자가 면역성 간염에서 자가항체의 발현 양상과 스테로이드 치료의 효과

박기오,채경훈,허원석,강윤세,정재훈,김연수,문희석,이엄석,김선문,이병석,김남재,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 최근 8년간 본원에서 경험한 자기면역성 간염의 혈액학적 특징과 스테로이드의 치료효과를 알아보고자 본 연구를 시행하였다. 방법 : 1996년 이후부터 2002년까지 충남대학교 병원에서 1999년 International Autoimmune Hepatitis Group(LAHG)에서 제시한 수정 진단 기준안에 의거하여 총 진단점수가 probable 이상에 해당하는 환자들을 대상으로 임상적 특징, 검사실 및 조직 소견과 스테로이드와 azathioprine의 치료 효과를 후향적으로 조사하였다. 결과 : 9예의 환자들은 여성이 78%, 40대가 많았고, 급성 발병이 33.3%, 피로감, 식욕부진 및 황달 등이 나타났으며, 항핵항체가 55.6%에서 그리고 항평활근 항체가 77.8%에서 양성이었고, 동반 질환은 류마치스 관절염이 2예, 특발성 혈소판 감소증 1예, Henoch-Sch nlein 자반증 및 그레브스병이 각각 1예 씩이었다. 7예에 대해서 스테로이드와 azathioprine으로 치료하여 생화학적 임상적 완해가 이루어져서 유효한 치료 결과를 얻었다. 결론 : 자가면역성 간염은 우리 나라에서 원인을 찾을 수 없는 만성 간질환의 경우, 특히 중년여성에서 다른 자가면역성 질환이 동반되었을 때 자가면역성 간염을 의심하여 자가항체 선별검사를 시행해 보아야 할 것으로 생각된다. 향후 다기관 연구를 통하여 좀 더 많은 증례를 모으고 전향적인 연구를 시행하여야 할 필요가 있다. Although autoimmune hepatitis(AIH) is common in western contries, some studties have been reported in Korea. The aim of the study was to analyze the clinical and histological features and expression pattern of the autoantibody and to examine clinical course of AIH in Korea. For 9 patients diagnosed as having AIH in our hospital since 1996, we reviewed medical records and analyzed clinical and laboratory findings retrospectively. They had a probable or definite AIH according to the revised criteria of International AIH group. The mean age was 42.7(21∼68)years and 7(77.8%) were female. Three of them(33.3%) showed acute hepatitis and five of them showed cirrhosis. Fatigue and anorexia were the most frequently complained symptoms(55.6%). Four patients(44.4%) were accompanied with other autoimmune diseases. Antinuclear antibody was detected in 5(55.6%) and anti-smooth muscle antibody was detected in 7(77.8%). Three patients showed focal picemeal necrosis and four showed periportal fibrosis. Among 7 patients who received immunosuppressive therapy, six patients(85.7%) showed initial response. and biochemical and serologic remission were achived in 5(71.4%) and 3(42.8%) patients, AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. AIH should be suspected in female patients with unknown chronic liver disease of unknown etiolgy, especially accompanied with other autoimmune disease. The clinical characteristics of AIH may not be quite different from those of Western countries.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

Oxalate와 Enrofloxacin투여한 랫트신장에 대한 병리조직학적관찰

오원석,이차수,오규실,정원일,정재용,정다히,정규식 한국임상수의학회 2003 한국임상수의학회지 Vol.20 No.4

To investigate the renal effects of enrofloxacin administration on rats induced with dehydration or hyperoxaluria, male rats were treated with enrofloxacin of 50 mg to 500 mg/kg b.w.. The microscopical observations of kidney and urine sediment were carried out in the experimental groups. The result obtained were as follows; The male rats deprived of water for 72 hours and administered with enrofloxacin. As enrofloxacin administration dose was increased, clinical signs such as loss of appetite, depression, weakness, and loss of urine output became more severe. In the histopathological findings, there were hyperemia and hemorrhage in renal cortex, vacuolation and necrosis of renal tubular epithelia, proteinous casts within renal tubules. The male rats were orally administered with sodium oxalate and injected with enrofloxacin for 7days. As enrofloxacin administration dose was increased, clinical signs such as the loss of appetite and water consumption, and weakness became more severe. In the histopathological findings, there are hemorrhage of glomeruli and cortical hyperemia, vacuolation and necrosis of tubular epithelia, proteinous casts in renal tubules. In the microscopical findings of urine sediment, there are calcium oxalate crystal (diamond-like type) and magnesium ammonium phosphate crystals (rhomboid). The male rats were intraperitoneally injected with sodium oxalate and administered with enrofloxacin for 7days. As enrofloxacin administration dose was increased, clinical signs such as the loss of appetite and water consumption, weakness were more severe. In the histopathological findings, there were hyperemia and hemorrhage in both glomeruli and renal cortex. Severe necrosis of renal tubular epithelia, bluish materials within renal tubules were also found. In the microscopical findings of urine sediment, there were many calcium oxalate crystals. The present results suggest that enrofloxacin has some injurious effects in rats having dehydration or hyperoxaluria, and clinically, we should consider these renal injury effects when we use enrofloxacin in patients accompanied renal disease, dehydration and hyperoxaluria conditions.

결함핵연료에서 lodine 핵종의 방출 모형

오근석,양재춘 충남대학교 1990 忠南科學硏究誌 Vol.17 No.1

We have investigated the nuclear fuel state analysis from the physical characteristics of unclear fission products in the reactor core which are produced by reaction between neutron and U^235. We set up H which is the ratio of the number of defective fuel rod to the mass of tramp uranium and calculate the contributed rate of radioactivities of iodine isotopes in primary coolant. We have measured the radioactivities of fission products in the primary coolant of nuclear power reactor and utilized the ratios of radioactivities of I^131 to I^133 and I^135 to I^133 in order to calculate the number of defective fuel rod and the mass of tramp uranium. The ratio of the number of defective fuel rod to the mass of tramp uranium is more sensitive to variation of the number of defective fuel rod than to variation of the mass of tramp uranium. The model which is considered by the radioactivities of fission products released from the defective nuclear fuel and from the tramp uranium in the primary coolant is confirmed appropriateness.

모터구동형 안전벨트 리트랙터의 구동 메커니즘 설계

탁태오,박재순,국민구,김대희,신승언,최석 강원대학교 산업기술연구소 2006 産業技術硏究 Vol.26 No.A

Motorized retractors enhance the safety of passengers by removing the slack of webbing and by holding upright driving position. Reliability of a driving mechanism that includes one-way clutch between the driving motor and webbing is directly linked to the safety of passenger. In this research, conditions for locking one-way clutch, and also conditions for sustaining locking are theoretically investigated. The operation of a motorized retractor under realistic conditions is simulated in order to validate the proposed retractor design.

형상인식을 적용한 용접 결함의 특징변수 추출

김재열,마상동,오성민,송경석,김양중,김창현,곽이구 朝鮮大學校 機械技術硏究所 1999 機械技術硏究 Vol.2 No.2

In this study, the researches classifying the natural flaws in welding parts are performed using the signal pattern classification method. For this purpose 500MHz storage digital oscilloscope including FFT function and enveloped waveform generator are used and the signal pattern recognition procedure is made up the digital signal processing, feature extraction, feature selection and classifier design. Specially it is composed with and discussed using the distance classifier is based in euclidean distance the empirical Bayesian classifier. In feature extracting, it is performed using the class-mean scatter criteria. And the signal Pattern classification method is applied to the signal pattern recognition problems of natural flaw that is porosity inclusion, slag inclusion, lack of penetration, lack of fusion. center crack, side crack, toe crack. root crack as the planar and volumetric flaw classification problem. According to this results, if appropriately learned the neural network classifier is better acquire the recognition rate of 86.31% above through it is different a little according to domain extracting the feature and the classifier

소양호의 어류군집 동태

최재석,이광열,장영수,고명훈,권오길,김범철 한국어류학회 2003 韓國魚類學會誌 Vol.15 No.2

2001년 4월부터 2002년 9월까지 소양호의 어류군집 동태를 조사한 결과는 다음과 같다. 조사된 어류는 총 11과 38종이었다. 한국 고유종은 P. tenuicorpus, C. splendidus, S. gracilis majimae, S. japonicus coreanus, H. mylodon, G. brevibarba, M. yaluensis, M. longidorsalis, C. koreensis, C. rotundieaudata, S. microdorsalis, P. koreanus, L. andersoni, C. herzi, O. patycephala 등 15종(40.54%)이었다. 우점종은 Z. platypus(39.60%), H. olidus(39.47%), S. gracilis majimae(12.24%), S. japonics coreanus(2.11%), P. fulvidraco(1.48%), L. macrochirus(1.40%) 등이었다. 채집된 어종들의 생체량을 보면 Z. platypus가 19.48㎏, H. olidus로 8.75㎏, C.cuvieri 7.42㎏, L. maeroehirus 7.39㎏, H. labeo 6.85㎏의 순으로 나타났다. 소양호에서 확인된 도입종은 A. japonica, H. eigenmanni, H. olidus, P. altivelis, C. urotaenius, R. giurinus, T. brevispinis, C. carpio(Israeli type), c. euvieri, Onchorhynchus mykiss, L. macrochirus, M. salmoides, I. puntatus 등 13종이었다. 이 중 C. carpio(Israeli type), C. cuvieri, Onchorhynchus mykiss, L macrochirus, M. salmoides, I. puntatus는 국외종이며, A. japonica, H. eigenmanni, H. olidus, P. altivelis, C. urotaenius, R. giurinus, T. brevispinis 등은 국내 다른 하천ㅇ로부터 유입된 종이다. The dynamics of the fish community in Lake Soyang, Korea, was investigated from April 2001 to September 2002. During the surveyed period 38 species belonging 11 families were collected. There were 15 Korean endemic species 39.47%, including Pseudopungtungia tenuicorpus, Coreoleuciscus splendidus, Squalidus gracilis majimae, S. japonicus coreanus, Hemibarbus mylodon, Gobiobotia brevibarba, Microphysogobio yaluensis, Microphysogobio longidorsalis, Iksookimia koreensis, Iksookimia rotundicaudata, Silurus microdorsalis, Pseudobagrus koreanus, Liobagrus andersoni, Coreoperca herzi, and Odontobutis platycephala. Dominant species were Zacco platypus (39.60%), Hypomesus olidus (31.70%), Squalidus gracilis majimae (12.24%), Squalidus japonicus coreanus (2.11%), Pseudobagrus fulvidraco (1.48%) and Lepomis macrochirus (1.40%). The biomass of collected fishes were Zacco platypus (19.48 ㎏), Hypomes olidus (8.75 ㎏), Carassilus cuvieri (7.42 ㎏), Lepomis macrochirus (7.39 ㎏) and Hemibarbus labeo (6.85 ㎏). Of the 13 introduced fishes in Lake Soyang Cyprinus carpio (israeli type), Carassius cuvieri, Onchorhynchus mykiss, Lepomis macrochirus, Micropterus salmoides and Ictalurus puntatus were originated from foreign countries but Anguilla japonica, Hemiculter eigenmanni, Hypomesus olidus, Plecoglossus altivelis, Chaenogobius urotaenius, Rhinogobius giurinus. Thridentiger brevispinis were introduced from other native river systems.

T1b 병기의 신세포암에서 수술 후 예후를 예측할 수 있는 임상 및 병리학적 인자에 대한 연구

오승용, 김영원, 윤형윤, 서성필, 이상근, 김원태, 윤석중, 이상철, 김원재, 김용준 충북대학교 의과대학 충북대학교 의학연구소 2014 忠北醫大學術誌 Vol.24 No.1

연구목적: T1병기의 국소신세포암(localized clear-cell renal cell carcinoma)은 근치적신적출술이 나 부분신절제술이 표준치료이며 수술 후 타 병기에 비해 양호한 예후를 보인다. 하지만, 많은 수의 환 자에서 추적관찰 중 재발 및 사망이 발생하는데, 이는 T1b 병기에서 더 높게 보고되고 있다. 본 연구 에서는 국소신세포암 중 T1b 병기의 신세포암에서 표준적 치료 후 환자의 예후에 영향을 주는 임상 및 병리학적 인자에 대하여 알아보고자 하였다. 대상 및 방법: 1999년부터 2011년 까지 5개 기관에서 근치적신적출술이나 부분신제술을 시행 받은 3567명의 국소신세포암 환자들 중 병리학적 병기가 T1b로 확진 된 702명을 대상으로 하였다. 이들 환자가 가지는 임상 및 병리학적 특성 [연령, 성별, 고혈압, 당뇨, 비만도, European Cooperative Oncology Group(ECOG) 수행도, 증상유무, 수술방법, 종양크기, 분화도, 조직학적 형태 등]을 이용 하여 환자의 예후 [무재발생존율(relapse-free survival), 암특이생존율(cancer-specific survival) 및 전체생존율(overall survival)]에 영향을 미치는 인자에 대하여 다양한 방법으로 비교분석 하였다. 결과: 추적 관찰 기간은 34.0개월 (중앙값, 0-152개월)이었으며, 이 기간 중 재발, 사망 및 암특이사 망은 각각 72례 (10.3%), 57례 (8.1%) 및 24례 (3.4%)에서 발생하였다. 단변량 및 다변량 Cox 비례위험회귀분석에서 다양한 인자들이 무재발생존율(당뇨 유무, 종양크기 및 Fuhrman등급), 암특이 생존율(나이, 체질량지수, 당뇨 유무, 종양크기) 및 전체생존율(나이, 체질량지수, ECOG 수행도, 종 양크기)에 영향을 줄 수 있는 독립적 예후인자였다. 결론: 본 연구결과 국소신세포암의 예후를 예측할 수 있는 다양한 임상 및 병리학적 인자를 확인 할 수 있었다. 이러한 위험인자를 가지고 있는 환자는 보다 적극적인 추적관찰을 통하여 재발을 조기에 발 견한다면 이들의 생존율 향상에 많은 기여를 할 수 있을 것으로 생각한다.

모터구동형 안전벨트 리트랙터의 구동 메커니즘 설계

탁태오,박재순,국민구,김대희,신승언,최석 강원대학교 산업기술연구소 2006 産業技術硏究 Vol.26 No.B

Motorized retractors enhance the safety of passengers by removing the slack of webbing and by holding upright driving position. Reliability of a driving mechanism that includes one-way clutch between the driving motor and webbing is directly linked to the safety of passenger. In this research, conditions for locking one-way clutch. and also conditions for sustaining locking are theoretically investigated. The operation of a motorized retractor under realistic conditions is simulated in order to validate the proposed retractor design.

결핵균 약제감수성 검사의 비용효율성에 관한 다기관 연구

정석훈,이대동,최재철,김선주,신정환,정윤성,이은엽,오승환,배길한,장철훈 대한감염학회 2005 감염과 화학요법 Vol.37 No.1

목적 : 우리나라에서의 결핵균 감수성 검사는 검출 균주의 일부에서만 시행되고 있다. 본 연구에서는 모든 검출 균주들에 대해서 감수성검사를 실시하면서, 진료에 필요한 결과를 충분히 제공하고 경제적이면서 현실적인 감수성검사 방안을 제시하고자 한다. 재료 및 방법 : 5개 대학병원에서 일정기간 연속적으로 의뢰된 502균주의 감수성 결과를 분석하였다. 검사결과의 해석 및 2차 약제 감수성검사의 필요성은 NCCLS approved standard M24-A의 권고 기준에 따라 판단하였다. 결과 : 최소한 1가지 이상의 약제에 내성을 보인 경우는 초치료 환자의 10% (38/363), 재치료 환자의 61%(85/139)였으며, 다약제 내성을 보인 경우는 초치료 환자의 3% (11/363), 재치료 환자의 44% (61/139)였다. NCCLS 권고에 따라 2차 약제에 대한 감수성 검사를 시행하지 않아도 되는 경우는 초치료 환자의 96%, 재치료환자의 47%였다. 결론 : 초치료 환자는 95%에서 1차 약제에 대한 검사만으로 충분하므로 필요한 경우에만 2차 약제를 추가로 검사하고 재치료 환자에서는 1, 2차 약제를 동시에 검사할 필요가 있을 것으로 생각한다. Background : The anti-mycobacterial susceptibility test is performed on only a small percentage of clinical isolates in Korea. The aim of this study is to propose an anti-mycobacterial susceptibility testing scheme, which is not only economic and practical but also fully informative to physicians. Materials and Methods : The anti-mycobacterial susceptibility test results of 502 strains, isolated from five university-affiliated hospitals, were analysed. The interpretation of the results and the need for second-line drug susceptibility test were judged according to the recommendation of NCCLS M24-A guidelines. Results : The isolates from 10% (38/363) of treatment-navie patients and 61% (85/139) of retreatment patients showed resistance to at least one of the anti-mycobactial agents; 3% (11/363) and 44% (61/139) of isolates from each group were multi-drug resistant. According to the recommendation by NCCLS, the percentage of patients not needing the susceptibility test results for second-line drugs were 96% for treatment-naive and 47% for re-treatment patients. Conclusion : Since the susceptibility test against first-line drug is sufficient for 95% of treatment-navie patients with tuberculosis patients, susceptibility test against second-line drugs may be performed only when it is necessary. As for the re-treatment patients with tuberculosis, susceptibility test for both first-line and second-line drugs should be performed simultaneously.