간암 환자에 합병된 Citrobacter braakii 패혈증 1례 보고

이해미,배성하,이수남,이정우,신아영,류시영,이수연,윤문희,한선영,한남익,이영석,유진홍 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Citrobacter species is a gram-negative bacilli that can cause opportunistic infections in immunocompromised hosts. Citrobacter braakii refers to the genomospecies 6 of the Citrobacter freundii complex. There are no detailed studies on infections caused by this newly identified specific genetic species in Korea. We herein report a case of a patient with hepatocellular carcinoma who, after undergoing transcatheter arterial chemoembolization, developed biloma which later progressed to C.braakii sepsis and did not respond to treatment. To our knowledge, this is the first reported case in Korea on C. braakii infection resulting in septic shock in a patient with malignancy in Korea.

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.

주파수확산통신을 위한 카오스 PN 시퀀스의 특성

이익수,여지환 대구대학교 과학기술연구소 1999 科學技術硏究 Vol.5 No.5

The existing random numbers or PN sequences are secure and reproducible with a implementation of digital circuit. But it is hard to change random sequences that is due to limit period size and digital system realization. This work proposes the chaotic PN sequence(CPNS) of analog and binary types which is coded by the chaotic sequence, that can be extracted from a 3-dimensional discrete time chaotic generation equation(3D²CGE) for generating various chaotic signals. A CPNS method using 3D²CGE has several advantage: the generation is easy, and various families with arbitrary size and sequence period can be obtained because the chaotic systems has parameters. Furthermore, we have tested a correlation function and the degree of statistical independence of each CPNS that is evaluated in order to apply to spread spectrum communication. Experimental results show that the proposed CPNS codes are used for the spreading sequence and secure communication codes.

연작업자들에서의 δ -aminolevulinic acid dehydratase 유전형질의 다형성이 신기능에 미치는 영향

안익수,황보영,김용배,리갑수,이성수,장봉기,함정오,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

δ-aminolevulinic acid hehydratase (ALAD) is a polymorphic enzyme that has two alleles, ALAD1 (ALAD1-1 as phenotype) and ALAD2 (ALAD1-2 or ALAD2-2 as phenotype). ALAD genotype has been reported to modify the toxicokinetics of lead. To investigate the influence of ALAD genotype polymorphism on renal function in lead workers, author studied 1022 male lead workers and 149 non lead workers in the same industries. For the cross-sectional renal function indices, blood urea nitrogen (BUN), serum creatinine, uric acid and total protein were selected. Blood lead and blood zinc protoporphyrin were also measured as indices of lead exposure. Information on weight, age, job duration, smoking & drinking history were collected. Following results are as follows: 1. Whereas the mean (standard deviation) of blood lead and blood ZPP of lead workers were 27.2±12.5 ㎍/㎗ and 57.7±37.8 ㎍/㎗, those of non-lead workers in the same premises were 14.9±6.5 ㎍/㎗ and 44.6± 15.8 ㎍/㎗ respectively. The difference of mean blood lead and blood ZPP between two groups were statistically significant. 2. Whereas the prevalence of the variant allele, ALAD2 in 1022 lead workers was 10.2 %, the prevalence of that in 149 non-lead workers was 7.4 %. But there was no difference of prevalence between two groups. 3. The mean±standard deviation of blood lead of subjects with ALAD1 was 25.5± 12.7 ㎍/㎗ and was slightly lower than that of subjects with ALAD2 (26.5±10.9 ㎍/㎗), and the mean±standard deviation of blood ZPP of subjects with ALAD1 was slightly higher than that of subjects with ALAD2 (56.7±37.3 ㎍/㎗ vs 48.9±18.6 ㎍/㎗). But the differences of blood lead and blood ZPP between two genotypes were not statistically significant. 4. There were no differences of cross-sectional renal function indices (BUN, serum creatinine, uric acid and total protein) either by lead workers and non-lead workers or two genotypes. 5. In multiple regression analysis of ALAD genotype on BUN after controlling for possible confounders (sex, weight, job duration, smoking and drinking status), the mean of BUN in ALAD2 subjects was 0.629 ㎎/㎗ lower than ALAD1 subjects with a weak statistical significance (p=0.07). But in logistic analysis of ALAD genotype on median value of BUN revcaled that subjects of ALAD2 genotype were 32% less likely to have median value or more of BUN than subjects of ALAD1 with odd ratio of 0.618 (95% confidence interval 0.411-0.920). 6. In multiple regression analysis of ALAD genotype on serum creatinine after controlling for possible confounders (sex, weight, job duration, smoking and drinking status), the mean of serum creatinine in ALAD2 subjects was 0.0271 ㎎/㎗ lower than ALAD1 subjects with statistical significance (p=0.02). On the other hand, in logistic analysis of ALAD genotype on median value of serum creatinine revealed that subjects of ALAD2 genotype were 30% less likely to have median value or more of scrum creatinine than subjects of ALAD1 with odd ratio of 0.700 (95% confidence interval 0.442-1.080). With the above results, it was found that the variant allcle, ALAD2 appeared to modify the association of lead and renal function and ALAD2 genotype may be supportive for the protective effect of lead.

직업적 연폭로가 일부 신경행동학적 검사수행에 미치는 영향

안익수,안현철,김용배,리갑수,김화성,황규윤,최은,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to investigate that blood lead levels of lead exposed workers is associated with decreased performance in neurobehavioral tests in adults, we investigate 78 workers in a battery industry. Three items among neurobehavioral core test battery of World Health Organization, including digit span, Santa ana dexterity, digit symbol were administered to workers occupationally lead exposed workers by operational guide for the WHO neurobehavioral core test battery. Blood lead (PbB) and zinc protoporphyrin in whole blood (ZZP) were selected as an index of lead exposure. Detailed occupational history such as exposed agent, age, work duration, smoking and drinking habits, were recorded as confounding factors. After controlling age, the results of digit span and digit symbol among the neurobehavioral tests were significant contributed by PbB.

HVPM의 카오스 신호와 치환동기

이익수,여지환 한국정보전략학회 1999 추계공동학술대회 논문집 Vol.- No.01

본 논문에서는 카오스 현상을 나타내는 수식을 변형하여 암호시스템이나 PN(pseudo-noise)시퀀스에 적용하기 위하여 복잡한 카오스 신호를 발생시키는 하이퍼카오스 VP사상(HVPM, Hyper chaos Volume Preserving Maps)과 이들간의 카오스 동기화를 제안한다. 단계별 모듈러(modulus)함수를 이용하여 랜덤한 카오스 신호를 발생시키기 위하여 이산시간(discrete-time) HVPM 모델을 설정하고, 수치해석 실험드로 아날로그 카오틱 시퀀스(CAS. chaotic analong sequence)의 특징을 분석한다. 그리고 HVPM의 신호를 기존의 단순한 PC(Pecora, Carroll)방법을 응용한 치환동기화 (synchronous substitution)를 이용하여 구동 및 응답시스템간의 카오스 동기화(chaos synchronization) 제어를 한다. 수치실험에서 카오스 신호가 갖는 특징들을 확인할 수 있었으며, 치환동기시스템에서 효과적인 카오스 동기화가 수행됨을 증명할 수 있었다.

카오스 뉴랄네트워크의 동기화를 기반으로 한 주파수확산 통신

이익수,여지환,이동록 대구대학교 과학기술연구소 1997 科學技術硏究 Vol.4 No.2

In this paper, spread spectrum communication system based on chaotic carrier sequence are considered and simulated for their security and robustness in the presence of additive noise, system parameters variance and other interferences_ And chaotic synchronization in chaotic neural network and its possible application to secure communication are discussed. Toshimitsu Ushio has recently shown that it is possible to synchronize one-dimensional chaotic neural networks with weight connection by utilizing feedback control techniques. Thus their networks are used as transmitter and receiver circuits in chaotic communication schemes. We have verified the secure communication method experimentally for applying to analog speech signal using two chaotic synchronized neurons. The implementation of spread spectrum communications technique results in reliable performance in the presence of considerable system perturbation and noise in the channel.

韓國의 動物標本保存 現況과 問題에 關한 豫備 調査

李炳勛,金益秀 全北大學校 生物學硏究所 1984 生物學硏究年報 Vol.5 No.-

To determine the present state of animal collections in scope, nature and accessibility a questionnaire was designed and mailed to 85 university or college departments and systematics-related institutes of the country. From 35 answers returned it has been revealed that major number of respondents maintained each about 3000 specimens(7 departments), and 300 species(11 departments), housed spaces of 50㎡ approximately(13 departments). Seven of the respondents were revealed not to keep more than 1000 specimens and five were without any space for collection, of less than 33㎡ if any. Size and type of the collections were outlined as: invertebrates, 1,550,000 individuals in total, including 1,250,000 insects in 10 collections, one of them preserving 16,000 species approximately; vertebrates of 15,700 specimens, with fishes comprising the majority by 13,400, including one of the collections with 300 species. Cataloguing of the specimens were not performed but in 15 places, in which only two were employing computerized systems. The collection were used, in addition, for both graduate and undergraduate courses ranging over 20 titles of subjects throughout the country, including mostly Animal Systematics and Lab Work as required one. Utilizations of the specimens were also made for in-serve training, as reference specimens for identification service and for exchange program with institutes either domestic or overseas(11 departments). Major problems and ideas proposed by the respondents concerning the serious situations as revealed in this survey as well as for developing systematic studies in the country ranged from adequate funding for providing curatorial capabilities, training manpower in animal systematics in higher education and systematics institutes, establishing certain mechanism for communication and cooperation in systematics community, and setting up a national funding program for undertaking a faunal survey of the country and related programs, comparable either to the Biological Survey of Canada or the Biological Survey of the United States, which would ensure the solution of the ancillary problems explored in the present investigation. Moreover, the lack of a central depository of type specimens in the country as well as the abrupt suspension in the current year of the program supporting the publication of "Illustrated Flora and Fauna of Korea "by the Ministry of Education were pointed as matter of grave concern by the systematists.

카오스 랜덤신호 발생기를 위한 3D²CGE의 분석

이익수,이동록,여지환 대구대학교 과학기술연구소 1999 科學技術硏究 Vol.5 No.5

in this paper, we have designed, proposed and demonstrated a novel 3-dimensional discrete-time chaotic generation equation(3D²CGE) for generating chaos signals such as pseudo-random signals. The chaos signals of 3D²CGE which is used specific parameters space are analyzed by general nonlinear signal process methods. The chaos signals that are calculated numerical and statistical process with computer simulation have proved chaos properties; aperiodicity, fractal structure, chaos attractor etc. The time series of the equation have extremely rich dynamics and the 3D²CGE is indeed chaotic. Specially, the dynamic bifurcation structures are represented using varying initial values and control parameters such as α , β , μ , κ , γ , ε , Φ . Finally, we demonstrate the probability density of chaos signals and randomness properties of proposed equation.

주요우울증에 대한 Milnacipran의 효과 및 안정성 : Fluoxetine과의 비교

이민수,함병주,기백석,김정범,연병길,오강섭,오병훈,이철,정한용,지익성,최병무,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This 6-week, open label randomized, multicenter study was conducted to evaluate the antidepressant effect and safety of milnacipran and fluoxetine in patients with major depression. Methods : The study was done in patients with major depression diagnosed by DSM-IV who score ≥17 in 17 items Hamilton Rating Scale for Depression (17-item HAM-D) and score ≥25 in Montgomery and Asberg Depression Rating Scale (MADRS). A total of 87 patients were randomized to milnacipran group and fluoxetine group. In cases of the patients taking other antidepressants, 6 weeks of each medication was administered after 7 days of drug excretion period. The evaluation was done using 17 item HAM-D, MADRS, Clinical Global Impression Scale (CGI), and COVI scale after baseline, 1 week, 2 weeks, 4 weeks, and 6 weeks. The side effects that had occurred during the period of our study were put in records by developed/disappeared time, severities, incidences, managements and results. Results : A total of 87 patients were enrolled. 70 (mitnacipran group 39 ; fluoxetine group 31) of them were included for the 6 weeks of research and 17 of them dropped out with in the first week, not due to adverse reactions or deficiency of effects. Total 17 item HAM-D scores, total points of MADRS, and CGI showed significant decrease after 1 week in each treatment group and continued decrease after 2 weeks and 4, 6 weeks. But there was no difference between milnacipran group and fluoxetine group in the antidepressant effect. There were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The commonly reported side elfects of minlacipran were nausea (25.0%), headache (10.7%), vomiting (7.1%),constipation (7.1%), dizziness (7.1%) and those of fluoxetne were GI trouble (11.1%), diarrhea (11.1%), insomnia (11.1%),agitation (5.6%), and dizziness (5.6%). Conclusion : Milnacipran was effective for the improvement of depressive symptoms and was well tolerated and safe in patients with depression.