아시아 12개국의 응급의학 실태에 대한 연구 조사

정제명,왕순주,안무업,박재형,유기철,박준석,강재구,제프리 아놀드 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : To assess the current level of development of emergency medicine (EM) systems in Asia. Method : Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. Results : 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. Conclusions : Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.

Uncoupling Protein 3의 골격근 세포내 과발현이 OLETF 백서 및 배양된 골격근 세포에서 포도당대사에 미치는 영향

한정희,박혜선,고정민,김하영,강호경,이인규,박중열,홍성관,이재담,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:Uncoupling protein(UCP)는 미토콘드리아의 내막에 위치하는 단백질로 세포내의 과다한 에너지를 열로 발산시키는 기능을 가진다. 최근 동물의 갈색지방조직에만 존재하는 UCP와 유사성을 가진 아형들(UCP2,3)이 사람에게도 존재함이 알려져 큰 관심을 끌도 있는데 이중 UCP3는 그 발현이 골격근세포와 갈색지방조직에만 국한된다. 본 연구에서는 UCP3가 체내 인슐린 감수성을 결정하는데 가장 중요한 조직인 골격근에 국한되어 발현되는 점에 착안하여 UCP3를 골격근세포에 과발현시켰을 때 포도당 대사에 어떠한 영향이 나타나는 지를 조사하였다. 방법:25주령의 8마리의 OLETF 백서를 대상으로 하여 4마리는 골격근에 adenovirus 2mL(1×10¹²pfu/mL)를 주사하여 대조군으로 하였고 4마리는 골격근에 재조합법으로 제작된 adenovirus­UCP3 2mL(1×10¹²pfu/mL)를 주사하였다(UCP3 과발현군). UCP3를 투여한 백서에서 먹이섭취가 증가하는 경향이 있어 그 전날 대조군이 먹은 야의 먹이만큼 투여하였다. 골격근에 adenovirus를 주사한 10일 후에 euglycemic hyperinsulinemic clamp를 시행하였다. Adenovirus­UCP를 C2C12 골격근 세포에 transfection시켜 UCP3를 C2C12 골격근 세포에 transfection시켜 UPS3­C2C12를 만들고 C2C12 골격근 세포와 UPS3­C2C12 골격근 세포에서 포도당 수송 및 당원합성을 측정하였다. 결과:UCP3 과발현 OLETF에서 체중이 감소하는 경향을 보였고 인슐린 감수성이 증가하였다. C2C12세포에서 기저상태 포도당 수송은 1.28±0.17μmol/L/min였고 100nM 인슐린으로 2시간 처리한 후 2.67±0.20 μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 포도당 수송이 3.98±0.13μmol/L/min로 증가되었고 인슐린 처리 후 5.74±0.44μmol/L/min로 증가하였다. 인슐린을 처리한 UCP3­C2C12 세포에 P13K 억제제인 wortmannin을 첨가하였을 때 포도당 수송활성이 3.81±0.20μmol/L/min로 감소하였다. 기저상태 당원합성은 C2C12 세포에서 0.25±0.01μmol/L/min였고 인슐린 처리 후 0.45±0.01μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 당원합성이 0.62±0.01μmol/L/min였고 인슐린 처리 후 1.26±454μmol/L/min로 증가하였다. UCP3­C2C12세포에 wortmannin을 첨가하였을 때 당원합성율이 0.80±0.04μmol/L/min로 감소하였다. 결론:UCP3 과발현이 OLETF 백서에서 인슐린 감수성을 증가시켰고 골격근세포에서 포도당 수송 및 당원합성을 증가시켰다. wortmannin을 첨가하였을 때 포도당 수송 및 당원합성이 감소함으로 보아 이 과정이 인슐린 신호전달체계인 P13K에 일부 의존함을 알 수 있었다. Background : UC P3 is a mitochondrial membrane protein expressed selectively in the skeletal muscle and brown adipose tissue. Since the skeletal muscle is the main organ determining insulin sensitivity in the body, it was hypothesized that UCP3 overexpression in skeletal muscle cells would improve glucose metabolism. Methods : An adenovirus-UCP3 was produced by a recombinant DNA method. OLETF rats were divided into 2 groups. Four rats were injected with the adenovirus-UCP3 (UCP3 group) and others were injected with the adenovirus(control group) in the skeletal muscle. The UCP3 group was provided with the same quantity of food as that consumed by the control group on the previous day. Insulin sensitivity was evaluated by the euglycemic hyperinsulinemic clamp method. In a separate experiment, glucose transport and glycogen synthesis we evaluated in C2C212 cells transfected with ether an adenovirus or the adenovirus-UCP3. Results : The insulin sensitivity improved significantly and the body weight decreased in the UCP3 group. The glucose transport and glycogen synthesis were higher in the UCP3-C2C12 skeletal muscle cells at the basal state. After insulin treatment, glucose transport and glycogen synthesis were also higher in the UCP3-C2C12 cells but the increments were reduced after treatment with wortmannin, a PI3K inhibitor. Conclusion : Insulin sensitivity was higher in the UCP3-overexpressed OLETF rats in the in vivo study. UCP3 transfection also increased glucose transport and glycogen synthesis in the cultured skeletal muscle cells by a PI3K dependent mechanism(J Kor Diabetes Asso 25 :460~468, 2001).

어항(漁港)을 활용한 해양스포츠 활성화 방안

이재빈,지삼업 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

The plan of utilizing the fishing port for the revitalization of marine sports If you are making the plan which utilize the fishing port for the revitalization of marine sports, you can find the location-wise existing facilities and uni-function. At first, it is necessary to utilize a fishing village & port and a function of fishing port, it has to transport a fishing village & port to a place of marine sports experience tourism. Second, there are two different fishing ports. One is a law court fishing port, another is a regular court fishing port. A law court fishing port becomes multi functional one. Third, in the Pusan Su-yong Yacht Dock, which has a boat harbor, people can use it for enjoying the marine sports. Fourth, An advanced nation is supposed to accepted the concept of a fisherina which help increasing the income of fisherman. Fifth, there are conditions of location, development form, utilization form activity form. management facilities, safety facilities to build the marine sports place. It is important that the fishing port, which attach a program of marine sports, unfold the a marine sports experience tourism and use a law court fishing port.

골뱅이(Buccinum Undatum) 알레르기 : 감작률과 다른 음식물 항원과의 연관성 Sensitization rate and its relationship with other food allergens

이재영,윤성호,서유진,최정희,서창희,남동호,김윤근,민경업,박해심 대한천식 및 알레르기학회 2004 천식 및 알레르기 Vol.24 No.1

Background : The common whelk (Buccinum undatum) is one of the largest and most common snails in the North Atlantic. In Korea and Japan, common whelk is a popular eatable shellfish. Although shellfish has been known as the one of the most common causes of food allergy, there has been no published report on allergenecity and clinical significance of this sea snail. In this study, we determined the sensitization rate to common whelk and its relationship with other food allergens in allergy patients. Method : We carried out the skin prick test (SPT) with commonly consumed food stuffs in Korea including common whelk in 1700 patients over 1 year. The specific IgE to common whelk were detected by enzyme-linked immunosorbent assay (ELISA). ELISA inhibition test using sensitized sera was conducted. Results : SPT to common whelk was positive (≥2+) in 83 (4.9%) patients studied. Twenty-four (38.7%) of 62 SPT-positive patients had high serum specific IgE to common whelk. ELISA inhibition test showed significant inhibitions by abalone as well as by common whelk and, minimal inhibition were noted by shrimp. Significant correlation was also noted in specific IgE levels between common whelk and abalone (r=0.58, F<.05). Conclusion : IgE-sensitization rate to common whelk was 4.9% in allergy patients. Further stuides are needed to evaluate the clinical significance of sensitized patients to common whelk, and to confirm a cross reactivity with abalone. (J Asthma Allergy Immunol 24 : 77-84, 2004)

초등학교 자연과 교육과정안의 작성과 그 연구

임정환,김병업,김명환,김재경 대구교육대학교 1970 論文集 Vol.6 No.-

This researching group of four members of us organized this test plan on the ground of following standpoints: 1. Science education should be designed for the general outline of natural science to be taught till the period of compulsory education is expired. 2. Natural science consists of two elements; one is the scientific method as a way of understanding nature and the other is the system of concept which is got as the result. 3. Science education should be designed, after increasing the belief in sciecne, for the effects of learning to be transformed into the sources of the judgements and behaviours. In this test plan, we definitely represented the above three standpoints as followings: 1. These system of concept of natural science can be condensed into several basic general concepts. These basic concepts become the essence of curriculum plan. Field of Non-living Matters Field of Living Thing 1. Matter 1. Feed 2. Force and Motion 2. Growth 3. Energy 3. Reproduction 4. Time and Space 4. Interaction to Environments 2. The general conepts are incessantly extended and deepened through the process while the scientific methods are applied. The scientific methods which are applied here are these: 1) Observation 2) Classification 3) Experiment 4) Modeling 3. The contents of the thextbook were chosen all over the fields of the natural science but the various contents should be taught wholly and connectively all over the nature. We settled the syllabus between the first grade and the sixth of elementary school on the ground of the above-mentioned basic standpoints and principles.(Refer attached table.) When this test plan is organized successfully, a desirable character who can flexibly adapt to the rapidly changing society and has extentive possibilities will be expected through science education.

과학기술계산을 위한 전자계산기용 특수 Library 개발에 관한 연구

金相萬,姜承業,沈在洪,文東纘,徐光烈,洪勝弘,愼哲宰 광운대학교 1972 論文集 Vol.2 No.-

In this paper the subroutine library of digital computer techniques to the solution of electronic networks problem are discussed. The application of digital-computer techniques to the solution of the integrations relating the terminal variables for linear time invariant inductos and capaciters are analyzed, then on the techniques of numerical integrations trapezoidal method is used. The subroutine library for differential equations and determinations which are used in electronic networks analysis have been developed. Since these programs are the general form, anybody can utilize the programs for his own purpose.

제2형 당뇨병 환자에서 Voglibose와 Acarbose의 비교임상연구

정인경,정재훈,민용기,이명식,이문규,김광원,정윤이,박중열,홍성관,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:아카보스와 보글리보스는 ­glucosidase inhibitors로써 비록 약리학적 작용이나 부작용에 있어서 두 약물간에 차이가 있다는 것은 잘 알려져 있으나 당뇨병 환자를 대상으로 아직 이에 대한 두 약물간에 직접적인 비교에 대해 연구된 바는 없었다. 이에 저자등은 국내 2형 당뇨병 환자에 대해 유효성과 부작용 발현에 대해 두 약제를 비교하고자 무작위법에 의한 위약 대조군의 이중 맹검법 연구를 시행하였다. 방법:시험 약제 투여 4주간의 관찰기를 설정하여 공복혈당의 변화가 30㎎/dL 이하이고, 식후 혈당이 200㎎/dL 이상인 환자로 기타 제외 기준에 해당하지 않은 환자 53명을 대상으로 하여 보글리보스 군(24명)과 아카보스 군(29명)으로 무작위로 나누었다. 치료기간은 총 8주로 하였으며, 4주간 간격으로 혈청학적 검사와 부작용을 분석하여 치료 효과가 부작용을 평가하였다. 결과:1)혈당 변화:보글리보스군은 식후 1시간 혈당이 치료 후 4주, 8주째 의미 있게 감소하였도, 아카보스군은 식후 1시간과 2시간 혈당이 치료 후 4주, 8주째 의미있게 감소하였다. 또한 관찰기 혈당에 대한 치료 4주째 감소량은 아카보스군에서 더 큰 경향을 보였으나, 치료 8주째에는 두 군 간의 강하정도에 의미있는 차이가 없었다(p=0.569). 2)인슐린 치의 변화:보글리스 군은 식후 1시간 인슐린 치가 치료 전에 비해 치료 4주, 8주째 감소하는 경향을 보였고, 공복 인슐린이나 식후 2시간 인슐린치는 치료전 후에 의미 있는 차이가 없었다. 아카보스군에서는 치료 전후로 공복 인슐린, 식후 1시간과 2시간 인슐린치에 의미 있는 차이를 보이지 않았다. 두약제 간에 치료 전과 치료 8주사이의 식후 2시간 인슐린의 감소량이 보글리보스 군에서 의미있게 높았다(p=0.040). 3)당화혈색소:보글리보스 군은 치료 전에 비해 치료후 당화혈색소가 감소하는 경향을 보였고, 아카보스군은 치료 전에 비해 의미있게 감소하였다. 당화혈색소 변화량은 두 군간에 의미 있는 차이는 없었다(p=0.412). 4)지질대사의 변화:중성지방, 콜레스테롤, 고밀도 진단백 콜레스테롤에 대해 두 군간에 의미 있는 차이는 없었다. 5)부작용:소화기계 부작용의 빈도는 치료 4주째 보글리보스 군에서 의미 있게 낮았으나(p=0.028), 치료 8주째 부작용의 빈도는 두 군간에 의미 있는 차이가 없었다(p=0.215). 결론:2형 당뇨병 환자에서 보글리보스와 아카보스의 두 약제의 임상적 유효성과 부작용발현에 대해 비교한 결과 치료 후 8 주 후 혈당강화효과는 두 약제간에 유사한 효과를 보였으나 보글리보스군에서 4주째의 초기 위장관 부작용이 적었다. Background : Acarbose and voglibose are alpha-glucosidase inhibitors. Although different pharmacological effects and adverse abdominal events associated with the two drugs have been reported, no study directly compared acarbose and voglibose in diabetes has been undertaken. To compare the pharmacological effects and gastrointestinal adverse events between two drugs, a randomized, placebo-controlled, double-bind study was performed in type 2 diabetes patients. Methods : The period of study was 12 weeks(observation period: 4 weeks; treatment period: 8 weeks). Fifty-three patients were randomized into two groups(the acarbose group: 24 patients; the voglibose group: 29 patients). The serum glucose, insulin, fructosamine, HbA_1c, cholesterol, triglyceride and the incidence of adverse events were measured. Results : 1) The reduction of glucose from before treatment to 4 weeks after treatment was significantly higher in the acarbose group, but the change before treatment and 8 weeks after treatment in the two groups was similar(p=0.569). 2) The insulin significantly decreased after voglibose treatment(p=0.040). 3) HbAa_1c level tended to decrease in voglibose group, and there was a significant decrease after acarbose treatment. However, the change in HbA_1c level before and after treatment was similar between the two groups(p=0.412). 4) The two drugs did not cause any other changes in the total, HDL-cholesterol and triglyceride. 5) The number of patients with gastrointestinal adverse events was significantly low 4 weeks after voglibose treatment (p=0.049), but the incidence in the two groups was similar after 8 weeks(p=0.215). Conclusions : Acarbose and voglibose significantly improved postprandial hyperglycemia in diabetes. The incidence of gastrointestinal adverse events was low 4 weeks after voglibose treatment(J Kor Diabetes 26:134~145, 2002).

2×2 교차설계에 의한 생물학적 동등성 시험에서 결측치가 있을 때의 통계적 해석 방법

박상규,이재영,최성업,윤미경,이재휘,최영욱 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.5

Statistical interpretations in a bioequivalence trial are considered and studied when the missing observations occurred in 2 × 2 crossover experiment. Patel (1985) suggested the approximate test procedures for carryover effect and drug effect in 2 × 2 crossover design when some of data are missing in the second period. A modified Patel method is newly pro-posed to the bioequivalence trial and it is compared with the current method through the simulation study.

Response Rates to Medical Treatments and Long-term Clinical Outcomes of Nonsurgical Patients With Intestinal Behçet Disease

Chung, Moon Jae,Cheon, Jae Hee,Kim, Seung Up,Park, Jae Jun,Kim, Tae Il,Kim, Nam Kyu,Kim, Won Ho Lippincott WilliamsWilkins, Inc. 2010 JOURNAL OF CLINICAL GASTROENTEROLOGY Vol.44 No.6

BACKGROUND: The aims of this study were to evaluate the efficacy of medical treatments and to identify factors to predict clinical outcome of intestinal Behçet disease (BD) during medical treatment. METHODS: We performed a retrospective review of the medical records of 93 patients who were diagnosed and medically treated with intestinal BD at Severance Hospital, Seoul, Korea from 1992 to 2007. A therapeutic response was evaluated 8 weeks after the initiation of medical treatment, and cumulative recurrence and surgery rates were also assessed during long-term follow-up. RESULTS: The initial remission rate at 8 weeks after treatment was 66.7%. During the follow-up period, cumulative recurrence rates for intestinal BD were 24.9% at 2 years and 43.0% at 5 years. The recurrence rate was significantly higher in patients with apparent gastrointestinal symptoms at their initial presentation, volcano-type and deep intestinal ulcers, and those who failed to achieve complete remission during the initial treatment. Cumulative rates for surgery were 6.7% at 2 years and 15.1% at 5 years. The typical type of ulcers was the only predictive factor for the likelihood of surgery. CONCLUSIONS: Our study demonstrates that a considerable number of patients experience disease relapse during follow-up despite a high-remission rate after medical treatment for intestinal BD. Careful observation and intensive treatment should be carried out, especially in patients without complete remission after initial treatment, with deep and volcano-shaped ulcers, or with apparent gastrointestinal symptoms at the time of diagnosis.

Poster Session : PS 1035 ; Others : Diagnostic Yield and Clinical Impact of Multidetector CT Angiography in Patients with Obscure astrointestinal Bleeding

( Jae Min Jo ),( Hyun Joo Song ),( Soon Jae Lee ),( Sun Jin Boo ),( Soo Young Na ),( Heung Up Kim ),( Seung Hyoung Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Obscure gastrointestinal bleeding (OGIB) accounts for 5% of all gastrointestinal (GI) bleeding cases. Multidetector CT angiography (MDCTA) is not generally recommended in OGIB patients due to its low sensitivity. However, it can be used to quickly and simply diagnose OGIB according to some guidelines. The aim of this study was to evaluate the diagnostic yield and clinical impact of MDCTA in OGIB patients Methods: We retrospectively analyzed the medical records of 363 patients who underwent MDCTA between March 2009 and December 2013. A total of 46 patients were diagnosed as having OGIB, and their baseline characteristics and treatment outcomes were analyzed. The sensitivity, specifi city, and positive and negative predictive values of MDCTA for the detection of bleeding sites were assessed Results: The mean age of the patients was 59 ± 24 years. Melena was the most common symptom (39.1%). Positive MDCTA findings were observed in 8 patients. Of these 8 patients, bleeding occurred from the small bowel in 7 patients and from the colon in 1 patient. The sensitivity, specifi city, and positive and negative predictive values of MDCTA were 34.8% (8/23), 88.2% (15/17), 80.8% (8/10), and 41.7% (15/36), respectively. Thirty-three patients (71.7%) underwent conservative management, and 10 patients (21.7%) underwent specifi c treatment. Patients who showed true positivity in MDCTA tended to receive specifi c treatment rather than conservative management (62.5% vs 37.5%, p=0.10). Patients who underwent specifi c treatment and showed true positivity in MDCTA more frequently had recurrent bleeding (p=0.008). The mean follow-up period was 18.3 ± 16.9 months, and the total 8 patients (17.4%) had recurrent bleeding Conclusions: MDCTA showed a low sensitivity, a relatively high specifi city, and a positive predictive value for OGIB. MDCTA may be useful for identifying bleeding sites in OGIB patients.