한국인에게서 그레이브스병 약물치료의 적정기간

이형숙,이동훈,정희선,이종우,김정은,신승수,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 그레이브스병의 치료에는 항갑상선제, 수술 및 방사성 요오드법이 선택되어 사용되고 있다. 이중 항갑상선제는 가장 많이 선호되고 있으나 낮은 관해율과 높은 재발율로 장기간 치료기간이 요구된다. 저자들은 그레이브스병 환자에게서, 선택되는 치료법의 선호도와 각 치료법의 관해율을 조사하고자 본 연구를 시행하였다. 또한 본 연구에서는 항갑선제 치료의 적정기간을 평가하고자 하였다. 방법: 아주대학교병원에 내원한 환자 중 1년 이상 추적관찰이 가능한 205명의 그레이브스병 환자를 대상으로 조사하였다. 항갑상제군, 수술군 및 방사성 요오드군은 각각 170명, 29명 그리고 6명이었다. ROC curve를 이용하여 약물치료의 예후예측인자를 분석하였다. 결과: 1) 그레이브스병 환자의 치료 방법의 선택은 항갑상선제군, 수술군 및 방사성 요오드군 각각 170명(83.0%), 29명(14.1%) 그리고 6명(2.9%)으로 항갑상선제 치료가 가장 선호되었다. 2) 그레이브스병의 관해율은 항갑상선제군, 수술군 및 방사성 요오드군에서 각각 60.0%(102/170명), 96.5%(28/29명) 그리고 83.0%(5/6명)으로 수술군이 가장 높았다. 3) ROC curve의 AUC는 치료기간과 진단시 TBII가 각각 0.709 및 0.648이었고 적절한 약물투여 추적 관찰기간은 26개월이었다. 결론: 그레이브스병의 일차 치료법으로는 항갑상선제가 선호되고 있으나 수술 및 방사성 요오드 치료군에 비해 상대적으로 낮은 관해율을 보였다. 따라서 항갑상선제 치료로 26개월 이상 관해가 되지 않을 경우에는 치료 방법의 변경을 고려하는 것이 관해율을 높이는데 도움이 될 것으로 생각된다. Background: Graves' disease in an organ specific autoimmune disease. Three kinds of therapeutic modalities (antithyroid drugs, ablation with radioactive iodine and subtotal thyroidectomy) are frequently performed for the management of this disease. The most popular therapeutic policy for the disease in Korea is antithyroid treatment. We analysed and compared the remission rates of all three modalities for Graves' disease, and evaluated the antithyroid modality to determine the correct duration of treatment. Subjects & Methods : The medical records of 205 patients with Graves' disease were reviewed. For the evaluation of the antithyroid modality medical treatment, antithyroid drugs were administered for more than 1 year. The prognostic factors associated with remission were analysed by means of an ROC curve. Results: 1) Of the 205 patients, proportions that received medical therapy, subtotal thyroidectomy and radioiodine therapy were 83.0, 14.1 and 2.9%, respectively. 2) The remission rates of the medical therapy, surgery and radioiodine therapy were 60.0, 96.5 and 83.0%, respectively. 3) The remission rate of the medical therapy was associated with the duration of medication and TBII activity. The determined proper duration for the antithyroid treatment was 26 months from the ROC curve analysis. Conclusion: The above results suggest that the proper duration of antithyroid treatment for Graves' disease is 26 months, after which time the subtotal thyroidectomy or radioiodine therapy should be considered if the disease has not remitted (J Kor Soc Endocrinol 18:24∼31, 2003).

Toluene, Xylene, Trichloroethylene 투여가 흰쥐의 시상하부와 뇌하수체의 GnRH, GnRH Receptor, Pit-1 유전자 발현에 미치는 영향

기노석,이종태,강대성,김대환,이채관,이헌,전진호,김정호,이채언 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.2

The workplace exposure of chemicals has steadily increased, therefore the concern for subsequent effect on reproductive outcome has been an important issue in occupational medicine. In previous studies, higher rates of spontaneous abortion, reduced fertility and menstrual disorder among women, and an impairement of sperm quantity and quality among men have been associated with a wide variety of chemical agents. This study was conducted to evaluate the effects of toluene, xylene and trichloroethylene(TCE) injection on the mRNA levels of GnRH, GnRH receptor and Pit-1 genes in male rats hypothalamus and pituitary and the effects on the plasma levels of FSH, LH, prolactin and testosterone. Sprague-Dawley male rats were divided into five groups of five each according to concentration of toluene, xylene and TCE. The rats were injected subcutaneously to 0, 50, 100, 200, 400 mg/kg body weight/day of toluene, xylene and TCE, respectively for 6 days. Rat brains were excised and hypothalamus and pituitary were separated. Reverse transcription-polymerase chain reaction (RT-PCR) and RNase protection assay(RPA) were used to evaluate the GnRH, GnRH receptor and Pit-1 mRNA levels. Plasma concentrations of FSH, LH, prolactin and testosterone were assayed by radioimmunoassay(RIA). The results were as follows; 1. GnRH, GnRH receptor and Pit-1 mRNA levels in toluene and xylene injected groups, and GnRH receptor mRNA levels in TCE injected group were lowered dose-dependently. Especially, GnRH receptor and Pit-1 mRNA levels in 200mg/kg of toluene injected group, and GnRH, GnRH receptor and Pit-1 mRNA levels in 400mg/kg of toluene injected group were significantly lower than control group (p<0.05). GnRH receptor and Pit-1 mRNA levels in 400mg/kg of xylene injected group, and GnRH receptor mRNA levels in 400mg/kg of TCE injected group were significantly lower than control group(p<0.05). 2. The plasma levels of prolactin and testosterone in 400mg/kg of toluene injected group, and LH in 100, 200 and 400mg/kg of xylene injected group, and testosterone in 400 mg/kg of TCE injected group were significantly lower than control group(p<0.05). In conclusion, we speculated that toluene and xylene affected reproductive system secondarily through hypothalamus-pituitary axis, and TCE affected directly through steroidogenesis. And we recommended that further study for assessment of the reproductive toxicity of mixed organic solvent exposures should be conducted.

직접추정법에서 작업평가에 대한 기준작업 변화의 영향 연구

양진석,이관석 弘益大學校 科學技術硏究所 1996 科學技術硏究論文集 Vol.7 No.2

Among various method in determining the maximum acceptable weights of lift(MAWL), the psychophysical method has been popularly used for the infrequent but repetitive lifting. This method still takes substantial amount of time in case there are many different combinations of tasks. To further shorten the time taken to determine MAWL's for different tasks, the direct estimation method which employs the ratio scale between the person's feeling of stress in lifting has been used. However, no study was conducted about the standard lifting task which is used as a basis for the scale in the direct estimation method. Therefore, the effect of different standard lifting tasks to the MAWL in certain lifting situations was studied in this research. Four lifting frequencies(1,2,4, and 6 lift/min) were tested in two different lifting situations(Floor to knuckle, Knuckle to shoulder) in a laboratory. It was found that the MAWL determined in the task of 1 lift/min showed the closest value to the MAWL determined by the psychopysical method in the floor to knukle lifting situation. The MAWL in the task of 4 lift/min also showed the closest value to the MAWL obtained by the psychophysical method in the knuckle tl shoulder lifting situation.

연령증가와 성별에 따른 아이콘 인식력의 차이에 관한 연구

李寬錫 弘益大學校 科學技術硏究所 1994 科學技術硏究論文集 Vol.5 No.-

This paper described the influence of the age & sex on the perception of icons and established an icon design guideline for software development. The number of older persons in the population is increasing and will continue to rise in the next few decades. Since the use of computers is prevalent within jobs, use of computers by the elderly is a significant issues which must be addressed by employers and system designers. It is important to understand what types of computer tasks are appropriate for older workers and how these tasks should be designed to accommodate changes in ability which occur with occur with age. In this study, 23 college students and 30 older persons were tested to test icon acceptability 135 icons in MS-Windows system were used. Icons were classified by job characteristics, depictive method, color and boundary. Older persons made a lower acceptability than college students. There was a significant icon characteristics which affected icon cognition. The results of the acceptability test were analyzed and used to establish a guideline which can be use to develop icons.

효율적인 2인 들기 작업을 위한 고찰

이관석,이준한 弘益大學校 科學技術硏究所 1997 科學技術硏究論文集 Vol.8 No.-

골형성부전증 10예의 임상적 특징

이형숙,김현주,조재현,이승원,김현아,최준혁,송영준,김대중,이관우,정윤석 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경 및 방법: 골형성부전증은 비교적 희귀한 유전병으로 교원질 대사 장애로 인한 골의 취약성과 다발성 골절 및 척추측만증 등을 특징으로 한다. 유전방식과 표현형의 발현 정도에 따라 다양한 임상 양상을 보이며, 임상적 중증도에 따라 4가지 형태로 분류된다. 지금까지 국내 보고는 분만과정이나 태아 진찰시 골격이상으로 발견된 증례보고가 주였다. 저자들은 비교적 경미한 임상 양상을 보이는 예를 포함한 다수의 골형성부전증 환자들의 전반적인 임상적 특징에 대해 보고하는 바이다. 결과: 2001년 6월부터 2003년 2월까지 골형성부전증으로 진단받은 6 가계, 10예를 대상으로 하였다. 평균 나이는 27.3(5∼56)세였고 소아가 2예였다. 모두 상염색체 우성으로 유전되었으며, 제 I형이 4예, 제 III형이 4예, 그리고 제 IV형이 2예였다. 전 예에서 다수의 골절 경험이 있었고, 골밀도 저하와 골피질 두께 감소 소견이 관찰되었다. 전신의 평균 골밀도는 0.690(0.421∼1.039) g/cm²였다. 골형성지표로 측정된 sAlk는 소아의 경우만 증가되어 있었고, 골흡수지표로 측정된 uDPD의 평균치는 12.9(4.4∼36.3) nM/mM Cr으로 증가된 소견을 보였다. mobility score는 대부분 3,4단계에 속해 있었다. 중증형일수록 진단 시의 mobility score가 낮은 경향을 보였다. 결론: 한국인 골형성부전증 환자의 임상적 특징을 살펴본 결과 기존의 보고된 II형 외에도 I, III, IV형이 다양하게 존재함을 알 수 있었으며, 모든 예에서 상염색체 우성으로 유전됨을 확인할 수 있었다. 또한 모든 예에서 증가된 골흡수로 인한 골밀도 저하와 골절을 확인할 수 있었다. Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis (J Kor Soc Endocrinol 18:496∼503, 2003).

낙농경영의 경제분석

이동관,조석진 한국농업정책학회, 한국축산경영학회 2000 농업경영정책연구 Vol.27 No.1

Enterprise, production function and cost function analyses were applied to 128 dairy farm records surveyed by the National Livestock Cooperatives Federation in 1997. Both production efficiency and herd size turned out to be going parallel. And farms with higher production efficiency were lower in fixed input and concentrate per cow than the otherwise. The results of production function analysis suggest that both concentrate and labor are overinvested, roughage is less than properly invested and miscellaneous cost is rationally invested. Optimum herd size of the sample farms appeared 36 heads in cow equivalent which by far exceeds the current cow herd size 16 heads.

할로겐화 탄화수소의 흡착제거기술 Ⅱ. Pressure Swing Adsorption 공정에 의한 할로겐화 탄화수소/공기 혼합물의 분리

이태진,안희관,김윤갑,강석호 嶺南大學校 環境問題硏究所 1990 環境硏究 Vol.10 No.1

An experimental study was performed for the bulk separation of halogenated hydrocarbons and air mixture(CF₂Cl₂/air, CH₂Cl₂/air=0.1/99.9 Vol.%) in a pressure swing adsorption (PSA) process packed with various adsorbents, The PSA process cycle comprised four stes : I pressurizaton, II adsorption, III countercurrent depressurrzation, IV purge. The order of appearance of break-through curve is MS-5A > MS-13X > W-AC > S-AC for CF₂Cl₂/Air and W-AC > S-AC > MS-13X for CH₂Cl₂/Air respectively. The separation effects for the variation of adsorption pressure were investigated. In a steady state PSA cycles, high purity air from step II and CFCs-rich gas from step IV were obtained.

근골격계질환 감소를 위한 인간공학적 Intervention : 사례연구 : K Motors Case study : K Motors

李寬錫,金在炯 弘益大學校 科學技術硏究所 2005 科學技術硏究論文集 Vol.16 No.-

This objective of this study is to present a desirable direction of an ergonomic intervention for the prevention of the musculoskeletal disorders by analyzing the ergonomic prevention effort and the number of patients who suffer from a musculoskeletal disorder. The safety and health data obtained from three K motors' factories were analyzed. We also used the Lickert's scale and Focus Group Interviews. Among the three factories, the G factory shows the lowest rate of the accidents(1.01%), the highest score of the scale and Focus Group Interviews (6.4 points) and field improvement reflecting the hazard analysis(97%), and it became the best factory (6.8 points) among the three factories that complied with the safety and health law by using an ergonomic intervention. A correlation analysis shows that the ergonomic intervention (the field improvement & the compliance with the law) is relevant to the decline of the accident's rate (r=-0.91 and -0.98) and the increase of the subjective evaluation by company experts (r=0.98 and 0.99).

Wall-Bed 디자인에서의 인간공학의 적용

이관석 외 弘益大學校 科學技術硏究所 2000 科學技術硏究論文集 Vol.11 No.-

지속적으로 증가하고 있는 침대의 보급은 젊은 세대의 서구화 된 의식의 영향과 풍족한 경제력 등을 바탕으로 확산되고 있으며, 새로움에 대해 혁신적으로 대처하는 생활 양식은 기존의 것과는 다른 무엇인가를 원하고 있다. 그런 의미에서 본 Wall Bed에 대한 연구는 국내 침대시장의 Wall Bed 진입에 시작점이 될 수 있을 것으로 기대되며 소비자 욕구에 보다 부합되는 제품을 개발한다는 데에 큰 의미가 있다 하겠다. 따라서 본 연구는 Wall Bed에 대한 세부적 환경 조사와 실제 제품을 사용한 소비자 조사를 통하여 보다 소비자 욕구에 충족되는 감성적 디자인을 개발하며, 제품 사용성에 대한 안전성 향상과 Wall Bed의 조립/해체 작업을 보다 용이하도록 제품을 개선하는데 그 목적이 있다.