대장수술 후에 발생한 급성신부전의 위험인자

이혜미,황창재,김재황,김흥대,박대팔,서일숙,송선옥,김세연,이덕희,지대림 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

연구 배경 : 급성 신부전은 술 후 발생할 수 있는 합병증 중에서 사망률은 큰 영향을 줄 수 있으므로 이 연구를 통해 위험인자를 알아보려고 한다. 재료 및 방법 : 2004년 1월부터 2006년 12월까지 3년간 영남대학교 의과대학 부속병원에서 대장 수술을 받은 570명의 환자들을 대상으로 하였다. 환자들의 성별과 연령, 미국 마취과학회 신체등급, 동반질환, 수술의 종류, 응급수술의 여부, 수술 시간, 재수술의 여부, 술 중의 투약 상황, 술 후에 자가 통증 조절기에 사용한 약제, 술 중에 저혈압의 유무, 수혈 여부, 술 후 기계적 환기를 시행한 경우를 비교하였다. 결과 : 비교 결과에서 성별과 수술의 종류, 응급 수술의 여부, 개복여부 등에는 유의한 차이를 보이지 않았다. 반면 환자의 나이와 수술 시간, 재수술의 여부, 술중에 이뇨제 등을 사용한 경우, 술 중에 저혈압의 유무, 술 후에 기계적 환기를 시행한 경우 등에는 유의한 차이를 보였다. 결론 : 이상의 결과로 급성신부전의 원인은 어느 한 가지라고 하기 보다는 위험인자에 얼마나 노출되어 있는가가 결정하는 것 같고, 그 원인들이 모여서 상승효과를 내는 것 같다. 그러므로 수술 전부터 많은 위험에 노출된 환자는 술 중 더 적극적인 감시를 시행하여 수술 후의 합병증 발생을 줄이는 노력을 기울여야 하겠다. Background : Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. Materials and Methods : Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. Results : The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). Conclusion : Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

성균관대학교 멀티미디어 원격교육 시스템(배움 한마당) 개발에 관한 연구

김석수,권해문,이상권,김상진,전진호,황대준 成均館大學校 科學技術硏究所 1997 論文集 Vol.48 No.1

We propose SKKU Multimedia Distance Education System for distance education between nature science campus(Suwon) and social science campus(Seoul) in Sung Kyun Kwan University on DooRae (Distributed Object Oriented Multimedia Application Crafting Environment for Collaboration) framework (or platform). We support ONE : N study mode for a group lecture and discussion between two campus, and also we support mediation for floor mode of a group lecture and brain storming for floor mode of discussion. The communication portocol of this system is composed of TCP/IP and UDP, and the network type is composed of WAN(El line)for between the Suwon campus and Seoul campus, ATM LAN for each campus(local site). And, this system supports the application development of the collaborative multimedia environment connected with the various network in the CBM (Computer based Multimedia) based. Also, it does not restrict on space between a teacher(s) and a student(s) into cyberspace which made by network. This system has an interaction, late comer, a question and an answer, multi-session, application sharing and whiteboard which resembles chalkboard. Also, various supplementary functions such as video conference and voice conference for this system are what makes face-to-face education effective. Also it supports real or non-real type. The operation system developed on windows 95.

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

미세혈관 협심증 환자의 임상상 및 지표에 관한 연구

박상호,온영근,김현정,이태훈,길효욱,김현건,박수진,송해정,한대희,방덕원,신원용,이내희,김성구,권영주 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background : Microvascular angina or syndrom X is heterogenous and encompasses different pathogenetic entities. Several studies suggest that microvascular angina have good prognosis and occurs predominantly in postmenopausal women. Lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, CRP and fibrinogen are the independent risk factor of acute coronary syndrome and are the chief underlying cause of atherosclerosis. We investigated clinical characteristics and markers in patients with microvascular angina. Methods : We studies 23 patients diagnosed with microvascular angina and 16 control group with negative treadmill exercise test and no significant coronary angiogram. We investigated clinical characteristics in patients group and evaluated symptom during a follow-up period of 4.2± 2.5 month. Exercise time in treadmill exercise test was compared between patients and control group. We assessed the level of markers, such as lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, CRP and ESR in two groups. Results : There is no difference in age between two groups. Patients group had a tendency to increase in female, hypertension, DM, and smoking history, but there was no statistical significance difference. Exercise duration time was significantly decreased in patients with microvascular angina (p<0,05). Serum lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholestrol, Triglyceride, ESR, Fibrinogen and Homocystein value were no significant difference between microvascular angina and control group. Only CRP was significantly high in patients with microvascular angina (p<0.05). Conclusion : There was no statistical significance difference in age, sex, hypertension, DM and smoking history between two groups but patients group had a tendency to increase the prevalence in hypertension, DM and smoking history, female. Also, Symptom improvement and disappearance in follow-up was presented in 11 patients of 19(57.9%). Exercise tolerance was worse in patients group than control group. CRP value was significantly higher in patients group than control group. There was no statistical significance difference in lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, ESR and Fibrinogen between two groups.

成功的인 營農定着者의 營農定着 過程에 관한 硏究

宋海均,李永大 서울大學校 農科大學 1981 서울대농학연구지 Vol.6 No.2

The objecives of this study were to ①find out how young farmers have established their farms, ②to develop a model of the farm establishment process, and ③to make a recommendation for the training programs for the prospective young farmers utilizing the model developed in this study. Six hundred eighty nine young farmers were surveyed by mailed questionnaires and the data were analysed with percentile, correlation, Chi square, and analysis of variance utilizing the HP 3000 Computor at the College of Agriculture, Seoul National University. The main findengs of the study were as follows: 1. The respondints were 1) 28.6 years old, 2) graduates of middle school or high school, 3) experienced 5.5 years on the farm, 4) operated large farms, 5) having high farm income, 6) having low off farm income ratio, 7) deverse farming type. 2. Most of the successful young farmers were born and raised in rural areas. Young farmers had experienced in farming by helping their parents and paricipated in Rural Youths Club activities. More than half of the successful young farmers had conducted the farming programs which were large in scale and quite good income. 3. The main reason of the decision making in farm establishment were strong desire for rural development (13.6%), through 4-H Club activities (13.6%), interested in agiculture or aptitute for farming (10.6%), and agricultural education etc. 4. Most of the parents of the youngfarmers were farmers in a middle class of the socio econ omic status. 5. They established in their farming at the age of 22.3 years with the land size of 3,200 pyeong (approximately one ha), Cash of 1.02 million won, and total capital of 5.9 million won. 6. Most of the respondents have learned their farming knowledge and skills from 4-H Club activities and agricultural high school education and they obtained parents' assistance for obtaining the farm land, machineries and the capitals for running the farming. 7. The successful young farmers have had many difficulties at the beginning. The most serious problems they have faced were lacks of capotal (72.7%), purchasement of the farming land (47.9%), farming experiences (41.3%), understanding of the parents in practice the new technologies. 8. They have served the military service soon after beginning of their farming and therefore they had to ask to take care their farming to either their parents or tenants. 9. The characteristics of the successful farmers were as follows: 1) parents were farmers, 2)parents encouraged their children in the establishment of farming and assisted them in the various ways. 3) they had experienced 3 years of minus income with their farming.

Integrated dataset of the Korean Genome and Epidemiology Study cohort with estimated air pollution data

Hae Dong Woo,Dae Sub Song,Sun Ho Choi,Jae Kyung Park,Kyoungho Lee,Hui-Young Yun,Dae-Ryun Choi,Youn-Seo Koo,Hyun-Young Park 한국역학회 2022 Epidemiology and Health Vol.44 No.-

Public concern about the adverse health effects of air pollution has grown rapidly in Korea, and there has been increasing demand for research on ways to minimize the health effects of air pollution. Integrating large epidemiological data and air pollution exposure levels can provide a data infrastructure for studying ambient air pollution and its health effects. The Korean Genome and Epidemiology Study (KoGES), a large population-based study, has been used in many epidemiological studies of chronic diseases. Therefore, KoGES cohort data were linked to air pollution data as a national resource for air pollution studies. Air pollution data were produced using community multiscale air quality modeling with additional adjustment of monitoring data, satellite-derived aerosol optical depth, normalized difference vegetation index, and meteorological data to increase the accuracy and spatial resolution. The modeled air pollution data were linked to the KoGES cohort based on participants’ geocoded residential addresses in grids of 1 km (particulate matter) or 9 km (gaseous air pollutants and meteorological variables). As the integrated data become available to all researchers, this resource is expected to serve as a useful infrastructure for research on the health effects of air pollution.

The Sintering Behavior and Piezoelectric Properties of Pb(Ni1/3Nb2/3)O3-PbTiO3-PbZrO3 Ceramics Using Two-Step Calcination

Dae Su Lee,Ill Won Kim,Bok Ki Min,Chang Won Ahn,Hae Yun Choi,Jae Shin Lee,Jae Sung Song,Soon Jong Jeong,Yeon Hak Jeong 한국물리학회 2003 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.42 No.IV

The 0.15[Pb(Ni1=3Nb2=3)O3]-0.85[PbTiO3-PbZrO3] + xPbO (x = 0, 3, 6, 9 wt%, PNN-PZT) ceramics are investigated in order to obtain the lower sintering temperature and improve their piezoelectric properties using both conventional and two-step calcination method. The stoichiometric 0.15PNN-0.85PZT ceramics require the sintering temperature above 1000 C, but the addition of excess PbO in the 0.15PNN-0.85PZT ceramics display the sintering temperature of 900 C. The pyrochlore phases appear with increasing PbO concentrations in the conventional method, but it is exhibited the pure perovskite phases without appearing pyrochlore phases in the two-step calcinated samples. The 0.15PNN-0.85PZT ceramics with excess PbO are prepared by the two-step calcination process can be obtained with sintering temperature of 100 200 C lower than those for the stoichiometric ceramics fabricated by conventional calcination method. The excess of PbO and two-step calcination method enhance not only the structural stability of the perovskite phase, but also the piezoelectric properties.

<i>PHEX</i> Gene Mutations and Genotype-Phenotype Analysis of Korean Patients with Hypophosphatemic Rickets

Song, Hae-Ryong,Park, Joo-Won,Cho, Dae-Yeon,Yang, Jae Hyuk,Yoon, Hye-Ran,Jung, Sung-Chul KOREAN ACADEMY OF MEDICAL SCIENCE 2007 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.22 No.6

<P>X-linked hypophosphatemic rickets (XLH) results from mutations in the <I>PHEX</I> gene. Mutational analysis of the <I>PHEX</I> gene in 15 unrelated Korean patients with hypophosphatemic rickets revealed eight mutations, including five novel mutations, in nine patients: two nonsense mutations, two missense mutations, one insertion, and three splicing acceptor/donor site mutations. Of these, c.64G>T, c.1699C>T, c.466_467 insAC, c.1174-1G>A, and c.1768+5G>A were novel mutations. To analyze the correlation between genotype and phenotype, phenotypes were compared between groups with and without a mutation, in terms of mutation location, mutation type, and sex. Skeletal disease tended to be more severe in the group with a mutation in the C-terminal half of the <I>PHEX</I> gene, but no genotype-phenotype correlation was detected in other comparisons. Further extensive studies of the <I>PHEX</I> gene mutations and analyses of the genotype-phenotype relationships are required to understand PHEX function and the pathogenesis of XLH.</P>

Effect of an Endoplasmic Reticulum Retention Signal Tagged to Human Anti-Rabies mAb SO57 on Its Expression in Arabidopsis and Plant Growth

Song, Ilchan,Lee, Young Koung,Kim, Jin Wook,Lee, Seung-Won,Park, Se Ra,Lee, Hae Kyung,Oh, Soyeon,Ko, Kinarm,Kim, Mi Kyung,Park, Soon Ju,Kim, Dae Heon,Kim, Moon-Soo,Kim, Do Sun,Ko, Kisung Korean Society for Molecular and Cellular Biology 2021 Molecules and cells Vol.44 No.10

Transgenic Arabidopsis thaliana expressing an anti-rabies monoclonal antibody (mAb), SO57, was obtained using Agrobacterium-mediated floral dip transformation. The endoplasmic reticulum (ER) retention signal Lys-Asp-Glu-Leu (KDEL) was tagged to the C-terminus of the anti-rabies mAb heavy chain to localize the mAb to the ER and enhance its accumulation. When the inaccurately folded proteins accumulated in the ER exceed its storage capacity, it results in stress that can affect plant development and growth. We generated T₁ transformants and obtained homozygous T₃ seeds from transgenic Arabidopsis to investigate the effect of KDEL on plant growth. The germination rate did not significantly differ between plants expressing mAb SO57 without KDEL (SO plant) and mAb SO57 with KDEL (SOK plant). The primary roots of SOK agar media grown plants were slightly shorter than those of SO plants. Transcriptomic analysis showed that expression of all 11 ER stress-related genes were not significantly changed in SOK plants relative to SO plants. SOK plants showed approximately three-fold higher mAb expression levels than those of SO plants. Consequently, the purified mAb amount per unit of SOK plant biomass was approximately three times higher than that of SO plants. A neutralization assay revealed that both plants exhibited efficient rapid fluorescent focus inhibition test values against the rabies virus relative to commercially available human rabies immunoglobulins. KDEL did not upregulate ER stress-related genes; therefore, the enhanced production of the mAb did not affect plant growth. Thus, KDEL fusion is recommended for enhancing mAb production in plant systems.

비장 종대 및 범혈구 감소증을 동반한 간외 문맥류 1 예

송영식,이혜경,원종호,박희숙,윤석구,홍대식,허경열,이현아,남궁은경 대한내과학회 1996 대한내과학회지 Vol.51 No.5

Aneurysm of the portal vein is a rare entity. Portal vein aneurysms are lesions whose etiology, clinical features, and management are not well understood. Recently we experienced a case of portal vein aneurysm which was diagnosed by ultrasonography, abdominal computed tomography and angiography. A 26-year-old woman was admitted because of palpable mass on left upper quadrant abdomen and general weakness. Physical examination revealed remarkable splenomegaly. Laboratory date yieled the following results: WBC 2,000/㎣, Hb 8.7g/dl; Hct 22.5%; platelet 32,000/㎣, PT 57%; HBs Ag(+); HBs Ab(-); HBc Ab IgG(-); HCV Ab(-). Two D and coronal view of three D abdominal computed tomography demonstrated well defined circumscribed, oval and enhancing mass in the portal vein and enhancing mass that contained thrombosis in the splenic vein. Arterial portography via splenic artery showed fusiform portal vein aneurysm and splenie vein aneurysm containing thrombosis. She has achieved clinical improvement after splenectomy.