비안와대뇌형 모균증 치험 3례

문영일,김종남,홍순관,이지애,정옥경,김문정 梨花女子大學校 醫科大學 醫科學硏究所 1997 EMJ (Ewha medical journal) Vol.20 No.3

Rhinocerebral mucormycosis is a well-described fulminant fungal infection that typically presents in a rapidly fulminant manner. This condition is more likely to occur among patient with diabetes mellitus, malignant tumors, who have long-term steroid treatment, or who suffer from some debilitating diseases. We report 3 cases of rhinoorbitocerebral mucormycosis, all suffered from diabetes mellitus. In all 3 cases, endoscopic sinus surgery was done and the antifungal agent(amphotericin B) was administered intravenously, and two patients died. One survivor who had focal extension of paranasal sinus and orbit, required one surgical intervention without orbital exenteration and he is alive without recurrence disease. The severity of the disease is probably dependent upon the gost resistance to the invasion of phycomycetes. Early diagnosis and immediate, effective treatment are the key for cure of the disease.

On the Strengthening Effects Affecting Tensile and Low Cycle Fatigue Properties of Low-Alloyed Seismic/Fire-Resistant Structural Steels

Jung‑Ho Sim,Tae‑Yeong Kim,Jun‑Yeon Kim,Chi‑Won Kim,Jun‑Ho Chung,Joonoh Moon,Chang‑Hoon Lee,Hyun‑Uk Hong 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.2

In the present study, low carbon ferritic and bainitic steels with different contents of Mo, Ti, and Nb were designed for bothseismic and fire-resistant applications. The microstructure of steels containing 0.3 wt% Mo–0.02 wt% Nb (‘A’ hereinafter)was mainly composed of bainite. By contrast, the microstructure of steels with 0.2 wt% Mo–0.13 wt% Ti (‘B’ hereinafter)consisted of ferrite with a high density of nano-sized (Ti,Mo)-rich MX precipitates. The results showed that the bainiticmicrostructure (‘A’ steel) was quite favorable to high-temperature strength and thermal stability. The yield strength of ‘A’ steelat both room and 600 °C temperatures increased consistently with increasing thermal exposure time (600 °C/200–1000 h),since the precipitation of NbC particles occurred while maintaining bainitic ferrite platelets with a high density of dislocationsduring exposure. In the ‘B’ steel, the formation of nano-sized (Ti,Mo)-rich MX particles was effective to impededislocation movement, leading to excellent plasticity (lower yield ratio) at room temperature. However, their contributionto precipitation hardening was not so much at 600 °C, as compared to the bainitic strengthening. During low cycle fatiguetests at room temperature, the main different feature between the two steels is that the ‘A’ steel showed cyclic softeningwhile cyclic hardening was evident in the ‘B’ steel. The bainitic microstructure showed a better fatigue life due to increasedductility manifested by cyclic softening, by which dislocation cell was developed.

7개 대학 병원에서 조사한 지역사회 폐렴의 원인균

정문현,김성민,강문원,최희정,정희진,이경원,한성우,송재훈,신형식,김의종,최강원,김민자,박승철,배현주,정윤섭,김준명,백경란,신완식,이규만,김양리 대한감염학회 1997 감염 Vol.29 No.5

목 적 : 폐렴은 많이 발생하면서 사망률이 크게 줄지 않는 질환이며, 이를 적절히 치료하기 위해서는 원인균의 상대적 빈도, 기저 질환에 따른 변화, 항균제 내성률, 사망에 관련된 인자들을 알아야 한다. 원인균의 빈도는 지역마다 차이가 있고 국내에서는 항균제 내성률이 높아 지역사회에서 발생한 폐렴을 치료하기 위한 경험적 항균제 선택에 도움이 되기 위해 서울 소재 6개 대학 병원과 천안의 1개 대학 병원이 참여하여 위의 사항들에 대해 조사를 하였다. 방 법 : 1995년에 내과에 입원했던 16세 이상 환자를 대상으로 했다. 퇴원 진단명이 폐렴 또는 폐결핵인 병록지을 찾았고, 이중에서 병원 감염을 제외하였다. 특이도를 높이기 위해, 이들 중에서 호흡기 증상이 있고 발열이나 저체온이 있으면서 흉부 X-선에서 이상 음영이 있는 환자만을 대상으로 했다. 폐결핵은 위의 기준에 입원 초기에 항균제 치료를 하고 입원 7일 이후에야 항결핵제가 투여된 경우만을 폐렴의 원인균으로 하였다. 혈액 배양에서 양성, 객담에서 항상균이나 M. tuberculosis가 증명된 경우, 혈청학적으로 항체가가 4배 이상 증가된 경우, 조직에서 원인균이 진단된 경우는 확정(definitive) 원인균으로 하였고, 객담에서 배양된 균이 그람 도말과 일치할때, 항결액제에 대한 반응으로 진단한 폐결핵, 단일 항체가 양성이고 이에 대해 항균제를 사용했을 때는 가능(probable) 원인균으로 정의하였다. 다세균 감염균은 각각 다 른 원인균으로 처리하였다. 임상 조사와 함께 임상병리과에서 S. pneumoniae, H. influenzae, M. catarrhalis, mycoplasma, 항상균에 대해 검사 의뢰 건수, 배양 양성수, 항균제 감수성 결과를 조사하였다. 결 과 : 폐렴의 증례 정의에 부합하지 않은 135명과 폐결핵의 정의에 해당하지 않는 230명을 제외하고 남은 246명의 평균 나이는 58.2세이고 남성이 142명(58.2%) 이었고, 71%의 환자에서 기저 질환이 있었다. 진단 방법의 시행 횟수는 혈액 배양 77.6%, 혈청 검사 18.3%, 기관지경 검사는 4.1%였고, 세균의 항원 검사를 한 예는 없었다. 원인균이 밝혀진 예는 77명(31.3%)이었다. 다세균 감염이 4명에서 있었고, 원인균의 상대적 빈도는 결핵 20명(확정 17, 가능 3: 6개 병원 자료), 폐렴구균 18(확정8 가능 10)명과 폐렴구균이 아닌 Streptococcus 3명 (모두 확정), H. influenzae 11명(모두 가능), 그람음성간균 11명(확정 7, 가능 4) (K. pneumoniae 8건), Mycoplasma 5명(확정 1, 가능 4), S. aureus 4명(확정 2, 가능 2), mucormycosis 1명(확정)이었다. 평균 입원 기간은 19일이고, 중환자실 입원률과 인공 호흡기 사용율은 각각 18%와 9.3%였다. 사망률은 13.8%였고 사망까지 평균 기간은 14.6일 이었다. 다변량 분석에서 사망을 예측할 수 있는 인자는 저체온과 빈호흡이었다. 임상병리과에서 배양되었던 모든 폐렴구균의 Penicillin 내성률은 서울 3개 병원에서 82-88%, 천안에서 72%였다. 폐렴 환자의 혈액에서 배양된 7주는 모두 Penicillin에 감수성이 있었다. K. pneumoniae 8주 모두 cefotaxime과 gentamicin에 감수성을 보였다. 결 론 : 후향적 조사이고 병원마다 원인균 진단에 차이가 있지만, 원인이 밝혀진 경우에는 결핵과 폐렴균이 흔하였고, 무균 부위에서 배양된 폐렴구균의 항균제 내성률은 낮았다. 원인이 밝혀지지 않은 경우가 많고, 혈청검사로 진단되는 원인균이 드물며, 분리균주가 적어 항균제 내성 정도를 추정하기 어려워, 이를 밝히기 위한 전향적 조사가 필요하다. Background : Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, but its management is still challenging. The limitation of diagnostic methods to identify etiologic agents rapidly make it necessary to use empiric antibiotics in almost all patients, and furthermore the discovery of new respiratory pathogens and the emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric regimen. To clarify the factors necessary for the optimal choice of empirical antibiotics, such as the frequency of etiologic agents, the attributable rates to death and antimicrobial resistance rates in the community, six university hospitals in Seoul and one university hospital in Cheonan were participating in this study. Methods : medical records of adults (>15 years of age) hospitalized for CAP or pulmonary tuberculosis between April 1995 and March 1996, were reviewed. Patients who satisfied all of the following criteria were included in the study: (1) fever or hypothermia; (2) respiratory symptoms; and (3) pulmonary infiltrates on chest roentgenogram. To exclude cases of pulmonary tuberculosis whose roentgenographic features were so typical that it could be easily differentiated from conventional pneumonia, two additional criteria were required for inclusion: antibiotic treatment during the first week of hospital admission and initiation of anti-tuberculosis medications thereafter. Organisms isolated from sterile body sites, acid-fast bacilli or Mycobacterium tuberculosis isolated from sputum, pathogens diagnosed by a 4-fold rising titer of antibodies to “atypical”pathogens, or pathogens revealed by histopathology were defined as definitive cause of pneumonia; isolates from sputum withcompatible Gram stain, pathogens diagnosed by a single diagnostic titer plus use of a specific antimicrobial agent, or tuberculosis diagnosed by clinucal response to anti- tuberculosis medications were considered probable cause of pneumonia. The records of the clinical microbiology were reviewed for isolates of S. pneumoniae, H. influenzae, M. catarrhalis, Mycobacterium or acid-fast bacilli, and Mycoplasma. Then the frequency of these agents, antimicrobial resistance rates of resiratory pathogens from all body sites, and their clinical significance were evaluated. Results: After excluding 365 patients (230 with pulmonary tuberculosis and 135 with CAP) who were screened for inclusion but did not meet the inclusion criteria,246 persons were enrolled in this study. Their mean age was 58.2 years old with slight male predominance (58.2%), and 171(71%) patients had underlying illnesses. Blood cultures were performed on 191 (77.6%) patients and serologic tests on 44(18.3%) patients. The etiologic agents were identified in 31.3%, and the list of individual agents, in decreasing order, was pulmonary tuberculosis (17 definite and 3 probable: data of six hospitals), S. pneumoniae (8 definite and 10 probable), non-pneumococci (3 definite), aerobic gram-negative bacilli (7 definite and 4 probable), Haemophilus spp. (11 probable), mycoplasma (1 definite and 4 probable), polymicrobial infections (2 definite and 2 probable: E. coli and S. agalactiae, M. tuberculosis and S. aureus, S. pneumoniae and H. influenzae and A. baumannii and K. pneumonias), S. aureus (2 definite and 2 probable) , and mucormycosis (1 definite). Among gram-negative bacilli, K. pneumoniae was the most common agent (8isolates). therates of admission to the intensive care unitand of using assisted ventilation were 18% and 9.3%, respectively. The mortality was 13.8% and logistic regression analysis showed that hypothermia and tachypnea were associated with death. Hospital stay averaged 19 days. Susceptible rates of S. pneumoniae isolated from all body sites to penicillin ranged from 8% to 28% but seven isolated from blood of patients with pneumonia were susceptible to penicillin. Also all 8 isolated of k> pneumoniae from patients with pneumonia were susceptible to cefotaxime and gentamicin. Conclusion: In Korea, in addition to S. pneumoniae, M. tuberculosis is an important agent causing community-acquired pneumonia. The low incidence of etiologic diagnosis is probably related to infrequent requesting of test "atypical" pathogens and does not represent the true incidence of infections by "atypical" pathogens, which well be answered by a prospective study. The antimicrobial resistance rates of major respiratory pathogens from sterile body sites are low, however, because of a small number of the isolates this result needs confirmation by a nationwide surveillance of antimicrobial resistance.

테니스 주(tennis elbow)에 대한 레이저치료와 관절가동화기법의 효과: 메타분석

문미향,남경모,정이정 한국전문물리치료학회 2003 한국전문물리치료학회지 Vol.10 No.3

웅접흄이 환기기능에 미치는 영향

문태인,구정완,정치경 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.3

In order to study the effects of welding fume on ventilatory function, forced expiratory spirogram was performed on 563 male workers exposed to welding fume in motor vehicles industry and 589 male control workers. Ventilatory indices such as forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), the ratio of one-second forced expiratory volume to forced vital capacity(FEV₁%=FEV₁/FVC) and maximal mid-expiratory flow(MMF) were obtained by analyzing forced expiratory spirogram which were measured by Vitalograph in standing position. The result were as follows: 1. Mean values of FVC, FEV₁, FEV₁%, and MMF expressed as percent of the predicted were significantly lower in exposure group than in control group. 2. No significant differences for mean ventilatory indices were demonstrated between smokers and nonsmokers both in exposure group and control group. However, mean MMF of welders tended to reduce in smokers(77.4%) than in nonsmokers(82.4%). 3. In exposure group mean FEV₁was significantly lower in more than 20 years than those of control group. However, mean MMF, FEV₁% were significantly reduced with increasing exposure duration compared to control group, indicating 90.8% and 62.2% of the predicted in more than 20 years group. 4. In exposure group workers with obstructive ventilatory impairment(7.5%) was markedly higher than that with restrictive ventilatory impairment(2.0%). 5. In exposure group the proportion of workers with low ventilatory indices was the highest in MMF(26.8%), and followed by FEV₁(11.9%), FEV₁(7.6%) and FVC(2.1%) in descending order. Workers with low MMF and FEV₁% were significantly increased with increasing exposure duration compared to control group, indicating 64.3% and 32.1% in above 20 years group. With the above consideration in mind it suggested that the exposure to welding fume be associated with reduced pulmonary function and obstructive ventilatory impairment, increasing exposure duration be associated with reduced pulmonary function, and MMF be the most sensitive index in the evaluation of ventilatory impairments of workers exposed to welding fume.

151종 생약제 추출물이 B형 간염 바이러스 표면 항원(HBsAg)과 항체(HBsAb)의 결합반응 그리고 HBV DNA polymerase 활성에 미치는 효과 : 한국산 각종 생약제를 이용한 B형 간염치료제의 개발

정태호,김정철,김문규,이인선,채성철,김승래,정준모,이인수,김승호,함경수 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3

세계인구 43억명 중 B형 간염 바이러스 보균자는 2억 1천 5백만명이며 이중 78%인 1억 6천만명 이상이 아시아 대륙에 집중되어 있다. 한국도 B형 바이러스 간염의 침윤지대이다. 본 연구는 B형 바이러스 보균자 혹은 만성간염을 치료할 수 있는 생약제를 탐색할 목적의 일환으로 한국에서 시판하는 생약제 151종을 구입하여 증류수로 추출하고 여과한 후 냉동건조하여 HBs 항원에 대한 결합능, HBV DNA polymerase억제능, tumor necrosis factor(TNF) 유리에 미치는 영향, 그리고 galactosamine 유발 간염에 대한간장보호 작용을 조사하였다. 151종의 생약제중 0.16㎍/㎖ 농도에서 간염 vaccine 내에 함유된 HBs 항원과 결합하는 생약제는 지유, 가자, 복분자, 대황, 정향, 빈량, 산수유, 소목, 마황, 쇄양, 후박, 목과, 양강, 오약, 산사, 목단피 등 16종이었다. 이들 생약제중 대황(Rheum palmatum L. 大黃), 가자(Terminalia chebula R. 訶子), 지유(Sanguisorba officinalis L. 地楡), 복분자(Rubus coreanus M. 覆盆子)는 HBV DNA polymerase 활성도를 비교적 강하게 억제하였으며 빈량(Areca catechu L. 빈랑), 정향(Eugenia caryophyllata T. 丁香), 목과(Chaenomeles japonica L. 木瓜), 산수유(Cornus officinalis S. 山茱萸)는 약하게나마 HBV DNA polymerase 활성을 억제하였다. 또한 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 대상으로 TNF 유리에 미치는 영향을 조사한 결과 소목을 제외한 8종의 생약제 모두가 대식세포를 자극하여 TNF를 유리시켰다. 그리고 장차 임상에 사용함을 전제로 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 galactosamine 유발 간염(백서)에 투여하여 간기능 검사에 미치는 효과를 조사하였으나 간기능 검사상으로는 특별한 보호작용을 나타내지 못하였으며 생약제 단독 투여로서는 간기능에 대하여 나쁜 영향을 주지 않았다. Hepatitis B virus infection is major cause of acute and chrome hepatitis, cirrhosis of liver, and hepatocellular carcinoma. There are over 200 million carriers of hepatitis B virus in the world, nearly 80 % of whom live in the South East Asia, Korea is also highly endemic area of hepatitis B virus infection. This study was performed to evaluate the effect of extracts of traditional Korean herbal medicines on hepatitis B virus. 151 traditional herbs were extracted, filtered and lyophilized. Using 151 herbal extracts we tested binding capability to the HBs Ag, inhibition of HBV DNA polymerase, release of tumor necrosis factor (TNF), and protection against galactosamine induced liver damage. Among 151 herbs, 16 herbs (Sanguisorba officinalis L., Terminalia chebula R., rubus coreanus M., Rheum palmatum L., Eugenia caryophyllata T., Areca catechu L., Cornus officinalis S., Caesalpinia sappan L, Ephedra sinica S., Cynomorium songaricum R., Machilus thunbergii S., Chaenomeles japonica L., Alpinia officinarum H., Lindera strychnifolia V., Crataegus pinnatifida B., Paeonia suffruticasa A. ) had binding capability to HBs Ag which contained in the commercial hepatitis vaccine, at 16 ug/㎖ of concentratioa Among the above 16 herbs, Rheum palmatum L., Terminalia chebula R., Sanguisorba officinalis L., Rubus coreanus M. significantly inhibited the HBV DNA polymerase activity, and Areca catechu L., Eugenia caryophyllata T., Ephedra sinica S., Caesalpinia sappan L., Chaenomeles Japonica L., Cornus officinalis S. also inibited the HBV DNA polymerase activity but less effective. All of the herbs, except Caesalpinia sappan L., which inhibited the HBV DNA polymerase activity, actively stimulated the mononuclear cells to release tumor necrosis factor(TNF) in whole blood culture system. The herbs which inhibited the HBV DNA polymerase activity, did not show any protective effect in galactosamine-induced hepatitis in rats, but there was no direct toxic effect when herbs were administered alone.

인라이닝을 이용한 XML 스키마의 관계형 스키마 변환 기법

정지문,조정길 남서울대학교 공학연구센터 2003 공학연구 Vol.4 No.-

데이터 중심의 XML 문서를 관계형 데이터베이스에 저장하고 관리할 경우에 XML 스키마로부터 관계형 스키마를 추출하는 것이 보다 시급한 일이다. 또한 생성된 테이블에 XML 문서를 분할하여 저장할 경우에 많은 널 값을 초래하거나 조인 비용의 증가를 가져오기 때문에 이에 대한 해결책이 필요하다. 이 논문에서 제안한 관계형 스키마 생성의 구체적인 연구 내용은 다음과 같다. XML 스키마로부터 관계형 스키마를 생성하는 Schema Hybrid Inlining 기법을 제안하였다. 제안된 기법은 XML 스키마 그래프를 바탕으로 관계형 스키마를 생성하게 되는데, 기존의 Inlining 방식을 확장하여 출현 지시자와 진입 차수에서의 테이블 생성 방법을 휴리스틱하게 매뉴얼 처리를 하며, 유도 관계에서 최종 노드인 조상 노드는 새로운 테이블을 생성한다. When any data-centric XML documents are stored and managed in RDBMS, schema extracting from XML Schema is an imminent problem. Furthermore, when they are stored in partitioned way on created table, there will be produced lots of null values and/or be increased cost for join, so we need a solution to solve these problem. This thesis proposes a Schema Hybrid Inlining technique to generate relational schema. The suggested technique creates a relational schema based on the XML Schema graph. Also, the technique expands the legacy Inlining method to manual and heuristical processes table generation method of appearance indicator and in-degree, and an ancestor node, terminal node, createds a new table on derived relation in this technique.

고장식염수가 토끼 공장 점막 술잔세포의 미세구조에 미치는 영향

문정석,정윤영,장인엽,김종중,정주현,김흥중 대한해부학회 1995 Anatomy & Cell Biology Vol.28 No.3

카드뮴을 투여한 랏드의 혈액 및 간조직 내의 카드뮴 농도의 문포형에 관한 연구

문재혁,박정덕,정규철 중앙대학교 의과대학 의과학연구소 1987 中央醫大誌 Vol.12 No.4

A group of 74 male rats of Sprague-Daweley strain was divided into serveral subgroups to which 0.1∼0.3% cadmium chloride soultions were adminsistered intraperitoneally by single injection of equivalent amount of 1∼32 ㎎/㎏ of body weight. the rats were sacrificed by decapitation at various intervals beinning from 3 hours to 14 days after a single injection. The cadmium concentrations in blood(㎍/l) and liver(㎍/g of tissue wet weight) were measured with atomic absorption spectrophotometer(Baird, Model A5100) by double beam flameless method. Cadmium concentrations in blood and those in liver were both log-normally distributed with logarithmic function on Y=-4.9204×1n Cd+27.7179 for the former and Y=-9.1557 1n Cd+40.7212 fot the latter. the frequency distribution of blood cadmium concentrations was also fitted to expoential and power function curves. Arithmatic means and standard deviations of cadmium concentrations in blood and those in liver were 78.6± 65.25㎍/l and 22.0 ±20.46㎍/g of tissue wet weight with coefficient of variations of 83.0% and 93.0%, repectively. On the other hand, geometric means and standard deviations were 57.0±2.90㎍/l and 15.1 ±2.42㎍/g of tissue wet weight for blood and liver, respectively. Skewness and kurtosis of distribution curves calculated on the basis of asithmatic frequency were 3.27 and 15.24 for the blood cadmium and 1,98 and 7,06 for the liver cadmium, whereas these valurs turned out to be 0.28 and 2.25 for the blood and 0.21 and 2.19 for the livrt when the log-transformed values of frequency were empolyed for calculation. Cummulative relative frequency of log-transformed cadmoum concentrations in blood and liver plotted on the normal probability paper showed a good linearity. The above findings indicate that the cadmium concentrations in blood and hepatic tissue are well fitted to the normal distribution curves when logarithmic transformations were made on these values.

폭약 에너지를 이용한 이종재료의 접합 메카니즘 해석

金靑均,文正基 弘益大學校 科學技術硏究所 1993 科學技術硏究論文集 Vol.3 No.-

The pressure distributions of impact zone, the mechanism analysis of jetting and wave formations between the two colliding plates have been simulated using the numerical hydrocode DYNA2D. The data for the computer simulation was given by the experimental results. The calulated results indicated that the sinusoidal wave and jet formation were clearly developed at the interface between the two impacting plates.