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)

파트너십에 의한 지하철 입구 공간의 쌈지공원 설계 및 시공

김승환,강현우,손용욱,박승범,남정칠,이기철,차민준 東亞大學校 建設技術硏究所 2009 硏究論文集 Vol.32 No.2

A pocket park is valued in securing green space in downtown and improving urban view in the aspect of natural and environmental values, and it signifies a lot as the center of local residents’ community and harmony as well. Since subway exits and surroundings that have high portions in taking up street space due to lack of green space in downtown aren't made full use of, valuable pocket park place. Dangni Pocket Park of subway exits is a park completed with cooperative works and partnership by students, specialists, administrative organizations, businesses and civilian organizations, etc. without support of special budget. The study site was finally chosen to the space between exit No.1 of Dangni subway station, after analyzing the surrounding circumstances, availability and accessibility of the space among the several subway station exits of Saha, Dangni, and Hadan Station in Busan Metropolitan city. For the designing process, The Citizens organization for Million Amenity Park performed the planning and project proceeding, and 19 design drafts were proposed during the class of landscape architecture in Dong-a University. Design review panel members discussed to select the best draft in practical and authentical, and the related experts reviewed and revised to present the final design plan. The construction was conducted was performed under the cooperation between the civil, authorities, and industrial organizations, among which Saha District office managed for the waste treatment and maintenance matters. The graduates of landscape architecture department of Dong-a University and related industrial enterprises supplied landscape materials and related labors, were supported by 20 members of GPM, one of clubs of Dong-a University volunteered durig the most of construction progress, completing the Pocket Park of subway exits through partnership.

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.

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.

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.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

병원과 지역사회에서 메티실린 내성 황색 포도상구균(methicillin-resistant Staphylococcus aureus) 감염의 임상 분자역학 연구

박정원,이종섭,송준영,김철현,엄중식,정희진,김우주,박승철 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.2

목적 : 국내에서 1990년대 이후 중요한 병원균으로 대두되고 있는 methicillin-resistant S. ureus(MRSA)는 주로 입원환자에서만 분리되는 것으로 알려져 있으나, 최근들어 지역사회에서도 퍼져있는 것으로 알려지기 시작하였다. 이에 병원획득 및 지역사회획득 MRSA의 임상역학 및 분자역학적 연구를 통하여 획득요인, 병원과 지역사회 획득 균주간의 교류 양상등을 규명하고자 하였다. 방법 : 1998년 1월부터 12월까지 고려대 부속 구로병원에서 임상검체로부터 분리된 S. aureus 균주중에서 MRSA 균주의 빈도를 구하였고, 이중 1998년 10월 1개월 동안 분리되었던 42균주에 대하여 지역사회획득 균주와 병원획득 균주로 나누고, 임상역학적 조사를 하였다. 지역사회 획득 18주와 병원획득 22주에 대하여 PCR 방법으로 mecA 유전자를 확인하였고, PFGE를 시행하여 균주의 클론형(clonal type)을 결정하고 이 결과에 준하여 덴드로그램 분석을 시행하여 분자적 친밀도를 결정하였다. 결과 : 1998년 1년간 분리된 총 1,587주의 S. aeureus 균주중 73.8%(1,163주)가 MRSA 였다. 1998년 10월 1개월 동안 임상자료의 고찰이 가능하였던 MRSA 감염환자 42명 중 20명이 지역사회획득 환자였고, 병원획득 환자가 지역사회획득 환자보다 항생제사용 과거력(17 vs 5, p=0.001), 기저질환의 존재(18 vs 8, p=0.002) 등이 통계적으로 의미있게 높았다. 지역사회획득환자가 이루(7/20[35.0%] vs 2/22[9.1%] ; p=0.041)와 밀접한 관계가 있음도 확인하였다. 분자생물학적연구가 진행된 40주의 MRSA 균주는 모두 mecA 유전자 양성이었고, 18주의 지역사회획득 균주에서 총 8가지의 PFGE 클론형이 존재하였으며 A형이 가장 많았다(7/18, 38.8%). 22주의 병원획득균주에서는 6가지의 클론형이 존재하고 A형이 가장 많았으며(15/22, 68%), 15주의 지역사회획득 균주(83.3%)가 21주의 병원획득균주와 공통적인 클론형을 공유하고 있었다. 결론 : 지역사회 획득 MRSA는 주로 이루나 창상부위에서 많이 분리되는 반면 병원획득 MRSA는 객담에서 많이 분리되고 또한 당뇨병을 가진 환자에서 감염을 잘 일으키는 것으로 밝혀졌다. PFGE 분석 결과 원내감염은 단일균주에 의한 유행양상을 보였고, 지역사회에서도 같은 형의 균주에 의한 감염빈도가 가장 높음을 보여 MRSA 균주가 지역사회로 유입되어 지역사회내 MRSA 감염의 발생에 기여했을 것으로 사료된다. Background : Until recently, methicillin-resistant Staphylococcus aureus (MRSA) infection has been acquired primarily in hospital settings. During the late 1990s, the incidence of community-acquired MRSA infections has been increased in this university hospital. This retrospective study evaluated the clinical features and risk factors for community-acquired MRSA infection compared with hospital-acquired MRSA infection; and molecular relatedness of MRSA strains determined by pulsed-field gel electrophoresis(PFGE). Method: MRSA isolates collected from patients during October of 1998 were classified as community-acquired("community') or hospital-acquired("hospital") cases. MRSA infections were defined as hospital-acquired if organisms were isolated > 48 hours after admission to the hospital or isolated from patients with a history of admission to a hospital within the last 3 months. A comparative analysis of risk factors for community MRSA compared with hospital MRSA was performed. mecA gene PCR and PFGE of MRSA isolated was used as a tool of strain identification and molecular typing. Result : During one month, there were 42 patients with MRSA infection or colonization. Of 42 patients with MRSA isolates, 22(52%) were hospital cases and 20(48%) were community cases. Previous exposure to antibiotics(17 vs 5, p = 0.001) and presence of underlying diseases (18 vs 8, p = 0.002) were more common in hospital cases than in community cases. MRSA were more frequently isolated in otorrhea specimens from patients with otitis media in community cases compared with hospital cases. Of the 40 MRSA isolates subjected for PFGE typing, 18 were community isolates and 22 were hospital isolates. There were 8 distinct PFGE types among the 18 community isolates and type A was the most common clonal type (7/18, 38.8%). 22 hospital isolates were of 6 distinct PFGE types, and type A was dominant clonal type (15/22, 68%). PGFE subtyping indicated that 15(83.3%) of 18 community MRSA strains were clonally related with that of 21 hospital MRSA strains. Conclusion : Our results suggest that hospital MRSA strains may have disseminated in the community setting. PFGE subtyping support the finding that MRSA is circulating beyond nosocomial settings in the regional community.

슬관절 골관절염 증상이 환자에게 미치는 우울 효과

박영규,이윤영,이계우,김정아,윤도경,박승회,조경환,홍명호,박용규 대한노인병학회 2001 대한노인병학회지 Vol.5 No.4

만성질환자에서 인풀루엔자 예방 접종의 효능 분석 : 후향적 환자-대조군 연구

박승철,정희진,손장욱,최선주,엄중식,우흥정,천병철,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.4

목적: 인플루엔자는 예방접종을 통하여 효과적으로 예방이 가능한 대표적인 호흡기 감염질환이다. 미국이나 국내의 인플루엔자 예방접종 지침에서 고령인구(50세 또는 65세 이상)와 그 외의 만성질환자들을 인플루엔자 예방접종의 일차 대상자로 정하고 있다. 그러나 국내에서는 아직까지 만성질환자들에서의 인플루엔자 백신의 효능평가에 대한 연구결과가 없는 실정이며 국내에서의 만성질환의 분포가 외국의 그것과 일치하지 않기 때문에 본 연구에서는 국내 만성질환자들에서 인플루엔자 예방접종과 연관된 병원입원율의 차이를 비교해 보고자 하였다. 재료 및 방법 : 1999년 11월-2000년 3월(5개월간) 서울 소재 2개 대학병원에 입원한 만성질환자중 발열과 호흡기 증상이 있어 인플루엔자 또는 인플루엔자양 질환이 의심되거나 그로인한 만성질환의 악화로 추정되는 환자군과 이를 배제한 대조군을 중심으로 혈중 인플루엔자 항체가를 조사하였고 인플루엔자 백신접종력을 조사하였다. 결과의 해석은 로지스틱 회귀분석을 이용하였다. 결과 : 만성질환자를 대상으로한 환자 대조군 연구에서 2개 대학병원에서 1년간 조사한 결과 항체 검사에 기준하여 최종적으로 환자군 64명, 대조군 117명이 포함되었다. 환자군에서는 대부분이 호흡기질환(253%)과 심혈관계질환(313%)였던 반면에 대조군은 암(466%)이 가장 많았고 심혈관계질환과 호흡기계질환은 각각 134%, 60%로 낮았다. 또한 두군간에는 예방접종의 경력에서 통계적으로 유의한 차이를 보였으며 이때의 비차비(OR)은 0328로서 인플루엔자 예방접종의 입원 예방효능은 672%이었다. 결론 : 만성질환자, 특히 만성 심폐질환들에서의 인플루엔자 예방접종은 불필요한 입원을 줄이는 효과가 관찰되었다. 따라서 의료인들은 고위험군의 환자들에 대하여 인플루엔자 에방접종을 적극적으로 권장하고 실천하여야 하겠다. Background : Influenza is one of the preventable respiratory disease by annual vaccination. Elderly people and patients with chronic medical disease are the primary target for influenza vaccination according to ACIP (Advisory Committee on Immunization). This study was done to determine whether influenza vaccination affects hospitalization due to influenza like illness or it's related complications among chronic ill patients. Materials and methods : Retrospective, case-control study was conducted for 5 months (Nov. 1999-Mar. 2000). Physicians from two-university hospitals in Korea were instructed to collect clinical data, sera from subjects presenting with a flu-like illness or flu-related exacerbation in patients with chronic underlying diseases. We compared the vaccination history of case patients with control. Logistic regression analysis was used to calculate the odd ratio and efficacy of influenza vaccination. Results : Hospitalization due to ILI (influenza like illness) or it's related complications were observed more frequently in patients with chronic lung disease (25.3%) and chronic cardiac disease (31.3%) compared to others. Influenza vaccination resulted in fewer hospitalization with ILI or ILI-related acute exacerbation of underlying disease in chronic ill patients (adjusted odd ratio, 0.328 [CI, 0.14 to 0.73]) during influenza seasons. Conclusion : For patients with chronic disease, influenza vaccination is associated with substantial health benefit including fewer hospitalization. Health care providers should take advantage of all opportunities to immunize these high-risk patients.

반도체 공정에서의 기상 세정장비 개발에 관한 연구

박헌휘,이춘수,최승우,함승주 호서대학교 반도체제조장비국산화연구센터 2001 반도체장비학술심포지움 Vol.2001 No.-

저압 기상 영역에서 Anhydrous HF 가스와 Methanol vapor를 사용하는 산화막 식각공정을 수행하기 위하여 (1) 반응기 부피의 최소화, (2) 공정압력의 최소화, (3) 고순도 알루미나 Reactor 적용, (4) Cluster화의 개념을 적용한 VPC 장치를 제작하였다.Wafer의 온도, HF의 분압 및 Working Pressure 등의 공정변수에 따른 Oxide Wafer의 식각특성의 변화를 확인하였다 또한 Etch Uniformity를 향상시키기 위하여 Shower Head의 구조를 변경시켜서 실험하였으며, CFD Simulation을 이용하여 Reactor 내에서의 HF gas 및 Methanol vapor의 분율을 예측하였다.