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)

단무지 공장에서 발생한 질식 사고의 원인과 방사선학적 소견: 중례보고 및 가스분석 결과

박충기,김만구,김흥철,안범규,박만수,황우철,최철순,강익원 江原大學校 附設 環境硏究所 1994 環境硏究 Vol.11 No.-

목 적:단무지 공장에서 질식사고를 일으켰던 가스의 종류를 알아내고, 이러한 가스중독의 방서선학적 소견을 소개하기 위하여 본 연구를 하였다. 대상 및 방법:단무지 공장에서 발생한 질식 사고자 3예중 생존자 1예를 대상으로 단순흥부X-선검사와 CT 소견을 분석하였으며, 가스의 종류를 알아내기 위하여 단무지를 유리병에 넣어 발생된 가스를 가스크로마토그래픽을 이용하여 분석하였다. 결 과:단무지 공장에서 발생한 질식사고자중 생존한 1명의 방사선학적 검사에서 신속히 호전되는 폐경결(consolidation)을 볼 수 있었으며 이는 폐부종의 소견임을 알 수 있었다. 협기성 상태에서 단무지를 담은 유리병의 상층부 가스를 실험 분석한 결과 이산화탄소, 에칠알코올이 다량으로 검출되었으나 독성가스는 주로 황화수소이였다. 결 론:단무지 공장의 질식 사고자에서 폐방사선학적 소견은 폐경결을 보이는 폐부증으로서 이는 실험을 통해 단무지에서 발생되는 유독가스인 황화수소 때문임을 입증하였다. Purpose: To identify the main toxic gas released from salted radish in rice bran(Dan-M-Ji) and to introduce the radiological findings of the patient who was exposed to the gas. Materials and Methods: Chest radiographs and CT scans of one survivor among three men who were exposed to the gas from Dan-Mu-Ji were reviewed. Gas obtained from the closed bottle containing Dan-Mu-Ji was analized by using the gas chromatography. Results: The radiographlc examinations of the survivor were suggestive of pulmonary edema with it's rapidly improving consolidations in both lung. The headapace gas within the bottle containing Dan-Mu-Ji was mainly composed with carbon dioxide, ethyl alcohol and hydrogen sulfide, of which hydrogen sulfide was considered the main toxic gas released. Conclusion: Under the anaerobic condition, Dan-Mu-Ji released toxic hydrogen sulfide. Inhalation of hydrogen sulfide might produce non-cardiogenic pulmonary edema.

도심에 거주하는 남성 노인에 있어서 유산소 운동능력이 혈관내 염증수치와 동맥경직도에 미치는 영향

안기만(Ki man Ahn),김윤신(Yoon shin Kim),박원하(Won Hah Park) 한양대학교 고령사회연구원 2012 한양고령사회논집 Vol.3 No.1

Experimental epidemiology and clinical studies have provided strong evidence that physical exercise has beneficial effects on multiple physiological variables affecting cardiovascular health. Cardiopulmonary function has been previously associated with atherosclerotic disease and coronary events. The aim of this study was to examine the higher levels of cardiopulmonary function are associated with lower levels of hs-CRP(high sensitive C reactive protein) and baPWV(barcahial ankle pulse wave velocity) in Korean elderly men. Study participants were 115 elderly men (mean age 62.5±2.2) participated in the research. Age, body mass index(BMI), resting heart rate, blood pressure, medical history, lipid profile, high sensitivity C-reactive protein(hs-CRP), Brachial-ankle pulse wave velocity (ba-PWV), cardiopulmonary function were measured. VO2peak higher elderly man had a significantly decreased hsCRP(0.22±0.26, p<0.05) and PWV (1439.1±159.9, p<0.05). In addition, HDL-C(55.2±14.2, p<0.05) levels was significantly increased and LDL-C(1193±21.7, p<0.05) level was decreased. This study show that VO2peak levels are positively correlated with hsCRP, HDL-C and PWV. Apparently healthy subjects with increased inflammatory markers have increased systemic arterial stiffness, which might reflect early atherosclerotic changes. Higher physical conditioning status, indexed by VO2peak, was associated with reduced arterial stiffness and hsCRP and increased HDL-C. The results of our study suggest that high cardiopulmonary function reduces hsCRP levels and improves PWV, HDL-C in Korea elderly men. 심혈관질환은 현재 선진 산업 국가들에서 성인 사망 제 1원인으로 알려져 있다. 심혈관질환에 의한 사망률은 나이가 증가하면서 더 높아지는 것으로 보고되고 있다. 이러한 심혈관질환을 일으키는 위험인자로는 나이, 신체활동의 부족, C반응성 단백(CRP), 혈관경직도(baPWV) 등이 심혈관질환을 높이는 것으로 보고되고 있다. 무엇보다 인구의 고령화로 인해 심혈관질환이 증가하고 있다는 것이다. 심혈관질환을 예방하기 위해서는 생활 습관 개선이 중요하며 그 중에서도 신체활동은 매우 중요하다. 하지만 고령의 건강한 남성을 대상으로 심폐기능과 관상동맥질환의 위험인자와의 관련성을 살펴본 연구는 부족하다. 따라서 본 연구는 60세 이상의 건강한 노인 남성(62.5±2.2)을 대상으로 심폐체력의 수준에 따른 혈중 C반응성 단백(CRP), 혈관경직도(baPWV)의 변화를 알아보고자 했다. 심장병 증상이 없는 노인 남성 115명을 대상으로 하였으며, 심폐기능 측정을 위해 운동부하검사를 실시했다. 혈액검사를 통해 혈중 CRP와 동맥경직도를 평가하기위해 baPWV 검사를 실시하였다. 그 결과 혈중 CRP는 심폐기능이 높은 그룹에서 0.22±0.26로 심폐기능이 낮은 그룹의 0.49±0.49 보다 유의하게 낮은 것으로 나타났다(p<0.05). baPWV역시 심폐기능이 높은 그룹에서 1439.1±159.9로 심폐기능이 낮은 그룹의 1523.7±236.1보다 낮게 나타났다(p<0.05). 따라서 건강한 노인 남성의 경우 심페기능이 좋은 그룹에서 심혈관질환 위험인자인 CRP와 baPWV가 유의하게 낮은 것으로 나타났다.

도시근린공원의 편익비용분석 : 청주시를 대상으로 A Case of Chongju

권상준,명현,박구원,이만희 청주대학교 산업과학연구소 1993 産業科學硏究 Vol.11 No.-

As a consequence of this study, the analyses of urban community parks in Chongju are as follows; 1. The total benefit of three scenarios can be calculated at 200,031, 255,197, 368,411 million Won, respetively depending on the scenario, which of the percentage of indirect benefit is 57.7%, 49.3%, 53.3% respetively in the order of the scenario . 2. The total cost can be calculated at 231,840 million Won. 3. The ratio of Benefit and Cost comes out in the order of the scenario 3, 2, 1, depending on the relative importance factors according to the benefit. 4. The priority of developing community parks depends on the hiearchical order factors: location, developed area, scale of parks.

간경변 환자에서 Oro-cecal Transit Time의 측정

원경준,이준,변유미,조민근,조주연,서정균,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Background: Neurotransmitter like substances in the gut have been proposed to contribute to the overall portal systemic encephalopathy (PSE). The source of the ammonia in patients with PSE is mainly the small bowel, as a result of the conversion of glutamine in the diet to glutamate and ammonia. PSE is highly responsive to changes in diet, to antibiotic therapy and to ingestion of nondigestible disaccharides such as lactulose. This study was performed to evaluate the relationship between PSE and oro-cecal transit time. In addition, performed to evaluate the effect of severity, cause, complications of liver cirrhosis on oro-cecal transit time. Methods: Between August 2006 and February 2007, 48 cirrhotic patients consecutively was enrolled in study their oro-cecal transit time after informed consent was obtained. A non-invasive hydrogen breath test was used to study oro-cecal transit time (OCTT). Result: The OCTT were delayed in cirrhotic patients with PSE compared without PSE (123.3 ± 42.7 min vs 170.0 ± 58.3 min, p<0.05). OCTT tended to prolongate further as the damage in the liver got worse, nevertheless the result was statistically meaningless (p<0.111). Neither presence of ascites or cause of PSE had any influence on gastrointestinal transit. Conclusions: Cirrhotic patients with PSE have more delayed OCTT than without PSE. Further research is needed to find out the relationship between OCTT and severity of liver cirrhosis.

패턴 특징과 색상 특징을 이용한 내용기반 영상검색

박종현,박순영,방만원 木浦大學校 工業技術硏究所 1999 工業技術硏究誌 Vol.9 No.-

In this paper, we propose an efficient content-based image retrieval method using the color and wavelet based pattern features. The pattern features are extracted from the invariant moments of the high-pass band image through spatial-frequency analysis of wavelet transform and color features are extracted from color histograms of the global image. The proposed image retrieval method is called a pattern and color feature based query(PCBQ). Forward PCBQ and backward PCBQ perform similarity matching of cascade form using the pattern and color features. The first step matching is carried out to find the candidate images which are most similar to the query image using the pattern or color features. The second step matching is executed using the feature vectors for the accurate retrieval from the candidate images of the first step. Weighted PCBQ performs weighted similarity matching of parallel form using the pattern and color features. The experimental results show that the proposed retrieval systems yield more improved retrieval accuracy than the previous methods.

韓國國民의 選擧參與動向에 對한 小考

朴元萬 진주농과대학 1971 진주농과대학 연구논문집 Vol.- No.10

The election under the representative government is the system of which electors elect for their represenativesand let them speak for their profits, and its a great significance of which the election formalities have under the process of democratic policy is the same means 'as a party of the formation of democratic policy' as the representative formation with a legislative organ specially and the president election with the executive organ. Under this important election formalities, it is now tendency in Korea that electors for participating election is polling not so much on the rate of casting votes "in the city or by educated persons as in the rural and by uneducated persons". This is the main reason to be easy to bring in the society that is somehow from the distrust of clean election, the loss of confidence for carrying out their election pledges, the lack of candidates' talent and nature, and the present situation which comes from tendering to servile on other intention, and anti-politics utilitarianism or the disregard of elections which bring on the lack of elector' s politics refinment and training. However, these days are under the elections progressed by the party politics, casting off their past fatality outlook on the history and in the disirable ability for the future originality.

現行憲法上 韓國國民의 主權行使方法에 對한 小考

朴元萬 慶尙大學校 1972 論文集 Vol.11 No.-

The thought that sovereighty rests with the people has been the most fundermental principle of democratic constitution since recent times. Sovereignty was only the absolute right of the monarch in the past autocratic monarchy. In the constitutional monarch, however, the people are secured their constitutional freedom and rights against the state, and after the recent democratic state, the state and the people constitute public fate. For the most part, the state is for the rights of the people, not for the duties of them. In this way the people of modern democratic state cast their lot with the state, and they take the responsbility and competency for the existance and development of it. What is more the rise and fall of the state depends upon the people who are the constituents of it. Like this in the case of Korea the rights which the people can excercise are only as the following; 1. the right to vote pulbic officials, which is the way of direct excercise. 2. the right to take charge of official business, which is indirect way of excercise of it. As mentioned ahove, the people, the sovereign, can excercise their direct sovereignty only in the important matters which might infringe on the constitutional rights, but in the other cases it is excerc-ised by the representatives.

다공성 LiTi_2(PO_4)_3 Glass-Ceramics에서 기공 크기 제어에 관한 연구

박만규,강원호 단국대학교 신소재기술연구소 1997 신소재 Vol.7 No.-

다공성 LiTi_2(PO_4)_3 Glass-Ceramics에서 Li_2O 함량을 0∼8 mole ratio로 변화시켜 기공의 크기, 기공율 등을 측정·분석하였고, 최적 조성을 선정한 후 분상 열처리 온도와 시간의 변화에 의해 기공의 크기를 제어하였다. Li_2O 함량이 4 mole ratio일 때 16.85%로 가장 큰 기공율을 나타내었으며, 기공의 평균 직경은 약 0.2㎛였다. 열처리 온도와 시간이 증가함에 따라 기공의 크기도 증가하였고, 약 0.01∼0.2㎛까지 기공 크기의 제어가 가능하였다. The variations of pore size and porosity were examined with the Li_2O content from 0 to 8 mole ratio in the porous LiTi_2(PO_4)_3 glass-ceramics. After selection the optimum composition, pore size was controlled by phase separation time and temperature. The porosity was 16.85% and the mean pore diameter was about 0.2 ㎛ when the Li_2O content was 4 mole ratio. The pore size was extended by increasing the phase separation time and temperature. The pore size was able to be controlled from 0.01 to 0.2㎛.

일부 부인과 양성 질환자의 지방조직 및 혈청의 PCBs와 DDE 농도

박성균,이강숙,노영만,구정완,민선영,한진구,고원경,김미란,정재근,이종승,김진홍 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 본 연구는 지방조직과 혈청의 PCBs와 DDE 농도를 측정하고, 이에 영향을 미치는 것으로 알려진 요인들과의 관련성을 평가하고자 하였다. 방법 : 유방암, 자궁내막증 등 유기염소계 화합물의 영향이 있는 것으로 알려진 호르몬 관련 질병을 제외한 부인과 환자 52명을 대상으로 지방조직과 혈청을 분석하였으며, 설문조사를 통하여 연령, 교육수준, 직업, 비만도, 흡연과 음주, 출산력, 수유력등을 조사하였다. 지방조직과 혈청의 PCBs와 DDE 농도는 가스크로마토그래피를 사용하여 측정하였다. 결과 : 지방조직의 경우, 13개 PCBs congeners 농도의 합은 중앙값이 48.29 ng/g, 기하평균값이 56.78 ng/g이었고, DDE 농도는 중앙값이 142.89ng/g, 기하평균값이 117.06 ng/g이었으며, 혈청의 경우는 PCBs congeners 농도의 합은 중앙값이 4.67 ㎍/L, 기하평균값이 4.85 ㎍/L이었고, DDE 농도는 중앙값이 1.75 ㎍/L, 기하평균값이 2.09 ㎍/L로 나타났다. 지방조직과 혈청의 DDE 농도 사이는 높은 상관성을 보였으나(r²=0.310, p=0,0002), PCBs는 상관성이 약한 것으로 나타났다(r²=0.029, p=0.2582). 영향요인을 범주화한 후 로그변환 시킨 지방조직과 혈청의 PCBs, DDE 평균의 차이를 분석한 결과, 지방조직의 DDE만이 출산자녀수(p=0.015), 초산연령 (p=0.014), 비만지수(p=0.035)와 연관성이 발견되었다 다중회귀분석의 결과 지방조직의 DDE는 출산자녀수가 적을수록, 초산연령이 늦을수록 증가하는 경향을 보였다. 결론 : 출산자녀수와 초산연령, 비만도가 지방조직의 DDE와 관련성을 보였으며, 또한 유기염소계 화합물의 장기간의 노출에 의한 영향을 평가하는데 있어서 혈청보다 지방조직이 더 유용한 생물지표임을 알 수 있었다. Objectives : This study was purposed to determine the levels of PCBs and DDE in adipose tissue and serum and to evaluate the relations with factors affecting these levels. Methods : We analyzed adipose tissues and sera from 52 gynecologic benign disease patients aged 27-78 years, except hormonal diseases such as breast cancer and endometriosis. We also surveyed age, education, occupation, body mass index (BMI), smoking, drinking, number of children, and duration of breastfeeding by questionnaires. Tissue and serum levels of PCBs and DDE were measured using gas chromatography. Results : The median and geometric mean levels of PCBs were 48.29 ng/g, 56.78 ng/g for adipose tissue and 4.67 ㎍/L, 4.85 ㎍/L for serum, and those of DDE were 142.89 ng/g, 117.06 ng/g for adipose tissue and 1.75 ㎍/L, 2.09 ㎍/L for serum, respectively. Adipose tissue and serum levels for DDE showed high correlation (r²=0.310, p=0.0002), but those of PCBs didn't (r²=0.029, p=0.2582). In analyses of the differences of the means of log transformed adipose tissue and serum PCBs and DDE levels for groups of potential covariates, only adipose tissue DDE levels were significantly associated with number of children (p=0.015), age at first birth (p=0.074) and BMI (p=0.035). In multiple regression analysis, adipose tissue DDE levels were significantly increased with decreasing number of children and increasing age at first birth. Conclusions : This study suggested that parity and adiposity were associated with levels of DDE in adipose tissue, and adipose tissue is a better biomarker than serum for evaluating the long-term exposure of organochlorines.