지중내 공동 탐지를 위한 비파괴 검사 기법에 대한 실험적 연구

유정동(Jund Dong?Yoo),양학모(Hak Mo?Yang),장기창(Ki Chang?Jang),강승민(Seung Min?Kang),조소현(So Hyun?Cho),김현기(Hyun-Ki?Kim),Seung Soo?Kim,Da Bin?Jin 대한토목학회 2018 대한토목학회 학술대회 Vol.2018 No.10

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

기동장비용 지향구조물의 진동 감소 상태선정 연구

유진호,이동주 한국공작기계학회 2006 한국공작기계학회 추계학술대회논문집 Vol.2006 No.-

In order to predict vibration trends occurred during vehicle drive, acceleration data was processed by using data processing algorithm with moving average and Hilbert transform. Specific mode constants of acceleration were obtained under various disturbance. Vehicle velocity, road condition, property of pointing structure were considerd as factors which make change vibration trend in vehicle dynamics. Results of signal processing were compared and analysised.

해안서식 어패류 중 유해중금속 함량에 관한 연구 (Ⅰ)

유영찬,정진일,박유신,이종숙,인상환,최동기,김동우 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

혈액질환 환자에서 조혈모세포 이식과 화학요법 후의 침습성 진균감염의 분석

유진홍,최정현,이동건,최수미,신완식,김춘추 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 조혈모세포 이식이나 화학요법을 받은 혈액질환 환자에서 침습성 진균감염의 양상을 분석하고 예후 인자를 정하기 위하여 이 연구를 실시하였다. 방법 : 2000년 3월부터 2001년 2월까지 가톨릭 조혈모세포이식센터에 입원한 318명의 환자들 중 진균 감염으로 의심되어 항진균제를 투여받은 122명의 환자를 대상으로 후향적 분석을 실시하였다. 결과 : 74명의 환자가 EORTC/MSG 기준에 의해 침습성 진균증으로 판정되었다. 이들 중 6명이 확진이었고, 46명이 추정, 22명이 가능 증례이었다. 가장 많이 침습된 장기는 하부 호흡기이었다(72/74). 사망률은 32.4%이었다. 단변량 분석으로 예후 인자를 도출한 결과 입원 기간, 진단까지 걸린 시일, 그리고 amphotericin B의 총 투여량이 유의한 인자로 나왔다. 그러나 다변량 분석을 시행한 결과 입원 기간만이 독립적으로 유의하게 영향을 미치는 예후 인자로 산출되었다. 결론 : 침습성 진균 감염은 현재도 조혈모세포 이식이나 화학요법 후의 중요한 합병증으로 작용하고 있음을 알 수 있었다. 진균 감염 합병증의 예후에 영향을 미치는 요소로 입원 기간이외에 진단의 신속성과 항진균제의 투여도 유의한지에 대해서는 후속 연구를 통해 재치 규명해야 할 것으로 생각된다. Background : Invasive fungal infections (IFI) are one type of representing total infections in compromised patients. To analyze the characteristics and to determine the prognostic factors of IFI in patients with hematologic diseases undergoing hematopoietic stem cell transplantation (HSCT) and/or chemotherapy. Methods : We retrospectively reviewed consecutive patients (n=122) who received antifungal treatment with the impression of fungal infection complicating post-HSCT or chemotherapy from March-2000 to February-2001. Results : Seventy-four out of 122 registered patients belonged to the IFI on the basis of EORTC/MSG criteria. Six patients were proven IFI, 46 were probable, and 22 were in the category of possible one. The most commonly involved organ was lower respiratory tract (72/74). The mortality was 32.4%. Univariate analysis revealed duration of hospitalization, days to diagnosis of IFI, and total amount of amphotericin B as significant prognostic factors. But multivariate analysis determined only duration of hospitalization from these variables as an independently influencing factor on the prognosis. Conclusion : Invasive fungal infection is still the major threatening complication of HSCT and chemotherapy. Further follow-up and extension of this study is necessary to elucidate more prognostic factors.

전기화상 환자에 대한 임상적 고찰

유병대,김성진,이명갑,서영조,강재구,이동필 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. Methods: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. Results: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was electrothermal burn. The most common point of entry was hand. The average size of burn wounds was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patients with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. Couclusion: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.

스탬핑 성형해석을 위한 유한요소의 자동생성

유동진,윤정환 대진대학교 생산기술연구소 1999 생산기술연구소 논문집 Vol.2 No.-

In the present study, a general method for the mathematical description of arbitrarily shaped surface is proposed by introducing the parametric surface. A polynomial function is employed to descrive the base parametric surface and the boundary curves are defined to describe arbitrary three - dimensional trimmed surfaces. For the mesh generation of initial sheet blank, a grid-based mesh generation algorithm using quadtree is proposed. In order to generate the finite element mesh for tool surface, a hybrid method based on the grid approach and the Delaunay triangulation if proposed. To verify the validity of the proposed method, automatic mesh generation is carried out for some chosen complicated parts including actral automotive panel.

연부조직 육종에서 Cyclin D_(1) 유전자의 증폭에 대한 연구

유재훈,정동준,이정은,김창진 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

The molecular mechanisms of the soft tissue sarcoma is not elucidated. In general, deregulations of the several genes such as oncogenes, antioncogenes, genes regulating apoptosis and cell cycle are known to take part in the carcinogenesis of most carcinomas. Moreover, deregulation of the cell cycle is one of the major carcinogenic mechanisms. The cyclin D_(1) is the most important gene regulating the transition, G_(1). to S, which is the most importan check point in cell cycle. The cyclin D_(1) gene amplification was reported in various carcinomas, but not in sarcomas. In this study, we studied the cyclin D_(1) expression in 10 liposarcomas, 5 rhabdomyosarcomas and 5 malignant fibrous histiocytomas by imunohistochedmistry, and real-time polymerase chain reaction. The results were as follows; 1. Immunohistochemically, liposarcoma and malignant fibrous histiocytomas expressed moderate degree of cyclin D_(1), however expression was noted in few rhabdo- myosarcomas. 2. The cycline D_(1) gene amplification was not different between normal and sarcomas(p>0.05). 3. There was no positive correlation between cyclin D_(1) expression by immunohistochemistry and cylin D(1)gene amplification. Above results suggest that cyclin D_(1) gene amplifacation does not contribute to the oncogenesis of the sarcomas, and cyclin D_(1) expression by immunohistochemistry does not correlate with the gene amplification. As the sample cases are limited in this study, forther studies with more samples are needed.