진성다혈구증에서의 심근 및 뇌경색증 1예

조영호,유벙전,서영환,조경상,김상도,정춘해 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2

Polycythemia vera is one of the myeloproliferative diseases, and as such, is an example of clonal hematopoiesis. The progeny of a single, abnormal, hematopoietic stem cell gain a grwoth advantage over their normal counterparts resulting in overproduction of red cells generally accompanied by overproduction of granulocytes and platelets as well. There are a variety of nonspecific symptoms at onset related to the increased red cell mass and hematocrit accompanied by the more specific manifestations of pruhtis, erythromelalgia, and hepatic, portal, and mesenteric vein thrombosis. Splenomegaly and hypertension are common. Thrombosis and leukemia are frequent complication in polycythemia vera and are associated with severa organ damage and a high mortality. We report here the case of occurrence of myocardial and cerebral infarction in a patient with polycythemia vera.

국내 의료기관의 항생제 사용 실태와 규제 시스템 조사

방지환,송경호,박완범,김성한,조재현,김홍빈,김남중,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 이전 연구들에 따르면 아직까지 국내에서 불필요한 항생제 사용은 무시할 수 없는 수준이며, 특히, 수술환자들에 대한 예방적 항생제 투여가 문제로 지적되고 있다. 많은 병원에서 불필요한 항생제 처방을 제한하려는 노력을 하고 있지만 구체적인 현황에 대한 자료는 적은 실정이다. 이에 본 연구자 등은 국내 의료기관의 항생제 규제 시스템의 현황과 수술시 예방적 항생제 사용의 적정성을 알아보고자 한다. 재료 및 방법 : 전임 감염내과 전문의가 근무하는 의료기관 55곳에 대해 설문조사를 시행하였다. 설문의 내용은 적정한 항생제 사용을 유도하기 위한 정책 및 규제 프로그램, 실제 각 의료기관의 예방적 항생제 사용 현황 등으로 이루어져 있다. 결과 : 55개의 의료기관에 보낸 설문 중 44개가 회수되었다. 회신한 의료기관에서 항생제 처방 관리는 제한항생제 시스템을 가장 많이 이용하고 있었고(95.5%), 항생제에 대한 교육(79.5%), 전산시스템에서 관리(59.1%), 감염내과에 의뢰(54.5%), 항생제 사용 실적 검토(52.3%) 등의 순이었다. 대개의 병원에서 glycopeptides (100.0%), carbapenems (93.0%), quinupristin/dalfopristin 또는 linezolid(93.0%), 4세대 cephalosporin (74.4%), caspofungin 또는 voriconazole (62.8%), liposomal amphotericin B (60.5%) 등을 제한항생제로 분류하여 관리하고 있었다. 모든 의료기관에서 위절제술 및 유방절제술시에 불필요하게 예방적 항생제를 사용하고 있었다. 슬관절치환술의 경우 2세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았으며(30.2%), 관상동맥우회술의 경우 3세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았다(47.2%). 예방적 항생제의 투여 기간을 살펴보면 위절제술시 70.5%에서 4일을 초과하여 사용하고 있었고, 유방절제술시에는 63.6%에서, 슬관절치환술시에는 81.8%에서, 관동맥우회술시에는 81.1%에서 4일을 초과하여 장기간 예방적 항생제를 투여하고 있었다. 한편, 예방적 항생제 투여시 aminoglycoside계 항생제를 병용하는 경우도 많았다. 결론 : 아직까지 국내 의료기관에서 항생제 오남용을 막기 위한 노력이 더 필요할 것으로 생각되며, 특히 수술시 예방적 항생제의 올바른 투여에 많은 관심이 필요하다. Background : Previous studies in Korea showed that unnecessary antibiotic use could not be neglected, especially in prophylactic use. Currently many hospitals employ diverse antibiotic stewardship programs, but there are few studies on surveillance of such programs. So, we planned this study to evaluate current status of antimicrobial stewardship and adequacy of antimicrobial prophylaxis in surgery. Materials and Methods : We sent questionnaires about policy on antibiotic usage, control program for adequate antibiotic prescription, and actual status of prophylactic antibiotic usage to 55 infectious disease physicians in each hospital. Results : Of 55 contacted infectious diseases clinicians, 44 answered the questionnaire. Majority of hospitals employed restricted antimicrobial system (95.5%), education (79.5%), control by order communicating system (59.1%), consult to infectious disease physicians (59.1%), and review of cumulative antimicrobial usage (52.3%) to prevent inadequate antibiotic use. Glycopeptides were designated as a restricted antimicrobial agent in 100.0% of hospitals; carbapenems, 93.0%; quinupristin/ dalfopristin or linezolid, 93.0%; the 4th generation cephalosporins, 74.4%; caspofungin or voriconazole, 62.8%; liposomal amphotericin B, 60.5%, and so on. Unnecessary perioperative prophylactic antimicrobial agents were prescribed in gastrectomy and mastectomy in all the hospitals. The second generation cephalosporins and the third generation cephalosporins were the most commonly prescribed prophylactic antimicrobial agents in total knee replacement arthroplasty (TKRA) and coronary artery bypass graft surgery (CABG) respectively. In 70.5% of institutes they use prophylactic antimicrobial agents more than four days in gastrectomy; 63.6% in mastectomy; 81.8% in TKRA; 81.1% in CABG. Unnecessary combination of aminoglycosides with other antimicrobial agents for prophylactic use was another common problem. Conclusion : This study shows that more effort is required to diminish antimicrobial misuse or overuse, especially in prophylactic use for surgical patients.

STI571 (Glivec^(�))에 의하여 빠른 치료 반응을 보인 불응성 Gastrointestinal stromal tumor

윤경원,이제중,김여경,황호인,이병환,조상희,정익주,김형준 全南大醫大 2001 전남의대학술지 Vol.37 No.4

Cyclosporin A에 의한 비만세포 고사(apoptosis)

노환중,장형준,조규섭,김유선,유영현,전경명 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.12

건축공사시방서에서의 KS규격의 국제인증방안에 관한 연구

김경식,이재섭,김용수,이규진,조용훈,최완철,전재열,이현수,구재동,이기환 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

The purpose of this research is make out construction specifications for International Construction. Using off-shore products incur cost increase and longer delivery term of construction. and inconvenient on International Construction. Expand the range of additional local products conforming to performance. Life Cycle Cost. maintainability. operability. user's acceptability, etc.. And this study is suggest the standard formats and the techniques for construction specification.

함암요법으로 골수기능이 억제된 악성종양환자에서 rhG-CSF의 임상적 효과

김원민,서영환,조경상,유병전,김상도,이승일,정춘해 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2

We have studied the efficacy of rhG-CSF in patients with non-hodgkin's lymphoma, acute leukemia, and small cell lung cancer undergoing anticancer chemotherapy. These patients were below leukocyte count 3,000 cubic millimeter due to myelosuppression induced by the first cycle of intensive chemotherapy. Treatment with rhG-CSF (100㎍ per square meter of body surface area per day in a 30-minute intravenous infusion) was begun two days and for 14 consecutive days after the end of the second cycle of chemotherapy. The results were as follows. 1. The onset of myelosuppression was 6 days after chemotherapy, and the onset of recovery was 16.7 days after chemotherapy, and the duration of granulocytopenia was 10.7 days in patients with malignant tumor during contrast period. 2. The duration of granulocytopenia was shortened 5.2 days in patients administered rhG-CSF than without rhG-CSF, and we observed the shortest duration of granulocytopenia with increasing granulocyte in patients with small cell lung cancer. 3. Observing the differential count of leukocyte checked the highest level of leukocyte in contrast and rhG-CSF period, the persentage of neutrophil was increased in patients with acute leukemia and small cell lung cancer during rhG-CSF period, but not increased in patients with non-hodgkin's lymphoma. 4. rhG-CSF was not influenced on liver faction, renal fuction, uric acid, and glucose metabolism, also had no effect on recovery of platelet. In conclusion, rhG-CSF can be administered to patients with hematologic or nonhematologic malignant tumor that myelosuppression induced by anticancer chemotherapy result in shortening the duration of granulocytopenia and increasing the peripheral neutrophil, therefore full dose chemotherapy can be administered on time, and rhG-CSF may reduce the morbidity and mortality of patients with malignant tumor undergoing chemotherapy.

동일한 시료에 대한 국내 기관간의 STR 분석결과 비교 : STR 유전자좌 분석법의 표준화 설정을 위하여

박종태,신경진,양윤석,우광만,이숭덕,이승환,이정빈,정연보,조승희,한길로,한면수,홍승범 大韓法醫學會 2001 대한법의학회지 Vol.25 No.1

This paper described a collaborative exercise intended to see what kinds of short tandem repeat (STR) loci are used in different DNA typing laboratories in Korea and to compare their results for the demonstration whether uniformity of DNA profiling results from different laboratory could be achieved in Korea Laboratories were asked to test five tissue DNAs using methods routinely used in each laboratory and to report the results to the coordinating laboratory. The exercise demonstrated that each laboratory was using different STR loci for the typing with different STR numbers,2 VNTRS,36 STRs and amelogenin in total, and the direct comparison of the results from all the laboratory for the 18 loci could not be done as only one laboratory submitted typing results. Among 21 loci for which several laboratories submitted typing results, results for 14 loci were the same and results for the other 7 loci were different depending on the participating laboratory. D1S80, F13A01, D16S539, D21S11, D18S51, D3S1744 were the loci with different typing results. Even in the cases where commercial kits were used, the results were not the same depending on the machines used, that is the capillary electrophoresis or the gel based electrophoresis. The reason for the different results, points about the standardization of the methods arid the profiling data were described.

KCCH cyclotron neutron 및 60Co r-ray에 의한 인체 말초혈액 임파구의 염색체 이상측정

김성호,김태환,정인용,조철구,고경환,류성렬 대한방사선 방어학회 1992 방사선방어학회지 Vol.17 No.1

KCCH cyclotron neutron(30cCy/min) 및 ??Co γ-ray(210cGy/min)를 시험관내의 정상 인체 말초혈액임파구에 조사하여 염색체이상(dicentric 및 centric ring)을 관찰하고 이의 선량-반응관계식을 linear model(Y=K₁D+a), power-law model(Y=K₂Dⁿ), quadratic model(Y=K₃D²) 및 linear-quadratic model(Y=αD+βD²)을 사용하여 구하고 이들 model중 염색체이상의 측정치와 가장 일치하는 관계식을 근거로 하여 γ -ray에 대한 neutron의 relative biological effectiveness(RBE)를 산출하였다. 염색체 이상(dicentric plus centric ring)의 발생분포는 γ-ray의 경우 linear model(P=0.067)을 제외한 power-law model[Y=(5.81±1.96)×10??, P=0.931], quadratic model [Y=(3.91±0.09)×10?D², P=0.972] 및 linear-quadratic model [Y=(6.55±6.83)×10?D+(3.72±0.22)×10?D², P=0.922]에 적합하였다. Neutron의 경우 linear model [Y=(6.12±0.17)×10?³ D-022, P=0.987]에 가장 일치하였고 quadratic model (P<0.005)을 제외한 power-law model[Y=(2.43±0.70)×10?³D+(1.21±0.39)×10?D², P=0.415]에 비교적 적합하였다. 세포당 0.1-1.5개의 염색체이상을 나타내는 neutron의 γ-ray에 대한 RBE는 2.714±0.408이었다. The frequencies of KCCH cyclotron neutron(30cCy/min) or ??Co γ-ray(210cGy/min)-induced asymmetrical interchanges(dicentrics and centric ring) and acentric fragment(deletion) at several doses were measured in the normal human peripheral blood lymphocytes. Chromosome aberrations were scored at the first nitosis after stimulation with phytohemagglutinin. The neutron and γ-ray data were analysed on liner, power-law, quadratic and linear-quadratic model. When the dicentrics and centric rings of γ-ray datas were pooled and fitted to these model, good fits were obtained to power-law [Y=(5.81±1.96)×10??, P=0.931], quadratic [Y=(3.91±0.09)×10?D², P=0.972] 및 linear-quadratic model [Y=(6.55±6.83)×10?D+(3.72±0.22)×10?D², P=0.922] except for linear model(P=0.067). As in the case of neutron data, the best fits was obtained to the linear model [Y=(6.12±0.17)×10?³ D-022, P=0.987] and good fits were obtained to power-law[Y=(5.36±3.02)×10?⁴D??, P=0.601] and linear-quadratic model [Y=(2.43±0.70)×10?³D+(1.21±0.39)×10?D², P=0.415], except for quadratic model (P<0.005). The relative biological effectiveness(RBE) of neutron compared with γ-ray was estimated by best fitting model. In the asymmetrical interchanges range between 0.1 and 1.5 per cell, the REE was found to be 2.714±0.408.

새로운 매체현실과 문화변화

최문규,김회봉,조경식,서규환 한국독일어문학회 2000 독일어문학 Vol.11 No.-

Der Begriff "Medienrealita¨t" ist heute aktuell geworden. Obwohl die Medien zur Vemittlung der Kommunikation auch in der Vergangenheit sehr verallgemeinert worden sind, gelten sie heute nicht mehr als bloβes Mittel. Die Entwicklung der elektronischen bzw. technologischen Medien vera¨ndert sowohl die Realita¨t unserer Welt als auch das Sein schlechthin. Der Begriff "Medienrealitat" ist synonym mit den anderen Begriffen wie "digitaler Schein" bzw. "virtuelle Realita¨t". "Informationsgesellschaft", die den tradierten Gegensatz zwischen Sein und Schein. dem Wahren und dem Falschen auflo¨st und zu einer neuen "Form der Realita¨t" avanciert werden. Um die Medienrealita¨t zu analysieren. werden im zweiten Kapitel die verschiedenen Elemente illuminiert, durch die neue Medienrealita¨t und Kultur konstituiert werden: ganz neue "immaterielle Basis der Information. Macht der Bilder, Geschwindigkeit, neue computerielle Wahrnehmung. "Medienwerk". Diese Elemente beherrschen sowohl die Realita¨t als auch die Kultur. Abschlieβend wird die Mo¨glichkeit reflektiert. wie die Kunst (besonders die Literatur) die Medienrealita¨t u¨berwinden und ihre alternativen Wege ero¨ffnen kann. Im dritten Kapitel wird der Begriff "virtuelle Realita¨t" philosopisch uberpruft, wobei er die Gemeinsamkeiten mit den tradierten philosophischen Begriffen wie "dynamis, "potentia, "virtualite"~possibi1ite usw. teilt. Auch kann der Widerspruch der "virtuellen Realita¨t" besta¨tigt werden, die vor allem auf der radikalen Vera¨nderung von Technik. Information und Kapital basiert. Das heiβt: es ist ein Widerspruch oder die Verhu¨llung der ontologischen Implikation, daβ die virtuelle Realita¨t durch die allma¨hliche Negierung ihrer Virtualita¨t zur Realita¨t erhoben wird. Im vierten Kapitel wird das Verha¨ltnis der Gesellschaft zu Umwelt. Information und Medien aus der Sicht der Luhmannschen Systemtheorie betrachtet. Daraus ergibt sich. dass die Gesellschaft als Sozialsystem bei ihrer Selbstreproduktion mit der Leitdifferenz von System/Umwelt operiert und damit die elbstreproduktion der Gesellschaft von der Vera¨nderung ihrer Umwelt (Technik, Bewuβtsein, Organismus usw.) abha¨ngig ist. Dabei ist deutlich, dass Medien (Schrift. Buchdruck. Elektronik usw.). die zur Verbreitung der Informationen dienen, bei der Evolution der Gesellschaft eine entscheidende Rolle gespielt haben. Schlieβlich handelt es sich um die unterschiedlichen soziologischen Theorien u¨ber das Verhaltnis von Medien und Gesellschaft. In den Vordergrund treten dabei die Theorien von D. Bell und M. Poster. Bells Theorie der postindustriellen Gesellschaft behandelt die Entwicklung der Technologie. die heute die Kultur und die Gesellschaftsstruktur stark vera¨ndert. Gegen Bell postuliert Poster eine Wende von der Produktionsweise zur Informationsweise, indem er die erwandtschaft mit der postmodernen Theorie teilt. Seiner Perspektive zufolge gilt heute nicht das Kapital. sondern die Information als Hauptmovens der Gesellschaft. Die Medien ko¨nnen weder das Absolute noch die Utopie sein. Was der Euphorie der sog. "idealen Entwicklung der Medien" kritisch gegenu¨berstehen kann. ist nichts anderes als die kritische Reflexion der Kunst.

결핵치료제인 시판 리팜피신제제의 생체내 이용율

김종두,안기완,서영환,조경상,김철,김상도,홍순표 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.1

This study was attempted to investigate the dissolution rate and the bioavailability of commercially available rifampicin preparations after oral administration in nine normal volunteers. Cross-over design was used for the analysis. The dissolution test was conducted in artificial gastric juice and artificial intestinal juice using basket method with four rifampicin preparations (A, B, C, and D) which were pharmaceutically equivalent. The results were as follows; The dissolution rate was higher in the order of A>C>B>D in artificial gastric juice, and A>B>C>D in artificial intestinal juice. Area under the blood concentration time curve (AUC) was larger in order of A>C>B>D. Relative bioavailability(%) of rifampicin preparations were 93.6% for B, 97% for C, 84.4% for D preparation compared with standard A preparation. Peak blood concentration (Cmax) was higer in order of A>B>C>D. Peak time (Tmax) was larger in order of D>C>A>B. Absorption rate constant (Ka) was larger in order of B>A>D>C. there was little difference in elimination rate constant and biological half-life. The correlation of the dissolution rate in artificial gastric juice and area under the blood concentration time curve as well as correlation of the dissolution rate in artifical intestinal juice and peak time showed significant linear relationship. From the result of the this experiments, it can be concluded that for the choice of preparations, bioavailability must be performed in man because the bioavailability of rifampicin preparations showed big differences among commercial preparations which were abvertised as pharmaceutically equivalent, and that the bioavailability of rifampicin preparations in man partially could be predicted from the results of dissolution rate.