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.

전기도금을 이용한 스테인레스스틸 각형 선재의 굵기 증가 후 물성 변화

이정석,황현식,최광철,문재동 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.1

The purpose of this study was to evaluate clinical applications of electroplating method through investigation of the physical properties of orthodontic rectangular wires according to varying their cross section. For the study, it was accomplished to electroplate the 0.016-inched orthodontic rectangular stainless steel wire. The cross section of stainless steel orthodontic rectangular wire increased from 0.016 X 0.016 inch to 0.017 X 0.017 inch by electroplating. The wire was heat treated to improve an adhesion between the wire and electroplated metal. A three-point bending test and torsion test were conduced in order to compare physical properties among three wire groups; 0.016 X 0.016 wires(group 016P) and 0.017 X 0.017 wires(group 017). Through the investigations of each wire group, following results were obtained. 1. At three-point bending test, the group 016P showed higher tendency in the degree of stiffness, yield strength and ultimate tensile strength than the group 016. Stiffness and ultimate tensile strength showed statistically significant differences between two groups at three-point bending test(p<0.05). 2. Stiffness, yield strength, and ultimate tensile strength of the group 016P showed lower tendency than those of the group 017. Stiffness showed statistically significant differences between two groups at three-point bending test(p<0.05). 3. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed higher tendency than those of the group 016. All measurements showed statistically significant differences between two groups after torsion test(p<0.05). 4. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed lower tendency than those of the group 017. Yield torsional moment, and ultimate torsional moment showed statistically significant differences between two groups after torsion test(p<0.05). Xylitol is a 5-carbons carbohydrate, which can be replaced with sucrose for preventing caries. The replication of Streptococcus mutans and its formation of artificial plaque were studied in the media containing xylitol. The combined effect of xylitol and other carbohydrates on Streptococcus mutans was also studied. The replication of Streptococcus mutans was inhibited according to the increased concentration of xylitol. Streptococcus mutans replicated at the initial stage of incubation in the media contaning glucose, fructose or lactose, while replication from the beginning of incubation in the media containing fructose as combining with xylitol. The formation of artificial plaque by Streptococcus mutans was significantly reduced in the media containing with xylitol and fructose. These results indicated that the replication of Streptococcus mutans was inhibited according to the increased concentration of xylitol, and the formation of artificial plaque by Streptococcus mutans was significantly inhibited in the media containing xylitol and fructose.

微生物에 의한 石油內 硫黃分除去에 관한 硏究 : Ⅳ. 脫黃菌의 特性에 대한 生理學的 硏究 Ⅳ. Physiological Studies on Characters of Sulfur-oxidizing Bacteria

李敏載,河永七,李光雄,邊宇玄 서울대학교 1975 서울대학교 論文集 Vol.25 No.-

Serveral physiological characterstics of sulfur­oxidizing bacteria such as Thiobacillus thiooxidans and T. concretivorus are described. 1) Effect of pH on inhibitory function of pyruvate. The rate of oxygen uptake was reduced in accordance with decrease of pH. And on the other hand inhibition rate of pyruvate was more severe in lower pH than in higher pH. High concentration of hydrogen ion seemed to accelerate inhibitory function of pyruvate. Limiting concentration of pyruvate which absolutely inhibit oxygen uptake was lowered with time. In O time, 10^-2M of pyruvate absolutely inhibited oxygen uptake in pH 5. After 24 hours limiting concentration was lowered to 10^-3M. 2) Effect of organic compounds on the oxygen uptake of T. concretivorns. Effect of glucose, fructose, xylose, glutamate, succinate, malate, glycine, lactate, acetate, pyruvate, citrate, formate, and cis­aconitate on thiosulfate oxidation and availability of these compounds as sloe source of energy by T. concretivorus were observed. A 0.5% concentration of malate and glycine accelerated thiosulfate oxidation almost react somewhat inhibitory. Pyruvate and citrate inhibited thiosulfate oxidation. In thiosulfate­free medium, organic compounds except formate and pyruvate affected no significant influences on oxygen uptake. 3) Enzyme assay. Of enzymes concerned TCA cycle and glycolysis, T. concretivorus had most of those enzyme activities even though they were low. Activities of hexokinase and succinic dehydrogenase were somewhat high and that of aconitase was very low on the contrary. 4) Optimum condition of mass culture of sulfur oxidizing bacteria. In a large jar fermenter opimum conditions including agitations speed, volume of supplying gases, and constitution rate of oxygen and carbon dioxide, etc. were experimented. The sulfur­oxidier, T. thiooxidans was grown most effectively under the condition of autom­atically controlled pH of 1.0, and with the aeration of oxygen and carbon dioxide mixture (5 : 1) at the flow rate of 0.05 vvm, and at the agitation velocity of 200 rpm in this laboratory scale fermenter.

모기유충에 대한 살충성 Bacillus thuringiensis H9B 균주의 특성

이기희,김광현,김병우 동의대학교 기초과학연구소 1994 基礎科學硏究論文集 Vol.4 No.1

One strain of mosquitocidal Bacillus thuringiensis, H9B, was isolated from soil. The biochemical characteristics and flagella antigenicity of the strain H9B is similar to that of B. thuringiensis subsp. darmstadiensis. The delta-endotoxin of the strain H9B coincided with that of B. thuringiensis subsp. darmstadiensis strain 73E10-2 on agarose double immunodiffusion test. The delta-endotoxin of B. thuringiensis subsp. israelensis contains hemolysin fragment (28 kd) on SDS-PAGE when the delta-endotoxin was solubilized in alkali, while that of the strain H9B does not contain 28 kd protein. In the biological activity, the delta-endotoxin of strain H9B was 2 or 3 times stronger than that of the strain 73E10-2; The LC_50 against mosquito larvae (Aedes agypti) of delta-endotoxin from the strain H9B is 70 ng/ml, and that from B. thuringiensis subsp. israelensis and the strain 73E10-2 26 ng/ml, 186 ng/ml respectively.; The hemolytic activity of delta-endotoxin from the strain H9B has twice stronger than that from the strain 73E10-2.

근로자 건강증진전략을 위한 행동변화에 대한 요구도 평가

이강숙,임현우,구정완,홍현숙,이정민,이원철,박정일,맹광호,M, O'Donnel 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the stage of behavior change for health promotion strategy in workplace Methods : Questionnaire survey was carried out for 309 workers who employed in H Electronics company in Kyong-in area from September to October 1998. Results : According to need assessment of four step such as precontemplation stage, contemplation stage, action stage, maintenance stage which were to change of behavior for health promotion, the percent for quitting smoking were observed 48.8%, 43.1%, 8.1%, 0%, and for the restriction of drinking were 29.8%, 10.6%, 9.3%, 5.3%; for fitness 11.1%, 31.0%, 37.3%, 20.6% in male 26.6%, 27.8%, 26.6%, 19.0% in female, for regular diet 26.1%, 19.8%, 38.7%, 15.3% in male, 27.8%, 22.2%, 40.0%, 10.0% in female and for stress management 5.8%, 10.6%, 8.7%, 75.0% in male, 13.6%, 22.7%, 19.7%, 44.0% in female. In heavy smoker(p=0.017) and heavy drinker,(p=0.021) the percent of precontemplation stage was significantly higher than in lower drinker and light smoker. Conclusions : This study suggested that company support for health promotion in workplace was and workers of high risk group for smoking and drinking were in precontemplation stage. So before conducting the health promotion program, health risk appraisal and need assessment for stage of behavior change should be taken for the efficient health promotion strategy.

쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악소구치에 대한 응력 분석 : 3차원 유한요소법적 연구

이선화,김현철,허복,김광훈,손권,박정길 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.6

이 연구의 목적은 쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악 제2소구치에 대한 응력 분포를 3차원 유한요소법으로 분석하여 평가하기 위한 것이다. 발치된 상악 제2소구치를 이용하여 Micro-CT로 스캔한 후 3D-D0C-TOR로 3차원 유한요소 모형을 제작하였다. 제작된 소구치 모형에 근관 와동을 형성하고 쐐기형 5급 와동과 글래스 아이오노머 기저재의 사용 여부를 구분하여 근관 와동을 혼합형 복합레진으로 충전하였다. 협측 교두 또는 설측 교두에 500 N의 하중을 가하고, ANSYS 8.0 프로그램으로 인장 응력의 분포를 분석하여 평가한 결과 베이스 사용유무에 따른 응력 분포의 차이는 없었다. 협측 교두에 하중이 가해질 때, 하중점과 교합면의 중심구, 구개측 백악법랑경계부에 과도한 인장 응력이 집중되었으며, 5급 와동이 없는 경우보다 5급 와동이 있는 경우에 약간 더 높았다. 설측 교두의 협측 경사면에 하중이 가해질 때, 하중점과 교합면의 중심구, 협측 치경부에 과도한 인장 응력이 집중되었으며, 5급 와동이 있는 경우가 5급 와동이 없는 경우보다 약간 더 낮았다. The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class Ⅴ cavity restored with composite resin using a 3D finite element analysis. The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class Ⅴ cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji Ⅱ LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS. Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class Ⅴ cavity were slightly higher than that of the tooth without class Ⅴ cavity. When the load was applied the palatal cusp, excessive" high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The ten-sile stress values of the tooth without class Ⅴ cavity were slightly higher than that of the tooth with class Ⅴ cavity.

고령 작업자를 위한 농작업 편이장비의 인간공학적 개선에 관한 연구

이창민,오연주,김대웅,유중현,신광현 東義大學校産業技術開發硏究所 2009 産業技術硏究誌 Vol.23 No.-

우리나라의 농업은 작업자의 고령화와 여성작업자의 증가 그리고 비정형화로 구성된 작업형태로 인해 근골격계질환의 위험성이 매우 높은 업종이다. 특히 과수업은 작업점이 작업자의 머리위에서 형성되어 지속적으로 이루어지고, 수확기에는 작업량이 집중되어 농업분야 중에서도 근골격계질환의 유병율이 가장 높게 나타난다. 본 연구에서는 고령농작업자에게 집중적으로 발생되는 근골격계질환을 예방하기 위해 수확기에 집중되는 대표작업 세 가지 운반 작업, 선별작업 그리고 포장작업을 선정하여 유해요인을 분석하고 공학적 개선책을 제시하고자 한다. 배농업의 수확기 작업에서 근골격계질환 유해요인으로 나타나는 중량물 운반 작업과 불필요한 작업 자세를 개선할 수 있는 자바라 컨베이어 벨트와 높이조절식 작업대의 도입을 통하여 고령 작업자뿐만 아니라 여성 작업자들이 효율적인 시스템에서 안전하게 작업할 수 있기를 기대하며 근골격계질환 발생으로 인한 사회․경제적 손실도 감소시킬 수 있을 것이다.

분산 네트워크 관리 시스템 지원을 위한 멀티캐스트 프로토콜의 설계 및 구현

조현주,이광휘,김한수 國立昌原大學校 基礎科學硏究所 1994 基礎科學硏究所論文集 Vol.6 No.-

This paper presents a new model for group communication facility which is gradually magnified. This model has been implemented in LAN environment and can get the enhancement in performance because a new manager can be dynamically created determined depending on the type of receiving message. As an object oriented approach has been introduced in designing the system, it provides an application programmer with the means to develop a new application facility without having to build the detail functions. As the members in a group are only identified by the index in a table, the overhead for the address referencing can be minimized. In this paper, some requirements for multicast communication, the structure of the system, and service primitives will be describe in detail. As the number of manager can be dynamically created and destroyed relying on the requirement, the system can efficeintly operated. Multicast facility designed in this paper is for supporting a distributed network management system.

유리단 국소의치 장착 후 M.K.G.에 의한 하악운동 형태 및 속도의 변화

최현미,조주온,이상돈,송광엽,박찬운 全北大學校 齒醫學硏究所 1992 전북치대논문집 Vol.10 No.1

The purpose of this study is to evaluate the effects of distal extension partial denture on the mandibular movement patterns and velocity. The subjects are 10 patients who have unilateral or bilateral distal extension edentulous area in maxillary and/or mandibular arches. Their mandibular movement patterns and velocity had been measured by Mandibular Kinesiograph(M.K.G.-K6 diagnostic system, Myo-tronics Inc. Seattle. WA. U.S.A.) once just before the treatment and 8 times every week since the dentures were placed. The data have been analyzed statistically by means of ANOVA and Tukey test. The results have been obtained as follows : 1. The placement of the dentures has reduced the amount of vertical and antero-posterior displacement in the habitual mandibular movement significantly(p<0.01). 2. The maximum opening and closing velocity and the mean opening and closing velocity showed no significant change with the placement of the partial dentures(p>0.01). 3. The velocity trace of maximum opening-closing movement has been more regularized and well-coordinated, and the number of clicks decreased continuously after placement of the dentures and showed stable patterns since the 5th week(p<0.01). 4. The left deviation has been decreased significantly after the placement of the dentures and showed no significant change since the 4th week. The right deviation has also been reduced, but there was shown no difference after the 1st week(p<0.01). 5. The crossover pattern has been most frequently observed in the frontal plane and the sagittal plane. It has not been changed with the denture placement and stabilized uniformly.

유리 신혈류화 골판(遊離新血流化骨瓣)을 有用한 家兎 不顎骨의 再建

김현태,박광,이종호 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.2

To overcome the limitations of conventional microsurgical tissue transfer, experimental creation of various neo-flaps using the vessel implantation technique has been reported. We have performed some experiments of fabrication of neo-osseous flap with local vessels and iliac bone slabs to know that the flap vascularity and neo-angiogenesis are achieved enough to microtransfer. As a next step of our previous experiments, the flap viability and the histologic change between the recipient bone and neo-oseous flap was assessed after microsurgical transplantation. The flap was created on the rabbit femoral region(n=25) using femoral vessel and the iliac bone segments(2.5×1.5cm in size). Three weeks after neovascularization, the newly formed flap was harvested and microtransferred to the mandibular defect. As a control, contralateral mandibular defect was created and reconstructed with conventional free iliac bone graft. Scintigrams of experimental group performed 3 days after microtransfer showed hot uptake, while that of control poor uptake. Histologic and vital stain labeling study revealed good bone viability and vascularity of neo-osseous flap. In conclusion, prefabricated neo-osseous flap of our model could be transferred to the recipient site with retaining the flap viability and showed advantages over the conventional bone graft in that it was living bone graft.