한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

Ki-67 Expression Gives Additional Prognostic Information on St. Gallen 2007 and Adjuvant! Online Risk Categories in Early Breast Cancer

Jung, So-Youn,Han, Wonshik,Lee, Jong Won,Ko, Eunyoung,Kim, Eunkyu,Yu, Jong-Han,Moon, Hyeong-Gon,Park, In Ae,Oh, Do-Youn,Im, Seock-Ah,Kim, Tae-You,Hwang, Ki-Tae,Kim, Sung-Won,Noh, Dong-Young Springer - Society of Surgical Oncology 2009 Annals of Surgical Oncology Vol.16 No.5

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

지르코늄 핵연료피복관의 부식에 미치는 내부압력의 영향

박정용,김선기,정용환,정연호 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.1

Effect of the internal pressure on the corrosion behavior was investigated for the Zr nuclear fuel cladding tubes which were pressurized up to 2500 psi using Ar gas and corroded in steam of 1500 psi at 400℃. It was found that corrosion resistance of Zr fuel cladding tube was decreased with increasing the internal pressure although corrosion behavior at the early stage was similar irrespective of internal pressure. X-ray diffraction result on the oxide showed that crystal structure was not affected by the applied pressure of 2500 psi. SEM observation on the oxide surface revealed that a number of cracks elongated in axial direction were propagated from surface to interior in the case of 2500 psi. The degradation of corrosion resistance with internal pressure was attributable to the extensive cracking at the oxide surface, which is thought to be originated from the difference of ductility between Zr alloy and oxide when Zr fuel cladding tube was deformed due to the applied internal pressure. However, the increase of corrosion rate with internal pressure was shown to be relatively small. It was therefore suggested that the crack induced at the surface did not propagate to oxide layer in the vicinity of oxide/metal interface which is known to be protective to oxygen diffusion and to control the corrosion behavior.

백서 허혈성 국소 뇌경색에서의 소뇌 실정핵 자극 효과

박윤관,김대환,정흥섭,이기찬,주정화,이훈갑 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

Elecrical stimulation of the cerebellar fastigial nucleus(FN) increases cerebral blood flow(CBF) and reduces brain damage after focal cerebral ischemia. The authors studied whether the neuroprotection elicited from electrical stimulation of the cerebellar FN is attibutable to the elevation in regional CBF(rCBF) or reduction in release of excitatory amino acid. Sprague-Dawley rats were anesthetized with a mixture of halothane(3% for the induction and 1% for maintenance) and oxygen, and artificially ventilated through a tracheal cannula. Arterial pressure, blood gases and body temperature were monitored. The middle cerebral artery(MCA) was occluded distal to the lenticulostriate branches. The FN was then stimulated for 1 hour(100uA : 50Hz : 1sec on/1sec off). The changes in rCBF were measured by hydrogen clearance method for 2 hours, over the regions corresponding to the ischemic core and penumbra. Postischemic release of glutamate and aspartate were measured by microdialysis for 2 hours at the same site of measurement of rCBF. Infarct volume was determined 8 hours later in 2, 3, 5-triphenyl tetrazolium chloride(TTC)-stained sections. FN stimulation(n=12) increased mean arterial pressure by 28±16mmHg. In nonstimulated control rats(n=12), mean AP was not changed significantly during the experimental procedures. Compared with nonstimulated animal, stimulation of FN for 1 hour following MCA occlusion significantly increased rCBF in ischemic core and penumbra by 53.6% and 67.6% respectively. And the volume of infarction decreased by 42% at 8 hours after MCA occlusion. The concentration of glutamate and aspartate in ischemic core after MCA occlusion increased both in the control group(to 12.2±3.3 folds and 10.4±4.1 folds, respectively) and in the stimulation group(10.5±2.8 and 11.2±4.1 folds, respectively). The concentration of glutamate and aspartate in penumbra did change significantly neither in the control group(to 2.5±1.3 folds and 1.8±0.6 folds, respectively) nor in the stimulation group(1.9±0.5 folds and 2.1±0.4 folds, respectively). There was no significant difference between the two groups. These data indicate that neuroprotection elicited from electrical stimulation of the erebellar FN is attributable to the elevation in rCBF but no to the reduction in release of excitatory amino acid.

腰部椎間板 脫出症의 物理治療에 關한 考察

朴閏基 대구보건대학 1981 대구보건대학 論文集 Vol.5 No.-

In the special case of Lumbar Intervertebral Disc protusion patient ; 1) When the sign of muscle weakness is clearly appeared because of nucleus pulposure of the Disc, 2) In the exception of paralegia by acute Lumbar Intervertebral disc protusion, it is a better way to try the surgical operation when the good process is not found after physical therapy for 2~3 weeks.

지주막하출혈 환자의 Atrial Natriuretic Factor와 심전도 이상 소견에 대한 연구

박윤관,정흥섭,이기찬,이훈갑 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.11

Atrial natriuretic factor(ANF) is a diuretic natriuretic peptide hormone produced by both the heart and brain. It has been postulated to play a role in the hemodynamic and sodium (EKG) abnormalities is known to occur frequently after cerebrovascular accident, specidly subarachnoid hemorrhage. A prospective study was undertaken to evaluate the relation between the changes of ANF and EKG findings and clinical findings. Thirtyfive nonselected patients with SAH were followed with serial measurements of plasma ANF, plasma antidiuretic hormone (ADH), serum sodium, serum osmolarity, and electrocardiography(EKG) at 2nd 5th, and 7th day after hemorrhage. Mean plasma ANF valeus at 2nd 5th, and 7th day of hemorrhage were 202.3& 109.6ppJm1, 134.6+ 83.5ppJml, and 1233+ 69.9pghl, respectively. Mean plasma ADH values were within normal limits(32-4.4pg/d). At a later stage, 9 patients showed hyponatremia and hypoosmolarity, among whom 8 patients had elevated ANF and 1 patient elevated ADH. The delayed and persistent rise of plasma ANF was correlated with the development of hyponatremia. One or more EKG abnormalities were found in 13 patients. Mean ANF values of patients with normal EKG(131.8_t48.7pg/ml) were significantly different from those with abnormal EKG(272.22 107.5ppJml). The changes of plasma ANF appeared unrelated to age, sex, clinical grade, CT grade, and bleeding site. The results of this study indicate that elevated plasma ANF is closely related with electrophysiological changes of myocardium and that the transitory myocardial ischemia might be the source of plasma ANF after SAH.

初·中·高 世界地理 單元 分析

朴潤子,徐贊基 慶北大學校 師範大學 地理敎育科 1994 地理敎育 Vol.7 No.-

The important of world regional geography education increases in the new and open g1obalization society. So, this thesis focuses on clarifying the characteristics of the unit structure, learning content and learning materials of world regional geography in the current geography textbooks in elementary and secondary schools. The result of unit analysis of world regional geography in elementary and secondary school suggest that the scope and intensity of geography be expanding and deepending in terms of the system of unit learing content and learning materials in advanced school. This means the systematic development of world regional geography according to levels of school is basically possible. However most textbooks simply show flat array of geographical information, from which we can see that world regional geography education still emphasize the past static encyclopedic facts. And yet, unit development in middle school seems more appropriate for learners. In high school, the most important step on the geography education, the point of issue is that most textbooks are a simple array of regional facts, so they cannot embody the spirit of the curriculum which emphasizes thematic approach in the regional geography learning. For the sake of geography education development in modern information society, the writers of textbook must have a thorough knowledge on curriculum and take careful notice on writing textbook. Moreover high teachers must to understand that the choice of textbook has an important effect on the geography education and need to take prudent attitude in selecting textbook.

AHRS을 이용한 자세결정과 Heading 산출을 위한 연구

박운용,백기석,송연경 東亞大學校 大學院 2004 大學院論文集 Vol.29 No.-

In this paper, the error compensation method of the low-cost IMU is proposed. In general, the position and attitude error calculated by accelerometers and gyros grows with time. Therefore the additional information is required to compensate the drift. The attitude angles can be bound accelerometer mixing algorithm and the heading angle can be aided by single antenna GPS velocity. The Kalman filter is used for error compensation. The result is verified by comparing with the attitude calculated by Attitude Heading Reference System with Micro Electro Mechanical System for a basis

주사전자현미경을 이용한 무당벌레에 기생하는 무당벌레기생파리(Degeeria separata)의 외부형태적 특징

윤영남,김남성,김기덕,박수진,서미자,채순용 충남대학교 농업과학연구소 2000 농업과학연구 Vol.27 No.1

External morphological characteristics of male and female of Degeeria separata, which was endoparasited in adult of the Asian ladybird, were studied by using the scanning electron microscopy(SEM). The antenna of Degeeria separata was consisted of three segment and arista. Anstae were about 750㎛ length and 30㎛ in diameter. The surface of antennae was covered with many sensilla. They were long or short, slender or thick, and straight or curved. Each three morphological types of sensilla were observed on the second and third segment of antennae. The mouthpart was sponging type. It was consisted with clypeus, labellum, labium, labrum, and maxillary palp. The labellum is 400㎛ width and double folded vertically. The leg consist of tarsus, tarsus claw, pulvilli, and empodium.