양측 선천성 누루 환자에서 누루절제술 시행 후 반복된 감염과 염증

김현아,최혜선,장선영,Hyun A Kim,Hye Sun Choi,Sun Young Jang 대한안과학회 2013 대한안과학회지 Vol.54 No.11

Purpose: To report a case of bilateral congenital lacrimal fistula that presented with repeated infection and inflammation after complete fistulectomy, which required an incision and drainage of pus from the operation site. Case summary: A 22-year-old male without any medical history presented with repeated erythematous swelling and inflammation, resulting in tenderness around the opening of congenital lacrimal fistula. The lacrimal fistula opening was located approximately 12 mm inferiorly apart from the medial canthus. The complete excision of lacrimal fistula was performed without any inter-operative events. However, 4 days postoperatively, the patient complained of discomfort and swelling, with purulent discharge from the bilateral operation site. There was no improvement although treatment with antibiotics, incision and drainage was performed. After 1 month, an additional incision and drainage was necessary due to inflammation in the left operation site. One month later, pus and purulent discharge were occurring from the right operation site, requiring an additional incision and drainage. At that time, Actinomyces israelli was identified on wound culture examination. One month later, an additional incision and drainage was performed due to repeated inflammation in the left operation site. In the present case, we hypothesized the opening site of congenital lacrimal fistula was relatively far apart from the medial canthus and played a role in atypical repeated inflammation and infection on the operation site. Conclusions: In surgical treatment of congenital lacrimal fistula, careful preoperative observation of the location of the lacrimal fistula’s opening site would be helpful in prediction of postoperative complication, such as wound infection and inflammation, as well as in educating and informing the patient. J Korean Ophthalmol Soc 2013;54(11):1778-1782

노인성치매(老人性痴呆)에 대(對)한 문헌적(文獻的) 고찰(考察)

김현아,정지천,이원철,Kim, Hyun-Ah,Jeong, Ji-Cheon,Lee, Won-Chel 대한한방내과학회 1992 大韓韓方內科學會誌 Vol.13 No.2

The study has been carried out to investigate of the senile dementia by referring to 35 literratures. The results were as follows ; 1. In oriental medical science, senile dementia is belong to the category of dullness(매病), insanity(癲狂證), weak(虛勞), amnesia(健忘), etc. 2. The cause of senile dementia summarize the phlegm preventid-heart hole(痰迷心竅), marrow lack(髓海不足), aged follow weaking of body and disfunction of the internal organs(年老體弱과 臟腑機能 失調), the bad blood with vatal block(氣滯血瘀), feeling inharmony, etc in the view of oriental medical science and make the vanishment of the cerebral atrophy and the cerebral cell but havn't indicated the remarkable cause in that of western medical science. The diseases with cause make a point of Alzheimer's dementia, frequent infarction dementia, etc and psychological and environmental factor too. The marrow lack is related to Alzheimer's dementia, the feeling inharmony, psychologic and environmental factor, the phlegm prevented-heart hole and bad blood with vatal block, frequent infarction dementia. 3. The senile dementia is related cleary to the function of the internal organs in oriental medical sciences respect Especially in relation to kidney and marrow, it is presented new cause view to solve the cure problem of western medical science is studying its cause only the anatomic pathology with cerebrum and is thinking to solve cure possibility. 4. The symptom of senile dementia is as follows. The obstacle of a aspect of the Language, Emotion, Behavior. mute, speech inversion, sometimes a laugh sometimes a cry, behavior strange, failure of memory etc. 5. The treatment of senile dementia is follows. The methodes of cure apply phlegm changed-mud(豁痰化濁), self-kidney and added marrow(補腎益髓), self-energy and nutritive blood(益氣補血), vital blood(祛瘀活血), peace of mind and relief(安神情志). The medicines of cure make the most of (sesimtang, jwagui-hwan, tonggwuhwalhuel tang) add and subtract, daeboweonjeon, guibitang, and so on.

노인(老人) 내과환자(內科患者)의 임상통계적(臨床統計的) 고찰(考察)

김현아,정지천,이원철,Kim, Hyeon-Ah,Jeong, Ji-Cheon,Lee, Won-Chul 대한한방내과학회 1992 大韓韓方內科學會誌 Vol.13 No.1

Clinical observation was done on 496cases of the Out-patients and 136cases of the In-patients more than 65 years of age in Department of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from March 1991 to February 1992. The results were as follows; 1. The ratio of senile (more than 65 years of age) was 16.4% in total Out-patients, was 38.1% in total In-patients. 2. The ratio of male to female was 1:1.1 in the Out-patients, In-patients was 1.2:1. The age distribution showed the large number in the 65-69 year group, the female more than the male in 70 th's group. 3. The diagnostic distribution was noted in the Out-patients as follows, Respiratory Dis. 50.6%, Cardiovascular Dis 16.4%, Brain Neurogic Dis. 14.5%, Gastrointestinal Dis. 8.1%. in the In-patients. Brain Neurogic Dis. was 76.5%, Cardiovascular Dis was 19.8%. 4. The ratio of the season distribution in the Out-patients was as follows, spring 40.2%, winter 21.2%, summer 20.9%, in the In-patients. winter was 35.9%, autumn was 25.0%, spring was 19.9%. 5. The utilization of therapeutic clinic before coming the Oriental Medical Hospital in Dong Guk Univ, was as follows, the ratio of the Out-patients was noted a hospital or clinic was 57.1%, no-treatment 22.9%, a oriental medical hospital or clinic was 8.3%. In the admission was noted no-treatment was 38.3%, a oriental medical hospital or clinic was 35.3%. 6. The ratio of the periods from onset to Out-patients department was noted within 5days was 7.3%, over 1 year was 52.6%. In the admission was noted within 1 day was 41.9%, within 7 days was 71.8%. 7. The ratio of the therapeutic periods in the Out-patients department was noted within 10 days was 48.3%, over 60 days was 7.1%. 8. The ratio of the admission periods was noted within 10 days was 45.6%, the median of the admissio was 10.8 days. Brain Neurogic Dis's median was 20.2 days. 9. The therapeutic result was noted the case of improvement was 75.7% in the admission. 10. The ratio of the Out-patients department after discharging was 53.7%, in the case of Brain Neurogic Dis. was 60.7%.

미세정자주입술로 임신이 된 남자태아의 Y 염색체 미세결실의 Vertical Transmission, de novo, 그리고 Expansion의 연구

김현아,이숙환,조성원,정혜진,손수민,강수진,배성근,김수희,윤태기,Kim, Huyn-Ah,Lee, Sook-Hwan,Cho, Sung-Won,Jeong, Hye-Jin,Son, Soo-Min,Kang, Soo-Jin,Bae, Seong-Keun,Kim, Soo-Hee,Yoon, Tae-Ki 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.2

Objectives: Despite severe oligospermia, males with Y chromosome microdeletion can achieve conception through ICSI (Intracytoplasmic Sperm Injection). However, ICSI may not only result in the transmission of microdeletions but also the expansion of deletion to the offspring. The purpose of this study was to screen vertical transmission, expansion of microdeletions and de novo deletion in male fetuses conceived by ICSI. Materials and Methods: A total of 32 ICSI treated patients with their 33 (a case of twin) male fetuses conceived by ICSI were used to make this study group. Sequence-tagged sites (STSs)-based PCR analyses were performed on genomic DNA isolated from peripheral blood of fathers and from the amniocytes of male fetuses. Ten primer pairs namely, sY134, sY138, MK5, sY152, sY147, sY254, sY255, SPGY1, sY269 and sY158 were used. The samples with deletions were verified at least three times. Results: We detected a frequency of 12.5% (4 of the 32 patients) of microdeletions in ICSI patients. In 4 patients with detected deletions, two patients have proven deletions on single STS marker and their male fetuses have the identical deletion in this region. Another two patients have two and three deletions, but their male fetuses have more than 3 deletions which include deletions to their father's. Meanwhile, seven male fetuses, whose fathers were analyzed to have all 10 STS markers present, have deletions present in at least one or more of the markers. Conclusions: Although the majority of deletions on the Y chromosome are believed to arise de novo, in some cases a deletion has been transmitted from the fertile father to the infertile patient. In other cases the deletion was transmitted through ICSI treatment, it is likely that one sperm cell is injected through the oocyte's cytoplasm and fertilization can be obtained from spermatozoa. Our tests for deletion were determined by PCR and our results show that the ICSI treatment may lead to vertical transmission, expansion and de novo Y chromosome microdeletions in male fetuses. Because the sample group was relatively small, one should be cautious in analyzing these data. However, it is important to counsel infertile couples contemplating ICSI if the male carries Y chromosomal microdeletions.

교재중심 강의와 문제중심학습 방식이 기초의학에서 과학적 추론에 미치는 효과 비교

김현아,김각균,이승우,Kim, Hyeon-A,Kim, Kack-Kyun,Lee, Sung-Woo 대한안면통증구강내과학회 2005 Journal of Oral Medicine and Pain Vol.30 No.1

Purpose: The aim of this preliminary study was to evaluate the effect of Problem-Based Learning (PBL) curriculum on development of comprehension of basic medical knowledge and quality of semi-structured problem solving including scientific reasoning skill. This scientific reasoning contained five components including: size of simple, design of research cause-effect, construction of risk factor, analysis statistic of data, interpretation of result. Materials and Methods: Seoul National University Dental students (100) participated in this experience during two weeks, 2004. Forty eight multiple-choice questions (MCQ) concerned "Infection Control and Prevention" were asked before and after two sections of Lecture-Based Learning (LBL) and PBL (pretest-posttest control group design). A semi-structured problem in epidemiological research was asked to these students after two sections (posttest-only control group design). Data (mean and SD) were analysed using the t Test for two independent samples (p<.05), comparing PBL versus LBL. Results: Our analyse of scores show no difference between LBL and PBL in the development of comprehension of "Infection Control and Prevention". The quality problem solving (epidemiological research) was significantly different between the two groups (p=.029); specially, two components' scores of reflection on scientific reasoning cause-effect (p=.000) and interpretation of result (p=.001) were significantly better for PBL than for LBL. Conclusion: Theses results indicate that comparing LBL and PBL, PBL curriculum have not been disadvantaged in comprehension of basic knowledge, and have contributed to develop the scientific reasoning in problem solving.

라벤더, 레몬, 유칼립투스 혼합 에센셜오일이 아토피 피부염 동물 모델의 Th2 관련인자에 미치는 영향

김현아,윤미영,송향희,정광조,유화승,Kim, Hyeon-Ah,Yun, Mi-Young,Song, Hyang-Hee,Cheong, Kwang-Jo,Yoo, Hwa-Seung 대한약침학회 2010 Journal of pharmacopuncture Vol.13 No.1

Purpose : To investigate the effects of the lavender, lemon and eucalyptus oil mixture on the atopy dermatitis skin lesions induced on NC/Nga Mice by dinitrochlorobenzene (DNCB). Material and Method : For this purpose, we fabricated the oil mixture blending three essential oils (lavender, lemon, eucalyptus : ELL) with one carrier oil (jojoba) and apply it on the atopic dermatitis skin lesions of NC/Nga Mice. Atopic dermatitis in NC/Nga Mice was induced by DNCB treatment on the dorsal skin of mice for 8 weeks. The mixture of ratio of each essential oil drop was 1 (eucalyptus) : 2 (lemon) : 2 (lavender) and this mixture was blended with jojoba oil 50ml (0.025%). The ELL-ointment was supplied for 8 weeks. We evaluated the effects of ELL on cell viability of mouse lung fibroblast, clinical skin features and severity, the level of serum Immunoglobulin (Ig) E & Ig G1, Interleukin (IL)-4, IL-13 and Interferon (IFN)-$\gamma$. Results : ELL showed safety on the cell viability of mouse lung fibroblast compared with control group. The cell viability was measured by SRB method. The effects of ELL on clinical skin features and severity in DNCB-induced dermatitis model of NC/Nga mice was significant compared with control group. EEL also showed significant effects on clinical symptom score compared with control group. Serum IgE & IgG1 level and development of atopy dermatitis skin lesions were evaluated. Serum IgE & IgG1 production was significantly down-regulated in EEL group compared with control group. ELL also down-regulated the levels of IL-4 and IL-13, and up-regulated the level of IFN-$\gamma$ compared with control group significantly. Conclusion : ELL was effective on atopy dermatitis by modulating Th2 related factors.

鼻茸(Nasal Polyp)에 對한 文獻的 考察

김현아,Kim, Hyun-Ah 대한한방안이비인후피부과학회 1999 한방안이비인후피부과학회지 Vol.12 No.1

In the treatment of Nasal Polyps. which are produced with allergic rhinitis, chronic paranasal sinusitis at clinic. Herb-med., acupuncture and some medicine for external application have been used. The symptoms, however, has taken a turn for the better in temporary, the nasal polyps was not removed in completely. So the origin treatment was impossible by the use of herb-med.. acupuncture and medicine. Although a surgical operation (excision) of western-medicine is effective for a specified period of time (about 6 months), the nasal polyps tend to recur. Because of that the second and third operation might be needed, so we cannot consider the operation as the treatment of nasal polyps. The study was observed to investigate the nasal polyps treatment, and to search practical attempt for the clinic application through a literature study on Bisikyuk and Bithch which are similar with nasal polyps. As results, the practical application of external treatment for the nasal polyps treatment in clinic might be more necessary, and internal use of the Herb-med. with the external treatment might be treated as supplementary treatment.

심.판결 사례 해설 및 평석 - 삼익악기.영창악기 간의 기업결합에 대한 대법원 판결에 대한 소고 - 1부

김현아,박진석,Kim, Hyeon-A,Park, Jin-Seok 한국공정경쟁연합회 2008 경쟁저널 Vol.- No.141

주택 거래 활성화를 위한 정책 방안

김현아,Kim, Hyeon-A 한국주택협회 2006 주택과 사람들 Vol.194 No.-

하반기 부동산 시장은 기반시설, 부담금 신설 등 부동산 시장의 발목을 잡는 각종 규제가 시작된다. 이에 따라 하반기에 집을 사고 팔 계획이 있는 사람들은 이러한 제도를 충분히 염두에 두고 움직여야 한다고 전문가들은 충고한다. 하반기 부동산 시장을 움직일 변수에 대해 알아보자.

알레르기性 鼻炎에 對한 文獻的 考察

김현아,정지천,Kim, Hyun-Ah,Jung, Ji-Chun 대한한방안이비인후피부과학회 1994 한방안이비인후피부과학회지 Vol.7 No.1

The study has been carried out to investigate of the Allergic Rhinitis by referring to 87 literatures. The results were as follows; 1. In oriental medical science, Allergic Rhinitis is belong to the category of the 'BiGu'(鼻구) 'GuChe'(구체). The 'Gu'(구) of the BiGu means watery rhinorrhea, the 'Che'(체) of the GuChe means sneezing. 2. The cause of a disease summarize the weak of Lung, Spleen and Kidney, and invasion into the nasal cavity of PoongHan etc a wrong air. Sometimes the pathologial change appear PoongHan changeHwa(風寒化火), HwaYeol is hidden in the inside(火熱內伏). The contributing factors are found a season(spring, winter), an abnormal weather(運氣 : 少陰 少陽 陽明 司天, 歲金不及), an emotional stress, an external wound of the harmful air, a food allergens and fatigue, a contact of substances, a sunlight etc. 3. Predominant symptoms are watery rhinorrhea, sneezing and nasal obstruction. Sometimes accompanic symptoms are nasal bleeding, mucopurulent rhinorrhea, olfactory disturbance, nasal polyp, rhinolalia clausa, respiratory disfunction etc. 4. The treatment-methodes is as follows, OnBoPaeJang GeoPoongSanHan(溫補肺臟 祛風散寒), GeonBilkGi(健脾益氣), BoSinNabGi (補腎納氣). The treatmentherbs is as follows, OnBoJiLuDan GaGam(溫補止流丹 加減), OkByeongPoongSan plus ChangIJaSan GaGam(玉屛風散合 蒼耳子散 加減), BoJungIkGiTang GaGam plus SoCheongLyongTang(補中益氣湯加減 配合 小靑龍湯), SinGiHwan GaGam(腎氣丸加減), GaeJiTang(桂枝湯) etc. 5. The external treatment is as follows, JeokBi(滴鼻), ChuiBi(吹鼻), SaekBi(塞鼻), stick and herbs-injection on the acupuncture-point, pressure ear acupuncture-point, herbs-pillow etc. 6. The acupuncture-moxa treatment is as follows, the methodes of cure apply TongJoGyeongGi(通調經氣), SanTongBiGui(宣通鼻竅) etc. Predominent acupuncture-points are YoungHyang(迎香), InDang(印堂), BiTong(鼻通), SangSeong(上星), HabGok(合谷) and so on. As mentioned above, from now on, it's need to the oriental medical scientific study of the Immunity and Allergy and to the external treatment's application for the ascent of the treatment-effect of the allergic disease.