증례 : 호흡기 ; 면역억제제 치료 중인 류마티스 관절염 환자에서 발생한 Streptococcus salivarius 및 Nocardia 폐렴 1예

정인아 ( In A Jeong ),허은영 ( Eun Young Heo ),이재석 ( Jae Seok Lee ),김혜련 ( Hye Ryoun Kim ),이은영 ( Eun Young Lee ),김영환 ( Young Whan Kim ),양석철 ( Seok Chul Yang ) 대한내과학회 2009 대한내과학회지 Vol.77 No.1

Streptococcus salivarius는 상재균으로 감염의 원인으로는 간과되는 경우가 많았으나 최근 이 균에 의한 심각한 감염이 일부 환자에서 드물게 보고되어 왔다. Nocardia 감염 또한 드문 기회감염으로 스테로이드 치료, 악성종양, 장기 및 동종골수이식, 후천성면역결핍증 등 면역억제 환자에서 위험이 높은 질환이다. 본 증례에서는 스테로이드와 methtraxate, leflunomide를 투여 중인 류마티스 관절염 환자에서 발생한 다발성 종괴양 폐침윤에 대해서 기관지폐포세척액과 경기관지폐생검, 경피적미세침흡인 폐생검 조직의 배양검사를 통하여 Streptococcus salivarius 폐렴과 동반된 폐 Nocardia 감염을 진단하였으며, 항생제 치료로 증상과 방사선 소견이 모두 호전되어 이를 문헌고찰과 함께 보고한다. Streptococcus salivarius is a Gram-positive organism that belongs to the viridians group of streptococci. It is a relatively non-virulent bacterium that is part of the normal flora. It is rarely isolated from blood and is usually considered a contaminant. Nevertheless, S. salivarius may cause life-threatening infections, especially in immunocompromised hosts. There have been relatively few reports of S. salivarius pneumonia. Nocardiosis is also a rare opportunistic infection. Pulmonary nocardiosis is difficult to diagnose and, consequently, the diagnosis is often delayed. We report an unusual presentation with multiple pulmonary mass-like consolidations caused by a mixed infection of S. salivarius and Nocardia sp. in a 58-year-old man with rheumatoid arthritis who was taking oral corticosteroid, methotrexate, and leflunomide. The patient`s symptoms and radiographic findings improved after six weeks of antibiotic therapy. (Korean J Med 77:128-132, 2009)

Diagnostic Accuracy of Notified Cases as Pulmonary Tuberculosis in Private Sectors of Korea

정인아,Hee-Jin Kim,Juyong Kim,Soo-Yeon Oh,Jin Beom Lee,Jeong Ym Bai,Chang-Hoon Lee 대한의학회 2012 Journal of Korean medical science Vol.27 No.5

The diagnostic accuracy of the data reported in the Korean tuberculosis surveillance system (KTBS) has not been adequately investigated. We reviewed the clinical data of pulmonary tuberculosis (PTB) cases notified from private medical facilities through KTBS between January and June, 2004. PTB cases were classified into definite (culture-proven), probable (based on smear, polymerase chain reaction, histology, bronchoscopic finding, computed tomography, or both chest radiograph and symptoms) or possible (based only on chest radiograph) tuberculosis. Of the 1126 PTB cases, sputum AFB smear and culture were requested in 79% and 51% of the cases, respectively. Positive results of sputum smear and culture were obtained in 43% and 29% of all the patients, respectively. A total of 73.2%of the notified PTB cases could be classified as definite or probable and 81.7% as definite,probable, or possible. However, where infection was not confirmed bacteriologically or histologically, only 60.1% of the patients were definite, probable, or possible cases. More than 70% of PTB notified from private sectors in Korea can be regarded as real TB. The results may also suggest the possibility of over-estimation of TB burden in the use of the notification-based TB data.

성인 피부근염 환자 52명의 임상적 분석

정인순 ( In Soon Jung ),윤숙정 ( Sook Jung Yun ),이지범 ( Jee Bum Lee ),김성진 ( Seong Jin Kim ),이승철 ( Seung Chul Lee ),원영호 ( Young Ho Won ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.1

Background: Dermatomyositis is one of the idiopathic inflammatory myopathies, characterized by unique cutaneous features. Unfortunately, there is little data regarding the clinical features of dermatomyositis in Korea patients. Objective: The study aimed to analyze the clinical features of Korean patients with adult-onset dermatomyositis. Methods: A total of 52 patients from 2002 to 2016 were analyzed retrospectively. Clinical features such as sex, age, symptoms, associated connective tissue disorders and malignancy were studied using medical records. Results: The mean onset age was 43.4 years, and the male to female ratio was 1 : 1.9. Forty-two patients (80.8%) were classified as having dermatomyositis, and 8 patients (15.4%), as having amyopathic dermatomyositis. Skin rash (94.2%) was the most common clinical feature, followed by proximal muscle weakness (61.5%), itching (55.8%), arthralgia (36.5%), and muscle pain (32.7%). Among skin rashes, symmetric violaceous erythema (67.3%) was the most frequent, followed by heliotrope rash (63.5%) and Gottron’s papule (59.6%). Serum aldolase level was elevated in 77.8%, and LDH in 69.6%. The prevalence of malignancy (23.1%) was similar to that in previous studies. Cervical cancer made up 25% (3/12) of the associated malignancies, followed by ovarian cancer and lung cancer (16.7%). Ten patients (19.2%) had other accompanying connective tissue diseases. Conclusion: To date, this is the first large-scale case study that analyzed the clinical features of Korean patients with adult-onset dermatomyositis. (Korean J Dermatol 2018;56(1):24∼29)

전치태반의 임상적 고찰

정인석 ( In Suk Jung ),오희연 ( Hee Yeon Oh ),이수 ( Soo Lee ),이재준 ( Jae Jun Lee ),성문수 ( Moon Su Sung ),김현찬 ( Hyun Chan Kim ) 대한주산의학회 1996 Perinatology Vol.7 No.3

급성전신발진농포증 환자의 임상 및 조직학적 분석

정인순 ( In Soon Jung ),윤숙정 ( Sook Jung Yun ),이지범 ( Jee-bum Lee ),김성진 ( Seong-jin Kim ),이승철 ( Seung-chul Lee ),원영호 ( Young Ho Won ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.10

Background: Acute generalized exanthematous pustulosis (AGEP) is typically a medication-induced acute febrile eruption. Few large-scale studies have reported clinical data regarding AGEP in Korea. Objective: This study analyzed the clinical and histopathological features of AGEP in Koreans to identify recent trends in this context. Methods: This study retrospectively reviewed 31 patients with AGEP. Age, sex, clinical features, etiologies, laboratory findings, histopathological features, and treatment outcomes were obtained from patients’ medical records and photographs. Results: The mean age of onset was 43.6 years, and the male:female ratio was 2.1:1. All patients showed non-follicular tiny pustules and erythema. Fever was reported in 13 patients and neutrophilia in 17 patients. Medications were considered the most common etiological contributors. Twenty patients showed drug-induced AGEP, and 11 of 20 patients showed antibiotic-induced AGEP. Serum C-reactive protein and lactate dehydrogenase levels increased in 93.8% and 77.8% of the patients, respectively. Histopathologically, all patients showed subcorneal or intraepidermal pustules, followed by exocytosis and neutrophilic dermal infiltrate. Twenty-five patients improved within a mean period of 7.5 days after the onset of the skin rash. The percentage of women in the drug-induced AGEP group was significantly higher than that in the non-drug-induced AGEP group. Conclusion: This report describes a large-scale study that analyzed the clinical and histopathological features of AGEP in Koreans and seems to accurately reflect the recent trends in this context. Clinically, it is important to note that the percentage of women in the drug-induced AGEP group was higher than that in groups showing other etiologies of AGEP. (Korean J Dermatol 2018;56(10):594∼602)

흉부 X-Ray 검사실에서 Auto Voice Device의 유용성과 방사선사의 편의성에 관한 고찰

정인아(In-A Jung),이동희(Dong-Hee Lee),이민우(Min-Woo Lee),김순배(Sun-Bae Kim) 대한영상의학기술학회 2012 대한영상의학기술학회 논문지 Vol.2012 No.-

목적: 음성안내가 많은 흉부 X-ray 검사실에서 사용할 Auto voice device를 제작하여 장비의 유용성과 이에 따른 방사선사의 업무 편의성에 대해 알아보고자 하였다. 대상 및 방법: 2012년 01월 09일 부터 02월 24일에 걸쳐 방사선사 87명에게 검사방법과 장비사용법이 담긴 동영상을 보여준 후 연구목적과 취지를 설명하고 협조를 요청하여 설문 지를 배부하여 분석하였다. 방사선사의 일반적 특성은 성별은 남성이 58명(67.7%)으로 9 명(33.3%)인 여성의 약 2배이고, 평균연령은 36(35.89±7.90)세이며, 근무기간은 13(13.41±7.54)년, 검사건수는 300~399건이 41명(28.7%)으로 가장 많은 비중을 차지했 다. 조사결과 분석은 방사선사의 검사에 대한 일반적 견해와 개선사항과 장비의 질에 대한 견해를 파악하기 위해 빈도와 백분율을 산출하고, 검사장비도입의 효과 및 효능의 통계적 처리는 SPSS를 이용하여 일원배치 분산분석(ANOVA)을 하였다. 결과: 설문조사 결과 연령과 근무기간에 따른 Auto voice device의 유용성은 유의확률이 0.05 이상으로 모두 통계적으로 유의하지 않아 상관관계가 적은 것으로 나타났다. 그러나 검사건수에 따른 검사자의 피로도 감소는 유의확률 0.000 (p<0.01)으로 매우 유의한 결과를 얻었고, 검사건수에 따른 업무의 편의성도 유의확률 0.001 (p<0.01)으로 매우 유의하다는 결과가 나왔다. 결론: Auto voice device를 사용함으로써 업무의 편의성 증가와 목의 피로도 감소는 매우 높은 평가를 얻었다. 하지만 장비를 조작하는 시간이 추가됨에 따라서 전체적인 검사시간은 단축되지 않았고, 호흡조절도 장비를 사용하는 것과 육성을 사용하는 것을 비교하였을 때크게 다르지 않았다. 향후 개선사항들을 토대로 장비의 음질 개선과 언어의 다양화, 자막기 능을 추가하여 현재 장비의 업그레이드를 진행 중이며, 더 발전된 Auto voice device로 방사선사의 업무에 보다 더 효율을 줄 것으로 기대한다. Purpose: This study investigated usefulness of the device and its work convenience for radiologic technologist by making auto voice device used at chest X-ray lab where many voice guidance is made. Materials and Methods: The subjects are 87 radiologic technologists and they were asked to see video clip where how to use the device and method of applying to examination was introduced during the period from Jan. 9, 2012 to Feb. 24, 2012. Since then, study purpose was explained to ask for cooperation. For general characteristics of the subjects, the gender is 58 males (67.7%); 29 females (33.3%) - male is double female. Average age is 36 (35.89±7.90). Working period is 13 (13.41±7.54) years. As for number of examination by radiologic technologist, 41 radiologic technologists (28.7%) did 300-399 cases each person. To show general opinion of the subjects about examination, and opinion about improvements and quality of device, percentage was used. Effect and efficiency of using Auto voice device was analyzed using ANOVA through statistical processing by SPSS. Results: For reduction of fatigue in radiologic technologist s throat according to number of examination, p-value 0.000 (p<0.01) - this is very significant result. For work convenience according to number of examination, p-value 0.000 (p<0.01) -this is also very significant result. Conclusion: Using auto voice device brought increase of work convenience and reduction of fatigue in throat. But whole time for examination was not saved because maneuvering device requires additional time. In controlling breathing, there is no much difference between using device and human voice. It is expected that if auto voice device is improved in sound quality, variety in provided language etc. through this study results, this device would be more useful for work of radiologic technologists in the future.

소비자 맞춤형 개념설계 및 쿠션부 충격해석을 통한 외피형 에어백 헬멧 개발

정인덕(In-Duck Jung),이용문(Yong-Moon Lee),오미옥(Mi-Ok Oh),김승철(Seung-Chul Kim),이태구(Tae-Gu Lee),강명창(MyungChang Kang) 한국기계가공학회 2016 한국기계가공학회지 Vol.15 No.6

This study was initiated to minimize head injuries, which is the largest cause of increased external activity, traffic accident injuries, and death. We developed a low cost airbag that can be covered by a safety helmet based on consumer needs. The results of the survey showed that safety is the most important aspect of consumers" safety helmets. It also predicted that increasing the weight would present the biggest problem. Curved airbag cushion parts that can be attached to a helmet and the sensor part of a block type were designed. Impact analysis was performed by specifying the pressure inside the airbag and the volume of the airbag as variables.

Do3 CuZnAl 합금에 있어서의 역형상기억효과

정인상,이인철,박정식,이순린 ( In Sang Chung,In Chul Lee,Jung Sig Park,Soon Lin Lee ) 한국열처리공학회 1990 熱處理工學會誌 Vol.3 No.2

Since the reverse shape memory effect(RSME) was reported in a CuZnAl alloy, further study has been done on the mechanism of this phenomenon and reported that it occurs by the bainitic transformation. But the present authors revealed in the previous work that the RSME in a B2 CuZnAl alloy is not caused by the shear process involved in the bainitic transformation and also that the RSME takes place as the remaining α`₂phase, which is two-step transformed strain induced martensite, is newly transformed into α phase. In order to provide further evidence in supporting the facts, thus, more detailed investigations have been carried out in a DO₃CuZnAl alloy.

경주 지역 대학생의 빵에 대한 인식과 이용 실태

정인창(In-Chang Jung),이혜상(Hye-Sang Lee),이종숙(Jong-Suk Lee) 동아시아식생활학회 2009 동아시아식생활학회지 Vol.19 No.6

기본 조성을 갖는 산화아연 바리스터의 깊은 전자덫에 관한 연구

鄭仁宰(In-Jae Chung),李經宰(Kyung-Jae Lee),李南良(Nam-Yang Lee),吳明煥(Myung-Hwan Oh) 대한전기학회 1989 전기학회논문지 Vol.38 No.4