인접구조물의 내진성능개선을 위한 준능동 MR감쇠기의 GA-최적퍼지제어

윤중원 ( Jung Won Yun ),박관순 ( Kwan Soon Park ),옥승용 ( Seung Yong Ok ) 한국안전학회(구 한국산업안전학회) 2011 한국안전학회지 Vol.26 No.4

This paper proposes a GA-based optimal fuzzy control technique for the vibration control of earthquake- excited adjacent structures interconnected with semi-active magneto-rheological(MR) dampers. Rule-based fuzzy logic controllers are designed first by implementing heuristic knowledge and the genetic algorithm(GA) is then introduced to optimally tune the fuzzy controllers for enhancing the seismic performance of semi-active control system. For practical implementation, the fuzzy controller simply uses locally measured responses of the dampers involved and directly returns the input voltage to the magneto-rheological dampers in real time through the fuzzy inference mechanism. The local measurement based fuzzy controller provides optimal damping force in a decentralized manner so that it does not require a primary central controller unlike the conventional semi-active control techniques. As a result, it can avoid the unbridgeable discrepancy between the desired control force and the actual damper force that may occur in the conventional control approaches. The validity and effectiveness of the proposed control method are shown numerically on two 20-story earthquake-excited buildings interconnected with MR dampers.

횡격막 탈장과 연관된 Budd-Chiari 증후군

윤중원 ( Jung Won Yun ),박용범 ( Young Bum Park ),공휘 ( Hwi Kong ),정성원 ( Sung Won Jung ),이태광 ( Tae Kwang Lee ),송재민 ( Jae Min Song ) 대한내과학회 2005 대한내과학회지 Vol.69 No.6

Budd-Chiari syndrome (BCS) is a rare disease caused by the obstruction of the hepatic venous outflow or the inferior vena cava above the hepatic vein. It has been attributed to various etiologic factors. Including intrinsic vascular thrombosis, hepatic tumor invasion/compression, or associated with an idiopathic obstructing membrane. However, in most cases no definitive etiologic factors have been identified. Recently, we experienced a case of 21-year-old man who had Budd-Chiari syndrome associated with diaphragmatic hernia. Venous flow returned to normal on reintroduction of the liver into the abdominal cavity and closure of the defect in the diaphragm. To our knowledge, this is the rare report in our country. Here, we report this case with review of literatures.(Korean J Med 69:692-695, 2005)

한국인 성인에서 내장지방량과 죽상경화증 위험인자 및 좌심실 비대와의 상관관계

윤중원(Jung Won Yun),이원영(Won Young Lee),김지연(Ji Youn Kim),박현덕(Hyun Duk Park),임성호(Seong Ho Lim),정찬희(Chan Hee Jung),김영춘(Young Chun Kim),김선우(Sun Woo Kim) 대한내과학회 2002 대한내과학회지 Vol.63 No.2

Background: Obesity is an independent risk factor for the development of coronary artery disease and associated with insulin resistance, hyperlipidemia and hypertension. In many studies, visceral adipose tissue is highly correlated with adverse coronary risk profile. Left ventricular (LV) hypertrophy also is an independent risk factor for cardiovascular mortality and morbidity. However, few data are available concerning the relations of LV hypertrophy to body fat composition, especially in Korean subjects. Therefore, this study was intended to evaluate the relation between body fat distribution and atherosclerotic risk factors including metabolic parameters and LV mass. Methods: Total 138 subjects who visited the healthy promotion center in Kangbuk Samsung hospital (97 men, 41 women) were to recruited to the study. Body fat distribution was assessed by Abdomial CT (computer tomography) and Bioelectrical impedance analysis (Body Composition Analyzer Inbody 2.0, Biospace, Seoul, Korea) Results: Visceral adipose tissue volume was higher in male subjects while subcutaneous adipose tissue volume and % body fat were higher in female subjects (p<0.05). Serum triglyceride and uric acid level were elevated in male subjects but HDL-cholesterol level was elevated in female subjects (p<0.05). Increasing age was correlated with waist-hip ratio, visceral adipose tissue volume, abdominal fat/total body fat ratio, LV mass (p<0.05). Visceral adipose tissue volume was positively correlated with body mass index, waist-hip ratio, blood pressure, total cholesterol, triglyceride, uric acid and negatively correlated with HDL-cholesterol (p<0.05). After adjustment for age and sex, this correlation was significantly remained. LV mass was positively correlated with body mass index, waist-hip ratio, visceral adipose tissue volume, abdominal fat/total body fat ratio (p<0.05). In the multiple regression analysis, the independent predictor for LV mass was visceral adipose tissue volume (β=0.252, p<0.05). Conclusion: Body fat distribution is associated with traditional cardiovascular risk factors. Especially, visceral adipose tissue is correlated with the components of metabolic syndrome and LV mass which is independent risk factor of cardiovascular morbidity and mortality. (Korean J Med 63:177-185, 2002)

간경병증 환자에서 섬유소 용해 활성도와 식도정맥류 출혈과의 관계

윤중원 ( Jung Won Yun ),김병익 ( Byung Ik Kim ),전한별 ( Han Byul Chun ),황상태 ( Sang Tai Hwang ),김정욱 ( Jeong Wook Kim ),박동일 ( Dong Il Park ),조용균 ( Yong Kyun Cho ),성인경 ( In Kyung Sung ),박창영 ( Chang Young Park ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.6

Background/Aims: Esophageal variceal bleeding in liver cirrhosis is a major complication and has high mortality rate. We tried to find fibrinolytic parameters, which correlated with variceal bleeding in cirrhotic patients. Methods: We divided the cirrhotic patients into two groups: bleeding group (group A, n=15) and non-bleeding group (Group B, n=17). Fibrinolytic parameters (fibrinogen, D-dimer, plasminogen, tissue plasminogen activator [t-PA], fibrin degradation product [FDP], and plasminogen activator inhibitor type-1 [PAI-1]) were compared between two groups. In the group A, serial samplings were taken at the initial period, 3 days, 8 days, 15 days and 6 weeks after the bleeding onset. Results: Plasma levels of FDP and D-dimer in the group A were significantly higher than the group B (1.7±1.16 vs. 0.95±1.27㎎/L and 10.96±6.58 vs. 4.99±3.50㎍/㎖, respectively, p value<0.05). The clinical, biochemical, and coagulation parameters didn`t show significant differences in both groups. The fibrinolytic parameters were improved along with the hemodynamic stabilization in group A. Conclusions: Cirrhotic patients with increased fibrinolytic activity were at higher risk of bleeding. Thus, the measurement of these parameters would be useful to identify patients at higher risk of esophageal variceal bleeding. (Korean J Gastroenterol 2004;43:349-354)

종설 : 비알코올성 지방간이 다른 내과질환에 미치는 임상적 영향

윤중원 ( Jung Won Yun ),조용균 ( Yong Kyun Cho ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1

Non alcoholic fatty liver disease (NAFLD) has been recognized as a hepatic manifestation of systemic metabolic disease associated with insulin resistance. Recent studies have reported that NAFLD is related with various systemic complications such as cardiovascular, renal, metabolic disease independent of obesity, other component of metabolic syndrome (MetS). Thus, NAFLD should be newly regarded as an early mediator of systemic metabolic disease as well as liver specific disease. The mechanisms of adverse effect of NAFLD on other medical diseases are not fully understood, so further study is needed for understanding and future management strategies of NAFLD. (Korean J Med 76:25-29, 2009)

제 2형 당뇨병 환자에서 혈중 요산 농도와 대사조절 정도 및 만성 합병증과의 상관관계

윤중원 ( Jung Won Yun ),강정묵 ( Kang Jeung Mook ),이원영 ( Won Young Lee ),김선우 ( Sun Woo Kim ) 대한내과학회 2003 대한내과학회지 Vol.64 No.1

Background : Several epidemiologic studies have shown that increased uric acid is a risk factor of cardiovascular mortality. Elevated serum uric acid is also a feature of insulin resistance. However, increased or decreased levels of uric acid have been va

Shunt가 있는 간세포암종의 치료 동문맥 단락을 동반한 간세포암종

윤중원 ( Jung Won Yun ),조용균 ( Yong Kyun Cho ),김병익 ( Byung Ik Kim ) 대한간암학회 2004 대한간암학회지 Vol.4 No.-

상부 소화관 내시경 검사시 midazolam의 적절한 투여용량 및 투여용량에 영향을 미치는 인자와 검사 후 flumazenil의 투여시기

서정열 ( Seo Jeong Yeol ),윤중원 ( Yun Jung Won ),김정욱 ( Kim Jeong Ug ),박동일 ( Park Dong Il ),조용균 ( Jo Yong Gyun ),성인경 ( Seong In Gyeong ),박창영 ( Park Chang Yeong ),손정일 ( Son Jeong Il ),전우규 ( Jeon U Gyu ),김병익 대한내과학회 2003 대한내과학회지 Vol.65 No.4

Background: Intravenous administration of midazolam is widely used as a premedication for esophagogastroduonenoscopy. However, there are individual differences in midazolam doses for premedication and controversies for starting point of esophagogastroduon

몇 가지 신장질환에서 혈청 및 요 Neopterin치 측정의 의의

정수석 ( Jeong Su Seog ),김향 ( Kim Hyang ),윤중원 ( Yun Jung Won ),서정열 ( Seo Jeong Yeol ),정찬희 ( Jeong Chan Hui ),이규백 ( Lee Gyu Baeg ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.2

배 경 : Neopterin은 γ-인터페론의 자극하에 주로 단핵세포와 대식세포에서 생성되는 pyrazino-pyrimidine 화합물로서 세포면역이 활성화된 상태를 나타낸다. 세포면역 기전이 매개가 되는 장기이식의 거부반응, 감염질환, 자가면역질환, 종양 및 심부전이나 신부전 등 여러 질환에서 증가하며 진단 및 예후의 지표가 된다고 알려져 있다. 특히 신질환에서 neopterin치 측정이 세포면역의 활성도를 나타내는데 유용하다고 알려져 있으나 전반적인 신질환과 neopterin와의 연관성온 정확히 알려져 있지 않다. 이에 저자들은 신증후군, 만성 신부전 및 말기 신부전으로 유지혈액투석을 받고 있는 신장질환 환자들에서 혈청 및 요 neopterin치를 측정하여 신장질환과 neopterin과의 연관성을 알아보고, neopterin과 다른 임상적인 표지자들과의 상관관계를 알아보아 neopterin치 측정의 임상적 유용성을 평가하고자 하였다. 방 법 : 총 91명 환자 (신장조직검사로 확진된 신증후군 19명, 만성 신부전 8명, 말기 신부전으로 유지혈액투석 중인 환자 64명)에서 혈청 및 요 neopterin치를 radioimmunoaasay 방범으로 측정하였고 임상지표로는 WBC, hemoglobin, hematocrit, BUN, creatinine, total protein, albumin, triglyceride (TG), iron, total iron binding capacity (TIBC) 등을 측정하였다. 결 과 : 혈청 neopterin치는 신증후군, 만성 신부전, 말기 신부전 환자들에서 각각 14.1±30.9, 28.2±19.4, 65,6±25.5 ng/dL로 모두 대조군 1.6±0.3 ng/dL에 비해 증가하였고, 이중 만성 신부전과 말기 신부전 환자에서 통계적으로 의미있게 증가하였다 (p<0.05, p<0.01). 요 neopterin치 또한 신중후군, 만성 신부전, 말기 신부전에서 각각 203.2±349.6, 319.2±107.7, 407.9±256.9 μ㏖ neopterin/㏖ creatinine로 모두 대조군 108.9±57.9 μ㏖ neopterin/㏖ creatinine 보다 각각 증가하였고, 역시 만성 신부전과 말기 신부전에서 통계적으로 의미있게 증가하였다 (p<0.05, p<0.05). 전체 대상군에서 혈청 neopterin치와 임상적 표지자들과의 관계에서 혈청 creatinine과는 양의 상관관계를, triglyceride, TIBC와는 음의 상관관계를 보였고 (각각 p<0.01), 요 neopterin치는 hemoglobin과 음의 상관관계를 보였다 (p<0.05). 결 론 : 신증후군, 만성 신부전, 말기 신부전 등 몇 가지 신장질환 환자들에서 혈청 및 요 neopterin치의 증가와 neopterin치와 몇 가지 임상지표들과의 의미있는 연관성을 통하여 신장 질환 환자에서 neopterin치의 측정이 이들 질환의 활동성 및 예후의 한 지표로 이용될 수 있을 것으로 생각되며 이는 앞으로 보다 많은 수의 연구대상과 지속적인 후향적 연구가 필요할 것으로 생각된다. Background : Neopterin is a pyrazino-pyrimidine compound, produced by human monocytes or macrophages primarily upon stimulation with gamma in terferon. Neopterin is a marker associated with cell mediated immunity. The levels of neopterin in body fluids are elevated in allograft rejection, infections, autoimmune diseases, malignancies, cardiac and renal diseases. We hypothesized that the levels of serum and urine neopterin maybe elevated in some renal disease including nephrotic syndrome (NS), chronic renal failure (CRF) and end stage renal disease (ESRD). Methods : We examnined the serum and urinary neopterin levels in 19 patients with NS underwent renal biopsy, 8 patients with CRF, 64 patients with ESRD undergoing maintenance hemodialysis. Twenty-two healthy controls were enrolled to define the normal range of neopterin levels. Serum and urinary neopterin were measured by radiommunoassay method. We also correlated the levels of serum and urinary neopterin with many clinical parameters such as WBC, hemoglobin, hematocrit, BUN, creatinine, total protein, albumin, triglyceride, iron, total iron binding capacity. Results : The serum neopterin levels elevated in patients with NS (14.1±30.9 ng/mL), CRF (28.2±19.4 ng/mL) and ESRD (68.6±25.5 ng/mL) than control (1.6±0.3 ng/mL). Particularly the patients with CRF and ESRD showed statistically significant elevation (p<0.05, p<0.01). The urine neopterin levels elevated in patients with NS (203.2±349.6 μmol/mol creatinine), CRF (319.2±107.7 μmol/mol creatinine) than control (108.9±57.9 μmol/mol creatinine). Particularly the patients with CRF and ESRD showed statistically significant elevation (p<0.05, p<0.05). The serum neopterin showed significantly positive correlation with serum creatinine levels, inverse correlation with total iron binding capacity and serum triglyceride levels among clinical parameters in all groups (respectively p<0.01). The urine neopterin showed significant inverse correlation with hemoglobin (p<0.05). Conclusion : The serum and urinary neopterin levels elevated in patients with some renal diseases. And also neopterin levels showed clinical correlations with some renal parameters in these patients. We suggest that serum and urinary neopterin levels may be useful marker to predict disease acitivity and prognosis in some renal diseases. They should be confirmed by a prospective study during a long-lasting and in a higher number of patients. (Korean J Nephrol 2004;23(2):241-247)

바이러스성 및 알코올성 간질환에서의 장투과성의 변화

김정욱 ( Kim Jeong Ug ),전우규 ( Jeon U Gyu ),윤중원 ( Yun Jung Won ),박동일 ( Park Dong Il ),조용균 ( Jo Yong Gyun ),성인경 ( Seong In Gyeong ),박창영 ( Park Chang Yeong ),손정일 ( Son Jeong Il ),김병익 ( Kim Byeong Ig ),김은정 ( 대한소화기학회 2004 대한소화기학회지 Vol.43 No.2

Background/Aims: Increased intestinal permeability has been possible contributing factors to the pathogenesis of alcoholic liver disease. Moreover, it can contribute to the development of bacterial infection and intestinal endotoxemia in patients with liver cirrhosis. This study aimed to examine the difference of intestinal barrier dysfunction between alcoholic and viral liver disease patients through the comparison of the intestinal permeabilities of patients with clinical characteristics. Methods: Intestinal permeabilities were measured in 18 healthy controls, 41 patients with alcoholic liver disease (17 cases of alcoholic liver disease without cirrhosis and 24 cases of alcoholic liver cirrhosis) and 46 patients with viral liver disease (14 cases of chronic viral hepatitis and 32 cases of viral liver cirrhosis) by measuring 24 hour urine excretion of 51Cr-EDTA. Results: The intestinal permeability was significantly increased in the patients with alcoholic liver disease without cirrhosis (5.62±80%), alcoholic liver cirrhosis (5.29±48%) and viral liver cirrhosis (3.15±39%) compared with that in control subjects (1.99±53%). On the contrary, it was not increased in the patients with chronic viral hepatitis (2.05±57%) versus controls. The significant correlation was not found between intestinal permeability and clinical and laboratory findings. Conclusions: The intestinal permeability was elevated in patients with alcoholic liver disease compared to those with viral liver cirrhosis. The pathophysiology of liver injury secondary to intestinal epithelial damage may be different between alcoholic and viral liver diseases. (Korean J Gastroenterol 2004; 43:104-111)