출산에 따른 그레이브스병의 재발 및 관련이자

임창훈,최현아,한승석,김해성,이창욱,정호연,한기옥,장학철,박원근,윤현구,한인권 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.2

Background: Pregnancy affects the course of Graves' Disease (GD), and patients who initially maintain euthyroid function into their middle trimester with minimum doses of antithyroid drugs become exacerbated after delivery. Even patients who are completely cured, requiring no treatment during pregnancy, can relapse after delivery. In this study, we examined the postpartum changes in the thyroid functions of patients with GD, and attempted to determine the factors contributing to these changes. Methods: The study subjects were recruited from pregnant women visiting our outpatient clinic for routine prenatal evaluations. 45 women previously diagnosed with GD, who had been treated and cured with hyperthyroidism, and were no longer taking any thyroid medications, were evaluated for 1 year post delivery. Results: Among 45 patients, 20 (44.4%) developed thyroid disorders following delivery. Postpartum thyroiditis (PPT) developed in 8 patients (17.8%), and GD developed in 12 (26.0%). The onset of the PPT disease 3.1 ± 1.4 months following delivery, which was significantly earlier than the 6.7 ± 2.7 months required for the post delivery onset of GD (p=0.003). The TBII values, measured during the thyrotoxic state in each womaen, were negative in women with PPT and positive in 71.4% of women with GD (p=0.030). The duration of treatment for hyperthyroidism prior or pregnancy, the number of recurrences, and the time interval without treatment, were not associated with the development of postpartum thyroid disorders. Whereas, the mean number of past pregnancies for women who developed PPT was 3.9 ± 2.1, and was significantly higher than the 2.2 ± 1.7 for women developing no thyroid dysfunctions (p=0.044). In 13 women their initial onset of GD occurred within one year postpartum, 7 (53.8%) having had a recurrence, which was significantly higher than in women whose disease onset occurred unrelated to delivery (5 of 32 women: 15.6%). Conclusion: Women with GD developed postpartum thyroid dysfunctions in 44.4% of cases. Women whose initial disease onset occurred within one year postpartum had higher recurrences of GD, and women who developed PPT had a history of higher gravidity compared to the euthyroid women postpartum. Therefore, if women with GD develop postpartum thyroid dysfunctions, the diagnosis should be made, and a treatment modality planned, following careful considerations of the patients' past obstetric history, changes in clinical manifestations and the TBII values

Effects of aerosol on evaporation, freezing and precipitation in a multiple cloud system

Lee, Seoung Soo,Kim, Byung-Gon,Yum, Seong Soo,Seo, Kyong-Hwan,Jung, Chang-Hoon,Um, Jun Shik,Li, Zhanqing,Hong, JinKyu,Chang, Ki-Ho,Jeong, Jin-Yim Springer-Verlag 2017 Climate dynamics Vol.48 No.3

<P>Aerosol effects on clouds and precipitation account for a large portion of uncertainties in the prediction of the future course of global hydrologic circulations and climate. As a process of a better understanding of interactions between aerosol, clouds and precipitation, simulations are performed for a mixed-phase convective multiple-cloud system over the tropics. Studies on single-cloud systems have shown that aerosol-induced increases in freezing, associated increases in parcel buoyancy and thus the intensity of clouds (or updrafts) are a main mechanism which controls aerosol-cloud-precipitation interactions in convective clouds. However, in the multiple-cloud system that plays much more important roles in global hydrologic circulations and thus climate than single-cloud systems, aerosol effects on condensation play the most important role in aerosol-induced changes in the intensity of clouds and the effects on freezing play a negligible role in those changes. Aerosol-induced enhancement in evaporation intensifies gust fronts and increases the number of subsequently developing clouds, which leads to the substantial increases in condensation and associated intensity of convection. Although aerosol-induced enhancement in freezing takes part in the increases in condensation by inducing stronger convergence around cloud bottom, the increases in condensation are similar to one order of magnitude larger than those in freezing. It is found that while aerosol-induced increases in freezing create intermittent extremely heavy precipitation, aerosol-induced increases in evaporation enhance light and medium precipitation in the multiple-cloud system here. This increase in light and medium precipitation makes it possible that cumulative precipitation increases with increasing aerosol concentration, although the increase is small. It is interesting that the altitude of the maximum of the time- and domain-averaged hydrometeor mass densities is quite robust to increases in aerosol concentration. This is because locations of gust fronts and homogeneous freezing do not vary significantly with changing aerosol concentration and this outweighs aerosol effects on hydrometeor size.</P>

가로조건에 따른 읍성마을의 좌향 및 배치특성에 관한 연구 : 낙안읍성과 성읍마을을 중심으로 Focused on the case of Nakan and Sungeup Villages

임창복,한경훈,김경완 대한건축학회 2004 대한건축학회논문집 Vol.20 No.7

The aim of this study is to verify the characteristic of the orientation and arrangement of the traditional settlement based on street condition. We select Nak-an, Sung-eup as example sites that were directed to the Cultural Properties protection Act in 1980's and well preserved their prototypes. We found some characteristics about the object. First, for street organization, Eup-sung style has direct order of the T type street, Second, for physical condition of the street, average width is 6-8m, road ratio is 25-30%. Third, is about orientation and arrangement based on street condition. If the building facing two roads which meet two directions, type arrangement and south orientation were common. They use side road to access the main building, direction of the gate is east, and have a strong tendency to locate in the side of site.

초고층건축물의 공공성 증진을 위한 계획방향에 관한 연구

신중진,임창복,류훈,박종현 대한건축학회 2004 대한건축학회논문집 Vol.20 No.10

The purpose of this study is to suggest the planning strategy of super tall building for publicness improvement in the points of urban, local and environmental level As a result is summarized with 8 theme, content is following as First, skyscrapers plan to consider urban grad and local character Second, urban landscape plan to promote city identity and image Third, context plan to consider local history and culture Fifth, pedestrian network plan to link near site and district Sixth, pedestrian environment plan to promote physical and sensibility Seventh, the security of residential environment and insurance of residential amenity In last, consideration to prevent corruption of surrounding local environment

연쇄상구균의 약제내성과 전이성 R-plasmid의 특성

김종훈,임대환,이창훈,이수정,이월라,황미혜,김은희 한국어병학회 2003 한국어병학회지 Vol.16 No.1

본 연구는 넙치 병어에서 분리된 연쇄상구균들의 항균제 내성 경향을 파악하고, 약제내성의 전이에 관여하는 R plasmid를 검출하여, 분리 균들 내에서 이들 plasmid의 분포를 알아보기 위하여 실시하였다. 넙치 병어에서 분리된 연쇄상구균 40 균주의 대부분은 ampicillin, doxycycilne (DOXY), erythromycin, florfenicol, flumequine, norfloxacin, osolinic acid, oxytetracycline (OTC)의 2~5약제에 동시내성을 나타내었다. 이들 내성균으로부터 내성 전이에 관여하는 R plasmid (pST9)가 검출되었으며, OTC와 DOXY내성이 R plasmid에 의하여 수용균인 Streptococcus sp.로 전이가 이루어졌다. 전이성 R plasmid의 분포를 알아보기 위하여 colony 혼성화 반응을 실시한 결과, 40 분리 균주 중 6 균주에 동일한 DNA 구조의 R plasmid가 존재하는 것으로 나타났다. 그러므로 이들과 DNA 구조가 다른 R plasmid도 넙치병어에서 분리되는 연쇄상구균의 약제내성에 관여하고 있음을 시사하였다. MICs of 8 chemotherapeutic agents against forty streptococcal isolates were determined. These strains were isolated from diseased olive flounder, Paralichthys olivaceus, and showed 2~5 multiple drug resistance against different antibacterial agents including ampicillin, doxycycline (DOXY), erythromycin, florfenicol, flumequine, norfloxacin, oxolinic acid, and oxytetracycilne (OTC). In conjugation experiment, we found transferable R plasmids carrying OTC and DOXY resistance determinant in 3 drug resistance strains analyzed. Six out of 40 isolates showed positive signal in colony hybridization with the R plasmid DNA (pST9) as a probe. It suggests that other types R plasmid different from pST9 is also involving in multiple drug resistance of streptococci isolated from olive flounder.

백서에서 자가 피부이식후 항T임파구 단일클론항체 분포에 관한 면역조직화학적 연구

朴晩圭,金慶助,任昌俊,高世勳 단국대학교 치의학연구소 1991 논문집 Vol.3 No.-

This article is intended to study histopathological and immunohistochemical response after autogenous full-thickness skin graft in rat. 12 male Sprague-Dawley rats were used as the experimental animals. A 1 cm×1 cm skin (0.7mm diameter) was taken on the right inguinal area of the rat. Another full-thickness skin graft (1cm × 1cm) was taken from the left inguinal area of the rat. And it was transplanted to the right inguinal area of the rat. The left side wound was closed directly. Light microscopic observation was made at the postoperative 1, 3, 8, 16 day, after the hematoxylin-Eosin staining of the 4u-thick paraffin embedded specimens and the immunohistochemical staining of the 10u-thick frozen specimens with mouse anti-rat monoclone antibodies and ABC staining kit. The results were as follows. 1. Electromicroscopic studies revealed interstitial tissue bleeding of transplanted autogenous skin. The response was severe in the 1 day group after operation, moderate in 3 day group, mild in 8 day group, and almost resolved in the 16 days group. 2. Electromicroscopic studies also revealed a mild monocyte response in the 3 day and 8 day groups. A histiocytic infiltrate was observed. There was a mild response in the 3 day group and moderate response in the 8 day group. 3. Immunohistochemically studies revealed a few pan T cells in the 1 day group, mild appearance of pan T cells and cyototoxic T cells in the 3 day group, a moderate infiltrate of pan T cells and helper T cells in the 8 day group, and total resolution of pan T cells in the 16 day group. 4. According to these finding, a strong inflammatory response was observed around transplanted autogenous skin in the 3 & 8 day groups. In the 16 day group this response had resolved histopathologically and immunohistologically.

시험 스트레스에 의한 단핵구의 IL1β합성 증가

임창훈,이 철,황채연,도규영,백인호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 심리적 스트레스는 주로 면역계와 신경내분비계를 포함한 중추신경계를 통하여 인체에 영향을 미친다. Cytokine은 스트레스에 대한 면역계의 반응을 총괄하며, 중추신경계와의 상호작용에 중요한 매개체로서 작용한다. 특히 IL1β는 스트레스에 의하여 발생되는 우울증과 같은 행동상의 변화와 밀접한 관계가 있는 것으로 알려져 있다. 따라서 본 연구에서는 45명의 건강한 의과대학생을 대상으로 시험 스트레스에 의한 스트레스 지각도 및 IL1β의 변화를 조사하고, IL1β유전자 TaqI 다형성과 관련을 알아보고자 하였다. 방 법: 시험당일과 시험 2주 후에 채혈을 하였으며, IL1β를 측정하기 위하여 말초혈액 단핵구를 37℃, 5% CO₂에서 3일간 배양하였다. DNA의 분리에는 Ficoll-Paque 방법을 이용하였으며, 다형성 부위를 PCR을 통하여 증폭하였다. TaqI 다형성의 대립유전자형을 구분하기 위하여, 증폭된 DNA를 TaqI으로 처리한 후 15% polyacrylamide gel에 전기영동 하였다. 결 과: 시험당일의 스트레스척도와 IL1β값이 시험 2주 후에 비하여 유의하게 높았으며, 스트레스 척도의 차이 값과 IL1β의 변화 값 사이에 상관관계가 있는 것으로 나타났다. 그러나 대립유전자 A2의 빈도가 매우 낮아 스트레스척도 및 IL1β값에 대한 유전적 관련은 통계적인 의의를 구하지 못하였다. 결 론: 이상의 결과는 시험스트레스가 말초혈액 단핵구의 IL1β 생성을 증가시키며, 스트레스의 자각정도와 IL1β의 변화 값 사이에 유의한 상관관계가 있는 것으로 보여준다. 뿐만 아니라 이는 심리적 스트레스에 의하여 유발될 수 있는 우울증의 발생기전의 이해에 중요한 단서를 제시해준다고 하겠다. Objectives: There is now some evidence that, in humans, psychological stress may affect immune and neuroendocrine system. In stress response, cytokines are known to orchestrate the cellular interaction of immune system and act as a major messenger in a communication with CNS. Specifically, IL1β has been reported to be colsely related with stress induced behavior change, such as depression. Accordingly, we assessed cytokine production by peripheral blood mononuclear cells(PBMC) before and after an academic examination in 45 healthy medical students. Furthermore the possibility that IL1β TaqI polymorphism may be associated with stress response of IL1β production was investigated. Methods: Blood samples were collected on the day of examination and at the second week after examination. For cytokine assay seperated PBMC were incubated for 3 days at 37℃, 5% CO₂. DNA was prepared by Ficoll-paque method and polymorphic region was amplified by PCR. After TaqI restriction, products were seperated by 15% polyacrylamide gel electrophoresis. Results: IL1β production and stress score were significantly higher on the examination day. The change of stress score was significantly correlated with the change of IL1β production. However. the frequency of allele A2 was too low that the significance of genetic association could not be properly estimated. Conclusion: This study reports that psychological stress is accompanied by an increased production of IL1β with significant correlation.

양성 갑상선결절에서 부피의 변화

임창훈(Chang Hoon Yim),최현아(Hyun Ah Choi),정호연(Ho Yeon Chung),한기옥(Ki Ok Han),장학철(Hak Chul Jang),윤현구(Hyun Ky Yoon),한인권(In Kwon Han),김희숙(Hy Sook Kim),이영호(Young Ho Lee) 대한여성건강학회 2001 여성건강 Vol.2 No.2

2000년대 초기의 국내 급성 B형 간염 발생 양상의 변화

임형준 ( Hyung Joon Yim ),장윤정 ( Yun Jung Chang ),변관수 ( Kwan Soo Byun ),서연석 ( Yeon Seok Suh ),김지훈 ( Ji Hoon Kim ),김진용 ( Jin Yong Kim ),연종은 ( Jong Eun Yeon ),박종재 ( Jong Jae Park ),김재선 ( Jae Seon Kim ),박영태 대한내과학회 2005 대한내과학회지 Vol.69 No.6

목적 : 우리나라 청소년층의 B형 간염바이러스(HBV) 보유율은 과거에 비해 현저히 감소하였는데(20세 이하 1.6%, 중고생 1.9%) 이는 B형 간염 예방 백신 도입과 전신생아 예방 접종 시행의 결과이며 우리나라 5~6세 아동의 백신 접종율이 98.5% 이상으로 보고되고 있다. 이에 따라 우리나라에서 근래 급성 B형 간염의 발생빈도가 청소년층에서는 급격히 감소되었을 가능성이 높으므로 전반적인 급성 B형 간염의 발생 양상에 변화가 있으리라 추정된다. 이번 연구의 목적은 근래 우리나라의 급성 B형 간염의 호발연령을 조사하여 성인에서의 catch-up vaccination의 필요성을 연구하고 급성 B형 간염과 만성 B형 간염의 급성 악화를 감별하는데 있어서 IgM anti-HBc의 진단적 가치를 재평가하기 위함이다. 방법 : 1999년 2월부터 2002년 2월까지 급성 B형 간염을 진단받은 57명과 만성 B형 간염의 급성 악화예 중 IgM anti-HBc를 측정하였던 99명을 대상으로 IgM anti-HBc양성 여부를 측정하고 간염을 최초로 진단받은 시기의 평균연령 및 연령별 분포를 후향적으로 분석하였다. 결과 : 급성 B형 간염이 발생하였던 57명 중 30대가 20명(35%)으로 가장 많은 분포를 차지하였고, 그 다음으로 20대(19명, 33%)에서 호발함을 알 수 있었다. IgM anti-HBc 양성인 만성 B형 간염의 급성 악화예는 25.3%(25명)였고, 30대가 11명(44%)로 가장 많은 분포를 차지하였다. 또한 IgM anti-HBc 양성인 만성 B형 간염의 급성 악화 예에서 S/CO ratio를 구한 결과 43.6%에서 3 이상의 역가를 보였고, 급성 B형 간염에서는 90%에서 3 이상의 역가를 보였다. 결론 : 현재의 우리나라 급성 B형 간염의 호발연령은 30대로 이전보다 성인에서 호발하므로, 성인에서의 catch-up vaccination이 필요하다. 또한 급성 B형 간염의 호발연령과 IgM anti-HBc 양성인 만성 B형 간염의 급성 악화예의 호발연령이 일치하므로 두 군의 감별에 좀 더 주의가 필요하고 이에 IgM anti-HBc 단독 검사만으로 감별이 어려운 경우가 있음을 주지하여야 하겠다. Background : The prevalence of the hepatitis B virus (HBV) carrier state in Korean children is markedly reduced after the introduction of routine HBV vaccination program. The aims of this study were to evaluate the recent changing patterns of acute HBV infection, and to elucidate the diagnostic value of IgM anti-HBc in distinguishing acute hepatitis B from acute exacerbation in chronic HBV infection (CHB). Methods : Fifty seven patients with acute hepatitis B and ninety nine patients with acute exacerbation in CHB were included. The titer of IgM anti-HBc was measured and the distribution of age was analyzed retrospectively. Signal to cut off ratio (S/CO ratio) of IgM anti-HBc was calculated in each IgM anti-HBc positive cases. Results : The peak age of acute hepatitis B was 30~39 years old in 2000`s. IgM anti-HBc was positive in 25.3% of CHB with acute exacerbation and the peak age of this group was also 30-39 years old. Mean(±SD) value of S/CO ratio was 8.3±9.1 in CHB group, while 22.9±18.7 in acute hepatitis group. The difference was significant between two groups (p value=0.001). However, S/CO ratio in 43.6% of CHB group was greater than 3. Conclusions : The incidence of acute hepatitis in Korea was highest in 30-39 years old recently. Therefore, catch-up vaccination is better to be recommended in adults. As the peak age of distribution of acute hepatitis B and CHB with acute exacerbation overlaps, much more caution is needed to differentiate these two conditions from each other by IgM anti-HBc only.(Korean J Med 69:601-607, 2005)

HCC : Usefulness of Alpha-Fetoprotein for the Detection of Hepatocellular Carcinoma In Patients with Chronic Hepatitis B Virus Infection

( Sun Young Yim ),( Yeon Seok Seo ),( Soon Ho Um ),( Yoon Tae Jeen ),( Hong Sik Lee ),( Hoon Jai Chun ),( Chang Duck Kim ),( Ho Sang Ryu ),( Yun Ji Park ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

Background/Aim: Serum alpha-fetoprotein (AFP) is widely used as a screening test for the detection of hepatocellular carcinoma (HCC) in patients with high risk group. However, serum AFP level can be elevated without HCC. We aimed to study the role of AFP as screening marker for detecting HCC in different ALT levels. Methods: Our study is based on 395 patients with chronic HBV infection. Diagnostic efficacy of AFP according to the presence of elevated ALT levels was analyzed. Results: The age was 52.7±12.1 years with male predominance 67.8%. HCC were initially diagnosed in 58 patients (14.7%) and serum AFP level was 81,386±28,568.4 ng/mL in these patients. The AUC of AFP for the detection of HCC was 0.911 and sensitivity/specificity of AFP cutoff values of 20, 200 and 400 ng/mL were 79.3%/87.2%, 56.9%/97.0%, and 51.7%/98.5%, respectively. The initial AFP levels for patients without HCC was 42.5±297.0 ng/mL which showed significant correlation with serum ALT levels (Spearman`s correlation coefficient, 0.479; P<0.001). Therefore, changes in AFP level according to the changes in ALT levels were studied. AFP levels at ALT elevation, after normalization, and 3, 6, 9, 12 months thereafter were 90.1±405.0 ng/mL, 9.4±9.5 ng/mL, 5.3±3.8 ng/mL, 3.9±2.3 ng/mL, 3.9±2.4 ng/mL and 3.2±1.5 ng/mL, respectively. AFP level was 2.9±1.7 ng/mL in patients who remained normal ALT level for 1 year. Patients without HCC were followed up for 75.5±37.0 months and HCC were detected in 28 patients. AFP increased significantly from 3.9±1.9 ng/mL to 30.0±45.8 ng/mL when HCC was diagnosed in these patients (P<0.001). AUC was 0.951 in diagnosing HCC and the sensitivity/specificity of AFP cutoff values for 7.7, 10.0 and 15.0 ng/mL were 89.3%/98.6%, 71.4%/99.3% and 39.3%/100%. Conclusion: AFP is a useful screening marker in normal ALT levels especially in the era of antiviral therapy where liver in- flammation can be effectively controlled.