Cobb syndrome 1례

박정욱,박지현,나정호,김영인,이광수,김범생 대한신경과학회 1996 대한신경과학회지 Vol.14 No.4

혈액암환자에서 조혈모세포 이식 후 따르는 헤르페스 바이러스 감영 양상

이호섭,탁희상,신성훈,김양수,남성진,김혜수,박진희,정수현,김성빈,김예나 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

배경 : 헤르페스바이러스과에는 단순포진 바이러스(HERPES SIMPLEX VIRUS, HSV), 수두대상포진 바이러스 (VARICELLA-ZOSTER VIRUS, VZV), 엡스타인-바 바이러스 (EPSTEIN-BARR VIRUS, EBV), 그리고 거대세포 바이러스 (CYTOMEGALOVIRUS, CMV) 등이 있다. 헤르페스바이러스 감염은 혈액암환자에서 조혈모세포 이식 환자에서 전파 (dissemination), 이차감염, 세균 중복 감염의 심각한 합병증을 일으킬 수 있다. 하지만 항암약물치료를 받는 림파종 환자에서 항 바이러스 약제의 사용 용량과 기간에 대한 concensus는 없다. 헤르페스바이러스 감염에 대한 발생율과 위험인자를 후향성으로 분석하였다. 방법 : 고신대학교 복음 병원에서 1995년 6월부터 2009 년 2월 사이에 새롭게 진단되어 조혈모세포 이식을 받은 전체 58명의 환자들이 후향적으로 현 연구에 등록했다. 헤르페스 바이러스 감염은 임상적 진단, 혈청학적 검사 또는 병리학적 진단에 기초하여 확진한다. 환자들의 특성은 다음과 같다: 평균 연령은 44세 (범위 19-62세)였고 남녀비는 30:28이었다. 등록된 질환은 백혈병 (n=9, 15.5%), 림프종 (n=30, 51.7%), 다발성 골수종 (n=12, 20.7%), 재생불량성 빈혈 (n=6, 10.3%) 그리고 골수이형성증후군 (n=1, 1.7%)이 포함되었다. 결과는 chi-squre test나 independent samples T test를 사용하여 분석되었다. Multivariate analysises에 대해 logistic regression test를 사용하였다. 결과 : 15명의 환자들 (25.9%)에서 조혈모세포 이식후 헤르페스 바이러스 감염이 발생하였다. 조혈모세포 이식 5년간 누적 발생율은 53.9%였다. Univariate analyses에서 헤르페스 바이러스 감염에 대한 유의한 위험 인자는 없었다. 하지만 조혈모세포 이식후 생존 기간(40.18 ± 30.14 months vs 20.06 ± 26.67 months, p=0.018)은 헤르페스 바이러스 감염의 낮은 발병율과 유의한 관련성이 있었다. 이식 편대 숙주질환 (GVHD)의 존재 (37.5% in developed GVHD vs 0% in no GVHD, p=0.200), 동종조혈 모세포 이식에서 면역억제요법의 기간 (15.98 ± 14.02 months vs 6.78 ± 3.67 months, p = 0.374)은 헤르페스 바이러스 감염에 대한 위험인자가 아니었다. 결론 : 조혈모세포 이식 후 생존 기간은 어사이클로비어 예방을 받은 혈액암 환자에서 헤르페스 바이러스 감염의 낮은 발병율과 연관성이 있는 것으로 보인다. 저용량의 어사이클로비어 예방은 헤르페스 바이러스 감염의 고위험군인 조혈모세포 이식을 받은 혈액암 환자에 필요하리라 생각된다. Background : Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection (HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with hematologic malignancy following hematopoietic stem cell transplantation (HSCT). But there was no consensus on the dose and duration of antiviral agents prophylaxis in patients undergoing chemotherapy. We retrospectively analyzed the incidence and the risk factors for HVI. Method : A total of 58 patients who newly diagnosed and received HSCT with prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, Korea between June 1995 and February 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 44 years (range 19-62 years) with a female-to-male ratio of 30:28. The enrolled diseases included leukemia (n=9, 15.5%), lymphoma (n=30, 51.7%), multiple myeloma (n=12, 20.7%), aplastic anemia (n=6, 10.3%) and myelodysplastic syndrome (n=1, 1.7%). The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysis, we used logistic regression test. Results : Fifteen patients (25.9%) developed HVI after HSCT. The cumulative incidence of HVI was 53.8% at 5 years after HSCT. In univariate analysis, there was no significant risk factor for HVI. The presence of graft-versus-host disease (GVHD) (37.5% in developed GVHD vs. 0% in no GVHD, p=0.200), duration of immunosuppressive therapy (IST) in allo-SCT (15.98 ± 14.02 months vs. 6.78 ± 3.67 months, p = 0.374) were not risk factors for HVI. Conclusion : The incidence of HVI was similar to that in historical other studies. There was no risk factor associated with development of HVI. Most of the HVI occurred within the first 24 months after transplantation. So long term use of antiviral prophylaxis may be needed to prevention of HVI after HSCT.

全蝎 抽出物의 抗癲癎效果에 關한 硏究

신현철,윤철호,김종대,정지천,신억섭,허근 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

In convulsion state by PTZ in rat, anticonvulsive effect and some γ-aminobutyric acid (GABA)-related mechanisms of Bythus extract in brain was experimented. It was ingibited GABA-T activity, lipid peroxide generation and xanthine oxidase activity as scheduled administration in vitro and vivo. And the content of brain gutathione was increased as scheduled administration in rat. In convulsion state by PTZ of previously managed rat by Buthus extract, onset eime and duration were non-specific changes but recovery time and severity was remarkably reduced. In conclusion speculated that Buthus extract inhibits convulsion by control of GABA content in brain.

대학 ‘글쓰기’ 교과 개선을 위한 교수 개발 프로그램의 내용과 효과 분석 : 전남대학교 사례

염민호,김영록,김현정 韓國敎員大學校 敎育硏究院 2009 敎員敎育 Vol.25 No.3

이 연구의 목적은 대학 글쓰기 교육의 성공적 요인으로 중시하는 '글쓰기 교과 교수 개발 프로그램’의 내용과 효과를 경험적으로 분석하여, '글쓰기 교과 교수 개발 프로그램’의 발전 방안을 모색하는데 있다. 전남대학교에서 지난 4년 동안(2005-2008) 개발하여 운영한 교수 개발 프로그램의 내용 분석 결과,글쓰기 교과 교수 개발 프로그램의 유형은 '글쓰기 강사 워크숍', '특별 연수 프로그램’,'더 나은 가르침을 위한 교수공동체’ 등으로 세분화되어 있었다. '글쓰기 강사 워크숍'의 주제는 교재 분석,강의안 개발,피드백 사례 공유 등이었다. '글쓰기 강사 워크숍'의 효과 분석을 위해 9차 워크숍에 참여한 43명의 강사들을 대상으로 한 설문 분석 결과, 워크숍은 실제 강의에 도움이 되며,워크숍에 많이 참석한 강사들이 적게 참석한 강사돌보다 강의에 어려움을 덜 겪는 것으로 나타났다. 결론에서는 교과 개선을 위한 교수 개발프로그램 개발 및운영과 관련하여 유념해야 사항을 ‘프로그램 목적의 명료화’,'워크숍 참여의 의무화’ '평가의 중요성’ 등 세 가지로 나눠 논의했다. This study analyzes the contents and effectiveness of a faculty development program and suggests ways to improve university writing courses. Through a content analysis the study explored a faculty development program developed and operated since 2005 at Chonnam National University, South Korea. The study revealed that the program included a specialized writing workshop for instructors and in-service training for beginning instructors, which led to the betterment of the teaching community. Major aspects of the program included the analysis of textbook, the development of lecture plans and the sharing of feedback. Employing a questionnaire divided into pre- and post tests, the authors examined the perceptions of 43 instructors who took part in the ninth workshop of the program. The results revealed that the participants generally recognized the positive effects of the workshop. Instructors who participated in several workshops found less difficulty in their own teaching compared with instructors who did not have multiple workshop experience. The authors discuss points from this study and offer suggestions on how to improve faculty development programs for specific subjects, including the importance of goal setting in the programs, the development of mandatory workshop programs, and the importance of appropriate evaluation.

전신성홍반성루푸스 환자에서 발생한 순수어농

김윤정,김해림,박시내,윤종현,이상헌,박성환,김호연 대한내과학회 2004 대한내과학회지 Vol.66 No.4

순수어농이란 발성언어에 대한 이해와 반복에 장애를 보이지만 읽기, 쓰기, 비발성언어에 대한 이해는 보존되는 경우를 일컫는다. 저자들은 45세 루푸스 환자에서 루푸스 혈관염으로 인해 일차 청각 피질을 포함한 왼쪽 관자이랑에 뇌경색이 발생하여 초래한 순수어농 1예를 경험하였기에 보고하는 바이다. Pure word deafness is characterized by an impairment of auditory comprehension and repetition of speech while a preservation of reading, writing, spontaneous speech and ability to comprehend non-verbal sounds. It is caused by trauma, infection in the temporal lobe of brain. In most cases, the lesions are bilateral, in the middle third of superior temporal gyri, but in a few cases unilateral lesions of dominant temporal lobe are localized. We experienced a case of 45 year-old right handed wonman with systemic lupus erythemato년 (SLE) who presented pure word deafness after left temporal lobe infarction including primary auditory center. Her comprehension was impaired, while reading and visual comprehension were normal. Audiometric tests and auditory evoked potentials disclosed no hearing defect. Brain MRI showed a left temporal lobe infarction without abnormal vascular finding in MRA. She wasdiagnosed as pure word deafness due to SLE vasculitis and managed with high dose steroid and cyclophosphamide therapies.

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.

초등과학영재학급 학생의 학습양식과 과학탐구능력 간의 상관관계

최선영,송현정,강호감 한국초등과학교육학회 2005 초등과학교육 Vol.24 No.2

The purpose of this study was to investigate the relation between the learning styles and science process skills of students of the gifted class in elementary school. Subjects were forty-eight students of the gifted class who are in the fifth grade studying at the gifted class of S elementary school in Bucheon, M and Y elementary school in Incheon on learning styles and science process skills of students. Learning Style Profile (LSP) was used as instrument to survey learning style of students of the gifted class which was developed by NASSP, and consists of four categories (cognitive skills, perceptual response, orientation and learning preferences) and twenty-four subscales. The results of this study were as follows: 1. In the learning styles test, students of the gifted class have higher scores of spatial skill, sequential processing skill, persistence orientation, manipulative preference, temperature preference and after-noon preference than general class students, but they have lower scores of discrimination skill and lighting preference, and there were statistically significant difference. 2. In science process skills test, there were statistically significant difference between students of the gifted class and general students. 3. In the correlation between the learning styles and science process skills, there was positive correlation of observing skill with spatial skill and manipulate skill of cognitive skill domain. For classifying skill, there was positive correlation with visual perceptual response, but was negative correlations with auditory and emotive perceptual response of perceptual response domain and with evening preference and verbal risk orientation of study preference domain. For measuring skill, there was positive correlation with sequential processing skill of cognitive skill domain. For formulating hypotheses, there was positive correlation with persistence orientation of study preference domain. For controlling variables, there was positive correlation with sequential processing skill and simultaneous processing skill of cognitive skill domain, and with verbal-spatial preference and early morning study preference of study preference domain. When planning and man-aging the gifted class, it will be beneficial and effective to consider the meaningful relations between the elements of learning style and science process skills in order to improve science process skills.

자색고구마가 사염화탄소 투여에 의한 흰쥐의 간손상 보호에 미치는 영향

조영자,김현아,방미애,오용비,정병춘,문윤호,정우진 한국식생활문화학회 2003 韓國食生活文化學會誌 Vol.18 No.3

The purpose of this study was to investigate the effects of dietary purple sweet potato(lpomoea batatas) powder on serum lipid levels and antioxidative enzymes in normal and pretective effect on hepatotoxicity rats induced by carbon tetrachlolide. Four groups of rats (3-week-old inbred Sprague-Dawley male rats) were normal rats fed control diet(C)_(1) induced hepatotoxicity rats fed control diet(EC)_(1) normal rats fed purple sweet potato diet(P), and induced hepatotoxicity rats fed purple potato sweet diet(EP). Rats were induced by single injection of 50% carbon tetrachloide(0.1 mL/100 g B.W., i.p.). The rats were fed ad libitum each of the experimental diet for 5 weeks. After 5 weeks the rats were sacrificed and activities of antioxidant enzymes and lipid peroxidation products were determined in their liver homogenates. But serum concentrations of lipid was not significant in all groups. Serum alanine aminotransferase(ALT/GPT) and aspartate aminotransferase(ALT/GPT)of the EC and EP groups were heigher than the C and P groups. The hepatic glucose 6-phosphatase(G9Pase) activity of the group fed purple potato diet(P) was lower than the other groups(p<0.05). However, The glutathione peroxidase(GPx) activities was not statistically different between the groups. Renal glutathione S-transferase(GST) activity of the EC and EP groups were lower than the C and P groups(p<0.05). In conclusion, these results suggest that purple sweet potato is believed to be possible protective effect on hepatotoxicity rats induced by carbon tetrachlolide.

중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

조기 발병 양극성 장애 환자의 임상적 특징 : 후향적 의무기록 조사 연구

우영섭,박민현,서호준,채정호,전태연,박원명 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

Objective : Bipolar disorder is a disease with diverse clinical profiles and outcomes. In recent years, it is suggested that if bipolar disorder occurs early in one's life, functional and symptomatic prognoses are poor. The prognoses include severe Symp-toms, frequent psychotic symptoms, comorbidity ofmental illnesses, slow improvement of the symptoms, and high suicide rate. We investigated the clinical characteristics of early onset bipolar inpatients. Method : The subjects of this study were selected from the patients who were discharged after hospitalization between January 1, 2001 and May 31, 2005 and diagnosed with bipolar disorder according to DSM-IV criteria. These patients were examined for the following data ; the type of bipolar disorder, comorbid psychiatric disorders, the age at onset of the illness, the acuteness of the disorder, and the duration of the disorder. The presence of four major clinical psychopathology, rapid cycling, Psychotic symptoms, comorbid psychiatric disorders, and suicide attempt, was also examined. The patients whose onset of the illness was before the age of 19 were classified as the early onset group and after the age of 19 were classified as the late onset group. Data on demographics, family histories, four major clinical psychopathologies and other clinical variables were compared between the early onset group and the late onset group. Results : Of the 53 patients, 19 patients belonged to the early onset group. There was higher incidence ofpsychotic Symp-toms in the early onset group than in the late onset group, and the difference was statistically significant according to the χ² - test (84.2% vs 44.1%, P=0.005). The incidence of comorbid psychiatric disorders was higher in the early onset group than in the late onset group, and the difference was also statistically significant according to the χ²-test (52.6% vs 23.5%, P=0.032).However, there was no statistically significant difFerence between the groups regarding the incidence of rapid cycling and suicide attempt. The result of logistics regression showed correlation of psychotic symptoms (0R=6.756 ; 1.655≤95% CI≤27.580) and comorbid psychiatric disorders (0R=3.611 ; 1.088≤95% CI≤11.984) with the early onset group. Conclusion : Early onset of bipolar disorder is related to the manifestation of psychotic symptoms and frequently accom-panies comorbid psychiatric disorders. The results of this study will help understand the mechanism of the onset of complexbipolar disorder and estimate the prognosis.