The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection

Chun, Yoon-Keun,Ha, Joo-hun,Hong-Jung-Woo,Oh, Soo-Myung,Kim, Sung-Soo 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Yoon-Keun Chun¹,Joohun Ha□Hong-Jung Woo□, Soo Myung Oh□,Sung Soo Kim□ ¹Department of Molecular Biology, College of Medicine,²Department of Surgery, college of Medicine,³Department of Internal Medicine, College of Oriental Medicine,and ⁴East-Weat Medical Reserch Institute,Kyung Hee University, Seoul, Korea. The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection. Proceedings of International Symposium on East-West Medicine, Seoul. 212-230, 1999. -Hepatitis B is caused by hepadnavirus. Hepatitis B virus replicates through 3.5kb pregenomic RNA intermediate which is regulated by core promoter. Pathogenesis of hepatitis B virus has been bilieved the result of host immune response. But recently many studies have reported that high level of viral replication caused by mutation in core promoter might result in severs hepatitis. But these studies were performed in vitro, not in vivo. So there is yet debate about which factor, viral of host factor, is more important in pathogenesis of hepatitis B virus. So we measured real viral replication level in 204 chronic hepatitis B patients by quantifying HBV DNA from sera by our novel PCR-based more sensitive method, and compared these results with ALT level measured from same sera, which indicates liver cell damage. Surprisingly there are no significant correlation between HBV DNA quantity and ALT level. Then we cloned core promoter region. In SSCP, we found that many viral mutants coexist in one patient. Base on SSCP result, we chose main viral core promoter type in each patients, which is thought to determine overall viral replication level in this patient. Main type of core promoter region of each 41 patients were directly sequenced. And with these we measured promoter activity by luciferase assay system and compared promoter activity with on another. We found tha there were some differences in promoter activity according to core promoter sequences. And we constructed replication-competent viral constructs with core promoter from 41 patients and Transfected these into HepG2 cell and measured HBV DNA by southern blot. There were also differences in HBV DNA quantity according to core promoter sequences. On these all results we investigated correlation between the effect of HBV core promoter on viral replication in vitro and HBN DNA quantity, ALT level from sera of each patients. We found there is no significant correlation among them. As a result, we concluded that in determining severity chronic hepatitis B patients, host factors of each patient is more important rather than replicative activity of virus itself.

TEOS 솔 침전공정에서 SiO2 과포화 농도 및 입자 크기에 미치는 반응조건 영향

김경수,김선근,김우식,김성수,김준경 한국화학공학회 2000 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.38 No.6

본 연구에서는 솔 침전공정에서 TEOS(Tetraethylorthosilicate) 반응물을 이용하여 실리카 분말 합성시에 TEOS 농도, 물농도, 반응물 주입속도, 교반속도 등의 반응조건이 실리카 과포화 농도 및 입자크기에 미치는 영향에 대해 연구하였다. TEOS 반응물과 물 농도가 증가할수록 입자유도시간은 짧아졌으며 입자유도시점에서의 과포화 농도는 감소하였다. 그러나, 반응물 주입속도가 입자유도시간과 입자유도시점에서의 과포화 농도에 미치는 영향은 서로 상반되었다. 즉, 반응물 주입속도의 증가에 따라 입자유도시간은 감소하였으나 입자유도시점에서의 과포화 농도는 증가하였다. 반응조건에 따라 서로 다른 과포화 농도에서 입자가 유도되는 것은 입자의 형성에 있어서 과포화도 이외의 용액의 조건에도 영향을 준다는 것을 의미하는 것이다. 한편, 교반속도는 입자유도시간과 유도시점에서의 과포화 농도는 거의 영향을 주지 않았다. 이것은 솔 침전공정에서 반응물 혼합시간이 충분히 짧아 실리카 생성에 있어서 반응속도가 입자유도 및 과포화 농도 결정에 가장 크게 영향을 미쳤기 때문이다. 반응조건에 따른 가수분해 및 축합 반응속도를 Kim등[15]이 제시한 식을 이용하여 예측하였으며 이 결과는 본 실험에서 측정한 입자유도시간의 함수로도 매우 잘 묘사될 수 있었다. 또한, 반응조건에 따라 합성된 최종입자의 크기 변화도 입자유도시간의 함수로 훌륭히 묘사될 수 있음을 보여 주었다. In a single feed semi batch reactor effects of reaction conditions, such as TEOS and water concentrations, react feed flow rate and agitation speed, on the silica supersaturation and particle size synthesized in sol precipitation were investigated. As the TEOS and water concentrations increased, the particle induction time and the supersaturation at the particle induction point were reduced. However, the dependencies of the particle induction time and supersaturation at the particle induction point on the reactant flow rate were opposite to each other. That was, the particle induction tune decreased with increase in the reactant flow rate but the supersaturation at the particle induction point increased. The fact that the supersaturation level to induce the particle was varied with the reaction condition implied that the solution condition determined by the reaction condition as well as the supersaturation level was important to the particle induction. Meanwhile, the particle induction time and supersaturation at the particle induction point were little influenced by the agitation speed in the reactor. This result was due to the micromixing time being short enough in comparison to the reaction time of TEOS. Thus, the particle induction time and supersaturation at the particle induction point was predominantly determined by the reaction time rather than the micromixing time of TEOS. The reaction rate constants of TEOS hydroysis and condensation, which was predicted with Kim et al.'s equations [15] at the reaction conditions was described as a function of the particle induction time. In addition, the particle size synthesized at the reaction conditions was able to be well fitted as a function of the particle induction time.

선택적 후근절제술의 수술중 근전도 감시방법과 치료효과

김형일,김연희,김완호,김근수,김동찬 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

Selective posterior rhizotomy(SPR) has been known to reduce the spasticity as well as to improve the quality of life in patients with intractable spasticity. Twenty patients underwent SPR under intraoperative electrophysiological monitoring(IOM). Fifty-two percent of sacrolumbar rootlet were cut after electrical stimulation. Eighteen patients(90%) with spastic type of cerebral palsy showed marked reduction of spasticity and functional improvement without any complication. The patients who did not respond to SRP had mixed types of spasticity. IOM facilitate the selection of pathological rootlets regardless of anaesthetic level. intensity of electrical stimulation, and individual variability of responses. It is concluded that careful selection of surgical candidates and of pathological rootlets under IOM are important to reduce the spasticity. thereby to obtain a better outcome.

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

목재가 선적된 선창에서 발생한 산소결핍에 의한 질식사

김동훈,김기권,장태정,김정란,이구,김수근,임현술 大韓法醫學會 2001 대한법의학회지 Vol.25 No.1

Oxygen deficiency has been frequent in a clouted space. Wood consumes oxygen and discharges carbon dioxide Instead of photosynthesis in closed space without light, so do some microorganisms on the surface. We experienced a case that a healthy Insect-proofer fell down and died of asphyxia on stair-board at 7 m below the hatch of the cargo-hold shipping wood Analysis of gases in cargo-hold revealed O2; 12.3%, CO; 105 ppm, CH4; 2.7%, and H2S; 1.9% at 1 m below the hatch, and then O2; 6.1%, CO; 220 ppm, CH4; 2.9%, and H2S, 2.3 ppm at 2.5 m below the hatch. Autopsy findings were unremarkable. We justiced the cause of death asphyxia due to oxygen deficiency. As seen in this case, the serious oxygen deficiency was accounted for oxygen consumption by wood and microorganisms.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

유산양 유방염에 대한 Chitosan 약침의 치료 효과

황수현,서진석,김덕환,김명철,신상태,전무형,南三郞,김영찬,이우근,표수일 충남대학교 수의과대학 동물의과학연구소 1999 動物醫科學硏究誌 Vol.7 No.-

To improve the therapeutic method for mastitis, treatment effect of chitosan pharmacopuncture was examined in three milking goats(A,B and C). Mastitis was artificially induced in two milking goats(A and B) and one goat(C) was naturally infected case with mastitis. The acupoint used was Yang-Ming and chitosan suspensions(provided from Tottory University, Japan: 30㎎ of chitosan/㎖)were injected to the acupoint with 5㎖/time for 3 days, respectively. As for the change of somatic cells in milk along with chitosan pharmacopuncture, they showed a decreasing tendency after increase on the 3rd day in all udders of B. In addition, as for the change of total leukocyte counts of peripheral blood with chitosan pharmacopuncture, they showed a decreasing tendency after increase on the 3rd day in B and C except A which showed a increasing tendency until on the 7th day. In the change of neutrophil/lymphocyte(N/L) ratio, increasing tendency was seen in A and C but increasing tendency after slight decrease was observed in B. Further, in the change of serum total protein and A/G ratio, serum total protein content was decreased after slightly increase on the 3rd day in A, and they were decreased after increase until on the 7th day in B and C, respectively. As for the change of A/G ratio, different pattern increasing tendency was shown in A, B and C.

안과종합검진의 유용성

임수현(Soo Hyun Lim),김국영(Kook Young Kim),정재근(Jae Keun Chung)한재욱(Jae Wook Han),김응수(Ungsoo Samuel Kim) 대한검안학회 2020 Annals of optometry and contact lens Vol.19 No.2

Purpose: To investigate the efficacy and detection rate of disease in the customized eye examination program. Methods: We reviewed the medical charts of 122 patients who have conducted the customized eye examination program from January 2018 to January 2019 in Kim’s Eye Hospital retrospectively. The customized eye examination program consisted of visual acuity test, intraocular pressure measurement, color vision test, slit-lamp examination, visual field tests, fundus photography, spectral domain optical coherence tomography (Cirrus HD-OCT, Zeiss), Optical Quality Analysis System (OQAS, Visiometrics, Terrassa, Spain), and dry eye test (LipiView II TearScience, Morrisville, NC, USA). The rate of newly diagnosed diseases and vision-threatening disorders including glaucoma and retinal disorders were calculated. Results: A total of 122 patients (46 males and 76 females, mean age; 47.8 ± 14.0 years old, from 22 to 85 years) were included. Nine patients (14 eyes) had a poor vision of less than 0.8. Newly detected diseases were found in 17 patients (13.9%), and among them, 10 glaucoma (8.2%) and retinal disorders (5.7%) were included. When it comes to glaucoma, 7 patients were diagnosed with definite glaucoma with visual field loss, and 3 patients had preperimetric glaucoma. Retinal disorders were composed of 5 epiretinal membranes, 1 diabetic retinopathy, and 1 central serous chorioretinopathy. Conclusions: Various diseases were identified by the customized eye examination program, and vision-threatening diseases such as glaucoma and retinal disorders were found. Therefore, a regular eye examination is needed to detect the serious ocular diseases in the early stage.

철강업체와 용접봉 제조업체에 근무하는 생산직 근로자의 직업성 요통 유병률과 관련 요인

임현술,김수근,김덕수,김두희,이종민,김양호 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.1

A cross-sectional study was conducted for detecting the risk factors and to propose an effective control program for occupational low back pain. The subjects were 1,665 male production workers employed at a steel factory and a welding material manufacturing factory. The data were collected by a self-reported questionnaire and a medical examination with a rehabilitation specialist for ten days in September, 1997. The contents of the questionnaire were as follows: general characteristics, physical characteristics, employment status, type of work, working environment and the experience of low back pain. The number of cases with symptoms of occupational low back pain were 321, so the point prevalence was 19.3 persons/100 persons. The number of cases with a history of occupational low back pain for one year were 554, so the one year period prevalence was 33.3 persons/100 persons. The point and one year period prevalences of occupational low back pain showed no significant differences in age, marital status, educational level and body mass index. The point and one year period prevalences of occupational low back pain showed no significant differences in alcohol drinking, smoking, stretching exercise and regular exercise. The point and one year period prevalences of occupational low back pain were significantly higher in the unsatisfied group that the satisfied group (p<0.01). However, no significant differences were found among tenures and shift work. The point and one year period prevalences of occupational low back pain were significantly higher in the lifting of heavy materials group than the nonlifting group(p<0.01). However, no significant differences were found among posture of the waist and the working posture. Through the multivariate logistic regression, significantly associated factors with occupational low back pain were found to be dissatisfaction with job (point prevalence: OR=1.78, 95% CI: 1.21-2.61: one year prevalence : OR=1.76, 95% CI: 1.26-2.47), lifting of heavy materials(point prevalence OR=1.94 95% CI : 1.44-2.61; one year prevalence: OR=2.17, 95% CI : 1.70-2.77) and tenure (point prevalence : OR=1.03, 95% CI : 1.01-1.06; one year prevalence : OR=1.02, 95% CI : 1.00-1.05).

생체분해성 고분자를 이용한 사시수술용 제형개발 및 효용성에 대한 연구

민병무,김용백,김승영,김창식,박근성,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A new device, muscle clamping system was developed to facilitate exact quatifying technique A strabismus surgery, and reduce the risk of complications. The device is composed of a lower fixing body with three jaws and an upper supporting body. They are used to clip an extraocular muscle and fix it to the sclera with a single bite. Superior rectus recession on 16 rabbit eyes were performed with this new device. Conjunctival injection, muscle adhesion strength, and light microscopic findings were examined at 1, 2, 4 and 8 weeks postoperatively. The Conjunctival injection were minimal, adhesion power ranged from 420 to 600 gram gravity, which is sufficient in withstand the normal pull of human extraocular muscle. In microscopic exam, some Inflammatory cells and fibrosis were found. The new device was technically easy, fast, and accurate, so it may be useful in stabismus surgery.