성인에서 Mycoplasma pneumoniae 페렴과 동반된 Stevens-Johnson 증후군 1예

이정현,엄영실,한우진,윤규현,이서영,서종구,김진용,김수연,박윤수,서일혜,조용균 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Stevens-Johnson syndrome is an acute mucocutaneous syndrome that is related to drugs and infections. Mycoplasma pneumonias infection is known as one of the causes of Stevens-Johnson syndrome in children and young adults, In Korea, Mycoplasma pneumoniae infection is rarely reported as a cause of Stevens-Johnson syndrome in adults. We report a case of Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia in an adult patient. A 34-years old woman was admitted to our hospital and was diagnosed with mycoplasma pneumonia. At the time of admission, she had hemorrhagic crusts on her lips. On the 2nd day of admission, target lesions also developed on her skin. We diagnosed her disease as Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia. She completely recovered from pneumonia and Stevens-Johnson syndrome after treatment with antibiotics and conservative management.

성남시 지역주민의 정신질환에 대한 태도 연구

고영,신수경,황태연,이충순,박연수,김인숙,황은숙,정원재 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.1

서동증과 의지감소증으로 발현한 간성 뇌병증 : 증례보고

문소영,정용,강수진,진주희,나덕렬 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.1

We report a 70-year-old woman who, without a prior history of liver disease, presented abulia and bradykinesia as the initial symptoms of hepatic encephalopathy (HE). Neurological examination showed bilateral extensor plantar responses in addition to mild parkinsonian features On neuropsychological tests, she was impaired at the attention, visuospatial function, memory, and frontal lobe function. Laboratory tests were remarkable for increased AST and ammonia, and positive igG HbcAb. The results of ultrasonography of the liver were consistent with chronic liver disease. Brain T1 weighted MRI revealed a high signal intensity in bilateral basal ganglia. Brain PET showed diffuse cerebral hypometabolism After treatment with oral lactulose, the above symptoms remained improved for the next 6-month of follow-up From this case, we learned that hepatic encephalopathy could be a reversible cause of dementia plus parkinsonism even in patients without a prior history of chronic liver disease.

위암환자의 피로와 영양상태의 관계

손수경,한영인,김경희 고신대학교 전인간호과학연구소 2003 전인간호과학연구 학술모음집 Vol.2 No.-

Purpose. The purpose of this study was to identify the relationship between fatigue and nutritional status in patients with gastric cancer. Design. A orrelational and crossectional study design was used Method. The data was collected from July to August 2002. 59 subjects with gastric cancer were recruited K university hospital in Busan, Korea. Fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al (1998). The parameters for nutritional status included body weight, body mass index, hemoglobin, Hct, total protein, albumin and lymphocyte count. Result. 1) The fatigue score was mean 94.31±22.08(mean average 4.48±1.00) The subdimension that showed behavior/severity score at 34.15±8.76, cognitive/mood score at 22.00±7.93, sensory score at 21.67±5.56, and affective score at 20.81±6.69. And among the parameters for nutritional starus, BMI, Hb, Hct were not included normal rage. 2) There was a significant difference in present diet(F=3.343, P= .026) according to general characteristics in the fatigue in patients with gastric cancer. 3) The disease-related characteristics such as Age, treatment type, after period diagnosis, care giver, payment were frequently related to poorer nutritional status. Subjects received chemotherapy showed lower lymphocyte level than subjects received operation, and the subjects were diagnosis less than 1 month, were showed lower Hematocrete level. 4) There was a significant negative correlation between fatigue and nutritional status(r= -.371, P=.004). Conclusion. Patients with gastric cancer experience in fatigue. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them

16S rRNA 유전자 염기서열 분석에 의해 확인된 Acinetobacter spp. 가성요로감염 유행

김수연,김진용,강지혜,박신영,이희승,박윤수,서일혜,조용균 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

목적 : 본 연구는 일개 대학병원의 한 병동에서 16SrRNA 유전자 염기서열 분석을 통해 확인된 Acinetobacter spp. 가성요로감염 집단 발생에 대한 조사이다. 재료 및 방법 : 일개 대학병원의 일반병동에서 2005년 9월 23일부터 26일까지 5명의 환자에서 Bordetelta bronchiseptica 세균뇨가 동시에 분리되었다. 해당 환자들에 대한 입원 진료 기록을 확인하고, 이학적 검사를 시행하였고, 의료진 면담 등의 역학적 조사와 의심되는 전파원의 환경 감시배양을 시행하였다. 또한 다섯 균주들의 상동성 확인을 위해 pulsed field gel electrophoresis (PFGE)를 하였고, 정확한 균 동정을 위해 16S rRNA 유전자 염기서열 분석을 하였다. 결과 : VITEK system에 의해 B. bronchiseptica로 보고된 다섯 균주들은 거의 유사한 항생제 감수성을 가지고 있었다. 유행조사에서 요로감염의 증상이나 균혈증을 보인 환자는 없었고, 환경 감시배양에서 공통의 전파원은 증명되지 않았다. 또한 PFGE와 16S rRNA 유전자 염기서열분석에서 상동성을 가진 동일 Acinetobacter spp.로 확인되어 이에 의한 가성요로감염의 유행으로 결론지었다. 결론 : 역학적 조사와 함께 PFGE와 16s rRNA 유전자염기서열 분석과 같은 분자생물학적인 조사를 시행하는 것은 희귀한 균에 의한 병원감염 유행조사에 도움이 될 것이다. Background : Acinetobacter spp. is increasingly implicated in hospital-acquired infections. We experienced a pseudooutbreak of Bordetella bronchiseptica bacteriuria identified with biochemical tests, that was later identified as Acinetobacter spp. by using 16S rRNA gene sequence analysis. Materials and Methods : Five in-ward patients were found to have B. bronchiseptica bacteriuria without symptoms of urinary tract infection between September 23 and 26 of 2005. We conducted pulsed field gel electrophoresis (PFGE) of the bacteria and epidemiological investigation of this pseudooutbreak. In addition, 16S rRNA gene sequence analysis was performed for the verification of the strains. Results : All 5 isolates were identified as B. bronchiseptica with similar antibiogram by VITEK system. There was no evidence of any symptom or sign of urinary tract infection. The source of this pseudooutbreak was not detected even after performing environmental culture and interviews with healthcare workers. We could not get the appropriate results from the first PFGE with XbaI restriction enzyme. B. bronchiseptica is an unusual organism in human so we conducted 16S rRNA gene sequence analysis for verification. The analysis of 16S rRNA gene sequence with 5 isolates demonstrated 99-100% similarity to a sequence of Acinetobacter spp. (AU1523). According to the results of 16S rRNA gene sequence analysis, we performed the second PFGE with SmaI restriction enzyme, which showed indistinguishable pattern among the all 5 isolates. Conclusion : This investigation suggests that the combined method of 16s rRNA gene sequence analysis and PFGE would be helpful for investigation of outbreak caused by unusual organisms.

암환자의 절망감과 영적요구의 관계

한영인,손수경 성인간호학회 1999 성인간호학회지 Vol.11 No.1

The purpose of this study was to identify the relationship of hopelessness and spiritual-need of cancer patients. Subjects for this study were 272 cancer patients sampled from a madical center in Pusan. The data were collected from Feb. 1 to Mar.10, 1998 using questionnaire method. Hopelessness measured hopelessness scale was the One(1986) modification of Beck(1974) and spiritual-need measured spiritual-need scale by Kim(1986) according to classification of Fish and Shelly. The questionnaire consisted of question regarding hopelessness scale(20 items 5 point) and spiritual-need scale(30 items 5 point scale). The reliability of this instrument was that the hopelessness scale was Cronbach's α=0.89 and the spiritual-need was Crobach's α=0.93. The data were analyzed with the SPSS program using mean, standard deviation, frequency and percentage, t-test, ANOVA, Post hok test and Pearson's Correlation Coefficient. The results of this study were as follow: 1. The mean score of the total hopelessness was 2.79 in 1(lowest)-to-5(highest) scoring system. The analysis of the hopelessness according to general characteristics of the cancer patients showed duration of treatment(F=3.77), cognition of prognosis(F=2.92) age (F=2.66), religional effect of life(2.48). 2. The mean score of the total spiritual-need was 3.47 in 1(lowest)-to-5(highest) scoring system, age(F=5.517), sex(F=.919), religion(F=25.89), religional effect of life(F=18.54), diagnosis(F=7.67), main care giver(F=4.09), cognition of disease(F=2.92), cognition of prognosis (F=3.31), inspiring source(F=12.72),acceptioal attitude of present situation(F=13.52). according to the categorised part were showed to the need for meaning and purpose(9.40), to the need for love and relatedness(7.08), and to the need for being forgiven(6.93). 3. There was significant correlation between the degree of hopelessness and spiritual-need(r=.146, P<0.05).

筋小胞體의 ATPase Kinetics에 關한 硏究

朴映淳,李承兩,朴泰水,庾基洙,李 弘,金允坤 圓光大學校 1982 論文集 Vol.16 No.2

본 연구에서는 토끼 골격근 소포체에서 분리한 근소포체의 ATPase활성에 대한 일반적 특성과 수종의 2가 양이온(??)의 영향에 관한 연구를 하였다. ATPase활성과 Ca uptake에 미치는 2가 양이온의 저해 효과와 저해기작은 Dixon plot, Lineweaver-Burk plot, Hanes-Woolf plot, Woolf-Augustinsson-Hofstee plot, Eadie-Scatchard plot, Arrhenius plot등을 이용하여 분석하였으며 그 결과는 다음과 같다. 1. 근소포체의 ATPase는 ??과 ??의 존재하에서 활성화 되어지며 ??의 농도가 4mM일 때 ??의 최적 농도는 0.1mM이었다. 2. 근소포체의 ATPase는 ??-ATPase와 (??)-ATPase로 구성되어 있고 (??) - ATPase의 활성은 ??-ATPase의 활성보다 높았다. 3. ATPase의 활성화 에너지는 약 19Kcal/mol이었다. 4. ATPase 활성에 미치는 2가 양이온은 12.5㎛과 400㎛의 범위 내에서 이온 농도가 증가됨에 따라서 활성도는 점점 감소되었다. 5. ATPase활성율 50% 저해시키는데 2가 양이온의 농도는 Ki값과 같아서 ??, ??, ?? Pd ??에 대한 각각의 농도는 10㎛, 30㎛, 130㎛ 및 350㎛이었다. 특히 ??은 저 농도에서 (12.5-100㎛)는 활성제로, 고농도에서 (200-400㎛)는 저해제로 작용하는 것 같다. 6. 2가 양이온은 ATPase의 Km에는 변화를 주지 않으나 Vmax의 저하를 일으키는 것으로 보아 비경쟁 저해제임이 판정되었다. 7. 2가 양이온은 가역적 저해제임이 판명되었다. 8. Ca 吸收能에 대한 CuCl₂의 阻害는 50~500㎛의 CuCl₂농도에서 현저히 나타났으며 이 현상은 Ca 吸收能과 ATPase 活性과 밀접한 관계를 보여주는 것이다. General properties of the ATPase and the effects of the divalent cations (??) on the total ATPase activity of the fragmented sarcoplasmic reticulum (FSR) isolated from rabbit skeletal muscle were investigated in the present resent research. The inhibitory effect of divalent cations on the FSR ATPase activity and its mechanism were analyzed by various plots such as Dixon plot, Lineweaver-Burk plot, Hanes-woolf plot, Eadie-Scatchard plot and Arrhenius plot. The results obtained were as follows: 1. The FSR ATPase is activated by ?? and ??; the optimum concentration of is 0.1 mM in the presence of 4 mM MgCl₂. 2. The FSR ATPase could be distinguished as ??-ATPase and (??)-ATPase. The activity of (??)-ATPase predomiant over that of ??-ATPase. 3. The apparent energies of activation for total ATPase was approximately 19Kcal/mole. 4. The inhibitory effects of the divalent cations on the enzyme activity increased as the concentrations of the divalent cations increased in the concentrations between 12.5 and 400㎛. 5. Concentration of 50% inhibition for each divalent cation was almost identical with the inhibition constant (ki). The Ki's were 10,30,130, and 350㎛ for ??, ??, ??, and ??, respectively. ?? seemed to be anactivator at lower concentrations and an inhibior at higher concentratios. 6. The divalent cations did not change the Km but decreased the Vmax of the FRS ATPase, suggesting that they are noncompetitive inhibitors on the FSR ATPase. 7. The divalent cations were also found to be revesible inhibitors on the FSR ATPase. 8. The inhibitory effect of CuCl₂on a uptake increased as the concentration CuCl₂increased in the range between 50㎛.

2개월 남아에서 발병한 Malignant Ectomesenchymoma

황지영,서지현,김점수,김용숙,이수진,박찬후,김유경,박선후,이정희,안인옥,정기현,박병규 대한소아과학회 2001 小兒科 Vol.44 No.8

FGF-mediated FGFR signaling 이 두개봉합부의 초기형태발생 및 유지기전에 미치는 영향

남순현,김영진,서경환,김현정,박미현,유현모 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.4

두개봉합부의 조기융합으로 알려진 Craniosynostosis는 두개봉합부 주위 조직들 사이의 조화로운 상호 작용이 파괴되었을 때 야기될 수 있다. 흥미롭게도 FGF receptor들, 특히 FGFR2의 point mutation은 여러 가지 형태의 craniosynostosis 증후군과 연관되어 있어, FGFR가 두개봉합부를 포함한 두개골 성장 발달과정에 중요한 유전자임을 시사하고 있다. Mouse 두개봉합부의 초기형태발생시 FGFR 유전자들의 기능을 알아보기위해, in situ hybridization 방법을 이용하여 FGFR2(BEK) 및 골아세포분화의 초기표지자인 osteopontin이, 태생기(E15-18)에서 출생후(P1-P3)까지, 두개골의 시상봉합부에서의 발현양상을 조사하였다. FGFR2(BEK)은 osteogenic front에 강하게 발현되었으며, osteopontin은 parietal bone의 exo-, endocranial부위에서 발현되었으나, parietal bone의 성장가장자리인 osteogenic front에서는 관찰되지 않았다. 두개봉합부에서의 FGF-mediated FGFR signaling의 역할을 좀더 심도깊게 조사 하기위해 E15.5 mouse의 두개골을 이용하여 in vitro 실험을 시행하였다. 흥미롭게도 osteogenic fronts 및 시상봉합부의 간엽조직 중앙에 FGF2 - soaked beads를 점적하여 36시간 기관배양한 결과, bead주위 조직들의 두께 및 세포수가 증가되었으며, osteogenic fronts 상에 FGF4 beads를 올려놓은 경우, 시상두개봉합부 중앙에 점적된 FGF4 beads나 BSA control beads에 비해, 골성장이 촉진되어 시상두개봉합부의 부분적인 소멸을 관찰할 수 있었다. 이와 더불어 FGFR2 beads는 osteopotin 및 Msxl 유전자의 발현을 유도하였다. 이 결과들을 종합해 볼 때, FGF - mediated FGFR signaling이 발육중인 두개골과 두개봉합부에서 세포의 증식과 분화의 균형을 조절하는데 중요한 담당하고 있음을 시사해주고 있으며, 이 과정중 FGF signaling이 osteopontin 및 Msxl 유전자의 발현을 조절하므로써 막내골 성장 및 두개봉합부의 유지기전에 기여할 것으로 사료된다. Craniosynostosis, the premature fusion of cranial sutures, presumably involves disturbance of the interactions between different tissues within the cranial sutures. Interestingly, point mutaions in the genes encoding for the fibroblast growth factor receptors(FGFRs), especially FGFR2, cause various types of human craniosynostosis syndromes. To elucidate the function of these genes in the early morphogenesis of mouse cranial sutures, we first analyzed by in situ hybridization the expression of FGFR2(BEX) and osteopontin, an early marker of osteogenic differentiation, in the sagittal suture of calvaria during embryonic (E15-E18) and postnatal stage (P1 - P3). FGFR2(BEK) was intensely expressed in the osteogenic fronts, whose cells undergo differentiation into osteoprogenitor cells that ultimately lay down the bone matrix. Osteopontin was expressed throughout the parietal bones excluding the osteogenic fronts, the periphery of the parietal bones. To further examine the role of FGF-mediated FGFR signaling in cranial suture, we did in vitro experiments in E15.5 mouse calvarial explants. Interestingly, implantation of FGF2 soaked beads onto both the osteogenic fronts and mid-mesenchyme of sagittal suture after 36 hours organ culture resulted in the increase of the tissue thickness and cell number around FGF2 beads, moreover FGF4-soaked beads implanted onto the osteogenic fronts stimulated suture closure due to an accelerated bone growth, compared to FGF4 beads placed onto mid-mesenchyme of sagittal suture and BSA control beads. In addition FGF2 induced the ectopic expression of osteopontin and Msxl genes. Taken together, these data indicate that FGF-mediated FGFR signaling has a important role in regulating the cranial bone growth and maintenance of cranial suture, and suggest that FGF-mediated FGFR signaling is involved in regulating the balance between the cell proliferation and differentiation through inducing the expression of osteopontin and Msxl genes.

석회유담즙증 1예

이지아,김도영,정혜경,문일환,신수연,곽재진 梨花女子大學校 醫科大學 醫科學硏究所 2003 EMJ (Ewha medical journal) Vol.26 No.1

Milk of calcium bile or limy bile is a rare disorder in which the gallbladder lumen is filled with a thick, paste-like, radio-opaque material. Churchman first reported a case of curious deposition of calcium salts within the gallbladder in 1911. Volkmann first used the term Kalkmilchgalle or "milk of calcium bile" in 1926. The radio-opaque material is almost entirely composed of calcium carbonate by weight. The mechanisms by which bile turns limy and radio-opaque or the time required for this biochemical alteration to occur are not well understood. The limy bile is found mostly in a gallbladder complicated by cholecystitis. Recently, we experienced a 33 year old woman who had a milk of calcium bile in the gallbladder lumen. We report this case with a review of literature.