간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

Midazolam의 백서 기관평활근 이완효과와 Flumazenil의 길항작용

윤석화,신용섭,손수창,이원형,김혜자,최세진 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Midazolam have been used widely as adjuvants in both regional and general anesthesia and in high risk patients in the intensive care unit. In the present study we evaluated the effect of midazolam and antagonistic effect of flumazenil on isolated rat tracheal preparations mounted for recording isometric contractile force. Trachea smooth muscle were contracted with acetylcholine (10^-5M, Ach) and potassium chloride (40mM KC1). Midazolam 5x10 exp (-6)M and 5x10 exp (-5)M produced dose-dependent relaxation and flumazenil (3.2 x 10 exp (-7)M), central antagonist of benzodiazepine, pretreatment had no significant change midazolaminduced relaxation. Midazolam probably did not relax airway smooth muscle by activatong central benzodiazepine receptors, as flumazenil did not block the concentration-related relaxation of midazolam. Our study suggests that flumazenil may be used satety for asthmatic patients who have been with midazolam, as flumazenil did not antagonize airway relaxation elicited by midazolam.

The Dielectric Relaxation of Space Charge Polarization at Insulated Electrode/Conductive Dielectric/Partially Insulated Electrode Interface

윤석수 안동대학교 기초과학연구소 1991 基礎科學 硏究論文集 Vol.2 No.1

The theoretical analysis on the spectrum of complex dielectric permitivity at insulated electrode/conductive dielectric/partially insulated electrode interface shows two regions of Debye type dispersion due to space charge relaxation. The characteristic features of the proposed model are verified by the measurements of the complex dielectric permitivity for water, and adapted to monitoring of the hydration process of cement paste in the frequency range of 10^(4)-10^(6) Hz.

資産再評價公示가 株主의 富에 미치는 影響 : Cash Flow를 중심으로

윤석곤,전정수 남서울대학교 1998 남서울대학교 논문집 Vol.4 No.-

The asset revaluation system, which was introduced for the first time in 1958, has been amended eight times. This system stipulates that the company might voluntarily revaluate the book value of fixed assets to the market value when the rate of wholesale prices rises cumulatively over 25 percent. This study intends to analyzed the effect the announcement of asset revaluation commencement has on the abnormal rate of return and its determinants. To analyze the effect of revaluation commencement on the stock prices, the cumulative abnormal rate of return for the 61 cases between January 1, 1989 and December 31, 1996 was measured for 30 days before and after the announcement day of asset revaluation commencement using the market and risk adjusted returns model. For this perpose, cross-sectional regression analysis was conducted. The variables used for the model are the ratio of depreciation cost to sales, the ratio of the sum of capital surplus plus earned surplus to total assets, the ratio of bond to capital, the ratio of the sum of tangible fixed assets plus investment assets to total assets, the ratio of revaluation balance to total assets and the ratio of revaluation taxes to the revaluation balance. This paper contributes to the previous understanding for the relationship between the revaluation system and market behavior; that is, the revaluation system generally has an information content for the stock market behavior even though some variables have not.

백서의 적출된 기도평활근에서 Ketamine의 이완효과

윤석화,김윤희,김상수,이상묵 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

The effects of anesthetics on airway smooth muscle tone are important in the management of patients with asthma. Airway epithelial cells and vascular endothelial cells modulate the tone of the underlying smooth muscle by releasing relaxing factors such as prostanoids and nitric oxide (NO). Ketamine, at concentrations achieved with the usual clinical doses, has a direct relaxant effect on airway smooth muscle. In the present study we evaluated whether the relaxant effect of ketamine depend on any of the epithelium-derived relaxing factors. Isolated rat tracheal preparations mounted in water-jacketed organ baths filled with modified Tris Tyrode buffer solution with 100% oxygen at 37˚C for recording isometric contractile force. In the first experimental step, Tracheae, in the absence and in the presence of epithelium, were contracted with acetylcholine(10^-8M-10^-3M), and we plotted concentration -response curve for the Ach. And then we examined the inhibitory effect of ketamine(10^-5 and 10^-4M) on the concentration-response curve for Ach. In the second experimental steps, we studied the effect of N-omega-nitro L-arginine methylester(L-NAME) on the relaxant activity of ketamine(10^-6-10^-3M) on trachea contracted by 10^-5M Ach. In the result, 1) Removal of the tracheal epithelium did not change the response to Ach. 2) 10^-5M ketamine not significantly changed, but 10^-4 M ketamine shifted to the right the concentration-response curves for Ach in both intact and denuded epithelium rings. 3) L-NAME did not influence the relaxant effect of ketamine on trachea contracted by 10^-5 M Ach. These results indicate that ketamine-induced tracheal smooth muscle relaxation is epithelium-independent and may be is mediated by inhibition of Ca^++ influx in nonspecific way.

정맥내 통증자가조절법을 이용한 Nalbuphine-Ketorolac과 Butorphanol-Ketorolac의 술후 진통효과 비교

윤석화,이원형,손수창,신용섭,김윤희,양신영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

This study aimed to compare analgegic efficacy, satisfaction score and side effect of nalbuphine-ketorolac and butorphanol-ketorolac by using intravenous patient controlled analgesia(IV-PCA) for postoperative anlgesia following a gastrectomy for stomach cancer. Ninety patients who had undergone gastrectomy for stomach cancer under general anesthesia were randomly divided into two groups. Each group recieived nalbuphine 50mg with ketorolac 150mg(Group 1, n=45) and butorphanol 5mg with ketorolac 150mg(Group 2, n=45) by using IV-PCA during postoperative 48hrs. Assessments for pain with numerical rating scale(NRS), and side effects were evaluated at 2hr, 6hr, 12hr, 24hr, 36hr and 48hr after the operation. There were no significant difference in NRS for pain during rest, but Group 2 requested significantly greater amount of supplementary diclofenac during first 24 hours. Side effects were higher Group 1 in pruritus, nausea and vomiting and Group 2 in sedation, nausea and vomiting. This study suggests that adding ketorolac with intravenous nalbuphine or butrophanol in using an intravenous PCA can decrease analgesics requirement and improve analgesic property without the major morbidity like respiratory depression, but needs for the careful observation and treatment on the side effects like nausea. vomiting, pruritis and sedation...

하수슬러지를 이용한 복합소재 개발연구

연규석,권윤환,유근우,김남길,김동준,이윤수 강원대학교 부설 석재복합신소재 제품연구센터 2002 석재연 논문집 Vol.7 No.-

본 연구는 하수 종말 처리에 의해 발생되는 하수 슬러지를 잔 골재(경량골재)로 사용하여, 폴리머 콘크리트를 제조하여 그 때의 역학적 성질에 대하여 검토하였다. 하수 슬러지는 5일간 110±5℃에서 수분함량 0.1%미만으로 건조한 후 파쇄하여 No.4∼No. 200 번체의 잔골재 표준 시방서 기준에 부합되도록 사용하였다. Pellet는 보통 회전pan에서 만드나, 본 실험에서는 수동으로 제조하였다. 제조한 하수 슬러지 경량 골재는 평균 겉보기 비중은 1.58(g/㎤), 단위용적중량은 1.98(t/㎥)으로 KS F 2534의 경량골재의 절건비중과 단위용적에 따른 분류에 의하면 중위급(medium weight) 경량골재에 속하는 것으로 측정되었다. 또한 잔 골재 중 하수 슬러지 경량 골재를 0%, 5%, 10%, 15%, 20%, 25%, 30%로 치환하여 그때의 압축, 휨, 인장강도를 측정하였다. 그 결과 하수 슬러지의 증가에 따라 강도 감소를 보였으나, 일반 경량콘크리트 제조 또는 단열용 콘크리트 블록 제조에 사용이 가능하다고 사료된다. 그러므로 앞으로 건조수축, 크리이프 특성 및 내구성에 관한 연구가 더욱 심도 있게 이루어져야 폐자원인 하수 슬러지를 이용한 건자재의 개발이 가능하리라 판단된다. In this study, the polymer concrete was produced by using the lightweight aggregate that had been manufactured using the sewage sludge and its physical properties were experimentally examined. Experimental results show that when the portion of sewage sludge lightweight aggregate in the fine aggregate increases, slump values decreases. Also, the compressive, the flexural and the tensile strengths decrease when the portion of sewage sludge lightweight aggregate increases. Although its strengths decreases, the sewage sludge lightweight fine aggregates is thought to be used for construction materials.

牛耳島의 植物相과 植生에 關한 硏究

金喆洙,張允錫,吳長根 木浦大學校沿岸生物硏究所 1987 沿岸生物硏究 Vol.4 No.1

The flora and vegetation of Ui-do were investigated two times from July 23th to July 29th in 1985, and from July 8th to July 15th in 1985. The vascular plants identified in these investigations were 102 families, 302 genera, 376 species, 58 varieties and 4 formae, summing up to 438 species total. Of these species, 126 species were found commonly in the lists reported previously by Lee, etc. (1980) and Lee (1981). The total number of species in this island was thus summerized as 104 families, 323 genera and 481 species. Also Fisher's index was calculated as 426.4. This value was higher than that of Hong-do. By the ZM school method, the vegetaion of Ui-do was classified into 15 community types, i.e. the evergreen broad-leaved forests(Camellia japonica-Machilus thunbergii, Camellia japonica-Castanopsis cuspidata var. sieboldii, Camellia japonica community), the evergreen needle-leaved forests (Pinus thunbergii community), the deciduous forests (Mallotus japonicus, Carpinus coreana community), Pseudosasa japonica community, the grassland vegetation (Miscanthus sinensis var. purpurascens, Arundinella hirta-Zoysia japonica, pennisetum alopecuroides-Artemisia princeps var. orientalis, Agrostis clavata-Artemisia princeps var. orientalis community), the sand dune vegetation (Carex pumila, Imperata cylindrica var. koengii-Vitex rotundifolia, Ligustrvm quihoui var. latifolium community) and the grazing land. Each community was described in term of floristic, structual and environmental features. The synthesis table and the actual vegetaion map were prepared.

忠州市 地域特性을 反暎한 共同住宅 計劃硏究 : 충주지역 거주자의 APT 선호특성을 중심으로

朴碩鉉,朴義權,柳顯紀,尹勝照,孫泰鎭,金基洙 충주대 2003 産業科學論文集 Vol.11 No.-

The purpose of this research is to analyze the correlation of the characteristics of dwellers and residential preference in apartment housing through the case study of 340 samples in 25 housing estates which were built in Chung-ju city The contents of this research consist of two main parts. The first part is to identify characteristics of dwellers, which might have an influence on residential preference in apartment housing. The second part is to identify the main physical elements of residential preference that can be influenced by the personal characteristics. Thus, this research will contribute to the establishment of the planning methods which increase residential preference in apartment housing, while promoting the quality of residential environment in Chung-ju city.