골수이식 후 골밀도 및 골대사의 변화 : 2년 추적관찰 2-Year Prospective Study

이원영,강무일,오은숙,오기원,한제호,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

업무처리과정의 재설계를 위한 모델

손달호,최무진 啓明大學校 産業經營硏究所 1997 經營經濟 Vol.30 No.2

사무자동화, MIS구축, 원격통신등의 막대한 정보기술에의 투자에도 불구하고 知識노동자의(Knowledge worker)생산성은 踏步상태였음이 최근 지적되어 왔다. 이러한 맥락에서 업무처리과정의 再設計 (Business Process Redesign·BPR)는 업무를 자동화 이전에 기존의 업무처리방식 및 과정을 심도있게 분석하므로 낭비적인 單位무들을 파악하고, 이러한 불필요한 업무처리과정을 제거하기 위해 적합한 정보기술을 탐색하며, 필요에 따라 職務도 재설계(Job Redesign)하는 새로운 MIS구축戰略 내지 哲學이라고 볼 수 있다. BPR이 처음 소개된 1990년 이후 적지 않은 연구들이 있었다. 그러나 BPR에 관한 대부분의 논문들이 BPR을 위한 사례연구를 기저로 한 개념적指針(conceptual guideline)들을 다루고 있으며, 몇몇 주요 컴퓨터제조업체들이 BPR을 지원하기위한 분석툴(tool)들을 개발하여 사용하고 있을 뿐이다. 그래서 知識노동자들의 업무처리방식및 과정의 構造的 이해를 위한 통찰력(insight)을 제공하고, 분석을 위한 槪念的 틀(frame)을 論하는 논문은 부족했다고 본다. 따라서 본 연구는 각양각색의 업무처리과정을 여덟類型으로 분류할 수 있는 記述的모델(descriptive model)을 제시함과 아울러, 이 모델을 기저로 한 BPR의 3가지 純粹전략을 제시했다. 제시된 모델과 전략들을 기존의 사례에 적용하므로 모델의 적용성 및 유용성을 논했다. Despite a huge amount of investment on office automation, MTS and telecommunication network, the productivity of knowledge workers has been stagnant. Business Process Redesign (BPR) has emerged as a new method or philosophy for developing MIS, with which present business processes can be analized, wasteful works are identified, appropriate infomation technology is identified to streamline the newly designed processes. Since the BPR was introduced in 1990, there are many studies, but most studies have focused on conceptual guidelines based on multiple cases, and some computer manufacturers suggested some analytical tools for BPR. Therefore, a study is needed to provide some insight that can help understanding of the business processes and a framework for analyses. Accordingly, this study proposes a descriptive model that can Identify 8 types of business processes. Then, 3 generic BPR strategies are also suggested. Finally the usefulness and appropriateness of the model are discussed using three cases.

문제해결과정의 段階別 回歸가 문제해결시간에 미치는 영향에 관한 연구 : A Simulation Study

손달호,최무진 한국경영과학회 1994 韓國經營科學會誌 Vol.19 No.1

Over the last decades, interest in the application of decision support systems(DSS) in organizations has increased rapidly. Despite the growing number of investigations examining decision support system, relatively few empirical studies have evaluated the effects of DSS on problem-solving processes. This study examined, using a computer simulation technique, the effects of recursion in problem-solving processes on the problem-solving time. Results indicate that the recursions at the early stage of problem-solving processes scarcely influenced the problem-solving time, which is contrasted with the case of the recursions at the final stage.

기-액병류상향 고정층반응기에서 액체의 흐름과 축방향분산

함병호,조지훈,편무실,김태옥,손민일 明知大學校 産業技術硏究所 1996 産業技術硏究所論文集 Vol.15 No.-

For upward cocurrent gas-liquid flow in a fixed bed reactor, the flow and axial dispersion of liquid were investigated in an air-water-Zeolite particle system. Based on experimental residence time distributions, parameters of mixing models were evaluated with two proposed liquid mixing models: axial dispersion model with stagnant zone(DSM) and plug flow model with stagnant zone(PFM). Accordingly, the applicability and parameters of each mixing model were analyzed for various operating conditions. We found that the flow and axial mixing characteristics of liquid could be analyzed well by DSM and parameters were well estimated by curve fitting using trial and error method. Also, the fraction of stagnant zone was decreased with increasing liquid velocity, while the dimensionless mass transfer coefficient between dynamic and stagnant zones was increased, and these parameters estimated by DSM were lower than those by PFM. In dynamic zone, calculated Peclet number were increased with increasing liquid velocity and axial mixing characteristics of liquid tended to access to plug flow for the high liquid Reynolds number(about Re1>50). For the porous catalyst particle system the flow and axial mixing characteristics of liquid had nearly same tendency that for the nonporous particle(glass bead) system, while dimensionless mass transfer coefficient was lower value than that for it. In these conditions, correlations of these parameters were obtained for various operating conditions.

조혈모세포이식술이 골수기질세포의 기원 및 조골세포로의 증식 및 분화에 미치는 효과

강무일,조성원,오은숙,백기현,이원영,오기원,김혜수,한제호,윤건호,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

Cyclosporin A 반복투여에 의한 랫드 간장의 조직학적 변화

윤화중,손무호,장병준,권구범 건국대학교 동물자원연구센터 1998 動物資源硏究誌 Vol.19 No.-

This study was carried out to investigate the histological changes of rat liver by repeated treatment of cyclosporin A that has been widely used for treating some autoimmune diseases and immunosuppressive drug in organ transplantation. 70 Sprague-Dawley rats were kept in experimental circumstances for 2 weeks and 50mg/kg B.W of cyclosporin A was injected once a day subcutaneously for 7 days and sacrificed at 1 hour, 1 day, 3 days, 7 days, 14 days, 28 days after the last injection. Histological changes were observed by H & E, Oil red O, and Masson trichrome stains and the results obtained were as follows. 1. 26 percent of animals has died during the treatment of cyclosporin A, and the animals survived were observed to be dull and inactivated. 2. The mild cytoplasmic changes of hepatocytes in portal area were observed by H & E stain in 1 hour lapse group and this finding was recovered with time lapse. 3. The lipid accumulation in periportal areas was observed in 1 hour and 1 day lapse groups and this finding was recovered with time lapse. 4. Although the cytoplasmic changes and lipid accumulation were started in the portal area and moved to intermediated and central areas, the changes in the intermediate and central areas were not as severe as that of portal area. 5. No specific increase of connective tissue was observed in all groups. 6. Histological changes of rat liver induced by cyclosporin A were recovered with time lapse, and the entire recovery was observed in 28 days lapse group after the last injection.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

개에 있어서 심장사상충증을 동반한 창상성 횡격막 허니아의 수술적 치료 1례

조승혁,임영환,손정민,노경완,박창식,전무형,김명철,송근호,정성목 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

A 7-month old. castrated male Shih-tzu dog was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with history of depression. dyspnea. mild scale. tachypnea. exercise intolerance and severe leanness. On physical examination. cardiac arrhythmias was heard and heart worm ELISA test was positive. Microfilaria was found on the direct blood smear. Survey radiographs showed loss of diaphragmatic line and cardiac silhouette. displacement of lung fields and presence of gas filled intestines in the thoracic cavity. Rib fracture and pelvic fracture with callus formation were found incidentally. On the basis of physical examination and radiographic findings. it was diagnosed as traumatic diaphragmatic hernia and heart worm disease. Herniorrhaphy was performed. Postoperatively. it was treated for heart worm disease and scale. There is no evidence of recurrence of diaphragmatic hernia and heart worm disease over 1 year.

개에 있어서 심장사상충증을 동반한 창상성 횡격막 허니아의 수술적 치료 1례

조승혁,임영환,손정민,노경완,박창식,전무형,김명철,송근호,정성목 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.-

A 7-month old, castrated male Shih-tzu dog was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with history of depression, dyspnea, mild scale, tachypnea, exercise intolerance and severe leanness. On physical examination, cardiac arrhythmias was heard and heart worm ELISA test was positive. Microfilaria was found on the direct blood smear. Survey radiographs showed loss of diaphragmatic line and cardiac silhouette, displacement of lung fields and presence of gas filled intestines in the thoracic cavity. Rib fracture and pelvic fracture with callus formation were found incidentally. On the basis of physical examination and radiographic findings, it was diagnosed as traumatic diaphragmatic hernia and heart worm disease. Herniorrhaphy was performed. Postoperatively, it was treated for heart worm disease and scale. There is no evidence of recurrence of diaphragmatic hernia and heart worm disease over 1 year.

동종골수이식 후 혈당 및 혈중 지질농도의 변화양상 및 관련인자

이원영,강무일,오은숙,오기원,손현식,윤건호,차봉연,이광우,손호영,강성구,신완식,민우성,김춘주 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.6

연구배경:골수이식은 비교적 젊은 연령의 환자들을 대상으로 하며 면역억제제의 사용기간이 비교적 짧으므로, 주로 고령의 만성 질환 환자에서 시행되는 고형장기이식에서와는 달리 당대사 및 지단백 대사에 있어서 많은 차이점이 있을 것으로 추측된다. 저자들은 전향적 연구를 통하여 골수이식 후 시기별로 혈당 및 혈중지단백 변화 양상을 알아보고 이와 관련된 임상인자들을 규명하고자 하였다. 방법:1998년 10월부터 1999년 8월까지 가톨릭대학교 성모병원에서 동종골수이식을 시행한 환자들 중 43명을 대상으로 이식 전 및 이식 후 1, 2, 3, 4주와 3개월, 6개월에 공복 혈당, 혈중 총 콜레스테롤, 중성지방, 고밀도지단백을 측정하여 골수이식 후 시기별 변화를 관찰하고 여러 임상인자들에 따른 차이를 알아보았다. 결과:1. 공복혈당은 골수이식 수 첫4주 동안 상승하였고 이후 감소하였으나 이식 6개월 시점의 평균 공복혈당은 이식 전보다 유의하게 높게 관찰되었다. 혈중 총 콜레스테롤은 이식 후 1주에 최고치를 형성하였고 이후 기저수준으로 회복되었다가 이식 수 3,6개월에 다시 증가하여 기저치에 비해 유의하게 높았다. 혈중 중성지방은 이식 후 1개월까지 유의하게 증가하였고 이후 감소하여, 3,6개월에는 기저치와 유의한 차이가 관찰되지 않았다. 혈중 고밀도지단백은 이식 후 2,3주에 이식 전보다 유의하게 감소하였고 이후 이식 전 수준으로 회복되었다. 혈중 저밀도지단백은 총 콜레스테롤의 변화와 매우 유사하였다. 2. 골수이식 후 6개월 시점에서 공복 혈당이 126㎎/dL이상인 환자는 7명(16%)이었다. 이들 환자들과 공복혈당 126㎎/dL 미만의 환자 36명을 비교한 결과, 공복혈당이 126㎎/dL 이상인 환자군에서 스테로이드 평균 투여량이 많았고 고밀도지단백이 유의하게 낮았다. 3. 이식편대숙주질환이 발생한 환자는 그렇지 않은 환자보다 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤이 더 낮았고, 3개월의 공복혈당이 더 높았다. 혈연골수이식 환자군은 비혈연골수이식 환자에 비해 투여된 스테로이드 용량이 더 적음에도 불구하고 이식 후 1, 2, 3주 및 6개월의 총 콜레스테롤 수치가 더 높았다. 스테로이드 고용량 투여군(하루 평균 7.5㎎기준)은 저용량군보다 이식 후 3개월 시점의 공복혈당이 더 높았으나 나머지 시점의 혈당, 혈중 지질농도에 있어서는 유의한 차이가 관찰되지 않았다. 결론:골수이식 후 초기시기에 주로 당 대사 및 지질대사이상이 관찰되며 이는 면역억제제 투여와 관련이 있음을 알 수 있었다. 면역억제제가 고용량 투여되는 합병증 발생 시 이들 대사이상에 관심을 기울여 대처해야 할 것이다. Background: In bone marrow transplantation(BMT), recipients are usually younger and immunosuppressants are open used in shorter period than in solid organ transplantation. Therefore, there might be a difference in glucose and lipid metabolism between BMT and solid organ transplantation. However, the serial changes of metabolic parameters following BMT have not been studied. Therefore, the aim of this study is to investigate the serial changes of blood glucose, lipids and the putative factors that are related with these changes after BMT. Methods: We have prospectively investigated 43 patients who underwent allogeneic BMT. Fasting plasma glucose(FPG), total cholesterol, triglyceride and high-density lipoprotein(HDL) were measured before BMT, and at 1, 2, 3, 4, 12 weeks and 6 months after BMT. The serial changes of these metabolic parameters according to clinical factors including type of BMT, mean daily steroid dosage, and occurrence of graft versus host disease (GVHD) were examined. Results: 1. Mean FPG level increased during 4 weeks after BMT and remained above basal value at post-transplant 6 months. Total Cholesterol level was increased during initial 4 weeks after BMT and was above basal value at post-BMT of 3 and 6 months. Triglyceride level was progressively increased during initial 4 weeks after BMT, but returned to basal value there after. HDL-cholesterol level was significantly decreased during initial 4 weeks after BMT, but returned to basal value there after. 2. Patients with FPG above 126 mg/dL and the other patients, the former received larger amounts of daily steroid and had lower HDL-cholesterol level. 3. The changes of metabolic parameters were different according to type of BMT, steroid dose, and occurrence of GVHD. Conclusion: Although there was increase of FPG, TC, TG and decrease of HDL-C during initial 4 weeks after BMT, these metabolic changes recovered slowly thereafter. Immunosuppressants are thought to be associated with these changes. Further observation will be needed for the long-term effect of BMT on metabolic changes(J Kor Diabetes Asso 24:689~698, 2000).