단기간의 저용량 Cytosine arabinoside 치료에 반응하였던 Down 증후군에 병발한 급성골수성백혈병 1례

김현수,이정호,이정찬,강정현,곽상혁,김철희,배광봉,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The incidence of hematologic disorders in patients with Down's syndrome is significantly increased, about 14∼30 - fold higher than in general population and includes neonatal transient abnormal myelopoieis and acute leukemias. The age of onset of leukemia in Down's syndrome is peaking first in the newborn period and then under 4 years of age. Down's syndrome with acute leukemia above the age of 20 is very rare and it's treatment oucome is unclear. The treatment of Down's syndrome with leukemia has been controversial because of toxicity and associated congenital cardiac and other abnormalities. But if treated adequately, children with Down's syndrome show a favorable response to anti-leukemia therapy. A 24-year-old man with Down's syndrome was first seen for the evaluation of anemia and thrombocytopenia. The peripheral blood morphology and bone marrow study revealed acute myelogenous leukemia, cytogenetic study of bone marrow showed trisomy 21. Beacuse of his sicioeconomic condition and medical abnormalities including deafness, visual loss, he was treated with low dose subcutaneous cytosine arabinoside(Ara-C) for 11 days. Complete remission was obtained after 37 days. The complete remission lasted for 5 months. He subsequently relapsed, and died 6 months later.

중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

항암화학요법을 받는 암 환자에 대한 Nucare^R의 영양지지효과

조덕연,김현수,곽상혁,강정현,김철희,배광봉,김종숙,박상준,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Purpose : The purpose of this study was to evaluate the effect of nutritional support with enteral liquid supplement in cancer patients receving chemotherapy for possible benefit in nutritional, immunologic and golbal function of patients. Patients and Methods : From October 1995 to February 1997, 30 advanced cancer patients receving chemotherapy were divided two roups. The Nycare group, in addition to normal diet, Nucare^R enteral supplement was given for 1week right after chemotherapy for the duration of 2 chemotherapy cycles. Control group received only normal diet without parenteral fluid supplement for 2 chemotherapy cycles. Results : Median ages were 53 end 56 years for Nucare group and Contrl group respectively. Performance scores was less than 2 by ECOG scale. All patients were stage Ⅲ or Ⅳ. The physical parameters, such as weight, arm muscle circumference(AMC) and triceps skin fold(TSF) were decreased in both groups after 2 cycles of anticancer therapy. but it was less severe in Nucare group(p<0.05). Serum transferrin was maintained in mild deficit state in Nucare group, whereas it aggravated form mild to moderate deficit in Control group(p<0.05). Serum albumin level increased in Nucare group without statistical significance. but it decreased from normal to mild deficit in Control group. Serum total protein did not change significantly in Nucare group. but in Control group, serum total protein was decreased from 7.24±0.9 to 6.52±0.5(P<0.05). Total lymphocyte count did not change significantly in both groups. Conclusion : This study shows that the nutritional support with Nucare^R was effective in the prevention of nutritional deficit status in patients receving a nticancer chemotherapy.

PVD 적용지반에서 단계성토시 침하량 예측

강성현(Seong-Hyeon Kang),김태형(Tae-Hyung Kim) 한국지반신소재학회 2014 한국토목섬유학회 학술발표회 Vol.2014 No.11

Settlement prediction has been conducted using Hyperbolic, Hoshino, and Monden methods, etc in the fields. These methods are only able to predict settlement after finishing the final filling stage. A new method is proposed to make up for such a weak point. This method was named as Kang"s method, which can be able to predict the settlement both the final filling stage and the staged filling from the initial filling stage in soft ground. To verify the applicability of this method, the measured settlement curve history was compared with the predicted one. The predicted settlement is well matched with the measured one. From the study, the Kang"s method can be possible to predict settlement during the staged filling with only the initial settlement data.

Azathioprine에 반응을 보인 류마티양 관절염에 의한 경막염(Pachymeningitis)1예

배광봉,이정호,이정찬,곽상혁,강정현,김철희,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Rheumatoid arthritis frequently involves the cervical spine and may lead to neurologic impairement. However, direct involvement of CNS structures by inflammatory cells has been reported infrequently. The prevalence of this complication of rheumatoid arthritis is unknown. Inflammatory CNS involvement in rheumatoid arthritis reportedly occurs in the setting of longstanding, active, erosive articular disease and is accompanied by extracranial and extraspinal nodules and vasculitis. This is diagnosed by radiologic finding of CNS nodules or meningeal thickening and by biopsy or autopsy. Treatment with corticosteroid, cytotoxic agent or surgical decompression is helpful. But the majority of patients die within several months of onset of neurologic symptom. Recently, we experienced a case of pachymeningitis caused by rheumatoid arthritis, which resolved repeatedly with azathioprine treatment.

에이즈 환자의 거대세포바이러스 감염증

김홍빈,박상원,김남중,최희정,신동현,오명돈,김우호,정흠,최강원 대한감염학회 1998 감염 Vol.30 No.4

배 경 : 거대세포바이러스 감염은 인간면역부전바이러스 (Human Immunodeficiency Virus, HIV) 감염자에서 발생하는 가장 중요한 기회감염증의 하나이다. 특히, 국내에서는 95%이상의 국민이 거대세포바이러스의 1차감염을 경험한 상태이므로 에이즈 환자에서 거대세포바이러스 질환의 빈도가 높을 것으로 예상된다. 대상 및 방법 : 1987년 10월부터 1996년 9월까지 서울대학교 병원에서 추적 관찰하였던 128명의 HIV 감염자를 대상으로 하였다. 이들 환자의 의무 기록에서 임상 자료를 얻었다. 거대세포바이러스 망막염은 안과 전문의의 임상적인 소견으로 진단하였으며, 위장관 등 망막이외 부위의 거대세포마이러스 질환은 조직학적으로 확인된 경우에 한하였다. 결 과 : 대상환자 128명의 추적관찰기간은 중앙값이 6(0∼59)개월 이었으며 7명 (5.4%)에서 거대세포바이러스 질환이 발생하였다. 거대세포바이러스 질환은 망막염이 6예, 식도염이 2예, 대장염이 1예, 폐렴 및 부신감염이 1예, 범발성 감염이 1예였다. 거대세포바이러스 질환의 발생빈도는 CD4+ 림프구 수가 적을수록 높았으며, CD4+ 수가 200/㎣미만인 환자 중 15% (6/33)에서 거대세포바이러스 질환이 확인되었다. 11예 중 9예를 ganciclovir로 치료하였으며 이중 7예에서 호전 또는 진행의 억제가 확인되었다. 추적관찰이 가능한 6예 중 3예 (50%)에서 재발하였다. 결 론 : 국내 에이즈 환자에서 거대세포바이러스 질환은 비교적 흔한 기회감염증이다. Background : Cytomegalovirus (CMV) infection is one of the important opportunistic infections in immunocompromised patients. In Korea, seroprevalence of IgG against CMV is over 95%. Therefore, CMV diseases are expected to be a prevalent opportunistic infection in AIDS patients. in Korea. Methods : We reviewed the medical records of 128 patients with HIV infection who visited the Seoul National University Hospital during the period from Nov. 1987 TO Sep. 1996. All the patients were examined by one ophthalmologist and the diagnosis of CMV retinitis were made by funduscopic findings. Other CMV diseases were diagnosed when histopathologic examinations showed the characteristic cytomegalic cells. Results : Median duratior, of follow-up was 8 months. Eleven CMV diseases were found in 7 patients (5.4%): 6 patients ahd retinitis, 2 esophagitis, 1 colitis, 1 pneumonitis, and one patient developed disseminated infection. Fifteen percent (6/33) of the patients whose CD4+ lymphocyte counts were less than 200/㎣ at baseline developed CMV diseases. Out of the 9 cases treated with ganciclovir, 7 improved or were stabilized. No patient received maintenance treatment and 3 had relapsed. Conclusion : CMV diseases are common opportunistic infections in AIDS patients in Korea.

고음질 오디오를 위한 워터마킹에 관한 연구

김정태,박종태,이강현 조선대학교 에너지.자원신기술연구소 2000 에너지·자원신기술연구소 논문지 Vol.22 No.2

In this paper, we proposed the high quality digital audio watermarking algorithm in the frequency domain. The spread spectrum technique is used t o encrypted a stream of information data a s much of the frequency spectrum a s possible. It's by spreading the technique adapt well to data hiding in audio signal. We have used the perceptual model and MDCT/IMDCT for the high quality digital audio watermarking. The proposed watermark algorithm preserved high quality audio data from watermark signal.

푸드뱅크 기탁식품의 안전성 확보를 위한 HACCP 제도 적용

김철재,박현신,배현주,이지해,양일선,강혜승 한국식생활문화학회 2002 한국식생활문화학회지 Vol.17 No.3

The purpose of this study was to analyze the problems arising from the actual conditions of the Foodbank, and to implement the HACCP system as a solution in terms of increasing the safety of donated food within the Foodbank. In order to apply HACCP system, the entire Foodbank working process such as preparation, collection, transportation, division, and distribution was considered and analyzed to decide the application point for CCPs. Donated foods mainly consisted of processed foods, raw materials, lunch boxes, and cooked foods from mass catering establishments, which dominated over the others in terms of quantity. Cooked foods were divided into three groups based on menu-types and processing methods. Temperature, pH, and aw were measured on cooked foods, and Total Plate Count, Coliforms, E. coli, Salmonella spp., Staphylococcus aureus, Listeria monocytogenes, and E. coli O157:H7 were conducted in order to apply a HACCP plan. Form these experiments, temperature, pH, and aw of donated food were likely contributed to microbial growth. Donated foods before HACCP implementation showed high numbers in terms of total plate count and Coliforms, both well over the acceptable standard levels. By setting the CCPs on maintenance of donated food below 10℃ and using a 75 ℃ reheating method, microbiological hazard levels were able to be controlled and lowered. From these results, it is concluded that in order to guarantee food safety, foods donated to the Foodbank must not only maintain a reasonable level of initial microbiological growth, but also must be handled properly through time and temperature controls within the Foodbank system. Furthermore, in terms of implementing the HACCP plan within the Foodbank management structure, basic food safety and sanitation measures, such as reheating facilities and various cold chain systmes such as refrigerated vehicle for food transportation are importantly needed. The training and education of Foodbank personnel and management in areas such as awareness of hygiene and safe food handling and practice are also required and necessary.

학생들이 사용한 엔진 구동형 Ni-Ti file systems의 근관 성형 효율 비교

강문성,김현철,허복,박정길 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.1

본 연구의 목적은 학생들이 사용한 세 가지 Ni-Ti 파일의 성형효율을 비교하고, 각 파일의 사용 경험 유무에 따른 차이를 비교하여 치과대학생을 위한 교육에 적합한 종류를 선택하는데 도움을 얻고자하는 것이다. Ni-Ti 파일 사용 경험이 없는 학생 50명과 Ni-Ti 파일을 사용한 근관치료 경력이 2년 이상인 경험자 10명이 세 종류의 Ni-Ti file - ProFile^(®) (PF), HeroShaper^(®) (HS), K3™ (K3) -을 사용하여 180개의 근관 모형을 성형하였다. 근관성형 시간 및 기구 변형, 근관 이형성을 조사하고 성형 전후 상을 중첩하여 근관 삭제폭, 근관변위량과 중심변위율을 1, 3, 5 ㎜에서 분석하였다. 1. 근관 성형시간은 HS군이 가장 빨랐으며, 총 삭제량은 모든 지점에서 K3군이 다른 군보다 컸다 (P<0.05). 2. 세 군 모두 1, 3 ㎜에서 외측 변이를 보였고, 1 ㎜ 지점에서 PF군이 가장 안정적이었다 (P< 0.05). 3. 중심변위율은 1, 3 ㎜에서 HS, PF군이 K3군보다 작았다. 5 ㎜ 지점에서 PF군이 가장 작았고, PF군 3 ㎜에서 학생은 경험자보다 유의하게 작았다 (P < 0.05). The purpose of this study was to compare the shaping ability of three Ni-Ti file systems used by dental students or the experts and consequently to aid in choosing a proper systems for educational courses of dental students and beginners. Fifty students and ten dentists who have clinical experience over two years prepared 180 simulated root canals in resin blocks with three Ni-Ti systems: ProFile^(®) (PF), HeroShaper^(®) (HS), K3™ (K3). After preparation, the Ni-Ti files were evaluated for distortion and canal preparation time was recorded. The images of pre- and post-instrumented canals were scanned and superimposed. Amounts of increased canal widths,deviation, and centering ratio were calculated at apical 1, 3 and 5 ㎜ levels and statistical analysis was performed. The results were as follows: 1. HS showed the shortest preparation time and instrumented canal width in K3 was significantly larger than other groups (P< 0.05). 2. At 1 and 3 ㎜ levels, all groups had outward deviation. In student group, at the 1 ㎜ level, PF had the least deviation (P< 0.05). 3. In the centering ratio, the PF had the best centering ability compared to the others at 5 ㎜ level. At 1 and 3 ㎜ level, HS and PF had better abilities than K3. Student group had better ratio than the expert at 3 ㎜ level with PF (P<0.05). Based on the results, it is surmised that the ProFile^(®) is the safest and most ideal instrument for students and beginners.〔J Kor Acad Cons Dent 31(1):1-10, 2006〕

사무직 근로자의 수면의 질 및 직무스트레스와 우울과의 관련성

강미나,강수영,권수정,김현주,배재원,이보연,이예진,임의롬,정다영,조한솔 이화여자대학교 간호과학대학 2013 이화간호학회지 Vol.- No.47

Purpose: The purpose of this study was to understand the degree of depression, sleep quality, job stress and their association among office workers. Method: A self-administered questionnaire was distributed to 147 workers employed in 5 big enterprises, and 5 small and medium enterprises from October 21 to November 21, 2012. The questionnaires included socio-demographic and health-related characteristics, job-related characteristics, sleep quality, job stress (KOSS) and depression (CES-D). Result: Among all subjects, 23.1% was in the depression group (21 points and over in the CES-D score). Depressive level was positively correlated with job stress and quality of sleep. The adjusted odd ratio for the effects of sleep quality and job stress on depression significantly increased in the depression group compared to that of the normal group. Multiple regression analysis revealed that the following factors of influence had combined explanatory powers on depression: BMI, life satisfaction, quality of sleep, and job stress. Conclusion: The study revealed that complicated influences were exerted on the level of depression by variable factors, as well as socio-demographic characteristics, health-related characteristics, quality of sleep, and job stress. Specifically, the level of depression was influenced by the quality of sleep and job stress.