대량의 각혈로 사망한 장티푸스 1예

한상우,유진홍,권순석,김성훈,박지찬,홍은정,최경성,박용완,장준희,안지원,박유경,강지영,박상미,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

이대생의 체력 및 건강도에 관한 조사 연구

강지용,김종선,윤남식,이희순,한성일 梨花女子大學校 韓國生活科學硏究院 1975 韓國生活科學硏究院 論叢 Vol.15 No.-

The following results were obtained from the survey of health status and the measurements of physical fitness of 914 students of Ewha Womans University by means of CMI, which were conducted from October 7 to October 27 for three weeks. The purpose of the research mainly consists in the improvement of university health adiministration and of physical education. A. Survey of Health Status 1. The average Number of Complaints are 26.8 for items A-L, 15.3 for items M-R, and 42.1 for items A-R. In terms of classes, the Numbers of Complaints are revealed on a decreasing scale as follows: sophomores, 44.0, the highest; seniors, 42.6; freshmen, 42.1; and juniors, 40.5. 2. Among all the items, the following figures of average Numbers of complaints per person are conspicuous: the seniors have shown 5.3 for item D, which is the highest; and the sophomores, 0,7, which is the lowest. Among the physiological item, D, which corresponds to the ailments of digestion system, shows the highest rate; and among the items for mental diseases, item M, which corresponds to non­adjustment, is 5.2, the highest. 3. The percentiles on the lower echelons of the Number of Complaints are the following: 26.1% for freshmen is the highest; 22.2% for sophomores, the lowest. The sophomores have shown 27.1%, the highest figure, of students who have Number of Complaints of four or above. 4. The percentile figures of 10 or above of Number of Complaints are displayed by seniors with 2.4% and by sophomores with 1.5%. On the other hand, the percentile figures of 80 or above are revealed by seniors with 5.4% and by sophomores with 5.3%. B. Physical Fitness Measurements The figures for the physical fitness measurements are found as given below: 1. Pull­up Freshmen 18.4 seconds Juniors 9.3 seconds Sophomores 7.5 seconds Seniors 7.0 seconds 2. 100 Meters Dash An approximation of 19 seconds is recorded by freshmen, and the tendency is to be slower as the years go up. 3. Sit­ups The freshmen recorded 13 sit­ups, and the tendency is to be fewer as the years go up. 4. Throwing An approximation of 19 meters is marked by freshmen, and the tendency is to be shorter as the years go up. 5. Long Jump The freshmen marked 249.5 centimeters, and the tendency decreases as the years go up. 6. 800 Meters Run 4'1"8"'(4 minutes 1 seconds 8 points) is obtained for freshmen, and the tendency is to be slower as the years go up. 7. Shuttle Run 12.5 seconds is recorded for freshmen, and the tendency is to be slower as the years go up. 8. Trunk Flexion 18 centimeters is marked by freshmen, and the tendency is to be decreasing as the years go up.

양식장 배출물 발효물의 어류 사료 첨가에 따른 넙치, Paralichthys olivaceus의 혈액학적 변동에 미치는 영향

강주찬,지정훈,송승엽,문상욱,강지웅,이영돈,김세재 한국어병학회 2004 한국어병학회지 Vol.17 No.1

본 연구는 우리나라 주요 양식어류인 넙치, Paralichthys olivaceus를 대상으로 육상수조식양식장 배출물 발효물의 어류 사료 첨가에 따른 혈액학적 변동에 미치는 영향을 검토하였다. 젖산균 및 효모를 사용하여 발효한 양식장 배출물의 이화학적 분석을 실시하였고, 발효물을 0.1, 0.5, 1.0 및 5.0% 농도로 8주간 투여하였다. 투여 4주째 및 8주째에 각 투여 구간별로 혈액학적 항목을 중심으로 그 차이를 확인하였다. 배출물 발효농도별 유의한 차이는 나타나지 않았지만, 분석시기에 따른 적혈구수, 혈색소 농도 및 혈색소 지수가 증가하는 경향을 나타내었으나, 주요 혈청 무기 및 유기성분은 배출 발효물 농도별로 유의한 차이는 나타나지 않았다. 또한 혈청 효소학적 조사에서는 조사시기별로 변동은 나타났지만, 동일 조시시기에서 각 구간별 유의한 차이는 나타나지 않았다. 따라서 이러한 육상 약식장 유래의 배출물 발효산물에 대한 다양한 방면의 연구가 진행되어야겠다. Effects of oral administration with fermented product from sewage in land-based seawater fish farm on haematological disturbance in the olive flounder, Paralichthys olivaceus was investigated. After 4 weeks of conditioning with a basal diet, fish were divided into 4 groups and provided experimental diet (0.1,0.5, 1.0 and 2.0%) supplement of fermented sewage for 80 days. Proximal analysis was performed for the product of sewage which was fermented by lactic acid and yeast. RBC count, hemoglobin concentration and hematocrit value were increased according to the treated periods, however, no statistical difference was observed between control and treatment groups. There were no significant difference in serum organic, inorganic compounds and enzyme activities between control and treatment groups. This study hypothesized that the supplement of fermented product from sewage in land-based seawater fish farm might be an additive sup plement for source of fish diet in view of haematological examination. Recycling of the sewage may be an economic artificial sources of diet for fish aquaculture practices.

전조가 없는 편두통과 동반되어 나타난 일과성 전기억상실증

강성진,김광수,이지현,김종국,김민정 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Transient global amnesia(TGA) is a transient neurological syndrome presenting total memory impairment. Although the pathophysiology of TGA is not yet clear, it may be associated with migraine or ischemia. A sixty seven year-old woman complained total memory impairment that occurred during migraine attack. The cognitive function test revealed impairment of orientation and memory. Her brain MRI, EEG and SPECT didn’t show any abnormal findings. Therefore TGA may be caused by migraine induced cerebral ischemia.

Cone-beam CT로부터 제작된 측모 두부계측방사선사진의 정확도 평가

강지영,임성훈,김광원 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.6

최근 computed tomography (CT) 데이터로부터 실제 두부계측방사선사진 촬영기에서 촬영한 사진과 동일한 확대율을 갖는 두부계측방사선사진을 형성할 수 있는 기능을 갖춘 소프트웨어 (Accurex, CyberMed, Seoul, Korea)가 소개되었다. 이에 본 연구에서는 cone-beam CT (이하 CBCT) 데이터로부터 이 소프트웨어를 이용하여 제작된 측모두부계측방사선사진과 기존의 두부계측방사선사진촬영기로 촬영된 측모 두부계측방사선사진에서 각각 두부계측방사선사진 분석을 시행하여 그 차이를 비교함으로써 소프트웨어를 통해 CBCT로부터 제작된 측모 두부계측방사선사진의 활용 가능성을 평가하고자 하였다. 20명의 교정 환자를 대상으로 CBCT와 측모 두부계측방사선사진을 동시에 촬영하였다. CBCT로부터 제작된 측모 두부계측방사선사진과 기존 방식의 측모 두부계측방사선사진에서 두부계측방사선사진 분석을 시행한 후 두 사진의 계측치의 차이를 paired t-test로 검정하였다. 23개의 계측치들 중, 20개 항목에서는 통계학적으로 유의한 차이가 관찰되지 않았으나, U1-FH, Mx6 to PTV, Maxillomandibular difference의 항목에서는 유의한 차이가 나타났다. 이러한 차이는 CBCT로부터 형성된 측모 두부계측방사선사진의 해상도가 낮아 일부 해부학적 지표를 확인하기 어렵기 때문이며, 임상에서 CBCT로부터 제작된 측모 두부계측방사선사진을 porion, PTV, condylion과 같은 일부 해부학적 지표를 이용하지 않는 SNA, SNB, U1 to SN, IMPA, interincisal angle 등 흔히 사용되는 간단한 측모 두부계측방사선사진 계측에 활용 가능할 것이다. Objective: Three-dimensional approaches for the diagnosis and analysis of the dentofacial area are becoming more popular in accordance with the development of cone-beam CT (CBCT). The purposes of this study were to evaluate the reliability of cephalometric measurements of lateral cephalograms generated from a CBCT image by making comparisons with the traditional digital lateral cephalogram, and to evaluate the possibility of the clinical application of CBCT generated cephalogram images. Methods: Twenty patients whose external auditory meatus could be identified in the CBCT image were selected, and both CBCT and digital cephalograms were taken. Differences between the measurements of both cephalograms were tested by paired t-test. Results: Among the 22 measurements used, only U1-FH, Mx6 to PTV, and maxillomandibular difference showed statistically significant differences between the CBCT generated cephalogram and the digital cephalogram. Conclusions: The results suggest that the CBCT generated cephalogram can be used for some cephalometric measurements not requiring porion, PTV, condylion as a landmark (SNA, SNB, U1 to SN, IMPA, interincisal angle, etc.).

광범위 베타 락탐계 항생제 분해 효소를 생성하는 폐렴간균에 의한 균혈증이 발생한 환자에서 감영의 위험 인자 및 치료 결과

강철인,김성한,방지환,김홍빈,박상원,최영주,오명돈,김의종,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2

목적 : 본 연구는 ESBL을 생성하는 K. pneumoniae에 의한 균혈증 환자에서 감염의 위험 인자 및 치료 결과를 알아보고자 시행하였다. 방법 : 1998년 1월부터 2002년 4월까지 혈액 배양 검사에서 동정된 K. pneumoniae를 대상으로 NCCLS guidelines과 이중 디스크 확산법(double-disk diffusion test)을 이용하여 ESBL 생성 여부를 확인하였다. ESBL 생성 균주에 의한 균혈증 환자 60명(환자군)에 대해 ESBL을 생성하지 않는 균주에 의한 균혈증 환자들(대조군)을 연령, 성별, 균혈증 발생 시점을 고려하여 1:2 또는 1:3으로 배정하였다. 총 159명의 대조군을 선정하였고 후향적인 환자-대조군 연구를 시행하였다. 결과 : 환자군과 대조군 사이에 연령, 성별, APACHE Ⅱ score, 주된 감염 부위의 유의한 차이는 없었다. ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 발생할 독립적인 위험 인자에는 요관 삽입, 균혈증 발생 이전 72시간 동안 침습적인 시술을 받은 경우, 균혈증 발생 이전 30일 동안 투여받은 항생제 개수가 있었다. 초기 항생제 치료 72시간 후의 반응을 평가하였을 때, 완전 반응(complete response)은 대조군에서 더 많았고(13.3% vs. 40.3%, P<0.001), 치료 실패(treatment failure)는 환자군에서 더 많았다(33.3% vs. 11.9%, P<0.001). 7일 사망률은 환자군에서 20% (12/60), 대조군에서 15.6% (25/159)이었고(P=0.451), 30일 사망률은 환자군에서 30% (18/60), 대조군에서 24.5% (39/159)이었다(P=0.410). ESBL 생성 균주에 의한 균혈증이 있는 환자들에서 최종 항생제 치료가 부적절했던 환자들을 제외하고 30일 사망률을 분석하였을 때 효과적인 항생제 치료의 지연은 사망률을 높이지 않았다(11.1% vs. 9.1%, P=1.000). 결론 : ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 있는 환자에서 초기 항균제 치료 72시간 후의 치료 반응률은 낮지만 사망률은 유의하게 증가하지 않았다. 원인균이 동정된 후 최종 치료 항생제의 선정이 적절하다면 초기에 효과적인 항생제 투여의 지연은 사망률을 유의하게 증가시키지는 않았다. Background : This study was conducted to evaluate risk factors for infection and treatment outcome of bloodstream infection due to extended spectrum β-lactamases(ESBL)-producing K. pneumoniae. Methods: ESBL production was evaluated by NCCLS guidelines and/or double-disk synergy test in K. pneumoniae blood isolates stored from January, 1998 to April, 2002. Sixty patients with bloodstream infection due to ESBL-producing K. pneumoniae (case patients) were compared with 159 matched control patients with bloodstream infection of non-ESBL-producing K. pneumoniae. Retrospective case-control study was performed. Results : There were no significant differences in age, sex, APACHE Ⅱ score, and the primary site of infection between the case and control groups. In multivariate analysis, significant independent risk factors associated with bloodstream infection due to ESBL-producing K. pneumoniae were urinary catheterization, invasive procedure within previous 72 hours, and the number of antibiotics administered within previous 30 days. In clinical response at 72 hours after initial antibiotic treatment, complete response rate was higher in the controls (13.3% vs. 40.3%, respectively, P<0.001), however, treatment failure rate was higher in the cases (33.3% vs. 11.9%, respectively, P<0.001). Overall 7-day mortality rates in the cases and the controls were was 20% (12/60) and 15.7% (25/159) (P=0.451), respectively, and overall 30-day mortality rates were 30% (18/60) and 24.5% (39/159), respectively (P=0.410). When the patients with bloodstream infection of ESBL-producing organism were evaluated and the patients who received inadequate definitive antibiotic treatment were excluded, delayed effective antibiotic treatment was found to be not associated with higher mortality. Conclusion : In patients infected with ESBL-producing K. pneumoniae bacteremia, clinical response rate at 72 hours after antimicrobial therapy was lower, but the increase of mortality rate was not significant. Delayed effective antibiotic treatment was not associated with higher mortality, when definitive appropriate antibiotic treatment was prescribed.

한국판 주의력결핍 장애 평가 척도-가정판: 신뢰도 및 타당도 연구

강지현,박성찬,박형배 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

저자들은 주의력결핍 과잉운동장애에 대한 부모 평가척도인 주의력결핍 장애 평가척도-가정판(ADDES-HV)의 한국판 개발을 위해 본 연구를 시행하였다. 대구시 지역에 소재한 3개 국민학교 2학년 아동 538명과 주의력결핍 과잉운동장애 환자 36명의 환자군을 대상으로 ADDES-HV의 신뢰도와 타당도에 관한 검증을 실시하여 다음과 같은 결론을 얻었다. 1) 세 학교사이의 ADDES-HV 점수는 차이가 없었다. 2) 세 학교 학생들의 남녀간 비교에서 남자가 ADDES-HV 소척도 및 전체 점수 모두에서 여자보다 유의하게 높았다(p<0.05). 3) 주의력결핍 과잉운동장애 환자군 및 정상 대조군에서 남녀간의 ADDES-HV의 점수에는 유의한 차이가 없었다. 4) 검사-재검사 신뢰도 검증에서 신뢰도 계수는 주의 산만이 0.80, 충동성이 0.69, 과잉 운동이 0.63, 전체 점수 0.82로 모두 만족할 만큼 높았다 (p<0.05). 5) 내적일관성에 의한 신뢰도 검증에서 Cronbach α값은 주의산만,충동성,과잉운동 소척도에서 각각 0.91, 0.88, 0.89(p<0.05)이었고, 반복신뢰도 계수는 주의산만, 충동성, 과잉운동 소척도에서 각각 0.86, 0.86, 0.80(p<0.05)이었다. 6) ADDES-HV와 DSM-Ⅲ-R 척도와의 공존 타당도는 주의력결핍 과잉운동장애 환자군에서 0.57(p<0.05), 정상 대조군에서 0.84(p<0.05)였다. 7) 주의력결핍 과잉운동장애 환자군과 정상 대조군간의 감별 타당도 검증에서 모두 유의하게 환자군이 높은 점수를 보였다(p<0.05). 8) ADDES-HV의 환자군에 대한 판별력을 평가하기 위한 판별 분석에서 전체 판별력은 94.44%였다. 9) 정상적인 점수의 상한선인 절단점은 표준편차 1.5로 볼 때, 국민학교 2학년 남학생은 80점, 여학생은 69점이었다. 따라서 ADDES-HV 척도를 한국인에 적용한 결과 신뢰롭고 타당함이 입증되었고 환자를 판별하는 능력이 우수하여 향후 주의력결핍 과잉운동장애에 대한 선별 검사 및 조사 연구에 유용한 도구임이 입증되었다. The purpose of this study was to examine the reliability and validity of a Korean version of Attention Deficit Disorder Evaluation Scale-Home Version(ADDES-HV). ADDES-HV was administered to 538 second grade students from 3 elementary schools and 36 Attention Deficit Hyperactivity Disorder patients. There were no differences in the mean scores of ADDES-HV among schools. Male students showed significantly higher scores than female students in both subscale and total scores(p<0.05). There were no significantly differences in ADDES-HV scale scores between male students and female students both in attention deficit hyperactivity disorder patients group and in normal control group. In the reliability test, the test-retest reliability coefficient 0.82, significantly high ; 0.80 for inattention, 0.69 for impulsivity, 0.63 for hyperactivity and total score was 0.82. In the reliability test by internal consistancy, the Cronbach αcoefficient was also high ; 0.91 for inattention, 0.88 for impulsivity, 0.88 for hyperactivity(p<0.05). The split-half reliability coefficients by first-second half method showed high correlation, and coefficient of inattention was 0.86, that of impulsivity 0.86, that of hyperactivity 0.80(p<0.05). The concurrent validity between ADDES-HV and DSM-Ⅲ-R scale was 0.57 in attention deficit hyperactivity disorder patient group and 0.84 in normal control group(p<0.05). The ADHD group was were more discriminated than control group by ADDES-HV(p<0.05). The total discriminant capacity of the patient group in ADDES-HV was 94.44%. Regarding the cutoff point as 1.5 standard deviations, the cutoff scores were 80 for male students and 69 for female students. In this point of view, ADDES-HV scale showed high reliability and validity in applying to Korean subjects and was proved to be the useful screening test tool for attention deficit hyperactivity disorder research.

點鳳山一帶 天然闊葉樹林의 地形的 位置에 따른 群集 構造的 屬性 分析(Ⅰ) : 樹種構性, 種多樣性, 生活型을 中心으로

姜聲基,金知洪,金光澤,梁熙文 강원대학교 삼림과학연구소 2000 Journal of Forest Science Vol.16 No.-

이 연구는 점봉산 일대 천연활엽수림을 대상으로 산림의 지형적 위치에 따라 군집의 구조적 속성이 달라진다는 가정하에 대상산림을 계곡, 산복, 능선으로 구분하고 각 군집별 수종구성, 종다양성, 생활형 분석을 통해 산림 생태계의 군집 속성을 파악하여 산림경영의 생태적 접근 방안을 위한 기초자료를 제공하고자 실시 되었다. 연구 결과, 계곡지역 상층의 수종구성은 신갈나무, 전나무, 들메나무 순으로 우점하고 있는 것으로 나타났고, 산복지역에서는 피나무, 신갈나무, 가래나무 순으로 나타났으며, 능선지역에서는 신갈나무, 피나무, 물푸레나무 순으로 나타났다. 그러나 중층과 하층에서 높은 우점률을 보이는 까치박달과 당단풍은 생육특성상 상층목으로의 도약을 기대하기 어려울 것으로 추정되었다. 종다양성은 계곡, 산복, 능선등 모든 지역의 중층과 하층에서는 유사한 것으로 파악되었으나, 상층에서는 능선지역이 계곡과 산복지역에 비해 매우 낮게 나타났다. 그리고 수분조건이 좋은 계곡보다 산복지역이 종다양성이 높은 것으로 파악되었다. 조사된 146종의 관속식물을 대상으로 생활형을 휴면형을 기준으로 구분한 결과, 지중식물, 교목, 반지중식물, 아교목, 관목, 1년생식물, 지표식물, 수생식물 순으로 나타났다. 특히 희귀 및 멸종식물로 지정된 금강초롱꽃은 본 연구 대상지 전역에서 쉽게 관찰되었다. Taking account of the structural variation on species composition according to the different topographic positions, i.e. valley, mid-slope, and ridge, the species composition, species diversity, life tool·m were comparatively analyzed fort· the three topographic positions in the natural deciduous forest of Mt. Chumbong area. The results are as follows. 1.Specise Composition : Dominant species in the overstory were Quercus mongolica. Abies holophylla, and Fraxinus mandshurica in valley ; Tilia amuresis, Quercus mongolica, and Juglans mandshurica in mid-slope ; and Quercus mongolica, Tilia amurensis, and Fraxinus rhynchophylla in ridge. Acer p. and Carpinus c. which have maintained high composition ratio in mid-story were not considered to be dominant overstory species due to inherent growth form. 2.Species Diversity : The species diversity indices of mid- and understory showed not much different value in three topographic positions. However, the index of overstory in ridge had smaller value than those of valley and mid-slope. The stand in ridge had greater species diversity index than in valley where moisture condition could be more favorable. 3.Life Form : The total of 146 vascular were observed in Mt. Chumbong in this study Especially, Hanabusaya asiatica Nakai, were supposed to be the rare and endangered species, was easily found in many places. The proportion of life form spectra in the study forest was G-MM-H-N-Th-Ch-HH. Key words : natural deciduous forest, species composition, species diversity, life form.

횡하중을 받는 SiC/Ti-15-3 MMC 복합재 계면영역에서의 탄소성 응력장분포거동(Ⅰ)

강지웅,김상태,권오헌 한국안전학회 2004 한국안전학회지 Vol.19 No.4

Unidirectional fiber-metal matrix composites have superior mechanical properties along the longitudinal direction. However, the applicability of continuous fiber reinforced MMCs is somewhat limited due to their relatively poor transverse properties. Therefore, the transverse properties of MMCs are significantly influenced by the properties of the fiber/matrix interface. In this study, the interfacial stress states of transversely loaded unidirectional fiber reinforced metal matrix composites investigated by using elastic-plastic finite element analysis. Different fiber volume fractions (5-60%) were studied numerically. The interface was treated as three thin layer (with different properties) with a finite thickness between the fiber and the matrix. The fiber is modeled as transversely isotropic linear-elastic, and the matrix as isotropic elastic-plastic material. The analyses were based on a two-dimensional generalized plane strain model of a cross-section of an unidirectional composite by the ANSYS finite element analysis code.

베체트병에서 비스테로이드성 소염진통제에 의해 발생한 대량 소장출혈 1예

강인숙,류연주,장지은,정성애,이지수,조영주,이경은,이지희 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

Bechet's disease(BD) is a chronic inflammatoroy condition involving several organs inclu-ding gastrointestinal tract. Gastrointestinal tracts involvement in BD has been identified throughout the entire alimentary tract and commonly accompanies ulcerative lesions in the small and large bowel. It is debatable whether BD could be included among seronegative spondyloarthropathy (SPA).SPA usually occurs without overt sign of intestinal inflammation, but significant number of patients have asymptomatic intestinal inflammation, usually affecting ileum. Since most patients with SPA in-cluding BD are treated with NSAIDS. However, NSAID may play a role in aggravation or provo-cation of intestinal inflammation. Special attention to asymptomatic intestinal inflammation is needed, especially when NSAIDs are used for management of arthritic symptom in SpA. We experienced a case of BD which was complicated by a massive small bowel bleeding precipitated by NSAID use. 저자들은 베체트병 환자에서 비스테로이드성 소염진통제 사용 후 발생한 대량 소장 출혈의 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.