악성 위궤양의 형태를 보인 원발성 위결핵 1예

한종대,이동욱,심성준,류운석,안현택,박찬욱,김배영,이미선 大韓消化器內視鏡學會 1999 Clinical Endoscopy Vol.19 No.부록2

위 전절제술을 받았던 환자에서 아급성 연합성 변성 1예

한정호,하현욱,이정석,송은향,김우정,김두응,최진영 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Subacute combined degeneration is a metabolic disorder of the spinal cord caused by vitamin B12 deficiency. A 72-year old man was admitted with weakness and tingling sensation of the bosh upper extremities. 9 years ago, he was diagnosed as having stomach cancer. So total gastrectomy with splenectomy was done at that time. The complete blood cell counts and morphology revealed megaloblastic anemia. Nerve conduction velocity study(NCV), electoromyography(EMG) and somatosensory evoked potentials(SEP) showed diffuse sensorimotor peripheral neuropathy. Magnetic resonance imaging(MRI) showed an increased T2-weighted signal, mild decreased T1-weighted signal, and slight contrast enhancement of the posterior columns of the cord in the cervical and upper thoracic spinal region. He was treated with vitamin B12 supplements and improved gradually. If abnormal sensation and muscle weakness was developed after gastrointestinal surgery, subacute combined degeneration should be considered in the differential diagnosis. We describe MRI findings of a typical case of subacute combined degeneration, which was induced by total gastrectomy.

유압식 인버터 제어기의 속도제어를 위한 퍼지기반 하이브리드 슬라이딩모드 제어기 설계

한권상,최병욱,안현식,김도현 제어·자동화·시스템공학회 2003 제어·자동화·시스템공학논문지 Vol.9 No.3

19세기 西進東漸의 파도 속에서 국가의 자립과 근대화를 위해 몸소 힘썼던 兪吉潛과 福澤??論의 사상 가운데 그들의 政淪論을 한국과 일본의 근대화 방향 차이를 중심으로 살펴보고자 한다. Due to the friction characteristics of pump, cylinder packing and passenger car, in the elevation system actuated with hydraulic inverter, there exist dead zones, which cannot be controlled by a PID controller. To overcome the drawbacks, in this paper, we propose a new hybrid fuzzy-sliding mode control scheme, which controls the controller output between a sliding mode control output and a PID control output by fuzzy control method. The proposed hybrid control scheme achieves an improved control performance by using both controllers: We first propose a design method of the hybrid controller for a hydraulic system controlled by inverters, then propose a design method of a hybrid fuzzy-sliding mode control scheme. The effectiveness of the proposed control scheme is shown by simulation results, in which the proposed hybrid control method yields better control performance then the PID controlled scheme, not only in the zero-crossing speed region but also in the overall control region including steady-state region.

3~6학년 자연 교과서와 SATIS 8-14 프로그램의교육 목표 비교 분석

한영욱,이현주 부산교육대학교 과학교육연구소 1998 科學敎育硏究 Vol.23 No.-

The purpose of this study is to analyze the educational objective of SATIS 8-14 program and korean science texts in terms of the three dimensional assessment framework of educational objectives for science education which is composed of the content, behavior and context domain. The major contents of this study are as follows; 1. a comparison between the educational objective of SATIS 8-14 program and korean science texts in the content domain; 2. a comparison between the educational objective of SATIS 8-14 program and korean science texts in the behavior domain; 3. a comparison between the educational objective of SATIS 8-14 program and korean science texts in the context domain.

원발성 연수 출혈증 1예

하현욱,한정호,이정석,송은향,김우정,김두응,최진영 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Pure primary medullary hemorrhage is a rare condition, which is characterized by ipsilateral hypoglossal nerve palsy and contralateral hemiparesis. The hemorrhage usually extended to medial and ventral medulla, these two characteristic signs distinguished from the classical presentation of Wallenberg's lateral medullary syndrome. A 53-years-old man was admitted with sudden onset left sides weakness and vertigo. Neurologic examination showed dysarthria, mild dysphagia, Horner syndrome of right side, spontaneous horizontal jerking nystagmus to left side and right deviation of tongue at protrusion. Pain and temperature sensation of left trunk, left extremity and right face were decreased. Brain CT scan and brain MRI revealed focal hemorrhage in the right medulla. We report a case of pure primary medullary hemorrhage with undetermined etiology.

소뇌 출혈을 동반한 침입성 부비동 아스페르길루스증 1예

양현덕,박성욱,손일홍,이지용,석승한,조광호,이성수 圓光大學校 醫科學硏究所 2003 圓光醫科學 Vol.18 No.2

안면비대칭 환자에서 하악의 측방변위와 두개관형태 사이의 연관성

신상욱,이상한,장현중 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

This study was intended to perform the relationships between mandibualr lateral deviation in facial asymmetry patients and morphology of the cranial vault. In 30 patients(males 14, female 16) using submento-vertical cephalograms that were taken in the pre-operaticve state and posteroanterioir cephalograms that were taken in centric occlusion before, immediate and long term after surgery. 1. Mean mandibular deviation was about - 3.12°and mean of absolute measurement was about 2.50°on the submento-vertical cephalograms. 2. On the submento-vertical cephalograms, there was no significant difference between non-deviation and deviation side but it had tendency that deviation side was larger than non-deviation side on the frontal portion of cranium(Y10 to Y6) and deviation side was samller than non-deviation on the temporal portion of cranium(Y5, Y-1 to Y-5). 3. Mean mandibular deviation was about 1.40°and mean of absolute measurement was about 3.95°on the posteroanterioir cephalograms. 4. There was statistical significance on the influence of surgical change(PT2A-PT1A) to the relapse(PTLA-PT2A)(p<0.05). The more increasing of the change, the more relapse on the posteroanterioir cephalograms. 5. There was no statistical significance on the influence of degree of mandibular deviation to morphology of the cranium on the submento-vertical cephalograms. But it had tendency that the more mandibular deviation, the larger the non-deviation side on the anterior cranium and deviation side on the posterior cranium(p>0.05). 6. There was statistical significance on the influence of the degree of mandibular deviation on the posteroanterioir cephalograms to the difference between non-deviation and deviation side. The more increasing of mandibular deviation, the larger the non-deviation side on the Y4 to Y-6(p<0.05). 7. There was no statistical significance on the influence of difference between non-deviation and deviation side to the relapse on the posteroanterioir cephalograms. But it had tendency that the more increasing of the differece between non-deviation and deviation side, the more increasing the relapse on temporal of cranium.

지속성 외래 복막투석 환자에서 염증 지표와 고해상도 B 모드 경동맥 초음파 소견의 연관성에 관한 연구

송현용,송영수,안철우,강신욱,최규헌,하성규,이현철,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

배 경 : 저알부민혈증 및 C-반응 단백(C-reactive protein, CRP)이 증가된 지속성 외래 복막투석 환자의 사망률이 높은 정확한 이유는 밝혀져 않다. 혈액투석 환자에서처럼 복막투석 환자에서 저알부민혈증 및 염증반응이 심혈관계 질환 위험인자 인지 알아보고자 하였다. 방 법: 비당뇨병성 말기 신부전, 지속성 외래 복막투석 환자 93명의 심혈관계 질환 위험인자들과 복막 투과 특성 및 알부민, CRP 등의 염증지표에 따라 고해상도 초음파를 이용한 경동맥내막-중간막 두께, 내막-중간막 면적, 플라크의 유무 등을 단면적으로 비교하였다. 결 과: 복막 투과 특성은 고투과막군 14명, 중간 고투과막군 38명, 중간 저투과막군 31명, 저투과막군 10명으로 각 군간의 경동맥 내막-중간막 두께, 플라크 유무 및 내막-중간막 면적의 차이는 없었다. 기존 관상동맥 질환 환자는 8예(8.6%)로 내막-중간막 두께는 관상동맥 질환이 없는 환자보다 증가되었고(0.79±0.21 vs 0.60±0.11 mm, p<0.05) 플라크 형성은 더 많이 보이나 통계적 유의성은 없었다(75.0 vs 63.5%, p>0.05). 혈청 알부민치와 경동맥 내막-중간막 면적은 역상관관계를 보였다(r=-0.27, p<0.05). 저알부민혈증 환자(혈청 알부민 <3.5 g/dL)는 정상 알부민혈증 환자보다 내막-중간막 두께가 증가되었고(0.67±0.15 vs 0.61±0.12 mm, p<0.05), 플라크도 유의하게 많았다(68.0 vs 55.8%, p<0.05). 혈청 CRP치와 경동맥 내막-중간막 면적은 양의 상관관계가 있었으며(r=0.21, p<0.05) CRP가 높은 환자(≥0.8 mg/dL, n=18)에서플라크가 많이 관찰되었으나(65.8 vs 50.0%, p<0.05) 경동맥 내막-중간막 두께 및 내막-중간막면적은 양군간에 차이가 없었다. 다변량 회귀 분석상 경동맥 내막-중간막 두께에 영향을 미치는 인자는 고령, 높은 CRP, 기존 심혈관계질환, 낮은 혈청 알부민 순이였다. 결 론 : 복막투석 환자에서 고해상도 초음파를 이용한 경동맥 내막-중간막 두께 측정은 심혈관계 질환 유무 예측의 비침습적 검사가 될 수 있고 저알부민혈증 및 높은 CRP과 같은 만성염증 지속상태가 복막투석 환자에서 죽상 동맥 경화증의 발생을 증가시킨다고 가정할 수 있다. Background : Continuous ambulatory peritoneal dialysis(CAPD) patients with low albumin(LA) and signs of inflammation reflected by increased C-reactive protein(CRP) level have an increased mortality, but the mechanism of this phenomenon is not clear yet. Methods : To answer whether LA and inflammation also enhance cardiovascular risk in CAPD patients, we performed cross sectional study measuring carotid artery intima-media thickness(IMT), calculated intima-media area(cIM area) and the presence of plaque by high-resolution B-mode ultrasonography in 93 non-diabetic CAPD patients. Results : Patients with coronary artery disease (CAD, n=8) had significantly increased IMT(0.79± 0.21 mm vs. 0.60±0.11 mm, p<0.05) and higher prevalence of carotid plaques(75.0% vs. 63.5%) compared to the non-CAD patients. Significant inverse correlation was observed between serum albumin (SA) level and cIM area(r=-0.27, p<0.05). Those patients with LA(SA <3.5 g/dL) had significantly increased IMT compared to non-LA patients(0.67±0.15 mm vs 0.61±0.12 mm, p<0.05). Prevalence of carotid plaques was also significantly higher in LA patients (68.0% vs. 55.8%, p<0.05). CRP level revealed a significant positive correlation with cIM area(r=0.21, p< 0.05). Patients with high CRP(≥0.8 mg/dL, n=18) had higher prevalence of carotid plaques (65.8% vs. 50.0%, p<0.05) compared to those patients with CRP <0.8 mg/dL, but IMT and cIMT area were not different. By multivariate logistic regression analysis, old age, high CRP, history of CAD and low SA were the independent risk factors affecting IMT. Conclusion : Our study strongly suggests that low albumin and chronic inflammatory state of CAPD patients could be associated with increasing atherosclerotic cardiovascular disease. (Korean J Nephrol 2002;21(2):285-294)

말기 신부전 환자에서 투여 경로에 따른 유전자 재조합 인 Erythropoietin(Epokine^(�))의 효과와 안정성에 대한 연구 : 제 4상 연구 A Phase 4 Single Center Study

송현용,윤향숙,강신욱,최규헌,하성규,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

목 적 : 국내 독자적 기술로 첫 개발된 유전자 재조합 인 에리트로포에틴(Epokineⓡ)의 투여방법에 따른 유효성과 안정성을 알아보고자 하였다. 방 법 : Epokineⓡ을 주당 100-150 U/kg, 주 2회, 12주간 피하 주사하여 목표 또는 안정된 혈색소치 유지 후 무작위로 피하 및 정맥 주사군으로 나누어 12주간 혈액투석 및 복막투석 환자13명, 28명에서 유효성, 안정성을 분석하였다. 결 과 : 양군에서 혈색소치와 헤마토크릿은 Epokineⓡ 투여 2주 후부터 증가, 혈색소치가 혈액투석 환자는 투여 전 7.3 g/dL, 투여 12주 9.5 g/dL, 24주 10.6 g/dL로, 복막투석 환자는 6.8g/dL에서 12주 10.2 g/dL, 24주 10.8 g/dL로 증가하였다. 양군에서 교정 망상적혈구수(%)는투여 1주 후부터 전 기간동안 증가하였다. 혈청 내 철분, ferritin치는 양군에서 투여 2주 후부터감소, 총 철분 결합능은 투여 2주 후부터 증가하였다. 12주째 혈액투석 환자에서 많은 Epokineⓡ용량이 필요했으나(142.2±20.5 vs 117.3±33.6 U/kg/wk, p<0.001) 24주 후 양군의 용량차이는 없었다(123.6±41.5 vs 99.2±49.3 U/kg/wk, p>0.05). 혈액투석 환자에서 피하 주사가Epokineⓡ 투여용량이 더 적었으나(97.4±15.4 vs 145.4±2.9 U/kg/wk, p<0.002) 복막투석 환자는 차이가 없었다(93.0±60.2 vs 105.4±9.7 U/kg/wk, p>0.05) 연구기간 중 9명(18.8%)에서혈압강하제 추가가 필요한 혈압상승, 근육통 동반 상기도 감염 유사증상 및 두통 등의 부작용이 있었다. 대부분 자연소실 혹은 대증요법으로 치유되었고 2명이 부작용으로 탈락하였다. 결 론 : 말기 신부전 환자의 빈혈 개선에 사용하는 Epokineⓡ의 효과는 복막투석 환자에서 더 좋았으며 투여 경로는 정맥주사보다 피하주사가 높음을 알 수 있었다. Background : We evaluated the clinical efficacy and safety of recombinant human erythropoietin(Epokine^(ⓡ)). Methods : A comparative prospective study of intravenously and subcutaneously administrated Epokine^(ⓡ) conducted 13 patients performing hemodialysis and 28 patients performing continuous ambulatory peritoneal dialysis with end-stage renal disease. Epokine^(ⓡ) was given initially at a dosage of 100 unit/kg, subcutaneously, two times a week. The patients had achieved stable or more than 10 g/dL of hemoglobin level for 12 weeks and then we randomized switching intravenously or subcutaneously administrated Epokine^(ⓡ) for another 12 weeks. Results : Hemoglobin(g/dL) and hematocrit(%) increased significantly from baseline levels beginning from 2 weeks after Epokine^(ⓡ) administration. In HD patients, hemoglobin increased significantly from 7.3 to 9.5 after 12 weeks and to 10.6 after 24 weeks. In CAPD patients, hemoglobin increased significantly from 6.8 to 10.2 after 12 weeks and then 10.8 after 24 weeks(p<0.05). Corrected reticulocyte count(%) was significantly increased from baseline levels beginning from 1 week after Epokine^(ⓡ) administration and continuously increased during study period in both group. Serum ferritin and serum iron decreased significantly and total iron binding capacity increased significantly after 2 weeks. At 12 weeks, HD patients were significantly needed more dosage of Epokine^(ⓡ) than CAPD patients(142.2±20.5 vs 117.3±33.6 U/kg/wk, p<0.001), but at 24 weeks, the dosage was not different(123.6±41.5 vs 99.2±49.3 U/kg/wk, p> 0.05). In HD patients, intravenously administrated Epokine^(ⓡ) group was more dosage than subcutaneously group(97.4±15.4 vs 145.4±2.9 U/kg/wk, p< 0.002), but CAPD patients were not different by administration method(93.0±60.2 vs 105.4±9.7 U/kg/ wk, p>0.05). The 9 cases(18.8%) were suffered from headache and flu-like syndrome, but these side effects were not severe and disappeared from conventional therapy. Conclusion : Epokine^(ⓡ) administration is safe and effective in treating anemia of ESRD patients and subcutaneously administration is significantly more effective than intravenously. (Korean J Nephrol 2002;21(2):190-198)

다국소 망막전위도를 통한 특발성 망막전막 제거술 전, 후의 황반 기능 평가

최성욱,이상엽,김현웅,윤일한 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

Objectives: To assess macular function after vitrectomy and membrane removal in eyes with idiopathic epiretinal membrane by means of multifocal electroretinogram (mfERG). Methods: Visual acuity, macular thickness measured by optical coherence tomography (OCT), and mfERG recordings were achieved for 14 eyes of 14 patients with idiopathic epiretinal membrane. All exams were performed before epiretinal membrane surgery and 1, 3, and 6 months after surgery. The average retinal response density and implicit time of each local response were estimated as anatomic macular areas corresponding roughly to 5 rings. Preoperative and postoperative responses of visual acuity, macular thickness, and mfERG were compared. The correlations of the change of retinal response density, visual acuity, and macular thickness were analyzed. Results: There were no significant changes in amplitude and implicit time measured by mfERG before and after the surgery (p>O.05). There were no significant correlations between the changes of amplitude and implicit time and visual acuity and macular thickness. Conclusion: Changes in mfERG recordings were not useful for predicting clinical prognosis after epiretinal membrane surgery.