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.

서울의 PPNG 발생 빈도(1990)

김재홍,김한중,노영석,김영태,김중환,황규홍,이정덕,백승철,김건우,조상현,김준영,김석민,김영호,김상순,이승한,김방순,전덕규,하상근 대한화학요법학회 1992 대한화학요법학회지 Vol.10 No.2

The prevalence of PPNG among pretreated gonorrhoeae cases isolates at the VD clinic of Choong-ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1990, 162 strains of N.gonorrhoeae were isolated, among which 80 were PPNG. The prevalence of PPNG in Seoul showed increased tendency till 1987, thereafter, it has been stationary.

Molecular Theory of Plastic Deformation (Ⅲ)$^*$

Kim, Jae-Hyun,Ree, Tai-Kyue,Kim, Chang-Hong Korean Chemical Society 1981 Bulletin of the Korean Chemical Society Vol.2 No.3

(1) The flow data of f (stress) and ${\dot{s}$ (strain rate) for Fe and Ti alloys were plotted in the form of f vs. -ln ${\dot{s}$ by using the literature values. (2) The plot showed two distinct patterns A and B; Pattern A is a straight line with a negative slope, and Pattern B is a curve of concave upward. (3) According to Kim and Ree's generalized theory of plastic deformation, pattern A & B belong to Case 1 and 2, respectively; in Case 1, only one kind of flow units acts in the deformation, and in Case 2, two kinds flow units act, and stress is expressed by $f={X_1f_1}+{X_2f_2}$where $f_1\;and\;f_2$ are the stresses acting on the flow units of kind 1 and 2, respectively, and $X_1,\;X_2$ are the fractions of the surface area occupied by the two kinds of flow units; $f_j=(1/{\alpha}_j) sinh^{-1}\;{\beta}_j{{\dot{s}}\;(j=1\;or\;2)$, where $1/{\alpha}_j\;and\;{\beta}_j$ are proportional to the shear modulus and relaxation time, respectively. (4) We found that grain-boundary flow units only act in the deformation of Fe and Ti alloys whereas dislocation flow units do not show any appreciable contribution. (5) The deformations of Fe and Ti alloys belong generally to pattern A (Case 1) and B (Case 2), respectively. (6) By applying the equations, f=$(1/{\alpha}_{g1}) sinh^-1({\beta}_{g1}{\dot{s}}$) and $f=(X_{g1}/{\alpha}_{g1})sinh^{-1}({\beta}_{g1}{\dot{s}})+ (X_{g2}/{\alpha}_{g2})\;shih^{-1}({\beta}_{g2}{\dot{s}})$ to the flow data of Fe and Ti alloys, the parametric values of $x_{gj}/{\alpha}_{gj}\;and\;{\beta}_{gs}(j=1\;or\;2)$ were determined, here the subscript g signifies a grain-boundary flow unit. (7) From the values of ($({\beta}_gj)^{-1}$) at different temperatures, the activation enthalpy ${\Delta}H_{gj}^{\neq}$ of deformation due to flow unit gj was determined, ($({\beta}_gj)^{-1}$) being proportional to .$k_{gj}$, the jumping frequency (the rate constant) of flow unit gj. The ${\Delta}H_{gj}\;^{\neq}$ agreed very well with ${\Delta}H_{gj}\;^{\neq}$ (self-diff) of the element j whose diffusion in the sample is a critical step for the deformation as proposed by Kim-Ree's theory (Refer to Tables 3 and 4). (8) The fact, ${\Delta}H_{gj}\;^{\neq}={\Delta}H_{j}\;^{\neq}$ (self-diff), justifies the Kim-Ree theory and their method for determining activation enthalpies for deformation. (9) A linear relation between ${\beta}^{-1}$ and carbon content [C] in hot-rolled steel was observed, i.e., In ${\beta}^{-1}$ = -50.2 [C] - 40.3. This equation explains very well the experimental facts observed with regard to the deformation of hot-rolled steel..

강변여과에서 파일럿규모 수평집수관의 수두분포 연구

정재민(Jae Min Jeong),박재영(Jae Young Park),이종진(Jong Jin Lee),김용운(Yong Woon Kim),김승현(Seung Hyun Kim) 大韓環境工學會 2013 대한환경공학회지 Vol.35 No.5

강변여과용 수평집수관을 모사하는 파일럿 규모의 모래통 실험을 수행하였으며, 다양한 출구유속에 대한 수평집수관에서의 수두분포를 구하였다. Kim24)이 수행한 실험실 규모의 수평집수관에서의 손실수두에 Kim25)이 개발한 이론 즉, 작은 규모의 수평집수관에서의 손실수두로부터 큰 집수관의 손실수두를 계산하는 방법을 적용하여 본 연구의 관측치와 비교함으로써 Kim25)의 이론이 타당함을 알 수 있었다. 또한, 이들의 이론을 적용하여 본 연구에서의 관측치로부터 실규모 집수관에서의 수두분포를 구하는 방안을 예를 들어 설명함으로써 강변여과의 수평집수관 설계방법을 제시하였다. A pilot-scale sand-box experiment simulating a lateral of collector well used in riverbank filtration was performed, and hydraulic head distributions along the lateral were measured according to the various drawdowns at the well. The results of this experiment were compared to the predicted values obtained using a theory previously developed by Kim25) in order for its validation. This theory predicts the head loss in a large-scale lateral given the loss in a small-scale one, and to have actual values for comparison, the results from a lab-scale experiment previously performed by Kim24) were employed. Comparing the experimental values to the extrapolated value indeed confirmed the validity of the theory. A procedure to determine the hydraulic head distribution of a practical-scale lateral was also presented applying the theory to the experimental result of this study in an effort to show the process of lateral design for riverbank filtration.

Handover Ranging Power Adjustment Using Uplink Channel Information in IEEE 802.16e/m Ji-Su Kim, and Jae-Hyun Kim, ETRI Journal, vol.32, no.5, Oct. 2010, pp.823-826.

Ji-Su Kim,Jae-Hyun Kim 한국전자통신연구원 2010 ETRI Journal Vol.32 No.5

This letter proposes a handover ranging power adjustment scheme to improve handover performance. Incorrect ranging power can degrade handover performance due to the increased handover latency; therefore, the proposed scheme exploits the uplink channel information to adjust the uplink handover ranging power. Simulation results demonstrate that the proposed scheme reduces call outage probability by 33% compared to that of the conventional scheme. It also improves the number of users who satisfy the system requirements for handover interruption time.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

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.

Do We Still Use The Camitta"s Criteria For Severe Aplastic Anemia?

( Hyun Hwa Yoon1 ),( Sung Hyun Kim1 ),( Ji Hyun Lee ),( Seok Jae Huh ),( Suee Lee ),( Sung Yong Oh ),( Hyuk Chan Kwon ),( Hyo Jin Kim ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-

Novel Repair Technique for Articular Cartilage Defect using a Fibrin and Hyaluronic acid Mixture

( Jae Deog Jang ),( Young Seok Moon ),( Yong Sik Kim ),( Nam Yong Choi ),( Hyun Su Mok1 ),( Young Ju Kim1 ),( Asode Ananthram Shetty ),( Seok Jung Kim ) 한국조직공학·재생의학회 2013 조직공학과 재생의학 Vol.10 No.1

We evaluated the cartilage repair potential of a hyaluronic acid and fibrin mixture when transplanted into cartilage defects. Circular, articular, cartilage defects 4-mm in diameter were made in the trochlear region in 21 New Zealand white rabbits divided into three groups. The seven rabbits in the control group underwent microfracture (M group), the seven rabbits in the experimental group underwent microfracture with subsequent injection of hyaluronic acid mixed with fibrin (MH group), and seven rabbits in the other experimental group underwent microfracture followed by injection of bone marrow concentrate and hyaluronic acid mixed with fibrin (MBH group). At week 12 following surgery, the cartilage was observed and histologically compared in the three groups. The surface of the newly generated cartilage was very smooth and even, and we noticed that the entire area was completely regenerated in both experimental groups. The control group showed incomplete and irregular cartilage formation in the defect. In histologic scoring, comparison of the MBH group (M= 2.333) and the M group (M= 9.000) differed significantly (P= 0.046). Therefore, injection of a mixture of bone marrow concentrate, hyaluronic acid and fibrin to treat articular cartilage defects of the knee appears to be an effective method of cartilage regeneration.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,