기관-기관지 협착에서 내시경적 확장술 및 실리콘 스텐트의 유용성 : 예비보고

이경수,박동욱,김규훈,김재욱,고윤우,김도진,이승원,Lee, Kyong-Soo,Park, Dong-Wook,Kim, Kyu-Hun,Kim, Jae-Wook,Koh, Yoon-Woo,Kim, Do-Jin,Lee, Seung-Won 대한기관식도과학회 2009 大韓氣管食道科學會誌 Vol.15 No.1

Objectives: Endoscopic airway dilatation and stenting has been developed to treat the airway stenosis without potential morbidities of open surgery. We report the clinical results of endoscopic airway dilatation with silicone stenting in patients with posttuberculous bronchial stenosis(PTBS) and with severe main tracheal stenosis who have poor general conditions Methods : A prospective observation study of five patients, who have undergone endoscopic airway dilatation and silicone stenting between Feb 2007 and Feb 2009. A total of twelve patients were treated with endoscopic airway dilatation, among them 5 patients were included in this study. three patients were treated with newly designed silicone stent (Natural stent: TNO Co., Seoul, South Korea) because of poor surgical conditions and longer stenotic segment Results: 3 patients were grade III PTBS, and the other 2 patients were grade IV post tracheotomy main tracheal stenosis. One patient of PTBS were treated with silicone stent following endoscopic dilatation because of longer stenotic segment. Two patients of main tracheal stenosis patients were treated with silicone stent because of tracheal lumen collapse. There was no severe postoperative complications except mild granulation tissue formations Conclusions : Endoscopic dilatation including silicone stenting could be a useful method for treating patients with PTBS, and for main tracheal stenosis patients with poor general surgical conditions

여유 자유도를 갖는 로보트의 기구학적 제어방법 연구를 위한 시뮬레이션 프로그램의 개발

이경수(Lee Kyoung-Soo),서일홍(Suh Il-Hong),서병설(Suh Byung-Suhl),김경기(Kim Kyong-Ki) 제어로봇시스템학회 1986 제어로봇시스템학회 국내학술대회 논문집 Vol.1 No.10

결체 조직 질환에서 조직학적으로 확진된 통상성 간질성 폐렴과 비특이성 간질성 폐렴의 임상상과 흉부 HRCT 소견의 비교 및 방사선학적 변화와 임상적 지표와의 연관성

안중경 ( Joong Kyong Ahn ),고은미 ( Eun Mi Koh ),이유선 ( You Sun Lee ),차훈석 ( Hoon Suk Cha ),정만표 ( Man Pyo Chung ),한정호 ( Jung Ho Han ),오대근 ( Dae Kun Oh ),이경수 ( Kyung Soo Lee ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.3

Objective: The purpose of this study is to assess the clinical characteristics and the serial changes of high resolution CT (HRCT) findings and to correlate those with the results of clinical parameters in biopsy proven nonspecific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP) with connective tissue diseases (CTD). Methods: Retrospective analysis was made of forty patients with CTD diagnosed of NSIP and UIP from a single tertiary hospital between January 1996 and February 2006. Results: UIP was common in rheumatoid arthritis, systemic sclerosis and Sjogren`s syndrome, while NSIP was frequent in polymyositis/dermatomyositis. No significant difference was found in the clinical characteristics of patients with NSIP and UIP. In initial HRCT findings, extents of honeycombing and reticulation pattern were significantly more in UIP-CTD than in NSIP-CTD. In bronchoalveolar lavage (BAL) results, proportion of alveolar macrophages was significantly higher in NSIP-CTD than in UIP-CTD. In NSIP-CTD, significant increment in the extent of reticulation and honeycombing was noted in the serial HRCT findings despite the aggressive treatment. Significant correlation was found between leukocytosis and honeycombing change in NSIP-CTD. Despite no significant difference of survival between two groups, patients with UIP-CTD seem to have a higher mortality than those with NSIP-CTD. Conclusion: It is suggested that chest HRCT and BAL fluid analysis may be helpful in the differential diagnosis of NSIP- and UIP-CTD and leukocytosis in initial blood test might be predictive of honeycombing progression in NSIP-CTD. Further study will be required to compare with the prognosis of NSIP- and UIP-CTD.

초정밀 스프레이 방법을 이용한 단일벽 탄소나노튜브 pH센서 개발

권재홍 ( Jae Hong Kwon ),이경수 ( Kyong Soo Lee ),이윤희 ( Yun Hi Lee ),주병권 ( Byeong Kwon Ju ) 한국센서학회 2006 센서학회지 Vol.15 No.2

가상점성감쇠요소 도입에 의한 막구조의 형상탐색에 관한 연구

한상을(Han Sang-Eul),이경수(Lee Kyong-Soo),김정화(Kim Jung-Hwa) 대한건축학회 2007 大韓建築學會論文集 : 構造系 Vol.23 No.11

In shape-finding process of membrane structure by dynamic relaxation method, three-node triangular membrane elements, the finite elements, are generally used. But serious changes of curvature in many membrane structures can make the mesh distortion. As a result, the final form of the membrane is not appropriate for the patterning and the stress analysis. To solve these problems, the viscous damping element is introduced to control the mesh distortion. It is placed at three sides of a triangular membrane element and the nodal force, residual force, can be controled by the damping force. Also, it does not prevent the convergence of residual force. The damping element is applied to various models to evaluate the improvement of mesh distortion and it is verified that the introduction of viscous damping element can control the mesh distortion, efficiently.

아토피성 천식 환자에서 특이적 면역요법이 말초혈액 단핵구의 IL-10 과 IL-13 mRNA 발현에 미치는 영향

이준성(Joon Sung Lee),이수중(Soo Jung Lee),이경수(Kyong Su Lee) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1999 소아알레르기 및 호흡기학회지 Vol.9 No.1

목 적 : 알레르기 질환의 치료에서 특이적 면역요법이 임상적인 치료효과를 가저오는 면역학적 작용기전은 명확하지 않다. 본 연구에서는 집먼지진드기 항원으로 특이적 면역요법를 받고 있는 천식환자들의 말초혈액 단핵구를 집먼지진드기 항원으로 자극하였을 때 발현되는 cytokine mRNA 양상을, 정상 대조군과 집먼지진드기에 대한 알레르기가 있으나 면역요법를 받지 않은 천식환자들에서의 양상과 비교하여 cytokine의 발현과 면역요법의 임상적인 치료반응과의 상관관계를 알아보고자 하였다. 방 법 : 알레르기 병력이 없는 정상 대조군 8명, 집먼지진드기 알레르기에 의한 천식 증상을 보이나 면역요법을 받지 않은 비면역요법군 25명, 그리고 일년 이상 집먼지진드기 백신으로 면역요법을 시행하여 임상적으로 호전을 보이지 않은 면역요법 무반웅군 19명과 증상의 호전을 보인 면역요법 반응군 20명의 말초혈액 단핵구를 분리하여 집먼지진드기 항원으로 18시간 자극배양하고 RNA를 분리한 다음 RT-PCR을 시행하여 전기영동 한 후 IL-10, IL-13, IFN-γ, IL-4 mRNA 함량을 densitomet로 측정하였다. 결 과: 1) 면역요법을 받지 않은 천식환자에서 정상 대조군에 비해 IL-10 mRNA의 발현이 유의하게 낮고, 면역요법시 IL-10 mRNA의 발현이 증가되었다. 임상적 호전을 보인 면역요법 반웅군이 무반응군보다 유의하게 IL-10 mRNA 발현이 증가되며, 정상 대조군 수준으로 IL-10 mRNA의 발현이 증가되었다. 2) 면역요법을 받지 않은 천식환자에서 정상 대조군에 비해 IL-13 mRNA의 발현이 유의하게 높고, 면역요법시 IL-13 mRNA의 발현이 감소되었다. 임상적 호전을 보인 면역요법 반응군이 무반응군보다 유의하게 IL-13 mRNA 발현이 감소되며, 정상 대조군 수준으로 IL-13 mRNA의 발현이 감소되었다. 3) 면역요법을 받지 않은 천식환자에서 정상 대조군에 비해 IFN-γ mRNA의 발현이 유의하게 낮고, 면역요법시 IFN-γ mRNA의 발현이 증가되었다. 임상적 호전을 보인 면역요법 반응군이 무반응군보다 유의하게 IFN-γ mRNA 발현이 증가되며, 정상 대조군 수준으로 IFN-γ mRNA 발현이 증가되었다. 4) 면역요법을 받지 않은 천식환자에서 정상 대조군에 비해 IL-4 mRNA의 발현이 유의하게 높고, 면역요법시 IL-4 mRNA의 발현이 감소되었다. 임상적 호전을 보인 면역요법 반응군이 무반응군보다 유의하게 IL-4 mRNA 발현이 감소되며, 정상 대조군 수준으로 IL-4 mRNA의 발현이 감소되었다. 결 론 : 집먼지진드기 알레르기에 대한 특이적 면역요법은 T_H2(IL-4, IL-狀)에서 T_H1(IFN-γ)으로 cytokine 발현의 변화를 유도하며 또한 IL-10의 생성을 증가시킴을 알 수 있었다. 이러한 cytokine 발현의 변화가 면역요법의 임상적 효과를 초래하는데 일부 기여할 것으로 생각된다. Purpose : Allergen-specific immunotherapy(IT) has been shown to be effective in the treatment for allergic diseases. But the immunologic mechanism of IT effect has not been fully elucidated. We studied house dust mite(HDM)-specific cytokine mRNA expression in peripheral blood mononuclear cells(PBMC) from patient with HDM-sensitive asthma and determined whether alterations in cytokine mRNA expression correlated with the clinical outcome of IT. Methods : PBMC were obtained from 64 children with mite-sensitive asthma : 25 had never received HDM-IT(NIT), 39 had been receiving HDM-IT for more than 12 months. The 39 patients were divided into two groups according to the clinical response based on the asthma scores(symptom and medication scores) before and after IT. Good responders were those patients who showed an improvement greater than 50%, whereas poor responders were those who showed an improvement less than 50%. After a 18 hr culture with HDM, cytokine mRNA expression was analysed by RT-PCR and densitometry. Results : 1) IL-10 mRNA expression in NIT was significantly lower than that in the normal controls and was significantly increased by IT. IL-10 mRNA expression in the good responders was significantly higher than that in the poor responders and NIT. 2) Little or no IL-13 mRNA were detected in the good responders and the normal controls. IL-13 mRNA expression in the good responders was significantly lower than that in the poor responders and NIT. 3) IFN-γ mRNA expression in NIT was significantly lower than that in the normal controls and was significantly increased with IT. IFN-γ mRNA expression in the good responders was significantly higher than that in the poor responders and NIT. 4) Little IL-4 mRNA were detected in the good responders and the normal controls. IL-4 mRNA expression in the good responders was significantly lower than that in the poor responders and NIT. Conclusion : These results show that IT not only induces a shift in cytokine expression from T_H2(IL-4 and IL-13) to T_H1 cytokines(IFN-γ), but also leads to induction of the antiinflammatory cytokine IL-10. These changes in cytokine expression may be responsible for clinical effects by immunotherapy.

1996년 대전시 서북부에서 발생한 A형 급성 간염

최진욱,이경일,이동준,한지환,황성수,이경수,Choi, Jin-Ook,Lee, Kyung-Yil,Lee, Dong-Joon,Han, Ji-Whan,Hwang, Sung-Soo,Lee, Kyong-Su 대한소아감염학회 1997 Pediatric Infection and Vaccine Vol.4 No.1

목 적 : 과거 소아기 간염의 대부분을 차지하던 A형 간염은 경제 발전에 따른 보건 위생 상태의 호전으로 최근 소아에서 점차 성인으로 전환되는 추세이며 소아기에서 보기드문 질환이 되었다. 저자들은 치근 대전지역에서 발생한 A형 간염의 환아에 대한 임상 및 역학적 연구로 A형 간염에 대한 관심을 다시 주지하고 폭발적 발생 가능성에 대비하는데 도움을 받고자 하였다. 방 법 : 1996년 7월부터 1996년 12월까지 가톨릭대학교 대전성모병원에 입원한 급성 A형 간염환아 31명을 대상으로 하여 발생시기, 발생지역, 성별, 연령, 임상증상 및 검사실 소견 등을 후향적으로 조사하였다. 결 과 : 1) 발생시기는 7월, 8월, 9월에 각각 6례, 16례, 2례로 여름철에 주로 발생하였으며(76%), 10월에 1례, 12월에 6례가 발생하였다. 2) 발생지역은 대전 서구가 27례로 87%를 차지했으며 특히 도마동에서 18례(58%)가 발생 하였다. 3) 발병 연령은 3세 이하는 없었으며 4~5세가 3명, 6~10세가 13명, 11~15세가 15명이었고, 남녀의 비는 1.4:1이었다. 4) 입원시의 주된 증상(symptom)으로는 짙은 소변 (83%), 오심 및 구토(74%), 식욕부진 (68%), 상복부통(65%), 발열(54%), 피로감(41%)이었으며, 그외 소양감(22%), 두통(19%), 관절통(6%), 변비(6%), 설사(6%), 어지러움(3%) 등을 보였고 입원하기 전까지의 증상 지속기간은 펑균 5.3일이었다. 징후(sign)로는 황달(77%), 간비대(90%)와 비장비대(48%)가 촉진 및 초음파 검사로 관찰되었다. 5) 검사실 소견으로 입원시 AST, ALT의 굉균치는 각각 910IU/dl, 1239IU/dl, ALP (alkaline phosphatase)는 856IU/이었으며, 입원중 최고 총빌리루빈치의 평균치 5.6mg/dl(직 접 빌리루빈 4.8mg/dl)이었다. 대부분 1달 후 정상화 되었으며 심각한 합병증을 보인 증례 는 없었다. 결 론 : 소아에서의 A형 간염은 중한 합병증이 없이 회복되는 질환으로 우리나라에서도 오염원에 의해 전염성 A형 간염이 폭발적으로 발생(outbreak)할 수 있음을 알 수 있었다. A형 간염 항체의 역학적 연구를 통해 예방 접종의 필요여부 결정 및 오염원의 제거 등 예방에 대한 더 깊은 연구가 있어야 할 것으로 보인다. Purpose : Recently a shift in hepatitis A incidence from children to adults has been well noted. We experienced under 15-years old 31 patients who presented hepatitis A infection. In order to prepare for the prevention on hepatitis A outbreak in the future, we studied the clinical and epidemiologic manifestations of these patients. Methods : We enrolled patients from July to December in 1996 (6 months) and evaluated the monthly incidence, geographical distribution, age and sex, and clinical manfestations, including laboratory fadings. Results : Many cases of hepatitis A occured in the summer months, especially August (16/31 cases). Most of patients (87%) were living in the Seo-Ku area (northwest district of the city). In age distribution, there were no cases under 3 years of age, 3 cases from 4~5 years, 13 cases from 6~10 years, 15 cases from 11~15 years. Clinical profiles showed that dark urine, nausea and vomiting, anorexia, abdominal pain, fever, and fatigue were the common presenting symptoms. The initial presenting laboratory tests included total bilirubin 3.3mg/dl, alkaline phosphatase of 856units/L, and serum asparate aminotransferase and alanine aminolransferase levels of 910IU/L and 1239IU/L, respectively. No patient presented atypical clinical courses or complications. Conclusions : Hepatitis A in children shows benign clinical features. This study showed that the possibility of another outbreak of Hepatitis A in the TaeJon area or elsewhere in the near future Korea will be possible. To prevent an outbreak we will be concerned about the anti-HAV IgG prevalance rate in children and preventive modalities including vaccination against hepatitis A.

가상점성감쇠요소를 이용한 막구조물의 형상해석

김정화(Kim Jung-Hwa),한상을(Han Sang-Eul),이경수(Lee Kyong-Soo) 대한건축학회 2007 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.27 No.1

In shape-finding process of membrane structure by dynamic relaxation method, three-node triangular membrane elements, the finite elements, are generally used. But serious changes of curvature in many membrane structures can make the mesh distortion. As a result, the final form of the membrane is not appropriate for the patterning and the stress analysis. To solve these problems, the artificial viscous damping element is introduced to control the mesh distortion. It is placed at three sides of a triangular membrane element and the nodal force, residual force, can be controled by the damping force. Also, it does not prevent the convergence of residual force. The damping element is applied to various models to evaluate the improvement of mesh distortion and it is verified that the introduction of artificial viscous damping element can control the mesh distortion, efficiently.

소아에서의 Sparganosis

임준,이재철,길동수,이경수 중앙대부설한국의과학연구소 1974 한국의과학 Vol.6 No.10

재발한 급성 파종성 뇌척수염 1예

김용호,이경일,한지환,황성수,이경수 대한화학요법학회 1995 대한화학요법학회지 Vol.13 No.2

Acute disseminated encephalomyelitis(ADEM) is an acute inflammatory demyelinating disease of the central nervous system. We experienced a case of recurrent ADEM in a 38 month-old boy who showed weakness of the lower extremities twice in 1 year interval(first attack after MMR vaccination; second attack after JBE vaccination). Brain magnetic resonance imaging(MRI) on first admission demonstrated multiple nodular gyriform high signal intensity(Sl) in the bilateral thalamus, and subcortical white matter with gadolinium-DTPA enhancing basal ganglia.. This boy recovered with prednisone therapy within 20days and he remained relatively good health for 1 year. 1 month before second admission, he received JBE vaccination 2 times 1 week interval. At this time brain MRl demonstrated also much dissemination of the high SI foci in most of brain parenchyme, and with the relatively same area and nature as the MRI before 1 year. Follow-up brain MRI after 3 months demonstrated a marked atrophic change of brain parenchyme with enlargement of ventricles and cisterns, but lesions in bilateral basal ganglia were still remained. The level of IgG in the cerebrospinal fluid was not elevated and olygoclonal band was not found. Despite various treatment including mlethylprednisolone pulse therapy, his neurologic symptoms progressively aggrevated and finally he died 3 months later. We report the case of 38 month-old boy with recurrent weakness of lower extremities, who was diagnosed as recurrent ADEM with clinical course and serial MRI.