장기요양노인병원에서 발생한 보라색 오줌 증후군 또는 Purple Urine Bag Syndrome 16예 보고 및 문헌 리뷰

최규동(Gyu-Dong Choi),가혁(Hyuk Ga),박기호(Ki-Ho Park),유병익(Byung-Ik Yoo),김성민(Sung-Min Kim),강문철(Moon-Chul Kang),이은자(Eun-Jah Lee),박승태(Seung-Tae Park) 대한임상노인의학회 2007 대한임상노인의학회지 Vol.8 No.2

연구배경: 1978년 란셋 잡지에 보라색 소변에 대한 보고가 최초로 있은 이래, 이 현상에 대한 생화학적, 미생물학적, 임상적 규명이 있었다. 보라색 소변은 환자나 환자 가족에게 불편하거나 걱정스러운 질병이다. 그러나 대개의 경우 환자의 건강에 실제적인 위험이 되는 경우는 거의 없다. 심지어 보라색 소변은 열심히 치료할 필요가 없다고 주장하는 사람도 있다. 이에 대조군 연구를 통하여 보라색 소변의 위험요인과 임상적인 의미(심각성)에 대하여 평가를 하고자 한다. 방법: 2007년 2월부터 4월 사이에 인천은혜병원에 입원하고 있는 381명의 환자들 중 도뇨관을 삽입하고 있는 65명을 대상으로 하였다. 이 65명은 65세 이하이거나 1개월 이하동안 도뇨관을 갖고있는 환자는 제외한 숫자이다. 대상 환자는 모두 실리콘제의 폴리카테터와 일회용 소변주머니를 사용하였고 카테터의 교환주기는 특별한 경우 외에는 1개월마다 교환하였다. 대상환자 중 16명이 보라색 소변을 보여, 멸균생리식염수로 방광세척을 한 뒤 카테터와 소변 주머니를 소독된 새 것으로 무균적으로 교환한 뒤 소변배양을 실시하였다. 관련 환자와 대조군의 비교항목들을 통계처리하여 통계적인 유의성을 확인하였으며, 변수의 분석은 신뢰도 95%로(P value 0.05) 카이스퀘어 가설검정과 만-휘트니 U검사를 실시하였다. 결과: 보라색 소변을 보였던 환자들의 나이 평균은 80세였고 전원이 와상상태의 할머니였다. 대상환자의 진단명 중 가장 많은 것은 치매였다. 평균 도뇨기간은 22개월 이었다. 보라색소변을 보인환자군은 보이지 않은 환자들 보다 평균 도뇨기간이 길었으며, 변비가 더 심하였고 변비치료용 좌약 사용빈도가 높았다. 대조군에서는 조사기간 전 1개월 이내에 항생제를 사용한 빈도가 약간 더 높았으나 통계적인 의미는 확실하지 않았다. 결론: 보라색소변은 장기요양노인병원에서 흔히 발생하는 문제이다. 이전 연구들에서 없었던 보라색 소변과 항생제사용과의 관련성 및 변비치료제로 bisacodyl 좌약사용과의 관련성, 소변 카테터의 삽입기간 등에 대한 정보를 추가하여 얻을 수 있었다. Background: Since the first report of purple urine bag syndrome (PUBS) by Barlow and Dickson in 1978, many researchers have tried to reveal the clinical and bacteriological background of this phenomenon. To the best of our knowledge, most of them were case or case series reports and only three were case-control studies which compared the clinical, biochemical, or bacteriological background between patients with and without PUBS. It is certain that PUBS is an uncomfortable or troubling issue for some patients and their families. However, most of the patients who presented with PUBS were, largely, asymptomatic and it is apparent that PUBS is not a disease per se, nor does it appear to represent any real danger to patient's health, and some authors go so far as to even advocate that it is unnecessary to treat PUBS-affected patients aggressively. In this case-control study, we reviewed risk factors and clinical significance of PUBS in geriatric wards. Methods: Of the 381 hospitalized patients in a hospital specialized in the long term care of the elderly handicapped (Incheon Eun-Hye Hospital, Incheon, Korea), 65 patients who featured urinary catheterization during the period from February 2007 and April 2007 were enrolled in this study. Subjects who were younger than 65 or catheterized duration was less than one month were excluded. The same types of silicone Foley balloon catheter and disposable plastic urine bag were used for all patients. Routine Foley catheter change interval was one month. For the 16 patients who exhibits PUBS, bladder irrigation with normal saline and immediate change of urine bag and catheter were performed. And urine culture was done. Variables were statistically analyzed by chi square test or Mann-Whitney's U-test. P values less than 0.05 were considered statistically significant. Results: The PUBS patients mean age was 80, and bed ridden female. Most common diagnosis was dementia. Mean duration of the catheterization was 22 months. The PUBS patients were more constipated than non-PUBS control group and used more bisacodyl suppository. Antibiotics usage within one month before this survey in PUBS group is more frequent than control group with borderline statistical significance. Conclusion: PUBS is frequently occurring problem in long-term care geriatric wards. Causative factors are tryptophan putrefaction (decreased intestinal absorption, motility), alkaline urine, oxygen (air, Foley catheterization). All factors are bacterial infection related. Our results were the same as previous results. Relationship with antibiotics usage, bisacodyl suppository and constipation, long term usage of the Foley catheter notified also. Female predomination is related with easy, frequent urinary infection, and more population in old age.

골수염의 진단에 있어서의 Tc-99m Hexamethylpropylene amine oxime 백혈구 스캔의 임상적 유용성

최상호,김양수,정준원,정진원,추은주,서동대,배인규,양승오,우준희,류지소 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

배경 : 골수염의 진단에 있어 Technetium-99m을 이용한 삼상 골스캔(Tc-99m MDP스캔)은 단순방사선 검사상 정상소견을 보이는 경우에 쓰이는 1차적 검사로 매우 높은 민감도를 보인다. 그러나 Tc-99m MDP 스캔은 골절이나, 정형외과적 삽입물, 신경병적 관절병변과 같이 뼈의 재형성이 증가되는 상황에서도 양성소견을 보여 특이도가 낮은 단점이 있다. 이러한 단점을 보완하고자 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 유용성을 알아보고자 하였다. 대상 및 방법 : 골수염이 의심되어 Tc-99m HMPAO 백혈구 스캔을 시행했던 15명의 의무기록을 후향적으로 분석하였다. 골수염의 확진은 임상관찰 소견과 배양검사 결과와 병리소견을 기준으로 하였다. 결과 : 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 민감도와 특이도는 각각 100%와 78%였고 Tc-99m HMPAO 스캔의 경우는 100%와 18%였다. 가장 흔한 원인균은 methicillin-resistant S. aureus였다. Tc-99m MDP 스캔에서 양성소견을 보였던 환자중 3명의 환자가 Tc-99m HMPAO 백혈구 스캔에서 음성 소견을 보였으며 이 환자들은 추적관찰상 골수염이 없는 것으로 확인되었다. 결론 : Tc-99m HMPAO 백혈구 스캔은 골수염의 존재를 진단하는데 있어 민감도와 특이도가 높으며, 특히 뼈의 재형성이 증가되어 Tc-99m MDP 스캔의 특이도가 낮게 나타나는 상황에서 유용하리라 사료된다. Background Three phase bone scintigraphy, performed with technetium-labeled diphosphonates (Tc-99m MDP scan), is the very sensitive radionuclide procedure of choice for diagnosing osteomyelitis. But, Tc-99m MDP scan is less specific when bone remodeling is increased. To overcome this limitation, we evaluated the diagnostic value of technetium-99m hexamethylpropyleneamine oxime (HMPAO) labeled leukocyte scan in osteomyelitis. Methods : We retrospectively reviewed 15 patients with suspected osteomyelitis who performed Tc-99m HMPAO labeled leukocyte scan. The diagnosis of osteomyelitis was based on clinical course and bacterial culture, and pathologic findings. Results The sensitivity and specificity of Tc-99m HMPAO leukocyte scan was 100% and 78%, and those of Tc-99m MDP scan was 100% and 18%, respectively. The most common organism was Methicilein-Resistant S. aureus. Among the patients that showed persistent accumulation on Tc-99m MDP scan, three patients showed no uptake on Tc-99m HMPAO leukocyte scan and these patients were confirmed that had no osteomyelitis. Conclusion : Tc-99m HMPAO leukocyte scan is a useful test for determining the presence or absence of osteomyelitis, especially under condition that bone remodelin is increased.

다발성 간종괴의 형태로 나타난 특발성 과호산구 증후군 치험1예

최승오,연규민,이승민,김순제,왕준호,박형석,이재동,진춘조,이창훈,신현준,김정은 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

Hypereosinophilic syndrome is characterized by persistent blood eosinophilia of 1,500/ul or more in the absence of known causes and multiorgan dysfunction by eosinophil-related tissue damage. In Korea, some cases of hypereosinophilic syndrome with hepatic involvement have been described with prolonged benign clinical courses. Most of them were diffuse or multifocal lesions in imaging studies, and a few case presenting as a single mass has been described. Here we report a case of hypereosinophilic syndrome with hepatic involvement in a 65-year-old man who presented with multifocal mass lesions. By abdominal US and CT scan, multiple, ill-defined nodules were detected in throughout the liver. Liver biopsy revealed severe eosinophilic hepatitis, suggestive of hypereosinophilic syndrome. Hepatic mass lesions improved after steroid administration for several weeks.

폐모세포종 : 1례보고 A Case Report

최영호,서홍주,임영혁,김정중,박성강,이석기,임진수,김은규 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Pulmonary blastoma is a very rare primary neoplasm of the lung. We experienced a case of pulmonary blastoma in a 40 years old man. The mediobasal segmentectomy of the right lower lobe was performed. The patient was discharge on the postoperative days 6. There is no evidence of recurrence or metastasis on followup study during 7 months period after operation.

수근관 증후군의 국소 스테로이드 주사

조민규,이성훈,강은영,전평식,최영태 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.5

사용자 인식 스마트 홈 미러

최건영,고성화,김종옥,박은서,김완규,백경동,박동규 순천향대학교 부설 산업기술연구소 2021 순천향 산업기술연구소논문집 Vol.27 No.2

The Internet of Things, the core of the Fourth Industrial Revolution, is growing by incorporating various technologies into various fields. Among them, smart home systems that apply IoT technology to home environments are being actively studied. The home hub market, a means of communication for smart homes, is also developing at the same time. As the home hub market develops, security threats are also increasing accordingly. In this paper, 'Smart Home Mirror' is implemented by combining mirror and IoT technologies so that users can use them to communicate with smart home applications and other devices. To meet security issues, users in it are recognized by using face recognition technology and AES between all data communications in it is applied. The proposed device’s usefulness is approved by implementing it in smart home environments.

Skin entrance dose for digital and film radiography in Korean dental schools

Cho, Eun-Sang,Choi, Kun-Ho,Kim, Min-Gyu,Lim, Hoi-Jeong,Yoon, Suk-Ja,,Kang, Byung-Cheol 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.4

Purpose : This study was aimed to compare skin entrance dose of digital radiography with that of film radiography and to show the dose reduction achievement with digital systems at 11 dental schools in Korea. Materials and Methods : Forty six intraoral radiographic systems in 11 dental schools were included in this study. Digital sensors were used in 33 systems and film was used in 13 systems. Researchers and the volunteer visited 11 dental schools in Korea. Researchers asked the radiologic technician (s) at each school to set the exposure parameters and aiming the x-ray tube for the periapical view of the mandibular molar of the volunteer. The skin entrance doses were measured at the same exposure parameters and distance by the technician for each system with a dosimeter (Multi-O-Meter : Unfors instruments, Billdal, Sweden). Results : The median dose was 491.2 μGy for digital radiography and 1,205.0 μGy for film radiography. The skin entrance dose digital radiography was significantly lower than that of film radiography (p<0.05). Conclusion : Fifty-nine percent skin entrance dose reduction with digital periapical radiography was achieved over the film radiography in Korean dental schools.

BCR-ABL 융합유전자를 동반한 급성 골수구성 백혈병 1예

최정민,송성은,이규진,이규원,이호섭 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.1

BCR-ABL 융합 유전자를 동반한 급성골수구성백혈병은 그 빈도가 매우 낮고, 만성골수구성백혈병의 급성악화기와 임상적으로 유사한 특징을 가진다. 항암화학요법으로 관해유도가 되기 어렵거나, 관해유도 후 재발의 빈도가 높은 특징을 가지고 있어 예후가 나쁘다고 알려져있다. 저자들은 BCR-ABL 융합 유전자를 동반한 급성골 수구성백혈병1례를 경험하였기에 문헌고찰과 함께 보고 하는 바이다. BCR-ABL fusion gene is the hallmark of chronic myelogenous leukemia (CML), but it has been rarely reported in acute myeloid leukemia (AML). AML with BCR-ABL fusion gene has different features from blast crisis of CML. We experienced a rare case of AML with BCR-ABL fusion gene. Here we report this case with a brief review of literatures.

국균세포벽을 모델로 한 새로운 고정화담체의 개발

유은정,김종덕,송상호,임현수,최명락,정규화 여수대학교 1997 論文集 Vol.11 No.2

The purpose of this investigation was to develop a new carrier using chitin and glucan as the model for Aspergillus oryzae cell wall. In case of the ratio of chitin and glucan(3/1), the activity of the immobilized protease had higher than that of model(chitin/glucan=1/3) and carriers were formed gel. In case of soluble chitin and glucan treated with calcium carbonate, there were a 1.8-fold increase in activity of immobilized protease compared with untreated chitin. The scanning electron microscope image showed that a pore size of this carrier had a homogenized pore size and a smooth surface.

정신분열병과 N-Methyl-D-Aspartate 수용체 유전자와 연관된 VNTR 표지자인 D9S158 다형성의 연합

김종원,채영규,정은기,김길숙,박강규,이영호,최인근,양병환,한진희 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

정신분열병과 NMDA 수용체와 연관된 D9S158 유전적 표지자와의 연관성을 알아보기 위해 75명의 정신분열병 환자군과 87명의 정상대조군을 대상으로 중합효소연쇄반응을 이용하여 연합연구를 시행하여 다음과 같은 결론을 얻었다. D9S158 유전좌위에는 모두 8개의 대립유전자가 있었고, 각 대립유전자는 cytosine-adenine염기가 반복되는 217염기쌍에서 233염기쌍의 형태였다. 먼저 정신분열병 환자와 정상대조군의 대립유전자의 빈도를 비교해 본 결과 통계적으로 유의한 차이를 보이지 않았다(p〉.05). 환자군을 좀 더 동질적으로 만들기 위해 정신분열병의 가족력 유무, 음성 및 양성증상, 연성신경학적 징후, DSM-IV 임상아형에 따라 환자군을 나누어 대립유전자의 빈도를 비교해 본 결과, 특정 임상양상과 관련이 있는 대립유전자를 발견하지 못하였다. 결론적으로 본 연구에서는 D9S158 유전좌위와 정신분열병의 연관성을 입증하지 못하였으나 NMDA 수용체 유전자주위의 다른 표지자나 좀 더 유전적으로 동질한 환자군을 대상으로 한 추후연구가 필요할 것으로 생각된다. An association study with Korean schizophrenic patients(N=75) and normal controls(N=87) was performed to find the relationship between D9S158 polymorphism and schizophrenia using polymerase chain reaction. Eight different alleles of a dinucleotide polymorphism on D9S158 locus were observed in both group. When we compared the frequencies of alleles between schizophrenics and normal controls, there was no significant difference between two groups. To increase homogeneity of schizophrenic group, we divided schizophrenic group by clinical phenotypes such as family history, negative and positive symptoms(PANSS), soft neurologic signs(NES-K) and DSM-IV diagnostic subtypes. Then we compared the frequencies of alleles among subgroups of clinical phenotypes, and there were no significant differences between subgroups(p〉.05). Although our findings fail to provide an evidence of association between schizophrenia and D9S158 locus, further investigation of other loci that are linked to NMDA receptor gene may be needed in genetically homogeneous subgroups of schizophrenia.