다발 신경병증과 혈관염 동반된 쇼그렌 증후군 환자 증례보고

김태헌,김윤철,유승정,허민영 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

서론: 쇼그렌 증후군(Sjigren’s syndrome)은 눈물샘, 침샘과 같은 외분비샘에 림프구가 침윤되어 눈 마름증과 입안 마름증이 나타나는 만성 자가 면역 질환으로, 다양한 선외 증상(Extra glandular)을 유발할 수 있으나, 혈관, 신경계를 침범하는 경우는 다른 자가 면역질환에 비해 드물다. 저자들은 쇼그렌 증후군에 의해 유발된 다발 신경병증, 혈관염 환자의 증례를 보고하고자 한다. 증례: 특이 과거력 없던 59세 여자 환자는, 내원 2개월 전부터 양하지의 열감, 부종 호소하였고 내원 당일, Lt.foot dorsiflexion되지 않으면서, foot drop 증상으로 정형외과로 내원하였다. Lymphangio scan상 Lt.leg lymphedema 소견 보이면서, 검사결과는 ANA 1; 320, C3/C4 60/10, anti R o (+) anti La (-), RF 115, anti CCP (-) 나왔다. Salivary scan상 양측 귀밑샘, 턱밑샘 모두 충만 되지 않으며, 타액선 배출장애 양상 관찰되었어, 쇼그렌 증후군 진단되었다. 이후 양하지 위약감 지속되어 시행한 근전도검사상 양 총비골 신경 손상 및 다발 신경변증 의심양상 관찰되어, 혈관염(vasculitis)에 의한 sensor polyneuropathy 확인 위해 Nerve bx.시행하였고, vasculitic neuropathy 진단되어, Steroid pulse (1 g) IV 3일간 시행후, cyclophosphamide pulse (1 g) IV 시행하였다. 이후 prednisolon 1 mg/kg po유지하면서, 외래 추적 관찰중, 증상 호전되어 점차적으로 감량하면서 현재는 중단한 상태이며, cyclophosphamide는 severe leukopenia로 중단후 Cyclosporine A로 변경하여 복용하며 외래 추적 관찰중이다. 본 증례는 쇼그렌증후군에서 혈관과, 말초신경 동시에 침범하는 첫번째 사례로 발현 환자 증례 보고하는 바이다.

여성 불임시술의 현황과 문제점

김태헌 釜山醫師會 1984 釜山醫師會誌 Vol.20 No.5

한·일 자동차산업의 대(對)인도네시아 수출경쟁력 비교연구

김태헌 경희대학교(국제캠퍼스) 국제지역연구원 2021 아태연구 Vol.28 No.3

This study aims to examine the problems for enhancing the export competitiveness of the Korean automobile industry in the era of CEPA in Indonesia by comparing and analyzing the export competitiveness of the Korean and Japanese automobile industries in Indonesia. In this study, we analyzed the Revealed Comparative Advantage Index (RCA), Comparative Advantage by Country (CAC), and Export Similarity Index (ESI). The analysis results showed that Korea is in a comparative heat state compared to Japan in the main export items such as passenger cars (8703), freight cars (8704), automobile chassis (8706), automobile parts/arrangements (8708), and motorcycles (8711). Japan has a comparative advantage in finished car sector of automobiles, vans, freight cars and motorcycles, as well as in the parts/equipment sectors that support the assembly production of overseas production bases. In particular, Korea has generally inferior competitiveness of most items in the Indonesian market, but in contrast, Japan has far superior competitiveness in the Indonesian market than the global market in most items. Meanwhile, the group with the most intense export competition in the Indonesian market in 2019 was the Japan-India group for HS87 items, and the German-Japanese group for HS8703 items. In the Indonesian automobile market, the so-called “four-party competition” has been formed between Japan, the UK, India and Germany, while relatively low competition between Korea and Japan has been formed. Therefore, the Korean automobile industry should enhance the competitiveness of exports to Indonesia with the entry into force of Korea-Indonesia CEPA, and learn thoroughly about the past experience of Hyundai Motor's failure to advance into Indonesia and the success factors of Japanese automobiles in Indonesia, and actively seek ways to advance into the local market, such as establishing a joint venture for local production of eco-friendly electric vehicles and developing a local specialization model. 본 연구는 인도네시아시장에서 현시되고 있는 한‧일 자동차산업의 수출경쟁력을 비교 분석함으로써 향후 본격적으로 전개될 한-인도네시아 CEPA시대의 한국자동차산업의 수출경쟁력 제고를 위한 문제점을 사전 점검해 보는 데 소기의 목적을 두고 있다. 연구에서는 현시비교우위(RCA), 국별 비교우위(CAC), 수출경합도(ESI) 분석이 시도되었다. 분석결과, 한국은 주력수출품목인 승용자동차(8703), 화물자동차(8704), 자동차 섀시(8706), 자동차 부품/부속품(8708), 모터사이클(8711) 부문에서 일본에 비교열위상태인 것으로 나타났다. 일본은 승용차, 승합차, 화물자동차, 모터사이클과 같은 완성차 부문과 해외생산기지의 조립생산을 뒷받침하는 부품/부속품 부문에서 절대적 비교우위 경쟁력을 확보하고 있는 특징을 보였다. 특히 한국은 인도네시아시장에서 대다수 품목군의 경쟁력이 대체로 열세이지만, 그와 대조적으로 일본의 경우는 대다수 품목군에서 글로벌시장보다 인도네시아시장에서의 비교우위경쟁력이 월등히 앞서 있는 것으로 확인되었다. 2019년 인도네시아시장에서 수출경합이 가장 치열한 그룹은 HS87류의 경우 ‘일본-인도’ 그룹이었으며, HS8703호는 ‘독일-일본’ 그룹이었다. 인도네시아 자동차시장에서는 일본, 영국, 인도, 독일 간의 4자 경쟁구도가 형성되어 있는 가운데, 한·일 간에는 상대적으로 낮은 경합관계가 형성되고 있는 것으로 나타났다. 따라서 한국의 자동차업계는 한-인도네시아 CEPA 발효를 계기로 대(對)인도네시아 수출경쟁력을 제고시키는 한편, 과거 현대자동차의 인도네시아 진출 실패경험과 일본자동차의 인도네시아 성공요인을 철저히 학습하여 친환경 전기자동차의 현지생산을 위한 합작법인 설립, 현지특화모델 개발 등 실현가능한 현지진출방안들을 적극 모색하여야 할 것으로 보인다.

누진제 완화와 전력사용량 변화: 매칭이중차분법을 활용한 주택용 전기요금 개편 효과 분석

김태헌,배관표 한국정책분석평가학회 2023 政策分析評價學會報 Vol.33 No.1

In December 2016, the government implemented changes to the electricity supply contract, including a revision of the progressive electricity rate system for residential use. The progressive rate system was significantly relaxed by revising the existing six-stage 11.7 times progressive structure to a three-stage 3 times structure, which had not been revised since 2004. Before the policy change, there were concerns that if electricity rates were reduced by relaxing the progressive rate system, household burdens would be reduced but ultimately lead to overconsumption of electricity. This study empirically analyzed changes in electricity usage levels. The results from 2016 and 2017 using matching difference-in-differences showed a 12% decrease in electricity usage after the rate system revision. Excluding the summer period when temperature has a significant impact, a 12.9% decrease was confirmed. To compensate for the short period of analysis, we analyzed periods from 2015 to 2018 before and after policy implementation and confirmed that the same trend was observed. This indicates that electricity usage did not increase significantly even if the progressive rate system was relaxed in the 201~400kWh range. As this trend can change in the long term, there is a need for follow-up studies that track the effects of progressive rate system relaxation over a long period of time. 2016년 12월, 정부는 주택용 누진제 개편을 포함한 전기공급약관 변경을 시행하였다. 누진제 개편은 2004년 이후 12년 만에 이루어진 것으로 기존 6단계 11.7배수의 누진구조를 3단계 3배수로 대폭 완화하였다. 제도 개편 전, 누진제 완화로 요금이 인하되면 가계 부담은 줄지만, 결국 전력 과소비가 발생할 것이라는 우려가 컸다. 이에 본 연구는 전력사용량 변동 수준을 실증분석으로 확인하였다. 2016년과 2017년 자료를 매칭이중차분법으로 분석하여 요금제 개편 전후의 변화를 측정한 결과 12%의 전력사용량 감소를 보였다. 기온이 영향이 큰 여름철 기간을 제외하고 분석하자 12.9%의 감소가 확인되었다. 기간의 짧음을 보완하기 위해 정책시행 전후 2년으로 시계열 길이를 늘려 2015년과 2018년 기간을 분석하여도 동일한 추세가 확인되었다. 이는 201∼400kWh 구간에서는 누진제를 완화해도 전력사용량이 크게 늘지는 않았음을 나타낸다. 이 같은 추세는 장기적으로 변화될 수 있으므로 누진제 완화의 효과를 장기간 추적하는 후속 연구의 필요성이 제기된다.

조기위암 형태의 위유암종 1예

김태헌,송인성,정현채,최규완,이준행,김정룡,한철주,장유현,신건성,조창락,임영석 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.3

The endoscopic diagnosis of gastric carcinoid has been considered difficult. Reported cases of this tumor diagnosed by endoscopic examination are rare. And the gastric carcinoid with massive upper gastrointestinal bleeding is a rare disease entity. We experienced a case of gastric carcinoid admitted to the hospital because of hematemesis, melena and syncope. And it was diagnosed by endoscopic biopsy, although it resembled type IIa+IIc early gastric cancer at endoscopic examination. To our knowledge, this is the first case report of gastric carcinoid tumor mimicking early gastric cancer. So we report this case with a review of relevant literatures.

소간세포암의 분화도와 혈관분포 양상에 따른 종괴 및 비종괴 부위에서 Insulin-like Growth Factor-II 발현 차

김태헌,송인성,정현채,이효석,김정룡,윤정환,이준성,우광훈,윤용범,장자준 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1

Background/Aims : The precise mechanisms of insulin-like growth factor-II (IGF-II) in hepatocarcinogenesis have not been clarified yet. Recently, it was suggested that IGF-II might be closely related to angiogenesis. This study was designed to verify mechanisms of IGF-II in hepatocarcinogenesis and its relation to angiogenesis. Methods : For seventeen patients with small hepatocellular carcinoma (HCC) (≤3 cm in diameter), tissues were obtained from both tumorous and nontumorous area. We analyzed the degree of histological differentiation by Edmonson and Steiner's criteria and vascularity shown on spiral computed tomography (CT). The level of IGF-II expression was analyzed by immunohistochemical staining. Results : The histological differentiation of HCCs in the 17 patients were observed as follows : grade I in 3, grade II in 7, grade III in 7. Eleven patients showed hypervascular tumors on spiral CT. There was a significant correlation between the relative expression patterns of IGF-II and the degree of histlogical differentiation of HCCs. That is, in case of the more differentiated HCCs, IGF-II was more expressed in in tumorous tissues than in nontumorous tissues (r=0.609, p=0.010). Conclusions : These results suggest that IGF-II might play a role in an early stage of hepatocarcinogenesis.

全身體熱撮影에 의한 憂鬱症과 顔面痲痺의 客觀的 診斷方法 摸索

김태헌,이용근,류영수 대한한방신경정신과학회 2000 동의신경정신과학회지 Vol.11 No.2

Depression is a psychiatric syndrom consisting of dejected mood, psychomotor retardation, insomnia and weight loss. sometimes associated with irrational quilt feeling. And it is also similiar to Hwa-byung(火病) symptom in oriental medicine. But it is difficult to diagnose with objective method. Digital Infrared Thermographic Imaging(D.I.T.I.) is one of diagnotic method that measure the changes of skin temperature in body. Specially we checked the skin temperature on depressed patients by using D.I.T.I. and compared with Bell's palsy patients and normal persons group. The results are as follows: Average body temperature of the depressed patient group is 36.62±0.58˚C, Bell's palsy patients group is 36.59±0.34˚C and that of the control group is 36.71±0.43˚C. So there is no meaningful difference. The depressed patient group has higher temperature than the Bell's palsy patients group and control group by △T〉1.0˚C at the following acupuncture points in these body parts - upper and lower, left and right, anterior and posterior. When acupuncture points temperature was compared superior and inferior part of the body, depressed patient group have meaningful difference at the GV-4 (Myung-moon) and also in the Bell's palsy patients group and control group. When acupuncture points temperature was compared left and right part of the body. ddpressed patient group have no meaningful difference and also in the Bell's palsy patients group and control group. When acupuncture points temperature was compared in the anterior and posterior part of the body, depressed patient group have meaningful difference at the Gv-4(Myung-moon) and also in the bell's palsy patients group and control group. From this study. we think that D.I.T.I. could be used to diagnose objectively on the depressed patients and useful to another psychoneurogenic diagnosis in oriental medicine.

Does Additional Aortic Procedure Carry a Higher Risk in Patients Undergoing Aortic Valve Replacement?

김태헌,박계현,유재석,이재항,임청 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.5

Background: With growing attention to the aortopathy associated with aortic valve diseases, the number of candidates for accompanying ascending aorta and/or root replacement is increasing among the patients who require aortic valve replacement (AVR). However, such procedures have been considered more risky than AVR alone. This study aimed to compare the surgical outcome of isolated AVR and AVR combined with aortic procedures. Materials and Methods: A total of 86 patients who underwent elective AVR between 2004 and June 2010 were divided into two groups: complex AVR (n=50, AVR with ascending aorta replacement in 24 and the Bentall procedure in 26) and simple AVR (n=36). Preoperative characteristics, surgical data, intra- and postoperative allogenic blood transfusion requirement, the postoperative clinical course, and major complications were retrospectively reviewed and compared. Results: The preoperative mean logistic European System for Cardiac Operative Risk Evaluation (%) did not differ between the groups: 11.0±7.8% in the complex AVR group and 12.3±8.0% in the simple AVR group. Although complex AVR required longer cardiopulmonary bypass (152.4±52.6 minutes vs. 109.7±22.7 minutes, p=0.001), the quantity of allogenic blood products did not differ (13.4±14.7 units vs. 13.9±11.2 units). There was no mortality, mechanical circulatory support, stroke, or renal failure requiring hemodialysis/filtration. No difference was found in the incidence of bleeding (40% vs. 33.3%) which was defined as red blood cell transfusion ≥5 units, reoperation, or intentional delayed closure. The incidence of mediastinitis (2.0% vs. 0%), ventilator ≥24 hours (4.0% vs. 2.8%), atrial fibrillation (18.0% vs. 25.0%), mean intensive care unit stay (34.5 hours vs. 38.8 hours), and median hospital stay (8 days vs. 7 days) did not differ, either. Conclusion: AVR combined with additional aortic or root replacement showed an excellent outcome and recovery course equivalent to that after isolated AVR.

Synthesis and Rheology of Intercalated Polystyrene/Na -montmorillonite nanocomposites by Emulsion polymerization

김태헌,장이욱,이동주,최형진 한국고분자학회 2001 한국고분자학회 학술대회 연구논문 초록집 Vol.2001 No.4

주요국 핵심광물 확보 전략 분석

김태헌,박지민 에너지경제연구원 2021 에너지경제연구원 수시연구보고서 Vol.- No.-