폐쇄성 수면 무호흡증 환자에 있어서 하악 재위치 장치 장착과 체위에 따른 상기도 구조와 근활성도의 변화에 관한 EMG 및 두부방사선학적 연구

박영철,배응권,이정권,이종석,김태관 대한치과교정학회 1998 대한치과교정학회지 Vol.28 No.4

폐쇄성 수면 무호흡증(obstructive sleep apnea, 이하 OSA로 표시)은 수면 도중 계속 반복 되어 일어나는 상기도 폐쇄로 인하여 무호흡증을 나타내는 장애(disorder)이다. 근래의 연구에 의하면 상기도 구조의 해부학적 요인뿐 아니라 생리적 요인도 무호흡 발생에 기여한다고 하였으며 또한 이설근이 상기도 유지에 중요한 역할을 한다고 하였다. OSA의 치료를 위해 다양한 술식이 시행되었으며 하악 재위치 장치를 통한 치료 역시 양호한 결과를 나타낸다고 하였다. 그러나 하악 재위치 장치 장착에 따른 구조적 생리적 작용기전에 대한 연구는 미비한 상태이다. 이에 본 저자는 연세대학교 치과대학병원 교정과에 내원한 OSA 환자 26명(남 17명, 여 9명)과 일반 정상 성인 20명(남 10명 여 10명)을 대상으로 앙와위에서 장치 장착 전후의 두부방사선사진을 채득하여 장치에 따른 상기도의 구조 변화를 연구하고 두군 사이의 장치 장착에 따른 효과를 비교하였으며, 또한 OSA 환자 14명(남자 10명 여 4명)을 대상으로 체위 변화와 장치장착에 따른 이설근 근전도 변화를 연구하여 다음과 같은 결론을 얻었다. 1. 상기도 구조에 대한 두부계측학적 측정치 중 연구개의 길이, 연구개 최대 두께와 SPAS, MAS, VAL, H-H1. MP-H에서 정상군과 OSA군 사이의 통계적 유의차를 보였으며, IAS와 EAS는 두 군간에 통계적 유의차를 보이지 않았다. 2. 정상군과 OSA군 모두에서 장치 장착에 따라 후두개가 전방 이동하면서 후두개 수준(epiglottis level)의 기도 폭경은 증가하였고 연구개의 최대 두께가 변하였으며 설골은 전방 이동하였으나 두 군 모두 IAS에서는 다양한 반응을 나타내었다. 장치 장착에 따른 상기도 구조에 대한 효과는 두 군 사이에 서로 차이을 나타내었다. 3. 체위 변화에 따라 앙와위에서 이설근 근전도가 증가하는 경향을 나타내었으나 통계적 유의차는 없었으며, 직립위와 앙와위 모두에서 하악 재위치 장치 장착시에 통계적으로 유의하게 이설근 근전도가 증가하였다. 하악 재위치 장치는 상기도의 해부학적 구조뿐 아니라 상기도 영향을 미치는 것으로 생각되며 장치에 대한 반응은 정상군과 OSA군 사이에 차이를 나타내었고, 두 군은 상기도 생리에 있어서도 서로 다르다고 사료된다. Obstructive sleep apnea (OSA)is a disorder characterized by repetitive episode of upper airway collapse during sleep. Recent studies showed that not only the anatomic factors but the physiologic factors of the upper airway also have effects on the occurrence of apnea and that the genioglossus muscle also plays in important role in the maintenance of the upper airway. A variety of therapies were performed to treat OSA, and among them the use of mandibular repositioning appliances showed reasonable results. But there is still a lack of research on the structural and physiological mechanism upon the use of mandibular repositioning appliances. The author selected 26(male 17, female 9) OSA patients that came to the Yonsei University Dental Hospital, Department of Orthodontics, and 20 normal adults (male 10, female 10) and took cephalometric radiographs of them in a supine position before and after the palcement of the mandibular repositioning appliance to see the structural changes of the upper airway and compare the therapeutic effects between the two groups. We also studied the waking genioglossus muscle activity in OSA patients and investigated the difference in the electromyogram of the genioglosssus muscle upon the change in body posture and the use of mandibular repositioning appliance. Following results were obtained. 1. Among the cephalometric measurements of the upper airway structure, the length of the soft palate, maximum thickness of the soft palate and SPAS, MAS, VAL, H-HI, MP-H showed statistically significant differences between the normal and OSA groups, but the IAS and EAS showed no statistically significant differences between the two groups. 2. In both the normal and OSA groups, as the epiglottis moved forward on wearing the mandibular repositioning appliance, the epiglottis level of the upper airway increased and the maximum thickness of the soft palate changed and the hyoid bone also moved forward, but the IAS in both groups showed various results and the effect of the mandibular repositioning appliance on the structure of the upper airway was different in the two groups. 3. Upon changing the position, the electromyogram of the genioglossus muscle showed a increasing tendency but there was no statistically significant differences, and when the mandibular repositioning appliance were worn there was a statistically significant increase in the electromyogram of the genioglossus muscle in both the upright and supine positions. The mandibular repositioning appliances not only have an effect on the anatomical structure of the upper airway but also on the physiology of the upper airway. There are different responses to the use of mandibular repositioning appliance between the normal and OSA groups therefore it could be considered to have the different physiology of the upper airway between the two groups.

급성심근경색증 때 내원 첫 심전도상 QRS파 끝부분의 비틀림과 조기 예후와의 관계

이영수,차태준,김현주,임진형,이철희,최환준,유호대,주승재,이재우 高神大學 醫學部 1998 高神大學醫學部 論文集 Vol.13 No.1-2

급성심근경색증 때 내원 첫 심전도상 QRS파 끝부분의 비틀림과 조기 예후와의 관계

이영수,차태준,김현주,임진형,이철희,최환준,유호대,주승재,이재우 고신대학교 의학부 1998 高神大學校 醫學部 論文集 Vol.13 No.1-2

There were some reports that magnitude of ST segment elevation reflects the extent of myocardial injury in acute myocardial infarction. And the magnitude of ST elevation, which is influenced by the extent and severity of ischemia, is also determined by other factors. Recently there were some reports that if terminal portion of QRS was distorted, it was related to severe myocardial injury. So we investigated the relationship between distortion of the terminal portion of the QRS complex and early outcome of the myocardial infarction. We classified 108 patients into two groups : 64 patients who had no distortion of terminal QRS portion and 48 patients with distortion of terminal QRS portions. Distortion of terminal QRS portion was defined as the emergence of the J point at a level above the lower half of the R wave or disappearance of the S wave in leads with an Rs configuration in 2 or more adjacent leads. We studied the first ECG checked in emergency room or intensive care units. And we followed the inhospital course of the two groups. 1. There were no significant difference in infarct sites, blood pressure, potassium, creatinine, cholesterol, HDL, triglycerides, smoker, hypertension and DM between two groups. 2. There revealed significantly higher level of peak CK-MB, SGOT and LDH in the QRS distortion group. And Killip class and mortality were also higher in the QRS distortion group. 3. Multivariate logistic regression analysis of mortality with various factors showed that reinfarction, fillip class, QRS distortion was associated with mortality. Distortion of the terminal portion of the QRS complex on the admission ECG was associated with severe myocardial injury and higher mortality rate in patients with acute myocardial infarction.

Effect of subcutaneous drain on wound dehiscence and infection in midline laparotomy for gynecological disease (KGOG 4001)

( Chel Hun Choi ),( Nam Kyeong Kim ),( Kidong Kim ),( Yong Jae Lee ),( Keun Ho Lee ),( Jong-min Lee ),( Kwang Beom Lee ),( Dong Hoon Suh ),( Sunghoon Kim ),( Min Kyu Kim ),( Seok Ju Seong ),( Myong Ch 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-

Objective: To identify the effect of subcutaneous (SQ) drain on wound dehiscence and infection in patients who underwent midline laparotomy for gynecological disease. Methods: Patients planned to undergo midline laparotomy for gynecologic disease, BMI< 35, age >18 years and ECOG performance status 0-2 were 1:1 randomized to case (with SQ drain) vs. control (without SQ drain) at 9 institutes in Korea, from February 2021 to December 2021. We compared the incidence of wound dehiscence at 4 weeks post-surgery and cumulative incidence of wound dehiscence and infection up to 4 weeks post-surgery between case and control group. Results: Of the 174 randomized patients (case 84, control 90), 12 patients were dropped due to follow-up loss (case 5, control 7) and 162 patients (intention-to-treat [ITT] cohort: case 79, control 83) were included. Fourteen patients (case 10, control 4) did not follow assigned intervention depending on the operator’s decision because the SQ layer was either too thick or too thin, and were excluded from per-protocol [PP] analysis (case 69, control 79). In ITT cohort, the frequency of cancer surgery (63/79 [79.7%] vs. 64/83 [77.1%]; p=0.683) and surgery time (mean ± standard deviation = 227.7±133.9 minutes vs. 226.7±118.2 minutes; p=0.960) were comparable in the case and control group. Mean wound length was also similar in both groups (case vs. control; 24.2 cm vs. 24.3 cm; p=0.933). There were no significant differences in the incidence of wound dehiscence at 4 weeks post-surgery (1/79 [1.3%] vs. 2/83 [2.4%]; p>0.999), the cumulative incidence of wound dehiscence (7/79 [8.9%] vs. 5/83 [6.0%]; p=0.491), and the cumulative incidence of wound infection (1/79 [1.3%] vs. 0/83 [0.0%]; p=0.488) between case and control group. PP analysis showed similar result to ITT analysis. Conclusion: SQ drain insertion did not decrease wound dehiscence and infection in patients who underwent midline laparotomy for gynecological disease.

리니어 컴프레샤용 LOA의 스트로크 센서 없는 제어 방법

유재유(Jae-Yoo Yoo),이철웅(Chel-Woong Lee),이재춘(Jae-Choon Lee),황민규(Min-Kyu Whang),김정철(Jung-Chul Kim) 전력전자학회 2001 전력전자학술대회 논문집 Vol.2001 No.7

In recent the energy efficiency of a refrigerator has been restricted extremely. A compressor consumes a great portion of input power in a refrigerator. So it is necessary to develop a more efficient compressor in these days. The existing reciprocating compressor need to a crank shaft to convert the rotating motion to the straight motion and is not efficient. But the linear compressor using mechanic resonance is efficient but need a drive instead of a crank shaft to control a position accurately. However it is impossible to apply a stroke sensor practically because of the internal circumstance of compressor. In this paper, A new sensorless stroke control method using the current and voltage of linear compressor is proposed.

표면 마이크로 가공기술을 이용한 비냉각 초전형 적외선 검출소자 제작

장철영(Chel-Young Jang),고성용(Sung-Yong Ko),이석헌(Suk-Hun Lee),김동진(Dong-Jin Kim),김진섭(Jin-Sup Kim),이재신(Jae-Shin Lee),이정희(Jung-Hee Lee),한석룡(Suk-Yong Han),이용현(Yong-Hyun Lee) 대한전자공학회 2000 대한전자공학회 학술대회 Vol.2000 No.6

Poster Session : PS 1399 ; Hemato-Oncology(Hematology) : Response to Induction Treatment Adapted Selection of Mobilization Regimen in Multiple Myeloma: The G-CSF Alone Versus High-Dose Cyclophosphamide Plus G-CSF Regimen

( Jung Yeon Lee ),( Ji Eun Jang ),( Soo Jeong Kim ),( Chel Won Suh ),( Hye Won Lee ),( Ho Young Yhim ),( Won Sik Lee ),( Chang Ki Min ),( Jae Hoon Lee ),( Joon Seong Park ),( Jin Seok Kim ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: The optimal method for mobilizing stem cells for autologous stem cell transplantation (ASCT) in multiple myeloma remains unclear. There is no guideline for choice of mobilizing regimen although both of G-CSF alone regimen and cyclophosphamide plus G-CSF regimens are recommended by International myeloma working group and used most commonly. Methods: A total of 179 patients who diagnosed with MM were admitted for PBSC mobilization using cyclophosphamide plus G-CSF or G-CSF alone between Sep. 2006 and Apr. 2013 from 8 institutions in Korea were analyzed retrospectively. The patients (N=62) who received G-CSF alone for mobilization in complete response (CR) or very good partial response (VGPR) status and the patients (N=65) who received HD-CY+G-CSF for mobilization in response less than VGPR were classed as the ‘Response adapted group’ (N=127). Results: In patients mobilized by HD-CY+G-CSF, the percentage of plasma cell in bone marrow at mobilization was significantly higher (4.0% vs. 0.7%, P<0.001). The total quantities of CD34+ cells collected per patients were 6.6 x10^6/kg in G-CSF group and 12.7 x10^6/kg in CY group (P<0.001). The rate of successful mobilization tend to be higher in CY group but had no statistical difference (79% and 91%, P=0.064). Duration of hospitalization for PBSC mobilization was longer in CY group (9days vs. 17days, P<0.001) and the treatment-related toxicity was greater in this group. Median time to neutrophil engraftment was 10 days for G-CSF alone and 11 days for HD-CY+G-CSF (P=0.004) despite the quantities of infused CD34+ cells were higher in CY group than G-CSF group (6.2 x 10^6/kg vs. 4.5 x 10^6/kg, P < 0.001). Conclusions: The risk adapted choice for mobilization with G-CSF alone is preferred in the MM patients who achieve a good response to induction treatment.

팬코일용 열교환기 회로변경에 따른 실험적 연구

이상재(Sang Jae Lee),이윤수(Yun Su Lee),권영철(Young Chel Kweon),박종운(Jong Un Park),장인규(In Kyu Jang) 대한기계학회 2001 대한기계학회 춘추학술대회 Vol.2001 No.9

The purpose of this study was to investigate the heat transfer characteristics of FCU(fan coil unit) heat exchanger, using Air-enthalpy Calorimeter. Experiments were carried out by changing air flow rate and water flow rate for φ 9.52㎜ heat exchanger with slit fin under cooling condition. The results show that the heat flux increases about 12% as changing circuit path(from 2 row series circuit to 1 row parallel circuit). The Capacity of sample 2 was about 28% as air flow rate and about 25% as water rate higher than that of sample 1. Also, j-factor of test condition A was better, compared with test condition B and f-factor of sample 2 was better since the pressure drop as changing circuit path.

Poster Session : PS 1587 ; Lung Cancer : MicroRNA-146a Inhibits Epithelial Mesenchymal Transition in Non Small Cell Lung Cancer by Targeting Insulin Receptor Substrate 2

( Ji Woong Son ),( Soo Young Lee ),( Hyo Sung Jeon ),( Hae Woo Lee ),( Jae Chel Lee ),( Jae Yong Park ),( Moon Jun Na ),( Yoo Sang Yoon ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: During cancer progression, some tumor cells show changes in their plasticity by morphological and phenotypical conversions, as an expression of mesenchymal markers and loss of epithelial markers, collectively referred to as epithelial-mesenchymal transition (EMT). EMT has been increasingly recognized as a critical phenomenon in lung cancer progression. The goal of this study was to identify microRNAs involved in lung cancer progression. Methods: A microarray and qRT-PCR were performed to investigate the miRNA expression profi les in mesenchymal lung cancer cells. The role of miR-146a in lung cancer progression was measured by invasion and migration assays in vitro. Bioinformatics and luciferase report assays were used to identify the target of miR-146a Results: The expression of miR-146a was reduced in mesenchymal phenotypes. The over-expression of miR-146a induced a marked reduction of mesenchymal marker and increase epithelial marker in several lung cancer cell lines. Moreover, the over-expression of miR- 146a suppressed lung cancer cells migration and invasion. The expression of miR-146a was down-regulated in advanced lung cancer tissues. Insulin receptor substrate 2 (IRS2) was a identifi ed target of miR-146a. IRSs are adaptor proteins that link signaling from upstream activators to multiple downstream effectors to modulate normal growth, metabolism, survival, and differentiation. miR-146a regulated the expression of IRS2 mRNA and protein level. Conclusions: These data demonstrate for the fi rst time that miR-146a was down-regulated in advanced lung cancer and suppressed lung cancer progression by repressing IRS2 expression. This sheds a new insight into the post-transcriptional regulation of lung cancer progression by miRNAs, a potential approach for the treatment of lung cancer.

위성기반 해상 위험ㆍ유해물질 원격탐지를 위한 초분광센서 활용

박경애(Kyung Ae Park),이민선(Min Sun Lee),박재진(Jae Jin Park),장재철(Jae Chel Jang),이문진(Moon Jin Lee),조득재(Deuk Jae Cho),오상우(Sang Woo Oh),김태성(Tae Sung Kim) 한국항해항만학회 2017 한국항해항만학회 학술대회논문집 Vol.2017 No.춘계