혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

표면위에 분사되는 원형 충돌제트의 열전달에 관한 실험적 연구

임경빈,최상경,송시영 한밭대학교 생산기반기술연구소 2001 생산기반기술연구소 논문집 Vol.1 No.1

The heat transfer characteristics on curved surfaces with an obliquely impinging circular jet were studied. In this study, the flat plate and hemispherically convex and concave surfaces were used. The Reynolds number used was Re=23,000. The nozzle-to-surface distance was L/d=4, 6 and 8. The jet angle was α=0˚ and 30˚. As the results of this study, the Nusselt number at the stagnation point decreases as the jet angle increases and has the maximum value for L/d=6. The secondary maximum Nusselt numbers in the downstream direction occur at long distances from the stagnation point as the jet angle increases or the nozzle-to-surface distance decreases. The Nusselt number distributions exhibit a displacement of the maximum heat transfer from the stagnation point to the upstream direction.

High Performance Liquid Chromatography를 이용한 멜라토닌 측정

최돈찬,임시내 龍仁大學校 2001 용인대학교 논문집 Vol.19 No.-

Melatonin is a pineal hormone that transduces the photoperiodic information into neuroendocrine system. It acts as a regulator of seasonal reproduction, a biological clock to time circadian rhythmicity, an inhibitor on the growth of tumor and cancer cells, and a controller of cardiovascular function. It also shows anti-aging and life-prolonging effects and a supportive role in the immune system. Melatonin was measured using a conventional HPLC apparatus. Although the sensitivity is low compared to the radioimmunoassay or HPLC with fluorescence or electrochemical detector, these results could be applied to the blood samples withdrawn from the living organisms to which a large amount of melatonin was administered. The method used in this study is simple, convenient, and rapid without need of any further equipments.

Prostacyclin synthase 유전자의 C1117A 다형성과 이형협심증과의 관련성

성인환,임대승,김정희,이재환,최시완,정진옥 대한내과학회 2004 대한내과학회지 Vol.66 No.4

목적 : Thromboxan A2의 혀관수축반응을 저해하는 prostacylin synthase exon 8 C117A의 변이가 관동맥 연축과 관련성이 있는지를 알아보고자 하였다. 방법 : 1998년 1월 1일부터 2000년 12월 31일까지 충남대학교병원 순환기내과에서 관동맥조형술과정맥내 에르고노빈 유발검사를 시행하여 관동맥 연축이 확진된 이형협심증 환자군(45예)과 정상 대조군(59예)을 대상으로 중합효소 연쇄반응법 및 restriction fragment length polymorphism을 이용하여 분석하였다. 결과 : Prostacyclin synthase exon 8 C117A 유전자형의 빈도는 대조군에서 A/A : A/C : C/C =3.4% : 30.5% : 66.1%, 이형협심증 환자군에서 A/A : A/C : C/C = 8.9% : 42.4% : 48.9%로 두 군간에 유의한 차이가 없었다. 대조군에 비해 변이형 협심증 환자군에서 남자의 비율과 흡연률이 높았지만, prostacyclin synthase exon 8 C117A 유전자형에 따른 군에서 당뇨병, 고혈압, 흡연, 고지혈증, 비만 등의 유의한 차이는 없었다. 결론 : 한국인에서 prostacyclin synthase exon 8 C117A 유전자 다형성과 관동맥 연축이 있는 이형협심증과의 유의한 연관성은 발견할 수 없었다. Backround : Coronary artery spasm plays an important role in the pathogenesis of variant angina(VA). Prostacyclin is one of the endothelium derived relaxing factors. The association between the novel single nucleotide polymorphism in the prostacyclin synthase gene and VA is not known. Therefore, we investigated the association between VA and the polymorphysm in the prostacyclin synthase gene. Methods : We compared 45 variant angina patients who had positive intravenous ergonovine test by coronary angiography with 59 control subjects who had negative intravenouis ergonovine test and normal coronary angiogram. Using the polymerase chain reaction-single-strand conformation polymorphism analysis, we identified a single nucleotide polymorphism, C117A, in exon 8. This nucleotide change did not cause an amino acid change in codon 373. Results : There was no significant difference in characteristics between the control group and the VA group, and there was no significant difference in the genotype distributions between the control group and the VA group. Conclusion : The C117A polymorphism in exon 8 of the prostacyclin synthase gene is not associated with variant angina.

응집공정에 적합한 In-Line 정적혼화기를 이용한 혼화공정의 개선

정철우,강민수,최시환,정수일,손인식,강임석 대한상하수도학회 2003 상하수도학회지 Vol.17 No.3

The rapid mixing process for coagulation is a critical component in a water treatment plant. However, at the present time a detailed understanding of the rapid mixing by in-line mixer or generally accepted criteria for the design of in-line static mixer are not available. The aim of this work is therefore to improve the understanding of how the in-line static mixer works and how to better utilize it in coagulation process in water treatment. To investigate the performance of static mixer, coagulation experiments were conducted to compare the static mixer to the traditional backmixer under several coagulation conditions. Experiments were also performed to compare the coagulation efficiency of different mixing type of static mixer which were made using different flow rates and the number of elements equipped in a pipe. The static mixer performed better than the backmixer for all coagulation and mixing conditions tested. Especially, the static mixer was very effective in the surface charge neutralization, as showing higher reduction of negative charge with increasing mixing intensity. However, little difference was observed in the performance of the static mixer equipped with 2, 3, and 5 elements. Also, in a series of bench-scale studies of rapid mixing, the in-line static mixer performed better than the traditional backmixer for both adsorption and charge neutralization (A/N) mechanism and sweep coagulation mechanisms. Especially, the static mixer was more efficient at producing A/N mechanism conditions as a result of its fast and uniform dispersion of the coagulant.

Most Probable Number 방법을 이용하여 측정한 중랑천 河床土壤의 혐기성 세균의 수와 수질과의 상관 관계

박두현,김병홍,임시근,최영효 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.3

중랑천의 하상 토양의 혐기성 호흡세균의 분포를 MPN법으로 조사하였다. 철이온환원세균을 조사하기 위해 배양액 중의 Fe(Ⅱ)을 확인하는 변형된 oxalate-ferrozine 법을 개발하였으며, 황산염환원세균(SRB)과 메탄생산세균을 각각 FeS 침전과 head space의 CH_4를 검출하는 방법을 채택하여 중랑천 지천과 본천의 혐기성 미생물 분포를 조사한 결과 오염 정도가 상대적으로 높은 본천에서 철이온환원세균이 10^7~10^8 cells/g 정도로 조사되었으며 지천의 경우 10^7 cells/g이었다. 우이천 상류를 제외한 모든 조사 지점에서 SRB와 methanogen 이 10^3 cells/g이었다. 이 결과는 분류 하수관의 설치로 유기물의 유입이 낮아진 조건에서도 하상의 침전층에서 유래하는 유기물을 이용하여 철이온환원세균이 생장할 수 있으며, SRB와 methanogen의 생장은 철이온환원세균에 의해 방해를 받는다는 것을 나타낸다. Sediments collected from the Jungnang-cheon and its tributaries were used to enumerate anaerobic bacteria by most probable number (MPN) methods. A simple method was developed to detect ferrous ion in the culture fluid in order to count the number of iron ion reducers, and sulfate-reducing bacteria (SRB) and methanogens were detected by the presence of FeS precipitate in the culture or methane in the head space, respectively. The numbers of iron reducer was in the range of 10^7~10^8/g in the sediment of the stream containing higher organic content than the tributaries. The sediments of tributaries were analyzed to contain iron reducers less than 10^7 cells/g. With one exception the numbers of SRB and methanogens were less than 10^3 cells/g in the sediment. From these results it is concluded that organics in the sediment support the growth of iron reducers, which out-compete SRB and methanogens.

노안수술후 각막형태검사 변화

박근성,고길환,김용선,이재림,민병무,최시환 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

We prospectively analyzed the corneal topography of 26 eyes in 26 patients who had undergone scleral expansion for correcting presbyopia. We examined 26 eyes of 26 patients which were devided into 2 groups (mean age: 51 years, range 40-60 years) according to type of scleral expansion band, with computerized corneal topographic analysis system. Preoperatively and 5 times postoperatively (1day, 1week, 2weeks, 1month, 2months), quantitative descriptors of corneal topograpgy such as Sim K (simulated keratometry value), SRI(surface regularity index), and SAI(surface asymmetry index) were measured at each visit. The mean follow-up period was 43 days. Sim K of the operative eyes ranged from 0 to 2.5 (mean, 0.93) before operation, and mean 2.24 at postoperative 1 day in group Ⅰ. In group Ⅱ, Sim K was mean 2.20 at postoperative 1 day and decreased thereafter. SRI was from 0.54 to 1.39 and SAI was from 0.09 to 0.45 before operation. After operation, mean SAI was maximum at postoperative 2 week and mean SRI was maximum at postoperative 1 day and decreased thereafter. After two months, it became minimum. This study demonstrates that quantitative topographic change after scleral expansion for correcting presbyopia were great during first 1 week after surgery but this change diminished thereafter. Further long studies are in progress to evaluate the long term effects of this procedure.

Complementary and Alternative Medicine Use among Cancer Patients at the End of Life: Korean National Study

Choi, Jin-Young,Chang, Yoon-Jung,Hong, Young-Seon,Heo, Dae-Seog,Kim, Sam-Yong,Lee, Jung-Lim,Choi, Jong-Soo,Kang, Ki-Mun,Kim, Si-Young,Jeong, Hyun-Sik,Lee, Chang-Geol,Choi, Youn-Seon,Lim, Ho-Yeong,Yun, Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.4

Objectives: To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. Design and location: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients. Results: The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1%. The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion. Conclusions: CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.

Whole-genome resequencing analyses of five pig breeds, including Korean wild and native, and three European origin breeds

Choi, Jung-Woo,Chung, Won-Hyong,Lee, Kyung-Tai,Cho, Eun-Seok,Lee, Si-Woo,Choi, Bong-Hwan,Lee, Sang-Heon,Lim, Wonjun,Lim, Dajeong,Lee, Yun-Gyeong,Hong, Joon-Ki,Kim, Doo-Wan,Jeon, Hyeon-Jeong,Kim, Jiwoo Oxford University Press 2015 DNA research Vol.22 No.4

<P>Pigs have been one of the most important sources of meat for humans, and their productivity has been substantially improved by recent strong selection. Here, we present whole-genome resequencing analyses of 55 pigs of five breeds representing Korean native pigs, wild boar and three European origin breeds. 1,673.1 Gb of sequence reads were mapped to the Swine reference assembly, covering ∼99.2% of the reference genome, at an average of ∼11.7-fold coverage. We detected 20,123,573 single-nucleotide polymorphisms (SNPs), of which 25.5% were novel. We extracted 35,458 of non-synonymous SNPs in 9,904 genes, which may contribute to traits of interest. The whole SNP sets were further used to access the population structures of the breeds, using multiple methodologies, including phylogenetic, similarity matrix, and population structure analysis. They showed clear population clusters with respect to each breed. Furthermore, we scanned the whole genomes to identify signatures of selection throughout the genome. The result revealed several promising loci that might underlie economically important traits in pigs, such as the <I>CLDN1</I> and <I>TWIST1</I> genes. These discoveries provide useful genomic information for further study of the discrete genetic mechanisms associated with economically important traits in pigs.</P>

개흉술을 받는 한국 성인 판막 환자의 유의한 관상동맥

최웅림 ( Uhng Lim Choi ),이선화 ( Sun Hwa Lee ),박재형 ( Jae Hyeong Park ),성석우 ( Seok Woo Seong ),김준형 ( Jun Hyung Kim ),이재환 ( Jae Hwan Lee ),최시완 ( Si Wan Choi ),정진옥 ( Jin Ok Jeong ),성인환 ( In Whan Seong ),이경석 ( 대한내과학회 2012 대한내과학회지 Vol.83 No.1

목적: 판막 질환으로 수술적 치료를 시행받는 환자들에서 유의한 관상동맥 질환의 유무를 확인하는 것은 동시에 관상 동맥우회술을 시행함으로써 향후의 재개흉술 및 이로 인한 합병증의 예방에 중요하다. 국내의 허혈성 심질환의 빈도는 서구에 비해 낮으나 어떤 환자군에서 관상동맥 조영술을 시행하여야 하는지에 대한 기초 통계자료는 없는 실정이다. 이에 저자들은 국내에서 판막 질환으로 개흉 술을 시행 받는 환자들을 대상으로 하여 관상동맥 조영술의 시행유무 및 유의한 관상동맥 질환의 유병률에 대해 연구하였다. 방법: 2005년 1월부터 2011년 6월까지 충남대학교 병원 및 전북대학교 병원 심장내과와 흉부외과에서 유의한 판막 질환으로 개흉 술을 시행 받은 성인 환자들을 대상으로 후향적 분석을 하였다. 급성 대동맥 박리 증이나 외상으로 인해 응급수술을 시행 받은 경우 및 관상동맥 협착증으로 관상동맥 우회로 술을 시행 받으면서 동시에 판막 질환을 수술한 경우는 제외하였다. 결과: 연구 기간 동안 총 431명의 환자(평균나이 58 ± 13세, 남자 204명)가 연구에 등록되었다. 질환 별로 보면 승모 판막 질환은 241명에서 관찰되었고, 대동맥판 질환은 230명에서 관찰되었다. 관상동맥 조영 술을 시행 받은 환자는 297명(68.9%)으로 이 중 36명(12.1%)에서 유의한 협착증이 관찰되었고, 32명에서 관상동맥 우회로 술이 판막 수술과 동시에 시행되었다. 다변 량 분석결과 관상동맥의 유의한 협착은 65세 이상의 고령 [Odd ratio (OR) = 3.081, 95% confidence interval (CI) = 1.372-6.921, p = 0.006], 심혈관계 위험인자가 많은 경우(≥3) (OR =3.002, 95% CI = 1.386-6.503, p = 0.005) 및 대동맥협착증(OR= 2.763, 95% CI = 1.269-6.013, p = 0.010)과 유의하게 연관되었다. 결론: 한국에서 판막 질환으로 수술적 치료를 시행 받는 성인 환자에서 유의한 관상동맥 질환의 빈도는 12.1%로 주로 고령, 대동맥판막 협착증 및 많은 수의 심혈관계 위험인자를 가진 환자에서 높게 나타났다. Background/Aims: The identification of significant coronary arterial disease (CAD) is important to reduce perioperative ischemic insult and the possibility of repeated open-chest surgery in patients scheduled to undergo valvular surgery. However, there are no published data on the incidence of significant CAD in these patients. Thus, we examined the prevalence of significant CAD in patients scheduled to undergo valvular surgery. Methods: From January 2005 to June 2011, all consecutive adult patients diagnosed with significant valvular disease and scheduled for an elective open valvular operation were retrospectively investigated at Chungnam National University Hospital and Chonbuk National University Hospital. Patients who underwent emergent valvular operations due to acute aortic dissection or trauma and concomitant valvular operations at the time of coronary artery bypass graft (CABG) surgery were excluded. Results: During the study period, a total of 431 patients (58 ± 13 years old, 204 males) were included. The distributions of mitral (241 patients) and aortic valvular disease (230 patients) were similar. Coronary angiography was performed in 297 patients (68.9%). Of these, 36 (12.1%) showed significant CAD and 32 underwent concomitant CABG operations. Based on a multivariate analysis, the presence of CAD was significantly associated with old age (≥ 65 years old) [odds ratio (OR) = 3.081, 95% confidence interval (CI) = 1.372-6.921, p = 0.006], more cardiovascular risk factors (≥ 3) (OR = 3.002, 95% CI = 1.386-6.503, p = 0.005), and the presence of aortic stenosis (OR = 2.763, 95% CI = 1.269-6.013, p = 0.010). Conclusions: The incidence of significant CAD was 12.1% in adult patients who underwent valvular operations in Korea. CAD was more common in patients with old age, aortic stenosis, and multiple cardiovascular risk factors.