장관골에 발생한 거대세포 종양의 국소 재발에 관한 연구

김인,김정만,이승구,장한,김용식,김성수,한창환,김형관 가톨릭 중앙의료원 가톨릭 암센터 1991 가톨릭 암센터 論集 Vol.5 No.1

담도 및 췌장 악성종양에서의 CAl9-9의 진단적 가치에 대한 평가

명승재,최승목,김은옥,최호순,이성구,김명환,민영일,류진숙 大韓消化器病學會 1995 大韓消化器病學會誌 Vol.27 No.3

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

學習者 變因의 相互關係 探索

金龍來,丘星淑 弘益大學校 敎育硏究所 1991 敎育硏究論叢 Vol.- No.7

The purpose of this research was to examine the interrelations among learner-related variables(IQ, academic self-concept : Asc, school-related adjustment : Sad and academic achievement : Aa) (LRV), the mutual differences by levels of LRV and the effect of LRV on each variables. This research were investigated through the following problems. 1) What significant interrelation coefficients are there among learner-related variables(LRV : IQ, Asc, Sad, Aa)? 2) What significant differences are there between high and low level of LRV respectively and each learner's variables? 3) What the combined and relative effects are there LRV and LRV's subfactors on each variables? The subjects for this research were 627(M : 333, F : 294) and selected randomly from secondary school(Middle : 293, High : 334) in Seoul area. And instruments used for this research were 'Self-concept scale'(Kim, Y. R., & Koo, S. S., 1989), 'School-related adjustment scale'(Kim, Y. R., & Koo, S. S., 1991), 'Teacher-made test' and various kinds of 'Standardization intelligence test'. The collected data were processed simple correlation, differences and regression analysis through SPSS program. The major findings of this research were as follows : 1) The correlation coefficients between learner-related variables(IQ, Asc, Sad and Aa) and one variable among learner-related variables(LRV) were statistically significant positives as the range of .1885(IQ and Sad)~.6699(Asc and Sad)(p<.01) respectively, and especially the correlation Asc and Sad was the highest(r=.6699, p<.01). And the correlations IQ and Asc's sub-factors were statistically significant positive coefficients respectively as range of. 1842(Sgs)~.3489(Aas)(p<.01), and also correlation coefficient with Sad were .4156(Acs)~.7280(Sgs)(p<.01), with Aa were .2711(Sgs)~.5096(Acs)(p<.01). Besides, the correlations between Sad's sub-factors and IQ were as range of .1406(Sen)~.2072(Sin)(p<.01), and correlations with Aa were .1368(Sen)~.3138(Sin)(p<.01), With Asc were as range of .4082(Sfr)~.6388(Sin)(p<.01). 2) There was a significant difference in Asc and Sad's sub-factors(adjustment toward school life : Sli, adjustment toward school environment : Sen, adjustment toward school teacher : Ste, adjustment toward school instruction : Sin, adjustment toward school friend : Sfr) by sex and level of school. And male students were higher than female students in Aas, Ins, Acs and Sms among achievement self-concept : Acs, academic ability self-concept : Aas and subject-matter self-concept : Sms) and well adjusted than female students in Sen and Ste among Sad's sub-factors. And middle school students were higher than high school students in Sgs, Ins, Acs and Sms among Asc's sub-factors and well adjusted than high school students in Sli, Sen and Ste among Sad's sub-factors. On the other hand, the well adjusted learner was high in IQ, Aa and Aas, Sms, Ins and Sgs among Asc's sub-factors, and learner who got higher level Aa was high in Asc and well adjusted toward Sli, Sen, Sfr and Ste among Sad's sub-factors than others(p<.01). The R^2(combined effect) of LRV(Sad, Aa and IQ) on Asc was 55.35%, and there were significantly relative effects of LRV on Asc respectively(Sad : 44.88%, Aa : 10.47, p<.01). And there were significantly relative effects of Sad's sub-factors on Asc respectively(Sin : 40.81%, Ste : 8.30% and Sli : 1.09%), the combined effect(R^2) of these sub-factors on Asc was 50.20%. There were significantly relative effects of LRV on Sad respectively(Asc : 44.88%, Aa : 0.8%), and the combined effect if these variables on Sad was 45.76%. There were significantly relative effects of Asc's sub-factors on Sad respectively(Sgs : 53.00%, Ins : 6.99%, Sns : 0.66%), and the combined effect(R^2) of these variables on Sad was 60.65%. Finally, the R^2 of LRV(IQ, Sad, Asc) on Aa was 44.92%, and the relative effects were 37.02%(IQ), 7.30%(Asc) and 0.60%(Sad). And there were significantly relative effects of Acs(25.97%) and Sms(2.79%) among Asc's sub-factors, and only Sin(9.85%) among Sad's sub-factors on Aa.

전침 자극에 의한 오디 괄약근 운동성 변화에 관한 연구

이성구,김명완,김홍자,서동환,이상수,김동일,유교상,주연호,민병일,김지훈 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2000 No.-

Background/Aims: This study was designed to evaluated the effects of electroacupuncture on the sphincter of Oddi (SO) motility in humans and to correlate the manometric findings with plasma cholecystokinin (CCK) levels. Methods: Eleven patients (M: F= 5: 6) who had various kinds of biliary disorders were enrolled. SO motility was monitored with a conventional low-compliant continuously perfused technique using ERCP (n=9) or percutaneous transhepatic cholangioscope (n=2). After baseline monitoring for phasic wave contractions of SO, electroacupuncture was applied at a specific acupoint, GB 34, in these 11 patients. A nonspecific acupoint 5 cm away from GB 34 was selected as a control. Manometric parameters of SO were also checked in 6 subjects during stimulation of the control acupoint. CCK plasma levels were measured during the time course of electroacupuncture stimulation. Result: All the manometric parameters including the basal pressure of SO, amplitude, frequency and duration of phasic wave contraction of SO were significantly decreased (p< 0.05) during electroacupuncture stimulation. The inhibition of SO contractility was accompanied by increased CCK plasma levels. After removal of electroacupuncture stimulation, restoration of amplitude and duration to basal condition were noted. A tendency towards the return of SO contractility was also observed in basal pressure and frequency. Stimulation of the control acupoint, however, did not affect the SO contractility and plasma CCK levels. Conclusions: Electroacupuncture stimulation of acupoint GB 34 showed reversible inhibition of SO contraction in humans. We speculate that the response of SO to electroacupuncture stimulation may be mediated by some neurohormonal mechanisms including CCK release. (Korean Journal of Gastrointestinal Motility 2000;6:44-41)

H9c2 심근 세포주에서 외인성 nitric oxide가 허혈에 의한 세포 독성에 미치는 영향

정성구,장현용,김명천,고영관,정주호,배영미,박원서,김대중,유영민,김성수,임성빈 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. Methods: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-Sdimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. Results: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100,1000μM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. Conclusion: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.

뇌혈관질환을 동반한 당뇨병 환자에서 지속적 혈당측정의 유용성 평가

정성훈,강인구,박철영,류미숙,우정택,김성운,김진우,김영설 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2

연구배경: 뇌혈관질환을 동반한 고령의 당뇨병환자는 이들의 신경학적 결손으로 경고 증상없이 심한 저혈당에 노출될 가능성이 크다. 실제로 하루 4번 정도의 자가 혈당 측정으로는 이를 감지하기 어려울 뿐 아니라 검사에 따른 고통으로 적극적인 혈당 조절에 제한이 따르게 된다. 이에 저자들은 Mini Med사의 지속적 혈당측정기(CGMS, continuous glucose monitoring system)를 이용하여 뇌혈관질환을 동반한 당뇨병 환자에서 24시간 혈당의 변동양상을 알아보고 각기 다른 인슐린 치료방침에 따른 혈당조절의 효율성을 비교하고자 하였다. 방법: 2001년 1월부터 6월까지 경희대학교 부속병원에 입원해 있는 10명의 뇌혈관질환을 동반한 제 2형 당뇨병환자를 대상으로 하였다. 이 들은 모두 튜브식이를 받고 있엇고 최소 1개월 이상 인슐린 치료를 시행 받았다. 지속적 혈당측정기를 착용하고 3일간의 연속적인 혈당을 측정하였고, 치료 첫 날은 NPH, 둘째 날은 속효성 인슐린과 NPH, 마지막 날은 혼합형 인슐린제제로 치료하여 그 효과를 비교하였다. 이들 각기 다른 인슐린 제재의 하루 총량에 차이는 없었다. 혈당치가 3.3mmol/L 미만이거나 7.8mmol/L를 초과하는 경우 그 차이값의 총합을 시간으로 나누어 이 값(△Glu)이 적을수록 치료효과가 우수한 것으로 판정하였다. 또한 당 수치가 3.3mmol/L 미만인 경우를 저혈당 event, 16.7mmol/L 초과한 경우를 고혈당 event로 임의로 정의하였고, 이를 통해 지속적 혈당측정의 유용성을 간접적으로 평가하고자 하였다. 결과: 평균 △Glu값은 첫째 날이 0.93 ± 0.43mmol/Lㆍmin?¹, 둘째날이 0.71 ± 0.29mmol/Lㆍmin?¹ 마지막 날이 0.58 ± 0.29mmol/Lㆍmin?¹로서 서로 다른 3가지 치료방침사이에 통계학적으로 유의한 차이는 없었다(p=0.115). 10명의 환자들 중 자가 혈당측정기로는 1명에서 저혈당 event, 2명에서 고혈당 event를 인지하였으나 지속적 혈당측정기로는 각각 9명에서 event를 확인하였다. 결론: 지속적 혈당측정기를 이용한 각각의 인슐린 치료방침에 따른 혈당조절 효율성의 차이는 없었으나, 자가혈당 측정기로는 알 수 없었던 일 중 혈당 변동사항을 정확하게 알 수 있어, 뇌혈관질환을 동반한 당뇨병 환자에서 보다 적극적인 인슐린 치료 및 관리를 할 수 있을 것으로 생각된다. Background: Diabetic stroke patients are susceptible to hypoglycemia. However, there are many limitations in detecting hypoglycemic events, even though glucoses levels are checked 3 to 4 times per day using the fingerstick method. Therefore, we investigated the glycemic excursions and pattern in diabetic stroke patients using the continuous glucose monitoring system (CGMS, MiniMed) and its clinical utility. The other objective was to compare the treatment dfficacy between insulin regimens. Methods: From jan 2001 to jun 2001, 10 adult type 2 diabetic stroke patients wore CGMS for consecutive 3 days, which continuously checked the glucose level. NPH insulin, multiple daily injection of regular insulin ± NPH and the mixed type(Novolet 30/70, Novo Nordisk) were used on the first, second and third days of the study, respectively. If the mean delta glucose(△Glu = A+B/time, A=∑(hlucose-7.8), glucose > 7.8 mmol/l, B=∑(3.3-glucose) if, glucose < 3.3 mmol/l) was calculated in order to recognize the degree of individual glycemic changes and to compare the efficacy of each treatment diverse insulin regimen. We arbitrarily defined a glucose level less than 3.3mmol/l, as a hypoglycemic event, and more than 16.7mmol/l as a hyperglycemic event. Results: Variable patterns of glycemic changes were observed among patients with the same dosage, but a different insulin regimen. The mean △Glu was 0.93±0.43 on the first day, 0.71±0.29 on the second day and 0.58±0.29 on the third. There was no significant difference in treatment efficacy between the 3 different insulin modalities(p=0.115). Of the 10 patients, a hypoglycemic event was detected in 1 with the fingerstick method, in contrast to 9 with CGMS, with hyperglycemic events being detedted in 2 and 9, respectively. Conclusion: Continuous glucose monitoring maybe useful in providing the information necessary for optimal glycemic control in the diabetic stroke patients.

크론병에 대한 CoPPLX의 방어효과에 대한 연구

이호학,김유림,문창기,이재일,양병윤,김종수,이정민,정재혁,안석진,박상준,김윤권,김소연,김영중,조민구,최영자,장성조 圓光大學校 醫科學硏究所 2005 圓光醫科學 Vol.20 No.1

급성 심근경색 초기에 도플러 심초음파를 이용한 좌심실 이완기 기능의 평가

신원용,김주성,김철현,이광희,최태명,현민수,김성구,권영주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background : Congestive heart failure after acute myocardial infarction relate to left ventricular systolic sysfunction. Also, left ventricular diastolic function contribute to heart failure. The aims of this study were, firstly to characterize left ventricular diastolic function by transmitral flow velocity, and secondly to study the significance of Doppler measurements in relation to the development of heart failure in the early phase of myocardial infarction. Method : Pulsed Doppler echocardiography of transmitral flow was assessed in 34 patients with acute myocardial infarction. According to the Doppler transmitral flwo velocity profile, the study patients were assigned to the three groups: normal filling pattern (DT > 140ms, IVRT < 100ms), relaxation abnormality (DT > 140ms, IVRT ≥ 100ms), pseudonormal or restrictive pattern (DT ≤ 140ms). Also, on the basis of the presence of heart failure during first week of hospitalization, the patients were divided into two groups: patients with no sign of heart failure (Killip class Ⅰ) and heart failure (Killip class Ⅱ-Ⅳ). Results : Of the 34 patients studied, 10(29%) were normal filling pattern, 17(50%) abnormal relaxation and 7(21%) were restrictive patterns. The left ventricular ejection fraction(EF, 40 ±6%) of restrictive pattern was significantly lower than that of normal filling pattern of abnormal relaxation(p < 0.01). And, the IVRT, DT, E/A and left ventricular EF were reduced in patients with heart failure(14 patients) compared to no sign of heart failure(20 patients)(p<0.05). Of the patients with heart failure, IVRT and left ventricular EF were reduced in patients with DT≤140 ms compared to DT> 140ms(p=0.001). Conclusion : Left ventricular diastolic dysfunction is present early after onset of symptoms of acute myocardial infarction. Assessment of left ventricular diastolic function complements measurements of systolic function in the evaluation of cardiac function. DT, IVRT, E/A and left ventricular EF are useful predictors for development of congestive heart failure following acute myocardial infarction.

신이식에서 이식신의 생존분석

오선미,김종학,황평주,구영선,강민규,나기량,김종섭,김성숙,이강욱,신영태,설종구,배진선,손기섭 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

To investigate the prognostic factors for the survival of transplanted kidney in patients with end-stage renal failure, 59 cases of renal transplantation from September 1986 to Feburary 1997 in Chungnam National University Hospital were analyzed retrospectively. The results were as follows: 1)The mean age of recipients was 33.8 years and that of doners was 38.9 years. The male to female ratio of recipients was 2.5:1, and that of donors was 1.03:1 2) Living related donore(LRD) were 79.6% and living non-related donors were 20.3%. The HLA-identical donors(ID) in LRD were 18.7% and HLA-haploidentical donors(HID) were 61.0%. In living non-related donors(LNRD), mean matched HLA-AB antigens were 1.56 and mean matched HLA-DR antigens were 0.56. 3) The average 5-year patient survival fate was 94%, and average 5-year graft survival rate was 70%. The 5-year graft survival fate of HLA-ID was 100%, and those HLA-HID and LNR were 70% and 36% respectively. 4) Total 33 episodes of acute rejection were found in 45.8% of transplanted patients. The number of acute rejection episode did not show significant difference between LRD and LNRD(P > 0.05). There was no significant difference in MLC between two groups(p > 0.05). 5) In comparison between the 18 patients who lost their graft function in 5 years and 17 patients who are maintaining graft function for more than 5 years, MLC was significantly lower in patients with functioning graft than of patients with non-functioning graft (p < 0.05). The number of rejection episode was also lower in patients with functioning graft than that of the patients with non-functioning graft(p < 0.05). However, there were no significant difference in recepient and donor age and history of pre-transplantation donor specific transfusion between two groups. With the results above, we can speculate that adequate donor selection according to good matched HLA typing and low MLC is very important for graft survival in renal transplantation. Prevention and treatment of acute rejection in renal transplantation is also na important factor for graft survival.