruthenium have been investigated at various partial pressures and temperatures within the frequency range of 1500∼2300 ㎝^-1. Also the infrared spectra for CO/O_2 gas mixtures adsorbed on silica supported ruthenium have been investigated at various partial pressure ratios within the frequency range of 1500∼2300 ㎝^-1. Three bands (2004.2-2038.9 ㎝^-1, 2077.5∼2089.0 ㎝^-1, 2141.1∼2145.0 ㎝^-1) were observed when CO and O_2 were coadsorbed on silica supported ruthenium. The frequencies of the bands observed correspond with the previous reports approximately. The relative intensities of 2077.5∼2089.0 ㎝^-1 band and 2141.1∼2145.0 ㎝^-1 band increased with raising O_2 partial pressure. These results support Brown and Gonzalez's argument that ∼2080 ㎝^-1 band and ∼2130 ㎝^-1 band are arised from the CO stretching vibration for CO molecules adsorbed on the ruthenium atoms perturbed by the oxygen atoms bonded to the ruthenium atoms and on the oxidized ruthenium atoms respectively.

Sedimentation Rate and Transport Features of Suspended Matter in the Changjiang Estuary and Adjacent Continental Shelf

윤정수,박상운,고윤영,오윤근 제주대학교 해양연구소 2000 해양자원연구소연구보고 Vol.24 No.-

The study area is situated between 31˚00' ~ 33˚30' N and 122˚30' ~126˚00' E as a part of the East China Sea continental shelf. The distribution of sediment in the study area can be classified three sedimentary types. Modern land derived muddy sediments consisting of silt and mud are distributed at mouth of the Changjiang River. and are also observed the southwest offshore of the Cheju Island. The sandsilt-clay miadre sediments are presented in the outer shelf area. The relict sand are distributed between the mordern and mixture sediment. The inner-shelf mud consisted of 8.89% sand. 59.05% silt. 32.06% clay and mean size of 6.90Φ. The offshore mud composed of 5.83% sand. 34.54% silt. 59.63% clay and mean size of 8.32). and also have higher water content and organic carbon. The C/N ratio showed higher in the inner-shelf mud (10.14) rather than that of the offshore mud (8.68). Most of the Changiiang River suspended matter is entrapped in the area around the Changjiang Estuary to the west of 123˚30' E. Only a small part of the suspended matter can be moved by Changjiang Diluted Plume to the southeastern and northeastern middle shelf. The higher suspended matter concentration gradient zone are observed in the northwest central region, and this plume zone separated from Changjiang Estuary by a low oncentration of less than 5 mg/ l or 15 mg/ l. The sediment accumulation rate in the inner shelf mud deposit near the mouth of the Changjiang River is 1.70 cm/yr and characterized by physical stratified mud. The sedimentation rate in the offshore mud deposit to the southwest of Cheju Island shows 0.28 cm/yr and characterized by homogenous mud. The difference in fine-scale stratigraphy is explained by the ratio of mixing rate to accumulation rate, which is much larger for the offshore mud deposit (27.34) than for the inner shelf mud deposit (1.65). these larger ratio allows biological mixing to destroy physical stratification.

대두유의 자동산화 및 가열산화에 미치는 정향추출물의 항산화 효과

박상일,손종연 한국조리과학회 2004 한국식품조리과학회지 Vol.20 No.1

This study was conducted to investigate the antioxidant activities of clove extracts in water, methanol and ether. The clove extracts, BHA and α-tocopherol were added to each oil at a level of 200ppm. The activities of the substrate oils and controls were tested under autoxidation and thermal oxidation conditions. The degree of the effects of the antioxidant activities under autoxidation condition were in the following order: ether extract〉methanol extract〉BHA〉α-tocopherol〉water extract=control group. The induction periods of the control, water, methanol and ether extracts, and BHA and α-tocopherol were 9.5, 9.6, 10.7, 11.8, 10.4 and 9.7 days, respectively. Under thermal oxidation condition, the methanol extract showed stronger antioxidant activity than those of the water and ether extracts. The antioxidant activity of the methanol extract was attributed to α-tocopherol and BHA.