B형 간염에 의한 간경변증에서 항바이러스제의 효과

심인경,윤병철,한병훈,이상욱,임성경,이혜원,조은주,김봉준,박세진,이신준 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.1

OBJECTIVES: Improvement of liver synthetic function and the incidence of complication in the patients with hepatitis B-related liver cirrhosis is important. In this study, we study whether antiviral therapy was effective in patients with hepatitis B-related liver cirrhosis. METHODS: 103 patients with hepatitis B-related liver cirrhosis treated with lamivudine 100mg daily over 6 months and followed up over 30 months. 71 patients were positive for serum HBeAg. HBeAg, HBV DNA , CBC, prothrombin time, biochemistry, ultrasonography and endoscopy were tested every 6 months. RESULTS: The medians of ALT, albumin improved after 6 months and then aggravated after 18 months, but they didn't aggravated at 30 months compared with initial test. The median of Child-turcotte-pugh (CTP) score imporved after 6 months and then aggravated after 12 months, but they didn't aggravated at 30 months compared with initial test. The CTP score improved (2 point reduction) in 29 patients. The finding of ultrasonography didn't aggravaed (improved or didn't changed) in 58 patients. The 5 year incidence rate of hepatocelluar carcinoma was 8.3%. CONCLUSIONS: The antiviral therapy in patients with hepatitis B-related liver cirrhosis is improved CTP score and biochmical data. The improvement is more useful in decompensated cirrhosis the compensated cirrhosis. The incidence of hepatocellular carcinoma decreases than other studies. Therefore, the antiviral medication in patients with hepatitis B-related liver cirrhosis is helpful to consider more aggressively.

통계학적 가능최대강수량의 재현기간 추정

심인경,이옥정,정상만,김상단 한국방재학회 2019 한국방재학회논문집 Vol.19 No.1

This study proposes a simple alternative to statistically estimate the Probable Maximum Precipitation (PMP). The PMP is the upper limit of physical rainfall depth and is contradictory to the concept of probability. However, since the upper limit of physical rainfall depth cannot be identified clearly from observed data, it was judged that making a probabilistic estimation of PMP might be reasonable. Hershfield's km, calculated from the daily rainfall depth recorded at 80 stations of the Automated Synoptic Observing System (ASOS) with more than 10 years of observations, was fitted to the Generalized Extreme Value (GEV) distribution with a shape parameter given as a linear function of the average of the annual maximum of the time series at each observation site. Data from the oldest 15 sites in Korea (1961-2017, 57 years) were used to verify the methodology suggested in this study. Hershfield's statistical PMPs and the hydro-meteorological PMPs were somewhat different; however, the return period for the PMPs in terms of daily rainfall depth was estimated to be approximately 20,000,000 years at all sites studied. 본 연구에서는 가능최대강수량(Probable Maximum Precipitation, PMP)을 통계학적으로 추정하는 간단한 대안이 제시된다. PMP는 물리적인 강우량 상한계로, 확률론적 개념과는 모순적이지만, 관측자료로부터는 물리적인 강우량의 상한계를 명확하게 규정할 수 없기 때문에, PMP를 확률론적으로 구하는 방법이 합리적일 수도 있다고 판단하였다. 10년 이상의 관측자료를 보유한 기상청 ASOS 80개 지점의 일 강우량 자료를 이용하여 산출한 Hershfield의 km은 각 관측 지점의 연 최대 시계열의 평균의 선형함수로 주어지는 형상 매개변수를 가지는 GEV 분포에 적합한 것으로 나타났다. 또한, 본 연구의 방법을 검증하기 위하여 우리나라에서 가장 오래된 15개 지점 자료(1961-2017, 57년)가 이용되었다. Hershfield의 통계학적 PMP와 수문기상학적인 PMP는 지점별로 다소 상이하였으나, 적용된 지점들 모두에서 일 강우량 PMP의 재현기간은 대략 20,000,000년인 것으로 추정되었다.

A Case of Persistent Apical Ballooning Complicated by Apical Thrombus in Takotsubo Cardiomyopathy of Systemic Lupus Erythematosus Patient

심인경,김봉준,김현수,이재우,차태준,허정호 한국심초음파학회 2013 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.21 No.3

Takotsubo cardiomyopathy, which is also known as “transient apical ballooning”, is a cardiac syndrome associated with emotional and physical stress that occurs in postmenopausal women. It may mimic acute coronary syndrome but coronary angiography reveals normal epicardial coronary arteries. The prognosis is favorable with the normalization of wall motion abnormalities within weeks. We report a case of persistent apical ballooning complicated by an apical thrombus in Takotsubo cardiomyopathy of systemic lupus erythematous patient. Takotsubo cardiomyopathy may not be always transient and left ventricular thrombus can occur in the disease course as our patient.

증례 : 알레르기 ; 옻닭 섭취 후 패혈증 쇼크 양상을 보인 급성 전신성 발진성 농포증 1예

심인경 ( In Kyoung Shim ),최윤정 ( Youn Jung Choi ),이신준 ( Shin Jun Lee ),이혜원 ( Hae Won Lee ),최길순 ( Gil Soon Choi ),김희규 ( Hee Kyoo Kim ),서기석 ( Kee Suck Suh ) 대한내과학회 2011 대한내과학회지 Vol.81 No.6

급성 전신성 발진성 농포증은 주로 약물에 의해서 유발되며 전신에 융합하는 양상의 홍반성 반과 작은 표재성 농포가 발생하고 흔히 발열과 호중구 증가증을 동반하며 급성으로 진행하지만, 원인 물질을 중단하면 대개 15일 이내에 병변이 호전되는 드문 질환이다. 옻에 의해 발생한 패혈성 쇼크 양상을 보인 급성 전신성 발진성 농포증 1예를 경험하고 드문 증례라 생각하며 문헌고찰과 함께 보고한다. Acute generalized exanthematous pustulosis (AGEP) is a rare disease characterized by multiple acute, small, non-follicular, sterile pustules on an erythematous background, usually accompanied by fever and leukocytosis. AGEP is attributed to systemic drugs, mainly ß-lactam and macrolide antimicrobials, in more than 90% of cases. Systemic contact dermatitis is not rare after ingesting lacquer broth, but few reported cases of AGEP have occurred after the ingestion of lacquer chicken broth without a past history of drugs, viral infection, or contact allergy to mercury. Here, we report a rare case of AGEP with a pattern of septic shock induced by the intake of lacquer chicken in a 40-year-old male patient. He developed a generalized pustular lesion with high fever and hypotension. Histologic examination showed subcorneal neutrophilic pustules, papillary dermal edema, and lymphohistiocytic perivascular infiltrates with some eosinophils and neutrophils. The patient was treated with empirical antibiotics and systemic steroids, and the pustular lesions improved 2 weeks later without recurrence. (Korean J Med 2011;81:802-806)

물수지 분석에 기반한 빗물이용시설의 정량적 효과 분석

심인경(Inkyeong Sim),김이호(Reeho Kim),이정민(Jungmin Lee),박종표(Jongpyo Park) 한국방재학회 2022 한국방재학회논문집 Vol.22 No.6

빗물이용시설은 「물재이용법」에 의거하여 설치되는 시설로 현재 공동주택, 업무시설, 학교, 체육시설 등의 다양한 건축물에 설치되어 있다. RHS에서 집수되는 빗물의 수요처별로 구분하면 화장실 세정수, 수목관수, 도로청소용수, 수경시설 등 다양한 수요처에 사용되고 있다. 본 연구에서는 수문학적 물수지 분석을 통한 물수요-공급 시계열 분석을 수행하여 빗물활용성을 산정하였다. 물 수요-공급 시계열 물수지 분석은 최근 10년 기간을 기준으로 분석을 수행하였으며, 빗물이용시설에 대한 물수지 분석은 각 시설의 수요 시나리오에 의한 공급충족률, 빗물이용률, 공급충족률을 분석하였다. 이와 같은 방법을 통해 건축용도 및 수요처가 다른 다양한 RHS에 대한 빗물활용성을 확인하여 향후 대상시설의 저류조 용량 설치 계획 및 운영을 위한 지원도구가 될 것으로 판단된다. The rainwater harvesting system (RHS) is a facility installed in accordance with the 「Act on promotion and support of water reuse」 and is currently installed in various buildings such as apartment houses, business facilities, schools, and sports facilities. Rainwater is used for various needs, such as toilet flushing water, tree irrigation, road cleaning water, and landscaped facilities. In this study, rainwater utilization was calculated by performing a water demand-supply time series analysis through a hydrological water balance analysis. The water supply-supply time series water balance analysis was performed based on the recent ten-year period, and the water balance analysis for RHS analyzed the supply satisfaction, rainwater utilization, and rainwater coverage rates according to the demand scenarios of each facility. Through this method, it is expected to become a support tool for planning and operating the storage tank capacity of the target facility by confirming the rainwater utilization for various RHSs with different building uses and demand sources.

The significance of blood pressure variation and metabolic risk factors in patients with different stages of hypertension

김선민,심인경,이주원,이준엽,이시원,조경임,김현수,이재우,허정호 고신대학교(의대) 고신대학교 의과대학 학술지 2017 고신대학교 의과대학 학술지 Vol.32 No.2

Objectives: Blood pressure variation (BPV) and metabolic syndrome is an independent risk factor for cardiovascular events. Ambulatory blood Pressure (ABP) has been shown to be more closely related to cardiovascular events in hypertensive patients than conventional office BP (OBP). Using both OBP and ABP, 4 groups of patients were identified: (1) normotensive patients (NT); (2) white coat hypertensives (WCHT); (3) masked hypertensives (MHT); and (4) sustainedhypertensives (SHT). We investigated the significance of BPV and metabolic risks of these 4 groups. Methods: This study is a retrospective analysis of patients between January 2008 and May 2013. Echocardiography and 24 hour ABP monitoring were performed. Results: BMI was significantly higher in the MHT compared with the NT. There were progressive increases in fasting glucose level from NT to WCHT, MHT, and SHT.MHT and SHT had higher 24h and nighttime BPV than NT.MHT was significantly related with BMI (r = 0.139, P = 0.010), creatinine (r = 0.144, P = 0.018), fasting glucose (r = 0.128, P = 0.046), daytime systolic BPV (r = 0.130, P = 0.017), and daytime diastolic BPV (r = 0.130, P = 0.017). Dyslipidemia (r = 0.110, P = 0.043), nighttime systolic BPV (r = 0.241, P < 0.001) and nighttime diastolic BPV (r = 0.143, P = 0.009) shown correlation with SHT. In multivariate logistic regression, MHT was independently associated with Body mass index (OR 1.086, 95% CI 1.005-1.174, P = 0.038) and creatinine (OR 1.005, 95% CI 1.001-1.010, P = 0.045). Conclusions: BPV and metabolic risk factors were found to be greater in MHT and SHT compared with NT and WCHT. This suggests that BPV and metabolic risks may contribute to the elevated cardiovascular risk observed in patients with MHT and SHT.

기상변수를 이용한 일강우량 비정상성 빈도해석

이옥정,심인경,김상단 한국방재학회 2018 한국방재학회논문집 Vol.18 No.7

본 연구에서는 극한 일강우량을 대상으로 기상 변수가 포함된 비정상성 GEV 모형이 개발되었다. 이 때 GEV 분포의 매개변수 중 축적매개변수를 공변량의 함수로 적용하였다. 본 연구에서 선택된 기상변수들은 추후 기후변화 시나리오를 적용하기에 용이한 지표면 기온(Surface air temperature, SAT)과 이슬점 온도(Dew point temperature, DPT)이다. 기상청 지점 중 서울 지점 자료를 대상으로, 7월부터 8월까지(여름철)의 월 최대 일 강우량 시계열을 이용하여 분석을 수행하였다. GEV 분포의 축척 매개변수를 위한 최적 공변량(기온과 이슬점) 함수를 선택하기 위하여 다양한 모델을 구성하였으며, 구성된 모델 중 AIC(Akaike Information Criterion)가 가장 작은 모델을 최적 모델로 선정하였다. 분석 결과, A·SAT B t 모델이 최종적으로 선택되었다. 선택된 모델을 이용하여 기후변화 시나리오에 따른 확률강우량의 영향을 분석하였으며, 서울지점의 경우 미래 기온이 증가함에 따라 확률강우량이 증가할 가능성이 매우 높음을 살펴볼 수 있었다. In this study, non-stationary GEV models with meteorological variables were developed for extreme daily rainfall depths. The scale parameter of the GEV distribution is regarded as a function of the covariate. The meteorological variables selected in this study were surface air temperature (SAT) and dew point temperature (DPT), which are suitable for future climate change scenarios. The data were collected from Seoul Station, and were analyzed using monthly maximum daily rainfall data from July and August (summer season). Various models were constructed to select the most appropriate covariate (SAT and DPT) function for the scale parameter of the GEV distribution, and the model with the minimum Akaike Information Criterion value was selected as the optimal model. As a result of the analysis, the model with A·SAT B t was selected. The selected model was used to analyze the effect of global warming on design rainfall depth. In the case of Seoul Station, it was shown that the design rainfall depth is very likely to increase as the future SAT increases.

지표면 기온 및 이슬점 온도를 고려한 여름철 월 최대 일 강수량의비정상성 빈도해석

이옥정,심인경,김상단 한국습지학회 2018 한국습지학회지 Vol.20 No.4

In this study, the surface air temperature (SAT) and the dew-point temperature (DPT) are applied as the covariance of the location parameter among three parameters of GEV distribution to reflect the non-stationarity of extreme rainfall due to climate change. Busan station is selected as the study site and the monthly maximum daily rainfall depth from May to October is used for analysis. Various models are constructed to select the most appropriate co-variate(SAT and DPT) function for location parameter of GEV distribution, and the model with the smallest AIC(Akaike Information Criterion) is selected as the optimal model. As a result, it is found that the non-stationary GEV distribution with co-variate of exp(DPT) is the best. The selected model is used to analyze the effect of climate change scenarios on extreme rainfall quantile. It is confirmed that the design rainfall depth is highly likely to increase as the future DPT increases. 본 연구에서는 기후변화에 따른 극한 강우의 비정상성을 반영하기 위하여 GEV 분포의 3개 매개변수 중 위치매개변수를 공변량으로적용하여, 지표면 기온(Surface air temperature, SAT) 및 이슬점 온도(Dew point temperature, DPT)을 고려한 비정상성 빈도해석이실시된다. 부산 지점이 연구대상지점으로 선정되었으며, 5월부터 10월까지의 월 최대 일강수량을 이용하여 분석을 수행하였다. GEV 분포의 위치 매개변수를 위한 가장 적절한 공변량(기온과 이슬점 온도) 함수를 선택하기 위하여 다양한 모델을 구성하였으며, 구성된 모델 중 AIC(Akaike Information Criterion)가 가장 작은 모델을 최적 모델로 선정하였다. 분석 결과, exp(DPT)가공변량인 비정상성 GEV 분포가 가장 적합한 것으로 나타났다. 선택된 모델을 이용하여 기후변화 시나리오에 따른 확률강우량의영향을 분석하였으며, 부산지점의 경우 미래 이슬점 온도가 증가함에 따라 확률강우량이 증가할 가능성이 매우 높음을 살펴볼수 있었다.

SLE 환자에서 발생한 심근염와 동반된 심내혈전에 대한 1예 (초)

이원형,심인경,허정호 대한내과학회 2012 대한내과학회 추계학술대회 Vol.2012 No.1

Confirmation of perivascular hematoma mistaken for deep vein thrombosis using IVUS : Case report

임지훈,김수홍,심인경,최종현 대한내과학회 2019 대한내과학회 추계학술대회 Vol.2019 No.1