지역 및 계절 별 식품 원재료 공급 취약성 평가모델

오하영(Ha Young Oh),박진우(JinWoo Park),김덕영(Duck Young Kim),조용주(Yong Ju Cho) (사)한국CDE학회 2016 한국 CAD/CAM 학회 학술발표회 논문집 Vol.2016 No.동계

루푸스 신염 관해 유도 치료로서 Mycophenolate Mofetil과 Cyclophosphamide 치료 효과

김용균 ( Yong Kyun Kim ),도연실 ( Yeon Sil Do ),최소연 ( So Yeon Choi ),장은희 ( Eun Hee Jang ),이정은 ( Jung Eun Lee ),차훈석 ( Hoon Suk Cha ),허우성 ( Woo Seong Huh ),김대중 ( Dae Joong Kim ),오하영 ( Ha Young Oh ),권기영 ( Ghee 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.2

목적: 사이클로포스파마이드 (CYC)정맥투여는 활동성 루푸스 신염에서 표준적 치료이나 심각한 독성이 발생할 위험이 높다. 저자들은 활동성 루푸스 신염 환자에서 관해 유도치료로 선택적으로 림프구 증식을 억제하고 독성이 적은 마이코페놀레이트 모페틸 (MMF)치료를 시행하여 CYC 치료와 비교하였다. 방법: 2000년 8월부터 2005년 8월까지 신조직 검사로 활동성 루푸스 신염으로 진단 받고 초기 관해 유도치료로 MMF 치료를 받은 환자 22명과 CYC 정맥투여 치료 받은 환자 28명들을 대상으로 6개월 치료 후 관해율과 부작용을 조사하였다. 완전 관해는 소변 단백 대 크레아티닌 비 (Up/Cr)가 0.3 이하이고 정상 요 침사 소견과 정상 혈청 알부민 수치를 보이며 혈청 크레아티닌이 기저 수치 보다 15% 이상 높지 않는 경우로 정의하였다. 불완전 관해는 Up/Cr가 0.3에서 2.9 사이에 해당되고 혈청 알부민 수치가 적어도 3 g/dL 이상이며 안정된 신기능을 보이는 경우로 정의하였다. 결과: MMF 군은 22명, CYC 군은 28명이었다. 신조직 검사상 class Ⅲ 8명 중 7명은 MMF로, class IV 27명 중 19명은 CYC 정맥투여 치료 했다. MMF 군에서 완전 관해는 7명, 불완전 관해는 10명, 치료 실패는 5명이였으며 CYC 군에서 완전 관해는 11명, 불완전 관해는 11명, 치료 실패는 6명으로 양 치료군 간 차이는 없었다. 4주 간격으로 3회의 CYC 정맥투여 후 MMF 치료로 전환하여 3개월간 관해 유도 치료한 환자는 4명이었으며 치료 후 완전 관해가 2명, 불완전 관해가 1명, 치료 실패가 1명이었다. 부작용은 MMF 군과 CYC 군 사이에 유의한 차이가 없었다. 결론: 활동성 루푸스 신염 환자 초기 관해 유도 치료로서 MMF는 CYC 정맥투여와 비교하여 치료 6개월 후 관해율에 차이가 없었다. 그러나 두 치료군 대상 환자들의 중증도에 차이가 있어 향후 잘 대조된 다수 환자를 대상으로 전향적인 연구가 필요 할 것이다. Purpose: The combination of intravenous cyclophosphamide (CYC) and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Mycophenolate mofetil (MMF) Is a new immunosuppressive agent that selectively inhibits activated lymphocytes. This study reports on the clinical experiences at our clinic with MMF and intravenous CYC for the initial induction treatment in patients with lupus nephritis. Methods: 50 patients with lupus nephritis received induction therapy consisting of MMF and prednisolone (n=22) or intravenous CYC and prednisolone (n=28), and followed up for six months. Complete remission was defined as a value for urinary protein: urinary creatinine ratio (Up/Cr) that was less than 0.3, with normal urinary sediment, a normal serum albumin concentration and values for serum creatinine that were no more than 15 percent above the base-line values. Partial remission was defined as a value for Up/Cr that was between 0.3 and 2.9, with a serum albumin concentration of at least 3.0 g/dL. Results: 22 patients treated with MMF and 28 patients with intravenous CYC resulted in complete remission (31.8% vs 39.3%), partial remission (45.5% vs 39.3%) and treatment failure (22.7% vs 21.4 %). Fewer severe infections occurred among patients treated with MMF and prednisolone. Conclusion: As for the induction therapy of lupus nephritis, the combination of MMF and prednisolone may be an effective regimen. However, further randomized, prospective studies are needed to prove the effectiveness of MMF therapy in lupus nephritis.

저출력 RFID 시스템에서 인식거리 확대를 위한 전력 공급용 RF Shower 시스템

鄭珍旭(Jin-Wook Jung),裵宰賢(Jae-Hyun Bae),吳夏嶺(Ha-Ryoung Oh),成榮洛(Yeong-Rak Seong),宋昊俊(Ho-Jun Song),張炳埈(장병준),崔炅(Kyung Choi),李政錫(Jung-Suk Lee),李弘倍(Hong-Bae Lee),李學龍(Hak-Yong Lee),金鍾旻(Jong-Min Kim),申在澈(Jae-Che 대한전기학회 2006 전기학회논문지 D Vol.55 No.12

In this paper, we presented the synchronization module between RF shower system and RFID Reader to extend interrogating range on Mobile RFID system, Costas Loop and FPLL(Frequency/Phase Lock Loop) were used. We achieved compromised range of 3㎒ locking frequency, 1㎳ locking time and figured out remarkable Hopping frequency of the Reader. The prototype of the new designed RFID system has been tested with ISO18000-6 type-B Tag. The read range between designed RFID Reader and Tag has been measured, it increased triple times by adjusting the Shower system output level.

만성 비당뇨성 신장병증에서 Losartan이 단백뇨와 요중 안지오텐시노겐 배설량에 미치는 효과

도연실 ( Yeon Sil Do ),최소연 ( So Yeon Choi ),장은희 ( Eun Hee Jang ),김용균 ( Yong Kyun Kim ),백현정 ( Hyun Jeong Baek ),이정은 ( Jung Eun Lee ),허우성 ( Woo Seong Huh ),김대중 ( Dae Jung Kim ),오하영 ( Ha Young Oh ),김윤구 ( Yo 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.2

서론: 신장내 레닌-안지오텐신계 활성화는 신장 손상과 함께 단백뇨를 악화시키고 요중 안지오텐시노겐 배설량이 신장내 레닌-안지오텐신계의 활성도를 반영한다는 동물 실험보고들이 있으나 이와 관련된 임상 연구는 부족하였다. 이에 연구자들은 만성 비당뇨성 신장병증 환자를 대상으로 (estimated GFR>60 mL/min/1.73m2, urinary protein to creatinine ratio 0.4-2.0 g/g) losartan이 단백뇨와 요중 안지오텐시노겐 배설량에 미치는 효과를 관찰하기 위한 전향적 연구를 시행하였다. 방법: 대상 환자는 32명 (치료군 17명, 대조군 15명)이었고 치료군에는 losartan 100 mg/일을 투여하였다. 연구 시작 6개월, 12개월에 수축기 및 이완기 혈압, 사구체 거름률, 요중 단백질-크레아티닌 비율 (urinary protein to creatinine ratio), 요중 알부민-크레아티닌 비율 (urinary albumin to creatinine ratio)을 측정하였고, 웨스턴 블롯 분석을 시행하여 요중 안지오텐시노겐 배설량 (urinary angiotensinogen), 혈중 안지오텐시노겐 (plasma angiotensinogen)의 변화 등을 관찰하여 비교하였다. 결과: 연구 시작 시 치료군과 대조군 사이에 요중 단백질-크레아티닌 비율 (1.13±0.36 g/g vs. 1.07±0.34 g/g), 요중 알부민-크레아티닌 비율 (0.96±0.34 g/g vs. 0.92±0.38 g/g)은 차이가 없었고, 두 군 모두 목표 혈압 내에서 수축기 및 이완기 혈압을 조절하였다. 6개월 후 치료군에서는 시험시작 시와 비교하여 요단백 배설량과 (0.63±0.35 g/g, p<0.01), 요알부민 배설량이 (0.52±0.31 g/g, p<0.01) 의미있게 감소하였으나 대조군에서는 요단백 배설량과 (0.97±0.41 g/g, p=0.40) 요알부민 배설량에 (0.86±0.37 g/g, p=0.65) 변화가 없었다. 12개월 후 치료군에서 시험시작 시와 비교하여 요단백 배설량과 (0.79±0.53 g/g, p<0.01), 요알부민 배설량이 (0.71±0.47 g/g, p<0.01) 의미있게 감소하였으나 대조군에서는 요단백 배설량과 (1.00±0.50 g/g, p=0.60) 요알부민 배설량에 (0.81±0.40 g/g, p=0.48) 변화가 없었다. 요중 안지오텐시노겐 배설량은 연구 시작 시를 기준으로 하여 (1.00) 밀도 비를 비교하였을 때 치료군에서 6개월과 (0.72±0.42, p<0.05) 12개월에 (0.60±0.51, p<0.01) 유의하게 감소하였으나, 대조군에서는 6개월과 (1.07±0.81, p=0.07) 12개월에 (1.51±1.36, p=0.93) 모두 감소하지 않았다. 혈중 안지오텐시노겐은 두 군 모두 6개월과 12개월 후에 유의한 차이를 보이지 않았다. 요중 안지오텐시노겐 배설량의 변화는 단백뇨의 변화와 높은 상관관계를 보였으나 (Correlation coefficient, C.C.=0.74, p<0.01) 혈중 안지오텐시노겐의 변화와는 상관관계를 보이지 않았다 (C.C.=0.04, p=0.83). 결론: 소량의 단백뇨를 보이는 초기 만성 비당뇨성 신장 병증 환자에서 losartan 치료는 단백뇨를 감소시키며 더불어 요중 안지오텐시노겐 배설량을 감소시킴을 알 수 있었다. Purpose: There were experimental evidences supporting that intrarenal activation of the renin-angiotensin system contributes to increase BP, proteinuria and urinary angiotensinogen (UAGT) excretion. The purpose of this prospective, open label, controlled study was to investigate the effect of losartan on proteinuria and UAGT excretion in chronic non-diabetic proteinuric (0.4 to 2.0 g/day) renal disease with normal renal function (glomerular filtration rate, GFR>60 mL/min/1.73m2). Methods: Thirty two patients were randomly allocated to the losartan group (100 mg/day; n=17) or the control group (n=15). Systolic BP, diastolic BP, estimated GFR, urinary protein to creatinine ratio (UP/Cr), UAGT and plasma angiotensinogen (PAGT) level were compared between two groups at baseline, 6 months and 12 months. Results: UP/Cr (1.13±0.36 g/g vs. 1.07±0.34 g/g) was similar in two groups at baseline. Target BP (<140/90 mmHg) was maintained in both groups. After 6 months, UP/Cr (0.63±0.35 g/g vs. 0.97± 0.41 g/g, p<0.01) was significantly decreased in the losartan group compared to the control group. In addition, UAGT (baseline 1.0) was noticeably suppressed in the losartan group (0.72±0.42 vs. 1.07±0.81, p=0.13). However, PAGT was not changed in both groups. Moreover, our study at 12 months period has demonstrated continuous suppression of UP/Cr (0.79±0.53 g/g vs. 1.00±0.50 g/g, p=0.06) and UAGT (0.60±0.51 vs. 1.51±1.36, p<0.05) in the losartan group. UP/Cr was highly correlated with UAGT (Correlation Coefficient=0.74, p<0.01), but not with PAGT. Conclusion: Losartan not only induced a remarkable decrease in proteinuria but also contributed a reduction in UAGT in patients with chronic non-diabetic proteinuric renal disease.

당뇨병과 고혈압이 없는 성인에서 대사증후군과 만성 신질환의 상관 관계

최소연 ( So Yeon Choi ),이정은 ( Jung Eun Lee ),도연실 ( Yeon Sil Do ),장은희 ( Eun Hee Jang ),김용균 ( Yong Kyun Kim ),허우성 ( Woo Seong Huh ),김윤구 ( Yoon Goo Kim ),김대중 ( Dae Jung Kim ),오하영 ( Ha Young Oh ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.4

Purpose : The significance of metabolic syndrome (MS) was recently raised as a risk factor in chronic kidney disease (CKD). Diabetes and hypertension are not only well known diagnostic criteria for MS, but also risk factors for CKD. However, the association between MS and CKD in patients without diabetes and hypertension is unknown. Methods : A total of 9586 subjects who registered in the health check service at Samsung Medical Center between January 2004 and December 2005 were included. MS was defined according to the criteria of the revised ATP III, and CKD was defined by the reduction of the glomerular filtration rate or the appearance of albuminuria. Results : The prevalence of MS was 9.0% of study subjects. CKD was noticed in 6.2% of the subjects without MS, and 13.1% with MS. MS was a significant determinant of CKD {Odd ratio (OR) 1.80 and 95% confidence interval (CI) 1.42-2.28, p<0.001}. Compared with subjects lacking components of MS, subjects with one, two, three, four or five components of MS had a higher risk of acquiring CKD (OR, 1.04, 1.43, 1.89, 2.48, 3.29, Respectably). The relationship between each component of MS and CKD was different according to sex and age groups. Abdominal obesity was a significant determinant for CKD in female subjects, while high fasting glucose levels were a significant determinant in younger subjects (<60 years) (p<0.05). Conclusion : Even in non-diabetic and non-hypertensive adults, MS is independently associated as a risk factor for CKD.

혈액투석을 받는 만성 신부전 환자의 인지기능과 삶의 질

이선영(Sun Young Lee),이헌정(Heon Jeong Lee),허우성(Woo Seong Huh),김대중(Dae Joong Kim),김윤구(Yoon Goo Kim),오하영(Ha Young Oh),조상경(Sang Kyoung Jo),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.3

N/A N/A

지속성 외래 복막투석 환자에서 갑상선 기능의 변화

이현희 ( Hyun Hee Lee ),김대중 ( Dae Jung Kim ),김정아 ( Jung Ah Kim ),이영기 ( Young Ki Lee ),윤수진 ( Su Jin Yoon ),허우성 ( Woo Seong Huh ),김윤구 ( Yoon Goo Kim ),오하영 ( Ha Young Oh ),김용림 ( Yong Lim Kim ),신석균 ( Sug Kyu 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.1

목적 : 말기신부전으로 투석 중인 환자에서 C반응단백 (C-reactive protein, CRP)은 이환률과 사망률의 주요한 원인으로 알려진 관상동맥질환을 예견하는 지표로 알려져 있으며, 최근 여러 연구에서 맥압의 증가가 정상인에서 심혈관 질환과 사망률의 위험인자로 대두되고 있다. 따라서 본 연구는 복막투석 환자에서 이 두 가지 지표를 함께 측정하여 관상동맥질환의 위험도를 예견하는 지표로서의 가치를 알아보고자 시행되었다. 방법 : 복막투석을 시행하는 환자 중 thallium single photon emision computed tomography (thallium SPECT)를 시행하고 6개월 이상 추적관찰이 가능하였던 총 71명의 환자 (남자 42명, 여자 29명)를 대상으로 하였다. 나이, 성별, 흡연, 당뇨, 고혈압, 맥압, 체질량 지수에 대하여 조사하였으며 혈중 알부민, 총 콜레스테롤, 섬유소원, lipoprotein (a), C반응단백을 검사 하였다. 결과 : Thallium SPECT 양성군과 음성군으로 분류하여 비교한 결과 thallium SPECT 양성군에서 C반응단백, 맥압, 흡연율, 섬유소원의 값이 의의있게 높았다 (p<0.05). 맥압이 1 mmHg 증가시 관상동맥질환의 상대 위험도는 1.017배 (95% 신뢰구간 1.011-1.023), C반응단백이 0.01 mg/dL 증가시 관산동맥질환의 상대 위험도는 1.014배 (95% 신뢰구간 1.008-1.019) 증가하였다. 다증회귀분석 결과 C반응단백과 맥압이 심근 허혈에 영향을 주는 독립인자였다. Log C반응단백과 맥압간에는 양의 상관관계가 있었다. (p<0.01>. 결론 : 복막투석 환자에서 C반응단백과 맥압은 모두 관상동맥 질환을 예측하는데 유용한 지표로 이용할 수 있을 것으로 기대된다. 그러므로 복막투석 환자에서 뚜렷한 원인 없이 지속적으로 C반응단백과 맥압이 상승되어 있는 경우 허혈성 심질환에 대하여 검사가 이루어져야 할 것으로 생각된다. Background : Atheroclerotic vascular disease is the major cause of morbidity and mortality in dialysis patients. C-reactive protein (CRP) appears to be clinically useful in prediction of coronary heart disease. Elevated pulse pressure has been associated with an increased risk of cardiovascular disease among apparently healthy adults. Therefore, we evaluated the association between a persistent elevation of C-reactive protein level, pulse pressure and the presence of ischemic heart disease in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods : A total of 71 CAPD patients (42 males 29 females) who underwent thallium SPECT and followed up more than 6 months were included. We collected the data about age, sex, smoking, diabetes, hypertension, pulse pressure and body mass index. Blood levels of albumin, total cholesterol, fibrinogen, lipoprotein (a) and C-reactive protein were measured. Results : The values of C-reactive protein, pulse pressure, smoking and fibrinogen were significantly higher in thallium SPECT positive group (p<0.05). A 0.01 mg/dL increase in C-reactive protein was associated with a 1.014 increase in the odds of having an elevated risk of coronary artery disease (95% confidence interval 1.008-1.019) and a 1 mmHg increase in pulse pressure was associated with a 1.017 increase in the odds of having an elevated risk of coronary artery disease (95% confidence interval 1.011-1.023). By multivariate logistic regression analysis, C-reactive protein and pulse pressure were independent risk factors for ischemic heart disease. Log CRP level was positively correlated with pulse pressure level (p<0.01). Conclusion : The baseline level of CRP and pulse pressure independently predicts the risk of coronary heart disease in CAPD patients. For patients who have a persistent elevation of CRP and pulse pressure without an apparent cause, we recommend a workup for ischemic heart disease.

위장관 ; 조기 위암 및 위선종 환자에서 내시경점막하박리술 후 시행한 근치적 부가적 위절제술의 임상, 병리학적 고찰

노혜진 ( Hye Jin Noh ),박종재 ( Jong Jae Park ),윤재원 ( Jae Won Yun ),권민정 ( Min Jung Kwon ),윤대웅 ( Dae Woong Yoon ),장원진 ( Won Jin Chang ),오하영 ( Ha Yong Oh ),주문경 ( Moon Kyung Joo ),이범재 ( Beom Jae Lee ),김지훈 ( Ji 대한소화기학회 2012 대한소화기학회지 Vol.59 No.4

Background/Aims: Endoscopic submucosal dissection (ESD) has been widely performed. However, procedure related-complications and the risk of tumor recurrence are limitations. We analyzed the clinicopathological characteristics of patients who underwent curative additional gastrectomy (gastrectomy) after ESD. Methods: The clinical characteristics of cases underwent gastrectomy after ESD were retrospectively analyzed. Results: Between January 2002 and August 2010, 1,512 cases underwent ESD for early gastric cancer (n=511) or adenoma (n=1,001). Thirty-two cases (2.1%) underwent gastrectomy after ESD. Thirty cases (2.0%) were EGC and 2 cases (0.1%) were adenoma. Extended indication, larger tumor size and piecemeal resection were risk factors for gastrectomy after ESD. According to the causes of gastrectomy, 13 cases underwent gastrectomy due to complications (40.6%; bleeding in 9, perforation in 4), and 19 cases based on pathological results (incomplete resection in 13, lymphatic invasion in 6). In cases with incomplete resection, the rate of residual tumor and lymph node metastasis after gastrectomy was 69.2% (75% lateral margin, 60% deep and 75% both) and 7.7%, respectively. Three (50%) of the 6 cases with lymphatic invasion had lymph node metatstasis. Conclusions: The causes of gastrectomy after ESD were the procedure-related complications, the incomplete resection and lymphatic invasion. For complete and curative ESD, endoscopists should try to minimize complications and determine the depth of invasion accurately before ESD. (Korean J Gastroenterol 2012;59:289-295)

혈액투석 중인 만성 신부전 환자에서 TT Virus의 감염률과 임상적 의의

이용욱,허우성,도재혁,백승운,최문석,김소정,이준행,고광철,이풍렬,이종철,최규완,박상종,이준혁,김재준,오하영,임윤정 대한소화기학회 2001 대한소화기학회지 Vol.37 No.1

Background/Aims: TT virus (TTV) is a unenveloped, single-stranded and circular DNA virus isolated from the serum of a patient with posttransfusion hepatitis of unknown etiology. We evaluated the prevalence, risk factors, and clinical significance of TTV in patients with chronic renal failure(CCRF) undergoing maintenance hemodialysis (HD). Methods: We examined TTV DNA in serum of HD-undergoing patients and healthy controls using the nested polymerase chain reaction. Results: TTV DNA was detected in 15 (20.0%) of 75 HD-undergoing patients and 10 (13.2%) of 76 healthy controls (p$gt;0.05). The prevalence of TTV did not differ according to the duration of HD or transfusion history of the patients. The prevalence of TTV was higher in IgG anti-HBc positive patients than IgG anti-HBc negative patients (27.5% vs. 4.2%, p=0.03). There was no relationship between TTV infection and liver diseases. Conclusions: The prevalence of TTV infection in CRF patients undergoing HD was similar with that of healthy controls. These results suggest that TTV infection may share the route of transmission with HBV infection in adults.

양하지의 동통과 근약증을 주소로 한 결절성 다발혈관염 -증례 보고-

김창환,정한영,김형석,오하영,김윤구,이규백 大韓再活醫學會 1997 Annals of Rehabilitation Medicine Vol.21 No.5