과립구감소증의 발열환자에 대한 Teicoplanin을 포함하는 제 2선 경험적 항생요법

이강욱,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

Background and Purpose : In recent years, the frequency of isolation of Gram-positive organisms, including coagulase negative Staphylococci and Streptococci, is increasing in neutropenic febrile patients. So, it seems reasonable to expect that at least a sub-population of these patients might benefit from the addition of a glycopeptide to the standard empiric regimen. Teicoplanin is a new glycopeptide with comparable activity to vancomycin, which needs be given only once daily. We therefore conducted a study to evaluate the efficacy and safety of teicoplanin as a second-line empiric therapy in neutropenic febrile patients. Patients and Methods : Neutropenic patients were given a empiric antibiotic regimen consisting of cephalosporin, aminoglycoside, and antipseudomonal penicillin when a significant febrile episode occurred. In cases of no clinical improvement after 72 hours of this therapy, cephalosporin was replaced with teicoplanin. Teicoplanin was administered initially 400mg intravenously at 12 hour-interval 2 times and then once daily. Results : 17 neutropenic febrile patients who did not respond to first line empiric antibiotic therapy were enrolled in this study. Infections were documented clinically or microbiologically in 10 of 15 assessable cases(67%). Infection sites were bacteremia in 4 cases, chest 1, Hickman catheter 2, and others 4. Staphylococcus epidermidis was the most frequently isolated organism(5/9, 56%). The others included Staphylococcus hemolyticus(11 %), Streptococcus group A(11%), Pseudomonas species(11%), and Candida tropicalis(11%). In 6 of 9 cases with microbiologically documented infection, causative organisms were eradicated with teicoplanin rescue(response rate 67%). 11 of 15 evaluable patients were cured clinically (response rate 73%). 2 patients were cured after the addition of amphotericin B and 2 patients died of infection (failure rate 13%). Mild elevations of liver enzymes were observed in 3 cases. The relationship of these abnormalities to teicoplanin was uncertain due to concurrent use of anticancer and/or antifungal agents. Any other toxicities requiring cessation of teicoplanin rescue were not observed. Conclusions : These results show that a large proportion of febrile episodes in neutropenic patients is related to infection caused by Gram positive organisms and that teicoplanin has high efficacy in the management of febrile episodes in neutropenic patients without significant toxicity.

IgA 신병증의 임상 및 병리학적 고찰

이강욱,최영환,신영태,노흥규,서광선 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1

Twenty eight cases of primary IgA nephropathy were diagnosed and studied in the Department of Internal Medicine, Chungnam National University Hospital over a period of 49 months from June 1981 to July 1985. The results were summerized as follows: 1. These cases represented 45.2% of patients with primary glomerular diseases undergoing renal biopsy and immunofluorescent studies during the same period. 2. There were 20 males and 8 females. They were 15 to 54 years old and the average age was 29.1. 3. The main symptoms were loin pain, gross hematuria, myalgia, fatigability and generalized edema in 18, 15, 12, 12, and 4 cases, respectively. Upper respiratory tract infection symptoms were presented in 50% of the cases of all patient just before and during the course of disease. 4. Proteinuria was observed in 27 cases and hematuria was seen in 23 cases, Among hematuria, the gross hematuria was observed in 15 cases. Hypoalbuminemia and hypercholesterolemia was presented in 4 cases with generalized edema. Serum BUN and creatinine were elevated in 3 cases with marked decreased Creatinine Clearence in 3 cases (Ccr<50ml/min). 5. The light microscopic findings showed mainly mesangial proliferative glomerulonephritis and focal and segmental glomerular sclerosis in 11 and 7 cases, respectively. Immunofluorescent microscopic findings disclosed diffuse mesangial deposit of IgA in all cases. IgG, igM, C3 and fibrinogen deposits were observed in mesangium in 5, 4, 20, and 7 cases, respectively.

위상최적화를 이용한 트레일러의 경량설계

안서욱,이신영,윤민수,장강원 한국공작기계학회 2009 한국공작기계학회 춘계학술대회논문집 Vol.2009 No.-

A new design for a lightweight flatbed trailer with high bending and torsional stiffness is presented by using an integrated CAE-based optimization procedure. The integrated design procedure consists of two main steps: topology optimization and thickness optimization. During topology optimization, a creative frame layout different from existing ladder-type frames can be obtained by searching the best layout out of all possible layouts of a simplified design domain model. After approximating the result of topology optimization as a thin-walled structure, the approximated thicknesses of the plates are optimized to minimize the mass of a trailer.

각종 갑상선질환에서 혈청 유리 T_3의 진단적 의의

노흥규,이강욱,이종화 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

To estimate the diagnostic significance of serum free T_3 in various thyroid diseases, the serum levels of free T_3, T_3, `ree T_4, T_4 and TSH were measured by radioimmunoassay method in 43 cases of euthyroid thyroid diseases, 19 cases of hyperthyroidism, 2 cases of primary hylothdism and 10 cases of normal subjects as controls at the Dept. of Internal Medicine, CNUH, since January to July, 1984. The diagnostic sensitivity and specificity of each hormone level were calculated according to the clinical diagnosis of the cases. The results were as follow; 1. The serum levels of thyroid hormones in normal controls were; free T_3 : 6.68±2.1 pmol/ml, T_3: 1.24±0.49 ng ml, free T4: 1.27±0.38 ng/dl, T_4, : 7.80±2.04 ug/dl and TSH :1.87±0.9uU/ml(M±2SD). 2. The diagnostic sensitivity of hyperthyroidism was 100% in serum T_3, free T_4 and T_4 , 84% in _fT_3 but the specificity was 93% in _fT_3, 92% in _fT_4. 3. The diagnose c sensitivity was highest as 86% in _fT_3 and _fT_4 while the specificity was 100% in _fT_4, 80% in _fT_3. With the above results, it can be concluded that measurement of serum _fT_4, and _fT_3 levels is the most specific and sensitive measure in diagnosing the hyperthyroidism and euthyroid thyroid diseases.

월드컵 경기장 조명설비에 관한 연구

金章漢,莘康旭,金吉永 홍익대학교 산업기술연구소 2002 産業技術 Vol.12 No.-

Nowadays the soccer becomes one of the best spot lighting sports in the world. Especially the 2002 Korea-Japan World Cup was deeply impressed on all the korean. One goal of illuminating engineering should be the design of lighting system that can provide consistently high task visibility regardless of where a task might be located within a working space. The television broadcasting on the soccer has been an important role in the media. The standard of FIFA(The Federation Internationale de Football Association) requires recommended illuminance levels for artificial lighting for a player, an audience, TV broadcasting, as well as everybody in the stadium. This paper has proposed an algorithm to select the suboptimal lighting tower position for watching and TV broadcasting a soccer game within a pleasant environment and an optimum illuminance distribution. The position using the software Philip`s Calculux was chosen based an the calculations of a horizontal illuminance, vertical illuminance, uniformity, glare, and so on by changing lighting tower positions.

Fosfomycin의 항균효과 및 capillary electrophoresis에 의한 측정법에 관한 연구

윤효인,박승춘,이규승,권진욱,조준형,신광순,김무열,허강준,조명행 충남대학교 수의과대학 동물의과학연구소 1996 動物醫科學硏究誌 Vol.4 No.-

Fosfomycin, a low molecular antibiotic, is to be easily synthesized, therefore to be possibly used in veterinary sectors due to econimic reasons. In this study, we determined the antibacterial activities of fosfomycin against some domestic animal-origin pathogens, and its combined effects with some important antibacterials available. We also compared detection methods of fosfomycin from various measuring instruments. The results obtained through this experiment were as follows: 1. Antibacterial activities of fosfomycin against the pathogens used in this experiment were appeared fairly low. We found the antobacterial activities depanded on the kinds of media and the addition of some material thereins, which suggests the importance of appropriate medium so as to judge the antibacterial activity of fosfomycin. 2. Fosfomycin showed varying antibacterial effects in combination with other antibacterials, which should be taken into consideration when combining other antobacterials especially in the clinical settings. Of the combined antivacterials, fosfomycin had synergistic effects in combination with amoxicillin but antagonistic effects with oxytetracyline. 3. Conventional detection methods using HPLC, GC and spectrophotometer were not appropriate to measure fosfomycin. Capillary electrophoresis by the way of the indirect ultraviolet detection method was good enough to detect fosfomycin in the range of expected concentration in tissues, with the limit of quantitation (LOQ) of 1.25 ㎍/㎖. We recommend the eletrophoresis method could be used to detect fosfomycin, thereby being able to set the optimal dosage for animals and providing the measures in relation with the residual concentration in the meat.

전신성 홍반성 낭창의 임상적 고찰

신영태,이정호,신승훈,이강욱 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

To elucidate the clinical feature and clinicopathologic correlation of systemic lupus erythematosus(SLE), the authors analized symptoms and signs, laboratory findings and kidney pathology in 25 patients with SLE who were admitted to the Department of Internal Medicine, Chungnam National University Hospital from My 1985 to October 1989. Kidny biopsy was performed in 15 patients out of 19 patients who showed lupus nephritis. The results were as follows: 1. The ratio of male of females was 1:11.5. They were 14 to 53 years old and mean age was 30.2 years old. The peak age incidence was 3rd and 4th decades. 2. The most frequent chief complaint on admission was fever and chills. Most patients had two or more symptoms such as arthralgia, malar rash, generalized edema or weakness. 3. In 84% of the patients, duration from onset of the disease to diagnosis of SLE was longer than 1 month, which suggested that diagnosis of SLE is not easy in early stage of SLE. 4. The positive anti -DNA was the most frequently observed ARA criteria of SLE. And positive ANA, malar rash, persistent proteinuria, leukopenia, positive LE cell preparation, arthritis and oral ulcer were observed in order of frequency. 5. The frequent and pertinent general symptoms, not included in ARA criteria were fever and chills, arthralgia and abdominal pain which were observed in more than half of the patients. 6. On immunologic test, serum concentrations of C3 and C4 were decreased in 96% of the patients, serum concentration of Ig G, Ig A were increased in 65%, 36.8% and 26.3% of the patients respectively. The RA test was positive in 25% of the patients. 7. Lupus nephritis represented 76% of all SLE patients and pathological classification on 15 patients with lupus nephritis revealed class IV lupus nephritis in 9 patients(60%), class II n 3 patients (21%), class V in 2 patients(13.3%) and class III in 1 patient. 8. 7 out of 9 patients with class IV lupus nephritis and 1 out of 2 patients with class V lupus nephritis showed nephrotic syndrome. Progressive azotemia were observed in 3 out of 9 patient with class IV lupus nephritis and in 1 out of 2 patients with class V lupus nephritis. There were no nephrotic syndroms or azotemia in class II and class III lupus nephritis. 9. Of 17 patients who can be followed up, 9 patients were improved, 5 patients became progressive azotemia and 3 patients resulted in death. The causes of death were myocarditis with pericarditis in 1 patients, pneumonia with acute respiratory failure in 1 patient and CNS involvement of SLE in 1 patient.

괴사후성과 비괴사후성 간경변증에서 원인별 주석교질 (^99mTc-tin colloid) 간스캔의 차이

이헌영,허승식,이강욱,정현용,김삼용,신영태,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

The differences of the liver scintigraphic features between postnecrotic and nonpostnecrotic liver cirrhosis were studied for 69 patients. Degrees of mottling and splenomegaly were no different between two groups but shrinked form was more frequent finding in postnecrotic type(23:10), and normal shape & enlarged left lobe with shrinked right lobe were relatively dominant in non-postnecrotic group(15:6, 10:2). Grade of extrahepatic uptake of ^99mTc-tin colloid was significantly higher in Child-Pugh B & C group than A group(p<0.05), but there was no difference between postnecrotic and non-postnecrotic groups. These will be important results on the dicision for the presence of cirrhosis according to the variable causes.

Co-계비정질 리본의 자기특성에 미치는 열처리 효과에 관한 연구

조치현,신용진,문현욱,서강수 明知大學校 産業技術硏究所 1993 産業技術硏究所論文集 Vol.12 No.-

This thesis describes the effect of annealing on the magnetic properties of Co-bsaed amorphous. The basic composition of the chosen samples were Co82Si2B15 of zero magnetostriction. The sample was melted in the quartz tube with 0.5[mm∮) nozzle. and the single roll technique was used to make a amorphous ribbon, under Ar-gas pressure 0.6〔kg/cm2] and ro11 speed 28[m/sec]. The average width and thickness of sample ribbons 2.4[mm] and 45(㎛). The sample ribbons were annealed to improve the magnetic properties at temperature of 325,350,375,400 and 450℃ respectively, for 15,30,45,60 and 120 [min] at each temperature. And I have measured high per meability of 8,000∼ 13,000 through the annealed amorphous ribbons. Especially, when the amorhpous samples were annealed at 325 for 45min, the permeability of the ribbon was 13,589. Consequently. I had effects of the improvment of permeability and the average loss at the low-frequency region.

폐경기 여성에서의 Cyclofenil의 효능에 관한 연구 : 갱년기 장애 및 Ca 장흡수에 관하여

노흥규,윤상임,성기양,이경숙,이강욱 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

In postmenopausal syndrome, most common symptoms are those of vasomotor irritability such as hot flush and palpitation, irritable bladder symptoms and dyspareunia according to atrophy of urogenital epithelium, anxiety, nervousness, depression and insomnia. Approximately 40 percent of women in postmenopausal period develop symptoms serious enough to seek medical assistance. Among non-steroid agents, cyclofenil(4, 4' cyclohexidene methlyene diphenoacetate) is known to be a quite interesting substance according to the action at the level of the hypophyseal and hypothalamic centers by reducing the incretion of FSH and restoring normal endorphin, dopamine and norepinephrine activities, thus favorably affecting the whole postmenpausal neurovegutative symptomatology. In order to evaluate effect of cyclofenil on postmenopausal symptomatology and calcium metabolism, we examined 32 patients with postmenopausal syndrome before and after 200mg/day of oral cyclofenil treatment for 30-60 days. The results were as follows: 1. With 30 days of cyclofenil administration, subjective symptoms such as facial flush, palpitation, anxiety, nervousness and dyspareunia were improved significantly (p<0.001, p<0.001, p<0.01, p<0.005, respectively). But insomnia and depression were improved significantly after 60 days of cyclofenil administration (p<0.05, p<0.001, respectively). 2. Intestinal calcium absorption rate disclosed tendency of improvement without statistical significance 30 days after cyclofenil treatment. 3. Serum calcium and phosphorus level were not changed significantly before and after cyclofenil. 4. There was no definite evidence of side effects such as uterine bleeding due to cyclofenil. In conclusion, we thought that cycofenil is effective in management of postmenopausal syndrome but for the effect on calcium metabolism, further evaluation should be needed.