지역사회 주민의 인비인후과 영역질환의 사회의학적 조사

최상규,남철현,김무룡,김기열,강영우,문기내 慶山大學校 保健福祉硏究所 2002 保健福祉硏究 Vol.7 No.-

This study was conducted to examine ear, nose, and throat diseases of community residents and related factors in Korea. 475 people who were experienced in suffering from the ear, nose, and throat diseases were chosen as the subjects of this study. Data were collected in Daegu, Kimchon, Andong, Pohang, Kyungsan from February 1, 2000 to May 30, 2000. The results of this study are summarized as follows. 1. Among ear, nose, and throat diseases, the incidence of throat diseases was highest (42.3%). The incidence rate of nose diseases was 31.9%, while that of ear diseases was 25.7%. The incidence of these diseases were significantly related to the variables of sex, age, occupation, religion, education level, smoking, and drinking. 2. When the respondents were afflicted with ear diseases, 47.7% of them was treated in ear, nose, and throat hospitals or clinics, while 29.4% of them was treated in general hospitals or clinics. 13.2% of them just endured without receiving treatment. 5.7% of them was treated in their homes and 3.9% of them was treated in pharmacies. 3. 28.9% of the respondents was treated for their ear diseases during two weeks; 24.2% 'during one week'; 20.5% 'during three to four days'; 12.6% 'during one to two days'; 9.0% 'during one to two days'; 4.8% 'during over six months'. The period of treatment was significantly related to the variables of sex, age, occupation, marital status, religion, smoking, drinking, and exercise. 4. When the respondents took nose diseases, 27.4% of them was treated in ear, nose, and throat hospitals or clinics, while 24.7% of them was treated in general hospitals or clinics. 18.6% of them just endured without receiving treatment. 17.7% of them was treated in pharmacies and 5.9% of them was treated in their homes. 5. 27.0% of the respondents was treated for their ear diseases during three and four days; 23.6% 'during on week'; 17.3% 'during two weeks'; 13.5% 'during one to two weeks'; 10.0% 'during one to two months'; 8.6% 'during over six months'. The period of treatment was significantly related to the variables of sex, ccupation, religion, education level, smoking, drinking, and exercise. 6. The throat diseases were caused by cold (30.2%), tonsils (29.3%), and bronchitis (15.7%). When the respondents took throat diseases, 26.1% of them was treated in ear, nose, and throat hospitals or clinics, while 25.3% of them was treated in general hospitals. 20.2% of them was treated in pharmacies and 12.4% of them just endured without receiving treatment. 10.3% of them received reatment in clinics, while 5.6% of them was treated in their homes. 7. The level of satisfaction with treatment for ear diseases was 3.58±1.12 points on the basis of 5 points, while that for throat diseases was 3.19±0.085 points. In case of information sources on ear, nose, and throat diseases, 31.8% of the respondents obtained the information from doctors, while 21.4% of them got it from TV or Radio. 15.9% of them obtained it from family members, neighbors, or friends and 10.0% of them obtained it from magazines, newspapers or pamphlet. Only 7.0% of them got it from pharmacists. 8. 67.2% of the respondents thought that mass media dealt with the ear, nose, and throat diseases lightly. 40.6% of them replied that education and publicity of those diseases would be necessary, while 10.7% of them replied those would not be necessary. Among the ear, nose, and throat diseases, the incidence rate of throat diseases was highest (42.3%). The ear diseases showed the highest level of satisfaction with treatment, while the throat diseases displayed the lowest level of satisfaction with treatment. Although the diseases are very serious in Korea, they are dealt with lightly in terms of education and publicity through using mass media. Therefore, the government, otorhinolaryngologists, and related associations must make great efforts to prevent the diseases.

轉用을 위한 建築物 保存의 論理的 考察

최보령,신교영,송용호 忠南大學校 産業技術硏究所 1993 산업기술연구논문집 Vol.8 No.1

This paper deals with the theoretical investigation-definitions, methods, values & criteria, motives and limits & problems-of preservation to adaptive use. The results of this study are as follows. 1) The definitions of preservation are record, symbolic, creative preservation, and its methods are restoration, rehabilitation & renovation, conservation, replication, relocation. 2) The values & criteria of preservation are archtectural, historical, economical value. 3) The motives of preservation are protection our legacy, ensurance variety in the urban fabric, economic, symbolic. 4) The problems of preservation concern the decision of limit and buildings to be preserved, the costs and benefits and the rights of owners & other critizens for preservation. 5) The countermeasers for preservation are demanded criteria for preservation, correct survay & analysis and the studies of development method, architectural engineering for preservation.

Graves 병과 혈청 면역글로불린-E의 연관성

김현영,박기룡,김성훈,김지연,송수근,최영식,박요한 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: Graves 병은 미만성 갑상선종, 갑상선기능한진, 안구침법 등을 특징으로 하는 자가면역성 질환으로, 갑상선자극호르몬 수용체에 대한 자가항체(TRAb)가 갑상선을 자극하여 발생된다. TRAb는 Graves병 환자의 약 85%이상에서 검출되며 활성화된 TRAb는 대부분 IgE로 알려져 있다. 그러나 최근 Graves병 환자의 갑상선조직과 안구조직에 IgE의 침착과 꽃가루 등에 의한 알레르기성 비염으로 인해 Graves병이 발생하거나 재발된 견우가 보고되어 Graves병의 병인에 IgE의 연관성이 제기 되고 있으나, 국내에서는 이에 대한 연구가 드물다. 본 연구에서는 Graves병에서의 혈청 IgE농도와 Graves병의 병기와의 관계 및 TRAb와 IgE 농도와의 연관성을 살펴보고자 하였다. 대상 및 방법 : 2000년 4월 1일부터 7월 1일까지 고신의료원 내분비내과를 방문한 환자 중 Graves병 46예, 만성갑상선염 6예 및 고신의료원 건강증진센터를 방문한 환자 중 갑상선질환의 병력이나 가족력 및 알레르기성 비염의 병력이 없는 35예의 정상대조군을 대상으로 연구를 시행하였다. TRAb는 갑상선자극호르몬 결합 억제 면역글로불린(TBII)으로 측정하였으며, IgE는 효소면역분석법으로 측정하였다. 결과: IgG인 TBII는 Graves병에서 만성갑상선염과 대조군에 비해 높았으며, IgE 평균농도는 Graves병에서 598.1±1112.9U/mL로 만성갑상선염 환자의 98350±79.7U/mL, 대조군 161.72±194.4U/mL에 비해 높았다(p<0.05). Graves병에서 알레르기성 비염의 발병율은 10.9%(5/46)였으며, Graves 병에서의 혈청 IgE 농도는 알레르기성 비염의 병력이 있는 경우 903.1±1152.2U/mL로 없는 경우 560.8±1117.0U/mL보다 높은 경향을 보였다. Graves병의 병기에 따른 TBII와 IgE 농도의 변화를 항갑상선제로 치료하지 않은 군(비치료군)과 치료한 군(치료군) 및 재발군으로 나누어 비교하였을 때, TBII는 치료군(7.4±18.6%)에 비해 비치료군(49.9±23.9%)과 재발군(21.1±3.1%)에서 높았으며(p<0.05), 혈청 IgE치도 치료군(233.8±432.7U/mL)에 비해 비치료군(758.6±1250.0U/mL)과 재발군(1198.5±1952.1U/mL)에서 높은 경향을 보였다. 항갑상선제로 치료한 치료기간에 따른 TBII와 IgE 농도 변화에서, TBII는 비치료군(49.9±23.9%)과 1년 미만 치료군(24.8±3.8%)에서 1년 이상 치료군(2.22±1.97%)에 비해 높았으며(p<0.05), 혈청 IgE 농도는 비치료군(758.6±1250.2U/mL)에서 1년 미만 치료한 군(158.3±91.5U/mL)과 1년 이상 치료군(252.7±483.4U/mL)에 비해 높았으나 유의하지는 않았다. 결론: Graves 병에서 IgE 농도는 증가되어 있었으며, Graves 병의 각각 다른 병기에서의 혈청 IgE 농도의 변화는 Graves qudd의 경과에 영향을 미치는 IgG인 TBII치의 변화와 유사한 경향을 보였다. 그러나 혈청 IgE와 Graves 병과의 연관성을 알아보기 위해서 IgE와 더불어 CD23항원 등의 다른 검사도 병행하는 전향적 연구가 필요할 것으로 생각된다. Background: It is widely believed that Graves' disease is and autoimmune disorder characterized by the presence of the circulation TSH receptor antibody (TRAb). The majority of the activity of TRAb is of the immunoglobulin G(IgG) class. However, other immunoglobulin such as immunoglobulin E(IgE), may play a rloe in the activity. IgE accumulation has been reported to occur in the thyroid gland and ocular muscles of subjects with Graves' disease. Furthermore, it has been noted that recurrence of Graves' disease can be induced by and allergy to pollen. Because an allergy to pollen is commonly associated with IgE, IgE might play a role in the induction of Graves' disease. Therefore, investigated whether IgE was elevated in Graves' disease, and evaluated the potential relationship between the levels of TRAb and IgE Graves' disease. Methods: Forty-six patients with Graves' disease, and 6 with chronic thyroiditis, diagnosed at the Kosin Medical Center between April, 2000 and July, 2000 were included in this study. Thirty-five persons without thyroid disease or a history of allergic rhinitis were used as normal controls. The level or TRAb was measured using thyrotropin binding inhibitory immunoglobulin (TBII). Serum total IgE was measured using as enzymeimmunoassay method. Test for thyroid function, TBII and total IgE were performed in all cases, and the results statistically analyzed. Results: TBII, as IgG, and the serum IgE level were higher in the patients with Graves' disease, and the levels of the latter were 598.1±1112.9U/mL, 98.5±79.7U/mL and controls 161.7±194.4U/mL in the Graves' patients, those with thyroiditis and the controls, respectively (p<0.05). The prevalence of allergic rhinitis in Graves' disease was 10.9%. The serum IgE level in Graves' disease with, and without, allergic rhinitis were 903.1±1152.2U/mL and 560.8±1117.0U/mL, respectively, although there was no significancant difference between the two groups. According to the clinical stage, the serum TBII level was higher in the untreated Graves', and relapsed patients 49.9±23.9% and 21.1±3.1%, respectively, than in the treated group, 7.4±18.6% (p<0.05). The serum IgE level was higher in the untreated Graves' and relapsed patients 758.6±1250.2U/mL and 1198.5±1952.1U/mL, respectively, than in the treated group 233.8±432.7U/mL, although this was not significant. According to the duration of treatment, the serum TBII levels were higher in the untreated Graves' patients, and those treated for less than 1 year, than in those treated for more than 1 year, with values of 49.9±23.9, 24.8±3.8 and 2.22±1.97%, respectively (p<.05). The serum IgE level was higher in the untreated Graves' disease (758.6±1250.2U/mL) than in the groups treated for less than 12 months (158.3±91.5U/mL) and more than 12 months (252.7±483.4U/mL), but the differences were not significant. Conclusions: The concentration of IgE was high in Graves' patients, and although not statistically significant, the serum igE level in Graves' patients with allergic rhinitis was higher than those without. With regard to the clinical stage of Grave's disease, the change in the IgE level tended to follow that of the TBII. Further study will be required to define the possible role of IgE in the pathogenesis in Graves' disease (J Kor Soc Endocrinol 17:640∼648, 2002).

WDHA(Watery diarrhea, Hypokalemia, Achlorhydria) syndrome 1예

박기룡,김현영,김지혜,임영찬,최영식,박요한,최경현,이재화,장희경 고신대학교 의학부 2003 高神大學校 醫學部 論文集 Vol.18 No.1

저자들은 부갑상선절제술 이후에도 교정되지 않는 고칼슘혈증과 계속된 수양성 설사로 인한 하지마비 및 전신쇠약을 주소로 내원한 70세 남자환자에서 일반 화학검사, 호르몬 건사, 방사선 검사 등으로 VIPoma와 동반된 MEN Ⅰ으로 진단하여 외과적 절제술 후 수양성설사, 저칼슘혈증 및 고칼슘혈증이 호전된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Multiple endocrine neoplasia I (MEN Ⅰ) is a genetic disorder that consists of neoplasia of neuroendocrine type in the parathyroid glands, in the islets of Langerhans in the pancreas, and in the anterior pituitary gland. Primary hyperparathyroidism is most common feature of the MEN I and occurs is approximately 95% of patients. Pancreatic islet cell tumors occur in 40% of MEN I patients. Most of these tumors produce excessive amounts of hormone, such as gastrin, insulin, glucagon and vasoactive intestinal polypeptide (VIP). VIP-producing pancreatic tumors (VIPoma) associated with MEN I are rare and there was only one case report in Korea so far. Recently we experienced a case of MEN I, especially VIPoma presented in a 70 year old man. He got subtotal parathyroidectomy for hyperparathyroidism 5 months ago, but his symptoms of watery diarrhea, severe general weakness and paralysis of lower limbs were not improved and hypercalcemia, hypokalemia were persisted. On computerized tomography scan of abdomen, demonstrated a mass of 3㎝ in diameter at the tail of pancreas. Serum level of VIP hormone was 250pg/㎖ (normal range : 0∼23pg/㎖). After partial pancreatectomy, his symptoms were improved dramatically and biochemical parameters such as, serum potassium, calcium, and VIP returned to the normal ranges.

조정선수의 훈련시 혈중구성 성분의 변화 관한 연구

조영희,최철호,채정룡 군산대학교 체육과학연구소 1999 體育科學硏究所 論文集 Vol.1 No.-

This study was carried to investigate the change of blood components in the raining of rowing player. The selected were eight male rowing player. The physical characteristics of subjects in choosing them were height, weight and careers. The period of this experimental training was 3weeks. The frequency of exercise on training schedule ws 5 times a week. The duration of exercise was 4 hours a day. The measured contents were RBC, WBC, HB, HCT, GOT, GPT, FBC. The following results were obtained in the blood sampling from the rowing athletes before and after summer camp training. 1) In the 1st, the 2nd week, RBC was lower then before training. But It was gradually increased in the 3rd week. 2) In the 1st, the 2nd week, WBC was lower then before training. But It was gradually increased in the 3rd week. 3) In the 1st, the 2nd week, HB was lower then before training. But It was gradually increased in the 3rd week. 4) In the 1st, the 2nd week, HCT was lower then before training. But It was gradually increased in the 3rd week. 5) GOT was slightly decreased in the 1st, the 2nd week. 6) GPT was slightly decreased in the 1st, the 2nd week(p <.05). 7) FBS was decreased at the same time as training(p < .05), but it was slightly increased in the 3rd week.

복합재료 주축계의 동적 해석

허성남,최영휴,조치룡 국립7개대학공동논문집간행위원회 2003 공업기술연구 Vol.3 No.-

Development of high speed spindle system is one of the most important things for high speed machine tool. Composite material has the advantage of light weight and high stiffness for high speed spindle system. However it is not easy to analyze dynamics of the composite spindle because composite material shaft has anisotropic property. In this paper, the stiffness coefficient matrix of a composite spindle shaft is derived by using Timoshenko beam theory, and its equations of motion are also derived by using Lagrange's equation. Natural frequencies and mode shapes of a composite shaft are analyzed. The dynamic analysis result of the two spindle systems which have the same configuration and dimensions the weight of composite spindle was reduced by 29% compared with the steel spindle. But, its first natural frequency was raised by 16% compared with the steel spindle.

악골에 발생한 악성 섬유성조직구종 2례

정종철,최홍란,오희균,박준아,류선열,이종호,김영운,정숭룡 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.3

Malignant fibrous histiocytoma rarely occurs in the jaws. Although the histogenesis of this tumor remains controversal, it is best regarded as a primitive and pleomorphic nature reflected by collagen production and occasional phagocytosis. It is common for metastatic foci to appear in lung and regional lymph node. There are variable treatments such as radiotherapy, surgical excision or combination, therapy of surgical excision, chemotherapy and radiotherapy. With the review of literatures, the authors report the clinical study of two cases of malignant fibrous histiocytoma of the jaw.

말초혈액에서 Tg mRNA에 대한 역전사 중합효소 연쇄 반응법의 갑상선 재발암의 분자생물학적 진단

권성일,박기룡,김현영,신채희,임영찬,최영식,박요한,이강대,장희경,이재화,염하용 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4

연구배경: 갑상선암은 다른 조직에 발생한 암에 비해 비교적 천천히 자라므로 대부분 예후가 양호하지만, 일부에서는 주위 조직으로 침윤하거나 혹은 원격 전이로 인하여 치명적인 결과를 초래할 수 있다. 갑상선전절제술 및 131^I 제거술 후 경과 관찰시 갑상선암의 재발과 전이의 진단에 있어 131^I 스캔과 혈청 Tg의 측정이 현재 임상에서 가장 많이 이용되고 있으나 이 방법에는 여러 가지의 결점이 있다. 최근 Tg mRNA에 대한 RT-PCR법을 이용한 여러 연구결과는 131^I 스캔과 혈청 Tg 측정의 결점을 보완할 수 있는 좋은 보조적인 진단법으로 이용할 수 있을 가능성을 제시하였다. 이에 말초혈액에서 측정한 Tg mRNA에 대한 RT-PCR법이 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무의 진단에 유용한가를 알아보고자 이 연구 시행하였다. 방법: 분화된 갑상선암으로 진단된 후 갑상선전절제술을 시행받고 방사성요드 치료를 받은 환자 중 현재까지 한차례에 이상 추적 방사성요드 전신 스캔을 시행하고 추적관찰이 가능했던 유두선암 35예, 여포선암 5예를 대상으로 연구를 시행하였다. 대상군은 131^I 스캔 소견상 음성인 군(Group Ⅰ), 잔여조직이 있는 군(Group Ⅱ), 국소전이가 있는 군(Group Ⅲ), 및 원격전이 군(Group Ⅳ)으로 구분하였다. 정상 대조군은 갑상선질환이 없는 10예의 건강인으로 하였다. 대상환자의 말초혈액을 이용한 Tg mRNA에 대해 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행하였다. 결과: 본 연구 결과는 다음과 같다. 1) 131^I 스캔 소견상 음성인 군 21예 중 1예에서 Tg가 양성소견을 보였다. Anti Tg Ab가 양성인 4예 모두 Tg가 음성을 보였다. 잔여조직이 있거나 국소전이 및 원격전이를 보인 군 19예 중 Tg가 양성인 경우는 4예였으나, Tg mRNA는 전예에서 양성이었다. 2) 131^I 스캔에서 국소 및 원격전이 소견을 보인 8예 중 4예에서 Tg가 음성으로 131^I 스캔과 혈청 Tg 사이에 불일치 소견을 보였다. 3) 말초혈액에서 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행한 결과 대상군 40예 및 정상 대조군 10예 모두에서 Tg mRNA가 양성을 보였다. 결론: 본 연구에서 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무를 평가함에 있어 역전사 중합효소 연쇄 반응법을 이용한 Tg mRNA 측정의 의의는 재평가되어야 한다고 생각된다. Background: Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyriod ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluated the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy. Methods: Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg. Results: The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131^I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls. Conclusion: From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications (J Kor Soc Endocrinol 17:501∼513, 2002).

흰쥐 Nucleus Raphe Magnus에 투여한 Morphine이 척수 Serotonin 유리에 미치는 영향에 관한 연구

이신재,임요한,최영님,김형룡,정동균 대한구강생물학회 1991 International Journal of Oral Biology Vol.15 No.1

It is known that the interaction between opioid neuron and serotonergic neuron in bulbospinal pathway has an important role on pain control. This experiment was perfomed to directly measure the release of serotonin into spinal cord superfusates before and after the microinjection of morphine and its antagonist, naloxone into the NRM of rats. High performance liquid chromatography with electrochemical detection was used to quantitate the amine. The injection of morphine into the NRM induced a significant increase in the amount of serotonin released in the spinal cord, which was reversed after the intraperitioneal injection of naloxone. These results support the proposal that : the analgesia produced by morphine microinjected into the NRM is mediated by the activation of spinally projecting serotonergic neuron.

수면 무호흡증 환자의 진단방사선학적 고찰

손은주,박정희,전혜정,최영칠,이창희,신현준,이경용 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

Our purpose was to determine whether there are statistical differences in upper airway size and compliance when patients with obstructive sleep apnea are compared with healthy volunteers using ultrafast CT, and to evaluate the diagnostic accuracy of ultrafast CT in obstructive sleep apnea. 29 patients clinically suspected of obstructive sleep apnea and ten healthy volunteers underwent examination of the upper airway with ultrafast computed tomography. All patients had operations; uvulopalatopharyngoplasty (UPPP,n = 19), UPPP with tosillectomy (n = 7) and UPPP with septoplasty (n = 3). Eight axial images every 0.7 sec in 8 ㎜ sections were obtained using flow mode. CT was performed twice while the subjects were awake with quiet breathing and were asleep with apnea. Smallest cross-sectional area in the nasopharynx, oropharynx and hypopharynx and compliances were assessed in patients and control subjects. Among the 29 patients, 22 patients showed narrowing at oropharyngeal level and six patients showed narrowing at two or more levels. Patients with obstructive sleep apnea had significantly smaller mean cross-sectional area than obstructive sleep apnea had significantly smaller mean cross-sectional area than control subjects in the oropharynx while sleeping (p<0.05). But there was no significant difference in mean smallest cross-sectional area of the nasopharynx (p = 0.47). In addition, the patients with obstructive sleep apnea had greater compliance of the oropharynx (79.8% vs 39.3%) and hypopharynx (58.9% vs 19.2%) (p<0.01). Patients with obstructive sleep apnea are characterized by a small oropharyngeal airway and collapsible oropharyngeal, hypopharyngeal airways. Ultrafast CT scanning allows rapid and noninvasive assessment of airway variables.