일 농촌지역의 우울 증상에 관한 역학연구 -위험요인 및 요인구조분석

하양숙,홍진표,김한규,이군희,한경자,조맹제,김용익,송미순,박성애,김창윤 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 세계적으로 널리 사용되는 우울증 척도인 the Center for Epidemiologic Studies Depression Scale(CES-D)을 이용하여 지역사회 주민의 우울증상의 정도를 평가하고, 우울증상의 위험요인을 분석하고, 한국인에서 우울증상의 요인구조를 알기 위해 본 연구를 실시하였다. 방 법 : 경기도 일 농촌 지역의 30세 이상 주민에 대해 무작위 군집 집락 추출을 실시하였고, 훈련된 면담원들이 가정 방문을 통하여 면접 및 자기보고 검사인 CES-D를 실시하였다. 총 1,315명에서 응답을 하였고 응답율은 59.3%이었다. 결 과 : CES-D에 의한 우울증 점수는 0∼5점이 57%정도를 차지하였고, 평균 점수는 남자 7.8점 여자 9.5점으로 비교적 낮은 편이었다. ANCOVA 분석 결과 비결혼, 저학력, 여성이라는 위험요인은 독립적으로 우울증상을 악화시키는 요인이었으나 연령은 통계적으로 유의하지 않았다. CES-D 결과를 요인분석을 시행한 결과 4가지 요인이 추출되었는데 우울증상 및 신체증상이 한 개의 요인으로, 다른 나라에서 보고되지 않는 정서적 고통이 별도의 요인으로 추출되었다. 결 론 : 국내 역학 조사에서도 외국과 유사한 우울점수 및 위험요인이 확인되었으나 우울증의 요인에서는 특이한 요인이 추출되었다. 한국인에 독특한 우울 반응에 관한 추가 연구가 필요하다. Objectives :The rates, correlates, and factor structure of depressive symptoms in a Korean rural sample were examined using Korean version of the Center for Epidemiologic Studies Depression Scale(CES-D). Methods : Door to door visiting survey was conducted by trained interviewers. A random cluster sample of 1,315 respondents, aged 30 and over completed the CES-D scale along with additional sociodemographic questionnaire. Results : In this sample, mean CES-D score of male and female were 7.8 and 9.5, respectively which were lower than those reported previously. Symptoms of depression were most common among the less educated, non-married and female according to ANCOVA. Age was not a significant risk factor for depressive symptoms. Different factor structures emerged from this sample as compared to other studies using this approach. Somatic symptoms and affective symptoms were combined as one factor and emotional hardship emerged as a separate factor. Conclusion : Symptoms scores and risk factors were similar to the results reported in other countries but unique factor structures were found in this study. Further research is needed about the Korean depressive symptomatology and related areas.

경쟁적 효소면역검사를 이용한 혈청내 매독균 항체 검사의 유용성

최하영,박건,장숙진,박영진,문대수 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background : Laboratory methods for detection of syphilis are Venereal Disease Research Laboratory (VDRL) and rapid plasma reagin (RPR) test to non-treponemal tests, and fluorescent treponemal antibody absorption (FTA-ABS) and microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP) to treponemal tests. However, RPR card test had many false positive results and FTA-ABS IgM method required high degrees of technical ability and experience. Recently, enzyme immunoassay (EIA) kits for IgM and IgG antibodies to T. pallidum in syphilis have been developed. So, we evaluated that usefulness of competitive EIA for detection of T. pallidum antibody in serum. Methods : RPR positive 38 specimens and negative 6 specimens were compared by T. pallidum hemagglutination (TPHA), two commercial competitive EIA kits for detection of syphilis and FTA-ABS IgM. Those data were compared with concordant and discordant rate of each RPR, TPHA, EIA and FTA-ABS IgM. Results : 28 of 34 RPR positive specimens were TPHA(+) and EIA (+), and 6 of 6 RPR negative specimens were TPHA (-) and EIA (-). The data of two EIAs were same results with TPHA. 3 of 28 EIA positive specimens were FTA-ABS IgM (+), and 16 of 16 EIA negative specimens were FTA-ABS IgM (-). Conclusion: Two commercial competitive EIA kits for detection of syphilis were evaluated. The EIA method could be replaced with RPR and TPHA, and this method was possible to combination for detection of syphilis.

국내 대학병원에서 정주용 Ciprofloxacin 사용의 적정성 평가

김신우,박효정,오원섭,김연숙,장현하,정숙인,정두련,이혁,염준섭,기현균,손준성,백경란,우건조,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 병원에서의 정주 ciprofloxacin 사용의 적정성을 평가하고자 하였다. 재료 및 방법 : 2003년 9월 25일부터 8개의 대학병원에서 정주 ciprofloxacin을 받았던 290명의 연속적으로 모집한 성인환자를 대상으로 약제사용 평가(DUE)를 전향적으로 수행하였다. 이 연구에 사용된 DUE 기준은 미국병원약사회의 기준을 국내 실정에 맡게 수정하여 사용하였으며 1) 사용의 정당성에 관한 항목, 2) 사용 시 준수되거나 시행되어야 할 사항에 대한 항목, 3) 부작용에 대한 항목, 4) 치료 효과에 대한 항목으로 나누어 조사하였다. 결과 : 환자의 평균 나이는 54세였다. 33예(26.9%)에서만 약제 사용의 적정성 측면에서 기준을 만족하였고 91예(73.1%)에서는 사용이 적절하지 않았다. 정주 cipro-floxacin의 부적절한 사용의 흔한 원인은 수술 전후의 예방약 사용, 비뇨기계 처치 전의 예방적 사용, 열성 질환에 대한 경험적 사용 등의 순이었다. 사용 시 준수사항 의 측면에서는 사용 전 배양검사(73.8%)와 사용 중 배양검사(68.6%)가 낮은 수행 정도를 보였으나 그 외는 비교적 높은 적정성(82.4-100%)을 보여주었다. 정주 ciprofloxacin사용의 합병증은 드물었다. 치료 효과의 면에서 치료반응은 93.3%였다. 결론 : 약제 사용의 정당성 기준에 따른 정주 cipro-floxacin의 부적절한 사용은 연구에 포함된 대학병원에서 매우 흔하였다(73.1%). 그러므로 적절한 항생제 사용에 대한 교육과 제도적 장치가 매우 필요한 것으로 판단되었다. Background : To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. Materials and Methods : We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. Results : Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. Conclusion : Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.

복부둔상에 의한 간 손상의 임상적 고찰

홍순찬,최상경,박순태,하우송,이진석,권수인,이영준,정은정,조현언,정광근,임병찬 대한외상학회 2000 大韓外傷學會誌 Vol.13 No.2

Because of the merit of nonoperative management of blunt hepatic trauma, which is the avoidance of operative morbidity, the use of nonoperative management has been extended. However the indications for such treatment have not been sufficiently determined. To suggest possible criteria for nonoperative management, we reviewed 95 cases with blunt hepatic injuries which were confirmed by abdominal exploration or abdominal CT in Gyeong Sang National University Hospital from January 1992 to October 2000. Of the 95 patients, 38 patients were treated with operation and 57 patients treated with nonoperative management. We analyzed the patients for age, sex, cause of injury, injured organ, injury grade, transfusion amount, and shock on admission, complications and mortality. The results are as follows; 1) The peak incidence of age was in the 3rd decade (20%), and the male-to-female ratio was 3:1. 2) The most frequent injury mechanism was traffic accidents (40, 42%). 3) The most frequently used diagnostic modality was abdominal CT (95 cases) in the nonoperative and the operative group. 4) On the liver injury scale of the American Association for the Surgery of Trauma (AAST), 13 were grade I, 18 were grade II, 10 were grade III, 13 were grade IV, and 3 were grade V in the nonoperative group ; 1 were grade I, 6 were grade II, 18 were grade III, 8 were grade IV, 4 were grade V, and 1 were grade VI in the operative group. 5) Between the nonoperative and the operative groups, there were significant differences in the systolic blood pressure in the first 8 and 24 hours, transfusion amount, and GOT/GPT level (p$lt;0.05). 6) In comparison of complication, there were 3 cases of heaptic abscess,1 case of intrahepatic hematoma, 1 case of bile leakage, 1 case of rebleeding in operative group (15.7%). There were 2 cases of intrahepatic abscess, 2 cases of intrahepatic hematoma, 4 cases of biloma, 1 case of subcapsular hematoma in nonoperative group (15.7%). In mortality cases, 6patients died in operative group. Among them, 5patiens died from DIC (disseminated intravascular coagulation) and multiorgan failure, 1patient died from ARDS (adult respiratory distress syndrome) in operative group and 2patients died from hypovolemic shock in nonoperative group. In conclusion, i) nonoperative management may be considered as a first choice in children and adults with blunt abdominal trauma and stable vital signs. ii) Patients with hemodynamically stable hepatic injury 8 hrs after resuscitation, even with an AAST OIS grade 4 injury, may be candidates for nonoperative management.

Clinical Characteristics of Korean Patients with Lung Cancer Who Have Programmed Death-Ligand 1 Expression

( Ha-young Park ),( In-jae Oh ),( Bo Gun Kho ),( Tae-ok Kim ),( Hong-joon Shin ),( Cheol Kyu Park ),( Yong-soo Kwon ),( Yu-il Kim ),( Sung-chul Lim ),( Young-chul Kim ),( Yoo-duk Choi ) 대한결핵 및 호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.3

Background: Programmed death-ligand 1 (PD-L1), a transmembrane protein, binds to the programmed death-1 (PD- 1) receptor, and anti-PD-1 therapy enables immune responses against tumors. This study aimed to assess clinical characteristics of PD-L1 expression using immunohistochemistry among Korean patients with lung cancer. Methods: We retrospectively reviewed the data of patients with pathologically proven lung cancer from a single institution. PD-L1 expression determined by Tumor Proportion Score (TPS) was detected using 22C3 pharmDx (Agilent Technologies) and SP263 (Ventana Medical Systems) assays. Results: From July 2016 to July 2017, 267 patients were enrolled. The main histologic type was adenocarcinoma (69.3%). Most participants were smokers (67.4%) and had clinical stage IV disease (60.7%). In total, 116 (42%) and 58 (21%) patients had TPS ≥1% and ≥50%, respectively. The patients were significantly older in TPS ≥1% group than in TPS <1% group (64.83 ± 9.38 years vs. 61.73 ± 10.78 years, p=0.014), not in TPS ≥50% cutoff value (64.69 ± 9.39 vs. 62.36 ± 10.51, p= 0.178). Regarding histologic grade, higher proportions of poorly differentiated tumor were observed in the TPS ≥1% (40.8% vs. 25.8%, p=0.020) and TPS ≥50% groups (53.2% vs. 27.2%, p=0.004). Among 34 patients examined with 22C3 and SP263 assays, 27 had positive results in both assays, with a cutoff of TPS ≥1% (r=0.826; 95% confidence interval, 0.736-0.916). Conclusion: PD-L1 expression, defined as TPS ≥1%, was related to older age and poorly differentiated histology. There was a similar distribution of PD-L1 expression in both 22C3 and SP263 results.

Comparison of tolvaptan treatment between patients with the SIADH and congestive heart failure: a single-center experience

( Gun Ha Park ),( Chang Min Lee ),( Jae Won Song ),( Moon Chan Jung ),( Jwa Kyung Kim ),( Young Rim Song ),( Hyung Jik Kim ),( Sung Gyun Kim ) 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.3

Background/Aims: Tolvaptan is a very effective treatment for hypervolemic or euvolemic hyponatremia. We compared the clinical efficacy of and response to tolvaptan in patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and congestive heart failure (CHF). Methods: We retrospectively reviewed the medical records of 50 patients (SIADH, n = 30; CHF, n = 20) who were prescribed tolvaptan between July 2013 and October 2015. Tolvaptan was prescribed when the serum sodium level was < 125 mmol/L and the standard treatment failed. Normonatremia was defined as a serum sodium level of > 135 mmol/L. Results: After the initiation of tolvaptan therapy, there was an immediate response in the urine volume and serum sodium level in all patients. The improvements in the urine volume and serum sodium concentration were highest within the first 24 hours of treatment. In addition, the mean change in the serum sodium level during the first 24 hours was significantly higher in patients with SIADH than in those with CHF (ΔNa, 9.9 ± 4.5 mmol/L vs. 6.9 ± 4.4 mmol/L, respectively; p = 0.025). Also, the mean maintenance dose was lower, and the total duration of tolvaptan use was slightly shorter in the SIADH group than CHF group (21.5 ± 14.9 days vs. 28.0 ± 20.1 days, p = 0.070). Conclusions: The early response to tolvaptan treatment was better in patients with SIADH than in those with CHF. Thus, the tolvaptan treatment strategy should be differed between patients with SIADH and those with CHF.

Long-term prognosis of end-stage renal disease patients with normal myocardial perfusion as determined by single photon emission computed tomography

Gun Ha Park,Jae Won Song,Chang Min Lee,Young Rim Song,김성균,김형직,Jwa Kyung Kim 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.1

Background/Aims: Normal myocardial perfusion is closely associated with very low rates of cardiac events and better long-term outcomes; however, little is known about its prognostic value in patients with end-stage renal disease (ESRD). Methods: A total of 286 incident patients underwent baseline cardiac evaluations using echocardiography and stress-rest single-photon emission computed tomography. Perfusion scans for 177 patients (61.9%) who had a summed stress score (SSS) < 4 were normal. Results: During the 4-year follow-up period, 79 cardiac events occurred. Patients with a SSS < 4 had significantly lower annual rates of cardiac events than did those with a SSS ≥ 4 (6.4% vs. 13.2%; hazard ratio, 0.54; 95% confidence interval, 0.31 to 0.94). Among patients with a SSS < 4, however, cardiac event rates significantly differed according to the presence of comorbid conditions such as old age, diabetes, history of coronary artery disease, and elevated C-reactive protein levels. In addition, the presence of left ventricular (LV) systolic dysfunction and LV hypertrophy at the start of hemodialysis strongly influenced future cardiac events. Conclusions: In patients with ESRD, normal perfusion scans usually indicate a significantly low risk of adverse cardiac events. However, even in patients with normal perfusion scans, the cardiovascular prognosis is largely dependent on baseline inflammation levels and comorbidities.

Characteristic Features of an α-Galactosidase from Penicillium purpurogenum

Park, Gwi gun,Lee, Sang Young,Park, Boo Kil,Ham, Seung Shi,Lee, Jin Ha 한국미생물 · 생명공학회 1991 Journal of microbiology and biotechnology Vol.1 No.2

A α-galactosidase (α-D-galactoside galactohydrolase; EC 3.2.1.22) was purified from the culture filtrate of Penicillium purpurogenum by DEAF-cellulose column chromatography, gel filtration of Bio gel p-100, and subsequent SP-Sephadex C-25 chromatography. The final preparation thus obtained showed a single band on polyacrylamide disc-gel and SDS-polyacrylamide gel electrophoresis. The molecular weight and isoelectric point were determined to be 63,000 and pH 4.0 by SDS-polyacrylamide gel electrophoresis and isoelectric focusing, respectively. The galactosidase exhibited maximum activity at pH 4.5 and 55℃, and was stable between pH 2 and 5, and also stable up to 40℃. The enzyme activity was not affected considerably by treatment with other metal compounds except mercuric chloride and silver nitrate. Copra galactomannan was finally hydrolyzed to galactose, mannose and mannobiose through the sequential actions of the purified galactosidase and mannanase from the same strain. The enzyme hydrolyzed melibiose and raffinose, but not lactose.

Clinical Characteristics of Korean Patients with Lung Cancer Who Have Programmed Death-Ligand 1 Expression

Park, Ha-Young,Oh, In-Jae,Kho, Bo Gun,Kim, Tae-Ok,Shin, Hong-Joon,Park, Cheol Kyu,Kwon, Yong-Soo,Kim, Yu-Il,Lim, Sung-Chul,Kim, Young-Chul,Choi, Yoo-Duk The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.3

Background: Programmed death-ligand 1 (PD-L1), a transmembrane protein, binds to the programmed death-1 (PD-1) receptor, and anti-PD-1 therapy enables immune responses against tumors. This study aimed to assess clinical characteristics of PD-L1 expression using immunohistochemistry among Korean patients with lung cancer. Methods: We retrospectively reviewed the data of patients with pathologically proven lung cancer from a single institution. PD-L1 expression determined by Tumor Proportion Score (TPS) was detected using 22C3 pharmDx (Agilent Technologies) and SP263 (Ventana Medical Systems) assays. Results: From July 2016 to July 2017, 267 patients were enrolled. The main histologic type was adenocarcinoma (69.3%). Most participants were smokers (67.4%) and had clinical stage IV disease (60.7%). In total, 116 (42%) and 58 (21%) patients had TPS ${\geq}1%$ and ${\geq}50%$, respectively. The patients were significantly older in TPS ${\geq}1%$ group than in TPS <1% group ($64.83{\pm}9.38years$ vs. $61.73{\pm}10.78years$, p=0.014), not in TPS ${\geq}50%$ cutoff value ($64.69{\pm}9.39$ vs. $62.36{\pm}10.51$, p=0.178). Regarding histologic grade, higher proportions of poorly differentiated tumor were observed in the TPS ${\geq}1%$ (40.8% vs. 25.8%, p=0.020) and TPS ${\geq}50%$ groups (53.2% vs. 27.2%, p=0.004). Among 34 patients examined with 22C3 and SP263 assays, 27 had positive results in both assays, with a cutoff of TPS ${\geq}1%$ (r=0.826; 95% confidence interval, 0.736-0.916). Conclusion: PD-L1 expression, defined as TPS ${\geq}1%$, was related to older age and poorly differentiated histology. There was a similar distribution of PD-L1 expression in both 22C3 and SP263 results.

The Application of Marine X-band Radar to Measure Wave Condition during Sea Trial

Park, Gun-Il,Choi, Jae-Woong,Kang, Yun-Tae,Ha, Mun-Keun,Jang, Hyun-Sook,Park, Jun-Soo,Park, Seung-Geun,Kwon, Sun-Hong The Society of Naval Architects of Korea 2006 Journal of ship and ocean technology Vol.10 No.4

The visual observation of wave condition depends on the observer's skill and experience. Also, the environmental conditions such as light and cloud heavily influence the visual measurement. In the speed test of sea trial, the wave measurement should be objective and accurate. In this paper, the problems of visual measurement and their effects on speed test are described. To overcome those problems, we developed the wave measurement system using commercial marine X-band radar, WaveFinder. The system installed at inland base was calibrated by waverider buoy and then the system's operability was defined. Onboard tests had also been performed three times for formal wave measurement to correct the ship speed. The results illustrated very good agreement with visual observation by experts. It can be concluded that the system would be useful to measure wave and swell information for the sea trial, irrespective of day and night.