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침 시술로 발생한 Non-O1, Non-O139 Vibrio cholerae에 의한 패혈증
임태섭,지아영,이중희,장수연,김인수,김영주,김범경,김승업,박준용,안상훈,한광협,김도영 Ewha Womans University School of Medicine 2013 EMJ (Ewha medical journal) Vol.36 No.S
Vibrio cholerae is mainly known to cause gastrointestinal infection after seawater exposure or raw seafood intake. It is rarely reported to cause cellulitis or sepsis, but threre has been no known case after acupuncture. Herein, We report a 56-year-old cirrhotic patient of non-O1, non-O139 Vibrio cholerae septicemia caused by cellulitis of both lower extremities after acupuncture.
Reference Equations for the Six-Minute Walk Distance in Healthy Korean Adults, Aged 22-59 Years
( Ah Lim Kim ),( Jae Choon Kwon ),( In Park ),( Ji Na Kim ),( Jong Min Kim ),( Bi Na Jeong ),( Sung Ken Yu ),( Byung Ki Lee ),( Yeon Jae Kim ) 대한결핵 및 호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.76 No.6
Background: The six-minute walk test has been widely used in people with chronic cardiopulmonary disorders as an outcome assessment with regards to therapeutic or prognostic determinants. This study was undertaken to determine the six-minute walk distance (6MWD) in a sample of healthy Koreans and to create a reference equation. We also compared the 6MWD of our cohort with previously published equations. Methods: Two hundred fifty-nine healthy subjects (95 males) aged 22-59 years performed two walking tests using a standardized protocol. 6MWD was defined as the greatest distance achieved from the two tests. The effect of anthropometrics on the 6MWD was also investigated. Results: The average 6MWD was 598.5±57.92 m, with significantly longer distances by males (628.9±59.51 m) than females (580.9±47.80 m) (p<0.001). Age, height, weight, and body mass index were significantly correlated with 6MWD in univariate analysis. Stepwise multiple regression showed height to be single independent predictor of 6MWD (r2=0.205, p<0.001). The reference equations derived in Caucasian and North African populations tend to overestimate the distance walked by Korean subjects, while Asian equations underestimate it. Conclusion: The average 6MWD in these Korean populations was 600 m. The regression equation revealed that individual’s height was the most significant predictor of distance, explaining 20.5% of the distance variance.
Lim, Jae Seok,Kim, Woo-il,Kang, Hoon-Chul,Kim, Se Hoon,Park, Ah Hyung,Park, Eun Kyung,Cho, Young-Wook,Kim, Sangwoo,Kim, Ho Min,Kim, Jeong A,Kim, Junho,Rhee, Hwanseok,Kang, Seok-Gu,Kim, Heung Dong,Kim, Nature Publishing Group 2015 Nature medicine Vol. No.
Focal cortical dysplasia type II (FCDII) is a sporadic developmental malformation of the cerebral cortex characterized by dysmorphic neurons, dyslamination and medically refractory epilepsy. It has been hypothesized that FCD is caused by somatic mutations in affected regions. Here, we used deep whole-exome sequencing (read depth, 412–668×) validated by site-specific amplicon sequencing (100–347,499×) in paired brain-blood DNA from four subjects with FCDII and uncovered a de novo brain somatic mutation, mechanistic target of rapamycin (MTOR) c.7280T>C (p.Leu2427Pro) in two subjects. Deep sequencing of the MTOR gene in an additional 73 subjects with FCDII using hybrid capture and PCR amplicon sequencing identified eight different somatic missense mutations found in multiple brain tissue samples of ten subjects. The identified mutations accounted for 15.6% of all subjects with FCDII studied (12 of 77). The identified mutations induced the hyperactivation of mTOR kinase. Focal cortical expression of mutant MTOR by in utero electroporation in mice was sufficient to disrupt neuronal migration and cause spontaneous seizures and cytomegalic neurons. Inhibition of mTOR with rapamycin suppressed cytomegalic neurons and epileptic seizures. This study provides, to our knowledge, the first evidence that brain somatic activating mutations in MTOR cause FCD and identifies mTOR as a treatment target for intractable epilepsy in FCD.
Reference Equations for the Six-Minute Walk Distance in Healthy Korean Adults, Aged 22-59 Years
Kim, Ah Lim,Kwon, Jae Choon,Park, In,Kim, Ji Na,Kim, Jong Min,Jeong, Bi Na,Yu, Sung Ken,Lee, Byung Ki,Kim, Yeon Jae The Korean Academy of Tuberculosis and Respiratory 2014 Tuberculosis and Respiratory Diseases Vol.76 No.6
Background: The six-minute walk test has been widely used in people with chronic cardiopulmonary disorders as an outcome assessment with regards to therapeutic or prognostic determinants. This study was undertaken to determine the six-minute walk distance (6MWD) in a sample of healthy Koreans and to create a reference equation. We also compared the 6MWD of our cohort with previously published equations. Methods: Two hundred fifty-nine healthy subjects (95 males) aged 22-59 years performed two walking tests using a standardized protocol. 6MWD was defined as the greatest distance achieved from the two tests. The effect of anthropometrics on the 6MWD was also investigated. Results: The average 6MWD was $598.5{\pm}57.92m$, with significantly longer distances by males ($628.9{\pm}59.51m$) than females ($580.9{\pm}47.80m$) (p<0.001). Age, height, weight, and body mass index were significantly correlated with 6MWD in univariate analysis. Stepwise multiple regression showed height to be single independent predictor of 6MWD ($r^2$=0.205, p<0.001). The reference equations derived in Caucasian and North African populations tend to overestimate the distance walked by Korean subjects, while Asian equations underestimate it. Conclusion: The average 6MWD in these Korean populations was 600 m. The regression equation revealed that individual's height was the most significant predictor of distance, explaining 20.5% of the distance variance.
김창식(Kim, Chang-S.),임학수(Lim, H.S.),김진아(Kim, Jin-Ah),김선정(Kim, Seon-Jeong),박광순(Park, K.S.),정경태(Jung, K.T.) 한국해안해양공학회 2010 한국해안해양공학회 논문집 Vol.22 No.6
경기만은 한강과 임진강 수계의 하구역을 중심으로 황해의 중부해역을 잇는 매우 중요한 해역이다. 특히 경기만 해역의 연안개발로 인한 하구습지와 연안습지의 훼손이 가속화되고 있다. 이러한 갯벌과 해저 퇴적체의 변화에 대한 이해와 원인 규명을 위해서는 조석 잔차류의 역할이 중요함을 제시하였다(Kim et al., 2009). 하지만 경기만에서의 조석 잔차류에 대한 정량적 연구는 잘 이루어져 있지 못하며, 연간 변동성에 대한 연구도 흔하지 않다. 본 연구에서는 경기만 주수로인 석모수로와 장봉수로에서 1년간 연속 관측한 수층별 조류를 이용하여, 조석 잔차류의 특성과 조류분조의 특성을 정밀하게 분석하였다. Kim et al.(2009)이 제안한 이동평균(Moving average) 기법을 이용하여 연간 월별 그리고 수층별 자료로 확대하여 분석하였다. 또한 조류조화분해를 실시하여 이동평균 기법의 잔차류 특성과 비교하였으며 계절별 수층별 조류분조의 특성을 제시하였다. 비조석성분인 잔차류 산정에는 이동평균 기법과 조류조화분해법이 동일한 결과를 보였으나 단주기 변동성 분석에는 이동평균기법이 장점을 가진 것으로 보인다. 석모수로의 잔차류는 연간 낙조류 방향이며, 표층에서 20-40 cm/s, 저층에서 10 cm/s 미만으로 분석되었다. 장봉수로에서는 연간 창조류 방향의 잔차류는 표층에서 15-30 cm/s, 저층에서 20 cm/s 안팎으로써 여름철에는 강한 경압형 구조를 보인다. 본 연구에서는 해저면에 설치된 음파식 유속계 자료의 처리, 조석잔차류의 산정과 경기만 수로에서의 연간 잔차류 수직 구조와 변동성에 대한 결과를 제시함으로써, 경기 일대의 물질이동과 퇴적체 변동성 연구에 기본적 자료로 활용될 것으로 판단된다. The Kyunggi Bay in mid-west of Korea is a relatively large estuarine system that connects the Han River system with Yellow Sea. Due to macro-tidal range of more than 8 m, the urban estuary shows deep tidal channels and wide tidal flats. Since last 30 years, the coastal development is undergoing, yielding noticeable change in environment. Particularly the tidal flat dynamics are generally accepted as being related with tidal residual flows in this area (Kim et al., 2009). We have estimated the annual variation and vertical structure of residual currents with one-year long observed flows in two major tidal channels of Kyunggi Bay. The moving average method and tidal current harmonic analysis yield nearly the same results on residual flow. The residual flow in Jangbong channel ranges from 20 cm/s in summer to 30 cm/s in winter. It is noticeable that the residual flow in Jangbong channel is flood dominant throughout the year, while the flow in Seokmo channel is ebb-dominant residual flow with current speed range of 20-40 cm/s. Due to the baroclinic response of relatively shallow estuary, significant reduction of energy in bottom layers have been observed, indicating the importance of residual circulation to the tidal flat behavior.
( Yu Ah Hong ),( Jeong Ho Kim ),( Yong Kyun Kim ),( Yoon Kyung Chang ),( Cheol Whee Park ),( Suk Young Kim ),( Yon Su Kim ),( Shin-wook Kang ),( Nam-ho Kim ),( Yong-lim Kim ),( Chul Woo Yang ) 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.1
Background/Aims: Parathyroid hormone (PTH) is an important factor influencing immunologic dysfunction, but the effect of PTH level on infection-related outcomes remains unclear in incident dialysis. Methods: We evaluated a multicenter prospective cohort study of 1,771 incident dialysis patients (1,260 hemodialysis and 511 peritoneal dialysis) in Korea. Patients were divided into three groups based on serum intact PTH (iPTH) level. The primary outcomes were all-cause and infection-related mortality and multivariate Cox regression analysis was performed to evaluate the role of iPTH in all-cause and infection-related mortality. Results: During the follow-up period of 27.3 months, 175 patients (9.9%) died, and infection-related death represented 20% of all-cause mortality. Both all-cause mortality and infection-related mortality rates (p < 0.001 and p = 0.003, by logrank) were markedly higher in patients with serum iPTH < 150 pg/mL than in the other groups. Multivariate Cox regression analysis revealed that patients with serum iPTH < 150 pg/mL remained at higher risk for infection-related mortality than patients in the target range of 150 ≤ iPTH < 300 pg/mL, after adjusting for confounding variables (hazard ratio [HR], 2.52; 95% confidence interval, 1.06 to 5.99; p = 0.04). The HR of infection-related mortality in patients with serum iPTH < 150 pg/mL was significantly higher in patients with low serum phosphorus, low Ca × P product, low serum alkaline phosphatase and those older than 65 years. Conclusions: Low serum iPTH level is an independent predictor of infection-related mortality in incident dialysis patients.
The Association of Visual Impairment With Clinical Outcomes in Hemodialysis Patients
Hong, Yu Ah,Kim, Suk Young,Kim, Su-Hyun,Kim, Young Ok,Jin, Dong Chan,Song, Ho Chul,Choi, Euy Jin,Kim, Yong-Lim,Kim, Yon-Su,Kang, Shin-Wook,Kim, Nam-Ho,Yang, Chul Woo,Kim, Yong Kyun Wolters Kluwer Health 2016 Medicine Vol.95 No.19
<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P>Visual impairment limits people's ability to perform daily tasks and affects their quality of life. We evaluated the impact of visual impairment on clinical outcomes in hemodialysis (HD) patients.</P><P>HD patients were selected from the Clinical Research Center registry a prospective cohort study on dialysis patients in Korea. Visual impairment was defined as difficulty in daily life due to decreased visual acuity or blindness. The primary outcome was all-cause mortality and the secondary outcomes were cardiovascular and infection-related hospitalization.</P><P>A total of 3250 patients were included. Seven hundred thirty (22.5%) of the enrolled patients had visual impairment. The median follow-up period was 30 months. The Kaplan–Meier curve and log-rank test showed that all-cause mortality rates (<I>P</I> < 0.001) as well as cardiovascular and infection-related hospitalization rates (<I>P</I> < 0.001 and <I>P</I> < 0.001) were significantly higher in patients with visual impairment than in patients without visual impairment. In the multivariable analysis, visual impairment had significant predictive power for all-cause mortality (Hazard ratio [HR], 1.77, 95% confidence interval [CI], 1.21–2.61, <I>P</I> = 0.004) and cardiovascular hospitalization (HR 1.45 [1.00–1.90], <I>P</I> = 0.008) after adjusting for confounding variables. Of these 3250 patients, 634 patients from each group were matched by propensity scores. In the propensity score matched analysis, patients with visual impairment had independently significant associations with increased all-cause mortality (HR 1.69 [1.12–2.54], <I>P</I> = 0.01) and cardiovascular hospitalization (HR 1.48 [1.08–2.02], <I>P</I> = 0.01) compared with patients without visual impairment after adjustment for confounding variables.</P><P>Our data demonstrated that visual impairment was an independent risk factor for clinical adverse outcomes in HD patients.</P></▼2>