혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

플레이트거더의 전단강도

최취경,김태영,서성연,김정석,김상섭,김규석 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

In the design of plate girder web panels, it is required to evaluate accurately the elastic buckling strength under pure shear. Whether or not the post-buckling strength is accounted for. Currently. Elastic shear buckling coefficients of web panels stiffened by transverse intermediate stiffeners are determined by assuming conservatively that web panels are simply supported at the juncture between the flange and the web. Although the notion of the real boundary condition at the juncture of the web and flanges to be somewhere between simple and fixed has been recognized from early days, the boundary condition has been conservatively assumed. Mainly due to lack of means to evaluate it in a rational manner. In this paper. A series of numerical analyses based on a three-dimensional finite element modeling is carried out to investigate the effects of the geometric parameters on the boundary conditions at the juncture between the flange and the web.

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

만성 신부전환자의 혈청 갑상선홀몬 농도의 변화

김민범,이정호,신영태,김삼용,노흥규 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.1

To investigate the thyroid hormonal changes and their mechanisms in patients with chronic renal failure (CRF), the author measured serum levels of the thyroid hormones using radioimmu-noassay and calculated each ratio of serum thyroid hormones in 17 patients with CRF. Ten patients were on hemodialysis therapy and seven patients had not undergone hemodialysis. The following results were obtained. 1) The serum T3 and T4 concentrations were significantly lower in patients with CRF(0.7±0.47㎍/1 and 5.53±2.95㎍/dl, respectively) than in normal subjects(1.21±0.18㎍/1 and 9.46±1.92㎍/dl, respectively. 2) The serum FT4(free T4) concentration was significantly lower in patients with CRF(1.20±0.50μu/dl) than in normal subjects(1.01±0.48μu/dl). 4) The serum rT3(reverse T3) concentration in patients with CRF(285.7±148.1pg/ml) tends to be greater than normal subjects(204.6±43.3pg/ml). But is was not significant statistically. 5) The calculated serum concentration ratio of T3/T4 in patients with CRF(0.17±0.04: presented as Mean±SEM) did not differ significantly from that of normal subjects(0.13±0.01). But the serum concentration ratio of rT3/T4 in patients with CRF(78.78±18.98) was significantly greater than in normal subjects(21.90±1.04). 6) There was no significant difference in thyroid functions between male and female patients with CRF, and also between patients on hemodialysis and non-dialyzed uremic patients. It was concluded that the serum T3, T4, FT4 concentration were significantly decreased in patients with CRF, while the serum TSH concentration was significantly increased. The calculated serum concentration ratio of rT3/T4 was also significantly increased in patients with CRF. Thus is appears that abnormalities found in patients with CRF may reflect both the possible intrathyroidal abnormalities and alteration of serum rT3 metabolism with increased peripheral generation of rT3 from T4.

어류 성장에 있어서 식물 및 동물플랑크톤의 먹이기여도

김백호,김미연,최환석,김정중,최민규,박승택,정연태,高村典子 원광대학교 환경과학연구소 2000 環境科學硏究誌 Vol.9 No.1

이탈리아 묘지 건축에 관한 연구

김종헌,김정태,전동훈 경희대학교 디자인연구원 2001 예술· 디자인학연구 Vol.4 No.1

The Korea tradition of burying the dead had caused many problems because of its disordered enlagement. It has become a social and civil problem when thinking about the usage of territory efficiency. And now that we are in the situation where many people think of cemeteries as a hatred place, on problem has occurred. We must not go on this tradition. This study deals with architectural historic changes and compositions in the Italian cemeteries, which show a sharp contrast from our cemeteries. And grasping the characteristics of architectural efficiency in the cemetery institutions and the culture of funerals.

LAN 성능 평가 및 모니터링 기법

김태우,박정식 성공회대학교 2001 성공회대학논총 Vol.- No.16

광반사를 이용한 광선반 채광시스템의 기본형상 설계 및 성능평가에 관한 연구

김정태,신현구,김곤 대한건축학회 2003 대한건축학회논문집 Vol.19 No.3

Good natural lighting and unimpeded views out of a building belongs to the minimum standards required by guidelines for natural, healthy, productive workplace. Attention, however, should be focused not so much on a simple maximization of the natural light available in a space, as on improving the quality of lighting by ensuring as even but intense distribution of illumination in all inner areas. An architectural means of optimal daylight distribution is by using so-called light shelf systems, horizontal shading and redirecting devices. They improve the uniformity of natural light in a space by reducing the level of illumination near the window and redirecting light deeply into the space. In most cases, systems of this kind consist of light-colored, reflecting or mirror elements in the area of the building facade. One problem in selecting and positioning elements of this kind is the facts that ultimately the amount of light available in the facade plane is merely redistributed and reduced a little with each reflection. This paper aims to provide the design guidelines for optimal light shelves based on their geometric and optical characteristics. Their role, that is, a tradeoff between optimal distribution of the daylight and glare control has been evaluated simultaneously. A series of computer simulation deals with the basic geometrical design elements of a commonly used light shelf and sky conditions. As is shown in the results, for best distribution, light shelves should be located as low in a space as possible without causing glare, typically above standing eye level. In addition, more uniformity of light distribution can be improved by extending of the shelf and reflectance of the shelf and higher ceiling height might play a role in increasing the effectiveness of light shelves.

HLA-DPB1 유전자 형별법 개발

김태규,이혜정,정서영,정태준,한훈 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

연구배경: HLA-DP 유전자는 DR 및 DQ와 같이 항원제공 세포(APCs), B 세포 및 활성화된 T 세포등의 표면에 발현되는 class Ⅱ 유전자로서 외인성 항원제공시 MHC 제한(restriction)과정을 통해 면역 반응에 관여한다. DP 항원 분자는 PLT(primed lymphocyte test)와 같은 세포학적 방법에 의해 처음으로 규명되었고, 이어서 혈청학적 형별이 시도되었으나, DR, DQ 분자에 비해 발현 정도가 낮아 형별에 어려움이 있었다. 최근 DP 유전자의 염기서열이 밝혀짐에 따라 DNA 수준에서 DP 형별이 가능하게 되었으며, 지금까지 DPA1 10개, DPBI 77개의 대립유전자가 밝혀졌다. 본 연구는 이식의 결과 및 질병 발생과 연관이 있다고 추정되는 HLA-DPB1 대립유전자를 DNA 수준에서 형별하고 정상 한국인의 DP 대립유전자 분포를 확인하기 위해 시도되었다. 방법: HLA-DPB1 유전자 중 초가변부위(hypervari-able region)가 있는 exon 2 부위를 일차적으로 증폭시킨후, 17종의 probe를 사용하여 PCR-SSOP를 실시하였고, PCR-SSP에는 5종의 primer를 사용하였다. 이들 방법은 DP형이 알려진 미국 UCLA 대학의 international cell exchange sample 88개를 표준 DNA 시료로 이용하여 확립하였다. 결과: 36종류의 HLA-DPBI 대립유전자를 형별할수 있음을 확인하였다. 그러나 DPBI*0402와 0601 대립유전자를 동시에 갖는 heterozygote인 경우에는 DPBI*0201와 2001을 동시에 갖는 heterozygous와 구분이 어려웠다. 100명의 정상 한국인에서 DPBI 대립 유전자형의 분포를 조사한 결과 한국인에서는 11종류의 HLA-DP 대립유전자가 존재함을 확인하였고, DPBI*0501(36.5%), 0201(27%), 0402(10.5%) 대립유전자의 순으로 분포되어 있었으며 검출율은 100%였다. 결론: 이상의결과로 골수 이식 등 이식시 공여자와 수혜자간의 조직적합성은 HLA-DP, DQ뿐만 아니라 DP도 확인 하게되었으며, 앞으로 질병과의 연관성 연구에서 이용될수 있을것으로 사료된다. Background: The HLA-DP genes are highly polymorphic, which encode heterodimeric cell surface glycoproteins that play a role in the immune response as restriction elements in antigen presentation. HLA-DP antigens were initially defined through the primed lymphocyte test (PLT), and the serological typing has been performed which is practically difficult because the expression of DP molecules is very low, comparing with that of DR and DQ. Recently, DNA sequencing and PCR have allowed the various and extensive study on the HLA-DP genes. We developed the molecular typing method for HLA-DPBI alleles, and studied the distribution in normal Korean population. Methods: After PCR amplification of hypervariable exon 2 regions in HLA-DPBI gene, both PCR-SSOP (sequence specific oligonucleotide probes) with 17 probes and PCR-SSP (sequence specific primers) by 5 Primers were used. And this method was tested using a international pannel DNA as standard. Results: Total 36 alleles of HLA-DPBI were defined in the standard DNA pannel. However, DPBI*0.402, and 0601 heterozygote could not be distinguished from DPBI*0201 and 2001 heterozygote. And 11 alleles were defined in 100 normal Koreans and the common alleles were DPBI*0501 (36.5%). 0201 (27%) and 0402 (10.5%). The detection rate was 100% in this study. Conclusion: As the results, the molecular typing of HLA-DPBI alleles is possible for the accurate matching between donor and recipient in born marrow transplantation and for the study of disease association.

흉통의 양상에 따라 분류한 불안정형 협심증 환자의 임상적 소견의 비교

김명수,김성구,정호석,온영근,신원용,김철현,최태명,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background and aims : The clinical syndrome unstable angina pectoris that encompasses a variety of symptoms and clincal presentations of transient episode of myocardial ischemia, was devided to several subgroups. Also, it has variable pathophysiologic factors to cause myocardial ischemia. According to clincal presentation, coronary angiographic finding and prognostic factor, the result of unstable angina pectoris is variable. In fact, there were a few data reported on the prognosis of wide spectrum of patients with unstable angina. However, the precise risk of subgroups according to classitication has not been established because it was difficult to compare between studies. We classified unstable angina pectoris by clinical nature of chest pain, and performed to establish and compare the clinical presentations, coronary angiographic findings, treatement and prognosis of patients with unstable angina within subgroups of classification. Methods : Retrospenctive data for 164 unstable angina pectoris patients admitted to the Internal Cardiology Division of Soon Chun Hyang University Hospital from May 1996 to July 1999 was analyzed. The patients were classified into one of the following categories: Class I, new onset of severe angina; Class II, acceleration of previous chronic stable angina; Class III, angina at rest. Clinical presentations, echocardiographic findings, coronary angiographic findings, treatment and prognosis were compared. Results : From the total 164 patients, the subjects of classes were as follows : Class I, 46 cases (28.1%); Class II, 74 cases (45.1%); Class III, 44 cases (26.8%). In view of age distribution, the 7th decade had the highest incidence, and then, 6th, 8th decades were followed. There was no baseline differences among the 3 classes with respect to gender, number of risk factors. Significantly, class II showed more severe findings in abnormal Q wave 15 cases (20.8%), total occclusive lesion 10 cases (20.8%) and three vessel coronary disease 11 cases (22.9%) than other classes. The change of ST segment was significantly apparent (p<0.02) among class I 28 cases (60.8%), class III 26 cases (59.0%), comparing with class II 30 cases (40.5%). Class III had the higher incidence of one vessel coronary artery disease than class I and III. The heparin treatment was performed in 99 cases (60.1%). The incidence of nonfatal myocardial infarction was much more in class I and III, each 4 cases (8.7%, 9.8%) than in class II 1 cases (1.4%). In-Hospital death was occurred in class I and II, each 1 case. Conclusion : The patients with the acclerated angina from chronic stable angina had more severe coronary artery disease than other classes, but they had better in-hospital prognosis.