일차성 Streptococcus pneumoniae 균혈증에 동반된 흉부 하행 대동맥염 1예

전민혁,고옥배,정우진,최영준,이정훈,최상호,김미나,김양수,우준희,류지소 대한감염학회 2005 감염과 화학요법 Vol.37 No.5

페렴구균에 의한 대동맥염은 국내에서 1예만 보고될 정도로 매우 드문 감염증이다. 저자들은 원발성의 폐렴구균혈증에 합병된 페렴구균 대동맥염 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Bacterial aortitis is rare and without surgical intervention, it usually leads to uncontrolled sepsis or catastrophic hemorrhage, ultimately, resulting in death. In the postantibiotic era, the dominant infecting organisms are Staphylococcus aureus and Salmonella spp.. In spite of frequent pneumococcal bacteremia, vascular seeding is rare and there is only one published report in Korea. We describe a 77-year-old female with primary pneumococcal bacteremia followed by aortitis of the descending aorta, which was successfully treated by aneurysmectomy, wide excision of periaortic tissue, aortobiiliac bypass via prosthetic graft, and antibiotic therapy.

골수염의 진단에 있어서의 Tc-99m Hexamethylpropylene amine oxime 백혈구 스캔의 임상적 유용성

최상호,김양수,정준원,정진원,추은주,서동대,배인규,양승오,우준희,류지소 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

배경 : 골수염의 진단에 있어 Technetium-99m을 이용한 삼상 골스캔(Tc-99m MDP스캔)은 단순방사선 검사상 정상소견을 보이는 경우에 쓰이는 1차적 검사로 매우 높은 민감도를 보인다. 그러나 Tc-99m MDP 스캔은 골절이나, 정형외과적 삽입물, 신경병적 관절병변과 같이 뼈의 재형성이 증가되는 상황에서도 양성소견을 보여 특이도가 낮은 단점이 있다. 이러한 단점을 보완하고자 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 유용성을 알아보고자 하였다. 대상 및 방법 : 골수염이 의심되어 Tc-99m HMPAO 백혈구 스캔을 시행했던 15명의 의무기록을 후향적으로 분석하였다. 골수염의 확진은 임상관찰 소견과 배양검사 결과와 병리소견을 기준으로 하였다. 결과 : 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 민감도와 특이도는 각각 100%와 78%였고 Tc-99m HMPAO 스캔의 경우는 100%와 18%였다. 가장 흔한 원인균은 methicillin-resistant S. aureus였다. Tc-99m MDP 스캔에서 양성소견을 보였던 환자중 3명의 환자가 Tc-99m HMPAO 백혈구 스캔에서 음성 소견을 보였으며 이 환자들은 추적관찰상 골수염이 없는 것으로 확인되었다. 결론 : Tc-99m HMPAO 백혈구 스캔은 골수염의 존재를 진단하는데 있어 민감도와 특이도가 높으며, 특히 뼈의 재형성이 증가되어 Tc-99m MDP 스캔의 특이도가 낮게 나타나는 상황에서 유용하리라 사료된다. Background Three phase bone scintigraphy, performed with technetium-labeled diphosphonates (Tc-99m MDP scan), is the very sensitive radionuclide procedure of choice for diagnosing osteomyelitis. But, Tc-99m MDP scan is less specific when bone remodeling is increased. To overcome this limitation, we evaluated the diagnostic value of technetium-99m hexamethylpropyleneamine oxime (HMPAO) labeled leukocyte scan in osteomyelitis. Methods : We retrospectively reviewed 15 patients with suspected osteomyelitis who performed Tc-99m HMPAO labeled leukocyte scan. The diagnosis of osteomyelitis was based on clinical course and bacterial culture, and pathologic findings. Results The sensitivity and specificity of Tc-99m HMPAO leukocyte scan was 100% and 78%, and those of Tc-99m MDP scan was 100% and 18%, respectively. The most common organism was Methicilein-Resistant S. aureus. Among the patients that showed persistent accumulation on Tc-99m MDP scan, three patients showed no uptake on Tc-99m HMPAO leukocyte scan and these patients were confirmed that had no osteomyelitis. Conclusion : Tc-99m HMPAO leukocyte scan is a useful test for determining the presence or absence of osteomyelitis, especially under condition that bone remodelin is increased.

다수의 동일한 입력원을 갖는 ATM Multiplexer의 정확한 셀 손실 확률 분석

최우용,전치혁 한국경영과학회 1995 한국경영과학회 학술대회논문집 Vol.- No.1(2)

We propose a new approach to the calculation of the exact cell loss probability in a shared buffer ATM multiplexer, which is loaded with homogeneous discrete-time ON-OFF sources. Renewal cycles are identified in regard to the state of input sources and the buffer state on each renewal cycle is modelled as a K(shared buffer size)-state Markov chain. We also analyze the behavior of queue build-up at the shared buffer whose distribution together with the steady-state probabilities of the Markov chain leads to the exact cell loss probability. Our approach to obtaining the exact cell loss probability seems to be more efficient than most of other existing ones since our underlying Markov chain has less number of states.

말기신부전 환자의 혈색소 순환 : 투석 방식에 따른 양상 비교 및 관련 인자들에 대한 고찰

최재혁,김준섭,원기범,박준형,탁우택,이정호 동국대학교 의학연구소 2009 東國醫學 Vol.15 No.2

혈색소 순환은 말기신부전 환자에서 인체 재조합 적혈구 조혈 인자를 투여하여 빈혈을 치료하는 동안 빈번히 관찰되며 이는 환자의 입원과 사망률과 관계가 있다고 알려져 있다. 이에 저자는 투석중인 말기 신부전 환자를 대상으로 혈색소 순환 양상과 이와 연관된 인자들을 알아보고자 하였다. 혈색소 순환의 관련 인자들을 알아보기 위하여 투석 치료를 받고 있는 환자 40명 (혈액투석 환자군: 20형, 복막투석 환자군: 20명)을 대상으로 투석 시작부터 1년 동안의 환자의 나이와 성별, 투석시작 1년간의 평균 Hb, 수혈 횟수, 총입원 횟수, 감염으로 인한 입원 횟수, 혈청 ferritin 농도, 혈청 transferrin saturation (TSAT), 철분제제 복용 유무, 일주일 동안 투여된 rHuEPO 양, rHuEPO의 변화량, 알부민, C-reactive protein (CRP) 및 입원 원인 등을 후향적으로 조사하였다. 전체 환자 40명 중 33명 (82.5%)에서 혈색소 순환이 관찰되었다. 혈액투석 환자군에 비해 복막투석 환자군에서 혈색소 순환 첫수가 유의하게 높았다 (p=0.037).혈색소 순환 발생군과 혈색소 순환 미발생군의 관련인자들을 비교하였을 경우 혈색소 순환 발생군에서 총 입원 첫수 (p=0.01), 감염으로 인한 입원 횟수 (p=0.036)가 유의하게 많았으며, 혈중 알부민 수치는 유의하게 낮았다 (p=0.003).그러나 두 군간의 나이, 성별, 수혈 횟수, 혈청 ferritin농도, 혈청 transferrin saturation (TSAT) 및 혈청 철분 농도는 유의한 차이가 없었다. 혈색소 순환의 빈도는 일주일 동안 투여된 r-HuEPO변화량과 양의 상관관계를 보였고 (p=0.003),혈중 알부민 수치와 음의 상관관계를 보였다 (p=0.013). 복막투석 환자군에서 혈액투석 환자군에 비해 혈색소 순환이 유의하게 높게 발생하였다. 일주일 동안 투여된 r-HuEPO 변화량, 입원 및 혈청 알부민 수치는 투석 시작부터 1년 동안의 혈색소 순환과 관련이 있었다. Hemoglobin cycling is frequently observed during treatment of anemia with recombinant human erythropoietin (r-HuEPO) in patients with end stage renal disease (ESRD) it is also reported to be associated with hospitalization and morbidity. We analyzed hemoglobin cycling and potential associated factors in patients on dialysis. Forty new dialysis patients (20 hemodialysis, HD and 20 peritoneal dialysis, PD) were recruited during their first year. Age, gender, mean hemoglobin level, frequency of transfusion, frequency of hospital admission, frequency of admission due to infection, serum ferritin, transferrine saturation, iron levels, rHuEPO dose per week, serum albumin, and c-reactive protein were retrospectively evaluated in order to examine the possible correlations with hemoglobin cycling. Thirty-three patients (82.5%) were identified in the hemoglobin cycling group. The PD group had a higher frequency of hemoglobin cycling than did the HD group (p=0.037). The hemoglobin cycling group showed a significantly higher frequency of hospital admission (P=0.001), admission due to infection (p=0.036) and a lower serum albumin level (p=0.003) than the other group, but there was no significant difference between the groups for age, gender, frequency of transfusion, serum ferritin, transferrine saturation, and iron levels. The frequency of hemoglobin cycling showed a positive correlation with the i-HuEPO dose variation per week (p=0.003) and a negative correlation with serum albumin level (p=0.013). The PD group had a higher frequency of hemoglobin cycling than the HD group, and the change of rHuEPO dose per week, hospitalization and serum albumin were associated with the hemoglobin cycling during the first year of dialysis.

환경교육을 위한 웹 기반 프로젝트 학습 시스템의 설계 및 구현

전우천,정효숙,김동용,엄종진,정성모,최수경 서울교육대학교 2001 한국초등교육 Vol.12 No.2

The use of the Web (World Wide Web) has been changing roles of traditional education style. Especially, the Web can overcome time and space limitations in the traditional schools. Teachers and students are now using the Web to access vast amounts of information and resources on cyber space. Also, the learning via the Web enables both synchronous and asynchronous communication. Despite of many benefits of the Web, it may weaken students motivation due to lack of face-to-face communication. In this paper, we provide a learning model called Web Project Learning, which is based on the contructivism, to provide motivation and collaborative learning for students in the Web environment. The model is based on the Project-Based Learning model and is revised for use in the Web. The model can also encourage the participation of parents as well as students, and be applied to any subject. We implement our model and show that the model can be used for environmental education as an instance.

두부외상환자에서의 예후인자

최성혁,문준동,김수진,문철규,이성우,홍윤식 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: Predicting outcome after head trauma is of great interest for clinicians, especially in the early stage. It may provide a basis for therapeutic strategies and may be helpful to select different approaches. But, reliable outcome prediction from head trauma is still unresolved. The purpose of this study is to determine which clinical parameters can be used effectively after an event of head trauma. Methods: In our study we studied head trauma patients who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of June 1998 to 31th of January 2000, looked into medical records, and studied the records in a retrospective manner. The head trauma patients were divied into two group, a) favourable outcome-related and b) unfavourable outcome-related. The two groups were then subdivided according to their sex, age, the mechanism of their injury, the time they came in, alcohol drinking, loss of consciousness, vomiting, pupil change, previous medical illness, associated injuries and were seperately compared and analyzed. And the factors affecting Glasgow Outcome Scale(GOS) were analyzed in the parameters of Injury Severity Score(ISS), Revised Trauma Score(RTS), Glasgow Coma Scale(GCS), motor score of GCS(mGCS), Marshall Computed Tomographic Classification(MCTC). Statistically, t-test and Mann-Whistney rank sum test using Jandel-sigma were used in the study and then were assessed in Chi-square analysis methods. The statistical significance was determined at a level of p less than 0.05. Results: The total of the head trauma patients, added up to 129 people, 99:males and 30:females. Among this sum, 99 patients showed a favourable outcome and 30 patients showed an unfavourable outcome at discharge. The causes of injury included: automobile accident in 42 cases; fallss in 26; assaults in 6; and accidental-slipping injury etc in 55 cases. 12 patients had bilateral unreactive pupils on admission, 2 had unilateral reactive pupils, and 113 had bilateral reactive pupils. Compared to the favourable outcome-related head trauma group, the unfavourable outcome-relared head trauma group had more history of loss of consciousness, unreactive pupils and tended to have previous medical illness. There were no difference in alcohol related, vomiting and associated injuries between two groups(favourable outcome-related head trauma group: unfavourable outcome-related head trauma group). Substantial difference were observed in GCS, mGCS, ISS, RTS, MCTC between two groups. Patients with unfavourable outcome had a significantly higher ISS, lower RTS, lower mGCS. After MCTC, patients with mass lesion had unfavourable outcome than patients with diffuse injury. Conclusion: Age, history of loss of consciousness, previous medical illness and unreactive pupil change are predictives of outcomes of head trauma patients with respect to Glasgow outcome scale. The lower GCS, lower RTS, lower mGCS, higher ISS, mass lesion based on CT scan provide poorer prognostic outcome in patients with head trauma. Use of prognostic factors thorough complete history taking and physical examination would provide useful prognostic information and facilitate improved therapeutic decision-malting in head-injuried patients.

Shot-Peening이 疲勞强度에 미치는 影響에 關한 實驗的 硏究

崔壯宇,任埈澤 弘益大學校 1989 弘大論叢 Vol.21 No.2

In this paper, to study shot-peening effect on the fatigue strength in elevated temperature, 10 and 15 min shot-peened smooth specimens which were made of SGD 41-D steel were experimented by the rotary bending test machine. And in order to study peening time effect on the fatigue strength, 20min shot-peened specimens were tested. The results are followed: 1. In the case of 200℃ test temperature, denoted at 10? cycle fatigue strength of not shot-peened, 10min and 15min shot-peened specimens tended to decrease 6.5%, 8.8%, 8.6% each and at 300℃ test temperature, these were increased 11.5%, 1.5% and 2.0% each compared with the fatigue strengths at room temperature. In case of 450℃ test temperature, these fatigue strengths were decreased just little bit. 2. Fatigue strength was shown the sequence; 15min shot-peened specimens, 10min shot-peened specimens and not shot-peened specimens at each temperature. The differance of the fatigue strength of not shot-peended specimens tested at each temperature was larger than that of any other specimens. 3. In case of room temperature and 200℃, the fatigue strength of not shot-peened specimens increased 20%, 18% as compared with the fatigue strength of not shot-peened specimens, and in case of 300℃ and 450℃ the difference of fatigue strength were very small. 4. In case of room temperature, the fatigue strength attendant upon peening time, shot-peened 10min increased 18.5% than not shot-peened, shot-peende 15min increased 3.2% than shot-peened 10min, and shot-peened 20min increased 1.1% than shot-peended 15min specimens. This results show that the fatigue strength increase ratio was diminish attendant upon peening time increment.

해수유동모델 결과의 3차원 가시화를 위한 GUI 구현

최우정,박성은,이원찬,구준호,서영상,김태현 한국지리정보학회 2004 한국지리정보학회지 Vol.7 No.3

해수유동모델 결과를 3차원적으로 가시화하기 위한 그래픽 유저 인터페이스를 구축하는 과정에서 지리정보시스템(GIS) 기술을 활용하였다. 연안역 관리에서 GIS 기법은 산재되어 있는 방대한 자료들을 저장하고 이를 3차원으로 가시화하는 기능을 제공하며 해석적, 통계적, 모델링 도구로써 주어진 상황에 적합한 데이터 변환이 가능하도록 해준다. 해수유동모델은 개방경계에서 조석, 바람, 수온, 염분, 강물 유입 및 태양복사 등과 같은 모델입력값을 부여함으로써 구동되며 대상해역은 진해만으로 하였다. 녈 연구에서는 국산 GIS 소프트웨어인 GeoMania (v2.5)를 사용하여 진해만을 대상으로 시뮬레이션된 해수유동모델 결과의 3차원 가시화 모듈을 구축하였다. This study presents an application of GIS technologies to construct the graphic user interface for 3-dimensional exhibition of the results obtained by ocean hydrodynamic model. In coastal management studies, GIS provide a receptacle for scattered data from diverse sources and an improvement of the 3D visualization of such data. Within the frame of a GIS a variety of analytical, statistical and modeling tools can be applied to transform data and make them suitable for a given application. A 3D hydrodynamic model was driven by time-dependent external forcing such as tide, wind velocity, temperature, salinity, river discharge, and solar radiation under the open boundary condition. The Jinhae bay was selected as a case study. Here, we have used GeoMania v2. 5 GIS software and its 3D Analyst extension module to visualize hydrodynamic model result that were simulated around the Jinhae bay.

방사선학적 치근단병소의 크기와 특징에 대한 치근단낭종 및 육아종의 상관관계연구

최호식,이우철,손원준,금기연,배광식,백승호 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.1

The purpose of this study was to find out the relationship of radiographic lesion size, gender, age of patients and radiographic character to the diagnosis of periapical cyst and granuloma. The data was collected from 187 periapical lesions of 167 patients who undergone apical surgery at Department of Conservative Dentistry, Seoul National University Dental Hospital from 2003 to 2005. The lesion were surgically removed and send for biopsy to the Oral Pathology Laboratory. From the initial radiograph, lesion size was calculated using PiViweSTAR (INFINITT, Korea) program. The obtained data were statistically evaluated using SPSS (p<0.05). The result were as followings: 1. From 187 biopsy samples, the incidence of periapical cyst was 28.34% and granuloma was 65.24%. 2. There was a significant correlation between periapical cyst and the size of radiographic lesion (p<0.01). 3. There were no significant correlations between age, gender, location of lesion and the final diagnosis (p>0.05). 4. There was a significant correlation between the non-demarcation of the lesion and the incidence of periapical granuloma (p<0.01). 본 연구는 2003년부터 2005년까지 서울대학교 치과병원 보존과에 내원한 환자 중 치근단수술을 시행한 환자 167명에서 생검을 위해 적출한 187개의 치근단병소를 대상으로 하였다. 수술 후 조직검사 결과 얻은 진단명과 환자의 진단기록에서 환자의 성별, 나이, 발병 부위, 방사선 사진 상의 특징 그리고 병소의 크기와의 상관관계를 조사하였다. 초진시 방사선 사진에서 치근단병소의 크기를 PiViewSTAR (INFINITT, Korea)를 이용하여 화소를 계산함으로써 면적을 구하였다. 이를 바탕으로 통계 분석프로그램 SPSS (version 12.0K, SPSS Inc., Chicago, IL, USA)를 이용해 방사선사진상 크기와 진단명과의 상관관계를 조사하였다. 나이와 진단명과의 상관관계는 일원배치 분산분석을 시행하고 성별, 부위, 방사선사진상의 특징과 진단명과의 상관관계는 교차분석을 통해 카이제곱검정으로 조사하여 다음과 같은 결론을 얻었다. 1. 187의 치근단병소 조직검사결과 치근단병소 중 치근단낭종의 비율은 28.34%, 육아종의 비율은 65.24%, 기타병소의 비율은 6.42%로 나타났다. 2. 방사선사진상 병소의 크기가 커질수록 치근단 낭종일 확률이 높았다(p<0.01). 3. 나이, 성별, 발병부위와 진단명사이에서 유의 한 상관관계가 없었다(p>0.05). 4. 병소의 경계가 명확하지 않은 것과 치근단육아종의 발생빈도는 통계적으로 유의한 상관관계를 보였다(p<0.01).

유입 전염병 열대열(Plasmodium falciparum) 1예

우준희,이지윤,최창현,홍성태 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

Recently the prevalence of malaria has been increasing around the world and there is an increasing concern about exogenous malaria in non-endemic areas, We experienced a case of imported malaria(Plasmodium falciparum) in a 37 year-old Koran male. The management with chloroquine was successful and wish to report this unusual case, along with a review of literatures.