조혈모세포이식 후 발생한 주폐포자층 폐렴에 대한 고찰

주지현,최정현,이동건,백지연,고윤호,이혜정,김세희,신호진,박윤희,박지영,김유진,신완식,김춘추 대한감염학회 2001 감염 Vol.33 No.4

Background : Pneumocytitis cainii pneumonia (PCP) can occur in immunocompromised hosts especially such as AIDS or cancer patients. Although recent research had focused on PCP in AIDS patients, few studies have described the clinical presentations of PCP in recipients of stem cell transplantation (SCT). We evaluated the clinical manifestations of PCP in SCT patients admitted at St. Mary's hospital, Seoul, Korea. Methods : The medical records of 17 PCP patients undergoing SCT between Feb. 1998 and Feb. 2000 were reviewed. The diagnosis of PCP was confirmed through the demonstration of Pneumocytitis cainii via either cytology of brochoalveolar lavage (BAL) or histological technique of lung biopsy. CMV disease and CMV infection were confirmed by BAL culture and antigenemia respectively . Results : Seventeen patients were all recipients of allogeneic SCT and 7 of 17 patients were performed non-sibling SCT. Patients presented with symptoms including brief period (4 ∼23 days) of fever (76%), dyspnea (70%), cough (64%), and signs such as rare(58.8%), Sixteen patients (94%) had been receiving immunosuppressive agent such as cyclosporine A (64%) or Fk506 (35%) without PCP prophylaxis. Eleven patients (64%) were treated with corticosteroid with mean dose of 16 mg/day prednisolone and mean duration of 4.6 months after post-SCT period. Twelve patients were co-infected with CMV. Another co-infected miCroorganisms were Pseudomonas aeruginosa, Mycobacterium tuberculosis, herpes simplex virus, parainfluenza virus, Average duration of treatment with trimethoprim-sulfamethoxazole (TMP/SMX) was 21 ±9 days. Four patients died, and three of them were related with PCP. Conclusion : PCP developed frequently in patients who were taking immunosuppressive drug due to graft versus host disease or were not taking TMP/SMX prophylaxis. High risk patients showing fever, cough, or dyspnea should be considered to take early bronchoscopic intervention for detection of PCP. When treat for PCP, it also be considered to the possibility of coinfection such as CMV. (Korean J Infect Dis 33:273∼279, 2001)

한국판 아동용 예일-브라운 강박 척도:신뢰도와 타당도 연구

정선주,이정섭,강윤형,조성진,서동혁,홍강의 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.1

목적 : 본 연구는 소아, 청소년의 강박 증상을 평가하기 위한 도구인 아동용 예일-브라운 강박척도(Childen's Yale-Brown Obsessive Compulsive Scale : Y-BOCS)의 한국판을 제작하여 그 신뢰도와 타당도를 검증하고자 시행되었다. 방법 : 강박장애로 진단된 42명의 아동과 청소년들을 대상으로 CY-BOCS를 시행하였다. 평가자간 신뢰도를 측정하기 위하여 20명의 환자를 2명의 평가자가 동시에 면담하였다. 수렴타당도와 변별타당도의 검증을 위해 총괄적인 임상 인상척도-강박장애(Clinical Global Impression-Obsessive Com-pulsive Disorder : CGI-OCD). 아동용 Leyton 강박 척도(Lryton Obsessional Inventory-Child Version : LOI-CV), 소아우울척도(Child Depression Inventory : CDI), 소아 상태-특성 불안척도(State-Trait Anxiety Inventory for Children : STAI-C)를 시행한다. 결과 : Cronbach's α값으로 평가한 내적 일치도는 0.86으로 높게 나타났다. CY-BOCS 전체 점수 강박사고, 강박행동 소척도 점수에 대한 군내 내적일치도는 각각 0.94. 0.94. 0.84로 우수한 평가자간 일치도를 보였다. CY-BOCS 전체 점수와 CGI-OCD 점수간의 상관관계는 매우 높게 나타났고(r-0.88), LOI-CY 총점과도 통계적으로 유의한 상관관계(r=0.51)가 관찰되었다. CY-BOCS 전체 점수와 STA-I-C의 상태불안 점수간에는 상관관계가 나타나지 않았고(r=0.25), 특성불안 점수(r=0.43) 및 CDI 점수(r=0.49)와는 유의한 상관관계를 나타냈다. 결론 : 본 연구결과, 한국판 CY-BOCS의 높은 타당도 및 신뢰도가 입증되었으며, 향후 강박 증상의 객관적인 평가 및 정량화를 위해 유용하게 사용될 수 있을 것이다. Objective : This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method : Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inven-tory-Child Version(LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory( CDI ). Results : Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion : The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity. KEY WORDS : Development · Rating scale · Obsessive-compulsive disorder · Reliability Validity.

Ⅰ급·Ⅱ급·Ⅲ급 부정교합환아에서의 설골의 위치

김영진,남순현,김현정,송윤주 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.3

설골은 주위골 조직과는 직접적인 연결이 없이 근육과 인대를 통해 혀,하악골, 두개골, 쇄골, 견갑골, 갑상연골, 인두 등에 연결된다. 이러한 특이한 해부학적 관계 때문에 설골의 위치는 하악의 위치, 머리의 위치,기도상태에 따라 변하게 된다. 이에 저자는 설골과 부정교합과의 관계,기도의 연관성에 대해 알아보고자 경북대학교 소아치과에 부정교합을 주소로 내원한 환아 64명(남자:39명,여자:25명,Ⅰ급 부정교합:25명,Ⅱ급 부정교합:15명, Ⅲ급 부정교합:24명)의 설골의 위치를 측면 두부방사선 규격사진상에서 계측하여 다음과 같은 결론을 얻었다. 1.Ⅰ,Ⅱ급 부정교합환아에 비해 Ⅲ급 부정교합환아에서 설골은 더 전방에 위치하였고,설골의 경사도도 더 완만하였다. 2.Ⅰ, Ⅱ, Ⅲ급 부정교합환아에서 설골은 하악골과 척추골사이의 전후방적 위치는 일정하였다. 3.설골은 하부기도의 전방경계를 이루는 골격구조임을 알 수 있었다. The importance of the hyoid bone lies in its unique anatomic relationships.It has no bony articulations but provides attachment for muscles,ligaments,and fascia of the pharynx,mandible,and cranium. Various studies have documented a variability of hyoid bone position in relation to changed mandibular position or head posture. The aim of this study is to investigate the hyoid bone position and inclination on cephalometric radiographs of three groups of patients exhibiting Class Ⅰ,Ⅱ,and Ⅲ malocclusions. The conclusions obtained from this study can be summarized as follows: 1.Class Ⅲ malocclusion patients show a more anterior position of the hyoid bone and also less steep inclination of the hyoid bone. 2.The anteroposterior position of the hyoid bone relative to the cervical vertebra and mendible was very constant. 3.The hyoid bone represented the anterior bony boundary of the pharynx at a lower level than PNS.

만성 요통환자의 복부 심부근과 표재근을 중심으로 한 운동 효과 비교

김진산,이창현,조미주,임연욱,정취산,김선엽 대한정형도수치료학회 2005 대한정형도수물리치료학회지 Vol.11 No.1

Objectives: To compare the efficacy of two types specific exercise intervention (deep and superficial abdominal muscle exercises) in the treatment of patients with chronic low back pain (CLBP). Design: A randomized, comparative, repeated-measures. Subjects: Twenty-four patients with CLBP (at least for 3 months), mean age±SD=51.58±16.21 (yrs). Methods: Twenty-four patients with this condition were assigned randomly to two treatment groups. Both first and second group underwent 3 weeks specific exercise treatment program. The first group specific trained for the deep abdominal muscles. The second group specific trained for the superficial abdominal muscles. Results: After intervention, the first group showed a statistically significant reduction in pain intensity and functional disability levels (p<.05). The second group showed no significant change in these parameters after intervention (p>.05). Conclusions: According to results, a "deep abdominal muscle exercises" treatment approach appears more effective than a "superficial abdominal muscle exercises" treatment in patients with CLBP.

외상 받은 치아의 치수생활력 검사 : Laser Doppler flowmetry를 이용한 증례보고

김영진,송윤주,김현정,남순현 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.2

외상받은 치아에서 치수강폐쇄, 치수괴사, 치근흡수, 인접치조골소실, 치근단염증성변화 및 치아상실 등의 부작용이 나타날 수 있으며, 이는 치근형성정도, 탈구의 종류, 고정의 기간에 따라 예후가 달라진다. 외상 후 부작용의 빈도를 줄이기 위해서는 조기에 치수생활력 유무를 판단하는 것이 중요하다. 그러나 미성숙치근을 가진 치아는 치수내 신경발달 분포가 불완전하고, 환자의 연령이 어려 술식에 대한 이해력이 부족하고 치과에 대한 공포감 때문에 전기치수검사등의 전통적인 치수생활력 방법의 신뢰도가 떨어진다. 반면 laser Doppler flowmetry는 치수 혈류량을 측정하여 치수생활력을 검사하는 방법으로서 보존적이며 객관적이고, 외상후 비교적 조기에 치수생활력을 측정할 수 있는 신뢰도가 높은 치수생활력 검사방법이다. 이에 저자는 외상받은 미성숙치아를 대상으로 냉검사, 전기치수검사, laser Doppler flowmetry를 이용하여 치수생활력을 검사하여 다음과 같은 결과를 얻었다. 1. 외상받은 치아의 치수생활력은 초기에는 음성으로 나타날 수 있으나 시간의 경과에 따라 양성으로 회복할 수 있어 장기간의 관찰이 필요하다. 2. 치수생활력은 냉검사, 전기치수검사 보다 laser Doppler flowmetry에서 더 빨리 나타났다. 3. 냉검사와 전기치수검사의 두가지 치수생활력 검사방법 중 전기치수검사 보다 냉검사가 신뢰도가 더 높았다. In the traumatized teeth, the major complications are pulp necrosis, and root resorption. The factors influencing to prognosis are the state of root development, type of injuries, quality of fixation. There are good prognosis in the case of immature teeth, minor luxation injuries. To minimize of occurrence of these complication, it is very important to determine the pulp vitality. This can help us decide whether or not to treat the teeth endodontically. But, it is difficult to determine of pulp vitality in immature teeth or traumatized teeth. In this case, pulp vitality test was done periodically on the traumatized upper central incisors, and the results were different among cold test, electric pulp test, and laser Doppler flowmetry. The conclusions were obtained from this case can be summarized as follows ; 1. Pulp vitality of traumatized teeth should be negative early, but with time going pulp vitality could be recovered. 2. The positive reaponse of pulp vitality test was detected earlier in laser Doppler flowmetry. 3. Between cold teat and electric pulp test, cold test was more reliable in determining pulp vitality.

40ㆍ50대 일부 남성근로자의 골감소증 및 골다공증 유병실태와 위험요인

장윤균,서현주,진영우,정미선,성숙희,박두용,김종순,김수근 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 최근 국내에서도 골다공증과 관련된 생활양식의 규명에 관한 연구가 이루어지고 있으나, 아직까지 남성 골다공증에 대한 연구가 활발하게 이루어지지 않아 40, 50대 남성근로자를 대상으로 유병률을 파악하고, 골감소증 및 골다공증 관련 위험요인을 확인하고자 하였다. 방법: 원자력발전소에 근무하는 40, 50대 남성 근로자 2,073명을 대상으로 2004년 3월~7월 기간동안 생활습관을 파악하기 위하여 자기기입식 전산입력 방식으로 최종학력, 흡연여부, 음주여부, 신체활동 횟수를 조사하였고, 골밀도검사, 체성분검사(체지방률, 허리-엉덩이둘레비), 신체계측(신장, 체중)을 시행하였고, 골밀도 검사는 Osteosys사의 EXE-3000을 이용하여 종골부위를 측정하였고, 체지방률, 허리-엉덩이 둘레비는 Biospace사의 Inbody 3.0을 이용하여 측정하였다. 통계분석은 골감소증 및 골다공증의 관련요인을 분석하기 위해 다중로지스틱회귀분석을 시행하였다. 결과: 연구대상자의 골감소증 및 골다공증 유병률은 22.8%와 3.0%이었으며, 골감소증 및 골다공증의 관련요인으로는 연령이 증가할수록, 흡연자이거나 과거흡연자일 경우, 체질량지수가 25 kg/m^(2) 미만일 경우, 30분 이상 신체활동 횟수가 주 3회 미만일 경우가 유의한 연관성이 있었다. 결론: 성인 남성 40, 50대의 골감소증 및 골다공증의 유병률이 높은 편이었으며, 골감소증 및 골다공증으로 이환을 예방하기 위하여 금연, 활발한 신체활동을 촉진하여 골밀도를 개선시키는 생활습관으로의 변화를 권고해야 할 것이다. Objective: This study was conducted to investigate the prevalence and risk factors of osteopenia and osteoporosis in 40-59 year-old male workers working at nuclear power plants. Methods: Bone density, body composition, and anthropometry data were analyzed for 2,073 subjects were carried out from March 2004 to July, 2004. Educational level, smoking status, drinking status and frequency of physical activity were investigated by self-reported questionnaires through internet to identify lifestyles related to bone mass density. Bone mass density was measured by EXE-3000 of Osteosys Co. And body fat percentage, and waist-to-hip ratio by inbody 3.0 of Biospace Co. Results: The prevalence of ostepeniaosteopenia and osteoporosis was 22.8% and 3.0%, respectively. According to multinominal multinomial logistic regression analysis, age, smoking status (current smoker and former smoker), low body mass index (< 25kg/m^(2)), and frequency of physical activity were significantly associated with osteopenia and osteoporosis. Conclusions: The prevalence of ostcopenia and osteoporosis wasseemed high for the, when it was inferred from subjects' age compared to the results of previous studies. The This study results suggeststhat it is necessary for 40-59 year-old male workers to stop smoking, and exercise regularly in order to prevent osteopenia and osteoporosis.

다량의 하부위장관출혈이 병발된 Vibrio vulnificus 패혈증 1예

최주연,유진홍,한석원,이대훈,최민호,박순민,김연식,김선우,신완식,강문원,강성구 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.2

최근 저자들은 Vibrio vulnificus 감염에 의해 패혈증 및 이차성 피부 병변을 보인 42세의 남자 환자의 치료중 하부 위장관 출혈이 병발된 1예를 경험하였기에 보고하는 바이다. We experienced a case of Vibrop vulnificus septicemia which showed an unusual manifestation such as hematochezia. The patient was a 42-year-old man with chronic liver disease. The blood and wound culture revealed the organism. During intensive care, he suffered from massive hematochezi for several days. Colonoscopy and abdominal CT showed findings suspicious of ischemic colitis. To our knowledge, this is the first unusual case of V.vulnificus infection which showed massive lower gastrointestinal bleeding.

노인들의 스포츠 활동 참가가 생활만족에 미치는 영향

김진수,김윤주 경희대학교 체육과학연구소 1997 體育學論文集 Vol.25 No.-

The purpose of this study was to find out the extent of living satisfaction depending on the existence of elders' participation in sports activities, to induce them to take part in sports activities, and to provide basic data to old people's welfare work. This study sampled 555 male and female elders above 65 years old(participants in sports activities 275, non-participants -280) who lived in Seoul randomly. Frequency and Crossing Analyses were performed at α=.05, and the result is as follows. 1.Among 555 subjects, 296 elders thought that they were healthy and it appeared that 175(63.6%) out of 275 participants attended sports activities in order to keep health and improve physical strength and 30(10.9%) for interpersonal relations and social life. And among 280 non-participants in sports activities, 67(23.9%) responded that they had no time and 36(12.9%) said that they had no interest in sports. 2.The comparison of life satisfaction according to whether they participated in sports activities or not showed significant differences by revealing that the participants had more positive thought and hope than non-participants. In conclusion, since elders' participation in sports activities brings better result to living satisfaction, it is desirable to encourage them to take part in sports activities more frequently and more moderately.

자생식물과 도입 화훼명의 어원 및 유형 비교

백진주,박천호,정성혜,박윤점,송채은,허북구 韓國植物·人間·環境學會 1998 인간식물환경학회지 Vol.1 No.2

This study was carried out to survey origins of native plants and introduced flowers. Naming of native plants was divided into two types : one type is based on the internal properties of plants(shape, color, length, thickness, size) and the other type on such properties as person, animal, object, place and time which are compared to shapes and properties of plants. Names of native plants originate from shape > color > length > thickness > size > width > number, and also from characteristics > state > inhaitation place and place of origin > flowering and fruiting season > function and use. Prefixes were added in order to describe shapes and properties of plants in detail. About 50% of the names of the introduced flowers, originates from their shapes, about 15% from persons' names and about 13% from mythologies and legends. This shows that countries have different ways naming flowers from other countries and that survey of origins of flower names helps understand the characteristics of the flowers.

식품 기준·규격의 합리적 관리 ·운영에 관한 연구(Ⅰ) : 두부,식용유지, 전분의 분말상 원료에 관하여 Powdered marerials of Tofu, Edible oil, Starch

김희연,홍진환,박혜경,한상배,박종석,이은주,이정성,송경희,최은희,최영준,소경아,성영제,이주엽 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

본 연구는 분말상 원료(전분, 대두분)의 저장유통시 품질변화를 건전성과 안전성 측면에서 검토하여 식품의 기준 ·규격 설정f.」 합지적으로 반영하고자 하였다. 전분과 패두분의 이물을 검사하고, 2종 대두분(중국산, 미국산)을 ?0일간 IS'c와 30t에 저장하면서 성상, 수분, 산가, 과산화물가, 지방산 조성,아플라톡신 BB의 생성여부를 분석하였다. 중국산 대두분 30'』 저장군에서 50일 이후 곰팡이가 발생한 것 이외에 모든 시료에서 양호한 성상을 나타내었고, 전분과 대두닥 모든 시료에서 이물은 검출되지 않았다. 산가는 중국산과 미국산 시료간에 편차를 보여 증국산 30"C, 50일 저장시료에서 약 10배끙도 증가하였고, 과산화물가는 저장 90일후 15'E 저장군은 약 2.3배, 30'c 저장군은 3배정도 증가하였다. 대두분의 주요 지방산은 linoleic acidf18. 2), oleic acid(18 : 1), palmitic acid(16 : 0)이었으며, 3개월 저장에 따른 지방산 함량의 변화는 미미하였다. 아플라톡신 B₁은 모든 시료에서 검출되지 않았다. The objective of this study was to investigate auality changes of type raw materials(starch, soy flour) during various storage conditions. Starchflour(source of China, U.S.A) were slfred under two temperature(15'C, 30'c) forSensory evaluation, (o.reign material test, moisture content, acid value, peroxide ualue,composition, aflatorin Bi were analyzed. China soy flour(stor·ed 30'f) was contaminated by fungj on 50 days. Except for soy flour contardnated by fungi, sensory characteristics were not changed and foreign mater;als were notdetected. Acid value of China soy flour(stored at 30'C, 90 days) was about 10 times higherlevel before storage and acid value was more influenced by source(China, USA). Peroxide valuewas in proportion with the storage period slightly. The major fatty acid of soy flour waslinoleic acid(18 . 2), an(3 the change of fatty acid composition was not observed. Aflatoxlrl Blwas not detected.