Long second toe: its nail and skin changes

( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Nail can be affected by trauma, infection, and systematic disorders. In particular, the toe nails are exposed to the repeated and cumulative minor traumas, which usually result in thickened, splitted, and discolorated nails. Considering these, it can be inferred that the long second toe can be related to various nail and skin changes by repeated minor traumas such as friction in shoes, but the study or report on this topic hasn’t been done yet. Objectives: The purpose of this study was to introduce various nail and skin changes on long second toe. Methods: We analyzed the kinds of nail/skin changes of 50 patients with long second toe, enrolled at Pusan National University Hospitals (Busan and Yangsan) from 2013 to 2018. Results: There was no significant difference in the incidence of left and right toe and toenail, and 7 (14%) patients presented bilateral distribution. The most common nail change on long second toe was melanonychia (23, 46%), followed by subungual hematoma (15, 30%), onycholysis (2, 4%), subungual hyperkeratosis (2, 4%), onychomadesis (1, 2%), and retronychia (1, 2%). The most common skin change was corn (9, 18%), followed by paronychia (2, 4%). Twenty (20/50, 40%) patients also had other toe or toenail changes. Among them, the most common site was big toe/nail (13, 62%), and the most common change was subungual hematoma (8, 42%). Conclusion: Through this study, the dermatologists can recognize and diagnose the nail and skin changes of long second toe.

Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees

Kim, Chang-Wook,Hyun, Seung-Jae,Kim, Ki-Jeong The Korean Neurosurgical Society 2021 Journal of Korean neurosurgical society Vol.64 No.6

The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.

건축 프로젝트 적정 설계변경 관리를 위한 사례조사

김성욱(Kim Sung-Wook),남혜원(Nam Hye-Won),이종식(Lee Jong-Sik),신창현(Shin Chang-Hyun),전재열(Chun Jae-Youl) 대한건축학회 2009 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.29 No.1(구조계)

Recent design changes in the existing research on the factors and issues of design changes and analysis, responsible for analyzing the relationship, procedural issues, and issues of research that can be active. However, changes in the design of problems are essentially designed to complement the book is for the procedure. Methodology for dealing with design changes in the characteristics of the country and to reflect more realistically, and various design changes and looked at trends in related research. the design Change of this study to examine the domestic status and problems, identify the status of the country about the design changes, and in suggesting the direction to the development of the design changes.

급성 심근허혈에 따른 심실활성시간(Ventricular Activation Time)의 변화

한성욱,김윤년,김기영,남창욱,김기식,김권배 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.3

Causes and Predictive Factors Associated with “Diagnosis Changed” Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

( Byung Ju Kang ),( Kyung Wook Jo ),( Tai Sun Park ),( Jung Wan Yoo ),( Sei Won Lee ),( Chang Min Choi ),( Yeon Mok Oh ),( Sang Do Lee ),( Woo Sung Kim ),( Dong Soon Kim ),( Tae Sun Shim ) 대한결핵 및 호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the “diagnosis changed” rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: “diagnosis maintained”, “diagnosis changed” (initially notified as TB, but ultimately diagnosed as non-TB), and “administrative error” (notified as TB due to administrative errors). Results: Excluding 17 patients in the “administrative error” group, the “diagnosis maintained” and “diagnosis changed” groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of “diagnosis changed” were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn`s disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a “diagnosis changed” result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high “diagnosis changed” rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the “diagnosis changed” rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of “diagnosis changed” cases is desirable.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Causes and Predictive Factors Associated with "Diagnosis Changed" Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

Kang, Byung Ju,Jo, Kyung-Wook,Park, Tai Sun,Yoo, Jung-Wan,Lee, Sei Won,Choi, Chang-Min,Oh, Yeon-Mok,Lee, Sang-Do,Kim, Woo Sung,Kim, Dong Soon,Shim, Tae Sun The Korean Academy of Tuberculosis and Respiratory 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). Results: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.

학교보건사업의 역사적 고찰을 통한 정책 방향에 관한 연구

김상욱,김윤신,장창곡 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Objectives : The purpose of this study is to provide a basic structure for the establishment of the direction of school health programs, an overview of the historical changes of school health programs and their results, and a conceptual framework on school health programs. Methods : The data analysis has been done using a statistical almanac, relevant laws and regulations, operation handbook of the program, theses, reports, records of public hearings, and other reports as a technical research primarily based on evidence. The methodology of this research classifies the development and growth transition of school health programs during a historical period through the investigation of regulations, organization, manpower, and its program via its development process and to provide a basic tool to design a solid school health policy. Results : A. The growth and development of school health programs The development of school health programs was classified into three different periods including the forthcoming period (1945~1967), the completion period (1967~1993), and the actualization period based on the establishment of legislation for School Health Law, other relevant legislation, and the contents of school health programs (1993~present). B. Policy direction of school health programs School health programs have reestablished their goals and range based on basic direction, and developed the unit model of information structure for school health program management and its basic structure. Finally, the stepwise support system through the building of the school health support center is recommended. (1) The basic direction of school health programs has proposed 7 basic goals to reestablish the policy direction of health improvement based on total health. (2) The unit model of information system and the school health information system for school health program management has been developed to utilize positive management. (3) School health policy through the study of the health laws and systems has been developed. The necessity of school health support center for the policy support, functional support and operation support has also been proposed. Conclusions : It is necessary to build a school health support center that consists of health professionals in charge of policy support, functional support, and program support of school health programs in order to realize and develop new policy.

좌측상지 Reflex Sympathetic Dystrophy 환자에게 Stellate Ganglion Block 실시후 나타난 동측 하지 마비 1예

김욱곤,이강창,김태요 圓光大學校 醫科學硏究所 1991 圓光醫科學 Vol.7 No.1-2

Reflex sympathetic dystrophy (RSD) may be defined as a disordered response by extremity to trauma manifested by pain, vasomotor disturbances, delayed return of function, and trophic changes. This 43 year old female patient had ruptured ulnar collateral ligament of metacarpophala-ngeal joint by rear-car during carrying the earth. She visited orthopedics on July 10, 1989 complaining of burning pain and swelling on M-P joint of left thumb. In spite of medication and physical therapy, there was continued severe pain and dystrophic change on left upper expremity. On March 5, 1990 after supraclavicular block was performed with 20 ㎖ of 0.5 % bupivacaine she had no pain for 18 hours. Next day stellate ganglion block (SGB) was performed with 10 ㎖ of 1.0 % lidocalin. Forty minutes after SGB, she became unable to move her leg. Afterward, her left lower extremity developed similar symptoms and signs as those of her left upper extremity. We know of no reported cases of lower extremity motor loss following SGB. Further evaluation is needed for diagnosis of this case.

열화된 HK40 강의 마식특성에 관한 연구

김창훈,김엄기,전용두,이금배,남승훈,안병욱 한밭대학교 생산기반기술연구소 2003 생산기반기술연구소 논문집 Vol.3 No.1

The erosion behavior of artificially aged HK40 steel was invested. Erosion tests were conducted at room temperature, 200℃ and 400℃ using Al_2O_3 particles. Erosion rates increased with the increment of temperature. The maximum erosion rate appeared with the impingement angle of 30 degree. The erosion rate increased, reached the maximum at 1000 hours, and after that, decreased with the heat treatment time. The mechanism of erosion seems to be the cutting wear which is very much associated with the strength of material. As results, the erosion rates were rather affected by the tensile strength and the strain hardening coefficient than the hardness and the yield strength. Such changes of material properties would be caused by the change of micro-structure due to the precipitation of carbide and the dissolution of solid element within matrix during the heat treatment.