일렬 자가조혈모세포이식을 받은 다발성 골수종 환자에서 발생한 뇌 톡소포자충증 1례

김계형,송경호,전재현,박완범,박상원,김홍빈,김남중,김인호,오명돈 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant recipients, usually associated with allogeneic hematopoietic stem cell transplantation (HSCT). We report a case of cerebral toxoplasmosis in a patient with multiple myeloma, following tandem autologous stem cell transplantation. A 55-year-old Korean male presented with weakness in both legs that had progressed to both arms. A magnetic resonance imaging scan of the brain revealed multiple, variablesized ring-enhancing lesions with surrounding edema in the cerebral hemispheres and brain stem. Stereotactic biopsy revealed bradyzoites of Toxoplasma gondii in the brain tissue. The patient received trimethoprim-sulfamethoxazole, followed by pyrimethamine and sulfadiazine, accompanying treatment for progressive multiple myeloma. Cerebral toxoplasmosis should be considered as one of the differential diagnoses in patients with neurologic signs following autologous HSCT.

공군사관학교 시뮬레이터 비행교육 서비스 품질과 만족도 개선 연구

김계형 한국품질경영학회 2019 한국품질경영학회 학술대회 Vol.2019 No.-

공군사관학교는 전 생도를 조종 특기로 선발하고 있으나 시뮬레이터를 활용한 비행교육 서비스는 필수과정으로 지정하지 않고 있다. 현장에서 교육을 담당하는 교관조종사의 인터뷰 결과 조종사 양성의 기초 단계인 시뮬레이터 교육에 생도들의 자발적인 학습시간이 부족함에 따라 졸업 후 정규 비행교육 과정 이수의 한계점으로 식별되고 있다. 이에 재학생들의 시뮬레이터 비행교육에 대한 만족도 분석을 통해 참여율과 비행교육 과정의 수료 성과를 높이기 위한 비행교육 과정 개선이 필요하다고 판단하였다. 비행교육 서비스의 만족도를 측정하기 위해 SERVQUAL 모형을 활용하였다. SERVQUAL 모형은 유형성, 신뢰성, 대응성, 확신성, 공감성의 5개 항목을 통해 고객의 서비스 지각 수준과 기대 수준을 평가 및 분석하여 서비스 품질에 영향을 줄 수 있는 요인들을 찾고 경쟁력 있는 서비스를 제공할 수 있게 한다. 공군사관학교 재학생들과 졸업생 학생 조종사들을 대상으로 연구를 실시한 결과, 공군사관학교 비행교육 서비스에 대한 재학생들과 졸업생들의 기대수준과 지각수준에 모두 차이가 있었으며, SERVQUAL 항목 중 신뢰성과 확신성 항목이 가장 큰 기대-지각 수준의 차이를 보였다. 따라서 비행교육 서비스의 품질 향상과 만족도 개선을 위해 신뢰성 및 확신성과 관련된 세부사항들에 대한 개선안을 제시하고, 기타 항목에도 우선 순위를 부여하여 순차적으로 개선하는 방안을 제시하고자 한다.

초등학교 곤충의 한 살이 학습을 위한 어플리케이션의 개발 및 적용

김계형,엄안흠 한국교원대학교 뇌기반교육연구소 2015 Brain, Digital, & Learning Vol.5 No.1

Since devices such as smart phones and smart pads have become popular and their use has expanded rapidly, several educational applications have been developed and can be used in those devices. However, only a few applications for biological science learning has been developed. The purpose of this study was to design and implement a smart phone application,‘the life cycle of insects’, as a study aid materials for exploratory learning of elementary students. The application developed in this study were used for science learning in classes of an elementary school and for usability evaluation of teachers. Results showed that the application increased interests the subjects of both students and teachers, suggesting valuable for learning science in the elementary school.

설사 환자에서 올바른 항생제 사용

김계형 대한내과학회 2022 대한내과학회 춘계학술대회 Vol.2022 No.-

중증열성혈소판감소증후군

김계형,오명돈 대한내과학회 2014 대한내과학회지 Vol.86 No.3

Severe fever with thrombocytopenia syndrome (SFTS) is firstly reported in China in 2011. It is an emerging infectious disease inChina, Japan and South Korea. It is caused by novel bunyavirus, called SFTS virus. The vector of SFTS is Haemaphysalislongicornis tick and domesticated animals may serve as intermediate hosts. The clinical manifestations of SFTS are fever,vomiting, diarrhea, thrombocytopenia and leukopenia. In severe cases, multiple organ failure, disseminated intravascularcoagulopathy, and central nervous systems manifestation are present. The case-fatality rate is 6-30%. There is no effective antiviraltherapy and supportive care is the main treatment.

A Case of Cerebral Toxoplasmosis Following Tandem Autologous Stem Cell Transplantation in a Multiple Myeloma Patient

김계형,송경호,전재현,박완범,박상원,김홍빈,김인호,오명돈,김남중 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.3

Toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant recipients, usually associated with allogeneic hematopoietic stem cell transplantation (HSCT). We report a case of cerebral toxoplasmosis in a patient with multiple myeloma, following tandem autologous stem cell transplantation. A 55-year-old Korean male presented with weakness in both legs that had progressed to both arms. A magnetic resonance imaging scan of the brain revealed multiple, variablesized ring-enhancing lesions with surrounding edema in the cerebral hemispheres and brain stem. Stereotactic biopsy revealed bradyzoites of Toxoplasma gondii in the brain tissue. The patient received trimethoprim-sulfamethoxazole, followed by pyrimethamine and sulfadiazine, accompanying treatment for progressive multiple myeloma. Cerebral toxoplasmosis should be considered as one of the differential diagnoses in patients with neurologic signs following autologous HSCT.

필리핀 여행 후 발생한 쯔쯔가무시병 1예

김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

필리핀 여행 후 발생한 쯔쯔가무시병 1예

김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 Infection and Chemotherapy Vol.40 No.6

Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up. Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

Severe Fever with Thrombocytopenia Syndrome Patients with Hemophagocytic Lymphohistiocytosis Retrospectively Identified in Korea, 2008–2013

김계형,이명진,고미경,이은엽,이종윤 대한의학회 2018 Journal of Korean medical science Vol.33 No.50

The incidence of severe fever with thrombocytopenia syndrome (SFTS) has increased in Korea since a first report in 2013. We investigated whether SFTS existed before 2013 using real-time reverse transcription polymerase chain reaction and stored blood samples from febrile patients with thrombocytopenia. Four cases of SFTS were identified, with the earliest occurring in 2008.

국내 이주민을 위한 정착 시기에 따른 보건의료 접근성 개선 방안

김계형,박상민 숙명여자대학교 아시아여성연구원 2014 다문화사회연구 Vol.7 No.2

최근 한국사회에는 이주민 인구가 증가하고 있으며, 그 보건의료 문제는 각 이주 정착시기에 따라 분석하고 이에 적절한 지원체계를 구축하는 것이 도움이 될 수 있다. 입국초기에 특정 연령군에서는 따라잡기 예방접종(catch-up vaccination)을 시행하는 것이 필요하며, 이는 이주민의 건강뿐 아니라 한국 전체 국민의 전염성 질환 관리에도 매우 중요하다. 또한 이주민이 이주 과정에서 겪는 정신보건학적 문제에 대한 지원이 필요하다. 이주 후 중장기 정착 기간을 거치면서는 만성병 예방 및 관리가 중요한 문제이다. 국내로 이주하기 전에 이루어졌던 다른 나라에서의 사회⋅문화적인 경험을 존중하고 이해하는 포용성을 전제로 한 보건의료 서비스 제공이 필요하다. 이주민을 위한 지원서비스 접근성 향상을 위해서는 1) 이들에게 필요한 다양한 지원서비스 재화를 파악하여 생산하고 배분하며 전달하는 ‘가용성’과 2) 정부, 이해당사자 및 전문가 단체 등 관련 집단들이 이러한 정책과 프로그램에 대해 동의하고 ‘채택’하는 과정과 3) 일련의 과정이 원활하게 진행되기 위해서는 경제적인 ‘감당능력’이 필요하다. 그리고 4) 일련의 과정들에 대한 의사결정 및 정책수행 과정을 체계적으로 수행할 수 있는 ‘조직적인 구조화’ 및 전략적 연합이 이루어져야 한다. 이와 함께 이주민 코호트를 정책적으로 수립할 수 있다면, 근거에 기반을 둔 실질적인 지원시스템을 구축할 수 있을 것이다. Immigrant population has increased recently in Korean society, andthus it is appropriate to establish a comprehensive health care system thatis helpful and fitting for those in the settlement years of immigration. Duringthe initial entry, it is necessary to enforce vaccination to a particular agegroup vaccination (catch-up vaccination), not only for the health ofimmigrants, but for the entire nation of South Korea to prevent infectiousdiseases. Immigrants are also in need of a mental health support. Aftersettlement, a long-term prevention and management of chronic diseasesshould be a major problem, therefore, inclusion of health care services providedto the premises is required during the primary, secondary, tertiary healthservices. To provide services for immigrants in order to improve healthcareaccess 1) ‘availability’ of the support services, 2) and the ‘adoption’ of policiesand programs by the government, professional organizations and other relevantstakeholders, 3) ‘affordability’ which is important in running a series ofsteps smoothly, are require, and 4) a set of processes for decision-makingand policy implementation process to carry out ‘Architecture’ and strategicalliances systematically is needed. In addition, if a policy to establish acohort of immigrants could be implemented, building a substantial fact-basedsupport system would be possible.