한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

Protein microarray를 이용한 Apin-단백질의 상호작용에 관한 연구

박주철,박선화,김흥중,박종태,윤성호,김지웅,이태연,손호현 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.5

혈중 및 호기 일산화탄소를 이용한 일산화탄소 헤모글로빈 농도간의 관련성 연구

김형수,박태혁,손지언,정갑열,김정만,김준연 동아대학교 2001 大學院論文集 Vol.26 No.-

This study was conducted to find a correlation between blood COHb and calculated COHb with expiratory air and related variables such as occupational and smoking factors. Author selected 69 healthy workers in 8 workplaces suspected CO exposure. Basic informations were collected by self-reported questionnaire and medical history taking. Author measured Indirect COHb concentration with expiratory air using Micro II-Smokerlyzer and blood COHb concentration using Oxymeter. The results of the study were summarized as follows : 1. In the smoker, mean blood COHb and calculated COHb with expiratory air were 2.21±0.98% and 2.27±0.97 %, and there was not a statistically significant difference. In the non-smoker, mean blood COHb and calculated COHb with expiratory air were 0.42±0.43 % and 0,65±0.30 %, and there was also not a statistically significant difference. 2. There were positive correlations between blood COHb and calculated COHb with expiratory air in both the smoker (r=0.91, p=0.0001) and non-smoker (r=0.73, p=0.0001). 3. In the smoker, the factors affected COHb were total smoking index (Pack × years) and passed time after the last smoking. 4. In the nonsmoker, the parking and driving groups had higher COHb concentration than others (p<0.05). In conclusion, there was no significant difference between indirect COHb concentration with expiratory air using Smokerlyzer and blood COHb concentration and there was a highly significant correlation between indirect and blood COHb concentrations. Therefore indirect COHb concentration with expiratory air is a useful screening method for CO exposure. Author suggest the resection of smoking during at least 90 minutes before measuring COHb concentration in order to exclude smoking effects.

충남지역 나환자에 대한 사회의학적 조사연구

박연우,오장균,이태용,심운택 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

We studied through February 1989 to August 1989 to investigate the demographic characteristics, disease status and deformity of leprosy patients registered at Chungnam provincial area on December 31, 1988. The results were as follows: 1. Older than 40 years of age occupied 83.3%, and most patients lived at his or her own home as farmer or stock breeder. 2. The infection source was more the extrafamilial than the intrafamilial source and the most common initial symptoms and signs by body site were sensory paralysis on extremities and infiltration on face and macule on trunk. 3. The deformity was higher in male than female, older the age and much more the deformity. 4. The deformity was higher in T type than L type, and more recent onset of disease and shorter the duration between the onset and the register of disease, more lighter the deformity. The settlement villiger than domiciliary and the group of patientnts being treated at health center than leprosy association, the deformity was heavier.

前腕部 經穴 取穴에서 骨度分寸法과 一夫法의 比較 硏究

박히준,채윤병,차웅석,박종배,이혜정,이향숙,인창식,고형균,김수영,최일환,김강식,문정배,배기태,유경환,육근영,정병주,손인철,임사비나 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Background : The cun measurement System, an essential and convenient method in locating acupoints, has been widely used in the practice of acupuncture. However, traditional cun measurement has been criticized for its lack of reliability. Objectives : The purposes of this study are to determine if one cun measured by the directional methods have a consistency with that of proportional methods and to investigate which factors are related with these differences, especially in forearm. Methods : The distance between the elbow crease and the wrist crease of forearm was compared to a reference value of one cun obtained by the directional method. In this method, one cun is one third of the distance between index finger and Small finger of a subject, measured at proximal interphalangeal joint. In addition, to investigate the factors influencing the differences between these two methods, we measured the height and body weight and calculated body mass index (BMI). Finally we analyzed the factors correlated with these lengths by linear regression test. Results : The results showed that one cun obtained by the directional methods were significantly different from one cun by the proportional methods in forearm. It was demonstrated that the length acquired with the directional method was more correlated with body weight and body mass index, while the length obtained by the proportional method was more correlated with the height.

단클론성 감마글로블린장애를 동반한 말초 T-세포 림프종 1례

박노진,최태윤 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

We report here a case of peripheral T-cell lymphoma, unspecified type showing monoclonal gammopathy in serum protein electrophoresis and immunoelectrophores-is. Lymph node biopsy and immunohistochemistry revealed findings cocsistenet with peripheral T-cell lymphoma, unspecified according to the WHO classification of tumors of hemtopoietic and lymphoid tissues, and bone marrow showed increased plasma cells in number and lambda restriction in immunohistochemistry. After 5 cycles of combination chemotherapy consisting of cyclophosphamide, vincristine, doxorubicin, prednisone, the patient achieved partial remission with normal level of serum protein.

제2형 당뇨병 환자에서 우연히 발견된 기종성 방광염 1례

박보민,김윤정,이영태,노정현,권수경,김동준,고경수,이병두,임경호,이순희,박정현 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Emphysematous cystitis is an uncommon disease in which bacterias produce gas within the bladder wall and surrounding tissue. Patients with diabetes, neurogenic bladder and chronic urinary tract infection are predisposed to the disease. It is usually caused by E.coli and Klebsiella. Severity of illness ranges from an asymtomatic condition to life threatening cystitis. Succesful management depends on early diagnosis with correction of underlying causes, administration of appropriate antibiotics, establishment of adequate bladder drainage and surgical excision of involved tissue when required. We report a case of 52-year-old woman who did not compain of symtoms of cystitis but epigastric pain, nausea, and vomitting. Emphysematous cystitis was revealed on the abdominal X-ray series incidentally. CT scans of the pelvis showed mottled gas bubble within the bladder. After treatment, the symtoms subsided and plain abdominal film showed no evidence of gas shadow in the pelvic cavity.

척수압박으로 발현된 급성 골수성 백혈병에 동반된 과립구성 육종 1 례

윤상준,김영곤,김희종,박유환,정춘해,김양수,김태균,박영진,전호종 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

저자들은 척수압박으로 하지마비를 보인 환자에서 수술 후에 급성 백혈병에 동반된 과립구성 육종으로 진단된 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Granulocytic sarcoma(GS) is an uncommon tumor composed of immature cells of the granulocytic series. Most case of GS occur in the course of acute leukemia and the blast crisis of chronic leukemia, Rarely, however, it may present before leukemia becomes clinically apparent. It may also occur in patients with myeloproliferative disoders. GS has been reported that it occurs in 3% to 9% of patients with acute myelogenous leukemia(AML) and the incidence of GS is reported to be higher in patients with t(8;21). GS occurs relatively commonly in africa and has been reported to affect 10-25% of black children presenting with AML. This is very rare case of granulocytic sarcoma with AML(FAB M5) presented with spinal cord compression which was supported by decompression laminectomy.

농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례

박태혁,김정일,손지언,김종국,김형수,정갑열,김준연 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례 보고. 방법 : 피로감, 전신무력감, 어지럼증, 보행장애 등의 증상을 주소로 내원한 브롬화메틸을 사용하여 방역작업에 종사하는 건강한 20세와 18세의 근로자를 대상으로 혈액검사, 신경정도 및 근전도검사, 뇌자기공명영상 등의 임상검사와 작업력조사를 시행하였다. 결과 : 1례에서 뇌자기공명영상에서 연수와 소뇌의 양측 측충부의 고신호강도가 관찰되었고 11일 후의 추적조사에서 동일 부위의 고신호강토가 감소된 소견이 관찰되었으며 뇌병증으로 최종 진단되었다. 다른 1례는 신경전도검사에서 다발성 신경병 소견과 뇌유발전위검사에서 우측 하부 뇌간부위 병소가 관찰되었고 뇌병증 및 말초신경 병으로 최종 진단되었다. 결론 : 근로자들의 증상은 소독과정에서 브롬화메틸 노출로 인한 신경 병으로 판단되며 훈증소독과방역작업에 종사하는 근로자들의 실태조사와 안전에 대한 대책이 시급하다고 하겠다. Objectives : To report two cases of neuropathy due to methyl bromide intoxication. Methods : Workers, engaged in the fumigating process, complained fatigue, general weakness, ataxia, and hypersomnia. We evaluated them with blood tests, neurophysiologic studies and MRI and investigated their occupational history. Results : Increased signal intensities were found in the medulla oblongata and paraver mian of cerebellum in MRI and after 11 days, high signal intensities were reduced in the following MRI. In the other case, polyneuropathy and rlght lower brainstem lesion were observed In the NCV and BAEP studies. Conclusions : We confirmed that worker's symptoms were related to methyl bromide exposure in the fumigation. It is necessary that we should evaluate present condition of fumigating process and prepare appropriate methods to protect workers engaged in the fumigation.

위점막조직에서 Ghrelin 양성세포의 발현

박도윤,전태용 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25