자가 면역성 간염에서 자가항체의 발현 양상과 스테로이드 치료의 효과

박기오,채경훈,허원석,강윤세,정재훈,김연수,문희석,이엄석,김선문,이병석,김남재,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 최근 8년간 본원에서 경험한 자기면역성 간염의 혈액학적 특징과 스테로이드의 치료효과를 알아보고자 본 연구를 시행하였다. 방법 : 1996년 이후부터 2002년까지 충남대학교 병원에서 1999년 International Autoimmune Hepatitis Group(LAHG)에서 제시한 수정 진단 기준안에 의거하여 총 진단점수가 probable 이상에 해당하는 환자들을 대상으로 임상적 특징, 검사실 및 조직 소견과 스테로이드와 azathioprine의 치료 효과를 후향적으로 조사하였다. 결과 : 9예의 환자들은 여성이 78%, 40대가 많았고, 급성 발병이 33.3%, 피로감, 식욕부진 및 황달 등이 나타났으며, 항핵항체가 55.6%에서 그리고 항평활근 항체가 77.8%에서 양성이었고, 동반 질환은 류마치스 관절염이 2예, 특발성 혈소판 감소증 1예, Henoch-Sch nlein 자반증 및 그레브스병이 각각 1예 씩이었다. 7예에 대해서 스테로이드와 azathioprine으로 치료하여 생화학적 임상적 완해가 이루어져서 유효한 치료 결과를 얻었다. 결론 : 자가면역성 간염은 우리 나라에서 원인을 찾을 수 없는 만성 간질환의 경우, 특히 중년여성에서 다른 자가면역성 질환이 동반되었을 때 자가면역성 간염을 의심하여 자가항체 선별검사를 시행해 보아야 할 것으로 생각된다. 향후 다기관 연구를 통하여 좀 더 많은 증례를 모으고 전향적인 연구를 시행하여야 할 필요가 있다. Although autoimmune hepatitis(AIH) is common in western contries, some studties have been reported in Korea. The aim of the study was to analyze the clinical and histological features and expression pattern of the autoantibody and to examine clinical course of AIH in Korea. For 9 patients diagnosed as having AIH in our hospital since 1996, we reviewed medical records and analyzed clinical and laboratory findings retrospectively. They had a probable or definite AIH according to the revised criteria of International AIH group. The mean age was 42.7(21∼68)years and 7(77.8%) were female. Three of them(33.3%) showed acute hepatitis and five of them showed cirrhosis. Fatigue and anorexia were the most frequently complained symptoms(55.6%). Four patients(44.4%) were accompanied with other autoimmune diseases. Antinuclear antibody was detected in 5(55.6%) and anti-smooth muscle antibody was detected in 7(77.8%). Three patients showed focal picemeal necrosis and four showed periportal fibrosis. Among 7 patients who received immunosuppressive therapy, six patients(85.7%) showed initial response. and biochemical and serologic remission were achived in 5(71.4%) and 3(42.8%) patients, AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. AIH should be suspected in female patients with unknown chronic liver disease of unknown etiolgy, especially accompanied with other autoimmune disease. The clinical characteristics of AIH may not be quite different from those of Western countries.

한 대학 신입생의 우울수준과 관련변인에 관한 연구

이명학,남해성,손석준,이정애,김병우 대한보건협회 1994 대한보건연구 Vol.20 No.2

1994년도 한 대학 1년생을 대상으로 8개항목의 생활만족지수(LSI-W) 그리고 20개항목의 우울지수(CES-D) 및 관련변인들을 조사하여 각각의 점수와 우울증의 유병률을 계산하고 서로간의 관련성을 조사하여 다음과 같은 결과를 얻었다. 1. 생활만족지수의 평균점수는 9.98이었고 비흡연군, 비음주군, 운동을 하는 군에서 평균점수가 유의하게 높았다(p<0.01). 2. 우울지수의 평균점수는 17.2였고 여학생에서 남학생보다 유의하게 높았고, 우울증의 유병률은 19.8%이었고 여학생에서 남학생보다 유의하게 높았다(p<0.01). 3. 우울증세 고위험군과 저위험군에 있어서 건강에 대한 본인의 생각과 본인이 인지하는 체중에서 차이가 있었으며, 생활만족지수, 가족수, 체중, 신장에서 유의한 차이를 보였다(p<0.05). 4. 우울지수와 생활만족지수, 연령, 종교활동기간, 신장, 체중등과는 음의 상관을 나타내고(p<0.01), 가족수, 수면시간, 경제수준과는 양의 상관을 보였다(p<0.01). 5. CES-D에 영향을 미치는 변수를 알아보기 위한 단계적 로지스틱 회귀분석에서 생활만족도, 성별, 건강에 대한 본인의 생각, 본인이 인지하는 체중, 흡연, 음주가 CES-D에 의한 우울증 발현에 있어서의 유의한 요인으로 나타났다(p<0.05). The questionnaire survey using the Center for Epidemiological Studies-Depression Scale(CES-D) and 8-items Life Satisfaction Index Well-being(LSI-W) and other variables was conducted to determine the prevalence of depression and to identify the correlation among CES-D and related factors. Study population was the whole freshman group newly enrolled in a university. The results were as follows; 1. Mean score of LSI-W was 9.98 and that score was higher in non-smokers, non-drinkers and exercise group (p<0.01). 2. Mean score of CES-D was 17.2 and the prevalence of depression was 19.8%. And those were significantly higher in female than in male(p<0.01). 3. Perceived health status, perceived weight, LSI-W, family size, weight and height were significant variables between high and low risk group of depression(p<0.05). 4. CES-D score was negatively correlated with LSI-W, age, duration of religious life, height, weight and po-sitively correlated with family size, sleeping time and economic status(p<0.01). 5. In the regression analysis significant predictors of the depression were sex, preceived health status, weight, smoking and drinking(p<0.05).

대형유통업체의 농산물 구매특성과 산지의 대응방안

이병서,위태석 한국식품유통학회 2003 食品流通硏究 Vol.20 No.2

This study discussed the large scale retailers’ preference and perception to the trading behavior and quality characterstics of farm products. Results are as follows : (1) The differentiation and quality uniformity are important factors in brand management. (2)Lager scale retailers want to deal with more environment-friendly products, but the procurement stability, quality trustworthiness, and crop assortment are still in the process of improvement. (3) It is important to keep uniformity of both external and internal quality factors in grading. (4) Large scale retailers prefer the products of small0sized boxes, but farmers have to consider the price premium and cost increase. (5) Farmer group feel that they have relatively weak bargaining power as compared with large scale retailer . (6) It is important to reduce the information asymmetrictiy. Farmers group need to inform the large scale retailers of farm level information. This may reduce large scale retailers searching cost of farm products.

소비자의 과일 브랜드 인지 수준과 개선방안

이병서,위태석 한국식품유통학회 2004 食品流通硏究 Vol.21 No.1

This study discusses the consumer's awareness level and some improvement strategies. Main results are summarized as follows : (1) Consumers' awareness level for fruit brand is estimated by surveys for 600 housewives residing in Seoul. Its result shows that awareness level is very low and these results are caused by quality management, product differentiation, and promotion. (2) Main strategies are discussed in quality condition and brand promotions and advertising, and large scale retailers' private brand. Especially, quality improvement is needed in strengthening sweetness and safety. And the box labelling management is important in raising consumers' awareness level. Finally, producers' countravailing strategies are required to keep producer's brand power relative to the private brand

일본의 도매시장법 개정과 시사점

위태석,이병서,황규석 한국식품유통학회 2004 食品流通硏究 Vol.21 No.1

For the last few years, the wholesale market system in Japan has been experiencing a lot of changes in the related sectors. The greatest changes in the environments surrounding the wholesale market were enlargement of the producers' cooperatives, increase of agricultural products marketed in the outside of the wholesale market system, and management aggravation of the related businessmen. These changes resulted in the revision of the Wholesale Market Law in 1999 to cope with the social needs successfully. Major purposes of the revision of the law would be summarized as follows : 1. To improve management ability of the related businessman 2. To improve dealing method in the Central Wholesale Market 3. To promote reorganization of the wholesale market

산지간 출하전략과 시장성과의 비교

위태석,이병서,황규석 한국식품유통학회 2003 食品流通硏究 Vol.20 No.3

This paper intends to find out the establishment possibility of competition superiority based on vegetable's selling conditions by analyzing the marketing behavior regarding the selling conditions and the middlemen's reaction to the producer's marketing behavior. And the survey on the middlemen indicates that the producer's selling conditions, as well as vegetable's quality itself, are regarded as an important factor when middlemen make a purchasing decision in the wholesale market. And the comparative analysis on the selling profits also shows that Nagano Prefecture has a competitive edge over Iwate Prefecture in the Tokyo Metropolitan Area Wholesale Markets where two are competing for lettuce market. Finally, the middlemen have a preference for Nagano' selling conditions rather than Iwate's ones overly. The results of this study tell us that the competitive strategy behavior in term of selling conditions in the producing district is making a success to some extent.

복수 공동 계산방식을 통한 농협 판매사업의 활성화 방안 : 일본의 나가노현 야츠가타케 농협 사례를 중심으로

위태석,이병서 한국식품유통학회 2004 食品流通硏究 Vol.21 No.4

This paper tried to seek sales enhancement measures of Agricultural Cooperative by analysing pooling system of Kawakami Branch Office of JA Yatugatake in Nagano Prefecture. Japan. The restructuring of business system for a favorable sales of vegetables & fruits in response to various requests from members was examined. The support measures of Agricultural Cooperative for member farmers are also devised. It was found out that to improve pooling system and to organize members as a functional form are effective for sales enhancement of Agricultural Cooperative.

기계적으로 밀링된 나노결정 Al-14wt%Ni-14wt%Mm 합금 분말의 열 안정성과 미세조직

홍순직,이윤석,천병선 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.10

Mechanical milling has been performed for Al-14 wt%Ni-14 wt%Mm(Mm=misch metal) alloy powders rapidly solidified by the gas atomization method. The microstructure, hardness, and thermal stability of the powders were investigated as a function of milling time using X-ray diffraction(XRD), transmission electron microscopy(TEM), Vickers micro-hardness tester and differential scanning calorimetry(DSC) methods. In the early stage of milling, a cold-welded layer with a fine microstructure was formed along the edge of the milled powder (Zone A). The interior of the powder remained unworked (Zone B), resulting in a formation of two-zone microstructure. With increasing milling time, the nanocrystallite size decreased gradually reaching a size of about 10-15 nm and the lattice strain increased reaching a maximum value of about 0.7% after milling for 200 hours. The microhardness of the mechanically milled powder was 132 kg/㎟ after milling for 72 hours, and it increased to 290 kg/㎟ after milling for 200 hours because of the presence of fine nano structured phases.

상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교

노승무,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Purpose: The aim of this study was to evaluate the short-term outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pylorus-preserving proximal gastrectomy is a common problem to be solved in the future. (J korean Gastric Cancer Assoc 2002;2:145-150)

상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교

노승무,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암공동연구소 2003 암공동연구소 업적집 Vol.3 No.

Purpose: The aim of this study was to evaluate the short-term outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pylorus-preserving proximal gastrectomy is a common problem to be solved in the future. (J korean Gastric Cancer Assoc 2002;2:145-150)