경북 최초의 신장이식 1례

이중현,김용섭,이정호,이창우,김상욱,이문섭,오민구,하달봉,이경섭 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

신장이식은 환자의 삶의 질을 높이고 거의 정상적인 사회생활을 가능하게 함으로써 말기신부전 환자의 3가지 신대체 요법(혈액투석, 복막투석, 신장이식) 중에 가장 효과적이고 각광받는 치료법이라 할 수 있다. 최근 들어 의료기술과 의학의 발달로 신장이식의 성공률은 과거에 비해 비약적으로 높아지고 있으며 국내에서도 점차 신장이식수술을 받는 환자가 증가하고 있으나 서울이나 다른 대도시에 비해 의료환경이 열악한 중소도시나 지방의 병원에서는 아직도 시행하지 못하고 있는 형편이다. 이에 저자들은 경북 최초로 자체 의료진에 의해 고혈압과 말기 신부전으로 동국대 포항병원에서 혈액투석을 받고 있던 32세의 남자환자에게 부인으로부터 신장을 제공받아 신장이식을 성공적으로 시행하였기에 문헌고찰과 함께 보고하고자 한다. Kidney transplantation is the preferred treatment modality for many patients with end-stage renal disease (ESRD), because it offers improved quality of life over both hemodialysis and peritoneal dialysis. Patients who do well after transplantation generally report improvement in vitality and freedom to return to the style of life that they experienced before their progression to ESRD. Recently, the success rate of kidney transplantation is greatly being increased as the surgical technique and immunosuppressive drugs are developed. Kidney transplantation is also popular in Korea which has good result. But, until now the general hospitals which are located at small city can't try the kidney transplantation because they don't have proper facilities and experts. We firstly experienced a case of kidney transplantation in a 32 years old man with hypertension and chronic renal failure at KyoungBuk province. So we report this case with references.

축산분뇨 혐기소화 잔재물의 특성 및 초지 적용성 평가

김승민(Seung Min Kim),정웅기(Woong-gi Jung),성용주(Yong Joo Sung),안희권(Hee-Kwon Ahn),김동성(Dong Sung Kim),윤도현(Do-Hyun Yoon),김동섭(Dong-Seop Kim1),정광화(Hwa Gwang Jung) 한국펄프·종이공학회 2014 펄프.종이기술 Vol.46 No.3

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

거푸집-동바리 시스템의 붕괴현황조사 및 원인분석

김곤묵,김호수,정성진,곽순섭 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

This study analyzes the defect causes under the investigation of collapse situation in form-shore system through the analysis of design criteria, loading and work conditions. Specifically, these defect causes can be classified as the three cases from the results of the investigation. Those are the external, design and construction defects which are closely related. So, one defect can induce another defect and this can lead to the collapse accident of form-shore system. Therefore, this study presents the improvement method to solve the problems relating to the design process and the actual construction application according to the defect causes.

치근단 병소의 임상적 연구

김상우,우순섭,유임학,이영수,심광섭 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.3

The purpose of this study was to find the clinical features of periapical lesions. A total of 130 periapical lesions which were obtained from biopsy and diagnosed histopathologically as periapical cyst, periapical abscess, and periapical granuloma at the Department of Dentistry in Hanyang University Hospital were throughly analysed according to the distribution and incidence of age, sex, location, and so on. The following results were obtained : 1.Out of 130 periapical lesions, 88 cases(67.7%) were periapical cysts, 30 cases(23.1%) were periapical abscesses, and 12 cases(9.2%) were periapical granulomas. 2.The periapical lesions occurred most frequently in the third decade, and followed by the fourth, fifth, sixth, and second decade. The periapical cysts occurred most frequently in the third decade(26.1%), the periapical granulomas in the fourth decade(33.3% ) the periapical abscesses in the sixth decade(26.7%). 3.The periapical lesions were more frequent in men than in women with the ratio of men to women of 1.4 : 1. The radio of men to women of periapical cysts was 1.6 : 1, that of periapical granulomas was 0.5 : 1, and that of periapical abscesses was 1.3 : 1. 4.The periapical lesions were more frequent in maxilla than in mandible with the ratio of 1.2 : 1. The ratio of maxilla to mandible of periapical cysts was 1.5 : 1, that of periapical granulomas was 0.5 : 1, that of periapical abscesses was 1 : 1. 5.The most commonly involved location of the periapical lesions was maxillary anterior teeth(40.8%), and followed by mandibular molars, mandibular premolars, and mandibular anterior teeth and maxillary molars. The most frequent location of the periapical cysts was maxillary anterior teeth(48.9%), that of periapical granulomas was mandibular molars(50.0%), that of periapical abscesses was mandibular molars(40.0%).

바람하중을 받는 76층 벤치마크 건물에 설치된 동조액체기둥 감쇠기의 등가 선형 시스템

김형섭,민경원,이상현 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

This paper presents equivalent linear system for benchmark building with nonlinear tuned liquid column damper (TLCD). The equivalent linear system is obtained first in terms of equivalent linear damping and second in terms of equivalent single degree of freedom system. Numerical results show that these equivalent linear methods can almost exactly predict the structural responses when compared with results by the nonlinear TLCD system. Finally, an equation which can estimate the peak response of structure induced by harmonic load is derived. This equation does not require any iteration process unlike usual procedures for the analysis of a structure with TLCD.

치수제거후 흰쥐 삼차신경절에서 VIP 면역반응세포의 변화: 공초점레이저주사현미경적 연구

김흥중,김승재,박주철,박주철,이상호 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.1

말초신경 손상에 의한 VIP의 변화를 연구하기 위해 흰쥐 하악대구치 치수제거 후 삼차신경 절에서 VIP의 분포 및 반응강도를 공초점레이저주사현미경을 이용하여 관찰하였다. 체중 200g내외의 Sprague-Dawley계 흰쥐를 대조군과 하악대구치 치수제거 후 14일군으로 분리하여 희생시켰다. 1차 항체로 rabbit anti-VIP, 2차 항체로 fluorescein isothiocyanate(FITC) conjugated anti-rabbit IgG를 사용하여 면역형광염색을 시행한 후 공초점레이저주사현미경으로 관찰하여 다음과 같은 결론을 얻었다. 1.삼차신경절 하악부위에서 VIP 양성반응세포의 비율은 대조군에서 7.40%를, 실험군에서는 28.42%를 보였다. 대조군에 비해 실험군에서 양성반응세포의 증가를 보였다. 2.삼차신경절 하악부위에서 VIP 면역반응세포체에 대한 상대성 형광강도는 대조군에서 87.78을, 실험군에서는 138.65를 보였다. 대조군과 비교하였을 때 실험군에서 상대성 형광강도의 증가를 보였다. 3.실험군의 광연속절편(1㎛) 관찰에서 VIP 면역반응세포는 9개의 절편 대부분에서 강하게 나타났다. 축삭의 면역반응을 살펴보면, 대조군의 축삭에서는 약한 반응을 보였으며, 실험군의 축삭에서는 강한 면역반응을 보였다. 또한 양성반응 세포체의 크기는 20∼25㎛의 중간 크기의 세포체에서 강한 면역반응을 보였다. 위의 결과로 보아 치수제거 후에 삼차신경절 하악부위에서 VIP면역반응세포의 증가와 함께 상대성 형광강도가 높아졌음을 알 수 있었다. The purpose of this study was to investigate the distribution and fluorescence intensity of vasoactive intestinal polypeptide immunoreactive(VIP-IR) cells in rat trigeminal ganglion following pulp extirpation of rat mandibular molar. The animals were divided into control group(n=6) and experimental group(n=6). The experimental animals were sacrificed at 14 days after pulp extirpation. The trigeminal ganglion was removed and immersed in the 4% paraformaldehyde in 0.1M phosphate buffer. Serial frozen sections about 20㎛ in thickness were cut with a cryostat The immunofluorescence staining was performed. The rabbit anti-VIP(1:8,000) was used as primary antibody and fluorescene isothiocynate(FITC) cojugated anti-rabbit IgG(1:80) as secondary antibody. The slides were observed under confocal laser scanning microscope(CLSM). Unprocessed optical sections were obtained and stored on a optical disk. Color pictures were printed by a video copy processor. The results were as follows ; 1. The positive ratio of VIP-IR cells in mandibular part of trigeminal ganglion were 7.40% in control group and 28.42% in experimental group(14 days affter pulp extirpation). 2. The relative fluorescence intensity of VIP-IR cells in mandibular part of trigeminal ganglion were 87.78 in control group and 138.65 in experimental group. The relative fluorescence intensity of experimental group was 58% higher than that of control group. 3. In optical serial section analysis of VIP-IR cells of experimental group, most of the 9 section showed high fluorescence intensity. At high magnification, axons of the experimental group displayed greater VIP-IR than in the control group, and the positive cells were mainly of medium size. The result indicate that number and fluorescence intensity of VTP-IR cells were increased in the mandibular part of trigeminal ganglion following pulp extirpation of mandibular molar, and it suggests that VIP could play a role in processing of nociception.

Transarticualr portal를 이용한 주관절의 관절경술

김성재,박인섭,김주영,정재훈,류상욱,천용민 대한견.주관절학회 2003 大韓肩.주關節學會誌 Vol.6 No.2

전압비교기를 이용한 AB급 연산증폭기의 슬루율 개선에 관한 연구

김요섭,손상희 청주대학교 산업과학연구소 2016 産業科學硏究 Vol.33 No.2

In this paper, we introduce a circuit which has improved power consumption and slew rate by adding a voltage comparator on the structure of the class AB rail to rail folded cascode OP amplifier. Using a voltage comparator, bias voltage near to VDD is applied in charging and discharging time and so high voltage is transferred to the output load. Therefore, proposed class AB rail to rail folded cascode OP amplifier circuit has high slew rate and low power consumption. From the simulation results of slew rate, we know that slew rate of proposed circuit is improved from 2.5V/us to 12V/us comparing to the conventional circuit. That is the reason why voltage comparator transmits voltage near to the value of VDD to the load stage. From the simulation results of power consumption, we know that power consumption of proposed circuit is improved from 1.2mW to 0.5mW comparing to the conventional circuit. Proposed class AB rail to rail folded cascode OP amplifier is designed and simulated by using the TSMC 0.18um 1-Poly & 6-Metal CMOS process.

구강악안면 영역의 치성 감염 환자에 대한 세균학적 연구

김일규,윤승환,오성섭,최진호,오남식,김의성,이성호,배수환,강문수 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4

Oral & maxillofacial infections are most commonly odontogenic in origin. Although such infections are usually self-limiting, they may occasionally spread deeply into fascial spaces or planes far from the initial site of involvement. If early diagnosis and appropriate therapy is delayed, complications such as mediastinal extension, retropharyngeal spread and airway obstruction could happen to the patients. For the study of the microbiology, we have retrospectively analysed the oral & maxillofacial infected patients in the Dept. of Oral & Maxillofacial Surgery, In-Ha University Hospital from 1997 September to 2000 April. The results were as follows 1.The male patients were more common than female, with male 61.9% and female 38.1%. 2.Dental originated infections were most common cause with the incidence of 62%. 3.Most common fascial space involved was buccal space 42cases(37.2%) followed by submandibular space 13cases(11.5%), infraorbital space 13cases(11.5%), masseteric space 11cases(9.7%) , periapical abscess 11cases(9.7%) . 4.The causative organisms isolated from the pus culture were Gram Positive Bacterial species, which were 46cases(31.9%) of Streptococcus viridans, 16cases(8.6%) of α and β-hemolytic streptococcus, 4cases(3.1%) of Strep.-group D non enterococci, 7cases(5.1%) of Staphylococcus Coa. Neg., 5cases(3.9%) of Staphylococcus aureus, 3cases(2.3%) of Enterococcus faecalis, 1case(0.8%) of Bacillus species, 1case(0.8%) of Peptostreptococcus, 1case(0.8%) of Clostridium and Gram negative bacterial species, which were 4cases(3.1%) of Acinetobacter baumannii, 2cases(1.6%) of Pseudomonas aeruginosa, 2cases(1.6%) of Burkholderia cepacia, 1case(0.8%) of Neisseria species, 1case(0.8%) of Klebsiella pneumoniae, 1case(0.8%) of Klebsiella oxytoca, 1case(0.8%) of Escherichia coli. 5.In drug sensitivity test, high resistant tendency was found in Penicillin system(Penicillin G 83.3%, Ampicillin 60%) and Aminoglycosides (Gentamycin 50%, Tobramycin 45.5%), but tertiary Cephalosporin system(Cefoperazone 9.1%, Ceftazidime 18.2%), and glycopeptides system (Teicoplanin 0% , Vancomycin 0%) showed lower resistancy.