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.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

PLSI 위상차 제어기에 의한 초음파 모터의 점탄성 특성

김동옥,김원배,성도생,고낙용,최한수,김영동 조선대학교 생산기술연구소 1996 生産技術硏究 Vol.18 No.1

As an actuator for direct drive(DD) manipulator. the travelling-wave type ultrasonic motor(USM) has many excellent performances and good advantages over conventional servo motors such as compact size, light weight, silent motion, low rotation-speed, high torque, low magnetic noise, high speed response, flexible free forms, large holding torque and so on. So it has been expected to be used as servo motor. This paper presents a design method of USM controller to adjust the phase difference of USM power using PLSI (Programmable Large Scale Intersration). we can control the elastic coefficient and the viscous coefficient of the USM by adjusting the phase difference of the motor power. By controlling the elasticity and viscosity, a robot can work in compliance with external environment. To use the result, we will be able to control the robot to reach its goal with compliance motion. It remains for further research to develop the impedance control of USM and to make cooperative robots.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

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.

CD34+ 조혈 모세포 이식 2례

김정아,정현식,김원석,윤성수,이홍기,박찬형,박성규,김동욱,이종욱,한치화,민우성,김춘추,김동집 대한조혈모세포이식학회 1996 대한조혈모세포이식학회지 Vol.1 No.1

Background: In most solid tumors, the CD34 antigen has not been detected, so positive selection of CD34+ cells may reduce tumor cell contamination and the CD34+ cells are capable of reconstituting hematopoiesis. We tried CD34+ cell transplantation in two patients. Method: CD34+ cells from chemotherapy + G-CSF mobilized PBPCs or bone marrow were positively selected with an avidin-biotin immunoadsorption column (CEPRATE SC system). Case 1. One course of chemotherapy using cyclophosphamide(200㎎/㎡) and etoposide (4.2g/㎡), combined with G-CSF(5㎍/㎏) S.C. was used in a relapsed lymphoma patient. This patient responded to the induction chemotherapy. CD34+ cells from harvested bone marrow were selected by the CellPro immunoadsorption column. The total number of mononuclear cells loaded onto the CellPro was 2.4×10^(8)/㎏, with 1.1% CD34+ cells. After column separation, the total number of positively selected cells was 5.16×10^(6)/㎏. The number of CFU-GM was 76.8×10⁴/㎏. This patient was treated with melphalan (140㎎/㎡) and TBI (1200cGy) and the positively selected CD34+ cells were infused. The time to neutrophil recovery greater than 0.5×10^(9)/L was 19 days and the time to platelet recovery greater than 50×10^(9)/L was 21 days. Case 2. Two courses of mobilizing chemotherapy were given 4 weeks apart using taxol(210㎎/m2) and adriamycin(60㎎/m2), combined with G-CSF(5㎍/㎏) S.C. in a breast cancer patients with 7 axillary node metastasis. CD34+ cells from each single leukapheresis product were selected by the CellPro immunoadsorption column. In the first collection, the total number of nucleated cells was 4.4×10^(8)/kg, with 0.42% CD34+ cells. In the second collection, the total number of nucleated cell was 2.8× 10^(8)/㎏ with 0.43% CD34+ cells. After colum separation, the total numbers of collected cells were 4.0×106/kg and 4.8×10^(6)/kg, the total number of CD34+ cells were 1.2×10^(6)/㎏ and 0.82×10^(6)/㎏. Colonogenic assays of positively selected CD34+ cells gave rise to myeloid erythroid, and multilineage colonies, with a median of 190 CFU-GM, 190 BFU-E, and 164 CFU-GEMM per 1×10³ adsorbed cells, respectively. High-dose chemotherapy with cumulative doses of 40mg/㎡ mitoxantrone, 750mg/㎡ thioptepa, and 1000mg/㎡ carboplatin was administered. Positively selected CD34+ cells were rapidly infused 24 hours after the end of high-dose chemotherapy. The time to neutrophil recovery greater than 0.5×10^(9)/L was 16 days and the time to platelet recovery greater than 50×10^(9)/L was 20 days.

알코올성 치매의 신경심리학적 소견

김태유,김지원,김상윤,김준모,이동기,연권인,김민정,이은아,손정은 대한노인병학회 2004 대한노인병학회지 Vol.8 No.1

Callus distraction method를 이용한 하악골 신장술 : 계단골절단술식의 적용

김명진,윤필영,신동준,김수경,김종원,김규식 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regeneracted bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1974 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

性別 및 年齡에 따른 體格과 體力의 特性과 變化에 關한 縱斷的 硏究Ⅱ : Emphasised on College Men of Department of Physical Education 體育專功 大學生을 中心으로

金尙國,姜東洹,張周鎬,金昇一,徐再均,金耕知,孫斗玉,鮮于攝,崔榮烈,尹宇相,金亨燉,方永鎭,朴英震,柳在忠 慶熙大學校 體育科學大學 1989 體育科學論叢 Vol.- No.2

The purpose of this study was to compare the characteristics, change in physique and physical function of college students majoring physical education and Taekwondo (454 males and 64 females of age groups ranging from 18 to 26). The results are as following: 1. The male group of 23yrs old in physical education showed highest values in 7 items(Weight, Chest Girth, Fore Arm Girth, Thigh Girth, Calf Girth, Scapular Skinfold Thickness and Suprailiac Skinfold Thickness). 2. In the Physical function, the male group of 18yrs old showed highest values in Power, Flexibility, and then 21yrs old at Back Strength, Vital Capacity, and 23yrs old at Grip Strength, and 25yrs old at Blood Pressure, respectively. 3. In the physique, the male group of 22yrs old showed highest values in Weight, Chest Girth, Thigh Girth, Calf Girth, and then 24yrs old Upper Arm Girth, Fore Arm Girth, and 19yrs old at Height, Upper Limb Length, respectively. 4. In Physical Function, the 22yrs old showed highest values in Back Strength, Vital Capacity, and then 23yrs old at Side Step, Trunk Extension, but 18yrs old showed lower Values in Grip Strength, Side Step, Vital Capacity and Blood Pressure. 5. The female group of 22yrs old showed highest values in 8 items(Height, Sitting Height, Waist Girth, Upper Limb Length, Lower Limb Length, Skinfold Thickness), and then 18yrs old at 5 items (Weight, Upper Arm Girth, Fore Arm Girth, Thigh Girth, Calf Girth), respectively. 6. In the physical function, the 22yrs old showed highest Values in Grip strength, Back Strength, Power, 5 Minute Run, and 18yrs old at flexibility, Harvard Step Test, respectively. 7. In the change of the physique for two years(1988-1989) in the male group, majoring Physical education the 22yrs old showed increase in 4 items, and the 20yrs old in 3 items, but 18yrs old showed decrease in 3 items. 8. In the change of the physical function for two years in the male group, the 20yrs old showed increase in 4 items, and the 21, 25, 26yrs old in 3 items, but the 19yrs old showed decrease in 6 items, and 18, 22 yrs old in 5 items, respectively. 9. The change of the physique for two years in all female group, of 18, 19, 20, 21yrs old showed increase in 11 items except Skinfold Thickness. 10. In the change of physical function for two years in female group, the 18yrs old showed increase in 3 items, and then 20yrs old in 5 items, but 19, 22yrs old decreased 12 items, respectively. 11. The highest significant difference in physique between male and female was found in weight(mean Value 17.5%), and the lowest difference was found Thigh Girth, Calf Girth(1,3%), Upper Limb Length, Lower Limb Length(2.5%). 12. The Highest difference in physical function was Strength (mean Value 40%), Vital Capacity (33%), Power(22%), but Lower Trunk Flexion, Foot Balance(3.4%). 13. In the difference of Physique and physical function between physical education major and taekwondo major, the physical education showed higher values in skinfold Thickines (mean Value 16.5%), Weight, Waist Girth(4.7%) and Strength(33%), Endurance(5.6%), but subjects majoring Taekwondo showed higher values in Flexibility and Foot Balance. 14. In all male groups, Waist Girth, Scapular Skinfold Thickness, Back Strength, Sargent Jump, Trunk Extension and Diastolic Blood Pressure were showed a significantly related at 0.001 level.

HID 램프용 디지털제어 전자식 안정기에 관한 연구

김영동,강원찬,김남오,김형곤,김병철 조선대학교 에너지.자원신기술연구소 2004 에너지·자원신기술연구소 논문지 Vol.26 No.1

In this paper, digitally controlled electronic ballast for the HID lamps driven by proposed frequency conversion method is described. This electronic ballast consists of a buck converter, a low frequency square wave full bridge inverter, a high voltage pulse generator for the lamp ignition, an over current protection circuit and an 8-bit microcontroller. The fuzzy logic digital control operation is carried out by the 8-bit microcontroller. In spite of the limited control bandwidth caused by low operation speed of the 8-bit microcontroller, the good control performance for the constant lamp current in the warm-up period is obtained using the proposed frequency conversion driving method. The HID lamp is controlled in a constant current mode during the lighting warm up process and is controlled in a constant power mode during lighting steady state. A controlled variable power mode is used to extend the lamp lifetime.