40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

Original Article : Geographic difference of epidemiological features of HCV infection in Korea

( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)

그람양성구균에 대한 Teicoplanin과 Vancomycin의 시험관내 항균력

최태열,김경숙,전용관,서일혜,김정욱,이웅수,안정열,김홍석,정재용,최효선,김덕언,유진우 대한감염학회 1994 감염 Vol.26 No.1

An increasing frequency of methicillin resistant S. aureus(MRSA), methicillin resistant coagulase negative staphylococci(MRCNS) and Enterococcal infection have been observed in recent years. Teicoplanin is a new glycopeptide antibiotic obstained from the Actinoplanes teicomycetius. The molecular structure and spectrum of antimicrobial activity of teicoplanin is simillar to those of vancomycin, and has been reported to have an excellent in vitro and in vivo effect against various gram-positive infections. Therefore, we evaluated the in vitor susceptibility of gram positive cocci, such as, S. aureus, coagulase negative Staphylococci(CNS), and Enterococci to teicoplanin and vancomycin. The total 253 strains consisted of MSSA(40), MRSA(53), MSCNS(47), MRCNS(48), and Enterococci(65). They were assayed by disc diffusion and agar dilution. During the study, 57% of S. aureus and 49% of CNS showed resistance to methicillin. The inhibitory diameter of teicoplanin was 15-20mm in MSSA, 12-19mm in MRSA, 13-24mm in MSCNS, 11-23mm in MRCNS, and 15-22mm in Enterococci respectively, and showed sensitivity in all but 8 strains(3.2%). The range of the minimum inhibitory concentration (MIC) of teicoplanin to MSSA, MRSA, MSCNS, MRCNS and Enterococci were 9.12-2.0㎍/ml, 0.25-2.0㎍/ml, & 0.25-32㎍/ml, 0.12-1.0㎍/ml respectively. One case of S. haemolyticus was resistant to teicoplanin (32㎍/ml) by the agar dilution method. Eight minor (3.2%) and one major(0.4%) error was observed when the MIC and disk diffusion data were correlated with teicoplanin. As for vancomycin the inhibitory diameter was 17-21mm in MSSA, 15-21mm in MRSA, 18-26mm in MSCNS, 18-25mm in MRCNS, and 16-22mm in Enterococci respectively. The range of the MIC of vancomycin to MSSA, MRSA, MSCNS, MRCNS, and Enterococci were 0.25-1.0㎍/ml, 0.25-4.0㎍/ml, 0.5-2.0㎍/ml and 0.5-2.0㎍/ml respectively. One minor error (0.4%) was seen with the vancomycin disk. The MIC90 of MSSA and MRSA exhibited the same results in teicoplanin (1.0㎍/ml, 1.0㎍/ml), and vancomycin(2.0㎍/ml, 2.0㎍/ml). MSCNS and MRCNS exhibited greater MIC90 with teicoplanin(4.0㎍/ml, 8.0㎍/ml) than vancomycin(2.0㎍/ml, 2.0㎍/ml). Incontrase Enterococci were more susceptible to teicoplanin(0.5㎍/ml) than to vancomucin (2.0㎍/ml). Results from this analysis indicated that both teicoplanin and vancomycin were very excellent for gram positive infections, especially those resistant to methicillin.

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

경수 손상의 임상적 분석

김정수,강재규,도종웅,김기욱,김상진 최신의학사 1991 最新醫學 Vol.34 No.1

응급실 내원시 예상치 못한 사망 환자의 예측 인자

김욱진,서정필,정성필,황태식,이한식 대한응급의학회 1998 대한응급의학회지 Vol.9 No.4

Background: Unexpected deaths of the patients at ED are surprising to the medical staffs as well as the families. It may also increase the possibilities of medico-legal problems. This study was conducted to review the unexpected death in ED and find the predictive factors leading patients to unexpected death. Methods: A retrospective study with reviewing available medical records of 183 patients who were expired at Ed of Shinchon Severance Hospital from Mar. 1997 to Feb. 1998 and 103 patients of Youngdong Severance Hospital from Mar. 1996 to Feb. 1998 was done. Analyses were done on 30 variables of physical findings, laboratory results, procedures and therapies. We used univariate analysis such as t-test and x²-test and multiple logistic regression analysis. Results: Of the total 286 deaths in Ed, 153 cases were enrolled in this analysis. The number of unexpected deaths were 76. Age, mental status, fraction of neutrophil count, BUN level, whether endotracheal intubation was done, use of inotropics were the factors with statistical significance on the univariate analysis, but only comatose mentality, endotracheal intubated case, and use of the inotropics were significant on logistic regression analysis. The longer the ED length of stay, the higher the rate of mortality and unexpected death. Conclusion: This result suggest that medical attention is needed on the patients with comatose decreased mental status, endotracheally intubated case and needing inotropic agents to prevent unexpected deaths shortening the ED length of stay may also be a factor for decrease the unexpected death rate.

돌돔, Oplegnathus fasciatus(Temminck et Schlegel)의 卵發生 및 仔稚魚期의 形態

高正樂,金容億 釜山水産大學校 1992 釜山水産大學 硏究報告 Vol.32 No.2

1991年 7月 6日에 제주도 한림 水産振興院 水産種苗 培養場과 1991年 6月 19日 경남 통영군 산양면에서 自然産卵하여 얻은 受精卵의 卵發生過程과 仔稚魚의 成長에 따른 外部形態와 내부골격의 骨化過程을 調査한 結果를 要約하면 다음과 같다. 受精卵은 1개의 油球를 가지는 分離浮性卵으로서 卵徑은 0.85±0.03 ㎜(n=20)였으며, 油球徑은 0.20±0.01 ㎜(n=20)이고, 水溫이 22.2℃에서 受精卵은 약 36時間만에 孵化하였다. 孵化直後의 仔魚는 全長이 平均 1.75㎜로 卵黃을 가지고 등쪽 막지느러미에 4∼6개의 黑色素胞가 있으며, 體表에는 黑色素胞와 黃色素胞가 골고루 분포한다. 孵化後 27日째 全長이 平均 10.42㎜에 달하면 기條數가 D.ⅩⅠ∼ⅩⅡ, 18,A. Ⅲ - 11, Ⅴ.4,C.9+9,P.14로 定數에 달하여 稚魚期로 移行하다. 頭蓋骨 및 內臟骨의 骨化는 孵化後 6日째(全長 3.74㎜)부터 처음으로 骨化가 시작되며 孵化後 34日째(全長 14.53㎜) 稚魚期에 달하면 대부분의 골격이 완성된다. 脊椎骨의 椎體는 後期稚魚期때가 되어서야 骨化가 일어나며, 腹椎骨의 중앙부에서 腹部 앞으로, 그리고 尾部로 骨化가 진행되며, 神經棘이 血管棘보다 먼저 骨化가 일어난다. 일반적으로 어류에 있어서 골격의 발달은 攝餌와 呼吸에 關聯된 部位부터 먼저 骨化가 일어 나는데, 돌돔의 경우에는 攝餌物이 미소하여 呼吸器 보다는 顎骨 부위의 骨化가 늦었다. 後期仔魚期에서 부터 빠른 속도로 骨化가 되어져 孵化後 35日째(全長 15.51㎜)에 달하면 골격이 完成된다. In July 6, 1991, the summary of the result of investigation of embryonic development, morphology, and ossification of skeleton process according to growth of larvae and juveniles of naturally spawned eggs at Che Ju island and Chung Mu is shown. A mature eggs with oil globule has a diameter of 0.85�0.03 ㎜(n=20), the oil globule diameter of 0.20�0.01 ㎜(n=20). Hatching takes 36hrs at 22.2�. The newly hatched larvae reached 3.75 ㎜ in total length, approximately, and possess yolk sac, about 4�6 melanophore at dorsal memberanous fin and distributed melanophore and xanthophore on body surface. Twenty seven days after hatching, the juveniles measured 10.42 ㎜ in mean total length, and each fin ray was identical with the juveniles, D.ⅩⅠ~ⅩⅡ, 18,A. Ⅲ-11, Ⅴ.4,C.9+9,P.14. Six days after hatching(T.L. 3.74㎜), ossification of cranium and visceral skeleton have occured and reached the juvenile stage, thirty four days after hatching(T.L. 14.53㎜), all bone was ossified. Ossification of vertebrae of centrum have occured in post larva stage. At first, ossification of skeleton occuring at the parts of related respiration, so that ossification of respiratory organ is faster than maxilla because the size of food is very small. From the post larvae skeleton development, after thirty five days of hatching(T.L. 15.51㎜), skeleton formation was completed.

Hinman 증후군(비신경인성 신경인성 방광) 1예

이경욱,채정호,이승주,김세웅,박원명,전태연,김광수 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.3

Objectives : The Hinman Syndrome is a condition representing urinary voiding dysfunction in a neurologically intact child. This syndrome probably is an acquired behavioral and psychosocial disorders. We present a case presenting voiding dysfuntion with no neurologic etiology. Case : The departmcnt of urology consulted the department of psychiatry for a psychiatric evaluation of a 14-year-o1d girl with a history of recurrent urinary tract infections, enuresis, and urinary dribbling since early childhood. She visited the emergency room bccausc of severe abdominal pain and hematuria. She was admitted to the department of urology. Neurological tests showed no abnormality, but a retrograde cystogram showed free vesicoureteral reflux to the level of the dilated intrarenal collecting systems. Marked blunting and dilatation of the caliccs suggested longstanding urinary flow obstruction. She had a history of scparation anxiety disorder and was very competetive, perfectionistic, and nervous. She also had very poor relationships with her friends and had difficults in managing them. Afer admission, she had stent operation and cystostomy. Antidepressant and anxiolytic medications with supportive psychotherapy were administered to treat anxiety, tension and depression. Gradually, her depressive symptoms and voiding difficulties improved. Conclusions : Psychological factors such as a perfectionistic and obsessive personality, a history of severe separation anxiety, stressors from poor interpersonal relationships and Ihe failure of an entrance examination seem to have contributes to the development and exacerbation of the urinary dysfunction. Pharmacotherapy and supportive psycho-therapy may be efective in treating associated psychiatric problems of these patients with hinman syndrome.

영아에 발생한 하마종

정정권,윤규호,전인성,김기엽,김현우,권순욱 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.5

The ranula is a form of mucocele which specifically occurs in the floor of the mouth. The ranula is classfied into simple ranula and plunging ranula according to the mechanism of development such as the salivary duct obstruction or the extravasation. Clinically this lesion develops as a slowly enlarging painless, fluctuant mass on one side of the floor of the mouth and the mucosa may have a translucent bluish color. An 8-month-old male infant visited our hospital with the chief complaint of the left submandibular swelling and the mass on the floor of the mouth. We tentatively diagnosed a simple ranula. The marsupialization was performed but the sign and the symptom did not subside, so we took the MRI. By the MRI we diagnosed a plunging ranula and excised the sublingual gland via the intraoral approach. The correct diagnosis is essential for the most effective treatment, which is the excision of the sublingual gland.

저빈도 반복성 경두개 자기자극이 정상인의 시각적 단기 기억에 미치는 영향

오해정,김원,이경욱,박원명,전태연,한진희,채정호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : Repetitive transcranial magnetic stimulation (rTMS) is a novel, noninvasive method of brain stimulation. Since conventional rTMS does not cause seizure, marked advantage over electroconvulsive therapy (ECT), rTMS can be used easily and widely. Once the effects of rTMS on cognitive function are elucidated, its application will be further extended. However, the effects of rTMS on cognitive function have not been well examined. This study aimed to evaluate the effect of low frequencyr TMS on visual short term memory. Methods : Forty normal healthy volunteers were randomly assigned to rTMS (n=20) or sham (n=20) groups. The rTMS group were again randomly divided into left prefrontal (n=10) and right prefrontal (n=10) groups. For each group rTMS was given at 1 Hz for 20 minutes with 100% of motor threshold. As a cognitive task, Corsi Block Tapping Test (CORSI) in the computerized Vienna Test System, which can assess visual short term memory, was performed before, during, and after the rTMS. Results : No significant difference was found in the visual short term memories between the rTMS and the sham groups before, during, or after 1 Hz rTMS, nor between the left and right prefrontal rTMS groups. Conclusion : This study demonstrates that rTMS, contrary to ECT, has no adverse visual short term memory effect when used as the standard treatment paradigm. Therefore, rTMS could be a new and safe treatment method in various neuropsychiathc fields without any interference of cognitive function.