천식치료의 현황과 대책

유광하,김미진,김순종 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Asthma is disease with affect in the almost every coner in the world and it is estimated worldwide we have 300 million people with this disease. The distribution of this disease varying from place to place such that in English speaking country such as USA, Canada, Australia and some part of South America, the prevalence of clinical asthma is more than ten percent. In Asia pacific area, the prevalence is about 2.5%. Several surveys have been done in the last 5 years starting with the AIA so called Asthma In America, followed ALA data, the AIRE data, AIRIAP data, AIJ data was done. The purpose of this survey were to see how well the disease is being controlled. According to the surveys asthma is possessed big burden on health care budget in worldwide. About 25% of patients in Europe, 47% of patients in Japan had urgent visit to local clinics and 10% in Europe and 23% in USA had an emergency room visit in the past year. The percentage of hospitalization ranged form 7% in Europe to 19% in Central and East Europe. Only 5% have what we called good control of asthma according to the GINA criteria. As a result, asthma impact significantly one's life. The goal of asthma treatment is to achieve every asthmatic should feel normal and be free to live their life. For achieving this, practical strategies have to be developed for well understanding about asthma, perception of asthma as a chronic disease, which needs persistent asthma management.

Expression of Cytochrome b_(5) Retropseudogenes in Hunam Blood

유민,--,-- THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 2003 Journal of biomedical laboratory sciences Vol.9 No.3

Cytochrome b_(5) (b_(5)) can be found in a variety of tissues and plays a role in the electron transfer pathways. Several retropseudogenes (numbered as Ⅰ, Ⅱ, Ⅱ, Ⅳ, Ⅴ) have been identified and well investigated for their structures. However, retropseudogene I is not clear in terms of its location on the chromosome. In addition the structure and the exression of retropseudogene Ⅴ have not been confirmed. To examine the structure of b_(5) retropseudogenes Ⅴ and to see whether it is expressed in human blood we applied recombinant DNA technologies including polymerase chain reaction (PCR) and DNA sequencing. Retropseudogene Ⅴ turned out to contain open reading frame (ORF) within its structure, however, no evidence of its expression was detected. Retropseudogene I was also found on the chromosome Ⅴ. This study should contribute to the understanding of the structure of b_(5) gene family.

문제 중심 학습법 수행을 위한 컴퓨터 프로그램 개발

유선미,이진형 단국대학교 1998 論文集 Vol.33 No.-

Medicine in the twenty-first century will be different from the medicine of today. Recent changes in medical environment, such as changes in disease and mortality pattern and rapid increase in medical knowledge, require change and adaptation of medical education. The task of medical education is to help people entering medicnie to prepare to meet their professional obligations in this new context. So we tried to join Problem-base learning(PBL), which challenges students to be more actively involved in defining what they learn and how they learn, and Computer-assisted learning(CAL), which uses multimedia and medical informatics as learning tools. Finally we developed Problem-oriented medical education program using the Internet. First, using simulated patient cases, we built clinical database with patients’ history, physical examinations, and various laboratory findings. To provide PBL program through the Internet, we constructed client-server system using IIS(Internet Information Server) on Windows-NT settings, and made user-friendly dynamic interface with HTML, JAVA, JAVE Script and so on. PBL on the WEB will make students learn effectively and actively, and offer vivid multimedia environment for medical education. We expect this PBL program to be used as an effective learning tool for residents or doctors as well as for medical students in the near future.

비만 개선 효과를 지닌 탄수화물 및 지방 흡수 억제 기능성 식이조성물 개발

윤유식,최선미,홍순복,홍정미,김정원,이홍석,홍성길 한국조리과학회 2002 한국식품조리과학회지 Vol.18 No.3

In a previous study, we developed a new food additive as an egg yolk antibody (IgY) against carbohydrate digestion enzymes for the regulation of blood glucose level and weight control. The IgY delayed and decreased the increment of blood glucose level after administration of sucrose in human being by 30% in 20∼30 min. We also developed a lipase inhibitor as a water extract of two kinds of herb, Platycodon grandiflorum and Solanum melongena. Twenty three volunteers were subjected to the intake of the egg yolk IgY plus the herbal extracts for 50 days. In average, the treated subjects appeared to lose 1.96 ㎏ of body weight and 3.4 ㎏ of body fat mass during the treated period. Furthermore, Panniculus adiposus and breech size were significantly decreased during the experimental period. Above results suggested that the administration of the dietary additives composed of egg yolk IgY and natural herbal extract improve the obesity by the decrement of body weight and body fat mass.

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.

임플란트의 collar design이 변연골과 연조직에 미치는 영향

유현상,강선녀,정창모,윤미정,허중보,전영찬 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

연구 목적: 임플란트 경부가 잘 설계된 경우 양호한 연조직 반응을 통해 변연골을 보존하는데 도움이 된다. 본 실험에서는 연, 경조직 경계부에 가장 가까이 위치하는 임플란트의 collar design이 변연골 변화와 연조직 반응에 미치는 영향을 동물실험을 통해 알아보고자 하였다. 연구 재료 및 방법: 2마리의 건강한 Beagle dog에 임플란트 collar design만 다른 두 종류의 임플란트(Neobiotech Co. Seoul, Korea)를 식립하였다. Collar에 bevel 을 부여한 군(Bevel 군)과 "S"자 형태를 부여한 군(Bioseal 군)으로 나누어 마리 당 7개, 군당 7개, 총 14개의 임플란트를 무작위로 식립한 후 Healing abutment를 즉시 체결하였다. 디지털 표준구내 방사선사진을 이용해 4주 간격으로 총 12주간 근원심 변연골 변화를 관찰하였고, 12주에 희생하여 조직학적 분석을 통해 협설 변연골 흡수 및 임플란트 주변 연조직 반응을 평가하였다. Mann-Whitney test를 통해 동일한 방사선 사진 촬영 시점에서 근원심 변연골 변화량 및 조직계측치를 군 간 비교하였고, Kruskal-Wallis test를 통해 방사선 사진상 근원심 변연골 변화량이 시간에 따른 차이가 있는지 군 내 분석 한 후 Duncan test를 통해 사후 검증하였다(α=.05). 결과: 방사선학적 분석 결과 각 촬영 시점에서 두 군간 근원심 변연골 변화량의 차이를 보이지 않았다(P>.05). 군 내에서 시간에 따른 근원심 변연골의 흡수량을 분석한 결과 Bevel 군에서는 시간에 따른 차이를 보이지 않았으나 (P>.05), Bioseal 군에서는 시간에 따른 차이를 보였으며, 4주및8주와 비교했을 때 12주에서 변연골의 증가를 보였다(P<.05). 조직학적 분석 결과 협설측 변연골 흡수량에서 두 군간 차이를 보이지 않았으나 (P>.05), Bevel 군에 비해 Bioseal 군에서 더 견고한 결합조직부착을 관찰할 수 있었으며, 생물학적 폭경의 값은 두 집단 간 차이를 보이지 않은 반면에 (P>.05), 접합상피부착은 Bevel 군에서 유의하게 길었고, 결합조직부착은 Bioseal 군에서 더 길게 나타났다(P<.05). 결론: Bevel 군에 비해 Bioseal 군에서 결합조직부착은 길게 형성된 반면에 접합상피부착은 더 짧게 나타났으며, 생물학적 폭경과 초기 변연골 흡수에는 차이가 없음을 알 수 있었다. 연조직 반응의 차이가 실제 기능하중 하에서 변연골 변화에 미치는 영향에 대해서 향후 연구가 필요할 것으로 생각된다. PURPOSE. The purpose of this study was to investigate the effects of implant collar design on marginal bone change and soft tissue response by an animal test. MATERIALS AND METHODS. Two types of Implant (Neobiotech Co. Seoul, Korea) that only differs in collar design were planted on two healthy Beagle dogs. The implants were divided into two groups, the first group with a beveled collar (Bevel Group) and the second group with "S" shaped collar (Bioseal group). Standardized intraoral radiographs were used to investigate the mesio-distal change of the marginal bone. Histological analysis was done to evaluate the bucco-lingual marginal bone resorption and the soft tissue response adjacent to the implant. Mann-Whitney test was done to compare the mesio-distal marginal bone change at equivalent time for taking the radiographs and the tissue measurements between the groups. RESULTS. Radiographic and histological analysis showed that there was no difference in marginal bone change between the two groups (P>.05). Histological analysis showed Bioseal group had more rigid connective tissue attachment than the Bevel group. There was no difference in biological width (P>.05). Bevel group showed significantly longer junctional epithelium attachment and Bioseal group showed longer connective tissue attachment (P<.05). CONCLUSION. For three months there were no differences in marginal bone change between the Bevel group and the Bioseal group. As for the soft tissue adjacent to the implant, Bioseal group showed longer connective tissue attachment while showing shorter junctional epithelium attachment. There were no differences in biologic width.

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.

저체중 또는 과체중 청소년에서 캠프 프로그램을 이용한 영양 교육효과에 관한 연구

성미경,승정자,류화춘,박재년,박동연,최미경,조경옥,최선혜,이윤신,김유경,이은주 대한지역사회영양학회 2003 대한지역사회영양학회지 Vol.8 No.4

This study was performed to evaluate the effectiveness of a nutrition education program developed for nutritionally imbalanced adolescents. A summer nutrition camp was held for 23 overweight and 16 underweight subjects. Its effectiveness with regard to was evaluated at the end of the camp and 6 months later. Nutrition knowledge, nutritional attitude, food behavior, nutrient intake, exercise habit and ideal body figures desired by the subjects. The results showed significantly higher nutrition knowledge scores at the end of the camp as compared to those obtained prior to the camp program, and these scores were maintained for at least six months. Nutrition attitude scores also improved after the education program, and these improved scores also lasted for 6 months. However, the food behavior scores measured 6 months after the education program were not significantly different from those obtained prior to the camp. Also, the exercise habit, the ideal body figures and the body figures desired by the subjects remained unchanged. When nutrient intakes of subjects were assessed before the program and 6 months later, the mean daily vitamin C intake was significantly increased after the education program. Also, the intake of iron from plant food sources increased in the overweight subjects, while less iron from animal source were consumed by the underweight subjects. Both groups tended to consume more vegetables and fruits 6 months after the education program which may have contribute to the higher vitamin C and plant-based iron intakes. These results indicate that a 4-day nutrition education camp program sustained changes in nutrition knowledge and nutrition attitude for 6 months. The increased intake of vegetables and fruits was also achieved through this education program. However, changes in dietary behavior in adolescents may require repeated education.

종합 건강진단을 실시한 정상성인에서의 혈청지질 분포에 관한 연구

박일환,유선미,정유석 단국대학교 1997 論文集 Vol.31 No.-

Background: Hypercholesterolemia and dyslipidemia are regarded as the risk factors of atherosclerosis of the coronary arteries. The purpose of this study is to measure the serum lipid levels of the normal persons and to calculate the cut-off values of serum lipid levels to predict the occurence of coronary events. Methods: We investigated the serum lipid profiles of the normal adults who had visited the health promotion center of Dankook University Hospital. The mean values of serum lipids were evaluated according to the groups of age, we calculated the percentile values of serum total choleterol. Results: In normal adult persons, the means of total cholesterol increased according to age. The cut-off values of serum total cholesterol for the risk of atherosclerotic coronary events were 189 ㎎/dl for the moderate risk group(75∼90 percentile of normal persons) and 225 ㎎/dl for the high risk group(over 90 percentile of normal persons). Conclusions: This study shows that the mean and the cut-off values of serum lipid in the persons who are not obese and have normal blood pressure are significantly lower than those values of normal Korean adult persons.

한국어 판 WHO-CIDI(Composite International Diagnostic Interview)-Alcohol의 개발:신뢰도 및 타당도 검사

남궁기,유계준,조은영,송선미,이희상,길계선,조현상,우용일 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

CIDI-Alcohol의 한국어 판 개발을 위해 이를 우리말로 번역, 수정하고, 정신병원에 입원한 환자 90명과 일반인 50명에게 시행한 후 임상 진단과 비교하여 일치도를 봄으로써 그 신뢰도 및 타당도를 조사하였다. 결과는 다음과 같다. 1) 주정 사용 각 진단 범주에 대한 한국어 판 CIDI-Alcohol의 일반 면담자간 진단 일치도는 97%∼100%의 높은 일치도를 보였다. 2) 임상 진단을 기준으로 한 한국어 판CIDI-Alcohol의 주정 사용 장애의 진단 일치도는 각 진단 범주별로 kappa치가 0.43∼0.55로 기존의 연구에 비해 비교적 낮았다. 3) CIDI-Alcohol의 진단 기준을 변화시켜, 각 진단 범주에 대한 임상 진단과의 일치도를 알아본 결과 ICD-10/harmful use는 진단 기준 항목의 수를 2개 이상으로 하였을 때, DSM-Ⅲ-R/주정 의존은 진단 기준 항목의 수를 4개 이상으로 하였을 때 임상 진단과 가장 일치하였다. 이런 결과는 한국어 판 CIDI-Alcohol의 진단 기준이 대체적으로 민감도는 높으나, 특이도가 떨어지는 것으로 생각할 수 있으며, 따라서 본 연구자들에 의해 작성된 한국어 판 CIDI-Alcohol는 일반인구 집단을 대상으로 하는 역학 조사보다는 주정 사용 장애로 이루어진 순수한 실험군의 연구에 적합하다고 생각된다. he authors translated a CIDI-Alcohol, a highly structured diagnostic interview, into Korean and examined the validity and reliability of the Korean version of CIDI-Alcohol. In order to examine the validity and reliability of CIDI-Alcohol, the authors calculated the degree of agreement of CIDI-Alcohol diagnoses between the two lay interviewers and sensitivity, specificity, kappa coefficient between clinical and lay CIDI-Alcohol diagnoses. The results were as follows: 1) Agreement rates of CIDI-Alcohol diagnoses between the two lay interviewers ranged from 97% to 100%. The kappa coefficient for each diagnosis was quite high(0.96-1.0). 2) The kappa value of agreement between clinical and lay CIDI-Alcohol diagnoses ranged from 0.43 to 0.55, which was lower than those of other studies. 3) With canging the diagnostic criteria of CIDI-Alcohol, The highest agreement rate between clinical and CIDI-Alcohol diagnoses was acquired when the authors used two or more diagnostic criteria of ICD-10/harmful use and four or more diagnostic criteria of DSM-Ⅲ-R/ alcohol dependence.