구리 섬유의 종횡비 변화에 따른 마찰재의 마찰 및 마모특성

정소라(So La Chung),이엽(Yeob Lee),신민욱(Min Wook Sin),장호(Ho Jang) 한국트라이볼로지학회 2008 한국트라이볼로지학회 학술대회 Vol.2008 No.6

The effect of the copper fiber length of the tribological properties of the brake friction material is investigated. Friction and wear of the friction materials are evaluated by a Krauss type tester using gray iron disks. Results shows that the friction material with short copper fibers (aspect ratio = 35) exhibits better friction stability at elevated temperatures than that with longer copper fibers (aspect ratio = 70), while the longer copper fibers shows higher brake effectiveness. On the other hand, the friction material with short copper fibers exhibits better wear resistance. Examination of the worn surface reveals that the formation of the nat area near the copper fibers appears to determine the level and stability of the friction coefficient. On the other hand, the wear resistance is affected by the thermal conductivity of the friction material, which is affected by the length of the copper fiber.

증례 : 호흡기 ; 가솔린 흡인에 의한 화학성 폐장염 1예

김자경 ( Ja Kyung Kim ),장태원 ( Tae Won Jang ),정만홍 ( Maan Hong Jung ),옥철호 ( Chul Ho Oak ),문대성 ( Dae Sung Moon ),장리라 ( Lee La Jang ) 대한내과학회 2009 대한내과학회지 Vol.76 No.4

저자들은 가솔린을 복용한 후 발생한 흉부불편감과 호흡곤란으로 내원한 20세의 남자 환자에서 방사선사진상 흡인성 폐렴의 소견이 뚜렷하고 기관지 세척액에서 육안적 혈성 소견을 보였으며 군용 가솔린을 흡인함으로써 세균성감염의 기회가 높다고 판단되어 화학성 폐장염 진단 후 항생제와 스테로이드 사용하였고, 큰 합병증 없이 회복된 1예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다. Hydrocarbons are a broad group of organic bodies consisting of hydrogen and carbon. They are commonly found in the environment in the form of gasoline (e.g., butane and propane) and are also used in stain removers, adhesives, lubricants, and a variety of paints. Ingestion of the compound accounts for approximately 3% of all poisoning cases in the United States, but such reports of poisoning are rare in Korea. Hydrocarbon poisoning has many adverse effects. In addition to potentially causing major damage to the respiratory and central nervous systems, direct exposure to hydrocarbons can also cause cardiac arrhythmia, hepatic dysfunction, renal failure, neuropathy, and other injuries. We present the case of a 20-year-old soldier who accidentally ingested a small amount of gasoline. He developed chemical pneumonitis, but recovered with no serious complications. (Korean J Med 76:494-498, 2009)

Pyrazinamide에 의한 전격성 간부전

문대성 ( Dae Sung Moon ),장태원 ( Tae Won Jang ),옥철호 ( Chul Ho Oak ),정만홍 ( Maan Hong Jung ),유찬희 ( Chan Hui Yoo ),송준영 ( Jun Young Song ),김성은 ( Sung Eun Kim ),김자경 ( Ja Kyung Kim ),장리라 ( Lee La Jang ),이은영 ( Eu 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5

Standard antituberculous therapy, including isoniazid (INH), rifampin, ethambutol, and pyrazinamide (PZA), is widely used to treat active tuberculosis. The most important side effect is hepatotoxicity. In a standard four-drug regimen, PZA was the most common cause of drug-induced hepatitis and was dose-related. The incidence of drug-induced hepatitis is high at doses of 40∼70 mg/kg per day but has fallen significantly since the recommended dose was reduced. Liver toxicity induced by PZA is rare at doses of 25 mg/kg per day or less. PZA-induced fulminant hepatic failure is also rare but fatal. We report a case of fulminant hepatic failure caused by a re-challenge of PZA. (Tuberc Respir Dis 2007;63:435-439)

진행성 비소세포폐암 환자에서 Gemcitabine/Cisplatin을 이용한 동시 화학 방사선 요법

옥철호(Chul Ho Oak),김자경(Ja Kyung Kim),장리라(Lee La Jang),문대성(Dae Sung Moon),장태원(Tae Won Jang),정만홍(Maan Hong Jung),조성환(Sung Whan Cho),정태식(Tae Sig Jeung) 대한방사선종양학회 2008 Radiation Oncology Journal Vol.26 No.3

목 적: 국소 진행성 폐암에서 동시 항암화학 방사선 요법이 표준 요법으로 자리 잡고 있다. 그러나 항암제의 그 사 용시기와 방법에 있어서는 확립된 바가 없어서 gemcitabine, cisplatin 병용화학요법과 동시 방사선치료의 치료효 과 및 안전성을 확인하였다. 대상 및 방법: 동시 항암화학 방사선요법시 gemcitabine 500 mg/m2, cisplatin 30 mg/m2 요법은 2주 간격으로 환자의 순응도에 따른 방사선치료 기간의 변동을 감안해서 3∼4회 치료하는 것을 원칙으로 하였고 흉부방사선치료는 1일 1회 1.8 Gy 씩, 주5회 분할조사 하였으며, 원발병소와 종격동 및 전이를 나타낸 림프절을 포함한 부분에 50.4 Gy를 조사 후 질환이 진행되지 않았을 경우 원발 병소에 18 Gy를 추가 조사하였다. 공고 화학요법은 3주 간격으로 2∼3회 치료하였다. 치료반응의 판정은 동시 항암화학 방사선요법 후와 공고 화학요법 후에 각각 WHO의 판정기준에 따라 평가했다.결 과: 29명의 대상 중, 동시 항암화학 방사선요법 후 완전관해는 1명(4%), 부분 관해는 20명(69%)이었고 공고 화학요법이 마친 후 치료 판정에서 완전 관해는 3명(10%), 부분 관해는 21명(72%)이였다. 중앙 생존 기간은 16개월(2.4∼39.2개월)이고 1년 생존율은 62.7%, 2년 생존율은 43.9%, 3년 생존율은 20%이었다. 치료 도중 독성의 빈도는 3도 이상의 과립구 감소증이 11명(37.9%)이었고 3도 이상의 식도염이 15명(51.7%)이 발생하였다. 2도 이상의 폐렴은 6명(20.7%)에서 발생하였다.결 론: 국소진행성 비소세포폐암환자에서 gemcitabine 500 mg/m2과 cisplatin 30 mg/m2의 2주 간격 투여와 동시항암화학방사선치료는 높은 치료반응률을 나타내었다. 그러나 3도 이상의 식도염과 폐렴이 예상보다 많이 관찰되어 이에 대한 부작용을 줄이기 위한 적절한 방법들이 강구되어야 할 것이며, 항암제의 용량조절, 방사선조사량의 조절과 특수 방사선치료방법들의 개발이 필요하리라고 판단되었다. Purpose: In cases of locally advanced non-small cell lung cancer (NSCLC), concurrent chemoradiotherapy (CCRT) is the leading therapeutic modality. However, much controversy exists about the chemotherapeutic regimens and radiation methods. Materials and Methods: During concurrent chemoradiotherapy, three or four cycles of gemcitabine (500 mg/m2) and cisplatin (30 mg/m2) were administered every two weeks while 50.4 Gy of irradiation was administered in 28 fractions (once/day, 5 treatment days/week) to the tumor site, mediastinum, and the involved lymph node region. In addition, a booster irradiation dose of 18 Gy in 10 fractions was administered to the primary tumor site unless the disease progressed. Two or three cycles of consolidation chemotherapy were performed with gemcitabine (1,200 mg/m2, 1st and 8th day) and cisplatin (60 mg/m2) every three weeks. Results: A total of 29 patients were evaluable for modality response. Response and treatment toxicities were assessed after concurrent chemoradiotherapy and consolidation chemotherapy, respectively. One patient (4%) achieved a complete response; whereas 20 patients (69%) achieved a partial response after concurrent chemoradiotherapy. Following the consolidation chemotherapy, three patients (10.3%) achieved complete responses and 21 patients (72.4%) achieved partial responses. The median follow-up period was 20 months (range 3∼39 months) and the median survival time was 16 months (95% CI; 2.4∼39.2 months). The survival rates in one, two, and three years after the completion of treatment were 62.7%, 43.9%, and 20%, respectively. Complications associated to this treatment modality included grade 3 or 4 esophagitis, which occurred in 15 patients (51.7%). In addition, an incidence of 24% for grade 3 and 14% for grade 4 neutropenia. Lastly, grade 2 radiation pneumonitis occurred in 6 patients (22%). Conclusion: The response rate and survival time of concurrent chemoradiotherapy with biweekly gemcitabine (500 mg/m2) and cisplatin (30 mg/m2) were encouraging in patients with locally advanced NSCLC. However, treatment related toxicities were significant, indicating that further modification of therapy seems to be warranted.

치과 병,의원의 의료서비스품질이 고객만족과 충성도에 미치는 영향에 관한 연구

김양균 ( Kim Yang Gyun ),정기택 ( Jeong Gi Taeg ),안영송 ( An Yeong Song ),이상은 ( Lee Sang Eun ),장영화 ( Jang Yeong Hwa ),한보라 ( Han Bo La ) 한국병원경영학회 2003 병원경영학회지 Vol.8 No.3

The purpose of the study is exploring the relationship among patient perceived quality of dental care, satisfaction, and royalty in dental clinics and hospitals. The observation of the study is outpatient visiting dental clinics and hospitals located in Seoul and Kyung-Gi Do area, and surveyed the outpatients. The contents of the survey are consisted with questions including quality of care perceived by the patients, costumer satisfaction, and royalty, and measurement for each question is using five point Likert scale. According to result of bi-variate analysis, there was the significant relationship among specialized care, value of the care, and kindness in quality of dental services, level of care in dentists significantly influenced on costumer satisfaction and costumer royalty, and there was the significant relationship between costumer satisfaction and royalty. According to result of regression analysis on the costumer satisfaction, the costumer satisfaction positively related with the convenience of facility, specialized care, value of care, patient age, number of visit, and spend time for treatment, and housewives and self-employees were likely to satisfy on care than regular employees. By result of full regression model and reduced model on costumer royalty, satisfaction could explain 86% on the costumer royalty such as re-visit and promoting other people, and increase of explain power is not significant when other independent variables joined model (full model). Considering efficiency of model, costumer royalty could be explained by satisfaction only rather than other independent variables used. Finally, This study shows that the social-demographic variables of patient influenced the patient satisfaction, and the patient satisfaction influenced patient royalty directly.

소세포 폐암의 갑상선전이 1예

장리라,최영식,박요한,문대성,김자경,김성은,최인수,유찬희,남성진 고신대학교 의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

Metastasis to the thyroid gland is usually considered uncommon. The most frequent sites of the primary tumor include the kidney, breast and lung. Its presence often indicates poor prognosis. Metastases represent the advanced stage of the tumors and fine needle aspiration cytology is and important way of diagnosis in thyroid metastasis. we experienced a case of Metastatic Small cell Lung Carcinoma to the Thyroid Gland. A 58-year-old man with Graves' disease diagnosed pulmonary nodule in the left upper lung field on his chest X-ray film. The patient's thyroid gland was diffusely swollen, and elastic to hard. A thyroid ultrasonography showed 1cm sized hypodense nodule on the left thyroid gland. The patient underwent a ultrasonography guided fine needle aspiration cytology of the mass. Cytological diagnosis was a metastatic small cell carcinoma. Then Chemotherapy was administered to the patient. The authors report this rare case of metastatic small cell lung carcinoma to the thyroid with literature review.

Bortezomib과 Dexamthasone으로 치료한 골수외 형질세포종 4예

백종현,이은영,장리라,손창배,신은경,서정아,이지숙,이호섭,이상민,신성훈,김양수 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Despite the use of aggressive local and systemic treatment including autologous stem cell transplantation in multiple myeloma, extramedullary recurrences are common and the prognosis of these patients is poor. Many novel drugs such as thalidomide, lenalidomide and bortezomib improve the response of treatment of multiple myeloma, but some reports failed to describe thalidomide has effect in extramedullary plasmacytoma. Recent data report on the successful treatment plasmacytomas with bortezomib in patients with advanced multiple myeloma. We treated 4 relapsed or refractory extramedullary plasmacytomas with bortezomib at our institution. We recognized all these extramedullary plasmacytomas decreased and showed more than partial response. This report lends support to the efficacy of bortezomib in the treatment of plasmacytoma and describes the safe use of bortezomib. Responses may, however, be of short duration. Therefore, despite our limited experience, we propose that bortezomib may be considered a therapeutic option for such patients who have risk of radiation therapy

위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예

김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.