한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

파트너십에 의한 지하철 입구 공간의 쌈지공원 설계 및 시공

김승환,강현우,손용욱,박승범,남정칠,이기철,차민준 東亞大學校 建設技術硏究所 2009 硏究論文集 Vol.32 No.2

A pocket park is valued in securing green space in downtown and improving urban view in the aspect of natural and environmental values, and it signifies a lot as the center of local residents’ community and harmony as well. Since subway exits and surroundings that have high portions in taking up street space due to lack of green space in downtown aren't made full use of, valuable pocket park place. Dangni Pocket Park of subway exits is a park completed with cooperative works and partnership by students, specialists, administrative organizations, businesses and civilian organizations, etc. without support of special budget. The study site was finally chosen to the space between exit No.1 of Dangni subway station, after analyzing the surrounding circumstances, availability and accessibility of the space among the several subway station exits of Saha, Dangni, and Hadan Station in Busan Metropolitan city. For the designing process, The Citizens organization for Million Amenity Park performed the planning and project proceeding, and 19 design drafts were proposed during the class of landscape architecture in Dong-a University. Design review panel members discussed to select the best draft in practical and authentical, and the related experts reviewed and revised to present the final design plan. The construction was conducted was performed under the cooperation between the civil, authorities, and industrial organizations, among which Saha District office managed for the waste treatment and maintenance matters. The graduates of landscape architecture department of Dong-a University and related industrial enterprises supplied landscape materials and related labors, were supported by 20 members of GPM, one of clubs of Dong-a University volunteered durig the most of construction progress, completing the Pocket Park of subway exits through partnership.

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

함치성 낭의 임상적 및 방사선적 특성

박성연,남동우,김영진,김현정,남순현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.2

이 연구의 목적은 함치성 낭의 임상적 및 방사선적 특성을 세 그룹으로 나누어 살펴보고자 하였다. Ⅰ, Ⅱ, Ⅲ군으로 나누었으며 첫 번째 Ⅰ군은 함치성 낭에 이환된 부위가 유치 하방의 계승 영구치인 군이며, Ⅱ군는 이환부위가 영구 대구치 부위인 군이며, Ⅲ군은 이환부위가 상악 전치부의 과잉치인 경우로 나누었다. 저자는 Ⅰ군의 49증례와 Ⅱ군의 36증례, Ⅲ군의 15증례들에 대하여 이들의 병록자와 파노라마 방사선 사진에 기초하여 임상적 및 방사선적 특성은 비교, 관찰하였다. 연구 결과는 다음과 같았다. 1. 유치 하방의 영구 계승치를 포함하는 Ⅰ군의 49증례로 가장 많았고, Ⅱ군과 Ⅲ군이 각각 36증례, 15증례였다. 2. 함치성 낭은 전체적으로 10대에 가장 호발하였으며, 계승치군인 Ⅰ군에서는 10대 이전과 초반에 87.8%, 대구치 군과 과잉치 군인 Ⅱ군과 Ⅲ군에서는 이보다 늦은 시기에 호발하였다. 3. 남자가 여자보다 2,5배 높은 발생 빈도를 보였다. 4. 환자의 내원 동기는 종창이 50%로 가장 많았고, 정기 검진(32%), 동통(9%) 순이었다. 5. 낭의 유형은 Ⅰ군에서 lateral type이 71.4%로 많았고, Ⅱ군과 Ⅲ군에서는 central type이 각각 94.4%, 100%로 많았다. 6. 병소의 크기는 Ⅰ군에서는 2치관 크기가, Ⅱ군에서는 1치관 크기가, Ⅲ군에서는 4치관 크기 이상이 많았다. 7. 이환된 치아의 대부분은 변위를 보였고, 변위된 치아의 일부에서 치근 발육이 지연되거나 치근 만곡 경향을 보였다. 8. 낭의 성장에 의한 치조골 반응은 Ⅰ근에서는 협측골 팽창(67.3%)이 많았고, Ⅱ군에서는 골팽창이 일어나지 않은 경우(66.7%)가 많았으며, Ⅲ군에서는 구개측 골팽창(60.0%)이 많았다. 9. 낭에 포함되는 치아로는 하악 제 3대구치가 31%로 가장 많았고 하악 제 2소구치(30%), 상악 전치부 과잉치(15%), 상악 견치(8%), 하악 제 1소구치(5%) 순이었다. 10. Ⅰ군에선 추정되는 낭의 발생 원인으로는 치수절단술을 받은 유치가 59.2%로 가장 많았고 이외에 심한 우식 및 치료받지 않은 외상 병력 등 기타 가능한 원인들이 있었다. 11. 함치성 낭의 치료법으로는 Ⅰ군의 경우 61.2%에서 조대술이 시행되었고, Ⅱ군과 Ⅲ군의 경우 61.1%, 80.0%에서 적출술이 시행되었다. The purpose of this study was t o discriminate clinically and radiographically among the three groups of dentigerous cysts studied. First, Group I , involved area of dentigerous cyst was successive permanent tooth area beneath deciduous tooth. Second. Group Ⅱ, involved permanent molar area, and the last. Group Ⅲ, involved maxillary anterior supernumerary tooth area. The author observed and compared the clinico-radiographic features of 49 cases of Group I , 36 cases of Group Ⅱ. and 15 cases of Group Ⅲ of dentigerous cyst and this observation and comparison had been done by based on the charts and panoramic films. The obtained results were as follows: 1. The cases of Group 1 mere 29 cases and, those of Group Ⅱ were 36 and those of Group Ⅲ were 15. 2. The incidence of dentigerous cyst is high in first decade. In Group I, before first decade and early first decade was 87.8%. in Group Ⅱ and Group Ⅲ, was discovered more lately. 3. The frequency of dentigerous cyst is 2.5 times higher in male than in female. 4. The sequence of chief complaint was swelling(50%), routine examination(32%). and pain(9%). 5. When considering the type of the cyst. lateral type is many most in Group I (71.4%) and central type is many most in Group Ⅱ(94.4%) and Group Ⅲ(100%) 6. The most size of dentigerous cyst was 2 crown size in Group I, 1 crown size in Group Ⅱ, above of 4 crown size in Group Ⅲ. 7. Almost involved teeth showed displacement and some tooth of displaced teeth showed delayed root development and dilaceration of root. 8. The most many response of alveolar bone was buccal bone expansion in Group I (67.3%). no bone expansion in Group Ⅱ(66.7%) and palatal bone expansion in Group Ⅲ (60.0%). 9. The percentage of involved teeth were as follows : The mandibular third molar was 31% and many most. The mandibular second premolar was 30%. Mesiodens of maxillary anterior area was 15%. The maxillary canine was 8%. The mandibular first premolar was 5%. 10. In the Group I, causes suggesting of dentigeous cyst are pulpotomized deciduous tooth(59.2%). severe dental caries of deciduous tooth, untreated traumatic history on the deciduous tooth etc. 11. The treatment method of dentigerous was marsupialization in 61.2% of cases of Group I and that was enucleation in 61.1% of cases of Group Ⅱ and in 80.0% of cases of Group Ⅲ.

완전뇌허혈후 재관류시에 국소뇌혈류, 체성감각유발전위 및 신경학적 회복에 대한 Mannitol과 Thiopental의 효과

박춘근,이상원,박영섭,최승진,허필우,정동섭,강준기,최창락 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

The cardiopulmonary bypass or cerebral circulation arrest is often used in the treatment of complex aneurysm or of arteriovenous malformation to decrease the risk of intraoperative aneurysm rupture. Although experimental studies have suggested that some drugs may protect the brain from ischemic injury, there are limitations in maintaining cerebral perfusion arrest without incurring neurologic deficits due to the initiation of detrimental processes including excitotoxic neuronal injury, activation of phospholipases, influx of calcium, and generation of damaging free radicals. The purpose of this study is to determine wheter mannitol or thiopental has any favorable effects on the recovery of neurologic deficits and on the regional cerebral blood flow(rCBF), somatosensory evoked potential(SEP) and electroencephalogram(EEG) in cats which underwent 15 minutes-complete global ishcemia-reperfusion. The complete global ischemia was produced in 38 cats by temporary intrathoracic occlusion of the innominate artery and the subclavian artery following ligation of bilateral mammary arteries and simultaneous induction of hypotension. The cats were allocated randomly to one of 4 treatment groups : (1) control group, 8 cats received equal volume of saline solution : (2) thiopental group, 10 cats received 45㎎/㎏ thiopental intravenously, (3) mannitol group, 10 cats received 2g/㎏ mannitol intravenously, (4) combined mannitol and thiopental group, 10 cats received equal dose of mannitol and thiopental intravenously. The drugs were administrated in a equally divided dosage before and after the ischemic episode. The results were as follos : 1) Eight animals which received saline showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia. 2) Ten thiopental-treated animals also showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours the ischemia. 3) Both mannitol-and combined treated groups showed early recovery of EEG, good recovery of SEP and EEG without the severe postischemic hypoperfusion, and 7 of 10 mannitol-treated animals and 8 of 10 combined treated animals were significantly recovered in all parameters. There were not significant differences in all parameters between the mannitol-and combined treated groups. 4) Thirty-four of 38 animals involved in this 15 minutes-ischemia resulted in the severe neurologic deficits inspite of treatment with mannitol, thiopental or both of them. These results suggest that, in cats, mannitol treatment is effective but not thiopental in preventing severe neurologic injury following complete global ischemia and the duration of complete ischemia should be far less than 15 minutes.

ADP에 의해서 활성화된 혈관평활근 세포의 증식에 관여하는 Integrin의 종류와 신호 전달 경로

박찬복,이지현,류종철,차태준,주승재,이재우 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background: Adenosine diphosphate(ADP), which is usually secreted from activated platelets activates integrin αvβ3. αvβ5, and α5β1 on human vascular smooth muscle cells. Integrins have an important role in the proliferation of vascular smooth muscle cells. ADP may stimulate the proliferation of vascular smooth muscle dells by the activation of integrins. Integrins mediating ADP-stimulate the proliferation of vascular smooth muscle cells and signal transduction pathway of ADP stimulation were investigated in this study. Methods: MTT(3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay was used to evaluate ADP or ATP-stimulated proliferation of human aortic smooth muscle cells (HASMC). In some experiments, HASMC were incubated with U73122, an inhibitor of phospholipase C, or monoclonal antibodies (mAb) to integrins after ADP of ATP stimulation. Results: ADP and ATP increased the proliferation of HASMC in a dose-dependent manner. U73122 inhibited ADP or ATP stimulated proliferation of HASMC ADP-stimulated proliferation of HASMC was inhibited either by c7E3, a blocking mAb to integrin β3 or by LM609, a blocking mAb to integrin αvβ3(37% and 26% inhibition, respectively: p<0.05), but neither by P1F5, a blocking mAb to integrin αvβ5 nor by JBSS, a blocking mAb to integrin α5β1. Conclusion: These results indicate that ADP increases the proliferation of human vascular smooth muscle cells through phospholipase C pathway, and only integrin αvβ3 mediates ADP-stimulated proliferation of human vascular smooth muscle cells.

생체신호 측정 및 데이트 수집 장치의 개발

우응제,박승훈 건국대학교 의과학연구소 1994 건국의과학학술지 Vol.4 No.-

We have developed biological signal measurement modules and PC-based data acquisition system. Biological signals included in this system are ECG, EEG, EMG, invasive blood pressure, respiration, and temperature. Parameters of each module can be controlled by PC through a data acquisition and control card. The data acquisition and control card can collect up to 16 channels of biological signals with sampling rate of 50~10,000Hz and 12-bit resolution. All measurement modules and data acquisition functions are controlled by microcontroller which receives commands from PC. All data transfers among PC, microcontroller, and ADC are done through a shared RAM access by polling method for real time operation. This system is being used in KKU BME Medical Instrumentation Laboratory in research areas such as ECG interpretation, high-resolution ECG, polysomnography, long-term monitoring of biological signals, design of intelligent alarm system, etc.