건축공사시방서에서의 KS규격의 국제인증방안에 관한 연구

김경식,이재섭,김용수,이규진,조용훈,최완철,전재열,이현수,구재동,이기환 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

The purpose of this research is make out construction specifications for International Construction. Using off-shore products incur cost increase and longer delivery term of construction. and inconvenient on International Construction. Expand the range of additional local products conforming to performance. Life Cycle Cost. maintainability. operability. user's acceptability, etc.. And this study is suggest the standard formats and the techniques for construction specification.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

동종 조혈모세포이식 후 발생한 크립토콕쿠스 척추염 1예

고윤호,임동준,이성수,조유경,이동건,최정현,김유진,민창기,김동욱,박정미,김춘추,신완식 대한감염학회 2001 감염 Vol.33 No.4

Skeletal cryptococcosis is an uncommon infection. Cryptococcus is a common cause of meningitis and infects 7∼10% of patients with AIDS. As well as AIDS, the infection may be seen in association with leukemia, lymphoma, Hodgkin's disease, sarcoidosis, tuberculosis and diabetes, also in patients on steroid medication. But there is no case report of skeletal cryptococcosis following allogeneic hematopoietic stem cell transplantation. A 40-year-old woman was admitted to the hospital because of low back pain. She had chronic myelogenous leukemia for 2 years and underwent allogeneic hematopoietic stem cell transplantation 8 months ago. She have been treated with steroid and cyclosporine orally because of chronic graft versus host disease. On examination she was afebrile and had posterior lower lumbar tenderness. But, she had no reduced strength of low extremities. Open biopsy was underwent. Histology demonstrated budding, round-to-oval, refractile yeast-like organisms within debris. The results of a lumbar puncture were unremarkable and cerebrospinal fluid culture failed to grow bacteria and yeast. The patient was treated with amphotericin B (1 gram) and AmBisome□ (2.8 gram) over 6 weeks. Three months after cessation of therapy, the patient was doing well.(Korean J Infect Dis 33:298∼301, 2001)

Indoprofen 및 Indoprofen Lysinate와 Human Serum Albumin의 結合에 관한 硏究

李琬夏,柳柄泰,智雄吉,金東吉 成均館大學校 科學技術硏究所 1984 論文集 Vol.35 No.1

Indoprofen, 4- (1, 3-dihydro-1-oxo-2H-isoindol-2-yl)-α-methylbenzene acetic acid, has many advantages over the other antiinflammatory drugs, such as salicylates, naproxen. Although indoprofen is widely used as an antiinflammatory agent, it shows poor solubility in water. In order to inhance water solubility, indoprofen was made as lysine salt. The purpose of this study was to inspect the binding of the 1-anilinonaphthalene-8-sulfonatc(ANS) to human serum albumin (HSA) and to be to comparative studies on indoprofen lysinate and indoprofen in aspect of the binding to HSA and the number of binding sites was obtained using a fluorescent probe technique. The numbers of binding sites for indoprofen and indoprofen lysinate appear to be 3.35, 3.4, respectively and the association constants were found as follows; HSA-Indoprofen. ; K_b1 = 6.62 × 10 exp(5), K_b2 = 5.44 × 10 exp(4) HSA-Indoprofen lysinate ; K_b1 = 2.32 × 10 exp(5), K_b2 = 5.03 × 10 exp(4)

측두하악관절의 초음파영상과 자기공명영상에서 하악과두 외측면과 관절낭간 거리 측정치 비교

이태완,유동수,한원정,김은경 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Purpose : To evaluate the reliability and clinical usefulness of ultrasonography in the temporomandibular joint (TMJ). Materials and Methods : Parasagittal and paracoronal 1.5 T MR images and 7.5MHz ultrasonographs of 40 TMJs in 20 asymptomatic volunteers were obtained. Disc position using MR imaging was evaluated and the distance between the lateral surface of mandibular condyle and the articular capsule using MR image and ultrasonograph of 27 TMJs with normal disc position was measured and compared. Intraobserver and interobserver measurements reliability was evaluated by using interclass correlation coefficients(ICC) and measurement error. Also, the distance measured on ultrasonographs was compared, according to mouth position and disc postion. Results : The normal disc position was found in 27 of 40 asymptomatic joints. At the intraobserver reliability of measurement, ICC at the closed and open mouth position were 0.89 and 0.91. The measurement error was 0.4% and 0.5%. At the interobserver reliability, ICC at the closed and open mouth position were 0.92 and 0.81. The measurement error was 0.4% and 0.7%. At the TMJ with normal disc position, the distances between the lateral surface of mandibular condyle and the articular capsule measured on MR images and ultrasonographs were 2.0±0.7 mm, 1.8±0.5 mm, respectively(p<0.05). On the ultrasonographs, the distances at open mouth position were 1.2±0.5 mm (p<0.05). At the TMJ with medially displaced disc, the distances at the closed and open mouth position were 1.3±0.3 mm and 0.9±0.2 mm (p<0.05). Conclusion: The results suggest ultrasonography of TMJ is a reliable imaging technique for assessment of normal disc position. (Korean J Oral Maxillofac Radiol 2006; 36 : 41-8)

국내 호중구감소성 발열 환자에게 경험적 항진균제로 투여한 Amphotericin B deoxycholate와 Itraconazole 주사제의 비용-확인분석 : 예비보고

이동건,송영구,유진홍,최수미,최정현,박선희,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : 진균감염이 점차 증가되고 있고 이를 치료하기 위한 비용 역시 증가하고 있지만 국내에서는 비용분석에 대한 연구가 거의 없는 실정이다. 본 연구에서는 호중구감소성 발열 환자에게 경험적 항진균제로 amphotericin B deoxycholate (ABV)혹은 정맥내 itraconazole (ITZA)을 투여할 때의 약물경제학적 측면을 후향적으로 비교해보고자 하였다. 재료 및 방법 : 같은 반응률을 보인다고 가정한 비용-확인분석 모델을 이용하여 가톨릭대학교 조혈모세포이식센터에서 혈액종양으로 항암치료 혹은 조혈모세포이식을 시행한 환자를 대상으로 자료를 수집하였다. 항진균제 투여에 대한 정보는 기존에 출판된 논문 및 학회 심포지움자료를 참고하였고, 논문에서 얻지 못한 정보는 가톨릭대학교 성모병원 의무기록실, 정보지원팀, 진료비관리팀의 협조를 받아 2003년 6월 1일부터 11월 30일까지의 자료를 분석하였다. ITZA에 대한 자료는 2003년 11월 제한적으로 1차 약제로 사용할 수 있게 되었던 때의 자료와 경험을 참조하였다. 결과 : 320명의 환자 중 149명(46.5%)에서 경험적 항진균제를 사용하였고 평균 투여일수는 ABV 17.0일, ITZA 9.8일이었다. 이상반응 발현율은 ABV 54%, ITZA 5%였다. ABV 투여환자 중 11명 (7.4%)에서 혈액투석을 평균 6.5일간 시행하였다. ITZA 투여시 간독성으로 혈장분리반출술, 인공간 등이 필요한 경우는 없었다. 경험적 항진균제를 ABV로 시작한 군(ABV군)은 1인당 1,229,495원, ITZA로 시작한 군(ITZA군)은 1인당 1,434,605원이 소요되어 ITZA군에서 205,110원 (16.7%)이 더 소요되었다. 평균 16일간 항진균제를 사용하여 1일 12,819.4원의 차이가 있었다. 결론 : 비용-확인 분석법에서 ITZA군이 ABV군 비해 하루 12,819.4원의 비용이 더 소요되었다. 비록 ITZA군에서 비용이 더 들었지만 1일 약가차이인 4.7배와 비교하여 많이 감소하여 항진균제의 비용을 1일 약가로 비교하는 것보다는 재원일수, 이상반응 발현율 등을 고려하는 총입원비용으로 약물경제학을 비교하는 것이 더 합당할 것으로 사료된다. 그 외에 환자의 예후, 삶의 질, 사회적 간접비용 등을 고려하는 전체적인 약물경제학을 비교하는 잘 계획된 전향적 연구가 추가로 필요하겠다. Background : The increasing incidence of systemic fungal infections and the rising medical cost have focused the need to determine the economic issues of antifungal agents. Nevertheless there have been only few reports about the cost analysis in Korea. We retrospectively investigated to compare the pharmacoeconomic aspects of amphotericin B deoxycholate (ABV) with those of intravenous itraconazole (ITZA) in the empirical treatment of febrile neutropenic patients. Materials and Methods : Through the cost-identification analysis model, on the presumption that two groups would show identical response, we collected data of patients who received hematopoietic stem cell transplantation (HSCT) or chemotherapy in Catholic HSCT center from Jun 1, 2003 to Nov 30, 2003. The literatures about information on antifungal therapy were extensively reviewed. Other unpublished information was provided by information assistant team, cost management team, and medical record unit in the same hospital. Results : Empirical antifungals were given to 149 out of 320 patients (46.5%). The average duration of administration were 17.0 days for ABV and 9.8 days for ITZA. The rates of adverse events were 54% and 5% for ABV and ITZA, respectively. Eleven (7.4%) patients given ABV received hemodialysis for 6.5 days in average. Among patients given ITZA, none developed hepatotoxicity requiring plasmapheresis or artificial liver. It cost 1,229,495 won/patient for the ABV group (starting ABV as empirical antifungal agent) and 1,434,605 won/patient for the ITZA group (starting ITZA as empirical antifungal agent) which was 16.7% more expensive than ABV group. When we compare the average daily cost for 16 days, the ITZA group spent 12,819.4 won/patient/day more than the ABV group. Conclusion : The cost-identification model in this study revealed that ITZA group cost more than ABV group. However, the difference in expense decreased when 1 day-cost was compared (4.7 times greater than ABV). It would be more reasonable to consider the total cost of anti-fungals during the hospitalization rather than 1 day cost in considering pharmacoeconomics. Well designed prospective study considering prognosis of patients, quality of life, and indirect social cost should be warranted.

시험관내 심내막염 모델에서 Methicillin 내성 포도구균에 대한 Vancomycin, Arbekacin, Gentamicin 단독 혹은 병합효과

이동건,전혜선,임동석,최수미,최정현,유진홍,신완식,강문원 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

목적 : Methicillin 내성 포도구균(methicillin resistant Staphylococcus aureus, MRSA)은 병원감염의 중요한 원인균으로 vancomycin이 선택약제이다. 그러나 심내막염 등의 중증감염에서는 vancomycin의 치료실패와 함께 최근 내성균도 증가하고 있어 vancomycin을 대체할 수 있는 항균제와 보다 효과적인 항균요법의 개발이 필요하다. 본 연구에서는 사람의 환경과 유사한 시험관내 감염 모델을 적용하여 MRSA 치료를 위한 vancomycin, arbekacin, gentamicin의 단독 및 병합효과를 비교하였다. 방법 : 임상에서 분리된 MRSA 2균주(GRI 53, gentamicin 내성 : GS171, gentamicin 감수성)로 fibrin clot을 제작하여 시험관내 심내막염 모델을 만들어 vancomycin, arbekacin, gentamicin을 단독 혹은 병합주입하였다. 반감기와 최고 및 최저농도는 사람의 약동학을 기준으로 하였다. Vancomycin은 6, 12, 24시간마다 주입하거나 24시간 연속주입하였고 arbekacin은 12, 24시간마다, gentamicin은 8, 24시간마다 주입하였다. 병합주입의 경우 vancomycin은 12시간마다, gentamicin, arbekacin은 24시간마다 투여하였다. 각 투여군의 살균효과는 0, 8, 24, 32, 48, 72시간째의 fibrin clot내 집락수로 측정하였다. 결과 : GRI153에 gentamicin을 주입한 군 이외의 모든 실험군에서 대조군에 비해 의미있게 fibrin clot내 집락수가 감소하였다(P<0.001). Vancomycin과 arbekacin 단독주입군내서 8시간째의 집락수는 GRI153보다 GS171에서 의미있게 낮았고(P=0.02), GS171에 arbekacin 12시간마다 투여한 군의 집락수가 가장 낮았다(P=0.01). 72시간째 집락수는 균주의 종류나 vancomycin 혹은 arbekacin의 투여간격에 따른 차이가 없었다. GRI153에서 vancomycin과 arbekacin의 병합주입군은 24시간까지 상가작용이 있었으나 vancomycin과 gentamicin 병합주입에서는 무관작용이었고 GS171에서도 72시간 동안 무관작용을 보였다. 또한 전 실험기간 동안 내성균은 발현되지 않았다. 결론 : 시험관내 심내막염 모델에서 MRSA에 대한 arbekacin의 항균력은 vancomycin과 유사하여 단독주입이 가능함을 시사한다. Gentamicin 내성균주의 경우 두가지 항균제의 병합주입으로 24시간까지 상가작용을 보이고 있으나 임상에 적용하기 위해서는 추가연구가 필요할 것으로 생각된다. Background : Glycopeptide has been used for the one-and-only treatment of choice in methicillin resistant Staphylococcus aureus (MRSA) infection, but its exclusive use for the MRSA infection has led to the increased risk of glycopeptide-resistance. To find an alternative (s), we employed an in vitro infective endocarditis model (IVIEM) to compare the efficacy of vancomycin (VCM). arbekacin (ABK), and gentamicin (GM) alone or in combination. Methods : Using two strains of clinically isolated MRSA, one GM susceptible (GS171) and the other GM resistant (GR153), fibrin clots were prepared and suspended in IVIEM. Antibiotics were added as a bolus to simulate human pharmacokinetics of regimens, including q 6 h, q 12 h, q 24 h, or continuous infusion with VCM, q 12h or q 24 h with ABK, and q 8 h or q 24 h with GM. In cases of combination, regimens were VCM q 12 h plus ABK q 24 h, and VCM q 12 h plus GM q 24 h. Fibrin clots were removed from each model at 0, 8, 24, 32, 48. and 72 h, and the bacterial densities (in CFU/g) were determined. Results : At 8 hour, the colony counts of GS171 were lower than those of GR153 (P=0.02), and the lowest with the ABK q12h against GS171 (P=0.01). At 72 hour, monotherapy with ABK or VCM produced same degree of bacterial reductions in IVIEM, regardless of dosing frequency or GM-resistance. In the case of GM-resistance, combination of VCM and ABK did show additive effect until 24 hours, although VCM and GM showed no indifference during all the experiments. Development of resistance during experiment was not observed with any regimens. Conclusions : Our data suggest that ABK monotherapy could be used as an alternative to VCM even in the treatment of GM-resistant staphylococcal endocarditis. Further studies will clinical trials are warranted to evaluate the additive effect of VCM and ABK.

중국 금융구조 변화의 실태분석

이종수,신동완,장재우 한국국제농업개발학회 2004 韓國國際農業開發學會誌 Vol.16 No.3

This study aims at analysing China's financial structure change concerning financial instruments, financial institutes and its affecting factors. Since early 1980's, China has entered into 4 stages of reforming financial system coping with market-oriented economic deregulation and liberalization. As results of adiusting the chinese finance system, some features can be summarized as follows; First, banking system of Central Bank of China and other national commercial banks has been extended to various non-banking finance system such as investment trust companies after 1983. Second China's financial assets and installment deposits has increased rapidly to RMB 15,222 billion yuan in 1996 from RMB 3,417billion yuan in 1978 with the growth of the national economy and change of national income structure. Third, there has been increasing finance activities throuth developing various financial commodities and loan systems. Such successful innovation of finance structure seems resulted from the changing financial resource distribution system, ownership structure, profit redistribution, macroeconomic arrangements, and governments' tacit supports.

수도권 근교농촌의 토지이용과 경관의 변화

이애란,고동완,김유일 성균관대학교 생명과학자원연구소 1996 生命資源科學硏究 Vol.2 No.2

The city's countryside is adjusting to change by urbanisation. As it, the recent phenomena in this area decline in rural landuse and damage of landscape which has local characteristics. But, no study think together landuse and landscape at present in this area. The aim of this study was to clarify causes and problems of change by investigating intersection of environments and causes, processes and results of landuse and landscape in city's countryside. The sites are 2 Up and 2 Myon belong to Yongin Gun closed by Seoul City. These site are rapidly changed and almost intermediate between city and rural at present. As methods, I exeminated not only various statistical data but also unstatistical data. This case study revealed the diversity of change in city's countryside. 1) The change of landuse is clarified by Local Main commercial district is Yongin Up, Development of Traffic and industry is Kihung Up, Bed-town closed by city is Suji Myon and Recreation development is Pogok Myon. Each landuse divided by landscape types as local diversity in several Ri. Also each case seperatied by its special shape from each Ri and have causes and problems. 2) From these results did I point out problems and make a proposal about national landuse plan and landscape management in city's countryside. It stressed the need of a long-ranged policy of development in countryside considering local characteristics and residential environments. This paper was the start of case study about landuse and landscape in city's countryside.

구치부 반대교합의 조기치료에 대한 치험례

이은미,강동균,김태완,김영진,남순현,김현정 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

구치부 반대교합은 유치열기와 혼합치열기에서 종종 나타나는 부정교합으로서,유병율은 7∼23%로 다양하게 나타난다. 이는 상악 치아의 협측 교두가 대합되는 하악 치아의 협측 교두의 설측에 교합하는 상태이며,하나의 치아 또는 한 치아군에서 나타날 수 있다. 구치부 반대교합의 경우, 보통 자발적 교정이 이루어지지 않으므로, 발견되는 즉시 치료해주는 것이 추천된다. 치성이나 기능성의 경우 성장함에 따라 골격성으로 이행하여 악골의 변형을 초래하고 교정적인 수단으로 개선이 불가능한 상태로 악화될 가능성도 있으므로 조기에 치료하는 것이 효과적이며,이러한 반대교합의 치료 방법으로는 하악의 변위를 유발하는 조기접촉을 제거하기 위한 교합조정,협소한 상악궁의 확장,치열궁내 비대칭을 치료하기 위한 개개 치아의 배열 등의 방법이 있다. 본 증례에서는 유치열기와 초기 혼합치열기 아동에서 구치부 반대교합이 관찰되어 치아의 선택적 삭제와 상악궁의 확장으로 반대교합을 교정한 후 정기적 검진시 양호한 결과가 관찰되기에 이를 보고하는 바이다. Posterior cross-bite is a relatively frequent malocclusion in primary and early mixed dentition and the reported prevalence of posterior cross-bite varies from 7% to 23%. It has been defined as a transverse discrepancy in arch relationship which the palatal cusp of the upper posterior teeth do not occlude in the central fossa of the opposing lower teeth, and can be manifested in a single tooth or in a group of teeth. Posterior cross-bite does not often self-correct and therefore immediate treatment is recommended. Occlusal adjustment to eliminate premature contact that causes mandibular deviation, expansion of narrow maxillary arch, arrangement of the individual teeth to treat asymmetry within the dental arch are the methods of treating cross-bite. In the present case, functional posterior cross-bite was observed in the primary and the early mixed dentition children. The children were treated by the slow maxillary expansion and occlusal adjustment. The outcome of periodic examinations after the correction of cross-bite was favorable.