서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

급성 췌장염의 시대적 변화

김배영(Bai Young Kim),김효종(Hyo Jong Kim),정형근(Hyung Keun Chung),김영관(Young Kwan Kim),동석호(Seok Ho Dong),김병호(Byung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: According to the rapid changes in social environment such as increasing alcohol consumption and the marked improvement in diagnostic technique, we expect that there have been major changes in various aspects of acute pancreatitis during the recent 12 years in Korea. Methods: The medical records of 317 patients with acute pancreatitis diagnosed from 1980 through 1992 were reviewed about clinical, laboratory and radiological findings in the three different time period. Results: 1) There has been an increasing incidence in male sex about three folds. 2) There has been an increasing trends in the duration of hospitalization. 3) A significant increase was observed in the proportion of patients with alcoholic pancreatitis in the three different time period; 26.9%, 45.7%, 50.7% respectively. 4) The complication rates have been slightly increased in the three different time period; 46.3%, 47.1%, 59.1% respectively. But, the type of complications has not been changed. 5) There is increasing severity in non-gallstone group, but no significant differences in gallstone group. There is a declining trends in the number of patients with muld severity index, but increasing trend in the number of patients with moderate severity index in non-gallstone group. 6) There was no significant differences in mortality rate. Conclusions: There has been major changes in the etiology ans severity of acute pancreatitis from 1980 through 1992. Especially, significant increase in the proportion of patients with alcoholic pancreatitis was observed in the three differnt time period. These results might be due to socioeconomic changes.

무증상 갑상선기능저하증 환자에서 Thyroxine 치료에 따른 혈청 지질 및 아포지단백의 변화

조보연,신찬수,김원배,고창순,김성연,박혜영,박건상,이홍규,박형규,김숙경 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.1

Background: Subclinical hypothyroidism(SCH) is a common biochemical abnormality which can be found in routine screening tests of thyroid function. We are increasingly faced with the question of whether its an indication for thyroxine replacement therapy. The effect of thyroxine replacement on lipid profile in SCH has aroused a great interest because of an association of overt hypothyroidism(OVH) with hyperlipidemia and increased risk of coronary artery disease. Method: We prospectively evaluated the changes in lipids and apoproteins before and after thyroxine replacement therapy in 23 patients with SCH and in 37 patients with OVH. We measured serum total cholesterol and triglyceride using autoanalyzer, high density lipoprotein(HDL) chole-sterol by dextran sulfate method, Apo A1 and Apo B by immunonephelometric assay. Results: Thyroxine replacement therapy significantly decreased total cholesterol, low density lipoprotein(LDL) cholesterol and apo B levels, but did not affect the level of triglyceride, HDL cholesterol or apo AI in patients with OVH. In SCH, thyroxine replacement therapy with the doses to normalize serum TSH concentrations also decreased significantly the level of cholesterol and LDL cholesterol albeit apo B levels did not change. Moreover, in most of patients with OVH (11 of 12) and in all of patients with SCH(5 of 5) who had had hyperchlesterolemia before treatment, thyroxine replament normalized their cholesterol and LDL cholesterol levels. Conclusion: In regard to the beneficial changes in blood lipid levels, patients with SCH should be treated, especially in cases who have other risk factors for the development of atherosclerosis. If thyroxine replacement only will reduce the incidence of coronary artery disease in SCH remains to be elucidated by long-term prospective studies(J Kor Soc Endocrinol 11:41-51, 1996).

Poster Session : PS 1239 ; Pulmonology : Azathioprine Induced Cholestatic Hepatitis in Patient with Boop

( Hyung Woo Kim ),( Joo Han Song ),( Kyung Soo Chung ),( Song Yee Kim ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae Kang ),( Young Sam Kim ),( Se Kyu Kim ),( Joon Chang ),( Moo Suk Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Azathioprine is widely used as an immunosuppressive drug in infiammatory bowel disease, many autoimmune disease and after organ transplantation to avoid rejection. Azathioprine has adverse reactions like hepatotoxicity. We report a case of azathioprine induced cholestatic hepatitis in patient with bronchiolitis obliterans organizing pneumonia(BOOP). A-37-year old woman was admitted because of pruritus and jaundice. She took transbronchial lung biopsy, bronchoalveolar lavage for cough, dyspnea and GGO patterns on chest computed tomography(CT) scan before she admitted. And it was revealed that she had BOOP. So she had been followed and treated for BOOP with prednisolone from 23th Nov 2012 and azathioprine from 8th Jan 2013. 42 days after taking Azathioprine, routine blood test was taken. Serum bilirubin, alkaline phosphatase(ALP), aspartate transaminase(AST), and alanine aminotransferase(ALT) was elevated(Bilirubin 4.4mg/dL, AST 75IU/L, ALT 104IU/L) and. Other laboratory test, including prothrombin time, serum albumin, and serum protein were within normal range. There was no history of alcohol abuse or herbal medication intake at this period. To exclude other reasons for hepatotoxicity, serological test was performed. The patient tested to negative for Hepatitis A, B, and C as well as for other markers of autoimmune hepatitis. CT scan showed hepatomegaly with lymph node enlargement and there was no evidence of bile duct obstruction. And TPMT(thiopurine methyltransferase) genotyping was done and revealed to be wild type. Azathioprine was stopped and she was monitored for laboratory changes. Because it was regarded as azathioprine induced cholestatic hepatitis and jaundice, we considered not to do liver biopsy. Day 55 after starting azathioprine therapy, total bilirubin reached peak (12.3mg/ dL). The patient was discharged on day 63 with cholestatic parameters of 115U/L(ALP), 36U/L(γ-GT), and 11.5mg/dL(total bilirubin). After 2 months, total bilirubin was decreased to normal(0.8mg/dL). Treatment of BOOP has been continued only with oral steroid.

울형성 심부전증에서 심혈관계 보상기전의 지표로서 저나트륨혈증의 의의에 관한 연구

김경환,김미경,이우형,홍사석,신길자,장일중 대한내과학회 1986 대한내과학회지 Vol.31 No.3

In patient with congestive heart failure, it is well known that the sympatho-adrenal system and the renin angiotensin system are activated to compensate for the reduction of cardiac output and the redistribution of blood flow. Although Lilly, et al. (1984) and Francis, et al. (1985) have insisted that the induction of these circulatory compensation mechanism by pastura1 changes is closely related to the concentration of plama sodium in congestive heart failure, it is still controversial. Thus, in an effort to clarify this hypothesis, present study was designed to determine the relationship between the existing sodium concentration in plasma and the changes of the plasma catecholamine concentration and renin activity during postural alterations in patients with congestive heart fai1ure and normal subjects. Ten patients with congestive heart failure who had been admitted to the Ewha Womans University Hospital from May, 1985 to July, 1985 and five normal volunteers were chosen. Patients with more than one year history of congestive heart failure belonging to class 3 or 4 as the criteria set by the New York Heart Association have been selected for this study. Among these ten patients, 5(3 males and 2 females) had low plasma sodium concentration(below 135mEq/l) and 5(3 males and 2 females) had normal plasma sodium concentration(above 135mEq/l). The observed results are as follows: 1) In the normal subjects, the observed plasma renin activity was 1,2±0.4ng/ml/hr and the concentrations of norepinephrine and epinephrine were 177.5±27 and 150.0±8pg/ml, respectively, at supine position. However, these values were increased by about 2 times by changing to upright position. 2) In patients with hyponatremic congestive heart failure, the values of plasma renin activity and catecholamine levels were significantly higher than those patients having normonatremia. 3) The increase in the plasma renin activity and catecholamin levels induced by upright position were minimal in patients with congestive heart failure having normonatremia. 4) However, in patients with hyponatremic congestive heart failure, the plasma renin activity and the levels of plasma catecholamines were not altered, or rather decreased, by the same postural changes. Based on the results, the levels of plasma sodium concentration in patients with congestive heart failure could provide an index for the induction of circulatory compensation mechaniams and may have important significance in determining the severity and prognosis of the disease. Particularly in the congestive heart failure patients with hyponatremia, as the circulatory compensation mechanism appear to be operating at maximum already, they would not be able to utilize the reflex compensation mechanism inducible with the changes of body position.

약물 중독 시 위 세척에 의한 산 - 염기 평형 및 전해질의 변화

윤형란(Hyung Ran Yun),손동현(Dong Hyun Sohn),이창범(Chang Bum Lee),이재웅(Jae Woong Lee),양석철(Suck Chul Yang),한동수(Dong Soo Han),손주현(Ju Hyun Sohn),김순길(Soon Kil Kim),김호중(Ho Jung Kim) 대한내과학회 1998 대한내과학회지 Vol.54 No.4

N/A Objectives: There is little information on the imbalance of electrolyte and acid-base metabolism associated with gastric lavage in acute drug intoxication patients. This study was aimed to analyze the acid-base and electrolyte abnormalities associated with gastric lavage in acute drug intoxication patients. Methods: We studied 24 acute drug intoxication patients who had performed gastric lavage with 10 liters of 0.9% NaC1. Electrolyte parameters and arterial blood gas analysis were carried out before and after gastric lavage. Results: After gastric lavage, acidosis was reduced in general. But there was no significant change in pH (7.34±0.02 vs. 7.38±0.15, p=NS). In acid-base balance, the mixed form of metabolic acidosis and respiratory acidosis was reduced from 7 to 2 cases, and the simple form of respiratory acidosis was reduced from 3 to 1 case. In contrast, normal form was increased from 5 to 7 cases and the simple form of metabolic acidosis was increased from 2 to 6 cases. In electrolyte parameters, serum sodium was reduced significantly (145±1.0 mEq/L vs. 141±0.8 mEq/L, p<0.01), but there was no case of significant hyponatremia (<135mEq/L). Bicarbonate level (20±1.1 mEq/L vs. 22±0.9 mEq/L, p< 0.05) and anion gap (19±1.6 mB vs. 13±1.3 mEq/L, p< 0.01) showed significant change. But, blood levels of potassium (3.6±0.1 mEq/L vs. 3.8±0.1 mEq/L, p=NS), chloride (106±0.6 mEq/L vs. 106±0.6 mEq/L, p=NS) and F'aCO2 (36±1.mmHg vs. 37±1.5 mmHg, p=NS) were no significant change before and after gastric lavage. Conclusions: Gastric lavage with 10 liters of 0.9% NaC1 in acute drug intoxication patients did not show clinically significant changes in electrolytes and acid-base balance.

Numerical analysis of flow and bed change at a confluence of the Namhan River and the Seom River using a two-dimensional model

Park Moonhyung,Kim Hyung Suk,Baek Chang Hyun 한국수자원학회 2018 한국수자원학회논문집 Vol.51 No.12

본 연구에서는 4대강 살리기 사업 후 퇴적현상이 지배적으로 발생하는 남한강과 섬강 합류부 구간을 대상으로 2차원 수치모형인 CCHE2D 모형을 이용하여 하천의 흐름 및 하상변동에 대한 해석을 수행하였다. 대상지점 합류부는 남한강 본류의 만곡부에 지류 섬강이 유입되는 특성을 갖는다. CCHE2D 모형은 비평형 유사이송을 해석하며 소류사와 부유사 조정거리가 중요한 입력변수로 대상지점에서는 소류사 조정거리가 하상변동에 가장 큰 영향을 주는 것으로 나타났다. 수치모의 결과 유량비(Qr) 변화가 남한강과 섬강 합류부 지점에서 흐름 및 하상변동에 영향을 미쳤으며, Qr≤ 2.5인 경우에는 합류전 본류의 유속이 증가하여 흐름박리구역을 감소시켰으며 이로 인해 합류부 내측의 퇴적이 감소하였다. Qr>2.5이면 합류부 구간에 퇴적이 증가하여 사주가 형성될 가능성이 높은 것으로 나타났다. 수치모의를 통해 2013년에 발생한 유량비 변화에 의해 합류부에 고정사 주가 형성된 것을 알 수 있었다. The flow and bed change were analyzed using the CCHE2D model, which is a two-dimensional numerical model, at a confluence of the Namhan River and Seom River where deposition occurs predominantly after the “Four Major Rivers Restoration Project.” The characteristic of the junction is that the tributary of Seom River joined into the curved channel of the main reach of the Namhan River. The CCHE2D model analyzes the non-equilibrium sediment transport, and the adaptation lengths for the bed load and suspended load are important variables in the model. At the target area, the adaptation length for the bed load showed the greatest influence on the river bed change. Numerical simulation results demonstrated that the discharge ratio (Qr) change affected the flow and bed change in the Namhan River and Seom river junction. When Qr ≤2.5, the flow velocity of the main reach increased before confluence, thereby reducing the flow separation zone and decreasing the deposition inside the junction. When Qr>2.5, there was a high possibility that deposition would be increased, thereby forming sand bar. Numerical simulation showed that a fixed sand bar has been formed at the junction due to the change of discharge ratio, which occurred in 2013.

농업부문 에너지 수급 구조와 전망

김연중(Yun-Jung Kim),박기환(Ki-Hwan Park),강창용(Chang-Yong Kang),김윤형(Yun-Hyung Kim),김한호(Han-Ho Kim),오세익 한국농촌경제연구원 2010 한국농촌경제연구원 기본연구보고서 Vol.- No.-

According to economic development and changes in internal and external economic conditions, the energy consumption structure and consumption by energy source of our country are largely changing. Nevertheless, South Korea depends on imports for most of its energy, because natural energy resources are insufficient, and is very sensitive to energy-related issues. Recently, because the International Convention on Climate Change raised concern about diminishing fossil fuels and global warming, the importance of energy efficiency is increasing. To understand the energy input structure of the agricultural sector in order to prepare for efficient energy management plans, it is necessary to predict energy consumption by main items. For this, input-outpur analysis was conducted. It was found that our agriculture and forestry and fisheries industry consumed 3.79 million tons oil equivalent(toe) in 2007, and the agriculture sector is expanding; on the other hand, the livestock and forestry and fisheries sectors are generally shrinking. The agriculture sector remarkably uses energy for vegetables and flowering plants, and in the case of vegetables, consumption has increased by more than 9%, and even consumption of flowering plants has increased by more than 11% above the annual average. In addition, the energy input coefficient in the agriculture sector decreased by more than 30% compared with 1995, confirming that, in general, dependence on energy is being avoided. The agriculture sector is an industry dependent on energy as a result of the relatively large input coefficient in horticulture. Meanwhile, domestic new renewable energy use in our country is just 2.43% of total consumption of the first energy but has shown a tendency to swiftly increase the supply rate of new renewable energy since 2000; however, consumption in the agriculture sector is mainly oil related compared with other industries, and the consumption of new renewable energy is almost nothing. Nevertheless, the government established a goal of expanding the supply rate level of new renewable energy to 4.3% in 2015, 6.1% in 2020, and 11% in 2030, so the use of new renewable energy is expected to increase even in the agriculture sector in the future. Energy is the most important resource for the entire range of the national economy, and because of the effect of oil price increases, it has become a major interest of agriculture. Therefore, the government is preparing various policies for the efficient use of energy as well as energy saving. Accordingly, it is important to plan energy-related efficient policy by supplying basic data on energy policy establishment in the agriculture sector by analyzing the supply and demand status of clean energy in the agriculture sector along with the potential energy demand of the main agricultural and livestock products.

한국인 담석증에 대한 임상적 고찰

김광하(Gwang Ha Kim),옥창민(Chang Min Ok),김병진(Byung Jin Kim),주형준(Hyung Jun Joo),송철수(Chul Soo Song),송근암(Guen Am Song),조몽(Mong Cho),양웅석(Ung Suk Yang) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3

N/A Background/Aitns: It has been reported frequently that clinical features of gallstone diseases in Koreans were different from those of Occidentals. These differences were thought to be due to inherent racial difference and acquired living habits. The purpose of this study is to evaluate whether the pattern of gallstone disease changes or not in Korea. Methods: We analyzed 5,488 cases of gallstone diseases which were reported in Korea frorn 1966 to 1994. We divided the period into 6 groups: the first period was 1,000 cases reported from 1966 to 1970, the second was 331 cases from 1971 to 1975, the third was 1,000 cases from 1976 to 1980, the fourth was 1,957 cases from 1981 to 1985, the fifth was 1,000 cases from 1986 to 1990, and the sixth was 200 cases from 1991 to 1993. Results: The age group of highest incidence was the fifth and sixth decade. The incidence below the third decade showed a decreasing tendency. In contrast, the incidence above sixth decade showed an increasing tendency. The male to female ratio was 1:1.25 to 1:1.71 and had no periological change. The duration of illness of highest frequency was below 6 months. In the case of duration above 5 years these was a decreasing tendency. The major complaints of biliary stone were right upper quadrant pain and tenderness. Nausea, vomiting, jaundice, and radiating pain showed a decreasing tendency. The major laboratory findings were leukocytosis, elevated SGOT and SGPT, elevated alkaline phosphatase, hyperbilirubinemia and hypoalbuminemia. Of these, only hypoalbuminernia had a decreasing tendency. By the second period, the main diagnostic procedures were oral cholecystogram and intravenous cholecysto- graphy. From the fourth period, ultrasonography, ERCP, CT and PTC were been used comrnonly. For the location of gallstone, the gallbladder stone revealed the only increasing tendency, the common bile duct stone had a decreasing tendency, and the intrahepatic duct stone had no periological change. From 1980, the cholesterol stone became the main composition of gallstones. But, there was no periological change between early and late 1980s. Positive bacterial culture rate was 57.0% and the most common microorganism was E. coli. Klebsiella and Enterobacter. Pseudomonas showed an increasing tendency. Of the diseases associated with gallstone, only diabetes had an increasing tendency. The frequency of residual stone had an increasing tendency. Conclusions: The age of peak incidence of gallstone diseases was the fifth and sixth decades and there was a little predominance in females. From 1980, the cholesterol stone becarne the main composition of gallstones. For the location of gallstone, the gallbladder stone showed an increasing tendency and the common bile duct stone revealed a decreasing tendency. These suggested clinical features of gallstone diseases in Koreans are somewhat similar to those of Occidentals. (Korean J Gastroenterol 1997;29:352 - 361)

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.