담낭암의 발생에서 담췌관합류이상의 역할 규명과 암화과정에 관한 연구

한기준,송시영,정재복,이세준,김호근,강진경 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.4

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.

담낭암 발생에서 담췌관합류이상의 역할 규명과 암화과정에 관한 연구

강진경,한기준,이세준,송시영,정재복,김호근 대한소화기학회 1998 대한소화기학회지 Vol.32 No.4

Baekground/Aims: To clarify the careinogenesis of gallbladder cancer (GBC) in patients with anomalous pancreaticobiliary ductal union (APBDU), we investigated the expression of mutated p53 protein and c-erbB2, the cell proliferation indices of Ki-67 and the histopathologic changes in gallbladder carcinoma and noncaneeraus mucosa which are associated with APBDU. Methods: In the clinical review, we analysed 62 patients (27 patients of GBC with APBDU and 35 patients of GBC without APBDU) who were diagnosed in Sevrance Hospital from January, 1992 to December, 1994. Immunohistochemical staining and histologic examination were performed on the specimens obtained from surgically resected gallbladders from the patients. For comparative study, the specimens were grogped as follows: 5 cases of carcinoma with APBDU, 4 eases of noneancerous mucosa with APBDU associated with GBC, 11 cases of noncancerous mucosa with APBDU not associated with GBC, 19 cases of carcinoma without APBDU and 7 cases of chronic inflammatory mucosa of gallbladder stones as controls. Results, GBC developed in 33.3% of patients with APBDU (especially, 66.7% of PC type) and showed no gallbladder stones. The frequency of papillary carcinoma was higher and depth of invasion was less in GBC with APBDU than in GBC without APBDU. Among 15 cases of noncancerous mucosa with APBDU, isolated dysplasia and adenomyomatous hyperplasia were noted in 10 cases and 4 cases, respectively. In one case of APBDU with GBC, the expression of p53 protein was noted in the focal area of low grade dysplasia. Cell proliferation indices of Ki-67 were stepwise increased with the progression of histologic findings from inflammation, papiUary hyperplasia, metaplasia and adenomyomatous hyperplasia to dysplasia. Particularly, remarkable increase was observed in adenomyomatous hyperplasia and dysplasia. Conclusions: The high incidence of isolated dysplasia and adenomyoma accompanying with increased cell proliferative indices seems to be closely related to th carcinogenesis of GBC in patients with APBDU. Additionally, the mutation of p53 may contribute to early event of carcinogenesis in some patients with APBDU.

정면밀링커터의 마모 특성 연구

鄭準基,金鍾太 弘益大學校 科學技術硏究所 1995 科學技術硏究論文集 Vol.6 No.-

According as concerns about unmaned and automated manufacturing systems recently is getting bigger and bigger, the study for constructing the latest system including FMS, CIMS, and so forth is proceeding at a rapid speed. Now here, this study can say these : If the condition of rapid wear stage(over 0.2mm)by the relative act between workpiece and tools, it severly degrades the high quality of the machined surface. As the result of that, the system which can sense the in-process monitoring in advance necessarily has to be used to checking the abnormal state of the tool like above things. Therefore this study suggested as a means for the in-process monitoring feasibility of tool wear checking, as gradual increasing tool wear, by using AE signals not being affected by noise. Therefore we can come to the following conclusions. 1) The AE signals to generate from workpiece are very sensitive to increasing tool wear. 2) We can observe that workpiece SM45C and SKD11 seldom changed until micro-breakage stage of tool wear(under 0.2mm), but largely increased an amplitude of AE signal after show that the rapid wear stage(over 0.2mm). These results show that AE signals in this step have much useful information to foretell heavy damage between workpiece and cutting tools. 3) Cutting force little change in case the change of the geometry shape like the tool wear change little appears the change is very indistinct. So we have a difficulty in checking the tool wear stage by in-process.

채터 發生抑制를 爲한 旋盤工具臺의 改善에 關한 硏究

鄭準基 弘益大學校 1989 弘大論叢 Vol.21 No.2

. High speed and heavy cutting performed for improving the surface quality and productivity, are often prevented due to chatter phenomena. Chatter is a violent relative vibration between workpiece and tool in machining of metals, and is an important limiting factor of production rate and surface quality, and reduces the tool life and the dynamic performance of machine tool itself. In this study, in order to suppress the chatter, a modified tool-post combined with the spring and damper was designed and used in the actual cutting test. The results of this study are summerized as follows; The spring and damper adopted in the modified tool-post have the suppressing effects of chatter, and there exists an optimum combination between spring constant and damping ratio.

CNC 선반의 절삭력 제어를 위한 퍼지제어기의 적용

鄭準基,徐永達 弘益大學校 科學技術硏究所 1998 科學技術硏究論文集 Vol.9 No.1

Cutting conditions including depth of cut, feedrate, cutting speed, tool geometry, and setting angle are parameters that give significant effect to the cutting force in metal cutting operations. And the cutting force can be controlled to maintain constant value by combining and regulating these parameters. Generation of excessive cutting force and cutting heat can be restrained at the constant cutting force and then, we can achieve the progressive cutting stability and performance of machine-tool and tool itself. In this study, fuzzy control is introduced to determine proper feed-override. The application of fuzzy systems can simulate human experience, human intelligence, and experimental information for cutting processes, and can be used to control very complex and uncertain processes(including machining processes) such as multi input-multi output, and non-linearity, etc. Fuzzy algorithm of automatic feed-override regulation is also proposed to control cutting forces in CNC lathe turning. The experimental results reveal that the fuzzy controller is suitable to the regulating feed-override of AC servo-motor of CNC lathe.

아시아 12개국의 응급의학 실태에 대한 연구 조사

정제명,왕순주,안무업,박재형,유기철,박준석,강재구,제프리 아놀드 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : To assess the current level of development of emergency medicine (EM) systems in Asia. Method : Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. Results : 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. Conclusions : Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.

三次元 切削에서 切削力의 解析的 硏究

鄭準基 弘益大學校 1982 弘大論叢 Vol.14 No.2

The cutting forces on obique cutting with single cutting edge are investigated analytically, based on the thin shear zone model. To predict the three components of oblique cutting forces analytically, an experimental data of orthogonal cutting and cutting energy method are used. And the predicted results are in good agreement with the experimental results under the equivalent cutting conditions. The results obtained in this study are summerized as follows, 1.The cutting forces of the oblique cutting can be predicted analytically by applying energy method even if only orthogonal cutting data are in hand. 2.The analytical prediction of cutting forces on oblique cutting with single cutting edge is applicable to the double cutting edge model.

旋盤切削에서 채터 發生抑制에 關한 硏究

鄭準基 弘益大學校 1984 弘大論叢 Vol.16 No.2

Chatter is the relative vibration between workpiece and tool in the machining of metals, and is an important limiting factor of the production rate and surface quality, and also reduces the life of the machine itself and it's tool. In this study, in order to suppress the machining chatter, the spring and the rubber damper are adopted to the tool post of a lathe. The results obtained in this experimental study are summarized as follows. 1. The spring and the damper employed in the tool post for the suppression of chatter increase the maximum chatter-free depth of cut and optimum values found for spring constant and compressive strain are 95kg/mm, 0.1954 respectively. 2. On the optimum condition resulting in this experimental study, the modified tool post increased 6 times in the maximum chatter-free depth of cut as compared with the conventional tool post.

공구진단을 위한 엔드밀 변위에 인프로세스 측정

鄭準基 弘益大學校 科學技術硏究所 1999 科學技術硏究論文集 Vol.10 No.1

Milling operations with endmill are performed to investigate the characteristics of laser beam signals due to tool deflection and fracture. The laser beam signals are obtained with adapt focusing of tool. Tool conditions are identified with scanning electron microscopy and optical microscopy. It is demonstrated that the laser beam signals provide reliable informations about the cutting processes and tool conditions. Moreover, tool fracture can be detected successfully using the coefficient of variation.