자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

대동맥 판막 치환술 후 반복되는 Acinetobacter baumannii 균혈증의 원인이 된 대동맥염 1예

정용필,김성철,송은희,장은영,김은경,김윤지,성흥섭,김미나,최상호,우준희,김양수 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

감염성 대동맥염은 흔하지 않지만 매우 위중한 질병으로 Salmonella so.와 S. aureus가 주된 원인균이다. 아직까지 병원내 감염의 주요 원인균인 Acinetobacter baumannii에 의한 감염성 대동맥염은 보고된 바가 없었다. 저자들은 대동맥 판막 치환술을 시행받은 76세 남자 환자에서 적절한 항생제 투여에도 반복되는 A. baumannii 균혈증의 원인이 감염성 대동맥염으로 진단되었던 1예를 경험하였기에 보고하는 바이다. Infectious aortitis is an uncommon yet, life threatening disease. Early surgical treatment and prolonged antibiotic therapy is crucial to survival. Salmonella sp. and Staphylococcus aureus are the most common organisms isolated. There is no case report of infectious aortitis caused by Acinetobacter baumannii, which has recently emerged as a major cause of health care-associated infections. Here, we describe a 76-year-old male with infectious aortitis who experienced recurrent bacteremia due to A. baumannii in spite of adequate antimicrobial therapy after aortic valve replacement.

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.

폐경기 증후군 환자에서 Cyclofenil의 치료 효과

김덕윤,고은미,우정택,양인명,김진우,김영설,김광원,최영길 최신의학사 1992 最新醫學 Vol.35 No.10

Inhibition of Cytokine-Mediated Nitric Oxide Synthase Expression in Rat Insulinoma Cells by Scoparone

Kim#, Eun Kyung,Kwon#, Kang Beom,Lee, Ju Hyung,Park, Byung Hyun,Park, Jin Woo,Lee, Hern Koo,Jhee, Eun Chung,Yang, Jeong Yeh Pharmaceutical Society of Japan 2007 Biological & pharmaceutical bulletin Vol.30 No.2

<P>Cytokines produced by immune cells infiltrating pancreatic islets are important mediators of β-cell destruction in insulin-dependent diabetes mellitus. Scoparone (6,7-dimethoxycoumarin) is known to have a wide range of pharmacological properties <I>in vitro</I>. In this study, the effects of scoparone on cytokine-induced β-cell dysfunction were examined. Presence of scoparone significantly protected interleukin-1β (IL-1β) and interferon-γ (IFN-γ)-mediated cytotoxicity of RINm5F, a rat insulinoma cell line, and preserved glucose-stimulated insulin secretion in rat pancreatic islets. Scoparone also resulted in a significant reduction in IL-1β and IFN-γ-induced nitric oxide (NO) production, a finding that correlated well with reduced levels of the inducible form of NO synthase (iNOS) mRNA and protein. The molecular mechanism by which scoparone inhibited iNOS gene expression appeared to involve the inhibition of NF-κB activation. These results revealed the possible therapeutic value of scoparone for the prevention of diabetes mellitus progression.</P>

카드뮴에 의해 유발된 선천성 기형에 대한 연구

김은주,김선,양은진,한승로,김수일,김원식 대한췌담도연구회 2000 대한췌담도연구회지 Vol.5 No.2

Rotavirus 전기영동형별을 위한 RNA 추출과정 및 조건의 비교연구

조은경,김은순,양재명,김경희,조양자 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.2

Rotaviruses (Rv) are the major cause of severe dehydrating dearrhea among young children in Korea, where they are frequently responsible for 68% of the cases requiring hospitalization. Laboratory diagnosis of rotaviral infection in Korea depends mainly on enzyme-linked immunosorbent assay (ELISA) that employs expensive commercial diagnostic kits purchased from abroad and that shous the presence or absence of group A Rv only. PACE have however provided epidemiologic evidence to demonstrate the sxistence of different strains (both group A and atypical Rv) during diarrgeal outbreak, the appearance of new strains and desappearance of old ones from a community, shifts in the prenalence of strains, and the persistance of a single strain in newborns. For such reasons, we have felt that it is essential to raise the sensitivity and shorten the processing time for PAGE. We therfore have devised a rapid method for Rv RNA extration by directly extracting the Rv RNA from the specimens (that is, skipping freon extraction and running as ultracectrifuge) and using an urea-containing dissociation mixture to dissolve dried RNA for PAGE. We have also shorten the PAGE diagnostic results by sequential staining of the same gel with ethidium bromide and silver stain. With the use of the rapid method, it was feasible to increase the efficacy of the PAGE with reduced cost and working time. Phenol extration of stools, however, was essential in maintaining the sensitivity of the method.

Mycobacterium intracellulare에 의한 요추부 척추염 1예

장은영,김미영,김정욱,송은희,백관미,정용필,성흥섭,김미나,김양수,우준희,이상호 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

비결핵성 미코박테리아에 의한 척추염에 대한 증례 보고가 국내에서는 아직 없었다. 저자들은 기저질환이 없는 환자에서 M. intracellulare에 의한 척추염을 rpoB 유전자에 대한 PCR-RFLP 방법을 통해 진단하였고 수술적 치료와 3제 병합 항균 요법으로 성공적인 임상 경과를 보인 1예를 경험하였기에 보고하는 바이다. We report a case of vertebral osteomyelitis due to Mycobacterium intracellulare in a 60-year-old man without predisposing conditions. He was successfully treated with surgical excision of the inflamed tissue and combined antimycobacterial therapy consisting of clarithromycin, ethambutol, and rifampin. In this case, polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) based on the rpo B gene of cultured isolates allowed rapid identification of M. intracellulare. Although very rare, nontuberculous mycobacteria (NTM) should be suspected as a causative pathogen of vertebral osteomyelitis. To the best of our knowledge, this is the first case of vertebral osteomyelitis caused by NTM reported in the Korean literature.

흡연에 의한 급성 호산구성 폐렴 2예

박종빈,김학렬,주현준,유태양,신성남,신정현,송정섭,황기은,김소영,양세훈,정은택 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

최근 흡연을 시작한 젊은 성언에서 급성 호산구성 폐렴의 발생에 대한 증례가 보고되고 있다. 급성 호산구성 폐렴은 대개 발열을 동반하기 때문에 초기에는 감염성 폐렴으로 잘못 진단, 치료되는 경우가 많다. 아직 정확한 병태 생리 및 조직학적 소견은 밝혀져 있지 않지만 병력 청취 및 임상 양상, 방사선 소견의 관찰을 통해 급성 호산구성 폐렴을 의심하고, 진단을 위해 기관지 폐포 세척액 검사를 시행한다면 좀 더 쉽게 진단 내릴 수 있을 것이다. 본 저자들은 최근 처음 시작한 흡연에 의해 발생한 급성 호산구성 폐렴을 진단하고, 스테로이드를 투여하여 성공적으로 치료한 환자 2예를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Acute eosinophilic pneumonia(AEP) is characterized by acute febrile respiratory illness associated with diffuse pulmonary infiltration and pulmonary eosinophilia. The specific etiology for acute eosinophilic pneumonia is elusive. By some investigators, cigarette smoking is suggested as a causative substance which can cause AEP. In recent, the authors experienced two cases of AEP following cigarette smoking. Both cases had characteristic features including age around 20 years, new onset smoking before occurance of AEP, diffuse infiltration on chest radiography, pulmonary eosinophilia based on bronchoalveolar lavage and acute improvement after steroid therapy. These clinical features are resemble with previous smoking induced AEP case reports. Base on these clinical features, cigarette smoking associated AEP could be diagnosed more easily.

8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.