급성전골수성백혈병에서 백혈구성분채집술에 이은 치명적인 뇌출혈 2예

오윤정,박소윤,김윤정,한동석,김현수,최진혁,남동기,임호영,김효철,주희재 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.1

The aim of this study is to report 2 cases of acute promyelocytic leukemia who died from intracranial hemorrhage following leukapheresis and to provide proper preventive measures against hemorrhage following leukapheresis. From 1994 to 1997, a total of twenty-six patients with leukemia underwent leukapheresis to control hyperleukocytosis at Ajou University Hospital. Two patients with acute promyelocytic leukemia received all-trans retinoic acid but developed drug-induced hyperleukocytosis. Shortly after leukapheresis, they died from intracranial hemorrhage. The risk factors for fatal hemorrhage are thought to be coexisting disseminated intravascular coagulation(DIC), thrombocytopenia aggravated by leukapheresis, exacerbated coagulopathy related to mechanical trauma through leukapheresis and the excess use of citrate during leukapheresis. To reduce the risk of the bleeding associated with leukapheresis, it is necessary to replace platelet sufficiently before and after leukapheresis and to give calcium to correct coagulopathy induced by excess citrate which is used as anticoagulant as well as the correction of disseminated intravascular coagulation.

The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection

Chun, Yoon-Keun,Ha, Joo-hun,Hong-Jung-Woo,Oh, Soo-Myung,Kim, Sung-Soo 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Yoon-Keun Chun¹,Joohun Ha□Hong-Jung Woo□, Soo Myung Oh□,Sung Soo Kim□ ¹Department of Molecular Biology, College of Medicine,²Department of Surgery, college of Medicine,³Department of Internal Medicine, College of Oriental Medicine,and ⁴East-Weat Medical Reserch Institute,Kyung Hee University, Seoul, Korea. The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection. Proceedings of International Symposium on East-West Medicine, Seoul. 212-230, 1999. -Hepatitis B is caused by hepadnavirus. Hepatitis B virus replicates through 3.5kb pregenomic RNA intermediate which is regulated by core promoter. Pathogenesis of hepatitis B virus has been bilieved the result of host immune response. But recently many studies have reported that high level of viral replication caused by mutation in core promoter might result in severs hepatitis. But these studies were performed in vitro, not in vivo. So there is yet debate about which factor, viral of host factor, is more important in pathogenesis of hepatitis B virus. So we measured real viral replication level in 204 chronic hepatitis B patients by quantifying HBV DNA from sera by our novel PCR-based more sensitive method, and compared these results with ALT level measured from same sera, which indicates liver cell damage. Surprisingly there are no significant correlation between HBV DNA quantity and ALT level. Then we cloned core promoter region. In SSCP, we found that many viral mutants coexist in one patient. Base on SSCP result, we chose main viral core promoter type in each patients, which is thought to determine overall viral replication level in this patient. Main type of core promoter region of each 41 patients were directly sequenced. And with these we measured promoter activity by luciferase assay system and compared promoter activity with on another. We found tha there were some differences in promoter activity according to core promoter sequences. And we constructed replication-competent viral constructs with core promoter from 41 patients and Transfected these into HepG2 cell and measured HBV DNA by southern blot. There were also differences in HBV DNA quantity according to core promoter sequences. On these all results we investigated correlation between the effect of HBV core promoter on viral replication in vitro and HBN DNA quantity, ALT level from sera of each patients. We found there is no significant correlation among them. As a result, we concluded that in determining severity chronic hepatitis B patients, host factors of each patient is more important rather than replicative activity of virus itself.

Insulin resistance mediates high-fat diet-induced pulmonary fibrosis and airway hyperresponsiveness through the TGF-β1 pathway

Park, Yoon Hee,Oh, Eun Yi,Han, Heejae,Yang, Misuk,Park, Hye Jung,Park, Kyung Hee,Lee, Jae-Hyun,Park, Jung-Won Nature Publishing Group UK 2019 Experimental and molecular medicine Vol.51 No.5

<▼1><P>Prior studies have reported the presence of lung fibrosis and enhanced airway hyperresponsiveness (AHR) in mice with high-fat-diet (HFD)-induced obesity. This study evaluated the role of TGF-β1 in HFD-induced AHR and lung fibrosis in a murine model. We generated HFD-induced obesity mice and performed glucose and insulin tolerance tests. HFD mice with or without ovalbumin sensitization and challenge were also treated with an anti-TGF-β1 neutralizing antibody. AHR to methacholine, inflammatory cells in the bronchoalveolar lavage fluid (BALF), and histological features were evaluated. Insulin was intranasally administered to normal diet (ND) mice, and in vitro insulin stimulation of BEAS-2b cells was performed. HFD-induced obesity mice had increased insulin resistance, enhanced AHR, peribronchial and perivascular fibrosis, and increased numbers of macrophages in the BALF. However, they did not have meaningful eosinophilic or neutrophilic inflammation in the lungs compared with ND mice. The HFD enhanced TGF-β1 expression in the bronchial epithelium, but we found no differences in the expression of interleukin (IL)−4 or IL-5 in lung homogenates. Administration of the anti-TGF-β1 antibody attenuated HFD-induced AHR and lung fibrosis. It also attenuated goblet cell hyperplasia, but did not affect the AHR and inflammatory cell infiltration induced by OVA challenge. The intranasal administration of insulin enhanced TGF-β1 expression in the bronchial epithelium and lung fibrosis. Stimulating BEAS-2b cells with insulin also increased TGF-β1 production by 24 h. We concluded that HFD-induced obesity-associated insulin resistance enhances TGF-β1 expression in the bronchial epithelium, which may play an important role in the development of lung fibrosis and AHR in obesity.</P></▼1><▼2><P><B>Obesity: A trigger for asthma onset</B></P><P>Insulin resistance may be an important causative factor underlying the increased risk of asthma and other respiratory issues in obese individuals. Obesity doubles the likelihood of developing asthma, with symptoms that are more difficult to control than in non-obese patients. The connection between these conditions is poorly understood, but researchers led by Jung-Won Park, Yonsei University College of Medicine, Seoul, South Korea, have identified a potential mechanism. They demonstrated that a signaling molecule called TGF-β1 contributes to airway sensitivity and tissue scarring in a mouse model of diet-induced obesity. Subsequent experiments showed that treatment with insulin also gives rise to increased TGF-β1 production in the mouse lung. Since insulin resistance is a common feature of obesity, resulting in abnormally high levels of circulating insulin, this could also account for the increased risk of respiratory problems.</P></▼2>

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

XML 웹서비스와 인식기술을 이용한 웹브라우저 구현

오지영,김윤중 한밭대학교 정보통신전문대학원 2003 정보통신전문대학원 논문집 Vol.1 No.1

본 연구에서는 XML 웹서비스와 음성인식기술을 사용하여 음성웹문서를 처리할 수 있는 웹브라우저 시스템을 설계하고 구현하였다. 이 시스템은 음성웹문서를 위한 웹브라우저와 웹서버, 음성인식을 수행하는 웹서비스의 구동 기능으로 구성된다. 이 웹브라우저에서는 음성인식용 웹문서의 하이퍼링크를 클릭하는 대신에 하이퍼링크 음성을 녹음하고 노이즈가 제거된 상태로 웹서버에 전달한다. 이 기능은 ActiveX 컨트롤로 구현하였다. 컨트롤은 인식 및 노이즈제거 처리가 완료되면 웹문서와의 상호동작을 위하여 이벤트와 속성을 제공한다. 웹문서에서는 컨트롤이 발생하는 이벤트의 처리를 위하여 script가 실행된다. 웹서버는 웹문서가 구축되는 사이트의 서버로서 수신되는 음성신호를 XML 웹서비스를 이용하여 인식하고 인식 결과의 웹페이지를 브라우저로 전송하는 기능이 필요하다. 이 기능은 XML 웹서비스로 구현하였다. 음성인식은 XML웹서비스로 구동되는 별도의 인식시스템에서 이루어진다. 본 연구에서는 이와 같은 방식을 채택하여 임의의 고객에게 음성인식스템의 서비스를 제공할 수 있다. In this thesis, we designed and implemented the web browser system that is able to handle the speech web document using the XML web service and speech recognition technology. The system is consisted of the web browser and web server for the speech web document and the function to drive the XML web service to activate the speech recognition. On the web browser, the hyperlinks are not clicked but also the speech sounds of the hyperlink text are recorded and the noises included in the speech data are eliminated and are transmitted to the web server. The functions are implemented in the ActiveX control which submits the event when completes the recording speech and eliminating noises and the web document catches the event and driving the handler function. The web server, which has the speech web documents, recognizes the speech sounds received from the web browser through calling the XML web service and replies the HTML pages to the web browser. The speech recognition is accomplished in the other system which has the function of the XML web service. Adopting the method of the XML web service, this study is able to supply the service of the speech recognition to any clients which are in any platforms.

정규식을 이용한 음성인식용 웹페이지 변환시스템

오지영,김윤중 한밭대학교 정보통신전문대학원 2004 정보통신전문대학원 논문집 Vol.2 No.1

본 연구에서는 인터넷 환경에서 음성인식기술을 이용하기 위하여 일반 웹페이지를 음성인식이 가능한 웹페이지로 변환하는 시스템을 구현하였다. 이 시스템은 음성 인식용 웹페이지를 사용하고 음성을 녹음하는 웹사이트 사용자와 웹사이트 서버, 음성인식기능을 수행하는 웹서비스로 구성된다. 웹사이트 서버는 웹페이지 변환 시스템과 사용자로부터 수신된 음성신호를 웹서비스를 이용하여 인식하고 인식결과의 웹페이지를 웹사이트 사용자에게 전송하는 기능을 포함하다. 본 연구에서는 정규식을 이용하여 웹페이지 변환 시스템을 구현하였다. 사용자의 음성을 분석하고 인식하는 음성인식기는 기존의 연구에서 구현된 음성인식 웹서비스 제공자를 이용하였다. 실험 결과, 웹페이지에서 태그를 분석하여 웹페이지를 변환하고 하이퍼링크를 추출하는 것을 확인할 수 있다. This paper implemented the conversion system that converts general web page to the web page using the speech recognition technology in the internet. This system has the web site consumer, the web site server and the web service provider that provides speech recognition. The web site server, which has conversion system, recognizes the speech sounds received from the web site consumer through calling the web service and replies the HTML pages to the web site consumer. The conversion system is implemented by using regular expression. The speech recognizer is the web service providers that is implemented in the previous study. As the result of experiment, we show that this system changes web page by analyzing tags and extracts hyperlink.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

Carbamoylethyl Starch의 製造와 종이 製造時 添加效果에 관한 硏究

尹世永,崔正箕,鄭文箕,趙炳默,吳正壽 동국대학교 생명자원과학대학 연습림 1995 연습림논문집 Vol.- No.4

Recently, paper strength properties come up to be lowered by increasing ratio of utilization of recycling paper. In order to overcome these problems, strengthening agents which may cause enviromental problems have been used. Therefore, acrylamide was added to starch which is a cheap natural polymer, carbamoylethyl starch(CES) with high activity was prepared, and so the applicability as a paper additive was examined. The results are following; FT-IR spectra of CES of which degree of substitution was 0.25 showed strong C=O band at 1680㎝^-1 which corresponds the carbonyl group n amides(amide Ⅰ). Analysis of bravender viscosity showed that cooking start point of CES is 60℃ and instant viscosity is 830 B.U.(bravender unit). Effect of carbamoylethl DS on strength properties was resulted that CES of DS 0.20 appeared to be the best choice for making handsheets from KOCC with good overall strength properties, and it was selected as standard sample. Effect of pH on strength properties was obvious for their increasing values as decreasing pH. Also, a 5-fold increase in size rate as well as significant increase in wet-tensile strength were obtained in handsheets from KOCC by 3% wet-end addition of CES.

전통적 체육교수법과 움직임 탐구 교수법간의 효과의 差

오정윤,박동근 淸州敎育大學校 1997 論文集 Vol.34 No.-

암환자에 대한 임상실습전 학생들의 견해에 관한 연구

오윤경,기정숙,박상학 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

We evaluated the attitudes towards cancer patients in third year medical students who did not receive a lecture before starting the poly-clinic education about radiation oncology in our medical school. We obtained a total of 142 answers from the students that completed the questionnaire of the following. 1) Should the patient be notified of the terminal cancer? The patient should be notified of terminal cancer in 95.1%, 91.6%, and 85.9% from the point of view of a patient, a doctor, and patients' families, respectively. 2) Who should notify the patient that the disease is terminal cancer? Doctor(53.3%), professor(22.2%). fami1y(17.1%). fnend(2.2%), and others(2.2%), respectively. 3) Do you have any experience of anticancer treatment with an intimate person? Yes(42.3%), No(56.3%). 4) Did the patient know about the cancer? Yes(81.6%), guess (15.0%). no(1.7%). 5) Do you wish to prolong the survival time from 1 year to 3 years with long courses of chemotherapy and radiation therapy? No(56.3%), yes(40.2%). 6) The attitude about marriage in the situation of engaged status and recently diagnosed cancer. As an engaged person: marry(30.3%), delay(43%). don't marry(23.9%). As family of a cancer patient who is engaged: marry(9.1%), delay(43.7%), don't marry(38,7%). As a cancer patient: marry(2.8%). delay (27.5%), don't marry(67.6%). The results of this study necessitate the education about the following: emotional state of cancer patients, decision about informing the patient of the true diagnosis, the method and timing of informing, sharing bad news with patients, and control of anxiety as a doctor. The students expressed pessimism about anticancer treatment. Therefore, the exact results and positive aspects of anti-cancer treatment should be emphasized more during the lecture and poly-clinic education about radiation oncology in our medical school.