65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

..

만성폐쇄성폐질환의 중증도와 폐고혈압 및 폐성심으로 진행과의 상관관계

김형호,박철진,이준,장광표,하성일,이재록,하재화,권세훈,권용운,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background: From many previous studies, Pulmonary hypertension is the known independent predictive factor of the mortality in COPD. Also pulmonary hypertension is the major cardiovascular complication of COPD and is associated with the progression to cor pulmonale and poor prognosis. Author want to analyze the correlation between pulmonary hypertension and the severity of COPD which are classified by forced expiratory volume in one second, and the extent of progression to corpulmonale. Methods: Retrospectively we investigated the medical records of 118 patients with COPD who had pulmonary function test and echocardiogaphy more than one times during one-year follow-up (from June, 2005 to May, 2006) at respiratory division in chosun university hospital, and then 50 patients were enrolled in this study. We classified the severity from FEVl in pulmonary function test based on the GOLD guideline, also this was comparably analyzed with RVSP, RVIDd, Visual Grading from echocardiography. Results: 16 patients out of 50 were classified as moderate severity, 25 patients were severe, and 9 patients were very severe group. RVSP was higher in more severe groups than less severe groups but when it comes to pulmonary hypertension that RVSP is over 35 mmHg, there was no valid difference lies in those groups. As FEVl decreases RVSP and RVIDd increases, and observed relationship between RVSP which was classified as below 35 mm and above 35 mm groups and visual grading which was classified as normal and dilatated groups revealed valid correlation, Conclusion: As pulmonary function decreases, progression to pulmonary hypertension and cor pulmonale increases but there was no remarkable difference of prevalence in above moderate severity groups. 연구배경 폐고혈압은 이전의 많은 연구에서 만성폐쇄성폐질환에서 독립적인 사망의 예측인자로 알려져 있다. 또한 폐고혈압은 만성폐쇄성폐질환의 주요한 심혈관계 합병증이며, 폐성심으로의 진행 및 불량한 예후와도 관련되어 있다. 이에 저자는 폐고혈압과 1초간 노력성호기량으로 분류되는 만성폐쇄성폐질환의 중증도 및 폐성심으로의 진행 정도를 비교 분석하여 이들의 상관관계를 밝혀보고자 한다. 방법 2005년 6월부터 2006년 5월까지 1년 동안 본 병원 호흡기 내과에서 폐기능검사와 심장초음파 검사를 각각 1회 이상 시행한 적이 있는 118명에 한하여 의무기록을 후향적으로 조사하여 이 중에서 50명을 대상으로 하였다. 폐기능검사 시행 결과 얻은 1초간 노력성호기량을 바탕으로 GOLD guideline에 따라 중증도를 분류하였으며 이를 심초음파 시행 결과 얻은 우심실수축기압, 확장기말 우심실내부간격, 시각등급과 비교분석하였다. 결과 대상 환자 50명중 16명은 중등증, 25명은 중증, 9명은 최고중증 그룹으로 분류되었다. 우심실수축기압은 중증도가 높은 그룹에서 낮은 그룹에 비해 더 높게 나타났으나 폐고혈압에 해당하는 우심실수축기압이 35 mmHg이상인 환자에 있어사는 각 그룹간에 유의한 차이를 보이지 않았으며, 확장기말 우심실내부간격, 시각등급 또한 중증도와 유의한 차이를 보이지 안항ㅆ다. 1초간 노력성호기량이 감소함에 따라서는 우심실수축기압, 시각등급은 증가하였으며 우심실수축기압을 35mmHg 미만과 이상인 그룹으로, 시각등급을 정상과 확장이 있는 그룹으로 분류하여 비교한 결과에서는 유의한 상관관계를 나타냈다. 결론 폐기능이 감소할수록 페고혈압 및 폐성심으로의 진행이 증가하였으나 폐기능검사에서 중등도 이상의 그룹에서 유병률의 차이는 크지 않았다.

변증법적 전략과 해체적 전략 : 브레히트의『사천의 선인』에 나타난 이중적 변신

김용록 건국대학교 2000 대학원 학술논문집 Vol.51 No.-

As we know, Good Woman of Setzuan is one of Brecht's masterpieces. I analyze this work from two theoretical perspectives. One is Freud, the other is Althusser and Baudrilliard. In this work, Shen Te, the protagonist, is a young and kind woman. But she does not know how to live in the real world. According to H. Sokel, she is in 'the imaginary state'. In order to live in the capitalistic world, she needs another self who is in 'the symbolic state'. Therefore she makes Shui Ta. Shui Ta, Shen Te's pseudo-self, is as cold as stone. He is a character appropriate for 'the symbolic world'. After all, he succeeds in his undertaking. We can imagine characters of Good Woman of Setzuan as dialectic. Shen Te is 'thesis' and Shui Ta is 'anti-thesis'. Also we can expect the third self which did not come into being until. S/he comes from future as 'synthesis'. In other aspect, we can read this work as a story of human(subject) warring against goodness(ideology). In the work, three gods(moral ideology) are incarnated into Shen Te. And then, Shen Te invents Shui Ta as a 'simulacre'. Shen Te emancipate herself from moral ideology and her dreadful identity through strategic 'simulation'. On Althusser's theory of ideology, there is no subject free from ideology. But we may look forward to a new fighting strategy against ideology not under the rule of moral or of rationality but under the rule of simulation. Looking for a solution to human existence problem, we must keep exploring for not old ways, but new ways all the time.

하경추부 손상환자에 대한 임상적 분석

박영록,홍순기,허철,김헌주,한용표 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.6

The authors analyzed 32 cases with lower cervical spine injuries according to their etiologies, the findings of cervical spine X-ray and computed tomography, initial neurological grading scales and time of operation. The results are summarized as follow : 1) Lower cervical spine injuries occurred in 32 of the 49 cervical spine injuried patients. 2) The important factors affecting on outcome were the initial neurological state(p=0.038) and the degree of spinal canal narrowing on cervical computed tomogram(p=0.046). 3) The degree of prevertebral soft tissue swelling and displacement of vertebral body on initial cervical spine X-ray did not significantly affect on outcome(p=0.052). 4) The most suitable operative time for lower cervical spine injuries was 10∼20 days after injuries and the mortality was 9.3%.

근골격계질환의 제도적 관리에 관한 연구

장성록,김용수,이관석,김유창,배동철 한국안전학회 2003 한국안전학회지 Vol.18 No.3

Recently, work-related musculoskeletal disorders(WMSDs) are one of major issues in occupational safety and health in Korea Main risk factors of WMSDs include manual handling of heavy weight loads, awkward posture, repetitive tasks, prolonged static muscle contraction, and so on. The number of injured workers has rapidly increased and the related regulation was amended to improve the work conditions and environments. And demands for workers' compensation and improvement of work conditions and environment to prevent WMSDs have increasingly been raised. This study focused on managerial system to prevent WMSDs. Literal survey and questionnaire survey were accomplished to propose a management system in Korea for preventing WMSDs.

흉막삼출의 유무에 따른 쯔쯔가무시증 환자간의 비교

권세훈,김형호,강지인,하재하,한경택,이재록,김동민,권용은,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Scrub typhus is a potentially fatal infectious disease caused by the organism Orientia tsutsugamushi. Clinical manifestations are fever, skin rash, eschar and varying degree of respiratory distress. The pleural effusion in scrub typhus is rare and secondary to the destruction of vascular endothelium. Because the respiratory symptoms are generally mild and the pleural effusion in scmb typhus is rare than in interstitial pneumonia, there are few comments about the characteristics of scmb typhus with pleural effusion. So we made the comparative study of scmb typhus patients between with pleural effusion and without pleural effusion. 연구배경 치명적일 수 있는 감염질환 중 하나인 쯔쯔가무시중(Scrub typhus)에서 드문 흉막삼출을 동반한 환자에 대한 고찰은 다른 문헌에서도 자주 언급되지 않았다. 따라서 본 저자들은 흉막삼출이 있는 경우와 없는 경우에 따른 쯔쯔가무시중 환자들을 비교하고자 하였다. 방법 2003년에서 2006년까지 조선대학교 병원 내과에 입원중인 환자 중 쯔쯔가무시중 진단을 받은 총 109명의 환자를 대상으로 하여 흉부 X선 검사 및 혈청학적 검사(CPK, LDH, ESR, CRP, AST, ALT, ADA), 혈액학적 검사(WBC, PLT) 및 백분율 검사등을 실시하였다. 결과 흉막삼출이 있는 환자들의 경우 흉막 삼출이 없는 환자들에 비해 ESR 수치가 통계학적으로 의의있게 높았다(p-vaule < 0.05). 결론 흉막삼출 유무에 따른 쯔쯔가무시중 환자간의 비교에 있어 ESR 수치가 통계학적인 의의를 가졌다.

열간단조 후 공냉에 의해 제조된 내마모강의 마모특성

최병영,김익수,장병록,이용희 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.4

Wear of blades, buckets, plates and chisel occurred in operation of construction machinery, agricultural equipments, earthmoving equipments and offshore structures cause earlier failure of the components, resulting in the increased energy consumption, cost of maintenance and replacement. To solve the problems, advanced materials with higher resistance to abrasive wear have been attempted to make through alloy design and hot deformation followed by air cooling. 0.25C-1.4Mn-1.0Cr-0.7Ni-0.2Mo-0.08V-0.02Cu steels produced by hot forging were cooled in air to form bainite, showing higher resistance to wear than any other steels with different chemical composition in the sliding wear tests under the applied load of 74N. Higher strain hardening during sliding wear of 0.25C-1.4Mn-1.0Cr-0.7Ni-0.2Mo-0.08V-0.02Cu steels to cause microploughing wear mode seems to be one of the main reasons for showing higher resistance to wear than any other steels in this study.

카드뮴 첨가된 α형 산화철에 의한 일산화탄소의 촉매산화 반응연구

이성한,김용록,김돈,정원양,김규홍,최재시 연세대학교 자연과학연구소 1983 學術論文集 Vol.11 No.-

α형 산화철에 카드뮴을 4mol%, 8mol% 및 12mol%로 각각 첨가시켜 외성영역의 특성을 갖는 산화물들을 제조하였다. 이 산화물들을 촉매로한 일산화탄소의 산화반응 속도론적 연구를 통하여 본산화물의 결함구조, CO 산화반응에 대한 촉매성 및 불순물 첨가효과등을 조사하였다. 또한 450℃에서 O_2 및 CO를 여러압력으로 도입시켜 Cd-doped α-Fe_2O_3의 전기전도도를 측정하고 이를 반응속도론적 데이타와 결부시켜 본산화물상에서 CO 의 산화반응 메카니즘과 율속단계를 제안하였다. 반응온도범위 350~460℃에서 산출된 활성화에너지는 10.1~11.3kcal.mol^-1이었다. CO_2흡착에 의한 CO산화반응의 억제효과는 본실험의 반응온도 영역인 350~460℃에서는 나타나지 않았으며 CO 산화반응의 전반응속도 차수는 1.5차로서 일산화탄소에 대해서는 1차, 산소에 대해서는 0.5차임이 밝혀졌다. 반응속도론적 데이타와 전기전도도 데이타에 의해 본촉매의 활성은 카드뮴도프로 인해 생성된 산소공위(Vo"-2e^-)에 기인한 것이었다. 카드뮴의 첨가량이 증가할수록 반응속도는 증가하였으나 12mol% 이상의 카드뮴이 첨가된 산화철상에서는 반응속도가 크게 증가하지 않는 것으로 나타났다. CO와 O_2는 근본적으로 화학흡착하며 CO의 흡착자리는 격자산소(O^-2_(latt))와 기흡착원산소 (O^-_(ads)), 그리고 O_2의 흡착자리는 산소공위(Vo"-2e^-)로 밝혀졌다. The α-Ferric oxide containing 4, 8, and 12mol% with cadmium were prepared. The oxidation rates of carbon monoxide in the presence of these oxide systems were measured to investigate the defect structure, the catalytic activity for the oxidation of carbon monoxide, and the impurity effect. The conductivity was also measured at 450℃ under the various pressures of oxygen and carbon monoxide. From the agreement between the kinetic and conductivity data, the oxidation mechanism of carbon monoxide and the rate determining step on this oxide catalyst were suggested. In the temperature range from 350 to 460℃, the calculated activation energy for the CO oxidation over Cd-doped α-Fe_2O_3 systems were 10.1∼11.3kcal·mol^-1. The inhibition by an adsorbed CO_2 during the CO oxidation was not observed in the above temperature range. The overall reaction order for the CO oxidation is 1.5; the first order with respect to CO and the one-half order with respect to O_2. The catalytic activity of this oxide system is due to oxygen vacancies induced by Cd-doping. The oxidation rates increase with increasing the amount of dopant and above 12mol%, however, don't highly increased. CO and O_2 are essentially chemisorbed as ions and the adsorption sites for CO are the lattice oxygens (O^2-_(latt)) and prechemisorbed oxygens (O^-_(ads)), the adsorption site for O_2 is the oxygen vacancies (Vo¨-2e^-).

時差性 多發病變을 보인 유전성 비용종성 대장암 1예

양동휘,강구정,민중기,김병구,박용기,최창록,지정희 대한대장항문학회 1992 Annals of Coloproctolgy Vol.8 No.3

Advanced Aggressive Non Hodgkin's Lymphima Treated with CHOP(Cyclophosphamide, Doxorubicin, Vincrstine and Prednisone) or CHOP plus Bleomycin with or without Focal Irradiation

Kim, Chul Soo,Kwon, Sung Woon,Kim, Yong Kyun,Sung, Young Joo,Lim, Chang Young,Kim, Yong Bok,Kim, Joon Hee,Suh, Hyun Suk,Kim, Sung Rok,Lee, Young Soo,Kim, Re Hwe 인제대학교 1993 仁濟醫學 Vol.14 No.4

예후불량 조직형 비호치킨 림프종으로 진단받은 1명의 제 3병기 환자 및 17명의 제 4병기 환자에게 Oncovin 1.5mg을 제 1일에, Adriamycin 50mg을 제 2일에, Cytoxan 400mg을 제 3, 4, 5일에 정맥주사하고, Prednisone 60mg을 제 1일에서 5일까지 경구 투여하는 동시에 경우에 따라 Bleomycin 15mg을 제 6,7일에 정맥주사하거나 대형의 종괴, 화학요법에 저항을 보이는 종괴, 골절의 위험이 있는 골침윤 부위 및 중추신경계의 종양침윤에 대하여 국소적인 방사선 요법을 시행하였다. 조직학적으로 11명은 미만성 대세포, 3명은 미만성 분절 소세포, 2명은 림프아구, 1명은 면역아구, 1명은 여포성 대세포형 림프종을 가지고 있었으며, 남녀의 비율은 16대 2, 연령은 15세에서 74세(중앙치 44)였으며 7명은 B증상을 가지고 있었다. 항암화학요법은 2차례에서 14차례까지 시행가능하였으며(중앙치 4) 5명에서는 Bleomycin을 추가하였고 8명에서는 국소적 방사선 조사를 시행하였다. 판정이 가능하였던 17명중 6명(35%)은 완전관해, 6명(35%)은 부분관해, 5명(30%)은 무반응을 보였고 완전관해의 지속기간은 6개월에서 27개월(중앙치 12.5)이었으며 완전관해군의 생존기간은 14개월에서 64개월(중앙치 29), 부분관해군의 생존기간 중앙치는 7개월, 무반응군의 생존기간 중앙치는 6개월로서 전체환자의 생존기간 중앙치는 10개월이였고 전체환자의 5년 생존율은 6%였다. 치료로 인한 독성은 경미하였고 치료로 인한 사망례는 없었다. 완전관해율및 생존율의 부진함은 의학적 권고를 제대로 따르지 못한 상당수 환자의 불충분한 치료및 대다수 환자의 불량한 예후인자에서 기인하였다. 항암화학요법에 민감한 환자군에서는 충분한 횟수의 항암화학요법이 요구되며 항암화학요법에 저항을 보이거나 재발한 환자에서는 고식적인 항암화학요법보다 더욱 혁신적인 치료가 필요할것으로 사료된다. Eighteen patients histologically proven as disseminated aggressive non Hodgkin's lymphoma were treated wish CHOP(vincristine 1.5mg IV on day 1, doxorubicin 50mg IV on day 2, cyclophosphamide 400mg IV on days 3∼5, prednisone 60mg PO on days 1∼5) or CHOP plus bleomycin(15mg IV on days 6∼7) with or without focal irradiation. There were 16 male and 2 female patients with their ages ranging 15∼74( median 44). The histological subtypes consisted of diffuse large cell in 11, diffuse small cleaved cell in 3, lymphoblastic in 2, immunoblastic in 1, and follicular large cell in 1. One patient was in stage IIIA, 10 in stave IVA, and 7 in stage IVB. The number of courses of chemotherapy ranged 2∼14(median 4). Focal irradiation was given to 8 patients. Therapy related morbidity was minimal with no case of mortality. Among 17 evaluable patients, six(35%) attained CR(complete remission) with a median remission duration of 12.5 months(range 6∼27). Six(35%) responded partially and five(30%) did not respond. The median survival durations were 29 months(range 14∼64) in patients who entered CR, 7 months in who achieved PR(partial remission), and 6 months in non responders. The overall median survival duration was 10 months and 5 year survival rate 6% (1 in 17). The poor CR and long term survival rate seemed to be resulted from poor compliance of the patients on one hand rather than the defect of our regimen and from poor prognostic factors of our patient group on the other hand. A strict application of the treatment schedule is needed for the chemosensitive group and an innovative treatment is required for the relapsed or chemoresistant group.