한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

웃음을 이용한 다중음성치료기법(SKMVTT<SUP>®</SUP>)이 성대용종 환자의 음성개선에 미치는 효과

김성태(Seong-Tae Kim),정옥란(Ok-Ran Jeong),안철민(Cheol Min Ahn) 한국음성학회 2008 음성과학 Vol.15 No.2

Vocal polyp is one of the representative chronic diseases of vocal folds, and it can be cured by voice therapy and/or laryngeal microsurgery. However, the existing therapeutic methods about vocal polyp are in great demand. The purpose of this study was to evaluate the effect of vocal improvement between laryngeal microsurgery and SKMVTT<SUP>®</SUP>(Seong-Tae Kim's Multiple Voice Therapy Technique), which was designed by the author. We identified 37 patients, who were diagnosed with unilateral vocal polyp, aged from 21 to 62 years(mean age: 46 years). 21 patients were treated by the SKMVTT<SUP>®</SUP> and the other 16 patients were only treated by the laryngeal microsurgery. All patients who were treated by the SKMVTT<SUP>®</SUP>, received 12 sessions of treatment, and were evaluated before therapy and after finishing the 12th session. The patients who were treated by laryngeal microsurgery, were evaluated prior to and at least 8 weeks after surgery. The results showed that the SKMVTT<SUP>®</SUP> produced better results compared to the laryngeal microsurgery alone. The SKMVTT<SUP>®</SUP> produced better results, especially, at the initial stage of voice therapy compared with those of laryngeal microsurgery. In this study, we can suggest that SKMVTT<SUP>®</SUP> may be useful in improving the voice qualities of vocal polyp patients. However, more data should be collected and evaluated to be widely used in other clinics.

동종 골수이식 후 만성 이식편대숙주질환과 동반되어 신증후군으로 발현된 IgA 신병증 1예

정철권,김현수,박준성,정성현,조도연,최진혁,남동기,임호영,김명성,신규태,임현이,김효철 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

동종 골수이식 후 발생하는 신기능부전은 원인이 다양하여 감별에 어려움이 있다. 만성 GVHD는 흉선의 기능저하에 따른 면역관용의 실패로 발생되는 자가면역현상에 의해 발생되는 것으로 알려져 있으며 드물게 신장을 침범하여 신증후군을 일으키기도 한다. CaA의 용량을 줄이거나 투약중지 후 발생한 만성 GVHD에 동반된 신증후군의 경우 조기에 신조직검사를 시행하여 감별진단하고 CsA의 용량을 증량하거나 재투약하여 좋은 치료 결과를 보일 것으로 기대된다. 저자들은 문헌고찰을 통해 동종 골수이식 후 발생된 신증후군이 유사한 임상양상을 보이며 발생기전에 만성 GVHD와 자가면역현상이 연관되어 있음을 확인하였으며 동종 골수이식 후 신증후군의 임상양상을 보이는 환자에서 병리조직학적으로 lgA 신병증을 진단하고 이러한 lgA 신병증이 발생기전에 만성 GVHD와 자가 면역현상이 연관되어 있을 가능성을 최초로 확인하였으며 CsA를 이용하여 성공적으로 치료한 경험을 하였기에 보고하는 바이다. Renal insufficiency is occasionally encountered in allogeneic bone marrow transplantation and its cause is difficult to ascertain. Chronic graft-versus-host disease (GVHD) related to thymic dysfunction is immune-mediated and involves autoreactivity of T-lymphocytes derived from donor marrow to recipient's major histocompatibility complex(MHC) minor antigens. The clinical mainifestations of chronic GVHD are similar to those of autoimmune disease but kidney involvement is rare. Few cases of nephrotic syndrome with membranous nephropathy or minimal change nephrotic syndrome have been reported to be associated with chronic GVHD in allogeneic bone marrow transplant recipient especially after cyclosporine A(CsA) withdrawal, and these cases have responded well to CsA. Therefore, it is prudent to differentiate the cause of post-transplant renal insufficiency using renal biopsy and to start CsA in a case of nephrotic syndrome associated with chronic GVHD as early as possible. We report a case who had a massive proteinuria during the post-allogeneic marrow transplantation period. The cause of nephrotic syndrome was diagnosed as IgA nephropathy by renal biopsy. The patient was successfully treated with reintroduction of CsA.

24주간 추적하는 임상 연구에서 한국인 남자 알코올 의존 환자의 비재발률

강철중,김성곤,남궁기,조동환,이병욱,최인근,최용성,박성봉,제영묘,김현경,김성연 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objetives : In order to provide useful data tbr the further clinical studies with Korean alcohol-dependent patients, enrollment and non-relapse rates were investigated while alcohol-dependent patients wcre followed up for 24 weeks. Methods : The subjects of this study were alcohol-dependent male patients who, for the first time, visited a hospital among 3 groups of hospitals, University Hospital, General Hospital or Mental Hospital, or those who needed to be followed up after discharge from those hospitals. After assigning 12 subjects to each hospital, we investigated enrollment and non-relapse rates while cognitive-behavioral therapy and pharmacotherapy were provided. Results : 1) Forty-eight patients were enrolled and the rate of enrollment was 36.4%. The enrollment rate in the University Hospital group was 52.1%, in the General Hospital group 50.0%. and in the Mental Hospital group 10.4%. 2) In 48 patients, non-relapse rate was 27.1% at 12 week and 18.8% at 24 weeks after starting follow-up. It was 24.4% and 20.0% at 12 and 24 weeks, repectively, in the University Hospital group while the General Hospital group showed 33.3% and 16.7%, respectively, and the Mental Hospital Group showed 20.0% at both 12 and 24 weeks. Conclusion : These results provide important data for further clinical studies of Korean alcohol-dependent patients.

축산분뇨중의 암모니아성 질소 제거

진양오,최성우,김성우,김익성,신남철,박승조 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.2

The purpose of thus study were to investigate the proper conditions of struvite formation in synthetic wastewater and then to apply these conditions to effluent of anaerobic digester of livestock wastewater The conditions of struvite formation had been studied by many researchers. But a little conditions were different among them. Especially, according to suspended solid variation in livestock wastewater was investigated by few researchers. In experiment of synthetic wastewater, the proper conditions of struvite formation were pH 105, l50rpm of mixing rate, 10 minutes of reaction time, and 20 minutes of precipitation time. At same time, the ammonia nitrogen removal rates were about 99.7%, 95.5%, and 96% of synthetic wastewater, raw wastewater, and effluent of anaerobic digester of livestock wastewater at molar ratio of 2(Mg):l(N)2(P) respectively. The larger factor of NH₄/SS constant was, the more effective the removal rate of ammonium nitrogen, SS was, but the less effective COD_(cr), and TOC was. By using XRD analysis, the most certain compound in precipitate of synthetic wastewater was struvite.

Charge Pump PLL을 적용한 주파수합성기의 특성 및 안정도 분석

김성철 우송대학교 부설 산업연구원 1999 산업연구 Vol.1 No.1

Defferential equation whose state variables are phase error and frequency error is derived to analyze the transient response of charge pump PLL. Because the PFD(Phase Frequency Detector) of the pll is not operated in continuous-time network, the PLL system is modeled in noncontinuous time basis. The relationship between input frequency and loop gain of the pll is analyzed, which is essential to the stable operation of charge pump pll. And it is recognized that the filter which reduce the reference frequency ripple deteriorate the stability, also. The simulation result will be helpful to design the third order phase locked loop systems.

한국의 전자민주주의 : 정부부문을 중심으로

김용철,이축묵, 윤성이 연세대학교 동서문제연구원 2001 東西硏究 JOURNAL OF EAST AND WEST STUDIES Vol.13 No.1

본 논문은 정부의 정보제공 방식과 특성을 파악하고, 가상공간에서 정부와 시민 사회간의 의사소통 내용을 분석함으로써, 정부부문에서의 전자민주주의 현황을 평가함과 동시에 이의 실현을 위한 구체적인 방안을 모색하는 것을 목적으로 한다. 정보제공과 관련하여, 공개하는 정보의 질과 양, 그리고 자료의 갱신주기 등은 정부부처에 따라 매우 상이한 것으로 나타난다. 일반적으로 인터넷으로 제공되는 정보의 질적 · 양적 수준은 대민접촉이 빈번하고 국민 실생활과 직접 관련되는 부서(즉, 교육부, 노동부, 보건복지부, 환경부 등)일수록 높은 것으로 보인다. 반면, 대민접촉이 그다지 활발하지 않은 부서의 경우 상대적으로 정보에 대한 수요가 많지 않고, 그에 따라 정보의 수준도 낮은 것으로 판단된다. 한편 정보의 보다 효율적인 제공을 위한 방안으로서, 정부 홈페이지는 현재 관련 사이트에만 국한되어 있는 항해기능을 좀 더 확대하여 정보유통 네트워크의 핵심 결절점 역할을 수행할 필요가 있다. 이를 위해서는 관련 연구소의 주요 정보, 즉 정책정보, 현황정보, 통계정보 등의 목록 및 소재 정보를 제공하고 그에 연계될 수 있는 링크기능을 확보해야 한다. 아울러 모든 정부기관이 보유하고 있는 현황정보나 정책정보에 대해 총괄적으로 검색할 수 있는 기능을 담당하는 기관으로서 청와대 홈페이지의 위상을 재정립 할 필요가 있다. 청와대는 행정부 전체의 활동을 총괄적으로 관장하는 기관이며, 또한 현재 홈페이지 접속 빈도도 매우 높기 때문에 이 기능을 수행하는데 가장 적합하다고 볼 수 있다. 가상공간에서 정부와 시민간의 의사소통은 진지하고 건설적인 방식으로만 이루어지지 않는 것으로 보인다. 행정상담이나 정보요청을 제외하면, 대부분은 항의성 메일, 일방적인 비난 · 비방으로 채워져 있고, 정책토론이나 정책건의와 같은 발전적인 논의는 극히 일부라고 볼 수 있다. 그러나 가상공간을 '사이버 아고라'로 만들려던 정부의 시도가 별 성과를 거두지 못한 데에는 정부의 안이한 대응에도 책임이 있다. 따라서 정부는 의사소통의 공간을 체계적으로 조직화 할 방안을 도출해 야 한다. 우선 행정상담 및 시민게시판의 효과적인 운영을 위해서는, 문의란과 답변란의 구별운영, 담당자의 즉각적 회신, 분야별 Q&A의 활성화 등이 시급하다. 둘째, '자유게시판' 코너의 운영을 개선하기 위해서는, 시민들의 의견에 대해 담당기관에서 적극적으로 대응할 필요가 있다. 또한 게시판의 주제에 맞지 않는 내용에 대해서는 네티즌의 의견을 물은 후 삭제하거나, 게시자에게 경고 후 접근을 제한하는 방법도 신중하게 고려할 필요가 있다. 셋째, 주제별 정책토론의 생산적 결과를 위해서는, 주제선택에 있어서의 시의성 고려, 토론에 필요한 자료의 확보, 담당자들의 적극적인 개입, 그리고 토론성과를 통한 정책반영 노력 등이 필요할 것이다.

UV-TiO_2 광촉매 반응기를 이용한 미생물의 살균효과

김시욱,이정섭,정혜광,박열,윤성명,유진철,이범규,이인화,박진열 조선대학교 환경연구소 1998 環境硏究 Vol.14 No.1

UV-TiO_2 반응기를 이용하여 Escherichia coli와 Aspergillus oryzae var. oryzae의 살균효과를 측정하였다. 254㎚에서 최대 14 watt의 자외선 방출량을 내는 램프를 원형 Pyrex유리관 중앙에 설치하였고 TiO_2는 석영관에 박막증착(Thin Film Coating)된 형태와 슬러리 형태로 나누어 회분식으로 살균정도를 측정하였다. E. coli에 대한 살균력은 1.7×10^7 cells/㎖에 대해 5분간 자외선 조사를 하였을 경우 2.0×10^2 cells/㎖으로 감소하였고, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 3.4×10 cells/㎖으로, 자외선 조사와 함께 TiO_2가 석영관에 박막증착된 경우에는 7.6×10^2 cells/㎖으로 감소하였다. 한편 위와 같은 조건에 유리관 하부에서 기포를 주입수 11분 동안 자외선을 조사시킨 경우에는 1.3×10^2 cells/㎖으로, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 1×102 cells/㎖으로, 자외선 조사와 함께 TiO_2가 박막증착된 경우에는 7.9×10 cells/㎖을 나타내었다. 결국 UV-TiO_2 반응기에 사용되는 TiO_2가 슬러리 형태일 때 최대 살균효과를 나타내었으나 기포가 첨가되었을때는 오히려 살균에 장애를 받는 것으로 나타난 반면 석영관에 박막증착된 경우에는 기포가 첨가되는 것이 살균에 효과적인 것으로 관찰되었다. The killing effect of UV-TiO_2 photocatalytic system on the Escherichia coli DH5-α and Aspergillus oryzae var. oryzae (KCTC 6095) was studied. The UV lamp which emits maximum 14 watts at 254 ㎚ was set on the center of pyrex round glass tube. Two types of TiO_2, one of which is slurry and another which is thin film coated form, were used to determine the killing effect. When UV was irradiated to 1.7×10^5 cells/㎖ of E. coli for 11 min, the living cell number decreased to 4.0×10^0 cells/㎖. The effect of UV system together with slurried TiO_2 was less than 1 cells/㎖, whereas that of UV-coated TiO_2 system decreased to 7.1×10^3 cells/㎖. To study the effect of bubble on the killing of microorganisms, air was bubbled to the bottom of glass tube. When 1.7×10^5 cells/㎖ were exposed to UV for 11 min in combination with air bubble, the living cell number decreased to 1.3×10^2 cells/㎖. In the same condition except the addition of slurried TiO_2, the living cells were 1×10^2 cells/㎖. However, more cells could be killed by the system which consists of UV, coated TiO_2, and air bubble (7.9×10^1 cells/㎖). From these results, it was found that UV-slurried system is the most effective one, but its killing effect is not stimulated by air bubble. However, bubbling was very effective in the UV-coated TiO_2 system.

고령 환자에서의 간 절제술

김병철,서거정,김경종,장정환,김성환 조선대학교 2003 The Medical Journal of Chosun University Vol.28 No.1

Hepatic resection for removal of lesion of the liver may be necessary for a wide variety of conditions. Partial hepatectomy for liver disease have become more common This reports describes a review of our experience for hepatic resection and an analysis of potential risk factors affecting the morbidity and the mortality in a hepatectomy methods : Between Jan 1,997 and Mar.2,001, we performed 112 cases of partial hepatectomy and retrospectively analyzed clinicopathological features of the presented. cases Results : The most common disease was intrahepatic duct stone(31.8%). The mean operative time was 324 minutes. The overall In-hospital mortailty an morbidity rates were 6.8%(3/44) and 59%(27/44), respectively, Various posmiddleerative complications developed, including 14 cardiopulmonary complications(53.8%), 8 wound Infections(30.7%), 2 Bile leakage(7%), 1 intraabdominal abscess(3.8%), 1 hepatic failure(38%), 1 posmiddleerative bleeding(3.8%). The old had more cardiopulmonary complications. The significant risk factors for perioperative mortality were high preoperative serum bilirubin level(above 2.0mg/dl), size of resection, massive operative bleeding(above 2,000cc), concomitant diseases, but cirrhosis was not a significant risk factor. Comparison of young age patients, the old had more complications, but it was not significantly Conclusion : Although the old patients had more cardiopulmonary complications but their operative mortality were not much different than younger patients significantly. Hepatic resection can be performed in over 60 years old with acceptable morbidity and mortality rates.