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      • SCOPUSKCI등재

        만성 신부전 환자에서의 심낭염과 심낭 삼출에 관한 임상적 고찰

        한대석,김홍수,이호영,하성규,김문재,최규헌 대한신장학회 1992 Kidney Research and Clinical Practice Vol.11 No.4

        Thirty-six chronic renal failure patients who had findings compatible to pericarditis such as pericardial friction rub, chest pain, high fever or who had pericar- dial effusion on echocardiography which was performed due to cardiomegaly were divided into uremic pericarditis and dialysis associated pericarditis according to the duration of dialysis. Pericarditis developed before the dialysis or less than 8 weeks of dialysis was defined as uremic pericarditis and pericarditis developed after than 8 weeks of dialysis was defined as dialysis associated pericarditis. We evaluated sex, age, incidence of diabetes mellitus, dialysis duration, blood pressure, blood chemistry, pericardial effusion amount, the incidence of cardiac tamponade, treatment modality in both type of pericarditis. 1) Among 36 patients uremic pericarditis were 21 (58. 3%) cases and dialysis associated pericardits 15 (41. 7%) cases. Cardiac tamponade were founded in 2 (9.5%) and 3(20%) cases each. 2) The sex ratio in uremic and dialysis associated pericarditis were 17:4 and 10:5, the mean age 42,9 and 46. 9 years. Diabetes mellitus were in 4 (19.1%) and 5(33. 3%) cases and the mean dialysis duration until the pericarditis revealed were 27.0 and 710.3 days each. 3) BUN, creatinine, total protein, albumin, hemoglo- bin, hematocrit level didnt show any statistical differences between the uremic and dialysis associated pericarditis. 4) The echocardiographic findings of the uremic per- icarditis at the time of the diagnosis revealed small amount 9 (42.9%), moderate 8 (38.1%), large 4 (19.0%) cases each. The findings of dialysis associated pericarditis were small amount 7 (46.7%), moderate 6 (40,0%), large 2 (13.3%) cases which showed no statistical differences with the amount of pericardial effusion of uremc pericarditis. 5) The treatment of uremic pericarditis were medical 18 (85.7%) cases and surgical 3 (14.3%) cases and the dialysis associated pericarditis were 11 (73,3%) and 4 (26.7%) case each. In conclusion, the dialysis associated pericarditis which developed more cardiac tamponade and needed more surgical treatment than the uremic pericarditis seems to have poor prognosis than the uremic pericar- ditis, but for better analysis of prognosis and pathogenesis prospective study with large group of patients are required.

      • KCI등재후보

        전신성 홍반성 낭창과 동반된 시신경염 1 예

        한대석,강신욱,김순현,이호영,고원기,서정훈,신석균,노현진,이루다,최규헌 대한내과학회 1998 대한내과학회지 Vol.55 No.5

        Systemic lupus erythematosus(SLE) is a disease of unknown etiology in which tissues and cells are damaged by pathogenic autoantibodies and immune complexes. Optic neuritis in SLE is very rare and the prevalence can be estimated to be approximately 1% of the patients of SLE. The main pathogenesis of optic neuritis with SLE is that of a vaso-occlusive disease in small vessels and the histopathologic appearance has varied from demyelination to definite vascular disease with axonal necrosis. The visual outcome of optic neuritis in SLE has often been poor. The treatments of optic neuritis in SLE are intravenous methylprednisolone, immunosuppressive agents and plasmapheresis. The authors experienced a case of lupus nephritis and CNS lupus which was complicated by optic neuritis in 18-year-old female patient who complained of sudden visual disturbance of the both eyes After treatment with plasmapheresis and systemic corticosteroid, her visual deficit was gradually recovered.

      • SCOPUSKCI등재

        환경가스조절 저장방법을 이용한 느타리버섯과 표고버섯의 유통기간 연장

        한대석,안병학,신현경,Han, Dae-Seok,Ahn, Byung-Hak,Shin, Hyun-Kyung 한국식품과학회 1992 한국식품과학회지 Vol.24 No.4

        버섯의 유통기간을 연장하기 위한 방법으로 환경가스조절(modified atmosphere, MA) 저장의 효과를 조사하기 위하여 표고버섯과 느타리버섯을 두께가 $50\;{\mu}m$인 폴리에틸렌 필름으로 포장한 후 $0.5^{\circ}C$에서 저장하였다. 재래식 골판지 상자에 4kg씩 포장된 대조구 버섯은 수분증발, 외관수축, 변색 및 균사발생으로 인하여 유통기간이 $5{\sim}6$일에 불과하였다. MA 저장구의 버섯은 저장 4주 후에도 중량감소가 $1.6{\sim}1.7%$로 낮아 갓 안쪽 주름의 변형이 없었고 갓이 퍼지지도 않았으며 변색도 거의 없었는데 이는 포장내 습도가 포화상태로 유지되고 포장내 산소가 $1.0{\sim}1.3%$, 이산화탄소가 10% 이상으로 유지되어 버섯의 호흡이 억제되었기 때문으로 생각된다. MA 저장 느타리버섯은 조직연화가 품질을 결정하는 가장 중요한 요인이었으며 이를 기준으로 판단한 유통기간은 15일 정도였으며 MA 저장 표고버섯은 갓의 황변이 품질저하의 가장 중요한 요인이었으며 이를 기준으로 판단한 동고의 유통기간은 15일, 화고의 유통기간은 30일 이상이었다. In order to study the effect of modified atmosphere storage on extending shelf life of mushrooms, oyster mushroom and Shiitake were wrapped with polyethylene film (PE, $50\;{\mu}m$), and stored at $0.5^{\circ}C$. Mushrooms packed with conventional hardboard box (4kg) lost marketability within $5{\sim}6$ days due to weight loss, shrinkage, browning, spore formation and/or mycellium growth. PE-packing could prevent or retard the deterioration of the mushrooms in the aspects of appearance, texture, discoloration, and microbial contamination. This situation can be best characterized by the reduced respiration rate resulted from the elevated level of carbon dioxide and the reduced level of oxygen in the bag. Although the appearance of the oyster mushroom was maintained for one month, its shelf life was limited to 15 days because of tissue softening. Discoloration of the pileus of shiitake mushroom appears to be the most important factor to determine its marketability. For example, extension of shelf life of Dongo was limited to 15 days, principally due to the browning of the pileus. Shelf life of Hawgo whose color of the pileus changed little over the experimental period, however, could be extened to more than one month.

      • SCOPUSKCI등재

        한국인 복막 투석 환자의 산-염기 상태에 관한 연구

        한대석,김용수,방병기,이호영,윤견일,강덕희 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.3

        Objectives:Any form of dialysis must provide a sufficient replenishment of buffer. Lactate with a concentration of 35 to 40mM/L is now the only buffer routinely used in CAPD. Buffer balance using lactate solutions will be governed essentially by the balance between the H+ generated, the amount of bicarbonate lost into the peritoneal effluent, and the lactate absorbed from the dialysate. Factors affecting buffer balance in CAPD patients will therefore include dietary protein intake which determine H+ generation and ultrafiltration which can affect bicarbonate loss. Although several studies reported a different prevalence of metabolic acidosis in their CAPD patients, it is uncertain whether the same prevalence of metabolic acidosis(MA) or the similar characteristics of acid-base status of Western CAPD patients can be found in Asian patients with smaller body size and relatively less amount of dietaryanimal protein intake. This study was undertaken to know the current acid-base status of CAPD patients in Kor with the exact information about buffer balance. We will also investigate the factors affecting acid-base homeostasis in CAPD patients such as dietary protein intake, the individual membrane characteristics and the various indices of dialysis adequacy and nutritional status of patients. Methods:The acid-base status of Korean CAPD patients was assessed based on arterial blood gas analysis along with various nutritional parameters including subjective global assessment(SGA), anthropometric measurements and standard peritoneal equilibration test in 198 clinically stable patients maintained on CAPD for more than 6 months using 35-40mM/L of lactate-based dialysate(M:F 106:92, mean age 47.9 years, mean duration 45.3 months). Results:Mean arterial bicarbonate concentration was 24.6±3.4mM/L with a range of 16.2-36.7mM/L and mean dialytic base gain was 29.4±15.2mM/day. Only 28(14.1%) patients showed MA while 52(26.3%) patients had a various degree of metabolic alkalosis. Normal acid-base status was observed i75 patients(37.9%). The rest showed mixed acid-base abnormalities of respiratory origin. Patients with MA (mean HCO3 19.5±1.9mM/L) showed significantly higher serum albumin(4.01±0.38 vs. 3.59±0.46 g/dl, P$lt;0.001) & protein equivalent of nitrogen appearance (NPNA, 1.2±0.1 vs. 0.9±0.2 g/kg/day, P$lt;0.05) compared to the metabolic alkalosis group(mean HCO3 28.1±1.9mM/L). Dialytic protein loss(6.39±1.86 vs. 7.64±2.71 g/day, P$lt;0.01) and D/PCr(0.60±0.09 vs. 0.71±0.13, P$lt;0.05) were significantly lower in MA group. There were no significant differences in residual renal function, KT/VUrea, number of malnourished patients by SGA and other anthropometric parameters according to the acid-base status of patients. There were significant inverse correlations of arterial HCO3 with serum albumin and NPNA while HCO3 was positively correlated with duration of dialysis, ultrafiltration volume, dialytic lactate gain and dialytic protein loss. Conclusion:Our results on the acid-base status of Korean CAPD patients includinlly lower incidence of MA appear to be quite different from other reports based on the Western population. The peritoneal membrane transport characteristics can be one of the important factors determining the acid- base status of peritoneal dialysis patients. Duration of dialysis and protein catabolic rate also influence arterial bicarbonate level independently.

      • KCI등재후보

        혈액투석환자에서 합병된 혈색소증 2 예

        한대석,함영환,최수임,전재윤,박찬일,김형길,이호영,정동균,정석호 대한내과학회 1989 대한내과학회지 Vol.36 No.3

        Iron overload from repeated blood transfusions and administration of iron agents in long term hemodialysis patients is a problem of increasing clinical significance, because eventually it can lead to secondary hemosiderosis and hemochromatosis. So it is important to diagnose iron overload early and restrict blood transfusions and administration of iron agents in these patients. Recently, we experienced two cases of hemochromatosis in long term hemodialysis, confirmed by serum ferritin level, bone marrow study and liver biopsy. One patient had received 110 pints of RBCs for 4 years, and the other patient received 120 pints of RBCs for 5 years. HLA typing was also studied and compared with hemochromatosis alleles (HA), HLA A3, B7, and B14. Treatment with desferrioxamine was started just after discharge, and we observed a reduction in the frequency of blood transfusions. We report these two cases with a brief review of the literature.

      • KCI등재

        Criteria for the Development and Improvement of PMS Models

        한대석,Kiyoshi Kobayashi 대한토목학회 2013 KSCE Journal of Civil Engineering Vol.17 No.6

        When road agencies seek to introduce, evaluate or improve their Pavement Management System (PMS), there is often confusion due to lack of a long-term PMS development strategy. In fact, many road agencies have relied on others’ experiences or ready-made software not well suited to their own PMS situation. Obviously, a PMS model should be developed step by step with a well-grounded long-term PMS development plan. As fundamental research on PMS, this paper aims to foster sustainable development of PMS models by suggesting criteria for the development of PMS. As contents of the criteria, 1) a general PMS framework, 2) the standardization of PMS capability level, 3) a definition of PMS functions and 4) data requirements and management are treated as the main focus of research. These criteria are expected to serve as a useful guideline for the initial introduction, self-examination, and extension of PMS capabilities. While this research may be usefully applied to individual cases, a much more important goal is to establish compatibility among PMS models. Mitigating heterogeneity among PMS models can greatly benefit the PMS world. In addition, the criteria could serve as a foundation for various undertakings in PMS research.

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