국내에서 분리된 Extended-Spectrum β-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의 빈도 및 유형

홍성근,김선주,정성훈,장철훈,조성란,안지영,신종희,이혜수,송원근,어영,염종화,용동은,이경원,정윤섭 대한임상미샐물학회 2003 Annals of clinical microbiology Vol.6 No.2

소장내 위석에 의한 장폐쇄증으로 발생한 급성신부전 1례

김승민,남지형,김준섭,이용국,최재혁,강혁주,탁우택,이정호,정호근 東國大學校醫學硏究所 2007 東國醫學 Vol.14 No.1

Gastric bezoars are concretions or hard masses of foreign matter found in the gastrointestinal tract. It may induce many complications including intestinal obstruction. No report has been proposed on a case of prerenal ARF induced by intestinal obstruction by small-bowel bezoar. Therefore, we report a case of the patient with ARF associated with small-bowel bezoar, who initially visited with the symptoms of nausea and frequent vomiting. 위석(bezoar)은 여러 가지 이물 및 내재성물질이 위장관내에서 혼합되어 응고물을 형성한 것을 말하며, 가장 흔한 형태의 합병증으로 장폐쇄증이 올 수 있으나, 그로 인하여 신부전의 양상으로 나타나는 경우는 흔하지 않다. 이에 저자들은 내원 당시의 병력 및 이학적 검사만으로 장폐색의 원인이 위석임을 의심할 수 없었던 비전형적인 소견을 보인 소장내의 위석에 의한 장폐쇄증과 이로 인해 발생한 급성신부전의 예를 경험하였기에 이에 보고하는 바이다.

후두부 발작성 간질파와 동반된 양성 소아기 간질의 임상적 연구

유영수,이상도,김지언,임정근,박영춘 대한신경과학회 1996 대한신경과학회지 Vol.14 No.4

심인성 어지럼증 환자의 정신과적 증상에 관한 연구

이경규,이지영,김현우,이정엽,백기청,김재일,이근호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 어지럼증을 호소하는 환자들 중에 심인성 어지럼증 환자가 상당수 있다는 것은 알려져 있고, 이러한 심인성 어지럼증과 동반되는 정신질환으로는 불안장애, 우울장애, 인격장애 등이 있다. 이에 본 연구에서는 심인성 어지럼증 환자들의 빈도와 정신과적 증상을 알아보고자 하였다. 방 법 : 어지럼증 환자들에게 평형검사, 자세운동측정검사, 자세변화검사, caloric testing을 시행하여 심인성, 말초성 및 중추성의 3군으로 분류한 후 각각 14명, 16명, 32명을 대상으로 하였다. 대상환자들에게 한국판 Beck 우울척도검사(K-BDI), Spielberg의 상태-특성 불안검사(STAI). 간이정신진단검사(SCL-90-R)를 이용하여 정신과적 증상을 측정하여 이들 세 군을 비교분석하였다. 결 과 : 1) 심인성 어지럼증을 가진 환자는 어지럼증을 나타내는 환자 총 62명중에서 14명으로 22.6%를 차지하였다. 2) K-BDI에 따른 세 군간의 비교에서는 세 군간에 유의한 차이를 보이지 않았다. 3) STAI에 따른 세 군간의 비교에서 상태불안(STAI-S) 및 특성불안(STAI-T) 모두에서 세 군간에 유의한 차이를 보이지 않았다. 4) SCL-90-R에 따른 세 군간의 비교에서는 9개의 척도 중에서 공포불안척도에서만 중추성 어지럼증군이 47.56±6.90, 말초성 어지럼증 군이 53.50±13.74, 심인성 어지럼증 군이 58.50±16.05로 심인성 어지럼증 환자군이 중추성 어지럼증 환자군에 비하여 유의하게 높은 것으로 나타났다(p<0.01). 5) 통증 증상에 있어서는 세 군간에 유의한 차이를 보이지 않았고, 위장관 증상과 성기능 장애 증상은 중추성과 말초성 어지럼증 군이 심인성 어지럼증 군에 비하여 유의하게 높은 것으로 나타났다(p<0.01). 결 론 : 상기 결과를 토대로 했을 때 어지럼증 환자들에 대한 정신과적 접근을 위하여 각 군을 나누는 것은 별 의미가 없으며 어지럼증 환자들의 어지럼증 자체에 대한 직접적이고 집중적인 치료가 더욱 필요할 것으로 생각된다. Objectives : This study was aimed to investigate psychiatric symptoms in patients with psychogenic dizziness and compare these findings with those of patients with central and peripheral dizziness. Methods : A total of 62 patients with dizziness was the subject of investigation, and patients were classified into 32 with central type, 16 with peripheral type, and 14 with psychogenic type. Korean standardized Beck Depression Inventory(K-BDI), State and Trait Anxiety Inventory(STAI), and Korean standardized edition of Symptom Checklist 90 Revised(SCL-90-R) were used for the assessment. Statistically, Pearson's chi-square test and one-way ANOVA with Scheffe's test were used with SPSS/PC for windows 6.0. Results : The results were as follows : 1) The proportion of psychogenic dizziness was 22.6% of the total subjects. 2) Total scores of K-BDI were not significantly different among the 3 groups. 3) Total scores of state anxiety and trait anxiety were not significantly different among the 3 groups. 4) In SCL-90-R, psychogenic dizziness group showed significantly higher score of phobic anxiety only(p<0.01) than central dizziness group. And others were not significantly different among the 3 groups. 5) In additional somatic symptoms, pain score was not different among the 3 groups, but gastrointestinal and sexual symptoms scores of central and peripheral dizziness group were significantly higher than those of psychogenic dizziness group(p<0.01). Conclusion : These results suggest that psychiatric symptoms in patients with psychogenic dizziness are not different from those of patients with central or peripheral dizziness. Therefore, the more direct and intensive treatment may be necessary regardless of the type of dizziness.

유산균들의 콜레스테를 저하성, 내산성, 내담즙성, 항생제 내성 비교

박소영,고영태,정후길,양진오,정현서,김영배,지근억 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.3

기능성 요구르트의 제조에 사용되는 유산균은 인체에 유익한 생리활성과 우수한 생존능력을 보유하고 있는 것이 바람직하다. 본 연구에서는 다양한 유산균주의 산과 담즙 및 항생제에 대한 내성을 조사하였으며 in vitro에서 콜레스테롤 저하능을 조사하였다. In vitro에서 콜레스테롤 저하능이 우수한 13균주를 선발하여 이들의 동결건조 분말을 고 콜레스테롤 식이의 실험쥐에 투여하였다. 그 결과 8균주는 비 투여구보다 유의적으로 18.3~27.3%의 콜레스테롤 저하능을 나타냈다(P≤0.05). 이들 중에서 Bifidobacterium infantis AM-220, Lactobacillus AM-245, Streptococcus MA-1의 3균주를 이용하여 요구르트를 제조한 후 동결건조 분말을 이용하여 급여실험을 수행한 결과, 총 콜레스테롤과 LDL 함량이 유의적으로 감소하는 것으로 나타났다. For a probiotic yoghurt it is desirable to utilize lactic acid bacteria with a high survival rate and beneficial function to human beings. We have examined a variety of lactic acid bacteria to assess the acid and bile tolerance and antibiotic resistance. In addition, an in vitro culture experiment was performed to evaluate their ability to reduce cholesterol levels in the growth medium. Thirteen strains were selected from in vitro cholesterol assays and fed to Sprague-Dawley rats with a high-cholesterol diet. Among the 13 strains tested, 8 strains were shown to reduce serum cholesterol levels significantly after 24 days of administration in vivo. Rats were fed lyophilized yoghurt powder fermented with a combination of 3 selected strains: Bifidobacterium infantis AM-220, Lactobacillus AM-245, and Streptococcus MA-1. The levels of total cholesterol and low density lipoprotein were significantly lower (p≤0.05) in rats fed the yoghurt powder compared with control group. These studies suggest that yoghurt fermented with appropriately selected lactic acid bacteria may have a anticholesterolemic effect.

全蝎 抽出物이 血栓症, 全腦虛血 및 腦細胞毒性에 미치는 影響

백명현,황영근,정지천,강정준,김성훈 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.8 No.1

본 실험은 전갈 추출물이 어혈병태 모델과 KCN으로 유발된 전뇌허혈, 뇌세포독성 등에 미치는 영향을 관찰하였다. 전갈은 Dextran에 의해 유도된 혈전으로 감소된 혈소판수, fibrinogen량, hemocrit치를 유의성 있게 증가시키고. 증가된 prothrombin time을 유의성 있게 단축시켰다. 전갈은 thrombin과 ADP에 의해 유도된 혈소판 응집을 억제하였으나 collagen에 의해 유도된 혈소판 응집에는 저해효과를 나타내지 않았다. 또한 collagen과 epinephrine에 의해 유도된 pulmonary embolism에 대하여 보호 효과를 나타내었다. 전갈은 KCN에 의한 전뇌허혈 유발 실험에서 혼수시간을 유의성 있게 단축시켰고, Amyloid β protein(25-35)에 의해 유도된 PC12 세포의 독성에 대하여 보호효과를 나타내었다. This following is effect of Buthus martensi Karsch (BMK) extract on dextran-thrombus model, KCN-induced coma, cytotoxicity of brain etc. BMK extract significantly increased number of platelet and fibrogen and significantly shortened the prothrombin time as compared with control group treated with dextran. BMK extract didn't affect the changes of hematocrit as compared with control group treated with dextran. BMK extract induced a significant inhibition of human platelet aggregation induced by thrombin and ADP but did not affect human platelet aggregation induced by collagen. BMK extract showed a protective effect on pulmonary thrombosis induced by collagen and epinephrine. BMK extract prolonged the duration of KCN-induced coma and showed a protective effect on cytotoxicity of PC12 cells induced by amyloid β protein(25-35) in a dose dependent manner. These results suggested that BMK extract might be usefully applied for prevention and treatement of thrombosis and brain damage.

한번의 간질발작 후 혈청 Neuron-Specific Enolase 농도 변화

최승호,박영춘,이장준,임정근,김지언,이상도 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.4

An increase in neuron-specific enolase (NSE) levels in serum and CSF has been shown to be an useful marker of brain damage after stroke, global ischemia, and coma. We report the changes of serum NSE levels after seizure attacks in epileptic patients compared with the levels in normal controls and epileptic patients without seizure attack at least 7 days (epileptic controls). Twenty-four seizures were included in this study. Blood was drawn within 1 hour, at 12 hour, 24 hour, and 48 hour after seizure attack. Serum NSE levels were measured with radioimmunoassay. The mean NSE levels for normal controls and epileptic controls were 6.94 ng/ml and 7.46 ng/ml, respectively. There were significant increase in level of serum NSE measured within 1 hour after seizure attack in epileptics compared with the level in normal controls (15.10ng/ml versus 6.94ng/ml, p<0.05) and epileptic controls (15.10ng/ml versus 7.46ng/ml, p<0.05). Serum NSE measured at 12 hours after seizure also increased compared with normal controls (12.32ng/ml versus 6.94ng/ml, p<0.05) and epileptic controls (12.43ng/ml versus 7.46ng/ml, p<0.05). Between normal controls and epileptic controls, there were no significant difference in serum NSE levels. We conclude that serum NSE level was elevated in epileptic patients who had seizure attack within 12 hours. Serum NSE levels can be useful marker for seizure within 12 hours after onser. The elevated serum NSE level after single seizure attack may suggest that the brain was injured in single seizure.

내측 측두엽 간질에서 간질발작 중 언어증상

이장준,이승환,이형,김지언,임정근,손은익,이상도,박영춘 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

Background and Objectives : Several speech manifestation are observed in temporal lobe epilepsy(TLE). We studied the frequency of ictal speech manifestations and their localizing and lateralizing value in TLE. Methods : We reviewed 379 seizures recorded on videotape in 135 patients who underwent temporal lobectomy for intractable TLE. We divided patients into group A(n=75) who became seizures free after surgery, and group B(n=60) who were only slightly benefited or unchanged after surgery. Speech manifestations were classified as normal speech, vocalization, or abnormal speech. Abnormal speech was subdivided into speech arrest, dysarthria, dysphasia, or nonidentifiable speech. Results : Speech manifestations occurred in 70(18.5%) seizures of 28 patients. Forty eight seizures of 20 patients were observed in group A, and 22 seizures of 8 patients were observed in group B. In group A, 25 seizures of 11 patients were originating from dominant hemisphere, 23 seizures of 9 patients from nondominant hemisphere. In group B, 13 seizures of 5 patients were originating from dominant hemisphere, and 9 seizures in Lt. side and 6 seizures in Rt. side, respectively) of group A(P>0.05), and eleven seizures of 4 patients(8 seizures from Lt. side and 3 seizure from Rt. side) in group B(P>0.05). Normal speech was observed only seizures from Rt. side in both groups(3 seizures in 1 patient, each group). Dysphasia occurred only in seizures originating from Lt. side. Nonidentifiable speech occurred in 22 seizures of 9 patients(11 seizures from each side) in group A(P<0.01), and 3 seizures of 1 patient occurred only from Lt. side in group B. Conclusion : Ictal speech manifestations were not uncommon(18.5%). All kinds of ictal speech manifestations except normal speech have no reliable lateralizing and localizing value in TLE. Normal speech could be a good indicator of seizure originating from nondominant hemisphere.

장중첩증을 동반한 맹장 지방종 1예

홍의실,나병규,김민옥,유일영,채지영,채희복,윤세진,이상전,송형근,박길선,정현용 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

대장 지방종은 주로 우측 결장에 호발하고 특히 회맹판 부위와 맹장 부위에 호발한다. 또한 50~60대에 빈도가 높고 증상이 있는 환자에서 장중첩증이 높게는 40~50%에서 보고되고 있어 성인 장중첩증의 원인으로 중요한 비중을 차지한다. 특히 성인 장중첩증 및 장폐쇄의 중요 원인인 악성 종양과 임상 양상이 유사하여 감별진단이 중요하다. 저자들은 반복적인 복통을 주소로 내원한 환자에서 맹장의 4×5㎝의 점막하 지방종이 말단 회장부위와 반복적인 장중첩중이 발생했던 1례를 부분 절제술로 치료하여 양호한 임상 경과를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Lipomas are one of the most common benign nonepithelial tumors of the colon which are often detected incidentally by radiologic investigation or on operation. These tumors are usually without specific symptoms. Colonic lipomas occur most often in the right colon, particularly in the ileocecal valve and the cecum. Most patients are asymptomatic. but tumors larger than 2 cm tend to produce a change in bowel habit. abdominal pain. rectorrhagia and complications including luminal obstruction or intestinal intussusception. Diagnosis can be made by colonoscopy abdominal CT. MRI, or barium enema. We report a case of lipoma of the cecum that originated in the submucosa and presented as a intussusception in a 50-year-old woman with a brief review of the literature.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.