신장이식 환자에서 HCMV 항원혈증 검사의 임상적 유용성

김탁,성흥섭,박관태,김송철,김성한,최상호,김양수,우준희,박수길,한덕종,이상오 대한감염학회 2009 감염과 화학요법 Vol.41 No.2

Background : This study was performed to determine the cut-off value and the predictability of symptomatic human cytomegalovirus (HCMV) infection according to the peak value of HCMV antigenemia assay in kidney transplant recipients. Materials and Methods : We reviewed the results of HCMV antigenemia assay (Chemicon, CA, USA) in patients who received kidney transplantation at our institution from May 2003 through May 2008, and investigated the existence and the type of HCMV infection by the medical record review. Patients who underwent the test only once during the episode or those who received ganciclovir for more than 48hrs before the test were excluded. The receiver-operator characteristic curve was drawn and the point showing maximum likelihood ratio (LR) was chosen as the cut-off value of symptomatic HCMV infection. Results : A total of 689 episodes were screened and 134 episodes were enrolled. Thirty-three (24.6%) episodes were symptomatic HCMV infection, 23 (17.2%) episodes were associated with HCMV syndrome, and 10 (7.5%) episodes were tissue-invasive diseases. The maximum LR was 7.5 (95% confidence interval, 4.014.2) and the cut-off value was 29.5 cells/200,000 WBC. The sensitivity, specificity, Positive predictive value, and negative predictive value were 66.7%, 91.1%, 71.0%, and 89.3%, respectively. Conclusions : The cut-off value of symptomatic HCMV infection by the peak value of HCMV antigenemia assay in our study was similar with previous results, although the sensitivity was relatively low.

강원도 화천군 수달(Lutra lutra) 서식지의 식생 구조

서형수 ( Hyung Soo Seo ),신영섭 ( Young Seob Shin ),이경은 ( Kyung Eun Lee ),김윤미 ( Yoon Mi Kim ),전미나 ( Mina Jeon ),남택우 ( Taek Woo Nam ),한성용 ( Sung Yong Han ),정연숙 ( Yeonsook Choung ) 한국하천호수학회 2014 생태와 환경 Vol.47 No.special

In order to determine whether vegetation would be one of the factors for the selection of otter home range, vegetation structure and other potential factors were studied in Hwacheon, Korea. Thirteen sites, otter’s activity found and not found, were investigated in North Han River and connected tributary streams of Hwacheon-gun. Three types of vegetation were classified by cluster analysis, which is short grass, tall grass and shrub type. Vegetation zone of each channel is composed of either one type, or mosaic of tall grass and shrub type. Short grass type is common in Lake Paro and upper North Han-river where water level is highly variable throughout a year. Therefore, annual species such as Persicaria nodosa, Fimbristylis dichotomam and Chenopodium ficifolium are the most dominant. Shrub type is common at the downstream sites of Jichon stream and along mainstream of North Han River down Lake Paro. A shrub species, Salix koreensis, is the most common. Tall grass type is dominant occupying the most vegetation zone of the tributary channels. Phragmites japonica is absolutely dominant. Due to its dense cover, a few plant species are co-existed. Otter activity was found in all three vegetation types and no marked activity was found at some sites of tall grass type. There is no difference in species composition and physiognomy between tall grass sites with and without otter activity, while it shows significant difference in fish availability between two groups. Overall we found that home range of otters in the region is along the mainstream and downstream of tributary streams with high fish availability in all vegetation types and in various human activity levels.

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.

用寒遠寒과 用熱遠熱에 대한 考察 : 六元正紀大論에서

채영진,신창환,임현택,여성원,한성규,이재원,정헌영,금경수 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

Five elements motion and six kinds of natural factors influence not only human disease but also difference of medicine effect. Because the climate of summer is very hot, that is easy to increase the properties of hot medicines, a doctor must be careful to use it in summer. Also the climate of winter is very cold, that is easy to increase the properties of cold medicines, a doctor must be careful to use it in winter. But in the certain conditions to use diaphoretics or purgatives, in spite of that regulation a doctor can use them.

HSC 기둥의 내진성능에 대한 횡보강근의 효과

한병찬,황선경,성수용,정수영 충남대학교 산업기술연구소 2000 산업기술연구논문집 Vol.15 No.1

In seismic-resistant design of buildings of ductile frame, the possibility of formation of plastic hinge at column end demands sufficient member ductility. The paper summarizes results of an experimental study of reinforced concrete columns with high-strength materials and subjected to simulated seismic loadings. The experimental program consisted of 6, approximately one-third-scale, rectilinearly confined, high-strength reinforced concrete columns with concrete compressive strengths of approximately 700kgf/cm2. The primary variables of the testing program were the volumetric ratio, spacing, and configuration of transverse reinforcement. Experimental results indicate as follows : 1.There is no expectation of improved effectiveness of deformability by the types of transverse reinforcement when using high yielding strength transverse reinforcement. 2.When using high yielding strength transverse reinforcement, it is possible to widen the spacing that are designed based on seismic provision of ACI 318-89 and get an appropriate deformability as well. 3.The significant parameter to determine the deformability is the spacing of transverse reinforcement in the HSC columns.

하악골 후방이동시 중안면부 연조직의 변화양상에 대한 임상통계학적 연구

한대희,김수남,민승기,김태성,성헌모 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalo-metrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1.There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2.There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3.The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4.The upper lip length was increased and moved posterior direction after mandibular setback surgery 5.The lower lip was moved posterior direction by posterior movement of the mandibular structure 6.Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes

직업적 연폭로에서 혈중 연량 수준에 따른 선별검사로서의 혈중 ZPP 검사의 타당도

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

In order to evaluate the validity of current screening criteria of lead exposure and to provide effective information for the better health management of lead workers, author investigated the interrelationship between blood lead and blood zinc protoporphyrin(ZPP) and evaluate the validity of blood zinc protoporphyrin as the screening test and blood lead as gold standard of diagnostic test. The total of 2245 lead workers (male workers: 1982, female workers : 263) from 12 lead using industries were studied. Blood lead, ZPP, hemoglobin and hematocrit were selected as lead exposure variables. Personal information on sex, age and work duration were also checked. Blood lead was measured with flameless atomic absorption spectrometry (model: Hitachi 8100) using standard addition method. Blood ZPP was measured with portable hematoflurometer (model: Aviv 206). The results obtained were as follows: 1. The mean blood lead of all lead workers were 0.7±14.3㎍/㎗(Male: 31.0±14.4㎍/㎗, Female: 28.2±12.9㎍/㎗), whereas the mean blood ZPP of those were 68.1±47.5㎍/㎗(Male: 63.9±43.7㎍/㎗, Female: 100.1±61.0㎍/㎗). The mean value of hemoglobin and hematocrit of all lead workers were 14.5±1.5g/㎗(Male: 14.7±1.3g/㎗, Female: 12.3±1.2g/㎗) and 45.4±3.6(Male: 46.2±2.8, Female: 39.5±3.1) respectively. 2. Validity of test using blood zinc protoporphyrin as screening test for blood lead levels of 30㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 50 and 90 ㎍/㎗ of ZPP respectively, showing 50 and 60 ㎍/㎗ of ZPP for all lead workers. While those test for blood lead levels of 40㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 and 90 ㎍/㎗ of ZPP respectively, showing 60 ㎍/㎗ of ZPP for all lead workers, those test for blood lead levels of 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 or 70 and 100 ㎍/㎗ ZPP respectively, showing 60and 70 or 80 ㎍/㎗ of ZPP for all lead workers. 3. Predictive value of test using blood zinc protoporphyrin as the screening test for different blood lead levels of 30, 40, 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that positive predictive value of screening test were decreased by the increase of blood lead level regardless of csreening criteria value ZPP and negative predictive value of screening test were increased accordingly regardless of screening criteria value of ZPP. On the other hand, within same blood lead level as a gold standard positive predictive values were inceased by the increase of screening criteria value of ZPP, whereas the negative predictive value were decreased accordingly by the the increase of screening criteria value of ZPP. 4. The correlation analysis of all lead workers among study variables revealed that CPbB and natural log transformation ZPP(LZPP) were better correlated with other variables and found to be better estimate than PbB and ZPP themselves. The age was correlated with all other variables, but the work duration was not. The correlation analysis of male and female workers among study variables revealed the same results with all lead workers. 5. The slope of simple linear regression of CPbB (independent variable) with ZPP in female workers(3.223)was steeper than in male workers(2.144). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But there was no slope difference between two groups divided by their work duration of 2 years less and more. The slope of simple linear regression of CPbB lead (independent variable)with ZPP in lead workers whose blood lead were higher than 30㎍/㎗and 40㎍/㎗ were steeper than those whose blood lead were less than 30㎍/㎗ and 40㎍/㎗. 6. The slope of simple linear regression of CPbB (independent variable) with ZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead. 7. The slope of simple linear regression of CPbB (independent variable) with LZPP in female workers(0.0308was steeper than in male workers(0.0253). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But where was no slope difference between two groups divided by their work duration of 2 years less and more. While the slope of simple linear regression of CPbB lead (independent variable) with LZPP in lead workers whose blood lead were hogher than 30㎍/㎗ was not steeper than those whose blood lead were less than 30㎍/㎗, there was no slope difference between two groups whose blood lead were less than 40㎍/㎗ and more than 40㎍/㎗. 8. The slope of simple linear regression of CPbB (independent variable) with LZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead, but the difference was not significant then that of CPbB and ZPP. With above results, it is recommended that the screening criteria value of ZPP should be down to 60-70㎍/㎗ from 100㎍/㎗ for male lead workers and screening criteria of ZPP for female lead workers was all right with current value of 100㎍/㎗. So it is recommended to make different screening criteria of ZPP for male and female workers like the hemoglobin and hematocrit screening criteria. It is also preferable to use CPbB and LZPP rather than uncorrected PbB and ZPP in the evaluation of lead exposure for lead workers.

高精密 高速 스핀들의 設計

韓福洙,朴性煥 한밭대학교 산업과학기술연구소 2001 논문집 Vol.5 No.-

The high speed precision spindle, which is an important element part of industrial machinery such as micro drilling, high speed machine tools and the atomizer. In this study, the aero-static spindle was designed and a stiffness analysis of air bearing was carried out to investigate the optimal design parameter for the high speed spindle.

장벽경색이 선행한 Henoch-Schonlein 자반증 1례

한헌석,하태선,송형근,이상전,안묘순,박범수 충북대학교 의과대학 충북대학교 의학연구소 1993 忠北醫大學術誌 Vol.3 No.1

Henoch-Schonlein 자반증은 피부, 위장관, 관절, 신장 등을 주로 침범하며 소혈관염을 기본 병리 소견으로하는 전신성 혈관 장애 질환이다. 위장관계 증상으로는 복통, 오심 및 구토, 잠혈, 토혈, 흑색변 등이 있을 수 있고, 이러한 증상은 합병증 없이 회복되는 것이 보통이나 드물게는 장중첩증, 장벽경색 및 괴사, 장천공 등의 심한 합병증을 동반할 수도 있다. 이러한 위장관계 증상들은 특징적인 피부 소견에 선행하여 나타날 수도 있으며, 이때는 급성복증에 대한 감별진단이 중요하다. 저자들은 장벽경색이 선행하여 감별진단에 어려움을 겪고 시험적개복술을 시행한 이후에 특징적인 피부 자반이 발현되어 Henoch-Schonlein 자반증으로 진단할 수 있었던 증례를 경험하였기에 이를 보고하고자 한다. 본 증례는 입원 1일전부터 시작된 복통을 주소로 입원한 5세 남아가 배꼽 주위에 심한 경련성 복통을 지속적으로 호소하였고 이학적 소견상 배꼽주위의 압통, 장음의 감소, 흑색변 등이 있었으며 소장조영술상 공장 부위에 미만성의 불규칙한 점막비후 소견을 보여 제 8병일에 시험적개복술을 시행한 결과 근위 공장에 국한된 장괴사의 소견이 발견되어 절제 및 문합술을 실시 하였다. 병리학적 검사에서는 장벽경색의 소견을 보였다. 수술후에 복통은 완화되었으나 경미하게 지속되었고, 제 13병일경에 급성 부고환염이 병발되었다가 회복되었고 제 15병일경에는 하지에서부터 발현된 자반이 3일간 지속되었다. 결구 Henoch-Schonlein 자반증과 이의 합병증으로 발생한 근위 공장의 장벽경색으로 진단하였다. Colicky abdominal pain as symptom of Henoch-Schonlein purpura occurs in up to 70% of patients, and results from submucosal edema and hemorrhage. Abdominal pain and other GI symptoms such as nausea, vomiting, melena and hematemesis resolve mostly without any complications. But rarely life-threatening GI complications such as intussusception, intestinal mural infarction and necrosis, and massive hemorrhage may develope. In 14% of patients, abdominal pain may precede other symptoms, and creats diagnostic difficulties. We reports a case of the Henoch-Schonlein purpura presented with colicky abdominal pain which resulted from intestinal mural infarction and preceded characteristic purpuric skin lesion by several weeks. This 5 year old male patient complained of colicky abdominal pain, nausea and melena. Exploratory laparatomy was done and revealed intestinal mural infarction in proximal jejunum. One week later operation, purpuric skin lesion develiped in both leg and feet, and then, Henoch-Schonlein purpura was diagnosed.

유기용제 사용 소규모사업장의 체계적 건강관리 프로그램 개발에 관한 연구1) : 신경행동학적 검사법의 적용 가능성 Application of Neurobehavioral Core Test Battery(NCTB)

한상환,하미나,권호장,윤덕로,조수헌 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2

It is known that there appear some nonspecific and delicate changes in neuropsychiatric aspect on the workers when they are exposed for a long period to low concentrated organic solvents in the work places. Therefore, it gives rise to the necessity of developing a program for the health supervisor stationed in the work place to supervise these neurobehavioral health affection. In addition to the questionnaire posed to the workers exposed to organic solvents, the study team conducted NCTB(Neurobehavioral Core Test Battery) respectively on an exposed group and a non-exposed group to organic solvents. The study team compared the results and decided whether or not to apply the results to the evaluation program of health affection. The study team divided 132 workers in 6 car repairing factories and 2 textile printing factories into exposed group and non-exposed group, pairing them off into 66 research objects according to their age, sex, and job. Neurobehavioral test was conducted on 6 items, except the POMS test, of NCTB developed by the World Health Organization(WHO). The study team conducted examinations of working environment on the exposed and non-exposed groups of each work place. The analysis of the collected materials for examinations were conducted with GC-MS. The concentration of the mixture in the air, relative to their respective threshold limit values(TLV) was calculated according to the formula of the ACGIH and the Korean threshold limits. The results indicated that for two of eight factories samples the recommended concentration limits for mixtures was exceeded. Of the six tests, the 'digit span forward', 'digit span backward' and 'digit symbol' produced conspicuous statistical differences between the two groups(p<0.1) as a result of compairing the test values by means of paired t-test. The results of respective analysis of the car repairing factories and textile printing factories revealed that the textile printing factories had greater differences between the exposed and the non-exposed than in the car repairing factories. It is presumably because the textile printing workers are continuously exposed to the organic solvents during working hours, whereas the car repairing workers are exposed only when they are doing painting works, The NCTB is assessed very useful in examining the neurobehavioral health affection under the exposure to organic solvents, and, therefore, the study team expects that the NCTB will play an important part in the course of developing a health program for the workers exposed to organic solvents.