대장내시경검사의 전처치로서 항콜린제 사용에 관한 연구 : 전향적, 이중맹검법으로

박경남,한동수,이민호,최호순,박준용,손주현,이오영,함준수,전용철,송승찬,기춘석,윤병철,이종희 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

Background: Use of antispasmodic medication prior to colonoscopy is controversial but someone believes antispasmodic may improve visualization of colonic mucosa and ease colonoscope insertion. So, we designed a study to assess the effect of premedication with the antispasmodic, hyoscine-N-butyl bromide(Buscopan') on the performance of colonoscopy. Methods: This study was prospective, double blinded, randomized, controlled study, One hundred three consecutive patients were randomized to receive intravenous buscopan lml(n=52) or placebo(n=51) combined with our standard initial medication(me- peridine 50 mg and midazolam 2 mg). Insertion of colonoscopy was timed, and 100 mm visual analogue scales (VAS) were used for asscssing difficulty of procedure, colonic motility, frequency of positional change, frequency of external compression, difficulty of assistance and degree of discomfort experienced by the patients. Results: There were no significant differences of intubation time between buscopan group(mean time, 7.23 min., range 2~15) and placebo group(7.07 min., range 3-25), (p=0.83) and withdrawal time between buscopan group (6.46 min., range 2-22) and placebo group(6.76 min., range 2 25), (p=0.69). Also, there was no significant differences in intubation time between males and females(buscopan; males 7.00 min., females 7.60 min., p=0.34, placebo; males 7.0~5 min., females 7.08 min., p 0.44). The VAS scores checked by endoscopist(p=0.29), assistant(p=0.32) and patient (p=0.15) were not significantly different in both groups. There were no significant differences in intubation time, VAS scores nf endoscopist, assistant, and patients. Conclusion: Premedication with intravenous bu.opan has no advantage on colonoscopy procedure. Use of antispasmodic medication prior to colonoscopy was not considered as recommendable agent.

불응성 자가면역질환에서의 자가조혈모세포이식

민도준,양동원,민창기,김완욱,이상헌,박성환,김동욱,이종욱,조철수,민우성,김범생,김호연,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: 기존의 치료에 불응하고 예후가 불량한 자가면역질환 환자들에게 최근 고용량 면역억제 및 조혈모 세포이식이 새로운 치료방법으로 대두되고 있다. 저자들은 다발성 경화증(multiple sclerosis, MS) 및 류마티스 관절염(rheumatoid arthritis, RA) 등 2명의 자가면역질환 환자들에서 자가조혈모세포 이식을 시행하였다. 방법: 말초혈액 조혈모세포 가동화를 위하여 cyclophosphamide (4 g/㎡) 및 granulocyte colony stimulating factor (10 g/kg/day)를 투여하였고, CD34+ 세포를 분리·채집 하였다, 이식 전처치로 MS 환자에서 BEAM 및 antihymocyte globulin (ATG) (3.75 mg/kg), RA 환자에서 fludarabine (180 mg/㎡), ATG (10 mg/kg)와 busulfan (8 mg/kg)을 투여하였다. 결과: 호중구 수가 500/㎕ 이상으로 회복되는 기간은 MS 환자에서 9일, RA 환자에서 15일이었다. 혈소판이 20.000/㎕ 이상으로 회복되는 가간은 RA 환자에서 9일 이었고, MS 환자에서는 혈소판 감소증이 발생하지 않았다. 비혈액학적 독성으로 MS 환자에서 WHO 1도의 오심 및 점막염이 관찰되었다. MS 환자는 이식 6개월 후까지 시력감소가 남아있었으나, 이식전에 관찰되던 감각이상 및 운동장애 등의 신경학적 이상 소견은 더 이상 관찰되지 않았다. RA 환자는 이식 1개월 후 관절 증상 및 검사소견의 호전을 보였다. 결론: 불응성 자가면역질환 환자에서 고용량 면역억제 및 조혈모세포이식은 적은 독성으로 높은 치료효과를 기대할수 있으며, 향후 이 시술의 임상적 의의를 규명하기 위하여 전향적이고 장기적인 연구가 필요할 것으로 사료된다. Background: High-dose immunosuppressive therapy followed by autologous hemathpoietic stem cell transplantation (HSCT) has been proposed as a new approach to treat severe, refractory autoimmune diseases. We describe two patients with refractory autoimmune diseases (one multiple sclerosis 〔MS〕and one rheumatoid arthritis〔RA〕) who underwent T-cell-depleted autologous peripheral bleed stem cell transplantation for the first time in Korea. Methods: We mobilized autologous stem cells with cyclophisphamide (4 g/㎡) and granulocyte colony-stimulating factor (10 ㎍/kg/day). Stem cells were enriched ex vivo using CD34-positive immunoselection and reinfused after high-dose chemotherapy with BEAM and antithymocyte globulin (ATG) (3.75 mg/kg) in MS, or fludarabine (180 mg/㎡), ATG (10 mg/kg) and busulfan (8 mg/kg) in RA. Results: The engraftment with an absolute nerutrophil count greater than 500㎕ occurred on day 9 in MS and 15 in RA, respectively. The time to nontransfused platelet count greater than 2.000/㎕ was 9 day in RA. MS patient did not show ant episode of thrombocytopenia. Regimen-related non-hematopoietic toxicity was minimal. For 6 months since HSCT, them patient with MS had been free from previously existed sensory and motor abnormalities except decreased visual acuity. Then patient with RA and only one tender joint and two mildly swollen joints with improvement in laboratory parameters at one month after HSCT. Conclusion: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of intractable autoimmune diseases. The durability of remission, however, remains to be clarified.

Clomiphene citrate에 의한 배란유도 후의 임신율에 관한 연구

임춘근,이민용,권경익,박세출,이두룡,남동호,양숙경 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

From March 1990 to February 1993, we evaluated completely follow-uped 68 cases of amenorrhea, oligomenorrhea, infertility(anovulation). The ratio of primary to secondary is 31: 37. Ovulation rate and pregnancy rate of 68 cases which were completely treated with clomphene citrate is 72%, 71.8% respectively. Among these 23 pregnat cases, 19 cases were full term delivered, 1 case is ongoing pregnant, and 3 cases were spontaneously aborted. No one of multiple pregnancy and congenital abnormality was noted.

노인외상환자의 예후 인자

문철규,전정민,최성혁,문준동,이성우,홍윤식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: It has been documented that certain prognostic factors may affect the outcomes of the old aged victims by trauma. Considering that trauma is the sixth most common cause of death in people over the age of 65 years and there is a rapid growth of elderly population, it is paramount to understand the prognostic factors when dealing with geriatric trauma patients. Hypothesis and Goals: It can be hypothesized that the prognostic factors should be determined independently between populations being consisted of different races, countries, socio-economic states, cultures, or so on. Thus, the study was designed to evaluate the factors affecting the outcomes of elderly Korean trauma patients. Methods: One hundred forty six patients aged over 65 years were retrospectively reviewed, who visited the Emergency Center of Korea University from January, 1997 to June, 1998. Of 146 patients, 7 were excluded due to discharge against advice or transfer to the other hospitals. Parameters analyzed were age, sex, mechanism of injuries, body region injured, Injury Severity Score (ISS), previous medical illness, hospital morbidity, duration of hospital stay, and cost. Each patient was classified into improved or not-improved group depending on the outcomes, and young-old or old-old group depending on the age. The factors affecting the hospital stay in improved patients were analyzed in the parameters of previous medical illness, hospital morbidity, multiple injuries, ISS, and age. All statistical tests were conducted with two-tailed levels of 0.05. Results: Of 139 patients, the mean age was 74±7.1 years, mean ISS 9.3±7.26, mean hospital stay 27±27.1 days. Most commonly injured body region was the extremities due to fall from a level surface. Rate of previous illness showed 0.94 medical diseases per person and were aggravated after trauma in 39 patients (60.9%). Hospital morbidity rate was 0.46 incidents per person. There were no differences in age and duration of hospital stay between the improved and the not-improved group. Substantial differences were noted in affected body region, incidence of previous illness, and hospital morbidity between the groups (p=NS). Not-improved group had higher ISS(p<0.05). ISS, previous illness and hospital morbidity affected the duration of hospital stay in the improved group. Hospital stay was 40±25.1 days in patients with ISS over 6 while 6±8.6 days in those with ISS 5(p<0.05). Hospital stay in the improved was 26±26.9 days while 31±24.8 days in the improved old-old group (p=NS). Hospital stay in the young-old minor trauma (ISS5) patients with previous illness and hospital morbidity was 26±10.1 days while 4±7.3 days in those without previous illness and hospital morbidity (p<0.05). Conclusion: Previous medical illness and hospital morbidity, not age, are predictive of outcomes of geriatric trauma patients with respect to hospital stay. As most of the hospital morbidity was a trauma-induced aggravation of previous medical illness and hospital morbidity contributing poor outcomes can be potentially avoidable, routine aggressive care for the geriatric trauma patients with previous medical illnesses is needed.

중소기업에서의 품질/환경 통합경영시스템 구축 사례 연구

강민석,장원철,박병춘 한국품질경영학회 2003 품질경영학회지 Vol.31 No.1

This study deals with a case analysis on the implementation of ISO 9000/14000 Integrated Management System. The intention is to provide some general guidelines, in particluar, to small-to-medium-sized companies that are planning to introduce the Integrated Management System. First we briefly review each of the ISO 9000 series, ISO 14000 series and Integrated Management System. We then investigate the case of a small-sized company that have built and is successfully operating the Integrated Management System. We start with introducing the company, and then examine the background and the procedure for implementing the Integrated Management System. We investigate effects of the Integrated Management System, which are the main focus of this paper. This study is meaningful in that, to our best knowledge, it is the first field report appearing in the literature in regard to the actual implementation of ISO 9000/14000 Integrated Management System in Korea.

GF(2m)상의 타원곡선 암호 프로세서 설계

김상철,이동호,최현민,김창훈,남영진,홍춘표 대구대학교 정보통신연구소 2008 情報通信硏究 Vol.5 No.1

This paper presents a high-performance elliptic curve cryptographic processor over GF(2m). The proposed design adopts L&oacute;pez-Dahab Montgomery algorithm for elliptic curve point multiplication and uses polynomial basis for GF(2m) field arithmetic operations. We select m=163 which is the smallest value among five recommended GF(2m) field sizes by NIST. The proposed elliptic curve cryptographic processor consists of host interface, data memory, instruction memory, control, and ALU. We simulate the proposed design using Xilinx XCV2000E hardware platform. Simulation result, we can see that our design is high flexibility and requires significantly less hardware resource compared with the previously proposed hardware implementation. 본 논문에서는 GF(2m)상의 고속 타원곡선 암호 프로세서를 제안한다. 제안한 암호 프로세서는 타원곡선 정수 곱셈을 위해 L&oacute;pez-Dahab Montgomery 알고리즘을 채택하고, GF(2m)상의 산술 연산을 위해 다항식 기저(Polynomial Basis: PB)를 이용한다. 본 논문에서 구현한 타원곡선 암호 프로세서는 m=163을 선택하였으며 NIST(National Institute of Standard and Technology)에서 권고하는 5개의 GF(2m) 필드 크기 중에서 가장 작은 값이다. 제안한 암호 프로세서는 Host Interface, Data Memory, Instruction Memory, Control, AU(Arithmetic Unit)로 구성되어 있으며 Xilinx XCV2000E 하드웨어 플랫폼으로 시뮬레이션을 한다. 그 결과 제안된 암호 프로세서는 기존의 연구 결과에 비에 높은 확장성과 낮은 하드웨어 복잡도를 가진다.

RSA 암호화 알고리즘의 구현에 관한 연구

신인철,이민섭,박창섭,김범식,우찬일,최춘수 단국대학교 1998 論文集 Vol.33 No.-

Recently, the information exchange through a communication network has been increased rapidly. When the sensitive information being sent or stored, the cryptographic technique can be employed in order to prevent it from being exposed or modified by the illegal third party. To implement public key encryption systems based on the integer factorization and the discrete logaritm problem, an efficient exponential arithmetic is mandatory due to large numbers involved. In this paper, the general analysis about the high­speed implementation of primality testing and exponentiations are investigated as well as implementing RSA public­key system. The public­key cryptosystem can be applied to any applications which need both the privacy and the authentication. Finally, suing the software package named MIRACL which provides the basic number theoretic routines for cryptographic software developers. we have implemented the RSA encryption and decryption with Blum­Goldwasser probabilistic algorithm under various key and message size.

농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

전기로 분진에서 납의 휘발반응에 대한 속도론적 연구

김병수,유재민,이재천,남철우,윤정모 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.4

"he removal of lead from electric arc furnace (EAF) dust is important in the process for recovering zinc by a reduction-volatilization method. In this study, experiments on kinetics of the volatilization reaction of lead by chlorine components as NaCl and KCl contained in the EAF dust were carried out in the temperature range of 973 to 1223 K under an air atmosphere using a weight-loss technique. As a result, the volatilization ratio of lead was about 99.0% at the temperature of 1223 K and the reaction time of 180 min. Jander equation was found to fit well the volatilization reaction rate over the entire temperature range. The volatilization reaction of lead is rate controlled by solid-solid diffusion. An activation energy of 175 kJ/mol(41.8 kcal/mol) was obtained. (Received January 8, 2004)

충남대학교 기초과학분야의 효율적 육성에 관한 연구

윤화중,진성일,윤민중,윤혜수,이영하,최철규,이천배,신대현 충남대학교 자연과학연구소 1986 忠南科學硏究誌 Vol.13 No.2

Chungnam National University (CNU) is located in Daeduk Science Town, a center of science and technology in Korea, and it is expected to play an important role in the development of science in Korea. With this in mind, the basic natural sciences at CNU should be more actively supported in both education and research. Accordingly analysis and comparison of the basic science program at major college in Korea as well as those in the USA and Europe has been performed. The current cooperative relationship between CNU and research institutes in the science town has also been analyzed. This study has resulted in propositions to make more efficient the upbringing of the basic sciences at CNU, by focusing on the following points ; a) to improve academic affairs, b) to make graduate studies substantial, c) to secure highly qualified faculty members, d) to increase cooperation in research between CNU and reserch institutes, e) to enlarge research laboratories and acquire more equipment and facilities.