지주막하출혈에 의해 발생한 Takotsubo 심근병증의 1예

김선영,김우식,박종혁,오명기,권선옥,나종천,조욱현,최석구 인제대학교 2007 仁濟醫學 Vol.28 No.-

A 64-years-old man was admitted to emergency department with symptom of chest pain. The characteristic of symptom was squeezing pain at substernal area. The patient had a history of hypertension and diabetes mellitus. His electrocardiogram(ECG) showed ST elevation in lead Ⅰ, Ⅱ, V3-6 and his laboratory results revealed mild increase in cardiac enzymes. And his echocardiogram showed apical hypokinesis. Based on the suspicious symptoms and results for acute anterior myocardial infarction, we decided to take a coronary angiogram for further evaluation. However, coronary angiogram revealed normal epicardial coronary arteries. He was admitted at Intensive Care Unit for monitoring and treatment of heart failure. After 3 days of hospitalization, his mental status was changed. His brain computed tomography revealed subarachnoid hemorrhage. After 5 days, hypokinesis of apex was improved to nearly normal on echocardiogram. This is a case of transient left ventricular apical ballooning or takotsubo cardiomyopathy associated with subarachnoid hemorrhage.

Sol-gel 공정에 의한 Silica sol의 합성 및 특성

이봉우,최용욱,우기석,박문수,김선일 조선대학교 생산기술연구소 1998 生産技術硏究 Vol.20 No.1

Reaction completion time was investigated to measure OH/CH ratio as reaction time at 25℃. In 50 and 60 minute reaction was completed in 1.0 ratio that was reached equilibrium state. In another method, equilibrium, state was investigated by measuring volume% of C₂H_(5)OH. From 40 to 50 minute. that was reached at 61.6 of volume% After reaction. monomer and tetrasilicate(92%) as main product was discovered and so oligomer(6%). Mean molecular weight (Mw) of sol solution was about 7.000. The beginning point and ending point of hardening was measured through the TGA investigation of reaction material. The hardening of sol solution was complected in 7 minute and viscosity was maximum from 4 to 5 minute and was set at 9 minute.

각종 소화성질환에서의 Campylobacter Pylori의 검출에 관하여

허정욱,강영우,박준호,박승국,하경임,김재룡,안성훈,박선우 啓明大學校 醫科大學 1988 계명의대학술지 Vol.7 No.2

Peptic disorders are among the most common maladies in korea as the world. In most cases their etiologies not be established and their pathophysioolgy remain obscure. Although the persence of fastric bacteria has been logn established, recently campylobacter pylori seems to be etiologic agent of peptic disorders. Campylobacter pylori is visualized in most cases of peptic disorders and not visualized after treatment of bctericidal agents, bismuth compound or metronidazole. We had a following results for identification of campylocacter pylori in stomach and duodenal mcuosa via endoscipc biopsy. 1. We studied 54 patients who had dyspeptic symptoms, 29 males. 2. Most patients are in 5th decades, next in 3rd and 6th in order. 3. Ptients were composed of 27 peptic ulcer, 22 gastitis and 5 gastric carcinoma. 4. Campylobacter pylori was identified in 69% of total patients, peptic ulcer 63%, gastritis 77%, stomach carcinoma leastly.

급성 ST 분절 상승 심근경색증의 표준진료지침 설계

권선옥,김우식,오명기,나종천,이홍기,조욱현,최석구 인제대학교 2006 仁濟醫學 Vol.27 No.-

The use of critical pathways for a variety of clinical conditions has grown rapidly in recent years, particularly pathways for patients with acute myocardial infarction. We intend to determine the impact of a clinical pathway on ST-elevation myocardial infarction (STEMI) and to evaluate the efficacy and safety of facilitated percutaneous coronary intervention (PCI) compared with primary PCI. Low risk STEMI patients (ST elevation >0.1mV in more than 2 limb leads or ST elevation >0.2mV in contiguous precordial lead, chest pain lasting more than 30 min without response to nitroglycerin) will be included. All patients will be also treated medically according to critical pathway. STEMI is one of the common diseases in emergency medicine and so it is necessary to establish realistic treatment guidelines. The use of critical pathways will improve the quality of care.

CaS : Ce와 Ca_1-χSr_χS : Ce 형광체의 Photoluminescence 특성

황해선,이우교,김영욱 동의대학교 기초과학연구소 1995 基礎科學硏究論文集 Vol.5 No.1

CaS:Ce and Ca_1-χSr_χS:Ce phosphors have been prepared using the sulfurizing flux method and the result of measuring photoluminescence is presented two peaks with extensively strong intensity, when flux (Na₂CO₃) is mixed 30 mol% and activator doped 0.1 mol% in the host (CaS). The two peaks of CaS:Ce phosphor are appeared at 513㎚ and 576㎚ wavelengthes when liminescenct transition in Ce^3+ is given as 5d(²D)→4f(²f_5/2) and 5d(²D)→4f(²f_7/2) and that of Ca_1-χSr_χS:Ce phosphor are shifted toward short wavelength as much as 30㎚ when χ is changed from 0 to 1, but the shape of wavelength is not varied.

아로마요법이 혈액투석환자의 불안과 우울에 미치는 효과

이명화,고광욱,송명숙,우경미,조선화 대한기초간호자연과학회 2004 Journal of korean biological nursing science Vol.6 No.1

Introduction : Chronic hemodialysis patients have been psychological problems because of being compelled to follow a dialysis schedule for a long period of time. Specificially, depression and anxiety are so frequently observed that psychological management is requireed for most hemodialysis patients. Fragnance has been known to have beneficial psychological and physiological effects on human. This study was designed to investigate the psychological effect of aromatherapy on chronic hemodialysis patients. Methods : 40 subjects of this study selected from Je Young-Sung Internal Medicine Clinic in Busan. The experimental group were random assigned to 20 subjects who had visited on Monday,& Wendesday & Friday and received aromatherapy every day for 2 weeks. the control group were random assigned to 20 subjects who had visited on Tuesday & Thursday & Saturday and did not receive any intervention. Experiment had been conducted from July. 7th July 21, 2003 and anxiety by Spilberger's state anxiety scale and depression by Zung's Scale were measured in the course of aromatherapy for both experimental group and control group. A control period consisting of natural hospital smells was established before each test session, and then aromatic test conditions were systematically evaluated for odorless conditions as well as aromatic conditions containing 100% lavender necklace for 2 weeks. Data were analyzed by, frequency, percentage, mean, S.D. χ²- test, t-test. Results : 1) Anxiety scores were not significantly decreased in the experimental group(54.57±13.20) after treatment compared to the control group(49.45±12.41)(t=1.225, p=.228). 2) Depression scores were significantly decreased in the experimental group(43.95±5.63) after treatment compared to the control group(49.65±9.84)(t=-2.367, p=.023). Conclusions : These findings indicate that the aromatherapy may decreased depression. It is suggested that the aromatherapy could be an effective nursing intervention to reduce to depression by chronic hemodialysis patients.

일개 대학병원근무자들에서의 인플루엔자 예방 접종 순응도 관련요인

정희진,손장욱,최선주,엄중식,우흥정,천병철,김우주,박승철 대한감염학회 2004 감염과 화학요법 Vol.36 No.4

목적 : 병원근무자에서의 인플루엔자 예방 접종은 병원내에서 인플루엔자 전파를 막기위한 수단으로 적극 권장되고 있으나 매년 인플루엔자 백신을 접종하는 병원근무자들은 소수에 지나지 않는다. 본 연구는 병원근무자들에서의 인플루엔자 예방 접종률을 향상시키기 위한 목적으로 첫째, 백신 접종자에서의 인플루엔자 백신 접종 계기를 알아보고 둘째, 인플루엔자 백신접종의 장애요인을 분석하여 그 문제점을 해결하는데에 목표가 있다. 재료 및 방법 : 서울 1개 대학병원의 병원종사자들을 대상으로 1999년 10월 1개월에 걸쳐 인플루엔자 예방 접종을 하도록 한 후 2000년 3월에 접종군과 비접종군을 대상으로 구조화된 설문지를 이용한 설문조사를 실시하였다. 백신 접종군을 대상으로 백신접종의 동기(que to action), 비접종군을 대상으로는 접종에의 장애요인(barrier) 등을 조사하였다. 이 외에도 양군을 대상으로 인플루엔자에 대한 지식 척도, 인플루엔자 백신으로 기대되는 효과(benefit)등에 대한 설문조사를 시행한 후 정답률을 조사하였다. 결과 : 1) 설문 조사에 응한 총 수는 309명으로 간호사가 60% 이상이었다. 백신접종군은 평균연령, 평균 근무연수가 비접정군에 비하여 유의하게 길었으나 성별, 직종별 분포는 양 군간 차이가 없었다. 2) 인플루엔자 예방 접종의 필요성에 대한 지식정도에 있어 접종군의 934%가 그 필요성을 잘 인식하여 비접종군의 779%보다 유의하게 높았으나 예방 접종이 필요한 구체적 이유에 대한 정확한 이해는 접종군 113%, 비접종군 119%에 불과하였다. 3) 인플루엔자 예방 접종을 받은 의료인들의 행동계기는 ‘감염관리실의 홍보’와 ‘주위사람들의 권유’에 의한 경우가 26.9%, 21.6%로 가장 많았고 본인이나 가족, 친구들을 통한 일종의 감지된 위협 때문에 접종한 경우 31명(186%)의 순이었다. 4) 비접종자들에서 예방 접종을 시행치 않은 가장 흔한 이유는 ‘업무에 바쁘고 시간이 없어서’라는 항목이었으며(37.3%) 특히 의사 집단에서는 이러한 이유가 68.8%로서 압도적으로 많았다. 간호사나 기타 직종에 종사하는 직원들의 경우는 자신의 건강에 대한 확신이 30%내외에 달하였고 예방 접종 자체의 효과에 의문을 갖는 경우도 직종에 따라 6.3-29.7%에 달하였다. 결론 : 병원근무자에서 인플루엔자 예방 접종률을 향상시키기 위해서는 백신 접종의 장애물(효과의 의문, 부작용)을 효과적으로 제거하고 인플루엔자 백신의 필요성과 효과를 인식시키기 위한 교육과 함께 시간, 공간상의 제약을 배제할 수 있는 접근성의 문제를 해결하여야 할 것으로 사료된다. Background : In spite of yearly recalls, influenza immunization rate among healthcare workers (HCWs) remained low in Korea University Guro Hospital. This study was conducted to identify the causes of non-compliance against influenza immunization and to analyze the barrier factors for the immunization. Materials & Methods : Questionnaires were distributed in March of 2000 at Korea University Guro Hospital. We evaluated factors associated with acceptance of influenza vaccination and opinions regarding influenza prevention (knowledge about influenza vaccination efficacy, que to action in vaccinee, perceptible benefit, barrier to vaccination). Results : 309 completed questionnaires from HCWs were returned. Mean age and mean duration of work in hospital were higher and longer among vaccinee than non-vaccinee. Even though the necessity of influenza vaccination among HCWs were accepted well in vaccinee compared to nonvaccinee, the accurate reasons for vaccination were not quite understood among HCWs regardless of compliance. Vaccine campaign (30.8%) and advise from doctors (24.7%) were important for the promotion of vaccination among vaccinee. However, major reason for non-compliance among nursing staff and was mis-confidence that their bodies' self defense mechanisms would ward off infection (33.5%) and 'too busy to get injection' for doctors (65%). Conclusion : We conclude that regular education about perceptible benefits and wrong concerns about influenza vaccination among HCW's and easy accessibility to vaccination were important determinants to improve the influenza vaccination. On-site availability of a vaccination-nurse also proved to be important.

민항기 소음 예측을 위한 데이터베이스구축에 관한 고찰

송혁,송민정,최형욱,김선우 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The prediction of aircraft noise is based on the database of airplane's noise characteristics such as take-off and landing style etc. In this study, to predict the airplane flight noise, airplane which is being used for passengers and cargos currently are surveyed. The airplanes were divided into types and the noise characteristics of take off, flight at constant speed and landing were analyzed to establish database for prediction of aircraft noise. And the result of this study should be connected with GIS(Geographic Information System) to measure the area which is affected by aircraft noise.

국내 조혈모세포이식 환자에서 Human Cytomegalovirus gB 유전형의 분포와 질환과의 연관성 : 예비 보고

최수미,김진희,이동건,박선희,최정현,유진홍,박철민,이종욱,민우성,황응수,신완식,김춘추 대한감염학회 2007 감염과 화학요법 Vol.39 No.2

목적 : 사람 거대세포바이러스(Human cytomegalovirus, 이하 HCMV) glycoprotein B (gB)는 UL55 유전자에 의해 부호화되는 당단백으로, UL55 유전자의 염기서열변화에 따라 4가지 유전형으로 나뉜다. 본 연구에서는 국내 조혈모세포이식 환자들에서 HCMV gB 유전형의 분포와 그 특성을 알아보고, gB 유전형에 따라 특정 HCMV 질환 발생과 연관이 있는지 그 임상적 의미를 분석해 보고자 하였다. 재료 및 방법 : 동종 조혈모세포이식 환자 52명의 혈액검체 94개에 대해, Chou 등이 제시한 방법에 따라, 먼저 UL55 유전자 부위를 nested PCR로 증폭한 후, RsaI과HinfI으로 Restriction fragment length polymorphism(RFLP) 분석을 시행하였다. 결과 : gB type 1은 73.1% (38/52), gB type 2는 13.5%(7/52), gB type 3는 1.9% (1/52), gB type 1과 type 2에 의한 혼합감염은 9.6% (5/52)로 나타났다. gB type 4는 관찰되지 않았다. 1명(1.9%)에서 gB 유전형을 결정할 수 없었는데, RFLP 패턴으로 보아 Trincado 등이 제시한 gB type 7에 해당하는 것으로 생각되었고, 이 새로운 아형에 대해서는 현재 염기서열 분석 중이다. 52명 중 5명(9.6%)에서 HCMV 질환이 발생하였고, 3명에서 HCMV 폐렴, 1명에서 망막염과 위장관염, 나머지 1명에서 망막염이 발생하였다. 5명 중 HCMV 질환과 관련하여 사망한 예는 없었고, 감염된 HCMV는 모두 gB type 1이었다. HCMV gB유전형과 HCMV 질환 발생 사이에 유의한 연관성은 없었고, 단일 주에 의한 감염과 혼합감염에 따른 HCMV 질환발생 사이에도 유의한 연관성은 관찰되지 않았다. 자료 분석 중 gB type 2에 감염되어 있던 환자에서 gB type 1에 재감염 되면서 발열, 간효소 수치 상승 및 pp65 HCMV 항원혈증이 나타난 예가 있었다. 결론 : 연구결과 gB type 1이 아주 우세하고, gB type 4는 검출되지 않았으며, 혼합감염의 빈도가 비교적 낮은 분포를 보였다. 이는 외국의 보고와는 다른 국내 조혈모세포이식 환자에서의 독톡한 감염 양상으로 추정된다. 본 연구에서 HCMV gB 유전형과 질환 발생과의 연관성을 밝힐 수는 없었으나, HCMV 유전형에 대한 연구는 바이러스 감염의 발병기전이나 전파 경로 및 양식과 같은 역학적 연구에 중요한 자료가 될 것이다. 현재 더 많은 수의 조혈모세포이식 환자를 대상으로 연구가 진행 중에 있으며, 앞으로 다른 질환군의 환자나 건강한 잠복 감염자에서의 추가 연구가 필요할 것으로 생각된다. Background : Human cytomegalovirus (HCMV) glycoprotein B (gB) is the major envelope glycoprotein, encoded by the UL55 gene. Based on sequence variation in the UL55 gene, HCMV can be classified into four gB genotypes. Previous studies have suggested an association between HCMV gB genotypes and clinical outcome in the immunocompromised hosts. The goal of this study was to determine the distribution of HCMV gB genotypes and the effect of gB genotype in the developement of HCMV diseases in hematopoietic stem cell transplant (HSCT) recipients in Korea. Materials and Methods : DNA was extracted from 94 blood specimen of 52 allogeneic HSCT recipients with HCMV infection. HCMV gB genotype was determined using polymerase chain reaction to amplify a region of UL55, followed by restriction fragment length polymorphism (RFLP) analysis based on RsaI and HinfI digestion. Results : The distribution of gB types were as follows: gB1, 73.1% (38/52) of patients; gB2, 13.5% (7/52); gB3, 1.9% (1/52) and mixed infection (gB1 and gB2), 9.6% (5/52). While gB4 was not detected, a new genotype (described as gB7 by Trincado et al, 2000) was identified on the basis of their RFLP pattern. During average 708 days’ follow up period, HCMV diseases developed in 5 patients. All of them had gB1 genotype. There was no statistically significant association between the incidence of HCMV diseases and the gB genotypes. Re-infection with gB1 strain was detected in one patient who had been previously infected with gB2. This episode was associated with fever, elevated liver enzyme and positive antigenemia. Conclusion : HCMV gB1 was the dominant genotype and no gB4 was detected in allogeneic HSCT recipients in Korea, which is an unique pattern compared with the previous reports. Although we can not find significant association between the HCMV diseases and the gB genotypes, genotyping of HCMV will serve in the study of pathogenesis and transmission of this virus in transplant patients. Further study is underway with large study population.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.