서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

혈액투석 환자의 가성 고칼륨혈증

최창렬,조형도,강태영,이준수,한호,정청일,이동규,유준호,한상웅,김호중 대한신장학회 2001 대한신장학회잡지 Vol.20 No.5

외상성 간손상과 비장손상시 CT분류의 의의

정준영,이창현,김현정,도호석,이삼범,도병수 大韓應急醫學會 1997 대한응급의학회지 Vol.8 No.1

The Organ Injury Scaling Committee of the American Association for the Surgery of Trauma recently published a consensus classification of hepatic and splenic injuries. The hepatic and splenic injury scales, based on parenchymal laceration and intrahepatic hematoma, include grade 1 to 6 and grade 1 to 5 respectively, representing the least to most severe injury. Forty-eight patients with hepatic and splenic injury were evaluate by abdominal CT from January 1995 to May 1996 and we compared abdominal CT grading with operative grading. Four CT grades did not correlate with operative finding. CT grading showed a sensitivity of 80%, specificity 80% in regard to operative grading. We conclude that 1) CT is an accurate technique to determine the extent of hepatic and splenic injury. 2) CT grading of hepatic and splenic trauma has a high correlation with operative grading.

구내 접근법에 의한 하악골 골절 치료에 대한 임상적 고찰

정성훈,박형식,권준호 大韓顎顔面成形外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.1

This is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans and extraoral approach. Among 92 sites of mandibular fractures 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.

경추 손상후 사망례에 대한 분석

정호성,김상은,이준형,박철완,이 근 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Mortality after cervical spine injury(CSI) is reported as high as 10∼30%, and it is intimately related to the initial management and cardiopulmonary function. We analyzed the cause of death for 29 patients who expired at Chung Ang Gil Hospital after CSI between 1990 and 1994. Of 198 patients with CSI, 43 patients(21m7%) died. Except 14 cases with concomitant fatal head injury and/or multiple systemic injuries, the mortality rate of CSI was 14.6%. Male to female ratio was over 6:1. Fourth to sixth decades constituted 69.0%. Common causes of CSI were traffic accidents(58.6%) and fall/slip(34.5%). The level of CSI was above C5(upper cervical group: UCG) in 65.5%, and below C4(lower cervical group: LCG) in 34.5%. Most of them(86.2%) died within four weeks after CSI. Early death(within 7 days) was more common in the UCG(57.9%) than the LCG(20.0%). Associated injuries were found in 72.4%, and the head injury was the most common one. The higher the Injury Severity Score(ISS), the earlier the patients expired(Fisher`s test, P<0.05). On arrival, hypotension(systolic blood pressure below 90mmHg), bradycardia(less than 60/min), and respiratory arrest was found in 31.0%, 34.5% and 17.2%, respectively. The episode of bradycardia was found in 58.6%. It was more common in cases of early death(69.2%) than those of the late death(50.0%). Hypoxia, hypercarbia, and acidosis was observed in 20.7%, 17.2%, and 51.7%, respectively. Respiratory failure was responsible for the majority(89.7%) of death. In UCG and the cases of the early death, primary respiratory dysfunction was the main cause of death, while in LCG and the cases of the late death, pulmonary complication was the major reason(Fisher`s test P<0.01, P<0.01, respectively).

기저질환이 없는 사람에서 발생한 Campylobacter fetus에 의한 재발성 심내막염 1예

전재범,정진원,김성혜,송문희,오형철,안성기,최상호,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

C. fetus 심내막염은 드물게 발생하는 질환으로 주로 면역능이 저하된 환자에서 발병하고 대동맥판을 침범하는 경우가 많으며 적절한 치료가 되지 않을 경우 치사율이 높다. 저자들은 기저질환이 없던 69세 남자에서 C. fetus 심내막염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 발열로 내원하여 시행한 혈액배양 검사상 C. fetus가 동정되었고 경식도 초음파 검사상 삼첨판에 증식증이 발견되어 심내막염 진단하에 ceftriaxone에 이어 meropenem으로 총 4주간 항생제를 투여받고 호전되었다가 한달 후 다시 재발하였고 판막부전 소견 진행하여 삼첨판 치환술을 시행받고 전신상태 호전되어 퇴원하였다. Campylobacter fetus is a rare cause of endocarditis. To date, only about 30 cases of C. fetus endocarditis have been reported mainly in the elderly with chronic underlying illnesses. Most cases showed tendency to involve aortic valve. This report describes a case of native tricuspid valve infective endocarditis in a 69-year-old man without any underlying disease. Despite adequate antibiotic therapy for 4-weeks, endocarditis recurred and leading to surgical valve replacement.

지속가능발전지표의 지수화 연구

정영근,강상목,여준호 한국환경경제학회 한국자원경제학회 2004 자원·환경경제연구 Vol.13 No.3

본 연구에서는 사회·환경·경제·제도 4개 부문의 지속가능한 발전지표들을 통합하여 지속가능발전지수 작성을 위한 방법론을 제시하고 한국의 지속가능발전 상태를 종합적으로 평가할 수 있는 지속가능발전지수를 1990~2001년간 실증적으로 계측해 보았다. 한국의 지속가능발전지수는 기준년도인 1995년을 중심으로 완만한 U자형 형태를 보이고 있는 것으로 나타났다. 지속가능발전지수가 1990년대 중반까지 하락한 주된 요인은 경제와 환경 부문의 하락에 기인하고 그 이후 상승은 사회와 제도 부문의 급격한 상승에 기인한 것으로 분석되었다. 지속가능발전지수가 주는 정책적 시사점은 첫째, 한국은 지속가능발전 측면에서 점차 긍정적인 추세를 보인다는 점과, 둘째, 지속가능발전지수의 상승과 하락이 4개 부분에 따라 사이하므로 하락하거나 보합적인 추세를 보이고 있는 부문에 대한 세심한 정책적 고려가 필요하다는 점이다. This paper develops the methodology for the indexation of Sustainable Development Indicators (SDIs) in 4 sectors (social, environmental, economic, and institutional sectors), and provides the empirical results of Sustainable Development Index (SDI) for Korea from 1990 to 2001. Given 1995 as the basic year. the trend of SDI for Korea displays a slowly curving U-shape. The down trend of SDI until mid-90's results from the decline of SDI in economic and environmental sectors, and the uptrend of SDI after mid-90's results from the sharp rising of SDI in social and institutional sectors. The implication of the results is that Korea generally shows a positive trend toward the sustainable development. However, there should be a careful consideration about partly downward trend in individual SDIs, because of the different trend of SDI in each sector.

급성흉통으로 내원한 환자에서 심근경색증을 조기 발견하기 위한 TROP-T?Rapid Assay의 유용성

정준영,이창현,김현정,도호석,이삼범,도병수 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Study Objectives : In the past, measurement of cardiac enzymes(i.e. CK and/or CK-MB, GOT, LDH)and myoglobin, cardiac specific serum troponin-T were widely used for the diagnosis of acute myocardial infarction, but it need a long time and have low specificity. Thus new diagnostic modality, TROP-T?? Rapid Assay, is very easy and rapid qualitative methods, is needed for the early detection of acute myocardial infarction. Methods : Total CK, GOT, LDH, myoglobin and serum troponin-T activities were measured in patients presenting with acute chest pain at the emergency department and at the same time TROP-T? Rapid Assay was done. Final diagnosis and diagnostic usefulness was evaluated. Results : Overall diagnotic sensitivity and specificity of initial results were as follows; TROP-T? Rapid Assay, 77.3, 100.0; myoglobin, 63.6, 70.4; CK, 95.5, 96.3; GOT, 86.4, 96.3; LDH, 90.9, 92.6; serum troponin-T, 86.4, 96.3, respectively. Conclusion : The TROP-T?? Rapid Assay is simple method and has a short time and nearly same sensitivity and specificity compared to other cardiac enzymes. Thus this is considered useful method in the early detection of acute myocardial infarction at emergency department.

체육교육에서 피그말리온 효과

정명수,문호준 조선대학교 스포츠과학연구소 1995 스포츠科學硏究 Vol.7 No.-

A 1948 paper by Robert Merton established that certain social events were, to a large extent, influenced by the expectancy effects in different social settings. It wasn’t until 20 years later that Merton’s concept of the self-fulfilling prophecy came to the attention of educational researchers (Clark, 1963; Goldberg,1963). Since the Oak Elementary School experiment, researchers have conducted well over 100 studies relative to teacher expectations. It is also important to note that impressions about a certain student may not be the same for two or more teachers. Futhermore, after an extensive review of the literature, Brophy and Good(1974) concluded that teachers, irrespective of gender, are more negative toward young males, particularly regarding their potential as behavior problems. In a follow-up study(Martinek & Karper, 1984a), it was discovered that the attractiveness cue was more influential in expectancy formation for older age groups than for younger ones. These data suggested that as children get older, attractiveness becomes increasingly related to performance expectations.

급성하벽심근경색에서 전흉부유도 ST절 하강의 의의

정병천,배호상,곽동훈,김영태,배용학,황종현,임현주,류재근,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 급성하벽심근경색증 환자에서 심전도상 흔히 동반되는 전흉부유도 ST절 하강의 의의를 알아보았다. 방법 : 심근경색후 24시간에서 48시간에 얻은 심전도를 기준으로 52명의 급성하벽심근경색증 환자를 전흉부유도에서 ST절의 하강이 있는 군과 없는 군으로 나누었으며 심도자, 관상동맥조영술, 심초음파도 및 방사성 핵종을 이용한 좌심구혈율 측정 등을 시행하였다. 결과 : 1) 좌심실확장기말압은 전흉부유도에서 ST절의 하강이 있는 경우에서 16.9±5.33mmHg로 없는 경우의 11.0±4.02mmHg보다 유의하게 높았다(p<0.05). 그러나 운동량 및 좌심구혈을은 흥부 유도상 ST절의 하강이 있는 경우 7.6±3.0 METs 및 53.9±9.1%로 없는 경우의 9.1±2.7 METs 및 54.6±9.5%보다 낮았으나 통계적 유의성은 없었다(p=0.180, p=0.823). 2) 관상동맥조영술상 전흉부 ST절의 하강이 동반된 군에서는 유의한 좌전하행지나 좌회선지의 협착이 있는 경우가 60.9% 및 57.9%로 ST절의 하강이 없는 군에서의 34.5% 및 7.7%와 비교해 좌관상동맥에 협착이 동반된 경우가 많았다(p=0.050, p=0.001). 3) 관상동맥조영술상 세 혈관질환의 빈도는 흉부유도상 ST절의 하강을 보인 23예에서 10예로 ST절 하강이 없었던 29예중 2예에 비하여 유의하게 많았고(P=0.007), 단 혈관질환의 빈도는 ST절의 하강을 보인 군에서 23예중 5예로 ST절 하강이 없었던 29예중 17예에 비하여 유의하게 적었다(P=0.002). 두 혈관질환의 경우에는 각각 8예와 10예로 양군간에 유의한 차이가 없었다. 4) 흉부유도상 ST절 하강의 빈도는 단 혈관질환 22예 중 5예에서, 두 혈관질환 18예중 8예, 세 혈관질환 12예 중 10예에서 관찰되어 협착이 있는 관상동맥의 수가 많을수록 ST절의 하강이 나타나는 빈도가 많음을 보였다(p=0.00308). 그러나 흉부유도상 나타난 ST절의 하강을 모두 합하여 구한 ST절 하강의 합은 협착이 있는 관상동맥의 수와 통계적인 유의성이 없었다. 5) 심초음파도상 좌심실 하벽의 벽운동은 ST절 하강을 보인 군에서는 akinesia가 83.3%, hypokinesia가 11.1%, 정상 벽운동이 5.6%로, ST절 하강이 없었던 군에서의 dyskinesia가 3.6%, akinesia가 39.3%, hypokinesia가 25.0%, 정상 벽운동이 32.1%와 비교하여 ST절의 하강이 있는 군에서 유의하게 벽운동의 장애가 빈번함을 보였다(p=0.03891). 그러나 좌심실전벽, 측벽 및 중격부위에서는 유의한 벽운동의 차이가 없었다. 결론 : 급성하벽심근경색증 환자의 전흉부유도에서 ST절의 하강이 동반되는 경우 다혈관 질환의 가능성이 높으며 좌심실확장기말압이 상승되었고 운동능력은 감소되어 있었다. 또한 심초음파도상 좌심실하벽의 벽운동장애도 심하였다. 따라서 전흉부 ST절의 하강을 동반한 급성하벽심근경색증 환자는 전흉부유도에 ST절 하강이 없는 경우보다 예후가 불량할 것으로 생각되며, 보다 적극적인 치료가 필요할 것으로 생각된다. The purpose of this study was to determine the significance of precordial ST segment depression appearing during acute inferior myocardial infarction and to assess the correlation of that with angiographic finding. 52 patients were allocated into two groups based on the existence of precordial ST segment depression : 23 patients with ST segment depression and 29 patients without ST segment depression. The extent of coronary artery disease as well as the prevalence of significant stenosis (≥70%) in left anterior descending artery were more frequent in patients showing precordial ST segment depression than in patients not showing them (p=0.050) and the result were similar in cases of left circumplex artery (p=0.001). On echocrdiographic examination of left ventricular (LV) wall motion, it showed more severely decreased inferior LV wall motion in patients showing precordial ST segment depression than in patients not showing them (p=0.03891) even though the other segment of LV wall motion didn't show the statistical difference between both groups. The other cardiac parameters such as LVEDP, exercise amount (METs) and ejection fraction were tend to showing bad profile in patients with precordial ST segment depression. From the above results, we could deduce that patients with precordial ST segment depression have relatively large infarction or concomitant left coronary artery disease, so they need more caution and intensive theraphy.