서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

한국인 제1형 당뇨병에서 체도 세포질 항체의 양성률 : 항GAD항체, 항ICA512항체, 항phogrin항체의 조합 측정으로의 대체 가능성 Possible Replacement with Combined Measurement of Anti-GAD, Anti-ICA512, and Anti-phogrin Antibodies

김경아,김동준,정재훈,민용기,이문규,김광원,진동규,고경수,김상진,이명식 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:최근 당뇨병의 분류를 새로 제정함에 있어 자가항체가 양성이면 임상형에 상관없이 제1형 당뇨병으로 분류하자는 제안이 나옴으로써 자가항체의 중요성은 더욱 커질 것으로 예상된다. 특히 우리나라와 같이 비비만형인 제2형 당뇨병이 많은 나라에서는 당뇨병의 병인 규명에 자가항체가 중요한 위치를 차지할 것으로 사료된다. 자가항체 중에서 전통적으로 측정되어온 췌도 세포질 항체(ICA)는 표준화하기 어렵고 기술적으로 제한점이 많으며 현실적으로도 췌장 공여자가 적은 점 등이 문제로 알려져 있다. ICA의 대응 항원들로는 GAD(glutamic acid decarboxylase), IA­2(islet­associaated antigen­2;ICA512), IA­2β(phogrin)등이 있다. 이러한 대응 항원에 대한 특이적인 자가항체의 측정은 ICA에 비해 표준화되었으며 최근에는 방사면역측정법(radioimmunoassay;RIA)키드까지 등장하여 손쉽고 정확히 이를 측정할 수 있게 되었다. 연구자들은 한국인 제1형 당뇨병에서 측정법이 표준화 되어 있는 항GAD항체 및 항ICA512항체 조합(combimation)의 조합으로 ICA의 측정을 대신할 수 있는지를 조사하였고 더 나아가 항phogrin항체의 조합 측정으로 임상적 유용성이 있는지 보고자 하였다. 방법: ICA는 면역조직화학 염색법을 이용하였다. 항 GAD항체는 상업화 된 키드(RSR??, United Kingdom)를 이용하였다. 항 ICA512항체와 항phogrin항체의 측정은 in vitro transcription&translation한 후 이를 이용해 방사면역 침전법을 이용하였다. 대상 환자로는 전형적 제1형 당뇨병 76명, 지진형 제1형 당뇨병 22명, 제2형 당뇨병 39명이었으며 각 군간의 연령은 각각 22.8±14.0, 37.9±13.9, 45.3±12.3세였다. 결과:1)전형적인 제1형 당뇨병에서는 ICA의 양성률이 30%, RIA조합만의(항GAD항체 또는 항 ICA512항체 또는 항phgrin항체 한가지에라도 양성인 경우)양성률이 57%이었다. 지진형 제1형 당뇨병에서는 각각 18%, 50%이었다. 제2형 당뇨병에서는 각각 7.7%, 5.1%이었다. 2)각 군에서 ICA가 양성인 군에서 RIA조합 양성률을 보면 전형적 제1형 당뇨병에서는 96%, 지진형 제1형 당뇨병에서는 100%에서 양성이었고 제2형 당뇨병에서는 RIA 조합 양성이 없었다. 각 군에서 ICA가 음성인 군에서도 RIA 조합시 전형적 제1형 당뇨병에서는 40%, 지진형 제1형 당뇨병에서는 39%에서 양성이었고, 제2형 당뇨병에서는 5.6%에서 양성이었다. 3)전형적 제1형 당뇨병에서 ICA가 양성인 군(n=23)에서 96%가 RIA조합 양성이었는데 이때 각각의 RIA유형을 보면 항GAD항체 양성이 87%였다. 한편 항 ICA512항체 양성이 48%, 항phogrin항체 양성이 44%이고 항GAD항체 도는 항ICA512항체 양성이 96%를 차지한다. 지진형 제1형 당뇨병에서는 ICA가 양성인 군(n=4)에서는 항 GAD항체 양성이 3명, 항ICA512항체 양성이 1명이었다. 따라서 기존의 ICA를 RIA조합으로 대체할 수 있을 것으로 사료되었는데 이때 항GAD항체와 항ICA512항체의 조합이 도움이 되겠고 항phogrin항체의 추가적인 검사는 일부의 환자에서만 도움이 되리라 사료된다. 4)이환 기간에 따라 ICA와 RIA조합을 비교시 ICA는 차이가 없었으나 RIA조합의 양성률은 지진형 제1형 당뇨병에서 4년 이상의 이환 기간이 지나면 그 이전보다 떨어졌다. 5)발병 연령에 따라 ICA와 RIA조합을 비교시 ICA 양성률이 전형적 제1형 당뇨병에서 15세 이전에 발병한 그룹에서 그 이후에 발병한 그룹보다 유의하게 높았다. 결론:이상의 결과를 요약하면 항GAD항체 및 항ICA512항체 측정의 조합은 ICA보다 민감도가 높아 기존의 ICA를 대체함은 물론 임상적 이용에서 현격한 우월성을 보이며, 성인에서 발병한 비전형적인 당뇨병의 분류에도 도움이 될 것으로 사료되었다. 추가적인 항phogrin항체의 측정은 임상적 유용성이 없었다. Background : Type 1 diabetes includes all forms of autoimmune-mediated and idiopathic beta-cell destruction leading to an absolute insulin deficiency. Evidence of an autoimune pathogenesis was assessed by studying cytoplasmic islet cell antibodies (ICA), antibodies to glutamic acid decarboxylase (GADA), antibodies reacting with an islet tyrosine phosphatase-related molecule referred to as ICA 512 (ICA 512A), or its homologue phogrin (phogrin-A). In comparison with ICA, the best validation to assess the risk of type 1 diabetes, shows that a combination of antibodies to GADA with ICA 512A has the power to detect a majority of ICA and 97 ~ 100% of subjects who progressed to overt diabetes. These findings suggest the possibility of replacing the laborious ICA test in the screening programs to identify subjects at risk of progressing to type 1 diabetes or for classifying the stage of diabetes at the time of diagnosis. Up to now, it is unclear whether these results are applicable to the slowly progressive type 1 diabetes that appears to be more prevalent in Asian than in western countries. The prevalence of combined autoantibody testing (1≥ of GADA, ICA512A, or phogrin-A) was investigated in the patients with type 1 diabetes (typical and slowly progressive) and type 2 diabetes, and compared with that of ICA which is a more laborious and insensitive test. Methods : The ICA assay was performed using immunoenzymatic staining of frozen human (blood group O) pancreatic sections with serial dilutions of serum samples with peroxidase-labeled protein A. For the GADA determination, commercially available GADA radiommunoassay kits utilizing the ^125I-labeled recombinant GAD65 (RSR®, United Kingdom) as an antigen was used. Either ICA512A or phogrin-A were detected by a radioligand-binding assay after in vitro transcription and translation using the clone ICA512bdc or phogrin c DNA. Serum was obtained from 76 patients with type 1 diabetes(mean age 45.3± 12.3 years). Typical and slowly progressive type 1 diabetes patients had the disease for between 4.0±4.6 and 10.1±9.5 years, respectively at the earliest serum sampling. Results: 1) In typicaltype 1 diabetes, 30% of patients tested positive for ICA and 57% for the combined autoantibody test. In type 2 diabetes, 7.7% and 5.1% tested positive, respectively. 2) Ninety-six percent of ICA-positive patients expressed one or more of the 3 auto-antibody specificities in typicaltype 1 diabetes. Among the 53 ICA-negative patients with typicaltype 1 diabetes, 40% had one or more of these auto-antibodies. In the slowly pregressive type 1 diabetes, 100% of the ICA-positive and 39% of the ICA-negative patients expressed one or more of the 3 autoantibody specificities. 3) Of the 23 patients with ICA-positive typical type 1 diabetes patients, 87% had a positive result for GADA, 48% FOR ICA512A, 44% for phogrin-A, and 96% for GADA or ICA512A. Of the 4 patients with ICA-positive slowly progressive type 1 diabetes, three had a positive result for GADA, and 1 for ICA512A. 4) When the prevalence of combined autoantibody testing was analyzed according to the duration of diabetes, the prevalence in patients tested within 4 years after the diagnosis and more than 4 years after the diagnosis was 61% and 52%, respectively in typical type 1 diabetes. Furthermore, that for the ICA was 37% and 21%, respectively. In the slowly progressive type 1 diabetes, the prevalence of combined auto-antibody testing was 88% and 25%, respectively (p<0.05), while that of ICA was 25% and 13%, respectively. 5) In typical type 1 diabetes, ICA were detected more frequently in patients younger than 15 years of age (48%) than in older patients (23%) (p<0.05), while the prevalence of combined auto-antibody testing -was not different according to the onset age(65% vs 53%). Conclusion : Combined autoantibody testing for GADA and ICA512A is more sensitive that ICA in type 1 diabetes. Therefore, it could replace the laborious ICA measurement and may be useful for discriminating the etiology of adult onset a typical diabetes(J Kor Diabetes Asso 25 :430~445, 2001).

Antiadhesive effect and safety of oxidized regenerated cellulose after thyroidectomy

Kyoung Sik Park,Kyu Eun Lee,Do Hoon Ku,Su-Jin Kim,Won Seo Park2,Hoon Yub Kim3,,Mi Ra Kwon1,Yeo-Kyu Youn1 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.84 No.6

Purpose: To evaluate the antiadhesive effects and safety of an oxidized regenerated cellulose (Interceed) after thyroidectomy. Methods: Seventy-six thyroidectomized patients were prospectively randomized into two groups with regard to the use of Interceed. We evaluated each group for their adhesive symptoms using four subjective and four objective items at the 2nd week, 3rd and 6th month after thyroidectomy. All patients were examined for vocal cord motility by indirect laryngoscope at each period. Results: Total adhesion scores at each postoperative follow-up period decreased with time, but were not significantly different in each group. The median score for swallowing discomfort for liquid was significantly lower in the Interceed group than in the control group 2 weeks after surgery. In addition, the severity of skin adhesion to the trachea was reduced in the Interceed group compared with the control group 6 months after surgery. During the study, there were no adverse effects or significant differences in postoperative complications between the groups. Conclusion: Interceed appeared to be safe and effective in improving neck discomfort at early postoperative periods and preventing skin adhesion to the trachea 6 months after thyroidectomy.

후복막강경 근치적 신적출술 : 개복 근치적 신적출술과의 비교

김경영,임동훈,문형윤,노준,김철성 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S

Purpose: Although kidney is located in the retroperitoneal space laparoscopic radical nephrectomy is usually performed by the transperitoneal approach. At our institution the retroperitoneal approach is preferred. We evaluated the surgical outcomes, safety, oncologic outcomes, and compared with the results those of open radical nephrectomy in a contemporary cohort. Materials and Methods: Between January 2000 and December 2005 we performed retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma in 37 patients with clinical stage cT1 and cT2. Data from the these patients were retrospectively compaired with 30 contemporary cases treated with open radical nephrectomy. The clinical parameters including perioperative outcomes, complications, pathologic data, learning curve and recurrence were evaluated. Results: For the 37 retroperitoneal radical nephrectomies mean tumor size was 4.6cm (range 2.3 to 8.0), surgical time was 203.6min (range 110-410) and blood loss was 241.8cc. Mean specimen size was 10.4cm (8.7-14.4). Mean analgesic used day was 1.3 (0-4) and mean postoperative hospital stay was 4.2 days. minor complications occur in 16 cases and no major complications occurred. Surgical margins were negative for tumor in all patients. Variable parameters were comparable between patients undergoing laparoscopic and open radical nephrectomy. However, laparoscopy resulted in decreased blood loss, surgical times, analgesia use, time to oral intake, time to drain removal and postoperative hospital stay. No different complication rate is between two groups Conclusions: Retroperitoneal laparoscopic radical nephrectomy can be a safe and effective treatment in renal cell carcinoma. Although no long-term follow-up is available, our follow up to mean 31 months confirm the effectiveness of retroperitoneal laparoscopic radical nephrectomy in terms of surgical principles and oncological effectiveness.

절수에 의한 Mongolian Gerbil 장기중량변화에 관한 분석연구

김무강,이기훈,이강이,송치원,이경열,권효정,박미선,정승혁,이행연,김명철 충남대학교 수의과대학 동물의과학연구소 2000 動物醫科學硏究誌 Vol.8 No.-

In this study, authors measured the each organ weight of the long term water deprived Mongolian gerbil, after then we calculated the mean, standard deviation, variance coefficient of the real measured organ weight and induced the organ weight change quantity, rate of quantity, deviation between measured and theological organ weight, deviation rate, sum of deviation rate, organ weight change rate, rate of organ weight by the mathematical formula. The results obtained as follow 1. The weight of the brains, lung, and testis were abruptly decreased after water deprived until the 5th day, after then slowly decreased until the 20th day. 2. The weight of the heart was decreased gradually from the first day until the 20th day. 3. The weight of the liver was abruptly decreased until the 10th day, after then the more slowly decreased until the 20th day. 4. The weight of the thymus, spleen, kidney, and pancreas were abruptly decreased until the 15th day, after then increased slowly until 20th day but the weight of the kidney was abruptly increased from the 10th day. 5. The organ weight change rate and the rate of the each day organ weight were very diversified.

폐좌상시 폐단락률과 PEEP치료의 효과

김영식,황성오,최경훈,안무업,오중환,임경수,윤정환,강성준 大韓應急醫學會 1992 대한응급의학회지 Vol.3 No.1

To evaluate the physiologic extent of pulmonary contusion and effect of PEEP therapy for pulmonary contusion, we studied 16 patients received PEEP therapy with pulmonary contusion from nonpenetrating chest trauma. Hemodynamic parameters including pulmonary vascular resistance index and intrapulmonary shunt fraction were calculated from standard measurement, and arterial oxygen tension was measured. Pulmonary vascular resistance index and intrapulmonary shunt fraction were increased in patient group. Arterial oxygen tension was decreased with increase of the intrapulmonary shunt fraction(R=0.75). Arter minimal PEEP therap(5-10 ㎝H₂O), pulmonary vascular resistance index was remained unchanged and intrapulmonary shunt fraction was decreased without significant changes of pulmonary hemodynamics. Increment of arterial tension was increased with decrease of intrapulmonary shunt fraction(R=0.43). Decreased stroke volume index suggested of cardiac injury such as cardiac contusion in patient group. These results of our study suggested that increased intrapulmonary shunt fraction caused arterial hypoxia in pulmonary contusion and arterial oxygen tension was increased as a result of reduced intrapulmonary shunt by PEEP therapy.

소아환자에 있어서 외상방지를 위한 마우스가드의 치험례

김경희,김종수,유승훈 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

구강악안면 영역의 외상은 치아파절, 탈구, 골절, 연조직 손상을 일으킬 수 있으며, 뇌진탕의 원인이 되기도 한다. 미국과 일본에서는 contact sports일부에서 마우스가드의 장착이 의무화되어 있으나, 현재 한국에서는 운동 시 마우스가드의 장착을 거의 볼 수 없는 실정이다. 마우스가드는 크게 ready-made type과 custom-made type으로 나눌 수 있다. Ready made type의 마우스가드에는 형태가 일정하고 조정이 곤란한 stock mouthguard와 다소 조정이 가능한 mouth formed mouthguard가 있다 Custom-made type의 마우스가드는 적합성이 뛰어나며 정확한 교합, 하악위를 재현할 수 있다는 장점이 있다. 마우스가드는 입술과 구강연조직을 치아로부터 보호하고, 치아에 가해지는 충격을 분산시켜 파절이나 탈구가능성을 줄여준다. 또한, 악골의 골절과 변위를 방지하고 충격을 흡수한다. 성장기 아동의 경우 치아손상의 30% 정도가 스포츠나 레포츠에 의한 것이라는 보고가 있으며 이 경우 치아나 잇몸은 물론 성장 중인 치조골에 악영향을 주게 된다. 이 때 외상처치는 어려우며, 그 예후 또한 불명확하다. 따라서 성장기 아동의 마우스가드 장착은 외상 예방차원에서 중요하다. 이에 저자는 단국대학교 치과병원에 내원한 환아에게 ERKODEN^(?)사의 ERKOFORM-RVE를 이용한 흡입성형 마우스가드(vacuum type mouthguard)를 적용한 임상경험을 보고하는 바이다. Dentofacial trauma can result in tooth fracture, avulsion, facial bone fracture. The Unites states and Japan mandated the use of mouthguards for contact sports. But, Korean didn't. Mouthguards divided into ready-made type and custom-made type. Mouthguards protect the lips, intraoral soft tissues, teeth and provide the mandible with resilient support to prevent jaw fracture and dislocations. Sports-related accidents have been reported to be one of the most common causes of dentofacial trauma. Sports trauma of involving teeth with incomplete root formation cause long chair time, multiple visit, economic considerations, additional dental services. So, mouthguards can offer considerable protection against sports-related trauma.

겨울철 제주연안 열수지 특성 : 강설현상 snowfall

김경보,장승민,김태희,우종규,윤용훈 濟州大學校 海洋硏究所 2004 해양과환경연구소 연구논문집 Vol.28 No.1

In other to know the characteristics of the air sea heat flux at on the coastal of Jeju Island. when there was a snowfall in winter. It is used as the basic data are Automatic Synoptic Observation System(ASOS) compiled by Jeju Regional Meteorological Office(JRMO) from 1993 to 2002, and SST data derived from National Oceanographic Research Institute(NORI) and National Fisheries Research & Development Institute(NFRDI) observations. the heat flux of the coastal of Jeju Island shows its maximum in January(latent heat flux : 35Wm^(-2) , sensible heat flux : 85Wm^(-2)), and shows its minimum in July(latent heat flux : -l3Wm^(-2), sensible heat flux : -5Wm^(-2)) the more the temperature gap between the air and SST is large and the stronger a wind is, the more it supplies the heat from the sea to the air. it shows that the north-western areas is about three times higher than other areas in Jeju Island. when fresh snow cover is 0.0∼0.9 ㎝, the mean bowen's ratio(for 1993∼2002) is 0.63∼0.67. when it is 1.0∼4.9 ㎝, the mean bowen's ratio(for 1993∼2002) is over 0.72 or more. When bowen's ratio increased upto 0.63∼0.80. fresh snow cover is increased gradually, therefore, it is researched the there is proportion between the fresh snow cover and the bowen's ratio.

건축공사시방서에서의 KS규격의 국제인증방안에 관한 연구

김경식,이재섭,김용수,이규진,조용훈,최완철,전재열,이현수,구재동,이기환 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

The purpose of this research is make out construction specifications for International Construction. Using off-shore products incur cost increase and longer delivery term of construction. and inconvenient on International Construction. Expand the range of additional local products conforming to performance. Life Cycle Cost. maintainability. operability. user's acceptability, etc.. And this study is suggest the standard formats and the techniques for construction specification.

음낭외상시 고환파열에 대한 초음파 검사의 진단적 유용성

김경영,한동준,신대은,노준,문형윤,임동훈,김철성,박성운 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3

Purpose: We determined the use of scrotal ultrasonography in the initial diagnosis and management of testicular injuries due to blunt scrotal trauma. Mateiials and Methods: We reviewed 54 patients of scrotal trauma in the last 8 years. Forty patients were evaluated by ultrasonography preoperatively. A heterogeneous echo pattern of the testicular parenchyma with loss of oval shape, contour definition was the basis for diagnosis of testicular rupture. Among them, 33 cases underwent scrotal exploration and 7 cases were managed conservatively. The remaining 14 patients were evaluated only by physical examination, 8 patients of them were explored immediately because of suspicious testicular mpture. The accuracy of ultrasonography were determined by comparing radiographic interpretations with intraoperative findings. Results: Among the 33 patients who were evaluated by ultrasonography and explored immediately, there were 26 suspected testicular ruptures on ultrasonography. Surgical exploration revealed testicular rupture in 23 and simple hematoma in 10. The testicular rupture was correctly diagnosed by ultrasonography in the 22 cases, and there were 4 false-positive and 1 false-negative diagnoses of testicular rupture. The sensivity and specificity for the diagnosis of testicular rupture are 96% and 60%, and the positive and negative predictive values are 85% and 86%, respectively, Conclusions: Scrotal ultrasonography, with the main radiographic finding of a heterogeneous echo pattern of the testicular parenchyma with loss of oval shape, contour definition, is highly sensitive on the diagnosis of testicular rupture. And it increases the salvage rate for testicular rupture with preservation of the testicular function and prevents delayed complications of chronic pain, atrophy and orchiectomy associated with missed testicular rupture.