한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

도시공원 입지특성에 따른 그린네트워크 활성화 연구 - 부산광역시 도심권을 대상으로 -

김승환,이규홍,박승범,Kim, Sung-Hwan,Lee, Gyu-Hong,Park, Sung-Bum 한국조경학회 2010 韓國造景學會誌 Vol.38 No.2

부산은 해안구릉지의 지형특성으로 인하여 공원의 입지가 이용가치가 낮은 산지 주변으로 다수의 공원이 지정되어 있으며, 지역 간의 균형적 입지 측면에서도 문제를 안고 있다. 본 연구에서는 도심생활권 내 도시공원에 대한 환경특성 분석과 더불어 주변시가지와의 상호 관계적 특성에 따라 유형을 구분하고, 그린네트워크 활성화를 위한 유형별 도시공원의 관리방안을 모색하였다. 이를 위해 내륙권역과 해안권역으로 구분하고, 녹지연계적 관점에서 결절부 녹지대에 해당하는 내륙권역의 표고 150~300m, 해안권역의 100~150m 내외의 산지 및 구릉지에 입지하는 도시공원을 분석한 결과, 시가지와 도시공원의 형태가 관입되거나, 지대(地帶)적 중첩의 영향력이 크게 나타나고 있다. 도시공원이 이루는 녹지대는 시가지의 형상과 도시기능에 의해 녹지연계의 방향성과 영향력이 결정적으로 작용하고 있다. 이러한 현황을 바탕으로 도시공원을 유형화하고, 유형별로 미조성 도시공원에 대한 이용성 증진 방안, 녹지연계를 통한 효과적인 그린네트워크 활성화방안을 검토하였다. 완사면 녹지대를 이루는 도시공원은 비교적 양호한 접근성과 뚜렷한 인식성을 지니고 있으며, 중심산지에서 연계된 녹지대가 수렴되는 도시하천과 해안지대에서의 도시기능의 활력과 개방성 확보가 그린네트워크 활성화의 중요한 요인으로 분석되었다. 또한 고지대생활권에서 녹지대에 분포하는 한정적 가용지와 배후녹지로 연계되는 주요 연결로를 중심으로 일상생활영역에서의 그린웨이를 활성화하고, 주요 도로와 도시공원의 주진입부가 교차하는 지역에 지역 커뮤니티의 거점을 형성하는 것이 그린네트워크 활성화의 주요방안으로 제시하였다. Seen topographically, Busan is a city that is coastal and hilly. In the city, most parks have been formed around mountain areas that are not so useful. They also are unbalanced in location among different regions of the city. The purpose of this study is to find how to manage urban parks towards green network promotion. For the purpose, this researcher first analyzed physical and environmental characteristics of urban parks located within the main living spheres of Busan. Then, the researcher examined interactive relations between those parks and downtown areas surrounding them to classify types of the parks. In association, the researcher classified the entire of the city into inland and coastal regions. And the researcher examined mountainous and hilly urban parks that were 150 to 300 meters above sea level in the former region and 100 to 150 meters above sea level in the latter. Findings of the study can be summarized as follows. The above examination found that parks of Busan feature physically penetrating and overlapping with downtown areas of the city. How well the green zones of Busan in form of urban park are inter-connective and influential to each other heavily depends on shapes and functions that the downtown areas of the city have. In this study, urban parks of Busan were grouped according to their types and then analyzed. Based on results of the analysis, the researcher tried to find how to increase the utility of another urban parks that are expected to be formed and how to promote so-called the green network that integrates greens. Considering findings of the study, the researcher would make the following suggestions. In case of forming an urban park in a gently sloped green zone which is easily accessible and noticeable, it's important that the park should include a stream to which another green zone is converged or, if the park is located near a costal area, contribute to promote urban functions and openness. While, in a high-altitude green zone, it's more effective to form so-called the green way that consists of some limited usable site of the zone and greens behind it and then form a hub of regional community at the intersection between the main road and main gate to the urban park, contributing to the green network promotion.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

정신의학적 증상을 수반한 Klinefelter 증후군 1예

박정주,허갑범,이홍식 大韓神經精神醫學會 1984 신경정신의학 Vol.23 No.4

The recent studies on Klinefelter's syndrome, which was first described by Klinefelter, et al. in 1942, revealed that intellectual impairment and neuropsychiatric disorders were combined in many cases of Klinefelter's syndrome. The authors present a 15 year old male patient with confirmed diagnosis of Klinefelter's syndrome, who showed various secondary psychiatric manifestations such as severe depression, anxiety, self and sexual identity confusion, various psychosomatic symptoms and adjustment problems with poor interpersonal relationship. The variety of psychiatric manifestations accompanying Klinefester's syndrome are reviewed from the literature. Comprehensive psychiatric evaluation and treatment via consultation-liaison psychiatry is strongly recommended for klinefelter's syndrome with psychiatric manifestations.

소아의 혈관내 응고증후군

박용훈,김홍배,강덕식,이상범 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.2

We have reviewed 11 cases of Disseminated Intravascular Coagulation (DIC) admitted to the Pediatric department of Kyungpook National University Hospital from January 1981 to July 1982. Age distribution showed 4 cases below, year of age including 2 neonatal cases, 2 between 1 to 5 years of age, 2 between 6 to 10 years of age and 3 between 11 to 15 years of age. Three of these 11 cases are male and the rest 8 female. DIC developed within the first 5 admission day in 7 cases, from the 6th to the 10th day in one and after the 10th in three. Factors predisposing to DIC included infection (11 cases) which were usually systemic, shock, recent surgery and malignancy. Diagnostic coagulation studies included low platelet count below 100,000/cumm (all 11 cases), prolonged PT (10 cases) and PTT (all 11 cases). All patients had abnormal hemorrhage and the majority being petechiae on the skin (8 cases) followed by oozing from the injection site (6 cases), melena (4 cases), epistaxis (3 cases), bleeding from the oral cavity (3 cases), intracranial hemorrhage (1 case) and hematuria (1 case). Local ischemic manifestations probablly due to the thrombus formation were respiratory distress (9 cases), mental disturbance (9 cases), diarrhea (8 cases), abdominal pain (7 cases) and acrocyanosis (3 cases). Shock due to systemic circulatory disturbance was also seen in 5 cases. Treatment included transfusion of fresh whole blood and Vitamin K admimistration in all cases, plalelet transfusion in 6 cases, Corticosteroid administration in 4 cases and none received Heparin. Only 3 cases showed improvement and the rest discharged hopelessly and/or died. key words: Disseminated Intravascular Coagulation.

임플란트 주위 조직 보존을 위한 임플란트 경부의 디자인에 관한 고찰

김홍준,김지환,김성태,이재훈,박영범 大韓齒科保存學會 2011 Restorative Dentistry & Endodontics Vol.36 No.6

연구 목적: 임플란트 식립 후 변연골 흡수에 따라 임플란트 주위 연조직이 재구성되며, 이에 따라 치료의 예후 및 심미성 등에 영향을 주게 된다. 그러므로 임플란트 경부 주위 골조직 보존을 위한 임플란트 경부에 다양한 디자인이 연구되고 있다. 본 고찰의 목적은 초기 변연골 흡수의 원인과 이에 따른 임플란트 주위의 연조직 변화에 대해 고찰하고, 어떠한 임플란트 경부 디자인이 임플란트 주위 조직의 보존에 유리한 지 알아보고자 한다. 연구 재료 및 방법: Pubmed database에서 임플란트 초기 변연골 흡수의 원인과 관련된 논문과 임플란트 경부의 여러 디자인에 관한 논문을 검색하여 분석하였다. 임플란트 경부 디자인은 one piece implant, two piece implant, internal hex abutment, external hex abutment, taper joint connection, butt joint connection, scalloped design abutment, platform switching concept에 관해 검토하였다. 결과: 초기의 임플란트 주위 조직 보존에 대하여 one piece implant가 two piece implant보다 유리한 것으로 여러 임상적, 실험적 연구가 있다. Two piece implant에서는 internal hex abutment가 external hex abutment보다, taper joint connection가 butt joint connection보다 유리할 것으로 보여진다. Scalloped design abutment에 대해서는 논쟁의 여지가 있어 더 많은 연구가 필요할 것으로 판단된다. Platform switching concept은 그 원인이 명확히 밝혀지지는 않았으나 임상적, 실험적으로 초기 임플란트 주위 조직 보존에 대해 유리한 것으로 판단된다. 결론: 임플란트 경부의 디자인마다 각각의 장단점이 있고 추가적인 연구가 더 필요한 제한이 있지만 현재까지의 선행 연구들을 분석 종합해 보면 초기 임플란트 주위 조직 보존을 고려한다면 가능한 경우 one piece implant가 유리할 것으로 판단되며, 보철적인 문제나 다른 이유로 인하여 two piece implant를 고려할 경우 platform switching concept, internal connection abutment, taper joint connection을 이용하는 것이 임플란트 주위 조직 보존에 좀더 유리할 것으로 사료된다 Purpose: The peri-implant soft tissue is remodeled by the initial marginal bone resorption affecting the prognosis and esthetic result of treatment. Thus various designs on implant neck design are studied to preserve peri-implant bone. The purpose of this study is to review on the causes of initial marginal bone resorption, the configuration of peri-implant soft tissue, and the implant crestal module favorable in preserving peri-implant tissue. Materials and methods: The studies on the causes of initial marginal bone resorption and the implant crestal modules are researched and reviewed using Pubmed database. The implant crestal modules including one piece and two-piece implant, internal and external hex abutment, taper and butt joint connection, scalloped design abutment, and platform switching concept are reviewed. Results: A number of clinical and experimental studies preferred one piece implant to two-piece in preserving initial peri-implant tissue. For two piece implants, internal hex abutment and taper joint connection appear more favorable than external hex abutment and butt joint connection relatively. Controversial issues still exist on scalloped design requiring more studies on it. Although the rationale is not certain, the concept of platform switching seems favorable in preserving initial peri-implant tissue based on clinical and experimental studies. Conclusion: Each implant crestal module contains its own advantages and disadvantages with various controversial issues. In the aspect of preservation of initial peri-implant tissue, however, one-piece implant seems beneficial. In cases when two-piece implant is more appropriate due to prosthodontic concerns or any other problems, the application of platform switching concept, internal connection abutment, and taper joint connection may be favorable for the preservation of peri-implant tissues.

하이브리드 섬유 보강 콘크리트의 휨인성 및 휨인장 강도에 관한 실험적 연구

趙勇範,朴弘用 明知大學校 産業技術硏究所 2009 産業技術硏究所論文集 Vol.28 No.-

Fiber reinforced concrete is increasing used in practice because of its excellent cracking resistance. There are various types of fiber such as steel fiber, glass fiber, synthetic fiber and organic fiber. Many trials to add more than two types of fiber to concrete mix have been being made to enhance ductility and maximum load bearing capacity as well as cracking resistance. Recently, a new type of polyolefin fiber having a good mechanical properties is developed, and it needs to examine a possibility for the new fiber to be used as a reinforcing fiber with other types of fiber or by itself. The objective of this study is to find out flexural toughness and tensile strength of concrete reinforced with steel and polyolefin fibers. Four point beam tests were performed with 324 specimens following two standard tests methods: KS F 2566 and ASTM 1399-02. From the test results, the effects of volume fraction of fibers, and aspect ratio of steel fiber on the toughness and tesile strength were found, and the optimal ratio of steel fiber to Dolvolefin fiber was suggested.

호르몬 불응성 전립선암 환자에서 mitoxantrone과 prednisone의 병합화학요법 후 통증완화 및 삶의 질 측정

이홍우,이지열,김세웅,이충범,강성학,조용현,황태곤,박용현,윤문수 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

목적 : 호르몬 불응성 전립선암 환자의 생명을 연장시키는 치료법은 현재로는 없으며, 현 시점에서의 치료목표는 증상의 경감 및 소실에 따른 삶의 질 향상에 두고 있다. 호르몬 불응성 전립선암의 고식적인 치료에 일차적인 치료법으로 간주되는 mitoxantrone과 prednisone의 화학요법이 호르몬 불응성 전립선암 환자의 통증완화 및 삶의 질에 어떠한 영향을 미치는지 알아보았다. 방법 : 1998년 7월부터 1999년 12월까지 증상이 있는 18명의 호르몬 불응성 전립선암 환자를 대상으로 하였으며, 일차적인 치료의 목표는 환자 본인이 기록하는 McGill-Melzack 6단계 통증척도에서 진통제의 증량 없이 2점이 감소(또는 첫 점수가 1점일 경우 통증의 완전소실)하는 것으로 하였다. 이러한 기준은 최소 3주 간격으로 시행한 자가 기록조사에서 연속적으로 2번 이상 유지될 때 유효한 것으로 간주하였다. 건강과 관련된 삶의 질 측정은 전신적 치료의 임상적 응용을 위한 실제적인 측정방법으로 개발되어 환자가 직접 작성하는 전립선암 특이성 삶의 질 측정기구(Prostate Cancer-Specific Quality-of-Life Instrument : PROSQOLI)의 비례연속형의 자가측정 척도(linear analogue self-assessment scale : LASA)를 이용하였으며, ECOG performance status를 사용하여 전신상태의 변화도 측정하였다. 결과 : 통증의 경감으로 나타나는 고식적인 치료의 반응은 66.7%(12/18)에서 나타났으며, 반응의 지속기간은 2개월에서 10개월까지로 평균 4.2±3.6개월이었다. PROSQOLI로 측정한 삶의 질은 통증에 대한 고식적인 치료반응을 보인 12명(66.7%) 모두가 삶의 질이 개선되었으며 특히 통증, 변비, 소변보기, 전반적인 복지상태에서의 유의한(p<0.05) 증가를 보였다. 치료 후 혈장 PSA 수치는 고식적인 반응의 유무에 관계없이 별 다른 변화를 보이지 않았으며, 골주사 또는 전산화 단층촬영으로 측정한 방사선학적 병변은 고식적인 반응을 보인 2명을 제외하고 치료 전과 비교하여 차이를 보이지 않았다. 병합 화학요법과 관련된 특별한 부작용은 관찰되지 않았다. 결론 : 통증을 동반한 호르몬 불응성 전립선암에서 mitoxantrone과 prednisone의 병합화학요법은 66.7%의 환자에서 통증의 감소 및 삶의 질이 향상되었다. 현재는 혈장 PSA 수치, 병소의 크기나 개수등이 치료의 지침이나 치료결과의 판정을 위한 객관적인 기준으로 사용되는 경향이 있지만, 앞으로는 환자를 중심으로 통증을 포함한 삶의 질 측정이 고식적 치료 후 치료결과 판정에 있어 객관적이고 적절한 방법이 될 것이다. Background : There is no evidence that therapeutic modalities prolong the survival of patients with hormone-refractory prostate cancer nowadays. The main goal of treatment is therefore improvement in quality-of-life including palliation of symptoms. We performed this study to investigate the benefit of mitoxantrone and prednisone chemotherapy in patients with symptomatic hormone-refractory prostate cancer using relevant end points of palliation regarding to pain and quality-of-life. Methods : From July 1998 to December 1999, we assessed the 18 patients with symptomatic hormone-refractory prostate cancer receiving mitoxantrone and low dose prednisone. The treatment end point was a palliative response defined as a 2-point decrease in pain assessed by a 6-point pain scale complemented by patients (or complete loss of pain if initially 1+) without an increase in analgesic medication and maintained for two consecutive evaluations at least 3 weeks apart. Health-related quality-of-life was evaluated with a series of linear analogue self-assessment(LASA) scale of the Prostate Cancer-Specific Quality-of-Life Instrument (PROSQOLI) and performance status was also measured. Results : Palliative responses were observed in 12(66.7%) of 18 patients. The duration of palliative responses were 4.2±3.6 months(range: 2 to 10 months). Treatment was well tolerated without specific side effects. There were no differences in prostate-specific antigen (PSA) level following treatment and no significant changes of radiologic findings evaluated by bone scan and/or CT were noted except 2 cases after chemotherapy. All the responding patients had an improvement in quality-of-life scales and performance status, however serum PSA levels were not changed. Conclusions : Chemotherapy with mitoxantrone and prednisone provides palliation and an improvement in quality-of-life for more than half (66.7%) of the patients with symptomatic hormone-refractory prostate cancer.

SFRC의 휨-압축 거동

鄭瑞鎬,朴弘用,趙勇範 明知大學校 産業技術硏究所 2008 産業技術硏究所論文集 Vol.27 No.-

When steel fiber reinforced concrete is used as an underground cavity or a lining of tunnel, the SFRC is subjected to loads which differ in type from those present in standard testing methods. This study is worthy of notice on this point. This study is aimed to investigate an experimental study on flexural-compression behavior of steel fiber reinforced concrete. When a combined bending moment-normal force loading is characteristic in such shells, it were aimed to construct a data for design under such conditions An experimental variables are steel fiber content, shape ratio, angle of end mill. Total 126 specimens using four different kinds of steel fiber products were evaluated from loading test. From the test results, it was known that a fracture occurred before reaching ε_(cu). A tensile strain was gauged 5‰ at that time. SFRC specimens occurred a tensile fracture, It was known that a location of neutral axis was not changed untill a crack occurred on specimens.

황색포도구균의 균혈증에서 초기 항생제 치료가 예후에 미치는 영향

김성한,박완범,이기덕,강철인,최영주,김홍빈,박상원,김의석,오명돈,김의종,최강원 대한감염학회 2002 감염 Vol.34 No.5