정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

코어안정화운동, 동방요법 및 병행처치가 골반변위에 따른 좌골신경통에 미치는 영향

김동호(Kim, Dong-Ho),김상현(Kim, Sang-Hyun),김성남(Kim, Sung-Nam),김재철(Kim, Jae-Cheol) 한국체육과학회 2019 한국체육과학회지 Vol.28 No.4

The purpose of this study was to confirm the effect of core stability exercise, dong-bang therapy, and combined treatment on reducing pain, pelvic correction and stress hormone concentration in patients suffering from sciatic neuralgia due to pelvic displacement. Middle aged(40~50age) suffering from sciatic neuralgia over 6 months were operated with core stability exercise, dong-bang therapy, and combined treatment 3 times a week for 12 weeks. VAS and X-ray was performed to collect pain scales and pelvic displacement data and cortisol and epinephrine concentration in blood were tested. 1. pain scale rate was reduced in all groups. especially, dong-bang therapy group and combined treatment group showed more directive pain reduce. 2. pelvic displacement improvement was not significant in core stability exercise group, and it was significant in dong-bang therapy group and combined treatment group. no significant difference was shown between dong-bang therapy group and combined treatment group. however, combined treatment group showed higher correction effect. 3. concentration of stress hormone was significantly increased in all groups after the first operation. after 12 weeks concentration level was reduced to same level before treatment. Dong-bang therapy and combined treatment improve pelvic displacement, and are effective treatments on reducing sciatic neuralgia due to pelvic displacement. combined treatment of dong-bang treatment and core stability exercise is considered an effective program of correction for pelvic displacement and maintenance.

출생후 흰쥐 구치의 발육에 따른 치수의 신경지배 발달에 관한 면역조직화학적 연구

김영진,남순현,배용철,김동길,김현정 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.4

The purpose of this study was to investigate the postnatal development of pulpal innervation with the tooth development and eruption process in developing rat mandibular molars (postnatal 1, 5, 10, 15, 20, 25, 35day-old and adult rats). Immunohistochemical method was carried out for the detection of nerve fibers, using the antibody against calcitonin gene-related peptide(CGRP). The results were as follows: The feature of CGRP-IR nerve fibers were shown in a bead-like appearance. The time of nerve entering into the dental papilla of tooth follicle began at the occured advanced dentinogenesis. The development of Raschkow plexus began at the formative stage of the roots and was accelerated at the stage of the crown emerged into the oral cavity. The number of nerve fibers entering the odontoblastic layer increased with the tooth eruption and mastication. The development of innervation was shown to be related with the stage of the development of individual teeth rather than the chronological age of the rat.

흰쥐 해마박편에서 acetylcholine이 gamma-aminobutyric acid 유리에 미치는 영향에 관한 연구

김익현,김형룡,김관식,정동균 대한구강생물학회 1991 International Journal of Oral Biology Vol.15 No.2

Present study was performed to clarify the effect of acetylcholine on the release of gamma-aminobutyric acid(GABA) employing hippocampal slices. Hippocampal slices (300∼400㎛ thick) were prepared by the method of Kim et al(1988) and pre-equilibrated in Krebs-bicarbonate medium(KBM, pH 7.4) for 1hr at 37℃. Pre-equilibrated slices were incubated in fresh KBM and then potassium(50mM)-containing KBM for 5 min period. Basal and potassium-induced release of GABA were determined from recovered medium by HPLC. After 30min resting period, in the presence of physostigmine(20μM) slices were reincubated in acetylcholine-containing KBM and acetylcholine plus potassium-containing medium consecutively for 5min period each to investigate the effect of acetylcholine on basal or potassium-induced GABA release from hippocampal slices. The observed results were as follows: 1. The release of GABA induced by the first and second 5 min-exposure of 50mM potassium was 107.3±8.2 nmol and 90.6±3.2nmol, respectively. When compared with released amounts of GABA during the corresponding spontaneous periods, these were 4.6 and 4.6-fold increase respectively. 2. Physostigmine(20μM) had no significant effect on the spontaneous release of GABA. 3. Acetylcholine(10-1000μM) increased spontaneous and potassium-induced GABA release in a dose-dependent manner.

한약에 의해 유발된 급성 간질성 신염 2례

김덕윤,박동건,김응석,강영모,양창헌,이정호,이동철,이영현,김정란 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

간질성 신염은 신장의 간질을 선택적으로 침범하는 염증성 질환으로 여러가지 원인에 의해 유발되며, 이 중 약물에 의한 경우는 각종 항생제, 비스테로이드성 진통제, 항경련제, 이뇨제, 면역억제제등에 의한 증례들이 보고되고 있다. 현재 각종 질환-특히 만성질환-의 치료에서 한약이 차지하는 비중이 적지 않으나, 그 각각의 성분들이 유발할 수 있는 부작용들에 대한 연구는 거의 없는 실정이다. 저자들은 관절염 치료를 위해 중국산 한약을 복용한 후 복통, 피로감 및 육안적 혈뇨를 주소로 내원한 두 환자에서, 단백뇨와 신기능 장애를 보여 시행한 신조직 생검상 급성 간질성 신염에 합당한 병리학적 소견을 보이고, 한약 복용 중지 후 급속한 회복을 보여, 한약에 의해 유발된 것으로 사료되는 급성 간질성 신염 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Acute interstitial nephritis is a disease characterized by renal interstitial inflammatory cell infiltration and acute renal functional deterioration. This is caused mainly by antibiotics, NSAID and diuretics such as thiazide, but cases induced by herb medication are rare. We experienced two cases of acute interstitial nephritis after treatment with herb medication. One 71-year-old female patient and the other 60-year-old female were admitted to the hospital because of general weakness and gross hematuria. Microscopic hematuria, pyuria, and proteinuria were presented. After definitive diagnosis with a renal biopsy, we noted rapid recovery of renal function by drug withdrawal and steroid therapy. We report these cases with a review of the referenced literatures. Key Words : Herb medication, Acute Interstitial nephritis.

인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

신경섬유종증-제 2형의 진단과 치료 : 16례의 임상경험 Experience of 16 Cases

김정은,백선하,김종수,이상형,오창완,김동규,정희원,김현집,조병규,한대희,최길수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

Neurofibromatosis type 2(NF-2) is a dominantly inherited disorder characterized by the occurrence of bilateral acoustic neurinomas and the frequent association of other central nervous system tumors. We present a retrospective review of 16 patients with NF-2 who were treated at our hospital from 1984 to 1995 in 13 cases, the diagnoses of Nf-2 were based on the criteria developed at the Consensus Development Conference of National Institute of Health in the United States, and in another 3 cases. the criterias of NF-2 were not fully satisfied, but the diagnoses of NF-2 were highly suspected. The average age of the patients was 27.6 years, ranging from 13 years to 56 years. The most common symptom was hearing difficulty : intervals between symptom onset and deafness ranged from 8 months to 6 years(mean : 2.9 years) One family of NF-2 was documented consisting of a sister a brother and their mother. Nine patients underwent operations on unilateral acoustic neurinomas : these were subtotally removed in eight patients and totally in one patient Among these patients five were deaf on the ipsilateral side at surgery. Among the other four patients with useful hearing before surgery, hearing was preserved to preoperative status in two patients. Four patients with diagnoses of meningioma, received operations to relieve mass effect with subtotal removal in two patients and total removal in the other two. Early diagnosis and treatment are the most important in the management planning of patients with NF-2 for reasons of early manifestation and rapid progression of the disease.

중소규모 사업장 근로자의 직무스트레스로 인한 결근, 조퇴 현황과 한국형직무스트레스 하부요인과의 관련성

김정훈,박신구,김동현,김환철,임종한,이의철,이동훈,이지영 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

목적: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴의 현황과 한국형 직무 스트레스 하부 요인과의 관련성을 알아보고자 하였다. 방법: 중소규모 사업장 83곳 근로자들에 대해 한국형 직무스트레스요인 평가도구-단축형(KOSS-SF)과 사회 일반적 특성, 직업적 특정 및 직무스트레스로 인한 결근이나 조퇴 경험여부 등을 묻는 구조화된 자가 기입식 설문을 실시하였고, 응답한 4,350명에 대해 최종 분석을 시행하였다. 직무스트레스로 인한 결근, 조퇴와 한국형 직무스트레스 하부 요인들과의 관련성을 확인하기 위하여 로지스틱 회귀분석을 시행 하였다. 결과: 직무 스트레스로 인한 결근, 조퇴를 한 근로자는 남자에서 7%(196명), 여자에서 8%(113명) 로 조사되었고 한국형 직무 스트레스 하부요인과의 관련성에서는 남, 여 모두 직무요구, 관계갈등, 조직체계, 보상부적절, 직장문화 영역의 스트레스가 높은 군에서 통계적으로 의미있게 직무스트레스로 인한 결근, 조퇴율이 증가하였다. 결론: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴와 한국형 직무 스트레스 하부요인과의 관련성은 남자에서는 조직체계 영역이 가장 높았고, 여자는 직장문화 영역에서 가장 높은 관련성을 보였다. Objective: The aim of this study was to examine the actual conditions of absence and early leave due to job stress of 4,350 workers in 83 small and medium scale industries, and its relationship to job stress factors using Korean Occupational Stress Scale-Short Form (KOSS-SF). Methods: A structured self-reported questionnaire was used to assess each respondent's Sociodemographics, job stress, experience of absence and early leave due to job stress. Seven KOSS-SF domains of job stress were used. We estimated the relation of absence and early leave due to job stress and job stress factors using logistic regression analyses. Results: Absence or early leave due to job stress occurred in 7% of male workers and 8% of female workers. Multiple regression analysis revealed a significantly positive association job stress-related absence/early leave and job demand, interpersonal conflict, organizational system, lack of rewards and occupational climate. Conclusions: Absence and early leave due to job stress is significantly attributed to organizational System and lack of reward for men, and occupational climate and organizational system for women.

경희대학교 평화의 전당 노래비 디자인

김동찬,김호겸,민창기,김태현,김용욱 경희대학교 디자인연구원 2003 예술· 디자인학연구 Vol.6 No.1

The purpose of this study is to design a basic draft of a monumental inscription with a poem of a peace for stirring up a peaceful mind. The inscription is expected to be a place for arousing a peaceful mind to visitors. Moreover, this place can be a place for culture and rest, which uplifts the image and phase of Kyunghee University to both.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.