Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

Multi-media and multi-pathway aggregate exposure assessment for polycyclic aromatic hydrocarbons to the inhabitant in Tae-an county after Hebei-spirit oil spill

Kim Chan-Kook(김찬국),Woo-Chul Jeong(정우철),Jong-il Hur(허종일),Pan-Soo Park(박판수),Tae-Woo Lee(이태우),Hwi-Soo Seol(설휘수),Jung-hyeon Park(박정현),Jong-Heop Lee(이종협),Jong-Ho Kim(김종호),Byeong-Kyu Kwak(곽병규),Jong-Hyeon Le 한국환경독성학회 2010 한국독성학회 심포지움 및 학술발표회 Vol.2010 No.11

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

Treatment of Radioactive Liquid Waste by the Forced-AirCirculation System

Tae-κuk Kim,IL Sik Kang,Jong-Sik Shon,Young-Gerl Ryu,Won-Hyuk Jang,Sang-Min Bae,Young-Yong Ji,Dae-Seok Hong,Kyung-Kil Kwak 한국방사성폐기물학회 2011 한국방사성폐기물학회 학술논문요약집 Vol.9 No.2

하악골에 발생한 골막 골육종

김태우,김승범,권혁찬,문선재,윤정훈,김형준,차인호,육종인,김진 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

Periosteal osteosarcoma is a distinct entity of malignant bone tumor with characteristic clinical, morphological, and histological features within the group of juxtacortical osteosarcoma. Periosteal osteosarcoma is predominantly located in the tubular long bones, and extremely rarely involving the jaws. A case of periosteal osteosarcoma of the right mandible is presented. A 27-year-old woman complained of the gingival swelling and bleeding tendency of the right posterior mandible. Clinical examination revealed a reddish brown strawberry-like swelling on the affected mucosa, which measured 1.5㎝×1.5㎝. The tumor was located on the lingual cortex of the mandible and extended into the surrounding soft tissues. Microscopically, the tumor consisted exclusively of atypical chondroblastic cells with a small osteoblastic area. A minimal bone marrow involvement was noted and the adjacent cortex was free of tumor. These findings suggested that the tumor originated from the periosteal cambium layer, which lies between the periosteal fibrous layer and the cortex of mandible.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

신축학교 실내공기질이 초등학생들의 인지기능에 미치는 영향

김태섭,김선주,박시영,전만중,김규태,김창윤,정종학,백성옥,사공준 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 신축초등학교와 대조학교를 선정하여 교실 내 포름알데히드와 TVOCs를 측정하고 컴퓨터 신경행동검사를 이용하여 실내공기 오염물질이 학생들의 인지기능에 미치는 영향을 평가하였다. 방법: 신축초등학교 5학년 71명을 실내공기 오염물질 노출군으로 하고, 개교한지 12년째인 대구시의 일개 초등학교 5학년 2학급 63명을 대조군으로 하여 실내공기 오염물질농도 측정 및 컴퓨터 신경행동검사를 실시하였다. 결과: 신축학교에서 의도적으로 창문을 개방한 학급에서 1교시 포름알데히드 농도는 34.6 ㎍/㎥, 4교시에는 27.3 ㎍/㎥, 창문을 개방하지 않은 학급에서 1교시 80.2 ㎍/㎥, 4교시 127.1 ㎍/㎥, 대조학교에서는 2학급 각각 1교시에 12.6 ㎍/㎥, 7.5 ㎍/㎥, 4교시에 19.8 ㎍/㎥, 25.2 ㎍/㎥였다. TVOCs의 경우 신축학교의 의도적으로 창문을 개방한 학급에서 1교시에 농도는 487.2 ㎍/㎥, 4교시에 428.2 ㎍/㎥, 창문을 개방하지 않은 학급에서 1 교시에 농도는 1,283.5 ㎍/㎥, 4교시에 1,715.4 ㎍/㎥, 대조학교의 경우 2학급에서 각각 1교시에 농도는 240.9 ㎍/㎥, 150.8 ㎍/㎥, 4교시에 농도는 371.9 ㎍/㎥, 448.0 ㎍/㎥였다. 부호숫자 짝짓기의 평균반응시간은 대조학급이 1교시에 2,585 msec에서 4교시에 2,459 msec으로 감소한 반면 신축학교의 창문을 의도적으로 개방한 학급은 2,343 msec에서 2,510 msec으로, 평소대로 수업한 학급은 2,340 msec에서 2,563 msec으로 반응시간이 각각 167 msec, 223 msec 증가하였다. 1교시의 부호숫자 짝짓기 의 반응시간을 100%로 했을 때 창문을 의도적으로 개방 한 학급은 4교시에 5.9% 증가하였고(p<0.01), 평소대로 수업한 학급은8.3% 증가하였다(p<0.01). 반면에 대조학급은 4교시에 5.0% 감소하였다(p<0.01). 결론: 향후 학교의 실내공기질의 안전성 평가는 샘플링 된 공기의 오염수준의 측정뿐만 아니라 학생들의 건강영향도 함께 고려되는 것이 바람직할 것이다. Objectives: Most studies on the indoor air quality of newly built schools have focused only on the number of schools exceeding a standard or on subjective symptoms, such as sneezing, irritated eyes and an irritated nose. However, there has been no report on how poor indoor air quality affects children's academic performance. This study evaluated the effects of indoor air quality on the neurobehavioral performance of elementary school children. Methods: This study measured the indoor air pollutants and compared children's performance, using a computerized neurobehavioral test, between a newly built and a 12-year-old school. In addition, a questionnaire was administered regarding the indoor air quality related symptoms of children in a newly built and a 12-year-old school. Results: In the newly built school, the formaldehyde levels in the 1^(st) and 4^(th) classes with an open window were 34.6 and 27.3 μg/㎥, respectively. The levels in the 1^(st) and 4^(th) classes with the window closed were 80.2 and 127.1 μg/㎥, respectively. In the 12-year-old school, the formaldehyde levels in 1^(st) and 4^(th) class with open and closed window were 12.6 and 7.5 μg/㎥, and 19.8 and 25.2 μg/㎥, respectively. With respect to total volatile organic compounds, the levels in the 1^(st) and 4^(th) classes with the window open in the newly built school were 87.2 and 428.2 μg/㎥, respectively. In the 1^(st) and 4^(th) classes with the window closed, the total volatile organic compounds were 1,283.5 and 1,715.4 μg/㎥, respectively. In the 12-year-old school, the total volatile organic compounds were 240.9 and 150.8 μg/㎥, and 371.9 and 448.0 μg/㎥ in the 1^(st) and 4^(th) classes, respectively. In the case of a newly built school, the performance of the students in the neurobehavioral test in the 4^(th) class with the window closed was 8.3% lower than for those in the 1^(st) class with the window closed, but was only 5.9% lower when the windows were open. There was a statistical significant difference in the total numbers of symptoms between the two schools. Conclusions: These results suggest a proper evaluation of the indoor air quality within schools is required into both the level of contamination and the health effects of these contaminants toward children.

자동차 조립작업자의 사회ㆍ심리적 스트레스와 근골격계 증상과의 연관성

김일룡,김재영,박종태,최재욱,김해준,염용태 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 이 연구는 자동차 조립라인 근로자들의 사회·심리적 스트레스와 작업관련 근골격계 자각증상간의 연관성을 확인하는 데에 있다. 방법 : 경인지역 소재 자동차 회사 두곳의 조립라인에 근무하는 근로자 636명을 대상으로 하여, 근골격계 자각증상에 대해서는 목과 어깨, 팔과 팔꿈치,. 손목과 손, 허리부위에서의 통증, 쑤심, 뻣뻣함, 화끈거림, 무감각 또는 저림 등을 묻는 표준화된 설문지로 질문하였고, 스트레스 정도는 4개 분야, 45개 항목으로 이루어진 Psychosocial Well-being Index 설문지를 배포후 3점 척도를 적용하였다. 이들간에는 카이자승법, ANOVA rm리고 로짓회귀분석을 사용하여 통계적으로 유의한 연관성을 알고자 하였다. 결과 : 1. 수면시간을 제외하고 연령, 근속기간, 결혼여부, 학력수준, 흡연력, 음주력에 따른 상지근골격계 증상의 빈도 차이는 없었다. 2. 30세 미만의 작업자군에서 사회 심리적 스트레스 점수(p-value: 0.0461)와 스트레스 Factor 3 (p-value: 0.0368), Factor 4 (p-value: 0.0053)의 점수가 높았다. 3. 11∼15년의 근속기간을 가진 작업자의 경우 Factor 1을 제외한 PWI(p-value: 0.0001), Factor 2(p-value:0.0001), Factor 3(p-value: 0.0004), Factor 4(p-value: 0.0001)에서 기타의 근속기간을 갖는 동료에 비해 높은 스트레스 점수를 보였다. 4. 미혼자는 Factor 4에서 기혼자보다 높은 스트레스 점수를 보였다(p-value: 0.0068). 5. 수면시간이 6시간 이하인 작업자군은 6시간을 초과하는 작업자보다 PWI(p-value: 0.0087), Factor 2(p-value: 0.0194), Factor 3(p-value: 0.0048), Factor 4(p-value: 0.0314) 등에서 높은 스트레스 점수를 보였다. 6. 스트레스 점수는 정규분포를 이루었으며 정상군과 스트레스위험군간에 증상의 빈도 차이는 없었다. 7. 근골격계 증상이 있는 작업자군은 무증상군과 비교하여 기타 스트레스 점수는 두 군간에 유의한 차이가 없었으나, Factor 2에서 통계적으로 유의하게 높은 스트레스 점수를 보였고(p-value: 0.028), 단변량(OR: 1.02) 및 다변량(OR: 1.04) 로짓 회귀분석에서도 Factor 2가 양의 회귀계수(0.0226; 0.0352)를 보여 증상에 영향을 주는 것으로 나타났다. 결론 : 근골격계 자각 증상이 있는 조립작업자군은 증상이 없는 군에 비해 우울증 항목에서 높은 스트레스 점수를 보였으나 기타 사회적 역할 수행 및 자기신뢰도, 수면장애 및 불안, 일반건강 및 생명력등의 사회심리적 스트레스 항목에서는 두 군간에 유의한 차이를 보이지 않았다. 로짓회귀분석예서도 우울증이 근골격계 증상에 영향을 주는 것으로 나타나서 비록 제한적이지만 우울증에 해당하는 항목인 Factor 2와 증상간의 연관성을 일부 확인할 수 있었다. 그러나 근골격계 증상발현에는 스트레스 이외에도 인간공학적 혹은 알려지지 않은 요인들 중요하게 작용하므로 이들을 통제한 후의 추가적인 조사를 해야 할 것으로 생각된다. Objectives : To determine the relationship between stress Factors and work-related muscul-loskeletal symptoms of assembly line workers in the automobile industry. Methods : A cross-sectional study was conducted in two Factories of automobile manufacturing companies where inappropriate posture and repetitive motions were required. The total number of subjects was 636, and consisted entirely of men. The Age, length of work duration, marital status, education level, smoking status, drinking status, sleeping time and stress scores were investigated according to subgroups of general characteristics. We divided the subjects into a Reference group and a Stress risk group to compare the frequency of the variables between them. The stress scores of the Positive symptom group were compared with the Symptom free group by the t-test. To measure the stress level, the PWI(Psychosocial Well being Index) which consists of 4 Factors, totaling 45 items, was used. A standardized self-reported questionnaire was used to assess the symptoms in workers. The criteria for positive symptoms were based on Operational Definition of Work-related Musculoskeletal Disorders of the NIOSH. Results : 1) The subgroups of Age, Work duration, Marital status, Education level, Smoking status, Drinking status and Sleeping time revealed no differences in frequencies in musculoskeletal symptoms. 2) Higher PWI(p<0.05), Factor 3(p>0.05) and Factor 4(p<0.01) scores were observed in younger workers compared with older workers. 3) The workers who had work durations betwen 11-15 years showed higher PWI(p<0.01), Factor 2(p<0.01), Factor 3(p<0.01), and Factor 4(p<0.01), compared with other work duration subgroups. 4) Singles had higher Factor 4 scores(p<0.01). 5) The sleeping time of less than 6 hours a day expressed a higher PWI(p<0.01), Factor 2(p<0.05), and Factor 3(p<0.01), Factor 4(p<0.05). 6) There was no difference in the prevalence of musculoskeletal symptoms between the Reference group and Stress risk group. 7) The subjects who had Positive musculoskeletal symptoms showed a significant difference in Factor 2 scores compared with the Symptom free groups. 8) According to a univariate logistic regression analysis, Factor 2(OR: 1.02, 95% CI:1.00-1.04, p-value: 0.0291) expressed significant but mild effects on the musculoskeletal symptoms and a multivariate logistic regression showed a statistically significant effect on musculoskeletal symptoms(OR:1.04, 95% CI: 1.01-1.07, p-value: 0.0170). Conclusion : Psychosocial stress scores were not higher in symptomatic subjects compared with those who had no symptoms. Sleeping longer showed a protective effect on symptoms but this was not statistically significant. There was no relationship between the stress scores and musculoskeletal symptoms in social performance and self-confidence, general well-being and vitality. Factor 2(Depression) was statistically significant though its effect was mild. Limited to this study, We could find partial relationship between psychosocial stress(Depression) and musculoskeletal symptoms. So it could therefore be suspected that ergonomic or other unknown factors may be more significant causes of musculoskeletal symptoms but we did not investigate these.

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

ZnO:In 가스 감지막의 특성 및 응용

김영범,박종아,김진해,김권태,김정규,마대영,박기철 경상대학교 생산기술연구소 2001 工學硏究院論文集 Vol.1 No.-

The microsensors to detect NH3 gas were fabricated by continous deposition of In film by evaporation and ZnO film by rf magnetron sputtering onto the Si3N4 diaphragm that was prepared by MEMS technology. The sensors were heat-treated to dope In into the ZnO thin film. The electrical characteristics of sensitive films were studied as a function of heat-temperature by 4-point probing method and electrometer. The dependence of the sensitivity, selectivity and time response of sensor on heat-treatment temperature was investigated. The microsensor heat-treated at 400℃ that 3000 A ZnO:In film was chosen as gas sensitive film, showed the highest sensitivity 23% at 350ppm NH3 under 366mW heater power. The time response was 90sec. The sensitivity for CO and NOx was not observed.