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        정상면역을 가진 성인에서 발생한 식도 방선균증

        김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

        Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

      • 건축벽체용 광택문양콘크리트의 성능평가에 관한 연구

        김종원,김재은,조상영,김성식,정재욱,정상진 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

        Contemporary, architecture calls for a wide range of surface textures and treatments. A surface compatible with the architecture's design may vary from a glass-smooth finish to one requiring special sculptured ornamentation. These surfaces require many different types of from sheathing and lining. The purpose of study development new design from and made elaborateness shape. Easy to used in field that architecture finish material not used expect effective reduce of working hours, personnel expenses, architecture finish material, cost. Through this study, we have figured out the best mix proportion for durability and glossability of glossing exposure concrete.

      • 간문부 담관암 환자에서 경피경관 양측성 금속 배액관의 효과

        김금래,김주형,박원규,장재천,조재호,김태년,김준화,장병익 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

        Background: The purpose of this study was to determine the effectiveness of percutaneously place self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self-expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cased of Bismuth type Ⅱ,21 cases of Bismuth typeⅢa 8 cases of Bismuth type Ⅲb and 15 cases of Bismuth type Ⅳ. Stent placement was technically successful in all patients All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage of 91.9% There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60 ~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method of palliation of patients with hilar cholangiocarcinoma.

      • KCI등재후보

        재발한 지주막하 포도낭미충증의 Albendazole 치험 1예

        김성범,박대원,이재갑,정혜원,송준영,손장욱,김민자,박승철,제보경,김정혁,이진수 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

        뇌실이나 뇌기조에 발생하는 포도낭미충증은 매우 드물며 유구조충 유충의 머리부분이 변성되면서 발생하는 낭성 막의 비정상적인 성장을 특징으로 한다. 이러한 유형의 병변은 지름술 후에도 진행적인 경과를 보이며 아직까지 항기생충제를 이용한 치료 사례들이 적고, 따라서 가장 적절한 치료 기간도 알려져 있지 않다. 본 증례 보고는 재발한 실비우스 틈새의 포도낭미충증 환자에서 4주간의 albendazole과 스테로이드로 효과적으로 치료하였던 예이다. 환자는 praziquantel과 뇌복막지름술로 치료를 받고도 포도상의 뇌실질외형의 병변이 악화되어, 뇌척수액 투과가 좋은 것으로 알려진 albendazole로 치료제를 바꾼 뒤 병변의 수와 크기가 감소였으며 이후 2년 간의 추척기간동안 다른 발작 없이 잘 지내고 있다. 지주막하의 포도낭미충증은 albendazole과 corticosteroid 치료에 잘 반응하는 것으로 보인다. The so-called racemose cysticercosis, a rare variety of neurocysticercosis occurring in ventricles or basal cisterns, is characterized by abnormal growth of cystic membranes with degeneration of Taenia solium heads (scolex). Although lesions of this type are known to follow a progressive course even after ventricular shunting, there are limitations of case series treated with antiparasitic drugs, and the optimal duration of the treatment is not yet known. We report a case of relapsed racemose cysticercosis in the Sylvian fissure, who has been successfully treated with albendazole and adjunct corticosteroid for 4 weeks. The patient had been previously treated with praziquantel and ventricul-operitoneal shunt, and maintained on the anticonvulsant drug for one year, but returned to the hospital due to seizure recurrence. The patient has been well in seizure-free state for the follow-up 2 years after albendazole therapy. The subarachnoid racemose cysticercosis seems to respond well to treatment of corticosteroid along with prolonged albendazole.

      • KCI등재후보

        일부 의료서비스업 VDT작업자의 상지 근골격계 증상의 정도와 관련된 요인

        김형렬,원종욱,송재석,김현수,김치년,노재훈 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.2

        목적: 본 연구는 상지 근골격계 질환의 유병율이 높은 집단으로 알려진 VDT작업자를 대상으로 이들의 근골격계 통증을 정량화하고, 정량화된 통증점수를 종속변수로 하여, 이와 관련성을 갖는 작업요인, 사회심리적 요인을 파악하고자 하였다. 방법: 서울지역에 위치한 1500병상 규모의 대학병원에 근무하고 단말기 작업을 주로 수행한다고 알려진 부서에 대해 병원내 안전관리과와 협의를 거쳐 163명을 연구대상으로 선정하였다. 이중 138명이 설문에 참가하였고, 이들을 최종 연구대상으로 하였다. 설문지를 가지고 연구변수를 측정하여, 나이, 근무연수, 가사노동의 정도 등의 인구학적 변수와 직무스트레스 및 사회적지지, 근골격계 증상, 통증의 양상 등을 조사하였다. 분석방법은 일반적 특성 및 작업특성, 통증의 양상을 성별에 따라 파악하였고, 통증점수의 타당성을 검정하기 위해, 통증점수의 구성요소와 통증점수를 시각적 상사척도와 상관성 검정을 시행하였다. 통증점수를 종속변수로 하고 직무요구도, 직무재량도, 동료의지지, 상사의지지, 여러작업환경특성, 인구학적 특징 등을 독립변수로 하여 다중회귀분석을 시행하였다. 결과: 첫째 통증의 정량화를 위해 사용한 통증평정지수는 시각적 상사척도와의 상관관계가 높은 것으로 나타나, 어느 정도의 타당성을 지닌 방법으로 해석할 수 있었다. 둘째, 이 통증 점수를 종속변수로 하여, 관련요인 분석한 다중회귀분석에서 직무요구도가 높을수록 통증의 정도가 높고(p<0.01), 여성일수록 남성에 비해 높은 통증점수를 보였다(p<0.01). 결론: 근골격계 질환의 높은 유병율을 보이는 집단의 경우, 이들의 증상 유무만을 가지고 관련요인을 분석하는 방법을 사용하기 어렵다. 따라서 이런 경우, 통증을 정량화하여, 다양한 관련요인을 찾으려는 노력이 필요하며, 본 연구에서 사용한 통증평정지수는 타당성을 지닌 정량화 방법이라고 여겨진다. 또한 본 연구에서는 직무요구도가 높을수록, 여성일수록 높은 통증점수를 보였다. Objectives: This study was designed to quantify symptoms in the upper extremities and to identify the pain related factors among hospital workers using video display terminals. Methods: The subject-group consisted of 138 employees working at a hospital using video display terminals. A structured questionnaire was used to estimate the participants' general characteristics, and job contents. Job stress was measured using Karaseks JCQ(Job Content Questionnaire). Pain in the upper extremities was identified according to the NIOSH symptoms survey criteria. Quantification was measured using Kim Chul's method. Pearson's Correlation analysis was used to identify validity in quantification. VAS(visual analog scale) was used to compare with this method. Multiple regression analyses elucidated the relationship between quantified pain and various work factors, such as job stress. Data were analysed with SAS 6.12 program. Results: First, in quantification using Kim Chul's method, the correlation between modified PRS(pain rating score) and VAS was extremely high by 0.60(P<0.01), indicating the high validity of PRS. Second, the groups of high job demand, high job control, and females were related to an increased pain level. Conclusions: These results suggest that the self pain assessment method, PRS, is valuable and useful in analyzing occupational musculoskeletal symptoms. High demand, job control and gender may influence the levels of pain. Prospective studies about musculoskeletal disorder are required.

      • RISS 인기논문

        수면량과 집중력의 상관관계

        김병우,류지근,박우진,박계원,김미정,임지은,백대현,최재덕,최윤호,이가현,이관,김덕수 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

        수면, 기억 그리고 학습의 연관성은 실제 매우 복잡하다. 많은 연구에도 불구하고 명확한 연구결과는 아직 없다. 우리는 이 연구에서 평소와는 달리 시험 전날 수면 변화 양상이 집중력에 어느 정도 영향력을 미치는지 알아보고자 하였고, 이를 이용해 효율적인 수면 관리를 할 수 있는 기초자료로 삼고자 하였다. 동국대 의대 본과 1학년생 중 지원자 30명과 본과 2학년생 10명을 대상으로 평상시 상태와 시험 직후 수면이 부족한 상태에서 각각 K-PES TEST를 실시하여 총 8항목에 걸쳐 암기력, 판단력, 단순반응의 변화정도를 검사하였다. 또 설문조사를 병행하여 결과에 영향을 미칠 수 있는 다른 인자들도 파악하였다. 수면량에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 인간의 최대 생리학적 기능은 꼭 수면부족에 의해 좌우되는 것은 아니다. 그러나, 수면감소는 피로를 증가시키고, 동기부여를 감소시키나 단, 새로운 사실을 학습하는 데에는 큰 영향을 끼치지 않는다. 즉, 수면부족으로 장시간 깨어있는 것은 정확성과 반응성을 떨어뜨린다. 흡연에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 니코틴의 수면에 대한 상호관계는 알려지지 않았고, 인간의 감정이나 의식, 인식에 영향을 주는 것으로 알고있지만, 장기적은 측면에서 흡연이나 알코올은 인식능력과 무관한 것 같다. 카페인에 대한 숫자 외우기(암기력)검사 결과, 카페인은 spacial selective attention에는 특별한 영향을 주지 않지만 지각과정이나 주의 집중에 큰 효과를 주며, 인간의 의식 수행에 긍정적인 효과를 준다. 즉 카페인은 활력, 혼란, 피로상태를 변화시키고 visual analog scales에서 휴식상태에 가까운 양상을 나타낸다. 또 48시간 동안 수면을 취하지 않은 사람에게 카페인은 집중력과 장시간의 좋은 기분을 유지하게 하였다. 그러나 규칙적, 비규칙적으로 먹는 사람간에는 인지수행력의 차이를 보이지 않으며 상용자에서는 상당한 내성이 보인다. 수면패턴에 대한 숫자 더하기(순간 판단력)검사 결과, 집중력은 수면패턴에 의해서도 영향을 받고, 수면패턴이 바뀌게 되면 순간판단력을 저하시킨다. This study was performed to evaluate relationship of sleep and attention, and to control sleep effectively. We conducted a K-PES test of 40 medical students. K-PES contains eight elements, for example, simple response, selective response, color pairing, OddEven discrimination, number addition, number-symbol matching, memory, right-tapping, left tapping. Through these, we tested changes of memory, judgement, simple response. And we conducted a questionnaire survey to exclude bias. Results are as follows. As a results of number-symbol matching test, we know that sleeplessness is not complete responsible for physiologic function for humans. But, decreased sleep increases fatigue and decreases motivation, but no influence on learning new materials. So, long term sleeplessness decreases precision and responsibility. As a results of number-symbol matching test on smoking, a relationship of nicotine and sleep is not certain. A point of view in long term period, smoking and drinking is not related cognition, even if we know that those influence mood, consciousness and cognition. As a results of memory work test on caffeine, caffeine does not influence spacial selective attention, but mainly does perception, attention and consiousness process. Namely caffeine changes energetic activities, chaos, fatigue states and shows resting state in visual analog scales In sleeplessness for 48 hours, caffeine produced attention and good mood for a long time. But, in case of cognitive process no significance shows in regular or irregular diet. Regular diet shows high resistance. As a results of number addition test on sleep patterns, seep patterns influence attention, changes of sleep patterns decrease a moment judgement.

      • KCI등재

        급성신부전을 동반한 알콜성 횡문근융해증 2례

        김영민,오동렬,이원재,김형국,황두영,이환,최경호,정시경,김세경,김영옥 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

        Rhabdomyolysis is a biochemical and clinical syndrome caused by lysis of skeletal muscle cell and release of muscle cell contents into the circulation. In addition to traumatic cause, various nontraumatic causes have been reported. Rhabdomyolysis has frequently been associated with seamy aspects of life and society: alcoholic abuse, drug addiction, sadistic drill exercise, war events and attempted suicide. The abuse of alcohol causes many hazards in many organs. One of these is acute alcoholic myopathy that may present as a fulminent syndrome of muscle pain and tenderness associated with rhabdomyolysis and acute renal failure. Because the prognosis of adequately treated rhabdomyolysis is excellent, early recognition and prompt management are essential in emergency situation. We experienced two typical cases of alcohol-induced rhabdomyolysis with acute renal failure and report these cases with literature review.

      • SCOPUSKCI등재

        Original Articles : Clinical significance of occult hepatitis B virus infection in chronic hepatitis C patients

        ( Jae Young Jang ),( Soung Won Jeong ),( Sung Ran Cheon1 ),( Sae Hwan Lee1 ),( Sang Gyune Kim ),( Young Koog Cheon ),( Young Seok Kim1 ),( Young Deok Cho1 ),( Hong Soo Kim ),( So Young Jin ),( Yun Soo 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3

        Background/Aims: We investigated the frequency of occult hepatitis B virus (HBV) infection in anti-hepatitis C virus (HCV)-positive individuals and the effects of occult HBV infection on the severity of liver disease. Methods: Seventy-one hepatitis B virus surface-antigen (HBsAg)-negative patients were divided according to their HBV serological status into groups A (anti-HBc positive, anti-HBs negative; n=18), B (anti-HBc positive, anti-HBs positive; n=34), and C (anti-HBc negative, anti-HBs positive/negative; n=19), and by anti-HCV positivity (anti-HCV positive; n=32 vs. anti-HCV negative; n=39). Liver biopsy samples were taken, and HBV DNA was quantified by real-time PCR. Results: Intrahepatic HBV DNA was detected in 32.4% (23/71) of the entire cohort, and HBV DNA levels were invariably low in the different groups. Occult HBV infection was detected more frequently in the anti-HBc-positive patients. Intrahepatic HBV DNA was detected in 28.1% (9/32) of the anti-HCV-positive and 35.9% (14/39) of the anti-HCV-negative subjects. The HCV genotype did not affect the detection rate of intrahepatic HBV DNA. In anti-HCV-positive cases, occult HBV infection did not affect liver disease severity. Conclusions: Low levels of intrahepatic HBV DNA were detected frequently in both HBsAg-negative and anti-HCV-positive cases. However, the frequency of occult HBV infection was not affected by the presence of hepatitis C, and occult HBV infection did not have a significant effect on the disease severity of hepatitis C. (Korean J Hepatol 2011;17:206-212)

      • KCI등재후보

        필리핀 여행 후 발생한 쯔쯔가무시병 1예

        김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

        Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

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