Graves 병 환자에서 항갑상선제 투여에 의한 TSH 수용체 항체의 변동에 관한 연구 : 치료 용량 및 기간에 따른 차이 및 임상상과의 관계 its relation to dose and duration of treatment~and clinical features

이문호,조보연,문대혁,고창순,민헌기,서교일 대한내과학회 1986 대한내과학회지 Vol.30 No.3

We undertook a prospective study of 59 patients with Graves' disease in order to clarify the influence of antithyroid drug on the immunological indices and to determine the association of the changes of TSH receptor antibodies activities with drug dosage, duration of treatment and clinical features according to mode of antitbyroid drugs treatment. Patients were divided into two groups. High dose group included 28 patients and conventional dose group 31 patients. We measured TBII activities, antimicrosomal antibodies, and the size of goiter every 3 months, comparing them with clinical features and laboratory findings. TBII activities declined from R months until 9 months following drug treatment. Therafter no significant change of TBII activities were observed. Antimicrosomal antibodies showed the same pattern of change. There was no statistically significant difference of declining rate of TBII activities, antimicrosomal antibodies, and reduction of size of thyroid between two treatment groups. TBII activities fell into normal range in 15 patients among those 44 patients who had been followed for more than 9 months (8 high dose group, 7 conventional dose group). In those 15 patients, TBII activities and frequency of exophthalmos were less than those whose TBII activity did not normalized. We conclude that TSH receptor antibodies activities and antithyroid autoantibodies are diminished by antithyroid drug treatment in patients with Graves disease and there is no relationship between dose of drug and declining of TBII activities. We suggest that changing levels of TBII activities might be secondary phenomenon which can be achieved by control of thyroid function by antithyroid drug rather than direct immunosuppressive effect of antithyroid drug per se.

캐스케이드 열펌프시스템의 운전 특성에 관한 연구

장기창(Ki-Chang Chang),백영진(Young-Jin Baik),나호상(Ho-Sang Ra),김지영(Ji-Young Kim),이재훈(Jea-Hun Lee) 한국지열·수열에너지학회 2009 한국지열에너지학회논문집 Vol.5 No.1

The purpose of this study is to investigate the performance of a water heat source cascade heat pump system R717(Ammonia) is used for a low-stage working fluid while R134a is for a high-stage. In order to gain a high temperature supply water in winter season, the system is designed to perform a cascade cycle. In this study, two experiments were carried out. One is a system starting test from the low load temperature of 10℃. The other is a system performance investigation over the R717 compressor capacity changes. Experimental results show that when it starts from the low load temperature, the suction temperature of the low-stage compressor is higher than that of a high-stage. The system performance increases when a water source temperature or a low-stage compressor rotational frequency goes higher.

Nelder-Mead 심플렉스 알고리듬의 수렴에 관한 수치실험

현창헌,이병기 江原大學校 産業技術硏究所 2002 産業技術硏究 Vol.22 No.B

To find the optimal solution as rapidly and exactly as possible with Nelder-Mead simplex algorithm, the present values of the reflection, expansion, contraction and/or shrink parameters of this algorithm are needed to be changed at appropriate time during the search process. The reflection parameter is selected in this study in order to be changed because reflection, expansion and contraction process can be simultaneously effected by only this parameter. Two independent indices for determining whether the present value of the reflection parameter of this algorithm should be changed or not during the search process are suggested in this study. Those indices were made of the equations of Nelder-Mead simplex algorithm's convergence criterion and Dennis-Wood's convergence criterion, repectively. It is appeared that the optimal solution can be find with smaller numbers of objective function evaluation than the original Nelder-Mead's one with fixed parameter when the those indices are used during the search process and the more remarkable reduction effect of the number of an objective function evaluation can be obtained when the latter index is used.

만성 화농성 중이염의 세균학적 고찰

조남순,이영훈,강기훈,최제환,송태현,이병돈,장혁순,강주원,김연준 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background and Objectives : Chronic suppurative otitis media is one of the frequent diseases in otolaryngologic field. It is important to choose of antibiotics in the management of infectious disease. But the organisms in infections have been changed and resistance to antibiotics has been grown as the development of antibiotics has been achieved. And so it has been necessary to recognize the changes of organisms and resistance in antibiotics. Our study was performed to identify the pathogens isolated from discharges in chronic otitis media and evaluate the antibiotic agents, to recognize the change of to resistance to·antibiotic agents and to use the appropriate anitiotics. Materials and Methods : Retrospectively, authors reviewed the backeriologic study of 114 cases of chronic suppurative otitis media who visited the Department of Otolaryngology, Soonchunhyang University in Seoul from Nov. 1996 to Oct. 1999 and analyzed 101 strains and its sensitivity test to various antibiotics. Result : In 93 cases in which pathogenic organism was isolated, single infection was 85 cases(91.4%) and mixed infection was 8 cases(8.6%). The most frequent pathogenic organism was Staphylococcus aureus(59.4%), Pseudomonas aeruginosa(13.9%), Providencia(4.8%), Alcaligenes(3.0%) and Streptococcus pneumoniae(2.9%) were the next. Methicilline-Resistance Staphylococcus aureus was 34 cases(57.6%) of Staphylococcus aureus. Staphylococcus aureus was sensitive to Vancomycin(96.7%), Trimethoprim-Sulfamethoxazole (57.6%), Cefuroxime(42.4%) and Ciprofloxacin(40.7%) but resistant to Penicillin(94.9%). Pseudomonas aeruginosa was sentitive Amikacin(100%), Ciprofloxacin(100%) and Gentamicin(67%). Conclusion : As MRSA recently was wide spread in community accquired infection as well as nosocomial infection, we must consider strict control of MRSA.

한국인 A 형 간염 환자에서 A 형 간염 바이러스의 유전자형에 관한 연구

권오상,송기준,박상훈,송진원,김재선,김종헌,변관수,이창홍,연종은,백락주,박영태 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.3

$quot;목적: 한국에서 과거 A형 간염은 낙후된 개인위생 및 자연환경으로 유소아기에 불현성 감염으로 앓고 지나가게 되어 청소년 및 성인에서 HAV에 대한 항체 보유율이 매우 높고 성인에서의 급성 A형 간염은 매우 드물게 보고되었다. 그러나 고도의 경제성장과 더불어 식생활, 위생상태의 개선, 상하수도의 보급 등으로 유소아기의 A형 간염 이환율이 현격히 감소하면서 청소년 및 성인에서 HAV 항체가 없는 인구집단 즉 HAV에 감염되면 현증 간염이 발생할 수 있는 인구 집단이 증가되어 최근 수 년 사이에 현증 A형 간염이 폭발적으로 증가하게 되었다. 이에 저자는 HAV의 유전자형을 알아보고 이미 보고된 각국의 HAV와 연관성을 알아보고자 본 연구를 시행하였다. 대상과 방법: 1994년부터 1998년까지 한국에서 산발적으로 발생한 18예의 A형 간염 환자의 혈청에서 HAV RNA를 추출, 역전사-중화효소 연쇄반응법(RT-PCR)으로 증폭하여 직접 염기서열의 분석을 통해 국내 HAV 사이에 염기서열, 아미노산의 차이 등을 알아보고 세계 각국에서 보고되었던 HAV 분리주들과 비교하였다. 결과: HAV 게놈의 특정부위인 VP1/2A 연결부위 168 bp 길이에서 시행한 염기서열 분석 결과 한국에서 분리된 18예의 HA이러스는 최근 해외에서 유입된 바이러스일 가능성은 적으며 따라서 장기간 국내에서 토착화된 바이러스일 것으로 생각된다. $quot;Background/Aims: Studies of genotypes and changes in nucleotide and amino acid sequences of hepatitis A virus (HAV) may provide valuable information on the epidemiological aspects of a particular region. In Korea the prevalence of anti-HAV in the 1 - 20 year age group declined from 60% in 1980 to 9% in 1995. As a result this age group has a high risk of HAV infection. Actually over 1,500 cases of clinically overt hepatitis A occurred in 1998 while few cases of clinical hepatitis A had been reported until the early 1990s. The aims of this study are to determine the genotypes of HAV which have been circulating in Korea and to define the phylogenetic relationships of geographically defined isolates. Method: From 1994 - 1998 a total of 18 serum specimens was obtained from patients in Korea with sporadic form acute hepatitis A. The HAV nucleic acid from serum specimens was subjected to genomic sequence analysis following viral RNA extraction, reverse transcription and amplification of the cDNA by PCR. DNA sequencing was performed in both directions of each PCR product. Results: All isolates clustered within the subgenotype IA irrespective of the geographic locations and timing of the clinical hepatitis. Among 18 Korean isolates, 9 isolates had 2 amino acid sequence changes and 2 isolates had 1 amino acid sequence change. These changes in the amino acid sequences are unique and have never been reported in HAV subgenotype IA. Conclusions: All isolated HAV had genotype (IA). Eleven of 18 isolates had unique changes in amino acid sequences. These data indicate that the endemic HAV has been circulating in Korea over a long period of time.

정상교하 아동의 두개안면부 성장에 관한 종적 연구

양규호,박창헌,손정수,김낙현,최남기,김선미,김기백,신혜성 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.3

혼합치열기 정상교합 아동 24명(남:14명 여:10명 초진 시 평균 나이 9±1.3세, 평균 관찰 기간: 13±1.3개월)에 대한 성장량을 측정하여 기능적 교정장치의 순수 치료효과를 평가하는데 도움이 되기 위해 3회(5~8개월 간격) 촬영한 측모 두부 방사선 규격 사진에 대한 분석 결과 다음과 같은 결론을 얻었다. 1. 남아는 상악골은 전하방, 하악골은 전방성장하였고, 여아는 상하악골이 전하방 성장하였다(p<0.05). 2. 상하악골의 남녀간 차이에서 수평적 성장상태는 여아가 컸고(A point 여아: 2.39mm, 남아: 1.26mm, p<0.05), 수직적 성장상태는 유의한 차이가 없었다. 3. 상악 전치의 치축은 두개저에 대해서 순측 경사하였고(p<0.01) 하악 전치의 치축은 큰 변화가 없었다. The purpose of this study was to provide the reference data evaluating the treatment effect of orthopedic appliances. The skeletal and dental growth increments were measured in 24 normal mixed dentition children(boys: 14, girls: 10) by three serial lateral cephalograms: initial mean age: 9±1.3 years, mean observation period: 13±1.3 months, Cephalometric changes were analysed. The results were as follows: 1. In boys, the maxilla showed forward and downward growth pattern and the mandible showed forward growth pattern(p<0.05). In girls, the maxilla and mandible showed forward and downward growth pattern(p<0.05). 2. Horizontal growth of both maxilla and mandible in girls was superior to those in boys(A point: girls: 2.39mm, boys: 1.26mm, with p<0.05), whereas vertical growth of both maxilla and mandible in boys was similar to those in girls. 3. The change in tooth axis showed labioversion of upper incisor(p<0.01) and comparatively stable lower incisor position.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

관상동맥 질환에서 도플러 심초음파도로 측정한 확장기 좌심실기능의 지표와 혈역학적 소견과의 비교 검토

임헌관,기신영,유창범,최태명,김성구,권영주 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

Background : Left ventricular diastolic dysfunction is now recognized as a significant cause of cardiac symptoms even in patient with normal systolic ventricular function. During the last several years, the use of Doppler echocardiography for assessing left ventricular diastolic function has attracted increased attention. Doppler study have demonstrated that patients with ischemic heart disease have abnormal diastolic filling pattern suggesting impaired relaxation. Methods : This study was designed to correlate Doppler mitral flow velocity patterns and measuared variance with hemodynamic findings in 33 patients: 10 with myocardial infarction(group 1), 10 with angina pectoris(group 2) and 13 with no coronary disease(group 3). Results: 1. E/A ratio (0.87±0.24 m/sec versus 1.09±0.91 m/sec, P<0.05) was lower in group 1 than in group 3. 2. Significant correlation were demonstrated between pulmonary capillary wedge pressure (PCWP) and isovolumic relaxation time(IVRT) (r=-0.58; p<0.001), and E velocity (r=0.61; p<0.005). 3. IVRT was (61±30msec versus 92±35msec, p<0.05) shorter in patients with PCWP>10mmHg than in patients with PCWP≤10mmHg. Conclusion: Doppler mitral flow recordings have partially clinical potentiality in assessing left ventricalar diastolic function in patient with ischmic heart disease.

퍼지 simplex search 알고리듬을 이용한 동력 스크류 효율의 최적설계

현창헌,이병기 江原大學校 産業技術硏究所 2002 産業技術硏究 Vol.22 No.A

The Nelder-Mead simplex algorithm has been one of the most widely used methods for the nonlinear unconstrained optimization, since 1965. Recently, the new algorithm, (so-called the Fuzzy Simplex Algorithm), with fuzzy logic controllers for the expansion, reflection and contraction process of this algorithm has been proposed. In this paper, this new algorithm is developed. And, the formulation for the optimum design of the power screw's efficiency is made. And then, the developed fuzzy simplex algorithm as well as the original one is applied to this optimum design problem. The Fuzzy simplex algorithm results in a faster convergence in this problem, as reported in other study, too.

럭비 펀트 킥시 선수, 비선수간의 운동역학적 분석

이기도,조병준,윤창진,이민형,김헌수 한국운동역학회 2000 한국운동역학회지 Vol.10 No.1

In this study, we kinematically compared and analized the features of movement at punt kick of 6 rugby players and 6 non-players. The outcome is as following; 1. On the anterior-posterior direction of the joint velocity, players and non-players showed similar change. They showed the tendency of decrease from touching the ground to impact, but increase in the vertical direction velocity. 2. On the angular velocity, players and non-players didn't show much difference in the ankle at the moment of impact. Players showed remarkable increase in the knee and in the hip joint. 3. On the ground reaction force of anterior-posterior direction, players showed distinguished increase at the two peaks. On that of vertical direction, players showed outstanding increase at the second peak. And non-players showed longer supporting time than players. This study was peformed about kinematic variables of rugby punt kick such as force, position, velocity, and angle of supporting foot. It's necessary to study other kinematic variables like launch angle, velocity, moved distance of the ball along with those studied in this research in further studies.