대형 화재로 인한 사상자의 손상 유형과 합병증 : 동인천 라이브호프 화재를 중심으로

신중호,김재광,염석란,신종환,민순식,임용수,양혁준,이근,황성연 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: High risks of fire alway exist for buildings in urban areas, especially those in downtown. Crowds, as well as more complex and larger structures, may cause more victims in the event of fire; therefore, emergency medical service plans must be established for such disastrous events. Methods: On the evening of October 30,1999, a fire broke out in downtown, Dong-Incheon Live-Hof restaurant; 56 people were killed and 76 were injured. Most of them were teenagers. We retrospectively reviewed the medical records of the victims, Results: 1) Among the 56 dead, 54 died from smoke inhalation, one from extensive burns, and one from sepsis during treatment. 2) Among the 76 injured, 70 patients suffered from smoke inhalation, 53 from burns, and 9 from several types of trauma (sprains, contusions, lacerations, abrasions, fractures, etc.). 3) Later complications were laryngeal edema, pulmonary edema, scar contracture, and hypoxic brain damage, and so forth. 4) Post traumatic stress syndrome was unexpectedly more prevalent in mildly to moderately injured survivors and witnesses than in seriously injured survivors. Conclusion: Many complications exist after a fire. Some may be resolved in time, but others may result in permanent sequelae. Early rescue, early triage, and early management during transport by emergency medical service (EMS) personnel can result in fewer complications and a lower mortality rate. Therefore, we propose the establishment of plans to be followed during various major disasters.

CASE REPORT : Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report

( Yeun Seoung Choi ),( Jung Soo Lim ),( Woocheol Kwon ),( Soon Hee Jung ),( Il Hwan Park ),( Myoung Kyu Lee ),( Won Yeon Lee ),( Suk Joong Yong ),( Seok Jeong Lee ),( Ye Ryung Jung ),( Jiwon Choi ),( 대한결핵 및 호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.4

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.

Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report

Choi, Yeun Seoung,Lim, Jung Soo,Kwon, Woocheol,Jung, Soon-Hee,Park, Il Hwan,Lee, Myoung Kyu,Lee, Won Yeon,Yong, Suk Joong,Lee, Seok Jeong,Jung, Ye-Ryung,Choi, Jiwon,Choi, Ji Sun,Jeong, Joon Taek,Yoo, The Korean Academy of Tuberculosis and Respiratory 2015 Tuberculosis and Respiratory Diseases Vol.78 No.4

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.

공장의 Dieulafoy 병변 1예

임연정 ( Yeun Jung Lim ),도인구 ( In Gu Do ),김영호 ( Young Ho Kim ) 대한소화기학회 2008 대한소화기학회지 Vol.51 No.2

증례 : 성인에서 발견된 단독 심실 비치밀화증 1예

임연정 ( Yeun Jung Lim ),김정순 ( Jeong Soon Kim ),김인환 ( In Hwan Kim ),박상순 ( Sang Soon Park ),조성욱 ( Seong Wook Cho ),김동진 ( Dong Jin Kim ),조상균 ( Sang Kyoon Cho ) 대한내과학회 2007 대한내과학회지 Vol.73 No.1

단독 심실 비치밀화증은 태아기에 심근의 치밀화 과정이 정지됨으로서 과도한 육주(trabecula)가 형성되고 그 육주 사이에 깊은 함몰이 생기는 선천성 심근병증이다. 진단을 위해 심초음파는 가장 중요한 검사이며, 심초음파로 진단이 확실하지 않을 때에는 비침습적인 방법으로 다중단면 컴퓨터 단층촬영(MD CT), 자기공명단층촬영(MRI)을 통해 도움을 받을 수 있다. 임상양상은 매우 다양하여 무증상인 경우부터 심장이식이 필요하거나 사망할 수도 있는 전격성 심부전까지 나타날 수 있으며, 부정맥, 혈전 색전증이 발생할 수 있다. 저자들은 성인남자에서 심계항진 및 호흡곤란을 주소로 내원하여 단독 심실 비치밀화증으로 진단받고 심부전, 심방 세동 및 심첨부의 혈전에 대한 치료를 하였으나 결국 난치심부전 및 다발성 장기부전으로 사망한 1예를 경험하였기에 보고하는 바이다. Noncompaction of the ventricular myocardium is a rare congenital cardiomyopathy that is thought to be caused by arrest of normal endomyocardial embryogenesis. It is usually diagnosed via echocardiography. The three major clinical manifestations of noncompaction are heart failure, arrhythmia and embolic events. We report here on a case of isolated noncompaction of the ventricular myocardium, and the patient was admitted due to palpitation and dyspnea. Sadly, he died of intractable heart failure despite that we administered intensive medical treatment.(Korean J Med 73:96-102, 2007)

누리과정 예술경험 영역에 대한 유아교사의 운영 실태

임부연 ( Boo Yeun Lim ),정문옥 ( Moon Ok Jung ),오정희 ( Jung Hee Oh ) 한국아동교육학회 2015 아동교육 Vol.24 No.1

본 연구는 누리과정 예술경험 영역의 운영 실태를 살펴보고 예술경험 영역의 활성화를 위한 유아교사들의 요구를 알아보고자 하였다. 이를 위해 유아교사 217명을 대상으로 설문조사를 실시하였으며, 설문조사에 참여한 교사 10명을 대상으로 면담을 진행하여 자료를 수집하였다. 연구결과, 유아교사들은 예술경험 영역 활동을 일상적으로 실시하고 있었고, 예술경험 영역의 하위내용도 균형 있게 전개하고 있었다. 그러나 유아교육기관의 유형과 교육경력에 따라 예술경험 영역의 운영에 차이가 있는 것으로 나타났다. 한편 유아교사들은 예술경험 영역 활동을 운영함에 있어 여전히 높은 어려움과 요구도를 가지고 있었다. 유아교사들은 참고자료의 한계와 교수·학습자료의 부족, 학부모의 잘못된 인식으로 인해 예술경험 영역을 운영함에 있어 어려움이 있으며, 예술경험 영역의 활성화를 위해 교수·학습자료의 개발, 예술경험을 위한 사회적 네트워크 구축, 체험 중심의 교사연수를 요구하였다. 이러한 결과를 바탕으로 누리과정 예술경험 영역의 본질적 의미를 구현할 수 있는 실천적인 방안의 모색이 요구된다. The purpose of this study was to analyze early childhood teachers’ practical status of ‘Art Experience field’ in Nuri Curriculum as well. To collect the data, 217 teachers were surveyed and 10 from the teachers were chosen for teacher interviews. The result of this study revealed that early childhood teachers implemented activities of ‘Art Experience field’ as daily routine activities generally and practiced the detailed contents of ‘Art Experience field’ variously. Nevertheless, early childhood teachers had difficulties and needs in implementing activities of ‘Art Experience field’. Early childhood teachers had difficulties in implementing the activities due to shortage of teaching materials, limitative references and parents’ misunderstanding art experience. In order to implement ‘Art Experience field’, early childhood teachers needed development of teaching materials, social networking and experience oriented teacher training. These results suggests the practical plans that can accomplish the intrinsic meaning of ‘Art Experience field’ should be sought.

Single-cell analysis of multiple myelomas refines the molecular features of bortezomib treatment responsiveness

Jung Seung-Hyun,Park Sung-Soo,Lim Ji-Young,Sohn Seon Yong,Kim Na Yung,Kim Dokyeong,Lee Sug Hyung,Chung Yeun-Jun,Min Chang-Ki 생화학분자생물학회 2022 Experimental and molecular medicine Vol.54 No.-

Both the tumor and tumor microenvironment (TME) are crucial for pathogenesis and chemotherapy resistance in multiple myeloma (MM). Bortezomib, commonly used for MM treatment, works on both MM and TME cells, but innate and acquired resistance easily develop. By single-cell RNA sequencing (scRNA-seq), we investigated bone marrow aspirates of 18 treatment-naïve MM patients who later received bortezomib-based treatments. Twelve plasma and TME cell types and their subsets were identified. Suboptimal responders (SORs) to bortezomib exhibited higher copy number alteration burdens than optimal responders (ORs). Forty-four differentially expressed genes for SORs based on scRNA-seq data were further analyzed in an independent cohort of 90 treatment-naïve MMs, where 24 genes were validated. A combined model of three clinical variables (older age, low absolute lymphocyte count, and no autologous stem cell transplantation) and 24 genes was associated with bortezomib responsiveness and poor prognosis. In T cells, cytotoxic memory, proliferating, and dysfunctional subsets were significantly enriched in SORs. Moreover, we identified three monocyte subsets associated with bortezomib responsiveness and an MM-specific NK cell trajectory that ended with an MM-specific subset. scRNA-seq predicted the interaction of the GAS6-MERTK, ALCAM-CD6, and BAG6-NCR gene networks. Of note, tumor cells from ORs and SORs were the most prominent sources of ALCAM on effector T cells and BAG6 on NK cells, respectively. Our results indicate that the complicated compositional and molecular changes of both tumor and immune cells in the bone marrow (BM) milieu are important in the development and acquisition of resistance to bortezomib-based treatment of MM.

영아기 심실중격결손 봉합술의 임상적 고찰

정태은,이장훈,이동협,이정철,한승세,김세연,지대림 영남대학교 의과대학 2002 Yeungnam University Journal of Medicine Vol.19 No.2

Background: Simple ventricular septal defect(VSD) is the most common congenital heart disease. Although closure of VSD is currently associated with a relatively low risk, experience with younger and smaller infants has been variably less satisfactory. We assessed the results of surgical closure of VSD in infant. Materials and Methods: Between 1996 and 2000, 45 non-restrictive VSD patients underwent patch repair and retrospective analysis was done. Patients were divided into two groups based on weight: group I infants weighed 5kg or less(n=16), and group II infants weighed more than 5kg(n=29). Both groups had similar variation in sex, VSD location, aortic cross clamp time and total bypass time. But combined diseases (ASD, PDA, MR) were more in group I. We closed VSD with patch and used simple continuous suture method in all patients. Results: There were no operative mortality, no reoperation for hemodynamically significant residual shunt and no surgically induced complete heart block. As a complication, pneumonia(group I: 2 cases, group II: 2 cases), transient seizure(group II: 2), wound infection(group I:, group II:1), urinary tract infection(group I: 1) and chylopericardium(group I: 1) developed, and there was no significant difference between two groups(p>0.05). Conclusion: Early primary closure with simple continuous suture method was applicable in all patients with non-restrictive VSD without any serious complications.

Draft Genome Sequence of Bacillus thuringiensis serovar aizawai AS23, Isolated from the Rhizosphere of Korean Melon (Cucumis melo L.)

Jung Da-Ryung,Lee GyuDae,Lim Kyeongmo,Lee Yeonkyeong,Nam Ga-Yeon,Won Do-Yeun,Park Na-Yun,Seo Young-Jin,Shin Jae-Ho 한국미생물·생명공학회 2023 한국미생물·생명공학회지 Vol.51 No.4

We report the draft genome sequence of Bacillus thuringiensis serovar aizawai AS23, an insecticidal strain targeting lepidopteran pests, which was isolated from the rhizosphere of Korean melon (Cucumis melo L.). The genome of strain AS23 comprising 6,846,584 bp with a G + C content of 34.83% was assembled to 11 contigs obtained using hybrid assembly. Additionally, we mined the genome for pesticidal genes, identifying several insecticidal genes, including Cry1Aa3, Cry1Ca9, Cry1Da2, Cry1Ia44, Cry2Ab41, Cry9Ea9, Spp1Aa1, and Vip3Aa86.

Nosocomial Outbreak of COVID-19 in a Hematologic Ward

Jung Jiwon,Jungmin Lee,Seongmin Jo,Bae Seongman,Ji Yeun Kim,Cha Hye Hee,Lim Young-Ju,Kwak Sun Hee,Hong Min Jee,Kim Eun Ok,Bae Joon-Yong,Kang Changmin,Sung Minki,Park Man-Seong,Kim Sung-Han 대한감염학회 2021 Infection and Chemotherapy Vol.53 No.2

Background: Coronavirus disease 2019 (COVID-19) outbreaks occur in hospitals in many parts of the world. In hospital settings, the possibility of airborne transmission needs to be investigated thoroughly. Materials and Methods: There was a nosocomial outbreak of COVID-19 in a hematologic ward in a tertiary hospital, Seoul, Korea. We found 11 patients and guardians with COVID-19 through vigorous contact tracing and closed-circuit television monitoring. We found one patient who probably had acquired COVID-19 through airborne-transmission. We performed airflow investigation with simulation software, whole-genome sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: Of the nine individuals with COVID-19 who had been in the hematologic ward, six stayed in one multi-patient room (Room 36), and other three stayed in different rooms (Room 1, 34, 35). Guardian in room 35 was close contact to cases in room 36, and patient in room 34 used the shared bathroom for teeth brushing 40 minutes after index used. Airflow simulation revealed that air was spread from the bathroom to the adjacent room 1 while patient in room 1 did not used the shared bathroom. Airflow was associated with poor ventilation in shared bathroom due to dysfunctioning air-exhaust, grill on the door of shared bathroom and the unintended negative pressure of adjacent room. Conclusion: Transmission of SARS-CoV-2 in the hematologic ward occurred rapidly in the multi-patient room and shared bathroom settings. In addition, there was a case of possible airborne transmission due to unexpected airflow.