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        수출입 컨테이너 장치장 배정을 위한 소프트웨어의 개발

        김갑환,김홍배,홍봉희,김기영,배종욱,최진오,김두열,이영기,박영만,박강태,손행대 한국경영과학회 1995 經營 科學 Vol.12 No.3

        The Pusan Container Terminal faces a rapid increase in berthing time of container ships as well as in waiting time of external trucks, which is due to an absolute lack of yard space. This research is focused on the development of a decision support system for the planning of the container terminal yard assignment so that the yard space would be utilized most effectively. Efforts should be given to the reasonable assignment of the yard storage and the dynamic adaptation to the ever changing environment. The software introduced here is based o the know-how of the field exports and its framework takes the approach of the hierarchical decision making.

      • SCISCIESCOPUS

        Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

        Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.

        <P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>

      • Multiple occurrence of recurrent nodular fasciitis after surgical extirpation: masquarding as in-transit metastasis of sarcomatous presentation

        ( Kyung-nam Bae ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

        Nodular fasciitis (NF) is a rare benign fibrous tumor related with a proliferative reactive process arising mostly from the muscular fascia or deep subcutaneous region. It distinctively appeared as solitary nodule in young-aged patient with rapid growth, which gives its other name as pseudosarcomatous fibromatosis. A 16-year old boy visited our clinic for the palpable mass on the left shoulder. The initial lesion had already been partially removed by the skin biopsy at local clinic. The biopsy specimen showed only fragments of fibrous mass consisting of collagenous stroma with spindle-shaped cells, but no atypia or mitotic figure. Surgical excision was performed, of which the surgical specimen showed invasion of spindle shaped cells involving subcutaneous layer interlacing with conspicious collagenous fiborus stroma without malignant features. After 3 months, two nodules reappeared near the operation sites and the following biopsy results showed the same as before. We decided to observe the remaining lesions and there had been no significant changes for 5 months. Multiple lesional occurrence is as quite uncommon feature of NF as the recurrence after surgical treatment. Herein, we report a rare case of multiple recurrence of NF after surgical extirpation, which presented with in-transit metastasis of sarcoma-like feature.

      • SCOPUSKCI등재
      • Erosive adenomatosis of the nipple presenting early improvement after short-term cryotherapy

        ( Kyung-nam Bae ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young ),( Yang Won-ku Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

        Erosive adenomatosis of the nipple (EAN) is a rare benign neoplasm characterized by the erosion of the nipple forming crust with serous or bloody discharge. Although there is no pronounced link between its nature course with the malignant transformation, the erosive deformity is directly related to the recurrent functional discomfort and cosmetic problem, resulting in deterioration of the quality of life. A 22-year old woman visited the breast clinic for her persistent deformity of the left nipple. She underwent a core-needle biopsy of a breast mass, which was incidentally found during a breast examination. However, no additional abnormalities were found except for fibrocystic change, and then visited to our clinic for evaluation of the skin lesion. The physical examination revealed serous and bloody erosion on top of the nipple with loss of half of its normal structure. The skin biopsy showed hyperplasia of the tubular structure composed of layers of cuboidal cells, but no atypia or pleomorphism. Then she received four times of cryosurgery every six-weeks, and after 6 months the nipple almost completely healed only remaining a tiny slit-like hole. Although the first choice of treatment for EAN is local excision, it is not quite feasible approach in young-aged female patients given the unsatifactory cosmetical outcomes and the anxiety for invasive procedure. Cryotherapy could be one of the acceptable option for the treatment of EAN.

      • 직장 Dieulafoy 병변으로 다량의 혈변을 보인 1 예

        김태영;이상헌;김지현;배영환;정은주;김승만;지삼룡;설상영 인제대학교 2011 仁濟醫學 Vol.32 No.-

        Dieulafoy’s lesion is very rare cause of gastrointestinal bleeding, Deiulafoy’s lesion is exposure of non ulcerative, abnormally large tortuous, thick- walled artery in the muscularis mucosa through a small submucosal defect. It is usullay found on stomach antrum and lesser curvature side of the proximal body, and possibly found on any sites throughout whole gastrointestinal tract, but rarely on rectum. The principal of treating Dieulafoy’s lesion was the surgical resection of lesion, but recently remarkable advances in endoscopic technique make endoscopic approach more popular. We report a case of rectal Dieulafoy’s lesion successfully treated with endoscopic hemoclipping in an elderly female patient.

      • 정상인에서 베타3-아드레날린 수용체 유전자의 변이가 복부 비만도 및 지질대사에 미치는 영향

        김영선,윤석기,김철희,서교일,김학선,김극배,변동원,유명희 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

        The β₃-adrenergic receptor is expressed in visceral adipose tissue in humans and is thought to contribute to the regulation of the resting metabolic rate and lipolysis. We studied the influence of a mutation in the β₃ -adrenergic receptor gene(Trp64Arg) on body fat distribution, central obesity, lipid metabolism in 65 healthy young male adults. One out of 65 subjects were homozygous (Arg/Arg) for the trp64Arg mutation, 17 subjects were heterozygous (Trp/Arg), and 47 lacked the mutation(Trp/Trp). The body weight, height, body mass index, waist-to-hip ratio were similar between the subjects with- and without the mutation. Total body fat, abdominal fat amount, body fat distribution, serum total- and HDL-cholesterol, triglyceride, glucose, and insulin concentrations were also not different according to the presence or absence of the mutation. These results suggested that Trp64Arg mutation in β₃-adrenergic receptor gene is not a major contributing factor for central obesity or change in lipid metabolism in Korean young adults.

      • 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

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