한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

산재보상을 신청한 뇌심혈관질환의 특성 분석

유재홍,하은희,김수근,김정연,김용규,이의철,이철호,손준석 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 이 연구는 뇌 · 심혈관 질환으로 업무상재해를 신청한 사례 중에서 승인된 사례와 불승인된 사례의 특성을 비교하여 뇌 · 심혈관 질환의 업무상 재해여부를 판단하는데 필요한 기초 자료를 제공하고자 한다. 방법: 2000년부터 2004년까지 근로복지공단에 업무상 재해로 요양이 신청되어 승인여부가 결정된 뇌 · 심혈관 질환자 12,309명을 대상으로 하였다. 승인여부와 관련된 특성을 확인하기 위해 연도별, 업종별, 규모별, 직업별, 성별, 연령별, 질환별, 생존유무별 그리고 기존질환 유무에 대하여 카이제곱 검정과 다변량 로지스틱 회귀분석을 이용하였다. 결과: 다변량 로지스틱 분석에서 뇌 · 심혈관 질환의 불승인에 대한 승인의 비차비는 광업을 기준으로 하였을 때에 전기가스 상수도업이 4.18(95% CI=1.43~12.17), 건설업이 2.39 (95% CI=1.22~4.69), 제조업이 2.10 (95% CI=1.08~4.07)이었고, 장치기계조작원 및 조립원에 비하여 서비스 근로자 및 상점과 시장 판매근로자 군이 1.90(95% CI=1.47~2.47), 전문가 군이 1.83(95% CI=1.50~2.23), 기술공 및 준전문가 군이 1.63(95% CI=1.35~1.97), 입법 공무원과 고위 임직원 및 관리자 군이 1.62(95% CI=1.24~2.12)이었고, 여성이 남성에 비하여 1.31(95% CI=1.13~1.53), 심장질환에 비하여 뇌혈관질환이 2.75(95% CI=2.42~3.13), 사망한 경우가 생존한 경우에 비하여 6.01(95% CI=4.89~7.38)이었다. 결론: 우리나라에서 뇌심혈관질환으로 업무상 재해를 신청하는 건수는 증가하고 있고 승인율은 비교적 높았으며 승인에 영향을 미치는 요인으로는 업종, 규모, 직종, 성, 연령, 질환, 생존유무 등이 확인되었다. 특히 업종과 직종에 따라서 승인율의 차이가 큰 것이 어떠한 요인의 영향 때문인지에 대한 검토가 필요하고, 특히 뇌실질내 출혈의 경우에 다른 질환에 비하여 승인율이 매우 높았던 것은 업무수행성에 대한 인정기준의 잘못된 적용의 결과 이므로 시정이 필요하겠다. Objectives: This study was performed to provide fundamental data to judge whether or not cerebro and cardiovascular diseases are work-related, by comparing the characteristics between approved and non-approved cases among the worker's compensation claims. Methods: We collected 12,309 cerebro and cardiovascular disease claims based on the worker's compensation records of the Labor Welfare Corporation from 2000 to 2004. The approved and non-approved cases were analyzed according to factors such as the calendar year, industry, company size, occupation, gender, age group, classification of cerebro and cardiovascular diseases, fatality and underlying diseases. We used x²-test and multivariate logistic regression for the analysis. Results: According to multivariate logistic regression, electricity gas and water supply (OR=4.18, 95% CI=1.43~12.17), construction (OR=2.39, 95% CI=1.22~4.69) and manufacturing (OR=2.10, 95% CI=1.08~4.07) industries had a higher approval rate than mining and quarrying industries. Service workers and sales & marketing department workers (OR=1.90, 95% CI=1.47~2.47), professionals (OR=1.83, 95% CI=1.50~2.23), technicians and associate professionals (OR=1.63, 95% CI=1.35~1.97) and legislators and senior officials and managers (OR=l.62, 95% CI=1.24~2.12) had a higher approval rate than plant and machine operators and assemblers. Female workers had a higher approval rate (OR=1.31, 95% CI=1.13~1.53) than male workers. Cerebrovascular diseases had a higher approval rate (OR=2.75, 95% CI=2.42~3.13) than cardiovascular diseases. Fatal cases had a higher approval rate (OR=6.01, 95% CI=4.89~7.38) than surviving cases. Conclusion: For cerebro and cardiovascular diseases, workers' compensation claims are increasing, approval rates are relatively high and factors such as industry, company size, occupation, gender and fatality are related. A remarkable difference in the approval rate was found according to industry and occupation, suggesting the need for further study to identify which factors influence the approval rate. The approval rate for intracerebral hemorrhage arising in the course of employment (COE) was significantly higher than that arising out of employment (AOE), suggesting the need to correct the approval criteria.

제 3 대구치 발치시 환자의 호흡 패턴이 스트레스 변화 양상에 미치는 영향

이상명,김형욱,박양호,김진철,박준우,이성준,안재목,Rhee, Sang-Myung,Kim, Hyung-Wook,Park, Yang-Ho,Kim, Jin-Cheol,Park, Jun-Woo,Rhee, Sung-Jun,Nyamdorj, Selenge,Ahn, Jae-Mok 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.5

Purpose: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats(RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern(0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min. Methods: These phases include before, during and after tooth extraction or anesthesia or something.36 patients' stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system(ANS) which represents the level of stress. Results: All HRV parameters including HF(high frequency), LF(low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz. Conclusion: After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest?after the?anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.

Therasonic LT-1000 압전기 체외충격파 쇄석기를 이용한 요로결석 700례의 In Situ 치료경험

金鎭弘,閔準基,金顯喆,朴泳炅 全北大學校 1996 論文集 Vol.41 No.-

The Thersonic LT-1000 was a third generation lithotriptor, and equipped with characteristic long focal distance (17cm), with a combined fluoroscopic and ultrasound localization system integrated in a multifunctional table. 685 patients in 700 renal units with symptomatic urinary calculi were treated with in situ extracorporeal shock wave lithotripsy utilizing Therasonic Lithotripsy system (Therasonic LT-1000) at Chonbuk National University Hospital from August 1992 to August 1995 (about 90.8% of stones were completely treated with mean 3.4±2.3 sesions from range 1 to 28 sessions). The stone-free rate for patients with renal, upper, middle and lower ureteral calculi was 92.8%, 90.8%, 86.4% and 98.9% respetively. Stone-free rate for individual patient depended on stone size, location, composition, and quality of disintegration. Complications of extracorporeal shock wave lithotripsy were minimal. Authors concluded that the Therasonic device showed characteristis of long focal distance in the treatment of deeply located urinary calculi as in lower urinary tract, but the increased treatment sessions were matters to be solved.

치과용 앨지네이트의 국산화를 위한 규격 및 안전성에 관한 연구

김철위,허준호 大韓齒科器材學會 1990 대한치과재료학회지 Vol.17 No.1

The purpose of this study was to investigate the setting time, viscosity, surface detail reproduction, working time, permanent deformation, strain in compression, compressive strength, temperature rise during gelation, differential thermal analysis, acidity and toxicological properties of representative fourteen commercially available dental alginate impression materials (AG, AP, AR, CC, ID-Ⅰ, ID-Ⅱ, JT, KG, PG, PC-I, PC-Ⅱ, SM-I, SM-Ⅱ and ZG) and three experimental dental alginate impression materials(Exp A, Exp B and Exp C). These tests were performed by the methods of KDA specification No. 8, ISO specification No. 1563 and ANSI/ADA specification No. 18. Form the experiments, the following results can be drawn: 1. The setting time of the fast setting types showed considerable differences according to the products, but there was no significant difference in setting time of the normal setting types. The significantly difference of viscosity values for the normal setting types was observed with various commercial products, but there was no significant difference for the fast setting types. 2. The reproduction of surface detail of the normal setting types was higher than that of the fast setting types, and the working time of the alginate impression materials showed considerable difference according to the products. 3. The permanent deformation of the fast setting types was lower than that of the normal setting types, and the strain in compression, the compressive strength, and the temperature rise during gelation of alginate impression materials showed considerable differences according to the products. 4. The rapid endothermic temperature curves of the alginate impression materials proceed at 127.0℃∼134.7℃, and the exothermic temperature curves showed at 327.7℃∼367.0℃ 5. The acidity of the alginate impression materials showed considerable differences according to the products, and the fast setting types was lower than that of the normal setting types. 6. The results indicated that the dental alginate ingredients did not increased the frequencies of micronucleated polychromatic erythrocytes when compared with negative controls.

응급의학과로 내원한 환자중 내원시 예상치 못했던 사망에 대한 고찰

김승렬,김상은,양혁준,정호성,박철완,이 근 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Patients die in the emergency department frequently ; however, there has been little about the incidence and cause of Emergency Department death in the emergency medicine literature. This study was conducted retrospectively to gain insight into the patients who die suddenly and unexpectedly in the Emergency Department(ED). A total of 360 patients were pronounced dead in the ED from 1991 through 1994 in Chung Ang Gil Hospital. Of the 360 patients, 309 (86%) were brought to the ED with cardiopulmonary resuscitation in progress or as do not resuscitation(DNR) patients, leaving 51(14%) patients who met the unexpected death criteria. Of the unexpected deaths, 32(62.7%) patients presented to the ED with either abnormal vital sign (24 of 32) or some alteration in consciousness (18 of 32), or both of them (10 of 56). Medical and surgical causes of death represented 47.1% (24 patients) and 15.6% (8 patients) of the unexpected deaths respectively. Trauma represented 19 (37.3%) of the unexpected deaths, with 14 of these being the result of motor vehicle collision. The yearly incidence of unexpected ED death is presented in numbers of deaths per 10,000 ED visits. In 1991, the incidence was 3.4, and in 1992, 1993 and 1994 those were 2.7, 2.2 and 2.1 respectively.

Enterococcus faecalis 추출물이 임파구의 IL-2, IL-4, TGF-β1분비에 미치는 영향에 관한 연구

김현식,이우철,손원준,이상탁,김철호,임성삼 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.1

In order to examine the immunoresponse of host cells to Enterococcus faecalis, this in vitro study monitored the production of Interleukin-2 (IL-2), Interleukin-4 (IL-4) and Transforming growth factor-β1 (TGF-β1) in human lymphocytes. Lymphocytes were activated with PHA in the presence or abscence of sonicated extracts of E. Faecalis (SEF) and further incubated for 72 hours. The level of each cytokine was measured by ELISA. Data were analyzed with Kruskal-Wallis test and Mann-Whitney U test (P < 0.05). PHA-activated group did exhibit higher level of IL-2 and IL-4 than untreated control group. The levels of expression of both cytokines were significantly decreased following the treatment of high (25㎍/㎖) and medium concentration (12.5㎍/㎖) of SEF (P > 0.05) than those of PHA activated group. But low concentration (5㎍/㎖) of SEF showed th similar level of IL-2 and IL-4 production as those of PHA activated group. TGF-β1 was unaffected by SEF treatment. These results suggested that E. faecalis may suppress IL-2 and IL-4 production by lymphocytes and this could be one of possible factors why E. faecalis are found frequently in the teeth with failed endodontic treatment. 근관치료의 실패원인 중 중요한 세균으로 알려진 Enterococcus faecalis는 최근에 중요성이 더해지며 많은 연구들이 진행중이다. 여러가지 기전들이 보고되고 있으나 면역반응에 관한 연구는 거의 알려져 있지 않은 상태이다. 본 연구에서는 Enterococcus faecalis의 초음파 분쇄 추출물을 성인의 말초혈액으로부터 얻은 임파구에 적용시켜서 여기서 분비되는 interleukin-2, interleukin-4, transforming growth fater-β1의 농도를 Enzyme linked immunosorbent assay (ELISA)로 측정하여 비교, 평가하는 것을 목적으로 한다. E. faecalis를 적절한 조건에서 배양한 뒤 초음파 분쇄를 하여 추출물을 얻어냈다. 임파구는 건강한 성인의 말초혈액에서 추출하여 분리하였다. 임파구를 적절한 농도의 mitogen (Phytohemagglutinin: PHA)으로 자극시킨 뒤에 다양한 농도의 E. faecalis 초음파 추출물을 적용시키고 72시간 동안 배양하였다 ELISA를 이용하여 IL-2, IL-4,TGF-β1 의 농도를 측정하였다. 실험결과는 Kruskal-Wallis test, Man-Whitney rank sum test (p < 0.05)를 사용하여 통계처리 하였다. 실험결과 PHA로 처리한 군은 아무것도 처리하지 않은 군에 비해서 IL-2, IL-4의 수치가 유의성 있게 높았다 (p < 0.05). PHA로 처리한 군중에서 고농도와 중농도의 sonic extract of E. faecalis (SEF)로 처리한 군은 그렇지 않은 군에 비해서 IL-2 IL-4의 농도가 유의성 있게 낮았다 (p < 0.05). PHA로 처리한 군중에서 저농도의 SEF로 처리한 군은 그렇지 않은 군과 비교하여 유의할 만한 차이를 보이지 않았다.TGF-β1의 농도는 모든 군에서 유의할 만한 차이를 보이지 않았다 (p > 0.05). 따라서, E. faecalis의 추출물은 임파구의 IL-2, IL-4의 분비능력을 저하시킨다고 할 수 있다.

성인 급성 백혈병의 치료에 관한 연구

김종완,장준,신승훈,윤일국,박철신,김삼용 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

19 adult ALL patients were treated with follwing regimens; VP regimen to 5 patients, VPA regimen to 4 patients, multi-drug combined intensive therapy of Hoelzer regimen to 10 patients. The results of therapy are as follows: 1. Complete remission occured in 3 patients on VP regimen(60%), 4 patients on VPA regimen (100%), 8 patients on Hoelzer regimen (80%), respectively, and overall complete remission rate was 78.9%. 2. Mean survival time of total patients was 13.8 months, and in complete remission group, it was 16.2 month, but in non-complete remission group, it was 1.8 month. 3. Factors favorable for complete remission were absence of organomegaly(P<0.05) and initial leukocyte count under 30,000/㎟(P<0.01), factors favorable for the survival duration were initial leukocyte count under 30,000/㎟(P<0.05) and remission within 4 weeks of treatment.(P<0.01). 4. Recurrence rate were 40% in VP regimen, 50% in VPA regimen, and 20% in Hoelzer regimen. 5. During the remission induction period, common side effects of chemotherapy were alopecia, nausea, vomiting, mucositis, and general weakness and it was severe in VPA regimen and Hoelzer reimen than in VP regimen. But no significant difference was noted between VPA regimen and Hoelzer regimen. From the above results, we could confirm the importance of multiple drug combined intensive chemotherapy of remission regimen and periodic reinduction chemotherapy.

공작기계 컨트롤러용 고속 신경망 필터의 기초설계

김진선,신우철,홍준희 한국공작기계학회 2003 한국공작기계학회 추계학술대회논문집 Vol.2003 No.-

This Paper describes a Nonlinear adoptive noise canceller using Neural Network for Machine Tools Controller System. Back-Propagation Learning Algorithm based MLP (Multi Layer Perceptron)is used an adaptive filters. In this Paper. it assume that the noise of primary input in the adaptive noise canceller is not the same characteristic as that of the reference input. Experimental reaults show that the neural network base noise canceller outperforms the linear noise canceller. Especially to make noise cancel close to realtime, Primary Input is divided by Unit and each divided part is processed for very short time than all the processed data are unified to whole data.