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LPG기관의 과류밸브가 가속성능에 미치는 영향에 관한 실험적 연구
장태익,김창헌,김철수,Jang Tae-Ik,Kim Chang-Hun,Kim Chul-Soo 한국마린엔지니어링학회 2004 한국마린엔지니어링학회지 Vol.28 No.7
This paper is to investigate on the effects of the hole size of spring type EFV(excessive flow valve) for automobiles The analytical and experimental methods were employed to measure the discharge coefficient. choked flowrate and Pressure wave in a bombe, line and vaporizor The size of EFV was determined to meet the legally permitted limits with the capacity of engine displacement up to 2000cc, according to the obtained discharge coefficient. The Purpose of this paper is 1) to find causes of bad acceration performance in LPG engines 2) to find optimal design determination of spring coefficient and orifice hole size of excessive flow valve in LPG engine 3) to find pressure wave of bombe, line and vaporizer through expeimental verification. Experimental results indicated that increase of orifice size 0.5mm to 1mm be caused to increase discharge coefficient, and choked flow rate and decrease operation range of difference pressure wave.
말기 신부전증으로 투석을 시작하는 당뇨병과 비당뇨병 환자에서 99mTc-sestamibi SPECT (MIBI) 및 심초음파 소견의 비교
장태익 ( Tae Ik Chang ),박정탁 ( Jung Tak Park ),이정은 ( Jung Eun Lee ),이승철 ( Seung Chul Lee ),김주성 ( Joy Seong Kim ),김형종 ( Hyung Jong Kim ),류동열 ( Dong Ryeol Ryu ),유태현 ( Tae Hyun Yoo ),최훈영 ( Hoon Young Choi ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.4
혈액투석을 시행받고 있는 말기 신부전증 환자에서 투석 방법에 따른 피부색의 변화
김찬호 ( Chan Ho Kim ),강신욱 ( Shin Wook Kang ),문성진 ( Sung Jin Moon ),고광일 ( Kwang Il Ko ),김동현 ( Dong Hyun Kim ),김은영 ( Eun Young Kim ),박정탁 ( Jung Tak Park ),장태익 ( Tae Ik Chang ),김현욱 ( Hyun Wook Kim ),박선영 ( 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.5
Purpose: Skin hyperpigmentation in end stage renal disease patients is known to be attributed to the accumulation of middle molecular weight (MMW) substances such as urochromic pigments and carotenoids. Therefore, there is a possibility that hyperpigmentation may be improved by high-flux hemodialysis (HF-HD) and online hemodiafiltration (HDF). This prospective study was undertaken to investigate the quantitative changes in skin color in HD patients according to dialysis modality. Methods: Eighty-two stable ESRD patients undergoing HD were enrolled and divided into three groups according to their dialysis modality. Melanin index and erythema index of forearm and abdomen (non-sun exposed area), and forehead (sun exposed area) were measured by narrow-band reflectance spectrophotometer at baseline and after 12 months. Results: There were no significant differences in the baseline values of melanin and erythema indices among the three groups. But the changes in forehead melanin index were significantly lower in HDF patients (-1.0±2.4%) compared to the LF-HD group (0.3±1.6%) (p<0.05), and forehead erythema index was significantly decreased in patients treated by HDF (-1.6±2.5%) relative to the low-flux hemodialysis group (-0.1±2.5%) (p<0.05). Conclusion: The changes in skin color of sun exposed area were reduced by HDF, suggesting that enhanced removal of MMW substances by convective therapy may be of advantage to skin hyper-pigmentation in ESRD patients.
특발성 결절성 사구체 경화증 (Idiopathic Nodular Glomerulosclerosis)
장태익 ( Tae Ik Chang ),김형종 ( Hyung Jong Kim ),박정탁 ( Jung Tak Park ),이정은 ( Jung Eun Lee ),이승철 ( Seung Chul Lee ),김유리 ( Yu Ri Kim ),강신욱 ( Shin Wook Kang ),최규헌 ( Kyu Hun Choi ),이호영 ( Ho Yung Lee ),김혜령 ( Ha 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.5
임상 연구 : 신이식 환자에 있어서 이식 초기의 요산 수치와 사구체 여과율 변화량과의 관계
박선영 ( Sun Young Park ),김동기 ( Dong Ki Kim ),장제현 ( Jae Hyun Chang ),김현욱 ( Hyun Wook Kim ),김은영 ( Eun Young Kim ),박정탁 ( Jung Tak Park ),장태익 ( Tae Ik Chang ),유태현 ( Tae Hyun Yoo ),김범석 ( Beom Seok Kim ),강신욱 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.6
목적: 혈중 요산의 증가는 신질환의 발생과 관련이 있는 것으로 알려져 있으나 신기능의 악화 및 진행과의 관련성에 대해서는 아직까지 논란이 많은 상태이다. 신이식 환자에서 고요산혈증은 흔히 일어나는 합병증으로 본 저자들은 신이식 환자에서 이식 초기의 혈중 요산 수치와 사구체 여과율(Glomerular filtration rate, GFR) 변화량 및 이식신 생존율과의 관계에 대해 알아보고자 하였다. 방법: 2002년부터 2004년까지 연세대학교 의과대학 신촌 세브란스 병원에서 신이식을 시행 받은 245명의 환자를 대상으로 이식 초기의 혈중 요산 수치 및 이식 신기능을 평가하였다. 이식 후 초기 6개월 간의 평균 요산 수치가 6.8 mg/dL 이상인 경우를 고요산혈증으로 정의하였다. 이식 후 이식 신기능은 Modification of Diet in Renal disease (MDRD) Study equation을 사용하여 3년 간의 GFR 변화량을 계산하여 평가하였다. 결과: 신이식을 받은 환자 245명 중 이식 초기 6개월 간 고요산혈증을 보인 환자는 55명으로 전체 24.4%에 해당하였다. 성별, 나이, BMI, 고혈압, 안지오텐신 전환 효소 및 수용체 억제제의 사용, 이뇨제의 사용, 면역억제제의 종류는 GFR 차이에 따른 이식 초기의 요산 수치에 영향을 주지는 않았다(p>0.05). 이식 후 초기 6개월 간의 요산 수치가 높을 수록 6개월 이후 이식신의 사구체 여과율 변화량 (GFR slope)이 빨리 감소하는 경향을 보였으며 두 군간의 차이는 통계학적으로 유의하였다(-0.055 vs. -0.363, p=0.03). 고요산혈증군과 비고요산혈증군의 생존율을 Kaplan-Meier 방법을 이용하여 분석한 결과, 고요산혈증군이 비고요산혈증군에 비하여 이식 후 3년간 이식신 누적 생존율이 의미 있게 낮았다(HR 1.7, p=0.003). 결론: 이식 초기 6개월 간의 요산 수치가 이식신의 사구체 여과율 변화량 및 이식신 생존율과 관계가 있었으며 이는 또한 이식신 생존율과 관계가 있었다. 하지만 본 연구결과는 비교적 짧은 3년 간의 이식신 생존율을 살펴본 바, 보다 장기적인 추적 연구가 도움이 될 것으로 사료된다. Purpose: Hyperuricemia is a common complication occurring shortly after kidney transplantation. Although increased uric acid level is a risk factor for cardiovascular disease and mortality, the relationship between uric acid level and graft function after transplantation has been a controversial issue. Therefore, we investigated the effects of uric acid on glomerular filtration rate (GFR) and graft survival in the early periods of kidney transplantation. Methods: Data were collected from 245 patients who underwent kidney transplantation between 2002 and 2004 at Yonsei University Medical Center. Uric acid level and estimated GFR were measured monthly during the first 6 months and then yearly for 3 years. Results: The mean age of the study population was 40.2±11.7 years. The proportion of patients with hyperuricemia (uric acid ≥6.8 mg/dL) showed increment during the 3 year follow up. Increased serum uric acid level showed a negative correlation with estimated GFR during the initial 6 months after transplantation (r=-0.026, p<0.05). In Kaplan-Meier analysis, patients with a mean uric acid level higher than 6.8 mg/dL during the first 6 months showed a lower cumulative graft survival during the consecutive 3 years compared to patients with a uric acid level lower than 6.8 mg/dL (HR 1.7, p=0.003). Conclusion: Uric acid levels were associated with the changes of GFR in the initial 6 months of kidney transplantation, and the hyperuricemia during the early stages of transplantation might influence the long term graft survival.
복막투석 환자에서 발생한 Chryseobacterium meningosepticum 복막염 1예
구향모 ( Hyang Mo Koo ),도화미 ( Fa Mee Doh ),김은진 ( Eun Jin Kim ),강이화 ( Ea Wha Kang ),신석균 ( Suk Kyun Shin ),장태익 ( Tae Ik Chang ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.3
Chryseobacterium meningosepticum is rarely encountered as a pathogen causing peritonitis in peritoneal dialysis (PD) patients. We report a case of peritonitis due to Chryseobacterium meningosepticum, which was treated successfully with intraperitoneal (IP) vancomycin and ciprofloxacin, and without PD catheter removal. Peritonitis was developed in a 53-year-old PD patient on the third hospital day. Although empirical IP treatment with cefazolin and tobramycin was initiated and maintained for 3 days, the fever and signs of peritonitis persisted. Antibiotics were changed to cefoperazone/sulbactam, amikacin, and vancomycin due to clinical deterioration. After 3 days of vancomycin use, leukocyte count in PD fluid was less than 100/mm3 and the patient became asymptomatic. On seventh day after the onset of peritonitis, Chryseobacterium meningosepticum was isolated from initial dialysate sample, and this strain was susceptible to ciprofloxacin, piperacillin, and piperacillin/tazobactam. Accordingly, we changed the antibiotics to ciprofloxacin and vancomycin, which were given for the total of 14 days. Even though Chryseobacterium meningosepticum is an uncommon causative organism of peritonitis in PD patients, this report suggests that vancomycin and ciprofloxacin are effective as empiric therapy, and early suspicion and appropriate antimicrobial therapy are crucial to the successful treatment of peritonitis due to Chryseobacterium meningosepticum without catheter removal.
장기간 집중적인 혈장반출법으로 치유된 mitomycin C에 의한 용혈요독증후군
신동호 ( Dong Ho Shin ),이미정 ( Mi Jung Lee ),박현성 ( Hyun Sung Park ),김좌경 ( Jwa Kyung Kim ),박정탁 ( Jung Tak Park ),장태익 ( Tae Ik Chang ),강신욱 ( Shin Wook Kang ),최규헌 ( Kyu Hun Choi ),유태현 ( Tae Hyun Yoo ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5
HUS (Hemolytic Uremic Syndrome) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. In classical HUS, hemorrhagic diarrhea precedes. It is frequently associated with E. Coli O157:H7. Less frequently, HUS may also develop after various treatments such as mitomycin C, cyclosporine, quinine, and ticlopidine. Plasmapheresis is effective in most of classical HUS, which induces a complete remission in most patients with classical HUS. However, this treatment is ineffective in HUS associated with mitomycin C. Although Plasmapheresis is effective on hematologic abnormality in this atypical HUS, chronic renal insufficiency frequently persists as a sequella in HUS associated with mitomycin C. We here report on one patient who developed HUS following mitomycin C therapy due to cervix cancer. The patient was treated with intensive and prolonged plasmapheresis. There was a complete hematologic improvement and steady improvement in renal function.