2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

Light-extraction efficiency control in AlGaN-based deep-ultraviolet flip-chip light-emitting diodes: a comparison to InGaN-based visible flip-chip light-emitting diodes.

Lee, Keon Hwa,Park, Hyun Jung,Kim, Seung Hwan,Asadirad, Mojtaba,Moon, Yong-Tae,Kwak, Joon Seop,Ryou, Jae-Hyun Optical Society of America 2015 Optics express Vol.23 No.16

<P>We study light-extraction efficiency (LEE) of AlGaN-based deep-ultraviolet light-emitting diodes (DUV-LEDs) using flip-chip (FC) devices with varied thickness in remaining sapphire substrate by experimental output power measurement and computational methods using 3-dimensional finite-difference time-domain (3D-FDTD) and Monte Carlo ray-tracing simulations. Light-output power of DUV-FCLEDs compared at a current of 20 mA increases with thicker sapphire, showing higher LEE for an LED with 250-관m-thick sapphire by ~39% than that with 100-관m-thick sapphire. In contrast, LEEs of visible FCLEDs show only marginal improvement with increasing sapphire thickness, that is, ~6% improvement for an LED with 250-관m-thick sapphire. 3D-FDTD simulation reveals a mechanism of enhanced light extraction with various sidewall roughness and thickness in sapphire substrates. Ray tracing simulation examines the light propagation behavior of DUV-FCLED structures. The enhanced output power and higher LEE strongly depends on the sidewall roughness of the sapphire substrate rather than thickness itself. The thickness starts playing a role only when the sapphire sidewalls become rough. The roughened surface of sapphire sidewall during chip-separation process is critical for TM-polarized photons from AlGaN quantum wells to escape in lateral directions before they are absorbed by p-GaN and Au-metal. Furthermore, the ray tracing results show a reasonably good agreement with the experimental result of the LEE.</P>

Bi-factor MIRT True-Score Equating for Testlet-Based Tests

이규민(Gue min Lee),Won Chan Lee,Michael J Kolen,박인용(In Yong Park),Dong In Kim,Ji Seung Yang 한국교육평가학회 2015 교육평가연구 Vol.28 No.2

Lee and Lee (2014) proposed bi-factor multidimensional item response theory model (BFM) "observed-score" equating procedures. The main purposes of this study were to develop BFM "true-score" equating procedures, and to investigate applicability of the proposed procedures with actual data. Eight equating methods (including both true- and observed-score) based on dichotomous IRT (2-parameter logistic model: 2PL), polytomous IRT (graded response model: GRM), testlet response model (TRM), and BFM were compared with target equipercentile equating. Data for this study were from the Reading Comprehension test for a large-scale state assessment program, which consisted of several passages and corresponding groups of items. True- and observed-score equating methods based upon 2PL and BFM produced similar equating results. The GRM true- and observed-score equating methods provided equating results somewhat different from others, and more similar to the target equipercentile equating. Lee와 Lee(2014) 연구는 혼합형 검사에서의 bi-factor 다차원 문항반응모형을 적용한 IRT "관찰점수" 동등화 절차를 제안하였다. 이 연구는 Lee와 Lee(2014) 연구의 추수연구로 단위검사를 대상으로 bi-factor 다차원 문항반응모형을 적용한 IRT "진점수" 동등화 절차를 제안하고, 그 적용 가능성을 실제 자료를 이용하여 탐색하고자 하였다. 이를 위해 단위검사로 구성된 대규모 독해 검사 자료를 이용하여, 2모수 로지스틱 모형(2-parameter logistic model: 2PL), 등급반응모형(graded response model: GRM), 단위검사모형(testlet response model: TRM), bi-factor 모형(bi-factor model: BFM)을 적용하였으며, 관찰점수 및 진점수 동등화를 시행하여 총 8개의 동등화 방법을 적용하고, 산출된 결과를 동백분위 동등화 결과와 비교하였다. 연구 결과, 2PL과 BFM을 적용한 관찰점수 및 진점수 동등화는 유사한 결과를 산출하였으며, GRM을 적용한 관찰점수 및 진점수 동등화 방법은 다른 방법들과 다소 차이를 보이는 결과를 산출하였고, 비교 기준이 된 동백분위 동등화 결과와 보다 유사한 결과를 보였다.

65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

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봉독약침이 류마티스 관절염 환자의 관절 통증, 종창 및 급성 염증 반응에 미치는 영향

이상훈,이현종,백용현,김수영,박재경,홍승재,양형인,김건식,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender Joint counts, swollen joint counts, Visual analog scale(VAS), morning stiffness, ESR. C-reactive protein(CRP) were analyzed before and after BV therapy. Results The results as follows. 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy(9.0±7.9 vs 15± 11.4, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy(50±61 vs 15±23, p=0.001). 3. VAS in patients after BV therapy was significantly lower than those before BV therapy(608± 17.6 vs 380± 159, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy(119.1± 112.6 min vs 59.0±89.7 min, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed on long-term effect of BV therapy.

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.

급성 단순하부요로감염의 경험적 치료로써 레보플록사신 3일요법의 효과

이지열,이승주,이상돈,정희창,오봉렬,김세웅,최한용,조용현,윤문수 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.4

목적 : 급성 단순요로감염의 원인균에 대한 내성증가에 따른 경험적 1차치료의 선택에 대한 어려움으로 인하여 최근 미국의 Infectious Disease Society of America(IDSA)에서는 이에 대한 가이드라인을 제시하였다. IDSA의 가이드라인에 따르면 그 지역의 TMP-SMX에 대한 내성균주의 비율이 10-20% 이상일 때는 급성 단순요로감염의 경험적 1차치료제로 플루오로퀴놀론제를 선택하도록 하였다. 이에 저자들은 급성 단순하부요로감염 환자에 있어서 레보플록사신에 대한 임상적, 미생물학적 유효성 및 안전성을 알아보고자 하였다. 방법 : 시험은 전향적, 비맹검, 공개, 비비교, 다기관 임상시험으로 시행되었고 전국 5개 대학병원을 방문한 56명의 급성 단순하부요로감염 환자에게 레보플록사신 100㎎을 1일 3회, 3일간 경구 투여하여 1-3일 후에 추적 관찰하였다. 결과 : 평가가 가능하였던 53명의 환자 중 50명의 환자에서 치료 후 5-7일 후에 증상이 소실되었거나 호전되어 94%의 임상적 유효성을 보였으며, 51명의 환자에서 치료 후 1-3일 후에 원인균이 제거되어 96%의 미생물학적 유효성을 보였다. 약물 관련 이상반응은 2%의 환자에서 나타났으나 이로 인한 치료 중단 사례는 없었으며 심각한 생화학적 또는 혈액학적 이상반응은 나타나지 않았다. 결론 : 레보플록사신 100㎎ 1일 3회 3일 요법은 임상적, 미생물학적 유효성이 뒤어나며 안전한 치료요법으로 급성 단순하부요로감염의 경험적 1차 치료에 적합할 것으로 생각된다. Background : The increasing frequency of clinical failure of uncomplicated urinary tract infections (UTIs) may be due to emerging resistance to commonly prescribed antimicrobials. Infectious Diseases Society of America guidelines state that uncomplicated UTIs should be treated empirically with a fluoroquinolone, if the proportion of trimethoprim/sulfamethoxazole-resistant isolates in the community is >10%-20%. The clinical efficacy and safety of levofloxacin were assessed in patients with acute, uncomplicated lower urinary tract infection. Methods : The study was a multicenter, prospective, open label, non-comparative, non-blinded trial. Fifty-six patients with acute, uncomplicated symptomatic lower urinary tract infections from five university hospitals were treated with levofloxacin 100㎎ tid for 3 days and were followed up for 1 to 5 days. Results : Fifty-three of the 56 patients were evaluable. Ninety-four per cent of patients were symptomatically cured or improved by the fifth to seventh day after therapy started. Bacteriological eradication of initial pathogen was achieved by 1 to 3 days in 96%. Drug related adverse experiences were seen in 2% of patients. None necessitated cessation of therapy. No significant biochemical or hematological abnormalities occurred. Conclusion : These results demonstrate the clinical efficacy and safety of empirical 3-day levofloxacin for acute, uncomplicated urinary tract infections.

두경부 편평세포암에서 형질전환 성장인자-알파(TGF-α)의 발현에 관한 연구

도남용,이승학,김완수,김경일,이동용,김용기,최봉남 조선의대 1996 The Medical Journal of Chosun University Vol.21 No.2

西州 曺夏望의 삶과 시세계에 관한 일고찰

이승용(Lee Seung yong) 대동한문학회 2017 大東漢文學 Vol.51 No.-

曺夏望(1682~1747)은 조선후기 少論에 속하는 인물로, 본관은 昌寧, 자는 雅仲, 호는 西州이다. 老·少論간의 黨爭이 가장 치열했던 景宗과 英祖시기에 관직에 진출하였지만, 당쟁에는 크게 관여하지 않았다. 서울에 거주할 때는 詩社를 결성하여 모임에 참여하기도 하였으나, 생애의 대부분을 외직을 떠돌며 유람과 詩文으로 보냈다. 耳溪 洪良浩(1724~1802)에 의하면 그는 經史에 밝고 詩賦에 뛰어났다. 그러나 세속에 얽매이지 않는 기질과 강직한 성품, 그리고 少論이라는 黨色으로 인해 크게 현달하지는 못했다. 조하망의 문학적 성취와 관련하여 가장 잘 알려진 것은 鏡浦臺와 관련된 작품이다. 1741년에 江陵府使로 부임하여 경포대를 중수하고 <鏡浦臺上樑文>을 지었는데, 이 작품은 당시에 膾炙되었다. 李裕元(1814~1888)은 林下筆記 에서 경포대와 관련한 역대 작가들의 뛰어난 詩를 소개하면서 조하망이 지은 <鏡浦臺>를 꼽았다. 그럼에도 불구하고 지금까지 조하망과 그의 詩文에 대한 관심은 적었으며, 본격적인 연구는 이루어지지 않았다. 이 논문에서는 이러한 사실에 주목하여 18세기 소론 文人인 조하망의 家系와 生涯 및 西州集 의 편찬과 詩篇의 구성에 대해 상세히 고찰하고, 특히 ｢模擬錄｣에 실린 擬作詩를 중심으로 작품의 성격과 특징을 살폈다. ｢모의록｣에 실린 시의 특징적인 면모는 車天輅의 樂府新聲 에 수록되어 있는 古樂府와 거의 일치하는 양상을 보인다. 첫째는 學唐風의 낭만성을 지향하는 작품이 주를 이루는 점, 둘째는 여성 정감이 돋보이는 艶情詩가 다수라는 점, 셋째는 7언 절구의 형식이 대부분이라는 점이다. 요약하자면, ｢모의록｣을 통해 살펴본 조하망은 前代 學唐風의 낭만성을 지향했던 시인들과 그들의 작품을 비판적 시각으로만 바라보지 않았다. 그는 비판적 시각을 견지하면서도 이전 시대의 문학적 전통을 적극적으로 수용하여 唐詩風의 선집류를 학습하고 여기에서 시의 재료를 취하여 唐詩의 시 취향과 특징을 습득하여 자기화의 과정으로 활용하였다. 이러한 詩認識과 學詩의 과정은 단순히 模擬에 그치지 않고, 그가 개성적이고 다양한 시 세계를 이루는 바탕이 되었다. 이 논문에서는 ｢모의록｣에 실린 의작시만을 대상으로 하였기 때문에 조하망이 지향했던 낭만적 당시풍이 악부시가 아닌 다른 형식의 시에서는 어떠한 양상으로 드러나는지에 대해서는 살피지 못했다. 이와 관련하여 추후 ｢모의록｣을 제외한 나머지 13편의 ｢詩錄｣과 그 안에 보이는 조하망의 작가의식 및 작품의 주제적 측면에 대한 다각적 고찰은 조하망 시세계의 전모를 논하기 위해서도 꼭 필요하다. Jo Ha-mang(曺夏望, 1682~1747) is a person belonging to Soron line in the late Joseon Dynasty, and his family clan is Chang-nyeong, his courtesy name is Ajung, and his pen name is Seo-ju. He advanced into official positions during the time of Gyeongjong and Yeongjo when the party strife between Noron line and soron line was most intense, but he was not greatly involved in the party strife. When residing in Seoul, he formed a poetry society and participated in the meetings, but he spent most of his life on the sightseengs and poetry and prose wandering in the outside positions. According to Lee-gye Hong Ryang-ho(洪良浩, 1724~1802), he was brilliant in classics and historic records and excellent in poetry and poetic writings. However, it was not able to achieve great eminence due to his temperament not fettered by the secular world and the upright character and the party color of Soron line. What is the most well known in connection with the literary achievements of Jo Ha-mang is a work related to Gyeongpodae. In 1741, he was appointed as Mayor of Gangneung and repaired Gyeongpodae and wrote “Commemoration on Framing Completion of Gyeongpodae”, and this work was widely known to everybody at the time. Lee Yu-won(李裕元, 1814~1888) introduced the excellent poems of writers of all the times related to Gyeongpodae in “Notes of Retired Life”, and he chose “Gyeongpodae” written by Jo Ha-mang. Nevertheless, there has been little interest in Jo Ha-mang and his poetry, and no full-fledged research has been done. In this paper, paying attention to such facts, I considered in detail the family line of Jo Ha-mang, the literary persom of Soron line in the 18th century and his life, the compilation of “Collection of Seo-ju” and the composition of the book of poems, and, especially, examined the features and characters of the works, focusing on the imitation poetry in “Imitation- Record”. The characteristic appearance of poems in “Imitation-Record” shows the aspect that almost corresponds with old folk songs included in “New Voices of Folk Songs” by Cha Cheon-ro. The first is that the works are mainly oriented towards the romantic nature of the scholarly Tang style, the second is that the majority are love poems that stand out women s feelings, the third is that the majority are the forms of 7 characters phrases. To sum up, Jo Ha-mang examined through “Imitation-Record” did not look at poets and their works, which aimed at the romanticism of the previous scholarly Tang style, only from a critical point of view. While adhering to a critical viewpoint, by actively accepting the literary tradition of the previous era, he learned the anthologies in Tang poetry style, and by taking materials of poetry here and learning the taste and characteristics of Tang poetry, he utilized it as a process of assimilation. The process of these poetry recognition and learning poetry were not just imitation, but became the basis for forming a unique and diverse poetic world. In this paper, I focused only on imitation poetry included in “Imitation- Record”, so I could not examine in what aspect the romantic Tang poetry style which Jo Ha-mang oriented, appeared in the poetry of other forms, not of folk songs. In relation to this, further diverse studies on remaining 13 “Poetry Records” excluding “Imitation-Record” and the writer consciousness of Jo Ha-mang and the thematic aspects in them are also necessary to discuss the whole picture of the poetic world of Jo Ha-mang.

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.