재발한 가와사끼병(Kawasaki disease) 1례

길홍량,한헌석,하태선,이경희,박범수 충북대학교 의과대학 충북대학교 의학연구소 1995 忠北醫大學術誌 Vol.5 No.1

가와사끼병은 5세 미만의 영유아에서 호발하는 급성 전신성 혈관염으로 아직 원인이 밝혀지지는 않았으나 감염성질환 또는 자가면역질환 등으로 추정되고 있다. 1967년 일본의 Tomisaku Kawasaki에 의해 처음 보고되었으며 국내에서도 많은 증례보고가 있어왔다. 가와사끼병은 발열, 발진, 안결막 충혈, 사지말단의 변화, 구강과 입술의 변화, 경부 림프선증 등을 특징으로 하며, 치료로는 면역글로블린의 대량 정주요법과 아스피린이 사용되고 있으며 합병증에는 관상동맥류를 비롯한 심혈관질환이 있고 이로 인한 사망율이 1-2%정도인 것으로 보고되고 있다. 이 질환의 재발은 드문 것으로 되어 있고 일본의 한 보고에 의하면 2-3%로 추정된다. 환아는 6세 남아로 14개월 전 처음 가와사끼병으로 진단받고 감마글로블린과 아스피린을 투약 받았고 당시 심혈관질환은 없었으며 본원 내원시에는 발열, 발진, 안결막 충혈, 붉고 갈라진 입술, 좌측 림프선병증과 손, 발의 부종이 있어 가와사끼병의 진단기준을 만족하였다. 환아는 역시 감마글로블린과 아스피린으로 치료받고 증세가 호전되었으며, 심초음파 검사상 관상동맥의 확장이나 관상동맥류의 증거는 없었다. 저자들은 가와사끼병의 재발 1례를 경험하였기에 보고하는 바이다. Kawasaki disease, acute systemic vasculitis, that usually occurs in infant and young children. The etiology is unknown, but is supposed to be infectious disease or autoimmune disease. Kawasaki disease was first reprted by Tomisaku Kawasaki at 1967 and then many cases have been reported in Korea. Kawasaki disease was characterized by fever, rash, conjunctival injection, changes of extremities, changes of oral cavity and lips, lymphadenopathy and has been treated with intravenous gammaglobulin and aspirin. The complications are cardiovascular lesions including coronary aneurysm and coronary thrombosis. Mortality is approximately 1-2%. Recurrence is rare and 2-3% in Japanese reports. A 6-year-old boy presented with the fever, rash, conjunctivitis, red fissured lips, left lymphadenapathy, and hands and feet edema. He had been treated with intravenous gammaglobulin and aspirin for Kawasaki disease 14 months ago. At that time, he didn't have cardiovascular lesion. He was also treated with intravenous gammaglobulin and aspirin at this episode. We didn't detect coronary artery dilatation or coronary aneurysm. So, authors report a case of recurrent Kawasaki disease.

고농도 Manitol용액의 관류에 의한 흰쥐 뇌혈관의 미세구조의 변화

엄순길,김경용,이원복,김동창 대한해부학회 1993 Anatomy & Cell Biology Vol.26 No.4

제주해협의 해류와 월별 유량변화

노홍길,방익찬,김상현,현경훈,김준택,양영진,홍창수 제주대학교 해양연구소 1997 해양자원연구소연구보고 Vol.21 No.-

Currents are measured in the Straits of Cheju by detecting surface buoy tracks and mooring current meters in 1996-1997. As a result, north-eastward currents are decteted in the Straits of Cheju all the year round, which is weak in spring and strong in summer and fall. Average speeds of 20 cm/s to the east. 7 cm/s to the north and 22 cm/s to the north-east appeared in the surface. Currents are fast in the middle of the strait and slow near Cheju Island. East-west components of the currents are about 3 times faster than the north-south ones. Also. it is shown that surface buoys released within the distance of 6 miles away from Cheju do not drift out of the Straits of Cheju because of tongue-like warm waters appeared in the eastern entrance of the strait. Volume transports calculated by geostrophic calculation are shown to be 0.05-0.2 Sv in winter and 0.4-0.5 Sv in summer.

성장기 여아에서 첫째 및 셋째 수지 지절 변화와 초경시기

김경호,최광철,정길용 대한치과교정학회 2002 대한치과교정학회지 Vol.32 No.4

성장기 환자의 발육 상태를 나타내는 여러 지표 중 수완부 골성숙도와 초경시기가 유용하게 사용될 수 있으며 수완부 골성숙도에서는 첫째와 셋째 수지의 변화가 비교적 중요한 의미를 가지고 있다. 이에 본 연구에서는 첫째 수지 및 셋째 수지의 지절 변화와 초경 및 부정교합과의 연관성을 조사하기 우해, 성장기여아 중 Ⅰ급 부정교합자 29명, Ⅱ급 부정교합자 27명, Ⅲ급 부정교합자 27명을 대상으로 약 6개월 간격으로 모지척측종자골 출현 전부터 수지 지절의 융합이 거의 이루어지는 시기까지 누년적으로 촬영한 수완부골 방사선 사진과 초경시기를 평가하여 다음과 같은 결론을 얻었다. 1. 부정교합에 따른 골성숙도의 차이는 없었다. 2. 부정교합에 따른 초경연령의 차이는 없었으며, 초경의 평균 연령은 12.30±0.98세였다. 3. 모지척측 종자골 출현은 10.35±1.01세, 첫째 수지의 원심부 지절에서 capping단계는 11.26±1.04세, 융합시기는 13.12±1.06세이고 셋째 수지의 중간 지절의 capping은 11.57±1.02세 융합은 13.72±1.01세에 일어났다. 4. 초경은 첫째 수지 원심부 지절의 융합이 진행되는 시기와(p<0.001, r=0.82), 세째 수지 중간 지절의 융합이 시작되는 시기와(p<0.001, r=0.78) 비슷한 시기에 나타났다. 이상의 결과로 첫째 또는 셋째 수지 지절 변화만으로 성장기 여아에서의 발육상태를 평가할 때 도움을 줄 수 있음을 알 수 있었다. Among many maturation indicators of growing patients, menarche and skeletal maturity are useful to assess growth and development, and the changes of the first and third finger are relatively important in hand-wrist X-rays. The objective of this study was to evaluate the relation between menarcha and the changes of the phalanx of the first and third finger and compare skeletal maturation among different malocclusion types. The sample used in this study was 29 Class Ⅰ, 27 Class Ⅱ and 27 Class Ⅲ females whose hand-wrist X-rays had been taken with 6 month interval before the appearance of ulnar sesamoid ossification till the phalanges of the fingers were almost fused. The results were as follows. 1. There was no skeletal maturity difference among malocclusion types. 2. There was no difference in the mean chronologic age of menarche among different malocclusion type and that was 12.30±0.98 years. 3. The ulnar sesamoid was observed at 10.35±1.01 years, and distal phalanx of the first finger, epiphyseal capping appeared at 11.26±1.04 years and fusion at 13.12±1.06 years. The epiphyseal capping on middle phalanx of the third finger was observed at 11.57±1.02 years and fusion at 13.27±1.04 years. 4. The timing of menarche occurred around the same time as the fusion process of distal phalanx of the first finger(p<0.001, r=0.82) and the initiation of fusion of middle phalanx of the third finger(p<0.001, r=0.78). Therefore, we can give the aid when we evaluate the growth and development of growing females seeing the changes at phalanx of the first and third finger.

남·서해의 계절 순환과 여름철 난류수의 서해 유입

현경훈,방익찬,노홍길 제주대학교 해양연구소 1996 해양자원연구소연구보고 Vol.20 No.-

In order to study on the seasonal circulation in the South and West Seas of Korean Peninsula and the inflow of warm waters into the West Sea(eastern Yellow Sea) in summer, water mass analysis is used with temperature and salinity data observed by National Fisheries Research & Development Agency du-ring 1970~1990. In the West Sea, warm waters are majorly mixed by the mixing rate of 40~60% in summer, while cold waters are dominant in winter. In the central region of the Yellow Sea. warm waters are distributed linked with the northwestern sea of Cheju Islands in winter but cold waters are distribu-ted in the lower layer in summer. The reverse of water mass distributions in winter and summer could be explained only by the seasonal circulations. In winter, warm waters are intruded to the central region and cold waters flow southward along the west coast of Korea. In summer, warm waters flow northward along the west coast of Korea and cold waters flow southward in the central region. Therefore, Yellow Sea Warm Waters can be defined as the northward flow of warm waters toward the central region of the Yellow Sea in winter and along the west coast of Korea in summer.

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

여름철 동중국해의 수괴분석과 대만난류의 북상경로

현경훈,방익찬,이재학,노홍길 제주대학교 해양연구소 1997 해양자원연구소연구보고 Vol.21 No.-

CO₂레이저빔에 의한 이종재질 및 이종두께의 Tailored Blank 용접에 관한 연구

이경돈,유병길,김도훈,황창선 한국레이저가공학회 1999 한국레이저가공학회지 Vol.2 No.3

This research was conducted as a fundamental study to apply tailored blank welding technique into automotive production process. The materials used in this study were 2.0mm thickness low carbon steel sheets and 1.2mm Zn-coated low carbon steel sheets. To ensure the reproducibility and to consider various factors, experiments were conducted by applying Taguchi experimental method with 6 factors. Every welding process was repeated 3 times to offset the effect of uncontrolled factors. Elongation and LDH(Limited Dome Height) were measured to evaluate formability of specimens and Optical microscopy, XRD, SEM, and EDS analysis were performed to observe the microstructures and to determine the solidification mode in the weld. The elongation of specimen welded with optimum condition was 83% of base metal, and LDH was 84% of base metal. In case of laser treated specimen where Zn coating was removed, elongation was 85% of base metal, and LDH was 85% of base metal. In fusion zone, phases were consisted of quasi-polygonal ferrite, banitic ferrite, and martensite.

Community Sports Club 육성을 둘러싼 학교의 기능에 관한 연구

이길민,백경운,육영숙 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.1

This aim of this study is to make clear the role(function) of schools in developing or materializing a comprehensive sports club. This study examines what type of relationship two organizations, the regional society and school system, should have, to develop a sports club, from the collective strategy perspective. The main results of this study is as follows: 1. The importance of a close interorganization relationship between the school system and the local society was proven. 2. Negotiation, compromise, and mutual interdependence were very important in developing an interorganizational relationship. 3. It is important that school plays a crucial role in the local community by taking a leadership when developing a general, regional sports club. For this reason, a reform on school system is in order.

차량용 와이퍼 시스템 프레임의 형상 최적설계

강경수,이종호,우호길 충남대학교 공업교육연구소 2002 論文集 Vol.25 No.1

In this study, a shape optimization for a frame of a vehicle windshield wiper system is presented. This study investigated how to optimize a shape and minimize mass(volume) and the number of parts with sufficient strength of a frame instead of a conventional structure. The dffectiveness of this analysis procedure is expected to reduce development lead time &cost actually.