당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

대동맥 협착증과 동반된 출혈성 위장관 동정맥 기형에서 Estrogen-Progesterone 치료 1예

김도연,김화정,김효정,남준식,박수영,박영미,신정은,주미순,황민규,정혜경,손혜영,이선영,이한주 大韓消化器內視鏡學會 1999 Clinical Endoscopy Vol.19 No.부록2

Silaethene CL₂Si=CHCH₂?Bu의 엔반응 : Unsaturated Compounds of 14Group Elements(Ⅸ)

김정균,박은미,구미영,박경래,손병영 東亞大學校 大學院 1992 大學院論文集 Vol.17 No.-

Silaethene Cl₂Si=CHCH₂?Bu 1, generated as a reaction intermediate by the thermal elimination of LiX from Cl₃SiCHLiCH₂?Bu 2, combines with ene-component containing compounds(propene, 2-methylpropene, DMB) to give 40∼90% yield ene-products. They can be isolated and spectroscopic identified.

한국 패션기업의 세계화 추세 연구

손미영,이은영 한국의류학회 2003 한국의류학회지 Vol.27 No.11

This research was conducted to find out what the general globalization trends of Korean fashion enterprises are, and what the factors required the Korean fashion enterprises to improve the global competitiveness under the globalized circumstances are. The data were collected from the survey by questionnaire on Korean leading fashion enterprises and the Directory of Companies Branching out abroad in 2000/2001(Korean Trade-Investment Promotion Agency, 2000). The Results of the research are as follows: First, Korean fashion enterprises expanded evenly worldwide in the sales and distribution functions while relying heavily on Asian countries for manufacturing functions; Secondly, the globalization of Korean leading fashion enterprises was progressed, but still remains at the stage of the sale of manufacturing capability or the sales of low products rather than at the stage of manufacturing products of high added-value or the sales of design or marketing capability. Thirdly, the factors for the global competitiveness of the Korean fashion enterprises are related to capability of low cost, quick response, product development, marketing, internationalization and high value added.

자가지방을 이용한 성대주입술

손영익,박주현,이은경,신준호,추광철 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.12

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

수면 무호흡증 환자의 진단방사선학적 고찰

손은주,박정희,전혜정,최영칠,이창희,신현준,이경용 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

Our purpose was to determine whether there are statistical differences in upper airway size and compliance when patients with obstructive sleep apnea are compared with healthy volunteers using ultrafast CT, and to evaluate the diagnostic accuracy of ultrafast CT in obstructive sleep apnea. 29 patients clinically suspected of obstructive sleep apnea and ten healthy volunteers underwent examination of the upper airway with ultrafast computed tomography. All patients had operations; uvulopalatopharyngoplasty (UPPP,n = 19), UPPP with tosillectomy (n = 7) and UPPP with septoplasty (n = 3). Eight axial images every 0.7 sec in 8 ㎜ sections were obtained using flow mode. CT was performed twice while the subjects were awake with quiet breathing and were asleep with apnea. Smallest cross-sectional area in the nasopharynx, oropharynx and hypopharynx and compliances were assessed in patients and control subjects. Among the 29 patients, 22 patients showed narrowing at oropharyngeal level and six patients showed narrowing at two or more levels. Patients with obstructive sleep apnea had significantly smaller mean cross-sectional area than obstructive sleep apnea had significantly smaller mean cross-sectional area than control subjects in the oropharynx while sleeping (p<0.05). But there was no significant difference in mean smallest cross-sectional area of the nasopharynx (p = 0.47). In addition, the patients with obstructive sleep apnea had greater compliance of the oropharynx (79.8% vs 39.3%) and hypopharynx (58.9% vs 19.2%) (p<0.01). Patients with obstructive sleep apnea are characterized by a small oropharyngeal airway and collapsible oropharyngeal, hypopharyngeal airways. Ultrafast CT scanning allows rapid and noninvasive assessment of airway variables.

난치성 측두엽 간질환자의 발작간 뇌파소견

김지언,손은익,김준식,이상도,박영춘 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

空氣壓 변화에 의한 실린더의 最適 位置制御에 관한 硏究

박창언,김일수,김기우,정영재,손준식,송창재 木浦大學校 工業技術硏究所 1999 工業技術硏究誌 Vol.9 No.-

With the increasingly strict demands on accuracy position control of the production line, the modelling and control of the activated process have become a subject of great interest. Much efforts have been made in understanding and modelling of this process in the last decade. This thesis concentrates on the position control of Pneumatic cylinder under parameter variation. An adaptive control is proposed to design the defferent controllers(P, PI, PID, PD controller) in order to choose the best controller based on the fast and accurate control of the system. It is shown that the adaptive control algorithm is robust and effective in attaining the fast and accurate position control of system under time-dependent parameter variation. Experimental results showed that PD controller law is effective to obtain the fast response and to increase the stability of the system. The method is a useful control algorithm which always automatically adjusts the position control in accordance with the error, using carrier wave of triangle type regardless of changes on the operating condition and physical differences between components.

진주지역 유치원의 변천과정에 대한 연구

강인언,임성혜,손영수 진주여자전문대학 1992 論文集 Vol.15 No.-

The main purpose of this study is to investigate the history of early childhood education in Chinju city. And the second purpose is to find out various problems in the field of early childhood education in Chinju, and seek improved suggestions. To carry out this study, the researchers gathered many kinds of data from forty kindergarten located in Chinju city. The opening date, the present situations, and the number of teachers, children and classes of each kindergarten were included in the data. The findings and suggestions of this study are as follows : 1. The kindergarten openting in Chinju for the first time in 「Chinju Chiristian Kindergarten」opened in 1916, which is two years later than the first kintergarten for the Korean childern, 「Ewha Kindergarten」opened in 1914 in Seoul. 2. Most of the private kindergartens in Chinju are very poor in financial aspect. 3. The salary level of the teachers of private kindergarten is lower than that of public kindergarten. 4. The concept of the parents on early childhood education is distorted much more than that of the specialists. 5. Educational programs according to ages (3-5 years old children)is required. 6. To elevate the efficiency of early childhood education, the financial support of provincial government as well as central government is required. 7. To recommendate the encouragement of learning in kindergaten, many of the school inspector are necessary in the special field of the early childhood education.