제2형 당뇨병 환자에게 적용한 표준진료지침이 혈당, 당화혈색소, 당뇨지식 및 재원일수에 미치는 효과

김희승,윤건호,유양숙,오정아,송민선,신미옥,김경희,송복례 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.1

연구배경 : 당뇨병 환자의 평균 재원기간을 단축시키고, 제한된 입원기간 내에서 질적인 면과 비용효과성을 고려한 총체적인 건강관리체계의 필요성이 요구됨으로써 생겨난 것이 당뇨병 표준진료지침(Critical Pathway: CP)이다. 현재 개발된 당뇨병 CP를 통한 진료가 환자의 당뇨병에 관한 지식을 개선시키고 이에 따라 장기적으로 당뇨병 환자의 혈당조절이 개선되었다는 과학적인 검증은 당뇨병 CP를 여러 병원에 정착시키기이전에 반드시 선행되어야 할 과제이다. 이에 본 연구는 2000년 3월부터 1년간 강남성모병원에 입원하는 당뇨병 환자를 대상으로 현재 개발된 1주일 CP를 적용한 실험군의 혈당, 당뇨병 관련 지식 및 재원일수가 대조군에 비하여 차이가 있는지를 조사하였다. 방법 : 1주일 CP를 적용한 실험군은 내과병동에 입원한 당뇨병 환자 89명이었고, 대조군은 기타병동에 입원한 당뇨병 환자 22명이었으며 CP를 적용하지 않았다. CP를 적용하기 전인 입원시에 실험군과 대조군의 공복혈당, 식후 2시간혈당, 당화혈색소 및 당뇨관련 지식을 측정하였고, 퇴원 시에 실험군과 대조군에게 공복혈당과 당뇨관련 지식을 재측정하고 재원일수를 파악하였다. 그리고 두 군에게 퇴원 3개월 후의 공복혈당, 식후 2시간 혈당 및 당화혈색소를 조사하였다. 결과 : 1) 실험군의 공복혈당은 입원 시 238.7: 1) 실험군의 공복혈당은 입원 시 238.7mg/dL에서 퇴원 시 139.4mg/dL로 감소하는 경향이었으나 퇴원 3개월 후에는 150.6mg/dL로 약간상승하는 경향을 보였다. 대조군은 입원 시 251.5mg/dL에서 퇴원 시 136.2mg/dL로 감소하는 경향이었으나, 퇴원 3개월 후에는 219.3mg/dL로 현저히 증가하는 경향이었다. 2) 실험군의 입원 시 식후 2시간 혈당은 312.5mg/dL에서 퇴원 3개월 후 248.5mg/dL로 감소하는 경향이었다. 대조군도 입원 시 식후 2시간 혈당이 300.1mg/dL에서 퇴원 3개월 후 262.5mg/dL로 감소하는 경향이었으나 실험군보다 감소의 폭이 적은 경향이었다. 3) 실험군과 대조군의 입원 시 당화혈색소는 각각 10.3%와 9.7%로 유의한 차이가 없었으나,퇴원 3개월 후 실험군은 7.5%로 대조군의 9.1% 보다 유의하게 감소하였다. 4) 실험군의 입원 시 당뇨지식 점수는 실험군이 12.1점 대조군은 12.0점으로 유의한 차이가 없었으나 퇴원 시는 실험군이 15.5점으로 대조군의 14.6점 보다 높은 경향이었다. 5) 재원일수는 실험군이 8.4일로 대조군의11.0일 보다 유의하게 적었다. 결론 : 따라서 당뇨병 환자를 위한 CP는 재원일수의 감소뿐만 아니라 환자의 자가관리에 대한 체계적인 교육과 개선의 기회를 가짐으로써 장기적인 혈당 조절의 향상을 도모할 수 있는 효과적인 방법이라고 생각한다. Background: The aim of this study was to examine the effects of the critical pathway for the admitted patients with type 2 dia betes me llitus on glycemic control, the knowledge on the disease, and the length of hospital stay. Methods: 89 diabetic in-patients were applied with the 1 week critical pathwa which was consisted of intensive education program for self-management of diabetes me llitus such as glucose monitoring, excercise prescription, diet control, self-a djustment of the drugs and so on. The results were compared with 22 diabetic inpatients who were treated with conventional way. We assessed the effects of critical pathway on the degree of glycemic control, the knowledge on the disease, and the length of hospital stay. Results: Although fasting and postprandial 2 hours blood g lucose levels did not showed sta tistically significantd ifference between critical pathway group and conventional group on discharge , HbA1c was significantly decreased in critical pathwa group compared with the conventional group (7.5±1.8% vs 9.1±2.6%) on 3 months after discharge . Knowledge on the disease tended to increase in critical pathway group compared with the conventional group on discharge. The Length of hospital stay was significantly decreased in critical pathway group compared with the conventional group (8.4±2.8day vs 11.0±3.9da ) Conclusion: These results showed that critical pathway for the patients with diabetes mellitus might be a usefulway for improving the long term glycemic control through motivation, enhancing the knowledge on the disase as well as reducing the length of hospital stay.

한국판 임상가용 아동 및 청소년을 위한 외상후 스트레스장애 척도의 신뢰도 및 타당도 연구

구정일,김태형,은헌정,최말례,이선미,조수진,송옥선,김형욱 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : This present study was conducted to explore the reliability and the validity of Clinician Administered PTSD Scale for Children and Adolescents Korean version (CAPS-CA) Mcthods : The Subjects were children and adolescents (8-13yrs) from different places: a certain elementary school, three orphanages, a general hospital, and two neuropsychiathc local clinics. Only subjects who experienced a catastrophic traumatic event were tested by CAPS-CA, CDI, RCMAS, and TSC. Rcsults : The range of correlations between item-criterion were .67-.84. The coefficients of internal consistency were .87. and test-retest reliability was .90, were all the coefficients in the proper range. Inter-correlations of CAPS-CA, CDI, RCMAS, and TSC scale showed significant correlation. TSC showed the highest correlation coefficient. CAPS-CA can be a useful clinician-administered diagnostic instrument for children and adolescents PTSD symptoms. Conclusion : The reliability and the validity of CAPS-CA were confirmed. CAPS-CA could be applied for diagnostic purposes of PTSD in children and adolescents.

유방암종에서 p53, cyclin D1 및 cathersin D 단백발현의 의의

문경래,김환정,이미자,기근홍,서재홍,양정원,조현진 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives: Breast carcinoma is a heterogenous disease. The prognosis of this carcinoma correlates with various prognostic factors. The aim of this study was to assess the prognostic significance of expression of p53, cyclin Dl and cathepsin D protiens in association with various prognostic factors in invasive breast carcinoma. Materials and Methods: The relationship is presented between expression of p53, cyclin D1 and cathepsin D by immunohistochemistry and various established prognostic factors such as tumor size, histologic grade, lymph node status and extensive intraductal component in 55 cases of invasive breast carcinoma. Results: No significant correlations were observed between expression of p53, cyclin Dl and cathepsin D and tumor size. The expression of p53 correlated with high histologic grade. The expression of p53 and cyclin Dl correlated with lymph node metastasis. Conclusion: These results indicate that expression of p53 and cyclin Dl in invasive ductal carcinoma may be an important prognostic factor, closely related to the high histologic grade and lymph node metastasis.

원발성 양측 부신 비호즈킨 림프종 1 예

김봉석,박성기,이성규,변종훈,김정례,소군호,진교현,김서종,고정석,노용호 대한내과학회 2000 대한내과학회지 Vol.59 No.4

Primary adrenal lymphoma is extremely uncommon. The tumor is accidentally discovered by abdominal ultrasonography(USG), computed tomography(CT) or magnetic resonance imaging (MRI) in patients with nonspecific symptoms and diagnosed at operation or autopsy. In this case, a 60-year-old man was admitted for the evaluation of mild left frank discomfort for two months before admission. The abdominal USG was performed and showed the dense masses in both adrenal glands. The laboratory tests including blood count, chemistry and hormonal tests showed the normal levels except for the basal ACTH level of 108 pg/ml(normal range: 9∼52 pg/ml). The 123I MIBG scan was normal. The bilateral adrenalectomy was done. The tumor was diagnosed as diffuse large B-cell non-Hodgkin's lymphoma(NHL) according to the Revised European-American lymphoma(REAL) classification. He was treated with the adjuvant combination chemotherapy of CHOP(cyclophosphamide, adriamycin, vincristine and prednisolone) but expired due to sepsis after the secod chemotherapy. We describe the first case of primary bilateral adrenal NHL in Korea. Primary adrenal lymphoma should be included in the differential diagnosis of suprarenal mass.(Korean J Med 59:423-427, 2000)

Research Articles : Cloning and expression pattern of a hemolin homologue from the diamondback moth, Plutella xylostella

( Rye Jin Kim ),( Yong Hun Jo ),( Seung Han Oh ),( Cheol Hong Park ),( Mi Young Noh ),( Hyo Jeong Lee ),( Seon Gon Kim ),( Yong Seok Lee ),( Ik Soo Kim ),( Yeon Soo Han ) 한국유전학회 2010 Genes & Genomics Vol.32 No.1

Detection and Isolation of SARS-CoV-2 in Serum, Urine, and Stool Specimens of COVID-19 Patients from the Republic of Korea

Kim Jeong-Min,Kim Heui Man,Lee Eun Jung,Jo Hye Jun,Yoon Youngsil,Lee Nam-Joo,Son Junseock,Lee Ye-Ji,Kim Mi Seon,Lee Yong-Pyo,Chae Su-Jin,Park Kye Ryeong,Cho Seung-Rye,Park Sehee,Kim Su Jin,Wang Eunbye 질병관리본부 2020 Osong Public Health and Research Persptectives Vol.11 No.3

Objectives Coronavirus Disease-19 (COVID-19) is a respiratory infection characterized by the main symptoms of pneumonia and fever. It is caused by the novel coronavirus severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), which is known to spread via respiratory droplets. We aimed to determine the rate and likelihood of SARS-CoV-2 transmission from COVID-19 patients through non-respiratory routes. Methods Serum, urine, and stool samples were collected from 74 hospitalized patients diagnosed with COVID-19 based on the detection of SARS-CoV-2 in respiratory samples. The SARS-CoV-2 RNA genome was extracted from each specimen and real-time reverse transcription polymerase chain reaction performed. CaCo-2 cells were inoculated with the specimens containing the SARS-COV-2 genome, and subcultured for virus isolation. After culturing, viral replication in the cell supernatant was assessed. Results Of the samples collected from 74 COVID-19 patients, SARS-CoV-2 was detected in 15 serum, urine, or stool samples. The virus detection rate in the serum, urine, and stool samples were 2.8% (9/323), 0.8% (2/247), and 10.1% (13/129), and the mean viral load was 1,210 ± 1,861, 79 ± 30, and 3,176 ± 7,208 copy/µL, respectively. However, the SARS-CoV-2 was not isolated by the culture method from the samples that tested positive for the SARS-CoV-2 gene. Conclusion While the virus remained detectable in the respiratory samples of COVID-19 patients for several days after hospitalization, its detection in the serum, urine, and stool samples was intermittent. Since the virus could not be isolated from the SARS-COV-2-positive samples, the risk of viral transmission via stool and urine is expected to be low.

The relationship between the clinico-histologic subtypes of actinic keratosis and the efficacy of ablative fractional laser-assisted photodynamic therapy: a five year retrospective analysis

( Yeo-rye Cho ),( Jung-hwan Kim ),( Ho-jin Kim ),( Jeong-wan Seo ),( Ki-ho Kim ),( Ki-hoon Song ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Actinic keratosis(AK) has various clinical and histopathological subtypes and it is needed to compare the efficacy of ablative fractional laser-assisted photodynamic therapy (AFL-PDT) in each subtypes for optimal treatment. Objectives: The aim of this study is to investigate the difference in the complete remission(CR) of the AFL-PDT according to the clinical and histopathological subtypes of AK. Methods: We evaluated the clinical and histopathological subtypes of AK in 133 patients who were treated by same protocol of AFL-PDT. Total 851 facial AK lesions were classified by clinical subtypes and 178 lesions that underwent biopsy were classified by histopathological subtypes. We assessed CR after a year of every lesions and investigate the relationship between clinical or histopathological and CR rate. Results: In clinical subtypes, erythematous type showed highest CR(91.3%) rate and cutaneous horn(56.2%) or hypertrophic type(72.5%) showed relatively lower CR rate. In histopathological subtypes, atrophic type(89.2%) showed highest CR rate and Bowenoid type(70.7%) showed lowest CR rate. Conclusion: The efficacy of AFL-PDT in the treatment of AK revealed to be different depending on the clinical and the histopathological types. The AK lesions of erythematous type in clinical subtypes and atrophic type in histopathologic subtypes showed higher CR rate. Therefore, it can be helpful to investigate the type of AK before AFL-PDT to predict treatment outcome and make treatment strategy.

미래주의 영향 받은 작품을 통한 wedding up-style에 관한연구

이정례(Jeong rye Lee),김명주(Myung ju Kim),김민선(Min sun Kim) 대체의학회 2013 대체의학회논문지 Vol.2 No.3

현대사회는 대중문화의 확산과 정보 발달로 인하여 관습에 벗어나는 헤어스타일도 기존의 사고 변화를 가져와 대중에게 받아들여지고 있다. 다양한 표현 양식과 자신의 개성표현을 중시하는 사람들로 인해 새로운 유행이 창출되기도 한다. 이러한 영향은 이전의 형식적인 스타일 보다는 풍부한 상상력과 문화, 사회, 경제적 경향, 정신적 영감에 근거한 스타일로 표현 되고 있다. 이러한 미에 대한 개념과 가치기준의 변화와 새로운 형식의 도입을 가져오게 된 계기에는 20세기 초 이탈리아에서 일어난 전위적인 문화 운동인 퓨쳐리즘(미래주의)로부터 발전을 하게 되었다. 미래주의는 인습을 타파하고 기존의 예술을 부정하고 사물의 움직임을 역동적 미로 승화시켰다. 따라서 본 연구는 이러한 시대적 요구에 따라 미술사조의 한 분야인 미래주의의 배경을 바탕으로 헤어 업스타일 작품 제작을 통해 정신적 공감대 형성과 개성연출을 시도해 보고자한다. 이는 독창적으로 헤어스타일을 디자인 할 수 있는 제안 점이 되는 것이 목적이다. 작품1에서의 헤어스타일은 스페이스 룩으로 안테나와 헤드셋을 모티브로 해서 신부가 왕관을 쓴 모습을 표현하였다. 작품2에서는 우주인이 우주공간에 착륙했을 때 무중력 상태를 나타내는 패션 스타일로 드레스도 밖으로 활짝 퍼지는 것을 나타냈고, 헤어스타일 또한 위로 뻗쳐있는 상태를 만들어 보았다. 그 결과 미래주의의 역동감과 운동감을 표현한 비일상적인 헤어스타일을 통해 신비스러운 신부 업스타일을 창출하였다. 우리의 관심 대상이 되는 미래의 생활상의 일부분인 헤어스타일을 연구해 봄으로서 앞으로의 헤어스타일의 변화를 예측하는데 자료가 되는 것에 연구의 의의가 있었다. 주로 연구한 대상이 미래주의의 영향을 받은 헤어업스타일에 국한되어 있고 메이크업에 대한 연구를 제외시켰으므로 앞으로 미래주의 패션에 나타난 메이크업과 악세서리 등을 함께 알아봄으로써 보다 다각화되고 광범위한 연구가 필요할 것이다. Modern society, popular culture, due to the spread of information and the development outside the customs hairstyle changes conventional thinking has brought to the public accepted. Represented a variety of forms of expression and their emphasis on the personality of the people may be due to the creation of a new fad. These effects of the imagination rather than the old type style, culture, and social and economic trends, based on spiritual inspiration is expressed in the style. The beauty of the concept and value basis with changes that lead to the introduction of a new type instrument that took place in Italy in the early 20th century avant-garde cultural movement pyuchyeorijeum (Futurism) and was developed from. Futurism and breaking the conventions of traditional arts to deny the motion of objects has a dynamic maze sublimation. Therefore, this study in accordance with the requirements of the times, and the field of art history, like the background of the future on the basis of careful productions Hair Up Style consensus over the mental and personality to want to try directing. This creative hair style is that you can design point is thus proposed. Work in one of the hair style look with a space motif headset antenna and the bride was crowned figure represented. Work in two when landing astronauts weightless in space representing the fashion style dresses also showed that out of the wide spread, and hair style was also made out over the state. As a result, the image of futuristic sense of movement sense of the dynamics of the unusual hairstyle was created by a mysterious priest Up Style. We are interested in the subject, which is part of daily life in the future to study hair style hair style by looking forward data to predict the change in the significance of the research was being. The subject of future research attention mainly affected are limited to hair and make-Up Style has excluded because the study of Futurism in Fashion forward and out with make-up and accessories by looking more diversified and extensive research will be needed.

메두사를 모티브로 한 헤어아트작품에 관한 연구

이정례(Jeong rye Lee),김민선(Min sun Kim),김명주(Myung ju Kim) 대체의학회 2014 대체의학회논문지 Vol.3 No.1

A person's body can be represented using various artistic disciplines to get away from the practical purpose of hair art artistic value and expressing creative beauty. These are utilized in creative works of art history as a background motif is ancient architecture, art, Zeitgeist, and mythical stories of mythical Greece when it comes to hair to Medusa. Mythical Medusa so beautiful and feminine and admire the enchanting enough to be unnerving. However, the curse of the goddess Athens, take the hair is snake turned to see him all those turned to stone in order to Burry the snag in the end will die. The feeling that the unfortunate woman is cursed, but even I had to order this beautifully portrayed Medusa, makes me feel like witchcraft, mystery and beautifully expressed. We often think of witchcraft or spells we eumsan and creepy or frightening thoughts prior to it is that most people would be. However, the meaning of witchcraft Medusa itself, through which it is possible to create beautiful hair creations. A lot of people perceive disgust Medusa is a first-person gone up a lot, you have to create in the likeness of snake heads and Medusa's work is limited to awareness, but Sarah is a art of Medusa expresses a rather fantastic and colorful rendering by were able to portray the beauty. 사람의 몸을 이용하여 표현할 수 있는 다양한 예술분야 중 헤어아트는 실용적인 목적에서 벗어나 예술적 가치를 부여하고 독창적인 아름다움을 표현해 내고 있다. 이러한 예술 작품 창작에 활용되는 모티브는 역사를 배경으로 하는 고대 건축물, 미술사조, 신화 등이 있으며 그리스 신화 속 이야기 중 헤어에 관한한 메두사를 빼놓을 수 없다. 신화에 나오는 메두사는 너무나 아름답고 여성스러워 경탄스러울 만큼 매혹적인 인물이다. 그러나 아테네여신의 저주를 받아 머리카락은 뱀으로 변하고 그를 보는 모든 사람은 돌로 변해버리라는 주문에 걸리고 결국엔 죽게 된다. 저주받은 불행한 여인이지만 그 느낌마저도 아름답게 표현해 보고자 주문에 걸린 메두사를 주술적인 느낌을 나게 하면서도 신비롭고 아름답게 표현해보았다. 우리가 흔히 생각하는 주술이나 주문을 떠올리면 음산하고 소름끼치거나 두려운 생각이 먼저 앞서는 것은 대부분의 사람들이 그러할 것이다. 그러나 메두사 자체의 주술적인 의미를 살리면서도 아름다운 헤어작품을 만들 수도 있다. 많은 사람들이 메두사라는 인물이 혐오스럽다고 생각하는 선입감을 많이 갖고 있고 머리를 뱀 형상으로 만들어야 메두사라는 인식이 있어 작품에 제한점이 있지만 헤어아트적인 메두사를 표현함에 있어 오히려 환상적이며 다채로운 연출로 아름다움을 묘사 할 수 있었다.

A comparison of efficacy in ablative fractional laser assisted photodynamic therapy according to the density of ablative laser channel in treatment of actinic keratosis

( Yeo-rye Cho ),( Jung-hwan Kim ),( Ho-jin Kim ),( Jeong-wan Seo ),( Ki-ho Kim ),( Ki-hoon Song ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: The pretreatment of Er:YAG ablative fractional laser(AFL) has known to be beneficial in performing photodynamic therapy(PDT) for actinic keratosis. And it is needed to find the optimal settings of AFL, including the density of the ablative laser channel. Objectives: The aim of this study is to evaluate whether different laser densities make different results in efficacy, side effects, cosmetic outcomes, and protoporphyrin IX(PPIX) accumulation of AFL-PDT for facial AK. Methods: 246 AK lesions were randomized to 5.5%, 11%, 22% of AFL channel density groups respectively and treated with one session of PDT after AFL treatment with each density. Treatment efficacy was determined by the regression of lesions over time and side effects, cosmetic outcomes, and accumulated levels of PPIX were assessed. Results: The treatment of AK with 22% density was more significantly effective than that of the 5.5% density groups after 9 months(complete response rates: 94.5% vs.73.3%). Especially, the treatment outcome of AK with severe hyperkeratosis (Olsen grade III) was more affected with different laser density, in which the higher(22%) density groups showed significantly better CR rate (89.5%) than the lower(5.5%) density groups (53.3%). There were no difference in PPIX accumulation, side effects, cosmetic outcomes and safety among the groups. Conclusion: AFL-PDT with higher laser channel density showed better CR rate with lesser recurrence, especially in AK with severe hyperkeratosis.