물분쟁의 해소를 위한 기술적·제도적 측면과 사회적 장애 : 용담샘의 사례 Case Study of Yongdam Dam

윤근섭,宋正基 全北大學校 1996 論文集 Vol.42 No.-

The purpose of this research is to analyse conflict circumstances between the two regions (Chonbuk and Chungcheong) of Keum-Kang river basin and furthermore to suggest the ways of solving water-dispute from the viewpoint of technological and institutional aspects. In this study, I found the two regions' conflict is due to the probelm how to keep the appropriate amount of water in Keum-Kang river basin. I also suggest to develop a new coordinate procedure for solving this problem. Nevertheless, the best possible choice for this problem is to develop a way of integrating it with the consideration of social barriers accompanied by water-resource development projects.

한국인에서 Vancomycin의 치료적 약물농도 평가

송영구,김혜경,노은경,이서영,안보숙,김정호,박민수,윤희정,김준명 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : 상용화된 PK simulation software를 이용하여 vancomycin의 치료적 약물농도 측정(Therapeutic Drug Monitoring, 이하 TDM)이 의뢰된 환자에서, 측정된 vancomycin 혈청농도와 평균 약동학 지표를 이용하여 계산된 예측농도를 비교하고, 실측 농도와 예측 농도 사이에 차이를 나타내는 요인이 무엇인지를 알아보고자 하였다. 재료 및 방법 : 2001년 3월부터 2002년 9월까지 188명으로부터 vancomycin TDM이 의뢰된 239건의 결과를 분석하였다. Vancomycin을 투여하기 30분 전에 측정된 최저 농도로 CAPCIL^(R) (Simkin Inc.) 프로그램에서 single-point linear 방법으로 약동학 지표(분포용적 : Vd_(m), 청소율: Cl_(m), 반감기 : T_(1/2m))와 이에 따른 실측 농도(ECm, 이하 실측치)를 구하였다. 또한 CAPCIL^(R) 프로그램에서 이들 환자의 평균 약동학 지표(Vd_(p), Cl_(p), T_(1/2p))를 이용한 예측 농도(EC_(p), 이하 예측치)를 계산하였다. 먼저 전체에서 실측치와 예측치의 평균에 차이가 있는지 비교하였으며 신기능 및 체중에 따라 실측치와 예측치의 차이가 있는지 알아보았다. 다음으로 예측 최저 농도를 기준으로 실측 최저 농도와 차이(%dEC=(EC_(m)-EC_(p))/EC_(p))를 세 그룹으로 나누어서 각 그룹 간에 차이를 나타내는 요인이 무엇인지 알아보았다. 통계는 SAS 프로그램을 이용하여paired t-test, ANOVA, multiple regression 등으로 처리하였으며 P<0.05를 유의한 것으로 간주하였다. 결과 : Vancomycin TDM이 의뢰된 188명중 남자 1ll명, 여자 77명이었다. 총 239건에서 실측 최저 농도는 예측 최저 농도보다 유의하게 낮았고(11.9±9.9 ㎍/ml vs. 19.2±19.5 ㎍/ml), 약동학 지표 중 청소율과 분포용적은 예측한 값보다 유의하게 높았다. 신기능 및 체중에 따른 각각의 군에서도 비슷한 양상을 보였다. 예측 최저 농도와 실측 최저 농도의 차이에 따라 구분한 세 군간에 농도 차이를 나타낸 요인으로는 몸무게, 나이, 키, IBW, BUN, Ccr이었으며, 이중 다변량 분석에서 나이, 몸무게, BUN이 실측치와 예측치의 차이에 영향을 주는 요인으로 나타났다. 결론 : 신기능이 저하되었을 경우와 저체중, 고령인 경우 실측 농도에 비해 더 높은 농도로 예측하는 경향으로 나타나 최적의 치료 농도를 유지하기 위해서는 이와 같은 환자에서 특히 vancomycin TDM이 필요하다고 생각된다. Background : We measured plasma vancomycin concentrations as a part of therapeutic drug monitoring (TDM) consultation and compared and analyzed the estimated plasma steady-state therapeutic drug levels of vancomycin obtained on the basis of measured concentrations and by population PK parameters using a PK simulation software in Korean patients to find the factors influencing the discrepancies that lie between these estimates. Materials and Methods : We analyzed the PK parameters of the 188 patients for whom vancomycin TDM was done for 239 episodes between March, 2001 and September, 2002. The trough vancomycin plasma concentrations were measured from plasma samples that were drawn 30 minutes before a vancomycin dose. Based on the measured concentrations, we estimated the steady-state therapeutic levels (EC_(m)) and PK parameters (apparent volumes of distribution, Vd_(m); clearance, Cl_(m); and half life, T_(1/2m)) using the single-point linear method utilized in CAPCIL (Simkin, Inc.) software program. We compared these with the steady-state levels and PK parameters estimated based on population PK database supplied by the software (EC_(p), Vd_(p), Cl_(p), and T_(1/2p)). We stratified and compared the values based on the patients' renal functions, body weights relative to ideal body weights, the magnitude of differences between EC_(m) and EC_(p). Multiple logistic regression using SAS software package was done to analyze factors that significantly influence the discrepancies. Results:One hundred and eleven were males, and 77 were females. The mean ECm were significantly lower than the mean ECp (11.9±9.9 μg/ml vs. 19.2±19.5 μg/ml). Clm and Vdm were higher than Cl_(p) and Vd_(p), respectively. The same patterns could be applied to the subclasses of patients based on renal functions and body weights. The factors that contribute to the differences in EC_(m) and EC_(p) were body weight, age, height, IBW, BUN, and Clcr, of which age, body weight, and BUN were found to be most significant by multiple regression analysis. Conclusions : Significant sizes of discrepancies between the estimated plasma steady-state therapeutic drug levels of vancomycin obtained on the basis of measured concentrations and by population PK parameters using a PK simulation software in Korean patients necessitate adjustment of dosage and confirmation of steady-state levels by follow-up TDM. We emphasize the need for obtaining vancomycin population PK database in Korean patients.

전수면박탈이 정상인의 생리기능과 인지기능에 미치는 영향

정종현,송후림,신윤경,한진희,이성필,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Purpose of this study was to investigate physiological and neurocognitive effects of total sleep deprivation by using laboratory blood tests and the computerized neurocognitive function test in healthy subjects. Methods : Sixteen healthy volunteers participated in this study. Subjects were recommended to remain awake for 48 hour sunder continuous surveillance. Lab tests of cortisol, Prolactin, thyroid hormone, growth hormone, and immunoglobulin (IgG, IgA, IgM, IgD, IgE), CBC, BC and the Vienna test were performed before and after 48 hours of total sleep deprivation. Results : Concentration of T3 and T4 significantly increased after deprivation. In the reaction test, distribution reaction time significantly increased, and correct reaction significantly decreased. In the vigilance test, amount of correct reaction Signifi-cantly decreased, and the mean value of correct reaction time was significantly delayed. Level of fasting blood sugar, total protein, albumin, alkaline phosphatase and potassium significantly increased, respectively, except for the level of total bilirubin which was decreased. After total sleep deprivation, WBC counts significantly increased. Regarding immunoglobulin level, IgG,IgA and Ag M concentrations appeared to decrease, but the results were not statistically significant. Conclusion : The effect of total sleep deprivation on physiological function was significant in the level of thyroid hormone. Although statistically not significant, the results of growth hormone and the immune system showed a trend in relations to the effect oftotal sleep deprivation. Results of blood chemistry suggest that sleep dephvation may influence metabolism Of hepato-biliary system. Cognitive impairment was also seen in reactive and vigilant functions after total sleep deprivation.

7두의 개에서 배설성 요로조영술을 통한 신장 기능 평가

최윤정,이기자,최형준,이용진,박성준,송근호,정성목,최호정,이영원 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

Excretory urography is a type of contrast study used to verify and localize upper urinary tract disease. It is an inexpensive and easy way to visualize of anatomic and functional status of the kidney and has been used as a primary imaging modality for the evaluation of urinary tract abnormalities. We describe urological signs of 7 dogs who examined with excretory urography and ultrasonography. Six cases were referred to veterinary medical teaching hospital. Chungnam national university (VMTH, CNU) to evaluate renal function after the treatment for renal failure and one case was referred showing hematuria. In case 1, 2 and 4, blood test and urinalysis was normal and the results of excretory urography presented that renal function were normal range. In case 3, the results of urinalysis, ultrasonography, and excretory urography except blood test presented abnormal kidney and hydronephrosis was diagnosed. In case 5 and 6, blood test, urinalysis, ultrasonography and excretory urography indicated renal failure. In case 7, blood test, urinalysis and ultrasonography presented partially abnormal signs, however, the results of excretory urography was normal range.

Esmolo과 lidocaine의 혼합사용시 기관내 삽관에 따른 혈압과 심박수에 미치는 영향

하정량,손용,김태요,윤재승,송윤강 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.1

Background: Ultrashort acting β-adrenergic antagonist, esmolol and local anesthetics, lidocaine are well known about effects of hemodynamic stabilization to tracheal intubation. But, the effects of these drugs are still controversial. The aim of the present study is to assess whether a combination of both drugs are more effective than either drug alone. Methods: Forty eight patients, ASA physical status Ⅰ or Ⅱ, were randomly assigned to one of four groups (n=12 each): control (Group S), esmolol 1 ㎎/㎏ (Group E), lidocaine 1 ㎎/㎏ (Group L) and esmolol-lidocaine combination (Group M). Anesthesia was induced with thiopental 5 ㎎/㎏ intravenously, and then saline, esmolol, lidocaine and combination drug were administered as an intravenous bolus, and immediately followed by succinylcholine 1.5 ㎎/㎏. Tracheal intubation was done 90 seconds after intravenous injection of drugs, respectively. Systolic and diastolic blood pressure and heart rate were measured before induction and every minute for 5 minutes after tracheal intubation. Results: There was a significant attenuation in systolic, diastolic arterial pressure and heart rates after tracheal intubation in esmolol-lidocaine group compared to other three groups. Conclusions: Combination of esmolol 1 ㎎/㎏ with lidocaine 1 ㎎/㎏ seems to be useful for attenuation of the increases in blood pressure and heart rates compare to either drug alone after tracheal intubation.

물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가

김정철,윤정한,범희승,제갈영종,송호천,민정준,정환정,김성민,허영준,이명호,박영규,정준기 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.2

목적 : 분화갑상선암 환자에 대한 방사성옥소(I-131) 치료는 재발율과 사망률을 감소시키는 효과적인 치료법이지만, 치료용량을 증가시킴으로써 치료율을 향상시킬 수 있는지에 대해서는 아직 논란이 있다. 본 연구에서는 최대허용선량 치료법의 효용성을 검증하고자 하였다. 대상 및 방법 : 임상적 병기가 제3, 4병기이고, 6개월 이후에 I-131 전신스캔(이하 IWBS)과 혈중 thyroglobulin (이하 Tg), anti-thyroglobulin antibody (이하 ATA), 초음파검사 (이하 US) 및 F-18 FDG PET 등을 통해 치료여부를 확인할 수 있었던 58명(남:여=9:49, 평균연령 50±11세)의 유두상갑상선암 환자를 대상으로 하였다. 이중 11명은 제4병기, 47명은 제3병기였으며, 43명(남:여=4:39), 평균연령 50±11세)은 7.4 GBq 이하의 고식적인 저용량치료법으로 치료하였고, 9.25 GBq 이상의 고용량 치료를 받은 환자는 15명(남:여=5:10, 평균연령 50±12세)으로 고용량군에서 남자가 더 많았으나 연령의 차이는 없었다. 고용량군 환자 모두에서 추적용량의 방사성옥소(평균 77±3 MBq)를 경구 투여한 후 혈중 방사능소실곡선을 통해 최대허용선량(maximum permissible dose, 이하 MPD)을 계산하였으며, 7명에서는 말초혈액림프구의 중기염색체분석법에 의해 생물학적으로 MPD를 계산하였다. 14명에서는 치료용량의 방사성옥소를 투여한 후 혈중 방사능소실곡선을 통해 MPD를 계사하였다. 완전치유(complete response, 이하 CR)는 IWBS에서 병소가 없어지고, 혈중 Tg치가 1 ng/mL 이하로 감소한 경우로 정의하였으며, 부분치유(partial response, 이하 PR)는 IWBS에서 병소가 없어졌더라도 혈중 Tg, ATA치가 높거나, US 또는 PET 검사에서 병소가 남아있는 경우로 정의하였다. 치료후 IWBS에서 병소가 오히려 증가하거나 변함없는 경우는 없었다. 방사성옥소 치료에 의한 부작용은 입원기간 중 타액선이 현저하게 붓고 통증이 있거나, 구토를 심하게 하는 경우, 그리고 퇴원후 1개월째 백혈구수가 20% 이상 감소한 경우로 정의하였다. 결과 : 양 군간에 연속적인 수치변화를 비교하는 경우는 paired t-test를 이용하였으며, 대상군간 치료효과와 부작용의 비교는 chi-square test를 이용하였다. p값 0.05 미만을 통계적으로 유의한 차이로 인정하였다. 고용량군 환자 모두에서 추적용량과 치료용량의 방사성옥소 투여 후 혈액의 피폭선량은 각각 0.012±0.3 Gy, 1.66±25 Gy였으며, 방사성옥소 투여 후 혈액에 전달되는 피폭선량은 추적용량보다 치료용량에서 더 많았고 (1.21: 166 rad, p<0.001), 방사성옥소 1 mCi당 혈액에 전달되는 피폭선량은 차이가 없었다(0.58±0.1 vs. 0.56±0.1 rad/37 MBq, p=0.34). 추적용량 방사성옥소 투여 후 구한 MPD는 평균 13.3±1.9 GBq (9.7 ~ 16 GBq) 이였고, 치료용량 방사성옥소 투여 후 구한 MPD는 평균 13.8±2.1 GBq (10.4 ~ 16.3 GBq)로 유의한 차이가 없었으며 (p=0.20), 두 수치간에는 유의한 상관 관계가 있었다(r=0.8, p<0.0001). 7명의 환자에서 말초혈액림프구 중기염색체 분석법으로 MPD를 측정하였는데 혈액의 피폭선량은 1.78±0.03 G였으며, 같은 환자에서 혈중 방사능소실곡선으로부터 구한 피폭선량은 1.54±0.03 G로 유의하게 낮았으나 (p=0.01), 두 측정치 간에는 유의한 상관관계(r=0.86, p=0.01)가 있었다. 저용량 치료군 43명 중 22명(51.2%)에서 완전치유를 보였고 21명(48.8%)에서는 부분치유를 보인 반면 고용량 치료군 15명 중 12명(80%)에서 완전치유를 보였고 3명(20%)에서만 부분치유를 보여 고용량 치료군에서 유의하게 높은 완전치유를 얻을 수 있었다(p=0.05). 한편 부작용 발생빈도는 저용량 치료군 43명 중 13(30.2%), 고용량 치료군 15명 중 6명(40%)로 양군간에 유의한 차이가 없었다(p=0.46). 임상적인 병기, 연령 및 성별에 따라서는 치유의 차이가 없었다(p>0.05). 결론 : 혈중소실곡선으로부터 MPD를 결정하고 이를 토대로 환자 개개인별로 적절한 선량을 선택하여 치료하는 방법은 부작용을 최소화하면서도 치료효과를 높일 수 있는 매우 유용한 치료법이며, 고위험군 분화갑상선 암 환자에게 가장 적절한 치료법이라고 사료되었다. Purpose: Radioiodine (1-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age 50±11 years) of papillary thyroid cancer. Among them 43 patients were treated with ≤7.4 GBq, while 15 patients with ≥9.25 GBq. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up 1-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were 13.3±1.9 and 13.8±2.1 GBq, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were 1.54±0.03 and 1.78±0.03 Gy (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-does group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose 1-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.

방향족 화합물의 할로 메칠화 반응

박정서,김신종,백운필,이현주,송윤석,장정민 明知大學校 自然科學硏究所 1997 자연과학논문집 Vol.15 No.-

Biphenyl의 para position에 methylene group을 도입 시키는 방법으로 paraformaldehyde와 dimethylamine을 반응시켜 Mannich Base인 (1,1'-biphenyl-4,4'-dimethyl)-dimethli amine을 합성해 보았으나, 전혀 반응이 진행되지 않았다. 즉 , Biphenyl에 강한 activating group이 없으므로 Mannich Base을 사용한 방법은 효과적이 못된다. 따라서, 다른 방법으로 biphenyl에 bromomethylation을 진행 시켜서, 두 개의 methylene group을 도입시켰다. Bromomethylation은 다음과 같이 사용하는 시약 및 실험 방법 등을 고려하여 3가지 방법으로 시도 하였다. 1)1,3,5-trioxane + HBr in AcOH + paraformaldehyde 사용법, 2)Hbr in AcOH + paraformaldehyde 사용법, 3) NaBr + H₂SO₄+paraformaldehyde 사용법, 이상의 3가지 방법 중에서 NaBr+ H₂SO₄+ paraformaldehyde 사용법이 가장 좋은 결과를 얻었다. 이러한 system에서 반응을 진행시킨 결과 69% 의 높은 수율 (87%의 purity)로 4,4'-dibromomethylbiphenyl 합성에 성공할 수 있었다. The synthetic method for the induction of methylene group on the para position of arenes is of importance. Since the weak activation effect of phenyl group on the electrophilic substitution reaction, the induction of methylene group by way of Mannich base using paraformaldehyde and dimethylamine was unsuccessful. It was found that halomethylation of byphenyl is only the way for the preparation of di-p-methylenebiphenyl. Especially, bromomethylation was turn out to be more reliable synthetic method than chloromethylation. Herein, we developed 3 protocols for the synthesis of 4,4'-dibromomethylbiphenyl. In addition, the best result was obtained using NaBr + H₂SO₄paraformaldehyde protocol in 69% yield.

위암세포에 의한 종양침윤 림프구의 면역반응 억제기전에 관한 연구

박정규,송규상,서광선,최정목,배진선,장일성,윤완희,노승무,조은경,백태현 大韓免疫學會 1995 大韓免疫學會誌 Vol.17 No.3

Tumor-infiltrating lymphocytes ('1°ILs) interact most closely with tumor cells and thus are more likely to reflect tumor host interactions accurately. But it is unknown whether such T cells are nonspecific inflammatory cells or a subset of specific host immune responses. In this study, there was no clear correlation between the infiltration of T lymphocytes in stomach cancer and the overexpression of c-ErbB-2 or increasing class I MHC expression on tumor cells. A positive correlation was seen between the presence of TILs in the tumor and tumors with diploidy by flow cytometric DNA analysis. The proliferative responses of Ills stimulated with IL-2, anti-CD3 mAb, or both were examined. When compared to normal mucosal-associated lymphoid tissue lymphocytes, the proliferative response of TILs to high dose IL-2 was minimal. A similarly poor response to anti-CD3 mAb plus IL-2 was also observed. The freshly isolated TILs exhibit reduced ability to proliferate in response to IL-2, anti-CD3 mAb or both. The microenvironment of the tumor suppresses the proliferative capacity of the TILs. The mechanism of this suppression remains unknown. It could be mediated by suppressor cells, by soluble substances within the tumor, or both. To examine this question, supernatants of stomach cancer cells (SNSNU-1) were tested for the presence of immunosuppressive factors. Human peripheral blood T-cells and tumor-draining lymph node lymphocytes (TDLNL) were incubated for 3 days with SNSNU-1 and then assessed for proliferative responses to PMA, anti-CD28 mAb, or both and for the inducibility to express IFN- r or IL-4 mRNA to PMA. Peripheral blood T-cells pretreated with SNSNU-1 were unable to proliferate in response to PMA, anti-CD28 mAb or both. SNSNU-1 also produces inhibitory activities of TDLNL proliferative response to PMA or anti-CD28 mAb and PMA (49%, 52%, respectively). In contrast, culture supernatants obtained from HEp-2, K562 or Daudi showed normal proliferative responsiveness of peripheral blood T-cells and TDLNL by PMA, anti-CD28 mAb or both.

위암 환자에서 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김삼용,김영건 충남대학교 암연구소 1991 癌共同硏究所 硏究誌 Vol.1 No.1

We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly decreased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD_(4) positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-