한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

곰소만에 있어 바지락포자충 , Perkinsus sp. 의 출현에 관하여

박경일(Kyung Il Park),최광식(Kwang Sik Choi),최진우(Jin Woo Choi) 한국수산과학회 1999 한국수산과학회지 Vol.32 No.3

Mass mortality of the Manila clam, Ruditapes philippinarum has been reported all along the west and south coast of Korea for the past several years. As a pathogenic agent, Perkinsus sp., an endoparasitic protozoan has been identified in this study and believed to be responsible for the mass mortalities. Prevalence and infection intensity of Perkinsus sp. was investigated from a Manila clam population inhabiting at Komsoe Bay in the west coast where mass mortality of the clam has been reported. A total of 142 Manila clam, 50 oyster, Crassostrea gigas, 10 ark shell, Scapharca broughtonii, and 5 predatory gastropoda, Rapsna venosa were examined for the presence and the quantity of Perldnsus sp. Ray`s fluid thioglycollate medium method (FTM method) with modified Mackin`s infection intensity scale and Choi`s quantitative method were used in detecting and quantifying the parasite. All individuals of R. philippinarum examined in this study were infected with Perkinsus sp., indicaliag 100% prevalence white none of the oysters and the gastropods exhibited the parasite. Six to ten individual hypnospores of Perkinsus sp. were counted from the ark shells. The number of hypnospores in the clam tissues varied from 16,667 to 4,091,667, with a mean number of 1,077,628. Average infection intensity according to Mackin`s was 2.87, indicating a moderate infection. A negative correlation was observed between the number of Perkinsus sp. in the tissue and the condition index, a ratio tissue wet weight to shell cavity volume. The clam size and the infection intensity in terms of total number of parasites were positively correlated; the bigger clam, the heavier infection. Such high number of Perkinsus sp. counted in the clams could be enough to cause physiological disturbance of clams, such as retarded growth and reproduction. It is also believed that such a high infection leads mortality of the clam via continuous draining of the energy by metabolic activities and reproduction of the parasites. Correlation between the condition index and the infection intensity observed in this study supports this hypothesis.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

위암환자에서 근치적 위절제술후 시행한 보조적 PMF 항암 화학요법에 대한 무작위 전향적 연구

최우식,신연명,최경현 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

연구 목적: 위암 수술 후 보조 항암 치료의 효과에 대하여서는 아직 논란이 있다. 전향적으로 무작위표본 추출법으로근치 절제 수술한 위암 환자에서 수술 후 cisplatin, mitomycin C 그리고 5-FU(PMF)의 주사가 5년 생존율이나 무병생존율을 증가할 수 있는지를 연구하였다. 연구 방법: 1995년 5월부터 2002년 5월까지 147명의 근치 수술된 위암 환자들 중에 병기 IB, II, IIIA, IIIB 및 IV를 대상으로 하였으나 65세 미만을 대상으로 하여 무작위적으로 2군으로 나누어, 경구 5-FU제를 투여하는 군(대조군)과, PMF 항암 주사 치료군(치료군)으로 나누어 치료하였다. 경구 5-FU항암제는 수술 후 퇴원할 시기부터 투여하였다. PMF 주사치료는 수술 후 8주 이내에 시작하며 2코스 이상 완료한 사람들을 치료군에 포함하였다. 항암 주사는 다음과 같이 진행하였다; cisplatin 30mg 정맥 주사를 제 1-5일에, mitomycin C 4mg과 5-FU 250mg정맥 주사를 주 2회 4 주간 주사하였다. 이런 주사치료를 매 4주마다 시행하였다. 이 후 5년 생존율과 무병 생존율을 Kaplan-Meier 분석과 log-rank 검정으로 구하였다. 결과: 중앙 추적기간은 36개월이었다. 전체 5년 생존율은 치료군과 대조군에서 각각 68.8%와 65.2%(p=0.26), 무병 생존율은 각각 72%와 64%(p=0.24)로 치료군에서 다소 나았으나 유의성은 없었다. 치료에 동의한 환자의 수가 적어 각 병기별 생존율보다 비교적 조기인 병기 IB와 병기 II를 A군으로, 병기 IIIA을 B군, 그리고 진행된 병기인 병기 IIIB 와 병기 IV를 C군으로 나누어 생존율 비교하여 보았다. A군과 C군은 5년 생존률이나 무병생존율의 차이가 없었으나, B군에서는 5년 생존율이 치료군에서 100%, 대조군은 40.8%(P=0.0019)로 유의한 차이가 있었고, 무병 생존율도 치료군 100%, 대조군 52.94%(p=0.005)으로 의미 있게 차이가 있었다. 항암 주사치료에 의한 부작용은 심하지 않았으며, 사망자는 없었다. 결론: 위암 수술 후 PMF에 의한 항암 보조치료는 경구 5-FU에 비하여 병기 IB, II, IIIB와 IV에서는 5년 생존율이나 무병 생존율에 차이가 없었으나 병기 IIIA에서는 5년 및 무병 생존율에 의미있게 좋았다. 앞으로 C군에 대한 수술 후 보조 항암치료법의 연구가 요망된다.

운동분류에 따른 체구성 성분 및 BMI의 비교

최명화,권영우,김진해,민경선,민진아 한국스포츠리서치 2001 한국 스포츠 리서치 Vol.12 No.4

The purpose of the present was to investigate the body composition and BMI in different sports groups with classification of sports. 121 male collegiate athletes were recruited from varsity team of golf(n=10), field hokey(n=18), tennis(n=8), judo(n=17), weight lifting(n=27), boxing(n=19) and bicycle(n=22). Sports event can be classified as low static/low dynamic such as golf(LSLD), low static/high dynamic such as hokey and tennis(LSHD), high static/low dynamic such as judo and weight lifting(HSLD), high static/high dynamic(HSHD) such as boxing and bicycle. With classification of sports events, percentage of body fat was significantly higher with HSLD group compared to HSHD group, but no measurable difference was LSLD and LSHD groups. LBM was significantly greater with HSLD group compared to LSHD and HSHD groups. Furthermore BMI of the HSLD group was higher than the other groups(p<.05). In conclusion, high static/low dynamic group were greater in %fat, LBM, BMI than other groups. The differences observed between different sports groups and classification of sports are related to metabolic and dynamic properties in different sports events.

개에서 발생한 이혈종의 임상적 관리

이우철,윤기영,서경원,최호정,정성목,송근호,조종기,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2012 動物醫科學硏究誌 Vol.19 No.1

A 14-year-old male pomeranian was present with swollen left ear. The swelling occurred from base to apex of pinna. Otitis externa persisted for two years. Hematological and serum biochemistry values were not remarkable. The surgery treatment was the most appropriate method among indwelling drain, surgical, and steroid treatment in the aural hematoma because the dog was very sensitive to touching pinna and the size of aural hematoma. Longitudinal incision was applied after general anesthesia. Cefovecin was injected to prevent secondary infection. The outcome of surgery was good. There was no evidence of recurrence for one year.

두부방사선 분석에 의한 상악전치부 후방이동시 연조직 변화 예측에 대한 연구

최진희,이진우,차경석 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.1

본 연구는 성장에 의한 효과를 배제한 교정치료시의 연조직 변화와 치아 및 악골의 수평적, 수직적 움직임과의 상관 관계를 알아보고 예측 가능성을 검토하기 위해 Angle씨 2급 부정교합 환자 41명을 대상으로 치아 및 악골, 연조직의 수평, 수직이동의 평균 변화량을 측정하고 연조직에 대한 계단식 다중 회귀분석을 시행하였으며 다음과 같은 결론을 얻었다. 1. 경조직 계측항목 중 상악 중절치의 수평이동 및 기울기, 하악 중절치의 수평 및 수직이동, 수평피개량, 수직피개량, interincisal angle, 하악골 위치 변화 A, B, 경조직 측모 돌출각 등의 항목에서, 연조직 계측항목 중 상순의 두께 및 후방이동, 기울기, 하순의 후방이동 및 기울기, interlabial angle, 비순각, 이순각, Sn, Ss, Si, 연조직 측모 돌출각 등의 항목에서 치료 전과 후에 유의성 있게 변하였다(P<0.05). 2. 치료 전 후 유의한 변화를 보인 연조직 계측항목을 분석한 결과 모든 항목에서 경조직의 변화에 대해 영향을 받는 것으로 나타났다(P<0.05). 3. 연조직 회귀방정식에 중절치 수평피개량, 상악 전치 절단연의 후방이동량, 상악 전치 치근의 후방이동량, Pg의 수평변화량이 가장 높은 빈도로 포함됨으로써 이들은 연조직의 수직 및 수평변화에 영향을 많이 미치는 요소로 나타났으며 하악 전치의 수직이동량은 포함되지 않음으로써 연조직 변화와 관련성이 적은 것으로 나타났다. 4. Sn의 수직 및 수평변화는 경조직의 가장 많은 항목과 연관됨으로써 (A, B, Pg(H), overjet, upper incisor angle, Ur, Is(H)) 여러 경조직 변화의 복합적인 영향을 받는 것으로 나타났다. 5. 연조직 계측항목에 대한 상관계수(R2)의 범위는 0.2-0.6으로 중등도의 상관정도를 나타내었다. This study was carried out in order to determine soft tissue response to incisor movement and mandibular repositioning and to determine feasibility of predicting vertical and horizontal changes in soft tissue with hard tissue movement. For this study, cephalometric records of 41 orthodontically treated adult females who had Angle`s Class II division 1 malocclusion were selected and stepwise multiple regression analysis was employed. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. Hard tissue measurements that showed significant changes before and after treatment were horizontal and angular changes of maxillary incisor, horizontal, vertical and angular changes of mandibular incisor, overjet, overbite, interincisal angle, mandibular repositioning, A, B, skeletal convexity and soft tissue measurements that showed significant changes were horizontal, thickness and angular changes of upper lip, horizontal and angular changes of lower lip, interlabial angle, nasolabial angle labiomental angle, Sn, Ss, Si and soft tissue convexity(P<0.05). 2. All Soft tissue measurements changed significantly before and after treatment had between one and four hard tissue independent variables at statistically significant level, indicating that all soft tissue changes were direct relationship with hard tissue changes. 3. Overjet, horizontal change of maxillary incisor, horizontal change of maxillary root apex and horizontal change of pogonion entered into prediction equations most frequentely, indicating that they were more significant variables in prediction of vertical and horizontal changes in the soft tissue with treatment, but vertical changes of mandibular incisor not entered any prediction equations, indicating that it was not considered a good predictor for soft tissue changes with maxillary incisor retraction. 4. Horizontal and vertical changes in subnasale were found to have most independent variables, significant at the 0.05 level in prediction equations(△Sn(H):Ur, Is(H), Pg(H), UIA, △Sn(V): Is(H), Pg(H), overjet, A), indicating that subnasale changes are influenced by complex hard tissue interaction. 5. Multiple correlation coefficient(R2) of the soft tissue prediction equations ranges from 0.2-0.6.

mecA 양성 메티실린 내성 포도구균의 mec 조절유전자에 대한 분자역학적 연구 및 다양성 분석

우희연,이남용,맹성호,한승훈,인경수,김상욱,성승용,김익상,최명식 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

목적 : 병원 감염과 지역 감염의 원인균으로서의 중요성이 증가되고 있는 MRSA와 MRCNS의 메티실린 내성 관련 유전자에 대해 분자역학적인 조사를 시행하고 mec 조절유전자의 다양성을 분석하여 분자유전학적 연구와 감염 관리에 기본적 자료를 제공하고자 연구를 시행하였다. 방법 : 본 연구에서는 국내 동일 대학병원에서 분리된 mecA 양성 MRSA 78균주와 MRCNS 36균주를 대상으로 항균제 감수성 검사와 중합효소연쇄반응을 시행하여 표현형과 유전형의 분포를 알아보고 내성 정도와 유전형의 상관성을 분석하였다. 결론 : 최소억제농도를 측정하여 oxacillin 감수성 양상을 알아본 결과 총 90개의 MRSA 임상검체 중 3균주에서 감수성을 보였고, MRCNS 36균주는 모두 내성을 보였으며, 고도 내성을 보이는 균주일수록 다제내성을 보이고 있었다. 중합효소연쇄반응으로 mecA 유전자 유무를 분석하여 mecA 양성을 보인 MRSA 78균주와 MSCNS 36균주 만을 대상으로 mec 조절유전자에 대한 중합효소연쇄반응을 시행하여 유전형의 분포를 조사하였다. 그 결과 MRSA와 MRCNS 모두에서 mecA-Pr-mecA-mecR1-mecI형, mecA-Pr-mecA-mecR1형과 mecA-Pr-mecA-mecR-1의 5′말단형의 3가지 유전형이 공통적으로 관찰되었는데, 이외에 MRSA에서는 mecA-mecR1형, mecA-mecR1의 5′말단형이, MRCNS에서는 mecA-Pr-mecA형과 mecA형이 추가로 분리되었다. 유전형의 분포를 연도별로 분석한 결과 연도별로 우세한 유전형이 서로 다른 것을 알 수 있었다. 유전형과 내성 정도의 상관성을 분석한 결과, mecA-Pr-mecA-mecR1을 보유한 MRSA의 경우 mecA 억제유전자로 생각되는 mecI 유전자 유무에 관계없이 모두 고도 내성을 나타내어 mecI의 유무는 내성 정도와는 일정한 관련이 없었으나, MRSA와 MRCNS 모두에서 mecI와 동시에 mecR1의 3′말단이 결혼된 유전형이 저도 및 중등도 내성을 보이는 균주에서 유의하게 많이 관찰되어 mecI가 결손된 균주에서는 mecR1의 3′말단부위의 유무가 내성 정도의 결정에 중요한 역할을 할 것으로 생각하였다. 결론 : 국내에서 분리되는 메티실린 내성 포도구균의 유전형의 분포가 국외 분리주와 차이를 보이는 것으로 관찰되었다. 또한 기존의 보고와는 달리 메티실린 내성 정도와 유전형 사이에 유의한 연관성이 있는 것으로 관찰되어 mec조절유전자가 내성 발현 뿐만 아니라 내성 정도의 결정에 중요한 역할을 하는 것으로 관찰되었다. MRSA가 중요한 감염균임에도 불구하고 아직까지 MRSA의 내성기전에 대해 확실하게 규명되지 않아 치료가 더욱 어려워지고 있는 실정이므로 이에 대한 더욱 종합적인 연구와 동시에 발생과 확산을 막기 위한 노력이 필요할 것으로 생각된다. Background : High prevalence of methicillin resistance has been noticed in staphylococci which also have been recognized as important nosocomial and multi-drug resistant pathogens. In this study, we investigated the distribution of mec regulator genes and the presence of the mutation in mecIgene to reveal the resistance mechanism at molecular level. Methods : The isolates included 90 clinical isolates of MRSA, 36 MRCNS of which methicillin resistance were determined by disk diffusion test and isolated in a single hospital during 1996-1999. We performed microdilution MIC test for oxacillin resistance and Kirby-Bauer test for other antibiotics. Genotypes of mecA positive (determined by PCR) isolates (78 MRSA, 36 MRCNS) were investigated by PCR amplification of mec regulator genes such as 3' end and 5' end of mecR1. mecI, and Pr-mecA. Results : In MIC assay, all MRSA strains except 3 strains and all MRCNS strains showed oxacillin resistance. The level of resistance correlated to the multi-drug resistance. Seven genotypes were observed in mecA positive MRSA and MRCNS. Differences of predominant genotypes among years isolated and among species were observed. Deletions of the 3' end of mecR1 and the mecI were more frequently observed in the low- and borderline-level resistant MRSA and MRCNS (P(0.05). So the important role of 3' end of mecRI in determining resistance level was suggested. Conclusion : This study demonstrated that genomic distribution of methicillin-resistant staphylococci isolated in Korea was different from that of strains isolated in other countries. And important role of mec regulator genes for expression of methicillin resistance was suggested.