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성인 지역사회 폐렴의 원인 미생물에 대한 전향적 다기관 연구 : Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi
김민자,정희진,손장욱,심희선,박대원,박승철,우준희,강재명,김유겸,신완식,김양리,이환종,김지희 대한감염학회 2001 감염 Vol.33 No.1
Background : Despite rigorous investigations, the etiology of community-acquired pneumonia remains unknown in about 50% of hospitalized patients. The diagnosis of the etiological agent is becoming more challenging and more critical as number of newer pathogens have been recognized in recent years. In the 3-year period prospective study we investigated adult patients with community-acquired pneumonia for Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi as potential etiologic agents. Methods : A prospective multicenter study was performed from May 1997 to April 2000. A total of 431 patients with community-acquired pneumonia under the inclusion criteria were examined for specific microbial diagnosis; sputum culture and PCR, and serologic teats including indirect immunofluorescence antibody (IFA) test for Legionella, and hemagglutination tests for Leptosoira, Hantaan virus and O. tsutsugamushi. Etiologic diagnosis was determined on the basis of the review of case record forms and specific laboratory diagnostic criteria. Results : During the study period a total of 385 sputum and 283 serum samples were examined. Legionella pneumonia was diagnosed in 2.3% (10/431) of the cases examined : 1.4% cases with PCR-positive (5/367) and 2.1% with positive IFA test (6/283). Leptospirosis and scrub typhus were diagnosed in 0.4% (1/252) and 2.0% (5/252), respectively. All 5 cases with scrub typhus occurred in late fall, and rash or eschar was not found. None of cases was Hantaan virus infection. Conclusion : The results suggest that Legionella, Leptospira, and O. tsutsugamushi should be considered in the etiologic diagnosis and empirical antibiotic therapy of community-acquired pneumonia. (Korean J Infect Dis 32:24∼31, 2001)
민도준,양동원,민창기,김완욱,이상헌,박성환,김동욱,이종욱,조철수,민우성,김범생,김호연,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1
배경: 기존의 치료에 불응하고 예후가 불량한 자가면역질환 환자들에게 최근 고용량 면역억제 및 조혈모 세포이식이 새로운 치료방법으로 대두되고 있다. 저자들은 다발성 경화증(multiple sclerosis, MS) 및 류마티스 관절염(rheumatoid arthritis, RA) 등 2명의 자가면역질환 환자들에서 자가조혈모세포 이식을 시행하였다. 방법: 말초혈액 조혈모세포 가동화를 위하여 cyclophosphamide (4 g/㎡) 및 granulocyte colony stimulating factor (10 g/kg/day)를 투여하였고, CD34+ 세포를 분리·채집 하였다, 이식 전처치로 MS 환자에서 BEAM 및 antihymocyte globulin (ATG) (3.75 mg/kg), RA 환자에서 fludarabine (180 mg/㎡), ATG (10 mg/kg)와 busulfan (8 mg/kg)을 투여하였다. 결과: 호중구 수가 500/㎕ 이상으로 회복되는 기간은 MS 환자에서 9일, RA 환자에서 15일이었다. 혈소판이 20.000/㎕ 이상으로 회복되는 가간은 RA 환자에서 9일 이었고, MS 환자에서는 혈소판 감소증이 발생하지 않았다. 비혈액학적 독성으로 MS 환자에서 WHO 1도의 오심 및 점막염이 관찰되었다. MS 환자는 이식 6개월 후까지 시력감소가 남아있었으나, 이식전에 관찰되던 감각이상 및 운동장애 등의 신경학적 이상 소견은 더 이상 관찰되지 않았다. RA 환자는 이식 1개월 후 관절 증상 및 검사소견의 호전을 보였다. 결론: 불응성 자가면역질환 환자에서 고용량 면역억제 및 조혈모세포이식은 적은 독성으로 높은 치료효과를 기대할수 있으며, 향후 이 시술의 임상적 의의를 규명하기 위하여 전향적이고 장기적인 연구가 필요할 것으로 사료된다. Background: High-dose immunosuppressive therapy followed by autologous hemathpoietic stem cell transplantation (HSCT) has been proposed as a new approach to treat severe, refractory autoimmune diseases. We describe two patients with refractory autoimmune diseases (one multiple sclerosis 〔MS〕and one rheumatoid arthritis〔RA〕) who underwent T-cell-depleted autologous peripheral bleed stem cell transplantation for the first time in Korea. Methods: We mobilized autologous stem cells with cyclophisphamide (4 g/㎡) and granulocyte colony-stimulating factor (10 ㎍/kg/day). Stem cells were enriched ex vivo using CD34-positive immunoselection and reinfused after high-dose chemotherapy with BEAM and antithymocyte globulin (ATG) (3.75 mg/kg) in MS, or fludarabine (180 mg/㎡), ATG (10 mg/kg) and busulfan (8 mg/kg) in RA. Results: The engraftment with an absolute nerutrophil count greater than 500㎕ occurred on day 9 in MS and 15 in RA, respectively. The time to nontransfused platelet count greater than 2.000/㎕ was 9 day in RA. MS patient did not show ant episode of thrombocytopenia. Regimen-related non-hematopoietic toxicity was minimal. For 6 months since HSCT, them patient with MS had been free from previously existed sensory and motor abnormalities except decreased visual acuity. Then patient with RA and only one tender joint and two mildly swollen joints with improvement in laboratory parameters at one month after HSCT. Conclusion: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of intractable autoimmune diseases. The durability of remission, however, remains to be clarified.
급속 냉각한 Al-5Cr-2Zr 합금의 시효경화에 미치는 기계적 합금화 처리효과
金完哲 홍익대학교 산업기술연구소 1994 産業技術 Vol.4 No.-
The microstructual refinement process of Al - 5Cr - 2Zr alloys mechanical alloying 30h can be divided in five stages : initial stage welding predominance stage spherical partical formation stage convolution welding predominance stage and steady state. The rate of structural of aluminium splats was roughly logarithmic with processing time : ∈ = k/0.78 In (1+0.028t) The age hadening in rapidly solidified Al - 5Cr - 2Zr alloys is ascribed to the coherency and dispersion hardening Coherency hardening is occurred by matastable cubic Al_3Zr precipitates in Al - Cr - Zr alloys. Dispersion hardening after machanical alloying is attributed to the finely-dispersed Al_2O_3 and Al_4C_3 in Al - 5Cr - 2Zr alloys.
김두희,박완섭,손지연,이종영,홍성철 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2
폐암에 대한 직업의 관련성을 밝히기 위하여 1993년 11월에서 1994년 8월까지 대구 시내 2개 종합병원에 입원하여 병리 조직학적으로 진단된 168명의 폐암 환자와 같은 병동에 있는 내과 환자를 연령군과 성별로 빈도 짝짓기하여 168명의 대조군으로 선정하였다. 직업력과 유해 물질의 폭로력, 거주 환경, 흡연에 관한 정보는 설문지를 통하여 얻었다. 흡연 상태를 보정하고 연령군과 성별에 대한 짝지은 자료에 대하여 직업과 산업 분류에 대한 폐암 발생의 상대 위험은 농업 종사자에서 유의하게 높았고(OR=1.84 ; 95% 신뢰구간 1.16-2.94) 생산직, 가내 수공업, 운수창고통신업, 숙박음식업, 건설업에서도 높게 나타났으나 유의하지 않았다. 그러나 가사(OR=0.31 ; 95% 신뢰구간 0.11-0.89), 관리직(OR=0.22 ; 95% 신뢰구간 0.08-0.61), 공공 행정업(OR=0.23, 95% 신뢰구간 0.08-0.66), 공공 사회및 개인 서비스직(OR=13 ; 95% 신뢰구간 0.03-0.56)에서는 폐암 발생의 상대 위험이 유의하게 낮았으며, 전문직, 도소매업에서도 낮게 나타났으나 유의하지 않았다. 거주 환경에 따른 폐암 발생의 상대 위험은 연탄난로 사용자(OR=3.00 ; 95% 신뢰구간 1.06-8.52)와 농약 사용시(OR=2.14 ; 95% 신뢰구간 1.36-3.37)에 통계학적으로 유의하게 높았고, 공장지대 거주자에서도 높게 나타났다(OR=1.97 ; 95% 신뢰구간 0.92-4.27) 그러나, 중앙집중식난방사용자(OR=0.5 ; 95% 신뢰구간 0.28-0.89)에서는 낮게 나타났으며 통계학적으로 유의하였다. 유해 물질 폭로에 따른 폐암 발생의 상대 위험은 농약(OR=2.07 ; 95% 신뢰구간 1.31-3.26)과 용접 및 흄(OR=10.56 ; 95% 신뢰구간 1.07-103.90)에 폭로시 유의하게 높게 나타났다. 흡연에 의한 폐암 발생의 상대 위험은 비흡연자에 비하여 흡연자(OR=3.98 ; 95% 신뢰구간 1.88-8.45)와, 과거흡연자(OR=4.50 ; 95% 신뢰구간 1.99-10.16)에서 높게 나타났다. 이상의 결과로 비록 흡연이 폐암의 중요한 원인이지만 흡연의 영향을 보정한 후에도 대기오염 및 직업과 폐암과 관련성이 있음을 보여주고 있으며, 앞으로 이러한 직업에서 어떠한 위험 요인이 있는지에 대한 추구가 필요하여 그에 대한 예방 대책을 밝히는 연구가 필요하다. The relationship between occupation and risk of lung cancer was analyzed in hospitalbased case-control study conducted in Taegu on 168 patients with histologically confirmed lung cancer and age group(30-39, 40-49,etc) and sex frequency-matched 168 controls admitted into hospitals for other internal medicine problems. A self adminstered questionnaire was used to obtain occupation, resident environment, smoking histories and specific agent exposure history. The conditional logistic regression was used to estimate oddsratio for age group and sex frequency matched, after controlling for smoking status(non smoker, exsmoker, current smoker) Significant association was observed for farmer[odds ratio(OR), 1.84 ; 95% confidence interval(CI), 1.16-2.94], briquette stove users[OR, 3.0 ; 95% CI, 1.06-8.25], agricultural chemicals users[OR, 2.14 ; 95% CI, 1.35-3.37], and welding/fume exposures[OR, 10.56 ; 95% CI, 1.07-103.90]. Although there were elevated risks associated with production, home industry, transportation/storage/communication, lodgement/food worker and construction, none were statistically significant. The effect of smoking was showed significantly increased risk for exsmoker [OR, 4.50 ; 95% CI, 1.99-10.16] and current smoker [OR, 3.98 ; 95% CI, 1.88-8.45]. As results, although smoking is important risk of lung cancer, occupation and resident environment are showing association of lung cancer. So further evaluation is necessary for occupation risk and take preventive measures.
기계적 합금화한 Al-50Ni 합금의 조직에 관한 연구
金完哲,金容圭 홍익대학교 산업기술연구소 1993 産業技術 Vol.2 No.-
Particle properties such as size, distribution, shape, composition, and structure are greatly influencing on the mechanical properties of final P/M products. Therefore, it is necessary that powders should be uniformed and strengthened by mechanical alloying. Degree of mechanical alloying of Al-50Ni powders can be determined by observing the microstructural refinement, microhardness, and microstructure of composite metal powder during processing. The mechanical alloying Process could be divided in five stages : initial stage, welding predominance stage, spherical particle formation stage, random welding predominance stage and steady state. Mechanical alloying reached to a steady state after 600 min processing as the finer lamellar microstruture could to no longer resolved in the 10∼20㎛ and the powder particle size distribution remained constant with processing time and a saturation hardness of 450 Hv had been attained. The rate of structural refinement of Al-50 Ni Composite was roughly logarithmic with processing time : ε= 2.915 ln(1 + 0.014t).
AZ31-xCa 합금의 가공온도에 따른 열간 압연 특성
金完哲 弘益大學校 産業技術硏究所 2005 産業技術 Vol.15 No.-
In this study the microstructures, mechanical properties and hot rolling properties of the AZ31-xCa(x=0.5, 2.0wt%) magnesium alloy sheets were investigated by changing the amount of Ca, reduction ratio per pass, preheating temperature and heat treatment conditions. The reduction ratio per pass and preheating temperature were change in the ranges of 10~20% and 350~425℃, respectively. The sheets with best combination of external features and mechanical properties were fabricated under condition of reduction ratio per pass of 15% and preheating temperature of 400℃. It was considered that the inhomogeneity of as-cast AZ31-xCa alloys was reduced and the brittle Mg_(17)Al_(12) Phase was solved into matrix by homogenization treatment, which resulted in improvement of hot rolling properties and mechanical properties.
김완종,한상철 순천향대학교 기초과학연구소 1998 순천향자연과학연구 논문집 Vol.4 No.2
Despite being an organ whose cells are renewed at a slow rate the liver has an extraordinary capacity for regeneration. The loss of hepatic tissue by surgical removal or from the action of toxic substance triggers a mechanism by which liver cells begin to divide, continuing until the original mass of tissue is restored. The present study was designed to observe the morphological characteristics during the liver regeneration of rat Liver plants were collapsed in 24 hours after hepatectomy. At this time, liver was formed a clump of small hepatocytes surrounding capillaries and then rearranged to liver plate. During the regeneration of rat liver induced by hepatectomy, the prominent ultrastructural characteristics of hepatocytes were the increase in the size of nucleolus, the increase in the number of mirochondria and the decrease in the size of them, the development of rough endoplasmic reticulum and the transient decrease in glycogen granules in the cytoplasm. In conclusion, it is suggested that regenerating hepatocytes reveal morphological characteristics of typical cell proliferation.
시신경 유두를 침범한 급성 임파구성 백혈병 : 1예 보고 Report of One Case
김태운,이건수,이철민,심완섭 충남대학교 의과대학 지역사회의학연구소 1981 충남의대잡지 Vol.8 No.1
A ten-year-old boy with acute lymphoblastic leukemia, probably T-cell type, who had received intrathecal methotrexate for theprophylaxis of meningeal leukemia, acquired impaired vision during maintenance chemotherapy. Ophthalmologic examinations disclosed a leukemic infiltration of right optic disc. It was followed by meningeal leukemia and systemic relapse successively within 2 months. The response of the ocular lesion to systemic chemotherapy was good.
냉연한 Cu-10Zn 황동의 재결정립 핵생성에 관한 연구
金容圭,金完哲 홍익대학교 산업기술연구소 1993 産業技術 Vol.2 No.-
The effect of heating on the microstructure of cold rolled Cu-10Zn brass is described. Almost all of the inhomogeneities of deformation that occur in the microstructure of heavily deformed fcc metals and alloys can be observed in cold rolled Cu-10Zn brass and potentially each of these is a site for the nucleation of recrystallized grains. In 90% cold rolled brass the first nuclei developed in brass type shear bands and this nucleation process was associated sometimes with the lateral growth of recovery twins but also with subgrain coalescence and boundary migration processes. Nucleation also occured at interfaces between different types of inhomogeneity. The results are discussed with reference to the currently accepted view.
한국산 어류 미토콘드리아 DNA의 분자계통학적 이용 및 보존
김영자,김일찬,이세영,이완옥,조용철,이재성 한국육수학회 2003 생태와 환경 Vol.36 No.3
종다양성 규명을 위한 계통분류학적 연구는 원시형질의 상동성에 근거한 기존의 형태형질과 효율적인 새로운 분자계통분류학적 연구방법이 병행된다면 좀 더 정확한 분류 및 계통을 추적하는데 객관적인 결론을 제시할 수 있을 것이다. 현재 활발히 연구되고 있는 미토콘드리아 DNA를 이용한 분자계통분류학적 연구는 기존의 형태적 특징을 근간으로 한 계통분류를 재검토할 뿐 아니라 계통진화학상 조상과 자손과의 관계를 유추하는데 새로운 가설을 세울 수 있는 토대를 제공하는 기초자료로서 이용될 수 있다. Phylogenetic studies would clarify the diversity of fishes if the morphological analysis based on plesimorphy characters combined with new genetic analysis on molecular level, inferring more accurate and objective phylogeny and the taxonomy. Current molecular phylogenetic approach using mitochondrial genome provides the framework for a new hypothesis not only inferring the relationships between ancestor descendants but raveling the intra-, interspecies variation.