The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection

Chun, Yoon-Keun,Ha, Joo-hun,Hong-Jung-Woo,Oh, Soo-Myung,Kim, Sung-Soo 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Yoon-Keun Chun¹,Joohun Ha□Hong-Jung Woo□, Soo Myung Oh□,Sung Soo Kim□ ¹Department of Molecular Biology, College of Medicine,²Department of Surgery, college of Medicine,³Department of Internal Medicine, College of Oriental Medicine,and ⁴East-Weat Medical Reserch Institute,Kyung Hee University, Seoul, Korea. The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection. Proceedings of International Symposium on East-West Medicine, Seoul. 212-230, 1999. -Hepatitis B is caused by hepadnavirus. Hepatitis B virus replicates through 3.5kb pregenomic RNA intermediate which is regulated by core promoter. Pathogenesis of hepatitis B virus has been bilieved the result of host immune response. But recently many studies have reported that high level of viral replication caused by mutation in core promoter might result in severs hepatitis. But these studies were performed in vitro, not in vivo. So there is yet debate about which factor, viral of host factor, is more important in pathogenesis of hepatitis B virus. So we measured real viral replication level in 204 chronic hepatitis B patients by quantifying HBV DNA from sera by our novel PCR-based more sensitive method, and compared these results with ALT level measured from same sera, which indicates liver cell damage. Surprisingly there are no significant correlation between HBV DNA quantity and ALT level. Then we cloned core promoter region. In SSCP, we found that many viral mutants coexist in one patient. Base on SSCP result, we chose main viral core promoter type in each patients, which is thought to determine overall viral replication level in this patient. Main type of core promoter region of each 41 patients were directly sequenced. And with these we measured promoter activity by luciferase assay system and compared promoter activity with on another. We found tha there were some differences in promoter activity according to core promoter sequences. And we constructed replication-competent viral constructs with core promoter from 41 patients and Transfected these into HepG2 cell and measured HBV DNA by southern blot. There were also differences in HBV DNA quantity according to core promoter sequences. On these all results we investigated correlation between the effect of HBV core promoter on viral replication in vitro and HBN DNA quantity, ALT level from sera of each patients. We found there is no significant correlation among them. As a result, we concluded that in determining severity chronic hepatitis B patients, host factors of each patient is more important rather than replicative activity of virus itself.

제왕절개술 환자에서 수술전 투여한 ketamine의 혈청 interleukin-6 및 수술후 통증에 대한 효과

김진수,김유재,안기량,김천숙,김일호,한찬수 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

The inflammatory reaction to tissue damage during surgery may induce central sensitization followed by hyperalgesia. Previous studies suggest that central sensitization is related to N-methyl-D-aspartate (NMDA) receptor activation, which can be blocked with NMDA antagonist, ketamine. Thus, we compared the effect of preoperative intravenous and epidural low doses of ketamine with placebo on serum interleukin-6 (IL-6) level and postoperative pain. ASA class I and II women scheduled for C-sections received intravenous ketamine 0.15mg/kg(group 2) or placebo(group 1), or epidural ketamine(0.15 mg/kg) before the operation. IL-6 levels were measured before and during the operation, and 8, 24, and 48 hrs after the operation. Visual Analogue Scales(VAS) and Verbal Ration Scales(VRS) were measured at 8, 24, and 48 hrs after the operation. Serum IL-6 levels at 8, 24, and 48 hrs after the operation were significantly lower in the intravenous ketamine and epidural ketamine groups than in the control group. VAS at 8 hrs and 48 hrs after the operation were significantly lower in the epidural ketamine group. VAS at 8 hrs and 48 hrs after the operation were significantly lower in the epidural ketamine group than in the control and intravenous ketamine groups. In conclusion, in the preoperative intravenous and epidural administration of low doses(0.15mg/kg) of ketamine, both are effective in reducing postoperative IL-6 levels. Epidural Ketamine is more effective than intravenous ketamine in postoperative pain control.

MCR에 의한 혐기성 소화에 대한 암모니아의 영향

김양지,김춘미,김성일,김종수 선문대학교 ·중소기업기술지원연구소 2002 선문공대 연구/기술 논문집 Vol.7 No.1

혐기성 소화에서 미생물에 저해/독성 물질로 알려진 암모니아의 농도와 식종원에 따른 영향을 MCR(Master Culture Reactor)을 이용하여 회분식으로 분석하였다. 식종원은 축간농가 축산폐수 집수조의 침전슬러지 그리고 하수종말처리장 혐기성 소화조 잉여슬러지를 사용하였다. 식종원에 상관없이 암모니아는 1,500㎎NH_4-N/L에서 COD 제거율과 가스생성율로 측정된 혐기성 미생물의 활성에 저해영향을 주기 시작하여 2,500㎎NH_4-N/L에서 더욱 심하였다. 암모니아 저해 농도 범위에서 휘발성 유기산의 농도는 50㎎/L 범위로 유지되므로 메탄생성균 뿐만아니라 산생성균도 저해영향을 받는 것으로 나타났다. 축산폐수 집수조 침전슬러지로 식종된 경우 암모니아 2,500㎎NH_4-N/L 농도 범위 이상으로 운전하여도 COD 제거율과 가스생성율은 일정하게 나타났지만 하수종말처리장 혐기성 소화조 잉여슬러지로 식종된 경우 암모니아 농도가 증가할수록 COD 제거율과 가스생성율은 감소하였다. 결과적으로 암모니아에 장기간 순응된 축산폐수 집수조의 침전슬러지로 식종한 경우 암모니아의 저해 농도에 대하여 적응도 빨랐으며 저해영향도 적음을 알 수 있었다. The influence of ammonia and the sources of seeding on anaerobic digestion were investigated by batch operation of MCR(master culture reactor). The sources of seeding on anaerobic digestion were from swine wastewater collection pit and anaerobic digestion sludge of a municipal sewage treatment plant. The inhibition effects of ammonia on anaerobic microorganisms were initiated at ammonia concentration of 1,500 ㎎NH_4-N/L and the effects were increased by increasing ammonia concentration upto 2,500 ㎎NH_4-N/L regardless the sources of seeding as evidenced by decreases in COD removal efficiencies and biogas yields. The inhibition occurred to not only methanogens but also acidogens since the concentration of volatile fatty acids was maintained at 50 ㎎/L during the batch operations of MCR. The COD removal efficiency and biogas yield were maintained constantly while increasing ammonia concentration upto 2,500 ㎎NH_4-N/L when swine wastewater collection pit was used as seeding; however, those were decreased while increasing ammonia concentration when anaerobic digestion sludge was used as seeding. The results indicate that the seeding acclimated to high concentrations of ammonia for long time was easy in adaptation to high ammonia concentration and less subjective to ammonia inhibitory effects.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

기도이물에 관한 임상적 고찰

한찬수,김태정,김일호,김유재,김천숙,안기량 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Aspiration of a foreign body in the airway is common cause of sudden obstructive breathing, crouping cough, hoarseness, and wheezing. Especially that caused serious problem in case of the young children. A past history of foreign body aspiration is itself an indication for bronchoscopic examination of the airway, because some children with aspirated foreign bodies are without symptoms and chest X-ray films may not show abnormalities. So the anesthesiologist should take a notice of removing foreign body in the anesthetic procedure. The author have experienced 36 cases removal of foreign bodies in the airway under general anesthesia from July, 1982 to January, 1996 in Chunan Hospital, College of Medicine, Soonchunhyang University. The results were as follows 1) Among the 36 cases, 25 cases(69.7%) were under the age of 5. The ratio of male and female was 1.8 : 1. 2) In duration of lodgement, there was most frequent within one day in 15 cases(41.7%) and the longest duration was 20 days. 3) The most common symptom, sign and auscultation finding were cough 19 cases(52.8%). chest retractions 7 cases(19.4%) and decreased breathing sound 20 cases(55.6%) 4) Abnormalities in the chest X-ray were found in 15 cases(41.7%) among 36 cases. 5) Vegetable foreign bodies, expecially peanut were the most common airway foreign body(28.7%), followed by plastic foreign body(14.4%) and mucous plug(11.3%). 6) The foreign body involved the right bronchus 16 cases(45.7), left bronchus 10 cases(28.6%), trachea 5 cases(14.3%), and larynx 4 cases(11.4%). 7) Foreign body induced complications occurred in 9 cases(25.0%); pneumonia 8 cases and pneumomediastinum 1 case, and all of postoperative complication was pneumonia(25.0%). 8) 34 foreign objects(94.4%) were removed by endoscopy but tracheostomy was required in two patients.

서남해안 지방에서 발생한 Vibrio vulnificus 감염의 임상적 고찰

조남수,김춘호,김성중,김용배,조수형,안태훈 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: V. vulnificus infection in found between May and October when the man who has hepatic disorder or immunity disorder eats raw shellfish and it causes the systemic symptoms such as sudden fever, chilling, shock and stupor and local skin lesions like bleb and necrosis. This disease has 46∼61% of fatality rate in spite of intensive treatment. This study conducts the examination of history, epidemic study, ingesting raw fish and bacteriologic investigation in the patients with similar clinical symptoms to the above and examines the diagnostic dorrelations. Method: It is conducted with 31 cases who admitted at emergency medical center of Chosun University Hospital from May of 1995 to September of 1998 and are suspected to have V.vulnificus infection. It analyze bacteriologic examination, the survey of residence, eating raw shellfish, hepatic disorder, alcohol drinking habits and skin lesion. Results: 1) The rate of male and female is 15.5:1 and in the age, 18 cases are in fifties, seven are in forties and six are over sixties. 2) Clinically, V.vulnificus is detected in 20 of 31 cases which is suspected to have V.vulnificus infection and it is not detected in 5 cases. Other bacteria are detected in 6 cases and they include staphylococcus aureus, pseudomonas species, β-hemolytic streptococcus and E-coil. 3) In local distribution, Kohung has 10 cases, Shinan and Mokpo have six, Haenam and Kangjin have five, Yongkwang and Muan have five, Naju and Yongam have five and Kwangju has one. 4) Eating fishes and raw shellfishes is found in 31 cases. In the kind of shellfishes, eating raw clam is 10 cases, raw thin-shelled surf calm is 8 cases, raw oyster is 5 cases and sliced raw fish is 4 cases and pickled sea foods are 4 cases. 5) The cases with hepatic disorder are 23 and 15 cases with heavy alcohol drinking Carrier are included. The cases with Diabetic Mellitus are four and those with pulmonary tuberculosis are two. Two cases have not basal diseases. 6) On the opinion of skin lesion, 20 cases show vesicular necrosis, 7 cases have dendriform erythema, 3 cases have papule and one case doesn't show clear skin lesion. Conclusion: When V.vulnificus infection is detected, it is fatal and those who have hepatic disorder or heavy alcohol drinking habit must avoid eating fishes and shellfishes raw in summer. It is important to have emergency treatment for the patient whose V.vulnificus infection is suspected. It is considered that the administration of initial antibiotics is effective by generalizing the clinical symptom, epidemic opinion and patient history even before the results of bacteriologic confirmed.

소아 확장성 심근증의 임상적 고찰

이성환,김준식,박근수,김명성,권태찬,김천수,이상락 啓明大學校 醫科大學 1996 계명의대학술지 Vol.15 No.1

A Clinical assessment of the 25 patients with dilated cardiomyopathy who were admitted to the Department of Pediatrics, Keimyung University Dong San Hospital from January, 1982 to June, 1993 was performed. The result were as follows: 1) Among 25 patients with dilated cardiomyopathy. 8(32%) were younger than 1 year of age at the time of admission. 2) Adriamycin toxicity was the only encountered etiologic factor in 1 patient. 3) On admission, hepatomegaly and tachycardia were noted in almost all patients. 4) The Chest X-rays showed cardiomegalies in all 25 patients, pulmonary vein congestions in 15(60%) and pleural effusion in 2(8%). 5) The electrocardiography showed left ventricular hypertrophy in 72% and supraventricular tachycardia in 32%. 6) The echocardiographic examination showed left ventricular dilatations in all patients and left atrial dilatations in 20(80%). 7) Of 18 patients who had followed mean period of 2.9 years, 10 patients died within 9 months after the diagnosis.

굴착 주변의 지반침하 예측

김교신,류제천,김송만,박춘수 충남대학교 산업기술연구소 2000 산업기술연구논문집 Vol.15 No.2

Ground settlement and displacements of support structures due to deep excavation in urban area affect the stability of adjacent structures and retaining walls. Especially, the magnitude and distribution of ground settlements may directly give effects on the behavior of adjacent structures. So it comes to be important to judge precisely the effects on adjacent grounds and structures due to excavation. This can be achieved by means of ground settlements and differential settlements of structures, but present evaluating method on the ground settlement neglect the presence of adjacent structures. In this study, I have made Bowles and Bauer Method programs in order to find adjacent ground settlements. The results of program are like these. First, when you use measured horizontal displacement, the ratio of settlements of Bowles Method programs to Bauer is 0.86. Secondly, when you use measured horizontal displacement, settlements which Bowles Method program find is 5 times larger than settlements which Bauer Method program find when you use evaluated horizontal displacement.

改善된 Ritz벡터를 이용한 構造物의 動的 解析

金春浩,沈在守 慶熙大學校 1991 論文集 Vol.20 No.-

Direct integration methods are not economical for dynamic analysis of structures in time domain. For economical analysis, the dimension of system is generally reduced using the eigen solution. Eigen solution, however, includes a lot of calculations, and neglects the characteristics of dynamic loading. Therefore the economical analysis method incoporating the modified ritz algorithm considering load characteristics is presented for dynamic analysis of the structures. The results show that the modified ritz vector performs better than the eigen vector in economics and accuracy.

고정밀 선반 주축계의 열특성 해석

김용길,김수태,박천홍 한국공작기계학회 1997 한국생산제조학회지 Vol.6 No.3

Unsteady-state temperature distributions and thermal deformations of the spindle of a high precision lathe are studied in this paper. Three dimensional model is built for analysis, and the amount of heat generation of bearing and the thermal characteristic values including heat transfer coefficient are estimated. Temperature distributions and thermal deformations of a model are analyzed using the finite element method and the thermal boundary values. Numerical results are compared with the measured data. The results show that the thermal deformations and the temperature distributions of the spindle of a high precision lathe can be reasonably estimated using the three dimensional model and the finite element method.